When the stripe width is reduced to 1 5 mu m, a relative reductio

When the stripe width is reduced to 1.5 mu m, a relative reduction of thermopower up to 35% is measured in some metals. We suggest that the sidewall scattering due to rough edges of these stripes may be the origin of this unexpected phenomenon. The results may be applied to construct novel thermoelectric Selinexor manufacturer devices, such as thermocouples made from a single metal film. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3653824]“
“We present a method to measure the relative transmissibility (“”transmission

fitness”") of one strain of a pathogen compared to another. The model is applied to data from “”competitive mixtures”" experiments in which animals are co-infected with a mixture of two strains. We observe the mixture in each animal over time and over multiple generations of transmission. We use data from influenza experiments in ferrets to demonstrate the approach. Assessment of the relative transmissibility between two strains of influenza is important in at least three contexts: 1) Within the human population antigenically novel strains of influenza arise and compete for susceptible hosts. 2) During a pandemic event, a novel sub-type of influenza competes with the existing seasonal strain(s). The unfolding epidemiological dynamics are dependent upon both the population’s susceptibility profile and the inherent transmissibility of the novel strain BB-94 purchase compared to the

existing strain(s). 3) Neuraminidase inhibitors (NAIs), while providing significant potential to reduce transmission of influenza, exert selective pressure on the virus and so promote the emergence of drug-resistant strains. Any adverse outcome due to selection and subsequent spread of an NAI-resistant strain is exquisitely dependent upon the transmission fitness of that strain. Measurement of the transmission fitness of two competing strains of influenza is thus of critical importance in determining the likely time-course and epidemiology of an influenza outbreak,

or the potential impact of an intervention measure such as NAI distribution. The mathematical framework introduced here also provides an estimate for the size of the transmitted inoculum. We demonstrate the framework’s behaviour using data Nutlin-3 mw from ferret transmission studies, and through simulation suggest how to optimise experimental design for assessment of transmissibility. The method introduced here for assessment of mixed transmission events has applicability beyond influenza, to other viral and bacterial pathogens.”
“Valproic acid (VPA) is associated with hyperammonemia; however, little is known about this phenomenon in the geriatric psychiatric population. Of 12 such patients prescribed VPA, 83.3% had elevated ammonia. This occurred in the absence of elevated liver enzymes, and there was no association of VPA serum-level to hyperammonemia.

The pathological condition of the dorsal skin was evaluated histo

The pathological condition of the dorsal skin was evaluated histologically. Real-time polymerase chain reaction analysis was performed for cytokine expression in

the affected skin. The epidermal hyperplasia and allergic inflammation were reduced in atopic mice supplied with Jeju groundwater when compared to those supplied with tap water or other kinds of natural groundwater. The increase in scratching behavior with the aggravation of clinical severity of dermatitis was favorably controlled. Moreover, transepidermal water loss that reflects skin barrier function was recovered. The early inflammation and hypersensitivity in the atopic skin was alleviated in mice supplied with Jeju groundwater, suggesting selleck chemical its profitable potential on the daily care of patients with skin troubles including AD.”
“Lung transplantation offers a major survival benefit in selected patients with end-stage pulmonary disease. In recent years, there is accumulating evidence of an increase in solid organ tumors and especially in primary lung cancer. There is also some anecdotal evidence that lung transplantation may be beneficial as a treatment option in some patients with lung cancer,

such as the ones with extensive bronchoalveolar cell carcinoma. In this review, we analyze the literature data reporting the incidence of lung cancer after lung transplantation with its inherent risk factors, and we summarize the available data on possible treatment of lung cancer by lung transplantation. Erastin Finally, bronchial epithelial chimerism as possible cause for lung cancer is discussed. SCH 900776 price Copyright (C) 2011 S. Karger AG, Basel”
“A Kampo prescriptions, hochuekkito (HET) has been utilized for treating functional conditions such as general fatigue, compromised state and gastrointestinal motility disorder. Recently, HET has attracted the attention of dermatologists because of its clinically positive effects in atopic dermatitis (AD) treatment. To explain this positive effect of HET, we examined its protective ability against oxidative skin stress using a murine model. The dorsal region of 8-week-old male HR-1 hairless mice, which were raised on a HET (0%,

2% and 10%) mixed diet, was irradiated once with 70mJ/cm2 of ultraviolet (UV)-B light. After 4days, transepidermal water loss (TEWL) and stratum corneum water content (SCWC), were determined as a measure of degree of skin dysfunction. To estimate the amount of active oxygen generated, the stratum corneum catalase activity (SCCA) and stratum corneum carbonylated protein (SCCP) content in the tape-stripped stratum corneum samples were measured. We also measured the H2O2 scavenging ability of HET, and analyzed the changes in the expression levels of several inflammation and oxidative stress-related genes in the skin of HET-fed mice. In control mice, exposure to UV-B led to significant increases in TEWL and SCCP and significant decreases in SCWC and SCCA.

Conclusions: An intraamniotic inflammatory response to bacteria i

Conclusions: An intraamniotic inflammatory response to bacteria in pregnancies complicated by PPROM seems to be different below and above 32 weeks of gestation.”
“An ideal preparation for intravenous iron replacement therapy should balance effectiveness and safety. Compounds that release iron rapidly tend to cause toxicity, while large molecules can induce antibody formation and cause anaphylactic reactions. There is therefore a need for an intravenous iron preparation that delivers appropriate amounts of iron in a readily available form but with minimal side effects and thus with an excellent safety profile. In this paper, a review is given on the chemistry,

pharmacology, and toxicology of ferric carboxymaltose (FCM, Ferinject (R)), a stable and robust complex formulated as a colloidal ACP-196 cell line solution with a physiological pH.

The complex is gradually taken up mainly from the hepatic reticulo-endothelial system (RES), followed by effective delivery of iron to the endogeneous transport system for the haem

synthesis in new erythrocytes, as shown in studies on the pharmacodynamics and pharmacokinetics with radio-labelled FCM. Studies with radio-labelled FCM also demonstrated a barrier function of the placenta and a low transfer of iron into the milk of lactating rats. Safety pharmacology studies indicated a favourable profile with regard to cardiovascular, central nervous, respiratory, and renal toxicity. A high maximum non-lethal PF-6463922 Protein Tyrosine Kinase inhibitor dose was demonstrated in the single-dose toxicity studies. Furthermore, based on the No-Observed-Adverse-Effect-Levels (NOAELs) found in repeated-dose toxicity studies and on the cumulative doses administered, FCM has good safety margins. Reproductive and developmental toxicity studies did not selleck kinase 抑制剂 reveal any direct or indirect harmful effects. No genotoxic potential was found in in vitro or in vivo studies. Moreover, antigenicity studies showed no cross-reactivity of FMC with anti-dextran antibodies and also suggested that FCM does not possess sensitizing

potential. Lastly, no evidence of irritation was found in local tolerance studies with FCM.

This excellent toxicity profile and the high effectiveness of FCM allow the administration of high doses as a single infusion or bolus injection, which will enhance the cost-effectiveness and convenience of iron replacement therapy. In conclusion, FCM has many of the characteristics of an ideal intravenous iron preparation.”
“Background: Maternal diabetes causes neural tube defects (NTDs) in the embryos via activating protein kinase Cs (PKCs), which regulate programmed cell death (apoptosis). The aims of this study are to investigate the role of proapoptotic PKC delta in NTD formation and the underlying mechanisms.

Respiratory syncytial virus (RSV) was the agent that was most com

Respiratory syncytial virus (RSV) was the agent that was most commonly found (3.8% specific hospitalization

rate). Children receiving adequate RSV prophylaxis (90.5%) had a 58.2% (95% confidence interval: 37.6-78.3) reduction in RSV hospitalization. Risk factors for admission included malnourishment, infant age, male gender, chromosome alterations, wheezing, inadequate RSV prophylaxis fulfillment, and siblings <11 years of age. Pediatric intensive care unit care was required in click here 21.8% of the admissions and 9 patients (0.34%) died.

Conclusions: Hospital admission rate and severity of ARI remain as important issues in hemodynamically significant congenital heart disease patients. The strict fulfillment of prophylactic recommendations against RSV is the only protective factor that can be modulated to decrease the ARI hospital admission rate.”
“Introduction: Different types of grafts have been described in urethral reconstruction (UR), with penile skin graft (PSG) and buccal mucosa graft (BMG) as the most frequently used ones. It still remains unclear whether one graft is superior in terms of success when compared to the other. Material and Methods: A systematic review of the

literature was performed searching the MEDLINE database with the following Ferrostatin-1 chemical structure search strategy: ‘urethroplasty’ AND ‘penile skin’/'urethroplasty’ AND ‘buccal mucosa’. 266 and 144 records were retrieved for urethroplasty with PSG and BMG,

respectively. These records were reviewed to identify papers where PSG and BMG were used in UR and where individualized data on success were available within the same series. Results: 18 papers were found eligible for further analysis. In total, 428 and 483 patients were respectively treated with CDK inhibitor PSG or BMG. If available, follow-up duration was 64.1 versus 42.1 months (p < 0.0001) and stricture length 6.2 versus 4.6 cm (p < 0.0001) for PSG and BMG, respectively. Success of UR with PSG was 81.8 versus 85.9% with BMG (p = 0.01). Conclusions: Success of UR using BMG is significantly better compared to PSG. Results might be seriously biased by a longer follow-up duration and stricture length for PSG compared to BMG. Copyright (c) 2012 S. Karger AG, Basel”
“The stabilization effect, an increase of the reverse transition temperature T(C) with ferroelectric aging time, was recently found in acceptor doped ferroelectrics. Such an effect has found a microscopic explanation in the symmetry-conforming principle of point defects, which also accounts for a similar stabilization effect in ferroelastic/martensite materials. However, such a microscopic model is difficult to use to make a quantitative/semiquantitative evaluation of the aging process. In the present work, we propose a single-domain thermodynamic model that provides a semiquantitative fit to the experimentally observed stabilization kinetics.

Pine tannin foams without formaldehyde showed lower mechanical st

Pine tannin foams without formaldehyde showed lower mechanical strength and more elastic behaviour. (C) 2012 Elsevier B.V. All rights reserved.”
“Background and Purpose: Lithotripsy is an established method to fragment kidney stones that can be performed without general anesthesia in the outpatient setting. Discomfort and/or noise,

however, may deter some patients. It has been demonstrated that audiovisual distraction (AV) can reduce sedoanalgesic requirements and improve patient satisfaction in nonurologic settings, but to our knowledge, this has not been investigated Milciclib purchase with lithotripsy. This randomized controlled trial was designed to test the hypothesis that AV distraction can reduce perceived pain during lithotripsy.

Patients and Methods: All patients in the study received identical analgesia before a complete session of lithotripsy on a fixed-site Storz Modulith SLX F2 lithotripter. Patients were randomized to two groups: One group (n = 61) received AV distraction via a wall-mounted 32 ” (82 cm) television with wireless headphones; the other group (n = 57) received no AV distraction. The mean intensity of treatment was comparable in both groups. Patients used a visual analogue scale (0-10) to record independent pain and distress scores and a nonverbal pain score was documented by the radiographer during the procedure (0-4).

Results: In the group that received AV distraction,

all measures of pain perception were statistically lower. The patient-reported pain score was reduced from a mean of 6.1 to 2.4 (P < 0.0001), and the distress score was reduced from a click here mean of 4.4 to 1.0 (P = 0.0001). The mean nonverbal score recorded by the radiographer was reduced from 1.5 to 0.5 (< 0.0001).

Conclusions: AV distraction significantly lowered patients’ reported pain and distress scores. This correlated with the nonverbal scores reported by the radiographer. We conclude that AV distraction is a simple method of improving acceptance Vorinostat molecular weight of lithotripsy and optimizing

“BACKGROUND: Primary B-cell lymphomas of the cervix are rare entities and can present with hydronephrosis.

CASE: An 82-year-old woman with a history of chronic kidney disease presented with fever, altered mental status, and abdominal pain with bilateral hydronephrosis. Despite stent placement and antibiotic therapy, the patient’s condition worsened. Pelvic examination and biopsies were then performed, and a B-cell lymphoma of the cervix causing hydronephrosis was diagnosed. The patient’s family declined further treatment, and the patient died 2 weeks later.

CONCLUSION: Gynecologic examination and suspicion for pelvic malignancies are essential in the evaluation of patients presenting with hydronephrosis. Although squamous cell carcinoma is the most common type of malignancy associated with this presentation, malignancies of other cell lines, including lymphoma, should be considered. (Obstet Gynecol 2011; 117: 444-6) DOI: 10.1097/AOG.

In this study, batch experiments were carried out to verify this

In this study, batch experiments were carried out to verify this effect using synthetic solutions.

RESULTS: Addition of seed crystals could increase the rate of MAP crystallization and significantly shorten the reaction crystallization time, especially for solutions with a

lower supersaturation ratio (Omega). Crystallization time of MAP with and without seed addition can be expressed by two different formulas, in which the crystallization with feed addition followed an exponential function, and the secondary formula fitted a two-order power function. When 0.422 g L(-1) of seed crystals was added the equilibration time for crystallization calculated by the formula was reduced by 75min for low Staurosporine inhibitor supersaturation ratio solution and 26min for medium supersaturation ratio solution.

CONCLUSION: To increase the MAP reaction rate and to shorten induction

and equilibration times, seed crystal addition should be practiced (C) 2011 Society of Chemical Industry”
“Although Proteus mirabilis is a common human pathogen, bacteremia caused by the organism, especially strains producing extended-spectrum beta-lactamase (ESBL), has rarely been investigated. We examined 64 cases of P. mirabilis bacteremia identified in the Minami Ibaraki Area, Japan, between 2001 and 2010 and compared the characteristics of cases with ESBL-producing and ESBL-non-producing strains (13 and 51 cases, respectively). All ESBL-producing strains with the gene encoding the CTX-M-2-group were genetically nonidentical. Isolation of ESBL-producing strains was significantly associated with onset in

a hospital (p = 0.030), receiving hemodialysis find more (p = 0.0050), and previous antibiotic use within 1 month (p = 0.036; especially penicillin and/or cephalosporin (p = 0.010) and fluoroquinolone (p = 0.0069)). Isolation was also associated with inappropriate antibiotic therapy on the 1st and 4th days (p = 0.011 and 0.032, respectively) but not with mortality on the 30th day. These findings indicate that, for P. mirabilis bacteremia, isolation of ESBL-producing strains causes delay of initiating appropriate antimicrobial therapy but may not be associated with mortality.”
“A 68-year-old man developed a local recurrence with Buparlisib cell line multiple cutaneous and subcutaneous nodules three months after excision of a primary malignant melanoma of the temple. Despite extensive surgery and adjuvant irradiation, another local recurrence occurred. Following further local progression during dacarbazine chemotherapy, topical treatment with imiquimod was begun and the chemotherapy was changed to fotemustine. During this treatment further local progression occurred and two months later regional lymph node and distant metastasis were detected. The patient died from his tumor disease eighteen months after the first diagnosis of malignant melanoma.”
“BACKGROUND: Owing to the rapid depletion of petroleum fuel, the production of butanol through biological routes has attracted increasing attention.

Fifty matched control participants were examined


Fifty matched control participants were examined.

Results. The prevalence of TMJ symptoms was significantly higher in patients compared with control participants at inception (44% vs 20%, P = .0055) and remained significantly higher throughout the study period. The prevalence of disk displacement did not differ significantly between groups either

at inception (63% vs 53%) or at 15-year follow-up (63% vs 55%).

Conclusions. This prospective 15-year follow-up suggests that the development of TMJ symptoms, both immediate and delayed, is common in whiplash patients.”
“Background We analyzed the clinical response of pediatric and adolescent hereditary angioedema (HAE) patients to pdC1-INH in the International Multicenter Prospective Angioedema C1-INH

Trials (I.M.P.A.C.T.) 1 and 2. Methods Patients included in this post hoc analysis of prospectively collected data were between click here 10 and 18 yr old with type I or II HAE and a documented history of abdominal or facial attacks. Patients received a single injection of pdC1-INH concentrate (Berinert (R), CSL Behring, Marburg, Germany) 20 U/kg. Efficacy end-points were time from the administration of study drug to onset of symptom relief and time to complete relief of all symptoms. Results Seven pediatric patients were included in I.M.P.A.C.T.1 with only 1 attack Pevonedistat price analyzed per patient. Median time to onset of relief was 0.42 h and to complete resolution was 8.08 h. No patient experienced a worsening of symptoms during the 04-h GDC-0068 order assessment period. Nine patients

who experienced a total of 115 attacks were included in the analysis of I.M.P.A.C.T.2. Abdominal attacks were rated as severe more frequently than were other types of attacks. The number of attacks per patient ranged from 2 to 42, and study participation ranged from 1 to 38 months. Median times to onset of symptom relief and to complete symptom resolution were 0.49 h and 14.1 h, respectively. Of 4 treatment-emergent adverse events in both studies, only 2 were considered related to treatment. Conclusions Study results showed that outcomes with pdC1-INH treatment of HAE in pediatric patients are comparable with outcomes in adults.”

To establish the normal range of frontonasal angle (FNA) at 11+0 to 13+6 weeks of gestation and the feasibility of FNA measurement, evaluate the correlation of such a parameter with crown-rump length (CRL) and nuchal translucency (NT) and assess the potential of FNA in improving the performance of first trimester sonographic and biochemical screening for trisomy 21.


We conducted a prospective study in 400 singleton uncomplicated pregnancies. FNA was obtained during maternal screening for trisomy 21. NT thickness and FNA were measured by 2D ultrasound in a midsagittal plane of the fetal profile. FNA was measured between the line along the upper surface of the frontal bone and the superior edge of the nasal profile until the echogenic tip.

Records were reviewed for postoperative gastrojejunostomy leak,

Records were reviewed for postoperative gastrojejunostomy leak,

stricture, and marginal ulcer, and these early complications were classified according to anastomosis technique. Multivariate analysis was performed to MCC950 concentration determine associations between complications and anastomosis technique.

Preoperative demographics, length of hospital stay, and postoperative follow-up did not differ between the three groups. The majority of patients underwent LSA (n = 514, 61.6%) followed by HSA (n = 180, 21.6%) and CSA (n = 140, 16.8%). Using multivariate analysis, there were no statistically significant differences in the rates of leak (LSA 1.0%, HSA 1.1%, CSA 0.0%, p = 0.480), stricture (LSA 6.0%, HSA 6.1%, CSA 4.3%, p = 0.657), or marginal ulcer (LSA 8.0%, HSA 7.7%, CSA 3.6%, p = 0.180).

The three techniques can be used safely with a low complication rate. Our data do not identify a superior VEGFR inhibitor anastomosis technique.”
“Adenolipoma refers to a variant of a lipoma with entrapped eccrine or, rarely,

apocrine units. We present 5 cases of cutaneous adenolipoma to demonstrate the spectrum of changes in the lipomatous and epithelial components. The cases include 3 lesions having a conventional lipomatous element and 1 with a spindle cell lipomatous component, each additionally featuring entrapped minimally altered eccrine units. In the remaining case, the epithelial component manifested a combination of hyperplastic and metaplastic changes (clear cell and squamous metaplasia) and unusually altered polarity of luminal cells with expression of myoepithelial cell markers on the luminal cells while focal absence of basal/myoepithelial cell in the corresponding area as evident microscopically and immunohistochemically.”
“Helichrysum has long been used medicinally, proving to be beneficial in treatment of acne, asthma, bronchitis and circulatory problems, and lymphatic system diseases. The objective of this research was to study the antioxidant and antibacterial activities and chemical composition of the compounds derived from the stems and roots of cultivated Selleck TPX-0005 H oligocephalum

using gas chromatography (GC) and gas chromatography-mass spectroscopy (GC-MS). The primary components found in the stem oil were ortho-vanillin (51.0%) and carvacrol (16.0%), and those found in the root oil were 1,8-cineole (30.6%) and isobornyl acetate (13.9%). Stem and root oils of H. oligocephalum demonstrated antibacterial activity, particularly in relation to Gram-positive bacteria. In a beta-carotene/linoleic acid bleaching assay, the root oil of H oligocephalum demonstrated an antioxidant effect. Antioxidant capacity measured with 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was 1205.0 for the stem oil and 722.8 mu g/ml for the root oil.”
“Understanding of chronic heart failure (HF) has progressed from a syndrome of disordered hemodynamics caused by alterations in the structure of the heart to one that involves intertwined molecular pathways in disarray.


authors report 3 patients who encountered prominently


authors report 3 patients who encountered prominently rhythmic neck myoclonias with and without absences (loss of awareness). The descriptive symptoms of attacks by witnesses were head shaking or turning repeatedly instead of absences. The seizures were induced by hyperventilation in all 3 cases. Two cases had a history of previous febrile seizures. In all patients, video-electroencephalography showed a one-to-one correspondence relationship between the 2.5- to 3.5-Hz generalized spike and wave discharges and the rhythmic myoclonic jerks of the neck, which was further confirmed by sternocleidomastoideus PP2 clinical trial electromyography recording in 1 patient. Seizures had been controlled by 1 or 2 antiepileptic drugs. Neck myoclonia with absences might be classified either as 1 special subtype of typical absence or as an independent seizure type. Paying close attention to the special phenomenon will help to clarify the clinical spectrum of this seizure.”
“Purpose To critically appraise, compare and summarize the measurement SB525334 properties of self-report fatigue questionnaires validated in patients

with multiple sclerosis (MS), Parkinson’s disease (PD) or stroke.

Methods MEDLINE, EMBASE, PsycINFO, CINAHL and SPORTdiscus were searched. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of studies. A qualitative data synthesis was performed to rate the measurement properties for each questionnaire.

Results Thirty-eight studies selleck chemical out of 5,336 records met the inclusion criteria, evaluating 31 questionnaires. Moderate evidence was found for adequate internal consistency and structural validity of the Fatigue Scale for Motor and Cognitive functions (FSMC) and for adequate reliability and structural validity of the Unidimensional Fatigue Impact Scale (U-FIS) in MS.

Conclusions We recommend the FSMC and U-FIS in MS. The Functional Assessment

of Chronic Illness Therapy Fatigue subscale (FACIT-F) and Fatigue Severity Scale (FSS) show promise in PD, and the Profile of Mood States Fatigue subscale (POMS-F) for stroke. Future studies should focus on measurement error, responsiveness and interpretability. Studies should also put emphasis on providing input for the theoretical construct of fatigue, allowing the development of questionnaires that reflect generic and disease-specific symptoms of fatigue.”
“An alternative method to resonant tunneling for obtaining total transmission in semiconductor heterostructures is investigated. This nonresonant total transmission has been shown to be difficult to achieve for electrons at normal incidence. However, if the momentum of the electron is altered so that the component in the direction parallel to the material interface is nonzero, the transmission properties of the electron change, and the potential for total transmission is more promising.

(Funded by Boehringer Ingelheim; RE-MEDY and RE-SONATE ClinicalTr

(Funded by Boehringer Ingelheim; RE-MEDY and RE-SONATE ClinicalTrials.gov numbers, NCT00329238 and NCT00558259, respectively.)”
“The functional expression

of heterologous genes using standard bacterial expression hosts such as Escherichia coli is often limited, check details e.g. by incorrect folding, assembly or targeting of recombinant proteins. Consequently, alternative bacterial expression systems have to be developed to provide novel strategies for protein synthesis exceeding the repertoire of the standard expression host E. coli.

Here, we report on the construction of a novel expression system that combines the high processivity of T7 RNA polymerase with the unique physiological properties of the facultative photosynthetic bacterium Rhodobacter capsulatus. This system basically consists of a recombinant R. capsulatus T7 expression strain (R. capsulatus B10S-T7) harboring the respective polymerase gene under control of a fructose inducible promoter.

In addition, a set of different broad-host-range vectors (pRho) was constructed allowing T7 RNA polymerase dependent and independent target gene expression in R. capsulatus and other Gram-negative bacteria. The expression efficiency of the novel system was studied in R. capsulatus and 4SC-202 E. coli using the yellow fluorescent protein (YFP) as model protein. Expression levels were comparable in both expression hosts before and yielded up to 80 mg/l YFP in phototrophically grown R. capsulatus cultures. This result clearly indicates that the novel R. capsulatus-based expression system is well suited for the high-level

expression of soluble proteins. (C) 2009 Elsevier Inc. All rights reserved.”

Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter.


We prospectively assessed 100 patients with gastroesophageal reflux disease before and after sphincter augmentation. The study did not include a concurrent control group. The primary outcome measure was normalization of esophageal acid exposure or a 50% or greater reduction in exposure at 1 year. Secondary outcomes were 50% or greater improvement in quality of life related to gastroesophageal reflux disease and a 50% or greater reduction in the use of proton-pump inhibitors at 1 year. For each outcome, the prespecified definition of successful treatment was achievement of the outcome in at least 60% of the patients. The 3-year results of a 5-year study are reported.


The primary outcome was achieved in 64% of patients (95% confidence interval [CI], 54 to 73).