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Sample records for acute leukemic appendicitis

  1. Acute leukemic appendicitis in a patient with acute promyelocytic leukemia

    Directory of Open Access Journals (Sweden)

    Hatim Karachiwala

    2012-01-01

    Full Text Available Leukemic and lymphomatous infiltration of the appendix is a rare complication. We present the case of a 31-year-old male with acute promyelocytic leukemia who developed acute abdomen on day 11 of induction chemotherapy with idarubicin and cytarabine. After appropriate work-up, a clinical diagnosis of acute appendicitis was made. Despite severe pancytopenia, he successfully underwent laparoscopic appendectomy. The final pathology revealed leukemic infiltration of the appendix. It is hypothesized that the leukemic infiltration may play a role in the development of acute appendicitis. Further, this case demonstrates the need to maintain a high index of suspicion and prompt surgical intervention for surgical pathologies in neutropenic patients.

  2. Acute myelogenous leukemia and acute leukemic appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Po-Jen Hsiao; Shih-Ming Kuo; Jia-Hong Chen; Hsuen-Fu Lin; Pau-Ling Chu; Shih-Hua Lin; Ching-Liang Ho

    2009-01-01

    Acute myelogenous leukemia (AML) can involve the gastrointestinal tract but rarely involves the appendix.We report a male patient who had 1 year partial remission from AML and who presented with apparent acute appendicitis as the initial manifestation of leukemia relapse. Pathological findings of the appendix revealed transmural infiltrates of myeloblasts, whichindicated a diagnosis of leukemia. Unfortunately, the patient died from progression of the disease on the 19th d after admission. Although leukemic cell infiltration of the appendix is uncommon, patients with leukemia relapse can present with symptoms mimicking acute appendicitis.

  3. Acute Appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Qvist, Niels

    2017-01-01

    BACKGROUND: The classification of acute appendicitis (AA) into various grades is not consistent, partly because it is not clear whether the perioperative or the histological findings should be the foundation of the classification. When comparing results from the literature on the frequency...... patients were included. In 116 (89 %) of these cases, appendicitis was confirmed histological. There was low concordance between the perioperative and histological diagnoses, varying from 16 to 76 % depending on grade of AA. Only 44 % of the patients receiving antibiotics postoperatively had a positive...... peritoneal fluid cultivation. CONCLUSION: There was a low concordance in clinical and histopathological diagnoses of the different grades of appendicitis. Perioperative cultivation of the peritoneal fluid as a standard should be further examined. The potential could be a reduced postoperative antibiotic use...

  4. Acute appendicitis in pregnancy

    OpenAIRE

    Ortiz-Gualdrón César Augusto

    2012-01-01

    Acute appendicitis is the most common non-obstetric surgery pathology in pregnancy, itsincidence can be varied and occurs at a higher rate during the first and second trimesterof gestation. Its diagnosis is difficult and can be confused by the anatomical andphysiological changes during pregnancy, which alter their clinical presentation. Commonsymptoms are abdominal located pain, vomiting and nausea. The diagnosis is mainlyclinical, but laboratory tests and additional imaging help confirm or r...

  5. Challenges in uncomplicated acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Fernando Resende; Ana Beatriz Almeida; Jose Costa Maia; Renato Bessa Melo

    2016-01-01

    Acute appendicitis is one of the most common abdominal emergencies requiring surgery. It still represents, however, a challenging diagnosis. In order to facilitate this process, several scoring systems were developed, namely, the Alvarado score, acute inflammatory response and Raja Isteri Pengiran Anak Saleha Appendicitis scores, which are the most used in clinical practice. This clinical condition encompasses a wide spectrum of clinical presentations, from the uncomplicated form to the one with diffuse peritonitis. Treatment of uncomplicated acute appendicitis remains a matter of discussion. Although appen-dectomy has been regarded as the gold-standard, conservative management with antibi-otics is gaining more and more acceptance. The approach to appendectomy constitutes another controversial issue, namely, its performance through an open or a laparoscopic approach, which seems to be establishing itself, in some centers, as the standard of care. With this paper, we intend to give some insight on the aforementioned topics, through a review of the available literature on uncomplicated appendicitis.

  6. How to diagnose acute appendicitis

    DEFF Research Database (Denmark)

    Mostbeck, Gerhard; Adam, E Jane; Nielsen, Michael Bachmann;

    2016-01-01

    Acute appendicitis (AA) is a common abdominal emergency with a lifetime prevalence of about 7 %. As the clinical diagnosis of AA remains a challenge to emergency physicians and surgeons, imaging modalities have gained major importance in the diagnostic work-up of patients with suspected AA in order...... appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear....

  7. Acute appendicitis in acute leukemia and the potential role of decitabine in the critically ill patient

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    Deepti Warad

    2015-01-01

    Full Text Available Acute appendicitis in children with acute leukemia is uncommon and often recognized late. Immunocompromised host state coupled with the importance of avoiding treatment delays makes management additionally challenging. Leukemic infiltration of the appendix though rare must also be considered. Although successful conservative management has been reported, surgical intervention is required in most cases. We present our experience with acute appendicitis in children with acute leukemia and a case of complete remission of acute myeloid leukemia with a short course of decitabine. Decitabine may serve as bridging therapy in critically ill patients who are unable to undergo intensive chemotherapy.

  8. Abdominal actinomycosis mimicking acute appendicitis.

    Science.gov (United States)

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  9. Sonography in the diagnosis of acute appendicitis

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    Ahmad Ryazi

    2003-09-01

    Full Text Available Graded compressive sonography may be useful as an adjuvant in the diagnosis of acute appendicitis. To determine the role of sonography in the differential diagnosis of acute appendicitis, preappendectomy sonographic data of 164 consecutive cases in Fatemeh-Zahra Teaching Hospital were evaluated. Of 113 (68.9% patients who had acute appendicitis in histopathology, 64 (56.6% cases had preoperative sonographic diagnosis of acute appendicitis. Of 51 patients who had normal appendices, 40 (78.4% cases had normal appendices in sonographic evaluations. Sensitivity, specificity and accuracy of sonography for acute appendicitis were 56.7%, 78.4% and 0.63, respectively. The positive and negative predictive values were 85.3% and 44.49% respectively. As a result, sonographic evaluation is an additional diagnostic tool in acute appendicitis.

  10. Appendiceal endometriosis differentially diagnosed from acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Gastón Astroza; Victor Faundes; René Nanjarí; Marcelo Fleiderman; Carlos Rodriguez

    2010-01-01

    @@ Endometriosis is a common disease in premenopausal women involving pelvic organs specially. However endometriosis that affects the appendix is rarely seen except appendiceal endometriosis that mimics acute appendicitis. In a patient with acute appendicitis we diagnosed and operated on, histopathological examination of the appendix revealed appendiceal endometriosis which caused symptoms.

  11. Simultaneous acute appendicitis with right testicular torsion

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    Tanveer Akhtar

    2012-01-01

    Full Text Available We present a child with both acute appendicitis and torsion of the right testis presenting at the same time. Testicular torsion possibly occurring due to vomiting in acute appendicitis so far has not been reported in the literature.

  12. Acute Appendicitis in Infants. A Case Report

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2013-04-01

    Full Text Available Acute appendicitis is more common in school-age children, but it rarely occurs in infants. The younger the patient, the fastest the course of the disease. In addition, there are greater risks of complications. A case of a nine-month-old infant, admitted to the pediatric hospital with fever and diarrhea, is presented. After several tests, he underwent surgery. Peritonitis caused by acute gangrenous appendicitis was diagnosed. While the patient was in the intensive care unit, he suffered a septic shock and acute multiple organ failure. As a result, he died 24 hours later. The biopsy confirmed the diagnosis of acute gangrenous appendicitis. Acute appendicitis is a disease that must be considered by doctors who treat infants with fever, diarrhea and abdominal pain related to irritability. Thus, an early diagnosis of the disease as well as the implementation of an appropriate surgical treatment can be performed.

  13. A rare presentation of an acute appendicitis

    Science.gov (United States)

    Kordzadeh, Ali; Lorenzi, Bruno; Kalyan, Jiten P.; Hanif, Muhammad A.; Charalabopoulos, Alexandros

    2017-01-01

    Paraumbilical hernia sac usually contains omentum, bowel loop and rarely appendicular epiploicae, metastatic deposits and vermiform appendix. Presentation of acute appendicitis in a paraumbilical hernia is rare and limited to few case reports in the literature. Herein, we would like to report a case of a successfully treated acute appendicitis presenting in a paraumbilical hernia in an 84-year-old lady with 6-month follow-up. PMID:28096326

  14. [Enterobius vermicularis causing symptoms of acute appendicitis].

    Science.gov (United States)

    Antal, András; Kocsis, Béla

    2008-08-01

    The authors present a case of enterobiasis of the appendix. Enterobius infection is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible unless there is a strong clinical suspicion. Parasites may produce symptoms which resemble acute appendicitis. Careful observation of the appendix stump may lead to intraoperative diagnosis of enterobiasis. A quick diagnosis and appropriate treatment may prevent future complications.

  15. Evidence for eosinophil degranulation in acute appendicitis

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    Santosh G

    2008-04-01

    Full Text Available Finding of increased numbers of eosinophils in the muscle in cases of acute appendicitis has led to the hypothesis that it may have an allergic origin. This study aimed to measure the eosinophil degranulation resulting in a rise in the serum of eosinophil granule proteins that would be expected in such cases. The levels of serum eosinophil cationic protein (ECP measured by chemiluminescence assay in acute appendicitis were compared, with those of appropriate controls. Mean (95% CI serum ECP (µg/L levels were: acute appendicitis 45.3 (27.7-63.0; normal appendix 22.7 (16.0-29.3; asthma 24.2 (4.6-43.8; and healthy volunteers 13.2 (8.3-18.1. In cases of acute appendicitis, there is an inverse relationship between duration of symptoms and serum ECP. However, this was not statistically significant. Significant local eosinophil activation and degranulation occurs in acute appendicitis, enough to cause a rise in serum levels of eosinophil chemotactic protein

  16. The value of hyperbilirubinaemia in the diagnosis of acute appendicitis.

    LENUS (Irish Health Repository)

    Emmanuel, Andrew

    2011-04-01

    No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis.

  17. Imaging Acute Appendicitis: State of the Art

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    Diana Gaitini

    2011-01-01

    Full Text Available The goal of this review is to present the state of the art in imaging tests for the diagnosis of acute appendicitis. Relevant publications regarding performance and advantages/disadvantages of imaging modalities for the diagnosis of appendicitis in different clinical situations were reviewed. Articles were extracted from a computerized database (MEDLINE with the following activated limits: Humans, English, core clinical journals, and published in the last five years. Reference lists of relevant studies were checked manually to identify additional, related articles. Ultrasound (US examination should be the first imaging test performed, particularly among the pediatric and young adult populations, who represent the main targets for appendicitis, as well as in pregnant patients. A positive US examination for appendicitis or an alternative diagnosis of possible gastrointestinal or urological origin, or a negative US, either showing a normal appendix or presenting low clinical suspicion of appendicitis, should lead to a final diagnosis. A negative or indeterminate examination with a strong clinical suspicion of appendicitis should be followed by a computed tomography (CT scan or alternatively, a magnetic resonanace imaging (MRI scan in a pregnant patient. A second US examination in a patient with persistent symptoms, especially if the first one was performed by a less experienced imaging professional, is a valid alternative to a CT.

  18. Extraintestinal heterotopic gastric tissue simulating acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Elizabeth Bender; Steven P Schmidt

    2008-01-01

    We describe the case of a 68-year-old otherwise healthy male who presented to our emergency room with signs and symptoms of acute appendicitis. Exploratory surgery revealed a normal appendix. Further examination revealed an enlarged lymph node-like mass of tissue near the appendix, in the ileocecal mesentery. This mass was removed and was found to be inflamed heterotopic gastric tissue. Although reports of heterotopic gastric tissue in the literature are common, we believe that this case represents the first report of inflamed heterotopic gastric tissue simulating appendicitis.

  19. Acute appendicitis in pregnancy: literature review

    Directory of Open Access Journals (Sweden)

    Antônio Henriques de Franca Neto

    2015-04-01

    Full Text Available Introduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms “acute appendicitis” and “pregnancy”, in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases. Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video- assisted surgery in these cases remains controversial.

  20. Can fruit seeds and undigested plant residuals cause acute appendicitis

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    Omer Engin

    2011-04-01

    Conclusions: The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

  1. Acute amebic appendicitis: Report of a rare case

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    Singh Naorem

    2010-10-01

    Full Text Available Acute appendicitis of amebic origin is considered a rare cause of acute appendicitis. We report a case of amebic appendicitis presenting with fever, severe pain in the right lower quadrant of the abdomen and rebound tenderness. Lab investigations revealed neutrophilic leukocytosis. The patient underwent appendectomy. Histopathological examination revealed numerous Entameba histolytica trophozoites in the mucosa of the appendix. Acute appendicitis of amebic origin does not appear frequently. Appendicular amebiasis can give the clinical features of acute appendicitis and should be treated accordingly.

  2. Case Report and Management of Suspected Acute Appendicitis in Pregnancy

    OpenAIRE

    Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan

    2011-01-01

    Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed a...

  3. Gallbladder Volvulus Presenting as Acute Appendicitis

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    Zachary Bauman

    2015-01-01

    Full Text Available We encountered a case of gallbladder volvulus in an 88-year-old thin female in which the initial presentation was more consistent with that of acute appendicitis. After complete work-up, including physical exam, lab work, and computed tomography, the definite diagnosis of gallbladder volvulus was not made until intraoperative visualization was obtained. Gallbladder volvulus is a rare but serious condition, which requires a high clinical suspicion so prompt surgical intervention can be undertaken.

  4. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

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    Talwalkar N

    1994-01-01

    Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

  5. Acute appendicitis in a premature baby

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero; Alberici, Elisa [Department of Radiodiagnosis, Section of Paediatric Radiology, IRCCS Policlinico S. Matteo, Piazzale Golgi 2, 27100 Pavia PV (Italy)

    2002-07-01

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  6. Acute appendicitis in a femoral hernia

    Directory of Open Access Journals (Sweden)

    Zdravković Darko

    2007-01-01

    Full Text Available INTRODUCTION Acute appendicitis in a femoral hernia is an uncommon condition that can be serious. Complications are more frequent if the diagnosis is delayed and surgery is not performed on time. CASE REPORT We present a 71-year-old man with a painful swollen mass. The patient presented with fatigue and loss of appetite, while body temperature was normal. The abdomen was not painful, and peristaltic was normal. All laboratory findings were normal. After anamnesis and physical examination, the presumed diagnosis was incarcerated femoral hernia and the patient was sent to the operating room. Intraoperative findings revealed an incarcerated femoral hernia within a phlegmonous inflammated appendix. Appendectomy and McVay hernioplastics were done. The postoperative course was without complications. CONCLUSION It is very important to bear in mind that right femoral hernia with signs of incarceration and inflammation may contain an acutely inflamed appendix. Delayed diagnosis and misdiagnosis cause greater morbidity and mortality.

  7. Appendicitis

    Science.gov (United States)

    ... function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with ... to pass gas Low fever Not everyone with appendicitis has all these symptoms. Appendicitis is a medical ...

  8. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Emily K Smith; Edmund Ek; Daniel Croagh; Lavinia A Spain; Stephen Farrell

    2009-01-01

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature.

  9. Caecal diverticulitis presenting as acute appendicitis: a case report

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    Ayantunde Abraham A

    2009-07-01

    Full Text Available Abstract Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. Caecal diverticulitis is an infrequent cause of acute abdomen and usually presents in a manner similar to acute appendicitis. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room. The optimal management of this clinical condition is still controversial, ranging from conservative treatment with antibiotics to aggressive surgical resections. We report a case of a 61 year old Caucasian who presented with acute onset right iliac fossa pain indistinguishable from acute appendicitis. The true diagnosis of a perforated acute caecal diverticulitis with an abscess mass was only made at operation in the presence of a macroscopically normal appendix. We reviewed the literature to highlight the difficulty of a preoperative diagnosis and the need for a high index of suspicion especially in the older age group presenting in manner similar to acute appendicitis.

  10. Case report and management of suspected acute appendicitis in pregnancy.

    Science.gov (United States)

    Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan

    2011-02-01

    Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed at length, as well as the finer points in treatment of this population.

  11. No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis

    DEFF Research Database (Denmark)

    Jørgensen, Anders Bech; Amirian, Ilda; Watt, Sara Kehlet;

    2015-01-01

    OBJECTIVE: To examine if there were circadian variations in surgeons' ability to diagnose acute appendicitis. DESIGN: Retrospective database study of all patients admitted to an acute surgical procedure under the potential diagnosis of acute appendicitis in a 4-year period. The day was divided...... patients were included. There were no age limitations or selection in sex. RESULTS: There was no significant difference in the ability to diagnose appendicitis in day-evening hours vs night hours (p = 0.391), nor was any significant difference found on weekdays (Monday-Thursday) vs weekends (Friday...... of imaging had no effect on the ability to diagnose appendicitis. Male sex showed a higher probability of the diagnosis being appendicitis compared with other or no pathology (odds ratio: 3.094; p

  12. Schistosomiasis: A Rare Cause of Acute Appendicitis

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    Faten Limaiem

    2015-06-01

    Full Text Available Schistosomiasis is a water-borne trematode infestation and is one of the most widespread parasitic diseases in the world. Schistosomiasis can affect any organ, but is rare in the appendix. In this paper, the authors report a new case of appendicular schistosomiasis that was incidentally discovered in a 27-year-old male patient from Mali who underwent appendectomy for acute appendicitis. Appendectomy specimens removed from patients with appendicular schistosomiasis often appear macroscopically normal, but histopathological analysis of these cases confirms the diagnosis by revealing schistosomal eggs. The authors strongly recommend that all appendectomy specimens be examined histopathologically regardless of whether the specimens are macroscopically normal. [J Interdiscipl Histopathol 2015; 3(2.000: 78-80

  13. [Change in pancreatic exocrine function in acute appendicitis].

    Science.gov (United States)

    Ivanov, Iu A

    1979-10-01

    In order to study changes in the functional state of the pancreas 1572 investigations of the blood and urine amylase, atoxylresistant lipase of the blood serum before operation were performed in different postoperative periods in 131 patients with acute appendicitis. The enzyme activity was established to increase, especially in destructive forms of appendicitis and in elderly patients.

  14. MRI features associated with acute appendicitis

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    Leeuwenburgh, Marjolein M.N. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology (G1-223.1), Amsterdam (Netherlands); Jensch, Sebastiaan [Sint Lucas Andreas Hospital, Department of Radiology, Amsterdam (Netherlands); Gratama, Jan W.C. [Gelre Hospitals, Department of Radiology, Apeldoorn (Netherlands); Spilt, Aart [Kennemer Gasthuis, Department of Radiology, Haarlem (Netherlands); Wiarda, Bart M. [Alkmaar Medical Center, Department of Radiology, Alkmaar (Netherlands); Es, H.W. van [Sint Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Cobben, Lodewijk P.J. [Haaglanden Medical Center, Department of Radiology, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [University of Amsterdam, Department of Clinical Epidemiology, Academic Medical Center, Amsterdam (Netherlands); Boermeester, Marja A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Collaboration: on behalf of the OPTIMAP study group

    2014-01-15

    To identify MRI features associated with appendicitis. Features expected to be associated with appendicitis were recorded in consensus by two expert radiologists on 223 abdominal MRIs in patients with suspected appendicitis. Nine MRI features were studied: appendix diameter >7 mm, appendicolith, peri-appendiceal fat infiltration, peri-appendiceal fluid, absence of gas in the appendix, appendiceal wall destruction, restricted diffusion of the appendiceal wall, lumen or focal fluid collections. Appendicitis was assigned as the final diagnosis in 117/223 patients. Associations between imaging features and appendicitis were evaluated with logistic regression analysis. All investigated features were significantly associated with appendicitis in univariate analysis. Combinations of two and three features were associated with a probability of appendicitis of 88 % and 92 %, respectively. In patients without any of the nine features, appendicitis was present in 2 % of cases. After multivariate analysis, only an appendix diameter >7 mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall were significantly associated with appendicitis. The probability of appendicitis was 96 % in their presence and 2 % in their absence. An appendix diameter >7 mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall have the strongest association with appendicitis on MRI. (orig.)

  15. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael;

    2011-01-01

    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...

  16. Solitary caecum diverticulitis mimicking acute appendicitis.

    Science.gov (United States)

    Hot, Semih; Eğin, Seracettin; Gökçek, Berk; Yeşiltaş, Metin; Alemdar, Ali; Akan, Arzu; Karahan, Servet Rüştü

    2015-12-01

    Solitary cecum diverticulum is a benign formation, but it can be complicated with inflammation, perforation and bleeding. Cecum diverticulitis (CD) is the most common complication of caecal diverticulum and it has the highest incidence among Asians, but it is a rare condition in the western world. The incidence of colonic diverticular disease can vary according to national origin, cultural structure and nutritional habits. CD is not common in our country, but it is an important situation because of its clinical similarity with the commonly seen acute right side abdominal diseases like acute appendicitis. Preoperative diagnosis is difficult, and hence, the actual frequency is not known. The treatment of CD can vary from medical therapy to right hemi colectomy. In this study, we presented ten CD cases on whom surgical resection was performed in our surgery unit during the last 8 years. Our purpose was to increase the awareness of surgeons about this situation, and so, make them pay attention for not having their first experience in the operating room.

  17. Laparoscopic management of acute appendicitis in situs inversus

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    Golash Vishwanath

    2006-01-01

    Full Text Available Situs inversus is often detected incidentally in adults during imaging for a acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition. A 40 year old man was admitted with history of acute left lower abdominal pain, with uncontrolled diabetic keto-acidosis. Clinically, he was diagnosed as acute diverticulitis with localized peritonitis. Subsequent imaging studies and laparoscopy confirmed the diagnosis of situs inversus and acute left- sided appendicitis. He successfully underwent laparoscopic appendectomy. His postoperative recovery was uneventful. Although technically more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.

  18. Value of ultrasonography in the diagnosis of acute appendicitis

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    Sohn, Seok Ho; Jung, Kun Sik; Kim, Jung Sik; Woo, Seong Ku; Chung, Ki Yong [School of Medicine, Keimyung University, Daegu (Korea, Republic of); Kim, Hee Jin [Fatima Hospital, Daegu (Korea, Republic of)

    1993-03-15

    During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complications. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-ups in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examinations in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examinations in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis (n=5) and perforated appendicitis (n=1). Our results show that high-resolution, real-time US is an accurate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complications.

  19. Simultaneous Acute Cholecystitis and Acute Appendicitis Treated by a Single Laparoscopic Operation

    Directory of Open Access Journals (Sweden)

    Jonas P. DeMuro

    2012-01-01

    Full Text Available While acute appendicitis and acute cholecystitis are both common, they are only rarely seen simultaneously. The clinical presentation and hospital course of a 45-year-old female with concurrent acute appendicitis and acute cholecystitis is presented. The laparoscopic approach is ideal for dealing with multiple, simultaenous abdominal pathologies.

  20. Simultaneous Acute Cholecystitis and Acute Appendicitis Treated by a Single Laparoscopic Operation

    OpenAIRE

    DeMuro, Jonas P.

    2012-01-01

    While acute appendicitis and acute cholecystitis are both common, they are only rarely seen simultaneously. The clinical presentation and hospital course of a 45-year-old female with concurrent acute appendicitis and acute cholecystitis is presented. The laparoscopic approach is ideal for dealing with multiple, simultaenous abdominal pathologies.

  1. Study of 150 cases of acute appendicitis in children

    Directory of Open Access Journals (Sweden)

    Fallahi Gh

    1998-06-01

    Full Text Available Acute appendicitis is the most common condidition, requiring emergency operation in children. Late appendicitis is still a major sours of morbidity and potential mortality. The charts of all pediatric appendectomy patients (150 cases treated between 1367-1373 (Iranian calender in Amir Kabir Medical Center were reviewed. Mean hospital stay was 4.7 days. Mean ages of patients was 8.5 years. Male to female ratio was 1.2/1. Most common symptom was abdominal pain (100% and deep tenderness in right lower quadrant in 94.6%. Mean temprature was 37.2 and leucocytosis (more than 10000 were in the 76.3%. 14 patients had perforated appendicitis and most common pathology was acut supporative appendicitis. Accuracy of diagnosis was 96.6% and post operative pelvic abccess was 2%. Mortality occurred in one case (0.6%

  2. Appendiceal taeniasis presenting like acute appendicitis.

    Science.gov (United States)

    Sartorelli, Alesso Cervantes; da Silva, Márcia Guimarães; Rodrigues, Maria Aparecida Marchesan; da Silva, Reinaldo José

    2005-09-01

    A case of parasitic appendicitis caused by Taenia sp. in a 28-year-old woman from Brazil is reported. Histopathological data and a description of the helminthe found in the appendix lumen are presented.

  3. Acute Appendicitis Complicated by Pylephlebitis: A Case Report

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    Ricardo Castro

    2013-01-01

    Full Text Available Pylephlebitis is defined as septic thrombophlebitis of the portal vein. It is a rare but serious complication of an intraabdominal infection, more commonly diverticulitis and appendicitis. It has an unspecific clinical presentation and the diagnosis is difficult. The authors report a case of a 21-year-old man with acute appendicitis complicated by pylephlebitis. The diagnosis was made with contrast enhanced CT.

  4. What is the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after CT?

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Lee, Kwanseop [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)], E-mail: kwanseop@hallym.or.kr; Kim, Min-Jeong; Yoon, Hoi Soo; Jeon, Eui Yong; Koh, Sung Hye [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Min, Kwangseon [Department of Pathology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dongil [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (Korea, Republic of)

    2010-04-15

    The objective of our study was to estimate the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after abdominoplevic CT. A total of 104 patients initially underwent abdominopelvic CT before appendix US due to acute abdominal pain. All CT examinations were evaluated retrospectively for the presence of acute appendicitis. The findings of appendix on CT were classified into five categories (definite appendicitis, probably appendicitis, equivocal CT findings for diagnosis of appendicitis, probably not appendicitis, and normal looking appendix). Appendix US images and their radiologic reports were also evaluated retrospectively. Then, CT and US findings were correlated with clinical or pathologic diagnosis. Three all patients with definite appendicitis initially on CT again showed US findings of appendicitis. In the 32 patients of probably appendicitis on CT, US showed normal looking appendix in seven patients (21.8%, 7 of 32) who improved with medical treatment and discharged. In the 16 patients of equivocal CT findings for diagnosis of appendicitis, US showed appendicitis in seven patients (43.8%, 7 of 16) and normal looking appendix in nine patients. In the 12 patients of probably not appendicitis on CT, US showed acute appendicitis in two patients (16.7%, 2 of 12). In the 41 patients of normal looking appendix on CT, US showed acute appendicitis in five patients (12.2%, 5 of 41). US reevaluation enables us to avoid misdiagnosis of appendicitis on CT and improve diagnostic accuracy of acute appendicitis.

  5. Can fruit seeds and undigested plant residuals cause acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Omer Engin; Mehmet Yildirim; Savas Yakan; Gulnihal Ay Coskun

    2011-01-01

    Objective:To investigate the relation between fruit seeds, plants residuals and appendicitis. Methods: Among cases that underwent appendectomy, the appendicitis cases having fruit seeds and undigested plant residuals in their etiology were examined retrospectively. Also, histopathological features, age, sex, and parameters of morbidity and mortality were used. Results: Fruit seed was found in one case(0.05%) with presence of pus in appendix lumen, undigested plant residuals in 7 cases(0.35%). It was determined that there were appendix inflammation in 2 of the plant residuals cases, while there were obstruction and lymphoid hyperplasia in the appendix lumen of5 cases. No mortality was observed.Conclusions: The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

  6. Acute neonatal appendicitis: a diagnosis to consider in abdominal sepsis.

    Science.gov (United States)

    Arias-Llorente, R P; Flórez-Díez, P; Oviedo-Gutiérrez, M; Suárez-Rodríguez, M; Costa-Romero, M; Solís-Sánchez, G; García-López, E

    2014-01-01

    Appendicitis in the neonatal period is extremely rare. Its low incidence together with non-specific clinical symptoms often mean the diagnosis is delayed, leading to increased rates of peritonitis and mortality. We report the case of a 33-week premature infant, small for gestational age (1180 g at birth), clinically stable and receiving exclusive enteral feeding, who presented clinical manifestations of necrotizing enterocolitis at 14 days of life. Acute phase reactants were elevated and abdominal radiography showed pneumoperitoneum. Laparotomy revealed acute perforated appendicitis without intestinal involvement and purulent fluid in the peritoneum, for which appendectomy was performed. Neonatal acute appendicitis should be considered in the differential diagnosis of abdominal sepsis since early diagnosis and treatment significantly reduce associated morbidity and mortality.

  7. Appendiceal diverticulitis and acute appendicitis: differences and similarities

    Directory of Open Access Journals (Sweden)

    Irene Lobo-Machín

    2014-08-01

    Full Text Available Introduction: Acute appendiceal diverticulitis is an unusual cause of acute abdomen, considered clinically indistinguishable from acute appendicitis. Material and methods: In a historic cohort study with 27 cases of appendiceal diverticulitis and 54 cases of acute appendicitis, we compared clinical characteristics, diagnostic tests and pathology findings of the two processes. Results: Mean age at presentation was lower in acute appendicitis (37.24 ± 19.98 vs. 54.81 ± 17.55 years, p < 0.001, with significant differences between men (33.33 ± 15.89 vs. 57 ± 18.02 years, p < 0.001 but not between women (41.76 ± 24.87 vs. 50.44 ± 16.69 years, p = 0.34. In the diverticulitis group, 48.15 % had leukocytosis vs. 81.48 % in the appendicitis group (p = 0.02; there was no difference in leukocyte count (13770.37 ± 4382.55 vs. 14279.63 ± 4268.59, p = 0.61. Patients with appendiceal diverticulitis had a higher incidence of appendiceal mucocele (p = 0.01 and a lower proportion of appendiceal gangrene (p = 0.03. There were no differences in appendiceal perforation or ulceration. Symptom duration before emergency department attendance (71.61 ± 85.25 hours vs. 36.84 ± 33.59 hours; Z = -3.1 p = 0.002, duration of surgery (85 ± 40 minutes vs. 60 ± 21 minutes, Z = -3.2, p = 0.001 and the presence of appendicular plastron was higher in patients with diverticulitis vs. appendicitis (8 vs. 5 patients (p = 0.01, Odds ratio 2.2. Conclusions: Appendiceal diverticulitis presents a series of clinical, epidemiological and pathological differences with respect to acute appendicitis. The former shows a more indolent course with delayed diagnosis.

  8. Simultaneous acute appendicitis and pseudomembranous colitis in a pediatric patient.

    Science.gov (United States)

    Vidrine, Steven R; Cortina, Chandler; Black, Marissa; Vidrine, Steven B

    2012-01-01

    Acute appendicitis is a common cause for pediatric surgery, with an increasing incidence as this population ages. Pseudomembranous colitis (PMC) from Clostridum difficle is being seen more frequently in pediatric patients, especially after treatment with antibiotics and in those with Hirschsprung's disease. Only three prior cases of appendicitis associated with PMC have been described in the literature, and all of them occurred in adult patients. Here, we describe the first documented pediatric case: a 16-year-old female who developed acute appendicitis while concomitantly being treated for suspected pseudomembranous colitis. We concur with previous authors that there may be an association between these two pathologies; furthermore, this association may not always be clinically apparent and may be both under-diagnosed and under-reported.

  9. Appendicitis

    Science.gov (United States)

    ... of lymph nodes in the intestines, or even parasites. Once the appendix is blocked, it becomes inflamed ... of appendicitis can happen in other illnesses (like kidney stones, pneumonia, and urinary tract infections). That's why ...

  10. Torsion of an Epiploic Appendix Pretending as Acute Appendicitis

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    Kamran Ahmad Malik

    2010-07-01

    Full Text Available Torsion of an epiploic appendix is a rare surgical entity. Its unusual symptomatology, wide variation in physical findings and the absence of helpful laboratory and radiological studies makes it very difficult to diagnose pre-operatively. This is a report of this rare entity found in a patient upon diagnostic laparoscopy performed for suspected acute appendicitis

  11. Acute appendicitis following endoscopic mucosal resection of cecal adenoma.

    Science.gov (United States)

    Nemoto, Yukako; Tokuhisa, Junya; Shimada, Nagasato; Gomi, Tatsuya; Maetani, Iruru

    2015-07-21

    Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm(3), a neutrophil count of 14144/mm(3), and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis.

  12. Ileocecocolic Intussusception Induced by Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Bang Sil; Kim, Min Jeong; Jang, Kyung Mi; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2009-09-15

    Intussusception is a rare disease in adults. Moreover, appendiceal disease is very rarely the leading cause of adult intussusception. We report a case in which ileocecocolic intussusception is secondary to an acute appendicitis in an adult, and describe the radiologic, clinical, and pathologic findings.

  13. Perforation rate in acute appendicitis: association with different risk facotrs

    Directory of Open Access Journals (Sweden)

    B. Khorasani

    2006-08-01

    Full Text Available Background: The early diagnosis of acute appendicitis before progression to gangrene or abscess formation is recognized as important to minimize morbidity from this common disease process. The aim of this study was to assess the value of different risk factors in the diagnosis of perforation. Methods: This descriptive-analytic and retrospective study was conducted to investigate epidemiological characteristics in patients with perforated and non-perforated appendicitis. A series of 1311 patients who were operated on for acute appendicitis between years 1380-1382 in Shahid Beheshti and Yahya-nejad hospitals were reviewed.. Data gathered included age at operation, gender, care sought prior to admission for appendectomy including antibiotic and analgesic therapy, time of presentation in the year, duration of symptoms, signs and symptoms at the time of admission, and the patient’s living area. Results: One hundred twenty one of 1311 patients (9% had perforated appendicitis and 1190 patients (91% had unperforated appendicitis. Presentation and referral in the first 6-month was associated with higher perforation rate. Patients from rural area showed a higher rate of perforations. The perforation rate was significantly higher in elderly patients (>65 year. When the duration of symptoms was more than 12 hours at presentation, the risk of perforation showed a five-fold increase. 30.7% of perforated cases had used antibiotic or sedative before referring to the hospital. Conclusion: Appendiceal perforation continues to be a complication in patients with acute appendicitis and increased in the frequency as the age of the patients increase and the duration of symptoms lengthen. We also found that the perforation rate is higher in patients from rural area and in whom present in the first 6-month of the year, a finding that was not reported so far.

  14. Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases

    Directory of Open Access Journals (Sweden)

    Kurtulus Idris

    2008-04-01

    Full Text Available Abstract Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum.

  15. Case report of recurrent acute appendicitis in a residual tip.

    LENUS (Irish Health Repository)

    O'Leary, Donal P

    2010-01-01

    INTRODUCTION: Residual appendicitis involving the stump of the appendix has been well described in the literature in the past. CASE REPORT: We report the case of a 43 year old male with acute onset of abdominal pain who had undergone an appendicectomy ten years previously. Ultrasound revealed the presence of an inflamed tubular structure. Subsequent laparotomy and histology confirmed that this structure was an inflamed residual appendiceal tip. CONCLUSION: Residual tip appendicitis has not been reported in the literature previously and should be considered in the differential diagnosis of localised peritonitis in a patient with a history of a previous open appendicectomy.

  16. CT diagnosis of suspected acute appendicitis in adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Yamase, Hiroshi; Sahashi, Kiyomi; Kawai, Masayuki; Kishida, Yoshihiko; Sumida, Kei; Kawamura, Ken-ichi [Gifu Syakaihoken Hospital (Japan)

    1998-06-01

    In order to assess the CT diagnosis of suspected acute appendicitis, we performed abdominal contrasted CT measurements in 77 patients from 20 to 86 years old, and of 50 men and 27 women from June 1993 to June 1996. The surgical findings were compared with the preoperative CT findings. By the preoperative CT imaging, we can know the degree and the position of inflammation in appendix vermiformis and the degree and the spread of periappendicular inflammation in the case of appendicitis, and can make a differential diagnosis of diverticulitis or gynecological diseases from appendicitis. It is important to make a preoperative diagnosis by the objectively excellent abdominal CT imaging and to avoid unnecessary surgery. (K.H.)

  17. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: inbal@heh.regionh.dk [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: micach01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: svad@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: petgoc01@heh.reginh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: stkibr01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: viloe@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: heth@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)

    2011-08-15

    Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.

  18. [Immunotherapy for the treatment of acute appendicitis in children].

    Science.gov (United States)

    Bulanova, A A; Akhanzaripov, Z A

    1994-08-01

    The immune status was studied during the development of the disease in 182 children who were operated on for acute appendicitis. T lymphocytes and their subpopulations circulating in the blood, as well as B lymphocytes, immunoglobulins A, M, G, and immune complexes were determined. The character of changes of these values before the operation and in various postoperative periods were determined. The effect of complex treatment, including T-activin, on the clinical and immunological parameters in children with acute appendicitis was appraised. Analysis of the results showed that a transitory immunodepressive state forms in children with the disease, which is more marked in the destructive form, with normalization of the main values of cell-mediated and humoral immunity by the 7th day after appendectomy. In a complicated course of acute appendicitis the state of immunodeficiency is torpid in character and does not return to normal values even after clinical recovery, i.e. before discharge from the clinic. Inclusion of the immunostimulating agent T-activin into the complex treatment of patients with appendicitis ensures a more rapid involution of the main clinical manifestations of the disease. The therapeutic effect was most pronounced in destructive appendicitis: after 3 days of treatment the pain syndrome was encountered twice less frequently and intestinal paresis more than twice less frequently in these patients, and the term of hospital stay (8.8 +/- 0.4 days) was less shorter than for children of the control group (12.2 +/- 1.9 days) who did not receive T-activin in the therapeutic complex.

  19. Laparoscopic appendectomy in surgical treatment of acute appendicitis

    Directory of Open Access Journals (Sweden)

    G. I. Ohrimenko

    2016-06-01

    Full Text Available Relevance of the topic. At the present time laparoscopic appendectomy has taken its own place at the urgent surgery. In spite of this less is studied in the field of the use of the minimally invasive technologies in the cases of complicated acute appendicitis. The aim of research: to investigate the close results of the patients with acute appendicitis treatment with laparoscopic appendectomy, and to compare them with the open appendectomy results; to estimate the possibilities of laparoscopic appendectomy in the cases of complicated acute appendicitis. Materials and methods. The results of surgical treatment of 146 patients with acute appendicitis were analyzed – 59 patients in the main group, who undergone laparoscopic appendectomy, and 80 patients in the control group, who undergone open surgery. 7 patients who passed through conversion were included in the additional group. Results. The frequency of acute appendicitis complications, which were diagnosed during the operation, in the both groups had no significant distinction (50.8 % in the main group and 47.5% in the control group. But 5 patients with diffuse peritonitis and appendicular abscesses needed a conversion of laparoscopic operation into open one, because of the full sanitation necessity and technique difficulties. In the postoperative period among the patients of main group the suppuration of the wound was observed in 2 (3.4% cases, in the control group – in 10 (12.5%. The average duration of laparoscopic operation was 33.12±2.51 min, open surgery – 66.45±3.33 min. The average hospitalization period in the control group was 6.95±0.2 days and was statistically proved higher than in the main group – 4.72±0.21 days (p≤0.01. Conclusion. Laparoscopic appendectomy can be wide used in the cases of acute appendicitis, including complications, but it can be restricted in the cases of diffuse peritonitis and appendicular abscesses. This minimally invasive surgical operation

  20. Fecal loading in the cecum as a new radiological sign of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Andy Petroianu; Luiz Ronaldo Alberti; Renata Indelicato Zac

    2005-01-01

    AIM: Although the radiological features of acute appendicitis have been well documented, the value of plain radiography has not been fully appreciated. The aim of this study was to determine the frequency of the association of acute appendicitis with images of fecal loading in the cecum.METHODS: Plain abdominal radiographs of 400 patients operated upon for acute appendicitis (n = 100), acute cholecystitis (n = 100), right acute pelvic inflammatory disease (n = 100) and right nephrolithiasis (n = 100)were assessed. The presence of fecal loading was recorded and the sensitivity and specificity of this sign for acute appendicitis were calculated.RESULTS: The presence of fecal loading in the cecum occurred in 97 patients with acute appendicitis, 13 patients with acute cholecystitis, 12 patients with acute inflammatory pelvic disease and 19 patients with nephrolithiasis. The sensitivity of this sign for appendicitis was 97% and its specificity to this disease was 85.3%. Its positive predictive value for appendicitis was 68.7%; however, its negative predictive value for appendicitis was 98.8%.CONCLUSION: The present study suggests that the presence of radiological images of fecal loading in the cecum may be a useful sign of acute appendicitis, and the absence of this sign probably excludes this disease.This is the first description of fecal loading as a radiological sign for acute appendicitis.

  1. Does breast feeding provide protection against acute appendicitis? A case-control study.

    Science.gov (United States)

    Alves, João Guilherme Bezerra; Figueiroa, José Natal; Barros, Isabela

    2008-10-01

    Breast feeding stimulates a more tolerant lymphoid tissue at the base of the appendix and this could provide protection against acute appendicitis. Two studies reported that children and adolescents with appendicitis were less likely to have been breast fed. In a case-control study of 200 children with histologically confirmed acute appendicitis matched by 200 siblings with the same sex and difference age - up to three-year-old - we found breast feeding in at least the first two months of life and for more than four months provides protection against acute appendicitis. These findings suggesting that breast feeding may possibly give protection against the development of appendicitis.

  2. Abdominal Pain in the Female Patient: A Case of Concurrent Acute Appendicitis and Ruptured Endometrioma

    Science.gov (United States)

    Louis, Martine A.; Lin, Elizabeth; Baek, Ji Yoon; Andoni, Alda; Wang, Xiao Hui

    2016-01-01

    General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma. PMID:28097032

  3. The activity of granulocyte alpha-amylase in acute appendicitis.

    Science.gov (United States)

    Zakrzewska, I; Gajda, R

    1994-01-01

    The activity of alpha-amylase was measured in isolated granulocytes, serum and urine of 35 patients with acute appendicitis. The measurements were performed before operation and on the 7th day after operation. Slightly increased activity of alpha-amylase was found in the serum and urine of 15 patients. On the 7th day after operation the activity of this enzyme reached normal value. The activity of granulocyte alpha-amylase was elevated in 22 patients. In 2 of them the increased activity still maintained on the 7th day after operation. Positive correlation between the serum and granulocyte alpha-amylase activities was found. These observations allow to conclude that granulocytes are the source of increased alpha-amylase activity in the serum of patients with acute appendicitis.

  4. Computed Tomography Diagnosis Utilizing Compressed Image Data: An ROC Analysis Using Acute Appendicitis as a Model

    OpenAIRE

    2002-01-01

    Using receiver-operating characteristic (ROC) methodology, the ability to diagnose acute appendicitis with computed tomography (CT) images displayed at varying levels of lossy compression was evaluated. Nine sequential images over the ileocecal region were obtained from 53 consecutive patients with right lower quadrant pain who were clinically suspected to have acute appendicitis. Thirty were proven surgically to have acute appendicitis, alternative diagnoses confirmed in 23. The image sets w...

  5. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  6. Contrast-enhanced power Doppler US in the diagnosis of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Incesu, L.; Yazicioglu, A.K.; Selcuk, M.B.; Ozen, N

    2004-05-01

    Introduction/objective: To determine the value of power Doppler (PD) ultrasonography (US) and contrast-enhanced power Doppler (CEPD) US in the diagnosis of acute appendicitis and the prediction of histopathologic stages. Methods and material: 50 patients with suspected acute appendicitis were evaluated by the same radiologist with PD US and CEPD US. Air micro bubbles stabilized by a granulate of 'galactose and palmitic acid' were used as a contrast medium for sonography with the concentration of 400 mg/ml. PD US and CEPD US results were later correlated with the surgical and histopathologic findings. PD US and CEPD US findings were considered positive for appendicitis; if there was depiction of hyperemia in the wall of the appendix or if there was depiction of prominent peripheral vascularity when compared with normal soft tissues; and negative if both hyperemia and peripheral hyperemia were not prominent. Results and discussions: Of the 50 patients, 35 patients had histopathologically proven acute appendicitis. CEPD US showed prominent hyperemia in the appendiceal vessels or feeding vessels of the inflamed appendix, and resistance index (RI) calculations were easier. There was statistically significant difference between mean RI values of the normal appendix, suppurative appendicitis and gangrenous appendicitis. PD US has accuracy of 80%, sensitivity of 74% and CEPD US has 98%, and 100% in the diagnosis of acute appendicitis. CEPD US identified 100% of suppurative appendicitis and gangrenous appendicitis. Conclusion: CEPD US is a promising method in the diagnosis of acute appendicitis and determination of the inflammation stage.

  7. Acute Appendagitis Presenting with Features of Appendicitis: Value of Abdominal CT Evaluation

    Directory of Open Access Journals (Sweden)

    Sukhpreet Dubb

    2008-05-01

    Full Text Available We report a case of acute appendagitis in a patient who presented initially with typical features of acute appendicitis. The diagnosis of acute appendagitis was made on pathognomonic signs on computed tomography (CT scan. Abdominal pain is a common surgical emergency. CT is not always done if there are clear features of acute appendicitis. The rare but important differential diagnosis of acute appendagitis must be borne in mind when dealing with patients with suspected acute appendicitis. A CT scan of the abdomen may avoid unnecessary surgery in these patients.

  8. Are acute exacerbations of chronic inflammatory appendicitis triggered by coprostasis and/or coproliths?

    Institute of Scientific and Technical Information of China (English)

    George Sgourakis; Georgios C Sotiropoulos; Ernesto P Molmenti; Charis Eibl; Stylianous Bonticous; Jurgen Moege; Christoph Berchtold

    2008-01-01

    AIM:To examine the role of coprostasis and coproliths in recurrent appendicitis.METHODS:We evaluated four hundred and twentyseven consecutive pathology reports of all appendectomy specimens from January 2003 to December 2004.Findings were categorised as showing acute append icitis,acute recurrent appendicitis,subacute recurrentappendicitis,chronic appendicitis,or appendices without inflammation.All patients had presented with acute right lower quadrant pain.In 94 instances,there was a history of recurrent similar episodes in the past.RESULTS:Of the 427 histology reports,294 were interpreted as showing acute appendicitis,56 acute recurrent appendicitis,34 subacute recurrent appen-dicitis,28chronic appendicitis,and 15 non-inflamed appendices.Coprostasis was observed in 58 patients (13.58%) and the presence of coprolith in 6 (1.4%).Coprostasis,and age,were among the predictors in the final model.CONCLUSION:Coprostasis but not coproliths seems to be a contributing factor to acute exacerbations of chronic inflammatory appendicitis.

  9. Differentiation of Acute Perforated from Non-Perforated Appendicitis: Usefulness of High-Resolution Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Gyu Chang [Dept. of Radiology, Gumi Hospital, Soonchunhyang University College of Medicine, Gumi (Korea, Republic of)

    2011-07-15

    To evaluate the usefulness of high-resolution ultrasonography (US) for the differentiation of acute perforated appendicitis from non-perforated appendicitis. The high-resolution US features in 96 patients (49 males, 47 females; mean age, 33.8 years; age range, 4-80 years) with pathologically proven acute appendicitis were evaluated. The following US findings were evaluated for differentiation of acute perforated appendicitis from non-perforated appendicitis: circumferential loss of the echogenic submucosal layer, periappendiceal fluid collection, disruption of the serosal layer, asymmetrical wall thickening, maximum overall diameter > 10.5 mm, and the presence of appendicoliths. The sensitivity and specificity of the US features in the diagnosis of acute perforated appendicitis were calculated. All of the US findings, except for appendicoliths, were significantly more common in the acute perforated appendicitis group (p < 0.001). The sensitivity of circumferential loss of the echogenic submucosal layer, periappendiceal fluid collection, disruption of the serosal layer, asymmetrical wall thickening, maximum overall diameter > 10.5 mm, and the presence of appendicoliths was 85.4, 73.2, 68.3, 70.7, 80.5, and 36.6%, respectively, while the specificity was 65.5, 89.1, 96.4, 98.2, 81.8, and 80.0%, respectively. High-resolution US was found to be useful for differentiating acute perforated appendicitis from non-perforated appendicitis.

  10. A rare cause of acute abdomen in adults: Parasitic infection-related acute appendicitis.

    Science.gov (United States)

    Küpeli, Aydın Hakan; Özdemir, Murat; Topuz, Sezgin; Sözütek, Alper; Paksoy, Tuğba

    2015-01-01

    Ascaris lumbricoides is a common parasitic disease all over the world, especially in less developed countries. Acute appendicitis related to parasitic infection is a rare condition. Parasitic infections should be kept in mind in patients who are admitted to the emergency department with acute abdomen, especially in endemic areas.

  11. Clinical impact of leukemic blast heterogeneity at diagnosis in cytogenetic intermediate-risk acute myeloid leukemia

    DEFF Research Database (Denmark)

    Hoffmann, Marianne Hutchings; Klausen, Tobias Wirenfeldt; Boegsted, Martin;

    2012-01-01

    Individual cellular heterogeneity within the acute myeloid leukemia (AML) bone marrow samples can be observed by multi parametric flow cytometry analysis (MFC) indicating that immunophenotypic screening for leukemic blast subsets may have prognostic impact.......Individual cellular heterogeneity within the acute myeloid leukemia (AML) bone marrow samples can be observed by multi parametric flow cytometry analysis (MFC) indicating that immunophenotypic screening for leukemic blast subsets may have prognostic impact....

  12. Acute Appendicitis and Pneumatosis in a Duplicated Appendix With Schistosoma Remnants.

    Science.gov (United States)

    Handra-Luca, Adriana; Bisseret, Damien; Dragoescu, Ema

    2016-02-01

    Appendiceal pneumatosis is rare, reported either in the context of acute appendicitis or enterocolitis. Here, we report the case of an elderly adult in whom the acute appendicitis was associated with pneumatosis and occurred in the context of a malformed appendix with pathogenic organism remnants. A 72-year-old man presented with abdominal pain 3 weeks after posttraumatic dorsolumbar surgery. The computed tomography scan showed acute appendicitis and 2 diverticula. On microscopy, the appendix showed acute appendicitis along with a Cave-Wallbridge type A duplication. In addition, several optically clear spaces were observed in the entire appendiceal wall consistent with pneumatosis of the appendix. Focally, calcified structures suggesting pathogenic organisms such as Schistosoma were noted as well. In conclusion, we report a case of appendiceal pneumatosis occurring in the context of acute appendicitis in a duplicated appendix, with presence of calcified structures suggestive of pathogenic organisms.

  13. Kinetics of indium-111-labeled leukemic cells in patients with acute nonlymphocytic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Yamauchi, K.; Suzuki, Y.; Sugihara, M.; Nagao, T.; Arimori, S.

    1984-08-01

    The distribution within the body of autologous leukemic cells labeled with indium-111 oxine was studied in seven patients with acute nonlymphocytic leukemia. The leukemic blood cells initially entered the spleen and liver, and the major site of localization was the former rather than the latter. The majority of the leukemic cells had not left the spleen and liver within 48 hr. Liver radioactivity fell transitorily up to the third hr after the initial rise. The clearance curve of radioactivity from the blood showed a plateau or the appearance of a ''hump'' from 1 to 5 hr after injection of labeled leukemic cells. These results might reflect recirculation of a portion of the leukemic cells between these organs and the bloodstream. In a patient with acute monoblastic leukemia. OKM1 monoclonal-antibody-treated monoblasts showed the lowest recovery into the blood and a greater increase of liver than splenic radioactivity at 30 min after injection. These results suggest the removal of damaged cells by the cytotoxic effects of antibody mediated by reticuloendothelial clearance mainly of the liver and others. In one patient with acute promyelocytic leukemia, leukemic cells accumulated in both kidneys, indicating the possible infiltration of these cells. Since indium-111 oxine stays firmly attached to the cells in spite of the possibility of radiation damaged in a long-term survey, it seems an ideal label for studying leukemic cell kinetics.

  14. Analysis of Recurrence Management in Patients Who Underwent Nonsurgical Treatment for Acute Appendicitis.

    Science.gov (United States)

    Liang, Tsung-Jung; Liu, Shiuh-Inn; Tsai, Chung-Yu; Kang, Chi-Hsiang; Huang, Wei-Chun; Chang, Hong-Tai; Chen, I-Shu

    2016-03-01

    The recurrence rate for acute appendicitis treated nonoperatively varies between studies. Few studies have adequately evaluated the management of these patients when appendicitis recurs. We aimed to explore the recurrence rate and management of patients with acute appendicitis that were first treated nonoperatively.We identified patients in the Taiwan National Health Insurance Research Database who were hospitalized due to acute appendicitis for the first time between 2000 and 2010 and received nonsurgical treatment. The recurrence and its management were recorded. Data were analyzed to access the risk factors for recurrence and factors that influenced the management of recurrent appendicitis.Among the 239,821 patients hospitalized with acute appendicitis for the first time, 12,235 (5.1%) patients were managed nonoperatively. Of these, 864 (7.1%) had a recurrence during a median follow-up of 6.5 years. Appendectomy was performed by an open and laparoscopic approach in 483 (55.9%) and 258 (29.9%) patients, respectively. The remaining 123 (14.2%) patients were again treated nonsurgically. Recurrence was independently associated with young age, male sex, percutaneous abscess drainage, and medical center admission by multivariable analysis. In addition, age appendicitis, percutaneous abscess drainage, nor length of first time hospital stay had an influence on the selection of surgical approach.In conclusion, a laparoscopic appendectomy can be performed in recurrent appendicitis cases, and its application may not be related to previous appendicitis severity.

  15. Acute promyelocytic leukemia associated with a paraprotein that reacts with leukemic cells.

    Science.gov (United States)

    Atkins, H; Drouin, J; Izaguirre, C A; Sengar, D S

    1989-05-01

    A 29-year-old woman developed acute promyelocytic leukemia during pregnancy. At diagnosis, immediately postpartum, she was found to have IgG kappa immunoglobulin on the surface of the leukemic cells as well as a monoclonal protein of IgG kappa specificity in her serum. These resolved with chemotherapy which induced a complete remission. Immunoglobulin gene rearrangement was not found in the leukemic cells, thus indicating that the blasts were not secreting the monoclonal protein. The authors believe that the patient had an autoantibody directed at myeloid cells which was amplified by the development of the leukemic process.

  16. Ultrasonography Manifestation of Acute Appendicitis%急性阑尾炎的超声表现

    Institute of Scientific and Technical Information of China (English)

    刘晓芳

    2016-01-01

    目的:探讨急性阑尾炎的超声表现。方法收集我2014年6月~2014年12月通过超声检查诊断为急性阑尾炎患者66例影像表现进行分析。结果46例患者为急性单纯阑尾炎,急性化脓性阑尾炎10例,急性坏疽性阑尾炎10例。结论超声检查诊断急性阑尾炎精准,方便快捷,无创,能在临床的诊断及手术时提供重要的依据。%Objective To investigate the ultrasonographic features of acute appendicitis.Methods Selected the imaging findings of 66 patients with acute appendicitis who were diagnosed as acute appendicitis by ultrasound examination from June 2014 to December 2014 were collected and analyzed.Results 46 patients with acute simple appendicitis, 10 cases of acute suppurative appendicitis, 10 cases of acute gangrenous appendicitis. Conclusion Ultrasound diagnosis of acute appendicitis is accurate,convenient, non-invasive, can provide an important basis for clinical diagnosis and surgery.

  17. Macroamylasemia in a patient with acute appendicitis: a case report.

    Science.gov (United States)

    Um, J W; Kim, K H; Kang, M S; Choe, J H; Bae, J W; Hong, Y S; Suh, S O; Kim, Y C; Whang, C W; Kim, S M

    1999-12-01

    Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided.

  18. Isolated submucosal lipomatosis of appendix mimicking acute appendicitis: computed tomography findings

    Directory of Open Access Journals (Sweden)

    Şükrü Şanlı

    2014-03-01

    Full Text Available Acute appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of acute abdominal pain. Intestinal lipomatosis is a rare condition particularly the isolated form of lipomatosis of the appendix which may mimic or present as an acute appendicitis, that frequently requires the surgical exploration.In this paper, we report computed tomography findings of a case wıth isolated form of submucosal lipomatosis of appendix.

  19. Asymptomatic early acute appendicitis initiated and diagnosed during colonoscopy: A case report

    Institute of Scientific and Technical Information of China (English)

    Michelle Petro; Anil Minocha

    2005-01-01

    Colonoscopic diagnosis of asymptomatic early acute appendicitis is exceedingly rare. Although obstruction of the lumen due to various causes is believed to be the most common physiologic mechanism of acute appendicitis, all of the previously documented cases in the literature have only shown a patent appendiceal lumen with pus flowing into the cecum. We present the case of a patient undergoing colonoscopy for colorectal cancer evaluation with no abdominal symptoms. An obstructed, swollen appendix was seen. The process was probably initiated during the colonoscopy, documenting perhaps the earliest stage of acute appendicitis for the first time. Endoscopic, CT and microscopic documentation of the case is also presented.

  20. Synchronous presentation of acute acalculous cholecystitis and appendicitis: a case report

    LENUS (Irish Health Repository)

    Sahebally, Shaheel M

    2011-11-14

    Abstract Introduction Acute acalculous cholecystitis is traditionally associated with elderly or critically ill patients. Case presentation We present the case of an otherwise healthy 23-year-old Caucasian man who presented with acute right-sided abdominal pain. An ultrasound examination revealed evidence of acute acalculous cholecystitis. A laparoscopy was undertaken and the dual pathologies of acute acalculous cholecystitis and acute appendicitis were discovered and a laparoscopic cholecystectomy and appendectomy were performed. Conclusion Acute acalculous cholecystitis is a rare clinical entity in young, healthy patients and this report describes the unusual association of acute acalculous cholecystitis and appendicitis. A single stage combined laparoscopic appendectomy and cholecystectomy is an effective treatment modality.

  1. Changes in the epidemiology of acute appendicitis and appendectomy in Danish children 1996-2004

    DEFF Research Database (Denmark)

    Andersen, S B; Paerregaard, A; Larsen, K

    2009-01-01

    PURPOSE: Aim of the study was to describe changes in the epidemiology of acute appendicitis in Danish children between 0-19 years of age for the period 1996-2004. METHODS: The study was based on discharge diagnoses taken from the Danish National Patient Registry of all 28 274 patients with a diag......PURPOSE: Aim of the study was to describe changes in the epidemiology of acute appendicitis in Danish children between 0-19 years of age for the period 1996-2004. METHODS: The study was based on discharge diagnoses taken from the Danish National Patient Registry of all 28 274 patients...... with a diagnosis of acute uncomplicated or complicated appendicitis, and/or a registered procedure code of appendectomy. These data were computed together with data on the background population, and incidences were calculated. RESULTS: A significant decrease in the incidence of acute uncomplicated appendicitis...... was found for all age groups (range, 13-36%). The decrease was present for both sexes, but most prominent in girls. The incidence of complicated acute appendicitis decreased by 10%. CONCLUSION: The incidence of acute appendicitis is declining. The incidence of uncomplicated appendicitis appears...

  2. A case of acute appendicitis in a patient with crossed renal ectopia

    Institute of Scientific and Technical Information of China (English)

    Ulvi Meral; Murat Zor; Orhan Ureyen; Nisa Cem Oren; Hilmi Gungor

    2016-01-01

    Crossed renal ectopia is a rare anomaly in urological clinical practice. Patients with this anomaly are usually asymptomatic. Herein, we reported a case of acute appendicitis in a patient with crossed renal ectopia. A 22-year-old man with abdominal pain admitted to the emergency department. His physical examination revealed muscular defense and painful mass at the lower quadrant. Abdominal ultrasonography revealed crossed renal ectopia with no sign of stones and acute appendicitis. Tomography confirmed crossed renal ectopia but not acute appendicitis. On-going clinical symptoms lead to surgical intervention and acute appendicitis diagnosis. The patient was treated with appendectomy with no perioperative complications. Appendectomy is a common surgical procedure in surgical clinical practice. Acute abdominal pain must be managed carefully in patients with unusual anatomy. Also surgeons should be aware of ectopic organs in surgical procedures, to avoid iatrogenic intraoperative injuries.

  3. Acute appendicitis in children: ultrasound and CT findings in negative appendectomy cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho; Choi, Young Hun; Kim, Woo Sun; Cheon, Jung-Eun; Kim, In-One [Seoul National University Hospital, Department of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    To decrease the negative appendectomy rate in children, knowledge of the misleading imaging findings on US and CT in negative appendicitis cases is important. To evaluate the negative appendectomy rate and describe the imaging findings of US and CT that lead radiologists to misdiagnose acute appendicitis in children. From 2007 to 2013, 374 children operated for suspected appendicitis were proved to either have acute appendicitis (n = 348) or to be negative for appendicitis (n = 26) on pathological reports. Negative appendectomy rates were compared among imaging modalities, age groups and genders. We retrospectively reviewed US and CT findings from negative appendectomy cases. The overall negative appendectomy rate was 7.0% (26/374). There were no statistically significant differences among the subgroups. The most common misleading presentations on US were sonographic tenderness (9/16, 56%) and non-compressibility (9/16, 56%). The most common misleading finding on CT were the presence of an appendicolith or hyperdense feces (5/12, 42%). Periappendiceal fat inflammation was observed in only one case of negative appendicitis on US and on CT. Radiologists can misdiagnose children with equivocal diameters of appendices as having acute appendicitis when sonographic tenderness or non-compressibility is present on US and when an appendicolith or hyperdense feces is noted on CT. The possibility of negative appendicitis should be borne in mind when periappendiceal fat inflammation is absent or minimal in indeterminate cases. (orig.)

  4. Histopathological Feature of Acute Appendicitis in Kerman-Iran from 1997 to 2003

    Directory of Open Access Journals (Sweden)

    Fatemeh Nabipour

    2005-01-01

    Full Text Available Acute appendicitis is one of the most common surgical conditions that affect about seven percent of the population. The histopathologic stages of appendicitis are important to regarding prognosis. To evaluate pathologic features of appendix after operation, this study was designed. 2753 appendices specimen that had been received to department of pathology of two major hospitals in Kerman-Iran during five years periods were reviewed by two pathologist and classification was performed by followed: Normal, early acute, acute, suppurative or purulent, gangrenous and perforated appendicitis. There were 54.6% males, the average age of patients was 24.9+/-13.3 (mean+/-SD, that 76.6% was under 30 years old. 34.2% of reports were normal histopathologically. The accuracy rate of acute appendicitis was 65.8%. Perforation observed to 0.8%. There was significant difference between sex and stage of development of appendicitis. Seasonal incidence was difference in various histopathology views, significantly. Finally, acute appendicitis was more frequent in men than women and was increase by age specially 19-30 years. Our results showed appendicitis was more frequent and higher in stage at winter.

  5. Extramedullary Acute Myeloid Leukemia (AML: Leukemic Pleural Effusion, Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Naveen ePemmaraju

    2014-06-01

    Full Text Available Objective and Importance: Malignant pleural effusions occur in the setting of both solid and hematologic malignancies. Pleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML with fewer than 20 cases reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature. Clinical presentation: In this case, a 55 year old man with previous history of myeloproliferative neoplasm (MPN experienced transformation AML, heralded by appearance of leukemic pleural effusions. The patient was identified to have leukemic pleural effusion based upon extended cytogenetic analysis of the pleural fluid, as morphologic analysis alone was insufficient. Intervention: The patient was treated with hypomethylator-based and intensive chemotherapy strategies, both of which maintained resolution of the effusions in the remission setting. Conclusion: Due to the rarity of diagnosis of leukemic pleural effusions, both cytogenetic and fluorescence in situ hybridization (FISH testing are recommended. Futhermore, systemic chemotherapy directed at the AML can lead to complete resolution of leukemic pleural effusions. Objective and ImportancePleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML, but may be more common than previously thought. Fewer than 20 cases have been reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature.

  6. Amebiasis presenting as acute appendicitis: Report of a case and review of Japanese literature

    Directory of Open Access Journals (Sweden)

    Daisuke Ito

    2014-01-01

    CONCLUSION: We report a case of acute amebic appendicitis in a 31-year-old woman and review the ages at presentation, causative factors, treatments, and outcomes of 11 cases reported in Japan between 1995 and 2013.

  7. De Garengeot’s Hernia; Acute Appendicitis In An Incarcerated Femoral Hernia

    Directory of Open Access Journals (Sweden)

    Kokoszka Maciej

    2015-07-01

    Full Text Available Acute appendicitis and incarcerated femoral hernia belong to relatively well known surgical diseases with regard to diagnostic workup and treatment. de Garengeot’s hernia is an entity involving concurrent occurrence of both the above mentioned problems.

  8. The current utility of ultrasound in the diagnosis of acute appendicitis.

    Science.gov (United States)

    Lourenco, Pedro; Brown, Jacquie; Leipsic, Jonathan; Hague, Cameron

    2016-01-01

    The purpose of this study is to evaluate the current performance of ultrasound in the diagnosis of acute appendicitis. Retrospectively, patients who presented to a single institution between 2011 and 2012 were included. Diagnostic accuracy was calculated, with surgery considered gold-standard. Our data demonstrates that US relative to surgery-confirmed appendicitis has a sensitivity and specificity of 48.4% and 97.9%, respectively. The diagnostic accuracy was further increased when there was a low pre-test probability, with a NPV of up to 96.6%. Ultrasound has a strong PPV in the diagnosis of acute appendicitis, and in equivocal cases, the NPV is reliable.

  9. Round ligament lipoma mimicking acute appendicitis in a 24-week pregnant female: a case report.

    Science.gov (United States)

    Miller, T J; Paulk, D G

    2013-04-01

    An exhaustive search of the literature using the Pub Med database revealed no reports of round ligament lipomas mimicking acute appendicitis in pregnant patients. There are relatively few articles on round ligament lipomas and even less on round ligament lipomas during pregnancy. This case report is on a 27-year-old 24-week pregnant female who presented with signs and symptoms similar to acute appendicitis who in fact had a large right pelvic round ligament lipoma that was causing her pain.

  10. Acute primary haemorrhagic omental torsion mimicking perforated appendicitis: an unorthodox surgical paradox.

    Science.gov (United States)

    Rehman, Abdul

    2014-08-01

    Acute primary haemorrhagic omental torsion is an atypical and deceptive cause of acute abdomen that could closely mimic a myriad of intra-abdominal catastrophes, especially perforated appendicitis. The author reports a 30 years man who had presented with gradually worsening right-sided abdominal pain of 2 days duration. Laboratory work-up and abdominal radiographs were inconclusive. Abdominal sonography detected presence of free fluid in the pelvic cul-de-sac. Based on clinical and sonographic findings, presumptive diagnosis of perforated appendicitis was made and the patient was explored through extended Rockey-Davis incision. About 500 - 700 ml of dark-coloured blood (haemoperitoneum) was present in the peritoneal cavity and the pelvis secondary to acute haemorrhagic omental torsion. The appendix was grossly normal. Omentectomy and prophylactic appendicectomy resulted in uneventful recovery of the patient. Acute primary omental torsion is an uncommon pathology that must be kept in mind during differential diagnosis of acute abdomen, especially acute or perforated appendicitis.

  11. Acute isolated appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia.

    Science.gov (United States)

    Decembrino, Nunzia; Zecca, Marco; Tortorano, Anna Maria; Mangione, Francesca; Lallitto, Fabiola; Introzzi, Francesca; Bergami, Elena; Marone, Piero; Tamarozzi, Francesca; Cavanna, Caterina

    2016-01-01

    We describe a case of isolated acute appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia (AML) treated according to the AIEOP AML 2002/01 protocol. Despite prophylaxis with acyclovir, ciprofloxacin and fluconazole administered during the neutropenic phase, 16 days after the end of chemotherapy the child developed fever without identified infective foci, which prompted a therapy shift to meropenem and liposomial amphotericin B. After five days of persisting fever he developed ingravescent abdominal lower right quadrant pain. Abdominal ultrasound was consistent with acute appendicitis and he underwent appendectomy with prompt defervescence. PAS+ fungal elements were found at histopathology examination of the resected vermiform appendix, and galactomannan was low positive. A. carneus, a rare species of Aspergillus formerly placed in section Flavipedes and recently considered a member of section Terrei, was identified in the specimen. Treatment with voriconazole was promptly started with success. No other site of Aspergillus localization was detected. Appendicitis is rarely caused by fungal organisms and isolated intestinal aspergillosis without pulmonary infection is unusual. To our knowledge, this is the first report of infection due to A. carneus in a child and in a primary gastrointestinal infection.

  12. Enterobius Vermicularis infection of the appendix as a cause of acute appendicitis in a Greek adolescent: a case report

    OpenAIRE

    Efraimidou, Eleni; Gatopoulou, Anthia; Stamos, Charilaos; Lirantzopoulos, Nikolaos; Kouklakis, George

    2008-01-01

    Gastrointestinal infection due to Enterobius vermicularis occurs worldwide and is considered to be the most common helminth infection. The simple presence of E. vermicularis in the appendix usually produces symptoms of acute appendicitis. The association of this parasitic infestation with acute appendicitis varies from 0.2%–41.8% worldwide. We present a case of a 15 year old female with enterobiasis of appendix presented with clinical features of acute appendicitis. The appendix was surgicall...

  13. Discovery and validation of urine markers of acute pediatric appendicitis using high accuracy mass spectrometry

    Science.gov (United States)

    Kentsis, Alex; Lin, Yin Yin; Kurek, Kyle; Calicchio, Monica; Wang, Yan Yan; Monigatti, Flavio; Campagne, Fabien; Lee, Richard; Horwitz, Bruce; Steen, Hanno; Bachur, Richard

    2015-01-01

    Study Objective Molecular definition of disease has been changing all aspects of medical practice, from diagnosis and screening to understanding and treatment. Acute appendicitis is among many human conditions that are complicated by the heterogeneity of clinical presentation and shortage of diagnostic markers. Here, we sought to profile the urine of patients with appendicitis with the goal of identifying new diagnostic markers. Methods Candidate markers were identified from the urine of children with histologically proven appendicitis by using high accuracy mass spectrometry proteome profiling. These systemic and local markers were used to assess the probability of appendicitis in a blinded, prospective study of children being evaluated for acute abdominal pain in our emergency department. Tests of performance of the markers were evaluated against the pathologic diagnosis and histologic grade of appendicitis. Results Test performance of 57 identified candidate markers was studied in 67 patients, with median age of 11 years, 37% of whom had appendicitis. Several exhibited favorable diagnostic performance, including calgranulin A (S100-A8), α-1-acid glycoprotein 1 (orosomucoid), and leucine-rich α-2-glycoprotein (LRG), with the ROC AUC and values of 0.84 (95 % CI 0.72-0.95), 0.84 (0.72-0.95), and 0.97 (0.93-1.0), respectively. LRG was enriched in diseased appendices and its abundance correlated with severity of appendicitis. Conclusions High accuracy mass spectrometry urine proteome profiling allowed identification of diagnostic markers of acute appendicitis. Usage of LRG and other identified biomarkers may improve the diagnostic accuracy of clinical evaluations of appendicitis. PMID:19556024

  14. Ultrasound Findings of Lymphoid Hyperplasia of the Appendix in Children: Differentiation from Acute Appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Jae; Seo, Jung Wook; Lee, Byung Hoon [Inje University Ilsan Paik Hospital, Koyang (Korea, Republic of)

    2009-12-15

    To evaluate the ultrasound (US) findings that can help differentiate lymphoid hyperplasia in the appendix from acute appendicitis. A total of 1230 patients (below 20 years old) suspected of having appendicitis received an appendectomy between November, 1999, and March, 2008, with US findings in 27 patients with pathologically proven lymphoid hyperplasia of the appendix. Of 167 patients that received an appendectomy from January, 2007, to December, 2007, 52 patients with acute appendicitis were retrospectively reviewed as a control group. Retrospective review of US images was performed by two radiologists who were blinded to the pathologic results. The review was based on 12 ultrasonographic criteria derived from reports on the diagnostic findings of the appendicitis. Compared with acute appendicitis, lymphoid hyperplasia in appendix had a smaller diameter (7.14{+-}1.22 mm vs 9.37{+-}1.80 mm, p < 0.001) and less wall thickening(1.38{+-}0.36 mm vs 1.74 {+-} 0.56 mm, p =0.001). Periappendicular inflammation (p < 0.001), intraluminal air (p = 0.006), round shape in transverse scan (p = 0.002),increased blood flow on color Doppler US (p = 0.03) were also different. US is a useful modality to differentiate lymphoid hyperplasia in the appendix from acute appendicitis

  15. Utility of diffusion-weighted imaging in the diagnosis of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Inci, Ercan; Hocaoglu, Elif; Aydin, Sibel; Bayramoglu, Sibel; Cimilli, Tan [Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology, Istanbul (Turkey); Kilickesmez, Ozgur [Yeditepe University, School of Medicine, Department of Radiology, Istanbul (Turkey)

    2011-04-15

    To evaluate the value of diffusion-weighted MRI (DWI) in the diagnosis of acute appendicitis. 119 patients with acute appendicitis and 50 controls were enrolled in this prospective study. DWI was obtained with b factors 0, 500 and 1000 s/mm{sup 2} and were assessed with a visual scoring system by two radiologists followed by quantitative evaluation of the DW images and ADC maps. Histopathology revealed appendicitis in 79/92 patients (78%) who had undergone surgery. On visual evaluation, except for one patient with histopathologically proven appendicitis all inflamed appendixes were hyperintense on DWI (98.7%). Quantitative evaluation with DW signal intensities and ADC values revealed a significant difference with normal and inflamed appendixes (p < 0.001). The best discriminative parameter was signal intensity (b 500). With a cut-off value of 56 for the signal intensity the ratio had a sensitivity of 99% and a specificity of 97%. The cut-off ADC value at 1.66 mm{sup 2}/s had a sensitivity of 97% and a specificity of 99%. DWI is a valuable technique for the diagnosis of acute appendicitis with both qualitative and quantitative evaluation. DWI increases the conspicuity of the inflamed appendix. We recommend using DWI to diagnose acute appendicitis. (orig.)

  16. [Nature of the relation of acute appendicitis morbidity to meteorological and heliogeophysical factors].

    Science.gov (United States)

    Khaavel', A A; Birkenfeldt, R R

    1978-04-01

    The authors analyzed 2009 appendicitis case records for the period from 1964 to 1973. In a sea climate region an evident season distribution of the apendicitis morbidity was found, with the rise of the incidence rate in January, March and April. The rise of the appendicitis incidence rate during the periods of vast fluctuations of air temperature, increase of air humidity and decrease of actual duration of sun radiance was established. The rise of the incidence of acute appendicitis was also noted during the months of a great and extremely great magnetic storms.

  17. EVALUATION OF HYPERBILIRUBINAEMIA AS A NEW DIAGNOSTIC MARKER FOR ACUTE APPENDICITIS AND ITS ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION

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    Lalit Kumar Regar

    2016-07-01

    Full Text Available BACKGROUND There are various investigations recommended to diagnose acute appendicitis; however, till date there is no confirmatory laboratory marker to diagnose preoperatively acute appendicitis & appendicular perforation. The purpose of study is to evaluate hyperbilirubinaemia as a new diagnostic marker for acute appendicitis and its role in the prediction of appendicular perforation. Preoperative assessment of serum bilirubin appears to be a promising new laboratory marker for diagnosing acute appendicitis & have a predictive potential for the diagnosis of appendicular perforation. METHODS A prospective analytical study of 100 cases comprising of a non-randomised cohort. RESULTS Hyperbilirubinaemia was found in most of the patients diagnosed with acute appendicitis (68.23% or appendicular perforation (73.33%. The mean total bilirubin level in patients diagnosed with acute appendicitis was 1.34 mg% while in patients diagnosed with appendicular perforation was 2.12 mg%. CONCLUSIONS Preoperative assessment of serum bilirubin should be routinely performed in cases of acute appendicitis as it can help in diagnosis of acute appendicitis as well as also serve as an important maker of acute gangrenous appendicitis.

  18. An unusual manifestation of acute appendicitis with left flank pain

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    Roland Talanow, MD, PhD

    2008-08-01

    Full Text Available The author presents a case with an unusual presentation of early appendicitis. The patient presented initially with left sided flank pain. Workup for nephrolithiasis, including non-contrast CT of the abdomen and pelvis was negative for renal stones or hydronephrosis. After discharge, the patient presented one week later in the ED with right lower quadrant pain. Contrast enhanced CT of the abdomen revealed perforated appendicitis.

  19. Co-infection with Enterobius vermicularis and Taenia saginata mimicking acute appendicitis.

    Science.gov (United States)

    Saravi, Kasra H; Fakhar, Mahdi; Nematian, Javad; Ghasemi, Maryam

    2016-01-01

    In this report, we describe an unusual case of verminous appendicitis due to Enterobius vermicularis and Taenia saginata in a 29-year-old woman from Iran. The histopathological examinations and parasitological descriptions of both worms found in the appendix lumen are discussed. The removed appendix exhibited the macroscopic and microscopic features of acute appendicitis. Antihelminthic therapy was initiated with single doses of praziquantel for the taeniasis and mebendazole for the enterobiasis, and the patient was discharged.

  20. Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.

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    Po-Li Wei

    Full Text Available BACKGROUND: Although procedures like appendectomy have been studied extensively, the relative importance of each surgeon's surgical volume-to-ruptured appendicitis has not been explored. The purpose of this study was to investigate the rate of ruptured appendicitis by surgeon-volume groups as a measure of quality of care for appendicitis by using a nationwide population-based dataset. METHODS: We identified 65,339 first-time hospitalizations with a discharge diagnosis of acute appendicitis (International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM codes 540, 540.0, 540.1 and 540.9 between January 2007 and December 2009. We used "whether or not a patient had a perforated appendicitis" as the outcome measure. A conditional (fixed-effect logistic regression model was performed to explore the odds of perforated appendicitis among surgeon case volume groups. RESULTS: Patients treated by low-volume surgeons had significantly higher morbidity rates than those treated by high-volume (28.1% vs. 26.15, p<0.001 and very-high-volume surgeons (28.1% vs. 21.4%, p<0.001. After adjusting for surgeon practice location, and teaching status of practice hospital, and patient age, gender, and Charlson Comorbidity Index, and hospital acute appendicitis volume, patients treated by low-volume surgeons had significantly higher rates of perforated appendicitis than those treated by medium-volume surgeons (OR = 1.09, p<0.001, high-volume surgeons (OR = 1.16, p<0.001, or very-high-volume surgeons (OR = 1.54, p<0.001. CONCLUSION: Our study suggested that surgeon volume is an important factor with regard to the rate of ruptured appendicitis.

  1. The platelet indices in pediatric patients with acute appendicitis

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    Yunus Yilmaz

    2015-06-01

    Full Text Available Background: The diagnosis of Acute Appendicitis (AA remains a problem in pediatric population. It has been suggested that Mean Platelet Volume (MPV is lower in the patients with AA. The purpose of this study was to investigate the diagnostic value of platelet indices in pediatric AA cases. Methods: A retrospective case-controlled study was designed: 224 subjects were included in this study. All patients had been operated on in division of pediatric surgery at the Kars Government Hospital with the preliminary diagnosis of AA. 204 and 20 of these patients were pathologically diagnosed as AA (group 1 and normal appendix vermiformis (group 2, respectively. Platelet indices had been studied in the biochemistry laboratory of the hospital, before the surgery. Results: In group 1, platelet count, mean platelet volume, plateletcrit and platelet distribution width were 305 +/- 94x103/ and micro;L; 7.37 +/- 0.90 fL; 0,220 +/- 0.057 % and 16.3 +/- 0.5%, respectively. In group 2, platelet count, mean platelet volume, plateletcrit and platelet distribution width were 283 +/- 85 103/ and micro;L; 7.60 +/- 1.24 fL; 0.208 +/- 0.045 % and 16.4 +/- 0.7%, respectively. There was no statistically significant difference between the groups studied with regard to platelet indices (P>0.05. Conclusions: Our study showed that platelet indices have no diagnostic value in the diagnosis of AA at pediatric age group. [Int J Res Med Sci 2015; 3(6.000: 1388-1391

  2. An evidence for adhesion-mediated acquisition of acute myeloid leukemic stem cell-like immaturities

    Energy Technology Data Exchange (ETDEWEB)

    Funayama, Keiji; Shimane, Miyuki; Nomura, Hitoshi [Department of Integrative Bioscience and Biomedical Engineering, Waseda University, 4-3-1 Ohkubo, Shinjuku-ku, Tokyo 169-8555 (Japan); Asano, Shigetaka, E-mail: asgtkmd@waseda.jp [Department of Integrative Bioscience and Biomedical Engineering, Waseda University, 4-3-1 Ohkubo, Shinjuku-ku, Tokyo 169-8555 (Japan)

    2010-02-12

    For long-term survival in vitro and in vivo of acute myeloid leukemia cells, their adhesion to bone marrow stromal cells is indispensable. However, it is still unknown if these events are uniquely induced by the leukemic stem cells. Here we show that TF-1 human leukemia cells, once they have formed a cobblestone area by adhering to mouse bone marrow-derived MS-5 cells, can acquire some leukemic stem cell like properties in association with a change in the CD44 isoform-expression pattern and with an increase in a set of related microRNAs. These findings strongly suggest that at least some leukemia cells can acquire leukemic stem cell like properties in an adhesion-mediated stochastic fashion.

  3. ACUTE APPENDICITIS SECONDARY TO ENTEROBIUS VERMICULARIS INFESTATION IN A YOUNG FEMALE: A CASE REPORT

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    Kumar Premjeet

    2014-05-01

    Full Text Available Gastrointestinal infection due to enterobius vermicularis occurs worldwide and is considered to be the most common helminth infection. The simple presence of enterobius vermicularis in the appendix usually produces symptoms of acute appendicitis. Acute appendicitis due to enterobius vermicularis is very rare, affecting mostly children. The association of this parasitic infestation with acute appendicitis varies from 0.2%–41.8% worldwide. Whether pinworms cause inflammation of the appendix or just appendiceal colic has been a matter of controversy. We present a case of an 18 year old female with enterobiasis of appendix presented with clinical features of acute appendicitis. The appendix was surgically removed and the specimen was pathologically diagnosed to contain of enterobius vermicularis in non-inflamed and histologically mild mononuclear cell infiltrated appendix. One should keep in mind that the clinical signs of intestinal parasite infection may mimic acute appendicitis, although rare. A careful evaluation of symptoms such as pruritus ani, or eosinophilia on laboratory examination, could prevent unnecessary appendectomies.

  4. Acute appendicitis in preschoolers: a study of two different populations of children

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    Sivridis Efthimios

    2011-07-01

    Full Text Available Abstract Objective To assess the incidence and the risk factors implicated in acute appendicitis in preschoolers in our region. Methods Over a 7-year period, 352 children underwent appendectomy for suspected acute appendicitis. Of these, data for 23 children were excluded because no inflammation of the appendix was found on subsequent histology. Of the remaining 329, 82 were ≤ 5 years old (i.e., preschool children and 247 were 5-14 years old. These two groups of children were further divided according to their religion into Muslims and Christian Orthodox: 43 of the children aged ≤ 5 years were Muslims and 39 were Christian Orthodox. A household questionnaire was designed to collect data concerning age, gender, type of residence area, living conditions, vegetable consumption, and family history of surgery for acute appendicitis as preschool children. The removed appendices were also assessed histologically for the amount of lymphoid tissue. Results Acute appendicitis of preschoolers developed more frequently in Muslims (39.4% than in Christians (17.7%; p p p > 0.05. Conclusions In our region, the percentage of preschool-aged Muslim children with acute appendicitis was remarkably high. One possible explanation for this finding could be the higher amount of lymphoid tissue in the wall of the appendix in Muslim preschool children together with their low standard of hygiene.

  5. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

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    Danielle I. Miano

    2015-12-01

    Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

  6. Limits and advantages of abdominal ultrasonography in children with acute appendicitis syndrome

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    Valentina Pastore

    2014-01-01

    Full Text Available Background: Graded compression ultrasonography (US has become the most popular technique used in suspected appendicitis and in our prospective study, we have evaluated its contribution to the diagnosis of acute appendicitis during the period 2010-2013. Materials and Methods: Four hundred and eighty children underwent urgent abdominal suspected of having acute appendicitis. Patients were divided into operated groups; (220 patients and non-operated (260 patients the final diagnosis was established on histopathological findings in the first group and on the phone interview in the second one. US was the sole imaging modality in all the non-operated patients and in 203 out of 220 operated ones. Seven children in the operated group underwent CT, while a second US was performed in 10 patients. Results: Acute appendicitis was confirmed in 188 operated patients while no one in the non-operated group returned to the hospital or was operated for appendicitis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 79%, 78%, 95%, 39% and 79%, respectively. Negative appendectomy and perforation rates were 14% and 8%. Seventeen children in the operated group required a second diagnostic imaging: 7 CTs and 10 USs. All the seven CTs were consistent with appendicitis and 6 out of 10 USs showed ecographic signs of appendicitis. Conclusion: Our results support routine US in all the children with suspected appendicitis because it helps in reducing negative appendectomy and perforation rate. Moreover, a negative US does not justify a subsequent and immediate CT because clinical re-evaluation and a second US can clarify the diagnosis.

  7. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

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    Platon, Alexandra; Jlassi, Helmi; Becker, Christoph D.; Poletti, Pierre-Alexandre [University Hospital of Geneva, Department of Radiology, Geneva 14 (Switzerland); Rutschmann, Olivier T. [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Verdun, Francis R. [University Institute for Radiation Physics, Lausanne (Switzerland); Gervaz, Pascal [University Hospital of Geneva, Clinic of Digestive Surgery, Geneva (Switzerland)

    2009-02-15

    The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) {>=} 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI {>=} 18.5. (orig.)

  8. Mucosal invasion by fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China

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    Alexander Swidsinski

    2012-01-01

    Full Text Available Background/Aim: To investigate the geographic occurrence of mucosa-invading Fusobacteria in acute appendicitis. Patients and Methods: Carnoy- and formalin-fixated appendices from Germany, Russia, and China were comparatively investigated. Bacteria were detected using fluorescent in situ hybridization. Cecal biopsies from patients with inflammatory bowel disease and other conditions were used as disease controls. Results: Fusobacteria represented mainly by Fusobacterium nucleatum were the major invasive component in bacterial infiltrates in acute appendicitis but were completely absent in controls. The occurrence of invasive Fusobacteria in Germany, Russia, and China was the same. The detection rate in Carnoy-fixated material was 70-71% and in formalin-fixated material was 30-36%. Conclusions: Acute appendicitis is a polymicrobial infectious disease in which F. nucleatum and other Fusobacteria play a key role.

  9. Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results

    Energy Technology Data Exchange (ETDEWEB)

    Inci, Ercan, E-mail: ercan_inci@mynet.com [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Turhan, Ahmet Nuray; Ayguen, Ersan [Department of Surgery, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul (Turkey)

    2011-11-15

    Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 {+-} 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.

  10. Septic thrombophlebitis of the porto-mesenteric veins as a complication of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Yeon Soo Chang; Sun Young Min; Sun Hyung Joo; Suk-Hwan Lee

    2008-01-01

    Pylephlebitis, a rare complication of acute appendicitis,is defined as thrombophlebitis of the portal venous system. Pylephlebitis usually occurs due to secondary infection in the region drained into the portal system.We report a case of pylephlebitis caused by acute appendicitis. The patient was transferred from a private clinic 1 wk after appendectomy with the chief complaints of high fever and abdominal pain. He was diagnosed with pylephlebitis of the portal vein and superior mesenteric vein by CT-scan. The patient was treated with antibiotics and anticoagulation therapy,and discharged on the 25th day and follow-up CT scan showed a cavernous transformation of portal thrombosis.

  11. Can New Inflammatory Markers Improve the Diagnosis of Acute Appendicitis?

    DEFF Research Database (Denmark)

    Andersson, Manne; Rubér, Marie; Ekerfelt, Christina;

    2014-01-01

    , and myeloperoxidase [MPO]) were compared with traditional diagnostic variables included in the Appendicitis Inflammatory Response (AIR) score (right iliac fossa pain, vomiting, rebound tenderness, guarding, white blood cell [WBC] count, proportion neutrophils, C-reactive protein and body temperature) in 432 patients...

  12. Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists

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    Chang

    2016-01-01

    Full Text Available Background Low-dose computed tomography (LDCT techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed. Objectives To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT and contrast-enhanced standard dose CT (CE-SDCT for acute appendicitis among attending and resident radiologists. Patients and Methods This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI subgroups and noise using independent T test. Results Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05 for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically significant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018 on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not

  13. [Contribution of abdominal sonography in acute appendicitis diagnostics--our experience].

    Science.gov (United States)

    Smíd, D; Skalický, T; Treska, V

    2009-08-01

    Acute apendicitis is the most frequent case of acute abdomen. During a two year period (2006-2007) it was performed in Department of Surgery of Faculty Hospital in Pilsen 678 appendectomies, 30 days post-operative mortality rate was 0%. Abdomen ultrasonography like helping method to clinic examination was performed in 313 patients, suspect of acute appendicitis was in 191 patients (61%), in remaining patients was normal ultrasound picture.

  14. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

    DEFF Research Database (Denmark)

    Jahn, H; Mathiesen, F K; Neckelmann, K;

    1997-01-01

    of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively...... accuracy of 76%, specificity of 58%, and negative appendicectomy rate of 36%. 193 Patients underwent diagnostic US conducted by the radiologist on call of whom 123 were operated on, 78 for histologically proven appendicitis. US had a diagnostic accuracy of 72%, sensitivity of 49%, and specificity of 88......%. Of the 21 predictive factors for acute appendicitis 11 were significant (p 10 x 10[9]/1), migration of pain to the right lower quadrant, gradual onset of pain, increasing intensity of pain, pain aggravated by movement, pain aggravated by coughing, anorexia, vomiting...

  15. Systemic Mastocytosis Presenting as Acute Appendicitis: A Case Report and Review of the Literature

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    Syed A. Akbar

    2013-03-01

    Full Text Available Systemic mastocytosis is characterized by abnormal growth and accumulation of mast cells in various organs. Gastrointestinal (GI symptoms are common disease manifestations in this disease and can significantly impair the quality of life. Signs of GI systemic mastocytosis include steatorrhea, malabsorption, hepatomegaly, splenomegaly, portal hypertension, and ascites. Acute appendicitis as a presenting feature in systemic mastocytosis has not been reported in the literature previously. In this report, we discuss the case of a female patient with systemic mastocytosis (c-KIT D816V (+ who was admitted for right-sided acute abdominal pain. Laboratory study revealed an normal white blood cell count with eosinophilia and an elevated serum tryptase level of 23 μg/l. CT of the abdomen and pelvis showed an enlarged appendix of 12 mm in diameter, with minimal wall enhancement. Laparoscopic appendectomy was performed. The appendix was found to be hyperemic and firm, and it was densely adherent to the posterior cecum, the surrounding peritoneal wall, and the overlying mesenteric fat. Pathology revealed acute appendicitis with greater than 30 mast cells per high-power field by immunoperoxidase studies with mast cell tryptase and CD117. The patient subsequently improved and was discharged home. This case is the first reported case with a histological diagnosis of acute appendicitis resulting from mast cell infiltration. Physicians should be aware of acute appendicitis as a manifestation of systemic mastocytosis. Prompt diagnosis and management may prevent potentially fatal complications of appendiceal perforation and peritonitis.

  16. [Acute appendicitis and coinfection with enterobiasis and taeniasis: a case report].

    Science.gov (United States)

    Çallı, Gülhan; Özbilgin, Mücahit; Yapar, Nur; Sarıoğlu, Sülen; Özkoç, Soykan

    2014-01-01

    Parasites are rarely associated with inflammation of the appendix. Generally, parasites cause acute abdominal pain via blocking the gut lumen. In this article, we presented a case of appendicitis where Enterobius vermicularis was detected in the surgical specimen and Taenia was detected in the stool. A 31 year old male patient was admitted to the emergency room with severe abdominal pain, which has begun two days ago. On physical examination, tenderness was positive on palpation of the right lower abdominal quadrant and the patient was operated on with the diagnosis of acute appendicitis. Histopathological examination of the patient's appendectomy material revealed numerous parts of parasites resembling Enterobius vermicularis and slight mucosal erosion. On parasitological examination of the patient's stool, Taenia eggs and adult forms were determined. Antiparasitic therapy was started with niclosamide for taeniasis and albendazole for enterobiasis. Parasitic infections can mimic acute appendicitis clinically. Radiological and laboratory findings do not help to distinguish the diagnosis of acute appendicitis. In the histopathological examination of the appendix, the findings of acute inflammation of the appendix wall may not be defined. For patients with normal histopathological examination, screening for parasites should be done, and anti-parasitic treatment should be started after appendectomy.

  17. Relief of abdominal pain by morphine without altering physical signs in acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    YUAN Yong; CHEN Jia-yong; GUO Hao; ZHANG Yi; LIANG Dao-ming; ZHOU Dong; ZHAO Hui; LIN Feng

    2010-01-01

    Background Abdominal pain is a common symptom among patients with acute appendicitis, yet these patients havelong been denied relief from suffering because of widespread misconceptions associated with the use of opioids. Wedetermined whether morphine hydrochloride masked the physical signs in adults with acute appendicitis and assessedthe efficacy of morphine in relieving abdominal pain.Methods A prospective, double-blind, placebo controlled, clinical trial was conducted with 106 adult patients between16 and 70 years old with acute appendicitis. Patients were randomly divided into a morphine group (n=54) or a normalsaline group (n=52). All patients presented with acute abdominal pain with onset within 3 days. The morphine groupreceived hypodermic injection of morphine (0.15 mg/kg; maximum 20 mg) and the control group members were given anequivalent volume of normal saline solution. The clinical symptoms, physical signs, and patients' cooperation duringphysical examination were assessed before and after 30 minutes of morphine or normal saline administration.Results Abdominal pain was significantly relieved and the patients' cooperation was improved in the morphine groupafter 30 minutes treatment compared with the control group and before morphine administration (P0.05).Conclusions Morphine relieved abdominal pain and improved the patients' cooperation for treatment and care.Furthermore, the morphine did not mask the physical signs of acute appendicitis.

  18. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis.

    Science.gov (United States)

    Platon, Alexandra; Jlassi, Helmi; Rutschmann, Olivier T; Becker, Christoph D; Verdun, Francis R; Gervaz, Pascal; Poletti, Pierre-Alexandre

    2009-02-01

    The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) >or= 18.5. In slim patients (BMIor= 18.5.

  19. Evaluation of Tc-99m leukocyte scan in the diagnosis of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Butler, J.A.; Marcus, C.S.; Henneman, P.L.; Inkelis, S.H.; Wilson, S.E.

    1987-05-01

    A new /sup 99m/Tc Microlite leukocyte scan was performed in 38 patients to assess its value in the diagnosis of acute appendicitis. Autologous leukocytes are labeled with /sup 99m/Tc by inducing phagocytosis of /sup 99m/Tc albumin microcolloid particles. The advantages of this test over the standard indium-111 scan include superior imaging capability, a marked reduction (greater than 75%) in the radiation dose, and performance of the test including labeling, in less than 3 hr. Imaging is performed at 5-90 min postinjection of labeled cells. There were 19 male and 19 female patients with ages ranging from 10 to 80 years, in whom the diagnosis of appendicitis was indeterminate on clinical examination. Of the 13 of the 38 patients (34%) who came to surgery 12 had acute appendicitis. The WBC scan correctly identified 10 of the 12 cases of appendicitis. There were two false-negative studies. In the nonoperative group of 25 patients admitted for observation, 21 studies were reported as negative and four identified other sites of inflammation. All patients with a negative study have remained asymptomatic on follow-up. With a sensitivity of 83% (10/12) and a specificity of 100% (26/26) the /sup 99m/Tc leukocyte scan provides a rapid and highly accurate method for diagnosis of appendicitis in this preliminary study of patients with equivocal clinical exams.

  20. Computed Tomography (CT) Findings of a Diagnostic Dilemma: Atypically Located Acute Appendicitis

    Science.gov (United States)

    Evrimler, Sehnaz; Okumuser, Irfan; Unal, Nermin

    2016-01-01

    Summary Background Acute appendicitis is an emergent surgically treated disease generally represented by right lower abdominal pain. The most common location of the appendix is descending intraperitoneal. However, it can also show atypical locations such as inguinal canal, femoral canal, subhepatic, retrocecal, intraperitoneal abdominal midline and left side in situs inversus or intestinal malrotation patients. Atypical location can lead to atypical clinical presentations. Ultrasonography is the first choice modality for imaging. However, it can be insufficient for demonstration of the appendix. Therefore, computed tomography (CT) is needed for further examination. We aim to review the CT findings of atypically located acute appendicitis with cases and remind the clinicians and radiologists the importance of the prompt diagnosis. Case Report We presented five atypically-located appendix cases, including four with acute appendicitis that presented to our emergency department with acute abdominal pain. Two of the acute appendicitis cases had normal, the other two had elevated white blood cell count, but all of them had elevated CRP. Ultrasonography imaging was performed as a first-line imaging modality. Because of the inconclusive results of both clinical-laboratory findings and ultrasonography, CT imaging was performed. Abdominal CT demonstrated all of the atypically localised appendices successfully, which were left-sided in a malrotated patient, retrocecal, subhepatic, retrocecal ascending, intraperitoneal abdominal midline localised. Conclusıons Atypically located acute appendicitis can show atypical presentation and result in misdiagnosis. If ultrasonograpgy is inconclusive, we suggest abdominal CT in such confusing, complicated cases, because misdiagnosis or delay in the right diagnosis can result in complications and increased morbidity and mortality rates. PMID:28058072

  1. The impact of diagnostic delay on the course of acute appendicitis

    NARCIS (Netherlands)

    V.C. Cappendijk; F.W.J. Hazebroek (Frans)

    2000-01-01

    textabstractBACKGROUND: The diagnosis of acute appendicitis is often delayed, which may complicate the further course of the disease. AIMS: To review appendectomy cases in order to determine the incidence of diagnostic delay, the underlying factors, and impact on the co

  2. Acute Appendicitis as Complication of Colon Transit Time Study; A Case Report.

    Science.gov (United States)

    Ghahramani, Leila; Roshanravan, Reza; Khodaei, Shahin; Rahimi Kazerooni, Salar; Moslemi, Sam

    2015-07-01

    Colon transit time study with radio opaque markers is a simple method for assessment of colon motility disorder in patients with chronic idiopathic constipation. We report a case of acute appendicitis that was induced by impaction of radio opaque markers after colon transit time study. We think that this case report is first significant complication of colon transit time study until now.

  3. A young man with concurrent acute appendicitis and incarcerated right indirect inguinal hernia

    Directory of Open Access Journals (Sweden)

    Ditsatham C

    2016-01-01

    Full Text Available Chagkrit Ditsatham, Areewan Somwangprasert, Kirati Watcharachan, Phanchaporn Wongmaneerung Division of Head, Neck, and Breast, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: Acute appendicitis and incarcerated hernia rarely present in the same episode. Our study reports patient presentation, diagnosis method, and treatment of an unusual case at the Chiang Mai University Hospital. Method: Case report. Result: A 20-year-old man visited the Chiang Mai University Hospital with right lower quadrant pain and a right groin mass which could not be reduced. The computerized tomography scan showed acute appendicitis and omentum in the hernia sac. Operative treatment was an appendectomy and herniorrhaphy. The treatment was successful, and the patient was discharged from our hospital without any complications. Conclusion: Concurrent acute appendicitis and incarcerated hernia are very rare, but should be kept in mind if a patient presents with right lower quadrant pain and a right groin mass. Further investigation may be helpful if the diagnosis is uncertain. Operative priority treatment depends on each individual case. Keywords: combined acute appendicitis and incarcerated inguinal hernia

  4. Case report of idiopathic cecal perforation presenting as acute appendicitis on ultrasound

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    Calista Harbaugh

    2016-08-01

    Full Text Available Cecal perforation is an uncommon phenomenon in a pediatric population. It has been linked to a number of underlying medical conditions, which may result in focal inflammation or relative ischemia including hematologic malignancy, infection, and inflammatory bowel disease. We present an otherwise healthy 16-year-old male diagnosed with acute uncomplicated appendicitis on ultrasound, who was found to have cecal perforation with normal appendix intraoperatively, ultimately requiring ileocectomy. With this report, we aim to present the numerous pathophysiologic etiologies of cecal perforation, and to promote a comprehensive differential diagnosis despite the clinical and radiologic findings consistent with uncomplicated appendicitis.

  5. Total leucocyte count, C-reactive protein and neutrophil count: Diagnostic Aid in acute appendicitis

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    Shafi Sheikh

    2009-01-01

    Full Text Available Background/Aim: Acute appendicitis is one of the most common acute intraabdominal affections seen in surgical departments, which can be treated easily if an accurate diagnosis is made in time. Otherwise, delay in diagnosis and treatment can lead to diffuse peritonitis. Materials and Methods: A study was conducted on 110 patients who were operated for acute appendicitis to determine the role and predictive value of the total leucocyte count (TLC, C-reactive protein (CRP and percentage of neutrophil count in the diagnosis of acute appendicitis. Preoperative TLC, CRP and percentage of neutrophil count were determined and were compared with the results of the histopathology of the removed appendix. Results: Of all the patients studied, 92 had histopathologically positive appendicitis. The TLC was found to be significantly high in 90 patients who proved to have acute appendicitis, whereas CRP was high in only 88 patients and neutrophil percentage was raised in 91; four had a normal CRP level. Thus, TLC had a sensitivity, specificity and positive predictive value of 97.82%, 55.55% and 91.8%, respectively. CRP had a sensitivity, specificity and positive predictive value of 95.6%, 77.77% and 95.6% respectively. Percentage of neutrophil count had a sensitivity, specificity and positive predictive value of 98.9%, 38.88% and 89.21%, respectively. When used in combination, there was a marked improvement in the specificity and the positive predictive value to 88.04% and 98.7%, respectively. Conclusion: The inflammatory markers, i.e., TLC, CRP and neutrophil count can be helpful in the diagnosis when measured together as this increases their specificity and positive predictive value.

  6. Changes in appetite hormone (ghrelin) levels of saliva and serum in acute appendicitis cases before and after operation.

    Science.gov (United States)

    Cetinkaya, Ziya; Aydin, Suleyman; Cerrahoglu, Yusuf Z; Ayten, Refik; Erman, Fazilet; Aygen, Erhan

    2009-02-01

    This study was designed to measure the levels of serum and saliva ghrelin concentrations before and after surgery in an attempt to clarify whether this hormone plays any significant roles in acute appendicitis and cholelithiasis patients when compared with healthy controls. Samples were obtained from 20 patients with appendicitis, 10 patients with cholelithiasis before and after operation, and 16 healthy controls. The levels of ghrelin (acylated) were measured by means of a RIA assay. The results revealed that preoperative levels of ghrelin in saliva and serum were significantly decreased with respect to post-op in patients undergoing appendectomy, and control levels. This was also the case when the preoperative ghrelin concentrations in patients with appendicitis were compared with those having choelithiasis. Taken together, decreased ghrelin concentration in preoperative appendicitis might be a causative factor for the "loss of appetite" observed in an acute inflammatory condition such as acute appendicitis. However, further studies are necessary to reveal the exact mechanisms behind this observation.

  7. Spontaneous chylous peritonitis mimicking acute appendicitis: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Fu-Chi Fang; Sheng-Der Hsu; Chuang-Wei Chen; Teng-Wei Chen

    2006-01-01

    Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.

  8. Influence of delays on perforation risk in adults with acute appendicitis.

    LENUS (Irish Health Repository)

    Kearney, D

    2012-02-03

    PURPOSE: This study analyzed whether prehospital or in-hospital delay was the more significant influence on perforation rates for acute appendicitis and whether any clinical feature designated patients requiring higher surgical priority. METHODS: A retrospective analysis was conducted over one year at a tertiary referral hospital without a dedicated emergency surgical theater. Admission notes, theater logbook, and the Hospital Inpatient Enquiry system were reviewed to identify the characteristics and clinical course of patients aged greater than 16 years who were operated upon for histologically confirmed acute appendicitis. RESULTS: One hundred and fifteen patients were studied. The overall perforation rate was 17 percent. The mean duration of symptoms prior to hospital presentation was 38.1 hours with the mean in-hospital waiting time prior to operation being 23.4 hours. Although body temperature on presentation was significantly greater in patients found to have perforated appendicitis (P < 0.05), only patient heart rate at presentation and overall duration of symptoms, but not in-hospital waiting time, independently predicted perforation by stepwise linear regression modeling. CONCLUSION: In-hospital delay was not an independent predictor of perforation in adults with acute appendicitis although delays may contribute if patients are left to wait unduly. Tachycardia at presentation may be a quantifiable feature of those more likely to have perforation and who should be given higher surgical priority.

  9. Assessing Murphy Sequence as a Clinical Element in Acute Appendicitis Diagnosis

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    Andy Rocha Quintana

    2011-04-01

    Full Text Available Background: at present, the presence or lack of agreement between clinical diagnosis and evidence when exploring the abdominal cavity and performing excision of the pathological piece in cases of acute appendicitis, has become an increasingly contested issue. Objective: to characterize the presentation of Murphy Sequence in patients who underwent acute appendicitis surgery. Methods: descriptive study on a case series of patients who underwent acute appendicitis surgery in the General University Hospital of Cienfuegos between March and September 2006. Variables analyzed: age, sex, skin color, evolution duration and order of appearance of symptoms, presentation of Murphy Sequence, complementary tests and pathological diagnosis. Results: the average age for cases where Murphy Sequence was not presented was 34 years old, predominantly brown skinned males. The sequence was not completed in 96, 8% of cases, mainly those found in catarrhal stage. Laparoscopy was not performed in 69.7% of patients and, within this group, 97.7% of patients did not complete the sequence. In 51.9% of the cases, the first symptom was epigastric pain that then moved to the right iliac fossa. A broad spectrum of values of white blood cells was found in cases of catarrhal appendicitis. Conclusions: in 96.8% of cases Murphy Sequence was absent. Even in cases of long evolutions, these symptoms were not related to the disease stages.

  10. BACTERIAL PATTERN OF APPENDIX IN ACUTE AND CHRONIC APPENDICITIS WITH ITS CLINICAL CORRELATION

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    Surajit

    2016-02-01

    Full Text Available BACKGROUND Acute appendicitis is a common, sometimes confusing and often treacherous cause of acute abdomen at all ages. The only way to reduce morbidity and to prevent mortality is to perform appendicectomy before perforation or gangrene occurs. As appendicectomy is a very common practice, it is essential to know in detail the various etiological factors that precipitate appendicitis. Bacterial invasion being a very common cause makes it imperative that we have a clear picture of the bacterial pattern of appendix in acute and recurrent appendicitis and to correlate this with clinical findings. A proper idea of bacterial flora of appendix thus helps us not only to prevent postoperative complication, but also to impart effective conservative treatment by pinpointing sensitive drugs. AIMS AND OBJECTIVES Knowledge of bacterial flora of appendix also has socio-economic benefits through low rates of post-operative complications, reduced hospital stay and also reduced indiscriminate use of multiple costly drugs. The aim of this study is to establish the bacterial profile in acute as well as recurrent appendicitis and to correlate the findings with the severity of the disease. MATERIALS AND METHODS This study was conducted on 90 patients irrespective of age and sex who attended the emergency and OPD during the course of the work with symptoms suggestive of appendicitis. Following appendicectomy, each of the specimens was cut into two pieces. One was sent for histopathological examination and other was sent for bacterial culture. RESULT The commonest bacteria isolated were Escherichia coli in 67.78% cases, which is a facultative anaerobe and it was closely accompanied by Klebsiella species in 47.78% cases. Other isolates that were recorded included Staphylococcus aureus in 3.33% cases with Pseudomonas aeruginosa and Proteus species in 2.22% cases each. Mixed infections were seen in phlegmonous, gangrenous and perforative appendicitis. Bacteroides

  11. Acute right lower quadrant pain beyond acute appendicitis: MDCT in evaluation of benign and malignant gastrointestinal causes

    Directory of Open Access Journals (Sweden)

    Reem Hassan Bassiouny

    2014-09-01

    Conclusion: Using a systematic pattern approach MDCT has proved to be an extremely useful noninvasive method for evaluation of patients with acute RLQP, allowing diagnosis and management of not only the most common conditions such as appendicitis but also less common conditions.

  12. An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Antonio [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)]. E-mail: pinto@neomedia.it; Di Raimondo, Domenico [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Tuttolomondo, Antonino [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Fernandez, Paola [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Caronia, Aurelio [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Lagalla, Roberto [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Arnao, Valentina [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Law, Robert L. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Licata, Giuseppe [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)

    2007-05-15

    Midgut malrotation occurs as a result of failure in normal intestinal rotation and fixation during early pregnancy. Pathological conditions reported in the literature involving midgut malrotation predominantly relate to infants and children. In adults malrotation is often revealed as an incidental finding on computed tomography (CT), or the associated altered anatomy can be the cause of atypical clinical symptoms of relatively common intestinal disorders. An unusual presentation of acute appendicitis, with fever and recurrent pain in left iliac fossa is reported. Underlying intestinal malrotation delayed the correct clinical diagnosis of acute appendicitis. It was not until a CT scan was performed that a malrotation was identified. The predominant appearances of malrotation are the siting of the ascending colon, caecum (and appendix) in the left side of the abdomen and the right-sided placement of the duodenojejunal junction.

  13. MODIFIED ALVARADO’S SCORE: A DIAGNOSTIC TOOL FOR ACUTE APPENDICITIS

    Directory of Open Access Journals (Sweden)

    Chandrashekar

    2014-04-01

    Full Text Available BACKGROUND: Alvarado score is simple and can be instituted easily as this scoring is clinical, non-invasive and can be used to support diagnosis of acute appendicitis. Alvarado system combined with ultrasound can be used as a cheap and inexpensive way to confirming acute appendicitis and reducing negative appendicectomy rate. METHODS: The patients on admission were evaluated on the basis of Alvarado scoring. In this study we used a slightly modified version of Alvarado score by excluding one lab finding – shift to the neutrophils maturation. (Score 1, instead patients were subjected to ultrasonography of abdomen. CONCLUSION: Alvarado scoring system is dynamic allowing observation and critical reevaluation of evolution of clinical picture.

  14. Identification of residual leukemic cells by flow cytometry in childhood B-cell precursor acute lymphoblastic leukemia: verification of leukemic state by flow-sorting and molecular/cytogenetic methods

    OpenAIRE

    2012-01-01

    Reduction in minimal residual disease, measured by real-time quantitative PCR or flow cytometry, predicts prognosis in childhood B-cell precursor acute lymphoblastic leukemia. We explored whether cells reported as minimal residual disease by flow cytometry represent the malignant clone harboring clone-specific genomic markers (53 follow-up bone marrow samples from 28 children with B-cell precursor acute lymphoblastic leukemia). Cell populations (presumed leukemic and non-leukemic) were flow-s...

  15. Comparative analysis between single incision and conventional laparoscopic appendectomy for acute appendicitis

    OpenAIRE

    Sreeram Sateesh; Harsha Subraj; Gangaiahgari Mahesh; Pasupuleti Sreenivasa Rao

    2014-01-01

    Appendicitis is an acute inflammatory condition of appendix. Since it is a surgical emergency, needs early diagnosis and treatment strategies which include clinical examination, followed by Laboratory investigations and Imaging studies. The scoring systems like Alvarado score have been considered for better diagnosis. In most studies surgery has been reported as the best modality of treatment. Several studies clearly mentioned the impact of various surgical procedures which include Open appen...

  16. De Garengeot's hernia: acute appendicitis in a femoral hernia. Case report and literature overview.

    Science.gov (United States)

    Snoekx, R; Geyskens, P

    2014-01-01

    Migration of the appendix vermiformis into a femoral hernia is also known as De Garengeot's hernia. We report the case of an elderly patient who was diagnosed with an acute appendicitis within a strangulated femoral hernia sac. Emergency incision and abscess drainage was performed, followed by delayed laparoscopic appendectomy and herniorraphy. Both procedures were uneventful and the patient fully recovered. Although exceedingly rare, the surgeon needs to be aware of this entity to prevent a delay in diagnosis with potentially serious adverse events.

  17. [Early oral feeding versus classic oral feeding after appendicectomy for acute appendicitis].

    Science.gov (United States)

    Kassi Assamoi, B F; Yenon, K S; Lebeau, R; Traore, M; Akpa-Bedi, E; Kouassi, J C

    2010-01-01

    The appendectomies for acute appendicitis are the most frequent surgical interventions (43.6%) in our service. The recent studies demonstrated the feasibility and the economical gain of the early oral feeding vs. classic oral feeding, after elective digestive surgery. We wanted to spread these results therefore to the appendectomy for acute appendicitis. It is about a prospective survey carrying on 110 patients also left in two groups, and comparing the classic postoperative oral feeding vs. the early postoperative oral feeding on one year. The two groups were comparable and the studied parameters were : the length of the postoperative ileus, the hospitable morbidity, the length of the hospitalization and the cost of the hold in charge. The length of the postoperative ileus was not different in the two groups as well as the morbidity. The difference of the median length of hospitalization in the two groups was not meaningful. The cost of the hold in charge was meaningfully more elevated in the group with classic postoperative feeding. In conclusion, the early postoperative oral feeding in our survey doesn't reduce the length of the postoperative ileus and don't drag a morbidity anymore that the classic oral feeding. However if it doesn't shorten the length of the hospitalization, it drags a reduction of the cost of the hold in charge. There is a gain therefore precociously to nourish the patients after appendectomy for acute appendicitis.

  18. Acute appendicitis presenting with abdominal wall and right groin abscess: A case report

    Institute of Scientific and Technical Information of China (English)

    Mustafa Yildiz; Ahmet Sevki Karakayali; Saadet Ozer; Hilal Ozer; Aydin Demir; Bugra Kaptanoglu

    2007-01-01

    We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.

  19. [Validation of a diagnostic scoring system (Ohmann score) in acute appendicitis].

    Science.gov (United States)

    Zielke, A; Sitter, H; Rampp, T A; Schäfer, E; Hasse, C; Lorenz, W; Rothmund, M

    1999-07-01

    A diagnostic scoring system, recently published by Ohmann et al. in this journal, was validated by analyzing the clinicopathological data of a consecutive series of 2,359 patients, admitted for suspicion of acute appendicitis. The results of the scoring system were compared to the results of clinical evaluation by junior (provisional) and senior surgeons (final clinical diagnosis). To assess the diagnostic ability of the score, the accuracy and positive predictive value were defined as the major diagnostic performance parameters; the rate of theoretical negative laparotomies and that of diagnostic errors served as the major procedural performance parameters. Of 2,359 patients admitted for suspected acute appendicitis, 662 were proven to have acute appendicitis by histology, for a prevalence of 28%. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the provisional clinical diagnosis were 0.50, 0.94, 0.77, 0.83, and 0.82; 0.93, for the score 0.63, 0.93, 0.77, 0.86 and 0.84, and for the final clinical diagnosis 0.90, 0.94, 0.85, 0.96, and 0.93, respectively. Of the main diagnostic performance parameter, the accuracy of the score was significantly better than that of provisional clinical diagnosis (P apendicitis, the score demonstrated a superior performance, with only 6 cases missed (0.9%). However, the number of patients with acute appendicitis, including those with perforated disease, who were not identified by the score, was almost four times that of the final clinical diagnosis (245 vs 63). With regard to the main procedural performance parameter, the score resulted in a significantly smaller number of diagnostic errors than the provisional clinical investigator (P < 0.05, chi 2 test). The results of this study indicate that the diagnostic scoring system might be helpful when experienced investigators or additional diagnostic modalities such as ultrasonography are not available. It may therefore be of value

  20. Optimizing imaging in suspected appendicitis (OPTIMAP-study: A multicenter diagnostic accuracy study of MRI in patients with suspected acute appendicitis. Study Protocol

    Directory of Open Access Journals (Sweden)

    Bossuyt Patrick MM

    2010-10-01

    Full Text Available Abstract Background In patients with clinically suspected appendicitis, imaging is needed to substantiate the clinical diagnosis. Imaging accuracy of ultrasonography (US is suboptimal, while the most accurate technique (CT is associated with cancer related deaths through exposure to ionizing radiation. MRI is a potential replacement, without associated ionizing radiation and no need for contrast medium administration. If MRI is proven to be sufficiently accurate, it could be introduced in the diagnostic pathway of patients with suspected appendicitis, increasing diagnostic accuracy and improving clinical outcomes, without the risk of radiation induced cancer or iodinated contrast medium-related drawbacks. The multicenter OPTIMAP study was designed to estimate the diagnostic accuracy of MRI in patients with suspected acute appendicitis in the general population. Methods/Design Eligible for this study are consecutive patients presenting with clinically suspected appendicitis at the emergency department in six centers. All patients will undergo imaging according to the Dutch guideline for acute appendicitis: initial ultrasonography in all and subsequent CT whenever US does not confirm acute appendicitis. Then MRI is performed in all patients, but the results are not used for patient management. A final diagnosis assigned by an expert panel, based on all available information including 3-months follow-up, except MRI findings, is used as the reference standard in estimating accuracy. We will calculate the sensitivity, specificity, predictive values and inter-observer agreement of MRI, and aim to include 230 patients. Patient acceptance and total imaging costs will also be evaluated. Discussion If MRI is found to be sufficiently accurate, it could replace CT in some or all patients. This will limit or obviate the ionizing radiation exposure associated risk of cancer induction and contrast medium induced nephropathy with CT, preventing the burden and

  1. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    Institute of Scientific and Technical Information of China (English)

    Michael J Forster; Jacob A Akoh

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  2. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

    Science.gov (United States)

    Forster, Michael-J; Akoh, Jacob-A

    2008-03-21

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  3. Acute Appendicitis in an Incarcerated Femoral Hernia: A Case of De Garengeot Hernia

    Directory of Open Access Journals (Sweden)

    Kiyoko Ebisawa

    2009-11-01

    Full Text Available Appendicitis and incarcerated hernia are frequently encountered reasons of emergency surgery for acute abdomen. The treatment in early stages of each condition is generally simple, but when these conditions are combined, the symptoms become slightly complicated, obscuring specific symptoms. Especially the lack of symptoms for appendicitis leads to delayed diagnosis, resulting in high morbidity. Amyand hernia, which contains appendix in its inguinal hernia sac, is perhaps more familiar to the general surgeons than De Garengeot hernia, which is an incarcerated femoral hernia with an appendix in its sac. We report the case of a 90-year-old female with incarcerated femoral hernia who underwent emergency hernioplasty only to reveal an inflamed appendix in its sac. The patient underwent both appendectomy and hernia repair simultaneously with synthetic mesh and was discharged on postoperative day 7 without any complications. We will also discuss the physical and radiological findings of De Garengeot hernia.

  4. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of); Park, Seong Jin [Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of)

    2012-06-15

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  5. Intra-appendiceal air at CT: Is it a seful or a onfusing sign for the diagnosis of acute appendicitis?

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hye Suk; Cho, Hyun Suk; Woo, Ji Young; Lee, Yul; Yang, Ik; Hwang, Ji Young; Kim, Han Myun; Kim, Jeong Won [Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2016-02-15

    To investigate the significance of intra-appendiceal air at CT for the evaluation of appendicitis. We retrospectively analyzed 458 patients (216 men, 242 women; age range, 18-91 years) who underwent CT for suspected appendicitis. Two independent readers reviewed the CT. Prevalence, amount, and appearance of intra-appendiceal air were assessed and compared between the patients with and without appendicitis. Performance of CT diagnosis was evaluated in two reading strategies: once ignoring appendiceal air (strategy 1), and the other time considering presence of appendiceal air as indicative of no appendicitis in otherwise indeterminate cases (strategy 2), using receiver operating characteristic (ROC) analysis. Of the 458 patients, 102 had confirmed appendicitis. The prevalence of intra-appendiceal air was significantly different between patients with (13.2%) and without (79.8%) appendicitis (p < 0.001). The amount of appendiceal air was significantly lesser in patients having appendicitis as compared with the normal group, for both reader 1 (p = 0.011) and reader 2 (p = 0.002). Stool-like appearance and air-fluid levels were more common in the appendicitis group than in the normal appendix for both readers (p < 0.05). Areas under the ROC curves were not significantly different between strategies 1 and 2 in reader 1 (0.971 vs. 0.985, respectively; p = 0.056), but showed a small difference in reader 2 (0.969 vs. 0.986, respectively; p = 0.042). Although significant differences were seen in the prevalence, amount, and appearance of intra-appendiceal air between patients with and without appendicitis, it has a limited incremental value for the diagnosis of acute appendicitis.

  6. The Role of Digital Rectal Examination for Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis.

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    Toshihiko Takada

    Full Text Available Digital rectal examination (DRE has been traditionally recommended to evaluate acute appendicitis, although several reports indicate its lack of utility for this diagnosis. No meta-analysis has examined DRE for diagnosis of acute appendicitis.To assess the role of DRE for diagnosis of acute appendicitis.Cochrane Library, PubMed, and SCOPUS from the earliest available date of indexing through November 23, 2014, with no language restrictions.Clinical studies assessing DRE as an index test for diagnosis of acute appendicitis.Two independent reviewers extracted study data and assessed the quality, using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate random-effects models were used for the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR as point estimates with 95% confidence intervals (CI.The main outcome measure was the diagnostic performance of DRE for diagnosis of acute appendicitis.We identified 19 studies with a total of 7511 patients. The pooled sensitivity and specificity were 0.49 (95% CI 0.42-0.56 and 0.61 (95% CI 0.53-0.67, respectively. The positive and negative likelihood ratios were 1.24 (95% CI 0.97-1.58 and 0.85 (95% CI 0.70-1.02, respectively. The DOR was 1.46 (0.95-2.26.Acute appendicitis cannot be ruled in or out through the result of DRE. Reconsideration is needed for the traditional teaching that rectal examination should be performed routinely in all patients with suspected appendicitis.

  7. The value of pancreatic stone protein in predicting acute appendicitis in patients presenting at the emergency department with abdominal pain

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    Tschuor Christoph

    2012-10-01

    Full Text Available Abstract Background Pancreatic Stone Protein (PSP is a protein naturally produced mainly in the pancreas and the gut. There is evidence from experimental and clinical trials that blood PSP levels rise in the presence of inflammation or infection. However, it is not known whether PSP is superior to other established blood tests (e.g. White Blood Count, Neutrophils or C - reactive protein in predicting appendicitis in patients presenting with abdominal pain and a clinical suspicion of appendicitis at the emergency room. Methods/design The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis. 245 patients will be prospectively recruited. Interim analysis will be performed once 123 patients are recruited. The primary endpoint of the study concerns the diagnostic accuracy of PSP in predicting acute appendicitis and therefore the evidence of appendicitis on the histopathological specimen after appendectomy. Discussion The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis. Trial registration ClinicalTrials.gov: NCT01610193; Institution Ethical Board Approval ID: KEKZH- Nr. 2011–0501

  8. Comparative analysis between single incision and conventional laparoscopic appendectomy for acute appendicitis

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    Sreeram Sateesh

    2014-08-01

    Full Text Available Appendicitis is an acute inflammatory condition of appendix. Since it is a surgical emergency, needs early diagnosis and treatment strategies which include clinical examination, followed by Laboratory investigations and Imaging studies. The scoring systems like Alvarado score have been considered for better diagnosis. In most studies surgery has been reported as the best modality of treatment. Several studies clearly mentioned the impact of various surgical procedures which include Open appendectomy (OA, Conventional laparoscopic appendectomy (CLA and Single incision laparoscopic appendectomy (SILA. Hence, the present study is carried in an aim to assess and compare the merits and demerits between the surgical procedures Like SILA and CLA. The patients were randomly selected from the surgical department (NMCH who presented with acute pain abdomen and diagnosed as acute appendicitis. 50 patients were enrolled in the study after fulfilling the inclusion and exclusion criteria. The various demographic variables have been studied between the surgical procedures to demonstrate their impact, which include wound infection rate, pain scores at 24 and 48hrs, the amount of time period for surgery in minutes, patient satisfaction scores and post-operative stay tenure at the hospital in days. The laparoscopic hand instruments used in both techniques are similar, except covidien port which was reused in SILA, following gas sterilization to reduce the cost. Findings reveal that the pain score was significantly lower in SILA than CLA group. The procedure time is comparatively more in SILA than CLA group. Patients had significant satisfaction score in SILA measured at 6 weeks after appendectomy. However the post operative stay, wound infection rate was almost similar in both the groups. There was no conversion to open Appendectomy performed in either of these groups. Results also clearly suggest that the SILA procedure is the safe, alternative and effective

  9. First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma.

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    Suppiah, A; Barandiaran, J; Morgan, R; Perry, E P

    2008-02-01

    A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.

  10. Identification of hepatic niche harboring human acute lymphoblastic leukemic cells via the SDF-1/CXCR4 axis.

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    Itaru Kato

    Full Text Available In acute lymphoblastic leukemia (ALL patients, the bone marrow niche is widely known to be an important element of treatment response and relapse. Furthermore, a characteristic liver pathology observed in ALL patients implies that the hepatic microenvironment provides an extramedullary niche for leukemic cells. However, it remains unclear whether the liver actually provides a specific niche. The mechanism underlying this pathology is also poorly understood. Here, to answer these questions, we reconstituted the histopathology of leukemic liver by using patients-derived primary ALL cells into NOD/SCID/Yc (null mice. The liver pathology in this model was similar to that observed in the patients. By using this model, we clearly demonstrated that bile duct epithelial cells form a hepatic niche that supports infiltration and proliferation of ALL cells in the liver. Furthermore, we showed that functions of the niche are maintained by the SDF-1/CXCR4 axis, proposing a novel therapeutic approach targeting the extramedullary niche by inhibition of the SDF-1/CXCR4 axis. In conclusion, we demonstrated that the liver dissemination of leukemia is not due to nonselective infiltration, but rather systematic invasion and proliferation of leukemic cells in hepatic niche. Although the contribution of SDF-1/CXCR4 axis is reported in some cancer cells or leukemic niches such as bone marrow, we demonstrated that this axis works even in the extramedullary niche of leukemic cells. Our findings form the basis for therapeutic approaches that target the extramedullary niche by inhibiting the SDF-1/CXCR4 axis.

  11. Localized pseudomembranous colitis in the cecum and ascending colon mimicking acute appendicitis.

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    Chyung, Ju Won; Shin, Dong Gue

    2013-05-27

    A 61-year-old male was admitted to our hospital due to right lower abdominal pain and watery diarrhea for 3 d. Beginning 3 wk before he arrived in our hospital, he took 3(rd)-generation cephalosporin (cefixime) for 2 wk due to chronic left ear otitis media. Colonoscopic examination revealed yellowish patches of ulcerations and swelling covered with thick serosanguineous exudate in the cecum and ascending colon. After 7 d of oral metronidazole treatment, his symptoms completely disappeared. We report a case of localized pseudomembranous colitis in the cecum and ascending colon mimicking acute appendicitis associated with cefixime.

  12. Enterobius Vermicularis infection of the appendix as a cause of acute appendicitis in a Greek adolescent: a case report.

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    Efraimidou, Eleni; Gatopoulou, Anthia; Stamos, Charilaos; Lirantzopoulos, Nikolaos; Kouklakis, George

    2008-12-06

    Gastrointestinal infection due to Enterobius vermicularis occurs worldwide and is considered to be the most common helminth infection. The simple presence of E. vermicularis in the appendix usually produces symptoms of acute appendicitis. The association of this parasitic infestation with acute appendicitis varies from 0.2%-41.8% worldwide. We present a case of a 15 year old female with enterobiasis of appendix presented with clinical features of acute appendicitis. The appendix was surgically removed and the specimen was pathologically diagnosed to contain of E. vermicularis in non-inflamed and histologically normal appendix. Even if this condition is not uncommon in the Greek population, to the best of our knowledge this is the first report presented in the English literature.

  13. Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

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    Didier, Ryne A. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Vajtai, Petra L. [Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Hopkins, Katharine L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States)

    2014-07-05

    Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI{sub vol}). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI{sub vol}. Reduced CTDI{sub vol} was achieved primarily by reductions in effective tube current-time product (mAs{sub eff}) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI{sub vol}, size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI{sub vol} was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI{sub vol} and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

  14. CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

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    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo-Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Department of Radiology, Asan Foundation, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440 (Korea, Republic of)

    2016-11-01

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  15. CT findings of foreign body reaction to retained endoloop ligature plastic tube mimicking acute appendicitis: A case report

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    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Dept. of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2016-07-15

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  16. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

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    Amanda Jensen

    2016-04-01

    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  17. The significance of urinary beta-2 microglobulin level for differential diagnosis of familial Mediterranean fever and acute appendicitis.

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    Ugan, Yunus; Korkmaz, Hakan; Dogru, Atalay; Koca, Yavuz Savas; Balkarlı, Ayse; Aylak, Firdevs; Tunc, Sevket Ercan

    2016-07-01

    The clinical and laboratory parameters widely used are not specific to discriminate the abdominal pain due to FMF attack from that of acute appendicitis. The present study aims to investigate the urinary beta-2 microglobulin (U-β2M) level as a potential parameter to identify these two diseases mimicking each other. A total of 51 patients with established FMF diagnosis due to Tel Hashomer criteria on colchicine treatment (1-1.5 mg/day), 15 patients with acute appendicitis who had appropriate clinical picture and were also supported pathologically after the surgery, and 20 healthy controls were enrolled in the study. Of the 51 patients with FMF, 25 were at an attack period, while remaining 26 were not. For the diagnosis of acute attack, as well as physical examination, laboratory tests including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were performed. From urine specimens U-β2M, microalbumin, and N-acetyl glucosaminidase (U-NAG) were measured. U-β2M levels were significantly higher in acute appendicitis group compared to FMF attack, FMF non-attack, and control groups (p appendicitis, FMF attack, and FMF non-attack groups compared to controls (U-NAG p appendicitis group compared to the FMF attack group (p = 0.004). Determination of U-β2M levels may be helpful for differential diagnosis of peritonitis attacks of FMF patients on colchicine treatment and acute appendicitis. However, this finding should be substantiated with other studies.

  18. Diagnostic performance of contrast-enhanced MR for acute appendicitis and alternative causes of abdominal pain in children

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    Koning, Jeffrey L. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Naheedy, John H.; Kruk, Peter G. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Rady Children' s Hospital, Department of Radiology, San Diego, CA (United States)

    2014-08-15

    Unenhanced MRI has emerged as a useful tool for diagnosing pediatric acute appendicitis. The use of contrast-enhanced MRI for diagnosing pediatric appendicitis has not been documented. The purpose of this study is to examine the diagnostic performance of contrast-enhanced MRI for acute appendicitis and alternative entities in the pediatric population presenting with acute abdominal pain. A retrospective review was conducted of 364 consecutive pediatric patients undergoing contrast-enhanced MRI for the evaluation of possible appendicitis at a single institution between November 2012 and September 2013. There were 132 cases of pathologically confirmed appendicitis out of 364 pediatric patients (36.3%) included in the study. Overall sensitivity and specificity were 96.2% (95% CI [91.4-98.4%]) and 95.7% (95% CI [92.3-97.6%]), respectively. Positive predictive value and negative predictive value were 92.7% (95% CI [86.6-96.3%]) and 97.8% (95% CI [94.7-99.1%]), respectively. The appendix was visualized in 243 cases (66.8%). Imaging confirmed alternative diagnoses in 75 patients, including most commonly colitis, enteritis or terminal ileitis (n = 25, 6.9%), adnexal cysts (n = 25, 6.9%) and mesenteric adenitis (n = 7, 1.9%). Contrast-enhanced MRI is capable of accurately diagnosing acute appendicitis while detecting many alternative entities of abdominal pain, and it allows good visualization of the appendix. Further evaluation is needed to determine whether contrast-enhanced MRI provides an advantage over non-enhanced MRI for imaging evaluation of acute abdominal pain in the pediatric population. (orig.)

  19. Alvarado score: A valuable clinical tool for diagnosis of acute appendicitis –a retros-pective study

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    Swagata Brahmachari1 and Ashwini B. Jajee2

    2013-08-01

    Full Text Available Appendicitis is a common surgical emergency and diagnosis is still a great challenge. Accurate diagnosis and timely intervention re-duces morbidity and mortality. The present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appen-dicitis in Indian set up. The study was carried out on 200 patients admitted in Surgery ward between January 2009 and December 2010 with right lower quadrant abdominal pain. Alvarado score was calculated and all patients were divided in three groups. Mean age of presentation was 29.12 years and male to female ratio was 1.27:1. Higher the Alvarado score, more is the sensitivity. So pa-tients having score 7 or above had sensitivity of 66%. We con-clude that Alvarado score is unique since it incorporates signs, symptoms and laboratory findings of suspicious patients. Alvarado score can be utilized safely for diagnosis of acute appendicitis.

  20. A hybrid decision support model to discover informative knowledge in diagnosing acute appendicitis

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    Son Chang Sik

    2012-03-01

    Full Text Available Abstract Background The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules. Methods We enrolled 326 patients who attended an emergency medical center complaining mainly of acute abdominal pain. Statistical analysis approaches were used as a feature selection process in the design of decision support models, including the Chi-square test, Fisher's exact test, the Mann-Whitney U-test (p Results Of 55 variables, two subsets were found to be indispensable for early diagnostic knowledge discovery in acute appendicitis. The two subsets were as follows: (1 lymphocytes, urine glucose, total bilirubin, total amylase, chloride, red blood cell, neutrophils, eosinophils, white blood cell, complaints, basophils, glucose, monocytes, activated partial thromboplastin time, urine ketone, and direct bilirubin in the univariate analysis-based model; and (2 neutrophils, complaints, total bilirubin, urine glucose, and lipase in the multivariate analysis-based model. The experimental results showed that the model with univariate analysis (80.2%, 82.4%, 78.3%, 76.8%, 83.5%, and 80.3% outperformed models using multivariate analysis (71.6%, 69.3%, 73.7%, 69.7%, 73.3%, and 71.5% with entry and removal criteria of 0.01 and 0.05; 73.5%, 66.0%, 80.0%, 74.3%, 72.9%, and 73.0% with entry and removal criteria of 0.05 and 0.10 in terms of accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under ROC curve, during a 10-fold cross validation. A statistically significant difference was detected in the pairwise comparison of ROC curves (p p Conclusions The decision model developed in this study can be applied as an aid in the initial decision making of clinicians to increase vigilance in cases of suspected acute

  1. A novel application of furazolidone: anti-leukemic activity in acute myeloid leukemia.

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    Xueqing Jiang

    Full Text Available Acute myeloid leukemia (AML is the most common malignant myeloid disorder of progenitor cells in myeloid hematopoiesis and exemplifies a genetically heterogeneous disease. The patients with AML also show a heterogeneous response to therapy. Although all-trans retinoic acid (ATRA has been successfully introduced to treat acute promyelocytic leukemia (APL, it is rather ineffective in non-APL AML. In our present study, 1200 off-patent marketed drugs and natural compounds that have been approved by the Food and Drug Administration (FDA were screened for anti-leukemia activity using the retrovirus transduction/transformation assay (RTTA. Furazolidone (FZD was shown to inhibit bone marrow transformation mediated by several leukemia fusion proteins, including AML1-ETO. Furazolidone has been used in the treatment of certain bacterial and protozoan infections in human and animals for more than sixty years. We investigated the anti-leukemic activity of FZD in a series of AML cells. FZD displayed potent antiproliferative properties at submicromolar concentrations and induced apoptosis in AML cell lines. Importantly, FZD treatment of certain AML cells induced myeloid cell differentiation by morphology and flow cytometry for CD11b expression. Furthermore, FZD treatment resulted in increased stability of tumor suppressor p53 protein in AML cells. Our in vitro results suggest furazolidone as a novel therapeutic strategy in AML patients.

  2. Pro-inflammatory-Related Loss of CXCL12 Niche Promotes Acute Lymphoblastic Leukemic Progression at the Expense of Normal Lymphopoiesis

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    Balandrán, Juan Carlos; Purizaca, Jessica; Enciso, Jennifer; Dozal, David; Sandoval, Antonio; Jiménez-Hernández, Elva; Alemán-Lazarini, Leticia; Perez-Koldenkova, Vadim; Quintela-Núñez del Prado, Henry; Rios de los Ríos, Jussara; Mayani, Héctor; Ortiz-Navarrete, Vianney; Guzman, Monica L.; Pelayo, Rosana

    2017-01-01

    Pediatric oncology, notably childhood acute lymphoblastic leukemia (ALL), is currently one of the health-leading concerns worldwide and a biomedical priority. Decreasing overall leukemia mortality in children requires a comprehensive understanding of its pathobiology. It is becoming clear that malignant cell-to-niche intercommunication and microenvironmental signals that control early cell fate decisions are critical for tumor progression. We show here that the mesenchymal stromal cell component of ALL bone marrow (BM) differ from its normal counterpart in a number of functional properties and may have a key role during leukemic development. A decreased proliferation potential, contrasting with the strong ability of producing pro-inflammatory cytokines and an aberrantly loss of CXCL12 and SCF, suggest that leukemic lymphoid niches in ALL BM are unique and may exclude normal hematopoiesis. Cell competence ex vivo assays within tridimensional coculture structures indicated a growth advantage of leukemic precursor cells and their niche remodeling ability by CXCL12 reduction, resulting in leukemic cell progression at the expense of normal niche-associated lymphopoiesis. PMID:28111575

  3. Diagnostic value of maximal-outer-diameter and maximalmural- thickness in use of ultrasound for acute appendicitis in children

    Institute of Scientific and Technical Information of China (English)

    Bo-Kyung Je; Sung-Bum Kim; Seung Hwa Lee; Ki Yeol Lee; Sang Hoon Cha

    2009-01-01

    AIM: To evaluate the maximal-outer-diameter (MOD) and the maximal-mural-thickness (MMT) of the appendix in children with acute appendicitis and to determine their optimal cut-off values to diagnose acute appendicitis. METHODS: In total, 164 appendixes from 160 children between 1 and 17 years old (84 males, 76 females; mean age, 7.38 years) were examined by high-resolution abdominal ultrasound for acute abdominal pain and the suspicion of acute appendicitis. We measured the MOD and the MMT at the thickest point of the appendix. Patients were categorized into two groups according to their medical records: patients who had surgery (surgical appendix group) and patients who did not have surgery (non-surgical appendix group). Data were analyzed by MedCalc v.9.3. The rank sum test (Mann-Whitney test) was used to evaluate the difference in the MOD and the MMT between the two groups. ROC curve analysis was used to determine the optimal cut-off value of the MOD and the MMT on diagnosis of acute appendicitis.RESULTS: There were 121 appendixes (73.8%) in the non-surgical appendix group and 43 appendixes (26.2%) in the surgical appendix group. The median 26.2%) in the surgical appendix group. The median MOD differed significantly between the two groups (0.37 cm vs 0.76 cm, P 0.57 cm (sensitivity 95.4%, specificity 93.4%) and > 0.22 cm (sensitivity 90.7%, specificity 79.3%), respectively. CONCLUSION: The MOD and the MMT are reliable criteria to diagnose acute appendicitis in children. An MOD > 0.57 cm and an MMT > 0.22 cm are the optimal criteria.

  4. Acute appendicitis: Is removal of a normal appendix still existing and can we reduce its rate?

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    Khairy Gamal

    2009-01-01

    Full Text Available Background/Aim: To determine the incidence of negative appendectomies and to identify factors that may reduce the risk of having the normal appendices removed surgically. Design: Cross-sectional study. Setting: College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia. Materials and Methods: The surgical and histological data of 852 patients who underwent appendicectomy were reviewed. All incidental or interval appendicectomies were excluded. Only patients who were admitted and whose appendices were removed and subjected to histology were included (585 patients. The data on patients who had a normal appendix on histology further analyzed to include demographics, specific investigations, operative findings of the appendix and additional operative findings that need other surgical procedures. Results: A normal appendix was removed in 54 (9.2% of the patients. Only 5.5% of those patients had a computed tomography (CT scan preoperatively and 3.7% had diagnostic laparoscopy. In 21 patients, additional operative and histological findings were obtained that might have caused the right lower abdominal pain. Conclusion: In spite of the advances in the diagnostic and imaging techniques, the rates of negative findings on appendicectomy have not decreased much. Clinical judgment is still the most important factor in the management of patients with suspected acute appendicitis. The routine use of CT scan or diagnostic laparoscopy for all patients who are suspected to have appendicitis is neither cost-effective nor safe.

  5. Evaluation of modified Alvarado score in the diagnosis of acute appendicitis

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    Abhinandan B. Vandakudri

    2016-01-01

    Results: The result of the study showed that high scores in men and children (7-9 had a sensitivity of 92.3% and 83.3% respectively, whereas in females it had a sensitivity of 72.7%. The score (5-6 in males and females had a sensitivity of 57% and 50% respectively. Conclusions: The high scores in modified Alvarado score is dependable aid in the early diagnosis of acute appendicitis in men and children but it's not true as far as women are considered. Ultrasonography of abdomen is a useful tool in avoiding negative appendicectomy rates particularly in females. [Int J Res Med Sci 2016; 4(1.000: 84-88

  6. Diagnosis and Treatment of Mucinous Appendiceal Neoplasm Presented as Acute Appendicitis

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    Ioannis Kehagias

    2016-01-01

    Full Text Available Appendiceal mucocele is a rare cause of acute abdomen. Mucinous appendiceal neoplasms represent 0.2–0.7% of all appendix specimens. The aim of this study is to report a case of a mucinous appendiceal neoplasm presented as acute appendicitis, discussing the clinical and surgical approach in the emergency setting. A 72-year-old female patient was admitted to the emergency department with a clinical examination indicative of acute abdomen. The patient underwent abdominal computed tomography scan which revealed a cystic lesion in the right iliac fossa measuring 8.3 × 5.2 × 4.1 cm, with calcified walls, and a mean density indicative of high protein content. The patient was taken to the operating room and a right hemicolectomy was performed. The postoperative course was unremarkable. The histopathological examination revealed a low-grade mucinous appendiceal neoplasm with negative regional lymph nodes. Ultrasound and CT are useful in diagnosing appendiceal mucocele and synchronous cancers in the emergency setting. The initial operation should include appendectomy and resection of the appendicular mesenteric fat along with any fluid collection for cytologic examination. During urgent appendectomy it is important to consider every mucocele as malignant in order to avoid iatrogenic perforation causing pseudomyxoma peritonei. Although laparotomy is recommended, the laparoscopic approach is not contraindicated.

  7. Stump Appendicitis: A Clinical Enigma.

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    Çiftci, F; Abdurrahman, I; Tatar, Z

    2015-01-01

    Appendectomy is one of the most frequently performed operations. Stump appendicitis, as a postoperative complication of appendectomy, is inflammation of the remnant residue when an incomplete excision occurs. We present a patient with stump appendicitis who had been operated on, laparoscopically, for acute appendicitis 6 months before. The patient was diagnosed with acute appendicitis, underwent surgery, and was discharged on postoperative day 3 without complications. Stump appendicitis is a rare cause of acute abdominal disease but should be considered in the differential diagnosis. Ultrasonography is helpful in the diagnosis.

  8. A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone.

    Science.gov (United States)

    Kim, Changsun; Kang, Bossng; Choi, Hyuk Joong; Park, Joon Bum

    2015-08-01

    We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.

  9. Research of Ultrasound Diagnosis for Acute Appendicitis%超声对急性阑尾炎诊断价值的研究

    Institute of Scientific and Technical Information of China (English)

    尤焕焕

    2015-01-01

    目的通过急性阑尾炎的超声图像表现,探讨急性阑尾炎的超声诊断价值。方法搜集本院2011年2月~2014年3月手术病例证实的50例急性阑尾炎的临床和超声资料,回顾性分析超声图像特征对急性阑尾炎的诊断价值。结果本组50例急性阑尾炎的超声诊断正确者48例,诊断准确率为96%,其中单纯性阑尾炎10例,化脓性阑尾炎32例,坏疽性阑尾炎5例,1例为回盲部肿瘤。结论超声图像特征对急性阑尾炎的诊断准确率高,已经成为疑似急性阑尾炎患者的最为行之有效的方法。%Objective The sonographic findings of acute appendicitis, To explore the value of ultrasound in the diagnosis of acute appendicitis. Methods Col ect the clinical and ultrasound date of 50 cases of confirmed by operation, a retrospective analysis of the ultrasonographic charateristics of value in the diagnosis of acute appendicitis. Results 48 cases of true ultrasound diagnosis in this group of 50 cases of acute appendicitis, the diagnostic accuracy was 96%, among 13 patients with simple appendicitis, 32cases of suppurative appendicitis, 5 cases of gangrenous appendicitis, 1 cases of ileocecal tumor. Conclusion Ultrasonography in the diagnosis of acute appendicitis rate has become the most ef ective method for the patients with suspected acute appendicitis.

  10. 多层螺旋CT在急性阑尾炎诊断中的价值%Multislice CT Value in the Diagnosis of Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    冯彦琦

    2014-01-01

    目的:探讨MSCT在临床诊断急性阑尾炎中的应用价值。方法回顾性分析67例急性阑尾炎的临床表现、CT扫描特征和手术病理资料。结果67例经手术、病理证实的急性阑尾炎中,单纯性阑尾炎15例,阑尾炎并阑尾周围炎33例,坏疽性阑尾炎8例,阑尾穿孔并周围脓肿例11例。结论急性阑尾炎有典型的 CT表现, MSCT在三维重建及图像后处理技术能从多角度显示阑尾及其周围情况,在急性阑尾炎的诊断、术前病理分型、鉴别诊断及治疗方案的拟定中有较高的临床应用价值。%Objective To investigate the value of MSCT in the clinical diagnosis of acute appendicitis. Methods A retrospective analysis of 67 cases of acute appendicitis, the clinical manifestation, CT scanning features and surgical pathology. Results 67 cases were confirmed by operation and pathology, acute appendicitis, 15 cases were simple appendicitis, appendicitis and appendiceal inflammation around 33 cases, 8 cases of gangrenous appendicitis, and perforated appendicitis abscess cases around 11. Conclusion Acute appendicitis has the typical CT manifestations, MSCT in 3D reconstruction and image post-processing technology can display the appendix and the sur ounding situation from various angles, in the diagnosis of acute appendicitis, preoperative pathological classification, dif erential diagnosis and treatment of the proposed high clinical application value.

  11. Apendicite aguda: modelo experimental em coelhos Acute appendicitis: model experimental in rabbits

    Directory of Open Access Journals (Sweden)

    João EBRAM-NETO

    2000-04-01

    Full Text Available Com objetivo de estudar experimentalmente as diversas fases evolutivas da apendicite aguda, foram utilizados 60 coelhos (Oryctogalus cuniculus, fêmeas, da linhagem Nova Zelândia, com peso variando de 2510 a 3040 gramas. Os animais foram divididos em dois grupos denominados controle e experimento, e estes subdivididos em três subgrupos com períodos de observação de 12, 24 e 48 horas. No grupo experimento foi realizada a oclusão do lume apendicular por meio de sutura seromuscular circular a 8 cm da extremidade distal do apêndice cecal, com fio de polipropileno 4-0. No controle foi feita somente a simulação da cirurgia. Os aspectos macroscópicos (aumento do tamanho, necrose, perfuração, aderência e secreção na cavidade abdominal bem como os microscópicos do grupo experimento, evidenciaram uma progressão das alterações anatomopatológicas mostrando haver uma relação entre a intensidade dos achados histopatológicos e o tempo de observação. Conclui-se que o método utilizado causa apendicite aguda com alterações anatomopatológicas distintas, de acordo com a fase evolutiva da doença.The evolving phases of acute appendicitis were studied experimentally. Sixty female rabbits (Oryctogalus cuniculus of New Zealand lineage weighing about 2510 to 3040 g were divided in two groups: a control group and experimental group. The experimental group was divided into three subgroups for observation after 12, 24 and 48 hours of the operation, that consisted on a 4-0 polypropylene circular suture at 8 cm from the distal part of the cecal appendix. The control group was sham operated. The macroscopic exam (increase of the appendix volume, necrosis, perfuration, adherence and secretion in the abdominal cavity and the microscopic finding showed a progression in the anatomopathological alterations. There was a close relationship between the histopathological findings and time after the appendiceal obstruction. We conclude that the method

  12. NF-κB in T-cell Acute Lymphoblastic Leukemia: Oncogenic Functions in Leukemic and in Microenvironmental Cells

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Nuno R. dos, E-mail: nrsantos@ualg.pt; Ghezzo, Marinella N.; Silva, Ricardo C. da; Fernandes, Mónica T. [IBB-Institute for Biotechnology and Bioengineering, Centre for Molecular and Structural Biomedicine (CBME), University of Algarve, Campus de Gambelas, 8005-139 Faro (Portugal)

    2010-11-05

    Two main NF-κB signaling pathways, canonical and noncanonical, performing distinct functions in organisms have been characterized. Identification of mutations in genes encoding components of these NF-κB signaling pathways in lymphoid malignancies confirmed their key role in leukemogenesis. T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of thymocytes that despite significant therapeutic advances can still be fatal. Although mutations in NF-κB genes have not been reported in T-ALL, NF-κB constitutive activation in human T-ALL and in acute T-cell leukemia mouse models has been observed. Although these studies revealed activation of members of both canonical and noncanonical NF-κB pathways in acute T-cell leukemia, only inhibition of canonical NF-κB signaling was shown to impair leukemic T cell growth. Besides playing an important pro-oncogenic role in leukemic T cells, NF-κB signaling also appears to modulate T-cell leukemogenesis through its action in microenvironmental stromal cells. This article reviews recent data on the role of these transcription factors in T-ALL and pinpoints further research crucial to determine the value of NF-κB inhibition as a means to treat T-ALL.

  13. Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

    Directory of Open Access Journals (Sweden)

    Kutovoy A.B.

    2015-09-01

    Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

  14. The role of DNA amplification and cultural growth in complicated acute appendicitis

    Directory of Open Access Journals (Sweden)

    Francesca Tocchioni

    2016-09-01

    Full Text Available Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases, Pseudomonas aeruginosa (3, Fusobacterium necrophorum (3, Adenovirus (2, E.coli (1, Klebsiella pneumoniae (1, Serratia marcescens/Enterobacter cloacae (1. Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus. Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.

  15. Lessons to be learned: a case study approach--acute appendicitis masquerading as macroamylasaemia.

    Science.gov (United States)

    Ganesh, Muniappan; Salam, Imroz

    2008-05-01

    Macroamylasaemia is a condition in which serum amylase is elevated in the presence of a low to normal urinary amylase and normal renal function. It is rare but can masquerade as other clinical disorders. Discussed here is a case report of a patient who presented initially with abdominal pain (later recognized as being due to gangrenous appendicitis) and in whom there was a very high serum amylase level, leading to an erroneous initial diagnosis and management as acute pancreatitis. The CT scan of the abdomen was normal without any evidence of pancreatitis. Subsequently, the renal amylase:creatinine clearance ratio (C(am)/C(cr)) was found to be low, being characteristic and diagnostic of macroamylasaemia; the latter was, in turn, the cause for the elevated serum amylase level. The underlying macroamylasaemia had thus masqueraded as pancreatitis. The patient underwent appendicectomy and hence made an excellent recovery. It is vitally important to recognize this condition in order to avoid both an incorrect diagnosis and inappropriate treatment/management.

  16. The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

    Science.gov (United States)

    Tocchioni, Francesca; Tani, Chiara; Bartolini, Laura; Moriondo, Maria; Nieddu, Francesco; Pecile, Patrizia; Azzari, Chiara; Messineo, Antonio; Ghionzoli, Marco

    2016-01-01

    Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases), Pseudomonas aeruginosa (3), Fusobacterium necrophorum (3), Adenovirus (2), E.coli (1), Klebsiella pneumoniae (1), Serratia marcescens/Enterobacter cloacae (1). Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated. PMID:27777701

  17. Defective quorum sensing of acute lymphoblastic leukemic cells: evidence of collective behavior of leukemic populations as semi-autonomous aberrant ecosystems

    Science.gov (United States)

    Patel, Sapan J; Dao, Su; Darie, Costel C; Clarkson, Bayard D

    2016-01-01

    Quorum sensing (QS) is a generic term used to describe cell-cell communication and collective decision making by bacterial and social insects to regulate the expression of specific genes in controlling cell density and other properties of the populations in response to nutrient supply or changes in the environment. QS mechanisms also have a role in higher organisms in maintaining homeostasis, regulation of the immune system and collective behavior of cancer cell populations. In the present study, we used a p190BCR-ABL driven pre-B acute lymphoblastic leukemia (ALL3) cell line derived from the pleural fluid of a terminally ill patient with ALL to test the QS hypothesis in leukemia. ALL3 cells don’t grow at low density (LD) in liquid media but grow progressively faster at increasingly high cell densities (HD) in contrast to other established leukemic cell lines that grow well at very low starting cell densities. The ALL3 cells at LD are poised to grow but shortly die without additional stimulation. Supernates of ALL3 cells (HDSN) and some other primary cells grown at HD stimulate the growth of the LD ALL3 cells without which they won’t survive. To get further insight into the activation processes we performed microarray analysis of the LD ALL3 cells after stimulation with ALL3 HDSN at days 1, 3, and 6. This screen identified several candidate genes, and we linked them to signaling networks and their functions. We observed that genes involved in lipid, cholesterol, fatty acid metabolism, and B cell activation are most up- or down-regulated upon stimulation of the LD ALL3 cells using HDSN. We also discuss other pathways that are differentially expressed upon stimulation of the LD ALL3 cells. Our findings suggest that the Ph+ ALL population achieves dominance by functioning as a collective aberrant ecosystem subject to defective quorum-sensing regulatory mechanisms. PMID:27429840

  18. C-reactive protein and white blood cell count do not improve clinical decision-making in acute appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Lassen, Annmarie Touborg; Zimmermann-Nielsen, Erik;

    2015-01-01

    INTRODUCTION: Acute appendicitis (AA) remains a diagnostic challenge as indicated by the high rate of unnecessary surgery. Blood samples, primarily C-reactive protein (CRP) and leucocyte counts, are used as a diagnostic supplement despite their relatively low sensitivities and specificities....... However, their influence on diagnostic decision-making has not previously been investigated. The aim of the present study was to investigate if the results of CRP and leucocytes had any positive or negative influence on the decision-making of surgeons handling patients with suspected AA. METHODS...... the blood results and re-evaluate their diagnosis. The surgeon's diagnosis before and after was compared with the final diagnosis defined by surgical findings or follow-up. The gold standard was any degree of appendicitis on histology. RESULTS: A total of 226 patients were included of whom 91 (40.3%) had...

  19. The validity and reliability of iridology in the diagnosis of previous acute appendicitis as evi-denced by appendectomy

    Directory of Open Access Journals (Sweden)

    L. Frank

    2013-01-01

    Full Text Available Iridology is defined as a photographic science that identifies pathological and functional changes within organs via biomicroscopic iris assessment for aberrant lines, spots, and discolourations. According to iridology, the iris does not reflect changes  during  anaesthesia,  due  to  the  drugs inhibitory  effects  on  nerves  impulses,  and  in cases of organ removal, it reflects the pre-surgical condition.The profession of Homoeopathy is frequently associated with iridology and in a recent survey (2009  investigating  the  perceptions  of  Masters of  Technology  graduates  in  Homoeopathy  of University of Johannesburg, iridology was highly regarded as a potential additional skill requirement for assessing the health status of the patient.This  study  investigated  the  reliability  of iridology  in  the  diagnosis  of  previous  acute appendicitis, as evidenced by appendectomy. A total of 60 participants took part in the study. Thirty of the 60 participants had an appendectomy due to acute appendicitis, and 30 had had no prior history  of  appendicitis.  Each  participant’s  right iris  was  documented  by  photography  with  the use  of  a  non-mydriatic  retinal  camera  that  was reset for photographing the iris. The photographs were then randomized by an external person and no identifying data made available to the three raters.  The  raters  included  the  researcher,  who had little experience in iridology and two highly experienced  practising  iridologists.  Data  was obtained  from  the  analyses  of  the  photographs wherein  the  presence  or  absence  of  lesions (implying acute appendicitis was indicated by the raters. None of the three raters was able to show a significant  success  rate  in  identifying  correctly the  people  with  a  previous  history  of  acute appendicitis and resultant appendectomies

  20. The diagnostic value of a panel of serological markers in acute appendicitis

    DEFF Research Database (Denmark)

    Farooqui, W; Pommergaard, H-C; Burcharth, J

    2015-01-01

    markers could increase the prognostic accuracy of diagnosing non-perforated and perforated appendicitis. MATERIAL AND METHODS: Demographic data, histological findings, blood tests, and clinical symptoms were collected on all patients who underwent a diagnostic laparoscopy, a laparoscopic appendectomy...

  1. Clinical value of CT in diagnosis of acute appendicitis%急性阑尾炎的CT诊断及临床应用价值

    Institute of Scientific and Technical Information of China (English)

    唐俊军; 黄宗良; 王国良

    2015-01-01

    目的 提高对CT在急性阑尾炎诊断中重要性的认识.方法 回顾性分析经手术病理证实的87例急性阑尾炎的CT表现.结果 87例急性阑尾炎中,单纯性阑尾炎45例,阳性40例,阴性5例;化脓性阑尾炎28例,坏疽穿孔性阑尾炎7例,阑尾周围脓肿7例均出现相应的CT表现.CT表现为阑尾肿大,管径增粗,阑尾壁不同程度水肿,同时可合并周围炎性渗出或脓肿形成.结论 CT对急性阑尾炎的诊断及临床应用有很大的价值.%Objective To enhance the application value of CT in diagnosis of acute appendicitis. Methods CT findings of 87 cases with acute appendicitis confirmed by surgery and pathology were retrospectively analyzed. Results There were 87 cases of acute appendicitis,45 cases of simple appendicitis,28 cases of suppurative appendicitis,7 cases of gangrenous appendicitis,7 cases of appendiceal abscess. CT findings of 5 cases of simple appendicitis were negative. CT showed swelling of the appendix,edema of the appendix wall and the abscess of the appendix. Conclusion CT imaging is of great value in the diagnosis of acute appendicitis.

  2. Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, Pierre-Alexandre; Platon, Alexandra [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Perrot, Thomas de; Becker, Christoph D. [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); Sarasin, Francois; Rutschmann, Olivier [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); Andereggen, Elisabeth [University Hospital of Geneva, Emergency Center, Geneva (Switzerland); University Hospital of Geneva, Department of Surgery, Geneva (Switzerland); Dupuis-Lozeron, Elise; Perneger, Thomas [University Hospital of Geneva, Division of Clinical Epidemiology, Geneva (Switzerland); Gervaz, Pascal [University Hospital of Geneva, Department of Surgery, Geneva (Switzerland)

    2011-12-15

    To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media. (orig.)

  3. Polymorphisms in the IL-6 and IL-6R receptor genes as new diagnostic biomarkers of acute appendicitis: a study on two candidate genes in pediatric patients with acute appendicitis

    OpenAIRE

    Sarsu, Sevgi Büyükbeşe; Yılmaz, Şenay Görücü; Bayram, Ali; Denk, Affan; Kargun, Kürşat; Sungur, Mehmet Ali

    2015-01-01

    Background Acute appendicitis (AA) (OMIM: 107700) is an inflammatory disease which is characterized by appendiceal inflammation. Genetic and environmental factors contribute to the development of AA. Especially, multiple genetic factors appear to be promising in the explanation of etiopathogenesis of AA. IL-6 (Interleukin-6) is an inflammatory cytokine and IL-6 receptor (IL-6R) plays an important role in the immune response. IL-6 (-572G/C rs1800796) and IL-6R (1:G.154448302 T > C rs7529229) g...

  4. Improving the false-negative rate of CT in acute appendicitis-Reassessment of CT images by body imaging radiologists: A blinded prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Poortman, Pieter [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: ppoortman@wlz.nl; Lohle, Paul N.M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: plohle@elisabeth.nl; Schoemaker, Cees M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: mcschoemaker@elisabeth.nl; Cuesta, Miguel A. [Department of Surgery, VU Medical Centre, Amsterdam (Netherlands)], E-mail: ma.cuesta@vumc.nl; Oostvogel, Henk J.M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: h.oostvogel@elisabeth.nl; Lange-de Klerk, Elly S.M. de [Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam (Netherlands)], E-mail: esm.delange@vumc.nl; Hamming, Jaap F. [Department of Surgery, Leiden University Medical Centre (Netherlands)], E-mail: j.f.hamming@lumc.nl

    2010-04-15

    Purpose: To compare the accuracy of computed tomography (CT) analyzed by individual radiology staff members and body imaging radiologists in a non-academic teaching hospital for the diagnosis of acute appendicitis. Patients and methods: In a prospective study 199 patients with suspected acute appendicitis were examined with unenhanced CT. CT images were pre-operatively analyzed by one of the 12 members of the radiology staff. In a later stage two body imaging radiologist reassessed all CT images without knowledge of the surgical findings and without knowledge of the primary CT diagnosis. The results, independently reported, were correlated with surgical and histopathologic findings. Results: In 132 patients (66%) acute appendicitis was found at surgery, in 67 patients (34%) a normal appendix was found. The sensitivity of the primary CT analysis and of the reassessment was 76% and 88%, respectively; the specificity was 84% and 87%; the positive predictive value was 90% and 93%; the negative predictive value was 64% and 78%; and the accuracy was 78% and 87%. Conclusion: Reassessment of CT images for acute appendicitis by body imaging radiologists results in a significant improvement of sensitivity, negative predictive value and accuracy. To prevent false-negative interpretation of CT images in acute appendicitis the expertise of the attending radiologist should be considered.

  5. Analysis of the features of sonogram in acute appendicitis%急性阑尾炎65例超声声像图分析

    Institute of Scientific and Technical Information of China (English)

    金亮培

    2012-01-01

    Objective To evaluate the feastures of sonogram and the diagnostic value of ultrasonography in acute appendicitis. Methods 65 cases of acute appendicitis were examined with ultrasonography. The features of sonogram overe analyzed and compared with postoperative pathology. Results The ultrasonic features of acute appendicitis were notable in 65 cases, different pathological type of appendicitis show different ultrasonographic features. Conclusion Ultrasonography has great value in the diagnosis and classification of acute appendicitis.%目的探讨急性阑尾炎的声像图特征和诊断价值。方法回顾65例急性阑尾炎的超声检查资料,分析不同病理类型急性阑尾炎的声像图特征。结果65例患者中超声检查均有明显的超声声像图改变,各型急性阑尾炎之间存在声像图区别。结论超声检查对急性阑尾炎的诊断和分型具有重要的临床价值。

  6. 86例急性阑尾炎的超声诊断%In 86 Cases the Ultrasound Diagnosis of Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    张丽

    2013-01-01

      目的探讨急性阑尾炎的超声诊断价值。方法运用高频及低频超声对经手术病理证实的86例急性阑尾炎的超声声像图进行回顾性分析。结果根据86例急性阑尾炎的超声声像图特征,归纳为4种类型,单纯性阑尾炎46例,化脓性阑尾炎22例,坏疽及穿孔性阑尾炎8例,阑尾周围脓肿形成10例。结论急性阑尾炎有多种超声表现,熟悉这些表现有助于提高超声诊断的准确性。%  Objective Explore the value of ultrasound in the diagnosis of acute appendicitis. Methods Application of high frequency and low frequency ultrasound on confirmed by operation and pathology of 86 patients with acute appendicitis ultrasound were retrospectively analyzed. Results Based on 86 cases of acute appendicitis ultrasonography characteristics, grouped into 4 types, 46 cases of simple appendicitis, 22 cases of suppurative appendicitis, 8 cases of gangrenous and perforated appendicitis, 10 cases of appendiceal abscess formation. Conclusion Acute appendicitis with multiple ultrasonic manifestations, familiar with these performance contributes to improve the diagnostic accuracy of ultrasound.

  7. A young man with concurrent acute appendicitis and incarcerated right indirect inguinal hernia

    Directory of Open Access Journals (Sweden)

    Farwana M

    2016-04-01

    Full Text Available Mohammad Farwana,1 Reem Farwana,2 Ikram Nasr3 1King's College London, London, 2University of Birmingham, Birmingham, 3Guy's and St Thomas' Hospital, London, UKWe read with great interest the expert opinion of Ditsatham et al1 on an extremely interesting case. Ditsatham describes a patient who presented with both appendicitis and an indirect inguinal hernia. There is very little known on the subject of concurrent appendicitis and hernia throughout the literature. There were some aspects to the history that stood out.View original paper by Ditsatham and colleagues.

  8. B-ultrasound diagnosis characteristics of acute appendicitis%急性阑尾炎B超诊断特点分析

    Institute of Scientific and Technical Information of China (English)

    曾茜; 邹亚卓

    2013-01-01

    目的探讨急性阑尾炎的B超诊断特点。方法选取本院2009年12月~2010年12月收治的疑似急性阑尾炎患者89例。全部进行B超检查,对B超诊断特点进行回顾性总结分析。结果本组患者经病理检查急性阑尾炎阳性66例(其中单纯性阑尾炎患者32例,化脓性阑尾炎患者15例,坏疽性阑尾炎患者12例,阑尾周围脓肿患者7例),急性阑尾炎阴性23例;经B超检查急性阑尾炎阳性64例,急性阑尾炎阴性25例。B超检查急性阑尾炎检查率为71.91%,敏感度为92.42%,特异度为86.96%,准确度为91.01%。结论 B超在急性阑尾炎的临床诊断上具有方便、快捷、特异性强、结果可靠的特点,可以更好的辅助医师进行临床诊断,早期确定治疗方案,为急性阑尾炎诊断、治疗提供了客观依据,值得临床推广使用。%Objective To explore B-ultrasound diagnosis characteristics of acute appendicitis. Methods 89 cases of suspected acute appendicitis were selected in our hospital from December 2009 to Decembe2010.All the patients were given B-ultrasound diagnosis,retrospectively analyzed B-ultrasound diagnosis characteristics. Results 66 cases checked by pathological examination were acute appendicitis positive(32 cases had simple appendicitis,15 cases had suppurative appendicitis,12 cases had gangrenous appendicitis,7 cases had appendiceal abscess),acute appendicitis negative had 23 cases;64 cases checked by B-ultrasound diagnosis were acute appendicitis positive,25 cases were acute appendicitis negative. B-ultrasound diagnosed acute appendicitis,the examination rate was 71.91%,sensitivity was 92.42%,specificity was 86.96%,accuracy was 91.01% . Conclusion B ultrasound in the clinical diagnosis of acute appendicitis is convenient,fast,specificity and reliable. It can better assist physicians for clinical diagnosis,it can provide an objective basis for acute appendicitis diagnosis in early identification

  9. Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis.

    Science.gov (United States)

    Shrestha, Binod Bade; Karmacharya, Mikesh

    2014-06-18

    Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.

  10. Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis

    OpenAIRE

    2014-01-01

    Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.

  11. 手术治疗急性阑尾炎的效果分析%The Effect of Surgical Treatment of Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    杨小平

    2013-01-01

    Objective To study the ef ect of the diagnosis and treatment of acute appendicitis. Methods Observation on treatment of 150 cases of acute appendicitis operation treatment after hospitalization June 2007~June 2013 year in the internal hospital. Results:among the 150 cases of acute appendicitis patients operation was successful in 146 patients,4 patients were misdiagnosed. Conclusion the treatment of acute appendicitis operation treatment is the most ef ect,it is worthy of popularization and application.%目的:为了研究急性阑尾炎的诊断依据和治疗效果。方法观察2007年6月~2013年6月内在本院住院治疗的150例急性阑尾炎患者手术完成后的治疗效果。结果在150例急性阑尾炎患者当中有146例患者手术成功,4例患者被误诊。结论手术治疗急性阑尾炎是最具疗效的治疗方法,值得推广应用。

  12. Initial antibiotic treatment for acute simple appendicitis in children is safe: Short-term results from a multicenter, prospective cohort study

    NARCIS (Netherlands)

    Gorter, R.R.; Lee, J.H. van der; Cense, H.A.; Kneepkens, C.M.; Wijnen, M.H.W.A.; Hof, K.H. In 't; Offringa, M.; Heij, H.A.

    2015-01-01

    BACKGROUND: Initial antibiotic treatment for acute appendicitis has been shown to be safe in adults; so far, not much is known about the safety and efficacy of this treatment in children. The aims of this study were to investigate the feasibility of a randomized controlled trial (RCT) evaluating ini

  13. The Value of Ultrasound in the Diagnosis of Acute Appendicitis%急性阑尾炎的超声诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘世锋; 熊彩霞

    2014-01-01

    目的:探讨超声诊断急性阑尾炎的超声图像特征及价值。方法对我院160例临床怀疑急性阑尾炎的患者进行右下腹及全腹检查,观察异常改变,对其声像图特征进行总结分析。结果急性阑尾炎的超声诊断符合率为92%。结论超声对急性阑尾炎的诊断安全、快捷,给临床治疗及时提供信息,为临床提供客观的诊断依据,具有重要临床应用价值。%Objective To investigate the ultrasonic image characteristics and the value of ultrasound in the diagnosis of acute appendicitis.Methods The right lower abdomen and abdominal examination in 160 patients with clinical y suspected acute appendicitis,abnormal changes were observed,to summarize and analyze the sonographic characteristics.Results The ultrasonic diagnosis of acute appendicitis rate was 92%.Conclusion Ultrasound diagnosis of acute appendicitis is safe、fast, clinical treatment to provide timely information,to provide the objective diagnostic basis for clinic,which has important clinical value.

  14. Gangrenous appendicitis presenting as acute abdominal pain in a patient on automated peritoneal dialysis: a case report

    Directory of Open Access Journals (Sweden)

    Ekart Robert

    2012-09-01

    Full Text Available Abstract Introduction Presentations of abdominal pain in patients on peritoneal dialysis deserve maximal attention and careful differential diagnosis on admittance to medical care. In this case report a gangrenous appendicitis in a patient on automated peritoneal dialysis is presented. Case presentation We report the case of a 38-year-old Caucasian man with end-stage renal disease who was on automated peritoneal dialysis and developed acute abdominal pain and cloudy peritoneal dialysate. Negative microbiological cultures of the peritoneal dialysis fluid and an abdominal ultrasonography misleadingly led to a diagnosis of culture negative peritonitis. It was decided to remove the peritoneal catheter but the clinical situation of the patient did not improve. An explorative laparotomy was then carried out; diffuse peritonitis and gangrenous appendicitis were found. An appendectomy was performed. Myocardial infarction and sepsis developed, and the outcome was fatal. Conclusion A peritoneal dialysis patient with abdominal pain that persists for more than 48 hours after the usual antibiotic protocol for peritoneal dialysis-related peritonitis should immediately alert the physician to the possibility of peritonitis caused by intra-abdominal pathology. Not only peritoneal catheter removal is indicated in patients whose clinical features worsen or fail to resolve with the established intra-peritoneal antibiotic therapy but, after 72 hours, an early laparoscopy should be done and in a case of correct indication (intra-abdominal pathology an early explorative laparotomy.

  15. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

    Cobben, L.P.; Groot, I.; Haans, L.; Blickman, J.G.; Puylaert, J.

    2004-01-01

    OBJECTIVE: The purpose of this study was to evaluate whether MRI can be used to accurately diagnose or exclude appendicitis in pregnant patients with clinically suspected appendicitis. CONCLUSION: Our results suggest that MRI is helpful in the examination and diagnosis of acute appendicitis in pregn

  16. APPENDICITIS: YOUNG ADULTS ARE SUSCEPTIBLE

    Directory of Open Access Journals (Sweden)

    Somashekhar V. Hiremath

    2016-08-01

    Full Text Available CONTEXT Appendicitis is the one of the most common emergencies of the acute abdomen encountered by the clinicians; peritonitis is the common cause due to appendicular perforation. Ultrasonography of abdomen is the preferred method of diagnosis of acute appendicitis. The study is done to diagnose acute appendicitis in a tertiary care hospital to ascertain early diagnosis prevalent in this part of the country, which might differ from other studies. AIM To ascertain prevalence, presentation and management of appendicitis in this part of India in a tertiary care government hospital with provisional diagnosis of appendicitis. MATERIAL AND METHODS Cases of acute abdomen, clinical diagnosis of acute appendicitis admitted in KIMS Hospital, Hubli, a tertiary care government hospital, from January 2014 to January 2015 for materials of this study. 100 cases have been taken for study; cases included in this study are acute appendicitis, appendicular abscess; method used is USG abdomen, a simple diagnostic tool. RESULTS In present study, 100 cases of acute abdomen with clinical diagnosis of acute appendicitis were taken and laparotomy was done for 98 cases and two cases of appendicular abscess. Youngest patient was 7 years old and oldest was 65 years. Peak incidence between 11 to 30 years of age group and male to female ratio is 3:2. Postoperative wound infection was a common complication in 21 cases and retention of urine was noticed in 7 cases, and there was a death in one case due to septicaemia. CONCLUSION Acute appendicitis is a second most common indication for early laparotomy in KIMS Hospital, Hubli, first being perforative peritonitis. Acute appendicitis is common between 11 to 30 years of age group, early diagnosis and intervention is required to prevent appendicular perforation and its complications. Diagnosis of acute appendicitis is to be done in patients presenting with atypical pain, absence of vomiting does not rule out appendicitis. Anorexia

  17. De Garengeot's hernia: a case of acute appendicitis in a femoral hernia sac.

    Science.gov (United States)

    Tanrıkulu, Ceren Sen; Tanrıkulu, Yusuf; Akkapulu, Nezih

    2013-07-01

    The presence of an appendix vermiformis in a femoral hernia sac is called De Garengeot's hernia. It is a very rare clinical condition and requires emergency surgery. However, preoperative diagnosis of De Garengeot's hernia is difficult. Herein, we report a 58-year-old female who presented with sudden-onset painful swelling in the right groin region. Diagnosis was established based on computed tomography findings, and appendectomy with mesh-free hernia repair was performed. The postoperative period was uneventful, and the histopathologic examination of the specimen revealed gangrenous appendicitis.

  18. Conservative treatment and nursing of acute appendicitis%阑尾炎的保守治疗和护理

    Institute of Scientific and Technical Information of China (English)

    董桂霞

    2013-01-01

    Objective:To explore the method of appendicitis in conservative treatment and effective nursing measures. Methods:a retrospective analysis of our hospital for conservative treatment of 90 cases of acute appendicitis in patients with clinical data, conservative treatment with combination of TCM and Western medicine, and the comprehensive nursing measures. Results:90 patients were cured, 1 cases turned to operation without treatment, among them, 63 cases of conservative treatment after 7 days cure, 27 cases were cured with conservative treatment for 14 days;the average hospital stay was 7.1 days. Conclusion:application of conservative treatment of integrated traditional Chinese and Western medicine, not only eliminates the operation on the patients with fear, and avoid serious complications caused by operation and anesthesia. Nursing science, system contributes to acute appendicitis in conservative treatment of patients, shorten the hospitalization time, reduce the economic burden.%目的:探讨阑尾炎保守治疗的方法及有效护理措施。方法:回顾性分析我院行保守治疗的90例急性阑尾炎患者临床资料,采用中西医结合的保守治疗方法,并采用综合护理措施。结果90例患者均痊愈出院,无1例转为手术治疗,其中,63例保守治疗7日后痊愈,27例保守治疗14天后痊愈;平均住院时间为7.1天。结论应用中西医结合的保守治疗,既消除了患者对手术的恐惧,又避免了手术和麻醉带来的严重并发症。科学、系统的护理措施有助于急性阑尾炎保守治疗患者的痊愈,缩短患者住院时间,降低经济负担。

  19. Comparison of imaging strategies with conditional versus immediate contrast-enhanced computed tomography in patients with clinical suspicion of acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Atema, J.J.; Gans, S.L.; Boermeester, M.A. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Randen, A. van; Stoker, J. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Lameris, W. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Spaarne Hospital, Department of Surgery, Hoofddorp (Netherlands); Es, H.W. van; Heesewijk, J.P.M. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Ramshorst, B. van [St Antonius Hospital, Department of Surgery, Nieuwegein (Netherlands); Bouma, W.H. [Gelre Hospital, Department of Surgery, Apeldoorn (Netherlands); Hove, W. ten [Gelre Hospital, Department of Radiology, Apeldoorn (Netherlands); Keulen, E.M. van [Tergooi Hospital, Department of Radiology, Hilversum (Netherlands); Dijkgraaf, M.G.W. [Academic Medical Centre, Clinical Research Unit, Amsterdam (Netherlands); Bossuyt, P.M.M. [Academic Medical Center, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam (Netherlands)

    2015-08-15

    To compare the diagnostic accuracy of conditional computed tomography (CT), i.e. CT when initial ultrasound findings are negative or inconclusive, and immediate CT for patients with suspected appendicitis. Data were collected within a prospective diagnostic accuracy study on imaging in adults with acute abdominal pain. All patients underwent ultrasound and CT, read by different observers who were blinded from the other modality. Only patients with clinical suspicion of appendicitis were included. An expert panel assigned a final diagnosis to each patient after 6 months of follow-up (clinical reference standard). A total of 422 patients were included with final diagnosis appendicitis in 251 (60 %). For 199 patients (47 %), ultrasound findings were inconclusive or negative. Conditional CT imaging correctly identified 241 of 251 (96 %) appendicitis cases (95 %CI, 92 % to 98 %), versus 238 (95 %) with immediate CT (95 %CI, 91 % to 97 %). The specificity of conditional CT imaging was lower: 77 % (95 %CI, 70 % to 83 %) versus 87 % for immediate CT (95 %CI, 81 % to 91 %). A conditional CT strategy correctly identifies as many patients with appendicitis as an immediate CT strategy, and can halve the number of CTs needed. However, conditional CT imaging results in more false positives. (orig.)

  20. Appendicitis in Children. Clinical, diagnostic and pathogenic factors

    OpenAIRE

    Salö, Martin

    2016-01-01

    Background: Appendicitis is the most common disease requiring abdominal surgery in children. However, the diagnosis of pediatric appendicitis is still a challenge, resulting in perforation and negative appendectomies, especially in girls and young children. Further, the pathogenesis of acute appendicitis is not known. Aim: To examine acute appendicitis in children in the aspects of evaluation of the utility of the pediatric appendicitis score (PAS) in young children and evaluate factors respo...

  1. Transplantation of marrow cells from children with standard risk-acute lymphoblastic leukemia at the end of therapy into NOD/SCID mice for detecting residual leukemic cells with in vivo growth potential.

    Science.gov (United States)

    Ramírez, Manuel; Díaz, Miguel A; Madero, Luis; Bueren, Juan A

    2003-12-01

    In the present work, we developed a strategy for detecting residual leukemia in the marrow of children with standard risk-acute lymphoblastic leukemia (sr-ALL) at the end of therapy, based on the capacity of human leukemic cells for growing in the NOD/SCID mice marrow microenvironment. Mononuclear (MN) marrow cells from 62 patients were injected into sublethally irradiated NOD/SCID mice and the engraftment kinetics and composition of the human grafts were determined periodically. The presence of human leukemic cells with immunophenotypes and clonal DNA markers similar to those of the original leukemic clone was studied.

  2. Anti-leukemic effects of HDACi Belinostat and HMTi 3-Deazaneplanocin A on human acute promyelocytic leukemia cells.

    Science.gov (United States)

    Valiulienė, Giedrė; Stirblytė, Ieva; Jasnauskaitė, Monika; Borutinskaitė, Veronika; Navakauskienė, Rūta

    2017-03-15

    Development of acute myeloid leukemia is usually sustained by deregulated epigenome. Alterations in DNA methylation and histone modifications are common manifestations of the disease. Acute promyelocytic leukemia (APL) is not an exception. Therefore, drugs that target epigenetic processes suggest an appealing strategy for APL treatment. In this study we tested the anti-leukemic activity of histone deacetylase inhibitor (HDACi) Belinostat (PXD101, (2E)-N-Hydroxy-3-[3-(phenylsulfamoyl)phenyl]prop-2-enamide), and histone methyltransferase inhibitor (HMTi) 3-Deazaneplanocin A (DZNep, 5R-(4-amino-1H-imidazo[4,5-c]pyridin-1-yl)-3-(hydroxymethyl)-3-cyclopentene-1S,2R-diol) combined with retinoic acid (RA) in APL cells NB4 and HL-60. We demonstrated that APL cell treatment with combinations of differentiation inductor RA, HDACi Belinostat and HMTi DZNep caused a depletion of leukemia cell growth and viability, initiated apoptosis and exaggerated RA induced granulocytic differentiation. Also an increased expression of transcription factors C/EBPε and PPARγ was demonstrated, while no significant reduction in C/EBPα gene level was detected. Furthermore, combined treatment depleted gene expression levels of EZH2 and SUZ12, especially in HL-60 cells, and diminished protein levels of Polycomb Repressive Complex 2 (PRC2) components EZH2, SUZ12 and EED. In addition, our study has shown that Belinostat and DZNep together with RA caused a depletion in HDAC1 and HDAC2 protein levels, HDAC2 gene expression and increased hyperacetylation of histone H4 in both leukemia cell lines. Using ChIP method we also demonstrated the increased association of hyperacetylated histone H4 with the C/EBPα and C/EBPε promoter regions in HL-60 cells. Summarizing, these findings indicate that combined treatment with RA, Belinostat and 3-Deazaneplanocin A is an effective epigenetic inducer for leukemia cell differentiation.

  3. Evaluation of high mobility group box 1 protein as a presurgical diagnostic marker reflecting the severity of acute appendicitis

    Directory of Open Access Journals (Sweden)

    Wu Chuanxin

    2012-09-01

    Full Text Available Abstract Objectives To validate the role of high mobility group box-1(HMGB1 in diagnosis of acute appendicitis (AA with different pathological severity. Methods According to the pathologically diagnosis, 150 patients underwent appendectomies between Jan. 2007 and Dec, 2010 were divided into acute simple, acute suppurative and acute gangrenous appendicitis as group 1, 2 and 3, respectively. Each patient group contains 50 sex and age matched cases to make comparison with 50 healthy volunteers. The mRNA and protein expression levels of serum HMGB1 were determined by real-time quantitative PCR and enzyme linked immunosorbent assay (ELISA. Serum High-sensitivity C-reactive protein (hs-CRP levels were determined by rate nephelometric immunoassay. Results In comparison with health volunteers, relative HMGB1 mRNA levels in group 1, 2 and 3 were significantly increased 3.05 ± 0.51,8.33 ± 0.75 and 13.74 ± 1.09 folds, reflecting a tendency of augmented severity. In accordance, serum protein levels of HMGB1 were 10.97 ± 1.64, 14.42 ± 1.56 and 18.08 ± 2.41 ng/ml in 3 patient groups, which are significantly higher than that of healthy volunteers’ 5.47 ± 0.73 ng/ml. hs-CRP levels were 12.85 ± 3.41, 21.04 ± 1.98 and 31.07 ± 5.46 ng/ml in 3 patients groups compared with 2.06 ± 0.77 ng/ml in controls. The concentrations of HMGB1 and hs-CRP were both positively correlated with disease severity. Conclusion Serum HMGB1 constitutes as a valuable marker in diagnosis of AA. Positively correlated with hs-CRP level, mRNA and protein expression of HMGB1 to a certain extent reflected the severity of AA.

  4. MSCT在无典型临床表现阑尾炎诊断中的应用%Helical CT scanning in the diagnosis of acute appendicitis without typica clinical features

    Institute of Scientific and Technical Information of China (English)

    吴丽卓; 王景宇; 王淑清

    2011-01-01

    Objective To investigate the value of helical CT in diagnosis of appendicitis with atypical clinical feature .MethodsHelical CT manifestations of 64 cases of appendicitis which were not initially considered on clinical presentation confirmed surgically and pathologically were retrospectively analyze .Results Helical CT findings of appendicitis included ;23cases of dissect abnormal ap-pendicitis (36.0 %)(7cases of pelvic appendicitis ,10cases of retro-peritoneal appendicitis ,6cases of superior position appendicitis ) ; 15cases of the infant acute appendicitis (23.0 % ) ; 26cases of the senior citizen acute appendicitis (41.0% ) .Conclusion MSCT has important significance to the diagnosis and the differential diagnosis of appendicitis and its complications atipica appendicitis .%目的 探讨MSCT扫描在临床表现不典型阑尾炎诊断中的价值.方法 回顾性分析64例特殊类型阑尾炎的临床表现、CT扫描特征和手术资料.结果 64例经手术、病理证实的急性阑尾炎中,CT诊断与手术相符者57例,诊断符合率89.0%.CT扫描诊断为解剖异常阑尾23例(36.0%)(盆腔阑尾7例,腹膜后位阑尾10例,肝下阑尾6例);小儿急性阑尾炎15例(23.0%);老年人急性阑尾炎26例(41.0%).结论 MSCT扫描对临床表现不典型阑尾炎的诊断,具有较高的临床价值.

  5. Increased gene transfer in acute myeloid leukemic cells by an adenovirus vector containing a modified fiber protein.

    Science.gov (United States)

    Gonzalez, R; Vereecque, R; Wickham, T J; Vanrumbeke, M; Kovesdi, I; Bauters, F; Fenaux, P; Quesnel, B

    1999-03-01

    Applications of gene transfer in acute myeloid leukemia (AML) blast cells have still not been developed, mostly due to the lack of an efficient vector. Adenoviruses have many advantages as vectors, but remain poorly efficient in cells lacking fiber receptors. A promising strategy is the retargeting of adenoviruses to other cellular receptors. We report the dramatic enhancement of gene transfer efficiency in AML blasts using AdZ.F(pK7), a modified adenovirus containing a heparin/heparan sulfate binding domain incorporated into the fiber protein of the adenovirus. We transduced 25 AML blast samples with efficiency reaching 100% of the cells in most samples. Optimal results were obtained at 8400 physical particles per cell, corresponding to a multiplicity of infection of 100 plaque forming units per cell. Control AdZ.F adenovirus efficiently transduced leukemic cell lines but gave poor results in AML samples. Both addition of soluble heparin and cell treatment with heparinase inhibited AdZ.F(pK7) gene transfer, showing that heparan sulfates are the major receptors mediating AdZ.F(pK7) transduction of AML blasts. Although adenoviruses can infect nondividing cells, we observed that a combination of growth factors (GM-CSF, IL-3, stem cell factor) was required for efficient transduction in order to maintain AML blast cell viability. This study demonstrates that retargeting the adenovirus fiber protein to heparan sulfates can overcome the low efficiency of adenovirus in AML blast cells and may provide a useful tool for gene therapy approaches in AML.

  6. Cell-specific modulation of drug resistance in acute myeloid leukemic blasts by diphtheria fusion toxin, DT388-GMCSF.

    Science.gov (United States)

    Frankel, A E; Hall, P D; McLain, C; Safa, A R; Tagge, E P; Kreitman, R J

    1998-01-01

    Radiochemotherapy-resistant blasts commonly cause treatment failure in acute myeloid leukemia (AML), and their resistance is due, in part, to overexpression of multidrug resistance (mdr) proteins. We reasoned that targeted delivery of protein synthesis inactivating toxins to leukemic blasts would reduce the cellular concentrations of relatively short half-life resistance proteins and sensitize the cells to cytotoxic drugs. To test this hypothesis, we employed human granulocyte-macrophage colony-stimulating factor fused to truncated diphtheria toxin (DT388-GMCSF). The human AML cell line HL60 and its vincristine-resistant sublines, HL60Vinc and HL60VCR, were incubated in vitro for 24 h with varying concentrations of toxin. Doxorubicin was added for an additional 24 h, and cell cytotoxicity was assayed by thymidine incorporation and colony formation in semisolid medium. DT388-GMCSF sensitized HL60Vinc and HL60VCR but not HL60 to doxorubicin. Combination indices for three log cell kill varied from 0.2 to 0.3. In contrast, pretreatment with doxorubicin followed by toxins failed to show synergy. At least in the case of the vincristine-resistant cell lines, modulation of drug resistance correlated with reduction in membrane P-glycoprotein concentrations based on immunoblots with C219 antibody, flow cytometry with MRK16 antibody, and cell uptake of doxorubicin. These observations suggest clinical trials of combination therapy may be warranted in patients with refractory AML. Further, targeted toxins may represent a novel class of cell-specific modulators of drug resistance for a number of malignancies.

  7. Alfa-2-glicoproteína rica en leucina urinaria en pacientes con apendicitis aguda (Urinary leucine-rich alpha-2-glycoprotein in patients with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Heberto Machado-Montero

    2015-04-01

    Full Text Available The objective of research was to determine diagnostic efficacy of urinary concentrations of leucine-rich alpha-2-glycoprotein (A2GRL in patients with acute appendicitis. There were included patients with high suspicion of acute appendicitis (group A; cases, n = 30. In group B (controls, n = 30 were included patients with non-surgical abdominal pain who attended to Hospital Central “Dr. Urquinaona”, Maracaibo, Zulia. General characteristics, urinary concentrations of A2GRL and diagnostic efficacy of assay were evaluated. Mean age of patients in group A was 36.3 +/- 8.8 years-old and in group B was 35.8 +/- 9.6 years-old (p = ns. There were not found significant differences in sex distribution, weight and height between groups (p = ns. Urinary concentrations of A2GRL were significantly higher in group A (1543.8 +/- 762.7 ng/mL compared with mean value in patients of group B (774.1 +/- 356.1 ng/mL; p < 0.0001. A2GRL presented a value below curve 0.81. A cut-off value of 1000 ng/mL, showed sensivity 73.3%, specificity 70.9%, positive predictive value 72.4% and negative predictive value 72.4%. It is concluded that urinary concentrations of A2GRL have a high diagnostic efficacy in patients with acute appendicitis

  8. Comparison and Efficacy of LigaSure and Rubber Band Ligature in Closing the Inflamed Cecal Stump in a Rat Model of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Chun-Chieh Yeh

    2015-01-01

    Full Text Available Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A and 7 days (Group B after cecal resection, respectively. The cecal stumps were closed by silk ligature (S, 5 mm LigaSure (L, or rubber band (R. Seven days after cecal resection, the LigaSure (BL and silk subgroups (BS had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR. The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES.

  9. Use of cytosar in pediatric acute myelocytic leukemia and leukemic meningitis.

    Science.gov (United States)

    Sullivan, M P

    1982-01-01

    For children with acute myelocytic leukemia, 5-day courses of Cytosar in combination with cyclophosphamide (with or without vincristine sulfate and prednisone) has shown excellent, age related results in relapse patients. The regimen known as Mini-COAP has been incorporated into front-line studies. Cytosar given intrathecally in combination with methotrexate has produced superior results in treating meningeal disease in the African presentation of Burkitt disease. This "synchronizing" technique has been incorporated into a high Cytoxan-high methotrexate regimen with coordinated intrathecal therapy with good results. Triple (Cytosar, methotrexate, and hydrocortisone) intrathecal prophylaxis is now demonstrated to have equivalent effectiveness to conventional CNS prophylaxis employing radiotherapy 2400 R and 5 doses of intrathecal methotrexate.

  10. 急性阑尾炎术后并发症的防治%Prevention and Treatment of Acute Appendicitis Postoperative Complications

    Institute of Scientific and Technical Information of China (English)

    景玉萍

    2013-01-01

    Objective To observe the prevention and treatment of complications of acute appendicitis. Methods:a retrospective analysis of the clinical data of 800 patients with acute appendicitis patients in our hospital from 2007 January to 2012 December were analyzed. Results:suppurative appendicitis in 300 cases, incision infection in 10 cases, the complication rate was 3.3%;80 cases of appendiceal abscess, a total of 15 cases of complications, the incidence of complications was 18.8%. Conclusion:the early diagnosis of acute appendicitis, timely operation are the key to prevent operation incision infection.%目的:观察急性阑尾炎术后并发症的防治。方法回顾性分析我院自2007年1月~2012年12月收治的800例急性阑尾炎患者的临床资料。结果单纯性化脓性阑尾炎300例,并发切口感染10例,并发症发生率为3.3%;阑尾脓肿80例,并发症发生总数15例,并发症发生率为18.8%。结论对急性阑尾炎的早期诊断、及时手术是预防手术切口感染的关键。

  11. The MDM-2 Antagonist Nutlin-3 Promotes the Maturation of Acute Myeloid Leukemic Blasts

    Directory of Open Access Journals (Sweden)

    Paola Secchiero

    2007-10-01

    Full Text Available The small-molecule inhibitor of murine double minute (MDM-2, Nutlin-3, induced variable apoptosis in primary acute myeloid leukemia (AML blasts, promoted myeloid maturation of surviving cells, as demonstrated by analysis of CD11 b, CD14 surface antigens, by morphologic examination. Although the best-characterized activity of Nutlin-3 is activation of the p53 pathway, Nutlin-3 induced maturation also in one AML sample characterized by p53 deletion, as well as in the p53-/- human myeloblastic HL-60 cell line. At the molecular level, the maturational activity of Nutlin-3 in HL-60 cells was accompanied by the induction of E2F1 transcription factor, it was significantly counteracted by specific gene knockdown with small interfering RNA for E2F1. Moreover, Nutlin-3, as well as tumor necrosis factor (TNF α, potentiated the maturational activity of recombinant TNF-related apoptosis-inducing lig, (TRAIL in HL-60 cells. However, although TNF-α significantly counteracted the proapoptotic activity of TRAIL, Nutlin-3 did not interfere with the proapoptotic activity of TRAIL. Taken together, these data disclose a novel, potentially relevant therapeutic role for Nutlin-3 in the treatment of both p53 wild-type, p53-/- AML, possibly in association with recombinant TRAIL.

  12. Leukemic blasts are present at low levels in spinal fluid in one-third of childhood acute lymphoblastic leukemia cases

    DEFF Research Database (Denmark)

    Levinsen, Mette; Marquart, Hanne V; Groth-Pedersen, Line;

    2016-01-01

    with available CC data (P blast counts compared to patients positive by FCM only (medians: 0.10 vs. 0.017 leukemic blasts/μl, P = 0.006). Patients positive by FCM had higher white blood cell counts in peripheral blood than patients negative by FCM (medians...

  13. Laser and Non-Coherent Light Effect on Peripheral Blood Normal and Acute Lymphoblastic Leukemic Cells by Using Different Types of Photosensitizers

    Science.gov (United States)

    El Batanouny, Mohamed H.; Khorshid, Amira M.; Arsanyos, Sonya F.; Shaheen, Hesham M.; Abdel Wahab, Nahed; Amin, Sherif N.; El Rouby, Mahmoud N.; Morsy, Mona I.

    2010-04-01

    Photodynamic therapy (PDT) is a novel treatment modality of cancer and non-cancerous conditions that are generally characterized by an overgrowth of unwanted or abnormal cells. Irradiation of photosensitizer loaded cells or tissues leads via the photochemical reactions of excited photosensitizer molecules to the production of singlet oxygen and free radicals, which initiate cell death. Many types of compounds have been tested as photosensitizers, such as methylene blue (MB) and photopherin seemed to be very promising. This study involved 26 cases of acute lymphoblastic leukemia and 15 normal volunteers as a control group. The cell viability was measured by Light microscope and flowcytometer. Mode of cell death was detected by flowcytometer and electron microscope in selected cases. The viability percentage of normal peripheral blood mononuclear cells (PBMC) incubated with methylene blue (MB) alone or combined with photo irradiation with diode laser (as measured by light microscope) was significantly lower than that of untreated cases either measured after 1 hour (pdecrease in viability was more enhanced with increasing the incubation time. For normal cells incubated with photopherin either for 1/2 an hour or 1 hour, there was a weak cytotoxic effect compared to the effect on untreated cells. There was a significant decrease in viability percentage of cells incubated with photopherin either for 1/2 an hour or 1 hour and photoirradiated with He:Ne laser compared to normal untreated cells. The decrease in the cell viability percentage was significantly lower with the use of PDT (photopherin and He:Ne laser ) compared to either photopherin alone or He:Ne laser alone. The decrease in viability was more enhanced with increasing the incubation time. The same effects reported on normal cells were detected on leukemic cells on comparing different methods used. However a more pronounced decrease in cell viability was detected. The most efficient ways of decreasing viability

  14. Acute uncomplicated appendicitis study: rationale and protocol for a multicentre, prospective randomised controlled non-inferiority study to evaluate the safety and effectiveness of non-operative management in children with acute uncomplicated appendicitis

    Science.gov (United States)

    Xu, Jane; Liu, Yingrui Cyril; Adams, Susan; Karpelowsky, Jonathan

    2016-01-01

    Introduction This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention. Design A multicentre, prospective randomised controlled clinical trial, conducted in 2 Australian tertiary paediatric hospitals. Participants Children who meet the inclusion criteria of an age between 5 and 15 years and a clinical diagnosis of AUA will be invited to participate, and after consent will be randomised via a computer-based program into treatment groups. The study started in June 2016, and the target recruitment is 220 patients. Interventions Children in the control group will be treated with prophylactic antibiotics and appendicectomy, and those in the intervention group will be treated with antibiotic therapy alone. Primary outcome measures include unplanned or unnecessary operation and complications at 30 days. Secondary outcomes include longer term complications within 1 year, length of stay, time off work and school analgesic requirements and cost. Analysis Data analyses will be on the intention-to-treat principle using non-inferiority analysis. Analysis will include the Pearson χ2 test for categorical variables and independent sample t-test or Mann-Whitney test for continuous variables. Non-inferiority for NOM will be tested using 1-sided Wald tests with an α level of 0.05. Ethics and dissemination The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospital Network. In addition, results will be reported through academic journals, seminars and conference presentations. Trial

  15. Imaging of acute appendicitis in children: EU versus U.S.... or US versus CT? A North American perspective

    Energy Technology Data Exchange (ETDEWEB)

    Frush, Donald P. [Duke University Medical Center, McGovern-Davison Children' s Health Center, Division of Pediatric Radiology, Department of Radiology, Box 3808 DUMC, Durham, NC (United States); Frush, Karen S. [Duke University Health System, Duke University Medical Center, Division of Pediatric Emergency Medicine, Department of Pediatrics, Durham, NC (United States); Oldham, Keith T. [Children' s Hospital of Wisconsin, Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI (United States)

    2009-05-15

    The timing, type, and technique of imaging evaluation of suspected appendicitis in children are all debated. This debate is both local and international. The fact is that choices in imaging evaluation will depend on both local and national influences, which are reasonable and to be expected. There still is a responsibility, though, for those involved with evaluation of patients with possible appendicitis to come to agreement about an appropriate diagnostic pathway that considers standards of care and available resources. (orig.)

  16. Ultrasonic Direct and Indirect Signs of Acute Appendicitis-diagnostic Value%超声直接与间接征象对急性阑尾炎分型的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张爱红; 申国升

    2013-01-01

      目的:通过超声的直接和间接征象,探讨急性阑尾炎分型的诊断价值.方法:回顾性分析106例经手术和病理证实的急性阑尾炎的声像图,根据其直接和间接征象进行超声分型,并与病理对照.结果:超声分型诊断符合率,急性单纯性阑尾炎83.3%(25/30),急性化脓性阑尾炎91.9%(57/62),坏疽性阑尾炎85.7%(12/14).结论:超声直接和间接征象能较确切的反映不同类型的急性阑尾炎,正确认识这些征象,有助于对急性阑尾炎的分型作出诊断.%Objective: By the direct and indirect signs of the ultrasound,g enotyping diagnostic value of acute appendicitis. Method: A retrospective analysis of 106 cases of surgically and pathologically confirmed acute appendicitis,ultrasonography,ultrasound type,in accordance with its direct and indirect signs and pathology.Result: Ultrasound Diagnostic Classification coincidence rate of acute simple appendicitis was 83.3%(25/30), acute suppurative appendicitis was 91.9%(57/62),gangrenous appendicitis was 85.7%(12/14).Conclusion: Ultrasonography is the direct and indirect signs of the exact reflection of the different types of acute appendicitis,the correct understanding of these signs will help make a diagnosis of acute appendicitis typing.

  17. The diagnosis of acute appendicitis with the combined use of different frequency ultrasound: Analysis of 115 Cases%不同频率超声联合应用诊断急性阑尾炎115例分析

    Institute of Scientific and Technical Information of China (English)

    张辉

    2012-01-01

    目的 探讨不同频率超声联合使用在急性阑尾炎诊断中的价值.方法 回顾性分析经手术病理确诊的115例阑尾炎患者的超声声像图,分析各型阑尾炎的图像特点.结果 急性单纯性阑尾炎41例,急性化脓性阑尾炎52例,坏疽性阑尾炎13例,阑尾周围脓肿9例,各类型急性阑尾炎声像图改变具有特异性.结论 不同频率超声联合使用在急性阑尾炎诊断及分型中有其重要的临床价值.%Objective To investigate the value of the combined use of different frequency ultrasound in the diagnosis of. Acute appendicitis Methods One hundred fifteen cases with acute appendicitis underwent ultrasound and confirmed by surgical pathology. The ultrasonic characteristics were compared with the histopathological findings. Results Each type of acute appendicitis ultrasonogra-phy was specific,including41 cases of acute simple appendicitis,52 cases of acute suppurative appendicitis, 13 cases of gangrenous appendicitis,9 cases of appendiceal abscess. Conclusion It was useful to combine different frequency ultrasound in the diagnosis of a-cute appendicitis.

  18. Mutated Ptpn11 alters leukemic stem cell frequency and reduces the sensitivity of acute myeloid leukemia cells to Mcl1 inhibition.

    Science.gov (United States)

    Chen, L; Chen, W; Mysliwski, M; Serio, J; Ropa, J; Abulwerdi, F A; Chan, R J; Patel, J P; Tallman, M S; Paietta, E; Melnick, A; Levine, R L; Abdel-Wahab, O; Nikolovska-Coleska, Z; Muntean, A G

    2015-06-01

    PTPN11 encodes the Shp2 non-receptor protein-tyrosine phosphatase implicated in several signaling pathways. Activating mutations in Shp2 are commonly associated with juvenile myelomonocytic leukemia but are not as well defined in other neoplasms. Here we report that Shp2 mutations occur in human acute myeloid leukemia (AML) at a rate of 6.6% (6/91) in the ECOG E1900 data set. We examined the role of mutated Shp2 in leukemias harboring MLL translocations, which co-occur in human AML. The hyperactive Shp2E76K mutant, commonly observed in leukemia patients, significantly accelerated MLL-AF9-mediated leukemogenesis in vivo. Shp2E76K increased leukemic stem cell frequency and affords MLL-AF9 leukemic cells IL3 cytokine hypersensitivity. As Shp2 is reported to regulate anti-apoptotic genes, we investigated Bcl2, Bcl-xL and Mcl1 expression in MLL-AF9 leukemic cells with and without Shp2E76K. Although the Bcl2 family of genes was upregulated in Shp2E76K cells, Mcl1 showed the highest upregulation in MLL-AF9 cells in response to Shp2E76K. Indeed, expression of Mcl1 in MLL-AF9 cells phenocopies expression of Shp2E76K, suggesting Shp2 mutations cooperate through activation of anti-apoptotic genes. Finally, we show Shp2E76K mutations reduce sensitivity of AML cells to small-molecule-mediated Mcl1 inhibition, suggesting reduced efficacy of drugs targeting MCL1 in patients with hyperactive Shp2.

  19. [The local complications of appendicitis].

    Science.gov (United States)

    Ortega León, L H; Vargas Domínguez, A; Miranda Fraga, P

    1994-01-01

    In order to find out the predisposing factors of local complications after appendectomy in two general hospitals, 268 charts of patients with acute appendicitis confirmed by surgery were reviewed. There were 142 males and 126 females. All wounds were closed and prophylactic antibiotics were not used. Sixty patients (22 per cent) developed local complications; 49 (81.7 per cent) surgical wound infection and 11 (18.3 per cent) with intra-abdominal abscess. In the wound infection group 25 per cent had complicated acute appendicitis and only one per cent non-complicated acute appendicitis. The correlation between the preoperative period and wound sepsis showed, the longer period the higher incidence of wound infection, 1.7 per cent with less than 24 hr. 11 per cent with less than 72 hr. and 78.9 per cent with more than 96 hr.

  20. High levels of the adhesion molecule CD44 on leukemic cells generate acute myeloid leukemia relapse after withdrawal of the initial transforming event.

    Science.gov (United States)

    Quéré, R; Andradottir, S; Brun, A C M; Zubarev, R A; Karlsson, G; Olsson, K; Magnusson, M; Cammenga, J; Karlsson, S

    2011-03-01

    Multiple genetic hits are detected in patients with acute myeloid leukemia (AML). To investigate this further, we developed a tetracycline-inducible mouse model of AML, in which the initial transforming event, overexpression of HOXA10, can be eliminated. Continuous overexpression of HOXA10 is required to generate AML in primary recipient mice, but is not essential for maintenance of the leukemia. Transplantation of AML to secondary recipients showed that in established leukemias, ∼80% of the leukemia-initiating cells (LICs) in bone marrow stopped proliferating upon withdrawal of HOXA10 overexpression. However, the population of LICs in primary recipients is heterogeneous, as ∼20% of the LICs induce leukemia in secondary recipients despite elimination of HOXA10-induced overexpression. Intrinsic genetic activation of several proto-oncogenes was observed in leukemic cells resistant to inactivation of the initial transformation event. Interestingly, high levels of the adhesion molecule CD44 on leukemic cells are essential to generate leukemia after removal of the primary event. This suggests that extrinsic niche-dependent factors are also involved in the host-dependent outgrowth of leukemias after withdrawal of HOXA10 overexpression event that initiates the leukemia.

  1. INCIDENCE, RISK FACTORS AND COMPLICATIONS OF ACUTE PERFORATED AND NON - PERFORATED APPENDICITIS IN A RURAL SETUP OF ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2015-05-01

    Full Text Available Appendicitis is one of the most common surgical emergencies. The incidence of appendicitis and chances of complication in the form of perforation are dependent on both the patients and non - patient factors . There are various studies conducted to address this problem, but there are no studies conducted to look in to the incidence of appendicitis in east Godavari district of Andhra Pradesh. Our study was aimed to bridge thi s gap. METHOD S AND MATERIALS: this was a retrospective study, patient data from 2009 - 2014 was analyzed and the age, distance from hospital, educational and socioeconomic background of the patients was collected. The duration between first appearance of sy mptoms and hospitalization was recorded. The incidence of post - op complication was also recorded. RESULTS: T he incidence of perforation was 15% in our study population, most of the patients were from low socioeconomic group and having income less than 5000 /month. The middle age group between 30 - 40 years was commonly affected by the appendicitis. The time laps between appearance of symptoms and hospitalization was found to be a predominant factor in the perforation. Surgical site infection was most common co mplication in the patients treated. CONCLUSION: T he incidence of perforation is still high and the time laps between first appearance of symptoms and hospitalization is a major determinant of perforation or complication in the appendicitis.

  2. Surgical audit: A prospective study of the morbidity and mortality of acute appendicitis.

    Science.gov (United States)

    Malatani, T S; Latif, A A; Al-Saigh, A; Cheema, M A; Abu-Eshy, S

    1991-03-01

    Between March and September 1989, acute apendicitis was clinically diagnosed in 317 patients who were studied as part of a prospective surgical audit. The study was designed to determine the accuracy of diagnosis, comparison of the macroscopic appearance of the appendix at operation, and subsequent histopathology and complications associated with the morbidity and mortality of emergency appendectomy. The clinical diagnosis was correct in 278 patients (88%). Thirty-nine (12%) of the patients had a negative laparotomy. There was no mortality, and wound infection was the source of increased morbidity in 37 (12%) patients. The highest incidence of wound infection was among those who had pus in the peritoneum (20%) or had a perforated or gangrenous appendix (25%). When the macroscopic appearance of the appendix was compared with the subsequent histopathological findings, a false positive error of 7% and a false negative error of 42% was found. During appendectomy the gross appearance of the appendix must be carefully noted so that a meticulous surgical technique can be complemented by appropriate antibiotic prophylaxis against wound infection, started at the time of surgery.

  3. The features of physical diagnosis for acute appendicitis in children%小儿急性阑尾炎的检体诊断特征分析

    Institute of Scientific and Technical Information of China (English)

    雷学锋; 柳良好; 刘丹丹; 鲍俏; 张刚

    2016-01-01

    目的:探讨不同年龄段的小儿急性阑尾炎腹部检体诊断特点。方法将手术证实的431例小儿急性阑尾炎患儿分为新生儿组、婴幼儿组、学龄前组、学龄期组,对各组检体情况进行回顾性分析,总结其各自特点。结果新生儿组3例(0.70%)以腹胀、精神差、肠鸣音改变等为主,婴幼儿组31例(7.19%)以叩痛、减速带试验阳性、反跳痛等为主,学龄前组162例(37.59%)以叩痛、反跳痛、肠鸣音改变等为主,学龄期组235例(54.52%)以叩痛、减速带试验阳性、反跳痛等为主。结论各年龄段小儿急性阑尾炎的腹部检体诊断特点不相同,细致、准确的检体可提供重要诊断依据。%Objective To investigate the features of physical diagnosis for acute appendicitis in the children of different age periods. Methods Four hundred and thirty⁃one cases with acute appendicitis ( postoperative diagnosis) were enrolled in this study,and divided into newborn,infant,preschool,and school age⁃groups. The clinical physical diagnosis of each group was retrospectively analyzed to summarize the features. Results Three newborns ( accounting for about 0. 70%) were characterized by abdominal distention,bad spirit, weak bowel sounds, and so on. Thirty⁃one infants′ ( 7. 19%) physical diagnosis were mainly percussion pain,positive speed humps test,rebound tenderness.The features of preschool group (162 cases,37. 59%) were mainly percussion pain, rebound tenderness, bowel sounds changing. The features of school age group (235 cases,54.52%) were principally percussion pain,speed humps test positive,rebound tenderness. Conclusions There are discrepancies between four age⁃groups in the features of acute appendicitis.Detailed and accurate physical diagnosis can provide important diagnostic evidences of acute appendicitis in children.

  4. Discriminating between simple and perforated appendicitis

    NARCIS (Netherlands)

    M. Bröker (Mirelle); E.M.M. van Lieshout (Esther); M. van der Elst (Maarten); L.P. Stassen (Laurents); T. Schepers (Tim)

    2012-01-01

    textabstractBackground: Several studies have been performed in order to diagnose an acute appendicitis using history taking and laboratory investigations. The aim of this study was to create a model for the identification of a perforated appendicitis. Methods: All consecutive patients who have under

  5. Infantile perforated appendicitis: A forgotten diagnosis

    Directory of Open Access Journals (Sweden)

    Katherine W. Gonzalez

    2015-04-01

    Full Text Available Acute appendicitis in the infant is a rare surgical diagnosis despite its frequency in older patients. The clinical presentation is often vague and can be misleading. We present the successful diagnosis and treatment of a 3 month old female with perforated appendicitis.

  6. Activated leukemic oncogenes AML1-ETO and c-kit: role in development of acute myeloid leukemia and current approaches for their inhibition.

    Science.gov (United States)

    Rulina, A V; Spirin, P V; Prassolov, V S

    2010-12-01

    Acute myeloid leukemia (AML) is a malignant blood disease caused by different mutations that enhance the proliferative activity and survival of blood cells and affect their differentiation and apoptosis. The most frequent disorders in AML are translocations between chromosomes 21 and 8 leading to production of a chimeric oncogene, AML1-ETO, and hyperexpression of the receptor tyrosine kinase KIT. Mutations in these genes often occur jointly. The presence in cells of two activated oncogenes is likely to trigger their malignization. The current approaches for treatment of oncologic diseases (bone marrow transplantation, radiotherapy, and chemotherapy) have significant shortcomings, and thus many laboratories are intensively developing new approaches against leukemias. Inhibiting expression of activated leukemic oncogenes based on the principle of RNA interference seems to be a promising approach in this field.

  7. 急性阑尾炎术后切口感染的防治%Prevention of wound infection after acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    张崇广; 王文江

    2016-01-01

    目的:探讨综合措施预防急性阑尾炎术后切口感染的效果。方法选取2008年1月~2014年12月我院接受急性阑尾炎手术患者363例作为研究对象,从术前刷手、皮肤消毒等到术中操作以及术后围手术期处理的各个环节进行回顾性分析。结果本组患者仅发生切口感染3例,感染发生率为0.8%。结论采取综合方法预防阑尾术后切口感染,明显降低切口感染率,效果满意。%Objective To explore effective comprehensive measures of acute appendicitis postoperative infection prevention.Methods 363 cases of acute appendicitis from preoperative surgical scrub,skin disinfection until surgery operations and all aspects of perioperative treatment were analyzed retrospectively.Results Wound infection occurred in this group only three cases,the infection rate was 0.8%.Conclusion We take an integrated approach to the prevention of wound infection after appendectomy,signiifcantly reduced wound infection rate,results were satisfactory.

  8. Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

    Science.gov (United States)

    GUERCIO, G.; AUGELLO, G.; LICARI, L.; DAFNOMILI, A.; RASPANTI, C.; BAGARELLA, N.; FALCO, N.; ROTOLO, G.; FONTANA, T.; PORRELLO, C.; GULOTTA, G.

    2016-01-01

    Acute appendicitis is common in an Emergency Surgery Unit. Although the laparoscopic approach is a method accepted for its treatment, no strong data are available for determining how many procedures must an experienced surgeon carry out for obtaining all the advantages of this technique and if this approach can become the gold standard in the activity of a general emergency unit with senior surgeons variously skilled on the basic laparoscopy. 142 patients that underwent appendectomy (90 laparoscopic, 52 conventional) for acute appendicitis were enrolled in this institutional retrospective cohort study. The surgeons were classified with a descriptor-based grading and divided in two groups regarding the skill. The only relevant result of our study was the significant reduction of conversion rate in case of laparoscopic approach. No strong differences were found concerning the duration of the procedure and the hospital stay between the two groups. The rate of complications were very low in both groups. In conclusion, the experienced surgeons can easily perform a laparoscopic approach independently from the specific skill in this approach. PMID:27938536

  9. The value of ultrasonography in early diagnosis of acute appendicitis%超声检查在急性阑尾炎早期诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    牛子长; 温雪娟; 王小英; 周迎莉

    2012-01-01

    Objective To explore the value of ultrasonography in early diagnosis of acute appendicitis. Methods The clinical date of 118 cases with acute appendicitis analyzed retrospectively. Results There were 118 cases of acute appendicitis, the diagnose accordance rate was 92. 4% , including 28 cases of acute simple appendicitis, the diagnose accordance rate was 85. 7% , 62 cases of acute purulent appendicitis, the diagnosis accordance rate was 96.7% , 16 cases of acute necrosis appendicitis, the diagnosis accordance rate was 93. 6% , 12 cases of blending lump appendicitis, the diagnosis accordance rate was 83. 3%. Conclusion Ultrasonography in early diagnosis of acute appendicitis have a higher value, by combining syndromes history, physical examination, development observation and laboratory medical report and ultrasonic examination can improve diagnosis rate obviously.%目的 探讨超声检查在急性阑尾炎早期诊断中的价值.方法 回顾性分析118例急性阑尾炎患者的临床资料.结果 急性阑尾炎118例,超声诊断符合率92.4%;其中急性单纯性阑尾炎28例,诊断符合率85.7%;急性化脓性阑尾炎62例,诊断符合率96.7%;急性坏疽性阑尾炎16例,诊断符合率93.6%.混合包块型阑尾炎12例,诊断符合率83.3%.结论 超声检查在急性阑尾炎的早期诊断中有较高的价值,结合病史、查体、动态观察及实验室检查可明显提高诊断率.

  10. Leukemic meningitis involving the cauda equina: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Hyun; Kim, Ho Kyun; Lee, Young Hwan [School of Medicine, Catholic University of Daegu, Daegu (Korea, Republic of)

    2008-07-15

    The CNS involvement by leukemia may either be meningeal or parenchymal, although meningeal infiltration of leukemic cells, known as leukemic meningitis is more common. We report a case of leukemic meningitis involving the cauda equina in a patient with an acute lymphoblastic crisis which transformed from the chronic phase of chronic myeloid leukemia. An MR image revealed diffuse enlargement and peripheral ring enhancement of the nerve roots of the cauda equina.

  11. 64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值%application of 64-Slice Spiral CT Reconstruction Technique in diagnosis of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    任春慧; 冯华; 梁爽; 曲世巍

    2013-01-01

    Objective To investigate the effectiveness of 64-slice spiral CT reconstruction technique in diagnosis of acute appendicitis. Methods Retrospective analysis of 64-slice spiral CT scan images was performed on 60 patients who underwent abdominal 64-slice spiral CT scans and were confirmed through clinical pathology as acute appendicitis sufferers. After multi-planar and curve reconstruction of all the images in the workstation, observation and analysis of appendicitis were made on the size, morphology and surrounding changes. Results Among 60 patients with acute appendicitis, 21 cases were found acute simple appendicitis, 32 superlative appendicitis, 5 appendiceal abscess, 2 appendiceal perforation. Two kinds of features - direct and indirect features could be gained from 64-slice spiral CT findings. Direct features include thickened and enlarged appendicitis(diameter> 6 mm), thickened wall of the appendicitis, appendicitis calculus. Indirect features included inflammation, abscess or inflammatory mass around the appendicitis, free intraperitoneal gas and swelling local lymph nodes. Conclusion Acute appendicitis had typical features in its CT iamges. Application of 64-slice spiral CT reconstruction techniques could have a better reveal of appendicitis and its surrounding circumstances, which significantly improved the diagnosis of appendicitis and was of great application value.%  目的探讨64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值。方法对60例经临床病理证实的急性阑尾炎患者的64排螺旋CT扫描资料进行回顾性分析,所有患者行全腹部64排螺旋平扫,所得图像在工作站进行多平面及曲面重建,对阑尾的大小、形态及周围改变进行观察分析。结果60例资料中,急性单纯性阑尾炎21例、化脓性阑尾炎32例、阑尾脓肿5例、阑尾穿孔2例。64排螺旋CT直接征象为阑尾增粗、增大(直径>6 mm),阑尾壁增厚,阑尾结石;间接征象

  12. Scrotal absceso following an appendicitis

    Directory of Open Access Journals (Sweden)

    León Hernández Angélica,

    2014-07-01

    Full Text Available Appendicitis is the most common cause of acute abdomen in children; approximately one third of all cases present with appendiceal perforation at the time of surgery. Some of postoperative complications in this condition are abscesses. In unusual places such as the scrotum however, for an intraabdominal event to cause a scrotal abscess, fluid displacement requires the presence of a patent processus vaginalis. We report the case of a child with perforated appendix followed by a scrotum abscess owing to a permeable vaginal canal. The abscess was and the patient wes and treatment was performed based triple scheme antibiotics, evolving satisfactorily. Key words: appendicitis, postoperative complications, residual abscess, inguinal canal.

  13. Apendicite aguda: análise institucional no manejo peri-operatório Acute appendicitis: institutional evaluation in the peri-operative managment

    Directory of Open Access Journals (Sweden)

    Orli Franzon

    2009-06-01

    avançado o estágio de evolução da apendicite, maior a prevalência de complicações.BACKGROUND: Acute appendicitis is one of the most common cause of acute abdomen and is responsible for high morbidity. Correct diagnosis remains a challenge, thus accurate perioperative assessment is important in planning surgical therapy. AIM: To evaluate institutional findings in perioperative workup, operative approach and adverse outcomes in patients who underwent open surgical intervention for acute appendicitis. METHOD: A prospective chart was performed of 88 adults patients undergoing open appendectomy. Variables compared were imaging methods and laboratory evaluation, pathologic findings and early complications. Statistical analysis was performed by SPSS 8.0 and EpiInfo6.0. RESULTS: Thirty patients underwent ultrassonography (56,7% females and five computorized tomography (all women. The differencial white cell count was directly related to more advanced phases regarding increased of "stabs", segmented and eosinophyls/lymphocytes decrease (P>0,005. Sixty (67% patients used antibiotic therapy and 38,33% of them had perforated appendicitis. Was found 23,8% of complications, 11,4% was wound infections and patients with perforated appendicitis. CONCLUSION: Females demand more imaging methods. The differencial white cell count in complicated appendicitis has an increment in less mature neutrophils and reduction of the eosinophils and lymphocytes. Advanced phases has increase risk of early complications mainly superficial wound infections and shows more prevalence in using.

  14. Recurrent epiploic appendagitis mimicking appendicitis and cholecystitis

    Science.gov (United States)

    Hearne, Christopher B.; Taboada, Jorge

    2017-01-01

    Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain. A correct diagnosis of EA will prevent unnecessary hospitalization, antibiotic use, and surgical procedures. PMID:28127129

  15. 儿童急性阑尾炎住院费用的统计分析%The Statistic Analysis on Hospitalization Expenses of Children Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    房芳

    2011-01-01

    目的 探讨儿童急性阑尾炎住院费用的分布特点和影响因素.方法 统计分析医保患者与自费患者费用构成,采用多元逐步回归模型分析急性阑尾炎住院费用的影响因素,用非参数秩的方法检验各因素的差异.结果 住院费用医保患者高于自费患者,住院天数越长费用越高,而且儿童急性阑尾炎的药费比例高;付费方式、药品、住院天数、年龄、手术方案以及切口愈合对住院费用有显著影响.结论 合理用药、加强对住院天数较长患者诊疗情况的监测,以有效缩短平均住院日可以节约医疗成本,降低医疗费用,合理分配医疗资源.%Objective A discussion on the distribution characteristics and influence factors about hospitalization expenses of children acute appendicitis.Methods A statistic analysis on expenses formation of medical insurance patients and self-financed patients; an analysis on influence factors about hospitalization expenses of acute appendicitis by using multiple stepwise regression, testing the differences of the factors by using non-parametric order.Results The hospitalization expenses of medical insurance patients are higher than self-financed patients; The more days of hospitalization the higher of expenses, while the proportion of drug expenses about children acute appendicitis is high; the way of payment, drug, hospitalization day, age, operation plan and wound healing affect the hospitalization expensos obviously.Conclusion The article suggests that reasonable medication, monitor about long hospitalization days patients strengthening in order to reduce effectively the average hospitalization day, which can achieve medical cost saving,medical expenses reduction and reasonable medical resources distribution.

  16. Laparoscopic Appendectomy for Acute Gangrenous Perforated Appendicitis%腹腔镜阑尾切除术治疗急性坏疽穿孔性阑尾炎

    Institute of Scientific and Technical Information of China (English)

    王东君; 张新元; 张震波; 刘瑞鹏; 孙宏伟

    2016-01-01

    目的:探讨腹腔镜切除术治疗急性坏疽穿孔性阑尾炎的临床价值。方法2011年6月~2014年9月对36例急性坏疽穿孔性阑尾炎施行腹腔镜下阑尾切除术,腹腔镜下探查腹腔,吸净脓液及渗液,提起阑尾显露系膜,用双极电凝钳切断阑尾系膜,编织线双重套扎阑尾根部,阑尾残端予以荷包包埋,放置腹腔引流。结果36例均顺利完成手术,无中转开腹,无并发症发生。手术时间45~115 min,平均65 min。术后引流管留置2~4 d。术后5~7 d出院。33例随访3~6个月,无腹痛、腹胀等表现。结论腹腔镜阑尾切除术治疗急性坏疽穿孔性阑尾炎安全、有效,可直视下腹腔冲洗,放置准确有效的引流管。%Objective To explore the clinical value of laparoscopic appendectomy for acute gangrenous perforated appendicitis . Methods A total of 36 patients with acute gangrenous perforated appendicitis underwent laparoscopic appendectomy from June 2011 to September 2014.After laparoscopic exploration and suction of purulent fluid and exudate , the appendix was lifted to expose and cut off mesenterium with bipolar electrocoagulation .The appendix root was double-ligated and the stump was purse string sutured.An abdominal drainage was placed . Results All the 36 cases were successfully operated .There was no conversion to laparotomy and complications .The operation continued for 45 -115 min, with a mean of 65 min.The postoperative drainage was indwelled for 2-4 d.All the patients recovered and went home after 5-7 d.Follow-ups for 3-6 months in 33 patients found no abdominal pain or distention . Conclusion Laparoscopic appendectomy for acute gangrenous perforated appendicitis is safe and effective, with advantages of peritoneal washing under direct vision and accurately and effectively placing drainage tube .

  17. 小儿急性化脓性阑尾炎150例治疗分析%Clinical Analysis of Pediatric Acute Suppurative Appendicitis of 150 Cases

    Institute of Scientific and Technical Information of China (English)

    安俊军; 张生格

    2015-01-01

    Objective To summarize diagnosis and treatment of infantile suppurative appendicitis, in order to im-prove the comprehensive understanding of infantile suppurative appendicitis,reduce the occurrence of postoperative com-plications.Methods 860 cases of appendicitis in children with clinical medical records of the statistics, of which the clinical data of 150 cases of children with purulent appendicitis were retrospectively analyzed.Results All 150 cases were performed surgical treatment, 62 cases of traditional laparotomy, laparoscopic surgery in 88 cases, 2 cases of lapa-roscopic transfer laparotomy.Preoperative diagnosis and postoperative diagnosis of 138 cases of appendicitis, coincidence rate was 92.0% .Postoperative complications in 11 cases, mergers were recovered and discharged, no deaths.Conclusions Children with acute suppurative appendicitis small age of perforation rate is high, the clinician should be detailed history, careful physical examination, reasonable use of auxiliary examination, comprehensive analy-sis, as far as possible the diagnosis of early diagnosis, timely surgical treatment, reduce the incidence rate of perforation, reduce the occurrence of postoperative complications.%目的:总结小儿化脓性阑尾炎的临床诊治,提高临床医师对于小儿化脓性阑尾炎的全面认识,做到早诊断,早治疗,并减少术后并发症的发生。方法对收治的860例阑尾炎患儿临床病历资料进行统计,其中150例化脓性阑尾炎患儿的临床资料进行回顾性分析、总结。结果本组150例均行手术治疗,行传统开腹手术62例,腹腔镜手术88例,腹腔镜中转开腹2例,术后阑尾标本行病理检查:化脓性阑尾炎150例,平均就诊时间为32.5 h,临床症状表现为:腹痛、发热、恶心与呕吐、腹泻、肠梗阻、腹部压痛等,术前诊断与术后诊断均为阑尾炎者138例,符合率为92.0%。术后合并并发症11例,均痊愈出院,

  18. 急性阑尾炎超声鉴别及漏误诊分析%Application of Ultrasound for Differential Diagnosis in Acute Appendicitis and the Analysis of Reasons for Missed Diagnosis and Misdiagnosis

    Institute of Scientific and Technical Information of China (English)

    贾莉; 宗华凤; 王希春; 温爽; 宋涛

    2013-01-01

    目的 探讨超声在急性阑尾炎鉴别诊断中的应用及漏误诊原因,进一步提高诊断准确率.方法 回顾性分析103例临床疑似急性阑尾炎声像图表现,对照手术病理.结果 急性阑尾炎93例,超声确诊84例,漏诊7例,误诊2例,超声诊断敏感度90.3%、特异性90.0%、准确性90.3%、漏诊率7.5%、误诊率2.2%.非急性阑尾炎10例,超声确诊9例,误诊1例,超声鉴别诊断准确率90.0% (9/10).结论 急性阑尾炎超声鉴别诊断具有重要价值,密切结合临床拓宽超声检查思路是减少漏误诊的关键.%Objective To investigate the value of ultrasound for differential diagnosis in acute appendicitis, and to summarize the reasons of missed diagnosis and misdiagnosis, so as to further improve the diagnostic accuracy. Methods The sonograma of 103 cases suspected clinically as acute appendicitis were retrospectively analyzed and compared with operation and pathology. Results Totally 93 cases of acute appendicitis were proved. 84 cases were diagnosed correctly by preoperative ultrasound, 7 cases were missed diagnosed, 2 cases were misdiagnosed. The sensitivities, specificities, accuracies, missed diagnosis rate and misdiagnosis rate of ultrasound in the diagnosis of acute appendicitis were 90. 3% , 90. 0% , 90. 3% , 7. 5% and 2. 2% , respectively. Ten cases of non - acute appendicitis were proved. 9 cases were diagnosed correctly by ultrasound, and 1 cases were misdiagnosed. The differential diagnosis concordance rate was 90.0% (9/10) in non -acute appendicitis. Conclusion Ultrasound has important value for differential diagnosis of acute appendicitis. Marriage with clinic and broadening the ultrasound examination ideas are the keys of reducing missed diagnosis and misdiagnosis.

  19. 28例急性阑尾炎CT诊断与临床诊断对照分析%CT diagnosis and clinical diagnosis of acute appendicitis control analysis

    Institute of Scientific and Technical Information of China (English)

    黄秋林

    2014-01-01

    Objective CT in the diagnosis of acute appendicitis and its clinical significance.Methods Retrospective analysis of CT scan data of our hospital in 2009-2012 were 28 cases of atypical clinical manifestations in patients with acute appendicitis and other similar clinical manifestations of disease in patients with acute appendicitis, CT diagnostic results with the results of the surgery, pathology or clinical fol ow-up control.Results CT diagnosis of acute appendicitis in 24 cases, 21 cases as true positive, 3 were false-positive diagnosis of acute appendicitis four cases.Conclusion CT in the diagnosis of acute appendicitis with high accuracy, specificity and sensitivity, and timely identification of other diseases other than appendicitis, is of great significance to the clinical treatment options.%目的:探讨CT检查对急性阑尾炎的诊断及临床意义。方法回顾性分析我院2009-2012年收治的28例临床表现不典型的急性阑尾炎患者及其他疾病临床表现类似急性阑尾炎患者的CT检查资料、CT诊断结果与手术、病理或临床随访结果对照。结果 CT诊断急性阑尾炎24例,21例为真阳性,3例为假阳性,未诊断急性阑尾炎4例。结论 CT检查对急性阑尾炎的诊断具有较高的准确度、特异度及敏感度,而且能及时地发现除阑尾炎以外的其他病变,对临床治疗方案的选择具有重要意义。

  20. Antibiotika som primær behandling af appendicitis

    DEFF Research Database (Denmark)

    Hupfeld, Line; Pommergaard, Hans-Christian; Burcharth, Jakob;

    2014-01-01

    Acute appendicitis has traditionally been treated surgically. Conservative approach with antibiotic treatment has been suggested as an alternative to the surgical procedure. The available studies on surgery versus antibiotics may indicate the safe use of conservative treatment for uncomplicated...... appendicitis, but the available studies are typically of low quality. Thus, further studies are needed to clarify the role of conservative treatment, and in the meantime appendectomy remains the standard treatment for acute appendicitis....

  1. 妊娠期急性阑尾炎72例临床分析%Analysis of 72 pregnant patients with acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    张伊凡; 杨星海

    2011-01-01

    Objective To evaluate the clinical presentation,diagnosis,management,and outcome of acute appendicitis in pregnancy. Methods Seventy-two cases of acute appendicitis in pregnancy were retrospectively analyzed. Results There were 13 cases at 1st trimester,27 at 2nd trimester, and 12 at 3rd trimester. Forty-seven cases complained of abdominal pain in right lower quadrant, and 42 cases had tenderness in the same area. Twenty-three cases had rebound tenderness and 12 cases had myotoni-a. Thirty-one cases (43 %) had abnormal findings of ultrosound. Forty-nine cases (68 %) received surgical operations and 23 cases (32 %) were given conservative treatment. Wound infection occurred in 3 cases (6 %) and abdominal abscess in one (2 %). Nineteen cases developed threatened abortion or preterm contraction. Four cases progressed to abortion and 2 preterm delivery. Conclusion It is crucial to diagnose and manage acute appendicitis in pregnancy timely. Temporary observation is reasonable whenever the diagnosis is in doubt. Positive findings of ultrasound can confirm diagnosis. Antibiotics as conservative treatment could be applied selectively. Tocolytics has obvious effects on the patients with non-perforated appendicitis. The incidence of abortion and preterm delivery increases dramatically when appendix is perforated.%目的 探讨妊娠期急性阑尾炎的临床特点、诊治方法和术后并发症.方法 回顾性分析6年间72例妊娠期急性阑尾炎的临床资料.结果 早期妊娠合并急性阑尾炎13例,中期47例,晚期12例.右下腹痛47例,右下腹压痛42例、反跳痛23例、肌紧张12例.B型超声征象异常31例(43%).手术49例(68%),保守治愈23例(32%).术后伤口感染3例(6%),腹腔残余脓肿1例(2%).先兆流产或先兆早产19例,流产4例,早产2例.结论 妊娠期急性阑尾炎及时诊治至关重要,诊断不明确者可作短暂观察,B型超声结果阳性能够确诊.抗生素保守治疗可选择性应用.保胎治

  2. Appendicitis Presenting Concurrently with Cecal Arteriovenous Malformation in a Child

    Directory of Open Access Journals (Sweden)

    Sahil P Parikh

    2015-09-01

    Full Text Available Acute appendicitis is a commonly diagnosed surgical problem in the pediatric population. Arterio-venous malformations (AVM of the colonic tract are rarely reported in the pediatric literature. A 13-year old boy who presented with acute appendicitis with concurrent cecal AVM is reported in whom appendectomy was done. Later on radiological investigations AVM was confirmed.

  3. [Appendicitis in the aged (author's transl)].

    Science.gov (United States)

    Hupe, K

    1981-01-01

    In cases of partially uncharacteristic clinical symptoms with no typical leukocytosis and no ESR elevation, laparotomy reveals not seldom an acute phlegmonous appendix. As compared with the similar disease in younger people appendicitis of the aged presents more complications and a higher mortality rate which can partially explained by clinically meaningful secondary findings and a lesser degree of peritoneal inflammation. The mortality rate of appendicitis in the aged could be markedly reduced. This may be attributed to emergency operation of clinically diagnosed appendicitis in the aged, to improve anaesthetic technique, to infusion therapy and parenteral feeding and last not least postoperative administering of antibiotics.

  4. Imaging of appendicitis

    Directory of Open Access Journals (Sweden)

    Himal Gajjar

    2008-12-01

    Full Text Available Appendicitis is one of the commonest causes of abdominal pain requiring surgery. Early diagnosis and management are essential to reduce morbidity and mortality. Imaging is valuable in the diagnosis of cases that are clinically atypical. Imaging also allows evaluation of the complications of appendicitis. In certain circumstances, conservative treatment of complicated appendicitis with percutaneous drainage is appropriate.

  5. 小儿急性阑尾炎20年回顾%A 20-year Review of Acute Appendicitis in Children

    Institute of Scientific and Technical Information of China (English)

    张金哲; 谢兴雅

    1987-01-01

    著者根据20年临床与病理观察提出早期急性阑尾炎应立即阑尾切除.但三天以上病例应看精神食欲,如已好转,双合诊摸到右下腹浸润块者不宜手术,反之继续恶化则仍需手术.三岁以下患儿发烧呕吐,应注意阑尾炎怕动怕震症状,反复对比腹部固定性压痛,可疑者腹穿常可确诊.近十年5000例(1/4穿孔)只1例死亡,无严重合并症.虽多次更换总住院及实习人员,证明上述方案经得考验.%Based on the previous studies in the early 1960s on the correlation between the local pathology and the clinical manifestations of acute appendicitis among children, a 20-year review of some 10000 cases and a further improvement in the treatment are presented. It is reported that about 5,000 cases treated in the decade(1976-1985), 1/4 perforated and one died and the postoperative complications have been reduced remarkably. The author emphasizes that if the general condition(especially appetite and activity)and the local tenderness of the Patients is worse than yesterday. appendectomy should be performed immediately. Otherwise, any surgical disturbance must be a voided. In order to make a correct digonsis of appendicitis in children under three years of age, a careful comparison-palpation of different parts of the abdomen to find out the definite tenderness, and to feel out an abdominal mass (under sedative) or peritoneocentesis looking for pus cells should be done.

  6. MSCT重建技术在急性阑尾炎诊断及鉴别诊断中的应用%Application of MSCT Reconstruction Technique in Diagnosis and Differential Diagnosis of Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    孙振平; 刘振元; 朱亚亮

    2014-01-01

    目的:探讨多层螺旋CT(MSCT)及重建技术在急性阑尾炎诊断及鉴别诊断中的应用价值。方法:回顾性分析57例临床拟诊急性阑尾炎病例,均行MSCT扫描,并在工作站进行MPR、CPR图像重建后综合分析CT表现,然后与临床病史及术后结果对照。结果:57例病例中,急性单纯性阑尾炎31例,急性化脓性阑尾炎9例,穿孔性阑尾炎7例,阑尾周围脓肿4例;回盲部肿瘤2例,阑尾黏液囊肿1例,大网膜囊肿1例,右侧输尿管结石1例,血管或肠管误认为阑尾1例。结论:MSCT扫描并结合MPR、CPR重建技术可明确显示阑尾及周围组织、器官的相关情况,在急性阑尾炎的诊断及鉴别诊断中有较高应用价值。%Objective:To explore the application value of multi-slice spiral CT(MSCT)and reconstruction techniques in the diagnosis and differential diagnosis of acute appendicitis.Method:A retrospective analysis of 57 clinical cases suspected acute appendicitis:scanned with multilayer spiral CT,reconstructed MPR and CPR images at workstation, then composite analyzed of CT findings,compared CT findings with clinical history and postoperative findings.Result:Among the 57 cases,31 cases of acute simple appendicitis,9 cases of acute suppurative appendicitis,7 cases of perforated appendicitis,4 cases of appendiceal abscess;ileocecal tumor in 2 cases,1 case of mucocele of the appendix,1 case of omental cyst,1 case of right ureter stones,1 case of intestinal vascular or mistaken railing tail.Conclusion:MSCT scanning combined with MPR,CPR reconstruction techniques can be clearly demonstrated appendix and surrounding tissues and organs of the relevant circumstances,in acute appendicitis diagnosis and differential diagnosis has a higher application value.

  7. IGK with conserved IGΚV/IGΚJ repertoire is expressed in acute myeloid leukemia and promotes leukemic cell migration.

    Science.gov (United States)

    Wang, Chong; Xia, Miaoran; Sun, Xiaoping; He, Zhiqiao; Hu, Fanlei; Chen, Lei; Bueso-Ramos, Carlos E; Qiu, Xiaoyan; Yin, C Cameron

    2015-11-17

    We have previously reported that immunoglobulin heavy chain genes were expressed in myeloblasts and mature myeloid cells. In this study, we further demonstrated that rearranged Ig κ light chain was also frequently expressed in acute myeloid leukemia cell lines (6/6), primary myeloblasts from patients with acute myeloid leukemia (17/18), and mature monocytes (11/12) and neutrophils (3/12) from patients with non-hematopoietic neoplasms, but not or only rarely expressed in mature neutrophils (0/8) or monocytes (1/8) from healthy individuals. Interestingly, myeloblasts and mature monocytes/neutrophils shared several restricted IGKV and IGKJ gene usages but with different expression frequency. Surprisingly, almost all of the acute myeloid leukemia-derived IGKV showed somatic hypermutation; in contrast, mature myeloid cells-derived IGKV rarely had somatic hypermutation. More importantly, although IGK expression appeared not to affect cell proliferation, reduced IGK expression led to a decrease in cell migration in acute myeloid leukemia cell lines HL-60 and NB4, whereas increased IGK expression promoted their motility. In summary, IGK is expressed in myeloblasts and mature myeloid cells from patients with non-hematopoietic neoplasms, and is involved in cell migration. These results suggest that myeloid cells-derived IgK may have a role in leukemogenesis and may serve as a novel tumor marker for monitoring minimal residual disease and developing target therapy.

  8. Schistosomal appendicitis: Incidence in Japan and a case report

    Institute of Scientific and Technical Information of China (English)

    Tadashi Terada

    2009-01-01

    Schistosomal appendicitis is very rare in developed countries like the USA, Europe, and Japan. The author reviewed 311 pathologic archival specimens of vermiform appendix over the past 10 years. One case of schistosomal appendicitis was recognized. Therefore, the incidence of this disease was 0.32% in all appendices surgically resected in our hospital. The patient was a 41-year-old woman presenting with lower abdominal pain. She was a sailor traveling to many countries including endemic areas. Physical examination, laboratory data, and imaging modalities suggested an acute appendicitis, and appendectomy was performed under the diagnosis of ordinary appendicitis. Histologically, numerous schistosomal eggs were present in the vasculatures throughout the appendiceal walls. Some of the eggs were calcified. Stromal foreign body reaction was also recognized. The appendicitis was phlegmonous consisting of severe infiltrations of neutrophils and eosinophils. Acute serositis was also noted. Examination of feces revealed numerous eggs of Schistosoma mansoni. Clinicians should be aware of schistosomal appendicitis.

  9. Liver Hemangioma Bleeding Rupture Misdiagnosed as Acute Appendicitis%肝血管瘤破裂出血误诊为急性阑尾炎

    Institute of Scientific and Technical Information of China (English)

    刘壮

    2014-01-01

    Objective To explore the clinical characteristics of liver hemangioma rupture bleeding, and evaluate its differ-ential diagnosis. Methods Retrospectively analysis of the clinical data of a case of multiple liver hemangioma rupture hemorrhage misdiagnosed as acute appendicitis was made. Results A patient with lower abdominal pain for 20 hours before admission was pri-marily diagnosed as having acute appendicitis, and underwent an emergency laparotomy. During the operation, no abnormal appen-dix was found, but a mass in liver with burst bleeding was found and the liver surface was full of millet qualitative hard nodules. Be-cause of impossible determination on the nature of the tumor, the patient was given local hemostasis therapy, and abdominal cavity was washed, then drainage tube was placed at the same time, some tissues surrounding bleeding mass was removed, and no active bleeding before abdominal closing was observed. Postoperative pathologic result of liver mass showed degeneration of liver cells, with cellulose and inflammatory cells, and reinforced CT scanning confirmed liver hemangioma rupture bleeding, but to define the cause of bleeding, a followed enquiry of history and related examinations were made before systemic lupus erythematosus (active phase) was confirmed. Gamma globulin and Methylprednisolone treatment were given and the patient was discharged after improvement. Conclusion Because of the particular position, patients with liver hemangioma (right liver lobe) rupture hemorrhage usually have atypical clinical symptoms and signs, which may be related to systemic lupus erythematosus and mistaken as acute appendicitis.%目的:探讨肝血管瘤破裂出血的临床特点及鉴别诊断要点。方法对肝多发血管瘤破裂出血误诊为急性阑尾炎1例的临床资料进行回顾性分析。结果本例因右下腹痛20 h急诊入院,按急性阑尾炎行剖腹探查术。术中探查示:阑尾未见异常,肝

  10. Apendicite aguda isquêmica em coelhos: um novo modelo com estudo histopatológico Acute ischaemic appendicitis in rabbits: new model with histopathological study

    Directory of Open Access Journals (Sweden)

    Fernando Costa Nunes

    2004-06-01

    Full Text Available OBJETIVO: Avaliar a isquemia parcial ou total do apêndice vermiforme de coelhos, através da ligadura com fio inabsorvível dos vasos do meso apêndice bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice a 1 cm do ceco, na patogênese da apendicite aguda. Avaliar a histologia do apêndice (normal e acometido. Estudar a flora bacteriana residente no apêndice vermiforme (normal e acometido e do exsudato peritoneal. MÉTODO: Foram utilizados 72 coelhos (Oryctogalus cuniculos, machos, da linhagem Nova Zelândia, com peso médio de 3.000 gramas. Foram divididos em grupos: piloto (A, flora bacteriana (B, controle (H e experimento (C, D, E, F e G com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do meso apêndice com fio inabsorvível nos grupos (D, E, F e G e da base do apêndice vermiforme a 1 cm do ceco, no grupo (C. No grupo experimento (D, E, F e G foi praticado o modelo isquêmico. No grupo experimento (C foi realizada a obstrução mec��nica e no grupo controle (H foi feita somente a simulação da cirurgia. RESULTADOS: Ocorreu apendicite aguda no grupo experimento (C,D,E,F, e G. CONCLUSÕES: O método utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi Escherichia coli.BACKGROUND: To evaluate partial or total ischemia, through ligature with an unabsorbed thread of vessels from the vermiform appendix of rabbits, as well as the mechanical obstruction, through ligature with an unabsorbed thread at the basis of the vermiform appendix, at 1 cm from the cecum, in the pathogenesis of acute appendicitis. To evaluate the histology of the appendix (normal and affected. To study the resident bacterium flora in the appendix (normal and affected and the peritonitis exudate. METHODS: Seventy- two male rabbits (Oryctogalus

  11. 综合护理对急性阑尾炎患者的影响分析%Analysis on the Influence of Comprehensive Nursing Care on the Patients With Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    刘寒梅

    2015-01-01

    目的:分析综合护理对急性阑尾炎患者的影响。方法将86例急性阑尾炎患者随机分为A组(综合护理)和B组(常规护理),各43例,分析两组护理效果。结果A组SAS评分、SDS评分及并发症发生率较B组低。结论给予急性阑尾炎患者综合护理可有效缓解患者不良情绪,减少并发症发生。%Objective To analyze the effect of comprehensive nursing care on the patients with acute appendicitis. Methods 86 cases of acute appendicitis were randomly divided into group A (Comprehensive Nursing) and group B (routine nursing),each of 43 cases,analyzed the nursing effect of the two groups. Results In group A,SAS score,SDS score and the incidence of complications were lower than that of B group. Conclusion Comprehensive nursing care given to patients with acute appendicitis patients can effectively al eviate the bad mood and reduce complications.

  12. Elevated frequencies of leukemic myeloid and plasmacytoid dendritic cells in acute myeloid leukemia with the FLT3 internal tandem duplication

    OpenAIRE

    Rickmann, Mareike; Krauter, Juergen; Stamer, Kathrin; Heuser, Michael; Salguero, Gustavo; Mischak-Weissinger, Eva; Ganser, Arnold; Stripecke, Renata

    2011-01-01

    Abstract Some 30% of acute myeloid leukemia (AML) patients display an internal tandem duplication (ITD) mutation in the FMS-like tyrosine kinase 3 (FLT3) gene. FLT3-ITDs are known to drive hematopoietic stem cells towards FLT3 ligand independent growth, but the effects on dendritic cell (DC) differentiation during leukemogenesis are not clear. We compared the frequency of cells with immunophenotype of myeloid DC (mDC: Lin?, HLA-DR+, CD11c+, CD86+) and plasmacytoid DC (pDC: Lin?, HL...

  13. Clinical outcome and efficacy of current anti-leukemic therapy for leptomeningeal involvement in acute myeloid leukemia.

    Science.gov (United States)

    Kwon, Ji Hyun; Koh, Young-Il; Yoon, Sung-Soo; Park, Seonyang; Kim, Inho

    2016-11-01

    We investigated risk factors and outcome in acute myeloid leukemia (AML) patients with leptomeningeal involvement. Medical records of patients with non-promyelocytic AML at Seoul National University Hospital from January of 2000 to November of 2013 were reviewed. Leptomeningeal involvement was defined as the presence of atypical or malignant hematopoietic cells in the cerebrospinal fluid. Among 775 patients with AML, 141 patients (18.2 %) underwent cerebrospinal fluid examination. Leptomeningeal involvement of AML, confirmed in 38 patients (4.9 %), was associated with high white blood cell count and high level of lactic. There were seven patients in the favorable risk group (19.4 %), 21 in the intermediate risk group (58.3 %), and eight in the adverse risk group (22.2 %). Twenty-eight patients (85.7 %) developed leptomeningeal involvement during relapse status or refractory status. Thirty-one patients (81.6 %) received intrathecal chemotherapy, and whole-brain and/or craniospinal radiotherapy was conducted in 10 patients (27.0 %). The rate of complete remission after induction chemotherapy was 63.2 %. Median overall survival was 9.9 months. Radiotherapy and complete remission after the first induction chemotherapy were associated with longer overall survival. Leptomeningeal involvement in acute myeloid leukemia is rare, but relatively common in relapsed status or refractory status. Craniospinal radiotherapy and complete remission after induction chemotherapy were found to favorable prognostic factors.

  14. Barium appendicitis: A single institution review in Japan

    Science.gov (United States)

    Katagiri, Hideki; Lefor, Alan Kawarai; Kubota, Tadao; Mizokami, Ken

    2016-01-01

    AIM To review clinical experience with barium appendicitis at a single institution. METHODS A retrospective review of patients admitted with a diagnosis of acute appendicitis, from January 1, 2013 to December 31, 2015 was performed. Age, gender, computed tomography (CT) scan findings if available, past history of barium studies, pathology, and the presence of perforation or the development of complications were reviewed. If the CT scan revealed high density material in the appendix, the maximum CT scan radiodensity of the material is measured in Hounsfield units (HU). Barium appendicitis is defined as: (1) patients diagnosed with acute appendicitis; (2) the patient has a history of a prior barium study; and (3) the CT scan shows high density material in the appendix. Patients who meet all three criteria are considered to have barium appendicitis. RESULTS In total, 396 patients were admitted with the diagnosis of acute appendicitis in the study period. Of these, 12 patients (3.0%) met the definition of barium appendicitis. Of these 12 patients, the median CT scan radiodensity of material in the appendix was 10000.8 HU, ranging from 3066 to 23423 HU (± 6288.2). In contrast, the median CT scan radiodensity of fecaliths in the appendix, excluding patients with barium appendicitis, was 393.1 HU, ranging from 98 to 2151 HU (± 382.0). The CT scan radiodensity of material in the appendices of patients with barium appendicitis was significantly higher than in patients with nonbarium fecaliths (P < 0.01). CONCLUSION Barium appendicitis is not rare in Japan. Measurement of the CT scan radiodensity of material in the appendix may differentiate barium appendicitis from routine appendicitis.

  15. Anti-Leukemic Activity of Shikonin: Role of ERP57 in Shikonin Induced Apoptosis in Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Rachana Trivedi

    2016-07-01

    Full Text Available Background/Aims: ER-Stress and activation of unfolded protein response belong to the major factors involved in chemoresistance in cancer cells. In this study we investigated the effect of shikonin on the survival of acute myeloid leukemia cells and the role of ER-stress protein ERP57, a protein disulfide isomerase, in improvement of chemotherapy. Methods: Using MTT assay we studied cytotoxic effects of shikonin on HL-60 cells. The flow cytometry was adopted to examine the shikonin induced mode of cell death in HL-60 cells. The overall protein expression alteration resulting from shikonin treatment was investigated using proteomics methods. Western blotting was performed to quantify the alteration in protein expression in HL-60 after shikonin treatment. Silencing and overexpression studies were carried out to highlight the therapeutic role of ERP57 in shikonin effect on AML cells. Results: Shikonin induces apoptosis in HL-60 cells without significant effect on Primary cells from healthy volunteers. The apoptotic effect was dose and time dependent and was accompanied by strong alteration in cell proteome. Among the proteins targeted by shikonin, ERP57 was significantly downregulated in HL-60 after treatment. Compared to healthy control ERP57 was found to be highly expressed in AML cell line HL60 and was downregulated after shikonin treatment. Overexpression of ERP57 protected HL-60 from shikonin induced apoptosis, whereas knockdown of ERP57 expression resulted in increase in shikonin induced apoptosis. Conclusions: Our results demonstrate that ERP57 plays a crucial role in resistance towards shikonin induced apoptosis in AML cells. Targeting of ERP57 might offer a new therapeutic option for the treatment of acute myeloid leukemia.

  16. In vitro and in vivo anti-leukemic activity of the peptidase-potentiated alkylator melflufen in acute myeloid leukemia

    Science.gov (United States)

    Strese, Sara; Bashir Saadia, Hassan; Velander, Ebba; Haglund, Caroline; Höglund, Martin; Larsson, Rolf; Gullbo, Joachim

    2017-01-01

    The novel aminopeptidase potentiated alkylating agent melflufen, was evaluated for activity in acute myeloid leukemia in a range of in vitro models, as well as in a patient derived xenograft study. All tested AML cell lines were highly sensitive to melflufen while melphalan was considerably less potent. In the HL-60 cell line model, synergy was observed for the combination of melflufen and cytarabine, an interaction that appeared sequence dependent with increased synergy when melflufen was added before cytarabine. Also, in primary cultures of AML cells from patients melflufen was highly active, while normal PBMC cultures appeared less sensitive, indicating a 7-fold in vitro therapeutic index. Melphalan, on the other hand, was only 2-fold more potent in the AML patient samples compared with PBMCs. Melflufen was equally active against non-malignant, immature CD34+ progenitor cells and a more differentiated CD34+ derived cell population (GM14), whereas the stem cell like cells were less sensitive to melphalan. Finally, melflufen treatment showed significant anti-leukemia activity and increased survival in a patient derived xenograft of AML in mice. In conclusion, melflufen demonstrates high and significant preclinical activity in AML and further clinical evaluation seem warranted in this disease. PMID:27974676

  17. Rectal contrast-enhanced computed tomography in the diagnosis of acute appendicitis; Tomografia computarizada con contraste rectal en el diagnostico de la apendicitis aguda

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    To assess the efficacy and utility of computed tomography (CT) in the diagnosis of appendicitis, and to evaluate the reliability of CT findings in right iliac fossa in the confirmation or exclusion of this diagnosis. Over a one-year period, 152 patients presenting clinical signs of appendicitis underwent CT scans. The images were reviewed by two radiologists who considered whether the appendix was normal or enlarged and the existence of other signs of appendicitis for the purpose of determining whether or not the patient presented appendicitis. The definitive diagnoses were established by surgery or by clinical follow-up. The sensitivity of CT for the diagnosis of appendicitis was 81.8%, the specificity was 95.3%, the positive predictive value was 93.1%, the negative predictive value was 87.2% and the reliability was 89.9%. The signs of appendicitis observed were: appendicoliths (sensitivity 30.3% and specificity 98.8%), fluid collections (sensitivity 19.7%, specificity 96.5%), cecal enlargement (sensitivity 21.2%, specificity 97.7%), inflammation of pericecal fat (sensitivity 72.7%, specificity 90.7%), fascial thickening (sensitivity 48.5%, specificity 91.9%) and an appendix measuring more than 6 mm (sensitivity 78.8%, specificity 94.3%). Adenopathy and free peritoneal fluid were not significantly related to appendicitis. The presence of a normal appendix filled with air or contrast material had an elevated negative predictive value with respect to appendicitis. In 35 of the 94 cases with negative CT scans, the images suggested alternative diagnoses. CT is a highly reliable diagnostic method for appendicitis. The observation of an appendix filled with air or contrast material has an elevated negative predictive value. The presence of appendicoliths has an elevated positive predictive value. (Author) 29 refs.

  18. Oral antibiotics for perforated appendicitis is not recommended

    DEFF Research Database (Denmark)

    Gögenur, Ismail; Rosenberg, Jacob; Alamili, Mahdi

    2010-01-01

    In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this paper...... was to give an overview of studies on acute perforated appendicitis with postoperative oral antibiotics. Five studies were found in a database search covering the 1966-2009 period. There is no evidence to support a conversion of the postoperative antibiotic regimen from intravenous to oral administration...... in patients with acute perforated appendicitis....

  19. Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children

    Directory of Open Access Journals (Sweden)

    Martin Salö

    2014-01-01

    Full Text Available Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS, diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n=102 and <4 years (n=20. Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.; P=0.005, despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.; P=0.001. PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.

  20. De Garengeot's hernia: an unusual right groin mass due to acute appendicitis in an incarcerated femoral hernia.

    Science.gov (United States)

    Salkade, Parag R; Chung, Alexander Y F; Law, Y M

    2012-10-01

    The presence of an acutely inflamed vermiform appendix in a femoral hernia sac is extremely rare; the condition is termed De Garengeot's hernia. Here we describe an elderly patient for whom preoperative computed tomography aided the diagnosis of this rare entity. This Chinese woman had presented with a painful right groin mass. The patient successfully underwent an emergency appendicectomy and primary femoral hernia repair. Once diagnosed, it is imperative to follow key surgical principles to limit the spread of infection.

  1. Appendicular pseudodiverticula and acute appendicitis: Our 12-year experience Pseudodivertículos apendiculares y apendicitis aguda: Nuestra experiencia en 12 años

    Directory of Open Access Journals (Sweden)

    María del Carmen Manzanares-Campillo

    2011-11-01

    Full Text Available Introduction: the presence of diverticula and their complications in the cecal appendix is an uncommon disease. We present a series of 13 patients with this condition, and perform a review of the literature. Patients and method: we carried out a retrospective study of patients undergoing appendectomy for acute appendicitis in the last twelve years in our department. The pathological examination of these episodes revealed 13 cases with a diagnosis of diverticular disease, all of them consisting of pseudodiverticula. Their clinical manifestations, laboratory results, imaging tests, and histology were analyzed, and findings were compared to those in the previous literature. Results: the incidence of diverticular disease in our setting was 13 cases (0.8% among 1634 appendectomies for acute appendicitis. Diverticulitis was found in 8 patients (61.5%, and diverticulosis (38.5% in 5. Appendicular perforation was more common in patients with diverticular disease (53.8% as compared to those without this condition (31.1%. Conclusions: complicated diverticular disease in the vermiform appendix of adult patients may result in insidious, recurrent manifestations that may confound preoperative diagnosis. A higher risk for appendicular perforation renders appendectomy the therapy of choice, even prophylactically when the condition is incidentally identified preoperatively.Introducción: la presencia de divertículos y sus complicaciones en el apéndice cecal constituyen una entidad infrecuente. Presentamos una serie de 13 pacientes con esta patología y realizamos una revisión de la literatura. Pacientes y método: realizamos un estudio retrospectivo de los pacientes apendicectomizados por apendicitis aguda en los últimos doce años en nuestro servicio. El examen anatomopatológico de estos episodios reveló el diagnóstico de 13 casos con enfermedad diverticular, todos ellos pseudodivertículos. Se analizaron la clínica, pruebas analíticas, de imagen y la

  2. Acute appendicitis in an incarcerated crural hernia: analysis of our experience Apendicitis aguda en una hernia crural incarcerada: análisis de nuestra experiencia

    Directory of Open Access Journals (Sweden)

    P. Priego

    2005-10-01

    Full Text Available Introduction: the finding of the vermiform appendix within a crural hernia (Amyand's hernia is a rare entity whose incidence is not described in the literature. Objective: the aim of this study was to report our hospital's experience in this kind of pathology. Material and methods: between 1993 and 2004, 4,572 acute appendicitis and 372 incarcerated crural hernia cases have been operated on in our hospital. We studied 6 cases of incarcerated crural hernia with vermiform appendix inside. We analyzed in retrospect the following parameters: age, sex, personal history, clinical manifestations, preoperative diagnosis, surgical technique, mean hospital stay, and outcome. Results: all patients were women with a mean age of 78.8 years. Most frequent clinical manifestations included pain and a mass in the right inguinocrural region, of variable intensity and duration. No clinical, laboratory, or radiographic signs help in reaching a correct preoperative diagnosis. General anesthesia and a crural approach are used in most surgical operations. In all cases an appendectomy was performed via the hernia sac, thus proving the presence of acute appendicitis in four of them (66.67%. A prosthetic mesh was used in 3 cases, and one case of wound infection was found. In the other cases we sutured the hernia ring using prolene. Conclusion: the finding of the appendix in an incarcerated crural hernia is a rare entity in old women that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh is controversial.Introducción: la presencia del apéndice vermiforme en el interior de un saco herniario crural (hernia de Amyand constituye una entidad poco frecuente y cuya incidencia no está descrita en la literatura. Objetivo: el objetivo del trabajo es presentar la experiencia de nuestro hospital en este tipo de patología. Material y métodos: entre 1993 y 2004 se han intervenido en nuestro centro 4.572 pacientes

  3. Practical issues in treatment of appendicitis

    NARCIS (Netherlands)

    van Rossem, C.C.

    2016-01-01

    Appendicitis is a common cause of acute abdominal pain and an appendectomy is still the gold standard of treatment. In spite of the high incidence, variance in diagnostic and treatment modalities remains an issue among surgeons. In this thesis several practical issues in the diagnosis and treatment

  4. Intrauterine contraceptive device appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Hao-Ming Chang; Teng-Wei Chen; Chung-Bao Hsieh; Chung-Jueng Chen; Jyh-Cherng Yu; Yao-Chi Liu; Kuo-Liang Shen; De-Chuan Chan

    2005-01-01

    Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously.This is a rare complication and only fourteen previous cases were recorded in the literature.

  5. An adult intussusception mimicking early appendicitis

    Institute of Scientific and Technical Information of China (English)

    Wei-Chun Tseng; Cheng-Ting Hsiao; Yu-Cheng Hung

    2012-01-01

    Adult intussusception is rare with variable clinical presentation. We reported a case of adult intussusception presenting with symptoms mimicking acute appendicitis. The patient presented as an abdominal pain from epigastric area with shifting gradually to RLQ. The atypical presentation of adult intussusception remains a diagnostic challenge to the emergency physician.

  6. Cytological diagnosis of xanthogranulomatous appendicitis

    Science.gov (United States)

    Kaushik, Rajni; Gulati, Anchana; Vedant, Deepak; Kaushal, Vijay

    2017-01-01

    Xanthogranulomatous reaction can occur in any organ but the most common sites are kidney and gallbladder. Xanthogranulomatous appendicitis (XA) is a rare clinical entity. There are a few case reports of XA diagnosed on histopathology but none on cytology. Here we report a case of a 47-year-old lady who presented with acute abdomen and was found to have a mass lesion in the right iliac fossa. She was diagnosed with XA intraoperatively on imprint cytology that was subsequently confirmed on histopathological examination. Due to the rarity of XA itself and the use of imprint cytology for intraoperative diagnosis the case is being presented. PMID:28182060

  7. Dynamic monitoring of serum LXA4 and procalcitonin in patients with acute appendicitis%血清LXA4与降钙素原在急性阑尾炎患者中的动态监测

    Institute of Scientific and Technical Information of China (English)

    朱克华; 张福

    2016-01-01

    Objective To analyze effects of LXA4 and PCT on the diagnosis and prognosis of patients with acute appendicitis by dynamic monitoring of peripheral blood lipoxin A4 (LXA4) and procalcitonin (PCT) levels. Methods 120 patients with acute appendicitis who were admitted to our hospital from March 2011 to June 2015 were selected.LXA4 and PCT levels before operation and the second day after operation (11-35h) were monitored by Enzyme-linked immunosorbent assay (ELISA) and they were analyzed and compared. Results In 120 patients with acute appendicitis,there were 35 cases of simple appendicitis,47 cases of suppurative appendicitis and 38 cases of perforated appendicitis or gangrenous appendicitis according to the surgery or (and) pathological diagnosis results. The levels of the serum LXA4 before operation of 120 patients with acute appendicitis before the operation were all higher than those after operation (P 0.05).Preoperative serum PCT levels of the simple,suppurative,perforated and gangrenous appendicitis groups were all higher than those before operation (P 0.05). Conclusion Monitoring of serum LXA4 and PCT levels of acute appendicitis patients has certain guiding significance in diagnosis, operation assessment and the prognosis recovery of acute appendicitis.%目的:通过动态监测急性阑尾炎患者手术前后外周血脂氧素A4(LXA4)与降钙素元(PCT)水平,分析LXA4、PCT在急性阑尾炎患者的诊断及预后中的作用。方法选取我院2011年3月~2015年6月,120例急性阑尾炎患者,采用酶联免疫吸附法(ELISA)检测术前及术后第2天(11~35h)患者外周血LXA4、PCT水平,并进行分析比较。结果120例急性阑尾炎患者,结合手术或(和)病理诊断结果分为单纯性阑尾炎(35例)、化脓性阑尾炎(47例)、穿孔性及坏疽性阑尾炎(38例)。120例急性阑尾炎患者术前血清LXA4水平均高于术后(P<0.05);化脓性、穿孔性及坏疽

  8. Trends in the Diagnosis and Management of Pediatric Appendicitis.

    Science.gov (United States)

    Hansen, Laura W; Dolgin, Stephen E

    2016-02-01

    • On the basis of class B evidence and consensus, acute appendicitis in children can often be diagnosed clinically with only selective use of imaging. (13)(14)(15)(16) • On the basis of class B evidence and consensus, ultrasonography is the test of choice when acute appendicitis is suspected but is unclear based on history, physical examination, and laboratory results. (17)(18)(19) • On the basis of class B evidence and consensus, the use of computed tomography scan should be limited to cases of suspected complex appendicitis with abscess or when there is clinical suspicion for acute appendicitis but ultrasonography results are not helpful. (16) • On the basis of class C evidence and consensus, children with possible appendicitis ideally should be treated in medical centers that have skilled sonographic personnel. (21) • On the basis of class B evidence and consensus, simple appendicitis should be treated by appendectomy during normal operating hours. Preoperative treatment with intravenous antibiotics and fluids during the overnight hours halts disease progression and allows for the safest surgery with the benefit of a full and rested staff. (24)(25)(26) • On the basis of class B evidence and consensus, complex appendicitis with a well-defined abscess can be treated nonoperatively initially, with the option of an interval appendectomy after recovery from the acute infection. (29)(30) (31)(32)(33)

  9. Livstruende appendicitis forårsaget af Fusobacterium necrophorum

    DEFF Research Database (Denmark)

    Hagen, Trine Langfeldt; Maeda, Yasuko; Lindberg, Jens Aage;

    2014-01-01

    Fusobacterium necrophorum is a well-known cause of Lemierre's syndrome. Recent studies suggest a causative association between F. necrophorum and acute appendicitis. We present a case of a 15-year-old previously healthy girl who presented with acute non-perforated appendicitis, intra......-abdominal abscesses and thrombosis that led to omental necrosis. This resulted in a life-threatening septic shock with the need for prolonged intensive care. We suggest that F. necrophorum identified in pus from the abdomen caused this fulminant variation of appendicitis with findings similar to those seen...

  10. Timely recognition of Amyand's hernia with appendicitis in infants

    Institute of Scientific and Technical Information of China (English)

    Zhen Shen; Shan Zheng

    2015-01-01

    Background: Amyand's hernia with acute appendicitis is rare in infants and is mostly delayed in diagnosis and treatment, resulting in a high morbidity. Methods: We presented two cases of infantile Amyand's hernia with acute appendicitis. Results: Early surgical interventions were performed and both patients recovered without complication. Conclusion: A practical strategy for this entity is to be aware of the rare disease and to perform early surgical exploration for suspected cases.

  11. Funiculitis mimicking appendicitis: A rare culprit

    Directory of Open Access Journals (Sweden)

    Lindsey L. Perea

    2017-01-01

    Full Text Available Acute appendicitis is an extremely common cause for pediatric admissions, most notably presenting with right lower quadrant pain. There are few other etiologies for a young male to have pain aside from appendicitis. We present a young boy who presented with right lower quadrant abdominal pain and fevers, but was found to have funiculitis. Funiculitis, or inflammation of the spermatic cord, is a very rare condition in the pediatric population, almost always occurring in the elderly with urinary flow conditions. We share our case to remind providers the importance of a full differential diagnosis.

  12. Gamma-irradiation enhances transgene expression in leukemic cells.

    Science.gov (United States)

    Vereecque, R; Saudemont, A; Wickham, T J; Gonzalez, R; Hetuin, D; Fenaux, P; Quesnel, B

    2003-02-01

    The majority of immunotherapy-based gene therapy protocols consist of ex vivo gene transfer in tumor cells. To prevent further in vivo growth, modified cells must be irradiated before reinjection into patients. The present study examines the effects of gamma-irradiation on transgene expression in transduced leukemic cells. Human and murine leukemic cells were transfected with retroviral vectors or plasmids carrying beta-galactosidase, GM-CSF or CD80 genes. Fresh leukemic cells from patients with acute myeloid leukemia (AML) were transfected with AdZ.F(pK7) adenoviral vector. gamma-irradiation at various lethal doses enhanced transgene expression in leukemic cell lines and fresh AML cells when the gene of interest was under CMV promoter but not when SV40 promoter was used. Oxidative stress also enhanced transgene expression and both irradiation and oxidative stress effects were inhibited by addition of N-acetyl-L-cysteine, a thiol anti-oxidant, indicating the involvement of reactive oxygen species. Transgene expression was also enhanced in vivo 48 and 120 h after subcutaneous injection of irradiated leukemic cells in syngeneic mice. These results show that a cell vaccine protocol using ex vivo gene transfer of transduced cells might be feasible in acute leukemia even if leukemic cells must be irradiated at lethal doses prior to reinjection to patients.

  13. std::string Append

    Science.gov (United States)

    2015-10-01

    UNCLASSIFIED AD-E403 689 Technical Report ARWSE-TR-14026 STD ::STRING APPEND Tom Nealis...DATES COVERED (From – To) 4. TITLE AND SUBTITLE STD ::STRING APPEND 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...two or more strings together while developing a C++ application is a very common task. For std ::strings, there are two primary ways to achieve the

  14. [Appendicitis in children under 3].

    Science.gov (United States)

    Baeza Herrera, C; Guido Ramires, O; González Galicia, J A; Rojas Aro, E

    1994-01-01

    There are many differences between acute appendicitis in the older child and the infants. An understanding of the under three years of age child's response to intra-abdominal infection in contrast to that of the older child and an appreciation for the supportive treatment of the child are vitally important in further lowering the morbidity of young children with acute appendicitis. The purpose of the present study was to investigate the factors contributing to the high perforation rate seen in this age group. A retrospective analysis was done in 88 patients under the age of three who underwent appendectomy. These patients ranged from 4 and 35 months in age. There were 51 (77.4%) male patients. The main complaints were fever, pain and vomiting. Duration of symptoms was more than 24 hours in 80%. Abdominal radiographs showed signs of small bowel obstruction. Peritonitis was found in the majority of the cases (90%). overall morbidity was 31.8% and mortality 1.1%. These data suggest that duration of symptoms is directly proportional to complications rate.

  15. Diagnosis and treatment of children with acute appendicitis with the performance of intestinal obstruction%以肠梗阻为表现的小儿急性阑尾炎的诊治

    Institute of Scientific and Technical Information of China (English)

    尚献会; 陈长梅; 王鑫; 金祝; 高明娟; 郑泽兵

    2016-01-01

    目的:分析表现为肠梗阻的小儿急性阑尾炎的临床诊治特点。方法:收治小儿急性阑尾患儿60例,分析患儿的临床资料。结果:60例患儿均出现了食欲不振,腹痛偶伴有腹泻,恶心,呕吐,少量患儿伴有发热等肠梗阻临床症状。入院后对患儿进行支持治疗。手术中明确急性阑尾炎导致肠梗阻发生。根据各患儿的病情进行针对性治疗。结论:提高对疾病的认识,做到早诊断、早治疗,这样大部分阑尾炎患者可以治愈,同时对患者认真探查,可有效减少并发症的产生。%Objective:To analyze the characteristics of clinical diagnosis and treatment of children with acute appendicitis with the performance of intestinal obstruction.Methods:60 children with acute appendicitis were selected.We analyzed the clinical data. Results:60 cases showed loss of appetite,abdominal pain occasionally accompanied by diarrhea,nausea and vomiting,a small amount of children with fever and other symptoms of intestinal obstruction.Support treatment for children after admission.In the operation,it was found the intestinal obstruction occurred due to acute appendicitis.According to the patient's condition for targeted treatment.Conclusion:Improve the understanding of the disease,make early diagnosis and early treatment,so that most of the patients with appendicitis can be cured,at the same time,serious exploration should be carried out for patients,which can effectively reduce the complications.

  16. Comparison of ultrasonography and computed tomography in the diagnosis of acute appendicitis; Comparacion de la ecografia y la tomografia computarizada en el diagnostico de la apendicitis aguda

    Energy Technology Data Exchange (ETDEWEB)

    Cura, J. L. del; Oleaga, L.; Grande, D.; Farina, M. A.; Isusi, M. [Hospital de Basurto. Bilbao (Spain)

    2001-07-01

    The compare the efficacy of ultrasonography and computed tomography (CT) in cases of suspected appendicitis. To study to what extent age, sex and habits of the patients, as well as the clinical context, influence the diagnostic yield of these two technique. Over a one-year period, 152 patients underwent ultrasonography and CT because of the clinical suspicion of appendicitis. The studies were carried out independently, and the results of each in terms of the presence or absence of appendicitis were unknown to the specialists performing the other. The final diagnoses were established by surgical treatment or clinical follow-up. The sensitivity of CT for the diagnosis of appendicitis was 82%, the specificity was 95%, the positive predictive value was 93%, the negative predictive value was 87% and the reliability was 90%. Ultrasonography has a sensitivity of 83%, a specificity of 97%, a positive predictive value of 95%, a negative predictive value of 88% and a reliability of 91%. Ultrasound was more efficient in patients in which there was a high clinical suspicion and in children, while the results with CT were better in patients in which the clinical diagnosis was less clear. The incidence of false negatives and positives was higher with ultrasound, while CT was more frequently able to identify a normal appendix. Sex and habits had no influence on the respective efficacies, although the performance of ultrasound was simplified in thin patients and that of CT in obese individuals. Ultrasonography and CT are highly reliable in cases of suspected appendicitis, especially when this diagnosis is conformed. Ultrasound is recommended as the technique of choice in children and in patients in which the clinical suspicion is strong. The yield of CT is somewhat greater when the clinical signs and symptoms are less clear. However, the efficacy of both techniques ultimately depends on the expertise of the specialist who interprets them. (Author) 62 refs.

  17. Expression of leukemic stem cell associated membrane antigens in acute leukemia cells%白血病干细胞相关抗原在急性白血病细胞中的表达

    Institute of Scientific and Technical Information of China (English)

    肖平; 曾耀英; 林蔚

    2011-01-01

    目的 探讨白血病干细胞(leukemia stem cell,LSC)相关抗原在不同亚型急性白血病细胞中的表达规律.方法 采用流式细胞术检测LSC相关抗原CD96,CD90,CD123,CD71等在50例不同亚型急性白血病细胞中的表达,包括急性粒细胞白血病未分化型(M1)、急性粒细胞白血病部分分化型(M2)、急性早幼粒细胞白血病(Ms)、急性粒-单核细胞白血病(M4)和急性B淋巴细胞白血病.结果 CD96在M.的表达率(90.00%)明显高于M2(18.18%)和急性B淋巴细胞白血病(20.00%)(P<0.05);各亚型急性白血病均表达CD123,但差异无统计学意义(P>0.05) ;CD71在急性髓细胞白血病各亚型中(M1、M2、M3和M4)阳性表达率分别为80.00%、72.73%、90.00%和100.00%,明显高于急性B淋巴细胞白血病(P<0.05);CD90在急性B淋巴细胞白血病中阳性表达率为13.33%,高于急性髓细胞白血病(P>0.05).结论 CD71与CD96的表达有亚型特异性,CD96可能具有指示系列分化和细胞分化程度的作用,CD71可用于区分急性淋巴细胞白血病和急性髓细胞白血病.%Objective To study the expression of leukemic stem cell associated membrane antigens in acute leukemia cells with different subtypes. Methods Leukemic stem cell associated membrane antigens CD96, CD90, CD123 and CD71 were detected with flow cytometry in 50 acute leukemia patients with different subtypes including acute myeloblast leukemia without cell maturation (M1), acute myeloblast leukemia with cell maturation (M2), acute promyelocytic leukemia (M3), acute myelomonocytic leukemia (AMML) and B-acute lymphoblastic leukemia (B-ALL). Results The positive rate of CD96 expression in M3(90. 00%) was significantly higher than that in M2(18. 18%) and B-ALL (20. 00%)(P 0. 05). The positive rate of CD71 expression in four subtypes of acute myeloid leukemia (M1 , M2, M3 and M4) was 80. 00%, 72. 73%, 90. 00% and 100. 00% respectively, all of which were significantly higher than

  18. Impact of appendicitis during pregnancy : No delay in accurate diagnosis and treatment

    NARCIS (Netherlands)

    Aggenbach, L.; Zeeman, G. G.; Cantineau, A. E. P.; Gordijn, S. J.; Hofker, H. S.

    2015-01-01

    Background: Acute appendicitis during pregnancy may be associated with serious maternal and/or fetal complications. To date, the optimal clinical approach to the management of pregnant women suspected of having acute appendicitis is subject to debate. The purpose of this retrospective study was to p

  19. Fiber Intake and Childhood Appendicitis.

    Science.gov (United States)

    Brender, Jean D.; And Others

    1985-01-01

    Parents of 135 children with appendicitis and of 212 comparison children were interviewed about their children's diet. Results suggest that a liberal intake of whole-grain breads and cereals may decrease the risk of appendicitis during childhood. (KH)

  20. 基层医院采用高频超声在急性阑尾炎诊断中的价值探讨%Discussion on the value of high frequency ultrasound in diagnosis of acute appendicitis in basic hospital

    Institute of Scientific and Technical Information of China (English)

    韦新鸿

    2015-01-01

    Objective:To explore the value of high frequency ultrasound in the diagnosis of acute appendicitis in basic hospital. Methods:Diagnosis of acute appendicitis by high-frequency probe.Results:In 128 patients by high frequency ultrasound diagnosis, 108 cases were diagnosed with acute appendicitis(84%).Conclusion:Most acute appendicitis can be diagnosed by high frequency ultrasound.It is worth promoting in ultrasound diagnosis in primary hospital.%目的:探讨基层医院采用高频超声在急性阑尾炎诊断中的价值。方法:采用高频探头对急性阑尾炎患者进行诊断。结果:128例患者中经高频超声诊断为急性阑尾炎108例(84%)。结论:高频超声可以诊断绝大多数急性阑尾炎,值得在基层医院超声诊断中推广。

  1. Appendicitis in Pregnancy: Presentation, Management and Complications

    Directory of Open Access Journals (Sweden)

    Abdoulhossein Davoodabadi

    2016-06-01

    Full Text Available Background Diagnosis of acute appendicitis in pregnancy is difficult. Delay operation, increase complications. Objectives This study focused on early operation on base of careful history, precise physical examination, and rational close observation and evaluates its results with conventional investigation in pregnant women suspected acute appendicitis. Materials and Methods A cross sectional study in100 pregnant women and 100 aged matched non pregnant women underwent appendectomy during Sep 2011 - Dec 2014. The data were analyzed by chi-square test through SPSS 16.0. Results Age 16 - 37 years, mean age in pregnant women and no pregnant women were24.75 ± 4.4 and 27.56 ± 6.53 years (P > 0.05, respectively. 20 - 25 years age group, were more frequent = 44%. 70% patients were gravid 1, mean hospital stay in pregnant women, and non-pregnant women were 48 ± 6 and 85.2 ± 43.19 hours (P value < 0.001. respectively. acute appendicitis was confirmed histological in non-pregnant was 72%, but In pregnant women 62%, most cases were in the third Trimester 66% (n = 41. Peri umbilical pain, with migration to the right lower quadrant, was in 75% of patients. Right-lower-quadrant pain was the most common presenting symptom. Diagnosis (62% was made on base care full history and precise physical examination and close observation of 12 ± 8 hours. there were no maternal and fetal complications related to all of the appendectomies during the all trimester up to delivery period. Conclusions There are no diagnostic laboratory findings in acute appendicitis during pregnancy. Careful history and physical examination and close observation of 12 ± 8 hours are sufficient for surgery decision making. In spite of high negative appendectomy since it has no Surgical and obstetric complication, early Appendectomy without aggressive investigation recommend.

  2. Idiopathic Renal Infarction Mimicking Appendicitis

    Science.gov (United States)

    Lisanti, Francesco; Scarano, Enrico

    2017-01-01

    Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%–0.007%). Usually, it manifests in patients aged 60–70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis. Here we highlight the extremely ambiguous presentation of renal infarct and the importance for clinicians to be aware of this condition, particularly in patients without clear risk factors, as it usually has a good prognosis after appropriate anticoagulant therapy. PMID:28203466

  3. 健康教育对老年急性阑尾炎患者的影响研究%Study on Health Education Influence on Elderly Patients With Acute Appendicitis

    Institute of Scientific and Technical Information of China (English)

    于静

    2015-01-01

    目的:研究健康教育对老年急性阑尾炎患者的影响。方法搜集本院2014年1月~2015年1月老年急性阑尾炎40例,依据数字随机法进行分组。给予对照组常规护理,共20例;在此基础上给予研究组健康教育,共20例。观察比较两组效果。结果两组比较,研究组住院天数短(P<0.05),知识知晓评分高(P<0.05),满意度高(P<0.05)。结论健康教育可有效提高老年急性阑尾炎患者知识知晓评分,缩短住院天数。%Objective Health education influence on elderly patients with acute appendicitis is to be studied.Methods To choose 40 elderly patients with acute appendicitis who were treated in hospital from January 2014 to January 2015 and separated them into control group and study group according to random digit table. 20 patients in control group were given conventional care, while 20 patients in study group were given additional health education. Then make a comparison on treatment efects between two groups.ResultsCompared to patients in control group, patients’ in study group hospitalization days was shorter (P< 0.05).Heir knowledge mastery assessment score was higher (P< 0.05) and satisfaction rate was higher (P< 0.05) in study group .Conclusion For elderly patients with acute appendicitis,health education is efective to improve patients’ assessment scores of knowledge mastery and reduce their hospitalization days.

  4. 妊娠期急性阑尾炎66例诊疗分析%Clinical Analysis of Diagnosis and Treatment for 66 Cases of Acute Appendicitis During Pregnancy

    Institute of Scientific and Technical Information of China (English)

    苏乃伟; 李新宁; 石群峰

    2012-01-01

    目的:探讨妊娠期急性阑尾炎的诊断及治疗方法.方法:回顾性分析66例妊娠期急性阑尾炎的临床资料,29例患者不同意手术而接受保守治疗,其中12例感染不能控制,改手术治疗,另37例入院急诊外科手术治疗.结果:66例患者顺利出院;8例患者出院后要求行人工流产术;2例患者术后流产,1例患者术后10d早产;无胎儿宫内窘迫、死胎及妊娠妇女死亡等严重并发症.结论:妊娠期急性阑尾炎的及时诊断和手术治疗,是保证临床效果及母婴安全的重要手段.但对感染症状轻、局部腹膜炎不明显、不同意手术的患者,可先予保守治疗,密切观察,治疗效果不明显时应立即手术.%Objective:To explore diagnosis and treatment of acute appendicitis during pregnancy. Methods:retrospective analysis of the clinical data of 66 cases of acute appendicitis during pregnancy,29 patients didn't agree with surgery,so received conservative treatment,and 12 cases of uncontrolled infection,change to surgical treatment,37 cases were admitted to the hospital emergency surgical treatment. Results:66 patients discharge smoothly;eight patients after discharge required abortion in obstetrics and gynecology;2 patients had the abortion,one patient was premature birth at 10 days after surgery;no serious complications such as fetal distress,stillbirth and pregnant women death. Conclusions:Important means for the safety of maternal and infant is that timely diagnosis and surgical treatment of acute appendicitis during pregnancy. If symptoms of light infection,unapparent local peritonitis,and patients don't agree with surgery,we first do conservative treatment,and closely observe. If the treatment effect is not obvious, we then immediately surgery.

  5. Enterobius vermicularis: A Controversial Cause of Appendicitis

    Directory of Open Access Journals (Sweden)

    "Gh Mowlavi

    2004-08-01

    Full Text Available Enterobiasis is undoubtedly one of the most common human helminths infections through the world, with an estimate of 1000 million cases worldwide. Although adult worms and their eggs are frequently found in inflamed appendices, but the role of the parasite in producing appendicitis in humans still remains controversial. Although acute appendicitis may occur at any age, but it is relatively rare at the extremes of age. A histopathological study of infested appendices with Enterobius vermicularis was performed in Khuzestan province, south western Iran, during 2001 to 2003. All 40 samples had surgically been removed during the emergency operations and histopathological process with (H&E staining has been performed for each. One of the main objects of this work was to collect more data about the possible role of this highly prevalent human round worm as a causative agent of appendicitis in humans, leading to different types of appendicitis in this part of the country. In this occasion over the slide examinations of the tissue sections, fewer cases than expected, with worm infested appendices were seen exclusively affected with this parasite.

  6. MRI in suspected appendicitis

    NARCIS (Netherlands)

    Leeuwenburgh, M.M.N.

    2014-01-01

    Dit proefschrift richt zich op de optimalisatie van beeldvormende diagnostiek bij patiënten met een klinische verdenking op appendicitis, waarbij het gebruik van ‘magnetic resonance imaging’ (MRI) wordt verkend. Het proefschrift omvat de resultaten van de OPTIMAP-studie (OPTimisation of IMaging Appe

  7. 急性阑尾炎患者外周血LXA4与降钙素原水平的检测及研究%The research and testing of the level of blood LXA4 and procalcitonin in the Acute appendicitis pa-tients

    Institute of Scientific and Technical Information of China (English)

    朱克华; 张福

    2016-01-01

    目的:通过监测比较急性阑尾炎患者外周血脂氧素A4(LXA4)与降钙素元(PCT)水平,分析LXA4、PCT在急性阑尾炎患者的诊断中的作用及机制。方法:随机选取120例急性阑尾炎患者,均于手术前采用酶联免疫吸附法( ELISA)检测患者外周血LXA4、PCT水平,并进行相关性分析。对照组选取同期健康体检者50例。结果:120例急性阑尾炎患者,结合手术或(和)病理诊断结果分为单纯性阑尾炎(35例)、化脓性阑尾炎(47例)、穿孔性阑尾炎(21例)、坏疽性阑尾炎(17例)。急性阑尾炎患者各组血清LXA4、PCT水平均显著高于对照组( P﹤0.01);化脓性阑尾炎组、穿孔性阑尾炎组及坏疽性阑尾炎组血清LXA4、PCT水平均显著高于单纯性阑尾炎组( P﹤0.05);坏疽性阑尾炎组及穿孔性阑尾炎组血清PCT水平高于化脓性阑尾炎组( P﹤0.05);急性阑尾炎患者血清LXA4与PCT水平呈显著正相关( r=-0.718,P=0.002)。结论:在急性阑尾炎患者中血清LXA4与PCT的水平与患者的病情有较高的相关性,对急性阑尾炎的诊断、术前病情评估及是否手术均有一定的指导意义。%Objective Through the detection of the level of blood LXA4 and PCT in the Acute appendicitis patients to re-search the role and mechanism of LXA4 and PCT in the diagnosis of patients with acute appendicitis. Method 120 cases of pa-tients with acute appendicitis were randomly selected,the level of blood LXA4 and PCT were detected and analyzed before the surgery by using the method of enzyme-linked immunosorbent( ELISA). 50 cases of healthy check-up were selected as the control group. Results According to the surgery or( and)the pathological diagnosis,the cases of 120 patients with acute appendi-citis was divided into simple appendicitis(35 cases),suppurative appendicitis(47 cases),perforated appendicitis(21 cases) and gangrenous appendicitis(17

  8. Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

    Science.gov (United States)

    Kobayashi, Taiichiro; Yano, Hideaki; Murata, Yukinori; Igari, Toru; Nakada-Tsukui, Kumiko; Yagita, Kenji; Nozaki, Tomoyoshi; Kaku, Mitsuo; Tsukada, Kunihisa; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Oka, Shinichi

    2016-01-01

    ABSTRACT Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis. PMID:27847377

  9. Asymptomatic leukemic-cell infiltration of the pancreas: US findings.

    Science.gov (United States)

    Collado, Laura; Dardanelli, Esteban; Sierre, Sergio; Moguillansky, Silvia; Lipsich, José

    2011-06-01

    Pancreatic infiltration of leukemic cells is a very rare manifestation at the onset of acute lymphoblastic leukemia (ALL) in childhood. Pancreatic enlargement in this situation is unusual and pancreatic involvement is often associated with biliary obstruction, cholestasis and pancreatitis. We report a 3-month-old girl who presented with asymptomatic leukemic infiltration of the pancreas, demonstrated by US with heterogeneous pancreatic enlargement associated with multiple hypoechogenic lesions, without cholestasis. Although these manifestations are rare, ALL should be considered a cause of pancreatic enlargement.

  10. Achados principais de exames laboratoriais no diagnóstico de apendicite aguda: uma avaliação prospectiva Main findings in laboratory tests diagnosis of acute appendicitis: a prospective evaluation

    Directory of Open Access Journals (Sweden)

    Rafael Nunes Goulart

    2012-06-01

    Full Text Available RACIONAL: Apendicite aguda é a doença abdominal cirúrgica mais comum nas unidades de emergência. Embora o diagnóstico seja clínico, a realização de exames complementares pode ser útil na dúvida diagnóstica. OBJETIVO: Avaliar as principais alterações de exames laboratoriais em pacientes com apendicite aguda, assim como sua relação com a fase evolutiva da doença. MÉTODOS: Avaliação prospectiva de pacientes com diagnóstico de apendicite aguda submetidos ao tratamento cirúrgico. RESULTADOS: Cento e setenta e nove pacientes participaram deste estudo, a maioria do sexo masculino. A idade média foi de 26 anos. Em relação à contagem de leucócitos, 46,9% apresentavam valores BACKGROUND: Acute appendicitis is the most common surgical abdominal disease in the emergency room. Although the diagnosis is clinical the complementary tests may be useful in doubt. AIM: To evaluate the main laboratory tests in patients with acute appendicitis, as well as its relationship with the evolutionary stage of the disease. METHODS: Prospective evaluation of patients with acute appendicitis who underwent surgical treatment. RESULTS: A total of 179 patients participated in this study, most were male. The mean age was 26 years. For leukocyte count 46.9% had values ​​<15.000mm3. The mean percentage of polymorphonuclear cells was 81,7%, 1,2% of sticks, 1% eosinophils, lymphocytes 12,8% and 2,9% monocytes. C-reactive protein was required for 54 patients. It was <10 mg/dl in 19, between 10 and 50 mg/dl in 24 and greater than or equal to 50 mg/dl in 11. Regarding the evolutionary phase 64% patients had early stage (stages 1 and 2, 16,2% stage 3 and 35 stage 4. A total of 57% of patients with white blood cell count greater than or equal to 20.000/mm3 had appendicular perforation (p<0,05. The percentage of polymorphonuclear leukocytes from patients with early stages was lower than the later stages (79,8% and 85,1%, respectively, with p<0,05. Patients

  11. The NOTA study: non-operative treatment for acute appendicitis: prospective study on the efficacy and safety of antibiotic treatment (amoxicillin and clavulanic acid) in patients with right sided lower abdominal pain

    Science.gov (United States)

    Giorgini, Eleonora; Biscardi, Andrea; Villani, Silvia; Clemente, Nicola; Senatore, Gianluca; Filicori, Filippo; Antonacci, Nicola; Baldoni, Franco; De Werra, Carlo; Di Saverio, Salomone

    2011-01-01

    Background Case control studies that randomly assign patients with diagnosis of acute appendicitis to either surgical or non-surgical treatment yield a relapse rate of approximately 14% at one year. It would be useful to know the relapse rate of patients who have, instead, been selected for a given treatment based on a thorough clinical evaluation, including physical examination and laboratory results (Alvarado Score) as well as radiological exams if needed or deemed helpful. If this clinical evaluation is useful, the investigators would expect patient selection to be better than chance, and relapse rate to be lower than 14%. Once the investigators have established the utility of this evaluation, the investigators can begin to identify those components that have predictive value (such as blood analysis, or US/CT findings). This is the first step toward developing an accurate diagnostic-therapeutic algorithm which will avoid risks and costs of needless surgery. Methods/design This will be a single-cohort prospective observational study. It will not interfere with the usual pathway, consisting of clinical examination in the Emergency Department (ED) and execution of the following exams at the physician's discretion: full blood count with differential, C reactive protein, abdominal ultrasound, abdominal CT. Patients admitted to an ED with lower abdominal pain and suspicion of acute appendicitis and not needing immediate surgery, are requested by informed consent to undergo observation and non operative treatment with antibiotic therapy (Amoxicillin and Clavulanic Acid). The patients by protocol should not have received any previous antibiotic treatment during the same clinical episode. Patients not undergoing surgery will be physically examined 5 days later. Further follow-up will be conducted at 7, 15 days, 6 months and 12 months. The study will conform to clinical practice guidelines and will follow the recommendations of the Declaration of Helsinki. The protocol

  12. Flow cytometric analysis of peripheral blood leukemic cells in relapse of acute leukemia%急性白血病复发外周血白血病细胞的流式细胞术检验分析

    Institute of Scientific and Technical Information of China (English)

    杨莉; 何浩明

    2015-01-01

    Objective To analyse status of peripheral blood leukemic cells detected by flow cytometry in patients with acute leu‐kemia(AL) ,and to provide references for evaluating clinical efficacy and prognosis of AL .Methods The peripheral blood specimens of 87 cases of patients with AL ,including 53 cases of patients with acute myelocytic leukemia and 34 cases of patients with acute lymphoblastic leukemia ,were detected by using flow cytometry ,morphological changes in bone marrow cells were detected ,as well . Results The sensitivity ,specificity and positive predictive value in determination of acute myelocytic leukemia was 95 .6% ,34 .5%and 81 .3% respectively ,and those in acute lymphoblastic leukemia was 87 .3% ,45 .6% and 68 .9% respectively ,statistically signif‐icant differences were found in sensitivity ,specificity and positive predictive value (P<0 .05) .A total of 19 cases with negative mini‐mal residual disease had recurrence(26 .31% ) after 24 months ,and 68 cases with positive minimal residual disease had recurrence (86 .76% ) after 24 months ,and the recurrence rate between the two groups was statistically significant (P<0 .05) .Among all pa‐tients with positive minimal residual disease ,the recurrence rate in patients with high expression level of minimal residual disease (88 .23% ) was higher than that in patients with low expression level of minimal residual disease (47 .09% ) ,and the difference was statistically significant (P<0 .05) .Conclusion Flow cytometric analysis of peripheral blood leukemic cells may has significance for diagnosing relapse of AL and guiding clinical medication .%目的:分析急性白血病(AL)患者外周血白血病细胞流式细胞术检测情况,为分析AL的临床疗效和预后提供参考。方法采用流式细胞术检测87例A L患者(急性髓细胞白血病53例、急性淋巴细胞白血病34例)外周血标本,同时检测骨髓细胞形态学变化。结果急性髓细胞白

  13. Incarcerated appendicitis in port-site hernia: A rare case report

    Directory of Open Access Journals (Sweden)

    Tamir A. Hassan

    2015-09-01

    Case presentation: We describe a distinctive case of incarcerated appendicitis in port-site hernia following laparoscopic cholecystectomy. Acute appendicitis was pre-operatively CT diagnosed and appendectomy was performed followed by primary repair of the hernia defect. Awareness of atypical presentation and possible complications may raise the clinical suspicion index to ask for early CT.

  14. Stump appendicitis is a rare delayed complication of appendectomy: A case report

    Institute of Scientific and Technical Information of China (English)

    Mehmet Uludag; Adnan Isgor; Muzaffer Basak

    2006-01-01

    Stump appendicitis is an acute inflammation of the residual appendix and one of the rare complications after appendectomy. Paying attention to the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy can prevent the delay of diagnosis and treatment. In patients with stump appendicitis,CT scan not only assists in making an accurate preoperative diagnosis but also excludes other etiologies. We report a 47-year old man with preoperatively diagnosed stump appendicitis by CT, who underwent an open appendectomy 20 years ago.

  15. A Rare Case: Appendectomy After Connected Stump Appendicitis Perforation of the Cecum

    Directory of Open Access Journals (Sweden)

    Berke Manoglu

    2016-01-01

    Full Text Available Stump appendicitis is a rare complication after appendectomy . Stump appendicitis made of incomplete appendectomy after a rest appendix tissue develops as a result of the inflammation. Admitted to the emergency department with acute abdomen and a history of appendectomy in patients with a history of current pain in the right lower quadrant , especially that of the patient must be evaluated in terms of stump appendicitis. The fact that the earlier story appendectomy patients , causing a delay in diagnosis and increasing the morbidity Cecal perforation was offered an advanced case of delayed depending on the stump appendicitis in this article.

  16. IMC-EB10, an anti-FLT3 monoclonal antibody, prolongs survival and reduces nonobese diabetic/severe combined immunodeficient engraftment of some acute lymphoblastic leukemia cell lines and primary leukemic samples.

    Science.gov (United States)

    Piloto, Obdulio; Nguyen, Bao; Huso, David; Kim, Kyu-Tae; Li, Yiwen; Witte, Larry; Hicklin, Daniel J; Brown, Patrick; Small, Donald

    2006-05-01

    The class III receptor tyrosine kinase FLT3 is expressed on the blasts of >90% of patients with B-lineage acute lymphoblastic leukemias (ALL). In addition, it is expressed at extremely high levels in ALL patients with mixed lineage leukemia rearrangements or hyperdiploidy and is sometimes mutated in these same patients. In this report, we investigate the effects of treating ALL cell lines and primary samples with human anti-FLT3 monoclonal antibodies (mAb) capable of preventing binding of FLT3 ligand. In vitro studies, examining the ability of two anti-FLT3 mAbs (IMC-EB10 and IMC-NC7) to affect FLT3 activation and downstream signaling in ALL cell lines and primary blasts, yielded variable results. FLT3 phosphorylation was consistently inhibited by IMC-NC7 treatment, but in some cell lines, IMC-EB10 actually stimulated FLT3 activation, possibly as a result of antibody-mediated receptor dimerization. Through antibody-dependent, cell-mediated cytotoxicity, such an antibody could still prove efficacious against leukemia cells in vivo. In fact, IMC-EB10 treatment significantly prolonged survival and/or reduced engraftment of several ALL cell lines and primary ALL samples in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. This occurred even when IMC-EB10 treatment resulted in FLT3 activation in vitro. Moreover, fluorescence-activated cell sorting and PCR analysis of IMC-EB10-treated NOD/SCID mice surviving 150 days post-leukemic cell injection revealed that FLT3 immunotherapy reduced leukemic engraftment below the level of detection in these assays (IMC-EB10 treatment did not select for resistant cells, because cells surviving IMC-EB10 treatment remain sensitive to IMC-EB10 cytotoxicity upon retransplantation. In vivo studies involving either partial depletion or activation of natural killer (NK) cells show that most of the cytotoxic effect of IMC-EB10 is mediated through NK cells. Therefore, such an antibody, either naked or conjugated to radioactive

  17. O uso da ultra-sonografia no diagnóstico e evolução da apendicite aguda Ultrasonography in the diagnosis and evolution of acute appendicitis

    Directory of Open Access Journals (Sweden)

    Arquimedes Artur Zorzetto

    2003-03-01

    Full Text Available OBJETIVO: Aproximadamente 35% das apendicites agudas têm diagnóstico clínico pré-operatório duvidoso ou incorreto, particularmente grávidas e crianças. A ultra-sonografia, em virtude do seu baixo custo e facilidade de acesso, tem-se mostrado um método diagnóstico importante. Este estudo propôs-se a demonstrar os principais achados de imagem das diversas fases da apendicite, com o objetivo de auxiliar o ultra-sonografista no diagnóstico precoce desta afecção. MATERIAIS E MÉTODOS: São relatados 14 casos de ultra-sonografias abdominais realizadas no período de janeiro a julho de 2001, em pacientes que se apresentavam com quadro de abdome agudo. O exame foi realizado com transdutores de 3,5 MHz e 7,5 MHz. RESULTADOS: O estudo ultra-sonográfico antes da perfuração demonstra apêndice não compressível, com espessamento e perda focal da definição das paredes. Após a perfuração, o apêndice pode não ser visualizado ao exame de ultra-sonografia, sendo evidenciadas alterações secundárias como efeito de massa, formação de plastrão, liquefação e formação de abscesso, além de ar dentro da coleção. CONCLUSÃO: O diagnóstico precoce da apendicite é essencial para minimizar a morbidade, que se mantém elevada se ocorrer perfuração. Apresentações atípicas resultam em confusão diagnóstica e retarde no tratamento. As principais dificuldades e erros são apendicite retrocecal, apendicite focal ou perfurada.OBJECTIVE: Approximately 35% of the patients with acute appendicitis have a doubtful or incorrect preoperatory diagnosis, particularly in pregnant women and children. Ultrasonography has demonstrated to be an important means of diagnosis due to its low cost and easy access. This study is intended to show the main imaging findings of the many phases of appendicitis, thus helping the ultrasonographist to establish an early diagnosis. MATERIALS AND METHODS: From January to June 2001, 14 patients with acute abdominal

  18. Profiles of US and CT imaging features with a high probability of appendicitis

    Science.gov (United States)

    Laméris, W.; van Es, H. W.; ten Hove, W.; Bouma, W. H.; van Leeuwen, M. S.; van Keulen, E. M.; van der Hulst, V. P. M.; Henneman, O. D.; Bossuyt, P. M.; Boermeester, M. A.; Stoker, J.

    2010-01-01

    Objectives To identify and evaluate profiles of US and CT features associated with acute appendicitis. Methods Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between appendiceal imaging features and a final diagnosis of appendicitis were evaluated with logistic regression analysis. Results Appendicitis was assigned to 284 of 942 evaluated patients (30%). All evaluated features were associated with appendicitis. Imaging profiles were created after multivariable logistic regression analysis. Of 147 patients with a thickened appendix, local transducer tenderness and peri-appendiceal fat infiltration on US, 139 (95%) had appendicitis. On CT, 119 patients in whom the appendix was completely visualised, thickened, with peri-appendiceal fat infiltration and appendiceal enhancement, 114 had a final diagnosis of appendicitis (96%). When at least two of these essential features were present on US or CT, sensitivity was 92% (95% CI 89–96%) and 96% (95% CI 93–98%), respectively. Conclusion Most patients with appendicitis can be categorised within a few imaging profiles on US and CT. When two of the essential features are present the diagnosis of appendicitis can be made accurately. PMID:20119730

  19. Profiles of US and CT imaging features with a high probability of appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Randen, A. van; Lameris, W. [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Es, H.W. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Hove, W. ten; Bouma, W.H. [Gelre Hospitals, Department of Surgery, Apeldoorn (Netherlands); Leeuwen, M.S. van [University Medical Centre, Department of Radiology, Utrecht (Netherlands); Keulen, E.M. van [Tergooi Hospitals, Department of Radiology, Hilversum (Netherlands); Hulst, V.P.M. van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Henneman, O.D. [Bronovo Hospital, Department of Radiology, The Hague (Netherlands); Bossuyt, P.M. [University of Amsterdam, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Boermeester, M.A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Stoker, J. [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

    2010-07-15

    To identify and evaluate profiles of US and CT features associated with acute appendicitis. Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between appendiceal imaging features and a final diagnosis of appendicitis were evaluated with logistic regression analysis. Appendicitis was assigned to 284 of 942 evaluated patients (30%). All evaluated features were associated with appendicitis. Imaging profiles were created after multivariable logistic regression analysis. Of 147 patients with a thickened appendix, local transducer tenderness and peri-appendiceal fat infiltration on US, 139 (95%) had appendicitis. On CT, 119 patients in whom the appendix was completely visualised, thickened, with peri-appendiceal fat infiltration and appendiceal enhancement, 114 had a final diagnosis of appendicitis (96%). When at least two of these essential features were present on US or CT, sensitivity was 92% (95% CI 89-96%) and 96% (95% CI 93-98%), respectively. Most patients with appendicitis can be categorised within a few imaging profiles on US and CT. When two of the essential features are present the diagnosis of appendicitis can be made accurately. (orig.)

  20. Computer-Aided Diagnosis Of Leukemic Blood Cells

    Science.gov (United States)

    Gunter, U.; Harms, H.; Haucke, M.; Aus, H. M.; ter Meulen, V.

    1982-11-01

    In a first clinical test, computer programs are being used to diagnose leukemias. The data collected include blood samples from patients suffering from acute myelomonocytic-, acute monocytic- and acute promyelocytic, myeloblastic, prolymphocytic, chronic lymphocytic leukemias and leukemic transformed immunocytoma. The proper differentiation of the leukemic cells is essential because the therapy depends on the type of leukemia. The algorithms analyse the fine chromatin texture and distribution in the nuclei as well as size and shape parameters from the cells and nuclei. Cells with similar nuclei from different leukemias can be distinguished from each other by analyzing the cell cytoplasm images. Recognition of these subtle differences in the cells require an image sampling rate of 15-30 pixel/micron. The results for the entire data set correlate directly to established hematological parameters and support the previously published initial training set .

  1. Study of molecular mechanism on PESV in inhibiting acute leukemic cell extramedullary infiltration and transmutation%蝎毒多肽干预急性白血病髓外浸润传变的机制

    Institute of Scientific and Technical Information of China (English)

    郝征; 杨文华

    2012-01-01

    Objective: To investigate the peptide extracts from scorpion venom (PESVs) interfering in urokinase-type PA(uPA) and its receptor, the matrix metalloproteinase2(MMP2), matrix metalloproteinase9(MMP9) expression in leukemia-NOD/SCID Mice, and to research the mechanism of PESV inhibiting the multiplication and infiltration of leukemic cells. Methods: To begin with, bone marrow mononuclear cells of leukemia patients were injected into NOD/SCID mice, irradiated 270 cGy on body by 137Cs beforehand, in order to establish the animal model of outer marrow infiltration of human leukemia in NOD/SCID mice. What's more, randomly to divide the mice of model establishment into four groups. Group Ⅰ-Ⅲ were respectively cured by the peptide extract from scorpion venom (PESV) with different concentrations and Group Ⅳ was the model group injected by the physiological saline water. Group Ⅴ was taken as control. Finally, To kill these mice after four weeks and to use Real-time PCR method to examine MMP2, MMP9 mRNA expression in mice, simultaneously to use western blot method to examine MMP2, MMP9 protein expression. Furthermore, to use ELISA method to examine uPA and uPAR expression in mice's blood serum. Results: The PESV, anticancer peptide in east asian pliers scorpion poisonous, has good inhibitory role in leukemic cell multiplication and infiltration, which effectively suppress the MMP2, MMP9 mRNA and protein expression and inhibit the uPA and its receptor in leukemia-NOD/SCID mice. The effect of inhibiting them was related to PESV concentration. Conclusion: The PESV has good role in inhibiting acute leukemic cell extramedullary infiltration and transmutation by influencing ECM degradation system.%目的:观察蝎毒多肽(PESV)对人白血病NOD/SCID小鼠髓外浸润模型体内uPA、uPAR、MMP2、MMP9表达的影响,探讨PESV干预急性白血病髓外浸润传变的机制.方法:首先选取急性白血病患者骨髓单个核细胞注入经过铯-137源照射的NOD

  2. Appendicitis/diverticulitis: minimally invasive surgery.

    Science.gov (United States)

    Mutter, D; Marescaux, J

    2013-01-01

    Complicated intra-abdominal infections such as acute appendicitis and complicated diverticulitis represent both diagnostic and therapeutic challenges. Both diseases, although different in many ways, are caused by the obstruction of a blind pouch leading to inflammation, abscesses, and perforation of surrounding tissues. For many decades, acute appendicitis was managed through a conventional surgical incision in the right iliac fossa. As for other diseases, there is a significant tendency to propose less invasive treatments. For many teams, laparoscopy, which leads to less postoperative pain, a shorter hospital stay, and a quicker recovery, represents the standard of care for appendectomy. For selected cases, a medical approach can be proposed with satisfactory outcomes. Additionally, the management of complicated diverticulitis is also quickly moving towards less invasive procedures than the deleterious '3-phase surgery', which is Hartmann's procedure, followed by reversal protected with a stoma, and finally stoma closure. Benefiting from the evolution of antimicrobial therapy and interventional radiology, many complicated cases classified as Hinchey stage I and Hinchey stage II complicated diverticulitis are now treated medically. CT images allow the identification of patients requiring radiological drainage of localized abscesses or collections over 5 cm in size. Patients with Hinchey stage III sigmoiditis may benefit from an initial laparoscopic exploration allowing, in some cases, a conservative nonresective approach that will prevent laparotomy and stoma. Major resection leading to temporary or definitive stoma is usually indicated for stage IV complications and is required only in exceptional cases. Although a surgical intervention can be the definitive treatment for complicated intra-abdominal infections, multidisciplinary management including radiology, medical treatment, and laparoscopic surgery may limit the severe consequences of an acute surgical

  3. Imaging of appendicitis in adults; Bildgebung der Appendizitis beim Erwachsenen

    Energy Technology Data Exchange (ETDEWEB)

    Karul, M.; Berliner, C.; Keller, S.; Yamamura, J. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Tsui, T.Y. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General, Visceral- and Thoracic Surgery

    2014-06-15

    Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2 mm, cross-sectional diameter greater than 6 mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance. (orig.)

  4. [Experimental study on induction of apoptosis of leukemic cells by Boswellia carterii Birdw extractive].

    Science.gov (United States)

    Qi, Z; Zhang, G; Zhu, W

    1999-01-01

    The purpose of the study was to investigate the apoptosis of leukemic cells induced by Boswellia Carterii Birdw(BCB). The target leukemia cell line HL60 and bone marrow leukemic cells from 30 acute non-lymphocytic leukemic(ANLL) patients (3 M1 11 M2a 10 M3 1 M4a 5 M5b) were studied. Apoptosis was detected by morphological observation, DNA electrophoresis, percentage of DNA fragmentation test and flow cytometric cell cycle analysis. It is concluded that BCB can induce apoptosis in ANLL cells and HL60 cells.

  5. Appendicitis/diverticulitis: diagnostics and conservative treatment.

    Science.gov (United States)

    Kruis, Wolfgang; Morgenstern, Julia; Schanz, Stefan

    2013-01-01

    Appendicitis and diverticulitis are very common entities that show some similarities in diagnosis and course of disease. Both are widely believed to be simple clinical diagnoses, which is in contrast to scientific evidence. An accurate diagnosis has to describe not only the initial detection, but particularly the severity of the disease. It is based mainly on cross-sectional imaging by ultrasound (US) and computed tomography (CT). Appendectomy is the standard treatment for acute appendicitis and is mandatory in complicated cases. Antibiotic therapy is similarly effective in uncomplicated appendicitis, but long-term results are not sufficiently known. Treatment of diverticulitis is related to the disease status. Complications such as perforation and bleeding require intervention. Uncomplicated diverticulitis as graded by US or CT are subject to conservative management, in the form of outpatient or hospital care. It is an unresolved debate as to whether antibiotic treatment offers benefits. Mesalazine seems at least to improve pain. The real challenge is treatment of recurrent diverticulitis. Lifestyle measures such as nutritional habits and physical activity are found to influence diverticular disease. Besides immunosuppression, obesity is a significant risk factor for complicated diverticulitis. Whether any medication such as chronic antibiotics, probiotics or mesalazine offers benefits is unclear. The indication for sigmoid resection has changed; it is no longer given by the number of attacks, but rather by structural changes as depicted by cross-sectional imaging.

  6. The ectopic appendicolith from perforated appendicitis as a cause of tubo-ovarian abscess

    Energy Technology Data Exchange (ETDEWEB)

    Vyas, Rajashree C.; Sides, Corey; Klein, Deborah J. [University of Rochester Medical Center, Rochester, NY (United States); Reddy, Sireesha Y. [University of Rochester, Obstetrics and Gynecology, Rochester, NY (United States); Santos, Mary C. [University of Rochester, Pediatric Surgery, Rochester, NY (United States)

    2008-09-15

    Acute appendicitis is a common surgical cause of abdominal pain in the pediatric population. History and physical examination are atypical in up to a third of patients. Known potential complications of untreated or delayed management of acute appendicitis include appendiceal perforation, periappendiceal abscess formation, peritonitis, bowel obstruction and rarely septic thrombosis of mesenteric vessels. We report an unusual complication of perforated appendicitis. A tubo-ovarian abscess developed secondary to appendicolith migration into the right fallopian tube in a patient who had undergone interval laparoscopic appendectomy for perforated appendicitis. The retained appendicolith was visualized within the obstructed and dilated fallopian tube on contrast-enhanced CT. We discuss the CT imaging features of this unusual complication of perforated appendicitis. (orig.)

  7. Conservative approach versus urgent appendectomy in surgical management of acute appendicitis with abscess or phlegmon Resultados del tratamiento conservador inicial y de la cirugía urgente en la apendicitis aguda evolucionada

    Directory of Open Access Journals (Sweden)

    J. M. Aranda-Narváez

    2010-11-01

    Full Text Available Background: Surgical management of acute appendicitis with appendiceal abscess or phlegmon remains controversial. We studied the results of initial conservative treatment (antibiotics and percutaneous drainage if necessary, with or without interval appendectomy compared with immediate surgery. Methods: We undertook an observational, retrospective cohort study of patients with a clinical and radiological diagnosis of acute appendicitis with an abscess or phlegmon, treated in our hospital between January 1997 and March 2009. Patients younger than 14, with severe sepsis or with diffuse peritonitis were excluded. A study group of 15 patients with acute appendicitis complicated with an abscess or phlegmon underwent conservative treatment. A control group was composed of the other patients, who all underwent urgent appendectomy, matched for age and later randomized 1:1. The infectious risk stratification was established with the National Nosocomial Infections Surveillance System (NNIS index. Dependent variables were hospital stay and surgical site infection. Analysis was with SPSS, with p Introducción: Existe controversia acerca del tratamiento idóneo de la apendicitis aguda evolucionada en forma de absceso o flemón. Realizamos un estudio para la evaluación de resultados del tratamiento conservador inicial (antibiótico y drenaje percutáneo si se precisa, con/sin apendicectomía diferida y del tratamiento quirúrgico urgente. Método: Estudio observacional analítico de cohortes retrospectivas. Criterios de inclusión: pacientes con diagnóstico clínico y radiológico de apendicitis aguda evolucionada en forma de absceso o flemón, tratados en nuestro hospital entre enero 1997 y marzo 2009, excluyendo pacientes pediátricos, con sepsis grave o peritonitis difusa. En 15 pacientes con apendicitis complicada con absceso o flemón (cohorte de estudio se indicó tratamiento conservador inicial. El grupo control se obtuvo del resto de pacientes (en

  8. 小切口手术复合抗菌药治疗急性阑尾炎的临床观察%Clinical observation of small incision operation combined with antibacterial drugs in the treatment of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    许志新

    2016-01-01

    目的:研究小切口手术复合抗菌药治疗急性阑尾炎的临床效果。方法:收治急性阑尾炎患者150例,平分为两组。比较组采取传统开腹手术方式,术前不静脉滴注抗菌药物;研究组采取小切口手术复合抗菌药物治疗,术前对患者静脉滴注抗菌药物,对比两组手术情况与切口感染率。结果:研究组手术时长与术后恢复时间均明显短于比较组,手术出血量相比于比较组明显减少;研究组切口感染率2.6%,显著低于比较组的14.6%,研究组手术情况均显著优于比较组,两组对比,差异具有统计学意义(P<0.05)。结论:小切口手术复合抗菌药方式在急性阑尾炎的临床治疗中效果明显。%Objective:To study the clinical effect of small incision operation combined with antibiotics in the treatment of acute appendicitis.Methods:150 patients with acute appendicitis were selected.They were divided into the two groups on average.The comparison group was taken the traditional open surgery,without preoperative intravenous infusion of antibiotics.The research group was taken small incision surgery combined with antibiotic therapy,intravenous infusion of antibiotics was applied before operation.We compared the surgical conditions and incision infection rate of the two groups.Results:The duration of operation and recovery time were significantly shorter in the study group than in the comparison group,and the amount of bleeding was significantly decreased compared with the comparison group.The incision infection rate in the study group was 2.6%,which was significantly lower than 14.6% of the comparison group;the operation status of the study group was significantly better than that of the comparison group;the differences between groups were statistically significant(P<0.05).Conclusion:The effect of small incision surgery combined with antibacterial drugs in the clinical treatment of acute appendicitis is significant.

  9. Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Departments of Radiology and Pediatrics, Rainbow Babies and Childrens Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Euclid Avenue, 11100, 44106-5056, Cleveland, OH (United States)

    2004-06-01

    Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively. Complications usually result from perforation and include abscess formation, peritonitis, sepsis, bowel obstruction and death. Cross-sectional imaging with sonography and computed tomography (CT) have proven useful for the evaluation of suspected acute appendicitis in children. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to precisely delineate gynecologic disease. The principal advantages of CT are its operator independency with resultant higher diagnostic accuracy, enhanced delineation of disease extent in perforated appendicitis, and improved patient outcomes including decreased negative laparotomy and perforation rates. (orig.)

  10. Oral antibiotics for perforated appendicitis is not recommended

    DEFF Research Database (Denmark)

    Alamili, Mahdi; Gögenur, Ismail; Rosenberg, Jacob

    2010-01-01

    In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this pap...

  11. High levels of the adhesion molecule CD44 on leukemic cells generate acute myeloid leukemia relapse after withdrawal of the initial transforming event

    OpenAIRE

    Quéré, R.; Andradottir, S; Brun, A C M; Zubarev, R.A.; Karlsson, G; Olsson, K.; Magnusson, M.; Cammenga, J; Karlsson, S.

    2010-01-01

    Multiple genetic hits are detected in patients with acute myeloid leukemia (AML). To investigate this further, we developed a tetracycline-inducible mouse model of AML, in which the initial transforming event, overexpression of HOXA10, can be eliminated. Continuous overexpression of HOXA10 is required to generate AML in primary recipient mice, but is not essential for maintenance of the leukemia. Transplantation of AML to secondary recipients showed that in established leukemias, ∼80% of the ...

  12. Ascending retrocecal appendicitis presenting with right upper abdominal pain: Utility of computed tomography

    Institute of Scientific and Technical Information of China (English)

    Eugene Mun Wai Ong; Sudhakar Kundapur Venkatesh

    2009-01-01

    Acute appendicitis is a common surgical condition that is usually managed with early surgery, and is associated with low morbidity and mortality. However, some patients may have atypical symptoms and physical findings that may lead to a delay in diagnosis and increased complications. Atypical presentation may be related to the position of the appendix. Ascending retrocecal appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from acute pathology in the gallbladder, liver, biliary tree, right kidney and right urinary tract. We report a series of four patients with retrocecal appendicitis who presented with acute right upper abdominal pain. The clinical diagnoses at presentation were acute cholecystitis in two patients, pyelonephritis in one, and ureteric colic in one. Ultrasound examination of the abdomen at presentation showed subhepatic collections in two patients and normal findings in the other two. Computed tomography (CT) identified correctly retrocecal appendicitis and inflammation in the retroperitoneum in all cases. In addition, abscesses in the retrocecal space ( n = 2) and subhepatic collections ( n = 2) were also demonstrated. Emergency appendectomy was performed in two patients, interval appendectomy in one, and hemicolectomy in another. Surgical findings confirmed the presence of appendicitis and its retroperitoneal extensions. Our case series illustrates the usefulness of CT in diagnosing ascending retrocecal appendicitis and its extension, and excluding other in- flammatory conditions that mimic appendicitis.

  13. C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study

    Science.gov (United States)

    Yokoyama, Shozo; Takifuji, Katsunari; Hotta, Tsukasa; Matsuda, Kenji; Nasu, Toru; Nakamori, Mikihito; Hirabayashi, Naoki; Kinoshita, Hiroyuki; Yamaue, Hiroki

    2009-01-01

    Background This study is an attempt to clarify the role of C-reactive protein (CRP) as a surgical indication marker for appendicitis. Methods One hundred and fifty patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between May 1, 1999 and September 31, 2007. The correlation between preoperative clinical factors and the actual histological severity, and identify surgical indication markers were assessed by univariate and multivariate analyses. Results Univariate analysis showed that only the CRP level significantly differ between the surgical treatment necessary group (gangrenous appendicitis) and the possible non-surgical treatment group (catarrhalis and phlegmonous appendicitis). Multivariate analysis indicated only the CRP level to be a surgical indication marker for acute appendicitis. The receiver-operating characteristic (ROC) curve indicated that the cutoff value of CRP for surgical indication of appendicitis is 4.95 mg/dl. Conclusion Only the CRP level is consistent with the severity of appendicitis, and considered to be a surgical indication marker for acute appendicitis. PMID:19878592

  14. C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study

    Directory of Open Access Journals (Sweden)

    Nakamori Mikihito

    2009-10-01

    Full Text Available Abstract Background This study is an attempt to clarify the role of C-reactive protein (CRP as a surgical indication marker for appendicitis. Methods One hundred and fifty patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between May 1, 1999 and September 31, 2007. The correlation between preoperative clinical factors and the actual histological severity, and identify surgical indication markers were assessed by univariate and multivariate analyses. Results Univariate analysis showed that only the CRP level significantly differ between the surgical treatment necessary group (gangrenous appendicitis and the possible non-surgical treatment group (catarrhalis and phlegmonous appendicitis. Multivariate analysis indicated only the CRP level to be a surgical indication marker for acute appendicitis. The receiver-operating characteristic (ROC curve indicated that the cutoff value of CRP for surgical indication of appendicitis is 4.95 mg/dl. Conclusion Only the CRP level is consistent with the severity of appendicitis, and considered to be a surgical indication marker for acute appendicitis.

  15. The Clinical Manifestations and CT Findings of Cecal Diverticulitis: Comparison Study with Acute Appendicitis%盲肠憩室炎与急性阑尾炎的临床与CT征象对照分析

    Institute of Scientific and Technical Information of China (English)

    李坤炜; 田素伟; 秦培鑫; 丁香莲; 柳学国

    2014-01-01

    目的 探讨盲肠憩室炎的CT影像特点,分析其与急性阑尾炎的临床与影像学表现异同.方法 回顾性分析经手术病理或临床证实的13例盲肠憩室炎与66例急性阑尾炎的临床症状、体征、实验室检查及CT影像资料,分析其异同.结果 盲肠憩室炎组与急性阑尾炎组在发病-就诊时间、中性粒细胞百分比、是否发热、是否存在右下腹反跳痛上差异存在明显统计学意义(P<0.05);而在男女比例、年龄、白细胞计数、右下腹痛类型、是否有恶心呕吐、是否右下腹压痛上相当,差异无统计学意义.两组在阑尾直径、阑尾腔积气、积液、结石、局灶盲肠顶端增厚、阑尾周围渗出上差异存在明显统计学意义(P<0.05).结论 盲肠憩室炎与急性阑尾炎的临床表现极为相似,但具有发病-就诊时间较长,全身症状略轻,右下腹反跳痛相对较少的特点.两者影像表现有着本质区别,前者阑尾正常或相对正常,炎症渗出以盲肠为中心,常累及腹部右上象限;后者存在炎症阑尾,炎性渗出以阑尾为中心,多局限于腹部右下象限.%Objective To explore the clinical and CT imaging characteristics of cecal diverticulitis,and to discuss the differentiation of cecal diverticulitis from acute appendicitis.Methods A total of 13 patients with cecal diverticulitis and 66 patients with acute appendicitis were enrolled in this study.The diagnosis was pathologically or clinically confirmed in all cases.The clinical symptoms,signs,laboratory results and CT findings were retrospectively analyzed.Results Statistically significant differences in the interval of onset-medical visit,the percentage of neutrophils,the presence or absence of fever and right lower quadrant rebound tenderness existed between the two groups (P < 0.05),while no significant differences in the sex ratio,age,white blood cells count,the type of right lower abdominal pain,the presence or absence of nausea

  16. Disparities in appendicitis rupture rate among mentally ill patients

    Directory of Open Access Journals (Sweden)

    Bai Ya-Mei

    2007-11-01

    Full Text Available Abstract Background Many studies have been carried out that focus on mental patients' access to care for their mental illness, but very few pay attention on these same patients' access to care for their physical diseases. Acute appendicitis is a common surgical emergency. Our population-based study was to test for any possible association between mental illness and perforated appendicitis. We hypothesized that there are significant disparities in access to timely surgical care between appendicitis patients with and without mental illness, and more specifically, between patients with schizophrenia and those with another major mental illness. Methods Using the National Health Insurance (NHI hospital-discharge data, we compared the likelihood of perforated appendix among 97,589 adults aged 15 and over who were hospitalized for acute appendicitis in Taiwan between the years 1997 to 2001. Among all the patients admitted for appendicitis, the outcome measure was the odds of appendiceal rupture vs. appendicitis that did not result in a ruptured appendix. Results After adjusting for age, gender, ethnicity, socioeconomic status (SES and hospital characteristics, the presence of schizophrenia was associated with a 2.83 times higher risk of having a ruptured appendix (odds ratio [OR], 2.83; 95% confidence interval [CI], 2.20–3.64. However, the presence of affective psychoses (OR, 1.15; 95% CI: 0.77–1.73 or other mental disorders (OR, 1.58; 95% CI: 0.89–2.81 was not a significant predictor for a ruptured appendix. Conclusion These findings suggest that given the fact that the NHI program reduces financial barriers to care for mentally ill patients, they are still at a disadvantage for obtaining timely treatment for their physical diseases. Of patients with a major mental illness, schizophrenic patients may be the most vulnerable ones for obtaining timely surgical care.

  17. AFM study shows prominent physical changes in elasticity and pericellular layer in human acute leukemic cells due to inadequate cell-cell communication

    Science.gov (United States)

    Guz, Nataliia V.; Patel, Sapan J.; Dokukin, Maxim E.; Clarkson, Bayard; Sokolov, Igor

    2016-12-01

    Biomechanical properties of single cells in vitro or ex vivo and their pericellular interfaces have recently attracted a lot of attention as a potential biophysical (and possibly prognostic) marker of various diseases and cell abnormalities. At the same time, the influence of the cell environment on the biomechanical properties of cells is not well studied. Here we use atomic force microscopy to demonstrate that cell-cell communication can have a profound effect on both cell elasticity and its pericellular coat. A human pre-B p190BCR/ABL acute lymphoblastic leukemia cell line (ALL3) was used in this study. Assuming that cell-cell communication is inversely proportional to the distance between cells, we study ALL3 cells in vitro growing at different cell densities. ALL3 cells demonstrate a clear density dependent behavior. These cells grow very well if started at a relatively high cell density (HD, >2 × 105 cells ml-1) and are poised to grow at low cell density (LD, communication must be taken into account when studying biomechanics of cells, in particular, correlating cell phenotype and its biophysical properties.

  18. Arsenic sulfide promotes apoptosis in retinoid acid resistant human acute promyelocytic leukemic NB4-R1 cells through downregulation of SET protein.

    Directory of Open Access Journals (Sweden)

    Yuwang Tian

    Full Text Available Tetra-arsenic tetra-sulfide (As4S4 is an arsenic compound with anti-tumor activity, especially in acute promyelocytic leukemia (APL that are resistant to retinoic acid (RA. Although recent studies revealed that the therapeutic action of As4S4 is closely associated with the induction of cellular apoptosis, the exact molecular mechanism of action of As4S4 in RA-resistant APL remains to be clarified. In this study, we found that As4S4-induced apoptosis was accompanied by reduced mRNA and protein expression of SET gene in RA-resistant NB4-R1 cells. Moreover, RNAi knockdown of SET gene further promoted As4S4-induced apoptosis, while SET over-expression inhibited it, suggesting that As4S4 induces apoptosis through the reduction of SET protein in NB4-R1 cells. We also demonstrated that the knockdown of SET gene resulted in the upregulation of protein phosphatase 2 (PP2A expression and the downregulation of promyelocytic leukemia and retinoic acid receptor α fusion gene (PML-RARα expression, which were enhanced by As4S4 treatments. By contrast, over-expression of SET gene resulted in PP2A downregulation and PML-RARα upregulation, which were abolished by As4S4 pretreatment. Since PP2A is a pro-apoptotic factor and PMLRARα is an anti-apoptotic factor, our results suggest that As4S4-induced apoptosis in NB4-R1 cells is through the downregulation of SET protein expression, which in turn increases PP2A and reduces PML-RARα expressions to lead to cell apoptosis.

  19. 血清高迁移率蛋白B1检测在急性阑尾炎诊断中的应用%Application of serum high mobility group box protein-1 level detection in diagnosis of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    张希儒; 张广文; 杨栋文; 李成利; 杨香玲

    2012-01-01

    目的:探讨急性阑尾炎患者血清中高迁移率蛋白B1( HMGB1)水平及其对急性阑尾炎诊断的意义.方法:采用ELISA定量试剂盒检测40例健康体检者(A组)和129例拟诊为急性阑尾炎患者血清HMGB1水平,同时检测白细胞(WBC)和C反应蛋白(CRP)水平.根据手术和病理结果将129例拟诊患者分为:B组(非阑尾炎15例),C组(急性单纯性阑尾炎63例),D组(急性化脓性、坏疽性、穿孔性急性阑尾炎及阑尾周围脓肿51例),比较上述指标在各组中的差异并采用受试者工作曲线( ROC)分析各指标对急性阑尾炎的诊断效率.结果:与A,B组比较,C,D组患者WBC,血清CRP及HMGB1均明显升高,差异均有统计学意义(均P<0.05),且D组各项指标均明显高于C组(均P<0.05);ROC曲线分析显示,WBC,CRP和HMGB1的曲线下面积(AUG)分别为0.729,0.811和0.850,HMGB1的诊断效率最高(均P<0.05).结论:急性阑尾炎患者血清HMGB1水平明显升高,血清HMGB1水平可望作为评价急性阑尾炎病变和炎症反应程度的辅助指标.%The serum HMGBl levels of 40 subjects undergoing health maintenance examination (group A) and 129 suspected acute appendicitis patients were detected by using quantitative ELISA kit, and their white blood cell (WBC) count and C-reactive protein (CRP) level were also determined. According to the surgical findings and postoperative pathological results, the 129 suspected cases were distinguished into group B (15 cases without appendicitis), group C (63 cases of simple acute appendicitis) and group D (51 cases of acute suppurative , gangrenous, perforated appendicitis or periappendiceal abscess). The differences in above mentioned indexes among the groups were compared and the receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficiency of each index for acute appendicitis. Results: The WBC count, serum level of HMGB1 and CRP markedly increased in group C and group D compared

  20. A functional study on the migration of human monocytes to human leukemic cell lines and the role of monocyte chemoattractant protein-1

    NARCIS (Netherlands)

    Legdeur, MCJC; Beelen, RHJ; Schuurhuis, GJ; Broekhoven, MG; vandeLoosdrecht, AA; Tekstra, J; Langenhuijsen, MMAC; Ossenkoppele, GJ

    1997-01-01

    In the present study the migration of human monocytes towards the supernatants of five different human myeloid leukemic cell lines, four different human lymphatic leukemic cell lines and blasts derived from three different patients with acute myeloid leukemia (AML) was studied and the role of monocy

  1. Class II-associated invariant chain peptide down-modulation enhances the immunogenicity of myeloid leukemic blasts resulting in increased CD4(+) T-cell responses

    NARCIS (Netherlands)

    van Luijn, M.M.; Chamuleau, M.E.D.; Thompson, J.A.; Ostrand-Rosenberg, S.; Westers, T.M.; Souwer, Y.; Ossenkoppele, G.J.; Ham, S.M.; van de Loosdrecht, A.A.

    2010-01-01

    Background Disease recurrence in patients with acute myeloid leukemia may be partially explained by the escape of leukemic blasts from CD4(+) T-cell recognition. The current study investigates the role of aberrant HLA class II antigen presentation on leukemic blasts by determining both the clinical

  2. Necrotizing fasciitis caused by perforated appendicitis: a case report.

    Science.gov (United States)

    Hua, Jie; Yao, Le; He, Zhi-Gang; Xu, Bin; Song, Zhen-Shun

    2015-01-01

    Acute appendicitis is one of the most common causes of acute abdominal pain. Accurate diagnosis is often hindered due to various presentations that differ from the typical signs of appendicitis, especially the position of the appendix. A delay in diagnosis or treatment may result in increased risks of complications, such as perforation, which is associated with increased morbidity and mortality rates. Necrotizing fasciitis caused by perforated appendicitis is extremely rare. We herein report a case of 50-year-old man presenting with an appendiceal abscess in local hospital. After ten days of conservative treatment with intravenous antibiotics, the patient complained about pain and swelling of the right lower limb and computed tomography (CT) demonstrated a perforated appendix and gas and fluid collection extending from his retroperitoneal cavity to the subcutaneous layer of his right loin and right lower limb. He was transferred to our hospital and was diagnosed with necrotizing fasciitis caused by perforated appendicitis. Emergency surgery including surgical debridement and appendectomy was performed. However, the patient died of severe sepsis and multiple organ failure two days after the operation. This case represents an unusual complication of a common disease and we should bear in mind that retroperitoneal inflammation and/or abscesses may cause necrotizing fasciitis through lumbar triangles.

  3. 腹腔镜诊治非急性阑尾炎性右下腹痛19例体会%Diagnosis and treatment of right lower quarter abdominal pain caused not by acute appendicitis with laparoscopic

    Institute of Scientific and Technical Information of China (English)

    程书榜; 朱量; 黄丽君

    2012-01-01

    目的 总结腹腔镜诊治非急性阑尾炎性右下腹痛经验体会.方法 回顾性分析2010年1月至2012年5月,19例以右下腹痛为主要临床表现的患者临床资料、诊治经过及预后.结果 19例病例中大网膜扭转并坏死3例,盲肠化脓性炎并穿孔4例,盲肠脂肪垂化脓性炎3例,盲肠憩室炎2例,克罗恩病1例,阑尾假粘液瘤3例,输卵管积脓3例.所有病例中,1例克罗恩病和2例盲肠憩室炎终止手术行内科治疗,1例盲肠化脓性炎并穿孔中转开腹行回盲部切除术,其他病例在腹腔镜下行以下手术:大网膜部分切除3例,回盲部切除2例,盲肠脂肪垂切除3例,阑尾切除2例,右半结肠切除2例,妇科治疗3例.术后出现腹腔炎性肉芽肿1例,无死亡病例.结论 右下腹痛往往误诊为急性阑尾炎,腹腔镜可以减少盲目探查和明确诊断,同时可以完成相应治疗;腹腔镜可作为右下腹痛患者诊治的理想选择.%Objective To summary the experience of diagnosis and treatment of right lower quarter abdominal pain caused not by acute appendicitis with laparoscopy.Methods The clinical data,process of diagnosis and treatment and prognosis of 19 cases with right lower abdominal pain between January 2010 and May 2012 were analyzed retrospectively.Results All of 19 cases,there was 3 cases with omental torsion with nicrosis,4 with suppurative typhlitis with perforation,3 with suppurative inflammation fat hanging of caecum,2 with diverticulitis of caecum,1 with crohn's disease,3 with pseudo myxoma of appendix and 3 with empyema of fallopian tube.Fifty cases were operated by laparoscopy.Conclusions Right lower quarter was always misdiagnosed as acute appendicitis,laparoscopy may be ideal selection for patient with right lower quarter.

  4. Hospital expenses of acute simple appendicitis in different medical insurance systems%急性单纯性阑尾炎不同医疗保险形式患者住院费用分析

    Institute of Scientific and Technical Information of China (English)

    路光贤; 江增强; 刘伟; 郑文贵

    2012-01-01

    Objective To compare the hospital expenses of patients with acute simple appendicitis under different medical insurance systems and to explore the influential factors for controlling the increase of the expense. Methods The case information of acute simple appendicitis hospitalized in our hospital from January 2006 to December 2011 were collected. The hospital expenses were analyzed by descriptive analysis,one -way ANOVA analysis and linear regression analysis. Results Drug expenditure accounted for the biggest proportion of 36. 16% in hospital costs. The average cost and the average expenses for medicine were the highest in medical insurance for urban workers,4 970. 07 yuan and 2 586. 33 yuan,respectively. The daily cost of 597. 62 yuan for new rural cooperative medical insurance patients was the highest,while the costs for the patients at one' s own expenses were lower. The major factors affecting the hospital expenses were hospital stay, any surgery, age and payment method. Conclusion The hospital expenses of patients under different medical systems vary a lot. To control the unreasonable increase of the hospital costs, much attention should be paid to managing the different medical insurance forms and controlling the hospital stay of patients.%目的 比较分析不同医疗保险形式急性单纯性阑尾炎患者住院费用,探索影响医疗费用的因素,为合理控制医疗费用增长提供参考.方法 收集某院2006-2011年间收治的住院急性单纯性阑尾炎病例信息,对住院费用进行描述性分析、单因素方差分析及多元线性回归分析.结果 费用中以药品费比例最高达36.16%,城镇职工医保病人平均费用4 970.07元和平均药费2 586.33元最高,新农合病人日均费用597.62元最高,自费病人平均费用、日均费用和平均药费均低.住院费用主要影响因素有住院天数、是否手术、年龄、保险方式、转归情况.结论 不同医疗保险患者的住院费用差别很

  5. The Effect of Acute Appendicitis in Patients With Clinical Treatment Effect of Nursing Intervention%护理干预对急性阑尾炎患者临床治疗效果的影响

    Institute of Scientific and Technical Information of China (English)

    王春燕

    2016-01-01

    Objective To explore the effect of nursing intervention on the clinical treatment of acute appendicitis.Methods 80 cases were randomly divided into observation group and control group. All patients were treated with appendectomy, routine nursing after operation, and the observation group received scientiifc nursing intervention.Results In the observation group, the time of operation, the feeding time and hospitalization time were signiifcantly shorter than the control group, the incidence of complications was significantly lower than that of the control group, the difference was statistically significant (P<0.05).ConclusionNursing intervention can significantly improve the prognosis and reduce the incidence of complications.%目的:探讨护理干预对急性阑尾炎临床治疗效果的影响。方法80例患者随机分为观察组和对照组。所有患者均行阑尾切除术治疗,术后行常规护理,观察组给予科学的护理干预。结果观察组手术治疗时间、术后进食时间和住院时间都低于对照组,并且并发症的发生率也低于对照组,数据差异具有统计学意义(P<0.05)。结论护理干预可以明显改善预后,减少并发症的发生。

  6. Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy

    Directory of Open Access Journals (Sweden)

    Jennings Jason

    2010-01-01

    Full Text Available Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP approach using Polypropylene Mesh (Mesh and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.

  7. Appendicitis-like clinical image elicited by Enterobius vermicularis: case report and review of the literature.

    Science.gov (United States)

    Vleeschouwers, W; Hofman, Ph; Gillardin, J P; Meert, V; Van Slycke, S

    2013-01-01

    A 17-year-old female patient presented with the clinical features of an acute appendicitis. During laparoscopic exploration a macroscopically normal appendix was found. Since there were no intra-abdominal abnormalities found, the appendix was resected. Anatomopathology demonstrated Enterobius vermicularis, a pinworm infecting only humans, and mostly living in the caecum. This parasite is responsible for possibly the most common helminthic infection in the developed world. Its role in the pathogenesis of acute appendicitis is controversial, but more recent studies indicate a stronger association between enterobiasis and appendicitis. Often, enterobius mimics appendicitis by obstructing the lumen of the appendix, thereby causing appendiceal colic. This case report stresses the importance of microscopic examination of all appendectomy resection specimens. In case of enterobius infestation, systemic therapy of patient and family is necessary.

  8. Determination of Plasma Beta-defensin-2 Concentration in the Patients with Acute Appendicitis and its Clinical Significance%急性阑尾炎患者血浆β-防御素-2的检测及临床意义

    Institute of Scientific and Technical Information of China (English)

    李欣; 吴震宇; 徐军辉

    2012-01-01

    目的:探索急性阑尾炎患者血浆β-防御素-2浓度的变化,探讨其与急性阑尾炎患病危险性的相关性.方法:收集急性阑尾炎患者作为阑尾炎组,共208例.收集同期健康体检者作为对照组,共104例.ELISA检测血浆β-防御素-2浓度.统计分析其与急性阑尾炎患病危险性的相关性.结果:t检验显示,阑尾炎组血浆β-防御素-2浓度(398.6±128.O)pg/ml显著低于对照组(629.1±47.2)pg/ml(t=6.470,P<0.05).Logistic回归分析显示,血浆β-防御素-2浓度(OR=0.429,95%CI=0.251~0.795,P<0.05)是罹患急性阑尾炎的独立危险因素.ROC曲线分析显示,血浆β-防御素-2浓度预测罹患急性阑尾炎有显著预测价值(曲线下面积=0.817,95%CI=0.778~0.865,P<0.001),且判定血浆β-防御素-2浓度<612.4 pg/ml,对预测罹患急性阑尾炎有75.0%的灵敏度和72.1%特异度.结论:急性阑尾炎患者血浆β-防御素-2水平降低,血浆β-防御素-2水平降低可能是急性阑尾炎发病的危险因素.%Objective To explore the change of plasma beta-defensin-2 level was determined in patients with acute appendicitis and its correlation with disease was evaluated.Methods 208 consecutive patients with acute appendicitis and 104 healthy controls were enrolled into this study.Plasma beta-defensin-2 concentration was measured by enzyme-linked immunosorbent assay.Its correlation with disease was analyzed statistically.Results The plasma beta-defensin-2 level (398.6 128.0 pg/ml) in patients was significantly lower than that (629.1 ±47.2 pg/ml) in healthy controls using t test ( t = 6.470, P < 0.05 ) .On a multivariate logistic regression, plasma beta-defensin-2 level (OR=0.429, 95% CI =0.251-0.795, P<0.05) was an independent variable predicting acute appendicitis.A receiver operating characteristic curve identified that a plasma beta-defensin-2 level < 612.4 pg/ml predicted acute appendicitis with 75.0% sensitivity and 72.1% specificity ( area under curve = 0.817, 95% CI =0

  9. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... Side Effects Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Department of Surgery, Lenox ... Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  10. Twisting lipoma presenting as appendicitis-a rare presentation.

    Science.gov (United States)

    Sathyakrishna, Basavapatna Ramakrishnaiah; Boggaram, Suryanarayan Giridhar; Jannu, Nagamalleswara Rao

    2014-08-01

    Right iliac fossa (RIF) pain is the most common presenting complaint in the general surgical ward. Though there are several causes for the RIF pain, acute appendicitis is the first and common diagnosis. Here we present one of the rare differential diagnoses of RIF pain in a young female patient with one month history of intermittent right lower abdominal pain. Patient's symptoms and clinical findings indicated acute appendicitis, though ultrasonography didn't show any significant abnormality. Through diagnostic laparoscopy we found that there was torsion of anterior abdominal wall parietal peritoneal pedunculated lipoma located in RIF region. The clinical presentation, examination, investigation, laparoscopic findings and further management is presented in this case report.

  11. Massive ovarian edema, due to adjacent appendicitis.

    Science.gov (United States)

    Callen, Andrew L; Illangasekare, Tushani; Poder, Liina

    2016-09-01

    Massive ovarian edema is a benign clinical entity, the imaging findings of which can mimic an adnexal mass or ovarian torsion. In the setting of acute abdominal pain, identifying massive ovarian edema is a key in avoiding potential fertility-threatening surgery in young women. In addition, it is important to consider other contributing pathology when ovarian edema is secondary to another process. We present a case of a young woman presenting with subacute abdominal pain, whose initial workup revealed marked enlarged right ovary. Further imaging, diagnostic tests, and eventually diagnostic laparoscopy revealed that the ovarian enlargement was secondary to subacute appendicitis, rather than a primary adnexal process. We review the classic ultrasound and MRI imaging findings and pitfalls that relate to this diagnosis.

  12. Complicated appendicitis: Analysis of risk factors in children

    Directory of Open Access Journals (Sweden)

    Mahavir Singh

    2014-01-01

    Full Text Available Background: Acute appendicitis (AA is the most common surgical emergency in childhood. The risk of rupture is negligible within the first 24 h, climbing to 6% after 36 h from the onset of symptoms. Because of difficulty in accurate diagnosis of AA a significant number of children still are being managed when it is already perforated. There is always a need to make an early diagnosis of AA and to find out the risk factors associated with development of complication in this condition. Patients and Methods: A total of 102 patients with a clinical diagnosis of AA were admitted during the study period. On admission, a good clinical history and proper physical examination was performed. All the eligible patients who finally diagnosed clinically as having AA were planned for emergency open appendectomy. The removed appendix was sent for histopathological examination in all the study subjects. Results: Out of 102 cases, 93 cases were histopathologically appendicitis, rest nine cases showed no evidence of inflammation so the rate of negative appendectomy was around 9%. On histopathology normal appendix was found in nine patients (8.9%, AA in 71 patients (69.6%, complicated appendicitis (CA which includes perforated and gangrenous appendicitis was present in 22 patients (21.5%. Perforations were more common in patients who were younger than 5 years. >60% patients presented with CA when the duration of pain was >72 h. Presence of appendicolith increased the probability of CA.

  13. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

    Energy Technology Data Exchange (ETDEWEB)

    Cobben, Lodewijk [Medisch Centrum Haaglanden, Department of Radiology, Leidschendam (Netherlands); Groot, Ingrid [Medisch Centrum Haaglanden, Department of Surgery, Leidschendam (Netherlands); Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien [Medisch Centrum Haaglanden, Department of Radiology, Den Haag (Netherlands); Blickman, Johan [Universitair Medisch Centrum St Radboud, Department of Radiology, Geert Grooteplein 10, GA, Nijmegen (Netherlands)

    2009-05-15

    To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

  14. Xanthogranulomatous appendicitis in interval appendectomy specimens of children

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    Yusuf Hakan Çavuşoğlu

    2016-05-01

    Full Text Available Xanthogranulomatous inflammation is common in interval appendectomy specimens in adults, but it is unusual in children. Histopathologic specimens of interval appendectomy, within an 8-year period, were reevaluated to assess the true incidence. A computer search of the hospital database of all appendectomies was performed between January 2008 and June 2015 to identify all interval appendectomy cases. A total of 2694 patients underwent appendectomies. Of these, 13 were interval appendectomies. After pathologic evaluation, 2 (15.4% of the specimens were reported as xanthogranulomatous appendicitis (XA. Histopathologic examination of these interval appendectomy specimens, granulomas (59%, xanthogranulomatous inflammation (36% and Crohn-like changes (50% were common in adults. However, XA is a particularly rare clinical entity among children. Two cases of XA were reported in children in the English literature. One was a 12-year old boy that underwent interval appendectomy 6 weeks after an episode of acute appendicitis. The other was an 11-year old boy with acute (non-interval appendicitis, but the complete blood count was suggestive of an acute suppurative inflammation. These two cases are the 3rd and 4th cases of XA reported in children in the English literature, and both were managed by interval appendectomy. Thus, XA may be encountered in interval appendectomy specimens and association with IBD has to be ruled out.

  15. Profiles of US and CT imaging features with a high probability of appendicitis

    NARCIS (Netherlands)

    van Randen, A.; Lameris, W.; van Es, H. W.; ten Hove, W.; Bouma, W. H.; van Leeuwen, M. S.; van Keulen, E. M.; van der Hulst, V. P. M.; Henneman, O. D.; Bossuyt, P. M.; Boermeester, M. A.; Stoker, J

    2010-01-01

    To identify and evaluate profiles of US and CT features associated with acute appendicitis. Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with

  16. Lipid Mediators and Human Leukemic Blasts

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    Rémi Fiancette

    2011-01-01

    Full Text Available Some of the most potent inflammatory mediators share a lipid origin. They regulate a wide spectrum of cellular processes including cell proliferation and apoptosis. However, the precise roles and ways (if any in which these compounds impact the growth and apoptosis of leukemic blasts remain incompletely resolved. In spite of this, significant advances have been recently made. Here we briefly review the current knowledge about the production of lipid mediators (prostaglandins, leukotrienes, platelet-activating factor by leukemic blasts, the enzymatic activities (phospholipase A2, cyclooxygenases, lipoxygenases involved in their productions and their effects (through specific membrane bound receptors on the growth, and apoptosis of leukemic blasts.

  17. Potential role of curcumin and taurine combination therapy on human myeloid leukemic cells propagated in vitro.

    Science.gov (United States)

    El-Houseini, Motawa E; Refaei, Mohammed Osman; Amin, Ahmed Ibrahim; Abol-Ftouh, Mahmoud A

    2013-10-01

    Curcumin and taurine are natural products that have been used in this study evaluating their therapeutic effect on myeloid leukemic cells propagated in vitro. Sixty patients with myeloid leukemia and 30 healthy volunteers were enrolled in the study. All patient groups were admitted to the Medical Oncology Department of the National Cancer Institute, Cairo University. There were statistically significant differences between treated leukemic cells compared to normal mononuclear leukocytes in cell density, interferon-γ and immunophenotypic profile, mainly CD4+, CD8 + and CD25+. This work highlights the possibility of using curcumin and taurine as a potential useful therapy in the management of patients suffering from chronic and acute myeloid leukemias.

  18. Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol; Indicacion de las tecnicas de diagnostico por la imagen en la sospecha de apendicitis aguda: propuesta de protocolo diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M. [Hospital de Basureto. Bilbao (Spain)

    2001-07-01

    To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs.

  19. Expression and Fuactional Role of HERG1, K+ Channels in Leukemic Cells and Leukemic Stem Cells

    Institute of Scientific and Technical Information of China (English)

    LI Huiyu; LIU Liqiong; GUO Tiannan; ZHANG Jiahua; LI Xiaoqing; DU Wen; LIU Wei; CHEN Xiangjun; HUANG Shi'ang

    2007-01-01

    In order to investigate the expression and functional role of HERG1 K+ channels in leukemic cells and leukemic stem cells (LSCs), RT-PCR was used to detect the HERG1 K+ channels expression in leukemic cells and LSCs. The functional role of HERG1 K+ channels in leukemic cell proliferation was measured by MTT assay, and cell cycle and apoptosis were analyzed by flow cytometry. The results showed that herg mRNA was expressed in CD34+/CD38-, CD123+ LSCs but not in circulating CD34+ cells. Herg mRNA was also up-regulated in leukemia cell lines K562 and HL60 as well as almost all the primary leukemic cells while not in normal peripheral blood mononuclear cells (PBMNCs) and the expression of herg mRNA was not associated with the clinical and cytogenetic features of leukemia. In addition, leukemic cell proliferation was dramatically inhibited by HERG K+ channel special inhibitor E-4031. Moreover, E-4031 suppressed the cell growth by inducing a specific block at the G1/S transition phase of the cell cycle but had no effect on apoptosis in leukemic cells. The results suggested that HERG1 K+ channels could regulate leukemic cells proliferation and were necessary for leukemic cells to proceed with the cell cycle. HERG1 K+ channels may also have oncogenic potential and may be a biomarker for diagnosis of leukemia and a novel potential pharmacological target for leukemia therapy.

  20. Aplicação multicêntrica informatizada da coleta de dados clínicos na apendicite aguda Computerized multicentric application of data collection on acute appendicitis

    Directory of Open Access Journals (Sweden)

    Crhistiano Coleto Druszcz

    2007-09-01

    êutica das infecções. As complicações pós-operatórias estiveram presentes em 10,32% dos pacientes, correspondendo principalmente às infecções de parede abdominal (64,28%. CONCLUSÃO: O protocolo informatizado de dados clínicos das doenças do cólon, especificamente em sua parte das doenças do apêndice cecal, é viável e eficaz na manipulação de informações clínicas para produção de estudos científicos uni ou multicêntricos.BACKGROUND: A clinical database allows a better way to collect and, consequently, search and cross information to scientific researches. Multicentric studies can be easily created by using this mechanism. AIM: a To analyze the functionality of the computerized database of the appendix diseases; b to show the results of the analyzed data to validate the computerized database of the colon diseases incorporated to SINPE® (Computerized Database Integrated System - INPI 00051543. METHODS: Information provided by 862 patients with acute appendicitis has been collected into the specific protocol of the appendiceal diseases, from three university centers: Hospital de Clínicas of the Universidade Federal do Paraná, Hospital Universitário Evangélico de Curitiba and Hospital do Trabalhador of the Universidade Federal do Paraná. SINPE© was the software used to store, to select and to search information thereby compared to general literature. RESULTS: The Hospital de Clínicas supported 53,83% of the patients, meanwhile, the other two included 31,32% e 14,85%, respectively. Abdominal pain was the most common and characteristic symptom in patients who had confirmation of acute appendicitis. Infectious hemogram (in 77, 81% and abdominal ultrasound showing parietal abnormalities of the appendix (in 67, 40% were the diagnostic exams more frequently adopted to prove the referred diagnosis. Appendectomy, applied in 98, 43% of the patients, was the standard therapeutic proceeding. The MacBurney incision, applied in 74, 55% of all conventional

  1. Lack of correlation between telomere length and telomerase activity and expression in leukemic cells.

    Science.gov (United States)

    Januszkiewicz, Danuta; Wysoki, Jacek; Lewandowski, Krzysztof; Pernak, Monika; Nowicka, Karina; Rembowska, Jolanta; Nowak, Jerzy

    2003-12-01

    The expression of three components of telomerase complex (hTR, hTERT, TP1) along with telomerase activity and telomere length in leukemic cells was investigated. Cells were isolated from peripheral blood and/or bone marrow of children with acute lymphoblastic (ALL) and non-lymphoblastic (ANLL) leukemia. Expression of three components of telomerase as well as telomerase activity was found in all leukemic cells. Chemiluminescent detection of terminal restriction fragments (TRF) from DNA isolated from ALL cells showed variable patterns expressing considerable heterogeneity of telomere length. The ALL cells appeared to have both long and short telomere lengths, in contrast to normal peripheral lymphocytes, which produced limited pattern of TRF. The ANLL cells produced predominantly short telomere pattern despite high telomerase activity and expression. It can be concluded that high telomerase activity and expression in leukemic cells is not always correlated with long telomeres (TRF pattern).

  2. ACUTE APPENDICITIS A CLINICO - RADIOLOGICAL STUDY

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    Govind

    2015-08-01

    Full Text Available Appendix Latin word means an addition or appendage was first identified as early as 3000 B.C. during the mummification process in Egypt. The prefix vermiform derived its name from its worm like appearance. Appendix was probably discovered by Celsus during dissecting criminal s executed by Caeser and was first depicted in anatomic drawings in 1492 by Leonardo da Vinci.

  3. Randomized clinical trial of preoperative dexamethasone on postoperative nausea and vomiting after laparoscopy for suspected appendicitis

    DEFF Research Database (Denmark)

    Kleif, J; Kirkegaard, A; Vilandt, J;

    2017-01-01

    BACKGROUND: Few studies have investigated the effects of preoperative dexamethasone in acute surgical patients. This study examined the effects of 8 mg dexamethasone administered intravenously 30 min before surgery for suspected acute appendicitis. METHODS: A multicentre, parallel-group, double......-blind, placebo-controlled study was conducted at two university hospitals in Denmark. Adults undergoing laparoscopic surgery for suspected appendicitis were eligible for inclusion. Participants, healthcare staff and investigators were blinded until all data analysis had been done. The primary outcome...

  4. A young leukemic patient with unusual catastrophic intestinal complication

    Directory of Open Access Journals (Sweden)

    Kim Vaiphei

    2015-01-01

    Full Text Available A 14-year-old child with acute lymphoblastic leukemia who had completed induction chemotherapy presented with fever and diffuse musculoskeletal pains which was thought to be a constellation of myositis, arthralgias and arthritis. Investigations revealed initially showed normal peripheral blood counts but had pancytopenia and pre-terminally blasts were seen in the peripheral blood smear. He had bone marrow necrosis. Disseminated intravascular coagulation was suspected with a positive fungal serology. At autopsy, he had evidence of disease relapsed in lymph nodes, liver, spleen, testes and kidneys. There was extensive pseudomembranous colitis and appendicitis with changes of toxic megacolon.

  5. Clinical significance of elevated serum and urine amylase levels in patients with appendicitis.

    Science.gov (United States)

    Swensson, E E; Maull, K I

    1981-12-01

    During the 45 month period beginning January 1977, 251 patients with a pathologically confirmed diagnosis of acute appendicitis underwent celiotomy at the Medical College of Virginia Hospital. A preoperative serum or urine amylase determination was recorded in 155 of the patients (62 percent). Of this group, 15 patients (10 percent) had elevation of serum amylase or 2 hour urine amylase. Hyperamylasemia or hyperamylasuria directly led to misdiagnosis or treatment delay in 5 of the 15 patients. Appendiceal rupture occurred in three patients, two of whom had prolonged (greater than 1 month) hospitalizations directly attributable to the misdiagnosis. As a result of this study, we conclude that (1) acute appendicitis and elevated amylase levels may occur concurrently, (2) hyperamylasemia or hyperamylasuria should not dissuade the surgeon from early operation if other clinical features suggest appendicitis, and (3) abdominal pain and elevation of amylase level define significant intraabdominal disease, not specifically pancreatic disease.

  6. An unusual presentation of perforated appendicitis in epigastric region☆

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Abuoglu, Hasan; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, M.A. Tolga

    2013-01-01

    INTRODUCTION Atypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation. PRESENTATION OF CASE A 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation of epigastric region. There was a left subcostal incision with the history of diaphragmatic hernia repair when the patient was 3 days old. He had an intestinal malrotation with the cecum fixed at the epigastric region and the inflamed appendix extending beside the left lobe of liver. DISCUSSION While appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality. CONCLUSION Atypical presentations of acute appendicitis should be kept in mind in patients with abdominal pain in emergency room especially in patients with previous childhood operation for diaphragmatic hernia. PMID:24441442

  7. Cyanobacteria as a Source for Novel Anti-Leukemic Compounds.

    Science.gov (United States)

    Humisto, Anu; Herfindal, Lars; Jokela, Jouni; Karkman, Antti; Bjørnstad, Ronja; Choudhury, Romi R; Sivonen, Kaarina

    2016-01-01

    Cyanobacteria are an inspiring source of bioactive secondary metabolites. These bioactive agents are a diverse group of compounds which are varying in their bioactive targets, the mechanisms of action, and chemical structures. Cyanobacteria from various environments, especially marine benthic cyanobacteria, are found to be rich sources for the search for novel bioactive compounds. Several compounds with anticancer activities have been discovered from cyanobacteria and some of these have succeeded to enter the clinical trials. Varying anticancer agents are needed to overcome increasing challenges in cancer treatments. Different search methods are used to reveal anticancer compounds from natural products, but cell based methods are the most common. Cyanobacterial bioactive compounds as agents against acute myeloid leukemia are not well studied. Here we examined our new results combined with previous studies of anti-leukemic compounds from cyanobacteria with emphasis to reveal common features in strains producing such activity. We report that cyanobacteria harbor specific anti-leukemic compounds since several studied strains induced apoptosis against AML cells but were inactive against non-malignant cells like hepatocytes. We noted that particularly benthic strains from the Baltic Sea, such as Anabaena sp., were especially potential AML apoptosis inducers. Taken together, this review and re-analysis of data demonstrates the power of maintaining large culture collections for the search for novel bioactivities, and also how anti-AML activity in cyanobacteria can be revealed by relatively simple and low-cost assays.

  8. Diagnosing Appendicitis: Evidence-Based Review of the Diagnostic Approach in 2014

    Directory of Open Access Journals (Sweden)

    Daniel J. Shogilev

    2014-11-01

    Full Text Available Introduction: Acute appendicitis is the most common abdominal emergency requiring emergency surgery. However, the diagnosis is often challenging and the decision to operate, observe or further work-up a patient is often unclear. The utility of clinical scoring systems (namely the Alvarado score, laboratory markers, and the development of novel markers in the diagnosis of appendicitis remains controversial. This article presents an update on the diagnostic approach to appendicitis through an evidence-based review. Methods: We performed a broad Medline search of radiological imaging, the Alvarado score, common laboratory markers, and novel markers in patients with suspected appendicitis. Results: Computed tomography (CT is the most accurate mode of imaging for suspected cases of appendicitis, but the associated increase in radiation exposure is problematic. The Alvarado score is a clinical scoring system that is used to predict the likelihood of appendicitis based on signs, symptoms and laboratory data. It can help risk stratify patients with suspected appendicitis and potentially decrease the use of CT imaging in patients with certain Alvarado scores. White blood cell (WBC, C-reactive protein (CRP, granulocyte count and proportion of polymorphonuclear (PMN cells are frequently elevated in patients with appendicitis, but are insufficient on their own as a diagnostic modality. When multiple markers are used in combination their diagnostic utility is greatly increased. Several novel markers have been proposed to aid in the diagnosis of appendicitis; however, while promising, most are only in the preliminary stages of being studied. Conclusion: While CT is the most accurate mode of imaging in suspected appendicitis, the accompanying radiation is a concern. Ultrasound may help in the diagnosis while decreasing the need for CT in certain circumstances. The Alvarado Score has good diagnostic utility at specific cutoff points. Laboratory markers have

  9. The photodynamic effect of Victoria blue BO on peripheral blood mononuclear and leukemic cells

    Energy Technology Data Exchange (ETDEWEB)

    Fiedorowicz, M. [Hugo Kollatay Univ. of Agriculture, Krakow (Poland); Pituch-Noworolska, A.; Zembala, M. [Polish-American Children`s Hospital, Krakow (Poland). Dept. of Clinical Immunology

    1997-05-01

    The photodynamic effect of Victoria blue BO (VB-BO) and photoirradiation on peripheral blood mononuclear cells was studied. The cells were preincubated with VB-BO followed by photoirradiation and overnight culture. The highest percentage of dead cells (propidium iodide assay in flow cyctometry) was seen in the monocyte population. The lymphocytes showed a lower sensitivity to VB-BO photodynamic action than the monocytes (12% vs 80% of PI-positive cells). The effect of VB-BO and phototreatment on lymphocyte function was studied using a mitogen-induced proliferation assay. A decrease of mitogen response was observed. The VB-BO and photoirradiation were also used on leukemic cells. The leukemic cells from acute myeloid leukemia and B precursors leukemia were sensitive to VB-BO photodynamic action. The high VB-BO sensitivity of monocytes and leukemic cells (myeloid and lymphoid B derived) suggests possible application of VB-BO for selective depletion of monocytes or sensitive leukemic cells. (author).

  10. A 7 YEAR-7-MONTH OLD BOY WITH LEUKEMIC RETINOPATHY

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    Ni Made Rini Suari

    2013-10-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Ocular problems in patient with leukemia which are called leukemic retinopathy and subhyaloid hemorrhage is one of its feature. Subhyaloid hemorrhage in children with acute lymphoblastic leukemia (ALL is rarely happened. We reported a boy 7 year 7 month old, complained sudden blurred vision on his both eyes and diagnosed with acute lymphoblastic leukemia. When patient had complained his vision, result of routine hematology showed anemia, thrombocytopenia, and leukocytosis. Treatment of leukemic retinopathy in this patient was supportive and causal therapy with transfusion of thrombocyte concentrate, hydration for leukocytosis, giving chemotherapy intrathecal methotrexate and systemic (vincristine, daunorubicin, L-asparginase. We found gradually undergone resolution of subhyaloid hemorrhages, visible flame shaped thin, and his vision recovered nearly completely to 6/6 OD and 6/20 OS /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  11. Left-sided appendicitis in children with congenital gastrointestinal malrotation: a diagnostic pitfall in the emergency department.

    Science.gov (United States)

    Taslakian, Bedros; Issa, Ghada; Hourani, Roula; Akel, Samir

    2013-06-10

    Acute appendicitis is one of the most common conditions requiring emergency surgery. However, acute appendicitis presenting with left lower quadrant abdominal pain is extremely rare. Imaging, particularly CT , plays an important role in establishing an accurate and prompt diagnosis, as delay in diagnosis may occur due to lack of uniformity in the clinical signs and symptoms. We report a rare case of a 10-year-old boy who presented with persistent left lower quadrant pain of several days duration, in which the CT scan of the abdomen and pelvis was essential in establishing the correct diagnosis. The malpositioned inflamed appendix was clearly identified in the left side of the abdomen, with the characteristic CT findings of uncomplicated intestinal malrotation. Left-sided acute appendicitis should be considered in the differential diagnosis of young patients presenting with left lower quadrant pain, in order to avoid delay in diagnosis and guide the surgical intervention.

  12. Leucograma, proteína C reativa, alfa-1 glicoproteína ácida e velocidade de hemossedimentação na apendicite aguda Leucocyte count, C reactive protein, alpha-1 acid glycoprotein and erithrocyte sedimmentation rate in acute appendicitis

    Directory of Open Access Journals (Sweden)

    Bruno Ramalho de Carvalho

    2003-03-01

    ína ácida e velocidade de hemossedimentação mostraram-se pouco sensíveis e específicos. CONCLUSÕES: O leucograma e a proteína C reativa apresentam-se alterados de forma significativa nos casos de apendicite aguda, independentemente do sexo ou da faixa etária. O leucograma e, principalmente, a proteína C reativa devem ser exames considerados em indivíduos com tempo de evolução sintomática superior a 24 horas. Valores aumentados, entretanto, devem ser somados e não substituir a avaliação clínica do médico examinador. Dosagens de velocidade de hemossedimentação e da alfa-1 glicoproteína ácida não trazem auxílio ao diagnóstico da apendicite aguda.BACKGROUND: The diagnosis of acute appendicitis is clinic, but in some cases, it can present unusual symptoms. The diagnostic difficulties still lead surgeons to unnecessary laparotomies, which reach rates from 15% to 40%. Laboratory exams, then, may become important to complement appendicitis diagnosis. The leucocyte count seems to be the most important value, but measurement of acute phase proteins, specially, the C-reactive protein, is object of several studies. PATIENTS AND METHODS: This was a prospective study, involving 63 patients submitted to appendecectomies for acute appendicitis suspicion, in "Hospital das Clínicas", Federal University of Uberlândia, MG, Brazil, in whose blood were made dosages of acute phase proteins and the leucocyte count. RESULTS: The sample was composed by 44 male and 19 female patients, and the majority of them was between 11 and 30 years of age. The flegmonous type was the most freqüent (52.4%. The leucocyte count was altered in 74.6% of the cases and C-reactive protein elevation was observed in 88.9%. The alfa-1 acid glycoprotein and the erithrocyte sedimmentation rate were predominantly normal. The C-reactive protein was augmented in more than 80% of the cases in all ages. Leucocyte count and C-reactive protein were altered in 80% of the patients with the limit of 24

  13. The Study of Combination Treatment of Lanweixiaoyan Tablets and Antibiotics for 96 Cases of Acute or Chronic Appendicitis%阑尾消炎片联合抗生素治疗急、慢性阑尾炎96例临床体会

    Institute of Scientific and Technical Information of China (English)

    王树地

    2015-01-01

    Objective Observed the effect of combination of lanweixiaoyan tablets and antibiotics for acute and chronic appendicitis. Methods The Lanweixiaoyan Tablets was used by oral, and the antibiltics through intravenous fluid therapy. We observed 96 cases in total, and stastisticed the effect after one week treatment by drug cure. Results 64 cases were healed (66.66%), 13 cases were effective (13.54%), 19 cases were ineffective (19.79). The cure rate was 66.66%. Conclusion Combination treatment through lanweixiaoyan tablets by oral and antibiotics by oral or intravenous fluid therapy have a very good effect to the appendicitis, and we can avoid many useless oprations and reduce the bitter of the patients.%目的:观察阑尾消炎片联合抗生素治疗急性阑尾炎的效果。方法采取阑尾消炎片口服,同时给予抗生素静点。结果本文报道96例,以用药一周为疗效统计依据。痊愈64例(66.66%),有效13例(13.54%),无效19例(19.79%),治愈率66.66%。结论口服阑尾消炎片联合抗生素口服或静点治疗阑尾炎效果很好,此种治疗方法可以免除一些不必要的手术,减少患者痛苦及经济上负担。

  14. sup 99m Tc-labeled monoclonal antibodies against granulocytes (BW 250/183) for the detection of appendicitis. sup 99m Tc-anti-Granulozyten-Antikoerper (BW 250/183) zum Nachweis der Appendizitis

    Energy Technology Data Exchange (ETDEWEB)

    Overbeck, B.; Briele, B.; Hotze, A.; Biersack, H.J. (Bonn Univ. (Germany). Klinik fuer Nuklearmedizin); Kania, U. (Bonn Univ. (Germany). Chirurgische Klinik); Vogel, J. (Bonn Univ. (Germany). Pathologisches Inst.); Lange, L.; Ott, G. (Evangelisches Krankenhaus, Bonn (Germany). Chirurgische Abt.)

    1992-02-01

    Scintigraphy with {sup 99m}Tc-labeled anti-granulocyte antibodies (AGAb) was performed in 50 patients with suspected appendicitis. Sequential and static imaging as well as SPECT of the pelvis and abdomen was performed 2 hp.i. In all patients the diagnosis was confirmed either histologically or by long-term follow-up. 13 patients had histologically proven acute appendicitis. In 11 patients the appendix scan had been positive and in 2 patients the scan had shown no significant tracer uptake in the right lower abdomen. The remaining 37 patients turned out not to have acute appendicitis. 29 out of these patients had negative and 3 had positive scan findings. In 5 patients the scan was equivocal. Out of these patients 2 had pathologic findings on the left side of the abdomen which turned out to be acute diverticulitis in one patient and acute peritonitis in the other. The remaining 3 patients with unclear scintigraphic findings had no acute appendicitis. Scintigraphy with AGAb is fast and easy to perform and thus superior to cell labeling methods for diagnosing acute appendicitis. Sensitivity for the diagnosis of acute appendicitis was 85% with a specifitiy of 91%. Chronic or scarred non-granulocytic appendicitis - in which there is often no definite indication for surgery - was negative in our study expect for two cases. (orig.).

  15. IL-27 Promotes Proliferation of Human Leukemic Cell Lines Through the MAPK/ERK Signaling Pathway and Suppresses Sensitivity to Chemotherapeutic Drugs

    Science.gov (United States)

    Dilger, Paula; Bird, Chris; Wadhwa, Meenu

    2016-01-01

    IL-27 is a pleiotropic cytokine of the IL-6/IL-12 family with diverse biological functions. Previous in vivo studies have suggested the antitumor activities of IL-27 in animal models, whereas clinical observations indicate the link of IL-27 in tumor progression. IL-27 has recently been shown to cause inhibition of proliferation on primary leukemic cells from pediatric patients, but information on its role in human leukemic cell lines is limited. In the present study, we investigated the ability of IL-27 to regulate cell growth and survival of various human leukemic cell lines. Our results showed that in human leukemic cell lines coexpressing both IL-27R chains, IL-27Rα and gp130, IL-27 did not inhibit cell growth, but caused dose-dependent proliferation of the acute myeloid leukemic cell line, OCI-AML5, and the erythroleukemic cell lines, TF-1, UT-7, and UT-7/EPO. Consistent with this, IL-27 promoted cell survival and reduced TNF-α-induced apoptosis of the leukemic cell lines. IL-27 also decreased the responsiveness of the leukemic cells to chemotherapeutic drugs, cytarabine and daunorubicin. We observed that IL-27 induced the activation of STAT1/3 and ERK1/2 in the leukemic cells. Growth stimulation by IL-27 was suppressed by the specific MEK inhibitor, U0126, indicating that IL-27-induced cell proliferation is mainly mediated through the activation of the MAPK/ERK signaling pathway. The present study is the first demonstration of the proliferative and antichemotherapeutic properties of IL-27 in human leukemic cell lines, suggesting that IL-27 can play an unfavorable role in tumor growth and can be an important determinant in the chemoresponsiveness of certain subtypes of human leukemia. PMID:27119567

  16. Doxycycline inhibits leukemic cell migration via inhibition of matrix metalloproteinases and phosphorylation of focal adhesion kinase.

    Science.gov (United States)

    Wang, Chunhuai; Xiang, Ru; Zhang, Xiangzhong; Chen, Yunxian

    2015-09-01

    Doxycycline, a tetracycline-based antibiotic, has been reported to attenuate melanoma cell migration through inhibiting the focal adhesion kinase (FAK) signaling pathway. However, it remains to be elucidated whether doxycycline exerts this effect on leukemia cell migration. The present study aimed to examine the role of doxycycline in leukemia cell migration. The invasion capacities of the human leukemia cell lines KG1a (acute myelogenous leukemia) and K562 (chronic myelogenous leukemia) were evaluated using Matrigel® matrix‑coated Transwell® chamber assays; leukemic cell lines treated with doxycycline (1 µg/ml) or anti‑β1‑integrin antibodies were added to the upper chamber, while untreated cells were included as controls. Reverse transcription quantitative polymerase chain reaction was performed in order to further understand the influence of doxycycline treatment on the expression of FAK and gelatinases in the KG1a and K562 leukemic cell lines. In addition, FAK protein expression and phosphorylation were determined using western blot analysis in order to investigate the mechanism by which doxycycline inhibited leukemic cell migration. The results revealed that doxycycline treatment significantly attenuated the migration of KG1a and K562 cells, which was demonstrated to be associated with inhibition of the expression and phosphorylation of FAK. In addition, doxycycline treatment inhibited matrix metalloproteinase (MMP)‑2 and MMP‑9 expression. Furthermore, incubation with blocking anti‑β1‑integrin antibodies had an analogous inhibitory effect on leukemic cell migration to that of doxycycline. In conclusion, the results of the present study suggested that doxycycline attenuated leukemic cell migration through inhibiting the FAK signaling pathway. Therefore, doxycycline may have potential for use as a novel strategy for the treatment of leukemia.

  17. Synthesis of Multiester-appended and Multicarboxylic-appended Imidazolium Ionic Liquids

    Institute of Scientific and Technical Information of China (English)

    Wei Guo GENG; Xue Hui LI; Le Fu WANG; Hong Li DUAN; Wei Ping PAN

    2006-01-01

    Multiester-appended imidazolium ionic liquids were synthesized in a quatemization reaction between the imidazole derivatives carrying single or double esters and ethyl chloroacetate or bromoethane. Multicarboxylic-appended imidazolium ionic liquids were achieved from the hydrolysis of the corresponding ionic liquids. The influences of multifunctional groups on the transition temperatures and viscosity of these new ionic liquids were investigated.

  18. Granulomatous appendicitis in children: A single institutional experience

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    Kamalesh Pal

    2014-01-01

    Full Text Available Background: Granulomatous appendicitis (GA is a rare entity, mostly mentioned in adults. There have been anecdotal case reports describing GA in the paediatric population. This study was aimed at reviewing the cases of appendectomies to assess the incidence and characteristics of GA in children in a tertiary care University hospital. Materials and Methods: Records of children (<13 years age with biopsy proven granulomatous lesions in the appendectomy specimen, treated during 1991-2011, were analysed. Data regarding demography, clinical presentation, radiological findings, intra-operative finding, histology, diagnosis and follow-up were recorded and descriptively analysed. Results: Twelve out of 1150 (1.04% appendectomies were biopsy proven GA. Male to female ratio was 8:4. Four had Yersinia enterocolitis, two had Crohn′s disease (CD; one isolated Crohn′s Appendicitis, one Ileo-cecal Crohn′ with appendicitis and five were idiopathic. Remaining one case, initially diagnosed as idiopathic GA, developed full blown ileo-cecal CD at 2 nd month post-operative. Age ranged between 4 and 11 years with inflammatory bowel disease (IBD affecting older children and Yersinia, seen in younger children. Majority (10/12 remained asymptomatic at a maximum of 5 years of follow-up. Two patients had recurrent symptoms; one with sub-acute obstruction (2 years follow-up and another with flaring of Crohn′s ileitis (2 months follow-up. Conclusions: GA in children is a rare entity, with incidence of 1.04% and male preponderance in our series. Idiopathic causes were the most common followed by Yersinia enterocolitis and CD. Although majority remained asymptomatic, IBD should be ruled out in case of recurrence of pain or alteration of bowel habit. Therefore, a long-term follow-up (at least for 5 years of idiopathic GA is suggested in children.

  19. Right adrenal abscess -- an unusual complication of acute apendicitis.

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    Dimofte, Gabriel; Dubei, Liviu; Lozneanu, Lili-Gabriela; Ursulescu, Corina; Grigora Scedil, Mihai

    2004-09-01

    Acute appendicitis represents one of the most frequent abdominal emergencies encountered in everyday surgical practice. Local infectious complications are not unusual and retroperitoneal abscesses after acute retrocaecal appendicitis have been previously described. The authors present the case of a 22-years-young female patient, admitted for a right iliac fossa abscess, secondary to gangrenous appendicitis. A right adrenal mass 35/40 mm was revealed during preoperative ultrasound evaluation, which evolved in an adrenal abscess that spontaneously drained 10 days after appendectomy and retrocecal drainage. Adrenal abscesses are exceptionally rare, with only a few cases being reported in the literature, but none of these after acute appendicitis.

  20. Diagnostic Value of White Blood Cell and C-Reactive Protein in Pediatric Appendicitis

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    Sevgi Buyukbese Sarsu

    2016-01-01

    Full Text Available Background. Acute appendicitis (AA associated with acute phase reaction is the most prevalent disease which requires emergency surgery. Its delayed diagnosis and unnecessarily performed appendectomies lead to numerous complications. In our study, we aimed to detect the role of WBC and CRP in the exclusion of acute and complicated appendicitis and diagnostic accuracy in pediatric age group. Methods. Appendectomized patient groups were constructed based on the results of histological evaluation. The area under a receiver operating characteristic (ROC curve (AUC was performed to examine diagnostic accuracy. Results. When WBC and CRP were used in combination, based on cut-off values of ≥13.1 × 103/μL for WBC counts and ≥1.17 mg/dL for CRP level, diagnostic parameters were as follows: sensitivity, 98.7%; specificity, 71.3%; PPV, 50.6%; NPV, 99.5%; diagnostic accuracy, 77.6%; LR(+, 3.44; LR(−, 0.017. AUC values were 0.845 (95% CI 0.800–0.891 for WBC and 0.887 (95% CI 0.841–0.932 for CRP. Conclusions. For complicated appendicitis, CRP has the highest degree of diagnostic accuracy. The diagnosis of appendicitis should be made primarily based on clinical examination, and obviously more specific and systemic inflammatory markers are needed. Combined use of cut-off values of WBC (≥13100/μL and CRP (≥1.17 mg/L yields a higher sensitivity and NPV for the diagnosis of complicated appendicitis.

  1. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yan; ZHAO Yang-yu; QIAO Jie; YE Rong-hua

    2009-01-01

    Background Appendicitis is the most common surgical problem in pregnancy, however the particular dangers of appendicitis in pregnancy lie in the varied presentation of symptoms and the higher chance of delayed diagnosis. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis during second and third trimester pregnancies.Methods This was a retrospective single-center study that presented a descriptive analysis of the results. A total of 102 pregnant women who were diagnosed with acute appendicitis and operated upon in Peking University Third Hospital,China between January 1993 and December 2007 were presented. SPSS 12.0 for Windows was used for data analysis.Results Seventy-eight pregnant women who were diagnosed with acute appendicitis (sixteen patients had a perforated appendix, 62 patients had a non-perforated appendix) were operated upon during late pregnancy. The interval between symptom onset and surgery was the only predictive variable. A longer interval between symptom onset and surgery was associated with appendix perforation ((109.5±52.7) hours) than with no appendix perforation ((35.1±19.62) hours;P=0.007). There was a significant difference in the rate of preterm labor (5.1% vs 1.3%) and the rate of fetal mortality (25% vs 1.7%) between patients with and without a perforated appendix.Conclusions Delaying surgery correlates to more advanced disease with an increased risk of perforation. This contributes to an increased risk of further complications, including premature labor or abortion, and to higher maternal complication rates. Prompt diagnosis may improve the prenatal outcome.

  2. Suspected appendicitis during pregnancy: prevalence and management at prince Hashem Ben AL-Hussein Hospital (Zarqa/Jordan

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    Hasan Al-Dahamsheh

    2012-09-01

    Full Text Available To evaluate the clinical picture and outcome of suspected appendicitis in pregnant women. Retrospective analytic study of 28 appendectomies performed during pregnancy for suspected appendicitis in our hospital at period April 2004 to September 2006. All files and medical records of these patients were analyzed and studied. Those including variables (demographic, clinical, laboratory and surgical outcomes data were collected retrospectively. Prevalence of appendicitis was calculated from the total number of deliveries and abortions that occurred during this period. Numbers of correct and wrong diagnosis were reported and comparison of perinatal outcome, maternal morbidity and different variables in negative and positive laparotomies performed. The prevalence of suspected appendicitis in pregnancy is 0.29%. Incidences of negative laparotomies were 36%. The most diagnostic findings for acute appendicitis were history of periumbilical pain, anorexia and Rt iliac fossa findings. Half of wrong diagnosis were related to premature labor pain or abortion. The prevalence of suspected appendicitis during pregnancy in our environment during this period was higher than the reported incidence and rate of wrong diagnosis still high. Good clinical assessment with adjunct ultrasonic examination could reduce the incidence of negative laparotomies or prevent late complication. Delay in operation leading to higher rate of maternal morbidity and adversely affect the obstetric outcome. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 36-43 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6824

  3. Utilidad de la tomografía computada en pacientes con dolor en fosa iliaca derecha: Apendicitis aguda y su diagnóstico diferencial Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

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    Sebastián Atilio Rossini

    2009-03-01

    fosa iliaca derecha. Conclusión: La TCH posee una elevada sensibilidad y especificidad para el diagnóstico de apendicitis aguda y para la evaluación y manejo de los pacientes con un cuadro de abdomen agudo de fosa iliaca derecha.Purpose: To review the tomography findings of the acute appendicitis, their complications and alternative diagnosis. To value the use of helicoidal computed tomography (HCT in the diagnosis of acute appendicitis and in the study of patients with right inferior abdominal quadrant (RIQ pain and acute abdomen, for diagnosis and eventual complications, in order to decide treatment. Materials and method: For five months, the populations included in this retrospectively study were all patients delivered for presenting with RIQ pain for a HCT exam. These exams were made with oral and intravenous contrasts, when there were not contraindications. The HCT results were correlated with clinical follow up, surgery and histopathologic exams. Results: Over a total of 100 patients studied, 53 presented tomographic diagnosis of appendicitis, 22 of which presented perforation signs; 27 showed an alternative diagnosis (ovaries follicles, uretheral litiasis, tiphlitis, diverticulitis, colitis, salpingitis, 18 patients did not present tomographic findings to support the clinical symptoms and 2 presented indetermined results. These data represented a sensibility of 100%, specifity of 95,7%, positive predictiv value (PPV of 96,2% and negative predictiv value (NPV of 100% for the tomography diagnosis of acute appendicitis and a sensibility of 100%, specificity of 81,8%, PPV of 95,1% and NPV of 100% for the tomography diagnosis of the different etiology in patient with right inferior acute abdomen. Conclusion: HCT is extremely useful in the study of patients with acute abdomen with origin in the RIQ, not only to make a diagnosis, but also to evaluate the complications, so as to decide proper treatment.

  4. Uncontrolled hypertension secondary to leukemic cell infiltration of kidneys in a hemodialysis patient

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    Kultigin Turkmen

    2010-06-01

    Full Text Available Kultigin Turkmen1, Lutfullah Altintepe2, Ibrahim Guney2, Ismet Aydogdu3, Osman Koc4, Mehmet Ali Erkut5, Halil Zeki Tonbul11Department of Nephrology, Meram School of Medicine, Selcuk University, 2Meram Training and Research Hospital, Selcuk University, 3Department of Hematology, Meram School of Medicine, Selcuk University, 4Department of Radiology, Meram School of Medicine, Selcuk University, 5Department of Hematology, Meram Training and Research Hospital, Selcuk UniversityAbstract: Leukemic infiltration of the kidney is usually silent, and the admission of the patients with renal dysfunction or acute kidney injury is uncommon. We present a 34-year old hemodialysis patient with new onset of uncontrolled hypertension, erythropoietin-resistant anemia, thrombocytopenia, and Bell’s palsy. On admission, his blood pressure (BP was 210/110 mmHg and he had petechiae and purpura at upper and lower extremities. Renal ultrasonography (USG showed bilaterally enlarged kidneys without hydronephrosis, unlike his previous USG, which determined bilaterally atrophic kidneys. Acute lymphoblastic leukemia, hypertensive crisis due to bilateral leukemic cell infiltration of kidneys, tumor lysis syndrome, and leukemic involvement of the facial nerve were diagnosed. Despite intense antihypertensive management, his BP was not controlled. After prednisolone, daunorubicine, and vincristine therapy, the size of kidneys diminished and his BP dropped under normal range. In conclusion, pathological findings such as uncontrolled hypertension, flank pain, skin rashes, and abnormal blood count should be considered carefully, even in patients with end-stage renal disease receiving renal replacement therapy.Keywords: leukemic cell infiltration, uncontrolled hypertension, hemodialysis

  5. THE EFFECTS OF RETINOIC ACID ON EXPRESSION OF C-MYC, C-FOS IN LEUKEMIC PROMYELOCYTES

    Institute of Scientific and Technical Information of China (English)

    邵国英; 徐荣婷; 孙关林; 欧阳仁荣; 应大明

    1992-01-01

    The expression of c-myc, c-fos of leukemic promyelocytes (HL-60 and acute promyelocytic leukemia cells) from 18 acute promyelocytic leukemia (APL) patients treated with all-trans retinoic acid (RA) in vitro was studied. There was no expression of c-fos in HL-60 cells and APL cells from 17 patients. But in one case, a slight expression of c-fos in leukemic cells was observed, and the alteration of expression level was found during the treatment of the cells with RA in vitro. The expression of c-myc in HL-60 cells induced by RA was altered, decrease in the early, increase in the middle, and decline in the later stage were found. The c-myc expression in leukemic cells of eighteen APL patients was variable. There was c-myc expression in eleven APL cells, but no expression in the others. The APL cells with c-myc expression were treated with RA in vitro to observe the kinetic changes of c-myc RNA level. The results showed that the expression of c-myc was gradually decreased except in few cases. Using in situ hybridization technique for detecting the alteration of c-myc expression in leukemic cells of two APL patients. the high level of c-myc before RA treatment and low level of c-myc expression after obtaining complete remission induced by RA were found. The possibility of different proto-oncogenes implicated differentiation was discussed.

  6. Acute myeloid leukemia presenting as galactorrhea

    Science.gov (United States)

    Nambiar, K. Rakul; Devi, R. Nandini

    2016-01-01

    Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifestation of AML. We report a case of AML presenting with galactorrhea. PMID:27695173

  7. Acute myeloid leukemia presenting as galactorrhea

    OpenAIRE

    Nambiar, K. Rakul; Nair, Sreejith G.; Devi, R. Nandini

    2016-01-01

    Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifestation of AML. We report a case of AML presenting with galactorrhea.

  8. Relation between Fiber Diet and Appendicitis Incidence in Children at H. Adam Malik Central Hospital, Medan, North Sumatra-Indonesia

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    Boyke Damanik

    2016-06-01

    Full Text Available Background: Appendicitis is the most occurred acute abdominal case found in children.1 In United States of America alone, there were 250,000 cases annually. The ratio between boys and girls are 3:2, with most cases caused by late diagnosis and the morbidity factor. Previous studies found that there’s a relation between eating patterns, fiber diet and food hygiene as risk factors for appendicitis.1, 2 At the time this paper is written, there hasn’t been any study that explains the relation between appendicitis and the diet pattern of children from various places in Indonesia. Another condition that further motivates this study is a common conception that children hate to consume vegetables and fruits, which contain the much-needed fiber. Obstruction of the appendix lumen is the main cause of inflammation in the appendix. Fecalith makes up one third of appendicitis cases, which is consists of fats (coprosterols, inorganic salts (calcium phosphate, and organic residual (fibers.3 Other causes including obstruction process by hypertrophy of mural lymphoid follicle as a response from the inflammation of the appendix lumen.3 Obstruction of appendix lumen can be caused by low fiber diet, which causes fecalith to build up in appendix lumen.4 The mechanism of lumen appendix inflammation can be caused by lymphoid hyperplasia, fecalith buildup, foreign object or parasite.4 Therefore, a study needs to be done to determine the mortality prediction easier, more efficient, and not static, in which it’s harder to measure the therapeutic response. In this case, lactate clearance is hoped to have the capability to determine the mortality rate in patients with severe sepsis. Method: This research is an analytic with cross-sectional design. The subjects were 35 child patients with appendicitis in RSHAM which fulfilled the criteria of severe sepsis diagnosis, and were receiving treatment in the period of January-December 2014. Results: Male children are the

  9. Usefulness and limit of CT diagnosis on appendicitis

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    Kuchiki, Megumi; Takanashi, Toshiyasu [Sakata Municipal Hospital, Yamagata (Japan); Yamaguchi, Koichi

    1997-08-01

    CT was performed in 104 patients with abdominal pain suspected appendicitis. CT showed positive finding (abnormal appendix, appendicolith, pericecal inflammatory change, fluid collection, LN swelling, abscess) and complication of appendicitis clearly. CT diagnosis showed high accuracy than clinical diagnosis. CT proved its usefulness especially only CT imaging showed the correct diagnosis. On the other hand, diverticulitis and terminal ileitis common diagnostic disease of appendicitis showed similar clinical appearance and CT image, caused to be difficult to diagnose correctly. In the cases showing similar image to appendicitis or atypical image, CT also proved its limit of the diagnosis on appendicitis. (author)

  10. PUMA promotes apoptosis of hematopoietic progenitors driving leukemic progression in a mouse model of myelodysplasia.

    Science.gov (United States)

    Guirguis, A A; Slape, C I; Failla, L M; Saw, J; Tremblay, C S; Powell, D R; Rossello, F; Wei, A; Strasser, A; Curtis, D J

    2016-06-01

    Myelodysplastic syndrome (MDS) is characterized by ineffective hematopoiesis with resultant cytopenias. Increased apoptosis and aberrantly functioning progenitors are thought to contribute to this phenotype. As is the case for other malignancies, overcoming apoptosis is believed to be important in progression toward acute myeloid leukemia (AML). Using the NUP98-HOXD13 (NHD13) transgenic mouse model of MDS, we previously reported that overexpression of the anti-apoptotic protein BCL2, blocked apoptosis and improved cytopenias, paradoxically, delaying leukemic progression. To further understand this surprising result, we examined the role of p53 and its pro-apoptotic effectors, PUMA and NOXA in NHD13 mice. The absence of p53 or PUMA but not NOXA reduced apoptosis and expanded the numbers of MDS-repopulating cells. Despite a similar effect on apoptosis and cell numbers, the absence of p53 and PUMA had diametrically opposed effects on progression to AML: absence of p53 accelerated leukemic progression, while absence of PUMA significantly delayed progression. This may be explained in part by differences in cellular responses to DNA damage. The absence of p53 led to higher levels of γ-H2AX (indicative of persistent DNA lesions) while PUMA-deficient NHD13 progenitors resolved DNA lesions in a manner comparable to wild-type cells. These results suggest that targeting PUMA may improve the cytopenias of MDS without a detrimental effect on leukemic progression thus warranting further investigation.

  11. Apendicitis del muñón apendicular Appendicitis of the appendicular stump

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    María Carolina Berrogain

    2012-03-01

    Full Text Available La apendicitis del muñón es una entidad rara, caracterizada por un proceso inflamatorio del remanente apendicular luego de una apendicectomía incompleta. Los signos y síntomas no difieren de una apendicitis aguda. Al no ser una patología usualmente pensada como posible diagnóstico diferencial del abdomen agudo inflamatorio, tiene mayor riesgo de complicaciones y morbi-mortalidad. Los métodos seccionales de diagnósticos por imágenes resultan muy beneficiosos para definir el diagnóstico. La ultrasonografía (US y tomografía computada (TC demuestran signos similares a los observados en cuadros habituales de inflamación aguda del apéndice cecal. Se presentan dos casos de apendicitis del muñón, uno de ellos recibió tratamiento quirúrgico y el otro tratamiento médico.Stump appendicitis is a rare entity characterized by inflammation of the appendiceal remanent after incomplete appendectomy. Signs and symptoms do not differ from acute appendicitis. As it is not a condition usually considered as a potential differential diagnosis of acute inflammatory abdomen, it has higher risks of complications and morbidity and mortality. Imaging methods are highly useful to define the diagnosis. Ultrasound (US and Computed Tomography (CT show signs similar to those found in standard cases of acute appendicitis. Two cases of stump appendicitis are reponed: one managed with surgical treatment and the other with medical treatment.

  12. MBA-induced differentiation of myeloid leukemic cell lines is associated with altered G1 cell cycle regulators and related genes

    Institute of Scientific and Technical Information of China (English)

    王钦红; 谢毅; 范华骅

    2004-01-01

    @@The proliferation and differentiation of hematopoietic cells can be regulated by a number of physiological agents including hexamethylene bisacetamide (HMBA). Clinically, HMBA has been used for the treatment of acute myeloid leukemia and myelodysplastic syndrome.1 However, the mechanism of the effect of HMBA on the differentiation of myeloid leukemic cells is largely unkown. Up to now, related reports have not been found. We used HL-60 and U937 cell lines to study the effect of HMBA on the differentiation of myeloid leukemic cells and to explore the possible mechanism.

  13. Bone Scintigraphic Findings in Leukemic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyo Sun; Park, Jeong Mi; Shon, Hyeong Seon; Chang, Soo Kyo; Kim, Choon Yul; Bahk, Yong Hee; Shinn, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1992-03-15

    The leukemias represent diffuse lesions of the bone marrow and significant bony abnormalities are associated with the more aggressive varieties of leukemias and with the younger age groups. On plain film, several roentgenographic findings are observed such as diffuse osteopenia, radiolucent metaphyseal bands, osteolytic lesions and periostitis. We evaluated bone scintigraphic findings using {sup 99m}Tc-methylene diphosphonate ({sup 99m}Tc-MDP) in ten patients with proven leukemia. The scan is abnormal in 90%. We classified abnormal scintigraphic findings to 3 types and these are increased diffuse juxta-articular uptake, focal increase of uptake and combined type. The common sites of focal uptake were femur, humerus, tibia, spine, ribs, calvarium, scapula and mandible. We concluded that {sup 99m}Tc-MDP bone scintigraphy is sensitive imaging modality in leukemic patients with bone pain.

  14. Clinico-pathological study of appendicitis in a tertiary centre in Vindhya region, Madhya Pradesh, India

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    Priyank Sharma

    2016-07-01

    Conclusions: In this study we found that clinical score is a simple, rapid and non-invasive method to early diagnosis of appendicitis. TLC are inflammatory marker are also useful in early diagnosis of acute appendicitis. Ultrasound abdomen is also useful to confirm the diagnosis. The majority of our patients presented early disease. Conservative approach of treatment gave positive response and then we planned for elective appendectomy after regular interval. Because of these negative appendectomy rate are decreasing and morbidity period are also decreasing pre or post appendectomy. There was much less post-operative complication, which were higher in emergency appendectomy. In our study we concluded that timely intervention reduce the negative appendectomy and reduce the length of morbidity. [Int J Res Med Sci 2016; 4(7.000: 2914-2920

  15. Xanthogranulomatous Appendicitis in a Child: Report of a Case and Review of the Literature

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    Sura M. Al-Rawabdeh

    2013-01-01

    Full Text Available Xanthogranulomatous inflammation is a well-described inflammatory process, which may involve any organ but is most frequently encountered in the gall bladder and the kidney. There are rare reports of xanthogranulomatous appendicitis (XA in the adult population, but only one brief mention of such a diagnosis in a child. In this report, we describe the case of an 11-year-old boy who presented with clinical signs and symptoms of acute appendicitis necessitating appendectomy. Upon microscopic examination, the appendix showed the typical features of XA. To the best of our knowledge, this is the first well-described case XA in a noninterval appendix in a child. We also reviewed the limited medical literature on the subject.

  16. Laparoscopic appendectomy in complicated appendicitis: Is it safe?

    OpenAIRE

    Ashraf A Mohamed; Mahran, Khaled M

    2013-01-01

    Background: Because of lack of good evidence supporting laparoscopic approach for complicated appendicitis, we carried out this study to evaluate efficacy of laparoscopic appendectomy (LA) in management of patients with complicated appendicitis. Materials and Methods: This study was carried out in Surgical Department, Minia University, Egypt involving 214 patients underwent appendectomy for complicated appendicitis over three years. 132 patients underwent LA and remaining 82 patients underwen...

  17. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Division of Pediatric Radiology, Department of Radiology, Hershey, PA (United States)

    2014-05-15

    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  18. UV-inactivated HSV-1 potently activates NK cell killing of leukemic cells.

    Science.gov (United States)

    Samudio, Ismael; Rezvani, Katayoun; Shaim, Hila; Hofs, Elyse; Ngom, Mor; Bu, Luke; Liu, Guoyu; Lee, Jason T C; Imren, Suzan; Lam, Vivian; Poon, Grace F T; Ghaedi, Maryam; Takei, Fumio; Humphries, Keith; Jia, William; Krystal, Gerald

    2016-05-26

    Herein we demonstrate that oncolytic herpes simplex virus-1 (HSV-1) potently activates human peripheral blood mononuclear cells (PBMCs) to lyse leukemic cell lines and primary acute myeloid leukemia samples, but not healthy allogeneic lymphocytes. Intriguingly, we found that UV light-inactivated HSV-1 (UV-HSV-1) is equally effective in promoting PBMC cytolysis of leukemic cells and is 1000- to 10 000-fold more potent at stimulating innate antileukemic responses than UV-inactivated cytomegalovirus, vesicular stomatitis virus, reovirus, or adenovirus. Mechanistically, UV-HSV-1 stimulates PBMC cytolysis of leukemic cells, partly via Toll-like receptor-2/protein kinase C/nuclear factor-κB signaling, and potently stimulates expression of CD69, degranulation, migration, and cytokine production in natural killer (NK) cells, suggesting that surface components of UV-HSV-1 directly activate NK cells. Importantly, UV-HSV-1 synergizes with interleukin-15 (IL-15) and IL-2 in inducing activation and cytolytic activity of NK cells. Additionally, UV-HSV-1 stimulates glycolysis and fatty acid oxidation-dependent oxygen consumption in NK cells, but only glycolysis is required for their enhanced antileukemic activity. Last, we demonstrate that T cell-depleted human PBMCs exposed to UV-HSV-1 provide a survival benefit in a murine xenograft model of human acute myeloid leukemia (AML). Taken together, our results support the preclinical development of UV-HSV-1 as an adjuvant, alone or in combination with IL-15, for allogeneic donor mononuclear cell infusions to treat AML.

  19. Amplification of hTERT and hTERC genes in leukemic cells with high expression and activity of telomerase.

    Science.gov (United States)

    Nowak, Tomasz; Januszkiewicz, Danuta; Zawada, Mariola; Pernak, Monika; Lewandowski, Krzysztof; Rembowska, Jolanta; Nowicka, Karina; Mankowski, Przemyslaw; Nowak, Jerzy

    2006-08-01

    Reactivation of telomerase plays an important role in carcinogenesis. Malignant cells almost always possess high activity and expression of telomerase. The aim of this study was to see whether there is any relationship between telomerase activity and expression and hTERT and hTERC gene amplification in acute lymphoblastic leukemia (ALL) and non-lymphoblastic leukemia (ANLL) cells. In addition telomere length was tested in leukemic cells at the time of diagnosis and during remission. Expression of the three components of telomerase (hTERT, hTERC and TP1) as well as telomerase activity was found both in ALL and ANLL cells. Telomerase activity was diminished in patients in remission. The leukemic cells showed considerable heterogeneity of terminal restriction fragments, that is telomere length. ALL cells showed a variable pattern of telomere length in contrast to ANLL cells which produced a predominantly short telomere pattern. Telomere length in the lymphocytes of leukemia patients was shorter in remission as compared to the time of diagnosis. FISH analysis revealed amplification of hTERT and hTERC genes in ALL and ANLL cells. Quantitative analysis showed that leukemic cells possess higher number of hTERT and hTERC copies than the normal PBL. Our results suggest that the activation of telomerase in leukemic cells is connected with amplification of hTERT and hTERC genes. The high expression and activity of telomerase found in leukemic cells may be partially explained by amplified hTERT and hTERC genes. Amplification of the telomerase genes seems to be a common event in carcinogenesis and may play a role in telomerase reactivation leading to cell immortalization.

  20. Patient and surgeon factors are associated with the use of laparoscopy in appendicitis.

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-02-01

    Aim The use of a minimally invasive approach to treat appendicitis has yet to be universally accepted. The objective of this study was to examine recent trends in Ireland in the surgical management of acute appendicitis. Method Data were obtained from the Irish Hospital In-Patient Enquiry system for patients discharged with a diagnosis of appendicitis between 1999 and 2007. An anonymous postal survey was sent to all general surgeons of consultant and registrar level in Ireland to assess current attitudes to the use of laparoscopic appendectomy. Results The use of laparoscopic appendectomy increased throughout the study and was the most common approach for appendectomy in 2007. Multivariate analysis revealed age under 50 years (OR = 1.51), female sex (OR = 2.84) and residence in high-density population areas (OR = 4.15) as predictive factors for undergoing laparoscopic appendectomy in the most recent year of the study. While 97% of surgeons reported current use of laparoscopy in patients with acute right iliac fossa pain, in most cases it was selective. Surgeons in university teaching hospitals (42 of 77; 55%) were more likely to report using laparoscopic appendectomy for all cases of appendicitis than those in regional (six of 23; 26%) or general (13 of 53; 25%) hospitals (P = 0.048). Conclusion This study has demonstrated a significant increase in laparoscopic appendectomy, yet a variety of patient and surgeon factors contribute to the choice of procedure. Differences in the perception of benefit of the laparoscopic approach amongst surgeons appears to be an important factor in determining the operative approach for appendectomy.

  1. Ex vivo assays to study self-renewal, long-term expansion, and leukemic transformation of genetically modified human hematopoietic and patient-derived leukemic stem cells.

    Science.gov (United States)

    Sontakke, Pallavi; Carretta, Marco; Capala, Marta; Schepers, Hein; Schuringa, Jan Jacob

    2014-01-01

    With the emergence of the concept of the leukemic stem cell (LSC), assays to study them remain pivotal in understanding (leukemic) stem cell biology. Although the in vivo NOD-SCID or NSG xenotransplantation model is currently still the favored assay of choice in most cases, this system has some limitations as well such as its cost-effectiveness, duration, and lack of engraftability of cells from some acute myeloid leukemia (AML) patients. Here, we describe in vitro assays in which long-term expansion and self-renewal of LSCs isolated from AML patients can be evaluated. We have optimized lentiviral transduction procedures in order to stably express genes of interest or stably downmodulate genes using RNAi in primary AML cells, and these approaches are described in detail here. Also, we describe bone marrow stromal coculture systems in which cobblestone area-forming cell activity, self-renewal, long-term expansion, and in vitro myeloid or lymphoid transformation can be evaluated in human CD34(+) cells of fetal or adult origin that are engineered to express oncogenes. Together, these tools should allow a further molecular elucidation of derailed signal transduction in LSCs.

  2. Epiploic appendagitis of caecum: a diagnostic dilemma [Appendicitis epiploica des Blinddarms: ein diagnostisches Dilemma

    Directory of Open Access Journals (Sweden)

    Rashid, Arshad

    2012-10-01

    Full Text Available [english] Epiploic appendagitis is a rare cause of acute abdomen. Depending on the site of occurrence, it can mimic any cause of acute abdomen or disease of the colon and caecal appendix; making its preoperative diagnosis very difficult. We present here a case of a 7-year-old boy misdiagnosed preoperatively as acute appendicitis and later on, upon surgical exploration, found to have caecal appendagitis. The affected epiploic appendage was removed and the patient had an uneventful recovery. We also review the relevant literature and discuss the measures to overcome this diagnostic dilemma. General surgeons should be aware of this self-limiting disease and consider it as a differential diagnosis of acute abdomen.[german] Appendicitis epiploica oder epiploische Appendagitis ist eine seltene Ursache des akuten Abdomens. Je nach Ort des Auftretens kann sie jede Ursache für akuten Unterleibsschmerz oder Erkrankungen des Dickdarms und Appendix vermiformis imitieren, was ihre präoperative Diagnose sehr schwierig macht. Wir präsentieren hier den Fall eines alten Jungen, bei dem präoperativ akute Blinddarmentzündung diagnostiziert wurde. Beim chirurgischen Eingriff stellte sich dann eine Appendicitis epiploica des Blinddarms als Befund heraus. Der betroffene Appendix epiploica wurde entfernt und der Patient erholte sich ohne besondere Vorkommnisse. Wir geben auch eine Übersicht über die relevante Literatur und diskutieren die Maßnahmen, um dieses diagnostische Dilemma zu überwinden. Allgemeine Chirurgen sollten sich dieser selbstlimitierenden Krankheit bewusst sein und sie als eine Differentialdiagnose bei akutem Abdomen in Betracht ziehen.

  3. 腰硬联合麻醉和硬膜外麻醉在早期妊娠孕妇的急性阑尾炎麻醉中的应用比较%Comparison of the Application of Combined Spinal Epidural Anesthesia and Epidural Anesthesia in Early Pregnancy with Acute Appendicitis in Pregnant Women

    Institute of Scientific and Technical Information of China (English)

    黄高廷; 陈琳敏; 陈梓轩; 蔡朝贤

    2016-01-01

    目的:探析腰硬联合麻醉和硬膜外麻醉在早期妊娠孕妇的阑尾炎麻醉中的应用价值。方法整群选取2015年8月—2016年3月因急性阑尾炎需急行手术的56例早期妊娠孕妇,按照麻醉方式的不同,随机分为观察组和对照组。其中观察组予以腰硬联合麻醉,共28例;对照组病例应用硬膜外麻醉,共28例。观察并比较两组患者的麻醉效果﹑患者与胎儿的血流动力学情况以及麻醉不良反应的发生情况。结果观察组患者麻醉有效率100.00%,对照组患者麻醉有效率78.57%;观察组患者发生不良反应发生率3.57%,对照组患者不良反应发生率21.43%,与采用硬膜外麻醉的对照组相比,予以腰硬联合麻醉的观察组患者麻醉总有效率更高(P0.05)。结论罹患急性阑尾炎的早期妊娠孕妇采用腰硬联合麻醉对孕妇以及胎儿安全性较高,麻醉效果确切,临床推广价值较高。%Objective To study the value of combined spinal epidural anesthesia and epidural anesthesia in the early preg-nancy of pregnant women. Methods Group selection a total of 2015August to 2016 March due to acute appendicitis should be sped surgery and treated of 56 cases of early pregnant women, according to the mode of anesthesia, were randomly divid-ed into the observation group and the control group. The observation group was given combined spinal epidural anesthesia, 28 cases; control group were used epidural anesthesia, 28 cases. Occurrence of anesthetic effect were observed and com-pared between the two groups of patients and the hemodynamics of patients with fetal and adverse reaction conditions. Re-sults Patients in the observation group anesthesia effectiveness 100.00%, control group anesthesia efficiency 78.57%;obser-vation group patients and the incidence of adverse reactions was 3.57%, control group, the adverse reaction rate was 21.43%, and the epidural anesthesia group and the control group was compared to be combined

  4. Clinical Outcome of Retrograde Laparoscopic Appendicectomy Using Single Hem-O-Lock Clip for Complicated Versus Non-Complicated Appendicitis

    Directory of Open Access Journals (Sweden)

    Sieda

    2016-07-01

    Full Text Available Background Laparoscopic appendicectomy is safe and feasible for non-complicated appendicitis. The use of retrograde appendicectomy allows feasibility also for complicated cases. Using single polymer clip for securing appendicular stump is safe as well as two clips. Objectives To evaluate the clinical outcome of using single Hem-O-Lock polymer clip and to compare technical feasibility of retrograde laparoscopic appendicectomy for complicated versus non-complicated appendicitis in adults. Patients and Methods A single institute prospective study was done between August 2012 and April 2014. From 78 patients presenting with acute appendicitis to emergency unit, Zagazig University hospitals, only 60 patients were eligible. Three retrograde laparoscopic appendicectomy ports were used in both groups (group I, complicated appendicitis and group II, non-complicated appendicitis and a single Hem-O-Lock polymer clip was applied to secure the appendicular stump. Standardized data collection was performed and data collected by the attending resident and attending physician. The primary clinical outcome was the severity of pain at 1 - 7 days. Secondary outcomes included the duration of operation (minutes, procedure-related complications, conversion rates, and length of hospital stay. Results Four patients (15.4% were converted to open surgery; three patients in group I and one in group II. Four patients developed postoperative complications; three patients in group I and one in group II. Operative time was less in group II and was statistically different and the P value was significant 0.05. Conclusions Retrograde laparoscopic appendicectomy using single polymer clip makes easy access to operating in complicated and non-complicated appendicitis.

  5. SIMULATIONS OF FLOWFIELDS AROUND UNDERWATER APPENDED BODIES

    Institute of Scientific and Technical Information of China (English)

    Huang Zhen-yu; Cheng Hong-rong; Zhou Lian-di; Miao Guo-ping

    2003-01-01

    The numerical method which is based on flux difference splitting, LU decomposition, and implicit high-resolution third-order Essentially Non-Oscillatory (ENO) scheme was constructed for the efficient computation of steady state solution to three-dimensional incompressible Navier-Stokes equations in general coordinates. The flowfields over underwater axisymmetric bodies, full-appended axisymmetric bodies and axisymetric bodies with a ring-wing duct were simulated. The method is proved to be capable of predicting the circumferential-mean velocity distribution at model scale to the accuracy of around 3% of measured values, and of predicting some details of flow features, for example, the wake harmonics.

  6. Improving diagnosis of appendicitis. Early autologous leukocyte scanning.

    Science.gov (United States)

    DeLaney, A R; Raviola, C A; Weber, P N; McDonald, P T; Navarro, D A; Jasko, I

    1989-10-01

    A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of apendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labelling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging111 In oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

  7. Musashi2 modulates K562 leukemic cell proliferation and apoptosis involving the MAPK pathway

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Huijuan; Tan, Shi; Wang, Juan; Chen, Shana; Quan, Jing; Xian, Jingrong; Zhang, Shuai shuai; He, Jingang; Zhang, Ling, E-mail: lingzhang@cqmu.edu.cn

    2014-01-01

    The RNA-binding protein Musashi2 (Msi2) has been identified as a master regulator within a variety of stem cell populations via the regulation of translational gene expression. A recent study has suggested that Msi2 is strongly expressed in leukemic cells of acute myeloid leukemia patients, and elevated Msi2 is associated with poor prognosis. However, the potential role of Msi2 in leukemogenesis is still not well understood. Here, we investigated the effect of Msi2 knockdown on the biological properties of leukemic cells. High expression of Msi2 was found in K562 and KG-1a leukemic cell lines, and low expression was observed in the U937 cell line. We transduced K562 cells with two independent adenoviral shRNA vectors targeting Msi2 and confirmed knockdown of Msi2 at the mRNA and protein levels. Msi2 silencing inhibited cell growth and caused cell cycle arrest by increasing the expression of p21 and decreasing the expression of cyclin D1 and cdk2. In addition, knockdown of Msi2 promoted cellular apoptosis via the upregulation of Bax and downregulation of Bcl-2 expression. Furthermore, Msi2 knockdown resulted in the inactivation of the ERK/MAPK and p38/MAPK pathways, but no remarkable change in p-AKT was observed. These data provide evidence that Msi2 plays an important role in leukemogenesis involving the MAPK signaling pathway, which indicates that Msi2 may be a novel target for leukemia treatment. - Highlights: • Knockdown of Msi2 inhibited K562 cell growth and arrested cell cycle progression. • Knockdown of Msi2 induced K562 cell apoptosis via the regulation of Bax and Bcl-2. • The MAPK pathway was involved in the process of Msi2-mediated leukemogenesis. • Our data indicate that Msi2 is a potential new target for leukemia treatment.

  8. Omental Torsion after Laparoscopic Roux-en-Y Gastric Bypass Mimicking Appendicitis: A Case Report and Review of the Literature

    Science.gov (United States)

    Basilicata, Giacinto; Nocito, Antonio

    2016-01-01

    Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP. Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed. Resection of the avital omentum was performed. Discussion. Omental torsion after antecolic LRYGBP is a rare complication. When appearing in the early postoperative phase, it may mimic an anastomotic leakage. It may also occur as late complication, presenting with acute abdomen as an appendicitis. PMID:27019758

  9. Left-sided appendicitis:Review of 95 published cases and a case report

    Institute of Scientific and Technical Information of China (English)

    Sami; Akbulut; Abdullah; Ulku; Ayhan; Senol; Mahmut; Tas; Yusuf; Yagmur

    2010-01-01

    AIM:To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM).METHODS:We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA,accessed via PubMed and Google Scholar databases.RESULTS:Ninety-five published cases of LSAA were evaluated and a 25-year-old female,who presented to our clinic with left lower abdominal pain caused by LSAA,is reported.In the reviewe...

  10. Left-sided appendicitis in a patient with congenital gastrointestinal malrotation: a case report

    Directory of Open Access Journals (Sweden)

    Welte Frank J

    2007-09-01

    Full Text Available Abstract Background While appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality. We present a case where CT was crucial diagnostically and helpful for pre-surgical planning in a patient presenting with an acute abdomen superimposed on complete congenital gastrointestinal malrotation. Case presentation A 46-year-old previously healthy male with four days of primarily left-sided abdominal pain, low-grade fevers, nausea and anorexia presented to the Emergency Department. His medical history was significant for poorly controlled diabetes and dyslipidemia. His white blood count at that time was elevated. Initial abdominal plain films suggested small bowel obstruction. A CT scan of the abdomen and pelvis was performed with oral and IV contrast to exclude diverticulitis, revealing acute appendicitis superimposed on congenital intestinal malrotation. Following consultation with the surgical team for surgical planning, the patient went on to laparoscopic appendectomy and did well postoperatively. Conclusion Atypical presentations of acute abdominal conditions superimposed on asymptomatic gastrointestinal malrotation can result in delays in delivery of definitive therapy and potentially increase morbidity and mortality if not diagnosed in a timely manner. Appropriate imaging can be helpful in hastening diagnosis and guiding intervention.

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  12. File list: DNS.Bld.05.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: Unc.Bld.10.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: Oth.Bld.20.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. File list: Pol.Bld.50.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  16. File list: Pol.Bld.05.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  17. File list: Unc.Bld.10.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  18. File list: His.Bld.50.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  20. File list: His.Bld.50.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: DNS.Bld.50.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: Oth.Bld.05.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Bld.05.AllAg.Leukemic_bone_marrow mm9 TFs and others Blood Leukemic bone marrow... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Bld.05.AllAg.Leukemic_bone_marrow.bed ...

  3. File list: DNS.Bld.20.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Bld.20.AllAg.Leukemic_blast_cell hg19 DNase-seq Blood Leukemic blast cell http:...//dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Bld.20.AllAg.Leukemic_blast_cell.bed ...

  4. Sonographic findings of acute appendiceal diverticulitis

    Institute of Scientific and Technical Information of China (English)

    Tadao Kubota; Toshihiro Omori; Joji Yamamoto; Motoki Nagai; Satoshi Tamaki; Ken Sasaki

    2006-01-01

    Preoperative images of acute appendiceal diverticulitis are rarely reported because of the difficulty of distinguishing appendiceal diverticulitis from other iliocecal diseases like acute appendicitis or cecal diverticulitis. We report a case of preoperatively diagnosed acute appendiceal diverticulitis. A 30-year-old female with a presumptive diagnosis of acute appendicitis from history and physical examination was admitted to our hospital. Ultrasound sonography showed inflamed appendiceal diverticula and inflammatory changes of the surrounding tissue.The swollen appendix was detected but its findings were slightly different from those of typical acute appendicitis in the following points. One difference was the thickened wall of the appendix, the other difference was the presence of air in the appendix. The patient underwent appendectomy and the pathological specimen revealed inflammatory changes of diverticula within the appendix.

  5. Pediatric CT dose reduction for suspected appendicitis: a practice quality improvement project using artificial gaussian noise--part 2, clinical outcomes.

    Science.gov (United States)

    Callahan, Michael J; Anandalwar, Seema P; MacDougall, Robert D; Stamoulis, Catherine; Kleinman, Patricia L; Rangel, Shawn J; Bachur, Richard G; Taylor, George A

    2015-03-01

    OBJECTIVE. The purpose of this study was to determine the effect of a nominal 50% reduction in median absorbed radiation dose on sensitivity, specificity, and negative appendectomy rate of CT for acute appendicitis in children. MATERIALS AND METHODS. On the basis of a departmental practice quality improvement initiative using computer-generated gaussian noise for CT dose reduction, we applied a nominal dose reduction of 50% to abdominal CT techniques used for bowel imaging. This retrospective study consisted of 494 children who underwent a CT for suspected acute appendicitis before (n = 244; mean age, 133 months) and after (n = 250; mean age, 145 months) the nominal 50% dose reduction. Test performance characteristics of CT for acute appendicitis and impact on the negative appendectomy rate were compared for both time periods. Primary analyses were performed with histologic diagnosis as the outcome standard. Volume CT dose index and dose-length product were recorded from dose reports and size-specific dose estimates were calculated. RESULTS. The nominal 50% dose reduction resulted in an actual 39% decrease in median absorbed radiation dose. Sensitivity of CT for diagnosis of acute appendicitis was 98% (95% CI, 91-100%) versus 97% (91-100%), and specificity was 93% (88-96%) versus 94% (90-97%) before and after dose reduction, respectively. The negative appendectomy rate was 4.5% (0.8-10.25%) before dose reduction and 4.0% (0.4-7.6%) after dose reduction. CONCLUSION. The negative appendectomy rate and performance characteristics of the CT-based diagnosis of acute appendicitis were not affected by a 39% reduction in median absorbed radiation dose.

  6. Neonatal acute apendicitis, case report

    OpenAIRE

    Romero Rojas, Nery; Instituto de Patología, UNMSM; Sánchez García, Luis; Hospital Nacional Docente de Cajamarca

    2016-01-01

    Introduction. Acute appendicitis is a rare disease in newborns with a high mortality because of unspecific clinical features. We report a case of non-perforated acute appendicitis in a newborn at the San Bartolome Hospital in Lima. Case report. A female newborn weighing 3 170 g in the first day repelled maternal lactation; at the third day, she presented 39°C fever, and later, abdominal distention, constipation, and abundant vomiting. The X-ray films showed a distended gastric camera and para...

  7. Integrated clinical-ultrasonographic diagnosis in acute appendicitis.

    Science.gov (United States)

    Summa, M; Perrone, F; Priora, F; Testa, S; Quarati, R; Spinoglio, G

    2007-12-01

    Sommario SCOPO: L'appendicite acuta è una delle urgenze chirurgiche addominali più comuni. Se non trattata, può rapidamente progredire verso complicanze severe, quali la perforazione e la peritonite. Spesso i chirurghi optano per un intervento chirurgico precoce anche in caso di diagnosi solo probabile, con il rischio di eseguire una quota importante di appendicectomie inutili. Lo scopo dello studio è di analizzare la nostra esperienza con la diagnosi integrata clinico-ultrasonografica dell'appendicite acuta. MATERIALI E METODI: Durante il periodo gennaio 1999-dicembre 2006 1447 pazienti sono stati sottoposti a valutazione clinica, a conta leucocitaria, dosaggio della proteina C reattiva ed ecografia addominale. È stata utilizzata la tecnica ecografia di compressione graduale, con sonda ad alta frequenza. RISULTATI: È stata formulata diagnosi ecografica di appendicite acuta in 368 pazienti (25%). Ulteriori 8 pazienti sono stati operati sulla base del solo giudizio clinico. Abbiamo osservato 7 casi di falsi positivi ecografici. In 1079 (75% del totale) pazienti è stato espresso un giudizio diagnostico negativo per appendicite acuta: in 173 di essi (12%) è stata formulata una diagnosi diversa. I restanti 906 pazienti sono stati sottoposti a controllo clinico fino alla risoluzione della sintomatologia, senza alcuna complicanza. I nostri risultati hanno dimostrato una sensibilità dell'ecografia del 98%, una specificità del 99%, un valore predittivo positivo del 98% e un valore predittivo negativo del 99%. L'accuratezza diagnostica globale è stata del 99%. CONCLUSIONI: La diagnosi integrata (clinica, di laboratorio ed ecografica) dell'appendicite acuta consente una diagnosi sicura, con risparmio di risorse evitando il ricorso ad appendicectomie inutili.

  8. Comamonas testosteroni: An Unusual Bacteria Associated with Acute Appendicitis

    OpenAIRE

    Bayhan, Gülsüm İclal; Tanır, Gönül; Karaman, İbrahim; Özkan, Şengül

    2013-01-01

    zation of unusual bacteria isolated from respiratory secretions of cystic fibrosis patients and description of Inquilinus limosus gen. nov., sp. nov. J Clin Microbiol 2002;40:2062-9. [CrossRef] 6. Jin L, Perper JA, Cina SJ. Comamonas testosteroni meningitis in a homeless man. J Forensic Sci 2008;53:1198-9. [CrossRef] 7. Brady TB, Marcon MJ. Less commonly encountered nonente

  9. [Acute appendicitis in children: serious complications when treatment is delayed

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Rieu, P.N.M.A.; Severijnen, R.S.V.M.

    2002-01-01

    Three children, two boys aged 9 and 6 and a 12-year-old girl, had diffuse abdominal complaints, diarrhoea and a (sub)febrile temperature for several days. On admission, they were found to have a perforated inflamed appendix and peritonitis. Following asystole, intra-abdominal abscesses and an entero

  10. Demographic characteristics and seasonal variations of acute appendicitis.

    Science.gov (United States)

    Bal, Ahmet; Ozkececi, Ziya Taner; Turkoglu, Ozgur; Ozsoy, Mustafa; Celep, Ruchan Bahadir; Yilmaz, Sezgin; Arikan, Yüksel

    2015-01-01

    L’appendicite è la patologia che più comunemente richiede un intervento chirurgico in emergenza, e l’appendicectomia è il procedimento chirurgico più commune in tutto il mondo, importante in quanto rappresenta un trattamento efficace. Il nostro scopo è stato quello di determinare le variazioni stagionali dell’appendicite nella nostra regione e di indentificare le differenze demografiche e regionali, e per questo abbiamo analizzato retrospettivamente I dati dei pazienti ricoverati nell’ospedale universitario Afyon Kocatepe e nell’ospedale statale Sivrihisar State tra il 2003 ed il 2012, cioè 839 pazienti. L’età media di tutti i pazienti era di 33 ± 14.7 anni, e la maggior frequenza dell’appendicite acuta è risultata in autunno e nella primavera (P > 0.05). Non si sono osservate differenze sigfnificative stagionali nell’ospedale universitario Afyon Kocatepe, mentre l’appendicite si è manifestata più frequentemente in autunno che non in inverno nell’ospedale statale Sivrihisar (P 0.05). In conclusion, sebbene l’appendicite presenta una variazione stagionale, altri fattori embientali e l’impatto delle abitudini alimentari non vanno ignorate. L’etiologia dell’appendicite è comunque.multifattoriale, e nei futuri studi multiparametrici nell’intero territorio nazionale potrebbero evidenziarsi delle etiologie territorio-specifiche di questa patologia.

  11. New synthetic strategies for xanthene-dye-appended cyclodextrins.

    Science.gov (United States)

    Malanga, Milo; Darcsi, Andras; Balint, Mihaly; Benkovics, Gabor; Sohajda, Tamas; Beni, Szabolcs

    2016-01-01

    Xanthene dyes can be appended to cyclodextrins via an ester or amide bridge in order to switch the fluorescence on or off. This is made possible through the formation of nonfluorescent lactones or lactams as the fluorophore can reversibly cyclize. In this context we report a green approach for the synthesis of switchable xanthene-dye-appended cyclodextrins based on the coupling agent 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-methylmorpholinium chloride (DMT-MM). By using 6-monoamino-β-cyclodextrin and commercially available inexpensive dyes, we prepared rhodamine- and fluorescein-appended cyclodextrins. The compounds were characterized by NMR and IR spectroscopy and MS spectrometry, their UV-vis spectra were recorded at various pH, and their purity was determined by capillary electrophoresis. Two potential models for the supramolecular assembly of the xanthene-dye-appended cyclodextrins were developed based on the set of data collected by the extensive NMR characterization.

  12. Enterobiasis Appendicitis in Infancy——A Report of 124 Cases%小儿蛲虫性阑尾炎(附124例报告)

    Institute of Scientific and Technical Information of China (English)

    胡家高; 鲁建生

    1986-01-01

    @@ 蛲虫又名蠕形住肠线虫(1),人类是蛲虫的唯一宿主,也是儿童肠道常见的寄生虫.1982~1985年我院急性阑尾炎行手术治疗共1,343例,其中蛲虫性阑尾炎124例,占9.2%.%Among the 1,345 patients of acute appen-dicitis we treated from 1982 to 1985, 124 had eaterobiasis appendicits. The youngest was 1 yr. and 3 mths. and the oldest 14 yrs., and the ratio of male to female was 1.21:1. Most of them came from urban areas. Their major complaints were paroxymal abdomenal pain and tenderness in the right hypogastrium, and fever in 70% of the cases. No remarkable local myotonia was noticed and 56.5% of the cases also had upper respiratory tract infection. Swollen lymph nodes of the mesentary were detected on operation in nearly half of the cases.According to the pathological findings, these can be 'divided into three groups: simple enterobiasis appendicitis (63 cases), appendic-itis superficialis(51) and appendicitis phlegmo-nosa(10).Microscopically pinworms were found hav-ing invaded the submucosa and the muscular layers of the appendix. The crests on both sides of the head of a pinworm, seen in the sections, seem to be responsible for the mechanical damage to the mucosa of the appendix.

  13. Effect Of Free Radical Quenchers On Dye-Mediated Laser Light Induced Photosensitization Of Leukemic Cells

    Science.gov (United States)

    Gulliya, Kirpal S.; Matthews, James L.; Fay, Joseph W.; Dowben, Robert M.

    1988-02-01

    The effect of free radical quenchers (ascorbate, catalase, and mannitol) on merocyanine 540 (MC540) mediated, laser light induced photolysis of human acute promyelocytic leukemia cell line (HL-60) was investigated. Results show that in the presence of human albumin (0.25%), dye-mediated (2014/m1), laser light induced photolysis of leukemic cells resulted in a 99.9999% cell kill. Seventy percent of the normal bone marrow cells survived the treatment. The addition of free radical quenchers prior to laser irradiation procedure increases the HL-60 cell survival. Increases of 5.5% and 4.4%, respectively, were observed in the presence of catalase and ascorbate or mannitol. In the presence of a mixture of catalase and mannitol or catalase and ascorbate, this increase in viability was not observed. However, the viability of normal bone marrow cells under these conditions also decreased from 70% to 63%. These findings may be useful in ex-vivo bone marrow purging.

  14. CD64-directed microtubule associated protein tau kills leukemic blasts ex vivo.

    Science.gov (United States)

    Mladenov, Radoslav; Hristodorov, Dmitrij; Cremer, Christian; Gresch, Gerrit; Grieger, Elena; Schenke, Lea; Klose, Diana; Amoury, Manal; Woitok, Mira; Jost, Edgar; Brümmendorf, Tim H; Fendel, Rolf; Fischer, Rainer; Stein, Christoph; Thepen, Theo; Barth, Stefan

    2016-10-11

    Fc gamma receptor I (FcγRI, CD64) is a well-known target antigen for passive immunotherapy against acute myeloid leukemia and chronic myelomonocytic leukemia. We recently reported the preclinical immunotherapeutic potential of microtubule associated protein tau (MAP) against a variety of cancer types including breast carcinoma and Hodgkin's lymphoma. Here we demonstrate that the CD64-directed human cytolytic fusion protein H22(scFv)-MAP kills ex vivo 15-50% of CD64+ leukemic blasts derived from seven myeloid leukemia patients. Furthermore, in contrast to the nonspecific cytostatic agent paclitaxel, H22(scFv)-MAP showed no cytotoxicity towards healthy CD64+ PBMC-derived cells and macrophages. The targeted delivery of this microtubule stabilizing agent therefore offers a promising new strategy for specific treatment of CD64+ leukemia.

  15. CT following US for possible appendicitis: anatomic coverage

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [University of Toronto, Princess Margaret Hospital, 3-920, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Alharbi, Fawaz [University of Toronto, Toronto General Hospital, NCSB 1C572, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Qassim University, Department of Medical Imaging, Buraydah, Qassim (Saudi Arabia); Chawla, Tanya P. [University of Toronto, Mount Sinai Hospital, Room 567, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Moshonov, Hadas [University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)

    2016-02-15

    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)

  16. Aberrant methylation of the M-type phospholipase A2 receptor gene in leukemic cells

    Directory of Open Access Journals (Sweden)

    Menschikowski Mario

    2012-12-01

    Full Text Available Abstract Background The M-type phospholipase A2 receptor (PLA2R1 plays a crucial role in several signaling pathways and may act as tumor-suppressor. This study examined the expression and methylation of the PLA2R1 gene in Jurkat and U937 leukemic cell lines and its methylation in patients with myelodysplastic syndrome (MDS or acute leukemia. Methods Sites of methylation of the PLA2R1 locus were identified by sequencing bisulfite-modified DNA fragments. Methylation specific-high resolution melting (MS-HRM analysis was then carried out to quantify PLA2R1 methylation at 5`-CpG sites identified with differences in methylation between healthy control subjects and leukemic patients using sequencing of bisulfite-modified genomic DNA. Results Expression of PLA2R1 was found to be completely down-regulated in Jurkat and U937 cells, accompanied by complete methylation of PLA2R1 promoter and down-stream regions; PLA2R1 was re-expressed after exposure of cells to 5-aza-2´-deoxycytidine. MS-HRM analysis of the PLA2R1 locus in patients with different types of leukemia indicated an average methylation of 28.9% ± 17.8%, compared to less than 9% in control subjects. In MDS patients the extent of PLA2R1 methylation significantly increased with disease risk. Furthermore, measurements of PLA2R1 methylation appeared useful for predicting responsiveness to the methyltransferase inhibitor, azacitidine, as a pre-emptive treatment to avoid hematological relapse in patients with high-risk MDS or acute myeloid leukemia. Conclusions The study shows for the first time that PLA2R1 gene sequences are a target of hypermethylation in leukemia, which may have pathophysiological relevance for disease evolution in MDS and leukemogenesis.

  17. Analysis of clinical characteristics and genetic mutations of three childhood acute leukemic patients with reduced-dose chemotherapy%6-巯基嘌呤减量治疗3例急性白血病患儿基因突变分析及临床表现

    Institute of Scientific and Technical Information of China (English)

    谢偲; 丁慧; 岳丽杰; 任艳飞; 郑苗苗; 杨春兰

    2014-01-01

    目的:分析6-巯基嘌呤(6-MP)减量化疗的急性白血病(AL)患儿维持治疗阶段临床资料及其巯嘌呤甲基转移酶(TPMT)、次黄嘌呤鸟嘌呤磷酸核糖转移酶(HGPRT)基因突变情况,探讨其基因型和临床表型的相关性。方法分别提取3例AL患儿骨髓液及77例对照组儿童外周血总RNA并逆转录成cDNA,PCR特异性扩增TPMT和HGPRT基因蛋白质编码区序列并测序。采用美国国立癌症研究所第3版常规毒性判定标准(NCI CTC 3.0)对维持治疗阶段药物不良反应进行评价和分级,应用国家食品药品监督管理局(SFDA)推荐的药物不良反应关联性评价标准评价6-MP与不良反应发生的相关性。结果1例AL患儿为TPMT*3C(Try240Cys)纯合突变基因型,减少6-MP剂量至常规剂量1/3~2/3可使骨髓抑制及肝脏毒性等重度不良反应转为轻度。对照组发现2例TPMT*3 C杂合突变,该位点在人群中的等位基因频率为1.3%。以上两组均未发现HGPRT基因突变。结论 TPMT*3 C纯合突变患儿可出现与6-MP剂量相关的不耐受现象,中断或减量治疗能够减少维持期间严重药物不良反应的发生。提示TPMT*3 C基因型的检出可能有利于提高6-MP用药的安全性。%Objective To investigate clinical dates and genetic mutations of hypoxanthine-guanine phosphoribosyl transferase (HGPRT ) and thiopurine methyltransferase (TPMT ) during maintenance therapy in three childhood acute leukemic (AL ) patients with reduced-dose chemotherapy,and to explore the correlation between their genotypes and phenotypes.Methods Total RNA was extracted from bone marrow samples of 3 child patients with AL and 78 peripheral blood of the control group,then reversed them to cDNA.The coding sequence regions of HGPRT and TPMT were amplified with PCR and subjected to direct DNA sequencing.Adverse reactions were evaluated by national cancer institute-common toxicity criteria version3

  18. Retinoic acid induction of CD38 antigen expression on normal and leukemic human myeloid cells: relationship with cell differentiation.

    Science.gov (United States)

    Prus, Eugenia; Fibach, Eitan

    2003-04-01

    Differentiation in the hematopoietic system involves, among other changes, altered expression of antigens, including the CD34 and CD38 surface antigens. In normal hematopoiesis, the most immature stem cells have the CD34 + CD34 - phenotype. In acute myeloid leukemia (AML), although blasts from most patients are CD38 +, some are CD38 - . AML blasts are blocked at early stages of differentiation; in some leukemic cells this block can be overcome by a variety of agents, including retinoids, that induce maturation into macrophages and granulocytes both in vitro and in vivo. Retinoids can also induce CD38 expression. In the present study, we investigated the relationship between induction of CD38 expression and induction of myeloid differentiation by retinoic acid (RA) in normal and leukemic human hematopoietic cells. In the promyelocytic (PML) CD34 - cell lines, HL60 and CB-1, as well as in normal CD34 + CD34 - hematopietic progenitor cells RA induced both CD38 expression as well as morphological and functional myeloid differentiation that resulted in loss of self-renewal. In contrast, in the myeloblastic CD34 + leukemic cell lines, ML-1 and KG-1a, as well as in primary cultures of cells derived from CD34 + -AML (M0 and M1) patients, RA caused an increase in CD38 + that was not associated with significant differentiation. Yet, long exposure of ML-1, but not KG-1, cells to RA resulted in loss of self-renewal. The results suggest that while in normal hematopoietic cells and in PML CD34 - cells induction of CD38 antigen expression by RA results in terminal differentiation along the myeloid lineage, in early myeloblastic leukemic CD34 + cells, induction of CD38 and differentiation are not functionally related. Since, several lines of evidence suggest that the CD38 - cells are the targets of leukemic transformation, transition of these cellsinto CD38 + phenotype by RA or other drugs may have therapeutic effect, either alone or in conjunction with cytotoxic drugs, regardless

  19. Ex vivo assays to study self-renewal, long-term expansion, and leukemic transformation of genetically modified human hematopoietic and patient-derived leukemic stem cells

    NARCIS (Netherlands)

    Sontakke, Pallavi; Carretta, Marco; Capala, Marta; Schepers, Hein; Schuringa, Jan Jacob

    2014-01-01

    With the emergence of the concept of the leukemic stem cell (LSC), assays to study them remain pivotal in understanding (leukemic) stem cell biology. Although the in vivo NOD-SCID or NSG xenotransplantation model is currently still the favored assay of choice in most cases, this system has some limi

  20. Appendicitis as an early manifestation of subsequent malignancy: an asian population study.

    Directory of Open Access Journals (Sweden)

    Shih-Chi Wu

    Full Text Available Cancer risk after appendectomy in patients with appendicitis remains unclear. This study examined the role of appendicitis as an early manifestation harbingering the distant malignancy.From the insurance claims data of Taiwan, we identified a cohort of 130,374 patients newly received appendectomy from 2000-2009, without cancer diagnosis. A comparison cohort of 260,746 persons without appendectomy and cancer was selected from the same database, frequency matched by age, sex, comorbidity and index year. We monitored subsequent cancers with a12-month follow-up.Over all, 1406 and 616 cancer cases were identified in the appendectomy cohort and comparisons, respectively, with all cancers incidence rate 4.64-fold higher in the appendectomy cohort (9.06 vs. 1.96 per 1000 person-months. Digestive and female genital organs harbored 80.9% of cancer cases in the appendectomy cohort. The Cox model measured site-specific hazard ratio (HR was the highest for female genital cancers (23.3, followed by cancers of colorectum (14.7, small intestine (10.1, pancreas (7.40, lymphoma (5.89 and urinary system (4.50, all significant at 0.001 level. The HR of all cancers decreased from 13.7 within 3 months after appendectomy to 1.37 in 7-12 months after the surgery. In general, relative to the comparison cohort, younger appendectomy patients tended to have a higher HR than older patients.The high incident cancers identified soon after appendectomy suggest the acute appendicitis is the early sign of distant metastatic malignancy. The risk of colorectal cancer, female genital cancer and haemopoietic malignancy deserve attention.

  1. Non-fecalith-induced appendicitis: etiology, imaging, and pathology.

    Science.gov (United States)

    Swischuk, Leonard E; Chung, Dai H; Hawkins, Hal K; Jadhav, Siddharth P; Radhakrishnan, Ravi

    2015-12-01

    This study aims to document the imaging and pathology findings in non-fecalith-induced appendicitis. We reviewed the imaging and pathologic findings in 40 patients with histologically proven purulent appendicitis seen over a 2-year period. Findings documented were (1) total appendiceal involvement, (2) predominant appendiceal tip involvement, (3) presence of a fecalith, and (4) presence of lymphoid hyperplasia. There were a total of 40 patients, 28 males and 12 females. The age range was 2-18 years with a mean of 11.5 years. Twenty-two (55 %) patients demonstrated classic purulent appendicitis of the whole appendix, 20 (91 %) of these appendices had a fecalith. Eighteen (45 %) patients demonstrated purulent appendicitis confined to or predominately involving the tip of the appendix, and all 18 (100 %) patients demonstrated marked lymphoid hyperplasia. Only two (11 %) of these appendices had a fecalith. Overall, a fecalith was found in only 55 % of our cases, while 45 % demonstrated no fecalith, but rather marked lymphoid hyperplasia. Lymphoid hyperplasia appeared to be the underlying predisposing cause of purulent appendicitis in these cases.

  2. Novel agents inhibit human leukemic cells

    Institute of Scientific and Technical Information of China (English)

    Wei-ping YU; Juan LI

    2012-01-01

    Ouabain (OUA) and pyrithione zinc (PZ) have been proved as the potential drugs for treating acute myeloid leukemia (AML).Selected from a screening among 1040 Food and Drug Administration-approved pharmacological agents,both drugs showability to induce apoptosis of the culturing AML cells,exhibiting the poisoning effect on the cells.Studies also reveal the efficiency of the drugs in inhibiting the growth of human AML cells injected into the mice lacking of immunity and killing primary AML cells from the peripheral blood of AML patients[1].

  3. Duplication and loss of chromosome 21 in two children with Down syndrome and acute leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Rogan, P.K.; Close, P.; Gannutz, L. [Pennsylvania State Univ., Hershey, PA (United States)] [and others

    1995-11-06

    Acute leukemia in Down syndrome (DS) is often associated with additional changes in the number of structure of chromosome 21. We present two DS patients whose leukemic karyotypes were associated with changes in chromosome 21 ploidy. Patient 1 developed acute lymphocytic leukemia (type L1); disomy for chromosome 21 was evident in all blast cells examined. Loss of the paternal chromosome in the leukemic clone produced maternal uniparental disomy with isodisomy over a 25-cM interval. The second patient had acute monoblastic leukemia (type M5) with tetrasomy 21 in all leukemic cells. DNA polymorphism analysis showed duplicate paternal chromosomes in the constitutional genotype. The maternal chromosome was subsequently duplicated in the leukemic clone. The distinct inheritance patterns of chromosome 21 in the blast cells of these patients would appear to indicate that leukemogenesis occurred by different genetic mechanisms in each individual. 57 refs., 2 figs., 3 tabs.

  4. Intramuscular leukemic relapse: clinical signs and imaging findings. A multicentric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Surov, Alexey [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany); University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Kiratli, Hayyam [Hacettepe University School of Medicine, Department of Ophthalmology, Ankara (Turkey); Im, Soo Ah [Seoul St. Mary' s Hospital, Department of Radiology, Seoul (Korea, Republic of); Manabe, Yasuhiro [National Hospital Organization Okayama Medical Center, Department of Neurology, Okayama (Japan); O' Neill, Alibhe; Shinagare, Atul B. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Spielmann, Rolf Peter [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany)

    2014-09-26

    Leukemia is a group of malignant diseases involving peripheral blood and bone marrow. Extramedullary tumor manifestation in leukemia can also occur. They more often involve lymph nodes, skin, and bones. Intramuscular leukemic relapse (ILR) is very unusual. The aim of this analysis was to summarize the reported data regarding clinical signs and radiological features of ILR. The PubMed database was searched for publications related to ILR. After an analysis of all identified articles, 20 publications matched the inclusion criteria. The authors of the 20 publications were contacted and provided imaging of their cases for review. The following were recorded: age, gender, primary diagnosis, clinical signs, pattern, localization and size of the intramuscular leukemic relapse. Images of 16 patients were provided [8 computer tomographic (CT) images and 15 magnetic resonance images, MRI]. Furthermore, one patient with ILR was identified in our institutional database. Therefore, images of 17 patients were available for further analysis. Overall, 32 cases with ILR were included in the analysis. In most cases acute myeloid leukemia was diagnosed. Most ILRs were localized in the extremities (44 %) and in the extraocular muscles (44 %). Clinically, ILR manifested as local pain, swelling and muscle weakness. Radiologically, ILR presented most frequently with diffuse muscle infiltration. On postcontrast CT/MRI, most lesions demonstrated homogeneous enhancement. ILRs were hypo-/isointense on T1w and hyperintense on T2w images. ILR manifests commonly as focal pain, swelling and muscle weakness. ILR predominantly involved the extraocular musculature and the extremities. Radiologically, diffuse muscle infiltration was the most common imaging finding. (orig.)

  5. Novel synthetic organosulfur compounds induce apoptosis of human leukemic cells.

    Science.gov (United States)

    Wong, W W; Macdonald, S; Langler, R F; Penn, L Z

    2000-01-01

    It has been well documented that natural organosulfur compounds (OSCs) derived from plants such as garlic, onions and mahogany trees possess antiproliferative properties; however, the essential chemical features of the active OSC compounds remain unclear. To investigate the association between OSC structure and growth inhibitory activity, we synthesized novel relatives of dysoxysulfone, a natural OSC derived from the Fijian medicinal plant, Dysoxylum richii. In this study, we have examined the antiproliferative effects of these novel OSCs on a model human leukemic cell system and show that the compounds segregate into three groups. Group I, consisting of compounds A, B, G and J, did not affect either cell proliferation or the cell cycle profile of the leukemic cell lines. Group II, consisting of compounds F and H, induced the cells to undergo apoptosis from the G2/M phase of the cell cycle. Group III, consisting of compounds C, D, E and I, decreased cell proliferation and induced apoptosis throughout the cell cycle. The apoptotic agonists of Group II and III shared a common disulfide moiety, essential for leukemic cell cytotoxicity. Interestingly, Group II compounds did not affect cell viability of normal human diploid cells, suggesting the regions flanking the disulfide group contributes to the specificity of cell killing. Thus, we provide evidence that structure-activity analysis of natural products can identify novel compounds for the development of new therapeutics that can trigger apoptosis in a tumor-specific manner.

  6. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  7. Imaging findings of perforative appendicitis: a pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, K.L.; Patrick, L.E.; Ball, T.I. [Dept. of Radiology, Children' s Healthcare of Atlanta, Egleston, GA (United States)

    2001-03-01

    Appendicitis is common in children. Early diagnosis depends on recognition of characteristic signs and symptoms: right lower quadrant or periumbilical pain, localized tenderness, fever, and leukocytosis. Because these classic features may be difficult to elicit or masked by other complaints, the incidence of perforative appendicitis in children is high. This paper reviews the imaging sequelae with emphasis on CT and sonography findings. Areas of focus include abdominopelvic abscess, peritonitis, pyelephlebitis, pyelethrombosis, and hepatic abscess. Secondary involvement of the urinary and gastrointestinal tracts is also discussed. (orig.)

  8. [Causes of late diagnosis of appendicitis in children].

    Science.gov (United States)

    Zlámal, Z

    1996-07-01

    The author evaluates the case-history of 51 children with perforated appendicitis treated during 1984-1995 at the First Surgical Clinic of the Faculty Hospital Olomouc. The purpose was to find an answer to the problem why in these children the diagnosis was delayed and whose was the fault of the substantial deterioration of the health status. In the evaluation four groups of causal responsibility are differentiated: a very rapid development of appendicitis-parents, arriving late in the surgery-paediatricians-surgeons. The authors discuss circumstances associated with the diagnostic error and delay.

  9. Crohn's disease and recurrent appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Ron Shaoul; Yosi Rimar; Aurora Toubi; Jorge Mogilner; Reuven Polak; Michael Jaffe

    2005-01-01

    The clinical diagnosis of classic Crohn's disease (CD)of the small bowel is based on a typical history, tender right lower quadrant fullness or mass, and characteristic radiographic findings of the terminal ileum. Appendicitis may as well present with chronic or recurrent symptoms and this presentation may be confused with CD. We herein describe the case of a young teenage girl with a presumptive diagnosis of CD, who was ultimately diagnosed as having chronic nongranulomatous appendicitis. The literature on the subject is reviewed.

  10. The value of ultrasonography in the diagnosis and classifi cation of appendicitis%超声检查对不同病理类型阑尾炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    余俊丽; 刘广健; 艳玲; 刘小银; 程文捷; 陈瑶; 覃斯; 王韦力

    2015-01-01

    ObjectiveTo assess the diagnostic value of ultrasonography in the diagnosis and pathological classifi cation of appendicitis with pathological results.MethodsThe study included 111 cases who confi rmed by surgery and pathology in the Six Affi liated Hospital of Sun Yat-sen University from June2012 to December 2013. The image characteristics of ultrasonic images performed before surgery were analyzed retrospectively. The cases were divided into five groups based on the pathology: 6 acute simple appendicitis, 45 acute suppurative appendicitis, 15 acute gangrenous appendicitis, 33 chronic appendicitis, and 12 acute attack of chronic appendicitis. The length, width and wall thickness of the appendicitis measured by preoperative ultrasound between various pathological type were compared with Kruskal-Wallis statistical methord, and also used the same method to compared the one which had statistically signifi cance between the fi ve groups. As in the above case, Fisher Exact Test was used to compare the characters′ of ultrasonography included gradations of the appendix, the tube cavity expansion, stercorolith, the appendiceal abscess, mergering lymph node enlargement and the appendix around effusion, if there was statistically signifi cance, the same methord was used to the further comparison between thefi ve groups.ResultsTotally 90 of 111 cases of were reminded appendicitis by preoperative ultrasound, the diagnostic accuracy rate was 81.08%, including acute suppurative appendicitis 91.11% (41/45), acute gangrenous appendicitis 93.33% (14/15), acute simple appendicitis 83.33% (5/6), chronic appendicitis 60.61% (20/33), chronic appendicitis onset acute 83.33% (10/12). There were no statistical differences of preoperative ultrasound measured between various pathological type of appendicitis in length, while the appendix width measured by preoperative ultrasound of acute gangrenous appendicitis was wider than the acute simple group and chronic group, and there were

  11. Value of Multi-Slice Spiral CT in the Diagnosis of Atypical Appendicitis%多排CT对非典型阑尾炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李水婷; 江魁明; 麦慧; 张家云; 侍丽

    2013-01-01

    To investigate the value of the multi-detector row computed tomography in the diagnosis of appendicitis with atypical clinical feature. Methods: 58 cases of appendicitis which were not initially considered on clinical presentation, were confirmed surgically and pathologically were collected, CT characteristics were retrospectively analyzed. Results: 54 of the 58 patients were correctly diagnosed on CT. It included: 6 cases of dissect abnormal appendicitis, 22 cases of women of childbearing age appendicitis. 19 cases of elderly appendicitis. 11 cases of pediatric appendicitis. The direct CT signs of acute appendicitis were an charged appendix with wall thickening and appendicolith. Indirect signs included appendiceal perityphlitis and periappendicular. Conclusion: Multi-detector row computed tomography is valuable for early diagnosis of appendicitis with atypical clinical feature.%目的:探讨多排CT对缺乏典型临床表现的阑尾炎的应用价值.材料方法:搜集2010年1月~2012年1月临床首诊未考虑阑尾炎,经手术、病理证实为阑尾炎患者58例,回顾分析其CT表现.结果:58例阑尾炎患者中CT术前诊断为阑尾炎54例,渗断准确率93%.其中:解剖位置异常的阑尾炎6例;育龄妇女急性阑尾炎22例;老年急性阑尾炎19例;小儿急性阑尾炎11例.急性阑尾炎CT直接征象:阑尾肿胀、阑尾壁增厚及阑尾结石.CT间接征象:阑尾周围炎、阑尾周围脓肿.结论:使用多排CT对临床早期明确非典型阑尾炎的诊断有重要意义.

  12. Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen.

    Science.gov (United States)

    Turnock, Adam R; Fleischer, Brian P; Carney, Martin J; Vanderlan, Wesley B

    2016-06-14

    Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique. Gestational integrity was preserved and the patient went on to experience a normal spontaneous vaginal delivery. At 5 years post-delivery the patient has had no surgical complications and her baby has met all developmental milestones.

  13. Appendicitis Diagnosed by Emergency Physician Performed Point-of-care Transvaginal Ultrasound: Case Series

    Directory of Open Access Journals (Sweden)

    Robert Bramante

    2013-09-01

    Full Text Available Lower abdominal pain in females of reproductive age continues to be a diagnostic dilemma for the emergency physician (EP. Point-of-care ultrasound (US allows for rapid, accurate, and safe evaluation of abdominal and pelvic pain in both the pregnant and non-pregnant patient. We present 3 cases of females presenting with right lower quadrant and adnexal tenderness where transvaginal ultrasonography revealed acute appendicitis. The discussion focuses on the use of EP-performed transvaginal US in gynecologic and intra-abdominal pathology and discusses the use of a staged approach to evaluation using US and computed tomography, as indicated. [West J Emerg Med. 2013;14(5:415-418.

  14. 老年人阑尾炎的特点及治疗%The Characteristics and Treatment of Elderly Patients with Appendicitis

    Institute of Scientific and Technical Information of China (English)

    于绍鹏

    2014-01-01

    目的:探讨老年人阑尾炎患者临床特点及治疗体会。方法选取2012年1月~2014年6月收治的老年人阑尾炎患者40例临床手术治疗进行分析。结果40例老年人阑尾炎患者平均住院8 d,经手术治疗均治愈,无感染病例发生。结论老年人急性阑尾炎的诊断一经确立,就应积极采取手术治疗。%Objective The clinical characteristics and treatment realize of elderly patients with appendicitis are to be investigated.Methods The clinical surgery treatments of 40 cases of elderly patients with appendicitis from January 2012 to June 2014 were selected for analysis. ResultsThe average hospitalization stay of the 40 cases of elderly patients with appendicitis was 8 days. After surgery treatment, they were all cured with no case of infection.Conclusion Once the elderly patients with acute appendicitis were diagnosed, surgery treatment should be adopted actively.

  15. New synthetic strategies for xanthene-dye-appended cyclodextrins

    Directory of Open Access Journals (Sweden)

    Milo Malanga

    2016-03-01

    Full Text Available Xanthene dyes can be appended to cyclodextrins via an ester or amide bridge in order to switch the fluorescence on or off. This is made possible through the formation of nonfluorescent lactones or lactams as the fluorophore can reversibly cyclize. In this context we report a green approach for the synthesis of switchable xanthene-dye-appended cyclodextrins based on the coupling agent 4-(4,6-dimethoxy-1,3,5-triazin-2-yl-4-methylmorpholinium chloride (DMT-MM. By using 6-monoamino-β-cyclodextrin and commercially available inexpensive dyes, we prepared rhodamine- and fluorescein-appended cyclodextrins. The compounds were characterized by NMR and IR spectroscopy and MS spectrometry, their UV–vis spectra were recorded at various pH, and their purity was determined by capillary electrophoresis. Two potential models for the supramolecular assembly of the xanthene-dye-appended cyclodextrins were developed based on the set of data collected by the extensive NMR characterization.

  16. Venstresidig appendicitis forårsaget af intestinal malrotation

    DEFF Research Database (Denmark)

    Ilangkovan, Nivethitha; Rindom, Alesia; Mogensen, Christian Backer

    2013-01-01

    Left-sided appendicitis due to malrotation is a rare condition with an atypical presentation. We report a history of a 31-year-old man who had four days of right-sided abdominal pain, moving across lower abdomen and tenderness in both right and left side on examination. A computed tomography...

  17. Recovery and convalescence after laparoscopic surgery for appendicitis

    DEFF Research Database (Denmark)

    Kleif, Jakob; Vilandt, Jesper; Gögenur, Ismail

    2016-01-01

    BACKGROUND: Information about predictors for the duration of convalescence and the overall general wellbeing after laparoscopic surgery for suspected appendicitis is missing in the scientific literature. We aimed to describe and identify predictors for the duration of convalescence and the qualit...

  18. Human TM9SF4 Is a New Gene Down-Regulated by Hypoxia and Involved in Cell Adhesion of Leukemic Cells.

    Directory of Open Access Journals (Sweden)

    Rosa Paolillo

    Full Text Available The transmembrane 9 superfamily protein member 4, TM9SF4, belongs to the TM9SF family of proteins highly conserved through evolution. TM9SF4 homologs, previously identified in many different species, were mainly involved in cellular adhesion, innate immunity and phagocytosis. In human, the function and biological significance of TM9SF4 are currently under investigation. However, TM9SF4 was found overexpressed in human metastatic melanoma and in a small subset of acute myeloid leukemia (AMLs and myelodysplastic syndromes, consistent with an oncogenic function of this gene.In this study, we first analyzed the expression and regulation of TM9SF4 in normal and leukemic cells and identified TM9SF4 as a gene highly expressed in human quiescent CD34+ hematopoietic progenitor cells (HPCs, regulated during monocytic and granulocytic differentiation of HPCs, both lineages giving rise to mature myeloid cells involved in adhesion, phagocytosis and immunity. Then, we found that TM9SF4 is markedly overexpressed in leukemic cells and in AMLs, particularly in M2, M3 and M4 AMLs (i.e., in AMLs characterized by the presence of a more or less differentiated granulocytic progeny, as compared to normal CD34+ HPCs. Proliferation and differentiation of HPCs occurs in hypoxia, a physiological condition in bone marrow, but also a crucial component of cancer microenvironment. Here, we investigated the impact of hypoxia on TM9SF4 expression in leukemic cells and identified TM9SF4 as a direct target of HIF-1α, downregulated in these cells by hypoxia. Then, we found that the hypoxia-mediated downregulation of TM9SF4 expression is associated with a decrease of cell adhesion of leukemic cells to fibronectin, thus demonstrating that human TM9SF4 is a new molecule involved in leukemic cell adhesion.Altogether, our study reports for the first time the expression of TM9SF4 at the level of normal and leukemic hematopoietic cells and its marked expression at the level of AMLs

  19. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease

    Institute of Scientific and Technical Information of China (English)

    Chi-Hsun Hsieh; Yu-Chun Wang; Horng-Ren Yang; Ping-Kuei Chung; Long-Bin Jeng; Ray-Jade Chen

    2006-01-01

    As a disease commonly encountered in daily practice,acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate.However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated C-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava,destroying psoas muscle and dissecting downward into the right thigh. Laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications.CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.

  20. Association between Gastroesophageal Reflux Disease and Appendicitis: A Population-Based Case-Control Study.

    Science.gov (United States)

    Kao, Li-Ting; Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

    2016-03-02

    Appendicitis and gastroesophageal reflux disease (GERD) are both prevalent diseases and might share similar pathological mechanisms. The aim of this study was to investigate the association between GERD and appendicitis using a large population-based dataset. This study used administrative claims data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 7113 patients with appendicitis as cases, and 28452 matched patients without appendicitis as controls. This study revealed that GERD was found in 359 (5.05%) cases and 728 (2.56%) controls (p appendicitis were 1.96 (95% CI: 1.56~2.47), 2.36 (95% CI: 1.94~2.88), and 1.71 (95% CI: 1.31~2.22) than controls, respectively. We concluded that patients with appendicitis had higher odds of prior GERD than those without appendicitis regardless of age group.

  1. Laparoscopic appendectomy in complicated appendicitis: Is it safe?

    Directory of Open Access Journals (Sweden)

    Ashraf A Mohamed

    2013-01-01

    Full Text Available Background: Because of lack of good evidence supporting laparoscopic approach for complicated appendicitis, we carried out this study to evaluate efficacy of laparoscopic appendectomy (LA in management of patients with complicated appendicitis. Materials and Methods: This study was carried out in Surgical Department, Minia University, Egypt involving 214 patients underwent appendectomy for complicated appendicitis over three years. 132 patients underwent LA and remaining 82 patients underwent OA. Parameters studied included operating time, return to oral feeding, postoperative pain, wound infection, intra-abdominal abscess, duration of abdominal drainage and hospital stay. Results: There were four conversions, two due to extensive cecal adhesions and two due to friable appendix. LA took longer time to perform (p = 0.0002 but with less use of analgesics (p < 0.0001, shorter hospital stay (p < 0.0001, shorter duration of abdominal drainage (p < 0.0001 and lower incidence of wound infection (p = 0.0005. Nine patients in LA and seven patients in OA group developed intra-abdominal abscess treated successfully with sonographic guided percutaneous drainage. Postoperative ileus was recorded in two patients in LA group and three patients in OA group, chest infection in one patient in OA group, hernia in one patient in LA and fecal fistula was present in one patient in OA. Overall complications were significantly lower in laparoscopy group and managed conservatively with no mortality in either group. Conclusions: LA in complicated appendicitis is feasible and safe with lower incidence of complications than OA and should be the initial choice for all patients with complicated appendicitis.

  2. Synthesis of ZnPc loaded poly(methyl methacrylate) nanoparticles via miniemulsion polymerization for photodynamic therapy in leukemic cells.

    Science.gov (United States)

    Feuser, Paulo Emilio; Gaspar, Pamela Cristina; Jacques, Amanda Virtuoso; Tedesco, Antônio Claudio; dos Santos Silva, Maria Claudia; Ricci-Júnior, Eduardo; Sayer, Claudia; de Araújo, Pedro Henrique Hermes

    2016-03-01

    The goal of this work was to synthesize and characterize ZnPc loaded poly(methyl methacrylate) (PMMA) nanoparticles (NPs) by miniemulsion polymerization. Biocompatibility assays were performed in murine fibroblast (L929) cells and human peripheral blood lymphocytes (HPBL). Finally, photobiological assays were performed in two leukemic cells: chronic myeloid leukemia in blast crisis (K562) and acute lymphoblastic leukemia (Jurkat). ZnPc loaded PMMA NPs presented an average diameter of 97±2.5 nm with a low polydispersity index and negative surface charge. The encapsulation efficiency (EE %) of ZnPc PMMA NPs was 87%±2.12. The release of ZnPc from PMMA NPs was slow and sustained without the presence of burst effect, indicating homogeneous drug distribution in the polymeric matrix. NP biocompatibility was observed on the treatment of peripheral blood lymphocytes and L929 fibroblast cells. Phototoxicity assays showed that the ZnPc loaded in PMMA NPs was more phototoxic than ZnPc after activation with visible light at 675 nm, using a low light dose of 2J/cm(2) in both leukemic cells (Jurkat and K562). The results from fluorescence microscopy (EB/OA) and DNA fragmentation suggest that the ZnPc loaded PMMA NPs induced cell death by apoptosis. Based on presented results, our study suggests that PDT combined with the use of polymeric NPs, may be an excellent alternative for leukemia treatment.

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    Full Text Available NoD.Bld.05.AllAg.Leukemic_bone_marrow mm9 No description Blood Leukemic bone marrow... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Bld.05.AllAg.Leukemic_bone_marrow.bed ...

  7. File list: His.Bld.05.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  8. File list: InP.Bld.05.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  9. File list: InP.Bld.10.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.10.AllAg.Leukemic_bone_marrow mm9 Input control Blood Leukemic bone marrow ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Bld.10.AllAg.Leukemic_bone_marrow.bed ...

  10. File list: InP.Bld.10.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  11. File list: NoD.Bld.10.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.10.AllAg.Leukemic_blast_cell hg19 No description Blood Leukemic blast cell ...http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Bld.10.AllAg.Leukemic_blast_cell.bed ...

  12. File list: NoD.Bld.50.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.50.AllAg.MLL-AF10_leukemic_cell mm9 No description Blood MLL-AF10 leukemic ...cell http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Bld.50.AllAg.MLL-AF10_leukemic_cell.bed ...

  13. File list: His.Bld.50.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Bld.50.AllAg.MLL-AF10_leukemic_cell mm9 Histone Blood MLL-AF10 leukemic cell SR...SRX671755,SRX671765,SRX671754 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Bld.50.AllAg.MLL-AF10_leukemic_cell.bed ...

  14. File list: His.Bld.20.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Bld.20.AllAg.MLL-AF10_leukemic_cell mm9 Histone Blood MLL-AF10 leukemic cell SR...SRX671761,SRX671759,SRX671756 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Bld.20.AllAg.MLL-AF10_leukemic_cell.bed ...

  15. File list: Oth.Bld.50.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Bld.50.AllAg.MLL-AF10_leukemic_cell mm9 TFs and others Blood MLL-AF10 leukemic ...cell http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Bld.50.AllAg.MLL-AF10_leukemic_cell.bed ...

  16. File list: InP.Bld.50.AllAg.Leukemic_bone_marrow [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.50.AllAg.Leukemic_bone_marrow mm9 Input control Blood Leukemic bone marrow ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Bld.50.AllAg.Leukemic_bone_marrow.bed ...

  17. File list: DNS.Bld.50.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Bld.50.AllAg.MLL-AF9_leukemic_cell mm9 DNase-seq Blood MLL-AF9 leukemic cell ht...tp://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Bld.50.AllAg.MLL-AF9_leukemic_cell.bed ...

  18. File list: NoD.Bld.20.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.20.AllAg.MLL-AF9_leukemic_cell mm9 No description Blood MLL-AF9 leukemic ce...ll http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Bld.20.AllAg.MLL-AF9_leukemic_cell.bed ...

  19. File list: NoD.Bld.05.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.05.AllAg.MLL-AF9_leukemic_cell mm9 No description Blood MLL-AF9 leukemic ce...ll http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Bld.05.AllAg.MLL-AF9_leukemic_cell.bed ...

  20. File list: InP.Bld.05.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.05.AllAg.Leukemic_blast_cell hg19 Input control Blood Leukemic blast cell h...ttp://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/InP.Bld.05.AllAg.Leukemic_blast_cell.bed ...

  1. File list: His.Bld.10.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Bld.10.AllAg.MLL-AF10_leukemic_cell mm9 Histone Blood MLL-AF10 leukemic cell SR...SRX671756,SRX671754,SRX671761 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Bld.10.AllAg.MLL-AF10_leukemic_cell.bed ...

  2. File list: NoD.Bld.05.AllAg.Leukemic_blast_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.05.AllAg.Leukemic_blast_cell hg19 No description Blood Leukemic blast cell ...http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Bld.05.AllAg.Leukemic_blast_cell.bed ...

  3. File list: DNS.Bld.20.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Bld.20.AllAg.MLL-AF10_leukemic_cell mm9 DNase-seq Blood MLL-AF10 leukemic cell ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Bld.20.AllAg.MLL-AF10_leukemic_cell.bed ...

  4. File list: His.Bld.50.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Bld.50.AllAg.MLL-AF9_leukemic_cell mm9 Histone Blood MLL-AF9 leukemic cell SRX8...,SRX115551,SRX692071,SRX734388,SRX692061,SRX061979,SRX884081 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Bld.50.AllAg.MLL-AF9_leukemic_cell.bed ...

  5. File list: NoD.Bld.10.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Bld.10.AllAg.MLL-AF9_leukemic_cell mm9 No description Blood MLL-AF9 leukemic ce...ll http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Bld.10.AllAg.MLL-AF9_leukemic_cell.bed ...

  6. File list: InP.Bld.05.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.05.AllAg.MLL-AF9_leukemic_cell mm9 Input control Blood MLL-AF9 leukemic cel...884068 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Bld.05.AllAg.MLL-AF9_leukemic_cell.bed ...

  7. File list: Unc.Bld.50.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Bld.50.AllAg.MLL-AF9_leukemic_cell mm9 Unclassified Blood MLL-AF9 leukemic cell... SRX692060,SRX692059 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Bld.50.AllAg.MLL-AF9_leukemic_cell.bed ...

  8. File list: His.Bld.05.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Bld.05.AllAg.MLL-AF10_leukemic_cell mm9 Histone Blood MLL-AF10 leukemic cell SR...SRX671759,SRX671756,SRX671755 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Bld.05.AllAg.MLL-AF10_leukemic_cell.bed ...

  9. File list: DNS.Bld.50.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.Bld.50.AllAg.MLL-AF10_leukemic_cell mm9 DNase-seq Blood MLL-AF10 leukemic cell ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Bld.50.AllAg.MLL-AF10_leukemic_cell.bed ...

  10. File list: Unc.Bld.20.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Bld.20.AllAg.MLL-AF9_leukemic_cell mm9 Unclassified Blood MLL-AF9 leukemic cell... SRX692060,SRX692059 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Bld.20.AllAg.MLL-AF9_leukemic_cell.bed ...

  11. File list: InP.Bld.20.AllAg.MLL-AF10_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.20.AllAg.MLL-AF10_leukemic_cell mm9 Input control Blood MLL-AF10 leukemic c...ell SRX671749 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Bld.20.AllAg.MLL-AF10_leukemic_cell.bed ...

  12. File list: InP.Bld.50.AllAg.MLL-AF9_leukemic_cell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Bld.50.AllAg.MLL-AF9_leukemic_cell mm9 Input control Blood MLL-AF9 leukemic cel...884068 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Bld.50.AllAg.MLL-AF9_leukemic_cell.bed ...

  13. Micro-Raman spectroscopy of single leukemic cells

    Institute of Scientific and Technical Information of China (English)

    Changmei Cai; Rong Chen; Juqiang Lin; Yongzeng Li; Shangyuan Feng

    2008-01-01

    The Raman spectra from leukemic cell line (HL60) and normal human peripheral blood mononuclear cells (PBMCs) are obtained by confocal micro-Raman spectroscopy using near-infrared laser (785 nm) excitation. The scanning range is from 500 to 2000 cm-1. The two average Raman spectra of normal PBMCs and carcinoma cells have clear differences because their structure and amount of nucleic acid, protein, and other major molecules are changed. The spectra are also compared and analyzed by principal component analysis (PCA) to demonstrate the two distinct clusters of normal and transformed cells. The sensitivity of this technique for identifying transformed cells is 100%.

  14. When and why use unenhanced computed tomography in patients with acute abdomen; Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar

    Energy Technology Data Exchange (ETDEWEB)

    Freire Filho, Edison de Oliveira; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: eofilho@ig.com.br; Jesus, Paulo Eduardo Marinho de [Clinica Radiologica de Anapolis, GO (Brazil)

    2006-01-15

    The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed. (auth0008.

  15. Effect of fractionation and rate of radiation dose on human leukemic cells, HL-60

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, J.G.; Song, C.W.; Kim, T.H.; Levitt, S.H.

    1985-03-01

    The capacity of HL-60 cells, human acute promyelocytic leukemic cells established in culture, to repair sublethal radiation damage was estimated from the response of the cells to fractionated irradiation or to a single irradiation at difference dose rates. After exposure of cells to a single dose of X rays at a dose rate of 78 rad/min, the survival curve was characterized by n = 2.5, D/sub q/ = 80 rad, and D/sub 0/ = 83.2 rad. Split-dose studies demonstrated that the cells were able to repair a substantial portion of sublethal radiation damage in 2 hr. The response of the cells to irradiation at different dose rates decreased with a decrease in the dose rates, which could be attributed to repair of sublethal radiation damage. The possibility that some of the malignant hemopoietic cells, if not all, may possess a substantial capacity to repair sublethal radiation damage should not be underestimated in planning total-body irradiation followed by bone marrow transplantation.

  16. Frank hematuria as the presentation feature of acute leukemia

    Directory of Open Access Journals (Sweden)

    Suriya Owais

    2010-01-01

    Full Text Available Muco-cutaneous bleeding is a common presenting feature of acute leukemias. Mucosal bleeding usually manifests as gum bleeding and/or epistaxis but may occur in any mucosal surface of the body. Hematuria as an isolated or main presenting feature of acute leukemia is rare. We describe two cases of acute leukemia, a 19 year old male with acute lymphoblastic leukemia and a 52 year old male with acute myeloid leukemia, both presenting with gross hematuria. There was no demonstrable leukemic infiltration of the urinary tract on imaging studies. Hematuria in these patients was likely to be due to occult leukemic infiltration of the urinary system, aggravated by thrombocytopenia, as it subsided after starting chemotherapy. Our cases highlight that hematuria should be remembered as a rare presenting feature of acute leukemia.

  17. Appendicitis within Morgagni Hernia and simultaneous Paraesophageal Hernia

    OpenAIRE

    2015-01-01

    Background Morgagni hernia is a congenital diaphragmatic defect that rarely presents with symptomatic findings in adults. The presence of one diaphragmatic defect may decrease the occurrence of a separate diaphragmatic defect. Appendicitis may be a unique presentation of incarcerated bowel in a Morgagni defect. Case presentation Review of recent literature and presentation of a patient with Morgagni defect. Only five cases of simultaneous Morgagni hernia and paraesophageal hernia have been de...

  18. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University, Stanford, CA (United States)

    2014-05-15

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  19. Idarubicin induces mTOR-dependent cytotoxic autophagy in leukemic cells

    Energy Technology Data Exchange (ETDEWEB)

    Ristic, Biljana [Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr. Subotica 1, 11000 Belgrade (Serbia); Bosnjak, Mihajlo [Institute of Histology and Embryology, School of Medicine, University of Belgrade, Belgrade (Serbia); Arsikin, Katarina [Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr. Subotica 1, 11000 Belgrade (Serbia); Mircic, Aleksandar; Suzin-Zivkovic, Violeta [Institute of Histology and Embryology, School of Medicine, University of Belgrade, Belgrade (Serbia); Bogdanovic, Andrija [Clinic for Hematology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade (Serbia); Perovic, Vladimir [Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr. Subotica 1, 11000 Belgrade (Serbia); Martinovic, Tamara; Kravic-Stevovic, Tamara; Bumbasirevic, Vladimir [Institute of Histology and Embryology, School of Medicine, University of Belgrade, Belgrade (Serbia); Trajkovic, Vladimir, E-mail: vtrajkovic@med.bg.ac.rs [Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr. Subotica 1, 11000 Belgrade (Serbia); Harhaji-Trajkovic, Ljubica, E-mail: buajk@yahoo.com [Institute for Biological Research, University of Belgrade, Belgrade, Despot Stefan Blvd. 142, 11000 Belgrade (Serbia)

    2014-08-01

    We investigated if the antileukemic drug idarubicin induces autophagy, a process of programmed cellular self-digestion, in leukemic cell lines and primary leukemic cells. Transmission electron microscopy and acridine orange staining demonstrated the presence of autophagic vesicles and intracellular acidification, respectively, in idarubicin-treated REH leukemic cell line. Idarubicin increased punctuation/aggregation of microtubule-associated light chain 3B (LC3B), enhanced the conversion of LC3B-I to autophagosome-associated LC3B-II in the presence of proteolysis inhibitors, and promoted the degradation of the selective autophagic target p62, thus indicating the increase in autophagic flux. Idarubicin inhibited the phosphorylation of the main autophagy repressor mammalian target of rapamycin (mTOR) and its downstream target p70S6 kinase. The treatment with the mTOR activator leucine prevented idarubicin-mediated autophagy induction. Idarubicin-induced mTOR repression was associated with the activation of the mTOR inhibitor AMP-activated protein kinase and down-regulation of the mTOR activator Akt. The suppression of autophagy by pharmacological inhibitors or LC3B and beclin-1 genetic knockdown rescued REH cells from idarubicin-mediated oxidative stress, mitochondrial depolarization, caspase activation and apoptotic DNA fragmentation. Idarubicin also caused mTOR inhibition and cytotoxic autophagy in K562 leukemic cell line and leukocytes from chronic myeloid leukemia patients, but not healthy controls. By demonstrating mTOR-dependent cytotoxic autophagy in idarubicin-treated leukemic cells, our results warrant caution when considering combining idarubicin with autophagy inhibitors in leukemia therapy. - Highlights: • Idarubicin induces autophagy in leukemic cell lines and primary leukemic cells. • Idarubicin induces autophagy by inhibiting mTOR in leukemic cells. • mTOR suppression by idarubicin is associated with AMPK activation and Akt blockade.

  20. [2 cases of acute disseminated intravascular coagulation in normal pregnancy and as the first symptom of acute promyelocytic leukemia].

    Science.gov (United States)

    Kardaszewicz, E; Bujak, M; Spychałowicz, W; Siudyka, A; Harbut-Gryłka, A

    Two cases of the acute disseminated intravascular coagulation (DIC) are presented. DIC in the first case was diagnosed in healthy pregnant woman without any obstetric pathology. This patient recovered completely. The acute DIC in another patient preceded the acute promyelocytic leukemia. The patient died despite a control of DIC. DIC therapy included antifibrinolytic agents and additionally corticoids in pregnant patient. Heparin was not administered because of post partum period and foreseen cytostatic therapy in the leukemic patient.