Membrane-covered stents have significantly better palliation than conventional bare metal stents because of decreased rates of tumor ingrowth that necessitate endoscopic reintervention for dysphagia.

A field research campaign, the Hail Spatial and Temporal Observing Network Effort (HailSTONE), was designed to obtain physical high-resolution hail measurements at the ground associated with convective storms to help address several operational challenges that remain unsatisfied through public storm reports. Field phases occurred over a 5-yr period, yielding hail measurements from 73 severe thunderstorms [hail diameter ≥ 1.00 in. (2.54 cm)]. These data provide unprecedented insight into the hailfall character of each storm and afford a baseline to explore the representativeness of the climatological hail database and hail forecasts in NWS warning products. Based upon the full analysis of HailSTONE observations, hail sizes recorded in Storm Data as well as hail size forecasts in NWS warnings frequently underestimated the maximum diameter hailfall occurring at the surface. NWS hail forecasts were generally conservative in size and at least partially calibrated to incoming hail reports. Storm mode played a notable role in determining the potential range of maximum hail size during the life span of each storm. Supercells overwhelmingly produced the largest hail diameters, with smaller maximum hail sizes observed as convection became progressively less organized. Warning forecasters may employ a storm-mode hail size forecast philosophy, in conjunction with other radar-based hail detection techniques, to better anticipate and forecast hail sizes during convective warning episodes.

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SLE is an autoimmune and polygenic disorder characterized by an accumulation and deposition of immune complexes. Several studies have indicated differential impact of FcgammaR polymorphism genotypes in different ethnic groups studied. The Fc receptor for IgG class IIA gene (FcgammaRIIA) occurs in two allelic forms. The allele FcgammaRIIA-H131 encodes a receptor with a histidine at the 131 amino acid position; the other allele FcgammaRIIA-R131 encodes an arginine. This polymorphism is believed to determine the affinity of the receptor for hIgG2 in immune complexes. FcgammaRIIA-H131 has a higher capacity for hIgG2 compared to FcgammaRIIA-R131 as measured by in vitro studies of insoluble immune complex clearance. We have investigated the polymorphism for FcgammaRIIA using a novel polymerase chain reaction-allele specific primer (PCR-ASP) method designed specifically to distinguish the two allelic forms. Our studies were based on 175 Chinese and 50 Malays SLE patients as well as 108 and 50 ethnically matched healthy controls for the respective groups. Analysis of the data (chi2 test with Yates correction factors and odds ratios) revealed that there were no significant differences between SLE patients and controls. We have not found evidence of a protective effect conferred by FcgammaRIIA-H131 in the ethnic groups studied.

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ObjectiveTo provide current information on the risks of endoscopic sphincterotomy for stone. Summary Background DataIn recent years (since the popularity of laparoscopic cholecystectomy), endoscopic sphincterotomy has been used increasingly for the management of bile duct stones in relatively young and healthy patients. The validity of this trend has been questioned using data on short-term complications derived from earlier decades that involved more elderly and high-risk patients. MethodsSeven academic centers collected data prospectively using a common database. Complications within 30 days of the procedures were documented by standard criteria. ResultsOf 1921 patients, 1 12 (5.8%) developed complications; two thirds of these events were graded as mild (<3 days in hospital). There was no evidence of increased risk in younger patients or in those with smaller bile ducts. There was only one severe complication and there were no fatalities in 238 patients age <60, with bile duct diameters of <9 mm. ConclusionSphincterotomy for stones can be performed very safely by experienced endoscopists. 201

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