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1. The Infrared Investigation on the Cassini Mission to Saturn

Author

Jennings, D.E., primary, Kunde, V.G., additional, Ade, P., additional, Barney, R., additional, Bergman, D., additional, Borelli, R., additional, Boyd, D., additional, Brasunas, J., additional, Calcutt, S., additional, Courtin, R., additional, Cretolle, J., additional, Crooke, J., additional, Davis, M., additional, Edberg, S., additional, Flasar, M., additional, Glenar, D., additional, Hagopian, J., additional, Hakun, C., additional, Hayes, P., additional, Herath, L., additional, Horn, L., additional, Karpati, G., additional, Kellebenz, C., additional, Lakew, B., additional, Lindsay, J., additional, Lyons, James, additional, Martineau, R., additional, Martino, A., additional, Matsumura, M., additional, Melak, T., additional, Michel, G., additional, Morell, A., additional, Mosier, C., additional, Pack, L., additional, Plants, M., additional, Robinson, D., additional, Rodriguez, L., additional, Romani, Paul, additional, Trujillo, C., additional, Vellacott, Tim, additional, and Wagner, K., additional

Published
2022
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4. C ring fine structures revealed in the thermal infrared

Author

Altobelli, N., Spilker, L., Pilorz, S., Brooks, S., Edgington, S., Wallis, B., and Flasar, M.

Subjects
Astronomy, Earth sciences
Abstract

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.icarus.2007.06.014 Byline: N. Altobelli (a), L. Spilker (a), S. Pilorz (a), S. Brooks (a), S. Edgington (a), B. Wallis (a), M. Flasar (b) Keywords: Planetary rings; Saturn, rings; Spectroscopy Abstract: We analyze data sets obtained with the Composite Infrared Spectrometer (CIRS) onboard the Cassini spacecraft after the Saturn Orbit Insertion (SOI). Using the mid-IR interferometer's FP3 channel (600-1100 cm.sup.-1), we derive radial temperature profiles for the C ring with a spatial resolution never achieved before. For the first time, the C ring's plateaus and ringlets can be clearly separated from the optically thinner background and their thermal behavior is studied separately for different viewing geometries. In particular, thermal phase curves derived for the plateaus reveal an interesting surge near 0[degrees] phase, not observed in the background. We show that mutual shadowing in the plateaus can explain the existence of the surge but is not sufficient to model the phase curves in detail. By analogy with thermal emission of asteroid surfaces we discuss the possible influence of small scale and large scale roughness of the ring structure itself. Because infrared emissivity cannot be derived without being deconvolved from the 'structural' filling factor, we examine temperature and filling factors measurements at opposition where the filling factor is most constrained. The occurrence of higher temperatures in the plateaus than in the background near opposition likely arises from enhanced mutual heating between particles, multiple scattering and surface roughness combined with a higher single-scattering albedo. Author Affiliation: (a) NASA-JPL, 4800 Oak Grove Drive, Mail Stop 230-205, Pasadena, CA 91109, USA (b) Goddard Space Flight Center, Greenbelt, MD 20771, USA Article History: Received 10 May 2006; Revised 31 May 2007

Published
2007

5. Measurements of C02 Distribution in Saturn's Atmosphere by Cassini-Infrared Observations

Author

Abbas, M. M, LeClair, A, Woodard, E, Young, M, Stanbro, M, and Flasar, M

Subjects
Lunar And Planetary Science And Exploration
Abstract

The Fourier transform infrared spectrometer aboard the Cassini spacecraft, inserted in Saturn s orbit in July 2004, has been providing high resolution/high sensitivity infrared (IR) spectra of the Saturnian system. The measurements cover the spectral range of 10-1400/cm with variable spectral resolutions of 0.53 to 15/cm, exhibiting spectral features of a series of trace gases including CO2 and H2O. The observed spectra may be analyzed for retrieval of global P/T and gas density profiles of Saturn. The infrared measurements of Saturn by ISO(SWS) have indicated unexpected large abundances of CO2 in Saturn's atmosphere. The rigorous photochemical models of Saturn's atmosphere that have been developed indicate exogenic oxygen influx of icy dust grains that lead to the production of CO2. The distribution of CO2 in Saturn's atmosphere needs to be confirmed, and the nature of exogenic sources remains to be investigated. This paper presents comprehensive measurements of the CO2 distribution in Saturn's atmosphere by Cassini IR observations.

Published
2013

6. Titan Orbiter with Aerorover Mission (TOAM)

Author

Sittler, E. C., Jr, Cooper, J. F, Mahaffy, P, Esper, J, Fairbrother, D, Farley, R, Pitman, J, Kojiro, D. R, Acuna, M, Allen, M, Bjoraker, G, Brasunas, J, Farrell, W, Burchell, M. J, Burger, M, Chin, G, Coates, A. J, Flasar, M, Gerlach, B, Gorevan, S, Hartle, R. E, Im, Eastwood, Jennings, D, and Johnson, R. E

Subjects
Spacecraft Design, Testing And Performance
Abstract

We propose to develop a new mission to Titan called Titan Orbiter with Aerorover Mission (TOAM). This mission is motivated by the recent discoveries of Titan, its atmosphere and its surface by the Huygens Probe, and a combination of in situ, remote sensing and radar mapping measurements of Titan by the Cassini orbiter. Titan is a body for which Astrobiology (i.e., prebiotic chemistry) will be the primary science goal of any future missions to it. TOAM is planned to use an orbiter and balloon technology (i.e., aerorover). Aerobraking will be used to put payload into orbit around Titan. One could also use aerobraking to put spacecraft into orbit around Saturn first for an Enceladus phase of the mission and then later use aerocapture to put spacecraft into orbit around Titan. The Aerorover will probably use a hot air balloon concept using the waste heat from the MMRTG approx. 1000 watts. Orbiter support for the Aerorover is unique to our approach for Titan. Our strategy to use an orbiter is contrary to some studies using just a single probe with balloon. Autonomous operation and navigation of the Aerorover around Titan will be required, which will include descent near to the surface to collect surface samples for analysis (i.e., touch and go technique). The orbiter can provide both relay station and GPS roles for the Aerorover. The Aerorover will have all the instruments needed to sample Titan's atmosphere, surface, possible methane lakes-rivers, use multi-spectral imagers for surface reconnaissance; to take close up surface images; take core samples and deploy seismometers during landing phase. Both active and passive broadband remote sensing techniques will be used for surface topography, winds and composition measurements.

Published
2007

8. Cassini CIRS observations of Saturn's rings

Author

Spilker, L. J, Ferrari, C, Showalter, M, Cuzzi, J, Achterberg, R, Pearl, J, Flasar, M, Kunde, V, Edberg, S, Wallis, B, Aiello, J, and Edington, S

Subjects
Lunar And Planetary Science And Exploration
Published
2002

10. Titan Orbiter Aerorover Mission

Author

Sittler Jr., E. C, Acuna, M, Burchell, M. J, Coates, A, Farrell, W, Flasar, M, Goldstein, B. E, Gorevan, S, Hartle, R. E, and Johnson, W. T. K

Subjects
Lunar And Planetary Science And Exploration
Abstract

We propose a combined Titan orbiter and Titan Aerorover mission with an emphasis on both in situ and remote sensing measurements of Titan's surface, atmosphere, ionosphere, and magnetospheric interaction. The biological aspect of the Titan environment will be emphasized by the mission (i.e., search for organic materials which may include simple organics to 'amono' analogues of amino acids and possibly more complex, lightening detection and infrared, ultraviolet, and charged particle interactions with Titan's surface and atmosphere). An international mission is assumed to control costs. NASA will provide the orbiter, launch vehicle, DSN coverage and operations, while international partners will provide the Aerorover and up to 30% of the cost for the scientific instruments through collaborative efforts. To further reduce costs we propose a single PI for orbiter science instruments and a single PI for Aerorover science instruments. This approach will provide single command/data and power interface between spacecraft and orbiter instruments that will have redundant central DPU and power converter for their instruments. A similar approach could be used for the Aerorover. The mission profile will be constructed to minimize conflicts between Aerorover science, orbiter radar science, orbiter radio science, orbiter imaging science, and orbiter fields and particles (FP) science. Additional information is contained in the original extended abstract.

Published
2001

11. Ustekinumab as induction and maintenance therapy for Crohn's disease

Author

Feagan, Bg, Sandborn, Wj, Gasink, C, Jacobstein, D, Lang, Y, Friedman, Jr, Blank, Ma, Johanns, J, Gao, Ll, Miao, Y, Adedokun, Oj, Sands, Be, Hanauer, Sb, Vermeire, S, Targan, S, Ghosh, S, de Villiers WJ, Colombel, Jf, Tulassay, Z, Seidler, U, Salzberg, Ba, Desreumaux, P, Lee, Sd, Loftus EV Jr, Dieleman, La, Katz, S, Rutgeerts, P, Bampton, P, Chung, A, Connor, S, Debinski, H, Leong, R, Macrae, F, Pavli, P, Sorrentino, D, van den Bogaerde, J, Vogel, W, Vogelsang, H, Louis, E, Mana, F, Zaltman, C, Aumais, G, Bernstein, C, Bressler, B, Dhalla, S, Dieleman, L, Feagan, B, Marshall, J, Panaccione, R, Ropeleski, M, Stehlik, J, Volfova, M, Brynskov, J, Glerup, H, Abitbol-Selinger, V, Allez, M, Beaugerie, L, Bourreille, A, Cadiot, G, Dupas, J, Grimaud, J, Laharie, D, Lerebours, E, Moreau, J, Baumgart, D, Brand, S, Ebert, M, Ehehalt, R, Hasselblatt, P, Howaldt, S, Klaus, J, Krummenerl, P, Kucharzik, T, Lügering, A, Mudter, J, Preiss, J, Schreiber, S, Stallmach, A, Stein, J, Strauch, U, Salamon, A, Patchett, S, Lahat-Zok, A, Rachmilewitz, D, Annese, V, Bossa, F, Guidi, L, Kohn, A, Rocca, R, Ando, A, Ashida, T, Hanai, H, Ishida, T, Ito, H, Matsumoto, T, Motoya, S, Nakamura, S, Sameshima, Y, Suzuki, Y, Watanabe, K, Yamagami, H, Yamamoto, T, Yao, K, Kim, H, Kim, Y, D'Haens, G, Pierik, M, van Bodegraven, A, van der Woude CJ, Gearry, R, Ciecko-Michalska, I, Malecka-Panas, E, Jojic, N, Aboo, N, Wright, J, Arranz, M, Viso, L, Ahmad, T, Bloom, S, Campbell, S, Creed, T, Cummings, F, Hawthorne, B, Iqbal, T, Ireland, A, Parkes, M, Pollok, R, Shaw, I, Shonde, A, Smith, M, Steel, A, Subramanian, S, Travis, S, Tremelling, M, Aberra, F, Abraham, B, Barish, C, Behm, B, Birbara, C, Bochner, R, Bologna, S, Brant, S, Charles, R, Cohen, N, de Villers, W, Dryden, G, Duvall, A, Flasar, M, Fleisher, M, Florez, D, Fogel, R, Gagneja, H, Gross, C, Hamilton, J, Hanauer, S, Hanson, J, Hardi, R, Higgins, P, Isaacs, K, Katz, J, Kaur, N, Khan, N, Lee, S, Leman, B, Levenson, S, Lichtiger, S, Loftus, E, Malik, P, Mcnair, A, Melmed, G, Miner, P, Nichols, M, Noar, M, Oikonomou, I, Oubre, B, Peterson, K, Pruitt, R, Quirk, D, Safdi, A, Safdi, M, Salzberg, B, Sandborn, W, Saubermann, L, Scherl, E, Schwartz, D, Schwarz, R, Sedghi, S, Selby, L, Shafran, I, Siegel, C, Sninsky, C, Stern, M, Stockwell, D, Stone, C, Swaminath, A, Swoger, J, Taormina, M, Williams, E, Winstead, N, Wolf, D, Wolosin, J, Yacyshyn, B, Yajnik, V, Yen, E, Hetzel, D, Muls, V, Bafutto, M, Francesconi, C, Sipahi, A, Steinwurz, F, Churchev, J, Kotzev, I, Marinova, I, Penchev, P, Spassova, Z, Stoinov, S, Takov, D, Vassileva, G, Fowler, S, Greenberg, G, Jones, J, Saibil, F, Salh, B, Banić, M, Duvnjak, M, Stimac, D, Goujon, G, Pelletier, A, Peyrin-Biroulet, L, Aldinger, V, Bokemeyer, B, Büning, C, Konturek, J, Krummenerl, T, Ochsenkuehn, T, Altorjay, I, Kis, J, Pecsi, G, Székely, A, Varga, M, Vincze, A, Wacha, J, Oddsson, E, Orvar, K, Avni-Biron, I, Fishman, S, Fraser, G, Konikoff, F, Melzer, E, Oren, R, Shirin, H, Danese, S, Marino, M, Sturniolo, Gc, Horiki, N, Iijima, H, Iwabuchi, M, Kanai, T, Kunisaki, R, Maemoto, A, Matsuoka, K, Osada, T, Sugimoto, K, Tanaka, S, Cheon, Jh, Han, Ds, Jang, Bi, Kim, Hj, Kim, Js, Kim, Yh, Park, Sj, Yang, Sk, Arnold, M, Claydon, A, Haines, M, Hill, J, Rowbotham, D, Schultz, M, Wallace, I, Bochenek, A, Niezgoda, K, Szura, M, Arutyunov, G, Baranovsky, A, Khalif, I, Osipenko, M, Milinic, N, Bloch, H, Kruger, Fc, Prins, M, Watermeyer, G, Ziady, C, Calvo, Xc, Domínguez-Muñoz, Je, Gisbert, Jp, Arsenescu, R, Beaulieu, D, Bedford, R, Behrend, C, Cleavinger, P, Cohen, J, Ertan, A, Freilich, B, Friedenberg, K, Glover, S, Gordon, G, Gunaratnam, N, Gupta, N, Holbrook, R, Jones, M, Kaufman, B, Khan, Nh, Khurana, S, Legnani, P, Mutlu, E, Phillips, R, Rai, R, Reichelderfer, M, Ritter, T, Safdi, Ma, Sands, B, Schulman, M, Smith, J, Suiter, D, Taylor, D, Vasudeva, R, Winstead, T, Zwick, A, Savoye, G, Atreya, R, Ochsenkuhn, T, Ott, C, Goldin, E, Motohiro, E, Takanori, K, Park, S, James, B, Cummings, J, Tariq, A, Willert, R, Allan, M, Bulat, R, Devilliers, W, Eaker, E, Hou, J, Mendu, S, Nicols, M, Proctor, D, Thosani, N, Zhang, C, and UNITI-IM-UNITI Study Group

Subjects
030203 arthritis & rheumatology, Adult, Male, Infusions, Medicine (all), Remission Induction, Crohn Disease, Female, Humans, Induction Chemotherapy, Infusions, Intravenous, Maintenance Chemotherapy, Middle Aged, Ustekinumab, General Medicine, Orvostudományok, Klinikai orvostudományok, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Intravenous
Abstract

Ustekinumab, a monoclonal antibody to the p40 subunit of interleukin-12 and interleukin-23, was evaluated as an intravenous induction therapy in two populations with moderately to severely active Crohn's disease. Ustekinumab was also evaluated as subcutaneous maintenance therapy.We randomly assigned patients to receive a single intravenous dose of ustekinumab (either 130 mg or approximately 6 mg per kilogram of body weight) or placebo in two induction trials. The UNITI-1 trial included 741 patients who met the criteria for primary or secondary nonresponse to tumor necrosis factor (TNF) antagonists or had unacceptable side effects. The UNITI-2 trial included 628 patients in whom conventional therapy failed or unacceptable side effects occurred. Patients who completed these induction trials then participated in IM-UNITI, in which the 397 patients who had a response to ustekinumab were randomly assigned to receive subcutaneous maintenance injections of 90 mg of ustekinumab (either every 8 weeks or every 12 weeks) or placebo. The primary end point for the induction trials was a clinical response at week 6 (defined as a decrease from baseline in the Crohn's Disease Activity Index [CDAI] score of ≥100 points or a CDAI score150). The primary end point for the maintenance trial was remission at week 44 (CDAI score150).The rates of response at week 6 among patients receiving intravenous ustekinumab at a dose of either 130 mg or approximately 6 mg per kilogram were significantly higher than the rates among patients receiving placebo (in UNITI-1, 34.3%, 33.7%, and 21.5%, respectively, with P≤0.003 for both comparisons with placebo; in UNITI-2, 51.7%, 55.5%, and 28.7%, respectively, with P0.001 for both doses). In the groups receiving maintenance doses of ustekinumab every 8 weeks or every 12 weeks, 53.1% and 48.8%, respectively, were in remission at week 44, as compared with 35.9% of those receiving placebo (P=0.005 and P=0.04, respectively). Within each trial, adverse-event rates were similar among treatment groups.Among patients with moderately to severely active Crohn's disease, those receiving intravenous ustekinumab had a significantly higher rate of response than did those receiving placebo. Subcutaneous ustekinumab maintained remission in patients who had a clinical response to induction therapy. (Funded by Janssen Research and Development; ClinicalTrials.gov numbers, NCT01369329 , NCT01369342 , and NCT01369355 .).

Published
2016

12. CIRS-lite, an FTS for Future Planetary and Earth Missions

Author

Brasunas, J., primary, Abbas, M., additional, Bly, V., additional, Edgerton, M., additional, Flasar, M., additional, Hagopian, J., additional, Jennings, D., additional, Mamakos, W., additional, Morell, A., additional, Pasquale, B., additional, and Smith, W., additional

Published
2013
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14. The helium abundance of Jupiter from Voyager

Author

Gautier, D, Conrath, B, Flasar, M, Hanel, R, Kunde, V, Chedin, A, and Scott, N

Subjects
Lunar And Planetary Exploration
Abstract

The helium abundance in the Jovian atmosphere is derived from Voyager 1 data by two methods. The first method uses only infrared spectra from selected locations on the planet while the second method uses a thermal profile independently derived from radio occultation measurements and infrared spectra recorded near the occultation point. A hydrogen mole fraction of 0.897 plus or minus 0.030 is obtained from the first method, while the second method gives 0.880 plus or minus 0.036, corresponding to helium mass fractions of 0.19 plus or minus 0.05 and 0.21 plus or minus 0.06, respectively. The estimated errors for the first method are primarily due to systematic uncertainties in the H2 and He absorption coefficients, while those for the second method result mainly from errors in the radio occultation profile and are less well known. Random errors in the measured infrared spectra are found to be negligible in both cases. The results are consistent with a uniform mix of hydrogen and helium within Jupiter's interior, but a modest amount of helium depletion (Delta Y equal to or less than 0.05) cannot be excluded.

Published
1981

16. Cassini infrared Fourier spectroscopic investigation

Author

Kunde, Virgil G., primary, Ade, Peter A. R., additional, Barney, Richard D., additional, Bergman, D., additional, Bonnal, Jean-Francois, additional, Borelli, R., additional, Boyd, David, additional, Brasunas, John C., additional, Brown, Gregory V., additional, Calcutt, Simon B., additional, Carroll, F., additional, Courtin, R., additional, Cretolle, Jacky B., additional, Crooke, Julie A., additional, Davis, Martin A., additional, Edberg, S., additional, Fettig, Rainer K., additional, Flasar, M., additional, Glenar, David A., additional, Graham, S., additional, Hagopian, John G., additional, Hakun, Claef F., additional, Hayes, Patricia A., additional, Herath, L., additional, Spilker, Linda, additional, Jennings, Donald E., additional, Karpati, Gabriel, additional, Kellebenz, C., additional, Lakew, Brook, additional, Lindsay, J., additional, Lohr, J., additional, Lyons III, James J., additional, Martineau, Robert J., additional, Martino, Anthony J., additional, Matsumura, Mack, additional, McCloskey, J., additional, Melak, T., additional, Michel, Guy, additional, Morrell, Armando, additional, Mosier, C., additional, Pack, LaTunia G., additional, Plants, M., additional, Robinson, D., additional, Rodriguez, Louis, additional, Romani, Paul, additional, Schaefer, Bill, additional, Schmidt, Stephen M., additional, Trujillo, Carlos, additional, Vellacott, Tim, additional, Wagner, K., additional, and Yun, D., additional

Published
1996
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17. Cassini infrared Fourier spectroscopic investigation

Author

Horn, Linda, Kunde, Virgil G., Ade, Peter A. R., Barney, Richard D., Bergman, D., Bonnal, Jean-Francois, Borelli, R., Boyd, David, Brasunas, John C., Brown, Gregory V., Calcutt, Simon B., Carroll, F., Courtin, R., Cretolle, Jacky B., Crooke, Julie A., Davis, Martin A., Edberg, S., Fettig, Rainer K., Flasar, M., Glenar, David A., Graham, S., Hagopian, John G., Hakun, Claef F., Hayes, Patricia A., Herath, L., Spilker, Linda, Jennings, Donald E., Karpati, Gabriel, Kellebenz, C., Lakew, Brook, Lindsay, J., Lohr, J., Lyons III, James J., Martineau, Robert J., Martino, Anthony J., Matsumura, Mack, McCloskey, J., Melak, T., Michel, Guy, Morrell, Armando, Mosier, C., Pack, LaTunia G., Plants, M., Robinson, D., Rodriguez, Louis, Romani, Paul, Schaefer, Bill, Schmidt, Stephen M., Trujillo, Carlos, Vellacott, Tim, Wagner, K., Yun, D., Horn, Linda, Kunde, Virgil G., Ade, Peter A. R., Barney, Richard D., Bergman, D., Bonnal, Jean-Francois, Borelli, R., Boyd, David, Brasunas, John C., Brown, Gregory V., Calcutt, Simon B., Carroll, F., Courtin, R., Cretolle, Jacky B., Crooke, Julie A., Davis, Martin A., Edberg, S., Fettig, Rainer K., Flasar, M., Glenar, David A., Graham, S., Hagopian, John G., Hakun, Claef F., Hayes, Patricia A., Herath, L., Spilker, Linda, Jennings, Donald E., Karpati, Gabriel, Kellebenz, C., Lakew, Brook, Lindsay, J., Lohr, J., Lyons III, James J., Martineau, Robert J., Martino, Anthony J., Matsumura, Mack, McCloskey, J., Melak, T., Michel, Guy, Morrell, Armando, Mosier, C., Pack, LaTunia G., Plants, M., Robinson, D., Rodriguez, Louis, Romani, Paul, Schaefer, Bill, Schmidt, Stephen M., Trujillo, Carlos, Vellacott, Tim, Wagner, K., and Yun, D.

Abstract

The composite infrared spectrometer (CIRS) is a remote sensing instrument to be flown on the Cassini orbiter. CIRS will retrieve vertical profiles of temperature and gas composition for the atmospheres of Titan and Saturn, from deep in their tropospheres to high in their stratospheres. CIRS will also retrieve information on the thermal properties and composition of Saturn's rings and Saturnian satellites. CIRS consists of a pair of Fourier Transform Spectrometers (FTSs) which together cover the spectral range from 10-1400 cm-1 with a spectral resolution up to 0.5 cm-1. The two interferometers share a 50 cm beryllium Cassegrain telescope. The far-infrared FTS is a polarizing interferometer covering the 10-600 cm-1 range with a pair of thermopile detectors, and a 3.9 mrad field of view. The mid-infrared FTS is a conventional Michelson interferometer covering 200-1400 cm-1 in two spectral bandpasses: 600-1100 cm- 1100-1400 cm(superscript -1 with a 1 by 10 photovoltaic HgCdTe array. Each pixel of the arrays has an approximate 0.3 mrad field of view. The HgCdTe arrays are cooled to approximately 80K with a passive radiative cooler.

19. Anti-Tumor Necrosis Factor-α Antibody Therapy Management Before and After Intestinal Surgery for Inflammatory Bowel Disease: A CCFA Position Paper.

Author

Holubar SD, Holder-Murray J, Flasar M, and Lazarev M

Subjects
Digestive System Surgical Procedures, Humans, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases surgery, Infliximab adverse effects, Inflammatory Bowel Diseases therapy, Infliximab administration & dosage, Perioperative Period, Postoperative Complications, Tumor Necrosis Factor-alpha antagonists & inhibitors
Abstract

Biologic therapy with anti-tumor necrosis factor (TNF)-α antibody medications has become part of the standard of care for medical therapy for patients with inflammatory bowel disease and may help to avoid surgery in some. However, many of these patients will still require surgical intervention in the form of bowel resection and anastomosis or ostomy formation for the treatment of their disease. Postsurgical studies suggest up to 30% of patients with inflammatory bowel disease may be on or have used anti-TNF-α antibody medications for disease management preoperatively. Significant controversy exists regarding the potential deleterious impact of these medications on the outcomes of surgery, specifically overall and/or infectious complications. In this position statement, we systematically reviewed the literature regarding the potential risk of anti-TNF-α antibody use in the perioperative period, offer recommendations based both on the best-available evidence and expert opinion on the use and timing of anti-TNF-α antibody therapy in the perioperative period, and discuss whether or not the presence of these medications should lead to an alteration in surgical technique such as temporary stoma formation.

Published
2015
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20. Radiating disparity in IBD.

Author

Flasar M and Patil S

Subjects
Female, Humans, Male, Radiography, Colitis, Ulcerative diagnostic imaging, Crohn Disease diagnostic imaging, Radiation Dosage, Safety-net Providers
Published
2014
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21. Response to Kotze et al.

Author

Flasar M, Syed A, and Cross RK

Subjects
Female, Humans, Male, Crohn Disease surgery, Immunosuppressive Agents adverse effects, Intraabdominal Infections etiology, Postoperative Complications, Surgical Wound Infection etiology, Tumor Necrosis Factor-alpha antagonists & inhibitors
Published
2014
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22. Contrast does not affect cholangioscope image quality.

Author

Laczek J, Flasar M, Goldberg E, and Darwin P

Abstract

Background/aims: Peroral cholangioscopy is a rapidly evolving technique that allows direct examination of the bile duct. We sought to determine if there was a difference in image quality with the cholangioscope immersed in normal saline compared with radiologic contrast or a mixture of contrast and normal saline., Methods: Images were captured using the SpyGlass® cholangioscope system (Boston Scientific Corp.) immersed in solutions ranging from 0 to 100% contrast. The images were then reviewed in a blinded fashion by a panel of 9 endoscopists with experience using the SpyGlass® system. The reviewers scored the quality of each image based on a scale of 0 (extremely poor) to 10 (excellent)., Results: With the cholangioscope immersed in saline and 100% contrast, the mean image quality scores were 7.6 (95% confi dence interval [CI], 6.7-8.5) and 6.9 (95% CI, 5.8-8.0), respectively. The highest mean image quality score was 7.8 (95% CI, 6.7-8.9), obtained in 70% contrast. No signifi cant difference was noted in mean image quality scores using a one way analysis of variance technique (p=0.414)., Conclusions: Although there are limitations to ex vivo studies, we encourage endoscopists to use intraductal contrast prior to peroral cholangioscopy, if needed for lesion localization.

Published
2011
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23. Dialysis reduces portal pressure in patients with chronic hepatitis C.

Author

Khurana S, Simcox T, Twaddell W, Drachenberg C, and Flasar M

Subjects
Hepatitis C, Chronic pathology, Hepatitis C, Chronic therapy, Humans, Liver pathology, Liver Cirrhosis pathology, Liver Cirrhosis physiopathology, Hepatitis C, Chronic physiopathology, Liver physiopathology, Portal Pressure, Renal Dialysis
Abstract

The purpose of this study was to characterize changes in hepatic venous pressures in patients with chronic hepatitis C. The histology and laboratory data from patients with chronic hepatitis C who underwent a transjugular liver biopsy (TJLB) and hepatic venous pressure gradient measurement were analyzed. Portal hypertension was defined as hepatic venous pressure gradient > or =6 mm Hg. A single pathologist masked to hepatic venous pressure gradient scored liver sections for inflammation and fibrosis. The patients with high-grade inflammation (relative risk [RR] 2.82, P = 0.027, multivariate analysis) and late-stage fibrosis (RR 2.81, P = 0.022) were more likely to have a hepatic venous pressure gradient > or =6 mm Hg, while the patients on dialysis (RR 0.32, P = 0.01) were less likely to have a hepatic venous pressure gradient > or =6 mm Hg. The patients on dialysis (n = 58) had an elevated serum blood urea nitrogen and creatinine when compared with those who were not (n = 75) (47.6 +/- 3.3 and 7.98 +/- 0.4 vs. 25.9 +/- 2.0 and 1.66 +/- 0.22 mg/dL, respectively; P < 0.001). While the hepatic venous pressure gradient increased with the rising levels of liver fibrosis in the latter group (P < 0.01), it did not change in the patients on dialysis (P = 0.41). The median hepatic venous pressure gradient was especially low in late-stage fibrosis patients on dialysis when compared with the latter group (5 vs. 10 mm Hg, P = 0.017). In patients on dialysis, serum transaminases were low across all levels of fibrosis. Twenty-three of the 92 patients with early fibrosis had a hepatic venous pressure gradient > or =6 mm Hg. In patients with chronic hepatitis C, concomitant TJLB and hepatic venous pressure gradient measurement identify those who have early fibrosis and portal hypertension. Long-term hemodialysis may reduce portal pressure in these patients.

Published
2010
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