Journal articles: 'Distal-SO'

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Maebashi, Manabu, Kentaro Miyake, Yasuhiro Shimizu, Gakuryu Nakayama, Yasuhiro Yabushita, Yuki Homma, Takahumi Kumamoto, Ryusei Matsuyama, Mitsuko Furuya, and Itaru Endo. "A Case of So-Called Sarcomatoid Carcinoma in the Distal Bile Duct." Japanese Journal of Gastroenterological Surgery 54, no. 4 (April 1, 2021): 262–69. http://dx.doi.org/10.5833/jjgs.2020.0061.

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Suzuki, T., W. J. Dodds, S. K. Sarna, W. J. Hogan, R. A. Komorowski, and Z. Itoh. "Control mechanisms of sphincter of Oddi contraction rate in the opossum." American Journal of Physiology-Gastrointestinal and Liver Physiology 255, no. 5 (November 1, 1988): G619—G626. http://dx.doi.org/10.1152/ajpgi.1988.255.5.g619.

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Our aim in this study is to determine whether extrinsic autonomic nerves regulated spike-burst rate in the opossum sphincter of Oddi (SO) during fasting or after feeding. We implanted electrodes on the distal SO, proximal SO, gastric antrum, duodenum, and jejunum of 20 animals. A cut transection and reanastomosis was done at different levels of the SO to interrupt putative extrinsic or intrinsic nerves, or the SO was painted with phenol to impair extrinsic nerves. Like controls, animals with a cut and reanastomosis at the proximal SO or at the SO-duodenal junction showed a normal fasting pattern of cyclic changes in SO spike-burst rate. In contrast, animals treated by a distal SO cut or phenol treatment at the distal SO lost the normal cyclic pattern of SO spike bursts and had a constant rate of approximately 4/min. A cut through the middle SO uncoupled the spike bursts in the proximal and distal SO. After feeding, all animals developed an SO spike-burst rate of 5-6/min that lasted for several hours. We conclude that the normal fasting pattern of SO spike bursts is regulated by extrinsic nerves that ascend cephalad along the sphincter segment, whereas the sustained increase in SO spike-burst rate after feeding is at least in part hormonal.

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Mattei, Jean-Camille, Véronique Brouste, Philippe Terrier, Sylvie Bonvalot, Axel Lecesne, Eberhard Stoeckle, Antoine Italiano, et al. "Distal extremities soft tissue sarcomas: Are they so different from other limb localizations?" Journal of Surgical Oncology 119, no. 4 (January 4, 2019): 479–88. http://dx.doi.org/10.1002/jso.25359.

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Lee, Na Young, Stephanie M. Noble, and Alex R. Zablah. "So distant, yet useful: The impact of distal stories on customers’ service expectations." Journal of Business Research 113 (May 2020): 230–42. http://dx.doi.org/10.1016/j.jbusres.2020.01.044.

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Parkar, AAH, S. Marya, and S. Auplish. "Distal radius triplane fracture." Annals of The Royal College of Surgeons of England 96, no. 8 (November 2014): e6-e7. http://dx.doi.org/10.1308/003588414x13946184902569.

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A triplane fracture is so named because of the three planes traversed by the fracture line. These are physeal fractures that result from injury during the final phase of maturation and cessation of growth. This fracture pattern typically involves the distal tibia. We present a rare case of a triplane fracture involving the distal radius.

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Jahangir, Jabed, Md Iqbal Hossain, Md Myen Uddin Mojumder, Mohammad Hossain, Md Anwar Hossain, and Md Imroz Uddin. "Management of Distal Femoral Fracture with Distal Femoral Nail." Chattagram Maa-O-Shishu Hospital Medical College Journal 16, no. 2 (July 3, 2018): 44–47. http://dx.doi.org/10.3329/cmoshmcj.v16i2.37293.

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Background: For a long time distal femur fracture were considered difficult to heal and often led to a degree of disability. The incidence of malunion, nonunion and infection are relatively high in many reported series. The management goal of distal femur fractures are correction of axial alignment, length, and rotation, restoration of motion and rapid union so as to return the patient to normal function. We present here result of retrograde nailing of extra-articular (AO 33A1 to A3) fractures of the distal femur using Distal Femoral Nail (DFN).Methods: In Between 2008 to 2010 total 17 patients (One lost to follow up so 16 available for final assessment) underwent open reduction and internal fixation for distal femoral fracture in Chittagong Medical College Hospital and Private Hospital in Chittagong city. There were 13 male and 3 female patients, age range from 18 years to 70 years, mean age 42.75 years. Average length of follow-up was 17.5months (12 months to 24 months).Results: Total 16 patients was available for follow up. Regular fracture healing was observed in 14 cases. Delayed union in 2 case. One patient had infection, and two patients had leg shorting of 0.5 and 1 cm. Axial misalignment (Varus/valgus angulations) was found in 4 cases (5º-10º) there were no implant failures. On the bases of a Leung score to measure functional outcome, 4 cases had excellent, 8 cases had good and 4 cases had fair result. Poor results were not seen in any patient. In this series 13 cases were satisfactory and 3 cases were unsatisfactory.Conclusion: Distal Femoral Nail is handsome tool to treat distal femoral fracture.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 44-47

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YAMAGUCHI, Ryuichi, Nobuyuki ITO, Eiji MAEMURA, Yoshiaki SHIOKAWA, and Isamu SAITO. "Bilateral Distal Anterior Cerebral Artery Aneurysms Mimicking So-called "Kissing Aneurysms": A Case Report." Surgery for Cerebral Stroke 31, no. 3 (2003): 197–202. http://dx.doi.org/10.2335/scs.31.197.

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Worcester, Elaine M., Fredric L. Coe, Andrew P. Evan, Kristin J. Bergsland, Joan H. Parks, Lynn R. Willis, Daniel L. Clark, and Daniel L. Gillen. "Evidence for increased postprandial distal nephron calcium delivery in hypercalciuric stone-forming patients." American Journal of Physiology-Renal Physiology 295, no. 5 (November 2008): F1286—F1294. http://dx.doi.org/10.1152/ajprenal.90404.2008.

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A main mechanism of idiopathic hypercalciuria (IH) in calcium stone-forming patients (IHSF) is postprandial reduction of renal tubule calcium reabsorption that cannot be explained by selective reduction of serum parathyroid hormone levels; the nephron site(s) responsible are not as yet defined. Using fourteen 1-h measurements of the clearances of sodium, calcium, and endogenous lithium during a three-meal day in the University of Chicago General Clinical Research Center, we found reduced postprandial proximal tubule reabsorption of sodium and calcium in IHSF vs. normal subjects. The increased distal sodium delivery is matched by increased distal reabsorption so that urine sodium excretions do not differ, but distal calcium reabsorption does not increase enough to match increased calcium delivery, so hypercalciuria results. In fact, urine calcium excretion and overall renal fractional calcium reabsorption both are high in IHSF vs. normal when adjusted for distal calcium delivery, strongly suggesting a distal as well as proximal reduction of calcium reabsorption. The combination of reduced proximal tubule and distal nephron calcium reabsorption in IHSF is a new finding and indicates that IH involves a complex, presumably genetic, variation of nephron function. The increased calcium delivery into the later nephron may play a role in stone formation via deposition of papillary interstitial apatite plaque.

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Helm, J. F., W. J. Dodds, J. Christensen, and S. K. Sarna. "Intramural neural control of opossum sphincter of Oddi." American Journal of Physiology-Gastrointestinal and Liver Physiology 257, no. 6 (December 1, 1989): G925—G929. http://dx.doi.org/10.1152/ajpgi.1989.257.6.g925.

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We evaluated the intramural neural control of the opossum sphincter of Oddi (SO) in an in vitro preparation. Force transducers were used to record contractions at four sites along the sphincter segment. To stimulate intramural nerves, 10- to 120-s trains of pulses (4-10 V amplitude, 0.5 ms duration, and 5 Hz frequency) were delivered to one of three electrode pairs implanted along the SO. Electrical stimulation in the proximal, mid, or distal SO elicited phasic contractions that invariably originated in the proximal SO and propagated antegrade along the entire length of the sphincter segment. Stimulus-evoked contractions resembled spontaneous antegrade peristaltic contractions, but occurred at a higher rate (12-20/min). Atropine completely blocked this excitatory response to nerve stimulation. After atropine, nerve stimulation in the proximal, mid, or distal SO abolished spontaneous contractions at and distal to the site of stimulation for the duration of the stimulus. The inhibitory response to nerve stimulation was completely blocked by tetrodotoxin but was unaffected by phenoxybenzamine, tolazoline, or propranolol. We conclude that 1) the opossum SO is innervated by intramural cholinergic excitatory nerves and nonadrenergic noncholinergic inhibitory nerves; 2) cholinergic excitatory nerves are organized in ascending neural pathways, whereas nonadrenergic noncholinergic inhibitory nerves descend along the length of the SO; and 3) these neural pathways may modulate SO peristalsis in vivo and participate in ascending excitatory and descending inhibitory reflexes.

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Helm, J. F., W. J. Dodds, J. Christensen, and S. K. Sarna. "Control mechanism of spontaneous in vitro contractions of the opossum sphincter of Oddi." American Journal of Physiology-Gastrointestinal and Liver Physiology 249, no. 5 (November 1, 1985): G572—G579. http://dx.doi.org/10.1152/ajpgi.1985.249.5.g572.

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We evaluated the control mechanism of peristaltic contractions in the opossum sphincter of Oddi (SO) by means of an in vitro preparation. At each of four sites spaced uniformly along the sphincter segment, a force transducer recorded contractions while a monopolar electrode recorded myoelectric activity. Spontaneous myoelectric and contractile activity occurred in 15 of the 20 intact SO specimens studied. Electrical recordings showed characteristic control waves and response activity. Each control wave was invariably accompanied by a phasic contraction, irrespective of whether or not response activity was superimposed on the control wave. The predominant motor activity of the SO was antegrade peristalsis. Retrograde peristalsis occurred when antegrade peristalsis failed to traverse the entire sphincter. Spontaneous SO phasic contractions were not antagonized by tetrodotoxin. Muscle rings sectioned from the SO exhibited spontaneous phasic contractions with a proximal-to-distal gradient of intrinsic contraction frequencies. We conclude that a) the frequency of SO phasic contractions is determined by control wave frequency, b) spontaneous SO peristalsis is myogenic in origin and may be modeled by a linear array of bidirectionally coupled relaxation oscillators, c) the predominance of antegrade peristalsis may be explained by a high-frequency oscillator in the proximal SO that drives the slower, more distal oscillators, d) retrograde peristalsis is initiated by an ectopic oscillator in the distal SO when antegrade contractions fail to propagate the entire length of the SO, and e) ectopic SO contractions can propagate retrograde when the more proximal oscillators are not in their absolutely refractory state.

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11

Rehman, F., and M. Ajmal. "Effect of malunited fractured distal end of radius on the morphometric parameters of distal radioulnar joint." Journal of Morphological Sciences 32, no. 03 (July 2015): 124–28. http://dx.doi.org/10.4322/jms.076514.

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Abstract Introduction: Malunion is the most frequent complication of fracture distal radius. Fracture malunion has been shown to associate with altered morphometric anatomy of distal radioulnar joint. Objective: This study aims to identify normal radiographic morphometry reference values and variations according to age and sex of distal radioulnar joint. This study was also carried out to determine the radiological correlation between normal and malunited distal radius in patient with unilateral malunited fracture to find out the effect of malunited fractured distal end of radius on the morphometric parameters of distal radioulnar joint. Materials and Methods: After twelve weeks of injury x-ray of injured wrist was compared with the radiograph of the contra lateral normal wrist for the difference in radial length, radial inclination, ulnar variance and palmar tilt. Results: Results of this study showed that there were signiicant difference in distal radius parameters between genders for both groups except for the difference in palmer tilt i.e. since value of P< 0.0001 so there is significant difference between two group 1% level of significant suggesting that with 99% confidence, there is significant difference between mean of normal male and female right wrist parameters of both age group except for palmer tilt. Similarly there were variations in all parameter measurements for those x-ray films showing severe malunion and signiicant differences were noted for all parameters distal radius between normal and malunited wrist in both age groups i.e. since value of P< 0.0001 so there is significant difference between two group 1% level of signiicant suggesting that with 99% conidence, there is signiicant difference for all parameters between mean of normal and malunion group. Conclusion: These results can be used in treatment of the malunited distal radius for correction of deformity at the wrist and achieving the best possible anatomical reduction in the young active patient and at minimizing the intervention in the low demand elderly patient with multiple comorbidities. These data also can be used for clinical research in the designing of wrist implants.

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Pelyhe, Liza, and Eszter Bognár. "Determination of the Guidewire’s Visibility." Materials Science Forum 812 (February 2015): 363–67. http://dx.doi.org/10.4028/www.scientific.net/msf.812.363.

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The purpose of our research was the development of a new algorithm to the objective quantification of guidewire’s visibility; which is suitable for the classification and comparison of different guidewires, according to this property. The guidewire is a flexible medical device, over which the catheter or the dilator is lead into the vascular system to assist the insertion and position of these devices. During the insertion and the removal of guidewire the movement of distal end is monitored under fluoroscopy. At the beginning of our experiments two algorithms were developed and applied: the first one investigated the total distal end, while the second one investigated two parts of the distal end. Both algorithms were tested on ten guidewires made of same brand and material, so their relative visibility (the visibility of guidewire’s investigated part compared the background) were determined by both method. The average relative visibility was 19.8%±3.0% in case of algorithm for total distal end, and it was 21.5%±2.9% in case of algorithm for two part of distal end. The coefficient of variation was calculated in case of both algorithms, thus characterized by their reliability. Both coefficient of variation were low (0.15 and 0.13), so the algorithms were considered to be reliable. The two algorithm were no significant different (p=0.15), therefore the investigation of the total distal end might be replaced by the investigation of two parts.

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Gogoi, Paragjyoti, Anshuman Dutta, Arun Kumar Sipani, and Arup Kumar Daolagupu. "Congenital Deficiency of Distal Ulna and Dislocation of the Radial Head Treated by Single Bone Forearm Procedure." Case Reports in Orthopedics 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/526719.

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Congenital deficiency of part of distal ulna affecting the distal radio-ulnar joint is a rare disorder. It is even rarer to find the association of proximal radio-ulnar joint dislocation along with distal ulnar deficiency. This type of congenital forearm anomaly is difficult to treat. Conversion to a single bone forearm in the expense of pronation-supination movement is a viable option. By doing so the elbow and wrist can be stabilized; however movement is possible in only one plane. We are describing here a girl of 8 years having proximal radio-ulnar joint dislocation along with deficiency of distal ulna treated by converting into a single bone forearm.

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GEHRET, ALLEN, and TRAVIS NELL. "HAMEL SPACES AND DISTAL EXPANSIONS." Journal of Symbolic Logic 85, no. 1 (August 29, 2019): 422–38. http://dx.doi.org/10.1017/jsl.2019.54.

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AbstractIn this note, we construct a distal expansion for the structure $$\left( {; + , < ,H} \right)$$, where $H \subseteq $ is a dense $Q$-vector space basis of $R$ (a so-called Hamel basis). Our construction is also an expansion of the dense pair $\left( {; + , < ,} \right)$ and has full quantifier elimination in a natural language.

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MIZUKAMI, Shoichiro, Koji IMAI, Hiroyuki TAKAHASHI, Masahiro HAGIWARA, Naoto MATSUNO, and Hiroyuki FURUKAWA. "So-called Carcinosarcoma of the Distal Common Bile Duct Diagnosed by Postoperative Histopathology—A Case Report—." Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 81, no. 2 (2020): 328–36. http://dx.doi.org/10.3919/jjsa.81.328.

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Chavhan, Ashish N., Ulhas J. Dudhekar, Chandrashekhar M. Badole, and Kiran N. Wandile. "Functional and radiological outcome in distal radius fractures treated with locking compression plate." International Journal of Research in Medical Sciences 5, no. 2 (January 23, 2017): 574. http://dx.doi.org/10.18203/2320-6012.ijrms20170155.

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Background: Fractures of distal end of radius are one of the most common skeletal injuries encountered in orthopaedics. There are various modalities for treatment like close reduction and cast application, external fixators, ORIF with plate etc. CR and cast application or K-wire fixation, external fixation is associated with immobilisation, wrist stiffness, loss of reduction postoperatively. So we performed volar plating for distal end radius fractures and calculated its results.Methods: We performed ORIF with plating (Volar approach) in 35 patients (22 male and 13 female) of distal end radius fractures depending on inclusion and exclusion criteria. Fractures were classified according to AO classification. All patients were operated under tourniquet. Results were analysed using Mayo score.Results: Out of 35 patients, 14 had type A, 16 had type B and 5 had type C fractures (AO classification). Average operative time was 45 minutes and blood loss of 50 ml. Average time to clinico-radiological union was 7 weeks. Average follow up time was 8 months. Average time to wrist mobilisation was 8 days. According to Mayo score, 16 patients had excellent results, 15 had well and 4 had satisfactory results.Conclusions: Volar plating for fracture distal end radius reduces chances of wrist joint stiffness and loss of reduction and good results can be obtained. So in our opinion, volar plating for treatment of fracture distal end radius is good method with excellent outcomes.

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Tandra, Varun Sharma, Krishna Mohan Reddy Kotha, Moorthy Gadisetti Venkata Satyanarayana, Kali Varaprasad Vadlamani, and Vyjayanthi Yerravalli. "Synchronous Multicentric Giant Cell Tumour of Distal Radius and Sacrum with Pulmonary Metastases." Case Reports in Oncological Medicine 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/354158.

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Giant cell tumour (GCT) is an uncommon primary bone tumour, and its multicentric presentation is exceedingly rare. We report a case of a 45-year-old female who presented to us with GCT of left distal radius. On the skeletal survey, osteolytic lesion was noted in her right sacral ala. Biopsy confirmed both lesions as GCT. Pulmonary metastasis was also present. Resection-reconstruction arthroplasty for distal radius and thorough curettage and bone grafting of the sacral lesion were done. Multicentric GCT involving distal radius and sacrum with primary sacral involvement is not reported so far to our knowledge.

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T, Sreenivas. "Congenital Distal Tibiofibular Synostosis - A Case Report." International Journal of Health Sciences and Research 11, no. 9 (September 14, 2021): 178–80. http://dx.doi.org/10.52403/ijhsr.20210927.

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Congenital tibiofibular synostosis is the fusion of tibia and fibula since birth. So far there are many reports of congenital proximal tibio fibular synostosis in English literature, but congenital distal tibio fibular synostosis is very rarely described. Imaging studies by means of X rays, CT and MRI are required to rule out osteochondromas arising from distal tibia, fibula and other conditions. If the patient is symptomatic by means of deformity surgical intervention in the form of corrective osteotomy may be considered to prevent alternation of joint biomechanics. We report a rare case of congenital distal tibiofibular synostosis in a 21 year old female presented with complaints of deformity and pain on and off in left lower leg since childhood. Key words: Congenital; Synostosis; Deformity; Osteochondroma.

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Kölbel, Tilo, Nikolaos Tsilimparis, Kevin Mani, Fiona Rohlffs, Sabine Wipper, E. Sebastian Debus, Yskert von Kodolitsch, and Anders Wanhainen. "Physician-Modified Thoracic Stent-Graft With Low Distal Radial Force to Prevent Distal Stent-Graft–Induced New Entry Tears in Patients With Genetic Aortic Syndromes and Aortic Dissection." Journal of Endovascular Therapy 25, no. 4 (May 8, 2018): 456–63. http://dx.doi.org/10.1177/1526602818774795.

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Purpose: To describe a novel modification technique to lower the distal radial force of a thoracic stent-graft so as to avert stent-graft–induced new entry tears (SINE) in the fragile aorta of patients with genetic aortic disease and aortic dissection. Technique: A commercially available thoracic stent-graft is partially deployed on a back table. The most distal Z-stent is removed, the distal fabric is marked by vascular clips, and the modified stent-graft is reloaded and deployed in the true lumen of an aortic dissection. The technique is demonstrated in 3 patients with aortic dissection related to genetic aortic diseases. Conclusion: Creating a low distal radial force stent-graft is easy and can be done in a short time. Endovascular implantation appears feasible and safe.

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Gary, Cyril, Ajul Shah, Jack Kanouzi, Alyssa R. Golas, Jordan D. Frey, Brian Le, Jacques Hacquebord, and Vishal Thanik. "Carpal Tunnel Syndrome Following Corrective Osteotomy for Distal Radius Malunion: A Rare Case Report and Review of the Literature." HAND 12, no. 5 (May 16, 2017): NP157—NP161. http://dx.doi.org/10.1177/1558944717708053.

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Background: Although median nerve neuropathy and carpal tunnel syndrome (CTS) are known complications of both untreated and acutely treated distal radius fracture, median neuropathy after correction of distal radius malunion is not commonly reported in hand surgery literature. We describe a patient with severe CTS after corrective osteotomy, open reduction internal fixation (ORIF) with a volar locking plate (VLP), and bone grafting for distal radius malunion. Methods: We report a case of severe acute CTS as a complication of corrective osteotomy with bone grafting for distal radius malunion. Results: The patient was treated with surgical exploration of the median nerve and carpal tunnel release. Conclusion: The authors report a case of acute CTS after ORIF with VLP for a distal radius malunion warranting surgical exploration and carpal tunnel release. Treatment teams must be aware of this potential complication so that the threshold for reoperation is low and irreversible damage to the median nerve is prevented.

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Sengodan, Mugundhan M. "Malunited Isolated Intra-articular Fracture of Ulnar Head." Journal of Orthopedics and Joint Surgery 2, no. 2 (2020): 74–78. http://dx.doi.org/10.5005/jp-journals-10079-1024.

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ABSTRACT Fractures of distal ulna are often associated with fracture distal radius. Isolated intra-articular fractures of ulnar head have very rarely been reported in the literature. Displaced intra-articular fractures of ulna head should be treated properly so that the distal radio ulnar joint congruence is maintained. I am reporting a case of malunited isolated intra-articular fracture of ulnar head in young girl which was treated by open reduction and internal fixation. Logan and Lindau in their review of literature and recommendations for treatment of distal ulna fractures in adults found only few case reports. All those reported cases were treated soon after the injury. This case has been presented not only for its rarity but also to recognize the importance of managing the intra-articular fractures properly even in distal ulna. How to cite this article: Sengodan MM. Malunited Isolated Intra-articular Fracture of Ulnar Head. J Orth Joint Surg 2020;2(2):74–78.

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Derrick, Donald, and Bryan Gick. "Aerotactile Integration from Distal Skin Stimuli." Multisensory Research 26, no. 5 (2013): 405–16. http://dx.doi.org/10.1163/22134808-00002427.

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Tactile sensations at extreme distal body locations can integrate with auditory information to alter speech perception among uninformed and untrained listeners. Inaudible air puffs were applied to participants’ ankles, simultaneously with audible syllables having aspirated and unaspirated stop onsets. Syllables heard simultaneously with air puffs were more likely to be heard as aspirated. These results demonstrate that event-appropriate information from distal parts of the body integrates in speech perception, even without frequent or robust location-specific experience. In addition, overall performance was significantly better for those with hair on their ankles, which suggests that the presence of hair may help establish signal relevance, and so aid in multi-modal speech perception.

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Wesson, Donald E., and George M. Dolson. "Endothelin-1 increases rat distal tubule acidification in vivo." American Journal of Physiology-Renal Physiology 273, no. 4 (October 1, 1997): F586—F594. http://dx.doi.org/10.1152/ajprenal.1997.273.4.f586.

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Because endothelin receptor inhibition blunts increased distal tubule acidification induced by dietary acid, we examined whether endothelin-1 (ET-1) increases acidification of in vivo perfused distal tubules of anesthetized rats. ET-1 was infused intra-aortically (1.4 pmol ⋅ kg−1 ⋅ min−1) into control animals and into those with increased distal tubule HCO3 secretion induced by drinking 80 mM NaHCO3 solution for 7–10 days. ET-1 increased distal tubule acidification in both control and NaHCO3 animals. Increased acidification in control animals was mediated by increased distal tubule H+ secretion (23.7 ± 2.2 vs. 18.7 ± 1.7 pmol ⋅ mm−1 ⋅ min−1, P < 0.05) with no changes in HCO3 secretion. By contrast, ET-1 increased distal tubule acidification in NaHCO3 animals predominantly by decreasing HCO3 secretion (−9.5 ± 1.0 vs. −18.7 ± 1.8 pmol ⋅ mm−1 ⋅ min−1, P < 0.001) with less influence on H+ secretion. When indomethacin was infused (83 μg ⋅ kg−1 ⋅ min−1) to inhibit synthesis of prostacyclin, an agent previously shown to increase HCO3 secretion in the distal tubule, ET-1 increased distal tubule H+ secretion in both control (24.3 ± 2.2 vs. 15.7 ± 1.6 pmol ⋅ mm−1 ⋅ min−1, P < 0.02) and NaHCO3 (20.0 ± 2.0 vs. 13.6 ± 1.4 pmol ⋅ mm−1 ⋅ min−1, P < 0.05) without affecting HCO3 secretion. The data show that ET-1 increases distal tubule acidification in vivo and can do so by increasing H+ secretion and by decreasing HCO3 secretion when the latter is augmented by dietary NaHCO3.

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Guedes-Correa, José Fernando, and Rosana Siqueira Brown. "An anatomical study of so-called fibrous bands around the ulnar nerve distal to the cubital tunnel." Acta Neurochirurgica 160, no. 8 (June 4, 2018): 1591–96. http://dx.doi.org/10.1007/s00701-018-3562-4.

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Celenza, John L., and Marian Carlson. "REARRANGEMENT OF THE GENETIC MAP OF CHROMOSOME VII OF SACCHAROMYCES CEREVISIAE." Genetics 109, no. 4 (April 1, 1985): 661–64. http://dx.doi.org/10.1093/genetics/109.4.661.

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ABSTRACT The genetic map of the right arm of chromosome VII of Saccharomyces cerevisiae includes markers on a distal segment for which meiotic linkage to the centromere-proximal marker cly8 has not previously been demonstrated. According to the currently accepted map, SUF4 is the most distal marker on the right arm. We have shown by tetrad analysis that SUF4 is linked to cly8 and ade6. The genetic distance between SUF4 and cly8 is 29 cM. These data indicate that the genetic map of the right arm of chromosome VII should be revised by inverting the orientation of the distal segment so that SUF4 is located near cly8, and SUC1 and MAL1 are the most distal markers. With this revision, all of the polymeric fermentation markers that have been mapped are located at the ends of chromosomes.

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Hartcher-O’Brien, Jess, and Malika Auvray. "The Process of Distal Attribution Illuminated Through Studies of Sensory Substitution." Multisensory Research 27, no. 5-6 (2014): 421–41. http://dx.doi.org/10.1163/22134808-00002456.

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When we interact with objects in our environment, as a general rule we are not aware of the proximal stimulation they provide, but we directly experience the external object. This process of assigning an external cause is known as distal attribution. It is extremely difficult to measure how distal attribution emerges because it arises so early in life and appears to be automatic. Sensory substitution systems give us the possibility to measure the process as it occurs online. With these devices, objects in our environment produce novel proximal stimulation patterns and individuals have to establish the link between the proximal stimulation and the distal object. This review disentangles the contributing factors that allow the nervous system to assign a distal cause, thereby creating the experience of an external world. In particular, it highlights the role of the assumption of a stable world, the role of movement, and finally that of calibration. From the existing sensory substitution literature it appears that distal attribution breaks down when one of these principles is violated and as such the review provides an important piece to the puzzle of distal attribution.

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O'Hara, E., B. Cohen, S. M. Cohen, and W. McGinnis. "Distal-less is a downstream gene of Deformed required for ventral maxillary identity." Development 117, no. 3 (March 1, 1993): 847–56. http://dx.doi.org/10.1242/dev.117.3.847.

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The homeotic selector (HOM) proteins are required for the diversification of the anterior-posterior axis of the Drosophila body plan, assigning unique identities to regional domains of cells comprising one or a few parasegments or segments. The HOM proteins apparently accomplish this task by the transcriptional regulation of numerous downstream genes. At present few downstream genes are known, so models of how downstream genes mediate HOM functions are based more on intuition than information. Our results indicate that Distal-less is a downstream gene of the HOM gene Deformed, and Distal-less function is required for the elaboration of a subset of the maxillary epidermal identities specified by Deformed. The regulatory effect of Deformed on Distal-less is mediated by a ventral maxillary-specific enhancer located 3′ of the Distal-less transcription unit. We propose that Deformed and Distal-less, both of which encode homeodomain transcription factors that are persistently expressed in ventral maxillary cells, combinatorially specify a subsegmental code required for a group of cells to differentiate maxillary cirri.

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Erdoğan, Çağdaş, Utku Cenikli, Eylem Değirmenci, and Attila Oğuzhanoğlu. "Effect of hyperglycemia on conduction parameters of tibial nerve’s fibers to different muscles: A rat model." Journal of Neurosciences in Rural Practice 04, no. 01 (January 2013): 09–12. http://dx.doi.org/10.4103/0976-3147.105602.

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ABSTRACT Introduction: Routine conduction studies reflect the summation of all nerve fibers in a peripheral nerve. Nerve fiber groups to distal, small muscles have smaller diameters than the ones to large proximal muscles. There may be minimal differences between the diameters of nerve fiber groups innervating different muscles; even they are all same type of fibers. So, in neuropathic processes some nerve fiber groups may be more seriously affected. Materials and Methods: 14 rats ( 7 diabetic, 7 control) were studied. Tibial nerve was stimulated from two points and while recorded from a distal (foot intrinsic muscles) and a proximal (gastrocnemius) muscle. Results: There was a significant difference between the proximal and distal recorded conduction velocities. Both proximal and distal recorded conduction velocities decreased during the hyperglycemic process. Discussion: Our method successfully demonstrated different nerve fiber groups; but, the neuropathic process seemed to be homogeneous in both fiber groups.

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Fan, You-Liang, Hai-Yun Xu, Ming-Yang Xia, Wen Zhang, Hui-Long Wen, Li-Bo Gao, and Yan-Hui Pei. "Biomechanical evaluation of axial-loading simulated experiment in wrist fractures: a finite element analysis." Journal of International Medical Research 48, no. 10 (October 2020): 030006052096688. http://dx.doi.org/10.1177/0300060520966884.

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Objective To assess the biomechanical properties that influence wrist fracture, so as to provide the theoretical basis for simulation experiments to aid the optimal design of wrist protectors. Methods Six cadaveric wrists were included as experimental specimens. Wrist specimens wearing wrist protectors formed the experimental group and unprotected wrist specimens formed the control group. The wrist specimens were axially loaded under physiological loads and the stress magnitude and distribution of the experimental and control groups were obtained. A three-dimensional wrist finite element model of a healthy volunteer was developed to verify the rationality and effectiveness of the cadaveric wrist models. Results Under normal physiological loads, the stress on the radioulnar palmar unit was high and manifested in the form of pressure, while the stress on the radioulnar dorsal unit was lower and manifested in the form of tension. The stresses on the radial distal palmar, ulnar distal palmar, radial distal dorsal, ulnar distal dorsal, radial proximal palmar and ulnar proximal palmar units in the experimental group were less than those in the control group. Conclusion Under physiological loads, wearing a wrist protector can reduce the stress on the radioulnar distal palmar, radioulnar proximal palmar and radioulnar distal dorsal units, while having no obvious effect on the radioulnar proximal dorsal units.

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de Wit, Nicole, Muriel Derrien, Hanneke Bosch-Vermeulen, Els Oosterink, Shohreh Keshtkar, Caroline Duval, Johan de Vogel-van den Bosch, Michiel Kleerebezem, Michael Müller, and Roelof van der Meer. "Saturated fat stimulates obesity and hepatic steatosis and affects gut microbiota composition by an enhanced overflow of dietary fat to the distal intestine." American Journal of Physiology-Gastrointestinal and Liver Physiology 303, no. 5 (September 1, 2012): G589—G599. http://dx.doi.org/10.1152/ajpgi.00488.2011.

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We studied the effect of dietary fat type, varying in polyunsaturated-to-saturated fatty acid ratios (P/S), on development of metabolic syndrome. C57Bl/6J mice were fed purified high-fat diets (45E% fat) containing palm oil (HF-PO; P/S 0.4), olive oil (HF-OO; P/S 1.1), or safflower oil (HF-SO; P/S 7.8) for 8 wk. A low-fat palm oil diet (LF-PO; 10E% fat) was used as a reference. Additionally, we analyzed diet-induced changes in gut microbiota composition and mucosal gene expression. The HF-PO diet induced a higher body weight gain and liver triglyceride content compared with the HF-OO, HF-SO, or LF-PO diet. In the intestine, the HF-PO diet reduced microbial diversity and increased the Firmicutes-to-Bacteroidetes ratio. Although this fits a typical obesity profile, our data clearly indicate that an overflow of the HF-PO diet to the distal intestine, rather than obesity itself, is the main trigger for these gut microbiota changes. A HF-PO diet-induced elevation of lipid metabolism-related genes in the distal small intestine confirmed the overflow of palm oil to the distal intestine. Some of these lipid metabolism-related genes were previously already associated with the metabolic syndrome. In conclusion, our data indicate that saturated fat (HF-PO) has a more stimulatory effect on weight gain and hepatic lipid accumulation than unsaturated fat (HF-OO and HF-SO). The overflow of fat to the distal intestine on the HF-PO diet induced changes in gut microbiota composition and mucosal gene expression. We speculate that both are directly or indirectly contributive to the saturated fat-induced development of obesity and hepatic steatosis.

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Chou, C. L., and D. J. Marsh. "Role of proximal convoluted tubule in pressure diuresis in the rat." American Journal of Physiology-Renal Physiology 251, no. 2 (August 1, 1986): F283—F289. http://dx.doi.org/10.1152/ajprenal.1986.251.2.f283.

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The role of different nephron segments in the diuretic response to acute arterial hypertension was studied with tubular microperfusion. Early proximal convolutes were perfused with synthetic glomerular ultrafiltrate; fluid was collected from the last visible loop of the same proximal or from the first loop of the distal tubule. In late proximal collections, an increase of arterial pressure of 24 +/- 2 mmHg reduced reabsorption of tubular fluid 44 +/- 4%. Perfusate chloride concentration fell, but only 2 meq/liter, so that chloride reabsorption was inhibited in proportion to the inhibition of fluid reabsorptions, with a corresponding increase in chloride delivery to the loop of Henle. In early distal collections, there was no significant difference of the early distal flow rate with hypertension, but early distal chloride concentration increased 31 +/- 8% and chloride load increased 45 +/- 12%. Qualitatively similar increases were obtained from paired collections made from free-flowing early distal tubules. Inhibition of proximal fluid reabsorption is a primary response to acute hypertension and may contribute to pressure diuresis. In addition, this inhibition increases the strength of the luminal signal to the macula densa, enhancing the autoregulatory response to hypertension.

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Furquan, Qazi Muhammad, Naveed Ahmed Solangi, Muhammad Bux Chachar, Ghulam Mustafa Kaimkhani, Malik Wasim Ahmed, and Muhammad Ishtiyaque. "INTRA-ARTICULAR DISTAL RADIUS FRACTURES." Professional Medical Journal 22, no. 07 (July 10, 2015): 944–48. http://dx.doi.org/10.29309/tpmj/2015.22.07.1191.

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Objectives: To determine functional outcome of percutaneous Kirschner wirefixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years.Study Design: Descriptive case series. Setting: Department of Orthopedic Surgery, DowUniversity of Health Sciences / Civil Hospital Karachi. Period: 1st April, 2013 to 30th September,2013. Methods: A total of 62 patients with closed type III distal fractures according to Frykmanclassification were included in this study. Patient lying in supine position and after generalanesthesia, closed reduction was done with the forearm in prone position, aiming to restorenormal anatomical position. Two Kirschner wires were inserted from radial styloid process inparallel and oblique fashion to the medial cortex of the radius and one transversely from lateralto medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks ofsurgery and recorded on pre-designed Proforma. Results: Acceptable functional outcome ofpercutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractureswas observed in 80.65% (50/62) cases. Conclusions: It is concluded that functional outcomeof percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intraarticulardistal radius fractures and it appears to be an easy, technically less demanding andeffective method for stabilization, so this procedure can be applied for patients with thesefractures.

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Patiño, Juan Martín, Alejandro Rullan Corna, Alejandro Michelini, Ignacio Abdon, and Alejandro José Ramos Vertiz. "Elbow Posterolateral Rotatory Instability due to Cubitus Varus and Overuse." Case Reports in Orthopedics 2018 (August 5, 2018): 1–5. http://dx.doi.org/10.1155/2018/1491540.

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A malunion as a complication of distal humerus fractures has been frequently linked with aesthetic problems but less frequently with posterolateral rotatory instability. We report 2 cases of childhood posttraumatic cubitus varus with subsequent posterolateral rotatory instability and their treatment with a minimum of 2 years of follow-up. The etiology of the so-called posterolateral rotatory instability of the elbow is mostly traumatic, but iatrogenic causes have also been described such as the treatment of tennis elbow and less frequently and chronically due to overuse and overload because of distal humerus malunion.

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BIYANI, A. "Over-Distraction of the Radio-Carpal and Mid-Carpal Joints Following External Fixation of Comminuted Distal Radial Fractures." Journal of Hand Surgery 18, no. 4 (August 1993): 506–10. http://dx.doi.org/10.1016/0266-7681(93)90160-h.

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Seven patients with Frykman type 7 and 8 distal radial fractures, who had been treated with external fixation, were noted to have significant over-distraction of 5-8 mm in the radio-carpal and mid-carpal joints. One patient, who also had abnormal negative ulnar variance of 2 mm, had a fair result using modified Gartland and Werly (1951) criteria. The remaining six patients had good results, indicating that over-distraction does not significantly alter the final outcome, so long as a normal distal radio-ulnar relationship is maintained.

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Asopa, Vipin, Robert J. Douglas, Andrew D. Saies, and James S. Church. "A Misdiagnosis of Traumatic Hypersupination of the Distal Radioulnar Joint: A Case Report." Case Reports in Orthopedics 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/209675.

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Traumatic hypersupination injury of the distal radioulnar joint is a rare injury, and occurs when sufficient supination force is applied to the joint so as to tear the volar radioulnar ligament, resulting in separation of the triangular fibrocartilage complex, and subluxation of the tendon of extensor carpi ulnaris. This allows the distal ulna to rotate such that the ulnar styloid comes to lie adjacent to the ulna notch of the radius. Treatment of this injury requires manipulation of the joint, under anaesthesia or sedation. We describe a case where posttraumatic radiological investigation of a patient with an anatomical variation of the wrist when in supination resembled a traumatic hypersupination injury of the distal radioulnar joint. A review of the literature has revealed this to be the first reported case of this type.

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Nambi, G. I., and M. Dhiwakar. "Retrograde vascularisation of fibula free flap in composite oro-mandibular reconstruction." Indian Journal of Plastic Surgery 46, no. 01 (January 2013): 134–37. http://dx.doi.org/10.4103/0970-0358.113733.

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ABSTRACTWe present a case of composite oromandibular reconstruction with fibula free flap in which the vascularity to the flap was established in a retrograde direction through the distal end of the peroneal pedicle vessels. The flap was initially designed in such a way so as to anastomose with superior thyroid artery. However after initial good flow, the superior thyroid artery flow became insufficient. Therefore, an attempt was made to vascularise the flap by anastomosing the distal end of peroneal vessels with the facial artery and a tributary of the internal jugular vein so that the flap was perfused in a retrograde direction. This was successful and the retrograde flow was adequate to ensure flap survival. We believe this to be the first successful case of reverse vascular flow reported for composite oromandibular reconstruction with the fibula free flap.

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Stiebellehner, Leopold, Maria G. Frid, John T. Reeves, Robert B. Low, Meena Gnanasekharan, and Kurt R. Stenmark. "Bovine distal pulmonary arterial media is composed of a uniform population of well-differentiated smooth muscle cells with low proliferative capabilities." American Journal of Physiology-Lung Cellular and Molecular Physiology 285, no. 4 (October 2003): L819—L828. http://dx.doi.org/10.1152/ajplung.00062.2003.

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The media of the normal bovine main pulmonary artery (MPA) is composed of phenotypically heterogeneous smooth muscle cells (SMC) with markedly different proliferative capabilities in response to serum, mitogens, and hypoxia. Little, however, is known of the SMC phenotype in distal pulmonary arteries (PA), particularly in arterioles, which regulate the pulmonary circulation. With a panel of muscle-specific antibodies against α-smooth muscle (SM)-actin, SM-myosin heavy chains (SM-MHC), SM-MHC-B isoform, desmin, and meta-vinculin, we demonstrate a progressive increase in phenotypic uniformity and level of differentiation of SMC along the proximal-to-distal axis of normal adult bovine pulmonary circulation so that the media of distal PA (1,500- to 100-μm diameter) is composed of a phenotypically uniform population of “well-differentiated” SMC. Similarly, when isolated and assessed in vitro, distal PA-SMC is composed of a single, uniform population of differentiated SMC that exhibited minimal growth responses to a variety of mitogens while their cell size increased substantially in response to serum. Their growth was inhibited by hypoxic exposure under all conditions tested. Distal PA-SMC also differed from MPA-SMC by exhibiting a distinct pattern of DNA synthesis in response to serum and mitogens. Thus, in contrast to the MPA, distal PA media is composed of an apparently uniform population of well-differentiated SMC that are proliferation resistant and have a substantial capacity to hypertrophy in response to growth-promoting stimuli. We thus speculate that distinct SMC phenotypes present in distal vs. proximal PA may confer different response mechanisms during remodeling in conditions such as hypertension.

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Swanstrom, Morgan, Kyle Morse, Joseph Lipman, Krystle Hearns, and Michelle Carlson. "Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement." Journal of Wrist Surgery 07, no. 01 (August 8, 2017): 066–70. http://dx.doi.org/10.1055/s-0037-1605381.

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Background Ideal internal fixation of the scaphoid relies on adequate bone stock for screw purchase; so, knowledge of regional bone density of the scaphoid is crucial. Questions/Purpose The purpose of this study was to evaluate regional variations in scaphoid bone density. Materials and Methods Three-dimensional CT models of fractured scaphoids were created and sectioned into proximal/distal segments and then into quadrants (volar/dorsal/radial/ulnar). Concentric shells in the proximal and distal pole were constructed in 2-mm increments moving from exterior to interior. Bone density was measured in Hounsfield units (HU). Results Bone density of the distal scaphoid (453.2 ± 70.8 HU) was less than the proximal scaphoid (619.8 ± 124.2 HU). There was no difference in bone density between the four quadrants in either pole. In both the poles, the first subchondral shell was the densest. In both the proximal and distal poles, bone density decreased significantly in all three deeper shells. Conclusion The proximal scaphoid had a greater density than the distal scaphoid. Within the poles, there was no difference in bone density between the quadrants. The subchondral 2-mm shell had the greatest density. Bone density dropped off significantly between the first and second shell in both the proximal and distal scaphoids. Clinical Relevance In scaphoid fracture ORIF, optimal screw placement engages the subchondral 2-mm shell, especially in the distal pole, which has an overall lower bone density, and the second shell has only two-third the density of the first shell.

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Stanu, Gusti Ngurah Putra, I. Gusti Ngurah Wien Aryana, Ivander Purvance, and Ni Made Puspa Dewi Astawa. "Reconstruction with interference screw of ruptured distal biceps brachii tendon at level of insertion into radial tuberosity: a case report." International Journal of Research in Medical Sciences 8, no. 3 (February 26, 2020): 1163. http://dx.doi.org/10.18203/2320-6012.ijrms20200799.

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Distal biceps tendon rupture is a relatively rare injury. The incidence of distal biceps rupture is 1.2 cases per 100,000 patients per year, with the average age is 47 years old and the majority is male patient with dominant extremity. A 43 years old male presented with pain of the left elbow and weakness to flex and supinate the forearm following gymnastic activity. He heard pop sound on his left elbow during lifting dumbbell and followed by a sudden pain on his arm and weakness to flex and supinate the elbow. The USG examination were performed and confirmed there was a rupture on the distal biceps tendon at the level of insertion. Durante operation confirmed a complete rupture of distal biceps tendon. A Henry approach incision is performed to expose radial tuberosity, and the ruptured tendon was reconstructed by anchored into the tuberosity of radius with bioabsorbable screw. After closing the incision, patient is immobilized by cast in 60 to 90o elbow flexion and neutral pronosupination. Distal biceps tendon rupture can be successfully repaired by single anterior approach using anatomical anchor on radial tuberosity, so that can avoid posterior approach and associated proximal radioulnar synostosis risk while conserving interosseous membrane.

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Oka, Kunihiro, and Hisao Moritomo. "Current Management of Scaphoid Nonunion Based on the Biomechanical Study." Journal of Wrist Surgery 07, no. 02 (March 14, 2018): 094–100. http://dx.doi.org/10.1055/s-0038-1637739.

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AbstractScaphoid nonunion causes abnormal wrist kinematics and typically leads to carpal collapse and subsequent degenerative arthritis of the wrist. However, the natural history, including carpal collapse and degenerative arthritis of scaphoid nonunion, may vary at different fracture locations. This article reviews recent biomechanical studies related to the natural history of scaphoid nonunion. In the distal-type fractures (type B2 in Herbert classification), where the fracture located distal to the scaphoid apex, the proximal scaphoid fragment and lunate, which are connected through the dorsal scapholunate interosseous ligament (DSLIL) and dorsal intercarpal ligament (DIC), extend together, and the distal fragment of the scaphoid flexes individually. Therefore, untreated type B2 fractures normally show the humpback deformity, resulting in dorsal intercalated segment instability deformity relatively earlier after the injury. In the proximal-type fractures (type B1), where the fracture is located proximal to the scaphoid apex, the connection between the distal fragment and lunate is preserved through the DSLIL and DIC so that the scaphoid–lunate complex remains stable and the carpal collapse is less severe than that in distal-type fractures. The fracture location relative to the apex of the dorsal scaphoid ridge is a reliable landmark in the determination of the natural history of scaphoid nonunion.

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Wang, Zhibing, Xingwang Cheng, Yuan Zhang, Xia Zhang, and Yue Zhou. "Restoration of Constitutional Alignment in TKA with a Novel Osteotomy Technique." Journal of Knee Surgery 33, no. 02 (January 16, 2019): 190–99. http://dx.doi.org/10.1055/s-0038-1677508.

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AbstractMany studies have shown that restoration of the preoperative constitutional varus may lead to a normal knee status in total knee arthroplasty (TKA). It is also known that coronal femoral lateral bowing contributes to constitutional varus of the femoral shaft, and bilateral femoral lateral bowing (BFLB) can decelerate medial knee osteoarthritis progression. In this sense, the BFLB should be reserved in TKA. To date, no study has yet reported the technique to reserve BFLB in TKA. Our study showed that the proximal and distal femur had no significant geometric difference between patients with varus knees and BFLB (> 5°) and volunteers with healthy knees and straight femoral shaft. So, the virtual center of femoral head fell on the distal femoral mechanical axis (DMA) after accurate correction of the bowing, indicating that the DMA should be the femoral original constitutional mechanical axis (CA). Subsequently, the distal femoral osteotomy was performed perpendicular to DMA in TKA, and the postoperative angle formed by DMA and tibial mechanical axis (TMA) was measured to assess whether CA was restored successfully. In this study, the gap balance was achieved without medial collateral ligaments release, and the patient's CA was successfully restored (range of DMA–TMA angle 178.2°–179.9°). This study provides a novel technique to restore preoperative CA in patients with varus knees and BFLB. It is found that the distal femur should be cut perpendicular to DMA, so the lower limb alignment and soft tissue strains can be restored to the preoperative state, and the knees would be stable and in a natural status after TKA.

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Khan, Atiquzzaman, Rubaba Ahmed, Shirin Sultana Chowdhury, and SM Abdul Qauder. "Incidence of four canals in root-canal-treated mandibular first molars in Bangladeshi population." Update Dental College Journal 4, no. 2 (July 9, 2015): 4–8. http://dx.doi.org/10.3329/updcj.v4i2.24040.

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The aim of this in-vivo study was to assess the incidence of four root canals in clinical cases of root-treated mandibular first molars in Bangladeshi population. A clinical study of 135 root canal treated permanent mandibular first molars was conducted. The teeth were examined clinically and radiographically. The results showed that 52.59% of the examined teeth had three root canals (two mesial and one distal), 45.92% had four root canals (two mesial and two distal) and 0.0148% had five root canals (three mesial and two distal). All the teeth had two roots and no three rooted mandibular first molar found. So it can be concluded that the occurrence of three root canals in mandibular first molar is higher but four root canals is also high in Bangladeshi population.Update Dent. Coll. j: 2014; 4 (2): 04-08

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Nijk, Arjan A. "Bridging the gap between the near and the far: Displacement and representation." Cognitive Linguistics 30, no. 2 (May 27, 2019): 327–50. http://dx.doi.org/10.1515/cog-2018-0042.

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AbstractThis article discusses the use of proximal deictic expressions to designate distal entities, focusing on the use of the present tense to designate past events. Cognitive approaches to this issue assume that such usages presuppose a special conceptual construal, in which the spatio-temporal distance between the ground and the designated event space is bridged in some way. In this paper, I argue that there are two distinct ways in which this may be accomplished. One is through mentally displacing the ground to the distal space, so that the designated events become proximal in relation to this alternative ground. The other involves bringing the distal space into the ground in the form of a representation. I describe the distinctive characteristics of the two scenarios, showing both where they converge and at what point the difference becomes relevant for linguistic analysis.

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Salimi, Rozhin, Ishmath Begum, Danturulu Muralidhar Varma, B. Nandakrishna, Radhakrishnan Rajesh, and Sudha Vidyasagar. "Tenofovir disoproxil fumarate-induced distal renal tubular acidosis: A case report." International Journal of STD & AIDS 31, no. 3 (January 29, 2020): 276–79. http://dx.doi.org/10.1177/0956462419887877.

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Tenofovir disoproxil fumarate (TDF) is an anti-retroviral drug that is known to cause nephrotoxicity including renal tubular acidosis (RTA). With increasing literature on proximal RTA caused by TDF, reports on distal RTA are scarce, with only one case reported so far. We report a case of distal RTA in patient living with human immunodeficiency virus, who presented with nausea and fatigue giving a history of TDF-based therapy for two years. Laboratory investigations revealed non-anion gap metabolic acidosis, positive urine anion gap, hyperchloremia, and hypokalemia. The patient improved after discontinuing TDF and supportive management.

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Weinstein, Alan M. "A mathematical model of distal nephron acidification: diuretic effects." American Journal of Physiology-Renal Physiology 295, no. 5 (November 2008): F1353—F1364. http://dx.doi.org/10.1152/ajprenal.90356.2008.

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Through their action on the distal nephron (DN), diuretics may produce systemic acid-base disturbances: metabolic alkalosis with thiazides or loop diuretics and metabolic acidosis with amiloride. Enhanced acid excretion may be due to a local effect on the diuretic target cell (a shift of Na+ reabsorption from NaCl transport to Na+/H+ exchange), or an effect at a distance: namely, increases in luminal fluid flow or luminal Na+ concentration may enhance more distal proton secretion. Both local and distance effects are supported by micropuncture data. In the present work, mathematical models of the distal convoluted tubule (DCT)/connecting tubule (CNT) (Weinstein AM, Am J Physiol Renal Physiol 289: F721–F741, 2005), and cortical and medullary collecting ducts (CD) (Weinstein AM, Am J Physiol Renal Physiol 283: F1237–F1251, 2002) have been concatenated to yield a model of rat DN. Among the segments of this DN, the DCT-CNT is responsible for the major portion of distal acidification. Predictions from the model calculations include the following. 1) With increasing distal Na+ delivery, there is little change in net acid excretion, but a shift in acidification locus from shared DCT and CNT contributions, to DCT prominence. 2) Urinary acidification by thiazides is primarily local (in the DCT) via the shift in Na+ reabsorption from NaCl cotransport to entry via NHE2. Increased NaCl delivery to the CNT increases β-cell HCO3− secretion, and thus blunts urine acidification. 3) In contrast to conclusions drawn from the isolated CD model, inclusion of the CNT now reproduces the observed distal acidification defect found with ENaC block, so that this action of amiloride appears to be sufficient to produce “voltage-dependent” distal renal tubular acidosis. 4) The effect of furosemide to enhance distal urinary acidification is not reproduced by the model without major upregulation of CNT α-cell transport, perhaps as a result of increased luminal flow.

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Tan, Si Heng Sharon, Sheng Yang Lim, Keng Lin Wong, Chintan Doshi, Andrew Kean Seng Lim, and James Hoipo Hui. "The Outcomes of Isolated Distal Realignment Procedures in Patellofemoral Instability: A Systematic Review and Meta-analysis." Journal of Knee Surgery 33, no. 06 (March 1, 2019): 547–52. http://dx.doi.org/10.1055/s-0039-1681052.

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AbstractDistal realignment procedures are now commonly performed routinely with proximal realignment procedures. Despite so, only a limited number of publications exist that have looked into the efficacy of isolated distal realignment procedures, and whether there is indeed a need for routine proximal realignment procedures to be added to the distal realignment procedures. The current systematic review and meta-analysis aims to evaluate the outcomes of isolated distal realignment procedures in the management of patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that reported the outcomes of isolated distal realignment procedures for patellofemoral instability were included. A total of six publications were included, with 347 knees. All studies consistently reported a decrease in the rates of patellofemoral instability or maltracking (odds ratio [OR]: < 0.01; 95% confidence interval [CI]: < 0.01–0.01) and an increase in the odds of having a good outcome (OR: 0.01; 95% CI: < 0.01–0.02) after distal realignment procedures. A total of 24 out of 306 patients (7.8%) had postoperative instability or maltracking, and a total of 220 out of 303 patients (72.6%) were rated to have good or excellent outcomes postoperatively. Isolated distal realignment procedures can lead to good outcomes when used in the management of patellofemoral instability. These include a significantly decreased rate of patellofemoral instability or maltracking and a significantly increased number of patients with excellent or good outcomes postoperatively. Comparisons between patients with and without additional proximal realignment procedures suggest that additional proximal realignment procedures do not definitely improve the outcomes of distal realignment procedures and, therefore, should not be routinely performed in all patients undergoing distal realignment procedures. The Level of Evidence for this study is IV.

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Kawamura, Hideki, Toshiro Tanioka, Kazuaki Shibuya, Munenori Tahara, and Masahiro Takahashi. "Comparison of the Invasiveness Between Reduced-Port Laparoscopy-Assisted Distal Gastrectomy and Conventional Laparoscopy-Assisted Distal Gastrectomy." International Surgery 98, no. 3 (August 1, 2013): 247–53. http://dx.doi.org/10.9738/intsurg-d-12-00025.

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Abstract It is unknown whether reduced-port gastrectomy has a less invasive nature than conventional laparoscopy-assisted distal gastrectomy (C-LADG). So we compared 30 cases of dual-port laparoscopy-assisted distal gastrectomy (DP-LADG; using an umbilical port plus a right flank 5-mm port) as a reduced-port gastrectomy with 30 cases of C-LADG alternately performed by a single surgeon. No significant differences were observed in blood loss, intraoperative complications, the number of dissected lymph nodes, postoperative complications, the day of first defecation, analgesic agents required, changes in body temperature, heart rate, white blood cell count, serum albumin level, or lymphocyte count between the 2 groups. The amounts of oral intake in the DP-LADG group were significantly higher on postoperative days 9 and 10. We concluded that the amount of oral intake in the DP-LADG group was superior to that in the C-LADG group; however, no other evidence of DP-LADG being less invasive than C-LADG was obtained.

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Créteur, Viviane, Afarine Madani, and Stefano Bianchi. "Sonographic Findings in Adult Congenital Madelung Deformity: A Case Study." Journal of Diagnostic Medical Sonography 36, no. 1 (August 27, 2019): 65–71. http://dx.doi.org/10.1177/8756479319872151.

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This case study describes six sonographic findings, with correlative imaging, in an adult patient with congenital Madelung deformity. Two are typical of congenital Madelung deformity: a thick volar hyperechoic band extending from the ulnar side of the distal radius toward the lunate-triquetrum area, the so-called Vickers ligament, adjacent to the radiotriquetral ligament, and a cortical defect on the ulnar and volar side of the distal radius. Other findings may be also observed, such as a narrowed distance between the Lister tubercle and the distal radioulnar joint, a dorsal subluxation of the ulnar head, an extensor tendons entrapment and pronator quadratus modifications. Although the diagnosis of congenital Madelung deformity is based usually on clinical examination, this rare malformation may remain undiscovered until adulthood. When sonography is used as the first imaging technique, the sonographic findings of congenital Madelung deformity can facilitate diagnosis and the appropriate radiographs.

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Vegas, Diego Herrera, Mario Alejandro Fabiani, Mauricio Gonzalez-Urquijo, Agustín Bignotti, Ignacio Seré, and Pablo Salvadores. "Novel Combined Approach for Digital Necrosis Secondary to Raynaud’s Phenomenon." Vascular and Endovascular Surgery 55, no. 7 (April 19, 2021): 766–71. http://dx.doi.org/10.1177/15385744211005663.

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Abstract:

The presence of severe Raynaud’s Phenomenon (RP), with permanent pain or digital necrosis is a rare condition. Cervical sympathectomy or distal sympathectomy or A botulinum toxin have demonstrated efficacy after medical treatment failure. We report the case of a 38-year-old female patient with an acute onset of severe RP in both hands secondary to systemic sclerosis. Medical treatment failed, so a novel approach by a combination of a modified distal sympathectomy and injection of A botulinum toxin on digital neuromuscular bundles was performed. Remission of the pain occurred immediately after the procedure and 45 days later she had complete healing of the digital wounds and recovered full mobilization of both hands. The patient remained asymptomatic 6 month after the procedure, and a Doppler ultrasound showed tri-phasic flows distal to the surgical site. This novel technique is described, and a brief review of the literature is performed.

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Pedersen, Kim B., Rebecca S. Buckley, and Ray Scioneaux. "Glucose induces expression of rat pyruvate carboxylase through a carbohydrate response element in the distal gene promoter." Biochemical Journal 426, no. 2 (February 9, 2010): 159–70. http://dx.doi.org/10.1042/bj20091266.

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Pyruvate carboxylase is an enzyme of the so-called pyruvate cycling pathways, which have been proposed to contribute to glucose-stimulated insulin secretion in pancreatic β-cells. In the rat insulinoma cell line 832/13, transcripts from both the distal and proximal gene promoter for pyruvate carboxylase are up-regulated by glucose, with pyruvate carboxylase being expressed mainly from the distal gene promoter. At position −408 to −392 relative to the transcription start site, the distal gene promoter was found to contain a ChoRE (carbohydrate response element). Its deletion abolishes glucose responsiveness of the promoter, and the sequence can mediate glucose responsiveness to a heterologous gene promoter. ChREBP (carbohydrate response element-binding protein) and its dimerization partner Mlx (Max-like protein X) bind to the ChoRE in vitro. ChREBP further binds to the distal promoter region at a high glucose concentration in situ. The E-box-binding transcription factors USF1/2 (upstream stimulatory factor 1/2) and E2A variant 2 [also known as E47 and TCF3 (transcription factor 3)] can also bind to the ChoRE. Overexpression of E2A diminishes the magnitude of the glucose response from the pyruvate carboxylase ChoRE. This illustrates that competition between ChREBP–Mlx and other factors binding to the ChoRE affects glucose responsiveness. We conclude that a ChoRE in the distal gene promoter contributes to the glucose-mediated expression of pyruvate carboxylase.

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Journal articles on the topic 'Distal-SO'

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