9, 20, 25 It has been shown that TLR4-stimulated IFN-β production

9, 20, 25 It has been shown that TLR4-stimulated IFN-β production, unlike other proinflammatory genes, is negatively regulated by Gsk3β.19 We demonstrate that although CXCL10 expression by BMM was not altered by SB216763 at early timepoints, it was down-regulated later on as compared with controls. Thus, although CXCL10 induction by TLR4 signaling is not directly down-regulated by Gsk3 inhibition, it can be suppressed by IL-10, which is readily up-regulated by SB216763. The phosphorylation of Gsk3β downstream

of TLR4 learn more is mediated by the PI3 kinase-Akt pathway.12, 33 Indeed, it is known that PI3K/Akt activation protects hearts and brains from IRI pathology.34-37 Our findings imply that PI3 kinase activation was responsible for Gsk3β phosphorylation in IR-livers, and that PI3 kinase-Gsk3β signaling was

a self-regulatory mechanism preventing the excessive IR-hepatocellular damage. It is interesting to note that PI3 kinase inhibition by wortmannin exerted the most profound effect when liver IRI was relatively mild, i.e., induced by 60 minutes rather than by 90 minutes of warm ischemia. This indicates the functional limit of liver self-protective mechanisms that fails after the extended warm ischemia Neratinib research buy time. Gsk3 inhibition protected livers despite PI3 kinase inhibition, confirming the functional relationship between the two kinases in IRI regulatory pathways. As PI3 kinase is upstream of Gsk3β, targeting the latter may have certain advantages as compared

with that of PI3 kinase in terms of both specificity and limited toxicity. Importantly, several potent and specific Gsk3β small molecule inhibitors have been recently tested in preclinical diabetic and Alzheimer’s disease models.13, 33 In summary, Gsk3β inhibition represents a potent and safe strategy to ameliorate liver IRI pathology. This approach click here may provide not only the direct cytoprotection means against stress-induced cell death, but also exert immune modulation to reduce local inflammation. Further preclinical studies with Gsk3β chemical inhibitors are warranted to pave the way for the development of a clinically applicable therapeutic strategy against organ IRI. “
“Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhosis, liver failure, and complicated hepatocellular carcinoma. In addition, NAFLD is a risk factor for the development of other serious diseases, such as diabetes or cardiovascular disease. Therefore, the detection of early-stage NAFLD is important. Many studies have described the factors that predict the presence of NAFLD and its onset, and several markers have been identified. These markers have enabled the identification of high-risk patients and have improved routine medical practice. To prevent advanced disease, clinicians need to have simple markers that predict the onset of NAFLD so that interventions can be started at much earlier stages of disease.

On a small number of occasions, we observed some bleeding around

On a small number of occasions, we observed some bleeding around the dart wound. However, biopsy darts should cause less injury than immobilization darts, particularly rapid injection darts (Cattet et al. 2006). On average, biopsy darting took <7 min per bear, which is a considerable reduction in time spent disturbing animals compared to immobilization. Although it is possible to biopsy dart dependent cubs, we did not in this study because

of the challenges involved in keeping family groups together during darting runs. During capture of polar bears, mothers are typically sedated first and the dependent cubs typically stay near the sedated mother. Since there is no sedation involved in biopsy darting there is an increased risk of separation while attempting to sample dependent cubs. Remote biopsy darting provides an additional Quizartinib cell line tool or an alternative to capturing polar bears and other wildlife, for the purpose Napabucasin of individual and sex identification and diet analysis. Although biopsy darting does not provide the detailed health and physiological information that can be attained

through capture, it is less invasive than immobilization and handling and may be more acceptable to local people who live in proximity to polar bears. Finally, biopsy darting can be used without the extensive equipment required for capture-based studies, and in some areas could be conducted on the ground with snowmachines to monitor remote subpopulations of polar bears that have limited research access

(Vongraven et al. 2012). The type of biopsy dart to use will depend on the type of habitat and season of the study. We thank K. Simac, P. Hessing, M. St. Martin, G. Durner, and M. Lockhart for field and logistical support. We also thank T. and P. Austin with Paxarms N.Z., Ltd. and T. Taylor with Palmer Cap-Chur Equipment, Inc. for their help in developing these biopsy darts. We thank S. Iverson (Dalhousie Non-specific serine/threonine protein kinase University) for support with the lipid and fatty acid analysis. We thank L. Pagano for creating dart images and S. Bee for help testing dyes. The U.S. Geological Survey (USGS) Ecosystem Mission’s Changing Arctic Ecosystems Initiative, USGS’ Climate and Land Use Change Research and Development Program, and the Bureau of Ocean Energy Management provided funding for biopsy darting field efforts, genetic, lipid, and fatty acid analyses. Biopsy darting of polar bears was made possible under U.S. Fish and Wildlife marine mammal research permit 690038 granted to the USGS, Alaska Science Center. Biopsy darting procedures were conducted under the approval of the Alaska Science Center Institutional Animal Care and Use Committee (IACUC) protocols (assurance no. 2010-14). We thank the U.

It is noteworthy that the S ORF is overlapped

with polyme

It is noteworthy that the S ORF is overlapped

with polymerase ORF in the HBV genome.3 Assuming the deletion of sW74* from nucleotide 1284-1744 (W64 to the end of S ORF), this deletion mutant also destroys amino acids 429-581 of polymerase, an important part of the reverse-transcriptase domain. This viral strain is therefore supposed to not replicate by itself. Virologically, other viral strains with competent replication must become the major strain. However, the results derived from the cloning and pyrosequencing check details failed to confirm this inference. In other words, if the pyrosequencing results are correct, the viral strain is supposed to not replicate profoundly, and this patient is unlikely to have such a high viral load. On the contrary, if the pyrosequencing results are not valid, the authors need to document the existence of other competent viral strains and prove that the HBsAg produced by this viral strain could Pifithrin-�� chemical structure not be detected by common HBsAg antibody. Taken together, these observations suggest that the peginterferon-related HBsAg loss reported by Hsu and Yeh may not be attributed to these viral mutants, but may instead be caused by certain epigenetic

or genetic modifications in hepatocytes that are driven by host immunity. These mutant strains are merely the products selected by host immune pressure. In conclusion, HBsAg loss after peginterferon therapy cannot be convincingly explained by these viral mutants. Further studies are required to examine the underlying mechanisms involved in peginterferon-induced HBsAg loss. Tai-Chung Tseng M.D.* ‡, Jia-Horng Kao Ph.D.† ‡, * Division of Hepatogastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan, † Division of Gastroenterology, Department of Internal Medicine, ‡ Graduate Institute of Clinical Medicine, National Taiwan University College

of Medicine and National Taiwan University Hospital, Taipei, Taiwan. “
“This chapter discusses the background, prevention, Dimethyl sulfoxide diagnosis, treatment and prognosis of Budd-Chiari syndrome (BCS). The most common causes of BCS are myeloproliferative disorders leading to a hypercoagulable predisposition. The key to prevention of the progression of disease is early identification and intervention with decompression/thrombolysis when the presentation is acute, and the initiation of anticoagulation in the subacute/chronic forms before the development of complications of portal hypertension. The diagnosis and clinical presentation will vary depending upon whether the thrombosis is acute or chronic. The medical management of BCS depends upon early diagnosis and treatment. If the patient already has end-stage cirrhosis with multiple complications of portal hypertension, the disease may be too advanced for anti-coagulation/decompression to change prognosis, and referral for liver transplantation is preferred.

F vesiculosus responded quickly to rapid shifts in irradiance re

F. vesiculosus responded quickly to rapid shifts in irradiance resulting in a highly dynamic microenvironment around and within its thallus. In combination with detailed morphological studies and molecular

approaches, microsensors offer a promising toolbox to quantitatively describe structural and functional adaptations of macroalgae to environmental conditions, such as flow and light climate, as well as their physiological responses to environmental stressors. GSK-3 activity
“An equation for the rate of photosynthesis as a function of irradiance introduced by T. T. Bannister included an empirical parameter b to account for observed variations in curvature between the initial slope and the maximum rate of photosynthesis. Yet researchers have generally favored

equations with fixed curvature, possibly because b was viewed as having no physiological meaning. We developed an analytic photosynthesis-irradiance equation relating variations in curvature to changes in the degree of connectivity between photosystems, and also considered a recently published alternative, based on changes in the size of the plastoquinone pool. When fitted to a set of 185 observed photosynthesis-irradiance curves, it was found that the Bannister equation provided the best fit more frequently compared to either of the analytic equations. While Bannister’s curvature parameter Ridaforolimus in vivo engendered negligible improvement in the statistical fit to the study data, we argued that the parameter is nevertheless quite useful because it allows for consistent estimates of initial slope and saturation irradiance for observations exhibiting a range of curvatures, which would otherwise have to be fitted to different fixed-curvature equations. Using theoretical models, we also found that intra- and intercellular self-shading can result in biased estimates of both curvature

and the saturation irradiance parameter. We concluded that Bannister’s is the best currently available equation accounting for variations in curvature precisely because it Amylase does not assign inappropriate physiological meaning to its curvature parameter, and we proposed that b should be thought of as the expression of the integration of all factors impacting curvature. “
“Dinoflagellates are the most abundant protists that produce bioluminescence. Currently, there is an incomplete knowledge of the identity of bioluminescent species arising from inter- and intraspecific variability in bioluminescence properties. In this study, PCR primers were designed to amplify the dinoflagellate luciferase gene (lcf) from genetically distant bioluminescent species. One of the primer pairs was “universal,” whereas others amplified longer gene sequences from subsets of taxa.

Interim data on 39 PUPs treated for bleeding, prophylactically an

Interim data on 39 PUPs treated for bleeding, prophylactically and for surgical coverage are reported. Two of 39 subjects (5.1%) developed clinically relevant inhibitor titres over the course of the study. Another H 89 two displayed inhibitors that disappeared spontaneously without Octanate® dose change. All inhibitors developed under on-demand treatment and before exposure day (ED) 50. Remarkably, no inhibitor was observed in PUPs receiving prophylaxis with Octanate®. Of 39 subjects,

30 had exceeded 50 EDs at the time of this analysis. All inhibitor subjects were found to have large FVIII gene defects, either intron 22-inversions or large deletions. Octanate® was well-tolerated and the adverse event profile was consistent with the population studied. The haemostatic efficacy of Octanate® in prophylaxis and treatment of bleeding were generally rated as ‘excellent’, and no complication was reported for surgery. Notable FVIII activity was present in blood at 15 min postadministration, Small molecule library in vivo and levels remained high at 1 h. Mean incremental in vivo recovery (IVR) was 2.0 (±0.6) % IU−1kg−1. These interim results indicate Octanate® to be an efficacious, well-tolerated human FVIII product for management of HA in PUPs, associated with a minimal

risk of inhibitors. “
“Lymphomas or hepatocarcinomas related to blood-borne transmitted diseases are well-known malignancies in persons with haemophilia (PWH). However, rising life expectancy has increased the number of PWH suffering from other malignancies. This study aimed to collect cancer occurrence data in PWH followed in five European haemophilia treatment centres (Brussels, Fossariinae Geneva, Marseille, Montpellier and Paris-Bicêtre) over the last 10 years and to analyse some particular features of cancer occurring in PWH. In total, 45 malignancies were diagnosed in 1067 PWH. The most common malignancies were hepatocellular carcinoma (12/45) and urogenital tract tumours (9/45). Bleeding at presentation or changes in bleeding pattern was indicative of cancer in four patients. Three patients with mild haemophilia developed anti-factor VIII inhibitors after intensive substitution

therapy prior to surgery or invasive procedures. There was no bleeding associated with chemotherapy or radiotherapy. A few bleeding complications occurred following invasive (3/39) or surgical procedures (2/27) as a result of insufficient hemostatic coverage or in spite of adequate substitution. No bleeding was noted after liver or prostate biopsies. Following cancer diagnosis, five patients were switched from on-demand to prolonged prophylaxis substitution. In the majority of cases, the standard cancer treatment protocol was not modified on account of concomitant haemophilia. Thus, oncological treatments are not contraindicated and should not be withheld in PWH assuming that adequate haemostasis correction is undertaken.

Results: The eradication rate of moxifloxacin based triple therap

Results: The eradication rate of moxifloxacin based triple therapy

was 61.7%(95% CI 56.1–67.0) by ITT, and 73.6%(95% CI 67.8–78.6) by PP. ITT Neratinib manufacturer and PT according to first regimen were 63.5/77.0%(95% CI 56.4–70.2/69.6–82.9) in standard triple group, 62/69.2%(95% CI 44.0–77.3/50.0–83.5) in bisthmus containing quadruple group, 56.4/66.7%(95% CI 40.9–70.7/49.6–80.2) in concomitant group and 58.6/69.2%(95% CI 44.3–71.7/53.5–81.4) in sequential group. There was no significant difference between groups (p = 0.504). Conclusion: Two-week moxifloxacin based triple therapy as second line did not show expected level for the primary outcome. The group treated with moxifloxacin after failure of standard triple therapy had highest rate of eradication, but there was no statistical significance in the efficacy among the first line regimens. Key Word(s): 1. Helicobacter pylori; 2. Erradication rate; 3. Moxifloxacin; 4. second line; Presenting Author: TIANTIAN SUN Additional Authors: HSP assay WAN DU, JIE HONG, JINGYUAN FANG Corresponding Author: JIE HONG, JINGYUAN FANG Affiliations: Shanghai Jiaotong University School of Medicine Renji Hospital Objective: TMEFF2 desregulation is related to tumorigenesis. However, little is known about its regulations and functions in the H.pylori-associated gastric cancer. Here we investigate its biological

roles and bidirectional regulation between TMEFF2 and STAT3 in H.pylori -induced gastric carcinogenesis. Methods: Gene expression profiling Selleck Fludarabine studies were done to identify pivotal genes regulated by H.pylori and TMEFF2 was discovered. TMEFF2 expression in human gastric mucosas and gastric cancer tissues was examined by immunohistochemistry. Biological functions of this gene on tumor growth

were detected in vivo and vitro. Role of STAT3 in modulating TMEFF2 expression was examined by chromatin immunoprecipitation assay and luciferase assay, while the effects of TMEFF2 on STAT3 was detected by GST pull-down and co-immunoprecipitation. Results: We found that H.pylori infection activated STAT3 signaling and reduced STAT3-dependent TMEFF2 expression in vivo and vitro. STAT3 regulated the expression of TMEFF2 by binding to its promoter and decreased its transcription. Conversely, TMEFF2 appeared to modulate the phosphorylation of STAT3 by its intracellular domain binding to the SH2 domain of SHP-1, which may negatively regulate the activation of STAT3. Conclusion: TMEFF2 plays important roles in H.pylori induced gastric cancer and displayed predictive value for the aggressiveness of gastric cancer. The negative feedback loop between STAT3 and TMEFF2 may contribute to H.pylori-associated human gastric tumorigenesis. Key Word(s): 1. TMEFF2; 2. gastric cancer; 3. H.

2005) Species richness (S) describes the number of species in th

2005). Species richness (S) describes the number of species in the assemblage, while evenness took into account the variation in the abundance of individuals per species in the assemblage. Species evenness was calculated using the Pielou’s evenness index (J’). We fitted two linear models to each of the biological responses examined. One had presence/absence (P/A) of S. muticum selleck kinase inhibitor and species richness as predictors, and the second model had P/A of S. muticum and species evenness as predictors. Additionally, we re-analyzed respiration and alpha data after normalizing values per assemblage biomass, in order to consider the efficiency of the assemblages. All the models analyzed main and interactive

effects of the predictive variables. When interaction terms were nonsignificant, models were re-run without the interaction. In order to obtain the minimum adequate model, nonsignificant main effects were also removed from the model and thus only significant effects

are shown in the correspondent table. However, for a better understanding, we distinguished between native and invaded assemblages in all the figures, even when the factor native versus invaded assemblages was nonsignificant. The coefficient of variation (CV) in an assemblage’s light-use efficiency, alpha, was quantified for native and invaded assemblages in May (i.e., the period of high biomass of the invader). CV was calculated see more as the ratio of the standard deviation to the mean (CV = σ/μ) and was used as a measure of spatial variation. General linear models were carried out using the linear model function (lm) in the R-program 2.15.0 (R Development Core Team 2012). In November 2010, we were only able to locate 37 macroalgal assemblage plates. These were Etofibrate collected from the intertidal pool to perform laboratory incubations and re-deployed

in the shore. In May 2011, we were able to locate 55 macroalgal assemblages. Algal assemblages varied in species richness, total biomass, and biomass of the invader. The presence of S. muticum did not affect the relationship between species richness and any biological response measured (F3,33 = 1.27, P = 0.30, R2 = 0.10). Moreover, no significant relationship was found between any biological response measured and species richness (see Table S1 in the Supporting Information). However, when species evenness was considered as the predictor variable, both respiration and alpha response functions showed a significant negative relationship (F1,35 = 5.61, P = 0.02, R2 = 0.14, and F1,35 = 14.00, P = 0.001, R2 = 0.28, respectively; Fig. 1). In addition, the presence of S. muticum did not affect any of the macroalgal biological responses measured (see Table S1 in the Supporting Information). In May 2011, the biomass of the invader ranged between 0 and 163.38 g DW (3.58 ± 2.91 g DW) per 64 cm2. Moreover, biomass of Corallina spp., S. muticum and C.

A univariate analysis showed that a lower ADC value (P = 0005) a

A univariate analysis showed that a lower ADC value (P = 0.005) and irregular circumferential enhancement (P = 0.020) showed statistically significant associations with MVI. A multiple logistic regression analysis showed that the ADC value and irregular circumferential KU-57788 cell line enhancement were independent predictors of MVI. With a cut-off of 1.227 × 10−3 mm2/s, the ADC value provided

a sensitivity of 66.7% and a specificity of 78.6% in the prediction of MVI with an odds ratio of 7.63 (P < 0.01). Lower ADC values (< 1.227 × 10−3 mm2/s) on DWI with b-value of 0.500 s/mm2 can be a useful preoperative predictor of MVI for small HCCs. "
“To evaluate the efficacy of a new ablation procedure for the stepwise hook extension technique using a SuperSlim needle for radiofrequency ablation (RFA) treatment of hepatocellular carcinoma (HCC), a randomized controlled trial was performed. Thirty patients with HCC measuring 20 mm or less were randomly treated with a conventional four stepwise expansion technique (group 1) and the new stepwise expansion technique (group 2; the electrode was closed in the shaft after the same three steps of the conventional procedure

and then fully extended). All find more patients underwent the RFA procedure using a 10-hook expandable electrode of 17-G diameter (LeVeen SuperSlim 30 mm). We compared the ablation time, required energy and ablated lesions in the two groups. The long and short diameters of RFA-induced necrosis were significantly larger in group 2 (37 and 28 mm) than group 1 (30 and 26 mm, P = 0.001 and =0.045, respectively). Irregular and small needle expansion resulting in the parachute-like or irregularly shaped ablated zone was observed in more cases in group 1 than in group 2. The new technique made all tines expand uniformly and largely, which produced a near-oval ablated zone of which the long axis is perpendicular Racecadotril to the needle shaft. The two kinds of stepwise procedures allow the selection of a more suitable procedure according to the tumor size and shape in each RFA. “
“We aimed to evaluate whether

acute esophageal instillation of capsaicin and hydrochloric acid had different effects on distension-induced secondary peristalsis. Secondary peristalsis was induced by slow and rapid air injections into the mid-esophagus after the evaluation of baseline motility in 16 healthy subjects. The effects on secondary peristalsis were determined by esophageal instillation with capsaicin-containing red pepper sauce (pure capsaicin, 0.84 mg) and hydrochloric acid (0.1 N). The administration of capsaicin induced a significant increase in the visual analogue scale score for heartburn as compared with hydrochloric acid (P = 0.002). The threshold volume for generating secondary peristalsis during slow and rapid air distensions did not differ between capsaicin and hydrochloric acid infusions.

Beads were washed with PBS, 20 mL of 2× sample buffer was added p

Beads were washed with PBS, 20 mL of 2× sample buffer was added per sample, and an immunoblot with α-KLF6 (sc7158) was performed. RNA was collected, reverse transcribed, and amplified as described.23 The following primers were selleck chemicals used: mCyclophillin F/R (CAGACGCCACTGTCGCTTT/TGTCTTTGGAACTTTGTCTGCAA), hKLF6 F/R (CGGACGCACACAGGAGAAAA/CGGTGTGCTTT CGGAAGTG), SV1 F/R (CCTCGCCAGGGAAGG AGAA/CGGTGTGCTTTCGGAAGTG). Cycloheximide (10 mg/mL) was added 24 hours after cotransfection and protein collected at 0, 15, 30, and 60 minutes. MG132 (Sigma C2211) was added

(5 mM) 4 hours prior to adding cycloheximide. Cotransfection of p21 luciferase and Renilla plasmids was performed as described.5 Cells were washed with PBS twice and 30 mL of Lysis Buffer (Promega passive Lysis Buffer 5x, #E194A) was added per well. Data are expressed as mean ± standard error of the mean (SEM) or standard deviation (SD). Student’s t test, analysis of variance (ANOVA), Mann-Whitney, and chi-square (3-way contingency table) were calculated to compare experimental groups. Differences were considered statistically GW-572016 supplier significant if P

< 0.05. Analyses were conducted using R statistical package and SPSS software (v. 14) for the human data,2 and GraphPad prism for the remaining data. The SV1/KLF6 mRNA splicing ratio is increased in 18% of HBV-associated10 and 0%-76% of HCV-positive10, 16 HCCs. Here we analyzed the SV1/KLF6 mRNA splicing ratio in liver tissues from 149 HCV-positive patients with progressive stages of HCV-associated liver disease.2 The splicing ratio was significantly increased in HCC samples pentoxifylline compared to nontumoral tissues, including normal liver (P = 0.03), cirrhotic liver (P = 0.01), or dysplastic nodules (P < 0.001). In addition, the ratio linearly increased with progressive stages of HCC (P < 0.001) (Fig.

1A). This finding raised the possibility that increased KLF6 splicing might contribute to tumor behavior or clinical outcomes. We examined whether the SV1/KLF6 mRNA ratio was correlated with features of more advanced disease. Accordingly, we correlated SV1/KLF6 mRNA ratio with clinical and pathological variables in a subset of 55 HCCs from whom these data were available. Increased SV1/KLF6 ratio was significantly associated with larger tumors (P = 0.04) and vascular invasion (P = 0.01) (Fig. 1B). The KLF6 splicing ratio was not correlated with survival, however (data not shown). These findings are consistent with earlier reports in prostate, lung,21 ovarian,20 and pancreatic19 cancers, where SV1 has been correlated with more aggressive disease. To clarify the role of an increased KLF6 splicing ratio in hepatocarcinogenesis, we generated mice with different SV1/KLF6 ratios by first crossing double floxed Klf6 mice (Klf6fl(+/+)) with albumin-Cre transgenic animals (AlbCre).

53,54 By comparison, gastric regurgitation episodes in individual

53,54 By comparison, gastric regurgitation episodes in individuals suffering from reflux esophagitis have been noted to occur more frequently during non-REM sleep.55 Given the physiology of both sleep bruxism and GERD, it is possible that these conditions may occur concurrently in some individuals. Randomized clinical buy Adriamycin trials have established a highly significant relationship between sleep bruxism and experimental intraesophageal acidification,56 and between sleep bruxism and

physiologic gastroesophageal reflux episodes.57 However, we are unaware of any sleep studies that have investigated associations between sleep bruxism and GERD. The current understanding of this relationship RG-7388 clinical trial has been extrapolated from the findings of a few case reports and observational

epidemiological studies reporting the association between GERD and tooth wear.27 Clinically, it is not unusual for patients with a history of both sleep bruxism and GERD to present with advanced tooth wear, which requires extensive treatment.58 Experimental findings support these observations and indicate that tooth wear under simulated bruxism and gastric acid conditions can occur at an alarming rate.59 While these findings point to the need for early preventive strategies, further research is also required to gain an insight into the relationships between GERD, various oromotor movements, and salivary gland secretions during the different stages of sleep. Earlier studies of persons with and without GERD reported an absence of significant differences in stimulated

Fossariinae salivary flow rates,35,60,61 buffering capacities and pH values.35,60 However, more recent studies have found a significant association between GERD, hyposalivation and the subjective sensation of “dry mouth” (xerostomia), which is frequently associated with an oral burning sensation.28,62 Though mixed saliva secretions consist of more than 99% water, numerous other variable and complex interacting components also are responsible for the normal functioning and protection of the oropharynx and esophagus. Saliva coats all of the relevant internal anatomical surfaces with mucin-rich secretions, providing a protective diffusion barrier or pellicle against mechanical, thermal, chemical and microbial damage. Saliva also lubricates these surfaces to allow efficient mastication, swallowing and speech. In response to various stimuli, a rapid increase in parotid gland serous secretions containing a high concentration of bicarbonate ions in particular dilutes, neutralizes and clears harmful oral material and acidic esophageal contents by either spitting, or swallowing to induce esophageal peristalsis.