Probucol decreased the plasma concentration of non-HDLC to the sa

Probucol decreased the plasma concentration of non-HDLC to the same extent as atorvastatin (i.e., by 22%) and the area of atherosclerotic lesions by 41%. Probucol with 0.003% atorvastatin decreased the plasma concentration of non-HDLC by 38% and the area of atherosclerotic lesions by 61%. Co-administration of probucol with atorvastatin did not affect the antioxidative Fujimycin effects of probucol, which were not evident on treatment with atorvastatin alone, such as prevention of in vitro LDL-oxidation, increase

in paraoxonase-1 activity of HDL, and decreases in plasma and plaque levels of oxidized-LDL in vivo. Conclusions: Probucol has significant add-on anti-atherosclerotic effects when combined with atorvastatin treatment; suggesting that this combination might be beneficial for treatment of atherosclerosis.”
“Introduction: Osteoporosis is the commonest metabolic bone disease worldwide. The clinical hallmark of osteoporosis is low trauma fracture, with the most devastating being hip fracture,

resulting in significant effects on both morbidity and mortality. Sources of data: Data for this review have been gathered from the published literature and from a range of web resources. Areas of agreement: Genome-wide association studies in the field of osteoporosis have led to the identification of a number of loci associated with both bone mineral density and fracture risk and find more further increased S3I-201 our understanding of disease. Areas of controversy: The early strategies for mapping osteoporosis disease genes reported only isolated associations, with replication in independent cohorts proving difficult. Neither candidate gene or linkage studies showed association at genome-wide level of significance. Growing points: The advent of massive parallel sequencing technologies has proved extremely successful in mapping monogenic diseases and thus leading to the utilization of this new technology in complex disease genetics. Areas timely for developing research: The identification of novel genes and pathways will potentially lead to the identification of novel therapeutic options for

patients with osteoporosis.”
“Mass spectrometry (MS) is a powerful tool for identification and quantitation of organic molecules from various matrices, especially when combined with liquid chromatography (LC). The aim of this review is to present different MS techniques and methods which can be utilized in drug and metabolism studies using cells and tissues. The first part focuses on the use of LC/MS in permeability studies across cell lines as well as in ABC transporter protein experiments. The second part describes the utilization of MS in drug metabolism studies using cell lines. The third part presents a relatively new application area of MS, namely mass spectrometric imaging (MSI) or imaging mass spectrometry (IMS).

In the Northern Hemisphere high morbidity and mortality rates in

In the Northern Hemisphere high morbidity and mortality rates in December are usually assigned to diverse factors in relation to the holidays, mTOR inhibitor but such an effect

is not observed in the present analysis. There seems to be no clearly preferred meteorological proxy among the different types of temperatures used. It is shown that the amount of occurrences depends mainly on season rather on its strength quantified by temperature.”
“OBJECTIVE: While current emphases on operative teaching focus on “virtual” education, residents and faculty engage most intimately in the operating room. The utilization of intraoperative teaching techniques, drawn from adult education principles, is understudied.\n\nDESIGN: A survey with both quantitative and qualitative elements was administered to surgical residents and their faculty. Thirty-eight analogous questions regarding teaching techniques, populating four general domains, were rated for frequency of application. Respondents were asked to rank best teaching practices and identify other effective educational approaches using open-ended questions.\n\nSETTING: University-based general surgical residency selleck chemicals (5 institutions).\n\nPARTICIPANTS: General surgical residents and their faculty.\n\nRESULTS: 46 residents (77%) and 37 faculty (63%; mean 17 yrs experience)

completed the survey. There was significant disagreement between residents and faculty in how frequently 32 of the 38 teaching techniques were applied (all p < 0.032). Faculty rated the technique “I set and communicate high standards” as the most frequently

applied strategy, while residents rated “The faculty demonstrate technical consistency” the highest. The least employed approach, acknowledged by both groups, was “The faculty ask how they might improve their teaching.” There were few differences between perceptions and preferences of junior vs. senior learners, and junior vs. senior faculty. Resident and faculty appreciation of most-effective teaching approaches was similar. Qualitative analysis of the open-ended questions yielded themes which resonate with both learners and teachers: communication signaling pathway processes, time pressures, optimization of the work/teaching environment, teacher engagement, patience/tolerance, autonomy, feedback, learner preparedness, and patient advocacy.\n\nCONCLUSIONS: The perceptions of residents and faculty regarding the frequency of using effective approaches for operative teaching are disparate. While faculty appear to value adult learning principles and perceive that they are employed regularly, residents have a discrepant viewpoint. However, themes that were identified by both residents and faculty through qualitative analysis provide the foundation for educational process improvements. (J Surg 68:485-494. (C) 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.


“3-Aza-6,8-dioxabicyclo[3 2 1]octane-based amino acids as


“3-Aza-6,8-dioxabicyclo[3.2.1]octane-based amino acids as reverse turn inducers have been introduced

into cyclic peptidomimetics containing the RGD or DGR retro-sequence, in order to achieve a stereochemical scanning of the binding capability of the resulting molecules towards alpha(v)beta(3) and alpha(v)beta(5) integrins, resulting in retro-inverso DGR peptides as micromolar ligands. A comparative analysis between the conformational preferences of 4 and of its isomer 3, having the opposite RGD sequence, was reported with respect to the binding activity, giving insight into the factors affecting the preferential binding of 4 to the alpha(v)beta(5) integrin.”
“Patients with heart failure (HF) are at high risk of hospitalization or death. The objective this website of this study was to develop 5-Fluoracil supplier prediction models to identify patients with HF at highest risk for hospitalization or death. Using clinical and administrative databases, we identified 198,460 patients who received care from the Veterans Health Administration and had >= 1 primary or secondary diagnosis of HF that occurred within 1 year before June 1, 2009. We then tracked their outcomes of hospitalization and death during the subsequent 30 days and 1 year. Predictor variables chosen from

6 clinically relevant categories of sociodemographics, medical conditions, vital signs, use of health services, laboratory tests, and medications were used in multinomial regression models to predict outcomes of hospitalization and death. In patients who were in the >= 95th predicted risk percentile, observed event rates of hospitalization or death within 30 days and 1 year were 27% and 80% respectively, compared to population averages of 5% and 31%, respectively. The c-statistics for the 30-day outcomes CA3 were 0.82, 0.80, and 0.80 for hospitalization, death, and hospitalization or death, respectively, and 0.82, 0.76, and 0.77, respectively, for 1-year outcomes. In conclusion, prediction

models using electronic health records can accurately identify patients who are at highest risk for hospitalization or death. This information can be used to assist care managers in selecting patients for interventions to decrease their risk of hospitalization or death. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:1342-1349)”
“Atopic dermatitis (AD) is an important chronic or relapsing inflammatory skin disease that often precedes asthma and allergic disorders. New insights into the genetics and pathophysiology of AD point to an important role of structural abnormalities in the epidermis as well as immune dysregulation not only for this skin disease but also for the development of asthma and allergies. Patients with AD have a unique predisposition to colonization or infection by microbial organisms, most notably Staphylococcus aureus and herpes simplex virus.

Study Design Demographic and clinical

\n\nStudy Design. Demographic and clinical click here data of 8 patients with foreign body granulomas

containing the characteristic microscopic appearance of hydroxyapatite microspheres were studied. Analysis of the microspheres of 1 case was carried out by energy dispersive x-ray microanalysis to confirm the calcium and phosphorus content.\n\nResults. The clinical and microscopic appearance of Radiesse-induced foreign body granulomas is illustrated and discussed.\n\nConclusions. Foreign body granulomas containing hydroxyapatite microspheres in patients receiving treatment with the cosmetic filler Radiesse have a characteristic microscopic appearance. Oral Radiesse-induced nodules occur more often in older women, most commonly in the lips and the mandibular labial vestibule. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:107-111)”
“Exposure to blood and body fluids is an occupational hazard in healthcare. Although the potential for blood-borne virus transmission through needlestick injury has been widely studied, the risk of this occurring through spatter contamination from safety-needle syringes is not well understood. This report examines this risk from three commonly used safety needles and suggests that this presents

a new and significant hazard. Further work should be commissioned to quantify this hazard and determine which type of safety needle would minimize spatter contamination following syringe discharge and safety activation. Crown Copyright (C) 2014 Published by Elsevier Ltd on behalf of the Healthcare Infection Society. All rights reserved.”
“Naked Galardin cell line barley is an underutilized crop that is suitable for the production of functional food: it contains remarkable amounts of beta-glucans, which are well known for their blood cholesterol and short-time blood sugar regulating properties and their impact on weight regulation. The aim of the present work was to develop naked barley bread with satisfying sensory characteristics and good baking qualities that could augment the intake

of dietary fiber, especially beta-glucans and therefore meet the requirements of the EFSA health claim for beta-glucans.\n\nThe results of the multiple response optimization suggest that the elevated use of water, malt flour and margarine in pure naked CSF-1R inhibitor barley bread augment the sensory attractiveness whereas the use of acidifier and pre-gelatinized flour has a negative effect on the sensory quality. (C) 2011 Elsevier Ltd. All rights reserved.”
“A novel antibacterial polymer, coated with a silver-containing organic composite antibacterial agent, was dispersed in a self-cured acrylic resin. Residual viable cell count of each oral bacterial and fungal species cultivated on acrylic resin specimens containing the antibacterial polymer was significantly decreased when compared to those cultivated on specimens prepared from untreated polymer.

In an in vitro model of wound contraction,

lactoferrin pr

In an in vitro model of wound contraction,

lactoferrin promoted fibroblast-mediated collagen gel contraction. These observations indicate that lactoferrin supports multiple biological processes involved in wound healing.”
“Obesity is associated with chronic low-grade inflammation, which contributes to systemic metabolic irregularities and obesity-linked metabolic disorders. Orosomucoid (ORM), an acute phase reactant protein, was shown to be produced in response to metabolic and inflammatory signals in the adipose tissue of obese mice, which protects them from severe inflammation and subsequent check details metabolic dysfunction. In this study, we examined whether there are site-specific differences between visceral and subcutaneous adipose tissue (VAT and SAT, respectively) ORM gene and protein expression from individuals with a wide range of obesity and the relationship between expressed and circulating ORM levels and measures of adiposity, insulin resistance, and pro- and anti-inflammatory markers and adipokines. The level of circulating ORM correlated positively with BMI, body fat mass, and serum leptin. It also correlated with fasting insulin, HOMA-IR values and C-reactive protein in men. There were no site-specific differences in ORM mRNA and protein expression

between VAT and SAT, nor did we find a relationship between circulating ORM levels and its mRNA expression in either fat depot. We found that ORM mRNA expression correlated with mRNA expression of TNF-alpha, IL-6, and adiponectin in VAT, and with TNF-alpha and adiponectin in SAT. These observations are the first description linking adipose tissue ORM and pro- and anti-inflammatory molecules in humans. click here The close

links of ORM and measures of adiposity, insulin resistance, and adipose tissue inflammation in humans reinforce previous experimental data and warrant further studies to explore a possible role of ORM in the pathogenesis of obesity-associated metabolic derangements.”
“The quality and ease of proteomics analysis depends on the performance of the analytical tools used, and thus of the performances of the protein separation tools used to deconvolute complex protein samples. Among protein samples, membrane proteins are one of the most difficult sample classes, because of their hydrophobicity and embedment in the lipid bilayers. This review deals with the recent progresses and advances made in the separation BLZ945 of membrane proteins by 2-DE separating only denatured proteins. Traditional 2-D methods, i.e., methods using IEF in the first dimension are compared to methods using only zone electrophoresis in both dimensions, i.e., electrophoresis in the presence of cationic or anionic detergents. The overall performances and fields of application of both types of method is critically examined, as are future prospects for this field.”
“Conazoles are fungicides used to control fungal growth in environmental settings and to treat humans with fungal infections.


“Background


“Background. learn more Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI)

leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa-O2). These Pa-O2 oscillations could also be forwarded to the cerebral microcirculation.\n\nMethods. In 12 pigs, partial pressure of oxygen was measured in the thoracic aorta (Pa-O2) and subcortical cerebral tissue (Pbr(O2)). Cerebral cortical haemoglobin oxygen saturation (Sbr(O2)), cerebral blood flow (CBF), and peripheral haemoglobin saturation (Sp(O2)) were assessed by spectroscopy and laser Doppler flowmetry. Measurements at different fractions of inspired oxygen (FIO2) were performed at baseline and during cyclic R/D. Statistics: frequency domain analysis, the Mann-Whitney test, linear models to test the influence of Pa-O2 and systolic arterial pressure (SAP) oscillations on cerebral measurements.\n\nResults. Parameters [mean (SD)] remained stable during baseline. Pa-O2 oscillations [10.6 (8) kPa, phase(reference)], systemic arterial pressure (SAP) oscillations [20 (9) mm Hg, phase(PaO2-SAP)-33 (72)degrees], and Sp(O2) oscillations [1.9 (1.7)%, phase(PaO2-SpO2) 264 (72)degrees] were detected during lung R/D at FIO2 1.0. Pa-O2 oscillations decreased [2.7 (3.5)

kPa, P=0.0008] and Sp(O2) oscillations increased [6.8 (3.9)%, P=0.0014] at FIO2 0.3. In the brain, synchronized Pbr(O2) oscillations [0.6 (0.4) kPa, phase(PaO2-PbrO2) 90 (39)degrees], Sapitinib in vitro Sbr(O2) oscillations [4.1 (1.5)%, phase(PaO2-SbrO2) 182 (54)degrees], and CBF oscillations [198 (176) AU, phase(PaO2-CBF) 201 (63)degrees] occurred that were dependent on Pa-O2 and SAP oscillations.\n\nConclusions. Pa-O2 oscillations caused by cyclic R/D are transmitted

to the cerebral microcirculation in a porcine model of ALI. These cyclic oxygen alterations could play a role in the crosstalk of acute lung and brain injury.”
“As patients near the end of life, bereaved family members provide an important source of evaluation of the care they receive. A study was conducted to identify which processes of care were associated with greater satisfaction with hospice services from the perception of bereaved family members. A total of 116,974 surveys from 819 hospices JQ-EZ-05 solubility dmso in the United States were obtained via the 2005 Family Evaluation of Hospice Care, an online repository of surveys of bereaved family members’ perceptions of the quality of hospice care maintained by the National Hospice and Palliative Care Organization. Overall satisfaction was dichotomized as “excellent” vs. “other” (very good, good, fair, and poor). Using multivariate logistic regression, the association between overall satisfaction and the individual item problem scores that compose the Family Evaluation of Hospice Care were examined.

Immunohistochemical analysis of DLC1 expression was carried out i

Immunohistochemical analysis of DLC1 expression was carried out in oral squamous cell carcinoma patients (n=214), dysplasia (n=51), hyperplastic squamous mucosa (n=45), and histologically normal oral LY2606368 inhibitor tissues (n=80), and correlated with clinicopathological parameters and disease prognosis over 91 months for oral squamous cell carcinomas. Loss of DLC1 expression was observed in oral squamous cell carcinoma (64%), oral dysplasia (31%), hyperplastic squamous mucosa (22%), and normal mucosa

(16%). Significant loss of DLC1 expression was observed in oral squamous cell carcinomas as compared with dysplasia (P<0.001, odds ratio=3.8, 95% CI=2.0-7.3), suggesting it may be an important event involved in cancer progression. Among oral squamous cell carcinomas, the loss of DLC1 expression was significantly associated with poor prognosis (P=0.021, LY3023414 in vivo hazards ratio (HR)=1.8, 95% CI=1.1-2.9). Multivariate analysis revealed loss of DLC1 (P=0.023, HR=2.1, 95% CI=1.2-3.9) and histopathological grade (P=0.015, HR=1.7, 95% CI=1.1-2.7) to be independent predictors for disease-free survival in oral squamous cell carcinoma patients in comparison with known prognostic factors,

viz, tumor stage, nodal status, and overall stage. Loss of DLC1 expression emerged as an important biomarker for predicting patients diagnosed with oral dysplasia at high risk of transformation upon future validation in longitudinal studies. Loss of DLC1 expression is a poor prognostic marker for oral OSI-906 datasheet squamous cell carcinoma patients.

Modern Pathology (2012) 25, 14-25; doi:10.1038/modpathol.2011.145; published online 14 October 2011″
“Background. The number of adolescent and adult patients with congenital heart disease undergoing heart transplantation is increasing. We aimed to better define the characteristics of these patients and their survival after transplantation.\n\nMethods. We describe a group of patients with end-stage heart failure owing to congenital heart disease undergoing heart transplantation at a single tertiary center and compare their short- and long-term survival with a group of matched controls with dilated cardiomyopathy and the entire cohort of transplanted patients at our center.\n\nResults. Between 1985 and 2006, a total of 322 orthotopic heart transplantations were performed at our center. Thirteen patients (mean age, 27.5 years) had a diagnosis of congenital heart disease with a wide spectrum of lesions. The survival of these 13 patients was 85% at 30 days, 1, 5, and 10 years and 77% at 20 years, which did not differ significantly to the short- and long-term survival of the entire cohort of patients with heart transplantation and to the survival of age-matched controls with dilated cardiomyopathy.\n\nConclusion.

We deem that the main pathophsyologic mechanism underlining this

We deem that the main pathophsyologic mechanism underlining this phenomenon is a gradual and irreversible decline in spinal function related to those hemodynamic modifications induced by the fistula and to the persistence

of a state of anatomofunctional deficiency of the spinal venous drainage. (C) 2009 Elsevier Inc. All rights reserved.”
“Corals rely on stored energy reserves (i.e., lipids, carbohydrates, and protein) to survive bleaching events. To better understand the physiological implications BMS-345541 of coral bleaching on lipid catabolism and/or synthesis, we measured the delta C-13 of coral total lipids (delta C-13(TL)) in experimentally bleached (treatment) and non-bleached (control) Porites compressa and Montipora

capitata corals immediately after bleaching and after 1.5 and 4 months of recovery on the reef. Overall delta C-13(TL) values in treatment corals were significantly lower than in control corals because of a 1.9 and 3.4aEuro AZD0530 degrees decrease in delta C-13(TL) immediately after bleaching in P. compressa and M. capitata, respectively. The decrease in delta C-13(TL) coincided with decreases in total lipid concentration, indicating that corals catabolized delta C-13-enriched lipids. Since storage lipids are primarily depleted during bleaching, we hypothesize that they are isotopically enriched relative to other lipid classes. This work further helps clarify our understanding of changes to coral metabolism and biogeochemistry when bleached and helps elucidate how lipid classes may influence recovery from bleaching and ultimately coral survival.”
“Hedgehog (Hh) signaling is essential for normal growth, patterning, and homeostasis of many tissues in diverse check details organisms, and is misregulated in a variety of diseases including cancer. Cytoplasmic Hedgehog signaling is activated by multisite phosphorylation of the seven-pass transmembrane protein Smoothened (Smo) in its cytoplasmic C-terminus. Aside from a short membrane-proximal stretch, the sequence of the C-terminus

is highly divergent in different phyla, and the evidence suggests that the precise mechanism of Smo activation and transduction of the signal to downstream effectors also differs. To clarify the conserved role of G-protein-coupled receptor kinases (GRKs) in Smo regulation, we mapped four clusters of phosphorylation sites in the membrane-proximal C-terminus of Drosophila Smo that are phosphorylated by Gprk2, one of the two fly GRKs. Phosphorylation at these sites enhances Smo dimerization and increases but is not essential for Smo activity. Three of these clusters overlap with regulatory phosphorylation sites in mouse Smo and are highly conserved throughout the bilaterian lineages, suggesting that they serve a common function.

The most effective modification

The most effective modification CAL-101 concentration of VMPP was initial position of fingers 12 cm apart (x=+/- 6) on the x-axis, 2 cm anteriorly from the posterior fourchette (y=+2) on the

y-axis with 1cm movement of both finger and thumb toward the midline on the x-axis (Delta x=1) with no movement on the y-axis (Delta y=0). Conclusions In a biomechanical assessment with simulation of vaginal delivery, exact placement of fingertips on the perineal skin, together with their co-ordinated movement, plays an important role in the extent of reduction of perineal tension.”
“STAR/StarD1, part of a protein complex, mediates the transport of cholesterol from the outer to inner mitochondrial membrane, which is the rate-limiting step for steroidogenesis, and where steroid hormone synthesis begins. Herein, we examined the role of oxidant-sensitive p38 MAPKs in the regulation of STAR gene transcription, using model steroidogenic cell lines. Our data

indicate that oxidant activation of p38 MAPK exhibits a negative regulatory role in the induction of functional expression of STAR, as evidenced by enhanced induction of STAR (mRNA/protein) expression and increased steroidogenesis during pharmacological VX-680 inhibition of p38 MAPK or in cells with increased transient overexpression of a dominant-negative (dn) form of p38 MAPK alpha or p38 MAPK beta. Studies with rat Star-promoter demonstrated that overexpression of p38 MAPK alpha-wt, -beta, or -gamma significantly reduced both basal and cAMP-sensitive promoter activity. In contrast, overexpression of p38 MAPK alpha-dn, -beta, or -gamma enhanced the Star promoter activity under basal conditions and in response to cAMP stimulation. Use of various constitutively active and dn constructs and designer knock-out cell lines demonstrated

that MKK3 and MKK6, the upstream activators of p38 MAPKs, play a role in p38 MAPK alpha-mediated inhibition of Star promoter activity. In addition, our studies raised the possibility of CREB being a potential target of the p38 MAPK inhibitory effect on Star promoter activity. Collectively, these data provide novel mechanistic information about how oxidant-sensitive p38 MAPKs, particularly Citarinostat datasheet p38 MAPK alpha, contribute to the negative regulation of Star gene expression and inhibit steroidogenesis.”
“MicroRNAs (miRNAs) are small endogenous RNAs of similar to 22 nucleotides that have been shown to play regulatory role by negatively affecting the expression of genes at the post-transcriptional level. Information of miRNAs on some important crops like soybean, Arabidopsis, and rice, etc. are available, but no study on heat-responsive novel miRNAs has yet been reported in wheat (Triticum aestivum L.).

Spectra were compared to the reference spectrum of bone via corre

Spectra were compared to the reference spectrum of bone via correlation Selleck 5-Fluoracil analysis. Our measurements

show a clear differentiation between the plasma spectra when cutting either a bone or a soft tissue. The spectral changes could be detected from one to the next spectrum within 200 ms. Continuous surveillance of plasma spectra allows us to differentiate whether bone or soft tissue is hit by the last laser pulse. With this information, it may be possible to stop the laser when cutting undesired soft tissue and to design an automatic control of the ablation process.”
“Purpose of review\n\nRandomized controlled trials have established that prophylactic implantable cardioverter defibrillator (ICD) therapy improves survival in patients with reduced left ventricular ejection fraction (LVEF). However, mortality

reduction is not uniform across the implanted population and recent data have highlighted the importance of nonsudden cardiac death (non-SCD) risk in predicting benefit from ICD therapy. This review explores the importance of non-SCD risk in patient selection for prophylactic ICD therapy, as well as the proposed approaches to identify potential ICD recipients at high risk of non-SCD.\n\nRecent findings\n\nData from randomized controlled trials have demonstrated that patients at high risk of non-SCD do not gain significant survival benefit from prophylactic ICD therapy irrespective of their risk of SCD. A variety of strategies to identify low LVEF patients at high risk of non-SCD have been proposed. These include the use of individual risk markers, such as advanced

Selleckchem LB-100 age and renal dysfunction, the presence of cardiac and noncardiac comorbidities, and the use of more complex Tozasertib datasheet risk scores.\n\nSummary\n\nNon-SCD risk is an important issue in patient selection for prophylactic ICD therapy. However, the optimal strategy to identify patients at high non-SCD risk is unclear and further research is needed.”
“The incidence of acute nonvariceal massive gastrointestinal bleeding (GIB) is higher in hemodialysis (HD) patients than in healthy individuals, and this is often a life-threatening event. We evaluated the efficacy of intra-arterial treatment for GIB in HD patients. Between January 2006 and June 2012, eight HD patients with GIB were treated with superselective transarterial embolization. Of the eight cases, one was duodenal bleeding, two were jejunal bleeding, one was ileocecum bleeding, two were ascending colonic bleeding, and two were sigmoid colonic bleeding. After examining the site of bleeding by endoscopy or contrast-enhanced computed tomography (CT), embolizations with microcoils, gelatin sponges, or N-butyl cyanoacrylate were performed through interventional radiology (IVR). In all cases, blood transfusions were frequently administered. Six of the eight patients with GIB were successfully salvaged by transarterial embolization.