Digital Commons Network^™

An Investigation Of Middle School Student Interest, Perception, And Attitude Toward Technology And Engineering, Kari Marie Cook

Theses and Dissertations

The purpose of this study was to investigate middle school student perception and attitude toward technology and engineering and to better understand how the gender of the teacher, gender of the student, and information provided in technology classes affected their perception and attitude. To accomplish this, the Technology Attitude Scale, and the Pupil's Attitudes Toward Technology—United States assessment instruments were used to form the basis of a new survey instrument focused on technology and engineering perception, use, and interest. The new survey instrument is called the Technology and Engineering Attitude Scale (TEAS) survey. Multiple 7th grade technology engineering classes from …

Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak

Yale Medicine Thesis Digital Library

The objective of this study was to evaluate the psychometric properties of the Kendler Social Support Interview modified for administration to pregnant women and to assess the relationship between social support and depression in the first trimester of pregnancy. Subjects were administered the Modified Kendler Social Support Interview (MKSSI) and the Composite International Diagnostic Index to diagnose depression. Principal components analysis was employed to construct the MKSSI score. Cronbachs coefficient alpha and principal factor analysis were run for items included in the MKSSI score. The relationship between a depressive diagnosis and the MKSSI score and subscales was assessed by logistic …

Use Of Media To Improve Human Papilloma Virus (Hpv)Vaccine Acceptability, Pavithra Venkat

Yale Medicine Thesis Digital Library

Our objective was to determine if using a video educational tool can influence (1) individual vaccine acceptability (2) parental acceptability, (3) parental views on vaccine mandates, and (4) age of vaccination accepted for the Human Papilloma Virus (HPV) vaccine. We conducted a cross-sectional study using bilingual surveys distributed at Brigham and Womens and Massachusetts General Hospital clinics and at the Coalition of Boston Public Health Association from January to March 2007. An initial 32-question survey addressing HPV knowledge, beliefs and vaccine acceptability was completed, followed by an eight-minute video about HPV and the vaccine. An additional 11-question post assessment was …

Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman

Yale Medicine Thesis Digital Library

INTUSSUSCEPTION OF THE APPENDIX: NEW TRENDS AND COMPREHENSIVE ANALYSIS OF 140 PUBLISHED CASE REPORTS. Barbara A. Wexelman, Cassius Ochoa Chaar, and Walter Longo. Section of Colorectal Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT. Statement of Purpose: This paper uses 139 published case reports to understand the demographic, diagnostic, and treatment trends of intussusception of the appendix. Methods: Using the PubMed literature search engine to find all English references of intussusception and appendix, and reviewing those that contained actual case reports of intussusception of the appendix, we analyzed the demographics, presentation, diagnostic methods, surgical treatment, and …

A Functional Difficulty And Functional Pain Instrument For Hip And Knee Osteoarthritis, Alan M. Jette, Christine M. Mcdonough, Pengsheng Ni, Stephen M. Haley

Dartmouth Scholarship

The objectives of this study were to develop a functional outcome instrument for hip and knee osteoarthritis research (OA-FUNCTION-CAT) using item response theory (IRT) and computer adaptive test (CAT) methods and to assess its psychometric performance compared to the current standard in the field.

Intrauterine Growth Restriction Increases Fetal Hepatic Gluconeogenic Capacity And Reduces Messenger Ribonucleic Acid Translation Initiation And Nutrient Sensing In Fetal Liver And Skeletal Muscle., Stephanie R Thorn, Timothy Regnault, Laura D Brown, Paul J Rozance, Jane Keng, Michael Roper, Randall B Wilkening, William W Hay, Jacob E Friedman

Paediatrics Publications

Expression of key metabolic genes and proteins involved in mRNA translation, energy sensing, and glucose metabolism in liver and skeletal muscle were investigated in a late-gestation fetal sheep model of placental insufficiency intrauterine growth restriction (PI-IUGR). PI-IUGR fetuses weighed 55% less; had reduced oxygen, glucose, isoleucine, insulin, and IGF-I levels; and had 40% reduction in net branched chain amino acid uptake. In PI-IUGR skeletal muscle, levels of insulin receptor were increased 80%, whereas phosphoinositide-3 kinase (p85) and protein kinase B (AKT2) were reduced by 40%. Expression of eukaryotic initiation factor-4e was reduced 45% in liver, suggesting a unique mechanism limiting …

Perirhinal Cortex Contributes To Accuracy In Recognition Memory And Perceptual Discriminations., Edward B O'Neil, Anthony D Cate, Stefan Köhler

Brain and Mind Institute Researchers' Publications

The prevailing view of the medial temporal lobe (MTL) holds that its structures are dedicated to long-term declarative memory. Recent evidence challenges this position, suggesting that perirhinal cortex (PRc) in the MTL may also play a role in perceptual discriminations of stimuli with substantial visual feature overlap. Relevant neuropsychological findings in humans have been inconclusive, likely because studies have relied on patients with large and variable MTL lesions. Here, we conducted a functional magnetic resonance imaging study in healthy individuals to determine whether PRc shows a performance-related involvement in perceptual oddball judgments that is comparable to its established role in …

Dicer Is Required For Female Reproductive Tract Development And Fertility In The Mouse, Gabriel Gonzalez, Richard R Behringer

Faculty, Staff and Student Publications

Dicer encodes a riboendonuclease required for microRNA biosynthesis. Dicer was inactivated in Müllerian duct mesenchyme-derived tissues of the reproductive tract of the mouse, using an Amhr2-Cre allele. Although Amhr2-Cre; Dicer conditional mutant males appeared normal and were fertile, mutant females were infertile. In adult mutant females, there was a reduction in the size of the oviducts and uterine horns. The oviducts were less coiled compared to controls and cysts formed at the isthmus near the uterotubal junction. Unfertilized, degenerate oocytes were commonly found within these cysts, indicating a defect in embryo transit. Beads transferred into the mutant oviduct failed to …

Il-9 As A Mediator Of Th17-Driven Inflammatory Disease, Elizabeth C. Nowak, Casey T. Weaver, Henrietta Turner, Sakhina Begum-Haque, Burkhard Becher, Bettina Schreiner, Anthony J. Coyle, Lloyd H. Kasper, Randolph J. Noelle

Dartmouth Scholarship

We report that like other T cells cultured in the presence of transforming growth factor (TGF) beta, Th17 cells also produce interleukin (IL) 9. Th17 cells generated in vitro with IL-6 and TGF-beta as well as purified ex vivo Th17 cells both produced IL-9. To determine if IL-9 has functional consequences in Th17-mediated inflammatory disease, we evaluated the role of IL-9 in the development and progression of experimental autoimmune encephalomyelitis, a mouse model of multiple sclerosis. The data show that IL-9 neutralization and IL-9 receptor deficiency attenuates disease, and this correlates with decreases in Th17 cells and IL-6-producing macrophages in …

Epidemiology And Outcomes Of Candidemia In 2019 Patients: Data From The Prospective Antifungal Therapy Alliance Registry., David L Horn, Dionissios Neofytos, Elias J Anaissie, Jay A Fishman, William J Steinbach, Ali J Olyaei, Kieren A Marr, Michael A Pfaller, Chi-Hsing Chang, Karen M Webster

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing.

METHODS: Clinical data from patients with candidemia were extracted from the Prospective Antifungal Therapy (PATH) Alliance database, a comprehensive registry that collects information regarding invasive fungal infections. A total of 2019 patients, enrolled from 1 July 2004 through 5 March 2008, were identified. Data regarding the candidemia episode were analyzed, including the specific fungal species and patient survival at 12 weeks after diagnosis.

RESULTS: The incidence of candidemia caused by non-Candida albicans Candida species (54.4%) was higher …

A Truncation Mutation In Tbc1d4 In A Family With Acanthosis Nigricans And Postprandial Hyperinsulinemia, Satya Dash, Hiroyuki Sano, Justin J. Rochford, Robert K. Semple

Dartmouth Scholarship

Tre-2, BUB2, CDC16, 1 domain family member 4 (TBC1D4) (AS160) is a Rab-GTPase activating protein implicated in insulin-stimulated glucose transporter 4 (GLUT4) translocation in adipocytes and myotubes. To determine whether loss-of-function mutations in TBC1D4 might impair GLUT4 translocation and cause insulin resistance in humans, we screened the coding regions of this gene in 156 severely insulin-resistant patients. A female presenting at age 11 years with acanthosis nigricans and extreme postprandial hyperinsulinemia was heterozygous for a premature stop mutation (R363X) in TBC1D4. After demonstrating reduced expression of wild-type TBC1D4 protein and expression of the truncated protein in lymphocytes from the proband, …

A Retrospective Claims Analysis Of Combination Therapy In The Treatment Of Adult Attention-Deficit/Hyperactivity Disorder (Adhd), Gerhardt M. Pohl, David L. Van Brunt, Wenyu Ye, William W. Stoops, Joseph A. Johnston

Behavioral Science Faculty Publications

BACKGROUND: Combination therapy in managing psychiatric disorders is not uncommon. While combination therapy has been documented for depression and schizophrenia, little is known about combination therapy practices in managing attention-deficit/hyperactivity disorder (ADHD). This study seeks to quantify the combination use of ADHD medications and to understand predictors of combination therapy.

METHODS: Prescription dispensing events were drawn from a U.S. national claims database including over 80 managed-care plans. Patients studied were age 18 or over with at least 1 medical claim with a diagnosis of ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 314.0), a pharmacy claim for …

Development And Validation Of An Index Of Musculoskeletal Functional Limitations, Jeffrey N. Katz, Elizabeth A. Wright, John A. Baron, Elena Losina

Dartmouth Scholarship

While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index.

Identifying Sleep Regulatory Genes Using A Drosophila Model Of Insomnia, Laurent Seugnet, Yasuko Suzuki, Matthew S. Thimgan, Jeffrey Donlea, Sarah I. Gimbel, Laura Gottschalk, Stephen P. Duntley, Paul J. Shaw

Biological Sciences Faculty Research & Creative Works

Although it is widely accepted that sleep must serve an essential biological function, little is known about molecules that underlie sleep regulation. Given that insomnia is a common sleep disorder that disrupts the ability to initiate and maintain restorative sleep, a better understanding of its molecular underpinning may provide crucial insights into sleep regulatory processes. Thus, we created a line of flies using laboratory selection that share traits with human insomnia. After 60 generations, insomnia-like (ins-l) flies sleep 60 min a day, exhibit difficulty initiating sleep, difficulty maintaining sleep, and show evidence of daytime cognitive impairment. ins-l flies …

Mitogen-Activated Protein Kinase (Mapk) Pathways Mediate Embryonic Responses To Culture Medium Osmolarity By Regulating Aquaporin 3 And 9 Expression And Localization, As Well As Embryonic Apoptosis., Christine E Bell, Nathalie M K Larivière, Patricia H Watson, Andrew J Watson

Obstetrics & Gynaecology Publications

BACKGROUND: In order to advance the development of culture conditions and increase the potential for supporting normal preimplantation embryo development in vitro, it is critical to define the mechanisms that early embryos utilize to survive in culture. We investigated the mechanisms that embryos employ in response to culture medium osmolarity. We hypothesized that mitogen-activated protein kinase (MAPK) pathways mediate responses to hyperosmotic stress by regulating Aquaporin (AQP) 3 and 9 expression as well as embryonic apoptosis.

METHODS: Real-time reverse transcription and polymerase chain reaction and whole-mount immunofluorescence were used to determine the relative mRNA levels and protein localization patterns of …

Cancer Information-Seeking Experiences: The Implications Of Hispanic Ethnicity And Spanish Language, Robin C. Vanderpool, Julie Kornfeld, Lila Finney Rutten, Linda Squiers

Health, Behavior & Society Faculty Publications

BACKGROUND: Strategies to support cancer information-seeking among Hispanics are needed.

METHODS: We analyzed data from the 2005 Health Information National Trends Survey (HINTS) to explore cancer information-seeking experiences among respondents according to ethnicity and language of interview.

RESULTS: Over 80% of Spanish-speaking Hispanics had never looked for cancer information. Compared to English-speaking respondents, Spanish-speaking Hispanics who sought cancer information indicated their search took a lot of effort (67%), was hard to understand (54%), and frustrating (42%). Spanish-speaking Hispanics noted minimal confidence in obtaining cancer information.

CONCLUSIONS: Language and cultural differences must be considered in the design, implementation, and dissemination of …

It Is More Than Just A Reproductive Healthcare Visit: Experiences From An Adolescent Medicine Clinic, Marlene B. Huff, Kimberly K. Mcclanahan, Heather A. Brown, Hatim A. Omar

Pediatrics Faculty Publications

The gynecologist may be the only physician that an adolescent depends on for primary and reproductive healthcare services. Because adolescent females often make personal healthcare decisions without the benefit of supportive parents/caregivers, it is imperative that the gynecologist understands the developmental issues encountered during this phase of life. The objective of this study is to identify cited complaints of adolescent females seeking reproductive care and, thus, provide gynecologists with needed information about the medical/mental health issues that may be encountered during routine reproductive care exams. The study group was adolescent females between the ages of 12 and 20 years old. …

Therapeutic Targeting Of Atp7b In Ovarian Carcinoma, Lingegowda S Mangala, Vesna Zuzel, Rosemarie Schmandt, Erik S Leshane, Jyotsna B Halder, Guillermo N Armaiz-Pena, Whitney A Spannuth, Takemi Tanaka, Mian M K Shahzad, Yvonne G Lin, Alpa M Nick, Christopher G Danes, Jeong-Won Lee, Nicholas B Jennings, Pablo E Vivas-Mejia, Judith K Wolf, Robert L Coleman, Zahid H Siddik, Gabriel Lopez-Berestein, Svetlana Lutsenko, Anil K Sood

Faculty, Staff and Student Publications

PURPOSE: Resistance to platinum chemotherapy remains a significant problem in ovarian carcinoma. Here, we examined the biological mechanisms and therapeutic potential of targeting a critical platinum resistance gene, ATP7B, using both in vitro and in vivo models.

EXPERIMENTAL DESIGN: Expression of ATP7A and ATP7B was examined in ovarian cancer cell lines by real-time reverse transcription-PCR and Western blot analysis. ATP7A and ATP7B gene silencing was achieved with targeted small interfering RNA (siRNA) and its effects on cell viability and DNA adduct formation were examined. For in vivo therapy experiments, siRNA was incorporated into the neutral nanoliposome 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine (DOPC).

RESULTS: ATP7A …

Memory Functioning In Developmental Dyslexia: An Analysis Using Two Clinical Memory Measures., Michelle Y. Kibby

Publications

The goals of this project were threefold: to determine the nature of the memory deficit in children/adolescents with dyslexia, to utilize clinical memory measures in this endeavor, and to determine the extent to which semantic short-term memory (STM) is related to basic reading performance. Two studies were conducted using different samples, one incorporating the Wide Range Assessment of Memory and Learning and the other incorporating the California Verbal Learning Test-Children's Version. Results suggest that phonological STM is deficient in children with dyslexia, but semantic STM and visual-spatial STM are intact. Long-term memory (LTM) for both visual and verbal material also …

Human Cerebral Neuropathology Of Type 2 Diabetes Mellitus, Peter T. Nelson, Charles D. Smith, Erin L. Abner, Frederick A. Schmitt, Stephen W. Scheff, Gregory J. Davis, Jeffrey N. Keller, Gregory A. Jicha, Daron Davis, Wang-Xia Wang, Adria Hartman, Douglas G. Katz, William R. Markesbery

Pathology and Laboratory Medicine Faculty Publications

The cerebral neuropathology of Type 2 diabetes (CNDM2) has not been positively defined. This review includes a description of CNDM2 research from before the ‘Pubmed Era’. Recent neuroimaging studies have focused on cerebrovascular and white matter pathology. These and prior studies about cerebrovascular histopathology in diabetes are reviewed. Evidence is also described for and against the link between CNDM2 and Alzheimer's disease pathogenesis. To study this matter directly, we evaluated data from University of Kentucky Alzheimer's Disease Center (UK ADC) patients recruited while non-demented and followed longitudinally. Of patients who had come to autopsy (N = 234), 139 met …

Genome Based Cell Population Heterogeneity Promotes Tumorigenicity: The Evolutionary Mechanism Of Cancer., Christine J. Ye, Joshua B. Stevens, Guo Liu, Steven W. Bremer, Aruna S. Jaiswal, Karen J. Ye, Ming-Fong Lin, Lesley Lawrenson, Wayne D. Lancaster, Markku Kurkinen, Joshua D. Liao, C. Gary Gairola, Malathy P. V. Shekhar, Satya Narayan, Fred R. Miller, Henry H. Q. Heng

Journal Articles: Biochemistry & Molecular Biology

Cancer progression represents an evolutionary process where overall genome level changes reflect system instability and serve as a driving force for evolving new systems. To illustrate this principle it must be demonstrated that karyotypic heterogeneity (population diversity) directly contributes to tumorigenicity. Five well characterized in vitro tumor progression models representing various types of cancers were selected for such an analysis. The tumorigenicity of each model has been linked to different molecular pathways, and there is no common molecular mechanism shared among them. According to our hypothesis that genome level heterogeneity is a key to cancer evolution, we expect to reveal …

State Infant Mortality: An Ecologic Study To Determine Modifiable Risks And Adjusted Infant Mortality Rates., David A. Paul. Md, Amy Mackley, Rnc, Robert G. Locke, Do, John L. Stefano, Md, Charlan Kroelinger, Phd

Department of Pediatrics Faculty Papers

OBJECTIVE: To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. DESIGN/METHODS: Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization …

Lineage-Specific T-Cell Responses To Cancer Mucosa Antigen Oppose Systemic Metastases Without Mucosal Inflammatory Disease., Adam E. Snook, Peng Li, Benjamin J Stafford, Elizabeth J Faul, Lan Huang, Ruth C Birbe, Alessandro Bombonati, Stephanie Schulz, Matthias J. Schnell, Laurence C. Eisenlohr, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Cancer mucosa antigens are emerging as a new category of self-antigens expressed normally in immunologically privileged mucosal compartments and universally by their derivative tumors. These antigens leverage the established immunologic partitioning of systemic and mucosal compartments, limiting tolerance opposing systemic antitumor efficacy. An unresolved issue surrounding self-antigens as immunotherapeutic targets is autoimmunity following systemic immunization. In the context of cancer mucosa antigens, immune effectors to self-antigens risk amplifying mucosal inflammatory disease promoting carcinogenesis. Here, we examined the relationship between immunotherapy for systemic colon cancer metastases targeting the intestinal cancer mucosa antigen guanylyl cyclase C (GCC) and its effect on inflammatory …

Depression And Resilience During The First Six-Months Of Internship, Rachel Laff

Yale Medicine Thesis Digital Library

Consistent with prior studies, the prevalence of depression in interns is significantly higher than the general population. There is a significant amount of suicidal ideation among interns during the first three-months of internship. It appears that international medical graduates are significantly less depressed than U.S. medical graduates during the first six-months of internship. A prior history of depression, longer work hours, female gender, and a lack of confidence in coping with challenges are associated with the development of depression during the first six-months of internship. Of greatest concern, very few interns with clinically significant levels of depression are seeking treatment. …

Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan

Yale Medicine Thesis Digital Library

The present study had several goals. First, we aimed to investigate the potential differences in the activation of the corticolimbic structures during emotional stress in healthy women across the menstrual cycle using stress imagery. Second, we searched for differences in the subjective anxiety under emotional stress across the menstrual cycle and tried to correlate the perceived level of anxiety to activation of the specific corticolimbic structures. Third, we attempted to compare central neural activation of women in follicular and in luteal phases of the menstrual cycle separately to that of men during emotional stress to investigate potential differences in neural …

Efficacy Of Formal Screening For Depression In Pediatric Type 1 Diabetes Clinic, Jeffrey Winer

Yale Medicine Thesis Digital Library

This study was undertaken to examine the efficacy of screening for depression in a pediatric diabetes clinic and how the yield of such screening compares with established screening protocols aimed at identifying early microvascular complications and associated autoimmune diseases. Two-hundred-fifteen children and adolescents 8-18 years old in the Yale Pediatric Diabetes Center were screened for depression using the Children's Depression Inventory (CDI), with information including gender, age, duration of diabetes, HbA1C, and results of other screening protocols compiled. A total of 8.4% of our cohort had CDI scores ≥13 indicative of clinically-significant depressive symptoms, with a range of 0-34. Depression …

The Relationship Between Cerebral Hemisphere Volume And Receptive Language Functioning In Dyslexia And Attention-Deficit Hyperactivity Disorder (Adhd)., Michelle Y. Kibby, Shital P. Pavawalla, Jill B. Fancher, Angela J. Naillon, George W. Hynd

Publications

Because poor comprehension has been associated with small cerebral volume and there is a high comorbidity between developmental dyslexia, attention-deficit hyperactivity disorder (ADHD), and specific language impairment, the goal of this study was to determine whether cerebral volume is reduced in dyslexia and attention-deficit hyperactivity disorder in general, as some suggest, or whether the reduction in volume corresponds to poor receptive language functioning, regardless of the diagnosis. Participants included 46 children with and without dyslexia and attention-deficit hyperactivity disorder, aged 8 to 12 years. Our results indicated that cerebral volume was comparable between those with and without dyslexia and attention-deficit …

Voices Raised, Issue 24, University Of Dayton. Women's Center

Women’s Center Newsletter

Included in this issue: First Female Endowed Chair of A&S; Lessons Learned; Creating a Culture of Respect; Administrative Professionals Week; Annual Miryam Award Winners; The Importance of Taking Time for Yourself; Equal Pay Day; Undercurrents of sexist and anti-feminist thought at UD.

Laparoscopic Treatment Of Pancreatic Pseudocysts In Children., Suzanne M. Yoder, Steven Rothenberg, Kuojen Tsao, Mark L. Wulkan, Todd A. Ponsky, Shawn D. St Peter, Daniel J. Ostlie, Timothy D. Kane

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pancreatic pseudocysts are problematic sequelae of pancreatitis or pancreatic trauma causing persistent abdominal pain, nausea, and gastric outlet obstruction. Due to the low volume of disease in children, there is scant information in the literature on the operative management of pseudocysts with minimally invasive techniques. We conducted a multi-institutional review to illustrate several technical variations utilized in achieving laparoscopic cystgastrostomy in the pediatric population.

METHODS: A retrospective review was conducted of all patients who underwent laparoscopic cystgastrostomy in five institutions. Patient data, operative techniques, and postoperative course were analyzed.

RESULTS: There were 13 patients with a mean age of …

Laparoscopic Duodenojejunostomy For Superior Mesenteric Artery Syndrome., Jason D. Fraser, Shawn D. St Peter, Jenevieve H. Hughes, James M. Swain

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting.

METHODS: Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy.

RESULTS: The patient achieved complete …