摘要:
Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alterative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.
摘要:
Apparatus and methods for endoluminal advancement are described herein. A shape-lockable tissue anchoring assembly generally has an elongate body, a handle assembly, and an anchoring assembly positioned at or proximal to a distal tip of the elongate body. A distal portion of the elongate body may optionally be steerable or curvable. The anchoring assembly may include various expandable or projecting anchoring features to contact and retain tissue relative to the elongate body such that pleated tissue is temporarily immobile relative to the elongate body. This anchoring can be actuated simultaneously with or independently from shape-locking of elongate body. The anchoring assembly can be actuated simultaneously with the shape-locking of the elongate body. Alternatively, the steerable distal portion of the elongate body can be angled against the pleated tissue to retain it while the endoscope is advanced relative to the pleated tissue.
摘要:
A system for treating gastroesophageal reflux disease (GERD) is disclosed herein. A variety of tools, such as a shape-lockable endoscopic device, can be advanced trans-esophageally and into the stomach or through the stomach wall to access regions of the tissue in and around the gastroesophageal junction. Utilizing expandable tissue anchors, the angle of Hiss can be reconfigured by deploying the anchors within the esophagus and fundus and approximating the two. Alternatively, the esophagus can be lengthened by approximating tissue from within the stomach to follow the lesser curve of the stomach. Alternatively, one or more tissue folds can be formed within or adjacent to the GEJ to form a barrier to refluxing stomach contents.
摘要:
A system for treating gastroesophageal reflux disease (GERD) is disclosed herein. A variety of tools, such as a shape-lockable endoscopic device, can be advanced trans-esophageally and into the stomach or through the stomach wall to access regions of the tissue in and around the gastroesophageal junction. Utilizing expandable tissue anchors, the angle of Hiss can be reconfigured by deploying the anchors within the esophagus and fundus and approximating the two. Alternatively, the esophagus can be lengthened by approximating tissue from within the stomach to follow the lesser curve of the stomach. Alternatively, one or more tissue folds can be formed within or adjacent to the GEJ to form a barrier to refluxing stomach contents.
摘要:
Methods and apparatus for maintaining sterility during transluminal procedures are described. The sterility is achieved by making use of a membrane in either the form, e.g., of a sheath, cap or umbrella to keep the instruments (endoscopes, overtubes, etc.) sterile while being advanced through lumens in the body and into the various cavities. Methods, such as vacuum acquisition, mechanical tissue anchoring, etc., of the underlying tissue followed by incision of the tissue with, e.g., a needle knife, can be utilized to gain access to the various cavities. It is expected that this procedure will provide the desired level of sterility for transluminal procedures.
摘要:
Apparatus and methods are provided for cleaning a patient's colon in preparation for colonoscopy. A rigidizable overtube is described, as well as several variations of a colon-cleaning element configured for use with the overtube to clean the patient's colon. In one variation, the colon-cleaning element comprises a fluid jet. In another variation, the colon-cleaning element comprises a mechanical brush. Aspiration optionally may be provided for removing blockage material disrupted during colonic cleaning.
摘要:
Helical tissue manipulation instruments and methods of their use are described herein. A helical tissue engager is adapted to reversibly engage tissue and is positioned upon a flexible shaft which is advanceable through a rigidizable endoscopic assembly. The flexible shaft defines a marked section proximal to the tissue engager which can include any number of markings, designs, patterns, projections, textures, etc., which acts to provide a visual indication to the user as to the translational movement, rotation, direction of rotation, etc., of the tissue engager and the shaft. An optional guidewire can be advanced through the tissue engager. Additionally, the tissue engager and shaft can be advanced through an optional tubular sheath which may be used for dilating tissue openings prior to passage of the helical engager through the tissue opening.
摘要:
A bathroom storage device for convenient concealed storage of a toilet plunger and visible storage of multiple vertically stacked rolls of toilet paper. The cup of the toilet plunger is concealed within a base unit having an open top from which the handle of the toilet plunger protrudes. A top member with a hollow vertical spindle is placed over the open top, thereby concealing the cup and handle of the toilet plunger within the base unit and hollow vertical spindle, respectively. Spaced vertical members about the periphery of the top member partially conceal the vertically stacked rolls of toilet paper while still enabling visual ascertainment of their number. The hollow vertical spindle may serve as a handle by which the top member and stacked rolls of toilet paper can be removed to gain access to the toilet plunger.
摘要:
A method of preparing anti-b amyloid immunoglobulin involves treating human plasma anti-b amyloid immunoglobulin under alkaline conditions, such as at pH 10.25 to 11.75 using diethylamine HCl, to dissociate b amyloid protein therefrom. Typically, the anti-b amyloid immunoglobulin is present in human immunoglobulin preparations obtained from plasma or serum. Anti-b amyloid immunoglobulin prepared by the method is substantially free of b amyloid protein and has therapeutic activity in compositions and/or methods for treating a disease or condition associated with b amyloid plaques, such as Alzheimer's disease.
摘要:
The present invention relates generally to an immunogenic complex comprising a charged organic carrier and a charged antigen and, more particularly, a negatively charged organic carrier and a positively charged antigen, wherein the charged antigen is a polyprotein of Hepatitis C Virus (HCV), particularly the core protein of HCV, or a fragment thereof, or a fusion protein comprising the polyprotein or a fragment thereof. The complexes of the present invention are useful, inter alia, in vaccine compositions as therapeutic and/or prophylactic agents for facilitating the induction of immune responses, and in particular a cytotoxic T-lymphocyte response, in the treatment of a disease condition which results from an HCV infection.