(2006), who found M leucophaeata in the Gulf of Finland (norther

(2006), who found M. leucophaeata in the Gulf of Finland (northern Baltic Sea), the mussel larvae had been transported there in ship ballast waters from the North Sea. The occurrence of this species in the Gulf of Finland could have depended on cooling water discharged from power plants. But there are no such ‘hot spots’ near the part of the Gulf of Gdańsk where I found these mussels. One question that still awaits

an answer is whether young M. leucophaeata will be able to develop successfully and reproduce in the Gulf of Gdańsk, as adult specimens have not yet been found in this area. I am very grateful to Prof. Anna Szaniawska for her constructive comments on the manuscript, to Dr Ari Laine for his help with identifying the species, and to Dr Urszula Janas and Halina MK0683 cost Rzemykowska MSc. for their support in obtaining the necessary information on M. leucophaeata. “
“Figure options Download Selleckchem Bioactive Compound Library full-size image Download as PowerPoint slide It is with deep sadness that we announce the passing of Professor Halina Piekarek-Jankowska on 26th May 2011. She was a distinguished scientist at the University of Gdańsk, a lecturer to and educator of students, an outstanding expert in the field of marine geology, contributing generously to the life of the scientific community. She was also a long-standing member of the Editorial Board of ‘Oceanologia’. Halina Piekarek-Jankowska was born at Rawa Mazowiecka on 8th March 1948. In 1965 she

began her studies of geology at the University of Warsaw. During her final student years she gained her first scientific experiences in the hydrogeology of post-lacustrine 3-mercaptopyruvate sulfurtransferase regions, when she participated in research in the Suwałki Lake District under the tutorship of Professor Zdzisław Pazdro. She incorporated some of the materials from this research into her M. Sc. thesis. Already then, as her fellow students recall, she displayed an outstanding intelligence and personality. In 1970 she graduated from the Faculty of Geology, University of Warsaw, with

distinction. On the recommendation of Professor Pazdro, she joined the team of geologists in the Department of Geology and Cartography at the newly founded University of Gdańsk (UG), and from 1975 onwards she assisted Doc. Leonard Bohdziewicz in organizing a course in marine geology at the Institute of Oceanography UG. It was in this institute that she climbed the ladder of her scientific career: from 1971 to 1970 she was employed as assistant lecturer, from 1979 to 1996 as reader, from 1996 to 2002 as associate professor, and since 2008 as full professor. She was awarded her professorship in 2002. At the start of her career she conducted research in the Kashubian Lake District into the hydrodynamic links between quaternary aquifers and the waters of Lakes Radunia and Ostrzyce. These were pioneering studies in this part of Poland and were of a distinctly utilitarian nature. She used the materials from this research in her Ph.D.

Right intra-hemispheric connections include right M1 to right IFG

Right intra-hemispheric connections include right M1 to right IFG, right PMC to

right M1 and right STG to right IFG. A negative coupling is seen from right IFG to right STG as well. Interestingly, negative pathways are generated during the shift condition that are not present in the no shift condition. This change of circuitry indicates differential processing necessary during the detection and correction of perceived vocal error. Cross-hemispheric connections include right primary motor cortex to left primary motor cortex, and left STG. Left IFG is coupled with right PMC. Importantly, a connection between left STG to right STG is observed. Additionally, http://www.selleckchem.com/products/MS-275.html a negatively correlated connection is present

from Buparlisib datasheet right STG to Left STG (Fig. 2). The focus of this study was to use effective connectivity modeling of fMRI data to determine neural networks involved in vocal control and identify pathways that are key to detecting and correcting vocal errors. Vocalization is a highly complex motor skill that requires coordination amongst multiple effector systems (e.g., respiratory and vocal) at a rapid pace. In order to execute voluntary actions with precision, both feedforward and feedback systems are integrated. Feedforward models compare anticipated changes to be imposed with the actual output (Jeannerod, Kennedy, & Magnin, 1979). Therefore, it is the difference between the actual and predicted sensory feedback that results in a sensory error, which is used to correct the current state estimate (Chang

et al., 2013 and Wolpert et al., 1995). Given that we delivered perturbation to the subjects during mid vocalization, these perturbations are processed mafosfamide as errors in self-vocalization (Behroozmand et al., 2011 and Liu et al., 2010). As a result, we predicted that STG would serve as a vital region in error detection; therefore, STG would show differences in connectivity when an error was present compared to unperturbed vocalization. Consistent with our hypothesis, we found differences in neural connectivity of the voice network associated with vocal perturbations. Data support the idea that STG plays a crucial role in vocalization and shift processing as evidenced by our model. Our analysis also revealed the emergence of negative pathways that we interpret as feedback loops for during shifted vocalization that are not present with unperturbed productions. Coupling between right STG and left STG in the no shift condition indicated that this path is critical to vocalization. Using a simple effect size computation (r2), one can see that approximately 5% of the variance in the direct relationship between left STG to right STG is accounted for in the no shift model; however, in the shift condition 50% of the variance is accounted for by this pathway.

1 and 1 3 m−1, and chlorophyll a concentrations 1 3 < Ca < 33 mg

1 and 1.3 m−1, and chlorophyll a concentrations 1.3 < Ca < 33 mg m−3 – both values similar to those recorded in the Baltic – see Figure 5, Darecki et al. 2008, Kowalczuk et al. 2010), displays a FG4592 broad peak on the reflectance spectrum at 560–580 nm and resembles the shape of the remote sensing reflectance spectra usually

observed in the Baltic Sea (see e.g. Darecki et al. 2003). The second type has a very high CDOM absorption coefficient (usually aCDOM(440 nm) > 10 m−1, up to 17.4 m−1) in Lake Pyszne; they have a relatively low reflectance (Rrs < 0.001 sr−1) over the entire spectral range, and two visible reflectance spectra peaks at ca 650 and 690–710 nm. The third type represents waters with a lower CDOM absorption coefficient, (usually aCDOM(440 nm)< 5 m−1) and a high chlorophyll a concentration (usually Ca > 4 mg m−3, up to 336 mg m−3 in Lake Gardno). The third type of remote

sensing reflectance spectra in lake waters always exhibits three peaks (Rrs > 0.005 sr−1): a broad one at 560–580 nm, a smaller one at ca 650 nm and a well-pronounced one at 690–720 nm. These Rrs(λ) peaks correspond to the relatively low absorption of light by the various OACs of the lake water and the considerable scattering due to the high SPM concentrations there. The remote sensing maximum at λ ≈ 690–720 nm is higher still Trametinib purchase as a result of the natural fluorescence of chlorophyll a ( Mitchell & Kiefer 1988). The position of this maximum in the red region shifts distinctly in the direction of the longer waves with increasing chlorophyll a concentration and are the signals available for the remote sensing detection of chlorophyll a ( Gitelson et al. 2007). This is shown for one of the lakes (L. Gardno) in Figure 6 a, b. The change in position of this maximum was used to construct a correlation formula linking Rrs and Ca. The correlations of the spectral reflectance band ratio with the concentrations of particular OACs enable the approximate

levels of these G protein-coupled receptor kinase components in the euphotic zones of the lakes investigated to be determined from reflectance spectra measurements. For example, the correlation shown in Figure 7 was obtained for chlorophyll a; it is described by the exponential equation: equation(1) Ca=6.432e4.556X,where X = [max Rrs(695 ≤ λ ≤ 720) – Rrs(λ = 670)]/max Rrs(695 ≤ λ ≤ 720), and the coefficient of determination R2 = 0.95. This approximation does not include the discrepant data from the dystrophic lake (humic lake – with brown water). The usefulness of this correlation is confirmed by its high coefficient of determination. We obtained another good correlation for the concentration CSPM ( Figure 8) and a slightly weaker one for aCDOM(440 nm) ( Figure 9). The use of these correlations may facilitate the monitoring of the state of these lakes with the aid of reflectance measurements. The errors of approximation were also estimated.

The hematocrit level of one patient was significantly reduced Th

The hematocrit level of one patient was significantly reduced. They received a blood transfusion after the cryoablation treatment and their hematocrit level had returned to the baseline level after 1 week. In our study, we have described our experience with a

minimally invasive method for ablating bladder tumors for the first time. We have demonstrated that CT imaging-guided percutaneous cryotherapy is a very effective and safe technique for treating bladder cancer. CT imaging can be used to monitor preoperative, intraoperative, and postoperative AZD9291 research buy tumors of patients, and to ensure that the tumor is completely ablated. Notably, this procedure can be accomplished with local anesthesia. Although percutaneous argon–helium cryoablation requires further

assessment, the method shows promise. “
“William F. Rayburn Geeta K. Swamy Geeta K. Swamy and Rebecca Garcia-Putnam Pregnant women are at risk for the same infectious diseases as nonpregnant individuals and often have increased morbidity and mortality associated with infection. Thus, immunizing women during pregnancy with recommended vaccines provides direct maternal benefit. Furthermore, maternal immunization has the potential for both fetal and infant benefit by preventing adverse pregnancy outcomes and infection during early life through passive immunity. This article reviews current knowledge on the importance and benefits of maternal immunization, which are 3-fold: protecting the mother

from antepartum Protein Tyrosine Kinase inhibitor infection; reducing poor pregnancy and fetal outcomes; and providing immunity for infants during the first few months of life. Richard H. Beigi Influenza infections are an important global source of morbidity and mortality. Pregnant Niclosamide and postpartum women are at increased risk for serious disease, related complications, and death from influenza infection. This increased risk is thought to be mostly caused by the altered physiologic and immunologic specifics of pregnancy. The morbidity of influenza infection during pregnancy is compounded by the potential for adverse obstetric, fetal, and neonatal outcomes. Importantly, influenza vaccination to prevent or minimize the severity of influenza infection during pregnancy (and the neonatal period) is recommended for all women who are or will be pregnant during influenza season. Meghan Donnelly and Jill K. Davies Contemporary management of HIV in pregnancy remains a moving target. With the development of newer antiretroviral agents with lower side-effect profiles and laboratory methods for detection and monitoring of HIV, considerable progress has been made. This review examines key concepts in the pathophysiology of HIV and pregnancy with emphasis on perinatal transmission and reviews appropriate screening and diagnostic testing for HIV during pregnancy.

It is not clear why verbal working memory is impaired, even when

It is not clear why verbal working memory is impaired, even when language deficits are controlled for, while visual working memory remains normal. One possibility is that poor visuo-spatial memory skills are found only in a subgroup of children with SLI (Archibald and Gathercole, 2006a). Another possibility is that working memory itself is actually AZD6244 price largely normal in SLI, and that problems in verbal working memory are due to the language deficits in the disorder (Alloway et al., 2009). In the current study, verbal working memory deficits remained, though with reduced effect sizes, once the language composite was covaried

out. However, it is possible that controlling for other language measures (e.g., of phonology) might further reduce or eliminate the observed verbal working memory deficit. Further studies seem warranted to elucidate the apparent dichotomy between impaired verbal but normal visual working memory in SLI. The PDH expects declarative memory to remain largely normal in the disorder. The finding that children with SLI were spared not only at visual declarative memory, but also at verbal declarative memory once working memory and language deficits were accounted for, supports this prediction. The sparing of visual aspects of declarative memory is consistent

with previous studies (see, Introduction). Together, this and other studies NVP-LDE225 chemical structure suggest that visual declarative memory remains largely intact in SLI. As we have seen, previous studies of verbal declarative memory have reported a mixed pattern of results in SLI. In particular, immediate recall in list or story learning paradigms has

generally been found to be impaired, while performance after a delay is inconsistent across studies. Based on the results of the current study, we hypothesise that previous inconsistent findings in SLI research with respect to delayed memory measures, and indeed declarative memory in general, might reflect at least in part individual or task differences in demands placed on working memory and language. Unoprostone Indeed, in this study, after holding these two variables constant, no SLI impairments in verbal declarative memory were observed. This pattern of results is consistent with a profile of some working memory impairments, but with spared declarative memory, even in the verbal domain (Ullman and Pierpont, 2005). The correlations between declarative memory and lexical abilities in both the TD and SLI children support the predictions of the PDH, and of the declarative/procedural (DP) theory more generally, that lexical memory depends on declarative memory, and that simple (underived) words must always be learned in this system (Ullman, 2001, Ullman, 2004, Ullman, 2007 and Ullman and Pierpont, 2005).

A number of studies provided clear evidence that primates could d

A number of studies provided clear evidence that primates could detect ICMS of visual cortex at much lower current levels, also using electrodes more closely-spaced than those of Brindley and Dobelle (Bartlett et al., 1977, Bartlett and Doty, 1980 and Doty, 1965). Intracortical microelectrodes were not benign however; chronic implantations revealed astrocytic proliferation around the electrode shank (Schmidt et al., 1976), and unbalanced or excess charge delivery could damage both the electrodes and check details neuronal tissue (Bartlett et al.,

1977 and Brummer et al., 1983). A preliminary human study examining ICMS of visual cortex was published in 1990, the results of which added significant impetus to the effort to develop a cortical visual prosthesis (Bak et al., 1990). Bak et al. reported that three sighted volunteers were able to perceive phosphenes from ICMS at currents up to 100 times lower than those required by surface stimulation. Moreover, the phosphenes were discriminable when stimulated by electrodes

700 µm apart (Bak et al., 1990). Further work identifying thresholds of total charge delivered and charge density, beyond which neuronal damage could be expected to occur ( McCreery et al., 1994), supported the progression to a more systematic evaluation of ICMS of visual PF-562271 mw cortex in a blind volunteer in 1996 ( Schmidt et al., 1996). A key finding from this study was that the chronically blind subject, who was unable to perceive phosphenes from surface stimulation,

perceived phosphenes from ICMS in a similar manner to sighted volunteers in the previous report ( Schmidt et al., 1996). While this study represents a milestone in the development of a cortical visual prosthesis, significant engineering, surgical, biological and psychophysiological MTMR9 issues still remained to be addressed before an implant fit for human use could be realized. In the period since, significant work has been undertaken in understanding and addressing these problems, with the goal of developing a functional, wirelessly-operated cortical visual prosthesis with stable long-term performance and an acceptable safety profile. The recent approval of Second Sight׳s Argus II retinal implant in both the US and Europe, and Retina Implant AG׳s European approval of the Alpha IMS implant represents a significant step forwards in the regulatory environment for visual prostheses. Cortical devices remain experimental, however one group recently reported plans to apply for US FDA approval to proceed with human clinical trials (Lane et al., 2012). Given the relatively uncertain outlook for the balance of risk versus benefit for cortical visual prostheses, great rigor must be exercised in the preclinical testing and the recipient selection process.

Interestingly, we also observed a higher population of adipocytes

Interestingly, we also observed a higher population of adipocytes in the bone marrow of myeloma patients with the high levels of heparanase expression (Fig. 2). Primary calvarial osteoblast progenitor cells were cultured 1:1 in the

CM from HPSE-low or HPSE-high cells and osteogenic medium as indicated (Fig. 3A). Osteoblast differentiation (ALP staining) and mineralization (Von Kossa staining) were significantly suppressed by the CM of HPSE-high cells, compared to CM of HPSE-low cells. Conversely, significantly higher numbers of adipocytes were observed in cells cultured with HPSE-high CM versus HPSE-low CM (Fig. 3A), suggesting that the Tyrosine Kinase Inhibitor Library in vivo CM of HPSE-high cells supports the differentiation of mesenchymal progenitors toward the adipocyte lineage. To begin to understand the mechanism(s) involved in the suppression of osteoblastogenesis, we

next performed Western blot analysis. A significant decrease in Runx2 CT99021 expression (a marker of osteoblastogenesis) and increase in PPAR-γ expression (a marker of adipogenesis) were observed in HPSE-high CM treated cells, compared to HPSE-low CM treated cells (Fig. 3B). In a separate experiment, primary murine osteoblast progenitor cells were cultured in the CM of HPSE-low or HPSE-high cells with 1:1 adipocyte differentiation medium for 10 days. Oil Red O staining demonstrated a significant increase in adipocytes in the presence of HPSE-high CM, compared with HPSE-low CM (Fig. 3C). Taken together, these data suggest that HPSE-high myeloma cells secrete soluble factor(s) to inhibit osteoblastogenesis and promote adipogenesis, even if the cells are in a pro-osteoblastogenic environment in vitro. To identify what soluble factor(s) secreted by HPSE-high myeloma cells may be responsible for the decreased osteoblastogenesis and increased adipogenesis, we measured the levels of known regulators transforming growth factor beta (TGF-β), Bone Morphogenetic Protein 2 (BMP-2) and Dickkopf1 (DDK1) in the CM of HPSE-low and HPSE-high cells by ELISA. There was no significant

difference in the levels of TGF-β and BMP-2 in the CM of the two types of cell lines (data not shown). However, Tacrolimus (FK506) a significant increase in DKK1 was found in the CM of three different HPSE-high expressing cell lines, compared to the comparable HPSE-low cells (Fig. 4A). In addition, decreased β-catenin activation was observed in primary osteoblast progenitor cells cultured in the CM of HPSE-high cells (Fig. 4B), which was rescued by the addition of a potent and selective DKK1 inhibitor (Fig. 4B). These data demonstrate that the canonical Wnt signaling pathway was inhibited by increased DKK1 secretion from HPSE-high myeloma cells. We identified a high level of human heparanase uptake by murine C3H10T1/2 osteoblast precursor cells cultured in CM of human HPSE-high cells or in the presence of exogenous human rHPSE (Fig. 5A).

Flavonoid-type phenolics can possibly detoxify Al inside plant ce

Flavonoid-type phenolics can possibly detoxify Al inside plant cells. Kidd et al. [77] found that phenolics including catechol and quercetin were released in maize treated with Al and Si, and the release was dependent on Al concentration. However, due to a lack of efficient methodologies, our understanding of internal mechanisms of Al tolerance in plants is still fragmentary. Genetic markers are useful tools to reveal Al tolerance mechanisms in higher plants following their detection by inheritance studies and identification

of relevant genes or loci. During the last two decades, molecular markers based on DNA sequence variations were widely used to study Al tolerance. By detecting molecular markers, the gene or trait could be easily identified and traced [78]. Based on the techniques used, molecular markers could be classified as PCR-based PD0332991 concentration or hybridization-based [79]. DArT (Diversity Arrays Technology) and RFLP (restriction fragment length polymorphism) are hybridization-based markers, whereas AFLP (amplified fragment length polymorphism), RAPD (randomly amplified of polymorphic DNA), SSR (simple sequence repeat) check details and SNP (single

nucleotide polymorphism) are based on polymerase chain reaction (PCR) techniques. PCR-based markers are preferred and widely used as they are highly efficient, use less DNA, are less labor intensive and amenable to automation and avoidance of autoradiography [80]. The use of molecular markers in Al-tolerance studies includes Al-tolerance gene/loci identification and molecular mapping as well as MAS. One RFLP marker bcd1230, co-segregating with a major gene for Al tolerance, on wheat chromosome 4DL, explained 85% of the phenotypic variation in Al tolerance [81]. Using an F2 population derived from barley varieties Dayton and Harlan, three RFLP markers, Xbcd1117, Xwg464 and Xcdo1395, were closely linked to Alp on chromosome 4H [82]. The authors pointed out that Al tolerance in barley was controlled by a single gene that could be an ortholog of AltBH on wheat chromosome

4D. Five AFLP markers, AMAL1, AMAL2, AMAL3, AMAL4 and AMAL5, were closely linked to, and flanked Alt3 on the long arm of chromosome 4R [83]. After screening 35 Al-tolerant wheat landrace accessions using ten AFLP primer combinations, Stodart et al. [84] found that these accessions had diverse Thalidomide genetic background and were therefore valuable germplasms for Al tolerance breeding. RAPD marker OPS14705 was linked to the Alt3 locus in rye. A SCAR marker ScOPS14705 derived from a RAPD marker, was further shown to be linked to Alt3 locus [85]. Ma et al. [86] reported SSR markers Xwmc331 and Xgdm125 flanking the ALMT locus and they indicated that these markers could be used for MAS in breeding Al-tolerant wheat cultivars. In barley, several SSR markers, Bmag353, HVM68 and Bmac310, were closely linked with an Al tolerance gene [87] and [88]. Wang et al.

Such extensive variations raised the question about the significa

Such extensive variations raised the question about the significance of different factors (such as instrument failure, observers’ error or noise in the data, Broman et al. 2006, Soomere & Zaitseva

2007) affecting the observed and measured changes. The relevant data from Almagrundet was even assessed as doubtful by Broman et al. (2006) because the annual mean wind speed in the northern Baltic Proper continued to increase. As the recorded changes occurred simultaneously at Almagrundet and Vilsandi, and with a similar relative range on both the eastern and the western coasts of the sea, they appear to show large-scale decadal variations in wave properties, EPZ-6438 order although the magnitude of the changes may be overestimated (see below). The decrease is mirrored by a certain decrease in the intensity and duration of severe wave heights in the North Sea since about 1990–1995 (Weisse & Günther 2007). As a result, the wave activity in 2004–2005 was equal to the global minimum that occurred at the beginning of the 1980s. Similar variations were much weaker or almost missing in the semi-enclosed bays of the northern coast of Estonia and on the Lithuanian coast (Kelpšaitė et al. 2008, 2009) as well as in the eastern part of the Gulf of Finland (Soomere et al. 2011). Interestingly, the wave intensity clearly increases on

the Lithuanian coasts in 2006–2008. This suggests that the decadal variations – unlike the interannual ones – are essentially uncorrelated in check details the southern and northern parts of the Baltic Proper. Despite drastic decadal variations, the overall course in the wave activity in different parts of the Baltic Sea reveals no clear Bacterial neuraminidase long-term trend (Soomere & Zaitseva 2007, Soomere 2008) except for Narva-Jõesuu, where wave intensity is gradually decreasing (Soomere et al. 2011).

Instead, a quasiperiodic variation can be identified for all the data sets. The interval between subsequent periods of high or low wave activity is about 25 years. The sea was comparatively calm at the end of the 1950s, became slightly rougher in 1965–1975, and then calmer again at the end of the 1970s. Another period of very high wave activity occurred in the 1990s. The use of climatologically corrected data sets does not change the overall pattern of decadal variations but considerably suppresses their magnitude (Soomere et al. 2011). The climatologically corrected annual mean wave heights differ by up to 30% from the relevant values based on the original data at Vilsandi in 1970–1990. The corrected values are larger for years with relatively low wave intensity and long ice cover (for example, in the 1970s). On the other hand, they are smaller by up to 20% in the 1990s and at the turn of the millennium. The best estimate for the wave intensity apparently lies between the two values. The large decadal variations in the 1980s and 1990s are still clearly evident.

° e o 7 ° dia, estando recomendada a abordagem cirúrgica se não s

° e o 7.° dia, estando recomendada a abordagem cirúrgica se não se obtiver eficácia terapêutica até essa altura8. No caso clínico descrito optou-se por iniciar infliximab, muito devido à experiência do centro no uso deste fármaco e ao facto Vemurafenib de ser uma opção válida não só para a remissão, mas também para a manutenção da doença, obtendo-se excelente resposta a curto/médio prazo. Apesar do desenvolvimento das terapêuticas médicas e otimização dos protocolos de abordagem destes doentes, a colite ulcerosa grave com megacolón tóxico constitui ainda um desafio clínico, pois é potencialmente ameaçadora da vida. Os autores declaram não

haver conflito de interesses. “
“Apresentamos o caso clínico de um adolescente de 17 anos de idade, do sexo masculino, raça caucasiana, com espinha bífida e incontinência fecal com múltiplas pequenas perdas diárias que o impossibilitavam de frequentar as atividades escolares. Efetuou estudo manométrico anorretal, que mostrou pressão anal de repouso normal, boa contração voluntária, reflexos à distensão retal normais e hipossensibilidade retal (volume máximo tolerável de 350 mL). O clister opaco realizado não revelou quaisquer alterações ao nível

da morfologia retal ou do cólon. Do ponto de vista urinário, mantinha-se continente pelo recurso a terapêutica adequada. Apesar de várias tentativas de terapêutica com laxantes e modificação dos hábitos alimentares, tinha dejeções diárias mas com soilling permanente. Introduzido esquema rigoroso de realização vespertina de enemas retrógrados, que, Ergoloid por não ter sido cumprido regularmente pelo JAK inhibitor doente, não possibilitou melhoria do quadro clínico. Assim foi proposta a colocação de cecostomia endoscópica percutânea (CEP) para a realização de enemas anterógrados, que o doente e familiares aceitaram. O procedimento (Figura 1, Figura 2, Figura 3 and Figura 4) realizado pela técnica descrita por Rivera et al. consistiu na realização de colonoscopia com identificação

do cego e transiluminação da parede abdominal no local correspondente ao mesmo. Por pressão digital sob a parede na fossa ilíaca direita, identificou-se o melhor local para a cecostomia. Sob visualização direta do colonoscópio, introduziu-se o fio guia após punção direta na região transiluminada selecionada com agulha mandrilada. Procedeu-se à exteriorização anal do guia com o auxílio do colonoscópio e ansa acoplada. Introduziu-se a sonda de cecostomia pelo ânus por tração abdominal do fio guia, com exteriorização da mesma na fossa ilíaca direita. O preenchimento do balão e ajustamento do disco fixador externo permitiu a criação de zona de aderência entre cego e parede abdominal, mantendo a sonda em local apropriado. Completado o procedimento, injetou-se produto contrastado pela sonda de cecostomia e confirmou-se por fluoroscopia o seu correto posicionamento e ausência de extravasamento de contraste.