WorldWideScience

Sample records for ampulla of vater

  1. Carcinoid of ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Tankshali Rajen

    2007-01-01

    Full Text Available Carcinoid tumors of ampulla are rare clinical entities. They form 0.35% of all the gastrointestinal carcinoids. So far, only 109 cases have been reported in the literature, mostly as individual case reports. Since the metastatic potential and the tumor size have no correlation, unlike in duodenal carcinoids, pancreatoduodenectomy is considered the treatment of choice. Here we present a case of carcinoid of ampulla presenting to our department.

  2. Large cell neuroendocrine carcinoma of the ampulla of Vater.

    LENUS (Irish Health Repository)

    Beggs, Rachel E

    2012-09-01

    Large cell neuroendocrine carcinomas of the ampulla of Vater are rare and confer a very poor prognosis despite aggressive therapy. There are few case reports of large cell neuroendocrine carcinomas of the ampulla of Vater in the literature and to date no studies have been done to establish optimal management. We describe a pooled case series from published reports of neuroendocrine carcinomas of the ampulla of Vater including a case which presented to our institution.

  3. Synchronous Carcinoma of the Ampulla of Vater and Colon Cancer

    OpenAIRE

    Karayiannakis, Anastasios J.; Kakolyris, Stylianos; Kouklakis, Georgios; Xenidis, Nikolaos; Bolanaki, Helen; Tsalikidis, Christos; Simopoulos, Constantinos

    2011-01-01

    Carcinoma of the papilla of Vater is a relatively rare tumor and its coexistence with other primary sporadic cancers is very exceptional. Here we report the case of a 76-year-old man who presented with painless obstructive jaundice, pathologically elevated liver function tests and increased serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen. Endoscopic retrograde cholangiography revealed a large polypoid mass in the ampulla of Vater. A large tumor in the ascending colon wa...

  4. Carcinoma of ampulla of vater : emphasis on the CT technique

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyun Seouk; Byun, Jae Young; Jung, So Lyung; Kim, Euy Neyng; Lee, Jae Moon; Shinn, Kyung Sub [Catholic Univ. Medical College, Seoul (Korea, Republic of)

    1997-06-01

    To demonstrate a CT technique by which carcinoma of the ampulla of Vater can be more accurately diagnosed, and to describe the radiologic findings of this carcinoma. We retrospectively reviewed CT findings in 26 patients with pathologically proven carcinoma of the ampulla of Vater. One additional cup of diluted oral contrast medium was ingested immediately before the scan. We analysed the difference in detection rate of the mass in the duodenal lumen with and without duodenal luminal opacification of gastrografin. We also evaluated the size and shape of the mass, dilatation of CBD and the pancreatic duct, and 1ymph node metastasis. In addition, we analyzed multimodality imaging findings(ultrasonogram(US):13;hypotonic duodenogram(HTDG):7;ERCP:17) of carcinoma of the ampulla of Vater. Nodular soft tissue masses protruding into the duodenal lumen were identified in 21 of 26 cases. In 95% of cases (21/22) with favorable opacification and distension of the duodenum, masses were clearly identified on CT imaging. However, in four cases with poor opacification and distension of the duodenum, masses could not be observed(P=0.000). The mass on CT scan showed a well-defined margin, round or lobulated contour, and contrast enhancement simiar to that of the pancreas. CBD dilatation was identified in 20 cases and pancreatic duct dilatation in 12. On US, protruding masses in the distal CBD were observed in nine of 13 cases(60%) and on HTDG, in six of seven cases(86%) as well-defined filling defects. Since the accuracy of CT diagnosis of intestinal lesions is directly proportional to the degree of intestinal distension and opacification with oral contrast, we believe that adequate CT technique for distending and opacitying the duodenal lumen are necessary for early diagnosis of carcinoma of the ampulla of Vater.

  5. Carcinoma of ampulla of vater : emphasis on the CT technique

    International Nuclear Information System (INIS)

    To demonstrate a CT technique by which carcinoma of the ampulla of Vater can be more accurately diagnosed, and to describe the radiologic findings of this carcinoma. We retrospectively reviewed CT findings in 26 patients with pathologically proven carcinoma of the ampulla of Vater. One additional cup of diluted oral contrast medium was ingested immediately before the scan. We analysed the difference in detection rate of the mass in the duodenal lumen with and without duodenal luminal opacification of gastrografin. We also evaluated the size and shape of the mass, dilatation of CBD and the pancreatic duct, and 1ymph node metastasis. In addition, we analyzed multimodality imaging findings(ultrasonogram(US):13;hypotonic duodenogram(HTDG):7;ERCP:17) of carcinoma of the ampulla of Vater. Nodular soft tissue masses protruding into the duodenal lumen were identified in 21 of 26 cases. In 95% of cases (21/22) with favorable opacification and distension of the duodenum, masses were clearly identified on CT imaging. However, in four cases with poor opacification and distension of the duodenum, masses could not be observed(P=0.000). The mass on CT scan showed a well-defined margin, round or lobulated contour, and contrast enhancement simiar to that of the pancreas. CBD dilatation was identified in 20 cases and pancreatic duct dilatation in 12. On US, protruding masses in the distal CBD were observed in nine of 13 cases(60%) and on HTDG, in six of seven cases(86%) as well-defined filling defects. Since the accuracy of CT diagnosis of intestinal lesions is directly proportional to the degree of intestinal distension and opacification with oral contrast, we believe that adequate CT technique for distending and opacitying the duodenal lumen are necessary for early diagnosis of carcinoma of the ampulla of Vater

  6. Vater's ampulla adenocarcinoma. A propos of a case

    International Nuclear Information System (INIS)

    99 % of the Vater's ampulla malignant tumours are carcinomas. They are infrequent and of difficult diagnosis, because there is a concurrence in the area of pancreatic diseases, of the distal third of the common bile duct, of the pancreatic duct and the adjacent duodenal mucosa diseases. The term ampullar carcinoma refers not only to a topographic location but also to their histological origin; because it implies that it derives from the intestinal mucosa that coats the region. We deal with a case diagnosed at the Teaching Military Hospital Dr. Mario Munnoz Monroy, of Matanzas, assisting the hospital with an icteric syndrome. After making an endoscopic retrograde cholangiography with biopsy, ultrasound and abdominal tomography, we arrived to the diagnosis of a Vater's ampulla mucoproductor adenocarcinoma. The patient received a radical surgery with successful results

  7. Brunner′s gland hyperplasia at the ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Janes SE

    2006-01-01

    Full Text Available Brunner′s gland hyperplasia (BGH is a diagnostic challenge where in the pathophysiology and natural history remain poorly understood. This Case Report describes BGH arising at the ampulla of Vater, causing abdominal pain and vomiting in a 46-year-old man. Owing to the inconclusive nature of imaging studies and suspicious intraoperative findings, a Whipple resection was performed without any complications. Histological analysis showed that the obstructing lesion was BGH, with no evidence of malignancy. This is only the second such case of its kind at the ampulla of Vater to be reported. In addition, we present the previously unreported endoscopic ultrasound findings. The subsequent literature review focuses on the pathophysiology, clinical presentation, diagnosis, and management of BGH.

  8. Radiologic Reevaluation of the ampulla of Vater cancer

    International Nuclear Information System (INIS)

    To evaluate the radiographic characteristics of the ampulla of Vater cancer. The authors analyzed retrospectively the US(n=25) and CT(n=15) findings in 25 cases of ampulla of Vater cancer, with emphasis on the potential of CT and US in regard to the detectability of the mass. ERCP(n=15) and hypotonic duodenography(n=5) were also evaluated for the configuration of obstructed duct. The tumor was detected on sonography in only 12 cases(48%) as a small, relatively well delineated mass with slightly low echogenicity to the pancreas. The tumor was shown by CT in 8 cases(53%) as a well delineated mass protruding into the second portion of duodenal lumen with slightly low attenuation to the pancreas. CBD was dilated in 25 cases(100%), but pancreatic duct was dilated in 15 cases(60%). Obstructed end of CBD was nipple shaped in 7 cases(47%), clubbed in 3, flat in 3, and indistrict in 2 by ERCP. Hypotonic duodenogram showed irregular filling defect in the medial wall of second portion of the duodenum in 5 cases(100%). Mass detection rate cursing US or CT were not high in ampulla of Vater cancer. Except for a CT finding of small mass protruding into the regional duodenal lumen, other findings were nonspecific. Therefore, additional studies or more aggressive approach should be attempted for a correct diagnosis

  9. Primary Squamous Cell Carcinoma of the Ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Helen Bolanaki

    2014-01-01

    Full Text Available Context Squamous carcinoma of the ampulla of Vater is a very rare tumor with only three cases been reported so far. Case report Here, we report the case of a 68-year-old man who presented with painless obstructive jaundice, general fatigue, loss of appetite and weight loss. Laboratory tests revealed hypochromic anemia. Total and direct bilirubin, alkaline phosphatase, liver enzymes, carbohydrate antigen 19-9 (CA 19-9 and carcinoembryonic antigen (CEA were all elevated. Abdominal ultrasonography and computed tomography showed a distended gallbladder, dilatation of the intra- and extra-hepatic bile ducts and enlargement of the pancreatic head. Endoscopic retrograde cholangiopancreatography revealed a bulging papilla with infiltrative growth at the ampulla of Vater but endoscopic biopsies were inconclusive. The patient was treated with classical Whipple’s pancreaticoduodenectomy. Histopathological examination showed a moderately differentiated squamous cell carcinoma. Multiple serial sectioning of the tumor specimen failed to detect an adenomatous component. Regional lymph nodes and resection margins were free of tumor and the disease was classified as stage IIA (T3N0M0 according to the TNM system. Adjuvant treatment was not given. Despite curative resection, multiple liver metastases developed after four months and the patient succumbed to progressive hepatic failure 5 months after the operation. Conclusion Primary pure squamous cell carcinoma of the ampulla of Vater is a very rare histological type of carcinoma. Clinical characteristics and optimal treatment are obscure. Primary surgical treatment with curative intent should be performed although this type of carcinoma associates with dismal prognosis.

  10. Role of Adjuvant Chemoradiotherapy for Ampulla of Vater Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the role of adjuvant chemoradiotherapy for ampulla of Vater cancer. Methods and Materials: Between January 1991 and December 2002, 118 patients with ampulla of Vater cancer underwent en bloc resection. Forty-one patients received adjuvant chemoradiotherapy [RT(+) group], and 77 did not [RT(-) group]. Postoperative radiotherapy was delivered to the tumor bed and regional lymph nodes, for a total dose of up to 40 Gy delivered in 2-Gy fractions, with a planned 2-week rest period halfway through the treatment period. Intravenous 5-fluorouracil (500 mg/m2/day) was given on Days 1 to 3 of each split course. The median follow-up was 65 months. Results: The 5-year overall survival rate in the RT(-) and RT(+) groups was 66.9% and 52.8%, respectively (p = 0.2225). The 5-year locoregional relapse-free survival rate in the RT(-) and RT(+) groups was 79.9% and 80.2%, respectively (p = 0.9582). When age, type of operation, T stage, N stage, histologic differentiation, and the use of adjuvant chemoradiotherapy were incorporated into the Cox proportional hazard model, there was an improvement in the locoregional relapse-free survival rate (p = 0.0050) and a trend toward a longer overall survival (p = 0.0762) associated with the use of adjuvant chemoradiotherapy. Improved overall survival (p = 0.0235) and locoregional relapse-free survival (p = 0.0095) were also evident in patients with nodal metastasis. In contrast, enhanced locoregional control (p = 0.0319) did not result in longer survival in patients with locally advanced disease (p = 0.4544). Conclusions: Adjuvant chemoradiotherapy may enhance locoregional control and overall survival in patients with ampulla of Vater cancer after curative resection, especially in those with nodal involvement.

  11. Prognostic Factors of Ampulla of Vater Carcinoma after Radical Surgery

    Institute of Scientific and Technical Information of China (English)

    Dongbing Zhao; Yongkai Wu; Yi Shan; Chengfeng Wang; Ping Zhao

    2009-01-01

    OBJECTIVE Ampullary carcinoma is a rare disease with better prognosis than other periampullary neoplasms.This study investigated the association between clinicopathologiC factors and prognosis after radical resection of ampulla of Vater carcinoma.METHODS Clinical data from 105 patients who underwent radical pancreaticoduodenectomy from January 1990 to December 2005 were retrospectively analyzed by the Kaplan-Meier method,log-rank test,and the Cox proportional hazard model.RESULTS The in-hospital mortalitv rate was 8.6%,the lymph node metastasis rate was 37.1%,and the five-year survival rate was 42.8%.Pancreatic involvement(P=0.027),tumor diameter(P =0.008),T stage(P=0.003),TNM stage(P<0.001),and number of metastatic lymph nodes(P<0.001)were associated with prognosis when the univariate analysis was used.Multivariate analysis showed that the number of lymph node metastases (P<0.001;OR:1.923;CI:1.367-2.705)and tumot diameter(P=0.03;OR:1.432;CI:1.035-1.981) were the independent prognostic factors.CONCLUSION The number of metastatic lymph nodes and tumor diameter are important pathologic factors predicting prognosis of ampulla of Vater carcinoma after radical resection,and lymph node dissection during the radical surgery effectively improves the survival rate.

  12. Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature

    OpenAIRE

    Dalma Udovčić Gagula; Faruk Skenderi; Srđan Gornjaković; Nermina Ibišević; Adisa Chikha; Semir Vranić; Aleksandra Ðuran

    2013-01-01

    Metastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma prese...

  13. A Carcinoid Tumor of the Ampulla of Vater Treated by Endoscopic Snare Papillectomy

    OpenAIRE

    Pyun, Dae-Keun; Moon, Gyoo; Han, Jimin; Kim, Myung-Hwan; Lee, Sang Soo; Seo, Dong-Wan; Lee, Sung-Koo

    2004-01-01

    Here, a case of a patient with incidental finding of a carcinoid tumor of the ampulla of Vater, who was treated with endoscopic snare papillectomy, is reported. A 62-year-old male was admitted to our hospital due to a carcinoid tumor of the ampulla of Vater, which was found during follow-up endoscopy after an endoscopic mucosal resection of early gastric cancer. No lymphadenopathy or visceral metastasis was found on an abdominal CT scan, In-111 octerotide scan and EUS. The ampulla was then en...

  14. Carcinoma of the ampulla and papilla of Vater

    Energy Technology Data Exchange (ETDEWEB)

    Nix, G.A.J.J.; Wilson, J.H.P.; Schmitz, P.I.M.; Dees, J.; Hofwijk, R.

    1983-05-01

    We reviewed 30 patients with a carcinoma of the ampulla and papilla of Vater. The first symptoms were weight loss, sudden onset of diabetes mellitus, loss of appetite, tiredness, and upper abdominal discomfort or pain. Jaundice and fever were found to be late symptoms. The mean delay between the onset of complaints and diagnosis was 2 1/2 months. The diamter of the tumour varied from 4 to 35 millimetres. Seven patients had a tumour diameter of less than 9 millimetres. Extension of the tumour in the duodenum was never seen with tumours less than 8 millimetres in diameter. Extension of the tumour into the pancreas and metastases in the peripancreatic lymph nodes were only found with tumours with a diameter greater than 15 millimetres. The mean delay between onset of symptoms and operation was 3 months. At 52 months 79% of the patients younger than 64 years were still alive, while the survival rate of the patients of 65 years and older was 11%. Also at 52 months 58% of patients with a tumour size less than 2 centimetres were still alive, while the survival rate of the patients with a tumour larger than 2 centimetres was 31%.

  15. [Tumors of Vater's ampulla. Review of 25 cases].

    Science.gov (United States)

    Benito Ruiz, J; Del Pino Porres, J; Herrero Bernabéu, C

    1989-08-01

    Cancer of ampulla of Vater is a infrequent tumor which was a much better prognosis after radical treatment than cancer of the pancreas. In this paper, 25 patients were studied, with a mean age of 59 years and a slight male predominance. The most frequent symptoms were related to jaundice and weight loss. The correct preoperative diagnosis was only reached in 54.16% of the patients, endoscopic retrograde cholangiopancreatography being the best diagnostic method, together with ?CTPH. We emphasize the difficulty of reaching a diagnosis and the variable results of both pre- and peroperative biopsy. The results of surgical treatment (9 Whipple operations, 7 ampullectomies and 7 bypass operations) are evaluated, showing that duodenopancreatectomy is the most effective therapy, although we had only one 5-year survival, 11.1% versus 0% for ampullectomy, which is an operation that carriers an elevated recurrence rate (greater than 50%). The mortality derived from Whipple's operation was 22.2%, and from local excision, 14.3%. The rate of complications was 55.5% after cephalic duodenopancreatectomy and null after ampullectomy. In view of these results, we think that the most appropriate therapeutic approach to ampulloma is the Whipple operation, and that ampullectomy should be reserved for those patients in poor general condition with small tumors, and that bypass operations should be used when the tumor is not resectable. PMID:2682830

  16. Coexistence of small cell neuroendocrine carcinoma and villous adenoma in the ampulla of Vater

    Institute of Scientific and Technical Information of China (English)

    Ji-Hong Sun; Ming Chao; Shi-Zheng Zhang; Guang-Qiang Zhang; Bin Li; Jian-Jun Wu

    2008-01-01

    Small cell neuroendocrine carcinoma of the ampulla of Vater is extremely rare and different from the common ampullary adenocarcinoma. The ampullary adenoma is also a rare neoplasm and has the potential to develop an adenocarcinoma. Their coexistence has been rarely reported in the literature. We herein describe an unusual case of a small cell neuroendocrine carcinoma associated with a villous adenoma in the ampulla of Vater with emphasis on computed tomography (CT)and histopathological findings. We also discuss their clinical, histopathological and radiological features as well as possible histogenesis.

  17. Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature

    Directory of Open Access Journals (Sweden)

    Dalma Udovčić Gagula

    2013-09-01

    Full Text Available Metastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma presented as an isolated metastasis to the ampulla of Vater, two years after the initial diagnosis. While the squamous cell carcinoma could occur as primary ampullary carcinoma, albeit very rare, it is necessary to exclude the possibility of metastatic cancer.

  18. Imaging findings of signet ring cell carcinoma of the ampulla of vater: A case of report

    International Nuclear Information System (INIS)

    Most malignant tumors affecting the ampulla of Vater (AoV) are adenocarcinomas, and signet ring cell carcinoma (SRCC) of the AoV is rare. We report a case of SRCC of the AoV in a 41-year-old man who presented with a small tumor in the AoV, which was discovered by multiple imaging modalities. Since most of the previously reported articles have been published in the clinical pathology literature, we mainly described the imaging features

  19. Imaging findings of signet ring cell carcinoma of the ampulla of vater: A case of report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Chul; Jung, Yoon Young; You, Myung Won; Kim, Dong Hee; Lee, Won Mee; Choi, Yun Sun [Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    Most malignant tumors affecting the ampulla of Vater (AoV) are adenocarcinomas, and signet ring cell carcinoma (SRCC) of the AoV is rare. We report a case of SRCC of the AoV in a 41-year-old man who presented with a small tumor in the AoV, which was discovered by multiple imaging modalities. Since most of the previously reported articles have been published in the clinical pathology literature, we mainly described the imaging features.

  20. Tumors of ampulla of Vater: A case series and review of chemotherapy options

    OpenAIRE

    2012-01-01

    Carcinomas of the Ampulla of Vater are rare tumors, accounting for 0.2% of gastrointestinal cancers. Compared with other biliary tract neoplasms, these tumors have a relatively favorable prognosis after surgical resection. Based on their epithelium of origin, two subtypes of ampullary carcinoma have been recently distinguished: intestinal and pancreatobiliary. This study evaluates histopathological features and outcomes of ampullary carcinoma and to compares the survival of these tumors to th...

  1. Adenomyomatous hyperplasia of the ampulla of Vater presenting as acute pancreatitis

    OpenAIRE

    Rafiullah,; Tanimu, Sabo

    2014-01-01

    We report an interesting and rare case of a man with adenomyomatous hyperplasia of the ampulla of Vater presenting as acute pancreatitis, which to our knowledge, is only the second reported case in the English literature. The patient presented with an acute onset of abdominal pain, nausea and vomiting, without fever, chills or rigours. CT of the abdomen revealed changes of acute pancreatitis with a peripancreatic adenopathy, and abdominal ultrasound revealed a slightly hyperechoic and oedemat...

  2. Neoplasia of the ampulla of Vater. Ki-ras and p53 mutations.

    OpenAIRE

    Scarpa, A.; Capelli, P.; Zamboni, G; Oda, T.; Mukai, K.; Bonetti, F; Martignoni, G; Iacono, C.; Serio, G; Hirohashi, S

    1993-01-01

    Eleven tumors of the ampulla of Vater (5 stage IV and 2 stage II adenocarcinomas, 1 stage II papillary carcinoma, 1 neuroendocrine carcinoma, and 2 adenomas, one with foci of carcinoma) were examined for Ki-ras and p53 gene mutations by single-strand conformation polymorphism analysis and direct sequencing of polymerase chain reaction-amplified DNA fragments. Ki-ras mutations were found in one adenocarcinoma and in the adenoma with foci of carcinoma, both involving mainly the intraduodenal bi...

  3. Contribution of the new imaging techniques in the diagnosis of tumors of the ampulla of Vater

    International Nuclear Information System (INIS)

    The tumor of the ampulla of Vater is a rare, malignant tumor of the biliopancreaticoduodenal confluent. It deserves being distinguished from the much more frequent lesions of the head of the pancreas because of its early, often symptomatic, rarely typical clinical expression and its prognosis, which is much more favorable than that of pancreatic adenocarcinomas when a correct diagnosis allows curative surgical treatment (DPC). The contribution of combined ultrasound and CT to the diagnosis is essential, as they quickly orient the investigation for histological evidence by fiberendoscopic (CPRE) or intraoperative radiological means (puncture guided by ultrasound or CT) and allow the assessment of tumoral extension

  4. Cancer of the ampulla of Vater: chromosome 17p allelic loss is associated with poor prognosis

    OpenAIRE

    Scarpa, A.; Di, P; Talamini, G; Falconi, M; Lemoine, N; Iacono, C.; Achille, A.; Baron, A; Zamboni, G

    2000-01-01

    BACKGROUND—Cancer of the ampulla of Vater kills 60% of affected patients. Local spread of the tumour (T stage) is the only reliable prognostic factor. Nevertheless, any cancer stage includes long term survivors and patients dying from the disease. The molecular anomalies involved in this process have the potential to serve as additional prognostic markers.
AIM—To evaluate if allelic losses (LOH) of chromosomes 17p and 18q may be of prognostic value in multivariate survival analysis.
METHODS—W...

  5. KL-6 mucin expression in carcinoma of the ampulla of Vater: Association with cancer progression

    Institute of Scientific and Technical Information of China (English)

    Wei Tang; Masatoshi Makuuchi; Yoshinori Inagaki; Norihiro Kokudo; Qian Guo; Yasuji Seyama; Munehiro Nakata; Hiroshi Imamura; Keiji Sano; Yasuhiko Sugawara

    2005-01-01

    AIM: To assess histochemical expression of KL-6 and its clinicopathological significance in carcinoma of the ampulla of Vater.METHODS: Ampullary carcinoma tissues were collected from 38 patients who underwent pancreatoduodenectomy or local resection. Tissues were subjected to immunohistochemical analysis using KL-6 antibody.RESULTS: Positive staining of ampullary carcinoma cells was observed in 26 (68.4%) cases. Staining was not found in the surrounding non-cancer regions of the ampullary tissues. Remarkable KL-6 expression was observed in invasive carcinoma cells in pancreatic and duodenal tissues and in metastatic carcinoma cells in lymph nodes. Positive KL-6 expression was related to lymph node metastasis (P = 0.020), pancreatic invasion (P = 0.016), duodenal invasion (P = 0.034), and advanced stage of TNM clinical classification (P = 0.010). Survival analysis showed that positive expression of KL-6 was related to a poorer prognosis (P = 0.029).CONCLUSION: The aberrant expression of KL-6 mucin is significantly related to unfavorable behaviors of carcinoma of the ampulla of Vater.

  6. Adenoma viloso com transformação carcinomatosa da ampola de Vater Villous adenoma with carcinomatous degeneration of the ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Guilherme Pinto Bravo Neto

    2001-02-01

    Full Text Available Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

  7. Poorly-Differentiated Signet-Ring Cell Carcinoma of the Ampulla of Vater: Report of a Rare Malignancy

    Directory of Open Access Journals (Sweden)

    Metesh Nalin Acharya

    2013-03-01

    Full Text Available Context Signet-ring cell carcinoma (SRCC of the ampulla of Vater is a very rare clinical entity, which is infrequently reported in medical literature. Case report A 78-year-old woman was admitted with jaundice, pruritus and postprandial vomiting. Abdominal ultrasound and computed tomography scanning demonstrated gross dilatation of the common bile and pancreatic ducts with gallbladder calculi. Endoscopic retrograde cholangiopancreatography suggested a duodenal tumour at the ampulla. The patient underwent Whipple’s procedure with cholecystectomy. Immunohistopathological examination confirmed poorly-differentiated SRCC of the ampulla of Vater. The tumour had infiltrated the duodenal muscularis propria and pancreatic parenchyma, but local lymph nodes were clear (T3N0M0. The patient was disease-free at 6-month follow-up. Conclusions We here report a case of poorly-differentiated SRCC of the Ampulla of Vater. The majority of patients with such tumours undergo pancreaticoduodenectomy, which affords good outcomes in early disease. However, owing to the rarity of cases, the exact prognosis of ampullary SRCC remains as yet undetermined.

  8. Local excision as a treatment for tumors of ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Kanellos Ioannis

    2006-03-01

    Full Text Available Abstract Background Although local excision (ampullectomy was first described by Halsted in 1899, its adequacy as an alternative surgical treatment for the ampullary tumors is still a matter of debate. The aim of this study was to evaluate the results of ampullectomy as a curative treatment for benign and malignant tumors arising from the ampulla, in a 14-year single-institution experience. Methods From 1990 to 2004, a total of 20 patients of adenocarcinoma (12 or adenoma (8 of the ampulla of Vater underwent local excision. Clinical data were collected and morbidity, mortality, as well as long-term survival were evaluated. The usefulness of several pre or intraoperative diagnostic methods was also recorded. Median follow-up was 85 (range 6–180 months. Results The combination of endoscopic preoperative biopsies and intraoperative frozen section examination adequately diagnosed ampullary tumors in all cases. The postoperative morbidity and mortality were 0%, whereas the 3 and 5-year survival rates for the patients with adenocarcinoma was 75 % and 33.3 % respectively. All the patients with adenoma are still alive without any sign of recurrence. Conclusion In our series, local excision was a safe option, associated with satisfactory long-term survival rates in patients with benign lesions and in those with small(

  9. Signet ring cell carcinoma of the ampulla of vater: Report of a case and a review of the literature

    OpenAIRE

    Masaki Wakasugi; Masahiro Tanemura; Kenta Furukawa; Maiko Murata; Masanori Miyazaki; Masahide Oshita; Ken-ichi Yoshida; Hironao Yasuoka; Hiroki Akamatsu

    2015-01-01

    Introduction: Signet ring cell carcinoma (SRCC) of the ampulla of vater is a very rare tumor that is reported infrequently in the literature. Presentation of case: A 59-year-old woman visited our hospital for evaluation of elevated transaminase levels. On laboratory examination of tumor marker levels, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19–9 levels were normal, and DUPAN-2 was elevated. Computed tomography (CT) confirmed a 2 cm, enhanced mass in the periampullary r...

  10. Metachronous Ampulla of Vater Carcinoma after Curative-Intent Surgery for Klatskin Tumor.

    Science.gov (United States)

    Chirita, D; Calita, M; Grasu, M; Dumitru, R; Gramaticu, I; Croitoru, A; Ionescu, M; Dumitrascu, T

    2015-01-01

    Resection represents the single hope for long-term survival in a patient diagnosed with a hilar cholangiocarcinoma (Klatskin tumor). However, the largest part of these patients develops a recurrent disease. Second metachronous periampullary cancers after a curative-intent surgery for a Klatskin tumor represent an exceptional pathology, and the management of these patients was poorly documented. Hereby, it is presented a 32-year-old patient with bile duct resection, left hemi-hepatectomy and loco-regional lymph nodes dissection, for a type IIIB Bismuth-Corlette Klatskin tumor, which, furthermore, 6 years later, underwent a pancreaticoduodenectomy for a metachronous carcinoma of the ampulla of Vater. The management and outcomes were discussed in the reported case, along with a literature review of the previously published patients. In conclusion, a metachronous periampullary carcinoma after resection of a Klatskin tumor should be distinguished from a loco-regional recurrent disease. While most of the patients with recurrences are suitable to only chemotherapy and or radiotherapy, a second curative-intent surgery (i.e., pancreaticoduodenectomy) is feasible in the largest part of the patients with a metachronous cancer, with good long-term outcomes. PMID:26305204

  11. Human equilibrative nucleoside transporter 1 and carcinoma of the ampulla of Vater: expression differences in tumour histotypes

    OpenAIRE

    Perrone, G.; Morini, S; Santini, D; Rabitti, C; Vincenzi, B; R. Alloni; Antinori, A.; Magistrelli, P; Lai, R.; Cass, C; Mackey, J R; Coppola, R.; Tonini, G; Onetti Muda, A.

    2010-01-01

    The human equilibrative nucleoside transporter 1 (hENT1) is the major means by which gemcitabine enters human cells; recent evidence exists that hENT1 is expressed in carcinoma of the ampulla of Vater and that it should be considered as a molecular prognostic marker for patients with resected ampullary cancer. Aim of the present study is to evaluate the variations of hENT1 expression in ampullary carcinomas and to correlate such variations with histological subtypes and clinicopathological pa...

  12. Neuroendocrine Tumors of the Ampulla of Vater: Presentation, Pathology and Prognosis

    OpenAIRE

    Mayank Jayant; Robin Kaushik; Rajeev Sharma; Ashok Attri; Rajpal Punia; Atul Sachdev; Nikhil K Nadkarni

    2012-01-01

    Context Neuroendocrine tumors of the pancreatic ampulla are uncommon. The final diagnosis is based on histology, and at times, it may be difficult to diagnose them pre-operatively since they present with a similar clinical picture to adenocarcinomas of this region. Objective To identify neuroendocrine tumors of the ampulla, as well as their presentation and management. Design A retrospective review of patients treated at a tertiary care institute was performed over a six-year period from 2005...

  13. Neuroendocrine Tumors of the Ampulla of Vater: Presentation, Pathology and Prognosis

    Directory of Open Access Journals (Sweden)

    Mayank Jayant

    2012-05-01

    Full Text Available Context Neuroendocrine tumors of the pancreatic ampulla are uncommon. The final diagnosis is based on histology, and at times, it may be difficult to diagnose them pre-operatively since they present with a similar clinical picture to adenocarcinomas of this region. Objective To identify neuroendocrine tumors of the ampulla, as well as their presentation and management. Design A retrospective review of patients treated at a tertiary care institute was performed over a six-year period from 2005 to 2010. Patients Cases with periampullary cancers were investigated. Main outcome measures The case records were scrutinised for the clinical presentation, management and outcomes. Results A total of 4 cases (7.7% of neuroendocrine tumors of the ampulla were identified from 52 patients with periampullary lesions, at a mean age of presentation of 49 years. The common mode of presentation was progressive jaundice (3 of 4 patients; pancreaticoduodenectomy was performed in 3 patients. One patient underwent palliative endoscopic stenting for metastatic disease. On histopathology, 2 of the patients had poorly differentiated (neuroendocrine carcinoma (highgrade, and 2 had well differentiated (neuroendocrine carcinoma (1 low grade and 1 intermediate. All the tumors stained positively with chromogranin A. The patients who underwent pancreaticoduodenectomy are on regular follow-up and remain free of disease. Conclusions Neuroendocrine tumors of the ampulla are distinct entities presenting clinically with jaundice. They stain positive with chromogranin A on histopathology. Pancreaticoduodenectomy should be performed as it is associated with good outcome.

  14. MEK inhibitor treatment is effective in a patient with metastatic carcinoma of the ampulla of Vater with BRAF and NRAS mutations shown by next-generation sequencing.

    Science.gov (United States)

    Tahover, Esther; Bar Shalom, Rachel; Bogot, Naama; Kelsen, David; Gabizon, Alberto

    2016-07-01

    Here, we present a case of an 84-year-old woman who developed obstructive jaundice and was diagnosed with nonoperable adenocarcinoma originating from the ampulla of Vater, a lethal disease with a median overall survival of less than a year. Her tumor was examined by next-generation sequencing, which showed BRAF and NRAS mutations. To target these mutations, a MEK inhibitor was chosen for treatment. The patient has been treated with a MEK inhibitor for the last 12 months since diagnosis, with clinical and laboratory improvement and manageable side effects. PET-computed tomography imaging has shown stable disease or improvement in the primary and metastatic lesions. This is the first case report of an ampulla of a Vater cancer patient with NRAS and BRAF mutations, identified in next-generation sequencing, and treated successfully with a MEK inhibitor. PMID:27075779

  15. Human equilibrative nucleoside transporter 1 and carcinoma of the ampulla of Vater: expression differences in tumour histotypes

    Directory of Open Access Journals (Sweden)

    G. Perrone

    2010-09-01

    Full Text Available The human equilibrative nucleoside transporter 1 (hENT1 is the major means by which gemcitabine enters human cells; recent evidence exists that hENT1 is expressed in carcinoma of the ampulla of Vater and that it should be considered as a molecular prognostic marker for patients with resected ampullary cancer. Aim of the present study is to evaluate the variations of hENT1 expression in ampullary carcinomas and to correlate such variations with histological subtypes and clinicopathological parameters. Forty-one ampullary carcinomas were histologically classified into intestinal, pancreaticobiliary and unusual types. hENT1 and Ki67 expression were evaluated by immunohistochemistry, and apoptotic cells were identified by the terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labelling (TUNEL method. hENT1 overexpression was detected in 63.4% ampullary carcinomas. A significant difference in terms of hENT1 and Ki67 expression was found between intestinal vs. pancreaticobiliary types (P=0.03 and P=0.009 respectively. Moreover, a significant statistical positive correlation was found between apoptotic and proliferative Index (P=0.036, while no significant correlation was found between hENT1 and apoptosis. Our results on hENT1 expression suggest that classification of ampullary carcinoma by morphological subtypes may represent an additional tool in prospective clinical trials aimed at examining treatment efficacy; in addition, data obtained from Ki67 and TUNEL suggest a key role of hENT1 in tumour growth of ampullary carcinoma.

  16. Transduodenal ampullectomy in the treatment of villous adenomas and adenocarcinomas of the Vater's ampulla Ampulectomía transduodenal en el tratamiento de los adenomas vellosos y adenocarcinomas de la ampolla de Vater

    Directory of Open Access Journals (Sweden)

    J. A. Fraguela Mariña

    2004-12-01

    Full Text Available Introduction: adenomas are the most frequent tumors of the Vater's ampulla. Their capacity for malignant transformation following the adenoma-carcinoma sequence is well known. It is because of this that resection after diagnosis is required. The identification of the appropriate technique according to tumor features would require that patients not be undertreated or overtreated, which would give rise to serious consequences derived from their location. Patients and methods: villous adenomas and adenocarcinomas of the Vater's ampulla candidates for local resection were revised from January 1st, 1998 through June 30th, 2003. We describe the methods of diagnosis and ampulectomy techniques we performed. Results: we performed an ampulectomy by first intention in all 8 patients included in this study. However, pancreatoduodenectomy was necessary in two patients because of the closeness of resection margins. We had no mortality in this series, and morbidity was limited to two episodes of digestive bleeding that were controlled by electrocoagulation and embolization. The mean follow-up was 28.5 months (range, 6-72 months. Conclusions: the difficulty of precise preoperatory diagnosis in adenomas of the Vater's ampulla demands resection after identification. Ampulectomy is the treatment of choice for villous adenomas and T1 adenocarcinomas, with 1 cm of resection margin to avoid local recurrence.Introducción: los tumores más frecuentes de la ampolla de Vater son los adenomas. Es conocida su capacidad de malignización mediante la secuencia adenoma-carcinoma, por lo que requieren su resección, tras su diagnóstico. El establecimiento de la técnica adecuada según las características del tumor permitiría no infratratar o sobretratar pacientes, con las graves consecuencias que se derivan de ello, debido a su localización. Pacientes y métodos: se revisan los adenomas vellosos y adenocarcinomas de ampolla de Vater subsidiarios de resección local desde

  17. Role of Adjuvant Chemoradiation Therapy in Adenocarcinomas of the Ampulla of Vater

    International Nuclear Information System (INIS)

    Purpose: The role of adjuvant chemoradiation therapy (CRT) in the treatment of ampullary cancers remains undefined. We retrospectively compared treatment outcomes in patients treated with pancreaticoduodenectomy alone versus those who received additional adjuvant CRT. Methods and Materials: Between May 1990 and January 2006, 54 of 96 patients with ampullary adenocarcinoma who underwent potentially curative pancreaticoduodenectomy also received adjuvant CRT. The median preoperative radiation dose was 45 Gy (range, 30-50.4 Gy) and median postoperative dose was 50.4 Gy (range, 45-55.8 Gy). Concurrent chemotherapy included primarily 5-fluorouracil (52%) and capecitabine (43%). Median follow-up was 31 months. Univariate and multivariate statistical methodologies were used to determine significant prognostic factors for local control (LC), distant control (DC), and overall survival (OS). Results: Actuarial 5-year LC, DC, and OS were 77%, 69%, and 64%, respectively. On univariate analysis, age, gender, race/ethnicity, tumor grade, use of adjuvant treatment, and sequencing of adjuvant therapy were not significantly associated with LC, DC, or OS. However, on univariate analysis, T3/T4 tumor stage was prognostic for poorer LC and OS (p = 0.02 and p < 0.001, respectively); node-positive disease was prognostic for poorer LC (p = 0.03). On multivariate analysis, T3/T4 tumor stage was independently prognostic for decreased OS (p = 0.002). Among these patients (n = 34), those who received adjuvant CRT had a trend toward improved OS (median, 35.2 vs. 16.5 months; p = 0.06). Conclusions: Ampullary cancers have a distinctly better treatment outcome than pancreatic adenocarcinomas. Higher primary tumor stage (T3/T4), an independent adverse risk factor for poorer treatment outcomes, may warrant the addition of adjuvant CRT to pancreaticoduodenectomy

  18. Villous Adenoma of Papilla of Vater

    OpenAIRE

    1990-01-01

    Biliary obstruction due to a benign villous adenoma of the ampulla of Vater treated by transduodenal local excision and sphincteroplasty is reported. Local surgical resection enabled a submucosal resection of the adenoma.

  19. A rare combination of an endocrine tumour of the common bile duct and a follicular lymphoma of the ampulla of Vater: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ryzman-Louloudis Charlotte

    2011-01-01

    Full Text Available Abstract Carcinoid tumours of the common bile duct represent an extremely rare entity. Similarly, primary follicular lymphomas of the ampulla of Vater constitute an infrequent neoplasia. Herein, we report the first case of a synchronous development of a carcinoid tumour of the common bile duct and an ampullary follicular lymphoma that was treated surgically with a Whipple's procedure, due to inability to establish definitive preoperative diagnosis despite the extensive diagnostic investigation.

  20. Analysis of Founder Mutations in Rare Tumors Associated With Hereditary Breast/Ovarian Cancer Reveals a Novel Association of BRCA2 Mutations with Ampulla of Vater Carcinomas.

    Science.gov (United States)

    Pinto, Pedro; Peixoto, Ana; Santos, Catarina; Rocha, Patrícia; Pinto, Carla; Pinheiro, Manuela; Leça, Luís; Martins, Ana Teresa; Ferreira, Verónica; Bartosch, Carla; Teixeira, Manuel R

    2016-01-01

    BRCA1 and BRCA2 mutations are responsible for hereditary breast and ovarian cancer, but they also confer an increased risk for the development of rarer cancers associated with this syndrome, namely, cancer of the pancreas, male breast, peritoneum, and fallopian tube. The objective of this work was to quantify the contribution of the founder mutations BRCA2 c.156_157insAlu and BRCA1 c.3331_3334del for cancer etiology in unselected hospital-based cohorts of Portuguese patients diagnosed with these rarer cancers, by using a strategy that included testing of archival tumor tissue. A total of 102 male breast, 68 pancreatic and 33 peritoneal/fallopian tube carcinoma cases were included in the study. The BRCA2 c.156_157insAlu mutation was observed with a frequency of 7.8% in male breast cancers, 3.0% in peritoneal/fallopian tube cancers, and 1.6% in pancreatic cancers, with estimated total contributions of germline BRCA2 mutations of 14.3%, 5.5%, and 2.8%, respectively. No carriers of the BRCA1 c.3331_3334del mutation were identified. During our study, a patient with an ampulla of Vater carcinoma was incidentally found to carry the BRCA2 c.156_157insAlu mutation, so we decided to test a consecutive series of additional 15 ampullary carcinomas for BRCA1/BRCA2 mutations using a combination of direct founder mutation testing and full gene analysis with next generation sequencing. BRCA2 mutations were observed with a frequency of 14.3% in ampulla of Vater carcinomas. In conclusion, taking into account the implications for both the individuals and their family members, we recommend that patients with these neoplasias should be offered BRCA1/BRCA2 genetic testing and we here show that it is feasible to test for founder mutations in archival tumor tissue. Furthermore, we identified for the first time a high frequency of germline BRCA2 mutations in ampullary cancers. PMID:27532258

  1. Mutational profiling of kinases in human tumours of pancreatic origin identifies candidate cancer genes in ductal and ampulla of vater carcinomas.

    Directory of Open Access Journals (Sweden)

    Vincenzo Corbo

    Full Text Available BACKGROUND: Protein kinases are key regulators of cellular processes (such as proliferation, apoptosis and invasion that are often deregulated in human cancers. Accordingly, kinase genes have been the first to be systematically analyzed in human tumors leading to the discovery that many oncogenes correspond to mutated kinases. In most cases the genetic alterations translate in constitutively active kinase proteins, which are amenable of therapeutic targeting. Tumours of the pancreas are aggressive neoplasms for which no effective therapeutic strategy is currently available. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a DNA-sequence analysis of a selected set of 35 kinase genes in a panel of 52 pancreatic exocrine neoplasms, including 36 pancreatic ductal adenocarcinoma, and 16 ampulla of Vater cancer. Among other changes we found somatic mutations in ATM, EGFR, EPHA3, EPHB2, and KIT, none of which was previously described in cancers. CONCLUSIONS/SIGNIFICANCE: Although the alterations identified require further experimental evaluation, the localization within defined protein domains indicates functional relevance for most of them. Some of the mutated genes, including the tyrosine kinases EPHA3 and EPHB2, are clearly amenable to pharmacological intervention and could represent novel therapeutic targets for these incurable cancers.

  2. [Ampulloma of Vater's papilla--case report].

    Science.gov (United States)

    Smejkal, P; Smejkal, M

    2002-01-01

    The authors discuss, based on a case-report, the diagnostic problems of malignities of the pancreas and ampulla of Vater. In the same patient they found an interesting complication after laparoscopic cholecystectomy (LCHE). It was a female patient who had LCHE four years previously where an ampulloma of the ampulla of Vater was diagnosed with invasion into the pancreas and a suspect secondary in the lower lobe of the right lung. On operation a pulmonary abscess was detected from a retained concrement. Duodenopancreatectomy which was performed did not reveal any tumour in the pancreatic area. PMID:11881293

  3. Signet ring cell carcinoma of the ampulla of vater: Report of a case and a review of the literature

    Directory of Open Access Journals (Sweden)

    Masaki Wakasugi

    2015-01-01

    Conclusion: Investigation to confirm the histological origin of SRCC by immunohistochemical staining might inform the treatment strategy and identify patients with ampullary SRCC who may have a good prognosis.

  4. Prognostic impact of immunohistochemical expression of CK7 and CK20 in curatively resected ampulla of Vater cancer

    OpenAIRE

    Yun, Sung Pil; Seo, Hyung Il

    2015-01-01

    Background In the consideration of ampullary adenocarcinoma, T stage, lymph node metastases, perineural invasion, tumor differentiation, pancraticobiliary type, and lymph node ratio are considered prognostic factors. The objectives of this study were to investigate surgical outcomes and the clinicopathological predictors affecting survival and recurrence, and to examine the prognostic roles of histopathological subtype and immunohistochemical markers. Methods From April 2006 to September 2012...

  5. Exceptional Response to Nanoparticle Albumin-Bound Paclitaxel and Gemcitabine in a Patient with a Refractory Adenocarcinoma of the Ampulla of Vater.

    Science.gov (United States)

    Kapp, Markus; Kosmala, Aleksander; Kircher, Stefan; Luber, Verena; Kunzmann, Volker

    2016-01-01

    Ampullary carcinoma is a rare tumor and evidence on the treatment of recurrent metastatic disease is scarce. We report the case of a 60-year-old patient with an R0-resected node-positive adenocarcinoma of the papilla of Vater of an initially diagnosed intestinal subtype who developed pulmonary metastases 2 months after adjuvant gemcitabine chemotherapy and, subsequently, liver metastases. Palliative combination chemotherapy with standard regimens for intestinal-type adenocarcinoma (FOLFOX and FOLFIRI) failed. However, subsequent combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine, a regimen with proven efficacy in metastatic adenocarcinoma of the pancreas, resulted in a durable, very good partial remission. Treatment was manageable and well tolerated. Primary tumor and metastatic tissue were reassessed by immunohistochemistry and had to be reclassified to a mixed phenotype containing predominant elements of the pancreatobiliary subtype. Our case suggests that combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine could represent a promising option for the treatment of this rare disease and warrants further investigation within controlled clinical trials. Moreover, thorough characterization of ampullary carcinomas by histomorphology and additional immunohistochemistry should become mandatory in order to start a chemotherapeutic regimen tailored for the definitive subtype. PMID:26933414

  6. Mutational Profiling of Kinases in Human Tumours of Pancreatic Origin Identifies Candidate Cancer Genes in Ductal and Ampulla of Vater Carcinomas

    OpenAIRE

    Corbo, Vincenzo; Ritelli, Rossana; Barbi, Stefano; Funel, Niccola; Campani, Daniela; Bardelli, Alberto; Scarpa, Aldo

    2010-01-01

    Background Protein kinases are key regulators of cellular processes (such as proliferation, apoptosis and invasion) that are often deregulated in human cancers. Accordingly, kinase genes have been the first to be systematically analyzed in human tumors leading to the discovery that many oncogenes correspond to mutated kinases. In most cases the genetic alterations translate in constitutively active kinase proteins, which are amenable of therapeutic targeting. Tumours of the pancreas are aggre...

  7. Diffuse Abdominal Splenosis Mimicking Peritoneal Metastases in a 35-Year-Old Man with a Resectable Carcinoma of the Ampulla of Vater

    OpenAIRE

    Sorensen, Steffen Filskov; Mortensen, Frank Viborg; Hellberg, Ylva; Ladekarl, Morten

    2013-01-01

    A 35-year-old man with a history of blunt abdominal trauma and splenic rupture was diagnosed with an ampullary adenocarcinoma. At workup, a CT scan showed multiple intra-abdominal lesions similar to peritoneal carcinosis, and the patient was referred for palliative chemotherapy. On clinical suspicion, however, a biopsy was performed on an intra-abdominal lesion, establishing the diagnosis of abdominal splenosis. A radical pancreaticoduodenectomy ad modum Whipple was performed, followed by adj...

  8. Somatostatinoma of the Ampulla: An Incidental Postoperative Finding Following Colorectal Cancer Resection

    OpenAIRE

    French, Joshua B.; Pawa, Rishi

    2016-01-01

    Somatostatinoma of the gastrointestinal tract is a rare finding, especially arising from the ampulla of Vater. We present a man recently diagnosed with rectal adenocarcinoma who was found on imaging to have an ampullary mass. Histology and immunohistochemical staining of the biopsied tissue were consistent with a nonfunctioning somatostatinoma. The patient had neurofibromatosis, which have been reported in patients with ampullary somatostatinomas. Our case highlights the importance of gastroi...

  9. Natural Gas Contrast PET-CT Diagnosis of Carcinoma in Situ of the Papilla of Vater: Report of a Case

    International Nuclear Information System (INIS)

    Benign and malignant villous adenoma (papillary adenoma) of the ampulla or papilla of Vater is a rare tumor and carcinoma in situ in the papilla is much rarer still. Terminologically, carcinoma in situ is defined as an epithelial malignant tumor in which tumor cells are confined to the epithelium, not invading the basement membrane. This communication describes a case of carcinoma in situ of the papilla of Vater visually detected by natural gas-contrast 18F-fluorodeoxyglucose (FDG) PET-CT, confirmed by duodenoscopy and pathology, and treated by extended pancreatic operation

  10. Large Somatostatin-Producing Endocrine Carcinoma of the Ampulla of Vater in Association with GIST in a Patient with von Recklinghausen?s Disease. Case Report and Review of the Literature

    OpenAIRE

    George H Sakorafas; Giannopoulos, George A; Aikaterini Parasi; George Konstantoudakis; Nikolaos Tzanakis; Spiridon Stergiopoulos; George Peros

    2008-01-01

    Context Somatostatin-producing endocrine tumors of the duodenum are very rare neoplasms of the gastrointestinal tract. These tumors may be associated with von Recklinghausen’s disease. Case report We present the case of a 49- year-old female patient with von Recklinghausen’s disease and an incidentally diagnosed ampullary neoplasm. The patient was treated with a classical pancreaticoduodenectomy. At surgery, a mass was found in the greater curve of the stomach which was resected using the cla...

  11. Large Somatostatin-Producing Endocrine Carcinoma of the Ampulla of Vater in Association with GIST in a Patient with von Recklinghausen?s Disease. Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    George H Sakorafas

    2008-09-01

    Full Text Available Context Somatostatin-producing endocrine tumors of the duodenum are very rare neoplasms of the gastrointestinal tract. These tumors may be associated with von Recklinghausen’s disease. Case report We present the case of a 49- year-old female patient with von Recklinghausen’s disease and an incidentally diagnosed ampullary neoplasm. The patient was treated with a classical pancreaticoduodenectomy. At surgery, a mass was found in the greater curve of the stomach which was resected using the classic Whipple procedure. Histology and immunohistochemistry showed that the duodenal tumor was an ampullary somatostatin-producing endocrine carcinoma while the gastric tumor was a gastrointestinal stromal tumor (GIST. The postoperative course was uneventful and the patient is alive, without tumor recurrence, six years after surgery. Conclusion Somatostatin-producing endocrine tumors of the duodenum are rare tumors, often associated with von Recklinghausen’s disease; these neoplasms should be treated aggressively using radical surgical resection. Although local resection may be appropriate for small duodenal somatostatin-producing tumors, a pancreaticoduodenectomy is usually required for larger tumors.

  12. Calpain system protein expression in carcinomas of the pancreas, bile duct and ampulla

    Directory of Open Access Journals (Sweden)

    Storr Sarah J

    2012-11-01

    Full Text Available Abstract Background Pancreatic cancer, including cancer of the ampulla of Vater and bile duct, is very aggressive and has a poor five year survival rate; improved methods of patient stratification are required. Methods We assessed the expression of calpain-1, calpain-2 and calpastatin in two patient cohorts using immunohistochemistry on tissue microarrays. The first cohort was composed of 68 pancreatic adenocarcinomas and the second cohort was composed of 120 cancers of the bile duct and ampulla. Results In bile duct and ampullary carcinomas an association was observed between cytoplasmic calpastatin expression and patient age (P = 0.036, and between nuclear calpastatin expression and increased tumour stage (P = 0.026 and the presence of vascular invasion (P = 0.043. In pancreatic cancer, high calpain-2 expression was significantly associated with improved overall survival (P = 0.036, which remained significant in multivariate Cox-regression analysis (hazard ratio = 0.342; 95% confidence interva l = 0.157-0.741; P = 0.007. In cancers of the bile duct and ampulla, low cytoplasmic expression of calpastatin was significantly associated with poor overall survival (P = 0.012, which remained significant in multivariate Cox-regression analysis (hazard ratio = 0.595; 95% confidence interval = 0.365-0.968; P = 0.037. Conclusion The results suggest that calpain-2 and calpastatin expression is important in pancreatic cancers, influencing disease progression. The findings of this study warrant a larger follow-up study.

  13. Calpain system protein expression in carcinomas of the pancreas, bile duct and ampulla

    International Nuclear Information System (INIS)

    Pancreatic cancer, including cancer of the ampulla of Vater and bile duct, is very aggressive and has a poor five year survival rate; improved methods of patient stratification are required. We assessed the expression of calpain-1, calpain-2 and calpastatin in two patient cohorts using immunohistochemistry on tissue microarrays. The first cohort was composed of 68 pancreatic adenocarcinomas and the second cohort was composed of 120 cancers of the bile duct and ampulla. In bile duct and ampullary carcinomas an association was observed between cytoplasmic calpastatin expression and patient age (P = 0.036), and between nuclear calpastatin expression and increased tumour stage (P = 0.026) and the presence of vascular invasion (P = 0.043). In pancreatic cancer, high calpain-2 expression was significantly associated with improved overall survival (P = 0.036), which remained significant in multivariate Cox-regression analysis (hazard ratio = 0.342; 95% confidence interva l = 0.157-0.741; P = 0.007). In cancers of the bile duct and ampulla, low cytoplasmic expression of calpastatin was significantly associated with poor overall survival (P = 0.012), which remained significant in multivariate Cox-regression analysis (hazard ratio = 0.595; 95% confidence interval = 0.365-0.968; P = 0.037). The results suggest that calpain-2 and calpastatin expression is important in pancreatic cancers, influencing disease progression. The findings of this study warrant a larger follow-up study

  14. Chromosome 5 allelic losses are early events in tumours of the papilla of Vater and occur at sites similar to those of gastric cancer.

    OpenAIRE

    Achille, A.; Baron, A; Zamboni, G; Di Pace, C.; Orlandini, S.; Scarpa, A.

    1998-01-01

    During our studies of DNA fingerprinting of tumours of the pancreas and papilla (ampulla) of Vater, using arbitrarily primed polymerase chain reaction (AP-PCR), we noticed two bands showing a decreased intensity in six of ten ampullary tumours with respect to matched normal tissues. Those bands were both assigned to chromosome 5. Such a finding was somewhat in contrast with the reportedly low frequency of APC gene mutations in ampullary cancers, located at chromosome 5q21, and suggested that ...

  15. Proton conductivity in ampullae of Lorenzini jelly.

    Science.gov (United States)

    Josberger, Erik E; Hassanzadeh, Pegah; Deng, Yingxin; Sohn, Joel; Rego, Michael J; Amemiya, Chris T; Rolandi, Marco

    2016-05-01

    In 1678, Stefano Lorenzini first described a network of organs of unknown function in the torpedo ray-the ampullae of Lorenzini (AoL). An individual ampulla consists of a pore on the skin that is open to the environment, a canal containing a jelly and leading to an alveolus with a series of electrosensing cells. The role of the AoL remained a mystery for almost 300 years until research demonstrated that skates, sharks, and rays detect very weak electric fields produced by a potential prey. The AoL jelly likely contributes to this electrosensing function, yet the exact details of this contribution remain unclear. We measure the proton conductivity of the AoL jelly extracted from skates and sharks. The room-temperature proton conductivity of the AoL jelly is very high at 2 ± 1 mS/cm. This conductivity is only 40-fold lower than the current state-of-the-art proton-conducting polymer Nafion, and it is the highest reported for a biological material so far. We suggest that keratan sulfate, identified previously in the AoL jelly and confirmed here, may contribute to the high proton conductivity of the AoL jelly with its sulfate groups-acid groups and proton donors. We hope that the observed high proton conductivity of the AoL jelly may contribute to future studies of the AoL function. PMID:27386543

  16. Proton conductivity in ampullae of Lorenzini jelly

    Science.gov (United States)

    Josberger, Erik E.; Hassanzadeh, Pegah; Deng, Yingxin; Sohn, Joel; Rego, Michael J.; Amemiya, Chris T.; Rolandi, Marco

    2016-01-01

    In 1678, Stefano Lorenzini first described a network of organs of unknown function in the torpedo ray—the ampullae of Lorenzini (AoL). An individual ampulla consists of a pore on the skin that is open to the environment, a canal containing a jelly and leading to an alveolus with a series of electrosensing cells. The role of the AoL remained a mystery for almost 300 years until research demonstrated that skates, sharks, and rays detect very weak electric fields produced by a potential prey. The AoL jelly likely contributes to this electrosensing function, yet the exact details of this contribution remain unclear. We measure the proton conductivity of the AoL jelly extracted from skates and sharks. The room-temperature proton conductivity of the AoL jelly is very high at 2 ± 1 mS/cm. This conductivity is only 40-fold lower than the current state-of-the-art proton-conducting polymer Nafion, and it is the highest reported for a biological material so far. We suggest that keratan sulfate, identified previously in the AoL jelly and confirmed here, may contribute to the high proton conductivity of the AoL jelly with its sulfate groups—acid groups and proton donors. We hope that the observed high proton conductivity of the AoL jelly may contribute to future studies of the AoL function. PMID:27386543

  17. High Volume Washing of the Abdomen in Increasing Survival After Surgery in Patients With Pancreatic Cancer That Can Be Removed by Surgery

    Science.gov (United States)

    2016-05-03

    Acinar Cell Carcinoma; Ampulla of Vater Adenocarcinoma; Cholangiocarcinoma; Duodenal Adenocarcinoma; Pancreatic Adenocarcinoma; Pancreatic Ductal Adenocarcinoma; Pancreatic Intraductal Papillary Mucinous Neoplasm, Pancreatobiliary-Type; Periampullary Adenocarcinoma

  18. Composite neuroendocrine and adenomatous carcinoma of the papilla of Vater

    Institute of Scientific and Technical Information of China (English)

    Joanna A Musialik; Maciej J Kohut; Tomasz Marek; Anatol Wodo(I)a(z)ski; Marek Hartleb

    2009-01-01

    Malignant tumors of papilla are usually adenocarcinomas.We present a 67-year-old female who became icteric as result of a malignant tumor infiltrating the papilla of Vater. Histopathological assessment of surgically excised tumor showed both neuroendocrine and adenocarcinomatous features. To our knowledge, this is the seventh report of this rare neoplastic association in the duodenal periampullary region.

  19. Acute Recurrent Pancreatitis: A Possible Clinical Manifestation of Ampullary Cancer

    Directory of Open Access Journals (Sweden)

    Athanasios Petrou

    2011-11-01

    Full Text Available Context Acute recurrent pancreatitis still poses diagnostic difficulties. The coexistence or moreover the causative relationship of carcinoma of the ampulla of Vater and acute recurrent pancreatitis is fairly rare. Case report We present a case of carcinoma of the ampulla of Vater that presented with acute recurrent necrotizing pancreatitis complicated with pseudocysts. A diagnosis of malignancy in the ampulla was only made after several ERCP attempts due to residual inflammation at the periampullary area. Conclusion Malignancy at the ampulla of Vater causing recurrent episodes of pancreatitis represents a realistic risk and attempts to diagnose the underlying cause should always take into account the possibility of cancer.

  20. Acute Recurrent Pancreatitis: A Possible Clinical Manifestation of Ampullary Cancer

    OpenAIRE

    Athanasios Petrou; Timothy Williams; Konstantinos Bramis; Alexandros Papalambros; Eleftherios Mantonakis; Evangelos Felekouras

    2011-01-01

    Context Acute recurrent pancreatitis still poses diagnostic difficulties. The coexistence or moreover the causative relationship of carcinoma of the ampulla of Vater and acute recurrent pancreatitis is fairly rare. Case report We present a case of carcinoma of the ampulla of Vater that presented with acute recurrent necrotizing pancreatitis complicated with pseudocysts. A diagnosis of malignancy in the ampulla was only made after several ERCP attempts due to residual inflammation at the peria...

  1. Poorly cohesive adenocarcinoma of the ampulla of Vater: a case report.

    Science.gov (United States)

    Yamauchi, Hayato; Sakurai, Shinji; Hagiwara, Kei; Yoshida, Tomonori; Tabe, Yuichi; Fukasawa, Takaharu; Kiriyama, Shinsuke; Fukuchi, Minoru; Naitoh, Hiroshi; Kuwano, Hiroyuki

    2016-12-01

    A 47-year-old Japanese male was submitted to pancreaticoduodenectomy for an ampullary cancer. Pathologically, the ampullary cancer was poorly cohesive adenocarcinoma without tubular structure. Moreover, locoregional lymph nodes were swollen with hypervascularity, plasmacytes infiltration, and hemorrhage. Our case seems to be different from usual poorly differentiated adenocarcinoma. PMID:26943691

  2. Poorly cohesive adenocarcinoma of the ampulla of Vater: a case report

    OpenAIRE

    Yamauchi, Hayato; Sakurai, Shinji; Hagiwara, Kei; Yoshida, Tomonori; Tabe, Yuichi; Fukasawa, Takaharu; Kiriyama, Shinsuke; Fukuchi, Minoru; Naitoh, Hiroshi; Kuwano, Hiroyuki

    2016-01-01

    A 47-year-old Japanese male was submitted to pancreaticoduodenectomy for an ampullary cancer. Pathologically, the ampullary cancer was poorly cohesive adenocarcinoma without tubular structure. Moreover, locoregional lymph nodes were swollen with hypervascularity, plasmacytes infiltration, and hemorrhage. Our case seems to be different from usual poorly differentiated adenocarcinoma.

  3. Assessment of takotsubo (ampulla) cardiomyopathy using iodine-123 metaiodobenzylguanidine scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Pessoa, Pinheiro M.C.; Xavier, Salles S.; Lima, Souza Leao R.; Mansur, J.; Almeida, Altino S. de; Carvalho, Pires A.C.; Gutfilen, B.; Fonseca, Barbosa L.M. da [Hospital Univ. Clementino Fraga Filho, Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia

    2006-12-15

    Purpose: To evaluate the role of cardiac sympathetic innervation in patients whose clinical features consisted of chest pain, transient ST-segment elevation, left ventricular apical akinesis, minimal elevation of cardiac enzymes, and onset of symptoms shortly after a severe stress condition. Material and Methods: Five female patients, mean age 67{+-}14 years, underwent thoracic {sup 123}I-MIBG (planar and SPECT) and 67Ga citrate (planar) scans within 5 days after the onset of symptoms. The {sup 123}I-MIBG myocardial washout rate between early (30 min) and delayed (3 hours) planar images was calculated. All patients presented findings consistent with takotsubo-like syndrome. Echocardiograms showed the characteristic wall motion pattern of significant apical dysfunction. Acute-phase coronary angiographies revealed a non-obstructive pattern. A peculiar apical akinesis and basal normokinesis were observed on the ventriculograms. Results: Impairment of cardiac neuronal uptake of {sup 123}I-MIBG based on a reduction of the heart-to-mediastinum uptake ratio was observed in all patients, while the washout rate was raised in four patients. All patients presented an apical uptake defect in the {sup 123}I-MIBG SPECT and planar images and a normal 67Ga scintigraphy. Conclusion: Our data indicate that ampulla cardiomyopathy (AC) is associated with a cardiac sympathetic innervation deficit characterized by a reduced global {sup 123}I-MIBG uptake and an apical uptake defect. The lack of 67Ga uptake in the acute phase of this syndrome indicates that AC is probably not associated with an inflammatory process.

  4. Coexistent ampullary squamous cell carcinoma with adenocarcinoma of the pancreatic duct

    Directory of Open Access Journals (Sweden)

    Gayatri S Pathak

    2011-01-01

    Full Text Available Primary squamous cell carcinoma (SCC of ampulla has seldom been reported. However, metastatic SCC to ampulla of Vater is well known. We report a case of primary SCC of ampulla of Vater coexistent with well-differentiated adenocarcinoma of the distal pancreatic duct. A 50-year-old female presented with evidence of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed bulging papilla with ulcero-infiltrative growth at the ampulla of Vater. An initial endoscopic biopsy of the ampullary mass showed a well-differentiated SCC. The patient underwent Whipple′s operation. Thorough sampling of the dilated portion of the pancreatic duct showed presence of well-differentiated adenocarcinoma of the distal pancreatic duct. Immunohistochemical study with synaptophysin and chromogranin was done with negative result, ruling out neuroendocrine differentiation. Also, a detailed clinical, endoscopic and radiological examination was carried out, that excluded the presence of primary SCC elsewhere.

  5. Morphology of the ampullae of Lorenzini in juvenile freshwater Carcharhinus leucas.

    Science.gov (United States)

    Whitehead, Darryl L; Gauthier, Arnault R G; Mu, Erica W H; Bennett, Mike B; Tibbetts, Ian R

    2015-05-01

    Ampullae of Lorenzini were examined from juvenile Carcharhinus leucas (831-1,045 mm total length) captured from freshwater regions of the Brisbane River. The ampullary organ structure differs from all other previously described ampullae in the canal wall structure, the general shape of the ampullary canal, and the apically nucleated supportive cells. Ampullary pores of 140-205 µm in diameter are distributed over the surface of the head region with 2,681 and 2,913 pores present in two sharks that were studied in detail. The primary variation of the ampullary organs appears in the canal epithelial cells which occur as either flattened squamous epithelial cells or a second form of pseudostratified contour-ridged epithelial cells; both cell types appear to release material into the ampullary lumen. Secondarily, this ampullary canal varies due to involuted walls that form a clover-like canal wall structure. At the proximal end of the canal, contour-ridged cells abut a narrow region of cuboidal epithelial cells that verge on the constant, six alveolar sacs of the ampulla. The alveolar sacs contain numerous receptor and supportive cells bound by tight junctions and desmosomes. Pear-shaped receptor cells that possess a single apical kinocilium are connected basally by unmyelinated neural boutons. Opposed to previously described ampullae of Lorenzini, the supportive cells have an apical nucleus, possess a low number of microvilli, and form a unique, jagged alveolar wall. A centrally positioned centrum cap of cuboidal epithelial cells overlies a primary afferent lateral line nerve. PMID:25515416

  6. Functioning gangliocytic paraganglioma of the ampulla: clinicopathological correlations and cytologic features.

    Science.gov (United States)

    Lei, Li; Cobb, Camilla; Perez, Mia N

    2016-04-01

    Gangliocytic paraganglioma (GP) is a rare neuroendocrine tumor almost exclusively found in the ampulla. It is considered nonfunctioning in the literature. We herein report the first case of functioning GP arising in the ampulla. Our patient had a constellation of ampullary neuroendocrine tumor, flushing, diarrhea, weight loss, diabetes mellitus, and cholelithiasis, consistent with effects of serotonin and somatostatin that were overexpressed by the ampullary neuroendocrine tumor. The serum serotonin level was elevated. Immunostaining confirmed somatostatin expression by the epithelioid cells and ganglion-like cells of GP. After surgical resection of the tumor, the patient became euglycemic. However, computed tomography (CT) scan 3 months post-surgery showed regional lymphadenopathy suspicious for residual/recurrent/metastatic disease. In the interim, his flushing and hyperglycemia recurred and worsened. Increased awareness about the functioning potential of GP is important so that the underlying pathophysiologic link is not overlooked and patients are appropriately managed. Moreover, we describe the cytologic features that help make the preoperative diagnosis, and these have not been previously described. PMID:27034808

  7. Changes of ampulla pressure in the semicircular canal of pigeons by caloric stimulation

    Science.gov (United States)

    Wada, Yoshiro; Suzuki, Hiroyuki; Watanabe, Satoru

    Still now several hypotheses about the mechanisms of the caloric nystagmus have been in conclusive. In this study we confirmed the convection effect and the volume change effect of the endolymph in horizontal semicircular canal following the caloric stimulation using pigeons ( Columba livia). Although the direction of the caloric nystagmus depended on the head position and the stimulus site of calorization, the caloric nystagmus disappeared after plugging of horizontal semicircular canal. On the other hand, the ampulla pressure increased by cold calorization and decreased by hot calorization and these pressure changes had no relation to the head position. These results show that the main role of the mechanisms of the caloric nystagmus under 1G is the convection effect but the volume change effect may act on the caloric nystagmus not only under 1G but also under microgravity.

  8. Perforation of the Papilla of Vater in Wire-Guided Cannulation

    Directory of Open Access Journals (Sweden)

    Yuichi Takano

    2016-01-01

    Full Text Available Background. WGC in ERCP is considered a safe technique, although rare complications can occur. One unique complication of WGC is the perforation of the papilla of Vater by the guidewire. Subjects and Methods. Of 2032 patients who underwent ERCP at our department between January 2010 and December 2014, we selected 208 patients who underwent WGC for naïve papilla as subjects. A detailed examination of patients in whom a perforation occurred was conducted, and risk factors for perforations were investigated. Results. The perforation was observed in 7 of 208 patients (3.4%. All patients recovered with conservative treatment without the need for surgery. The perforation rate was significantly higher in the patients with juxtapapillary duodenal diverticula than those without diverticula (12.5% versus 0.6%, p<0.001. Cannulation of the bile duct was ultimately achieved in 5 of 7 patients; PSP was performed for 4 of these patients. Conclusion. Caution must be exercised when dealing with patients who have a juxtapapillary duodenal diverticula because they are at higher risk of perforations. Because these are small perforations made by a wire, most of them heal with conservative treatment. However, perforations can make cannulation difficult, and PSP may be useful for deep cannulation.

  9. Somatostatinoma of the Vater's papilla in a patient with von Recklinghausen's disease

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2007-01-01

    Full Text Available Background. Somatostatinomas of the gastrointestinal tract secret hormone somatostatin which can cause "inhibitory syndrome" comprising diabetes mellitus, cholelithiasis and steatorrheic diarrhea. It is also secreted by the D cells of Langerhans's islands of the pancreas as well as endocrine cells of the stomack, small bowel, salivary glands and parafollicular cells of the thiroid gland. Somatostatinomas of the digestive tract appear within the pancreas and duodenum. Patients suffering from von Recklinghausens's disease are paticularly prone to the somatostatinomas of the duodenum. Case report. In this paper we presented a 51-year old female patient with von Recklinghausen's disease in whom, during the investigation for obstructive jaundice, tumor of the Vater's papilla was found. The patient was submitted to Whipple's duodenopancreatectomy. Histology and immunohistochemistry discovered type B glandular carcinoid tumor with strong antisomatostatin and mild antigastrin immunoreactivity. The patient stayed symptom-free more than four years now. Conclusion. Patients with von Recklinghausen's disease should be examined for other tumors, particularly carcinoids of the duodenum and papilla, especially if the signs of cholestasis are present.

  10. Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report

    Directory of Open Access Journals (Sweden)

    Sugizaki Katsuyoshi

    2010-05-01

    Full Text Available Abstract Background Gallbladder perforation is a rare clinical condition, which mostly occurs following acute cholecystitis associated with cholelithiasis. A tumor of the ampulla of Vater causes gradually progressive symptoms, and is rarely associated with perforation of the gallbladder. Case Presentation A 56-year-old man with carcinoma of the ampulla of Vater presented with spontaneous gallbladder perforation and localized bile peritonitis. He complained of right upper abdominal pain, and laparotomy revealed perforation of the gallbladder with no gallstones. Postoperative upper gastrointestinal endoscopy demonstrated a slightly enlarged duodenal papilla, and biopsy revealed adenocarcinoma of the ampulla. Pylorus-preserving pancreaticoduodenectomy was performed subsequently. Conclusion Ampullary carcinoma can be associated with gallbladder perforation and present with acute manifestations. Immediate surgical treatment is required for this condition.

  11. Clinical Usefulness of :18F 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scan in the Diagnosis of Ampullary Carcinoma

    International Nuclear Information System (INIS)

    To evaluate the clinical usefulness of the 18F 2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) scan in the diagnosis of the ampulla of Vater cancer. CT images of 39 patients with ampulla of Vater cancer were reviewed regarding the lesion size, location, and bile or pancreatic duct dilatation. The patients were divided into three groups according to the lesion visibility on CT (Group A: visible mass, Group B: no visible mass but prominent ampulla, Group C: no visible lesion). Standardized uptake value (SUV) was measured on PET scan and the detection rate on PET images was comparable with that of CT images. Twenty-four patients (61.5%) were classified as Group A, 11 (28.2%) as Group B and 4 (10.3%) as Group C. All of Group A, 10 (90.9%) of Group B and 3 (75.0%) of Group C showed biliary dilatation. Pancreatic duct dilatation was shown in 18 (75.0%) of Group A, 9 (81.8%) of Group B, and 1 (25.0%) of Group C. The average of SUV of all patients was 5.90 ± 3.1. Most (94.9%) of all patients showed high FDG uptake over 2.5 with 93.9% in Group B and C. '18F-FDG PET scan was use for the detection of ampulla of Vater cancer, even though the lesion was invisible on CT.

  12. Clinical Usefulness of :1{sup 8}F 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scan in the Diagnosis of Ampullary Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Se Jin; Chung, Jae Joon; Kim, Dae Jung; Cho, Eun Suk; Ahn, Jhii Hyun; Kim, Joo Jee; Yu, Jeong Sik [Dept. of Radiology, Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    To evaluate the clinical usefulness of the {sup 18}F 2-fluoro-2-deoxy-D-glucose positron emission tomography ({sup 18}F-FDG PET) scan in the diagnosis of the ampulla of Vater cancer. CT images of 39 patients with ampulla of Vater cancer were reviewed regarding the lesion size, location, and bile or pancreatic duct dilatation. The patients were divided into three groups according to the lesion visibility on CT (Group A: visible mass, Group B: no visible mass but prominent ampulla, Group C: no visible lesion). Standardized uptake value (SUV) was measured on PET scan and the detection rate on PET images was comparable with that of CT images. Twenty-four patients (61.5%) were classified as Group A, 11 (28.2%) as Group B and 4 (10.3%) as Group C. All of Group A, 10 (90.9%) of Group B and 3 (75.0%) of Group C showed biliary dilatation. Pancreatic duct dilatation was shown in 18 (75.0%) of Group A, 9 (81.8%) of Group B, and 1 (25.0%) of Group C. The average of SUV of all patients was 5.90 {+-} 3.1. Most (94.9%) of all patients showed high FDG uptake over 2.5 with 93.9% in Group B and C. '1{sup 8}F-FDG PET scan was use for the detection of ampulla of Vater cancer, even though the lesion was invisible on CT.

  13. Differential c-erbB-1 and c-erbB-2 mRNA expression in cancer of the pancreas compared with cancer of the papilla of Vater

    Institute of Scientific and Technical Information of China (English)

    Klaus L Prenzel; Ute Warnecke-Eberz; Jan Brabender; Stephan E Baldus; Elfriede Bollschweiler; Christian A Gutschow; Uta Drebber; Arnulf H Hoelscher; Paul M Schneider

    2006-01-01

    AIM: We examined quantitative mRNA expression of growth factor receptors (c-erbB-1, c-erbB-2) and the anti-apoptosis gene survivin known to be regulated in pancreatic adenocarcinomas and compared the expression pattern with that in carcinomas of the papilla of Vater.METHODS: Quantitative real-time reverse transcriptasePCR (QRT-PCR, TaqmanTM) was performed to analyze mRNA expression levels of c-erbB-1, c-erbB-2 and survivin in normal and corresponding tumor samples of 31 pancreatic adenocarcinomas and 8 cancers of the papilla of Vater.RESULTS: The overall median mRNA expression of survivin was significantly increased in both adenocarcinoma of the pancreas (P<0.01) and papilla of Vater (P<0.008) compared with uninvolved normal control tissue. In pancreatic cancer, expression of c-erbB-1 was significantly decreased compared with the normal pancreatic tissue (P<0.03), whereas in the cancer of the papilla of Vater expression of c-erbB-2 was significantly downregulated (P<0.05) compared with the paired normal samples. Gene expression was not associated with tumor stage, differentiation or prognosis.CONCLUSION: The common anti-apoptosis gene survivin is overexpressed both in the cancer of the papilla of Vater and pancreas. In contrast, the growth factor receptor genes c-erbB-1 and c-erbB-2 are differentially regulated in both tumor entities adding further evidence that pancreatic cancer is biologically different from the cancer of papilla of Vater.

  14. Die Entdeckung der Differenz: Zur Besonderheit des Vaters für das Kind The Discovery of Difference: On the Noteworthiness of the Father for his Child

    Directory of Open Access Journals (Sweden)

    Beate Kortendiek

    2003-07-01

    Full Text Available In dem Sammelband wird in zehn Beiträgen aus psychoanalytischer und -therapeutischer sowie bindungs- und systemtheoretischer Perspektive nach der Bedeutung des Vaters für Säugling und Kleinkind gefragt. Hierbei geht es u.a. um die Analyse von Vaterlosigkeit, Bindungsentwicklungen, Spielsituationen und Schlafstörungen unter besonderer Berücksichtung der Entwicklung dyadischer und triadischer Beziehungen zwischen Vater, Mutter und Kind. Die Berichte sind von Wissenschaftler/-innen und Therapeut/-innen aus Österreich, Deutschland und der Schweiz verfasst und gehen zurück auf die Jahrestagung (2001 der „Deutschen Gesellschaft für die seelische Gesundheit in der frühen Kindheit“ (Germanspeeking Association für Infant Mental Health/GAIMH. Die Veröffentlichung ermöglicht einen Überblick über die aktuelle psychologisch orientierte Forschung und Debatte der frühen Beziehung zwischen Vater und Kind.The ten contributions to this anthology all address the relevance of the father for the baby and infant, employing psychoanalytical and therapeutic perspectives, as well as attachment theory and systemic theory. Among other things, the texts analyse growing up without a father, developing attachment, child play, and sleep disorders with a special focus on the development of dyadic and triadic relations between father, mother, and child. The individual reports were written by scientists and therapists in Austria, Germany, and Switzerland, and were inspired by the 2001 annual Meeting of the “German Speaking Association for Infant Mental Health (GAIMH.” This publication offers an overview of current psychological research and debates about early father-child relationships.

  15. Imaging of malignancies of the biliary tract- an update

    OpenAIRE

    Hennedige, Tiffany Priyanthi; Neo, Wee Thong; Venkatesh, Sudhakar Kundapur

    2014-01-01

    Malignancies of the biliary tract include cholangiocarcinoma, gallbladder cancers and carcinoma of the ampulla of Vater. Biliary tract adenocarcinomas are the second most common primary hepatobiliary cancer. Due to their slow growing nature, non-specific and late symptomatology, these malignancies are often diagnosed in advanced stages with poor prognosis. Apart from incidental discovery of gall bladder carcinoma upon cholecystectomy, early stage biliary tract cancers are now detected with co...

  16. Percutaneous transhepatic removal of common bile duct stone: a case report

    International Nuclear Information System (INIS)

    Percutaneous transhepatic intervention for removal of common bile duct stones is introduced as a secondary choice of treatment in the high-risk patient. Through a percutaneous transhepatic biliary drainage catheter, a Dormia basket was inserted and the stone was entraped. Then the stone was crushed and fragments were passed spontaneously to the duodenum through the Ampulla of Vater. We experienced one case of successful treatment of a common bile duct stone using percutaneous transhepatic insertion of the Dormia basket

  17. Percutaneous transhepatic removal of common bile duct stone: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yong Moon; Han, Joon Koo; Choi, Byung Ihn; Park, Jae Hyung; Han, Man Chung; Park, Yong Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1992-01-15

    Percutaneous transhepatic intervention for removal of common bile duct stones is introduced as a secondary choice of treatment in the high-risk patient. Through a percutaneous transhepatic biliary drainage catheter, a Dormia basket was inserted and the stone was entraped. Then the stone was crushed and fragments were passed spontaneously to the duodenum through the Ampulla of Vater. We experienced one case of successful treatment of a common bile duct stone using percutaneous transhepatic insertion of the Dormia basket.

  18. Considerations Regarding Biliary-digestive Bypasses in Benign and Malignant Diseases of the Biliary- Pancreatic Confluence

    OpenAIRE

    Horațiu Flaviu Coman; Cornel Iancu; Octavian Andercou; Bogdan Stancu; Aurel Andercou

    2014-01-01

    Introduction. The usual indication for a biliary-digestive bypass is the obstruction by a benign or a malignant stricture which can occur at the biliary- pancreatic confluence. Benign strictures mostly occur in the distal bile duct as a result of stones or chronic pancreatitis. Malignant obstructions involve mostly the distal end as a result of a ductal adenocarcinoma of the head of the pancreas, the ampulla of Vater and cholangiocarcinoma and can be virtually impossible to distinguish from e...

  19. Polymorphisms of Genes in the Lipid Metabolism Pathway and the Risk of Biliary Tract Cancers and Stones: A Population-based Case-Control Study in Shanghai, China

    OpenAIRE

    Andreotti, Gabriella; Chen, Jinbo; Gao, Yu-Tang; Rashid, Asif; Chen, Bingshu E.; Rosenberg, Philip; Sakoda, Lori C.; Jie DENG; Shen, Ming-Chang; Wang, Bing-Sheng; Han, Tian-Quan; Zhang, Bai-He; Yeager, Meredith; Welch, Robert; Chanock, Stephen

    2008-01-01

    Biliary tract cancers, encompassing the gallbladder, extrahepatic bile duct, and ampulla of Vater, are uncommon, yet highly fatal malignancies. Gallstones, the primary risk factor for biliary cancers, are linked with hyperlipidemia. We examined the associations of 12 single nucleotide polymorphisms (SNPs) of five genes in the lipid metabolism pathway with the risks of biliary cancers and stones in a population-based case-control study in Shanghai, China. We included 235 gallbladder, 125 extra...

  20. Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study

    OpenAIRE

    Alexandrakis Georgios; Dimoulios Philippos D; Mouzas Ioannis A; Skordilis Panagiotis; Moschandrea Joanna; Kouroumalis Elias

    2002-01-01

    Abstract Background The relatively rare carcinoma of the ampulla of Vater is a neoplasia with a good prognosis compared to pancreatic cancer. Preoperative staging is important in planning the most suitable surgical intervention. Aim To prospectively evaluate the diagnostic accuracy of Endoscopic Ultrasonography (EUS) in comparison with conventional US and CT scan, in staging of patients with ampullary carcinoma. Patients and Methods 20 patients (7 women and 13 men) with histologically proven ...

  1. Gallstones and the risk of biliary tract cancer: a population-based study in China

    OpenAIRE

    Hsing, A W; Gao, Y-T; Han, T-Q; Rashid, A; Sakoda, L C; Wang, B-S; Shen, M-C; Zhang, B-H; Niwa, S; Chen, J.; Fraumeni, J F

    2007-01-01

    We conducted a population-based study of 627 patients with biliary tract cancers (368 of gallbladder, 191 bile duct, and 68 ampulla of Vater), 1037 with biliary stones, and 959 healthy controls randomly selected from the Shanghai population, all personally interviewed. Gallstone status was based on information from self-reports, imaging procedures, surgical notes, and medical records. Among controls, a transabdominal ultrasound was performed to detect asymptomatic gallstones. Gallstones remov...

  2. Assessment of Takotsubo (ampulla) cardiomyopathy using 99mTc-tetrofosmin myocardial SPECT. Comparison with acute coronary syndrome

    International Nuclear Information System (INIS)

    We assessed Takotsubo (ampulla) cardiomyopathy compared with acute coronary syndrome (ACS) using two-dimensional echocardiography and 99mTc-tetrofosmin myocardial SPECT. We examined 10 patients with Takotsubo cardiomyopathy and 16 with ACS at the time of emergency admission (acute phase), at three to nine days after the attack (subacute phase) and at one month after the attack (chronic phase). The left ventricle was divided into nine regions on echocardiograms and SPECT images, and the degree of abnormalities in each region was scored in five grades from normal (0) to severely abnormal (4). Coronary angiography revealed total or subtotal occlusion in patients with ACS but no stenotic legions in those with Takotsubo cardiomyopathy. The amount of ST segment elevation (mm) was 7.9±3.4 in patients with Takotsubo cardiomyopathy and 7.3±3.7 in those with ACS (N.S.). Abnormal wall motion scores on echocardiograms were 13.8±4.4, 4.4±3.8 and 1.8±2.3 during the acute, subacute and chronic phases in patients with Takotsubo cardiomyopathy, and 13.9±4.0, 11.7±3.7, 7.6±4.2, respectively in patients with ACS. The value of MB fraction of creatine phosphokinase (IU/l) was 34±23 in patients with Takotsubo cardiomyopathy and 326±98 in those with ACS (p99mTc-tetrofosmin myocardial SPECT were 11.4±3.2, 3.2±3.3 and 0.7±1.1 during the acute, subacute and chronic phases respectively, in patients with Takotsubo cardiomyopathy, and 15.8±4.1, 13.5±4.4, 8.2±4.4, respectively, in those with ACS. The numbers of myocardial segments that did not uptake 99mTc-tetrofosmin during the acute phase were 0.5±0.8 and 3.6±2.8 in patients with Takotsubo cardiomyopathy and ACS, respectively. Impaired coronary microcirculation might be a causative mechanism of Takotsubo cardiomyopathy. (author)

  3. Somatostatinoma of the Vater's papilla in a patient with von Recklinghausen's disease

    OpenAIRE

    Čolović Radoje; Micev Marjan; Grubor Nikica; Radak Vladimir

    2007-01-01

    Background. Somatostatinomas of the gastrointestinal tract secret hormone somatostatin which can cause "inhibitory syndrome" comprising diabetes mellitus, cholelithiasis and steatorrheic diarrhea. It is also secreted by the D cells of Langerhans's islands of the pancreas as well as endocrine cells of the stomack, small bowel, salivary glands and parafollicular cells of the thiroid gland. Somatostatinomas of the digestive tract appear within the pancreas and duodenum. Patients suffering from v...

  4. Usefulness of the helical CT in the diagnosis of periampullary malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Heoung Keun; Jeong, Yong Yeon; Kang, Min Seun; Kim, Jae Kyu; Jeong, Gwang Woo; Kim, Hyun Jong; Jeong, Sang Woo [Chonnam Univ. College of Medicine, Seoul (Korea, Republic of); Chu, Sung Nam [Seonam Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the usefulness of the helical CT in the differentiation of periampullary malignant tumors. Fifty-five periampullary carcinoma patients (pancreatic head carcinoma (n=18); distal CBD carcinoma (n=17) ; carcinoma of the ampulla of Vater (n=16) ; periampullary duodenal cancers,(n=4), all diagnosed by histopathologic study) underwent helical CT with 5mm scan thickness and 5mm/sec table speed. After scanning, retrospective reconstruction was performed at 2mm intervals, followed by multiplanar reformation. In both retrospective reconstructed axial and multiplanar reformation images, the authors analyzed the detection rate and size of the mass, and associated findings including invasion of peripancreatic fat, dilatation of CBD and its narrowing pattern, dilatation of the pancreatic duct and its degree of dilatation, wall thickening of CBD, extension of dilated bile duct into the ampulla, and of protruding mass into the duodenal lumen, and 1ymph node metastasis all according to the origin sites of tumors. Differential points were thus determined. The detection rate of the masses was 96% (53/55). Their size was 1-5cm, with a mean size of 2.4{+-}0.5cm in carcinoma of of ampulla of Vater and 3.5{+-}1.0cm in pancreatic head carcinoma. Invasion of peripancreatic fat was most commonly observed in pancreatic head carcinoma (100%, 18/18) (p<0.05), dilatation of CBD was observed in all cases except one of periampullary duodenal cancer (98%, 54/55), and abrupt termination of dilated bile duct was noted in all cases except one of the pancreatic head carcinoma (98%, 53/54). Dilatation of pancreatic duct was commonly observed in pancreatic head carcinoma (94%, 17/18) and carcinoma of the ampulla of Vater (75%, 12/16). Its degree of dilatation was mostly moderate in pancreatic head carcinoma (56%, 10/18) and mostly mild in carcinoma of the ampulla of Vater (63%, 10/16) (p<0.05). Wall thickening of the distal CBD was most commonly observed in distal CBD carcinoma (76%, 13

  5. Usefulness of the helical CT in the diagnosis of periampullary malignant tumors

    International Nuclear Information System (INIS)

    To evaluate the usefulness of the helical CT in the differentiation of periampullary malignant tumors. Fifty-five periampullary carcinoma patients (pancreatic head carcinoma (n=18); distal CBD carcinoma (n=17) ; carcinoma of the ampulla of Vater (n=16) ; periampullary duodenal cancers,(n=4), all diagnosed by histopathologic study) underwent helical CT with 5mm scan thickness and 5mm/sec table speed. After scanning, retrospective reconstruction was performed at 2mm intervals, followed by multiplanar reformation. In both retrospective reconstructed axial and multiplanar reformation images, the authors analyzed the detection rate and size of the mass, and associated findings including invasion of peripancreatic fat, dilatation of CBD and its narrowing pattern, dilatation of the pancreatic duct and its degree of dilatation, wall thickening of CBD, extension of dilated bile duct into the ampulla, and of protruding mass into the duodenal lumen, and 1ymph node metastasis all according to the origin sites of tumors. Differential points were thus determined. The detection rate of the masses was 96% (53/55). Their size was 1-5cm, with a mean size of 2.4±0.5cm in carcinoma of of ampulla of Vater and 3.5±1.0cm in pancreatic head carcinoma. Invasion of peripancreatic fat was most commonly observed in pancreatic head carcinoma (100%, 18/18) (p<0.05), dilatation of CBD was observed in all cases except one of periampullary duodenal cancer (98%, 54/55), and abrupt termination of dilated bile duct was noted in all cases except one of the pancreatic head carcinoma (98%, 53/54). Dilatation of pancreatic duct was commonly observed in pancreatic head carcinoma (94%, 17/18) and carcinoma of the ampulla of Vater (75%, 12/16). Its degree of dilatation was mostly moderate in pancreatic head carcinoma (56%, 10/18) and mostly mild in carcinoma of the ampulla of Vater (63%, 10/16) (p<0.05). Wall thickening of the distal CBD was most commonly observed in distal CBD carcinoma (76%, 13

  6. Ultrasonographic diagnosis of pancreatic and peripancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Churl Min; Kim, Ho Kyun; Yoon, Yup; Lee, Sun Wha; Kim, Soon Yong; Ahn, Chi Yul [Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    1982-09-15

    Seventeen cases of cancers in and adjacent to the pancreas were studied by high resolution and wide field real time ultrasonographic scanner with 3.5 MHz linear array electronically focusing transducer. The result were as follows: 1. In a total of 17 cases, 7 cases were pancreatic cancers and the rests were 3 cases of ampulla of Vaster cancer, 3 cases of distal CBD cancers, and 4 cases of metastatic cancers, respectively. 2. Pancreatic cancers were located mainly in head portion, and metastatic cancers were noted in head, tail, and retropancreatic areas. 3. The sizes of all distal CBD cancer were less than 1.8 cm, usually smaller than other tumors, and the size of metastatic cancers were variable (1-6 cm). 4. The shape, margin, contour and echogenicity of the tumors were variable. 5. Pancreatic duct showed marked dilatation in one of pancreatic cancer, and mild dilatation in one of ampulla of Vater cancer. 6. The caliber of extrahepatic duct were moderately or markedly dilated in nearly all cases except 2 cases of pancreatic body cancer. 7. The pancreatic margin is partially obliterated in pancreatic and ampulla of Vater cancers but not in distal CBD cancer. 8. Gallbladder enlargement is secondary change due to the obstruction of extrahepatic bile duct. 9. Effects on the vessels are due to not only direct mass effect but direct invasion resulting in obliteration. The most commonly involved vessels are spleno-portal junction, splenic vein and portal vein. In case of pancreatic cancer in uncinate process, the superior mesenteric vessels are displaced anteriorly. 10. Surrounding metastatic lesions were suspected in pancreatic and ampulla of Vater cancer, but not seen in distal CBD cancer. 11. Ascites were seen in only two cases of metastasis.

  7. Ultrasonographic diagnosis of pancreatic and peripancreatic cancer

    International Nuclear Information System (INIS)

    Seventeen cases of cancers in and adjacent to the pancreas were studied by high resolution and wide field real time ultrasonographic scanner with 3.5 MHz linear array electronically focusing transducer. The result were as follows: 1. In a total of 17 cases, 7 cases were pancreatic cancers and the rests were 3 cases of ampulla of Vaster cancer, 3 cases of distal CBD cancers, and 4 cases of metastatic cancers, respectively. 2. Pancreatic cancers were located mainly in head portion, and metastatic cancers were noted in head, tail, and retropancreatic areas. 3. The sizes of all distal CBD cancer were less than 1.8 cm, usually smaller than other tumors, and the size of metastatic cancers were variable (1-6 cm). 4. The shape, margin, contour and echogenicity of the tumors were variable. 5. Pancreatic duct showed marked dilatation in one of pancreatic cancer, and mild dilatation in one of ampulla of Vater cancer. 6. The caliber of extrahepatic duct were moderately or markedly dilated in nearly all cases except 2 cases of pancreatic body cancer. 7. The pancreatic margin is partially obliterated in pancreatic and ampulla of Vater cancers but not in distal CBD cancer. 8. Gallbladder enlargement is secondary change due to the obstruction of extrahepatic bile duct. 9. Effects on the vessels are due to not only direct mass effect but direct invasion resulting in obliteration. The most commonly involved vessels are spleno-portal junction, splenic vein and portal vein. In case of pancreatic cancer in uncinate process, the superior mesenteric vessels are displaced anteriorly. 10. Surrounding metastatic lesions were suspected in pancreatic and ampulla of Vater cancer, but not seen in distal CBD cancer. 11. Ascites were seen in only two cases of metastasis

  8. Shell Colour Polymorphism in Bulla ampulla

    DEFF Research Database (Denmark)

    Cedhagen, Tomas

    1999-01-01

    coexist over most of the distribution area. It is striking that many museum samples contain specimens of only one of the colour morphs. One possible explanation is that Bulla ampulla is a complex of sibling species. It should therefore be studied if the morphs for example occupy different habitats or......Colour patterns of Bulla ampulla shells collected from Africa eastward to Pacific Islands were studied. 1\\vo common colour morphs were found. The typical morph is commonest. It is closely and finely mottled or all over with pinkish-gray on a creamy or flesh~tinted ground, with darker clouds......, irregular, V-shaped, or as longitudinal bands. The colouration of the other common morph is more uniform. It is lacking the darker clouds or bands and the colour is more greyish. The entire shell surface is densely mottled all over with small brown spots on a grey or beige background. Both morphs seem to...

  9. Imaging features of benign and malignant ampullary and periampullary lesions.

    Science.gov (United States)

    Nikolaidis, Paul; Hammond, Nancy A; Day, Kevin; Yaghmai, Vahid; Wood, Cecil G; Mosbach, David S; Harmath, Carla B; Taffel, Myles T; Horowitz, Jeanne M; Berggruen, Senta M; Miller, Frank H

    2014-01-01

    The ampulla of Vater is an important anatomic landmark where the common bile duct and main pancreatic duct converge in the major duodenal papilla. Imaging evaluation of the ampulla and periampullary region poses a unique diagnostic challenge to radiologists because of the region's complex and variable anatomy and the variety of lesions that can occur. Lesions intrinsic to the ampulla and involved segment of the biliary tree can be neoplastic, inflammatory, or congenital. Neoplastic lesions include ampullary adenocarcinomas and adenomas, which often are difficult to differentiate, as well as pancreatic or duodenal adenocarcinomas, pancreatic neuroendocrine tumors, and cholangiocarcinomas. Ultrasonography (US), computed tomography, magnetic resonance (MR) imaging, and MR cholangiopancreatography are commonly used to evaluate this region. Endoscopic retrograde cholangiopancreatography or endoscopic US examination may be necessary for more definitive evaluation. Periampullary conditions in the duodenum that may secondarily involve the ampulla include neoplasms, duodenitis, duodenal diverticula, and Brunner's gland hyperplasia or hamartomas. Because these lesions can exhibit a wide overlap of imaging features and subtle or nonspecific imaging findings, diagnosis is made on the basis of patient age, clinical history, and imaging and laboratory findings. Given the complexity of imaging evaluation of the ampulla and periampullary region, it is essential for radiologists to understand the variety of lesions that can occur and recognize their imaging characteristics. PMID:24819785

  10. Angiodysplasia in gaint diverticulum of transverse duodenum causing massive gastrointestinal bleeding: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Pil Yeob; Lee, Sang Wook; Kwon, Jae Soo; Sung, Young Soon; Rho, Myoung Ho; Hwon, Oh Joon [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-12-01

    The incidence of duodenal diverticulum found incidentally during upper gastrointestinal roentgenographic examination varies between 2% and 5%. The majority of cases occur along the medial aspect of the second portion of the duodenum, within 2.5 cm of the ampulla of Vater. The majority of duodenal diverticual are asymptomatic, but in some cases, complications such as diverticulitis, hemorrhage, perforation, and fistula formation occur in the third and fourth portions of the duodenum. We describe a case of giant diverticulum of the transverse duodenum, revealed by UGI and angiography, massive gastrointestinal bleeding in a 80-year-old patient.=20.

  11. Synchronous Adenocarcinomas of the Papilla Major and Minor

    Directory of Open Access Journals (Sweden)

    Sriram Parthasarathy

    2008-05-01

    Full Text Available Context Synchronous malignancies affecting both the major and minor papilla are rare and are usually of endocrine origin. Case report A 60-year-old female presented with a two-week history of progressive jaundice and pruritus. Evaluation revealed features of a periampullary malignancy. A Whipple pancreaticoduodenectomy was done. There was a growth in the ampulla of Vater and another in the region of the minor duodenal papilla. On histopathology, both lesions were adenocarcinomas. Conclusion Although rare, synchronous adenocarcinomas can occur in the major and minor papilla.

  12. Body size and the risk of biliary tract cancer: a population-based study in China

    OpenAIRE

    Hsing, A W; Sakoda, L C; Rashid, A; Chen, J.; Shen, M. C.; Han, T Q; Wang, B. S.; Gao, Y.T. (Yu-Tang)

    2008-01-01

    Though obesity is an established risk factor for gall bladder cancer, its role in cancers of the extrahepatic bile ducts and ampulla of Vater is less clear, as also is the role of abdominal obesity. In a population-based case–control study of biliary tract cancer in Shanghai, China, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for biliary tract cancer in relation to anthropometric measures, including body mass index (BMI) at various ages and waist-to-hip ratio (WHR), a...

  13. Anomalies of the bile ducts: a case report of direct drain of the cystic duct into the papilla of Vater.

    Directory of Open Access Journals (Sweden)

    Watanabe,Akiharu

    1983-10-01

    Full Text Available Direct drain of the cystic duct and drain of the biliary tract through an internal fistula into the duodenum in a 81-year-old man were endoscopically diagnosed without an operation.

  14. Significance of cytomorphological and microbiological examination of bile collected by endoscopic cannulation of the papilla of vater

    Directory of Open Access Journals (Sweden)

    Misra Vatsala

    2009-07-01

    Full Text Available Background: Bile analysis yields important information such as "biliary microlithiasis" and biliary tract colonization by microorganisms like Salmonella typhi or paratyphi, Escherichia coli , etc., which may progresses to cholelithiasis and have been found to have a role in the development of gallbladder cancer in India. Aim: To perform microscopic, cytomorphological and microbiological examination of bile collected during endoscopic retrograde cholangiopancreatography in patients with benign and malignant lesions of the gallbladder. Materials and Methods: Bile was collected from 48 patients by a catheter inserted through the cystic duct during endoscopic retrograde cholangiopancreatography. Direct microscopy and grading of crystals was performed. Smears prepared from centrifuged deposits were stained with Giemsa, Papanicolaou stain and Gram′s stain for cytological and microbiological examination. Special staining for Helicobacter pylori was performed using Loeffler′s Methylene blue and Warthin Starry stain. The rest of the sample was used for culture and complete microbiological examination. Results: Thirty-six patients had inflammatory lesions while 12 had malignant lesions. Crystals were observed in 93% of the cases, 13 (28.8% had only cholesterol crystals, three (6.6% had bilirubinate and 29 (64.4% had both cholesterol and bilirubinate crystals. Smears from the centrifuged deposit mainly showed coccoid or cocobacillary bacteria on Gram′s staining (81.3%. Five of 12 (41.6% malignant cases showed epithelial atypia while none of the benign or inflammatory lesions showed such a change in hematoxylin and eosin and Pap-stained smears. Microbiologic analysis showed Staphylococcus aureus (14%, S. saprophyticus (5.5%, Peptococcus (5.5%, Peptostreptococcus (5.5%, Proteus mirabilis (5.5%, E. coli (17%, Enteorbacter cloacae (5.5% and H. pylori (2.8%. Conclusion: Complete microscopic and microbiological examination of bile directly obtained from

  15. [Trimming with argon plasma of self-expanding metal stents: report of 7 cases].

    Science.gov (United States)

    Jury, Gastón; Amieva, Leandro; López, Fagalde Rafael; Jury, Rubén

    2014-06-01

    The use of self-expandable enteral stents for palliation of malignant stenosis may present the complication of concealing the ampulla of Vater behind the metallic mesh. Anchoring in the duodenal wall (distal or partial migration) may also be a complication of biliary metallic stents and therefore may cause difficulty in gaining access to the biliary tract. In these cases of difficult access, a fenestration on the prosthesis ( biliary or enteral) can be created to allow reaching the obstructed biliary tract by means of argon plasma (AP). Were retrospectively analysed 7 cases. Under endoscopic vision, AP was directed to filgurate and cut 6 biliary prosthesis and a duodenal stent. Fulguration and cut of biliary stent was performed in 5 cases of distal partial migration and cholangitis. In one case of obstruction caused by distal migration inside the duodenal stent light, cutting of the biliary stent was performed. A window was created in the enteral prosthesis in order to access the ampulla of Vater and place a biliary tract prosthesis. All cases were resolved successfully and without complications. We conclude that the use of AP to fulgurate and cut nitinol prosthesis was effective and presented no complications in this series. PMID:25199306

  16. Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study

    Directory of Open Access Journals (Sweden)

    Alexandrakis Georgios

    2002-03-01

    Full Text Available Abstract Background The relatively rare carcinoma of the ampulla of Vater is a neoplasia with a good prognosis compared to pancreatic cancer. Preoperative staging is important in planning the most suitable surgical intervention. Aim To prospectively evaluate the diagnostic accuracy of Endoscopic Ultrasonography (EUS in comparison with conventional US and CT scan, in staging of patients with ampullary carcinoma. Patients and Methods 20 patients (7 women and 13 men with histologically proven carcinoma of the ampulla of Vater were assessed by EUS, CT scan and US. Results were compared to surgical findings. Results Endoscopic biopsies were diagnostic in 76% of the patients. Detection of ampullary cancer with US and CT scan was 15% and 20% respectively. Only indirect signs of the disease were identified in the majority of cases using these methods. Overall accuracy of EUS in detection of ampullary tumours was 100%. The EUS was significantly (p Conclusion EUS is more accurate in detecting ampullary cancer than US and CT scan. Tumor extension and locally metastatic lymph nodes are more accurately assessed by means of EUS than with other imaging methods.

  17. Support Vector Machine Based on microRNA Expression Profiles to Predict Histological Origin of Ampullary Carcinoma: Case Report of a Patient Affected From Adenocarcinoma of the Papilla of Vater With Lynch Syndrome.

    Science.gov (United States)

    Tavano, Francesca; Copetti, Massimiliano; Piepoli, Ada; Carella, Massimo; Gentile, Annamaria; Burbaci, Francesca Paola; Fontana, Andrea; De Bonis, Antonio; di Mola, Fabio Francesco; di Sebastiano, Pierluigi; Andriulli, Angelo

    2016-04-01

    Adenocarcinomas of Vater's papilla (PVAC) may originate from either the pancreatic duct or the intestinal epithelium. Conflicting data have been reported about the frequency of the 2 anatomical entities and their influence on patients' prognosis. To ascertain the anatomical origin of PVAC in a family member of a Lynch syndrome kindred, we searched for microRNA (miRNA) expression profiles on resected tumor specimens. The support vector machine was trained on our previous miRNAs expression data sets of pancreatic and colorectal tissue samples and used to classify the site of origin of the tumor in our patient. The support vector machine worked by contrasting the profiles of miRNAs in patients with pancreatic ductal and colorectal cancers to that of our patient, which was finally classified as pancreatic ductal adenocarcinoma accordingly to alterations of 55 miRNAs. The PVAC might be originated from ductal epithelium rather than from the intestinal mucosa of the papilla in the case at issue. Alteration of miR-548b-3p, miR-551a, miR-21, miR-92a, miR-let-7i, and miR-181a* emerged as potentially associated with cancer genetic susceptibility in PVAC. PMID:26954494

  18. Die Idealisierung des Vaters: eine notwendige Konsequenz in Scheidungsfamilien?

    OpenAIRE

    Seiffge-Krenke, Inge; Tauber, Martina

    1997-01-01

    Die dargestellte Studie untersucht an einer Stichprobe von 243 Jugendlichen, ob die Idealisierung des Vaters eine grundsätzliche Folge der Scheidung der Eltern sein muß. Ausgehend von bisherigen empirischen Befunden, die die negativen Folgen einer Ehescheidung für Kinder und Jugendliche betonen, werden neuere Konzepte und Forschungsbefunde dargestellt, die eine andere, weniger wertende Sicht des strukturellen Wandels familiärer Beziehungen betonen. In der vorgestellten Studie war eine Idealis...

  19. Imaging of ascariasis

    International Nuclear Information System (INIS)

    Full text: Ascaris lumbricoides is one of the most common parasitic infestations of the gastrointestinal tract worldwide. During the intestinal phase of the disease, the adult worms usually remain clinically silent, sometimes causing a variety of non-specific abdominal symptoms. When present in large numbers, the worms may get intertwined into a bolus, causing intestinal obstruction, volvulus or even perforation. Occasionally, the adult Ascaris worm may migrate into the Vater's ampulla and enter the bile duct, gall bladder or pancreatic duct, leading to a variety of complications such as biliary colic, gallstone formation, cholecystitis, pyogenic cholangitis, liver abscess and pancreatitis. Imaging plays a significant role in showing the presence of worms and possible complications in intestinal as well as hepatobiliary ascariasis. This pictorial essay aims to illustrate various imaging features of ascariasis and its associated complications

  20. Partial duodenectomy and translocation of the distal common bile duct in repairing duodenal defect near the papilla of Vater for a gastrointestinal stromal tumor

    Institute of Scientific and Technical Information of China (English)

    HE Qing-si; JIANG Jin-bo; LIU Feng-jun; SUN Guo-rui; LI Xue-mei

    2007-01-01

    @@ Surgical resection is preferred in the treatment of gastrointestinal stromal tumor (GIST).1-3 Duodenal GIST comprises 4.5% of all GISTs,1 but the optimal surgical procedure for it remains uncertain.

  1. Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm.

    Science.gov (United States)

    Vultaggio, Fabrice; Morère, Pierre-Henri; Constantin, Christophe; Christodoulou, Michel; Roulin, Didier

    2016-06-27

    Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else. Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery. The patient was successfully treated by selective embolization of microcoils. We discuss the etiologies of hemobilia and its treatment with selective embolization, which remains favored over surgical treatment. Although aneurysm of the hepatic artery is rare, especially without trauma, a high index of suspicion is needed in order to ensure appropriate treatment. PMID:27358680

  2. Replacement Gastrostomy Tube Causing Acute Pancreatitis: Case Series with Review of Literature

    Directory of Open Access Journals (Sweden)

    Anish M Shah

    2012-01-01

    Full Text Available Context Percutaneous endoscopic gastrostomy (PEG feedings are generally considered safe with few serious complications. Acute pancreatitis is a rare complication associated with replacement percutaneous endoscopic gastrostomy tubes. Case report We report two cases of acute pancreatitis induced by migrated replacement percutaneous endoscopic gastrostomy tubes. Conclusions Migration of a balloon into the duodenum can result in external manipulation of the ampulla of Vater thereby disturbing the flow of pancreatic secretions leading to acute pancreatitis. Recognition of this complication is important and should be included as potential etiology of acute pancreatitis in patients receiving percutaneous endoscopic gastrostomy feedings. Periodic examination and documentation of the distance of the balloon from the skin should be performed to document the position of the tubes or any inadvertent migration of the tubes. The use of Foley catheters as permanent replacement tubes should be considered medically inappropriate.

  3. Polyurethane-Covered Nitinol Strecker Stents as Primary Palliative Treatment of Malignant Biliary Obstruction

    International Nuclear Information System (INIS)

    Purpose: To evaluate the clinical efficacy of the polyurethane-covered Nitinol Strecker stent in the treatment of patients with malignant biliary obstruction.Methods: Twenty-three covered stents produced by us were placed in 18 patients with malignant biliary obstruction. Jaundice was caused by cholangiocarcinoma (n = 5), pancreatic cancer (n = 6), gallbladder cancer (n = 4), metastatic lymph nodes (n = 2), and tumor of the papilla (n 1).Results: The mean patency period of the stents was 37.5 weeks (5-106 weeks). Recurrent obstructive jaundice occurred in two patients (11%). Adequate biliary drainage over 50 weeks or until death was achieved in 17 of 18 patients (94.4%). Late cholangitis was observed in two patients whose stents bridged the ampulla of Vater. Other late severe complications were not encountered.Conclusion: Although more study is necessary, our results suggest the clinical efficacy of our covered Nitinol Strecker stent in the management of obstructive jaundice caused by malignant diseases

  4. Hemosuccus Pancreaticus: An Uncommon Cause of Gastrointestinal Hemorrhage. A Case Report

    Directory of Open Access Journals (Sweden)

    Chattopadhyay TK

    2004-09-01

    Full Text Available CONTEXT: Pseudoaneurysms of peripancreatic arteries usually arise as a complication of acute and chronic pancreatitis. These pseudoaneurysms may either bleed intra abdominally following rupture or may erode into the adjacent hollow viscera and manifest as gastrointestinal bleeding. Pseudoaneurysms rarely communicate with the pancreatic duct and bleeding occurs from the ampulla of Vater in the form of hemosuccus pancreaticus. CASE REPORT: We report a patient with chronic pancreatitis who presented with hemosuccus pancreaticus. Contrast enhanced computerized tomography and angiography revealed bleeding from a left gastric artery pseudoaneurysm. Despite multiple attempts, embolization was unsuccessful due to arterial spasm. The patient was successfully managed at emergency surgery by excision of the pseudoaneurysm sac and ligation of the left gastric artery. CONCLUSION: Bleeding from visceral artery pseudoaneurysms rarely manifests itself as hemosuccus pancreaticus. Most cases can be managed by angio-embolization. However, in patients with recurrent bleeding or failed embolization, emergency surgery is required.

  5. Chronic Calcific Pancreatitis Presenting as an Isolated Left Perinephric Abscess: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ragesh Babu Thandassery

    2011-09-01

    Full Text Available Context Acute and chronic pancreatitis may present with pseudocysts in atypical locations. Activated pancreatic enzymes track along anatomic fascial planes causing digestion of the surrounding tissues and resulting in distant pseudocysts. Pseudocysts at atypical locations pose significant diagnostic as well as therapeutic challenges. Case report We report an unusual presentation of a pancreatic pseudocyst in a young male who presented with a left perinephric abscess. Percutaneous drainage was not successful in resolving the abscess and he was subsequently diagnosed as having chronic pancreatitis together with a left perinephric abscess. Needle knife sphincterotomy of the ampulla of Vater resulted in the gradual resolution of the abscess. Conclusion We report a rare presentation of chronic pancreatitis with a perinephric abscess and its non-surgical management. This case report indicates that any patient presenting with a perinephric abscess of unknown etiology not responding to conventional treatment modalities should be investigated for underlying pancreatitis.

  6. Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm.

    Directory of Open Access Journals (Sweden)

    Shahani R

    1994-10-01

    Full Text Available Six male patients (age group: 30-60 years with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2, and bipolar ligation with underrunning of the aneurysm (3 were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.

  7. Hemosuccus pancreaticus: causa rara de hemorragia digestiva maciça Hemosuccus pancreaticus: a rare case of massive digestive hemorrhage

    Directory of Open Access Journals (Sweden)

    Fernando Antonio C. Spencer

    1999-04-01

    Full Text Available Hemosuccus pancreaticus is a unusual syndrome manifested by hemorrhage into the pancreatic duct and by blood loss through the ampulla of Vater: It may be caused by tumors, arteriovenous malformation, pancreatic lithiasis, aneurism rupture from adjacent vessels, or erosion of pancreatic and peripancreatic vessels due to chronic pancreatitis. The authors describe a case of massive and recurrent gastrointestinal upper hemorrhage in a 26-year-old man without known risk factors for pancreatitis. This man underwent urgent surgery due to gastrointestinal bleeding during the ínvestigation. During the procedure, blood was found in the intestinal lumen and a tumor in the head of pancreas with two centimeters of diameter: A gastroduodenopancreatectomy was performed. Histological study showed chronic pancreatitis with a fistula from the pancreatic vessels to the Wirsung duct. The patient was discharged without postoperative complications and after months, remains assymptomatic.

  8. Die Trauer von Kindern, Jugendlichen und jungen Erwachsenen um den verstorbenen Vater

    OpenAIRE

    Weiss, Sabine

    2006-01-01

    Die vorliegende Arbeit beschreibt die Trauer von Kindern, Jugendlichen und jungen Erwachsenen um den verstorbenen Vater. Dazu wird eine repräsentative nichtklinische Stichprobe aus 90 Kindern, Jugendlichen und jungen Erwachsenen im Alter von 10 bis 25 Jahren, deren Vater in den letzten Monaten und Jahren gestorben ist, zusammengestellt und mittels eines Fragebogens untersucht. Trauerreaktionen wie Kummer, Schuld, Verdrängung, fehlende Akzeptanz des Verlusts und Depression sind insgesamt be...

  9. Transplante renal em paciente pediátrico com associação de Vater: relato de caso Transplante renal en paciente pediátrico con asociación de Vater: relato de caso Renal transplantation in Vater association patient: case report

    Directory of Open Access Journals (Sweden)

    Antonio Paulo Nogueira Costa

    2003-06-01

    : La asociación de Vater es una ocurrencia extremamente rara y compleja y el presente relato se prende a la realización, por la primera vez, de transplante renal con donador cadáver en niño portador de ese defecto congénito cuyo resultado fue enteramente satisfactorio.BACKGROUND AND OBJECTIVES: Vater association is a polytopic disorder including several malformations of which radial hypoplasia is the most common observed at birth. This report aimed at describing a case of Vater association in a child submitted to renal transplantation. CASE REPORT: Male patient, 11 years old, 23 kg, Hbs positive, submitted to esophagostomy at 30 hours of life. Since 7 years of age patient is submitted to hemodialysis, currently via atrial catheter for the lack of other access ways. Renal transplantation with cadaver donor was performed without intercurrences with adequate diuresis after vascular anastomoses. Right iliac fossa hematoma was drained in the first postoperative day. Patient was discharged 21 days after transplantation with normal renal function. CONCLUSIONS: Vater association is an extremely rare and complex event and this report aimed at describing for the first time a renal transplantation with cadaver donor in a child with this congenital defect, the result of which has been fully satisfactory.

  10. Väter. Die Bedeutung des Vaters für die psychische Entwicklung des Kindes

    Directory of Open Access Journals (Sweden)

    Inge Seiffge-Krenke

    2004-11-01

    Full Text Available Das Buch behandelt die Bedeutung des Vaters für die psychische Entwicklung vor allem kleinerer Kinder anhand empirischer Daten und Befunde, die sich überwiegend auf Frankreich beziehen, z. T. aber auch deutsche und anglo-amerikanische Studien berücksichtigen

  11. „Der Sohn antwortet für den Vater nicht.“ Die deliktische Sippenhaftung: Ein deutschrechtlicher Grundsatz?

    OpenAIRE

    Harald Maihold

    2000-01-01

    Harald Maihold: Der Sohn antwortet für den Vater nicht (Zusammenfassung) Deutsche Rechtsquellen des Mittelalters und insbesondere deutsche Rechtssprichwörter werden oft allzu schnell als Ausdruck "älteren deutschen Rechts" gedeutet, ohne dabei den Zusammenhang mit dem gelehrten römisch-kanonischen Recht zu sehen. Anhand des Sprichwortes "Der Sohn antwortet für den Vater nicht" wird dieses Dilemma exemplarisch vorgeführt. Der genaue Inhalt des Sprichwortes ergibt sich erst im Kontext d...

  12. Die Entdeckung der Differenz: Zur Besonderheit des Vaters für das Kind

    Directory of Open Access Journals (Sweden)

    Beate Kortendiek

    2003-07-01

    Full Text Available In dem Sammelband wird in zehn Beiträgen aus psychoanalytischer und -therapeutischer sowie bindungs- und systemtheoretischer Perspektive nach der Bedeutung des Vaters für Säugling und Kleinkind gefragt. Hierbei geht es u.a. um die Analyse von Vaterlosigkeit, Bindungsentwicklungen, Spielsituationen und Schlafstörungen unter besonderer Berücksichtung der Entwicklung dyadischer und triadischer Beziehungen zwischen Vater, Mutter und Kind. Die Berichte sind von Wissenschaftler/-innen und Therapeut/-innen aus Österreich, Deutschland und der Schweiz verfasst und gehen zurück auf die Jahrestagung (2001 der „Deutschen Gesellschaft für die seelische Gesundheit in der frühen Kindheit“ (Germanspeeking Association für Infant Mental Health/GAIMH. Die Veröffentlichung ermöglicht einen Überblick über die aktuelle psychologisch orientierte Forschung und Debatte der frühen Beziehung zwischen Vater und Kind.

  13. Embryologic and anatomic basis of duodenal surgery.

    Science.gov (United States)

    Androulakis, J; Colborn, G L; Skandalakis, P N; Skandalakis, L J; Skandalakis, J E

    2000-02-01

    The following points should be remembered by surgeons (Table 1). In writing about the head of the pancreas, the common bile duct, and the duodenum in 1979, the authors stated that Embryologically, anatomically and surgically these three entities form an inseparable unit. Their relations and blood supply make it impossible for the surgeon to remove completely the head of the pancreas without removing the duodenum and the distal part of the common bile duct. Here embryology and anatomy conspire to produce some of the most difficult surgery of the abdominal cavity. The only alternative procedure, the so-called 95% pancreatectomy, leaves a rim of pancreas along the medial border of the duodenum to preserve the duodenal blood supply. The authors had several conversations with Child, one of the pioneers of this procedure, whose constant message was to always be careful with the blood supply of the duodenum (personal communication, 1970). Beger et al popularized duodenum-preserving resection of the pancreatic head, emphasizing preservation of endocrine pancreatic function. They reported that ampullectomy (removal of the papilla and ampulla of Vater) carries a mortality rate of less than 0.4% and a morbidity rate of less than 10.0%. Surgeons should not ligate the superior and inferior pancreaticoduodenal arteries because such ligation may cause necrosis of the head of the pancreas and of much of the duodenum. The accessory pancreatic duct of Santorini passes under the gastrointestinal artery. For safety, surgeons should ligate the artery away from the anterior medial duodenal wall, where the papilla is located, thereby avoiding injury to or ligation of the duct. "Water under the bridge" applies not only to the relationship of the uterine artery and ureter but also to the gastroduodenal artery and the accessory pancreatic duct. In 10% of cases, the duct of Santorini is the only duct draining the pancreas, so ligation of the gastroduodenal artery with accidental inclusion of

  14. Die Rolle des Vaters bei berufstätiger Mutter - Aufgabenbeteiligung, Lebenszufriedenheit und Schulleistung der Kinder

    OpenAIRE

    Röhr-Sendlmeier, Una M.; Bergold, Sebastian

    2012-01-01

    "Väterliche Rollenkonzepte, mütterliche Berufstätigkeit und die Zufriedenheit des Vaters in verschiedenen Lebensbereichen werden als Bedingungsfaktoren für die väterliche Beteiligung am Haushalt und an kindbezogenen Aufgaben untersucht und die Bedeutung dieser familiären Kontextvariablen für die Schulleistungen der Kinder in den Kernfächern Deutsch und Mathematik beleuchtet. Bei 279 Elternpaaren von Schülern und Schülerinnen in 3., 6. und 9. Klassen verschiedener Schultypen wurden Fragebogend...

  15. Pancreas divisum and duodenal diverticula as two causes of acute or chronic pancreatitis that should not be overlooked: a case report

    Directory of Open Access Journals (Sweden)

    De Filippo Massimo

    2008-05-01

    Full Text Available Abstract Introduction Pancreas divisum is a congenital anatomical anomaly characterized by the lack of fusion of the ventral and dorsal parts of the pancreas during the eighth week of fetal development. This condition is found in 5% to 14% of the general population. In pancreas divisum, the increased incidence of acute and chronic pancreatitis is caused by inadequate drainage of secretions from the body, tail and part of the pancreatic head through an orifice that is too small. The incidence of diverticula in the second part of the duodenum is found in approximately 20% of the population. Compression of the duodenal diverticula at the end of the common bile duct leads to the formation of biliary lithiasis (a principal cause of acute pancreatitis, pain associated with biliary lithiasis owing to compression of the common bile duct (at times with jaundice, and compression of the last part of Wirsung's duct or the hepatopancreatic ampulla (ampulla of Vater that may lead to both acute and chronic pancreatitis. Case presentation We describe the radiological findings of the case of a 75-year-old man with recurrent acute pancreatitis due to a combination of pancreas divisum and duodenal diverticula. Conclusion Magnetic resonance cholangiopancreatography is advisable in patients with recurrent pancreatitis (both acute and chronic since it is the most appropriate noninvasive treatment for the study of the pancreatic system (and the eventual presence of pancreas divisum and the biliary systems (eventual presence of biliary microlithiasis. Moreover, it can lead to the diagnostic suspicion of duodenal diverticula, which can be confirmed through duodenography with X-ray or computed tomography scan with a radio-opaque contrast agent administered orally.

  16. Small bowel gastrointestinal stromal tumours and ampullary cancer in Type 1 neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Fisher Cyril

    2004-01-01

    Full Text Available Abstract Background Type 1 neurofibromatosis (NF-1 is an autosomal dominant disorder with variable penetrance; approximately 50% of cases present as new mutations Case report We report a case of a 56 year-old man with Von Recklinghausen's disease, carcinoma of the ampulla of Vater and incidental benign gastrointestinal stromal tumours of the jejunum. Conclusions Coexistence between ampullary carcinoid, ectopic pancreatic tissue in the jejunum and neurofibroma of the jejunum in NF-1 has been previously described however; the association of synchronous carcinoma of the ampulla of Vater and gastrointestinal stromal tumour of the jejunum in NF-1 has not been previously reported.

  17. [Nephrotic syndrome associated with ampulloma].

    Science.gov (United States)

    López-Navidad, A; Colomina, J; Domingo, P; Franco, M; Algaba, F

    1989-06-01

    A patient is reported who presented simultaneously classic nephrotic syndrome and adenocarcinoma of the Vater ampulla. Morphological study of the renal biopsy revealed changes characteristic of membranous glomerulonephritis and subepithelial deposits. These deposits stained specifically for IgG and C'3 with a granular pattern, but deposits of CEA-antiCEA immune complexes were not found in glomerular capillaries. The association of nephrotic syndrome with lymphoproliferative diseases and a large variety of solid tumors, like carcinoma of the breast, bronchogenic, colon and stomach has been communicated, but the present case constitutes the first known association with adenocarcinoma of the Vater ampulla. PMID:2772382

  18. Die Lust am Vater The Desire for the Father

    Directory of Open Access Journals (Sweden)

    Heide Volkening

    2004-11-01

    Full Text Available Herrmanns Studie analysiert die Produktivität ödipaler Plot-Strukturen in der deutschsprachigen Literatur des 20. Jahrhunderts. Dabei zeigt sich die Persistenz männlicher Konfliktmuster des Expressionismus in der feministischen Literatur seit den 1960er Jahren. De-ödipalisierte Narrative findet Herrmann im US-amerikanischen Science-Fiction-Film.Herrmann’s study analyzes the productivity of Oedipal plot structures in German-language literature of the Twentieth Century. In doing so, the study illustrates the persistence of male modes of conflict as typical of Expressionism in post-60’s feminist literature. Herrmann finds de-oedipalized narratives in the American science fiction film.

  19. Computed tomography of obstructive jaundice

    International Nuclear Information System (INIS)

    It is well known that the computed tomography (CT) is very useful in the evaluation of obstructive jaundice. We have studied 55 cases of obstructive jaundice with whole body scanner from Jun.1980 to Jun. 1981. The results were as follows: 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice were seen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8 cases of common duct cancer, 4 cases of gallbladder cancer, 4 cases of ampulla vater cancer, 12 cases of common duct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15 cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorous condition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of the pancreas, 3 cases of the common bile duct, 1 case of the stomach, and 12 cases of adjacent lymph nodes. 5. Associated diseases were 12 cases of intrahepatic stone, 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst, 1 cases of hydronephrosis, and 1 case of renal cyst

  20. Computed tomography of obstructive jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Jung Hek; Lee, Joong Suk; Chun, Beung He; Suh, Soo Jhi [Kosin Medical College, Busan (Korea, Republic of)

    1982-09-15

    It is well known that the computed tomography (CT) is very useful in the evaluation of obstructive jaundice. We have studied 55 cases of obstructive jaundice with whole body scanner from Jun.1980 to Jun. 1981. The results were as follows: 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice were seen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8 cases of common duct cancer, 4 cases of gallbladder cancer, 4 cases of ampulla vater cancer, 12 cases of common duct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15 cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorous condition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of the pancreas, 3 cases of the common bile duct, 1 case of the stomach, and 12 cases of adjacent lymph nodes. 5. Associated diseases were 12 cases of intrahepatic stone, 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst, 1 cases of hydronephrosis, and 1 case of renal cyst.

  1. Radiological analysis of endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Advances in fiberoptic duodenscopy permit direct observation of interior of the duodenum and cannulation of the ampulla of Vater, and to perform endoscopic retrograde cholangiopancreatography. Authors analyzed the 30 cases of E.R.C.P. done at the Department of Radiology, Seoul National University Hospital between Feb. and Aug. 1977, which were compared with the final diagnosis. The results are as follows: 1. Out of 30 cases, successful visualization of the duct of concern was achieved in 23 cases. 2. Out of 10 cases of suspected pancreatic disease, pancreatic duct was visualized in 7 cases, and 5 cases revealed pathognomonic findings. All 5 cases were diagnosed as pancreatic cancer and their findings were encasement, local dilatation, poor filling and obstruction of pancreatic duct accompanying C.B.D. obstruction or stenosis, so called double doubt sign. 3. Out of 19 cases of suspected biliary tract disease, biliary tract was visualized in 16 cases and 14 cases revealed suggestive abnormal findings. In biliary stones, filling defect with proximal dilatation and obstruction were noted. 4. Post-E.R.C.P. complications were vague abdominal pain, asymptomatic hyperamyasemia, elevated amylase clearance ratio and symptoms due to premedication or post- E.R.C.P. antibiotics therapy. Elevated serum amylase concentration or clearance ratio were within normal range and it dose not seem to have clinical significance.

  2. Serum Hyperamylasemia as a prognostic indicator of acute viral hepatitis and cirrhosis of liver

    Directory of Open Access Journals (Sweden)

    N. Kaur

    2014-06-01

    Full Text Available Liver disease is a condition that causes liver inflammation or tissue damage and affects liver function. Liver functions tests are abnormal in various liver diseases such as hepatitis, cirrhosis and end stage liver disease. The study of pancreatic enzymes for prognostic purpose in evolving liver disease is gaining ground and act as prognostic indicator for liver diseases. Present study has been planned to assess the serum amylase status in 50 patients of acute viral hepatitis and 50 patients of cirrhosis of liver in comparison to 50 normal healthy control subjects. Levels of serum amylase were determined by CNP- G3 kinetic method. The serum levels of amylase were significantly raised (p<0.0001 in patients compared to control group and levels were observed to be constantly increased with increased severity of liver diseases. The probable cause of variation in serum amylase enzymes in acute viral hepatitis and cirrhosis of liver is its anatomical proximity and common egress system through Ampulla of vater into the duodenum.

  3. Spiral CT features of abdomen after whipple's operation

    International Nuclear Information System (INIS)

    To assess the CT features of postoperative anatomical changes, surgical complications, and patterns of tumor recurrence after Whipple's operation. 42 spiral CT scans of 31 patients who had undergone Whipple's operation were retrospectively reviewed. Postoperative diagnoses were distal CBD cancer in 13 patients, cancer of the ampulla of Vater in ten, cancer of the head of the pancreas in seven, and microcystic cystadenocarcinoma of the pancreas in one. Time intervals between surgery and CT ranged from 1 week to 5 years. CT features of postoperative anastomotic changes, surgical complications, and patterns of tumor recurrence were analyzed. Gastro- or duodeno-jejunal anastomosis was seen in 32 CT scans(74%), pancreaticojejunostomy in 27(64%), and choledochojejunostomy in 24(57%). Pneumobilia was seen in ten patients(34%). Abnormal fluid collections in the peripancreatic and perihepatic space were demonstrated in two patients who underwent CT scans within 3 weeks after operation. Other complications included wound abscess(n=2), and portal vein occlusion(n=1). The most common site of metastasis was the lymph node(n=8)(retroperitoneal:n=5; mesentery root:n=4; and celiac:n=2), followed by the liver(n=6), peritoneum(n=3), adrenal gland(n=2), and afferent loop(n=1). In three cases, there was local recurrence in the pancreatic bed. To reduce possible diagnostic errors during CT interpretation, a Knowledge of normal postoperative anatomy, common complications, and patterns of disease recurrence following Whipple's operation is important

  4. Delayed gastric emptying is associated with pylorus-preserving but not classical Whipple pancreaticoduodenectomy: A review of the literature and critical reappraisal of the implicated pathomechanism

    Institute of Scientific and Technical Information of China (English)

    Kosmas I Paraskevas; Costas Avgerinos; Costas Manes; Dimitris Lytras; Christos Dervenis

    2006-01-01

    Pylorus-preserving pancreaticoduodenectomy (PPPD)is nowadays considered the treatment of choice for periampullary tumors, namely carcinoma of the head,neck, or uncinate process of the pancreas, the ampulla of Vater, distal common bile duct or carcinoma of the peri-Vaterian duodenum. Delayed gastric emptying (DGE)comprises one of the most troublesome complications of this procedure. A search of the literature using Pubmed/Medline was performed to identify clinical trials examining the incidence rate of DGE following standard Whipple pancreaticoduodenectomy (PD) vs PPPD. Additionally we performed a thorough in-depth analysis of the implicated pathomechanism underlying the occurrence of DGE after PPPD. In contrast to early studies, the majority of recently performed clinical trials demonstrated no significant association between the occurrence of DGE with either PD or PPPD. PD and PPPD procedures are equally effective operations regarding the postoperative occurrence of DGE. Further randomized trials are required to investigate the efficacy of a recently reported (but not yet tested in largescale studies) modification, that is, PPPD with antecolic duodenojejunostomy.(C) 2006 The WJG Press. All rights reserved.

  5. [Relative increase and metacritic aggravation in the diagnosis of anicteric cholestasis].

    Science.gov (United States)

    Albot, G; Geraudias, P; Kind, M

    1975-02-14

    The authors report 3 cases and report the diagnostic usefulness of two signs of minor cholestasis described by one of them in 1966. A relative increase, in the absence of obvious virus hepatitis or cirrhosis, of the serum bilirubin, cholesterol, lipids and alkaline phosphatase, together with B.S.P. excretion. suggest minor cholestasis. The sign of "metacritical aggravation" when there is some suspicion of minor cholestasis, the supervision of the course of the disease, or a retrospective inquiry, permit, in the presence of minor symptoms, such as, pain, fever, jaundice, or pruritus, one to make the diagnosis of minor cholestasis. The latter is due either to the presence of small gall stones in the common bile duct, or to inflammation of the ampulla of Vater, or sphincter of Oddi, a Vaterian ampulloma, pancreatitis, or following damage to the common bile duct. In practice, liver biopsy confirms the diagnosis, and intravenous cholangiography, by the perfusion method, is usually able to demonstrate obstruction of the common bile duct. PMID:169583

  6. The Modified Kimura's Technique for the Treatment of Duodenal Atresia

    Directory of Open Access Journals (Sweden)

    Biagio Zuccarello

    2009-01-01

    Full Text Available Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results. Our “inverted-diamond-shaped-duodenoduodenostomy” (i-DSD allowed postoperative oral feeding to start on days 2 to 3, peripheral intravenous fluids discontinuity on days 3 to 8 (median values 3.6; time to achieve full oral feeds on days 8 to 12 (median values 9.4; the length of hospitalisation ranged from 10 and 14 days (median value 11.2. No complications related to the anastomosis, by Viz leakage, dehiscence, biliary stasis, or stenosis were observed. Conclusions. The i-DSD provides a safe procedure to protect the ampulla of Vater from injury and avoids any formation of a blind loop. The results show that patients who have i-DSD achieve full oral feeds in a very short time period and, consequently, the length of hospitalisation is also significantly reduced.

  7. Treatment of malignant biliary obstruction by endoscopic implantation of iridium 192 using a new double lumen endoprosthesis

    International Nuclear Information System (INIS)

    Iridium 192 seeds contained in a ribbon were preloaded into a new double lumen 11 Fr endoprosthesis which was then inserted into malignant strictures of the bile duct and ampulla and left in place for 48 hours until 5000 rads were delivered to the tumor. The procedure was carried out in 14 patients (7 women, 7 men; mean age, 63.2 years; range, 46 to 86 years). Six patients were treated for cholangiocarcinomas, four with pancreatic carcinomas, and four with ampullary carcinomas. No complications occurred. The mean survival of the group was 7 months (range, 3 days to 27 months). This new technique provides both intraluminal brachytherapy and biliary drainage and is inserted intraduodenally across the papilla of Vater avoiding puncture of the liver and external hardware required by the percutaneous technique and hardware necessitated with a nasobiliary tube. Following removal of the iridium prosthesis, a large caliber endoprosthesis is inserted for continued decompression. Because of proven efficacy of endoprostheses, this new technique should be considered when intraluminal irradiation is indicated

  8. Biliary tract intraductal papillary mucinous neoplasm: A brief report and review of literature

    Directory of Open Access Journals (Sweden)

    Raveendran Subhash

    2014-01-01

    Full Text Available Biliary Tract Intraductal Papillary Mucinous Neoplasm (BT-IPMN is a very rare entity, gradually emerging into attention as sporadic cases are being reported worldwide. In this brief report we discuss about such an entity from our part of the world, based on a case from our institution. A 47-year-old female was referred to our department with jaundice, intermittent fever with chills and rigor of 6 weeks duration. Initial evaluation revealed obstructive jaundice with distended gall bladder. Imaging with ultrasonogram (USG and magnetic resonance imaging (MRI showed hugely dilated intra and extrahepatic biliary radicles with multiple and diffuse soft tissue lesions filling the common bile duct (CBD extending to the ductal system of left lobe of liver. A side viewing endoscopy demonstrated mucin extruding from a prominent ampulla of Vater. The patient was managed successfully by left hepatectomy with pancreaticoduodenectomy (HPD. Gross pathological examination of the specimen showed marked dilatation of intra and extra hepatic bile ducts with multiple polypoidal lesions and plenty of mucin filling the entire biliary ductal system. Histopathology revealed predominantly intraductal papillary mucinous adenocarcinoma at the hilum extending to left bile duct with diffuse dysplastic changes throughout the biliary tree. Thus the clinical, radiological and pathological features of this lesion clearly fit into the diagnosis of BT-IPMN, which is slowly being established as a definite clinical entity with features much similar to its pancreatic counterpart.

  9. Polyorethaoe-covered nitinol strecker stents as primary palliative treatment of malignant biliary obstruction

    International Nuclear Information System (INIS)

    Purpose: To evaluate the clinical efficacy of the polyure-thane-covered Nitinol Strecker stent in the treatment of patients with malignant biliary obstruction.Methods: Twenty-three covered stents produced by us were placed in 18 patients with malignant biliary obstruction. Jaundice was caused by cholangiocarcinoma (n=5), pancreatic Cancer (n=6), gallbladder Cancer (n=4), metastatic lymph nodes (n=2), and tumor of the papilla (n=1).Resulrs: The mean patency period of the Stents was 37.5 weeks (5-106 weeks). Recurrent obstructive jaundice occurred in two patients (11%). Adequate biliary drainage over 50 weeks or until death was achieved in 17 of 18 patients (94.4%). Late cholangitis was observed in two patients whose stents bridged the ampulla of Vater. Other late severe complications were not encountered.Conclusion: Although more study is necessary, our results suggest the clinical efficacy of our covered Nitinol Strecker stent in the management of obstructive jaundice caused by malignant diseases.

  10. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Cha, Soon Joo [College of Medicine, Inje Univ., Kimhae (Korea, Republic of)

    2002-02-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 {+-}3.8 min. in the right approach and 9.6 {+-}3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9{+-}2.4 min. in the right approach and 3.8{+-}2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD.

  11. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    International Nuclear Information System (INIS)

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 ±3.8 min. in the right approach and 9.6 ±3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9±2.4 min. in the right approach and 3.8±2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD

  12. Emergency Pancreatoduodenectomy with Preservation of Gastroduodenal Artery for Massive Gastrointestinal Bleeding due to Duodenal Metastasis by Clear Cell Renal Cell Carcinoma in a Patient with Celiac Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kyriakos Neofytou

    2014-01-01

    Full Text Available Duodenal metastasis from renal cell carcinoma is rare, and even rarer is a massive gastrointestinal bleeding from such tumours. Coeliac occlusive disease, although rarely symptomatic, can lead to ischaemic changes with anastomotic dehiscence and leaks when a patient undergoes pancreatoduodenectomy. A 41-year-old man with known metastasis to the adrenal glands and the second part of the duodenum close to the ampulla of Vater from clear cell renal cell carcinoma was admitted to our department due to massive gastrointestinal bleeding from the duodenal metastasis. Endoscopic control of the bleed was not possible, while the bleeding vessel embolization was able to control the haemorrhage only temporarily. An angiography during the embolization demonstrated the presence of stenosis of the coeliac artery and also hypertrophic inferior pancreaticoduodenal arteries supplying the proper hepatic artery via the gastroduodenal artery (GDA. The patient underwent emergency pancreatoduodenectomy with preservation of the gastroduodenal artery. The patient had an uneventful recovery and did not experience further bleeding. Also the blood flow to the liver was compromised as shown by the normal liver function tests (LFTs postoperatively. To the best of our knowledge, this is the first report of a preservation of the GDA during an emergency pancreatoduodenectomy.

  13. Identification of new cancer biomarkers based on aberrant mucin glycoforms by in situ proximity ligation

    DEFF Research Database (Denmark)

    Pinto, Rita; Carvalho, Ana S; Conze, Tim;

    2012-01-01

    ) based on existing monoclonal antibodies directed to MUC1, MUC2, MUC5AC and MUC6 mucins and to cancer-associated carbohydrate antigens Tn, Sialyl-Tn (STn), T, Sialyl-Le(a) (SLe(a) ) and Sialyl-Le(x) (SLe(x) ) we screened a series of 28 mucinous adenocarcinomas from different locations (stomach, ampulla...... of Vater, colon, lung, breast and ovary) to detect specific mucin glycoforms. We detected Tn/STn/SLe(a) /SLe(x) -MUC1 and STn/SLe(a) /SLe(x) -MUC2 glycoforms in $50% of the cases, with a variable distribution among organs. Some new glycoforms-T/SLe(a) -MUC2, STn/T/SLe(a) /SLe(x) -MUC5AC and STn......Mucin glycoproteins are major secreted or membrane-bound molecules that, in cancer, show modifications in both the mucin proteins expression and in the O-glycosylation profile, generating some of the most relevant tumour markers in clinical use for decades. Thus far, the identification of these...

  14. Direct measurement of first-pass ileal clearance of a bile acid in humans

    International Nuclear Information System (INIS)

    The purpose of this study was to develop and validate a method of directly measuring ileal bile acid absorption efficiency during a single enterohepatic cycle (first-pass ileal clearance). This has become feasible for the first time because of the availability of the synthetic gamma-labeled bile acid 75Selena-homocholic acid-taurine (75SeHCAT). Together with the corresponding natural bile acid cholic acid-taurine (labeled with 14C), SeHCAT was infused distal to an occluding balloon situated beyond the ampulla of Vater in six healthy subjects. Completion of a single enterohepatic cycle was assessed by obtaining a plateau for 75SeHCAT activity proximal to the occluding balloon, which prevented further cycles. Unabsorbed 75SeHCAT was collected after total gut washout, which was administered distal to the occluding balloon. 75SeHCAT activity in the rectal effluent measured by gamma counter was compared with that of absorbed 75SeHCAT level measured by gamma camera and was used to calculate first-pass ileal clearance. This was very efficient (mean value, 96%) and showed very little variation in the six subjects studied (range, 95%-97%). A parallel time-activity course in hepatic bile for 14C and 75Se during a single enterohepatic cycle, together with a ratio of unity for 14C/75Se in samples obtained at different time intervals, suggests that 75SeHCAT is handled by the ileum like the natural bile acid cholic acid-taurine. Extrapolation of 75SeHCAT first-pass ileal clearance to that of the natural bile acid therefore seems justifiable. In a subsidiary experiment, ileal absorption efficiency per day for 75SeHCAT was also measured by scanning the gallbladder area on 5 successive days after the measurement of first-pass ileal clearance. In contrast with absorption efficiency per cycle, absorption efficiency per day varied widely (49%-86%)

  15. Expression of Bcl-2 and Bax in extrahepatic biliary tract carcinoma and dysplasia

    Institute of Scientific and Technical Information of China (English)

    Sheng-Mian Li; Shu-Kun Yao; Nobuyoshi Yamamura; Toshitsugu Nakamura

    2003-01-01

    AIM: To compare the difference of expression of Bcl-2 and Bax in extrahepatic biliary tract carcinoma and dysplasia, and to analyze the role of Bcl-2 and Bax proteins in the progression from dysplasia to carcinoma and to evaluate the correlation of Bcl-2/Bax protein expression with the biological behaviors.METHODS: Expressions of Bcl-2 and Bax were examined immunohistochemically in 27 cases of extrahepatic biliary tract carcinomas (bile duct carcinoma: n=21, carcinoma of ampulla of Vater: n=6), and 10 cases of atypical dysplasia.Five cases of normal biliary epithelial tissues were used as controls. A semiquantitative scoring system was used to assess the Bcl-2 and Bax reactivity.RESULTS: The expression of Bd-2 was observed in 10 out of 27 (37.0 %) invasive carcinomas, 1 out of 10 clysplasias, none out of 5 normal epithelial tissues. Bax expression rate was 74.1% (20/27) in invasive carcinoma, 30 % (3/10) in dysplasia,and 40 % (2/5) in normal biliary epithelium. Bcl-2 and Bax activities were more intense in carcinoma than in dysplasia,with no significant difference in Bcl-2 expression (P=0.1:10),and significant difference in Bax expression (P=0.038). Level of Bax expression was higher in invasive carcinoma than in dysplasia and normal tissue (P=0.012). Bcl-2 expression was correlated to Bax expression (P=0.0059). However, Bcl-2/Bax expression had no correlation with histological subtype,grade of differentiation, or level of invasion.CONCLUSION: Increased Bcl-2/Bax expression from dysplasia to invasive tumors supports the view that this is the usual route for the development of extrahepatic biliary tract carcinoma. Bcl-2/Bax may be involved, at least in part,in the apoptotic activity in extrahepatic biliary carcinoma.

  16. Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

    International Nuclear Information System (INIS)

    From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author)

  17. Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Masashi; Nakagawa, Hirofumi (National Shikoku Cancer Center Hospital, Ehime (Japan)); Kataoka, Masaaki (and others)

    1992-04-01

    From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author).

  18. Spiral CT features of abdomen after whipple's operation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T. H.; Lee, K. Y.; Shin, K. H.; Jung, M. H.; Park, C. M.; Cha, I. H. [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    To assess the CT features of postoperative anatomical changes, surgical complications, and patterns of tumor recurrence after Whipple's operation. 42 spiral CT scans of 31 patients who had undergone Whipple's operation were retrospectively reviewed. Postoperative diagnoses were distal CBD cancer in 13 patients, cancer of the ampulla of Vater in ten, cancer of the head of the pancreas in seven, and microcystic cystadenocarcinoma of the pancreas in one. Time intervals between surgery and CT ranged from 1 week to 5 years. CT features of postoperative anastomotic changes, surgical complications, and patterns of tumor recurrence were analyzed. Gastro- or duodeno-jejunal anastomosis was seen in 32 CT scans(74%), pancreaticojejunostomy in 27(64%), and choledochojejunostomy in 24(57%). Pneumobilia was seen in ten patients(34%). Abnormal fluid collections in the peripancreatic and perihepatic space were demonstrated in two patients who underwent CT scans within 3 weeks after operation. Other complications included wound abscess(n=2), and portal vein occlusion(n=1). The most common site of metastasis was the lymph node(n=8)(retroperitoneal:n=5; mesentery root:n=4; and celiac:n=2), followed by the liver(n=6), peritoneum(n=3), adrenal gland(n=2), and afferent loop(n=1). In three cases, there was local recurrence in the pancreatic bed. To reduce possible diagnostic errors during CT interpretation, a Knowledge of normal postoperative anatomy, common complications, and patterns of disease recurrence following Whipple's operation is important.

  19. A case report of an ampullary tumor presenting with spontaneous perforation of an aberrant bile duct and treated with total laparoscopic pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Kaplan Mehmet

    2012-07-01

    Full Text Available Abstract Background This case report discusses a patient who presented with bile peritonitis due to spontaneous perforation of an aberrant bile duct that originated in the triangular ligament of the liver. It was associated with an ampullary tumor and treated with total laparoscopic pancreaticoduodenectomy (TLPD. Case report A 58-year-old male patient was admitted to the emergency department of Medical Park Gaziantep Hospital in September 2009 with acute abdominal findings. He underwent an urgent laparoscopy, and, interestingly, bile peritonitis due to the rupture of an aberrant bile duct in the triangular ligament was noted. After laparoscopic treatment of the acute conditions, the follow-up examinations of the patient showed the finding of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed a 1-cm polypoid mass located at the ampulla of Vater (duodenal papilla with possible extension to the ampullary sphincter. A stent was inserted for temporary biliary drainage, and subsequent endoscopic biopsy showed the pathological finding of adenocarcinoma. After waiting for a 1-month period for the peritonitis to heal, the patient underwent pylorus-preserving TLPD and was discharged without any major complications on postoperative day 7. Conclusion In patients with bile peritonitis, it should be considered that the localization of the perforation may be in an aberrant bile duct localized at the triangular ligament and the etiology may be associated with an obstructing periampullary tumor. Laparoscopic pancreaticoduodenectomy is a feasible operative procedure in carefully selected patients. This technique can achieve adequate margins and follows oncological principles. Randomized comparative studies are needed to establish the superiority of minimally invasive surgery over traditional open surgery.

  20. Utility of single shot fast spin echo technique in evaluating pancreaticobiliary diseases: T2-weighted image and magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    To evaluate the accuracy of T2-weighted imaging an MR cholangiopancreatography using the single shot fast spin-echo technique for evaluating pancreaticobiliary disease. Between March and July 1997, axial and coronal T2-weighted images(TE: 80-200 msec) and MR cholangiopancreatograms (TE: 800-1200 msec) were obtained in two ways [single slab (thickness: 30-50 mm) and multislice acquisition under chemical fat saturation] using SSFSE pulse sequencing in 131 cases of suspected pancreati-cobiliary disease. The accuracy of SSFSE MR imaging was assessed in 89 lesions of 74 patients [male, 48; female, 26; age range, 30-86 (mean, 59) years] confirmed surgicopathologically (50 lesions in 39 patients) and clinically (39 lesions in 35 patients). Two radiologists reviewed the MR images and diagnosis was determined by consensus. Correct diagnosis was confirmed in 84 of 89 lesions (94%). Seven lesions were falsely interpreted, false positive and false negative results accounting for two and five cases, respectively. Two pancreatic cancers were misdiagnosed as pancreatitis and a cancer of the proximal common bile duct(CBD) was interpreted as a distal CBD cancer. The sensitivity of SSFSE MR imaging for malignancy was 93 %. One CBD stone revealed by endoscopic retrograde cholangiopancreatography (ERCP) was not detected on MR images. In contrast, a stone in the CBD seen on MR images was not apparent on subsequent ERCP. Sensitivity and specificity for calculous disease were 96% and 99.7%, respectively. A benign stricture of the ampulla of Vater was falsely interpreted as normal, and correct diagnosis was possible in two falsely diagnosed cases when MR images were reviewed retrospectively. The combination of T2-weighted and cholangiographic images using SSFSE is an accurate method for diagnosing pancreatcobiliary diseases

  1. Utility of single shot fast spin echo technique in evaluating pancreaticobiliary diseases: T2-weighted image and magnetic resonance cholangiopancreatography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byoung Wook; Kim, Myeong Jin; Chung, Jae Bok; Ko, Heung Kyu; Kim, Dong Joon; Kim, Joo Hee; Chung, Jae Joon; Yoo, Hyung Sik; Lee, Jong Tae [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To evaluate the accuracy of T2-weighted imaging an MR cholangiopancreatography using the single shot fast spin-echo technique for evaluating pancreaticobiliary disease. Between March and July 1997, axial and coronal T2-weighted images(TE: 80-200 msec) and MR cholangiopancreatograms (TE: 800-1200 msec) were obtained in two ways [single slab (thickness: 30-50 mm) and multislice acquisition under chemical fat saturation] using SSFSE pulse sequencing in 131 cases of suspected pancreati-cobiliary disease. The accuracy of SSFSE MR imaging was assessed in 89 lesions of 74 patients [male, 48; female, 26; age range, 30-86 (mean, 59) years] confirmed surgicopathologically (50 lesions in 39 patients) and clinically (39 lesions in 35 patients). Two radiologists reviewed the MR images and diagnosis was determined by consensus. Correct diagnosis was confirmed in 84 of 89 lesions (94%). Seven lesions were falsely interpreted, false positive and false negative results accounting for two and five cases, respectively. Two pancreatic cancers were misdiagnosed as pancreatitis and a cancer of the proximal common bile duct(CBD) was interpreted as a distal CBD cancer. The sensitivity of SSFSE MR imaging for malignancy was 93 %. One CBD stone revealed by endoscopic retrograde cholangiopancreatography (ERCP) was not detected on MR images. In contrast, a stone in the CBD seen on MR images was not apparent on subsequent ERCP. Sensitivity and specificity for calculous disease were 96% and 99.7%, respectively. A benign stricture of the ampulla of Vater was falsely interpreted as normal, and correct diagnosis was possible in two falsely diagnosed cases when MR images were reviewed retrospectively. The combination of T2-weighted and cholangiographic images using SSFSE is an accurate method for diagnosing pancreatcobiliary diseases.

  2. KL-6在肿瘤中的研究进展%Advanced research of KL-6 in malignant tumors

    Institute of Scientific and Technical Information of China (English)

    夏红强; 何建蓉

    2011-01-01

    KL - 6 ia a glycoprotein coded hy the MUCI gene , relative molecular weight close 200000 Dalton , has already been regarded as a indicator of interstitial lung diseases.In recent years some studies has confirmed the high expression of KL - 6 in patients with breast cancer, lung cancer, colon cancer, ampulla of Vater and the association with cancer progression, lymph node involvement and metastases.Serum KL - 6 is helpful marker and for predicting the development of cancer for lung cancer molecular targeted therapy.Evaluation of serum KL - 6 can be regarded as a predictive marker of radiation pneumonitis.%KL-6是由MUCl基因编码,相对分子量接近200000的糖蛋白.很早就已作为间质性肺疾病的血清学指标.近年来研究发现,KL-6在乳腺癌、肺癌、结肠癌、壶腹部癌等多种肿瘤中表达均增高,而且同有无淋巴结转移、远处转移密切相关.检测血清KL-6有助于了解乳腺癌、结肠癌等肿瘤的疾病发展和检测,并可以对肺癌某些靶向药物的疗效评估有预测作用.对于放射性肺炎有一定的预测作用.

  3. Pneumoperitoneum Caused by Transhepatic Air Leak After Metallic Biliary Stent Placement

    International Nuclear Information System (INIS)

    A self-expanding metallic biliary stent was placed for palliation of a common bile duct obstruction in a 68-year-old male with unresectable pancreatic head cancer 3 days after initial percutaneous right transhepatic catheter decompression. The stent crossed the ampulla of Vater. Three days later, the stent was balloon-dilated and the percutaneous access was removed. At removal, a small contrast leak from the transhepatic tract was seen. Three days later, pneumoperitoneum was found with symptoms of peritoneal irritation and fever. A widely open sphincter of Oddi caused by the metallic stent, accompanied by delayed sealing of the transhepatic tract, may have caused the air and bile leakage into the peritoneal space. This case shows that pneumoperitoneum may occur without ductal tear or bowel injury, with a biliary stent crossing the ampulla of Vater

  4. Small bowel gastrointestinal stromal tumours and ampullary cancer in Type 1 neurofibromatosis

    OpenAIRE

    Fisher Cyril; Wotherspoon Andrew; Spalding Duncan; Behranwala Kasim A; Thompson Jeremy N

    2004-01-01

    Abstract Background Type 1 neurofibromatosis (NF-1) is an autosomal dominant disorder with variable penetrance; approximately 50% of cases present as new mutations Case report We report a case of a 56 year-old man with Von Recklinghausen's disease, carcinoma of the ampulla of Vater and incidental benign gastrointestinal stromal tumours of the jejunum. Conclusions Coexistence between ampullary carcinoid, ectopic pancreatic tissue in the jejunum and neurofibroma of the jejunum in NF-1 has been ...

  5. Bone and brain metastases from ampullary adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Ioannis A Voutsadakis; Stergios Doumas; Konstantinos Tsapakidis; Maria Papagianni; Christos N Papandreou

    2009-01-01

    Ampullary carcinoma is the second most common cancer of the peri-ampullary area after pancreatic carcinoma and metastasizes mostly intra-abdominally and to the liver. Extra-abdominal metastases are less frequent. In this report we describe the case of a patient with resected adenocarcinoma of the ampulla of Vater who developed skeletal metastases in the lower extremity and brain metastases. We briefly discuss aspects of this comparatively rare gastrointestinal malignancy.

  6. Heterotopic Pancreas Mimicking Cholangiocarcinoma. Case Report and Literature Review

    OpenAIRE

    Atindriya Biswas; Ehab A. Husain; Roger M Feakins; Abraham, Ajit T

    2007-01-01

    Context Majority of the patients developing obstructive jaundice have an underlying malignancy. Identification of a benign pathology like heterotopic pancreas as an aetiology is uncommon and usually occurs only subsequent to a major operation. Case report We report a case of heterotopic pancreas adjacent to the ampulla of Vater mimicking distal cholangiocarcinoma. A 47- year-old patient presented with abdominal pain and obstructive jaundice. ERCP demonstrated a distal common bile duct strictu...

  7. Ascariasis cholecystitis: An unusual cause

    Directory of Open Access Journals (Sweden)

    Shetty Balakrishna

    2008-01-01

    Full Text Available Ascariasis is the most common helminthic infection to infest man. Usually the adult worm lives in the small intestine. Rarely it migrates through the ampulla of vater and enters the common bile duct. We are reporting a case of gall bladder ascariasis causing acute cholecystitis treated by laparoscopic cholecystectomy. Presence of Ascaris lumbricoides in gallbladder is rare entity as it is difficult to reach there due to the narrow and tortuous cystic duct.

  8. Ascariasis cholecystitis: An unusual cause

    OpenAIRE

    Shetty Balakrishna; Shetty Prashanth; Sharma Pritam

    2008-01-01

    Ascariasis is the most common helminthic infection to infest man. Usually the adult worm lives in the small intestine. Rarely it migrates through the ampulla of vater and enters the common bile duct. We are reporting a case of gall bladder ascariasis causing acute cholecystitis treated by laparoscopic cholecystectomy. Presence of Ascaris lumbricoides in gallbladder is rare entity as it is difficult to reach there due to the narrow and tortuous cystic duct.

  9. Ascariasis Presenting as Acute Abdomen—A Case Report

    OpenAIRE

    Nag, Hirdaya H.; Ji, Ram

    2012-01-01

    Infection with Ascaris lumbricoides is common in tropical and subtropical regions of the world. Prevalence of ascariasis is related to poverty, poor hygiene and poor fecal sanitation. This helminth usually lives harmlessly in small intestine but can also cause intestinal obstruction or perforation peritonitis which is common in childhood. Ascaris can also migrate through ampulla of vater to produce cholangitis, pancreatitis,cholecystitis and rarely hepatic abscess. Ascaris induced hepatic abs...

  10. Pressure morphology of the relaxed lower esophageal sphincter: the formation and collapse of the phrenic ampulla

    OpenAIRE

    Kwiatek, Monika A.; Nicodème, Frédéric; Pandolfino, John E; Kahrilas, Peter J

    2011-01-01

    This study aimed to apply novel high-resolution manometry with eight-sector radial pressure resolution (3D-HRM technology) to resolve the deglutitive pressure morphology at the esophagogastric junction (EGJ) before, during, and after bolus transit. A hybrid HRM assembly, including a 9-cm-long 3D-HRM array, was used to record EGJ pressure morphology in 15 normal subjects. Concurrent videofluoroscopy was used to relate bolus movement to pressure morphology and EGJ anatomy, aided by an endoclip ...

  11. Die Lust am Vater

    Directory of Open Access Journals (Sweden)

    Heide Volkening

    2004-11-01

    Full Text Available Herrmanns Studie analysiert die Produktivität ödipaler Plot-Strukturen in der deutschsprachigen Literatur des 20. Jahrhunderts. Dabei zeigt sich die Persistenz männlicher Konfliktmuster des Expressionismus in der feministischen Literatur seit den 1960er Jahren. De-ödipalisierte Narrative findet Herrmann im US-amerikanischen Science-Fiction-Film.

  12. Ampullary Xanthogranulomatous Inflammation Mimicking Periampullary Cancer: Report of a Case

    OpenAIRE

    Biju Pottakkat; Rajan Saxena; Hirdaya Hulas Nag; Neeraj Kumari; Narendra Krishnani

    2006-01-01

    Context : Xanthogranulomatous inflammation commonly affects the gallbladder. To date, there have been no reports of xanthogranulomatous inflammation of the ampulla. Case report :A 48-year-old female presented to us with fever, jaundice and a palpable gallbladder. Evaluation revealed features of periampullary malignancy. The patient underwent a Whipple’s pancreaticoduodenectomy. Histopathology revealed a xanthogranulomatous inflammation affecting the ampulla and the gallbladder. Conclusion :X...

  13. The evaluation of slow injection dynamic CT scan for the vascular invasion of cancer of biliary system and pancreas

    International Nuclear Information System (INIS)

    Dynamic CT body scans were performed under an injection rate of 3 ml/sec with a total amount of 100 ml angiografin by rapid table shift, upon 64 cancer patients, 21 patients with cancer of the bile duct, 21 with pancreatic cancer, 14 with cancer of the gallbladder and 8 with cancer of ampulla of papilla vater. In this study, the detectability of these cancers and the accuracy of their vascular invasion were compared between the above mentioned CT scan (slow injection D. CT) and angiography by our criteria. The detectability of the main tumors was 33.3 % by plain CT but 85.7 % by slow injection D. CT. The criteria of the vascular invasion by slow injection D. CT were classified to four types; separated type, contact type, contact invasive type and involved type. By this criteria, the diagnostic overall accuracy of the arterial invasion was 96.8 % in SMA, 98.4 % in celiac axis, 92.1 % in CH and 46.1 % in proper and bilateral hepatic arteries. The larger the arterial caliber was, the higher the diagnostic accuracy was in slow injection D. CT. On the other hand, the angiographic diagnostic accuracy of the arterial invasion was 79 % in SMA, 88.7 % in celiac axis, 90.3 % in CH and 98.4 % in proper and bilateral hepatic arteries. So, the smaller the arterial caliber was, the higher the diagnostic accuracy was in angiography. The overall accuracy of the portal venous invasion was 90.6 % by means of slow injection D. CT and 88.7 % by means of angiography. 33 of 64 cases were with portal venous invasion, and 15 of 33 cases were resectable by reconstraction of the portal vein. 4 of 15 were contact type, 10 of 15 were contact invasive type, 1 of 15 was involved type. 10 of 11 contact invasive type were resectable, and only 1 of 18 involved type was resectable, so it was safe to say the case of contact invasive type was resectable, and the case of involved type was unresectable. (author)

  14. Diagnosis, Preoperative Evaluation, and Assessment of Resectability of Pancreatic and Periampullary Cancer.

    Science.gov (United States)

    Verma, Ashish; Shukla, Sunit; Verma, Nimisha

    2015-10-01

    Periampullary region encircles a radius of 2 cm around the ampulla of Vater; accordingly, four distinct neoplasias with overlapping imaging features originate in the region. Each of these lesions has a different long-term prognosis; hence, imaging evaluation to characterize the lesion is important. Further certain specific features pertaining to the vascular invasion and systemic spread may decide about the treatment as well as surgical approach. An understanding of the advances in imaging and image processing technology as well as in the methods of image acquisition, for the purpose, is quite relevant towards etching out a rational pre-treatment evaluation protocol. Further, an evidence-based decision as to the choice of optimum modality for answering specific clinical question is of prime importance in achieving a reasonable post-treatment outcome. Pancreatic adenocarcinoma is the fourth most common cancer and a malignancy with one of the least 5-year survival rates (ranging from 6.8 to 15 % depending on peripancreatic extensions, dropping to 1.8 % for metastatic disease). A survival rate of 15-27 % can be achieved if the lesion is resectable but unfortunately, only 10-15 % of patients are eligible for resection. Cystic tumors of pancreas are a rarer variety of pancreatic neoplasia (5-15 % of pancreatic cysts and 1 % of all pancreatic cancers) which have a much better outcome and chances of resection. Being mostly incidentalomas, a timely differentiation of this lesion from the much more common pseudocyst (which would mandate a medical management and a different surgical protocol) is the key for curability. Lastly, the neuroendocrine tumors of pancreas are equally rare (1 % of all pancreatic tumors), but importantly due to associated clinical syndromes and their capability to metastasize early in the course of disease, a timely detection may hence be the key for successful treatment of these lesions. Imaging plays a vital role in the initial detection and

  15. Actinomycosis mimicking recurrent carcinoma after Whipple's operation

    Institute of Scientific and Technical Information of China (English)

    Jun-Te Hsu; Hung-Chieh Lo; Yi-Yin Jan; Han-Ming Chen

    2005-01-01

    Actinomycosis is a rare, chronic, spreading, suppurative,granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldom reported as pathogens. Herein, we reported on a 69-year-old male patient who had undergone Whipple's operation due to ampulla Vater carcinoma, and became infected with actinomycosis at the pancreaticojejunostomy, which mimicked a recurrent malignancy. He was treated with radical resection of the mass at the pancreaticojejunostomy and had an uneventful postoperative course.

  16. Vater einer großen Nachkommenschaft von Forschungsreisenden ...“ Ehrungen Alexander von Humboldts im Jahre 1869

    Directory of Open Access Journals (Sweden)

    Ilse Jahn

    2004-04-01

    Full Text Available Article in German, Abstracts in English and GermanIn 1869 the “Naturwissenschaftlicher Verein” was founded in Magdeburg (Saxony Anhalt. That was the time when the scientific world celebrated Alexander von Humboldt’s 100th birthday. In this context, Humboldt’s achievements were remembered during the founding ceremony of that society. The paper which was read in September 2003 on a meeting of this organisation, focuses on three famous naturalists who celebrated Humboldt because they owed him much help in their own professional careers. The botanist Matthias Jacob Schleiden gave a memorial speech in 1869 in Dresden. The physiologist and pioneer of electro-biology Emil du Bois-Reymond honoured his mentor A. v. Humboldt on the occasion of the dedication of the statues of Wilhelm and Alexander in 1883 in Berlin. Charles Darwin expressed his gratitude to Humboldt by sending him in 1839 the report of his travels and received an interesting reply. These three scholars represented a new epoch in the development of the natural sciences. The paper includes a recently re-discovered letter from Humboldt to Schleiden, dated April 13, 1842.

  17. Long-term follow-up of two patients with metastatic neuroendocrine tumours treated with octreotide

    NARCIS (Netherlands)

    van de Loosdrecht, AA; van Bodegraven, AA; Sepers, JM; Sindram, JW

    1998-01-01

    Two patients are described with metastatic neuroendocrine tumours of the pancreas head and region of Vater. After surgery, administration of the long-acting somatostatin analogue octreotide was started. In the first patient we found an IgG-lambda paraproteinaemia and a parathyroid hormone-related pr

  18. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed

  19. Ampullary Xanthogranulomatous Inflammation Mimicking Periampullary Cancer: Report of a Case

    Directory of Open Access Journals (Sweden)

    Biju Pottakkat

    2006-03-01

    Full Text Available Context : Xanthogranulomatous inflammation commonly affects the gallbladder. To date, there have been no reports of xanthogranulomatous inflammation of the ampulla. Case report :A 48-year-old female presented to us with fever, jaundice and a palpable gallbladder. Evaluation revealed features of periampullary malignancy. The patient underwent a Whipple’s pancreaticoduodenectomy. Histopathology revealed a xanthogranulomatous inflammation affecting the ampulla and the gallbladder. Conclusion :Xanthogranulomatous inflammation should be added to the differential diagnosis of patients presenting with a suspected periampullary lesion accompanied by a thick-walled gallbladder.

  20. Surfing and Swimming of Ejaculated Sperm in the Mouse Oviduct.

    Science.gov (United States)

    Ishikawa, Yu; Usui, Tomoyuki; Yamashita, Misuzu; Kanemori, Yoshinori; Baba, Tadashi

    2016-04-01

    To accomplish fertilization in the oviductal ampulla, ejaculated sperm are required to migrate through the female reproductive tract. However, this fundamental process largely remains unknown. In this study, we focused on the role of oviductal smooth muscle (myosalpinx) contractions in the sperm migration. Administration of prifinium bromide, padrin, to mice effectively suppressed myosalpinx contractions, resulting in a decreased rate of fertilization in a dose-dependent manner, and an abrogation of high-speed back-and-forth/shuttling flows of oviductal fluids around the isthmus. Regardless of padrin administration, no shuttling flows were found near the ampulla. In the isthmus, sperm formed a tight assemblage that was synchronized with the shuttling flows. The sperm assemblage was gradually loosened and then completely abolished near the ampulla. No sperm assemblage was formed in the isthmus when padrin was administrated. These results suggest that myosalpinx contractions play important roles in the formation of sperm assemblage in the isthmus, and in the transport of the assemblage to the middle region of the oviduct. It is also suggested that the motility of sperm is essential for the migration of sperm from the middle oviductal region to the ampulla. PMID:26962118

  1. Excitatory and inhibitory synaptic mechanisms at the first stage of integration in the electroreception system of the shark

    DEFF Research Database (Denmark)

    Rotem, Naama; Sestieri, Emanuel; Hounsgaard, Jørn Dybkjær;

    2014-01-01

    afferent nerve originating from the ampullae of Lorenzini targets specific neurons located at the Dorsal Octavolateral Nucleus (DON), the first stage of integration in the electroreception system. Using intracellular recordings in an isolated brainstem preparation from the shark we analyze the properties...

  2. Localization of transient receptor potential ion channels in primary and motile cilia of the female murine reproductive organs

    DEFF Research Database (Denmark)

    Teilmann, Stefan C.; Byskov, Anne Grete; Pedersen, Per Amstrup;

    2005-01-01

    polycystins are localized to motile oviduct cilia and this localization is greatly increased upon ovulatory gonadotropic stimulation. Further, the Ca2+ permeable cation channel, TRP vaniloid 4 (TRPV4), localizes to a sub-population of motile cilia on the epithelial cells of the ampulla and isthmus with high...

  3. Illustration of extensive extracellular matrix at the epithelial-mesenchymal interface within the renal stem/progenitor cell niche

    Directory of Open Access Journals (Sweden)

    Minuth Will W

    2012-09-01

    Full Text Available Abstract Background Stem/progenitor cells are promising candidates to treat diseased renal parenchyma. However, implanted stem/progenitor cells are exposed to a harmful atmosphere of degenerating parenchyma. To minimize hampering effects after an implantation investigations are in progress to administer these cells within an artificial polyester interstitum supporting survival. Learning from nature the renal stem/progenitor cell niche appears as a valuable model. At this site epithelial stem/progenitor cells within the collecting duct ampulla face mesenchymal stem/progenitor cells. Both cell types do not have close contact but are separated by a wide interstitium. Methods To analyze extracellular matrix in this particular interstitium, special contrasting for transmission electron microscopy was performed. Kidneys of neonatal rabbits were fixed in solutions containing glutaraldehyde (GA or in combination with cupromeronic blue, ruthenium red and tannic acid. Results GA revealed a basal lamina at the ampulla and a bright but inconspicuously looking interstitial space. In contrast, GA containing cupromeronic blue exhibits numerous proteoglycan braces lining from the ampulla towards the interstitial space. GA containing ruthenium red or tannic acid demonstrates clouds of extracellular matrix protruding from the basal lamina of the ampulla to the surface of mesenchymal stem/progenitor cells. Conclusions The actual data show that the interstitium between epithelial and mesenchymal stem/progenitor cells contains much more and up to date unknown extracellular matrix than earlier observed by classical GA fixation.

  4. Hepatic metastasis from bile duct cancer of the ampulla is effectively controlled by multidisciplinary treatment including S-1, gemcitabine and bevacizumab: A case report

    OpenAIRE

    TOKUNAGA, YUKIHIKO; KAWASAKI, TOSHIHIKO; Sasaki, Hirokazu; MATSUEDA, SHIGEKI; SAITO, TOHRU

    2010-01-01

    The liver is the most common site for recurrent metastases from bile duct cancer (BDC) in the ampullary area. However, the optimal chemotherapy regimen for recurrent hepatic metastases has not yet been established. An oral combined fluoropyrimidine drug, S-1 (tegafur, gimeracil and oteracil), has recently been introduced alone or in combination with gemcitabine for BDC. A 67-year-old man underwent a pancreaticoduodenectomy (PD) for early stage distal BDC in the ampullary area. A small hepatic...

  5. HYDRODYNAMIC BEHAVIOR OF AN UNDERWATER MOVING BODY AFTER WATER ENTRY

    Institute of Scientific and Technical Information of China (English)

    施红辉; 高见卓也

    2001-01-01

    An experimental study was conducted to investigate the vater entry phenomenon. A facility was designed to carry out the tests with the entry velocities of around 352 m/s. Visualization, pressure measurement, velocity measurement and underwater impact test were performed to investigate the hydroballistic behavior of the underwater moving body, the underwater flow field, the supercavitation,etc.. This study shows that the motion of a high-speed underwater body is strongly three-dimensional and chaotic. Furthermore, it is found that the distribution of the trajectory deflection of the underwater projectile depends on the depth of water. It is also found by measuring the deformation on a witness plate submerged in water,that the impact energy of an underwater projectile is reduced as it penetrates deeper into vater.

  6. Decompression of malignant biliary obstruction by duodenoscopic intubation of bile duct.

    OpenAIRE

    Laurence, B. H.; Cotton, P B

    1980-01-01

    Interest is increasing in non-operative methods of relieving malignant obstruction of the bile duct, and drainage tubes and prostheses may be placed in the bile duct via the percutaneous transhepatic route. Two cases are described, however, in which a duodenoscope was used and the approach was via the papilla of Vater. This method allows temporary or permanent drainage tubes to be placed through malignant strictures. This endoscopic approach is less invasive and should be safer than that by t...

  7. Sonographic images of hepato-pancreatico-biliary and intestinal ascariasis: A pictorial review

    OpenAIRE

    Lynser, Donboklang; Handique, Akash; Daniala, Chhunthang; Phukan, Pranjal; Marbaniang, Evarisalin

    2015-01-01

    Abstract Despite advancement in the diagnosis and treatment of intestinal helminthiasis, ascariasis remains the most common cause of helminthic infections in the developing countries. Ultrasound offers a rapid, safe, and noninvasive approach to the diagnosis of intestinal ascariasis. Ultrasound is also the modality of choice for diagnosis of hepatobiliary ascariasis, which is relatively rare and is due to migration of intestinal worms through the papilla of Vater. We present an imaging spectr...

  8. Ampullary Cancers Harbor ELF3 Tumor Suppressor Gene Mutations and Exhibit Frequent WNT Dysregulation

    Directory of Open Access Journals (Sweden)

    Marie-Claude Gingras

    2016-02-01

    Full Text Available The ampulla of Vater is a complex cellular environment from which adenocarcinomas arise to form a group of histopathologically heterogenous tumors. To evaluate the molecular features of these tumors, 98 ampullary adenocarcinomas were evaluated and compared to 44 distal bile duct and 18 duodenal adenocarcinomas. Genomic analyses revealed mutations in the WNT signaling pathway among half of the patients and in all three adenocarcinomas irrespective of their origin and histological morphology. These tumors were characterized by a high frequency of inactivating mutations of ELF3, a high rate of microsatellite instability, and common focal deletions and amplifications, suggesting common attributes in the molecular pathogenesis are at play in these tumors. The high frequency of WNT pathway activating mutation, coupled with small-molecule inhibitors of β-catenin in clinical trials, suggests future treatment decisions for these patients may be guided by genomic analysis.

  9. Clinical evaluation of a new serum tumour marker CA 242 in pancreatic carcinoma.

    OpenAIRE

    Pasanen, P. A.; Eskelinen, M.; Partanen, K.; Pikkarainen, P; Penttilä, I.; Alhava, E

    1992-01-01

    The aim of this study was to evaluate the new monoclonal tumour marker CA 242 in the diagnosis of pancreatic carcinoma and to compare it with the established markers CA 50 and CEA. Serum concentrations were determined in 113 patients with jaundice, in 20 patients with laboratory values suggesting cholestasis, and in 60 patients with a suspicion to have chronic pancreatitis. Twenty-four of these 193 patients had pancreatic carcinoma and two patients had carcinoma of papilla of Vater. The sensi...

  10. Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis

    OpenAIRE

    Hirokazu Inoue

    2001-01-01

    The characteristics of sites of intramural cancer spread were examined by comparing the intraductal ultrasonography (IDUS) and wall thickening findings at sites of intramural cancer spread and non-spread, in patients with malignant bile duct stenosis who had undergone percutaneous transhepatic biliary drainage (PTBD). The subjects were ten patients with extrahepatic bile duct cancer, two with pancreatic cancer, one with cancer of the gallbladder, and one with cancer of the papilla of Vater wh...

  11. [Current indications for pylorus saving duodenopancreatic head resection in malignancy].

    Science.gov (United States)

    Reith, H B; Kozuschek, W; Traverso, L W

    1996-01-01

    The Whipple procedure has been improved by preservation of a functioning pylorus. A functioning pylorus is important because marginal ulceration is avoided and, compared to the standard Whipple procedure with gastric resection, more patients can gain weight postoperatively. The most common indications are carcinomas of ampulla of Vater and periampullary tumors. In patients with pancreatic adenocarcinoma the pylorus-preserving variety results in equal or better survival rates. In 56 patients with pylorus preservation, 32 with ductal carcinoma, and 28 with Kausch-Whipple between 1985 and 1993, our results showed slightly better survival rates and better postoperative nutrition. The weakest aspect of the radical resection addresses the retroperitoneal margin of the pancreas head and not the gastric resection. PMID:8965594

  12. Planoepitheliale cell carcinoma arising from ampullopancreatic unit

    International Nuclear Information System (INIS)

    Background: We report a case of planoepitheliale cell carcinoma located in the ampulla of Vater. We report the surgical results and pathological findings of a patient with an ampullary planoepitheliale cell carcinoma. From what we know it is the first case with successful surgical treatment. Case Report: A 58-year-old woman who presented with jaundice and preoperative endoscopic and radiological procedures could not show whether the tumour was carcinoma planoepitheliale. The clinical presentation, biochemical, radiographic and endoscopic investigation pronounced advanced pancreatic adenocarcinoma. Results: We performed pancreaticoduodenectomy with curative intention. Histological examination revealed: planoepitheliale cell carcinoma of the ampullo-pancreatic unit. Conclusions: In conclusion, preoperative endoscopic and radiological evaluations can all prove insufficient to distinguish between benign and malignant tumour. Thus, for malignant tumours surgeons may be forced to perform extensive surgery. (authors)

  13. Endosonography-Guided Biliary Drainage with One-Step Placement of a Newly Developed Fully Covered Metal Stent Followed by Duodenal Stenting for Pancreatic Head Cancer

    OpenAIRE

    Kei Ito; Naotaka Fujita; Yutaka Noda; Go Kobayashi; Takashi Obana; Jun Horaguchi; Shinsuke Koshita; Yoshihide Kanno; Takahisa Ogawa; Yuhei Kato; Yasunobu Yamashita

    2010-01-01

    An 83-year-old man was admitted to our department, presenting with jaundice, fever, and nausea. CT revealed a pancreatic head tumor with duodenal invasion. Endoscopic transpapillary biliary drainage was unsuccessful due to stenosis at the second portion of the duodenum and tumor invasion to the papilla of Vater. Using a convex linear array echoendoscope, a fully-covered metal stent was placed across the puncture tract to bridge the duodenum and the bile duct. After improvement of jaundice, a ...

  14. Reporting tumor molecular heterogeneity in histopathological diagnosis.

    Directory of Open Access Journals (Sweden)

    Andrea Mafficini

    Full Text Available Detection of molecular tumor heterogeneity has become of paramount importance with the advent of targeted therapies. Analysis for detection should be comprehensive, timely and based on routinely available tumor samples.To evaluate the diagnostic potential of targeted multigene next-generation sequencing (TM-NGS in characterizing gastrointestinal cancer molecular heterogeneity.35 gastrointestinal tract tumors, five of each intestinal type gastric carcinomas, pancreatic ductal adenocarcinomas, pancreatic intraductal papillary mucinous neoplasms, ampulla of Vater carcinomas, hepatocellular carcinomas, cholangiocarcinomas, pancreatic solid pseudopapillary tumors were assessed for mutations in 46 cancer-associated genes, using Ion Torrent semiconductor-based TM-NGS. One ampulla of Vater carcinoma cell line and one hepatic carcinosarcoma served to assess assay sensitivity. TP53, PIK3CA, KRAS, and BRAF mutations were validated by conventional Sanger sequencing.TM-NGS yielded overlapping results on matched fresh-frozen and formalin-fixed paraffin-embedded (FFPE tissues, with a mutation detection limit of 1% for fresh-frozen high molecular weight DNA and 2% for FFPE partially degraded DNA. At least one somatic mutation was observed in all tumors tested; multiple alterations were detected in 20/35 (57% tumors. Seven cancers displayed significant differences in allelic frequencies for distinct mutations, indicating the presence of intratumor molecular heterogeneity; this was confirmed on selected samples by immunohistochemistry of p53 and Smad4, showing concordance with mutational analysis.TM-NGS is able to detect and quantitate multiple gene alterations from limited amounts of DNA, moving one step closer to a next-generation histopathologic diagnosis that integrates morphologic, immunophenotypic, and multigene mutational analysis on routinely processed tissues, essential for personalized cancer therapy.

  15. Heterotopic Pancreas Mimicking Cholangiocarcinoma. Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Atindriya Biswas

    2007-01-01

    Full Text Available Context Majority of the patients developing obstructive jaundice have an underlying malignancy. Identification of a benign pathology like heterotopic pancreas as an aetiology is uncommon and usually occurs only subsequent to a major operation. Case report We report a case of heterotopic pancreas adjacent to the ampulla of Vater mimicking distal cholangiocarcinoma. A 47- year-old patient presented with abdominal pain and obstructive jaundice. ERCP demonstrated a distal common bile duct stricture suspicious of cholangiocarcinoma. He underwent a pylorus-preserving pancreaticoduodenectomy. Histology showed a nodule of heterotopic pancreatic tissue adjacent to the ampulla. Conclusion We have reviewed the literature on heterotopic pancreas of the periampullary region presenting with biliary obstruction. This is a rare entity and remains difficult to diagnose, despite advances in radiological and endoscopic imaging techniques. For symptomatic patients with an established diagnosis of periampullary heterotopic pancreas, local excision may be sufficient. However, in the absence of unequivocal imaging or histological confirmation of benign pathology, and when there is a suspicion of underlying malignancy, pancreaticoduodenectomy may be the only treatment option, as in this case.

  16. Origins of bone repair in the armour of fossil fish: response to a deep wound by cells depositing dentine instead of dermal bone

    OpenAIRE

    Johanson, Zerina; Smith, Moya; Kearsley, Anton; Pilecki, Peter; Mark-Kurik, Elga; Howard, Charles

    2013-01-01

    The outer armour of fossil jawless fishes (Heterostraci) is, predominantly, a bone with a superficial ornament of dentine tubercles surrounded by pores leading to flask-shaped crypts (ampullae). However, despite the extensive bone present in these early dermal skeletons, damage was repaired almost exclusively with dentine. Consolidation of bone, by dentine invading and filling the vascular spaces, was previously recognized in Psammolepis and other heterostracans but was associated with ageing...

  17. Considerations of viscosity in the preliminaries to mammalian fertilisation

    OpenAIRE

    Hunter, Ronald H. F.; Coy, P; Gadea, J.; Rath, D

    2011-01-01

    Migration of spermatozoa in the female genital tract will be strongly influenced by the viscosity of the fluids encountered, yet little systematic analysis has been given to such a consideration. This essay reviews the series of milieux confronting a fertilising sperm during its progression to the oviduct ampulla. Two groups are discussed, first those in which ejaculation is into the vagina, second those in which semen enters the uterus during a protracted mating. Viscous glycoprotein secreti...

  18. What's in the Gift? Towards a Molecular Dissection of Nuptial Feeding in a Cricket.

    Directory of Open Access Journals (Sweden)

    Yannick Pauchet

    Full Text Available Nuptial gifts produced by males and transferred to females during copulation are common in insects. Yet, their precise composition and subsequent physiological effects on the female recipient remain unresolved. Male decorated crickets Gryllodes sigillatus transfer a spermatophore to the female during copulation that is composed of an edible gift, the spermatophylax, and the ampulla that contains the ejaculate. After transfer of the spermatophore, the female detaches the spermatophylax and starts to eat it while sperm from the ampulla are evacuated into the female reproductive tract. When the female has finished consuming the spermatophylax, she detaches the ampulla and terminates sperm transfer. Hence, one simple function of the spermatophylax is to ensure complete sperm transfer by distracting the female from prematurely removing the ampulla. However, the majority of orally active components of the spermatophylax itself and their subsequent effects on female behavior have not been identified. Here, we report the first analysis of the proteome of the G. sigillatus spermatophylax and the transcriptome of the male accessory glands that make these proteins. The accessory gland transcriptome was assembled into 17,691 transcripts whilst about 30 proteins were detected within the mature spermatophylax itself. Of these 30 proteins, 18 were encoded by accessory gland encoded messages. Most spermatophylax proteins show no similarity to proteins with known biological functions and are therefore largely novel. A spermatophylax protein shows similarity to protease inhibitors suggesting that it may protect the biologically active components from digestion within the gut of the female recipient. Another protein shares similarity with previously characterized insect polypeptide growth factors suggesting that it may play a role in altering female reproductive physiology concurrent with fertilization. Characterization of the spermatophylax proteome provides the

  19. What's in the Gift? Towards a Molecular Dissection of Nuptial Feeding in a Cricket.

    Science.gov (United States)

    Pauchet, Yannick; Wielsch, Natalie; Wilkinson, Paul A; Sakaluk, Scott K; Svatoš, Aleš; ffrench-Constant, Richard H; Hunt, John; Heckel, David G

    2015-01-01

    Nuptial gifts produced by males and transferred to females during copulation are common in insects. Yet, their precise composition and subsequent physiological effects on the female recipient remain unresolved. Male decorated crickets Gryllodes sigillatus transfer a spermatophore to the female during copulation that is composed of an edible gift, the spermatophylax, and the ampulla that contains the ejaculate. After transfer of the spermatophore, the female detaches the spermatophylax and starts to eat it while sperm from the ampulla are evacuated into the female reproductive tract. When the female has finished consuming the spermatophylax, she detaches the ampulla and terminates sperm transfer. Hence, one simple function of the spermatophylax is to ensure complete sperm transfer by distracting the female from prematurely removing the ampulla. However, the majority of orally active components of the spermatophylax itself and their subsequent effects on female behavior have not been identified. Here, we report the first analysis of the proteome of the G. sigillatus spermatophylax and the transcriptome of the male accessory glands that make these proteins. The accessory gland transcriptome was assembled into 17,691 transcripts whilst about 30 proteins were detected within the mature spermatophylax itself. Of these 30 proteins, 18 were encoded by accessory gland encoded messages. Most spermatophylax proteins show no similarity to proteins with known biological functions and are therefore largely novel. A spermatophylax protein shows similarity to protease inhibitors suggesting that it may protect the biologically active components from digestion within the gut of the female recipient. Another protein shares similarity with previously characterized insect polypeptide growth factors suggesting that it may play a role in altering female reproductive physiology concurrent with fertilization. Characterization of the spermatophylax proteome provides the first step in

  20. What’s in the Gift? Towards a Molecular Dissection of Nuptial Feeding in a Cricket

    OpenAIRE

    Pauchet, Yannick; Wielsch, Natalie; Wilkinson, Paul A.; Sakaluk, Scott K.; Svatoš, Aleš; ffrench-Constant, Richard H; Hunt, John; David G Heckel

    2015-01-01

    Nuptial gifts produced by males and transferred to females during copulation are common in insects. Yet, their precise composition and subsequent physiological effects on the female recipient remain unresolved. Male decorated crickets Gryllodes sigillatus transfer a spermatophore to the female during copulation that is composed of an edible gift, the spermatophylax, and the ampulla that contains the ejaculate. After transfer of the spermatophore, the female detaches the spermatophylax and sta...

  1. Copitarsia uncilata Burgos & Leiva sp. nov. de Cuculliinae para Colombia y México (Lepidoptera, Noctuidae Copitarsia uncilata Burgos & Leiva sp. nov. of Cuculliinae from Colombia and Mexico (Lepidoptera, Noctuidae

    Directory of Open Access Journals (Sweden)

    Rodrigo Burgos-Pino

    2010-01-01

    Full Text Available Se describe e ilustran los adultos y genitalia de macho y hembra de Copitarsia uncilata Burgos & Leiva sp. nov., que se distribuye en Colombia y México. La nueva especie se caracteriza por poseer un uncus ancho apicalmente espatulado con una diminuta proyección dorsal bulbosa, digitus de corte apical ampliamente cóncavo y una ampulla con ápice recurvado que sobresale de la valva, externamente es similar a Copitarsia decolora (Guenée.We describe and illustrate the adult and genitalia of male and female Copitarsia uncilata Burgos & Leiva sp. nov. which is distributed in Colombia and Mexico. The new species is characterized by having a broad spatulated uncus with an apical medium projection, digitus white a wide concave apical emargination and ampulla with recurved apex protruding from the valve. It is externally similar to Copitarsia decolora (Guenée.

  2. Efficacy of Black Tea as a Negative Oral Contrast Agent for MR Cholangiopancreatography (MRCP

    Directory of Open Access Journals (Sweden)

    Amir Hossein Jalali

    2010-05-01

    Full Text Available Background/Objective: Evaluation of the use of black tea as negative oral contrast agent in MR cholangiopancreatography (MRCP."nPatients and Methods: Thirty-five patients (mean age, 50.3±19.2 years, who were referred for MRCP, entered in this study. MRCP was performed before, after 5 minutes and after 15 minutes following consumption of 300 ml of black tea. Depiction of the gall bladder, cystic duct, proximal and distal parts of the common bile duct (CBD, intra hepatic ducts, ampula of Vater, main pancreatic duct (MPD and signal loss of the stomach and three different segments of the duodenum were investigated according to VAS and Lickert scores."nResults: Regarding visibility of seven different anatomical parts of the pancreatobiliary tree (gall bladder, cystic duct, CBD, common hepatic duct, intrahepatic duct, ampula of Vater and MPD, the post procedure images were better visualized only in the distal part of CBD, ampula of vater and MPD both in Lickert and VAS scoring (all Ps≤0.001."nThere was no significant difference between the images 5 and 15 minutes after tea consumption. Regarding the obliteration of high signal in the stomach and three different parts of the duodenum, all post tea images of the mentioned parts showed significant disappearance of high signal in Lickert and VAS scoring systems (all Ps≤0.001. "nConclusion: Black tea is an affordable, cheap, available, safe, and efficient oral negative contrast agent for MRCP which reduces the signal intensity of fluids in the gastrointestinal tract and is also efficient for better depiction of MPD, distal part of CBD and ampula.

  3. Gemcitabine-based versus fluoropyrimidine-based chemotherapy with or without platinum in unresectable biliary tract cancer: a retrospective study

    Directory of Open Access Journals (Sweden)

    Im Seock-Ah

    2008-12-01

    Full Text Available Abstract Background There is no standard palliative chemotherapy regimen in biliary tract cancers (BTC. Fluoropyrimidine or gemcitabine, with or without platinum, are most frequently used. We conducted this study to clarify the efficacy of palliative chemotherapy in BTC. Methods Patients with unresectable BTC treated with palliative chemotherapy between Oct 2001 and Aug 2006 at Seoul National University Hospital were reviewed retrospectively. Histologically confirmed cases of intrahepatic cholangiocarcinoma, gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater carcinoma were enrolled. We analyzed the efficacy of regimens: gemcitabine (G versus fluoropyrimidine (F and with or without platinum (P. Results A total of 243 patients were enrolled. 159 patients (65% were male and the median age of the patients was 60 years (range 26–81. Intrahepatic cholangiocarcinoma, gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater carcinoma were 92, 72, 58, and 21 cases, respectively. The median progression free survival (PFS was 4.3 months (95% CI, 3.7–4.9 and median overall survival (OS was 8.7 months (95% CI, 7.4–10.0. Ninety-nine patients received G-based chemotherapy (94 GP, 5 G alone, and 144 patients received F-based chemotherapy (83 FP, 61 F alone. The response rate (RR, disease control rate (DCR, PFS and OS of G-based chemotherapy versus F-based chemotherapy were 16.7% vs. 19.5% (P = 0.591, 52.8% vs. 58.9% (P = 0.372, 4.0 months vs. 4.3 months (P = 0.816, and 7.8 months vs. 9.1 months (P = 0.848, respectively. Sixty-six patients received F or G without P, and 177 patients received F or G with P. The RR, DCR, PFS and OS of chemotherapy without P versus chemotherapy including P were 12.7% vs. 20.6% (P = 0.169, 46.0% vs. 60.6% (P = 0.049, 3.3 months vs. 4.4 months (P = 0.887, and 10.6 months vs. 8.1 months (P = 0.257, respectively. Conclusion In unresectable BTC, F-based and G-based chemotherapy showed similar

  4. A 56-year-old woman with ampullary adenocarcinoma and acute pancreatitis Mujer de 56 años con adenocarcinoma de la ampolla de Vater y pancreatitis aguda

    Directory of Open Access Journals (Sweden)

    V. M. Santos

    2012-12-01

    Full Text Available A 56-year-old woman was admitted with jaundice, and laboratory data were indicative of pancreatitis, which recurred in spite of adequate clinical and nutritional management. The patient was an overweight diabetic using metformin, who had antecedents of cholelithiasis and recent cholecystectomy. Clinical and laboratory features were not conclusive about the cause of this acute pancreatitis. However, imaging data contributed to diagnosis suspicion, and the histopathology study of the transpapillary biopsy confirmed the ampullary adenocarcinoma. Whipple´s surgery was the procedure of choice, associated with radical lymphadenectomy, followed by an uneventful outcome. Recrudescence of signs and symptoms of acute pancreatitis, with elevated serum levels of bilirrubins and of hepatic canalicular enzymes, should enhance the suspicion index about periampullary tumors. High levels of CA 19-9 can constitute a useful marker of this condition. Transpapillary biopsy can characterize the diagnosis of ampullary malignancies.Se presenta el caso de una mujer de 56 años, que presentaba ictericia y cuyos exámenes de laboratorio fueran indicativos de pancreatitis. Presentó recurrencia a pesar de las medidas clínicas y nutricionales adecuadas. La paciente era diabética, con sobrepeso, tomaba metformina y con antecedentes de colelitiasis y reciente colecistectomía. Los datos clínicos y del laboratorio no fueron concluyentes acerca del origen de esta pancreatitis aguda. Sin embargo, los estudios de imagen contribuyeron a la sospecha del diagnóstico; los estudios de citologia exfoliativa y de biopsia transpapilar confirmaron un adenocarcinoma ampular. La cirugía de Whipple fue el procedimiento de opción, asociado con linfadenectomía radical, con resultado favorable. El recrudecimiento de señales y síntomas de pancreatitis aguda, con niveles séricos elevados de bilirrubina y de enzimas hepáticos debe reforzar el índice de sospecha acerca de tumores

  5. A case of carcinoma in an adenoma of the duodenal minor papilla successfully treated with endoscopic mucosal resection

    Science.gov (United States)

    Matsui, Toru; Matsubayashi, Hiroyuki; Hotta, Kinichi; Sasaki, Keiko; Ito, Hiroaki; Ono, Hiroyuki

    2016-01-01

    Background and study aims: Endoscopic papillectomy is currently used to treat noninvasive tumors of the papilla of Vater, but it is seldom reported for treatment of similar tumors of the minor papilla. This report describes the case of a 69-year-old female with a tumor located at the duodenal minor papilla. Findings of duodenoscopy, biopsy, and pancreatography indicated that her noninvasive tumor of the minor papilla was suitable for treatment with endoscopic resection. Glycerol-injected endoscopic mucosal resection (EMR) was performed, and the resected material histologically showed carcinoma in the adenoma, negative for neoplastic extension at the cut margin. No complications occurred during the treatment course, and no recurrence has been recognized for 80 months. Unlike the major papilla of Vater, the minor papilla can be lifted up by submucosal injection. Noninvasive epithelial tumors of the duodenal minor papilla without extension to the pancreatic duct can be successfully treated with EMR, as the technique is easy, it is minimally invasive, and it is curative. PMID:27004240

  6. Reproductive characteristics of the african pygmy hedgehog, atelerix albiventris.

    Science.gov (United States)

    Bedford, J M; Mock, O B; Nagdas, S K; Winfrey, V P; Olson, G E

    2000-09-01

    To obtain further perspective on reproduction and particularly gamete function among so-called primitive mammals presently grouped in the Order Insectivora, we have examined the African hedgehog, Atelerix albiventris, in light of unusual features reported in shrews and moles. Atelerix proves to share many but not all of the characteristics seen in these other insectivores. The penis of Atelerix has a 'snail-like' form, but lacks the surface spines common in insectivores and a number of other mammals. Hedgehog spermatozoa display an eccentric insertion of the tail on the sperm head, and they manifest the barbs on the perforatorium that, in shrews, probably effect the initial binding of the sperm head to the zona pellucida. As a possible correlate, the structural matrix of the hedgehog acrosome comprises only two main components, as judged by immunoblotting, rather than the complex of peptides seen in the matrix of some higher mammals. The Fallopian tube of Atelerix is relatively simple; it displays only minor differences in width and in the arborized epithelium between the isthmus and ampulla, and shows no evidence of the unusual sperm crypts that characterize the isthmus or ampulla, depending on the species, in shrews and moles. In common with other insectivores, Atelerix appears to be an induced ovulator, as judged by the ovulation of some 6-8 eggs by about 23 h after injection of hCG. The dense cumulus oophorus appeared to have little matrix, in keeping with the modest dimensions of the tubal ampulla and, while it was not quite as discrete as that of soricids, it did show the same insensitivity to 0.5% (w/v) ovine or bovine hyaluronidase. PMID:11006156

  7. Percutaneous placement of self-expandable metallic biliary stents in malignant extrahepatic strictures: indications of transpapillary and suprapapillary methods

    International Nuclear Information System (INIS)

    To compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. Stents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0 . 6 2 ). For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed

  8. Biliary endoprosthesis

    International Nuclear Information System (INIS)

    Biliary endoprosthesis could provide permanent internal biliary drainage in patient with obstructive jaundice with advantages of absence of troublesome external catheter and no loss of fluid, bile and electrolytes over external drainage. Incidence of sepsis and cholangitis be lowered. Endoprosthesis was performed in 18 patients of obstructive jaundice from January, 1985 to December, 1985 at Department of Radiology, Kyungpook National University Hospital. The results are as follows 2. The cases of obstructive jaundice included bile duct cancer in 11, stomach ca. metastasis in 3, ca. of ampulla of Vater in 1, ca. of head of pancreas in 1, CBD cancer with postop. recurrence in 1, and impacted CBD stone in 1 case. 2. The levels of obstruction were at the trifurcation in 8, CHD in 5, proximal CBD in 3, and distal CBD in 2 cases. 3. Decline of serum bilirubin level was noted in 15 cases with the most rapid decline within 1 week after the procedure. 4. The complication occurred in 5 cases. The three cases were recovered spontaneously, but one died of bile peritonitis, another experienced obstruction of endoprosthesis. 5. The endoprosthesis is beneficial in treatment of obstructive jaundice for which surgery is not indicated, and saving expensive abdominal surgery and less advantageous percutaneous external drainage, hence enhancing life quality.

  9. Morphometric Study of the Mare Oviductal Mucosa at Different Reproductive Stages.

    Science.gov (United States)

    Mouguelar, Horacio; Díaz, Tomás; Borghi, Damiana; Quinteros, Rolando; Bonino, Facundo; Apichela, Silvana Andrea; Aguilar, José Javier

    2015-11-01

    The objectives of this work were to describe some morphometric characteristics and to establish quantitative parameters of different regions of the equine oviductal mucosa from the isthmus, ampullary-isthmic junction (AIJ), and ampulla. Twenty-one mixed-bred mares were used for this study. Mares were selected in the following reproductive phases: anestrus, estrus, and diestrus. The left oviducts were examined with light microscopy, and rights ones were studied through the intraoviductal molds. The isthmus showed the smallest luminal area, mucosal area, epithelial perimeter, and luminal diameter. On the molds surfaces, some grooves extended as longitudinal canals, reducing their depth as they approached to the AIJ. Several small height projections, some obliquely positioned towards utero-tubal junction, were observed in all reproductive phases. These formations may represent pockets or cul-de-sacs in the basal areas of the epithelial folds. The AIJ mucosa gradually changed from the smooth isthmic region toward highly folded ampulla. The number and complexity of epithelial folds showed moderate increase in the same way that many of the morphometric parameters. Multiple curves were observed on the molds of the AIJ, creating a zigzag path in the oviductal lumen. In the ampulla, the high branched epithelial folds occupied most of the lumen, leaving a small luminal area free. A linear relationship between epithelial perimeter and mucosal area was found. The presence of glandular-like structures was observed in all the reproductive stages studied. The equine endosalpinx reveals a highly complex tridimensional arrangement where each region shows very particular and specific designs. PMID:26136388

  10. A note on the duodenum of the West Indian manatee (Trichechus manatus), with emphasis on the duodenal glands.

    Science.gov (United States)

    Reynolds, J E; Krause, W J

    1982-01-01

    The anatomy of the duodenum of the West Indian manatee has both macroscopic and microscopic features that are unusual when compared to other mammalian forms. Macroscopically, the voluminous duodenal ampulla and the paired duodenal diverticula are distinctive. The general microscopic structure of the manatee duodenum is not unusual, but the duodenal glands secrete an acid mucin (sialomucin). The cells of these glands appear to be intermediate between classical serous and mucous cell types. These cells also contain granules with regions of high peripheral electron density. The overall structure of the manatee duodenum most strongly resembles that of the dugong, another member of the order Sirenia. PMID:7148376

  11. The Rare Cancer Network: ongoing studies and future strategy

    Directory of Open Access Journals (Sweden)

    Mahmut Ozsahin

    2014-08-01

    Full Text Available The Rare Cancer Network (RCN was formed in the early 1990’s to create a global network that could pool knowledge and resources in the studies of rare malignancies whose infrequency prevented both their study with prospective clinical trials. To date, the RCN has initiated 74 studies resulting in 46 peer reviewed publications. The First International Symposium of the Rare Cancer Network took place in Nice in March of 2014. Status updates and proposals for new studies were heard for fifteen topics. Ongoing studies continue for cardiac sarcomas, thyroid cancers, glomus tumors, and adult medulloblastomas. New proposals were presented at the symposium for primary hepatic lymphoma, solitary fibrous tumors, Rosai-Dorfman disease, tumors of the ampulla of Vater, salivary gland tumors, anorectal melanoma, midline nuclear protein in testes carcinoma, pulmonary lymphoepithelioma-like carcinoma, adenoid cystic carcinoma of the trachea, osteosarcomas of the mandible, and extra-cranial hemangiopericytoma. This manuscript presents the abstracts of those proposals and updates on ongoing studies, as well a brief summary of the vision and future of the RCN.

  12. Laparoscopic ampullectomy for an ampullarian adenoma.

    Science.gov (United States)

    Borie, Frédéric; Zarzavadjian Le Bian, Alban

    2013-11-01

    Lesions involving the ampulla of Vater are rare entities (0.1-0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor's stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]. The continuous improvements in surgical techniques and instruments now allow the safe realization of laparoscopic ampullectomy, despite the few cases described in the literature [3, 4]. Here we present a surgical technique in a 52-year-old patient with an ampulloma. The ampulloma was discovered during a gastroscopy for abdominal pain. The endoscopic ultrasound with biopsy revealed a 15-mm adenoma with moderate-grade dysplasia. The thoracoabdominal CT scan was normal. The procedure was performed as shown. The tumor histology showed a R0 resection (5-mm surgical margin) of an adenoma with focal high-grade dysplasia. At 3-year follow-up, outcomes were unremarkable, without any complications. PMID:23836126

  13. 壶腹周围癌早期诊断和鉴别诊断%Eady and differential diagnosis of periampullary cancer

    Institute of Scientific and Technical Information of China (English)

    赵玉沛

    2008-01-01

    Periampullary cancer is a kind of malignant cancer of digestive tract.It arises within 2 cm of the major duodenal papilla and eomprises cancers of the ampulla,distal comliiOll bile duct,pancreas and duodenum.Their clinical features and anatomic locations are similar,as are the therapeutic approaches.However,their long-term outcomes vary.Due to the bad prognosis,it is very important to make an early,accurate diagnosis and differential diagnosis of periampullary cancer.This article summarizes some basic methods and new developments of early and differential diagnosis of poriampullary cancer.

  14. Co-Speciation of Earthworms and their nephridial symbionts, Acidovorax Spp

    DEFF Research Database (Denmark)

    Lund, Marie Braad; Fritz, Michael; Holmstrup, Martin;

    2006-01-01

    Earthworms (Annelida; Lumbricidae) harbour species-specific symbiotic bacteria in their nephridia (excretory organs) where the symbionts densely colonize a specific part of the nephridia called the ampulla [1]. The symbiosis is universal among earthworms, the symbionts form a monophyletic cluster...... of these non-Acidovorax symbionts are still to be investigated. [1] Knop, J. 1926. Z Morph Ökol Tiere, 6(3):588-624. [2] Schramm, A. et al. 2003. Environ Microbiol 5(9):804-809. [3] Davidson, S.K. & Stahl, D.A. 2006. Appl Environ Microbiol 72(1):769-775....

  15. Choledochoduodenal Fistula after the Placement of a Partially Covered Metal Stent for Unresectable Pancreatic Cancer.

    Science.gov (United States)

    Masuda, Daisuke; Ogura, Takeshi; Imoto, Akira; Onda, Saori; Sano, Tatsushi; Takagi, Wataru; Okuda, Atsushi; Takeuchi, Toshihisa; Fukunishi, Shinya; Inoue, Takuya; Higuchi, Kazuhide

    2016-01-01

    A 75-year-old Japanese man with type 2 diabetes mellitus suffered from unresectable pancreatic head cancer and was admitted to our institution due to acute cholangitis. A partially covered metal stent was placed at that time. 11 months later, he was readmitted for acute cholangitis. Upper endoscopy revealed complete stent distal migration and a small hole on the oral side of the ampulla. While attempting cannulation into the hole, an upstream biliary tract was revealed. Accordingly, we diagnosed the patient to have a choledochoduodenal fistula. After metal stent removal and balloon dilation, we placed two 7 Fr plastic stents, which successfully relieved the patient's cholangitis. PMID:27301511

  16. Earthworms and their Nephridial Symbionts: Co-diversification and Maintenance of the Symbiosis

    DEFF Research Database (Denmark)

    Lund, Marie Braad; Holmstrup, Martin; Davidson, Seana K.;

    Earthworms harbor in their nephridia (excretory organs) symbiotic bacteria which densely colonize a specific part of the nephridia, called the ampulla [1]. The symbiosis is species-specific and the symbionts form their own monophyletic genus Verminephrobacter (β-proteobacteria) [2] and are vertic......] Knop,J. 1926. Z Morph Ökol Tiere, 6(3):588-624. [2] Schramm,A. et al. 2003. Environ Microbiol 5(9):804-809. [3] Davidson,S.K. & Stahl,D.A. 2006. Appl Environ Microbiol 72(1):769-775. [4] Pandazis,G. 1931. Zentralbl Bakteriol 120:440-453....

  17. Dynamic and ultrastructural study of sphincter of Oddi in early-stage cholelithiasis in rabbits with hypercholesterolemia

    Institute of Scientific and Technical Information of China (English)

    Jing Guo Wei; Yao Cheng Wang; Fan Du; Hou Jun Yu

    2000-01-01

    AIM To study the relationship between preformation of gallstone and the kinetics and ultrastructure of sphincter of Oddi.METHODS Adult female rabbits were used and divided into 3 groups, and fed with either normal or high cholesterol diet for four or eight weeks.Each group contained eight rabbits. The manometry of sphincter of Oddi, biliary cineradiography, gallbladder volume measurement and ultrastructure observation under electron microscope were performed.RESULTS In groups Ⅰ and Ⅱ, the basal pressure in low-pressure ampulla or high pressure zone of sphincter of Oddi was elevated, the amplitude of phasic contraction was decreased and the volume of gallbladder were increased, with a significant difference (P<0.01) from those of control. Gallstones were found in group Ⅱ rabbits (7/8). Under cineradiography, low-pressure ampulla showed a spasmodic status without apparent peristaltic contraction. Under electron microscope, inside the muscular cells of sphincter of Oddi,loosening of microfilament and swelling of plasmosomes which congregated at the top were observed. The amount showed no obvious change under nitric oxide synthase (NOS) stain.CONCLUSION Twisting of the microfilament and disarrangement of kink macula densa inside the muscular cells suggested that the sphincter of Oddi was under spasmodic status. The impaired diastolic function caused and aggravated the stasis of cystic bile. The swelling plasmosome could be one of the important factors in elevating the tonic pressure of sphincter of Oddi.

  18. Considerations of viscosity in the preliminaries to mammalian fertilisation.

    Science.gov (United States)

    Hunter, Ronald H F; Coy, P; Gadea, J; Rath, D

    2011-03-01

    Migration of spermatozoa in the female genital tract will be strongly influenced by the viscosity of the fluids encountered, yet little systematic analysis has been given to such a consideration. This essay reviews the series of milieux confronting a fertilising sperm during its progression to the oviduct ampulla. Two groups are discussed, first those in which ejaculation is into the vagina, second those in which semen enters the uterus during a protracted mating. Viscous glycoprotein secretions that accumulate in the oviduct isthmus of both groups before ovulation are highlighted, as is the environment generated in the ampulla by the post-ovulatory suspension of oocyte(s), cumulus cells and spermatozoa; follicular and peritoneal fluids may also be present. The viscosity of all female tract fluids responds to cyclical variations in temperature, and these exist within the oviduct near the time of ovulation. Gradations in viscosity influence the pattern and strength of sperm flagellar activity and the rate of forward movement. Measurements of sperm motility are currently made in a physiological medium of constant viscosity and temperature, thereby overlooking changes in the female genital tract. A more sophisticated approach might reveal an adequate fertilising potential in a proportion of putatively poor semen samples. PMID:21234667

  19. An electrokinetic model of transduction in the semicircular canal.

    Science.gov (United States)

    O'Leary, D P

    1970-09-01

    Transduction in the semicircular canal was studied by focusing an infrared beam on either side of exposed ampullae from the posterior canals of Rana pipiens. The direction of fluid movement resulting from a stimulus was inferred by observing the polarity of the change in afferent impulse mean rate relative to the spontaneous value. On the basis of the accepted functional polarization of this receptor, the results indicate that fluid moved toward the warmer side of the ampulla. Convection and thermal reception were shown to be unlikely explanations for these results. Morover, cupular displacements toward the warmer side would not be expected. Because thermo-osmosis can cause fluid to move toward the warmer side in a gelatin membrane, the results can be interpreted as evidence that thermo-osmosis occurred in the gelatinous cupula and influenced the transduction mechanism. Thermo-osmosis of liquids appears to be due to an electric field that is set up in a charged membrane; hence, the hair cells might have detected an electric field that occurred in the cupula during thermo-osmosis. Electroreception might be an important link in the transduction of physiological stimuli also. Rotational stimuli could result in weak electric fields in the cupula by the mechanoelectric effect. Cupular displacements could be important for large stimuli, but extrapolations to threshold stimuli suggest displacements of angstrom amplitudes. Therefore, electroreception by the hair cells could be an explanation of the great sensitivity that has been observed in the semicircular canal and other labyrinthine receptors. PMID:5496906

  20. Choledochal Cysts with Chronic Pancreatitis in Adults: Report of Two Cases with a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Biswanath P Gouda

    2010-07-01

    Full Text Available Context Choledochal cysts, rarely present with chronic calcific pancreatitis. We report two patients with choledochal cysts who had concomitant chronic pancreatitis. Case report #1 A 27-year-old female with a history of recurrent abdominal pain, fever and jaundice presented with a type I choledochal cyst with calcifications in the uncinate process of the pancreas on CT scan. Her magnetic resonance cholangiopancreatogram (MRCP revealed calcifications in the region of the uncinate process of the pancreas, the presence of a type I choledochal cyst with dilatation of the right and left hepatic ducts at their confluence suggesting an anomalous pancreaticobiliary ductal junction. She underwent choledochal cyst excision with a Roux-en-Y hepaticojejunostomy. Case report #2 A 35-year-old male with colicky abdominal pain of four months duration whose CT scan was suggestive of an atrophic pancreas with a 1 cm dilatation of the pancreatic duct and a calculus in the pancreatic duct near the ampulla. MRCP showed significant atrophy of the pancreas with an isointense filling defect seen in the pancreatic duct at its distal end near the ampulla. A diagnosis of chronic calcific pancreatitis with type I choledochal cyst was made. He underwent choledochal cyst excision with a cholecystectomy, hepaticojejunostomy (end-to-side and side-to-side pancreaticojejunostomy. Conclusion Chronic calcific pancreatitis is a rare occurrence in patients with choledochal cysts and only six cases have been reported in the literature. Our two patients with choledochal cysts associated with chronic pancreatitis were treated surgically.

  1. Defecographic diagnosis of the puborectalis syndrome; Diagnosi mediante defecografia della sindrome del muscolo puborettale

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, Antonio; De Rosa, Aniello; De Luca, Luigi E.; Serpe, Alfredo; Losco, Matteo [Ospedale Loreto Mare, Naples (Italy). Servizio di Radiologia; Cavallo, Giovanni [Naples, II Univ. (Italy). Facolta` di Medicina

    1997-04-01

    The puborectalis syndrome is a defecation disorder supported by the nonrelaxation of puborectalis sling with consequent dyschezia. They report on a series of 98 patients submitted to clinical examination, defecography, anorectal manometry, electromyography and intestinal transit time studies. The main symptoms of puborectalis syndrome in their patients were incomplete defecation (89 %) and intermittent evacuation (63 %); 28 % of patients turned to finger defecation. In all patients, defecography showed an abnormal increase in puborectalis impression on the posterior anorectal wall, reduced anorectal angle opening under straining (mean value: 113 deg) and prolonged expulsion time with barium pooling in the ampulla (mean evacuation time: 38 seconds). Such anorectal abnormalities as rectal mucosal prolapse (47 cases) and anterior rectocele (36 cases) were also associated. In 33 of 98 patients (34 % of cases), sling assessment by bidigital palpation at preliminary clinical examination revealed puborectalis hypertonia, which was later confirmed at defecography. Manometry was not specific for the diagnosis of puborectalis syndrome, detecting increased external anal sphincter pressure under straining in 24 of 35 patients (68.8 %). Puborectalis activity was increased under straining in 16 subjects submitted to electromyography. Intestinal transit time studies showed a typical expulsion delay and radiopaque marker pooling in the ampulla in 18 of 23 patients (78.2 %). In their experience, defecography is a useful, simple and noninvasive method for the accurate diagnosis of the puborectalis syndrome.

  2. Minute ampullary carcinoid tumor with lymph node metastases: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sakano Shigeru

    2009-01-01

    Full Text Available Abstract Background Carcinoid tumors are usually considered to have a low degree of malignancy and show slow progression. One of the factors indicating the malignancy of these tumors is their size, and small ampullary carcinoid tumors have been sometimes treated by endoscopic resection. Case presentation We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT revealed a markedly dilated common bile duct (CBD and two enlarged peripancreatic lymph nodes. Endoscopy showed that the ampulla was slightly enlarged by a submucosal tumor. The biopsy specimen revealed tumor cells that showed monotonous proliferation suggestive of a carcinoid tumor. She underwent a pylorus-preserving whipple resection with lymph node dissection. The resected lesion was a small submucosal tumor (7 mm in diameter at the ampulla, with metastasis to 2 peripancreatic lymph nodes, and it was diagnosed as a malignant carcinoid tumor. Conclusion Recently there have been some reports of endoscopic ampullectomy for small carcinoid tumors. However, this case suggests that attention should be paid to the possibility of lymph node metastases as well as that of regional infiltration of the tumor even for minute ampullary carcinoid tumors to provide the best chance for cure.

  3. Sperm of Galeorhinus galeus (Elasmobranchii, Triakidae) Traverse an Excurrent Duct System Characterized by Pronounced Regionalization: A Scanning Electron and Light Microscopy Study.

    Science.gov (United States)

    Mcclusky, Leon Mendel

    2015-11-01

    The transport and subsequent maturation of spermatozoa in the vertebrate excurrent duct require the creation of a series of biochemically defined luminal milieus along the length of the duct. Such specialization is accomplished, among others, by changes in the epididymal histoarchitecture. Here we show that the intratesticular and extratesticular genital ducts of mating Galeorhinus galeus exhibit pronounced regionalization both in terms of epithelial histology and lumen diameter size. Findings also reveal distinct differences in the manner in which the spermatozoa were found in each segment of the duct. Novel scanning electron microscopy evidence is presented showing that the wide lumen ductuli epididymides, which ultimately convey the spermatozoa to the proximal epididymis, show functional specialization as well. The wall of the former consisted of cuboidal ciliated and nonciliated cells whose spatial arrangement in the duct wall resulted in a luminal surface showing lengthy rows of cilia-free areas, with each row bordered on both sides by a single row of cilia. The proximal epididymis comprised several subregions whose epithelial histology varied widely. The distal epididymis and ampulla of the epididymis possessed many fingerlike projections and transverse septa, respectively. As the main storage site for spermatozoa, the ampulla completed the bundling of spermatozoa into spermatozeugmata. These were circular sperm masses in which the heads of the spermatozoa were aligned side by side and embedded in a seminal matrix, while their tails extended outward. These findings of pronounced regionalization differ greatly from the rather uniform epididymal histology seen in some rays. PMID:26248611

  4. Denticle-embedded ampullary organs in a Cretaceous shark provide unique insight into the evolution of elasmobranch electroreceptors

    Science.gov (United States)

    Vullo, Romain; Guinot, Guillaume

    2015-10-01

    Here, we report a novel type of dermal denticle (or placoid scale), unknown among both living and fossil chondrichthyan fishes, in a Cretaceous lamniform shark. By their morphology and location, these dermal denticles, grouped into clusters in the cephalic region, appear to have been directly associated with the electrosensory ampullary system. These denticles have a relatively enlarged (˜350 μm in diameter), ornamented crown with a small (˜100 μm) asterisk- or cross-shaped central perforation connected to a multi-alveolate internal cavity. The formation of such a complex structure can be explained by the annular coalescence and fusion, around an ampullary vesicle, of several developmental units still at papillary stage (i.e. before mineralization), leading to a single denticle embedding an alveolar ampulla devoid of canal. This differs from larger typical ampullae of Lorenzini with a well-developed canal opening in a pore of the skin and may represent another adaptive response to low skin resistance. Since it has been recently demonstrated that ampullary organs arise from lateral line placodes in chondrichthyans, this highly specialized type of dermal denticle (most likely non-deciduous) may be derived from the modified placoid scales covering the superficial neuromasts (pit organs) of the mechanosensory lateral line system of many modern sharks.

  5. Ascariasis of the pancreatic duct.

    Science.gov (United States)

    Klimovskij, Michail; Dulskas, Audrius; Kraulyte, Zita; Mikalauskas, Saulius

    2015-01-01

    Ascariasis is a common helminthic disease worldwide, although Lithuania and other European countries are not considered endemic areas. The presence of the Ascaris worm in the biliary tree causes choledocholithiasis-like symptoms. We report a case of pancreatic duct ascariasis causing such symptoms. A 73-year-old Lithuanian woman underwent endoscopic retrograde cholangiopancreatography (ERCP) suspecting choledocholithiasis. Contrast injection into the common bile duct demonstrated a slightly dilated biliary tree without any filling defects, and the tail of an Ascaris worm protruding from the opening of the papilla Vater. The worm was captured by a snare but escaped deep into the duct. After a small wirsungotomy the worm was retrieved from the pancreatic duct. The patient received a 150 mg dose of levamisole orally repeated 7 days later and was discharged after complete resolution of symptoms. This first reported sporadic case of pancreatic duct ascariasis in Lithuania was successfully treated with ERCP and Levamisole. PMID:26374772

  6. Primary malignant tumours of the duodenum.

    Science.gov (United States)

    Nix, G A; Wilson, J H; Dees, J

    1985-04-01

    The clinical and radiological findings in 19 patients with primary duodenal malignancy are described. Weight loss, abdominal pain, nausea and vomiting were the main symptoms. Diagnosis was made by endoscopy or ERCP (71%) or by barium studies (68%). In retrospect the tumour was visible in 97% of the studies. Tumour growth was longitudinal, circular or spiral, the inner curvature being involved over a greater length than the outer curvature. Exophytic tumour growth, involvement of the papilla of Vater, malignant spikes, transient, non-constant tumour image, skip lesions and ulceration were often seen. Mean survival time was 18 months from start of symptoms in 10 inoperable patients, and 24 months in 9 patients undergoing resection. PMID:2986213

  7. The arc of Buhler: special considerations when performing pancreaticoduodenectomy.

    Science.gov (United States)

    Kageyama, Yumiko; Kokudo, Takashi; Amikura, Katsumi; Miyazaki, Yoshihiro; Takahashi, Amane; Sakamoto, Hirohiko

    2016-12-01

    A 74-year-old female was diagnosed as having a carcinoma of the papilla of Vater. Preoperative computed tomography showed stenosis of the celiac trunk and an enlarged artery arising from the superior mesenteric artery (SMA) joining the root of the splenic artery. Since this artery communicated with the SMA and the celiac trunk, independently of the gastroduodenal and dorsal pancreatic arteries, it was considered to be the arc of Buhler (AOB). The arterial blood flow to the liver, spleen, and stomach appeared to depend on the AOB, such that AOB preservation was considered to be essential. A subtotal stomach-preserving pancreaticoduodenectomy with preservation of the AOB was thus performed. Although AOB is a relatively infrequent type of arterial communication between the SMA and the celiac trunk, it needs to be preserved during pancreaticoduodenectomy when celiac trunk stenosis is present. PMID:26951124

  8. Successful Treatment of Colorectal Anastomotic Stricture by Using Sphincterotomes

    Directory of Open Access Journals (Sweden)

    Tzu-AnChen

    2014-06-01

    Full Text Available Colorectal or colocolic anastomotic stricture is a common complication after colorectal surgery. Traditionally, endoscopic balloon dilation technique was used for those patients with symptomatic stricture. The use of electroincision (radial incisions of the scar along with pneumatic balloon dilation was reported with good result in literature. We present a novel method for relieving colorectal anastomotic stricture by using sphincterotomes, which is indicated for use in the cannulation of the biliary ducts and the transendoscopic sphincterotomy of the papilla of Vater and the sphincter of Oddi. The use of sphincterotomes in upper GI tract anastomotic stricture were reported before, but the experience in managing lower GI tract was pending. Based on our preliminary report, sphincterotomes can be an effective and safe treatment option for colorectal anastomotic stricture.

  9. ERCP-the role of radiologist or what the endoscopist needs to know

    International Nuclear Information System (INIS)

    Endoscopic retrograde cholangiopancreatography (ERCP) is an interdisciplinary endoscopic-radiologic method for diagnosis and treatment of the diseases of the biliary and pancreatic ducts. The procedure requires an excellent technical experience and high professional qualification of the medical team. The cannulation of the papilla of Vater and the contrast imaging of the hepatobiliary tree and the pancreatic duct need co-operation between the radiologist and endoscopist for interpretation of the findings - malignant or benign stenosis, choledocholithiasis, iatrogenic lesions. The undertaken endoscopic therapeutic procedures are performed under fluoroscopic guidance as well as the subsequent assessment of their effective - stone extraction, stent placement, etc. The good collaboration of the team during each stage of the procedure can guarantee its success. (authors)

  10. Computed tomographic evaluation of pancreatic and peripancreatic cystic mass

    International Nuclear Information System (INIS)

    Forty-four cases of pancreatic cystic mass (pancreatic pseudocyst 37, pseudocyst caused by pancreatic carcinoma 2, mucous producing caner 2, cystadenoma 1, cystadenocarcinoma 2, and 16 cases of peripancreatic cystic mass (intestinal leiomyosarcoma 10, lymphonode metastasis 3, mesenteric hematoma 1, carcinoma of Vater's papilla 1, duplicating cyst of duodenum 1) were evaluated by computed tomography during the period from April 1978 to December 1984 at Fujita-Gakuen Health University Hospital. The most common cystic masses of pancreatic and peripancreatic lesion were pseudocyst. Although there are many cystic masses mimicking a pancreatic pseudocyst in pancreatic region, sometimes it is impossible to distinguish between cystic mass arising in the pancreas and the adjuvant organ. Difficulties in the computed tomographic differential diagnosis between pancreatic and peripancreatic cystic mass are analyzed and discussed in this paper. (author)

  11. Nitinol Stents for Palliative Treatment of Malignant Obstructive Jaundice: Should We Stent the Sphincter of Oddi in Every Case?

    International Nuclear Information System (INIS)

    Purpose: To evaluate the necessity of metallic stenting of the sphincter of Oddi in malignant obstructive jaundice when the tumor is more than 2 cm from the papilla of Vater.Methods: Sixty-seven self-expandable biliary stents were used in 60 patients with extrahepatic lesions of the common hepatic or common bile duct and with the distal margin of the tumor located more than 2 cm from the papilla of Vater. Stents were placed above the papilla in 30 cases (group A) and in another 30 with their distal part protruding into the duodenum (group B).Results: The 30-day mortality was 15%, due to the underlying disease. The stent occlusion rate was 17% after a mean period of 4.3 months. No major complications were noted. Average survival was 132 days for group A and 140 days for group B. In group A, 19 patients survived ≤ 90 days and in eight of these, cholangitis occurred at least once. Of 11 patients in group A with survival > 90 days, only two developed cholangitis. In group B, 13 patients who survived ≤ 90 days had no episodes of cholangitis and in 17 with survival > 90 days, cholangitis occurred in three. There is a statistically significant difference (p < 0.05) regarding the incidence of cholangitis in favor of group A.Conclusions: In patients with extrahepatic lesions more than 2 cm from the papilla and with a relative poor prognosis (≤ 3 months), due to more advanced disease or to a worse general condition, the sphincter of Oddi should also be stented in order to reduce the postprocedural morbidity

  12. Akut pancreatitis forårsaget af galdesten i barnealderen

    DEFF Research Database (Denmark)

    Zachariassen, G; Saffar, D F; Mortensen, J

    1999-01-01

    A 10 year-old girl presented with acute abdominal pain. Serum-amylase was 3959 U/l. Ultrasonography showed dilatation of both the common bile duct and the pancreatic duct and a high density area near the ampulla. Endoscopic retrograde cholangiography (ERC) verified a stone near the ampulla, which...

  13. Endosonography-Guided Biliary Drainage with One-Step Placement of a Newly Developed Fully Covered Metal Stent Followed by Duodenal Stenting for Pancreatic Head Cancer

    Directory of Open Access Journals (Sweden)

    Kei Ito

    2010-01-01

    Full Text Available An 83-year-old man was admitted to our department, presenting with jaundice, fever, and nausea. CT revealed a pancreatic head tumor with duodenal invasion. Endoscopic transpapillary biliary drainage was unsuccessful due to stenosis at the second portion of the duodenum and tumor invasion to the papilla of Vater. Using a convex linear array echoendoscope, a fully-covered metal stent was placed across the puncture tract to bridge the duodenum and the bile duct. After improvement of jaundice, a duodenal metal stent was placed across the stricture of the duodenum. No procedure-related complications occurred. Neither migration nor obstruction of the two stents was observed during the three months followup period. Combination of ESBD using a fully covered metal stent and duodenal stenting is a feasible technique and possibly a less invasive treatment option for malignant biliary and duodenal obstruction compared to surgery.

  14. Percutaneous transhepatic biliary drainage in 107 patients

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage has played a major role in treatment of patients of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was performed 128 times in 107 patients of obstructive jaundice for recent 2 years and 8 months from July, 1981 to March, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:1 and the age ranged from 19 to 88 with average of 54/ 2) The causes of obstructive jaundice included 94 malignant diseases and 13 benign diseases. Malignant diseases were 48 cases of bile duct cancer, 20 cases of metastasis, 20 cases of pancreatic cancer, 4 cases of gallbladder cancer, 1 case of ampulla Vater cancer, and 1 case of duodenal cancer. Benign diseases were 8 cases of common bile duct stone and 3 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 78 cases. 4) The overall success rate was 93.7%. Internal drainage was achieved in 34 (26.5%) and external drainage was accomplished in 86 (67.2%). 5) Decline in serum bilirubin level was found in 100 cases (93.3%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 6 of 107 cases (5.6%). Percutaneous transheaptic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery

  15. Percutaneous transhepatic biliary drainage in 107 patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn; Lim, Duk; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Percutaneous transhepatic biliary drainage has played a major role in treatment of patients of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was performed 128 times in 107 patients of obstructive jaundice for recent 2 years and 8 months from July, 1981 to March, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:1 and the age ranged from 19 to 88 with average of 54/ 2) The causes of obstructive jaundice included 94 malignant diseases and 13 benign diseases. Malignant diseases were 48 cases of bile duct cancer, 20 cases of metastasis, 20 cases of pancreatic cancer, 4 cases of gallbladder cancer, 1 case of ampulla Vater cancer, and 1 case of duodenal cancer. Benign diseases were 8 cases of common bile duct stone and 3 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 78 cases. 4) The overall success rate was 93.7%. Internal drainage was achieved in 34 (26.5%) and external drainage was accomplished in 86 (67.2%). 5) Decline in serum bilirubin level was found in 100 cases (93.3%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 6 of 107 cases (5.6%). Percutaneous transheaptic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery.

  16. Pancreaticoduodenectomy for periampullary tumors at Dr. Cipto Mangunkusumo Hospital, Jakarta

    Directory of Open Access Journals (Sweden)

    Toar J.M. Lalisang

    2004-09-01

    Full Text Available We reported our experience on 31 pancreaticoduodenectomy out of 141 periampullary tumors during 1994 until 2002; 16 of them were female, and age average 17-68 years. Jaundice was the most common presenting sign; 14 patients showed plasma albumin lower than 3.5 g/dl, and 10 patients had bilirubin level more than 10 mg/dl. We performed classical Whipple technique in 17, pyloric preserving pancreaticoduodenectomy in 11, and total pancreaticoduodenectomy in 3 patients. The mean of operative time was 436 minutes (290-570 minutes. The patients were grouped into 2 periods, between 1994-1999 and thereafter. With experience, the amount of blood loss has decreased from 2000 ml to 400 ml. Histopathologic results showed adenocarcinoma of the pancreas head in 11, adenocarcinoma of the ampulla of Vater in 11, carcinoma of duodenum in 4, head of pancreas benign cyst in 2, and benign tumor in 3 patients. The surgical mortality was 4 in the first 12 patients, in contrast to only 1 in the last 19 patients. The most serious complication was pancreatic leakage in 14 patients, in 4 of them it was responsible as the cause of death. The length of stay after operation varied between 12 and 47 days. Until the end of this report 7 patients are still alive, and 4 patients lost of contact. Recurrence was detected in 13 out of 22 survivors, occurring between 4 to 24 months after operation and 12 patients died 2-3 months later. Three patients died due to other causes. We conclude that pancreoticoduodenectomy is an effective technique, and the operative mortality is decreasing. Furthermore, morbidity especially from pancreatic leakages can be treated in our hospital. (Med J Indones 2004; 13: 166-70 Keywords: operative outcome, Whipple technique, pancreatic leakage

  17. Bile duct malignancies.

    Science.gov (United States)

    Tucek, S; Tomasek, J; Halámkova, J; Kiss, I; Andrasina, T; Hemmelová, B; Adámková-Krákorová, D; Vyzula, R

    2010-01-01

    Bile duct malignancies include intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gall bladder carcinoma (GC) and carcinoma of Vater's ampulla (ampulloma). Bile duct neoplasms are rare tumours with overall poor prognosis. The overall incidence affects up to 12.5 per 100,000 persons in the Czech Republic. The mortality rate has risen recently to 9.5 per 100,000 persons. The incidence and mortality have been remarkably stable over the past 3 decades. The survival rate of patients with these tumours is poor, usually not exceeding 12 months. The diagnostic process is complex, uneasy and usually late. Most cases are diagnosed when unresectable, and palliative treatment is the main approach of medical care for these tumours. The treatment remains very challenging. New approaches have not brought much improvement in this field. Standards of palliative care are lacking and quality of life assessments are surprisingly not common. From the scarce data it seems, however, that multimodal individually tailored treatment can prolong patients'survival and improve the health-related quality of life. The care in specialized centres offers methods of surgery, interventional radiology, clinical oncology and high quality supportive care. These methods are discussed in the article in greater detail. Improvements in this field can be sought in new diagnostic methods and new procedures in surgery and interventional radiology. Understanding the tumour biology on the molecular level could shift the strategy to a more successful one, resulting in more cured patients. Further improvements in palliative care can be sought by defining new targets and new drug development. The lack of patients with bile duct neoplasms has been the limiting factor for any improvements. A new design of larger randomized international multicentric clinical trials with prompt data sharing could help to overcome this major problem. Defining standards of palliative care is a necessity

  18. Endoscopic ultrasound-guided choledochoduodenostomies with fully covered self-expandable metallic stents

    Institute of Scientific and Technical Information of China (English)

    Tae Jun Song; Yil Sik Hyun; Sang Soo Lee; Do Hyun Park; Dong Wan Seo; Sung Koo Lee; Myung-Hwan Kim

    2012-01-01

    AIM:To investigate the long-term outcomes of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) with a fully covered self-expandable metallic stent (FCSEMS).METHODS:From April 2009 to August 2010,15 patients with distal malignant biliary obstructions who were candidates for alternative techniques for biliary decompression due to a failed endoscopic retrograde cholangiopancreatography (ERCP) were included.These 15 patients consisted of 8 men and 7 women and had a median age of 61 years (range:30-91 years).The underlying causes of the distal malignant biliary obstruction were pancreatic cancer (n =9),ampulla of Vater cancer (n =2),renal cell carcinoma (n =1),advanced gastric cancer (n =1),lymphoma (n =1),and duodenal cancer (n =1).RESULTS:The technical success rate of EUS-CDS with an FCSEMS was 86.7% (13/15),and functional success was achieved in 100% (13/13) of those cases.In two patients,the EUS-CDS failed because an FCSEMS with a delivery device could not be passed into the common bile duct.The mean duration of stent patency was 264 d.Early adverse events developed in three patients (3/13,23.1%),including self-limited pneumoperitoneum in two patients and cholangitis requiring stent reposition in one patient.During the follow-up period (median:186 d,range:52-388 d),distal stent migration occurred in four patients (4/13,30.8%).In 3 patients,the FCSEMS could be reinserted through the existing choledochoduodenal fistula tract.CONCLUSION:EUS-CDS with an FCSEMS is technically feasible and can lead to effective palliation of distal malignant biliary obstructions after failed ERCP.

  19. The Smell of Relics: Authenticating Saintly Bones and the Role of Scent in the Sensory Experience of Medieval Christian Veneration

    Directory of Open Access Journals (Sweden)

    Paul Anthony Brazinski

    2013-09-01

    Full Text Available ''The archaeology of smell is a burgeoning field in recent scholarship. This paper adds to existing literature by investigating the function of smell in relation to relic sales and veneration in medieval Europe, a hitherto understudied area of research. Collating historical texts concerning the translatio of saintly relics in Western Europe and the Byzantine Empire with archaeological sources associated with relic veneration and religious worship (including ampullae, unguentaria, sarcophagi, holy oils, pillow graves, and silk, this paper suggests that (1 smell was used in the medieval world as a means to challenge or confirm a relic’s authenticity, and (2 olfactory liquids that imbued or permeated material objects in the context of worship functioned as a means of focusing attention on relic veneration and were an essential part of the cult and/or pilgrimage experience.

  20. The Smell of Relics: Authenticating Saintly Bones and the Role of Scent in the Sensory Experience of Medieval Christian Veneration

    Directory of Open Access Journals (Sweden)

    Paul Anthony Brazinski

    2013-09-01

    Full Text Available The archaeology of smell is a burgeoning field in recent scholarship. This paper adds to existing literature by investigating the function of smell in relation to relic sales and veneration in medieval Europe, a hitherto understudied area of research. Collating historical texts concerning the translatio of saintly relics in Western Europe and the Byzantine Empire with archaeological sources associated with relic veneration and religious worship (including ampullae, unguentaria, sarcophagi, holy oils, pillow graves, and silk, this paper suggests that (1 smell was used in the medieval world as a means to challenge or confirm a relic’s authenticity, and (2 olfactory liquids that imbued or permeated material objects in the context of worship functioned as a means of focusing attention on relic veneration and were an essential part of the cult and/or pilgrimage experience.

  1. Anatomy of Tunga trimamillata Pampiglione et al., 2002 (Insecta, Siphonaptera, Tungidae and developmental phases of the gravid female

    Directory of Open Access Journals (Sweden)

    Pampiglione S.

    2005-09-01

    Full Text Available This paper deals with some internal anatomical features observed in histological sections and freshly dissected mounts of Tunga trimamillata, a Siphonaptera recently discovered in Andean regions of Ecuador from several mammals, including man. It was possible to study in males and also non-gravid and gravid females, the location and anatomy of several organs not previously described for this species: the testes, epididymis, ganglia, Malpighian tubules, eyes, rectal ampulla with one of its pads and structures which could be interpreted as midgut diverticula, whose presence has not been recorded in the Siphonaptera. The process of neosomy in the female during pregnancy is illustrated by photographs of the consecutive developmental phases, taken at the stereomicroscope. Furthermore, some details of the exoskeleton, spermatheca during different phases of pregnancy of the gravid female and the presence of a foreign body (parasite? within the haemocoel have been displayed in specimens cleared with Hoyer’s medium.

  2. False positive of the scintigraphy with octreoscan: a diagnosis of elimination; Faux positif de la scintigraphie a l'octreoscan: un diagnostic d'elimination

    Energy Technology Data Exchange (ETDEWEB)

    Charrier, N.; Brenot-Rossi, I.; Chuto, G.; Giovannini, M.; Delpero, J.R. [Institut Paoli-Calmettes, Marseille, (France)

    2009-05-15

    The imaging of receptors with somatostatin analogs by the pentetreotide-indium 111 (octreoscan) allows the detection of endocrine tumors essentially according to the density of S.S.T.2 receptors at the tumor level. The sensitivity of octreoscan for the detection of intestine endocrine tumors is included between 80 and 100% in the different studies. The clinical case presented here enlightens a case of false positive.We concluded to a physiological elimination of pentetreotide-indium 111 with intra pancreatic biliary stasis (perhaps a dysfunction of sphincter of ampulla of bile duct) and to the lack of tumor centre. It is here a diagnosis of elimination, supported by the different results of examination. all normal. This case of false positive induced expensive and traumatic explorations for the patient. (N.C.)

  3. Laparoscopic surgery in the treatment of nonruptured tubal pregnancy

    Science.gov (United States)

    Mutrynowski, Andrzej; Zabielska, Renata

    1996-03-01

    Introduction of the endoscopic techniques into gynecology enabled a change in the procedures in the case of ectopic pregnancy. This paper aims at presenting 76 cases of non-ruptured tubal pregnancies treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the Nd:YAG laser. The investigated group consisted of 76 patients. Forty-one (54%) of them were operated on using electrocoagulation and 35 (46%) using the Nd:YAG laser. Sixty-three pregnancies (83%) were localized in the ampulla. The ectopic pregnancy was confirmed histopathologically in 74 cases (97%). There were no complications noticed in the postoperative course. There were no differences in the efficacy and the postoperative general condition in cases treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the laser.

  4. Nodular renal blastoma in kidney with multicystic dysplasia. Report of a case.

    Science.gov (United States)

    Corsi, A; Boldrini, R; Caione, P; Bosman, C

    1995-04-01

    The clinico-pathologic association of nodular renal blastema, multicystic kidney and obstructive uropathy has been recently identified. We report on a female patient diagnosed as having unilater multicystic dysplasia by prenatal ultrasonography. The patient was nephrectomized at the age of 6 1/2 months. Examination of the resected kidney revealed multiple unilocular cysts in the cortex and hypoplasia of the homolateral ureter; histological study confirmed the presence of multiple cysts limited to the renal cortex, and revealed, among them, multiple cortical metanephric blastema cells islands. Our case supports a relationship between nodular renal blastema, cortical cysts and obstructive uropathy; ureter hypoplasia could cause intraluminal back pressure, with consequent abnormal development of the ampullae, normally endowed in nephronic anlagens induction, cystic tubular ectasia and persistence of nodular renal blastema. The peripheral location of renal nodular blastema and cysts supports a late error in nephrogenesis, at the time of formation of the last generation of nephrons. PMID:8532415

  5. Presentation and Surgical Management of Duodenal Duplication in Adults

    Directory of Open Access Journals (Sweden)

    Caroline C. Jadlowiec

    2015-01-01

    Full Text Available Duodenal duplications in adults are exceedingly rare and their diagnosis remains difficult as symptoms are largely nonspecific. Clinical presentations include pancreatitis, biliary obstruction, gastrointestinal bleeding from ectopic gastric mucosa, and malignancy. A case of duodenal duplication in a 59-year-old female is presented, and her treatment course is reviewed with description of combined surgical and endoscopic approach to repair, along with a review of historic and current recommendations for management. Traditionally, gastrointestinal duplications have been treated with surgical resection; however, for duodenal duplications, the anatomic proximity to the biliopancreatic ampulla makes surgical management challenging. Recently, advances in endoscopy have improved the clinical success of cystic intraluminal duodenal duplications. Despite these advances, surgical resection is still recommended for extraluminal tubular duplications although combined techniques may be necessary for long tubular duplications. For duodenal duplications, a combined approach of partial excision combined with mucosal stripping may offer advantage.

  6. mRNA Expression of VEGF and Its Receptors in Fallopian Tubes of Women with Ectopic Pregnancies

    Directory of Open Access Journals (Sweden)

    Nafise Zarezade

    2015-04-01

    Full Text Available Background: Establishment of viable pregnancy requires embryo implantation and placentation. Ectopic pregnancy (EP is a pregnancy complication which occurs when an embryo implants outside of the uterine cavity, most often in a fallopian tube. On the other hand, an important aspect of successful implantation is angiogenesis. Vascular endothelial growth factor (VEGF is a potent angiogenic factor responsible for vascular development that acts through its receptors, VEGF receptor 1 (VEGFR1 and VEGFR2. This study aims to investigate mRNA expression of VEGF and its receptors in fallopian tubes of women who have EP compared with fallopian tubes of pseudo-pregnant women. We hypothesize that expression of VEGF and its receptors in human fallopian tubes may change during EP. Materials and Methods: This was a case-control study. The case group consisted of women who underwent salpingectomy because of EP. The control group consisted of women with normal fallopian tubes that underwent hysterectomy. Prior to tubal sampling, each control subject received an injection of human chorionic gonadotropin (hCG to produce a state of pseudo-pregnancy. Fallopian tubes from both groups were procured. We investigated VEGF, VEGFR1 and VEGFR2 mRNA expressions in different sections of these tubes (infundibulum, ampulla and isthmus by reverse transcription polymerase chain reaction (RT-PCR and quantitative PCR (Q-PCR. Results: RT-PCR showed expressions of these genes in all sections of the fallopian tubes in both groups. Q-PCR analysis revealed that expressions of VEGF, VEGFR1 and VEGFR2 were lower in all sections of the fallopian tubes from the case group compared to the controls. Only VEGFR2 had higher expression in the ampulla of the case group. Conclusion: Decreased expressions of VEGF, VEGFR1 and VEGFR2 in the EP group may have a role in the pathogenesis of embryo implantation in fallopian tubes.

  7. Sylphella puccoon gen. n., sp. n. and two additional new species of aquatic oligochaetes (Lumbriculidae, Clitellata from poorly-known lotic habitats in North Carolina (USA

    Directory of Open Access Journals (Sweden)

    Pilar Rodriguez

    2014-11-01

    Full Text Available Three new species of Lumbriculidae were collected from floodplain seeps and small streams in southeastern North America. Some of these habitats are naturally acidic. Sylphella puccoon gen. n., sp. n. has prosoporous male ducts in X–XI, and spermathecae in XII–XIII. Muscular, spherical atrial ampullae and acuminate penial sheaths distinguish this monotypic new genus from other lumbriculid genera having similar arrangements of reproductive organs. Cookidrilus pocosinus sp. n. resembles its two subterranean, Palearctic congeners in the arrangement of reproductive organs, but is easily distinguished by the position of the spermathecal pores in front of the chaetae in X–XIII. Stylodrilus coreyi sp. n. differs from congeners having simple-pointed chaetae and elongate atria primarily by the structure of the male duct and the large clusters of prostate cells. Streams and wetlands of Southeastern USA have a remarkably high diversity of endemic lumbriculids, and these poorly-known invertebrates should be considered in conservation efforts.

  8. En varice i vortexvenens ampul er en sjælden differentialdiagnose til malignt melanom i årehinden

    DEFF Research Database (Denmark)

    Rimsaite, Audrone; Andersen, Carl Uggerhøj

    2015-01-01

    Melanoma of the choroid is the most frequent primary intra-ocular malignancy whereas a varix of the vortex vein ampulla is a benign, rare and asymptomatic condition requiring no treatment. A varix of the vortex vein ampulla is usually found acci-dentally and can easily be mistaken for a choroidal...... melanoma, a naevus or a haemorrhage. We present a case of a varix of the vortex vein ampulla, which can be distinguished from other more serious conditions by using simple clinical methods....

  9. Description of Sidneioides peregrinus sp. nov. (Tunicata: Ascidiacea: Polyclinidae: a possible exotic species in the Atlantic Ocean

    Directory of Open Access Journals (Sweden)

    Laura Pioli Kremer

    2011-12-01

    Full Text Available Three species of Sidneioides Kesteven, 1909 were known until now, all of them from the western Pacific. Sidneioides peregrinus is a new species we found in Paranaguá Bay, southern Brazil. Diagnostic characteristics of the species are: colonies with 1-5 lobes, closely clumped, and attached by the entire basal area or by a common smaller area; seven to ten thin longitudinal fiber muscles (some branched along the anterior two thirds of the thorax; no transverse muscle fibers; more than 30 tentacles of three orders forming one circle; pharynx with 10 to 12 rows of stigmata with 13 to 15 stigmata in each half row; bilobed anus at the level of the fourth or fifth row of stigmata; posterior abdomen not very elongated, oval, and joined to the abdomen by a narrow neck; numerous (> 30 testicular follicles; ovary with about 15 oocytes at about the ninth or tenth row of stigmata in the thorax; large number of embryos incubated in the atrial cavity in the right side of the thorax; larvae oval with a 0.65 mm long trunk, four club-shaped ectodermal ampullae in each side and three, linear and evenly spaced, adhesive papillae with thin stalks, two clusters of ectodermal vesicles, one postero-ventral (around 15 vesicles and another antero-dorsal (around eight vesicles between the ampullae and the oral siphon. This paper describes this new species and reports its occurrence in Brazil, where it is most likely introduced. The hypothesis that it is introduced is based on 1 it was never found in previous surveys, 2 in Brazil, it has a restricted and local distribution, 3 its type locality is near a major international port, and 4 the genus, prior to this description, had never been found in the Atlantic Ocean. Considering the great abundance found on the underside of natural boulders, it is imperative that S. peregrinus population growth be studied to evaluate the possibility of rapid distribution expansion.

  10. Diagnosing & Treating Digestive Tract Disorders Endoscopically

    Medline Plus

    Full Text Available ... or the ampulla. And we can visualize that system with a variety of imaging ranging from ultrasound ... course, endoscopic ultrasound, we have a lot of information, going in. So, basically, if you have obstruction ...

  11. Ultrasound-guided percutaneous transhepatic biliary drainage: Experiences in 146 patients

    International Nuclear Information System (INIS)

    Percutaneous biliary drainage is an important technique for palliative therapy of obstructive biliary disease and diagnostic information. The purpose of this study is to review and evaluate the experiences of ultrasound-guided percutaneous transhepatic biliary drainage. Ultrasound-guided percutaneous transhepatic biliary drainage was performed on 146 occasions in 134 patients. The causes of biliary obstruction were: benign diseases (19 cases, 14.2%) such as bile duct stones or stricture, cholangiocarcinoma (37 cases, 27.6%), pancreatic carcinoma (35 cases, 26.1%), metastasis (22 cases, 16.5%), gall bladder cancer (14 cases, 10.4%), ampulla of Vater cancer (4 cases, 3.0%), hepatocellular carcinoma (3 cases, 2.2%). Retrospectively reviewing medical records, we found out frequency of external or external/internal biliary drainages, puncture of left or right hepatic duct, and presence of bileinfection. Ultrasound-guided percutaneous transhepatic biliary drainage was compared with conventional biliary drainage of previous reports on the basis of frequency of complications. External (124 procedures, 84.9%) and external/internal biliary drainage (22 procedures, 15.1%) were carried out by puncture of dilated right (59.6%) or left (40.4%) intrahepatic duct. Sixty-nine complications occurred in 47 patients. Catheter related complications (33/69, 47.8%) were most common: catheter dislodgement (17/69, 24.6%), malfunction (9/69, 13.1%), leakage (7/69, 10.1%). Other minor complications such as simple fever (16/69, 23.2%), cholangitis (7/69, 10.1%), hemobilia (4/69, 5.8%), biloma (2/69, 2.9%) and wound infection (1/69, 1.5%) occurred. Major complications including sepsis (4/69, 5.8%) and bile peritonitis (2/69, 2.9%) were also noted. Puncture-related complications such as hemobilia, biloma and bile peritonitis occurred in 8 cases (5.5%). Comparing with conventional X-ray guided drainage, ultrasound-guided percutaneous transhepatic biliary drainage is a safe procedure for

  12. Ultrasound-guided percutaneous transhepatic biliary drainage: Experiences in 146 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jai Keun [Sohwa Children' s Hospital, Seoul(Korea, Republic of); Yu, Jeong Sik; Kim, Ki Whang; Chung, Soo Yoon; Jeong, Mi Gyoung [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Deuk Lin; Kwon, Gui Hyang; Lee, Hae Kyung [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1999-03-15

    Percutaneous biliary drainage is an important technique for palliative therapy of obstructive biliary disease and diagnostic information. The purpose of this study is to review and evaluate the experiences of ultrasound-guided percutaneous transhepatic biliary drainage. Ultrasound-guided percutaneous transhepatic biliary drainage was performed on 146 occasions in 134 patients. The causes of biliary obstruction were: benign diseases (19 cases, 14.2%) such as bile duct stones or stricture, cholangiocarcinoma (37 cases, 27.6%), pancreatic carcinoma (35 cases, 26.1%), metastasis (22 cases, 16.5%), gall bladder cancer (14 cases, 10.4%), ampulla of Vater cancer (4 cases, 3.0%), hepatocellular carcinoma (3 cases, 2.2%). Retrospectively reviewing medical records, we found out frequency of external or external/internal biliary drainages, puncture of left or right hepatic duct, and presence of bileinfection. Ultrasound-guided percutaneous transhepatic biliary drainage was compared with conventional biliary drainage of previous reports on the basis of frequency of complications. External (124 procedures, 84.9%) and external/internal biliary drainage (22 procedures, 15.1%) were carried out by puncture of dilated right (59.6%) or left (40.4%) intrahepatic duct. Sixty-nine complications occurred in 47 patients. Catheter related complications (33/69, 47.8%) were most common: catheter dislodgement (17/69, 24.6%), malfunction (9/69, 13.1%), leakage (7/69, 10.1%). Other minor complications such as simple fever (16/69, 23.2%), cholangitis (7/69, 10.1%), hemobilia (4/69, 5.8%), biloma (2/69, 2.9%) and wound infection (1/69, 1.5%) occurred. Major complications including sepsis (4/69, 5.8%) and bile peritonitis (2/69, 2.9%) were also noted. Puncture-related complications such as hemobilia, biloma and bile peritonitis occurred in 8 cases (5.5%). Comparing with conventional X-ray guided drainage, ultrasound-guided percutaneous transhepatic biliary drainage is a safe procedure for

  13. Association between alcohol consumption and cancers in the Chinese population--a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Ying Li

    Full Text Available BACKGROUND: Alcohol consumption is increasing worldwide and is associated with numerous cancers. This systematic review examined the role of alcohol in the incidence of cancer in the Chinese population. METHODS: Medline/PubMed, EMBASE, CNKI and VIP were searched to identify relevant studies. Cohort and case-control studies on the effect of alcohol use on cancers in Chinese were included. Study quality was evaluated using the Newcastle-Ottawa Scale. Data were independently abstracted by two reviewers. Odds ratios (OR or relative risks (RR were pooled using RevMan 5.0. Heterogeneity was evaluated using the Q test and I-squared statistic. P<.01 was considered statistically significant. RESULTS: Pooled results from cohort studies indicated that alcohol consumption was not associated with gastric cancer, esophageal cancers (EC or lung cancer. Meta-analysis of case-control studies showed that alcohol consumption was a significant risk factor for five cancers; the pooled ORs were 1.79 (99% CI, 1.47-2.17 EC, 1.40 (99% CI, 1.19-1.64 gastric cancer, 1.56 (99% CI, 1.16-2.09 hepatocellular carcinoma, 1.21 (99% CI, 1.00-1.46 nasopharyngeal cancer and 1.71 (99% CI, 1.20-2.44 oral cancer. Pooled ORs of the case-control studies showed that alcohol consumption was protective for female breast cancer and gallbladder cancer: OR 0.76 (99% CI, 0.60-0.97 and 0.70 (99% CI, 0.49-1.00 respectively. There was no significant correlation between alcohol consumption and lung cancer, colorectal cancer, pancreatic cancer, cancer of the ampulla of Vater, prostate cancer or extrahepatic cholangiocarcinoma. Combined results of case-control and cohort studies showed that alcohol consumption was associated with 1.78- and 1.40-fold higher risks of EC and gastric cancer but was not significantly associated with lung cancer. CONCLUSIONS: Health programs focused on limiting alcohol intake may be important for cancer control in China. Further studies are needed to examine the

  14. The role of magnetic resonance cholangiopancreatography (MRCP) in choledocholithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Yukinao; Nishikawa, Kunihisa; Ohtaki, Tetsuo; Hata, Masanori; Miyaji, Hideki; Hayashi, Shigeyuki [Fukui Red Cross Hospital (Japan)

    2001-07-01

    Recently, magnetic resonance cholangiopancreatography (MRCP) has been widely used in the clinical field as a noninvasive method to visualize the main pancreatic duct and the biliary system. We evaluated the accuracy of MRCP, abdominal CT and abdominal urtrasonography in the diagnosis of choledocholithiasis in comparison with that of endoscopic retrograde cholangiopancreatography (ERCP). Forty patients with choledocholithiasis with some complications, such as icterus, pancreatitis or cholangitis, were examined by MRCP, CT, US and ERCP. We studied the detection rate of the common bile duct stones in MRCP, CT, US separately, and the diagnostic value of each of the other techniques was compared with that of ERCP. The detection rate of common bile duct stones in MRCP, CT and US was 87.5%, 80.5% and 45.0%, respectively. The combined detection rate in MRCP and CT, MRCP and US, CT and US, and MRCP, CT and US was 95.0%, 97.5%, 80.0% and 100%, respectively. MRCP could not efficiently detect common bile duct stones less than 5 mm in size. Moreover, it was impossible to detect impacted stones in the papilla of Vater by MRCP. Currently, it would seem that the combination of MRCP, CT and US has comparable efficacy for the diagnosis of common bile duct stones in patients with the complications to that of ERCP. (author)

  15. Investigation of FGF10 as a candidate gene in patients with anorectal malformations and exstrophy of the cloaca.

    Science.gov (United States)

    Krüger, Victoria; Khoshvaghti, Mercedeh; Reutter, Heiko; Vogt, Hannes; Boemers, Thomas M; Ludwig, Michael

    2008-08-01

    The spectrum of anorectal malformations (ARM) comprises anal stenosis, ectopic anus, recto-urogenital fistula, persistent cloaca, multisystem VACTERL (VATER associations including cardiac and limb anomalies) associations, and exstrophy of the cloaca (CE). The latter also constitutes the most severe form of the bladder exstrophy epispadias complex. Since recent data revealed that fibroblast growth factor 10 (fgf-10) invalidation in mice resulted in a genetically reproducible urorectal defect, we considered FGF10 a suitable candidate gene for ARM and CE, as the protein seems to be involved in the development of this primary developmental field. A total of 20 patients (ten with ARM and VACTERL association, respectively, and ten with CE) were analysed for genomic mutations in the coding regions and exon-intron boundaries of FGF10. Aside from a common FGF10 variant no deviation from the wild-type sequence could be detected and data obtained is not supportive of FGF10 as a genetic cause of ARMs or CE in the patients investigated. Nonetheless, mutations in possibly further upstream located promoter regions and/or unknown regulatory sequences or non-coding regions cannot be excluded. Furthermore, it cannot be ruled out that other genes involved in the signalling pathway of FGF10 may contribute to the formation of these congenital malformations. PMID:18587586

  16. ["For me, painting is a continuation of dreaming by different means" (Neo Rauch 2006). Contributions of art to psychoanalytic dream interpretation].

    Science.gov (United States)

    Danckwardt, Joachim F

    2008-01-01

    This paper maintains that pictorial and scenic thinking (represented in dreams, daydreams, paintings, pictorial language) is not a regressive phenomenon usurping ego energy. It is rather a kind of thinking with eyes, hands and feet resp. with formative means such as point, line, plane, space, movement, color, and contrast which constitute consciousness from the ocean of the inner and outer unconscious. This is shown by discussing the painting "Vater [Father]" (2007) of Neo Rauch as well as the views of, among others, Kandinsky, Klee, and Rothko. Rauch's notion of painting as a continuation of dreaming is confirmed by a re-analysis of Freud's dream of the "castle by the sea". Here dream-work is similar to picture and film work. The choice of formative means determines whether pictures will be born or something else: a dream, fantasy, idea or interpretation, and by the same token it determines the kind of picture, dream, fantasy etc. Freud's dream of the "castle by the sea" is a "specimen dream" for interpretation via retranslation of picture/dream-work. PMID:19230327

  17. Ectopic duodenal insulinoma: a very rare and challenging tumor type. Description of a case and review of the literature.

    Science.gov (United States)

    La Rosa, Stefano; Pariani, Dario; Calandra, Calogera; Marando, Alessandro; Sessa, Fausto; Cortese, Ferdinando; Capella, Carlo

    2013-12-01

    Although most insulinomas are located in the pancreas, very rare ectopic cases have been described in the spleen, perisplenic tissue, duodenohepatic ligament, and adjacent to the ligament of Treitz. Moreover, three cases located in the duodenum have also been reported in the English literature. Ectopic insulinomas represent challenging neoplasms with clinical implications mainly due to the difficulties in their pre-operatory diagnosis and localization. In the present paper, we describe the fourth ectopic duodenal insulinoma so far reported. A 75-year-old woman presented at clinical observation due to neuroglycopenic symptoms that disappeared after glucose intake. Tumor was localized in the second portion of the duodenum in front of the papilla of Vater and was surgically enucleated. Microscopically, it was composed of monomorphic cells with eosinophilic cytoplasm arranged in trabecular and lobular patterns and diffusely positive for insulin, proinsulin, amylin, and PDX1. About 30 % of tumor cells also showed immunoreactivity for somatostatin, while no positivity for glucagon, pancreatic polypeptide, gastrin, serotonin, and somatostatin receptor subtype 2A was found. The Ki67 proliferative index was 1 %. We have also reviewed the literature on this topic to give the reader a comprehensive overview of this very rare tumor type. PMID:24006218

  18. A case of methicillin-resistant Staphylococcus aureus infection following bile duct stenting

    Institute of Scientific and Technical Information of China (English)

    Markus K Diener; Alexis Ulrich; Theresia Weber; Moritz N Wente; Markus W Büchler; Helmut Friess

    2005-01-01

    AIM: To present a case of methicillin-resistant Staphylococcus aureus (MRSA) infection following bile duct stenting in a patient with malignant biliary obstruction.METHODS: A 78-year-old male patient was admitted to a community hospital with progredient painless jaundice lasting over two weeks, weight loss and sweating at night.Whether a stent should be implanted pre-operatively in jaundiced patients or whether these patients should directly undergo surgical resection, was discussed.RESULTS: ERC and a biopsy from the papilla of Vater revealed an adenocarcinoma. In addition, a 7-Ch plastic stent was placed into the common bile duct. Persistent abdominal pain, increasing jaundice, weakness and indigestion led to the transfer of the patient to our hospital.A pylorus-preserving pancreatoduodenectomy wasperformed. Intraoperatively, bile leaked out of the transected choledochus andthe stent was found to be dislocated in the duodenum. A smear of the bile revealed an infection with MRSA, leading to post-operative isolation of the patient.CONCLUSION:As biliary stents can cause severe infection of the bile, the need for pre-operative placement of biliary stents should be carefully evaluated in each individual case.

  19. [Thoracoabdominal CT scan: a useful tool for the diagnosis of air embolism during an endoscopic retrograde cholangiopancreatography].

    Science.gov (United States)

    Tan, B K; Saunier, C-F; Cotton, F; Gueugniaud, P-Y; Piriou, V

    2008-03-01

    We report the case of an 82-year-old woman treated with biliary stents for an ampulloma of Vater's papilla, with recurrent stenosis of the common bile duct. She was hospitalized with a cholestasis. An endoscopic retrograde cholangiopancreatography (ERCP) was scheduled to change the biliary stent for a metallic one, under general anaesthesia, with oral intubation. The ERCP was performed initially without any complication, but as the metallic biliary stent was placed, an air embolism occurred and a cardiac arrest happened immediately. The etiologic diagnosis was quickly confirmed by an injected multislice body-scan, which showed liver, right heart and brain gas embolism. Cardiopulmonary resuscitation allowed a complete haemodynamic recovery but a poor neurological recovery. The patient was transferred in intensive care unit, were she died 12 days after, despite hyperbaric oxygen therapy and the disappearance of the air embolism on the following computed tomography scan. This case may be useful to recall the utility of a body-scan for the diagnosis, treatment and follow-up of an air embolism during ERCP. PMID:18313255

  20. Kindheit, Adoleszenz und Familienstrategie in den Briefen der Lobkowicz-Kinder an Ihren Vater Fürst Georg Kristian

    Czech Academy of Sciences Publication Activity Database

    Hlavačka, Milan

    München: Meidenbauer, 2006 - (Cerman, I.; Velek, L.), s. 213-226. (Studien zum Mitteleuropäischen Adel. 1). ISBN 3-89975-057-8 Institutional research plan: CEZ:AV0Z80150510 Keywords : Lobkowicz * aristocratic education * childhood Subject RIV: AB - History

  1. Treatment of malignant biliary obstruction with wallstent endoprosthesis

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the patency, procedure related complications and effectiveness of Wallstent application to the malignant biliary obstruction as a palliative treatment. We retrospectively reviewed the clinical results, duration of survival, patency rate and complication of the Wallstent application on 33 patients who had had obstructive jaundice by the malignant lesion in recent 3 years. One or two step procedures were mainly taken with 10 mm diameter Wallstents. Grouping according to place the stent at the hilum or not, and grouping according to place the stent through the ampulla or not were done to evaluate the difference of the patency and survival rate between the groups. Biliary endoprosthesis with Wallstent were successfully placed in all patients without difficulty. Procedure related short-term complication rate was about 18.1% (n = 6/33). Complications were fever (n = 4), cholecystitis (n = 1) and sepsis (n = 1). Long-term complications were mainly obstruction (n = 9/31) of the Wallstent during the follow-up period. Also cholecystitis occurred in one patient 3 months later. Mean survival duration was 139.72 (46-237) days among those who expired. Mean patency duration of stents was 139.67 (26-310) days. Survival rates were 93.5% at the second month, 68.8% at the third month, 61.2% at the 4th month, 53.5% at the 5th month, 49.1% at the 7th month and 35.7% at the 9th month. Patency rates were 93.7% at the second month, 84.2% at the 4th month, 66.9% at the 5th month, 59.5% at the 7th month and 39.6% at the 10th month. The application was repeated in the 6 patients with stent occlusion. Significant statistical difference could not be found between the groups according to placing the stent at the hilum and according to placing the stent through the ampulla. Patency rates were higher than survival rates in the follow-up period. Wallstent application provides good palliation with little discomfort and few complications in the patients with

  2. Treatment of malignant biliary obstruction with wallstent endoprosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Geun Seok; Kim, Sung Woo; Kim, Won Ho; Kim, Yong Joo [Kyung-pook National University Hospital, Daegu (Korea, Republic of)

    1995-01-15

    The purpose of this study was to evaluate the patency, procedure related complications and effectiveness of Wallstent application to the malignant biliary obstruction as a palliative treatment. We retrospectively reviewed the clinical results, duration of survival, patency rate and complication of the Wallstent application on 33 patients who had had obstructive jaundice by the malignant lesion in recent 3 years. One or two step procedures were mainly taken with 10 mm diameter Wallstents. Grouping according to place the stent at the hilum or not, and grouping according to place the stent through the ampulla or not were done to evaluate the difference of the patency and survival rate between the groups. Biliary endoprosthesis with Wallstent were successfully placed in all patients without difficulty. Procedure related short-term complication rate was about 18.1% (n = 6/33). Complications were fever (n = 4), cholecystitis (n = 1) and sepsis (n = 1). Long-term complications were mainly obstruction (n = 9/31) of the Wallstent during the follow-up period. Also cholecystitis occurred in one patient 3 months later. Mean survival duration was 139.72 (46-237) days among those who expired. Mean patency duration of stents was 139.67 (26-310) days. Survival rates were 93.5% at the second month, 68.8% at the third month, 61.2% at the 4th month, 53.5% at the 5th month, 49.1% at the 7th month and 35.7% at the 9th month. Patency rates were 93.7% at the second month, 84.2% at the 4th month, 66.9% at the 5th month, 59.5% at the 7th month and 39.6% at the 10th month. The application was repeated in the 6 patients with stent occlusion. Significant statistical difference could not be found between the groups according to placing the stent at the hilum and according to placing the stent through the ampulla. Patency rates were higher than survival rates in the follow-up period. Wallstent application provides good palliation with little discomfort and few complications in the patients with

  3. Study of 50 cases of modern management of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Rajita S. Jani

    2014-04-01

    Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte. These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases. Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 374-379

  4. Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hee Tae; Kim, Hong Soo; Kim, Jong Deok; Rhee, Hak Song [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1983-12-15

    PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter.

  5. Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

    International Nuclear Information System (INIS)

    PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter

  6. Functions of adrenergic and cholinergic nerves in canine effectors of seminal emission.

    Science.gov (United States)

    Arver, S; Sjöstrand, N O

    1982-05-01

    Spontaneous activity responses to acetylcholine (ACh), adrenaline (A), noradrenaline (NA) and barium chloride as well as the effects of various autonomic drugs on effects of field stimulation of nerves and muscle cells of isolated pieces or strips of cauda epididymidis, vas deferens, ampulla ductus deferentis and prostate of dog were studied. The main results and conclusions are: the muscles show little spontaneous activity but rhythmicity can easily be produced by e.g. stimulating agonists. The muscles are contracted by alpha-adrenoceptor stimulants. ACh has usually no or a very weak contractile effect in high concentrations. Muscles of young dogs are more sensitive to ACh. The excitatory innervation of the muscles is adrenergic and completely blocked by adrenergic neuron blockers as well as alpha-adrenoceptor blocking drugs. Stimulation of adrenergic nerves leads to maximum response already at low frequencies (4-6 Hz). This response is very similar to that provoked by a supramaximal dose of NA. Scopolamine enhances neurogenic contractile effects while physostigmine suppresses them. Hence cholinergic nerves may act by muscarinic prejunctional inhibition of the excitatory adrenergic neurotransmission rather than act directly upon the smooth muscle cells. Since secretory cells receive cholinergic innervation prejunctional inhibition of the adrenergic myomotor nerves may be of functional significance in at least the long copulatory events of the dog. PMID:6127870

  7. Cuban experience and the future perspectives of transanal endoscopic microsurgery

    International Nuclear Information System (INIS)

    Introduction: The aim of present study was to assess the indication and the results of transanal endoscopic microsurgery (TEM) for treatment of rectal benign and malign tumors in National Center of Minimal Access Surgery in Havana city. METHODS: A comprehensive review of literature was made on present managing of rectal benign and malign tumors by TEM and results of such technique were assessed during 4 years in National Center of Minimal Access Surgery. RESULTS: During study period 33 patients were operated on by this technique. Main indications of TEM were the presence of adenomas (72,8%). Mean surgical time was of 189,1 minutes; in 4 patients ( 12,1%) transoperative transfusion was used, and hospital stay was of 2,5 days. Main transoperative complications were the rectovaginal fistula, bleeding and dehiscence. Follow-up of patients fluctuates between 1 and 54 months (mean 28,3) with 4 local relapses in adenoma group. CONCLUSIONS: TEM is a safe and effective method for treatment of rectal benign and malign tumors (in early stages). It is the choice technique for the big rectal adenomas and rectum cancer with pT1 stages located in all the ampulla of rectum. It has all advantages of the minimal access surgery; relapse results are similar to that of abdominal surgery without complications of urinary or sexual dysfunction and that of fecal incontinence are minimal.(author)

  8. Behandlingsresultater hos patienter med cancer i papilla Vateri

    DEFF Research Database (Denmark)

    Dahl, Sune; Bendixen, Morten; Fristrup, Claus Wilki; Mortensen, Michael Bau

    2010-01-01

    Cancer of the papilla of Vater is a relatively rare disease. It is difficult to separate from other periampullary tumours at the time of diagnosis. Recent studies have shown that patients with cancer of the papilla tend survive longer than patients with pancreatic cancer and cancers of biliary and...

  9. Sexual dimorphism of the electrosensory system: a quantitative analysis of nerve axons in the dorsal anterior lateral line nerve of the blue-spotted Fantail Stingray (Taeniura lymma).

    Science.gov (United States)

    Kempster, R M; Garza-Gisholt, E; Egeberg, C A; Hart, N S; O'Shea, O R; Collin, S P

    2013-01-01

    Quantitative studies of sensory axons provide invaluable insights into the functional significance and relative importance of a particular sensory modality. Despite the important role electroreception plays in the behaviour of elasmobranchs, to date, there have been no studies that have assessed the number of electrosensory axons that project from the peripheral ampullae to the central nervous system (CNS). The complex arrangement and morphology of the peripheral electrosensory system has a significant influence on its function. However, it is not sufficient to base conclusions about function on the peripheral system alone. To fully appreciate the function of the electrosensory system, it is essential to also assess the neural network that connects the peripheral system to the CNS. Using stereological techniques, unbiased estimates of the total number of axons were obtained for both the electrosensory bundles exiting individual ampullary organs and those entering the CNS (via the dorsal root of the anterior lateral line nerve, ALLN) in males and females of different sizes. The dorsal root of the ALLN consists solely of myelinated electrosensory axons and shows both ontogenetic and sexual dimorphism. In particular, females exhibit a greater abundance of electrosensory axons, which may result in improved sensitivity of the electrosensory system and may facilitate mate identification for reproduction. Also presented are detailed morphological data on the peripheral electrosensory system to allow a complete interpretation of the functional significance of the sexual dimorphism found in the ALLN. PMID:23817033

  10. Effects of an electric field on white sharks: in situ testing of an electric deterrent.

    Directory of Open Access Journals (Sweden)

    Charlie Huveneers

    Full Text Available Elasmobranchs can detect minute electromagnetic fields, <1 nV cm(-1, using their ampullae of Lorenzini. Behavioural responses to electric fields have been investigated in various species, sometimes with the aim to develop shark deterrents to improve human safety. The present study tested the effects of the Shark Shield Freedom7™ electric deterrent on (1 the behaviour of 18 white sharks (Carcharodon carcharias near a static bait, and (2 the rates of attacks on a towed seal decoy. In the first experiment, 116 trials using a static bait were performed at the Neptune Islands, South Australia. The proportion of baits taken during static bait trials was not affected by the electric field. The electric field, however, increased the time it took them to consume the bait, the number of interactions per approach, and decreased the proportion of interactions within two metres of the field source. The effect of the electric field was not uniform across all sharks. In the second experiment, 189 tows using a seal decoy were conducted near Seal Island, South Africa. No breaches and only two surface interactions were observed during the tows when the electric field was activated, compared with 16 breaches and 27 surface interactions without the electric field. The present study suggests that the behavioural response of white sharks and the level of risk reduction resulting from the electric field is contextually specific, and depends on the motivational state of sharks.

  11. Biliær papillomatose er en sjælden årsag til intermitterende obstruktiv ikterus

    DEFF Research Database (Denmark)

    Veedfald, Simon; Vainer, Ben; Wettergren, André

    2011-01-01

    Over a five-year period a 67 year-old male had been experiencing recurring bouts of biliary obstruction with occasional superimposed cholangitis. Renewed endoscopic retrograde cholangiopancreatography revealed amorphous filling defects and excessive mucinous discharge from the papilla of Vater. S...

  12. Percutaneous transhepatic metallic stent insertion for malignant afferent loop obstruction following pancreaticoduodenectomy: a case report

    OpenAIRE

    Hosokawa Isamu; Kato Atsushi; Shimizu Hiroaki; Furukawa Katsunori; Miyazaki Masaru

    2012-01-01

    Abstract Introduction Malignant afferent loop obstruction following pancreaticoduodenectomy is a rare complication and may be fatal if suppurative cholangitis or obstructive jaundice develops. Effective and safe therapeutic strategies for malignant afferent loop obstruction following pancreaticoduodenectomy are scarce at present. Case presentation A 51-year-old Japanese man underwent pancreaticoduodenectomy for carcinoma of the papilla of Vater. Seven months postoperatively, he developed a hi...

  13. Repair of postirradiation damage to colorectum: a progress report

    International Nuclear Information System (INIS)

    The results of 21 operations for repair of rectovaginal fistula and/or stricture secondary to irradiation for pelvic cancer are presented. The operations rely on the use of proximal nonirradiated colon with normal blood supply for effecting the repair. In patients having had a previous colostomy, it is possible to use the proximal end of the bypassed colon for this purpose. There is minimal dissection of the rectal ampulla and the presacral space is never entered. Continuity is established by anastomosis to the anterior rectal wall via an abdominal approach alone, or by a combined abdominovaginal or abdominoperineal approach. It has been found that nonirradiated colon of normal vascularity can be expected to heal to irradiated colon or rectum, thus making the extensive resections associated with correction of these abnormalities unnecessary. The functional result in 18 of 19 patients who underwent this procedure was satisfactory to excellent. One patient had a poor result because of partial rectal incontinence. Two operations out of the 21 were total failures and one of these patients died of complications secondary to irradiation damage to the small intestine. One patient has not yet had final colostomy closure. The results are considered promising enough to warrant continued trial

  14. Observational study of children with aerophagia.

    Science.gov (United States)

    Loening-Baucke, Vera; Swidsinski, Alexander

    2008-09-01

    Aerophagia is a rare disorder in children. The diagnosis is often delayed, especially when it occurs concomitantly with constipation. The aim of this report is to increase awareness about aerophagia. This study describes 2 girls and 7 boys, 2 to 10.4 years of age, with functional constipation and gaseous abdominal distention. The abdomen was visibly distended, nontender, and tympanitic in all. Documenting less distention on awakening helped to make the diagnosis. Air swallowing, belching, and flatulence were infrequently reported. The rectal examination often revealed a dilated rectal ampulla filled with gas or stool and gas. The abdominal X-ray showed gaseous distention of the colon in all and of the stomach and small bowel in 8 children. Treatment consisted of educating parents and children about air sucking and swallowing, encouraging the children to stop the excessive air swallowing, and suggesting to them not to use drinking straws and not to drink carbonated beverages. The aerophagia resolved in all in 2 to 20 months (mean=8 months). PMID:18445758

  15. Application of percutaneous transhepatic biliary drainage and percutaneous transhepatic insertion of biliary stent in treating malignant biliary obstruction

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and percutaneous transhepatic insertion of biliary stent (PTIBS) for malignant biliary obstruction. Methods: PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were caused by hepatic carcinoma (n=14), biliary duct carcinoma (n=11), gallbladder carcinoma (n=5), stomach carcinoma accompanied with metastasis of lymph node (n=14), carcinoma of ampulla (n=1) or carcinoma of pancreatic head (n=11). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed. Results: PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11, PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65 ± 152.86) μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure (P<0.01). Postoperative infection could affect the fading of jaundice (P<0.01), but the location of the obstruction carried no relationship with the fading of jaundice (P=0.063). Conclusion: Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice, improve the quality of life and elongate the survival period. (authors)

  16. Reproductive Biology of Bothrops erythromelas from the Brazilian Caatinga

    Directory of Open Access Journals (Sweden)

    Verônica Alberto Barros

    2014-01-01

    Full Text Available The reproductive biology of Bothrops erythromelas, a small pit viper from the Caatinga, a semiarid biome in Brazil, is described based on analysis of individuals deposited in zoological collections. Males are smaller and also attain sexual maturity at a smaller size than females. Female reproductive cycle is seasonal with an extended period of secondary vitellogenesis and births occurring in a restricted period from late spring to early summer. Sperm storage in females may probably occur in infundibular tubular glands and uterine muscular twisting (UMT, which is a polymorphic condition within B. erythromelas. Seasonal spermatogenesis in males is variable with some intraspecific variation regarding the male reproductive stage per season. Most males are reproductively active during spring/summer and reproductively quiescent during autumn/winter, although some individuals vary (e.g., show testicular spermatogenesis and active sexual segment of the kidneys (SSK during winter. The SSK could be identified in every male. Most males showed highly hypertrophied SSK in spring/summer and moderately hypertrophied SSK in autumn/winter. The ampulla ductus deferentis was observed and histochemical reactions were conducted. We discuss the probable influence of the unique environmental conditions of the Caatinga region and phylogenetic inertia in the reproductive patterns of this snake species.

  17. Gross anatomy of the intestine and its mesentery in the nutria (Myocastor coypus).

    Science.gov (United States)

    Pérez, W; Lima, M; Bielli, A

    2008-11-01

    The intestines and mesentery of the nutria (Myocastor coypus) have not been fully described. In the present study 30 adult nutrias were studied using gross dissection. The small intestine was divided into the duodenum, jejunum and ileum as usual. The duodenum started at the pylorus with a cranial portion, which dilated forming a duodenal ampulla. The ileum was located within the concavity of the caecum and attached to the coiled caecum by means of the iliocaecal fold. The ascending colon had two ansae, one proximal and one distal. The proximal ansa was fixed to the caecum by the caecocolic fold. The base of the caecum and a short proximal part of the ascending colon belonging to the proximal ansa were attached to the mesoduodenum descendens. The distal ansa of the ascending colon had a proximal part which was sacculated and a distal part which was smooth. The two parts of the distal ansa of the ascending colon were parallel and joined by a flexure of variable localisation. The smooth part of the distal ansa of the ascending colon was attached to the initial portion of the descending colon by a peritoneal fold. The short transverse colon was directly attached to the mesoduodenum and greater omentum. In conclusion, we have described the anatomy of the intestines of the nutria and its mesentery in detail, and provided a nomenclature list adapted to the Nomina Anatomica Veterinaria. PMID:19085870

  18. Complementary role of helical CT cholangiography to MR cholangiography in the evaluation of biliary function and kinetics

    Energy Technology Data Exchange (ETDEWEB)

    Eracleous, Eleni; Genagritis, Marios; Kontou, Allayioti Maria [Diagnostic Center of Ayios Therissos, Department of Radiology, Nicosia (Cyprus); Papanikolaou, Nicos; Prassopoullos, P.; Chrysikopoulos, Haris; Gourtsoyiannis, Nicholas [University of Crete, Department of Radiology, Heraklion (Greece); Allan, Paul [Royal Infirmary of Edinburgh, Department of Radiology, Edinburgh (United Kingdom)

    2005-10-01

    To explore the potential role of computed tomographic cholangiography (CTC) in relation to magnetic resonance cholangiography (MRC) in cases in which knowledge of biliary kinetics and functional information are important for therapeutic decisions, 31 patients (14 men and 17 women) underwent MRC followed by CTC. We examined nine post-cholecystectomy cases with right upper quadrant abdominal pain, six cases with a previous biliary-enteric anastomosis and clinical evidence of cholangitis, eight biliary strictures with pain or symptoms of cholangitis, four cases with strong clinical evidence of sclerosing cholangitis, three cases with suspected post-laparoscopic cholecystectomy bile leakage, and one case with chronic pancreatitis and a common bile duct stent associated with cholangitis. In relation to MRC, CTC provided additional biliary functional information as follows: abnormal biliary drainage through the ampulla in 7/9 cholecystectomy cases, impaired drainage in 3/6 biliary-enteric anastomoses, and complete obstruction in 2/8 biliary strictures. CTC diagnosed early sclerosing cholangitis in 4/4 cases and confirmed suspected bile leakage in 1/3 post-laparoscopic cholecystectomy patients, and the patency of the biliary stent in the patient with chronic pancreatitis. Thus, CTC provides clinically important information about the function and kinetics of bile and complements findings obtained by MRC. (orig.)

  19. Modelling of energy expended by free swimming spermatozoa in temperature-dependent viscous semen.

    Science.gov (United States)

    Foo, Jong Yong Abdiel

    2010-01-01

    Derived models of fertilization kinetics have relied upon estimates of the swimming velocity of spermatozoa from the insemination site to a fallopian tube. However, limited derivations are available describing the probability and energy expended when spermatozoa collide with one another. An analytic approach of spermatozoon motion in a linear viscoelastic fluid is adopted to simplify the derivation. The complex kinematics of motion of an inextensible flagellum is modelled as planar flagellar wave of small amplitude. In humans, a temperature difference is expected between the cooler tubal isthmus and the warmer tubal ampulla. Thus, fluidic characteristics of semen such as viscosity can vary along the female reproductive tract. The results suggest that the probability of spermatozoa colliding in relatively lower viscous semen increases by 64.87% for a 0.5 degrees C surge in temperature. Moreover, this increases for a denser concentration of spermatozoa due to the limited semen volume available to manoeuvre. In addition, the propulsive forces and shear stress were 39.35% lower in less viscous semen due to an increase in temperature of only 0.5 degrees C. Hence, the described derivations herein can assist in the understanding of work done by a normal motile spermatozoon in a pool of semen. PMID:19939204

  20. Functional optical coherence tomography for high-resolution mapping of cilia beat frequency in the mouse oviduct in vivo

    Science.gov (United States)

    Wang, Shang; Burton, Jason C.; Behringer, Richard R.; Larina, Irina V.

    2016-02-01

    Since mouse is a superior model for genetic analysis of human disorders, reproductive studies in mice have significant implications on further understanding of fertility and infertility in humans. Fertilized oocytes are transported through the reproductive tract by motile cilia lining the lumen of the oviduct as well as by oviduct contractions. While the role of cilia is well recognized, ciliary dynamics in the oviduct is not well understood, largely owing to the lack of live imaging approaches. Here, we report in vivo micro-scale mapping of cilia and cilia beat frequency (CBF) in the mouse oviduct using optical coherence tomography (OCT). This functional imaging method is based on spectral analysis of the OCT speckle variations produced by the beat of cilia in the oviduct, which does not require exogenous contrast agents. Animal procedures similar to the ones used for production of transgenic mice are utilized to expose the reproductive organs for imaging in anesthetized females. In this paper, we first present in vivo structural imaging of the mouse oviduct capturing the oocyte and the preimplantation embryo and then show the result of depth-resolved high-resolution CBF mapping in the ampulla of the live mouse. These data indicate that this structural and functional OCT imaging approach can be a useful tool for a variety of live investigations of mammalian reproduction and infertility.

  1. Cupulin Is a Zona Pellucida-Like Domain Protein and Major Component of the Cupula from the Inner Ear

    Science.gov (United States)

    Dernedde, Jens; Weise, Christoph; Müller, Eva-Christina; Hagiwara, Akira; Bachmann, Sebastian; Suzuki, Mamoru; Reutter, Werner; Tauber, Rudolf; Scherer, Hans

    2014-01-01

    The extracellular membranes of the inner ear are essential constituents to maintain sensory functions, the cupula for sensing torsional movements of the head, the otoconial membrane for sensing linear movements and accelerations like gravity, and the tectorial membrane in the cochlea for hearing. So far a number of structural proteins have been described, but for the gelatinous cupula precise data are missing. Here, we describe for the first time a major proteinogenic component of the cupula structure with an apparent molecular mass of 45 kDa from salmon. Analyses of respective peptides revealed highly conserved amino-acid sequences with identity to zona pellucida-like domain proteins. Immunohistochemistry studies localized the protein in the ampulla of the inner ear from salmon and according to its anatomical appearance we identified this glycoprotein as Cupulin. Future research on structure and function of zona pellucida-like domain proteins will enhance our knowledge of inner ear diseases, like sudden loss of vestibular function and other disturbances. PMID:25369234

  2. Hartnäckige Anachronismen Stubborn Anachronisms

    Directory of Open Access Journals (Sweden)

    Barbara Drinck

    2004-11-01

    Full Text Available Väter sind anders ist die überarbeitete Fassung von Guter Vater – Böser Vater (1997. Uns liegen elf Kapitel vor, die sich mit der Entwicklung des Mannes vom Sohn zum Vater, mit dem Geschlechterverhältnis von Mann und Frau, der Bedeutung des Berufs für den Mann und der männlichen Aggression und Sexualität auseinandersetzen. Der Text basiert auf der orthodox-psychoanalytischen Annahme einer binären Geschlechtsidentität, sein Männlichkeitsbild gründet Petri auf die These von der angeblichen kulturellen Überlegenheit des Mannes, auf populär-evolutionistische Ansichten von der Rolle von Mann und Frau sowie auf die Vorstellung ‚gesunder‘ binärer geschlechtsadäquater Identität, die – wen wundert’s – zwangsläufig in Heterosexualität münde. Über den Nutzen dieser Vater-Studie lässt sich streiten.Väter sind anders (Fathers are Different is the revised edition of Guter Vater—Böser Vater (Good Father—Bad Father 1997. We are presented with eleven chapters that grapple with the development of the man from son to father, the gender relationship between man and woman, the importance of vocation for the man, and male aggression and sexuality. The text is based on the orthodox psychoanalytical acceptance of a binary gender identity. Petri grounds his conception of masculinity in the theory of the alleged cultural superiority of the man, popular evolutionist views on the roll of man and woman, as well as the perception of “healthy” binary gender-representative identity, which—no surprise here—inevitably leads to heterosexuality. The usefulness of this fatherhood study can be debated.

  3. Clinical analysis and management of infections relative to percutaneous biliary drainage or stenting dilation

    International Nuclear Information System (INIS)

    Objective: To analyze the occurrence of infectious relative to percutaneous biliary drainage (PTBD)or stenting for malignant obstructive jaundice and explore the therapy and prevention. Methods: 181 patients (130 male and 51 female; median age 64.5 years old) with malignant biliary obstructive jaundice were investigated including 81 hepatobiliary cancers, 42 pancreatico-ampullae tumors, 58 gestro-intestinal portal lymphatic metastasis. All cases accepted PTBD or placement of metallic stents and the perioperative complications were recorded and analysed including the occurance and treatment. Results: All cases accepted PTBD or stenting successfully. The perioperative biliary infection was the major complication including 50 out of 62 preoperative infected cases (34.25%). 18 cases (15.13%)suffered from biliary infection after operation with 13 under control, 5 without control, 4 complicated with pulmonary infection and 17 (9.39%)died of serious biliary infections. Gram-negative bacilli and endotoxin were the main cause of the severe biliary infection. Postoperative mild pancreatitis occurred in 65 cases (35.91%)without severe necrotic changes and were cured alter anti-inflammatory treatment. Hepatic abscess due to biliary leak occurred in 1 case (0.55%), and was cured by CT-guided drainage. Conclusion: Biliary infection is the most common complication after interventional therapy and should be promptly under control for preventing mortality and prolonging survival. Simultaneously, acute pancreatitis should also be on alert but good prognosis would be obtained with apt therapy. (authors)

  4. Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging in diagnostic workflow

    Directory of Open Access Journals (Sweden)

    Agnieszka Mielczarek

    2015-12-01

    Full Text Available Takotsubo cardiomiopathy (TTC (known also as “ampulla cardiomyopathy,” “apical ballooning” or “broken heart syndrome” is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise in cardiac troponin, and contractility abnormalities in echocardiography. A left ventricular dysfunction is transient and improves within a few weeks. Takotsubo cardiomyopathy typically occurs in postmenopausal women and the postulated mechanism is catecholamine overstimulation. Moreover, the distribution of contractility impairments usually does not correspond with typical region supplied by a single coronary artery. Therefore, the assessment of regional pattern of systolic dysfunction with speckle-tracking echocardiography and automated function imaging (AFI technique may be important in diagnosis of TTC and may improve our insight into its patophysiology. We described a 55-year-old female teacher with TTC diagnosed after acute psychological stress in workplace. The provoking factor related with occupational stress and pattern of contraction abnormalities documented with AFI technique including basal segments of left ventricle make this case atypical.

  5. X-ray diagnosis of acute gastritis

    International Nuclear Information System (INIS)

    Abnormal gastric wall configurations in 27 cases of cause-unknown acute gastritis were studied roentgenographically with reference to their causative origins. Studies were made on roentgenograms (abnormal gastric wall configurations), endoscopic findings and extension of lesions of the subjected cases. Gastric contour showed 'staying', 'thumbprinting', 'undulate configuration' and 'squarish undulation', while 'chimney-like' finding suggestive of poor gastric wall stretch was observed in the whole antral region as well. The widened angulus ventriculi and expanded pyloric ring (insufficient constriction) were also seen. In some cases the lesion extended over to the duodenum and, as in the cases of acute gastritis, duodenal wall 'staying', 'thumbprinting' and varied duodenal wall undulation were seen in addition to edema and morphological changes of the Kerkring's folds. The lesions in the studied patients mostly extended from an epicenter of the antrum upward to the gastric corpus and downward near to Vater's papilla in the descending part of the duodenum. The affected regions were clearly distinguishable. It has been known that above-described roentgenographical findings in our studied patients were similar in part to those known in experimental studies carried out on animals with ischemic digestive tract. This strongly suggests that some of our patients had developed the disease due to ischemic causes. There were some discrepancies between roentgenographical (abnormal gastric wall configuration) and endoscopic findings in some studied patients. It has been our belief that abnormal gastric wall configuration reflects lesions in the inner part of the wall and, accordingly, roentgenographical examinations, as well as endoscopy, should be performed for the purpose of making correct diagnosis. It is also to be emphasized that angiography should be carried out on patients with relapsing acute gastritis without any specific cause. (author)

  6. Assisted reproductive techniques and the risk of anorectal malformations: a German case-control study

    Directory of Open Access Journals (Sweden)

    Zwink Nadine

    2012-09-01

    Full Text Available Abstract Background The use of assisted reproductive techniques (ART for treatment of infertility is increasing rapidly worldwide. However, various health effects have been reported including a higher risk of congenital malformations. Therefore, we assessed the risk of anorectal malformations (ARM after in-vitro fertilization (IVF and intracytoplasmic sperm injection (ICSI. Methods Data of the German Network for Congenital Uro-REctal malformations (CURE-Net were compared to nationwide data of the German IVF register and the Federal Statistical Office (DESTATIS. Odds ratios (95% confidence intervals were determined to quantify associations using multivariable logistic regression accounting for potential confounding or interaction by plurality of births. Results In total, 295 ARM patients born between 1997 and 2011 in Germany, who were recruited through participating pediatric surgeries from all over Germany and the German self-help organisation SoMA, were included. Controls were all German live-births (n = 10,069,986 born between 1997 and 2010. Overall, 30 cases (10% and 129,982 controls (1% were born after IVF or ICSI, which translates to an odds ratio (95% confidence interval of 8.7 (5.9–12.6 between ART and ARM in bivariate analyses. Separate analyses showed a significantly increased risk for ARM after IVF (OR, 10.9; 95% CI, 6.2–19.0; P  Conclusions There is a strongly increased risk for ARM among children born after ART. Elevations of risk were seen after both IVF and ICSI. Further, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed increased risks in each group. An increased risk of ARM was also seen among both singletons and multiple births.

  7. Colony specificity and chemotaxis in the compound ascidian Botryllus schlosseri.

    Science.gov (United States)

    Cima, Francesca; Sabbadin, Armando; Zaniolo, Giovanna; Ballarin, Loriano

    2006-11-01

    We re-investigated the behavior of hemocytes during the non-fusion (rejection) reaction between genetically incompatible colonies of the ascidian Botryllus schlosseri. In the course of the reaction, hemocytes - mainly morula cells - crowd inside the blind ends of marginal vascular vessels (known as ampullae) of the colonial leading edge (LE) facing the foreign colony which suggests the occurrence of chemotactic attraction of circulating hemocytes towards the ampullar lumen. Then, cells migrate, through the ampullar tips, into the partially fused tunics and contribute to the formation of the necrotic spots along the contact borders which characterize the reaction. Studies on histological sections clearly indicate that, although morula cell concentration is always higher in ampullae of the LE than in those of the lateral (L) part of the colony, their frequency significantly increases in LE ampullae of rejecting colonies with respect to LE ampullae of both fusing and isolated colonies. In addition, in vitro chemotaxis experiments demonstrated that blood plasma from incompatible colonies can stimulate morula cell migration through polycarbonate filters and this passage is inhibited by antibodies raised against mammalian pro-inflammatory cytokines. The possible nature and role of molecules recognized by anti-cytokine antibodies in hemocyte migration are discussed. PMID:16962802

  8. Is routine drainage necessary after pancreaticoduodenectomy?

    OpenAIRE

    Wang, Qiang; Jiang, Yong-Jian; Li, Ji; Yang, Feng; Di, Yang; Yao, Lie; Jin, Chen; Fu, De-Liang

    2014-01-01

    With the development of imaging technology and surgical techniques, pancreatic resections to treat pancreatic tumors, ampulla tumors, and other pancreatic diseases have increased. Pancreaticoduodenectomy, one type of pancreatic resection, is a complex surgery with the loss of pancreatic integrity and various anastomoses. Complications after pancreaticoduodenectomy such as pancreatic fistulas and anastomosis leakage are common and significantly associated with patient outcomes. Pancreatic fist...

  9. Reversible transient apical ballooning syndrome with coronary lesions

    Institute of Scientific and Technical Information of China (English)

    Yunshan Cao; Min Zhang; Xiang Li; Ping Xie; Lynn Cronin

    2009-01-01

    Transient apical ballooning syndrome(Tako-Tsubo syndrome or ampulla cardiomyopathy) occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of a male patient with reversible transient apical ballooning syndrome with significant coronary lesions and other ECG changes that did not explain the clinical symptoms.

  10. Spatial differences in gene expression in the bovine oviduct.

    Science.gov (United States)

    Maillo, Veronica; de Frutos, Celia; O'Gaora, Peadar; Forde, Niamh; Burns, Gregory W; Spencer, Thomas E; Gutierrez-Adan, Alfonso; Lonergan, Patrick; Rizos, Dimitrios

    2016-07-01

    The aim of this study was to compare the transcriptome of the oviductal isthmus of pregnant heifers with that of cyclic heifers as well as to investigate spatial differences between the transcriptome of the isthmus and ampulla of the oviduct in pregnant heifers. After synchronizing crossbred beef heifers, those in standing oestrus (=Day 0) were randomly assigned to cyclic (non-bred, n=6) or pregnant (artificially inseminated, n=11) groups. They were slaughtered on Day 3 and both oviducts from each animal were isolated and cut in half to separate ampulla and isthmus. Each portion was flushed to confirm the presence of an oocyte/embryo and was then opened longitudinally and scraped to obtain epithelial cells which were snap-frozen. Oocytes and embryos were located in the isthmus of the oviduct ipsilateral to the corpus luteum Microarray analysis of oviductal cells revealed that proximity to the corpus luteum did not affect the transcriptome of the isthmus, irrespective of pregnancy status. However, 2287 genes were differentially expressed (P<0.01) between the ampulla and isthmus of the oviduct ipsilateral to the corpus luteum in pregnant animals. Gene ontology revealed that the main biological processes overrepresented in the isthmus were synthesis of nitrogen, lipids, nucleotides, steroids and cholesterol as well as vesicle-mediated transport, cell cycle, apoptosis, endocytosis and exocytosis, whereas cell motion, motility and migration, DNA repair, calcium ion homeostasis, carbohydrate biosynthesis, and regulation of cilium movement and beat frequency were overrepresented in the ampulla. In conclusion, large differences in gene expression were observed between the isthmus and ampulla of pregnant animals at Day 3 after oestrus. PMID:27069007

  11. Developmental origin of shark electrosensory organs.

    Science.gov (United States)

    Freitas, Renata; Zhang, Guangjun; Albert, James S; Evans, David H; Cohn, Martin J

    2006-01-01

    Vertebrates have evolved electrosensory receptors that detect electrical stimuli on the surface of the skin and transmit them somatotopically to the brain. In chondrichthyans, the electrosensory system is composed of a cephalic network of ampullary organs, known as the ampullae of Lorenzini, that can detect extremely weak electric fields during hunting and navigation. Each ampullary organ consists of a gel-filled epidermal pit containing sensory hair cells, and synaptic connections with primary afferent neurons at the base of the pit that facilitate detection of voltage gradients over large regions of the body. The developmental origin of electroreceptors and the mechanisms that determine their spatial arrangement in the vertebrate head are not well understood. We have analyzed electroreceptor development in the lesser spotted catshark (Scyliorhinus canicula) and show that Sox8 and HNK1, two markers of the neural crest lineage, selectively mark sensory cells in ampullary organs. This represents the first evidence that the neural crest gives rise to electrosensory cells. We also show that pathfinding by cephalic mechanosensory and electrosensory axons follows the expression pattern of EphA4, a well-known guidance cue for axons and neural crest cells in osteichthyans. Expression of EphrinB2, which encodes a ligand for EphA4, marks the positions at which ampullary placodes are initiated in the epidermis, and EphA4 is expressed in surrounding mesenchyme. These results suggest that Eph-Ephrin signaling may establish an early molecular map for neural crest migration, axon guidance and placodal morphogenesis during development of the shark electrosensory system. PMID:16409384

  12. A comparison of the electrosensory morphology of a euryhaline and a marine stingray.

    Science.gov (United States)

    Camilieri-Asch, Victoria; Kempster, Ryan M; Collin, Shaun P; Johnstone, Ron W; Theiss, Susan M

    2013-10-01

    The electrosensory system is found in all chondrichthyan fishes and is used for several biological functions, most notably prey detection. Variation in the physical parameters of a habitat type, i.e. water conductivity, may influence the morphology of the electrosensory system. Thus, the electrosensory systems of freshwater rays are considerably different from those of fully marine species; however, little research has so far examined the morphology and distribution of these systems in euryhaline elasmobranchs. The present study investigates and compares the morphology and distribution of electrosensory organs in two sympatric stingray species: the (euryhaline) estuary stingray, Dasyatis fluviorum, and the (marine) blue-spotted maskray, Neotrygon kuhlii. Both species possess a significantly higher number of ventral electrosensory pores than previously assessed elasmobranchs. This correlates with a diet consisting of benthic infaunal and epifaunal prey, where the electrosensory pore distribution patterns are likely to be a function of both ecology and phylogeny. The gross morphology of the electrosensory system in D. fluviorum is more similar to that of other marine elasmobranch species, rather than that of freshwater species. Both D. fluviorum and N. kuhlii possess 'macro-ampullae' with branching canals leading to several alveoli. The size of the pores and the length of the canals in D. fluviorum are smaller than in N. kuhlii, which is likely to be an adaptation to habitats with lower conductivity. This study indicates that the morphology of the electrosensory system in a euryhaline elasmobranch species seems very similar to that of their fully marine counterparts. However, some morphological differences are present between these two sympatric species, which are thought to be linked to their habitat type. PMID:23988133

  13. Acute toxicity and efficacy of postoperative combined modality therapy for adenocarcinoma of the pancreas

    International Nuclear Information System (INIS)

    PURPOSE: To examine the acute toxicity and outcome in patients (pts) treated with combined modality therapy following resection of adenocarcinoma of the pancreas. MATERIALS AND METHODS: From 2/88 to 2/96, 34 pts (M:20, F:14) received postoperative combined modality therapy following a pancreatic resection. Tumor location included; head only: 28, head and ampulla: 1, ampulla only: 1, body and tail: 2, and tail only: 2. Postoperative stages included: stage I: 7 (21%) and stage III: 27 (79%). Pts were referred for combined modality therapy based on surgeon preference. In general, pts were treated who had one or more adverse prognostic factors. These included positive local/regional lymph nodes (79%), positive margins (50%) or disease invasive into adjacent structures (85 %). Radiation fields included the original primary tumor bed (based on preoperative CT scans) and peri-pancreatic and para-aortic lymph nodes adjacent to vertebral bodies T10 through L3. No attempt was made to include the entire pancreas in the radiation field. Patients received 5040 cGy at 180 cGy/day using a 3 or 4 field technique and CT-based treatment planning. Concurrent bolus 5-FU (375-500 mg/m2) was delivered on the first three and last three days of radiation. Post-radiation maintenance bolus 5-FU was given to 7 patients for a median of 6 cycles. A toxicity assessment using the NCI toxicity criteria was performed at each weekly visit and 4 weeks following the completion of combined modality therapy. The median follow-up was 13 months (range: 2-36 months). Patterns of failure as a component of failure were assessed by radiographic criteria and, in 2 pts, by intraoperative evaluation for symptomatic progression of disease. Local/regional failure was defined as recurrence within the radiation field. Distant failure included liver, peritoneal seeding, and extra-abdominal sites. Actuarial survival was calculated from the time of surgery using the Kaplan-Meier method. RESULTS: The only grade 3

  14. Investigation of the potential of optical coherence tomography (OCT) as a non-invasive diagnostic tool in reproductive medicine

    Science.gov (United States)

    Trottmann, Matthias; Homann, Christian; Leeb, R.; Doering, D.; Kuznetsova, J.; Reese, S.; Stief, C. G.; Koelle, S.; Sroka, R.

    2015-02-01

    Introduction and objective: In Europe, nearly every sixth couple in the reproductive age is involuntarily childless. In about 30%, both male and female reveal fertility problems. In about 10% of infertile men, azoospermia is the underlying cause. As conventional therapeutic options are limited, surgical testicular sperm extraction (TESE) is necessary to obtain sperms for assisted reproductive techniques. Regarding the females, up to 30% of all idiopathic infertilities are due to alterations of the uterine tube So far, no imaging technique, which does not require any labelling, is available to evaluate the male and female genital tract at a microscopic level under in vivo conditions. Thus, the aim of this study was to investigate the potential of optical coherence tomography (OCT) as a non-invasive diagnostic tool in gynaecology and andrology. Material and Methods: Tissues samples from the bovine testis, epididymis, vas deferens, ovary, oviduct (ampulla and isthmus) and uterus were obtained immediately after slaughter (14 cows aged 3 to 8 years and 14 bulls aged 3 to 6 years; breeds: Holstein- Friesian, and Deutsches Fleckvieh). Imaging was done by using the US Food and Drug Administration (FDA) approved probe-based Niris Imaging System (Imalux, Cleveland, Ohio, USA) and the Telesto 1325 nm OCT System and Ganymede 930 nm OCT System (Thorlabs Inc., Dachau, Germany). All images obtained were compared to histological images after paraffin embedding and HE staining. Results: OCT imaging visualized the microarchitecture of the testis, epididymis, spermatic duct and the ovary, oviduct and uterus. Using the Thorlabs systems a axial resolution of approx. 5μm and lateral resolution of 8- 15μm could be achieved. Different optical tissue volumes could be visualized, which depends on the optical penetration depth of the wavelength of the system used. While the tissue volume observed by probe based Imalux-OCT is similar to the used Thorlabs systems, the optical resolution is

  15. Morphology and Aquaporin Immunohistochemistry of the Uterine Tube of Saanen Goats (Capra hircus): Comparison Throughout the Reproductive Cycle.

    Science.gov (United States)

    Arrighi, S; Bosi, G; Frattini, S; Coizet, B; Groppetti, D; Pecile, A

    2016-06-01

    The expression of six different aquaporins (AQP1, 2, 3, 4, 5 and 9), integral membrane water channels that facilitate bi-directional passive movement of water, was investigated by immunohistochemistry in the uterine tube of pre-pubertal and adult Saanen goats (Capra hircus), comparing the different phases of the oestrous cycle. Regional morphology and secretory processes were markedly different during the goat oestrous cycle. The tested AQP molecules showed different expression patterns in comparison with already studied species. AQP1-immunoreactivity was evidenced at the endothelium of blood vessels and in nerve fibres, regardless of the tubal tract and cycle period. AQP4-immunoreactivity was shown on the lateral plasmalemma in the basal third of the epithelial cells at infundibulum and ampulla level in the cycling goats, more evidently during follicular than during luteal phase. No AQP4-immunoreactivity was noticed at the level of the isthmus region, regardless of the cycle phase. AQP5-immunoreactivity, localized at the apical surface of epithelial cells, increased from pre-puberty to adulthood. Thereafter, AQP5-immunoreactivity was prominent during the follicular phase, when it strongly decorated the apical plasmalemma of all epithelial cells at ampullary level. During luteal phase, immunoreactivity was discontinuous, being weak to strong at the apex of the secretory cells protruding into the lumen. In the isthmus region, the strongest AQP5-immunoreactivity was seen during follicular phase, with a clear localization in the apical plasmalemma of all the epithelial cells and also on the lateral plasmalemma. AQP2, 3 and 9 were undetectable all along the goat uterine tube. Likely, a collaboration of different AQP molecules sustains the fluid production in the goat uterine tube. AQP1-mediated transudation from the blood capillaries, together with permeation of the epithelium by AQP4 in the basal rim of the epithelial cells and final intervening of apical AQP5, could

  16. Use of computed tomography to evaluate the intestinal tract of adult llamas

    International Nuclear Information System (INIS)

    In the llama, signs of colic are obscure and may be exhibited as persistent sternal recumbency and anorexia even in the presence of a surgical lesion. Diagnostic methods for evaluation of abdominal disorders are limited. As a result, surgical intervention may be prolonged and increase the risk of mortality and postoperative complications. The objective of this study was to determine the feasibility of computed tomography to evaluate the llama intestinal tract. Eighteen hours prior to the computed tomography scan, six llamas were given barium sulfate (15%) via an orogastric tube. Following induction of general anesthesia, the llamas were positioned in sternal recumbency, and 10 mm contiguous slices were obtained from the diaphragm to the tuber ischiadicum. Structures that were consistently identified included the first, second, and third compartments (C1, 2, and 3), small intestine, spiral colon, and ascending colon. C1 was easily identified in the cranial aspect of the abdomen due to its large size relative to the other compartments and characteristic saccules. C2 was located cranial, ventral, and to the right of C1, while C3 was visualized as a tubular structure to the right and ventral to C1 and C2, C3 was traced caudally until it turned dorsally and continued cranially to a dilated ampulla in the right cranial abdomen delineating the entrance to the small intestine. The spiral colon was identified consistently in the left ventral caudal abdomen. Structures that could not be conclusively identified included the cecum and mesenteric lymph nodes. Computed tomography allowed a consistent evaluation of the major intestinal structures associated with colic in the llama. Thus, computed tomography is a potentially valuable noninvasive diagnostic tool to effectively evaluate the abdominal cavity and differentiate medical from surgical lesions in the llama

  17. Discrimination of suppurative cholangitis from nonsuppurative cholangitis with computed tomography (CT)

    International Nuclear Information System (INIS)

    Purpose: Suppurative cholangitis is characterized by obstruction, inflammation, and pyogenic infection of the biliary tract. This disease represents a true emergency. The purpose of this study was to compare the computed tomography (CT) findings between acute calculous suppurative and nonsuppurative cholangitis and to determine if there are findings that assist in the differential diagnosis. Materials and methods: Fifteen patients with acute suppurative cholangitis were enrolled in this study. Findings at endoscopic retrograde cholangiopancreaticography (ERCP) were the standard of reference for suppurative cholangitis. To compare the findings of suppurative cholangitis with those of nonsuppurative cholangitis, 35 patients with nonsuppurative cholangitis were randomly selected. The following findings were evaluated: the presence of papillitis, the presence of stones in the ampulla, the presence of intrahepatic stones, the presence of early inhomogeneous enhancement of the liver, the degree of bile duct dilatation, the degree of bile duct wall thickening and presence of cholecystitis. Sensitivity and specificity for each of the individual findings were calculated. Statistical analyses were performed the Pearson χ2 test, Fisher's exact test and the Mann-Whitney U test. Results: Papillitis showed the highest specificity 86% with 60% sensitivity. Marked inhomogeneous enhancement of the liver during the arterial phase showed 80% specificity with 60% sensitivity. In multivariate logistic analysis, papillitis and marked early inhomogeneous enhancement of the liver were the most significant predictors of acute suppurative cholangitis. The combination of these two CT findings improved specificity (97% specificity) for the diagnosis of suppurative cholangitis. Conclusion: Papillitis and marked early inhomogeneous enhancement of the liver were found to be the most discriminative CT findings for the diagnosis of acute suppurative cholangitis and the differentiation between

  18. Discrimination of suppurative cholangitis from nonsuppurative cholangitis with computed tomography (CT)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Kyung [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kim, Suk [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)], E-mail: kimsuk@medigate.net; Lee, Jun Woo; Kim, Chang Won [Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kim, Gwang Ha; Kang, Dae Hwan [Department of Gastrointestinal Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Jo, Hong Jae [Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)

    2009-03-15

    Purpose: Suppurative cholangitis is characterized by obstruction, inflammation, and pyogenic infection of the biliary tract. This disease represents a true emergency. The purpose of this study was to compare the computed tomography (CT) findings between acute calculous suppurative and nonsuppurative cholangitis and to determine if there are findings that assist in the differential diagnosis. Materials and methods: Fifteen patients with acute suppurative cholangitis were enrolled in this study. Findings at endoscopic retrograde cholangiopancreaticography (ERCP) were the standard of reference for suppurative cholangitis. To compare the findings of suppurative cholangitis with those of nonsuppurative cholangitis, 35 patients with nonsuppurative cholangitis were randomly selected. The following findings were evaluated: the presence of papillitis, the presence of stones in the ampulla, the presence of intrahepatic stones, the presence of early inhomogeneous enhancement of the liver, the degree of bile duct dilatation, the degree of bile duct wall thickening and presence of cholecystitis. Sensitivity and specificity for each of the individual findings were calculated. Statistical analyses were performed the Pearson {chi}{sup 2} test, Fisher's exact test and the Mann-Whitney U test. Results: Papillitis showed the highest specificity 86% with 60% sensitivity. Marked inhomogeneous enhancement of the liver during the arterial phase showed 80% specificity with 60% sensitivity. In multivariate logistic analysis, papillitis and marked early inhomogeneous enhancement of the liver were the most significant predictors of acute suppurative cholangitis. The combination of these two CT findings improved specificity (97% specificity) for the diagnosis of suppurative cholangitis. Conclusion: Papillitis and marked early inhomogeneous enhancement of the liver were found to be the most discriminative CT findings for the diagnosis of acute suppurative cholangitis and the

  19. Congenital ductus arteriosus aneurysm: an unusual cause of transient neonatal hypertension

    Science.gov (United States)

    Murki, Srinivas; Deshbhatla, Sai Kiran; Sharma, Deepak; Rao, Nageshwar; Verma, Sudeep

    2014-01-01

    Case 1: A term male child was re-admitted on day 10 of life due to acute onset of respiratory distress. Physical examination revealed tachypnoea, tachycardia and blood pressure (BP) above the 95th centile in all four limbs. Cardiovascular examination revealed a short systolic murmur on the sternal border. Abdomen showed hepatomegaly of 3 cm below the costal margin. Chest X-ray showed a cardiothoracic ratio of 0.65 with normal vascularity. Ultrasound and Doppler of the kidneys and brain were normal. The high parasternal view showed a large ductus arteriosus aneurysm (DAA) of 2.0×2.5 cm. The baby was managed with inotropes and antihypertensives. CT angiogram showed 1.6×0.6 cm thrombosed DAA, which was extending from the posterior descending aorta to the ampulla. With the resolution of aneurysm BPs normalised and antihypertensives were stopped at 6 weeks of age. Case 2: A premature male neonate weighing 1.2 kg was admitted to the neonatal intensive care unit for respiratory distress syndrome. On the 4th day of life during routine measurement of vitals, the BP was consistently above 95th centile in all four limbs. Blood tests revealed thrombocytopenia that persisted inspite of single donor transfusions. The evaluation for sepsis was negative. The ultrasound and Dopplers of the kidneys and brain were all normal. A transthoracic echocardiogram showed a large DAA measuring 5×1.8 mm. Hypertension was managed with antihypertensives. Serial transthoracic echocardiogram showed organising DAA. CT angiogram showed 6 mm×2 mm thrombosed DAA. As the arterial BP normalised, antihypertensives were stopped on day 15 of life. The baby was discharged on day 29 of life and on follow-up BP remained normal. PMID:24798362

  20. Hirshsprung's disease; the clinical differentiation and treatment of children with Hirschsprung's disease and pseudo-Hirschsprung's disease.

    Science.gov (United States)

    RAVITCH, M M

    1958-07-01

    Hirschsprung's disease is marked by constipation from the time of birth, with the development, if uncorrected, of a protuberant abdomen and flared costal margins. The rectal ampulla is empty and the abdomen is filled with fecal masses. Pain is not prominent. Flatus is passed in large amounts. Encopresis does not occur. Barium enema shows the characteristic narrowed distal rectal segment and biopsy of the rectum shows absence of the ganglion cells of the myenteric plexus. Treatment is operative resection of the distal narrow segment and a primary anastomosis.Hirschsprung's disease may be mimicked in children with:1. Psychogenic constipation-pseudo-Hirschsprung's disease. Unlike Hirschsprung's disease, symptoms do not appear at birth, encopresis is common, and the barium enema shows no narrow distal segment.2. Mental retardation and cerebral defect.3. Corrected imperforate anus-on the basis of stenosis, imperfect innervation or poor habit training.4. Cretinism-with severe constipation and intestinal dilatation perhaps the presenting symptoms. Treatment of these four groups of children with severe constipation not due to Hirschsprung's disease is:For Group 1, open discussion with parent and child. Assumption by the physician of full control of the details of treatment, and relegation of parent to the role of the physician's agent in following the prescribed regimen. For Group 2, an enema regimen. Whereas fairly rapid restoration (and then persistence) of normal bowel habit can be expected in Group 1, the basic defects in Group 2 may require indefinite continuation of treatment. For Group 3, regular enema regimen, in the less severe cases-one identical with that used in Group 1, and dilatation of strictures or anoplasty. In Group 4, thyroid hormone therapy relieves the constipation of hypothyroidism and causes reversion of radiographic changes in the colon and rectum. PMID:13561108

  1. A late role for bmp2b in the morphogenesis of semicircular canal ducts in the zebrafish inner ear.

    Directory of Open Access Journals (Sweden)

    Katherine L Hammond

    Full Text Available The Bone Morphogenetic Protein (BMP genes bmp2 and bmp4 are expressed in highly conserved patterns in the developing vertebrate inner ear. It has, however, proved difficult to elucidate the function of BMPs during ear development as mutations in these genes cause early embryonic lethality. Previous studies using conditional approaches in mouse and chicken have shown that Bmp4 has a role in semicircular canal and crista development, but there is currently no direct evidence for the role of Bmp2 in the developing inner ear.We have used an RNA rescue strategy to test the role of bmp2b in the zebrafish inner ear directly. Injection of bmp2b or smad5 mRNA into homozygous mutant swirl (bmp2b(-/- embryos rescues the early patterning defects in these mutants and the fish survive to adulthood. As injected RNA will only last, at most, for the first few days of embryogenesis, all later development occurs in the absence of bmp2b function. Although rescued swirl adult fish are viable, they have balance defects suggestive of vestibular dysfunction. Analysis of the inner ears of these fish reveals a total absence of semicircular canal ducts, structures involved in the detection of angular motion. All other regions of the ear, including the ampullae and cristae, are present and appear normal. Early stages of otic development in rescued swirl embryos are also normal.Our findings demonstrate a critical late role for bmp2b in the morphogenesis of semicircular canals in the zebrafish inner ear. This is the first demonstration of a developmental role for any gene during post-embryonic stages of otic morphogenesis in the zebrafish. Despite differences in the early stages of semicircular canal formation between zebrafish and amniotes, the role of Bmp2 in semicircular canal duct outgrowth is likely to be conserved between different vertebrate species.

  2. Politische Ökonomie, Wirtschaftspolitik und Wirtschaftsethik : was bleibt vom Forschungsprogramm von John Neville Keynes?

    OpenAIRE

    Neck, Reinhard

    2006-01-01

    "Es wird untersucht, wieweit die von John Neville Keynes, dem Vater von John Maynard Keynes, stammende Unterscheidung von Volkswirtschaftstheorie, Wissenschaft von der Wirtschaftspolitik und Wirtschaftsethik heute noch sinnvoll ist und welche Aufgaben diesen Teildisziplinen der Volkswirtschaftslehre angesichts der Neuen Politischen Ökonomie und anderer jüngerer Entwicklungen zukommen sollen." (Autorenreferat) "In 1890, John Neville Keynes, the father of John Maynard Keynes, published a boo...

  3. Positron Emission Tomography with 2-Deoxy-2-[18F] Fluoro-DGlucose in the Detection of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas

    Directory of Open Access Journals (Sweden)

    Brian KP Goh

    2007-05-01

    Full Text Available A 79-year-old Indian male was admitted with upper abdominal discomfort of 1-year duration which was associated with loss of weight and appetite. Clinical examination of the abdomen did not reveal any palpable masses. Laboratory investigations including a complete blood count, liver function tests and serum amylase were unremarkable. Standard serum tumor markers were within normal limits: carbohydrate antigen (CA 19-9, 13.4 U/mL (reference range: 3-45 U/mL; carcinoembryonic antigen (CEA, 1.4 μg/L (reference range: 0.5-3.5 μg/L and alphafetoprotein, 1.3 μg/L (reference range: 1-10 μg/L. A contrast-enhanced computed tomographic (CT scan demonstrated a cystically dilated and tortuous pancreatic duct measuring 1.9 cm, suggestive of an intraductal papillary mucinous neoplasm (IPMN. The common bile duct was dilated up to the level of the ampulla and a 3.2x2.0 cm heterogeneous soft tissue mass was observed in the head of the pancreas which extended into the duodenum, suggestive of a malignant lesion (Images 1 and 2. Fusion positron emission tomography/computed tomography (PET/CT was subsequently performed with 12.7 mCi of 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG administered intravenously. A whole body PET/CT scan was performed 60 minutes later with CT data used for attenuation correction and anatomical correlation. This confirmed a metabolically active focus within the pancreatic head mass with a standard uptake value (SUVmax of 3.5 compatible with carcinoma (Image 3.

  4. Size of the Ovulatory Follicle Dictates Spatial Differences in the Oviductal Transcriptome in Cattle

    Science.gov (United States)

    Gonella-Diaza, Angela María; da Silva Andrade, Sónia Cristina; Sponchiado, Mariana; Pugliesi, Guilherme; Mesquita, Fernando Silveira; Van Hoeck, Veerle; de Francisco Strefezzi, Ricardo; Gasparin, Gustavo R.; Coutinho, Luiz L.; Binelli, Mario

    2015-01-01

    In cattle, molecular control of oviduct receptivity to the embryo is poorly understood. Here, we used a bovine model for receptivity based on size of the pre-ovulatory follicle to compare oviductal global and candidate gene transcript abundance on day 4 of the estrous cycle. Growth of the pre-ovulatory follicle (POF) of Nelore (Bos indicus) cows was manipulated to produce two groups: large POF large corpus luteum (CL) group (LF-LCL; greater receptivity) and small POF-small CL group (SF-SCL). Oviductal samples were collected four days after GnRH-induced ovulation. Ampulla and isthmus transcriptome was obtained by RNA-seq, regional gene expression was assessed by qPCR, and PGR and ERa protein distribution was evaluated by immunohistochemistry. There was a greater abundance of PGR and ERa in the oviduct of LF-LCL animals thus indicating a greater availability of receptors and possibly sex steroids stimulated signaling in both regions. Transcriptomic profiles indicated a series of genes associated with functional characteristics of the oviduct that are regulated by the periovulatory sex steroid milieu and that potentially affect oviductal receptivity and early embryo development. They include tissue morphology changes (extra cellular matrix remodeling), cellular changes (proliferation), and secretion changes (growth factors, ions and metal transporters), and were enriched for the genes with increased expression in the LF-LCL group. In conclusion, differences in the periovulatory sex steroid milieu lead to different oviductal gene expression profiles that could modify the oviductal environment to affect embryo survival and development. PMID:26699362

  5. [Ultrastructural description of Euglena pailasensis (Euglenozoa) from Rincón de la Vieja volcano, Guanacaste, Costa Rica].

    Science.gov (United States)

    Sánchez, Ethel; Vargas, Maribel; Mora, Marielos; Ortega, José Maria; Serrano, Aurelio; Freer, Enrique; Sittenfeld, Ana

    2004-03-01

    The euglenoids are unicellular eukaryotic flagellates living in a diversity of soils and aquatic environments and ecosystems. This study describes the ultrastructure of an euglenoid isolated from the surface of a boiling mud pool with temperatures ranging from 38 to 98 degrees C and pH 2 - 4. The hot mud pool is located in Area de Pailas de Barro, Las Pailas, Rincón de la Vieja Volcano, Guanacaste, Costa Rica. The morphological characterization of the Euglena pailasensis was performed by SEM and TEM. It was determined that, although the euglenoid was obtained from an extreme volcanic environment, the general morphology corresponds to that of a typical member of Euglena of 30-45 microm long and 8-10 microm wide, with membrane, pellicle, chloroplasts, mitochondria, nucleus, pigments and other cytoplasmic organelles. E. pailasensis is delimited by a membrane and by 40 to 90 pellicle strips. It was observed up to 5 elongated chloroplasts per cell. The chloroplast contains several osmiophilic globules and a pyrenoid penetrated by few thylakoid pairs. The nutritious material is reserved in numerous small paramylon grains located at the center of the cell, mitocondria are characterized by the presence of crests in radial disposition toward the interior of the lumen. It was also observed around the external surface "pili" like filaments originating from the pellicle strips. There is no evidence for the presence of flagella in the ampulla (reservoir/canal area), a fact confirmed by negative staining, and a difference regarding other species of Euglena. The observed ultrastructural characteristics are not sufficient to explain the adaptation of this species to acid and hot environments. PMID:17357397

  6. High-resolution T2-weighted MR imaging of the inner ear using a long echo-train-length 3D fast spin-echo sequence

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the value of a long echo-train-length 3D fast spin-echo (3D-FSE) sequence in visualizing the inner ear structures. Ten normal ears and 50 patient ears were imaged on a 1.5T MR unit using a head coil. Axial high-resolution T2-weighted images of the inner ear and the internal auditory canal (IAC) were obtained in 15 min. In normal ears the reliability of the visualization for the inner ear structures was evaluated on original images and the targeted maximum intensity projection (MIP) images of the labyrinth. In ten normal ears, 3D surface display (3D) images were also created and compared with MIP images. On the original images the cochlear aqueduct, the vessels in the vicinity of the IAC, and more than three branches of the cranial nerves were visualized in the IAC in all the ears. The visibility of the endolympathic duct was 80%. On the MIP images the visibility of the three semicircular canals, anterior and posterior ampulla, and of more than two turns of the cochlea was 100%. The MIP images and 3D images were almost comparable. The visibility of the endolymphatic duct was 80% in normal ears and 0% in the affected ears of the patients with Meniere's disease (p<0.001). In one patient ear a small intracanalicular tumor was depicted clearly. In conclusion, the long echo train length T2-weighted 3D-FSE sequence enables the detailed visualization of the tiny structures of the inner ear and the IAC within a clinically acceptable scan time. Furthermore, obtaining a high contrast between the soft/bony tissue and the cerebrospinal/endolymph/perilymph fluid would be of significant value in the diagnosis of the pathologic conditions around the labyrinth and the IAC. (orig.)

  7. Defecography of rectal wall prolapse conditions; Defecografia nelle malattie parietali del retto da prolasso

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, A.; Muto, M.; De Rosa, A. [Azienda Sanitaria di Rilievo Nazionale A. Cardarelli, Naples (Italy). Servizio di Neuroradiologia; Ginolfi, F.; Carbone, M.; Amodio, F.; Rossi, E. [Naples Univ. Federico 2. (Italy). Ist. di Scienze Radiologiche; Tuccillo, M. [Azienda Sanitaria di Rilirvo Nazionale A. Cardarelli, Naples (Italy). 2. Servizio di Radiologia

    1999-06-01

    Pelvic floor and rectal prolapse conditions have greatly benefited by new imaging and instrumental diagnostic approaches, and especially defecography, for both pathophysiological interpretation and differential diagnosis. The authors investigated the efficacy of defecography in the assessment of rectal prolapse, and in particular the role of videproctography in diagnosis such dynamic disorders. The dynamic changes of ampulla are well depicted by videoproctography, which showed anorectum normalization and spontaneous reduction of invagination after intussusception. Defecography exhibited good capabilities in showing rectal wall function abnormalities. Finally, some features of videoproctography such as low radiation dose, non-invasiveness and ease of execution, make the examination acceptable to patients with anorectal disorders and for the follow-up of rectal prolapse. [Italian] Le malattie del pavimento pelvico e dei prolassi del retto hanno tratto numerosi vantaggi da nuovi approcci di diagnostica per immagini e strumentali, specialmente dall'esame defecografico, sia nell'interpretazione fisiopatologica che nella diagnostica differenziale dei disordini anorettali. Scopo del lavoro: valutare l'efficacia della metodica defecografica nel riconoscimento delle malattie da prolasso del retto e in particolare il ruolo svolto dalla videoproctografia nella documentazione diagnostica e nel definire i principali elementi semeiologici riscontrabili in tali malattie in modo dinamico. Le fasi dinamiche della valutazione morfologica e posizionale dell'ampolla rettale sono ben evidenti nella viedeoproctografia, che documenta dopo l'intussuscezione la normalizzazione del complesso anorettale e la riduzione spontanea dell'invaginazione parietale. In questo studio si sottolineano le possibilita' diagnostiche della defecografia integrata da videoproctografia nel riconoscimento delle malattie parietali funzionali del retto e alcune peculiarita

  8. Epithelial cell stretching and luminal acidification lead to a retarded development of stria vascularis and deafness in mice lacking pendrin.

    Directory of Open Access Journals (Sweden)

    Hyoung-Mi Kim

    Full Text Available Loss-of-function mutations of SLC26A4/pendrin are among the most prevalent causes of deafness. Deafness and vestibular dysfunction in the corresponding mouse model, Slc26a4(-/-, are associated with an enlargement and acidification of the membranous labyrinth. Here we relate the onset of expression of the HCO(3 (- transporter pendrin to the luminal pH and to enlargement-associated epithelial cell stretching. We determined expression with immunocytochemistry, cell stretching by digital morphometry and pH with double-barreled ion-selective electrodes. Pendrin was first expressed in the endolymphatic sac at embryonic day (E 11.5, in the cochlear hook-region at E13.5, in the utricle and saccule at E14.5, in ampullae at E16.5, and in the upper turn of the cochlea at E17.5. Epithelial cell stretching in Slc26a4(-/- mice began at E14.5. pH changes occurred first in the cochlea at E15.5 and in the endolymphatic sac at E17.5. At postnatal day 2, stria vascularis, outer sulcus and Reissner's membrane epithelial cells, and utricular and saccular transitional cells were stretched, whereas sensory cells in the cochlea, utricle and saccule did not differ between Slc26a4(+/- and Slc26a4(-/- mice. Structural development of stria vascularis, including vascularization, was retarded in Slc26a4(-/- mice. In conclusion, the data demonstrate that the enlargement and stretching of non-sensory epithelial cells precedes luminal acidification in the cochlea and the endolymphatic sac. Stretching and luminal acidification may alter cell-to-cell communication and lead to the observed retarded development of stria vascularis, which may be an important step on the path to deafness in Slc26a4(-/- mice, and possibly in humans, lacking functional pendrin expression.

  9. Effects of contrast media on the hepato-pancreato-biliary system

    Institute of Scientific and Technical Information of China (English)

    Omer Topcu; Atilla Kurt; Isilay Nadir; Sema Arici; Ayhan Koyuncu; Cengiz Aydin

    2009-01-01

    AIM: To determine the effects of high osmolarity contrast media (HOCM) and iso-osmolar contrast media (CM) application, with or without pressure, on hepato-pancreato-biliary (HPB) system. METHODS: Sixty rats were divided into six equal groups as follows: Group 1: (0.9% NaCl, control), Group 2: (diatrizoate meglumine Na, ionic HOCM, Urographin~(R)), Group 3: (iodixanol, iso-osmolar nonionic CM, Visipaque~(R)); each of which was applied without pressure, whereas the animals of the remaining three groups (1p, 2p, 3p) were subjected to the same CM with pressure. We performed a duodenal puncture and introduced a catheter into the ampulla. After the catheterization, 0.2 mL CM or 0.9%NaCl was injected with or without pressure. Blood samples were taken for biochemical evaluations. The histopathological examinations of liver, common bile duct, and pancreas were performed. RESULTS: There were no significant differences between the six groups for blood amylase, alanine aminotransferases, aspartate aminotransferases, bilirubin levels ( P > 0.05). Alkaline phosphatase and γ glutamyl transaminase levels were higher ( P 0.05) between HOCM (2, 2p) and iso-osmolar CM (3, 3p) groups. Bile duct proliferation and regeneration in the Urographin(R) Groups (2, 2p) were significantly higher ( P 0.05) between the groups. Application of the CM with pressure did not cause additional damage to the HPB system. CONCLUSION: Iso-osmolar, non-ionic CM could be more reliable than the ionic HOCM, whereas the application of pressure during the CM application had no effect on the HPB system.

  10. Gastrointestinal 18F-FDG accumulation on PET without a corresponding CT abnormality is not an early indicator of cancer development

    Energy Technology Data Exchange (ETDEWEB)

    Heusner, Till A.; Hahn, Steffen; Baumeister, Rilana; Forsting, Michael; Antoch, Gerald [University Hospital Essen, University at Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Hamami, Monia E.; Kim, Un-Hi; Stahl, Alexander; Bockisch, Andreas [University Hospital Essen, University at Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2009-09-15

    Focal gastrointestinal 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose (FDG) uptake can frequently be found on FDG-PET/CT even in patients without known gastrointestinal malignancy. The aim of this study was to evaluate whether increased gastrointestinal FDG uptake without CT correlate is an early indicator of patients developing gastrointestinal malignancies. A total of 1,006 patients without esophagogastric or anorectal malignancies underwent FDG-PET/CT. The esophagogastric junction, the stomach and the anorectum were evaluated for increased FDG uptake. Patients without elevated uptake were assigned to group A, patients with elevated uptake were allocated to group B. The SUVmax values of both groups were tested for significant differences using the U test. A follow-up of longer than 1 year (mean 853 {+-} 414 days) served as gold standard. A total of 460 patients had to be excluded based on insufficient follow-up data. For the remaining 546 patients the mean SUVmax was as follows: (a) esophagogastric junction, group A 3.1 {+-} 0.66, group B 4.0 {+-} 1.11, p < 0.01; (b) stomach, group A 2.8 {+-} 0.77, group B 4.1 {+-} 1.33, p < 0.01; (c) rectal ampulla, group A 2.8 {+-} 0.83, group B 3.9 {+-} 1.49, p < 0.01; (d) anal canal, group A 2.7 {+-} 0.55, group B 3.9 {+-} 1.59, p < 0.01. Only one patient developed gastric cancer. In the case of an unremarkable CT, elevated esophagogastric or anorectal FDG uptake does not predict cancer development and does not have to be investigated further. (orig.)

  11. Gastrointestinal 18F-FDG accumulation on PET without a corresponding CT abnormality is not an early indicator of cancer development

    International Nuclear Information System (INIS)

    Focal gastrointestinal 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) uptake can frequently be found on FDG-PET/CT even in patients without known gastrointestinal malignancy. The aim of this study was to evaluate whether increased gastrointestinal FDG uptake without CT correlate is an early indicator of patients developing gastrointestinal malignancies. A total of 1,006 patients without esophagogastric or anorectal malignancies underwent FDG-PET/CT. The esophagogastric junction, the stomach and the anorectum were evaluated for increased FDG uptake. Patients without elevated uptake were assigned to group A, patients with elevated uptake were allocated to group B. The SUVmax values of both groups were tested for significant differences using the U test. A follow-up of longer than 1 year (mean 853 ± 414 days) served as gold standard. A total of 460 patients had to be excluded based on insufficient follow-up data. For the remaining 546 patients the mean SUVmax was as follows: (a) esophagogastric junction, group A 3.1 ± 0.66, group B 4.0 ± 1.11, p < 0.01; (b) stomach, group A 2.8 ± 0.77, group B 4.1 ± 1.33, p < 0.01; (c) rectal ampulla, group A 2.8 ± 0.83, group B 3.9 ± 1.49, p < 0.01; (d) anal canal, group A 2.7 ± 0.55, group B 3.9 ± 1.59, p < 0.01. Only one patient developed gastric cancer. In the case of an unremarkable CT, elevated esophagogastric or anorectal FDG uptake does not predict cancer development and does not have to be investigated further. (orig.)

  12. Optimizing management of pancreaticopleural fistulas

    Institute of Scientific and Technical Information of China (English)

    Marek Wronski; Maciej Slodkowski; Wlodzimierz Cebulski; Daniel Moronczyk; Ireneusz W Krasnodebski

    2011-01-01

    AIM: To evaluate the management of pancreaticopleu ral fistulas involving early endoscopic instrumentation of the pancreatic duct.METHODS: Eight patients with a spontaneous pancre aticopleural fistula underwent endoscopic retrograde cholangiopancreatography (ERCP) with an intention to stent the site of a ductal disruption as the primary treatment. Imaging features and management were evaluated retrospectively and compared with outcome.RESULTS: In one case, the stent bridged the site of a ductal disruption. The fistula in this patient closed within 3 wk. The main pancreatic duct in this case appeared normal, except for a leak located in the body of the pancreas. In another patient, the papilla of Vater could not be found and cannulation of the pancreatic duct failed. This patient underwent surgical treatment. In the remaining 6 cases, it was impossible to insert a stent into the main pancreatic duct properly so as to cover the site of leakage or traverse a stenosis situated down stream to the fistula. The placement of the stent failedbecause intraductal stones (n = 2) and ductal strictures (n = 2) precluded its passage or the stent was too short to reach the fistula located in the distal part of the pan creas (n = 2). In 3 out of these 6 patients, the pancre aticopleural fistula closed on further medical treatment. In these cases, the main pancreatic duct was normal or only mildly dilated, and there was a leakage at the body/tail of the pancreas. In one of these 3 patients, additional percutaneous drainage of the peripancreatic fluid collections allowed better control of the leakage and facilitated resolution of the fistula. The remaining 3 patients had a tight stenosis of the main pancreatic duct resistible to dilatation and the stent could not be inserted across the stenosis. Subsequent conservative treatment proved unsuccessful in these patients. After a failed therapeutic ERCP, 3 patients in our series devel oped super infection of the pleural or peripancreatic

  13. [Etiological factors of acute pancreatitis].

    Science.gov (United States)

    Spicák, J

    2002-09-01

    Acute pancreatitis develops immediately after the causative impulse, while chronic pancreatitis develops after the long-term action of the noxious agent. A typical representative of acute pancreatitis is biliary pancreatitis, chronic pancreatitis develops in alcoholism and has a long latency. As alcoholic pancreatitis is manifested at first as a rule by a potent attack, it is classified in this stage as acute pancreatitis. The most frequent etiological factors in our civilization are thus cholelithiasis and alcoholism (both account for 20-50% in different studies). The assumed pathogenetic principles in acute biliary pancreatitis are the common canal of both efferent ducts above the obturated papilla, duodenopancreatic reflux and intrapancreatic hypertension. A detailed interpretation is however lacking. The pathogenesis of alcoholic pancreatitis is more complicated. Among others some part is played by changes in the calcium concentration and fusion of cellular membranes. Idiopathic pancreatitis occurs in up to 10%, part of the are due to undiagnosed alcoholism and cholelithiasis. Other etiologies are exceptional. Similarly as in cholelithiasis pancreatitis develops also during other pathological processes in the area of the papilla of Vater such as dysfunction of the sphincter of Oddi, ampulloma and juxtapapillary diverticulum, it is however usually mild. The incidence of postoperative pancreatitis is declining. Its lethality is 30% and the diagnosis is difficult. In the pathogenesis changes of the ion concentration are involved, hypoxia and mechanical disorders of the integrity of the gland. Pancreatitis develops in association with other infections--frequently in mumps, rarely in hepatitis, tuberculosis, typhoid and mycoses. Viral pancreatitis is usually mild. In parasitoses pancreatitis develops due to a block of the papilla Vateri. In hyperparathyroidism chronic pancreatitis is more likely to develop, recent data are lacking. As to dyslipoproteinaemias

  14. Computed tomographic findings of intrahepatic peripheral cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Seong Ku; Suh, Soo Jhi [Keimyung University School of Medicine, Seoul (Korea, Republic of); Kim, Ho Joon; Chun, Byung Hee [Koshin University College of Medicine, Busan (Korea, Republic of)

    1986-08-15

    Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bile duct (peripheral type), a major intrahepatic duct including the hepatic hills, an extrahepatic duct, or near the papilla of Vater (central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of the liver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiate on the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinoma of the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male, and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases, abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7 cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Laboratory findings were not specific, but there were only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case, intrahepatic duct stones in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5 cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis from hepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2 cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4 cases. 8. Common CT features of the intrahepatic peripheral cholangiocinoma of the liver were irregular, inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompanied by diffuse or segmental dilatation of the intrahepatic bile duct. If there were normal alpha fetoprotein level, positive skin and/or stool examination for CS and diffuse or segmental dilatation of the intrahepatic duct

  15. Computed tomographic findings of intrahepatic peripheral cholangiocarcinoma

    International Nuclear Information System (INIS)

    Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bile duct (peripheral type), a major intrahepatic duct including the hepatic hills, an extrahepatic duct, or near the papilla of Vater (central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of the liver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiate on the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinoma of the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male, and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases, abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7 cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Laboratory findings were not specific, but there were only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case, intrahepatic duct stones in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5 cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis from hepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2 cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4 cases. 8. Common CT features of the intrahepatic peripheral cholangiocinoma of the liver were irregular, inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompanied by diffuse or segmental dilatation of the intrahepatic bile duct. If there were normal alpha fetoprotein level, positive skin and/or stool examination for CS and diffuse or segmental dilatation of the intrahepatic duct

  16. Hypoplasia of the thumb. Clinical presentation and reconstruction

    International Nuclear Information System (INIS)

    In the genesis of the partial or total absence of the thumb they are genetic, environmental factors or a combination of both. It is take part of a syndrome or to be isolated and frequently associated with problems of radial longitudinal deficiency of the forearm. Objective. The purpose of this study is shown the experience, the focus of the processing and the results obtained since the point esthetic and functional view. The most it accepted classification is the proposal by Blauth that helps to determine the forecast and the processing. Materials and methods. it is a work type series of cases in 22 children with hypoplasia of the thumb, with a minimum of 12 months, (average 28 months). In 15 cases there were association of radial dysplasia or another anomaly among them 4 patients with VATER, and the 7 remaining they corresponded to hypoplasia of the thumb as only entity. We carried out tendon transfer, with opening of the first comisure in 2 patients with hypoplasia type II. In 3 patients, with hypoplasia type III A, one carries out corner opening, transfer of the superficial flexor of the 4 finger to correct instability of the articulation MF and opposition of the thumb, and transfer for extension of the thumb. In 17 cases one carries out politicization of the index. Results. The outcome was evaluated in: non pinch, lateral pinch and fingertip pinch; the grade of opposition like good, minimal and non opposition, and the aesthetic result according to the satisfaction of the parents in bad, regular and good. The five children reconstructed with transfers of tendons and comisure opening had good result. In 17 children with politicization one patient had a necrosis, of the 16 remaining a good or acceptable result was obtained. Discussion. It is not easy to follow a good system of measure of the functional results. We find that a practical way to evaluate was the clip, opposition and aesthetics. Previous to the surgeries it is required to evaluate alterations

  17. Detection of acute gastrointestinal bleeding by means of technetium-99m in vivo labelled red blood cells

    International Nuclear Information System (INIS)

    the pancreas with bleeding vessel communicating to the transverse colon (1 patient), bleeding submucose varix in jejunum (1 patient), carcinoid of the ileum (1 patient), bleeding from the ileosigmoideoanastomosis six days after hemicolectomy for Crohn's disease (1 patient), bleeding from an ulcer close to the papilla of Vater (1 patient), bleeding from ulcer at jejunum after revious NSAIDs treatment (1 patient), bleeding inflammatory polyp at ileotransversoanastomosis (1 patient). GI bleeding stopped spontaneously in 5 patients with positive scintigraphy. Therefore these patients did not undergo intraoperative enteroscopy or surgery and we could not determine the final diagnosis. Scintigraphy with RBCs in vivo labelled technetium-99m hastened detection of the source of GI bleeding and improved management of the source of GI bleeding and improved management of disease. (author)

  18. One stage correction of anorectal malformations in newborns

    Directory of Open Access Journals (Sweden)

    Makedonsky I.O.

    2015-06-01

    Full Text Available The retrospective analysis of case histories of 35 infants (19 boys, 16 girls, treated in the department of reconstructive surgery of Dnipropetrovsk center of mother and child health in the period 2008-2013 was done. All the patients underwent one-stage treatment of anorectal malformations in neonatal period. Surgery was performed in the first 48 hours of life. Body weight of infants ranged from 2,8 to 4,4 kg (average weight 3,2 kg. Among related conditions there were observed vesico-ureteral reflux (VUR – in 11 (31,4%, VATER association - in 6 (17.1%, malformations of the spine – in 18 (51,4%, of the heart – in 2 (5,7% . During cystoscopy fistula in the urinary system was revealed in 16 boys. Surgical treatment was carried out by the posterior sagittal anorectoplasty (PSARP by A.Pena. 2 patients additionally underwent laparotomy. Among 16 patients with fistula in the urinary system, prostatic urethra fistula was revealed in 14, bladder neck fistula – in 2. Children were discharged from the hospital 2 weeks after surgery. All the children re­ceived anti­biotics due to the presence of VUR. After 1 month after surgery VCUG was performed. Long-term results were studied for a period of 10 to 24 months. All patients had VUR without evidence of hydronephrosis. In the period of 3-6 months after surgery 2 patients presented anal stenosis due to violation of dilatation. The evaluation results in the late period (10-24 months after surgery noted the presence of normal stool 2-3 times a day, 3 children had periodic con­stipations treated by diet. Available merits of the described method: only one operation and general anesthesia is per­for­med, no risk of prolonged contamination by pathogenic flora of the urinary system through the fistula, potential risk of complications of laparotomy and colostomy decreases, fistula visualization in cystoscopy allows to avoid the X-ray.

  19. Pancreatic Head Adenocarcinomas - Histopathologic Evaluation and Prognostic Factors

    OpenAIRE

    2014-01-01

    Primary adenocarcinomas located in the pancreatic head may arise from the distal bile duct, the ampulla, the periampullary duodenum, and the pancreatic tissue itself. These tumours are distinct cancer entities whose pathobiology, staging, and clinical course have unique features. The aims of the present study were to investigate how the standardized histopathological examination protocol ensures correct classification of tumour origin of pancreatic head adenocarcinomas. Furthermore, we exa...

  20. Large Duodenal Gastrointestinal Stromal Tumor Presenting with Acute Bleeding Managed by a Whipple Resection. A Review of Surgical Options and the Prognostic Indicators of Outcome

    Directory of Open Access Journals (Sweden)

    Norman Oneil Machado

    2011-03-01

    Full Text Available Context Duodenal gastrointestinal stromal tumors (GISTs are uncommon and constitute a relatively small subset of GISTs which presents a unique dilemma having various surgical options. A case of a large ulcerating duodenal GIST arising from the second and third parts of the duodenum and involving the pancreas which was managed by a Whipple resection is presented. The literature is also reviewed to present the current status on surgical options, outcome, prognostic indicators and the role of imatinib mesylate in its management. Case report A 58-year-old patient presented with acute gastrointestinal bleeding which was diagnosed to be due to a duodenal GIST following CT scan and endoscopic biopsy. The mass which measured about 10x9 cm originated from the 2nd part and extended into the 3rd part of the duodenum. He underwent a Whipple resection, and histopathology confirmed a duodenal GIST having a greater than 10 mitotic count per fifty high power field and areas of necrosis. Postoperatively, he received imatinib mesylate 400 mg bid; however, 4 months later, he presented with multiple disseminated peritoneal metastases and succumbed to the disease 2 months later. Conclusion GISTs of the duodenum which are small in size and do not involve the papilla of Vater are better resolved using a limited resection of the duodenum since the outcome in terms of operative risk or disease recurrence is not influenced in these cases. However, large tumors with more extensive involvement would require a pancreaticoduodenectomy to achieve adequate tumor clearance. Even though duodenal GISTs have a relatively better prognosis as compared to GISTs at other sites, their aggressiveness ranges from small indolent tumors to aggressive sarcomas. Following tumor resection, a recurrence rate of about 40% has been reported. A more favorable prognosis in duodenal GISTs is attributed to a lower prevalence of P53 loss, the duodenal location of the tumor, a smaller size of the

  1. A secondary copulatory structure in a female insect: a clasp for a nuptial meal?

    Science.gov (United States)

    Gwynne, Darryl T.

    2002-03-01

    Secondary copulatory structures are well-known in male dragonflies and spiders. Here I report a secondary copulatory organ in female ground weta, Hemiandrus pallitarsis (Ensifera, Orthoptera - crickets and allies). The organ, located on the underside of the abdomen, appears to secure the male's genitalia during the transfer of a spermatophylax nuptial meal to this location, an area quite separate from the female's primary copulatory structures, where the sperm ampulla is attached.

  2. Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review

    OpenAIRE

    Vleggaar Frank P; van Boeckel Petra GA; Siersema Peter D

    2009-01-01

    Abstract Background Benign biliary strictures may be a consequence of surgical procedures, chronic pancreatitis or iatrogenic injuries to the ampulla. Stents are increasingly being used for this indication, however it is not completely clear which stent type should be preferred. Methods A systematic review on stent placement for benign extrahepatic biliary strictures was performed after searching PubMed and EMBASE databases. Data were pooled and evaluated for technical success, clinical succe...

  3. Medline Plus

    Full Text Available ... ampulla, where secretions from the seminal vesicle are added. From the ampulla, seminal fluid is propelled forward ... the prostate gland, where a milky fluid is added to form semen. Finally, the semen is ejaculated ...

  4. The effect of DDT and its metabolite (DDE) on prostaglandin secretion from epithelial cells and on contractions of the smooth muscle of the bovine oviduct in vitro

    International Nuclear Information System (INIS)

    The insecticide DDT and its metabolite (DDE), due to their lipolytic nature and resistance to biodegradation, are accumulated in the living tissues. In cows, DDT and DDE were found to affect prostaglandin (PG) secretion from the endometrium and contractions of the myometrium. In this study, the impact of both xenobiotics (0.1, 1, 10 or 100 ng/ml) on the function of epithelial cells and muscle strips of bovine oviducts from 1 to 5 day of the oestrous cycle was examined. Therefore the concentration of PGE2 and PGFM (a metabolite of PGF2α) in culture media, mRNA expression of genes involved in PGs synthesis in epithelial cells and the force and amplitude of strips contractions were measured after 2 and 24 or 48 h of incubation. Neither DDT nor DDE affected the viability of cells after 48 h (P > 0.05). Both DDT and DDE increased the concentrations of PGFM in culture medium and secretion of PGE2 after only 2 h of cell culture (P < 0.05). Similar effects were seen for the influence of DDE on amount of PGFM after 48 h, while DDT decreased secretion of PGE2 (P < 0.05). DDT after 2 h increased (P < 0.05) mRNA expression of PGF2α synthase (PGFS), while both xenobiotics decreased (P < 0.05) mRNA expression of cyclooxygenase-2 (COX-2) after 24 h. DTT also increased the force of isthmus contractions after 2 h, as did both xenobiotics after 48 h (P < 0.05). Moreover, after 2 and 48 h, DDE stimulated the amplitude of contractions of the isthmus as well as the ampulla, (P < 0.05). The effect of both compounds on oviduct contractions was diminished by indomethacin, which blocks PG synthesis. We conclude that oviductal secretion of prostaglandins is affected, by DDT and DDE. The influence of these xenobiotics on PGF2α and PGE2 secretion and ratio may be part of the mechanism by which both DDT and its metabolite disturb the contractions of oviductal muscle. -- Highlights: ► DDT and its metabolite – DDE are accumulated in the living tissues. ► The insecticides affected PGF2

  5. The effect of DDT and its metabolite (DDE) on prostaglandin secretion from epithelial cells and on contractions of the smooth muscle of the bovine oviduct in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Wrobel, Michal H.; Mlynarczuk, Jaroslaw; Kotwica, Jan, E-mail: janko@pan.olsztyn.pl

    2012-03-01

    The insecticide DDT and its metabolite (DDE), due to their lipolytic nature and resistance to biodegradation, are accumulated in the living tissues. In cows, DDT and DDE were found to affect prostaglandin (PG) secretion from the endometrium and contractions of the myometrium. In this study, the impact of both xenobiotics (0.1, 1, 10 or 100 ng/ml) on the function of epithelial cells and muscle strips of bovine oviducts from 1 to 5 day of the oestrous cycle was examined. Therefore the concentration of PGE2 and PGFM (a metabolite of PGF2α) in culture media, mRNA expression of genes involved in PGs synthesis in epithelial cells and the force and amplitude of strips contractions were measured after 2 and 24 or 48 h of incubation. Neither DDT nor DDE affected the viability of cells after 48 h (P > 0.05). Both DDT and DDE increased the concentrations of PGFM in culture medium and secretion of PGE2 after only 2 h of cell culture (P < 0.05). Similar effects were seen for the influence of DDE on amount of PGFM after 48 h, while DDT decreased secretion of PGE2 (P < 0.05). DDT after 2 h increased (P < 0.05) mRNA expression of PGF2α synthase (PGFS), while both xenobiotics decreased (P < 0.05) mRNA expression of cyclooxygenase-2 (COX-2) after 24 h. DTT also increased the force of isthmus contractions after 2 h, as did both xenobiotics after 48 h (P < 0.05). Moreover, after 2 and 48 h, DDE stimulated the amplitude of contractions of the isthmus as well as the ampulla, (P < 0.05). The effect of both compounds on oviduct contractions was diminished by indomethacin, which blocks PG synthesis. We conclude that oviductal secretion of prostaglandins is affected, by DDT and DDE. The influence of these xenobiotics on PGF2α and PGE2 secretion and ratio may be part of the mechanism by which both DDT and its metabolite disturb the contractions of oviductal muscle. -- Highlights: ► DDT and its metabolite – DDE are accumulated in the living tissues. ► The insecticides affected PGF2

  6. Present and future use of semiochemicals in pest management of bark beetles.

    Science.gov (United States)

    Vité, J P; Baader, E

    1990-11-01

    Attractive compounds affecting the mass aggregation of bark beetle populations on host trees suitable for colonization usually consist of two obligatory components that act synergistically and species-specifically. Semiochemicals inhibiting response act on their own and seem less specific. From nearly 100 species investigated so far, mass aggregation can be simulated with commercial synthetics in about nine species of economic importance. Aspects leading to the application of attractants in monitoring and mass trapping pest populations affecting European spruce forests result from intensive coordinated research at the university, industry, and forestry level. Technology transfer was facilitated by, and adapted to, the infrastructure of European forestry; traps economically replace the trap tree methods conventionally used for centuries. Expected applications in the near future are refined monitoring methods to measure population levels and predict damages. Also, mass trapping should remain a worthwhile tool in preventing beetle damage in forests under management intensive enough to remove excessive breeding material. In the long run, response-inhibiting semiochemicals resulting in the dispersal of pest populations (Ablenkstoffe) may gain wider application. The spruce engraverIps typographus L. and its associatePityogenes chalcographus L. are used as examples to describe the feasibility of developing and applying inhibitors as new tools in the management of bark beetle pests: Applying a slow-release verbenone formulation (verbenone strip) wrapped around the trunk of spruce trees at breast height appears to protect spruces from destructive attack byIps typographus, while small polyethylene ampullae containing terpinene-4-ol counteract aggregation of P. chalcographus. Inhibitors appear applicable in both strategies, damage prevention as well as damage restriction, and consequently may accommodate also pest control in less intensively managed forests. Future

  7. Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease.

    Science.gov (United States)

    Puppo, Vincenzo; Puppo, Giulia

    2016-01-01

    Human semen contains spermatozoa secreted by the testes and a mixture of components produced by the bulbo-urethral and Littre (paraurethral) glands, prostate, seminal vesicles, ampulla, and epididymis. Ejaculation is used as a synonym for the external ejection of semen, but it comprises two phases: emission and expulsion. As semen collects in the prostatic urethra, the rapid preorgasmic distension of the urethral bulb is pathognomonic of impeding orgasm, and the man experiences a sensation that ejaculation is inevitable (in women, emission is the only phase of orgasm). The semen is propelled along the penile urethra mainly by the bulbocavernosus muscle. With Kegel exercises, it is possible to train the perineal muscles. Immediately after the expulsion phase the male enters a refractory period, a recovery time during which further orgasm or ejaculation is physiologically impossible. Age affects the recovery time: as a man grows older, the refractory period increases. Sexual medicine experts consider premature ejaculation only in the case of vaginal intercourse, but vaginal orgasm has no scientific basis, so the duration of intercourse is not important for a woman's orgasm. The key to female orgasm are the female erectile organs; vaginal orgasm, G-spot, G-spot amplification, clitoral bulbs, clitoris-urethra-vaginal complex, internal clitoris and female ejaculation are terms without scientific basis. Female sexual dysfunctions are popular because they are based on something that does not exist, i.e. the vaginal orgasm. The physiology of ejaculation and orgasm is not impaired in premature ejaculation: it is not a disease, and non-coital sexual acts after male ejaculation can be used to produce orgasm in women. Teenagers and men can understand their sexual responses by masturbation and learn ejaculatory control with the stop-start method and the squeeze technique. Premature ejaculation must not be classified as a male sexual dysfunction. It has become the center of a

  8. Digitalised endoscopic retrograde pancreatography (D-ERP): A comparison with ERCP

    Energy Technology Data Exchange (ETDEWEB)

    Soimakallio, S.; Pirinen, A.; Suhonen, M.

    1988-06-01

    Cannulation of the papilla of Vater was successful in 49 out of 65 cases (75.4%) and digital imaging of the pancreas in 38% of cases. Visualisation of the pancreatic duct with D-ERP was comparable to that of conventional ERCP. Absent or faint opacification of the parenchyma was seen in 39.5% of patients. Both methods were equally effective for the diagnosis of pancreatic tumours. D-ERP was better than ERCP for the diagnosis of chronic pancreatitis. Two patients (4.1%) had clinical evidence of mild acute pancreatitis following pancreatic duct injections.

  9. Digitalised endoscopic retrograde pancreatography (D-ERP): A comparison with ERCP

    International Nuclear Information System (INIS)

    Cannulation of the papilla of Vater was successful in 49 out of 65 cases (75.4%) and digital imaging of the pancreas in 38% of cases. Visualisation of the pancreatic duct with D-ERP was comparable to that of conventional ERCP. Absent or faint opacification of the parenchyma was seen in 39.5% of patients. Both methods were equally effective for the diagnosis of pancreatic tumours. D-ERP was better than ERCP for the diagnosis of chronic pancreatitis. Two patients (4.1%) had clinical evidence of mild acute pancreatitis following pancreatic duct injections. (orig.)

  10. The Mecyclothorax beetles (Coleoptera, Carabidae, Moriomorphini of Tahiti, Society Islands

    Directory of Open Access Journals (Sweden)

    James Liebherr

    2013-08-01

    Full Text Available The 101 species of Mecyclothorax Sharp known to inhabit Tahiti Island, French Polynesia are taxonomically revised, including 28 species that are newly described: M. claridgeiae sp. n., M. jeanyvesi sp. n., M. poria sp. n., M. aano sp. n., M. papau sp. n., M. manina sp. n., M. everardi sp. n., M. ramagei sp. n., M. pitohitiensis sp. n., M. curtisi sp. n., M. hoeahiti sp. n., M. ninamu sp. n., M. kokone sp. n., M. paahonu sp. n., M. kayballae sp. n., M. ehu sp. n., M. papuhiti sp. n., M. tuea sp. n., M. taatitore sp. n., M. konemata sp. n., M. arboricola sp. n., M. rahimata sp. n., M. oaoa sp. n., M. maninapopoti sp. n., M. hunapopoti sp. n., M. fefemata sp. n., M. maninamata sp. n., and M. niho sp. n. Mecyclothorax muriauxioides Perrault, 1984 is newly synonymized with M. muriauxi Perrault, 1978. Lectotypes are designated for: Thriscothorax altiusculus Britton, 1938; T. bryobius Britton, 1938; Mecyclothorax globosus Britton, 1948: and M. sabulicola Britton, 1948. Dichotomous identification keys augmented by dorsal habitus and male aedeagal photographs are provided to the various species-groups and all included species. The spermatophore of M. papau sp. n. is described, with the ampulla and collar found to correspond dimensionally to the length of the internal sac flagellar plate. Variation among characters of the female reproductive tract is presented for all newly described plus other representative species comprising the radiation. Taxa are assigned to species groups, modified from the classification of G.G. Perrault, based on derived character states polarized using the Australian outgroup taxon Mecyclothorax punctipennis (MacLeay. Much of the species-level diversity on this small Pacific island is partitioned allopatrically over very small distributional ranges. No species is shared between Tahiti Nui and Tahiti Iti, and nearly all species in Tahiti Nui are geographically restricted to one ridgelike massif of that volcano. Cladistically

  11. Duodenal Ampulla Ulcer、Cholelithiasis Combine With Billiary-duodenal Fistula%十二指肠球部溃疡、胆石症合并胆囊十二指肠瘘1例

    Institute of Scientific and Technical Information of China (English)

    王崇文; 邹平稳; 张小燕; 付唆林

    2016-01-01

    胆囊十二指肠漏是胆囊十二指肠之间形成的病理性通道,临床上少见,由于其无特异的临床症状,且早期胃镜阳性检查难发现瘘口,易漏诊.本文对我院1例十二指肠球部溃疡、胆石症合并胆囊十二指肠瘘的临床资料进行回顾性分析,并对该疾病的诊断及治疗做经验性总结.

  12. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    International Nuclear Information System (INIS)

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  13. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M. [Department of Radiology, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy); Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E. [Department of Surgery, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy)

    2000-07-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  14. HIPOPLASIA DEL PULGAR: PRESENTACIÓN CLÍNICA Y RECONSTRUCCIÓN Hipoplasia of the thumb: Clinical presentation and reconstruction

    Directory of Open Access Journals (Sweden)

    Enrique M Vergara Amador

    2008-03-01

    ógicas o renales. Pacientes con deficiencia longitudinal del radio tienen peores resultados que los pacientes que tuvieron hipoplasia única del pulgar. En general los resultados fueron buenos y están de acuerdo con los reportes de la literatura donde escriben que el procedimiento ideal para la reconstrucción de un pulgar hipoplásico tipo IIIb, IV y V sigue siendo la pulgarización.Background. in the genesis of the partial or total absence of the thumb they are genetic, environmental factors or a combination of both. It is take part of a syndrome or to be isolated and frequently associated with problems of radial longitudinal deficiency of the forearm. Objective. The purpose of this study is mostar the experience, the focus of the processing and the results obtained since the point esthetic and functional view. The most it accepted classification is the proposal by Blauth that helps to determine the forecast and the processing. Materials and methods. it is a work type series of cases in 22 children with hipoplasia of the thumb, with a minimum of 12 months, (average 28 months. In 15 cases there were association of radial dysplasia or another anomaly among them 4 patients with VATER, and the 7 remaining they corresponded to hipoplasia of the thumb as only entity. We carried out tendon transfer, with opening of the first comisure in 2 patients with hipoplasia type II. In 3 patients, with hipoplasia type III A, one carries out corner opening, transfer of the superficial flexor of the 4 finger to correct instability of the articulation MF and opposition of the thumb, and transfer for extension of the thumb. In 17 cases one carries out pollicization of the index. Results. The outcome was evaluated in: non pinch, lateral pinch and fingertip pinch; the grade of opposition like good, minimal and non opposition, and the aesthetic result according to the satisfaction of the parents in bad, regular and good. The five children reconstructed with transfers of tendons and comisure

  15. Ein vermisster Großvater, ein Tango und ein Museum. Erinnern und Vergessen des Zweiten Weltkriegs und der Shoah in der ukrainischen Gegenwartsliteratur (Larysa Denysenko, Jurij Vynnyčuk, Oksana Zabužko)

    Czech Academy of Sciences Publication Activity Database

    Kratochvil, Alexander

    2015-01-01

    Roč. 60, č. 2 (2015), s. 164-183. ISSN 0044-3506 Institutional support: RVO:68378068 Keywords : contemporary ukrainian literature * 2nd world war * shoah * memory * trauma Subject RIV: AJ - Letters, Mass-media, Audiovision

  16. A study on the changing of the irradiated mice salivary glands and it's influence to the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Funahara, Takayuki; Nasu, Masanori; Furumoto, Keiichi (Nippon Dental Univ., Tokyo (Japan))

    1991-02-01

    X-ray irradiation (10 Gy) was given to the salivary gland in mice. Protein and glycoprotein syntheses in the salivary glands and pancreas were examined by using {sup 3}H-leucine and {sup 14}C-acetylglucosamine as tracers. Quantitative analysis of serum amylase and histochemical examination were also conducted. Uptake of {sup 3}H-leucine was low in the parotid, submandibular, and sublingual glands 3 and 7 days after irradiation, which were close to those in the non-irradiated group 21 days after irradiation. Uptake of {sup 14}C-acetylglucosamine in the parotid, submandibular, and sublingual glands varied with time, which was similar to that of {sup 3}H-leucine uptake. The uptake of both {sup 14}C-acetylglucosamine and {sup 3}H-leucine in the pancreas, as opposed to that in the salivary glands, varied with time, with the highest levels on Days 3 and 7, respectively. Serum amylase level, determined by the maltopentaose method, was 5,341+-772 mU/ml in the non-irradiated group. On Day 3, it was 6,706+-583 mU/ml. This was slightly higher than the level in the non-irradiated group on Days 7 and 21, with no statistically significant difference. Hematoxylin-eosin staining revealed hypertrophy of the glandular cells on Day 3, atrophy of the glandular cells on Day 7, and irregular cell arrangement on Day 21 for the parotid gland; and atrophied granular ampulla on Day 3, and hypertrophy on Day 7 for the submandibular gland. No marked changes were observed in either the sublingual gland or pancreas. Ninhydrin staining revealed a decreased stainability in the submandibular gland on Day 3; and an increased stainability in the pancreas on Day 7. In conclusion, protein and glycoprotein syntheses in the salivary glands after X-ray irradiation of 10 Gy decreased on Days 3 and 7, respectively. This seemed to be associated with compensatory function of the pancreas. (N.K.).

  17. Magnetic field effects on the vestibular system: calculation of the pressure on the cupula due to ionic current-induced Lorentz force

    Science.gov (United States)

    Antunes, A.; Glover, P. M.; Li, Y.; Mian, O. S.; Day, B. L.

    2012-07-01

    Large static magnetic fields may be employed in magnetic resonance imaging (MRI). At high magnetic field strengths (usually from about 3 T and above) it is possible for humans to perceive a number of effects. One such effect is mild vertigo. Recently, Roberts et al (2011 Current Biology 21 1635-40) proposed a Lorentz-force mechanism resulting from the ionic currents occurring naturally in the endolymph of the vestibular system. In the present work a more detailed calculation of the forces and resulting pressures in the vestibular system is carried out using a numerical model. Firstly, realistic 3D finite element conductivity and fluid maps of the utricle and a single semi-circular canal containing the current sources (dark cells) and sinks (hair cells) of the utricle and ampulla were constructed. Secondly, the electrical current densities in the fluid are calculated. Thirdly, the developed Lorentz force is used directly in the Navier-Stokes equation and the trans-cupular pressure is computed. Since the driving force field is relatively large in comparison with the advective acceleration, we demonstrate that it is possible to perform an approximation in the Navier-Stokes equations that reduces the problem to solving a simpler Poisson equation. This simplification allows rapid and easy calculation for many different directions of applied magnetic field. At 7 T a maximum cupula pressure difference of 1.6 mPa was calculated for the combined ampullar (0.7 µA) and utricular (3.31 µA) distributed current sources, assuming a hair-cell resting current of 100 pA per unit. These pressure values are up to an order of magnitude lower than those proposed by Roberts et al using a simplistic model and calculation, and are in good agreement with the estimated pressure values for nystagmus velocities in caloric experiments. This modeling work supports the hypothesis that the Lorentz force mechanism is a significant contributor to the perception of magnetic field induced vertigo.

  18. Magnetic field effects on the vestibular system: calculation of the pressure on the cupula due to ionic current-induced Lorentz force

    International Nuclear Information System (INIS)

    Large static magnetic fields may be employed in magnetic resonance imaging (MRI). At high magnetic field strengths (usually from about 3 T and above) it is possible for humans to perceive a number of effects. One such effect is mild vertigo. Recently, Roberts et al (2011 Current Biology 21 1635–40) proposed a Lorentz-force mechanism resulting from the ionic currents occurring naturally in the endolymph of the vestibular system. In the present work a more detailed calculation of the forces and resulting pressures in the vestibular system is carried out using a numerical model. Firstly, realistic 3D finite element conductivity and fluid maps of the utricle and a single semi-circular canal containing the current sources (dark cells) and sinks (hair cells) of the utricle and ampulla were constructed. Secondly, the electrical current densities in the fluid are calculated. Thirdly, the developed Lorentz force is used directly in the Navier–Stokes equation and the trans-cupular pressure is computed. Since the driving force field is relatively large in comparison with the advective acceleration, we demonstrate that it is possible to perform an approximation in the Navier–Stokes equations that reduces the problem to solving a simpler Poisson equation. This simplification allows rapid and easy calculation for many different directions of applied magnetic field. At 7 T a maximum cupula pressure difference of 1.6 mPa was calculated for the combined ampullar (0.7 µA) and utricular (3.31 µA) distributed current sources, assuming a hair-cell resting current of 100 pA per unit. These pressure values are up to an order of magnitude lower than those proposed by Roberts et al using a simplistic model and calculation, and are in good agreement with the estimated pressure values for nystagmus velocities in caloric experiments. This modeling work supports the hypothesis that the Lorentz force mechanism is a significant contributor to the perception of magnetic field induced

  19. Cryptosporidium spp. infection in mares and foals of the northwest region of São Paulo State, Brazil Infecção por Cryptosporidium spp. em éguas e potros da região noroeste do estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Sandra Valéria Inácio

    2012-12-01

    Full Text Available The present study aimed to analyze the occurrence of infection by Cryptosporidium spp. in mares and their respective foals. This study was carried out in 11 farms located in the municipalities of Araçatuba, Birigui, Guararapes and Santo Antônio do Aracangua, in the northwest region of the State of Sao Paulo, from November 2010 to March 2011. A total of 98 mares and 98 foals of several breeds were analyzed; among foals, 59 were males and 39 females, aged from three to 330 days. Feces were collected directly from the rectal ampulla, purified and processed according to modified Kinyoun stain. Occurrence of Cryptosporidium spp. was 21.4% (21/98 for foals and 18.4% (18/98 for mares. Occurrence of Cryptosporidium spp. had significant association with breeds and age of animals. Results obtained led to the conclusion that foals older than two months and Mangalarga animals are less susceptible to the occurrence of Cryptosporidium spp.O presente estudo teve como objetivo analisar a ocorrência da infecção por Cryptosporidium spp. em éguas e seus respectivos potros. Este estudo foi realizado em 11 fazendas localizadas nos municípios de Araçatuba, Birigui, Guararapes e Santo Antônio do Aracangua, na região Noroeste do Estado de São Paulo, de novembro de 2010 a março de 2011. Um total de 98 éguas e 98 potros de diversas raças foram analisados, sendo que, entre os filhotes, 59 eram machos e 39 fêmeas, cujas idades variavam de três até 330 dias. Fezes foram colhidas diretamente da ampola retal, purificadas e processadas pela técnica de Kinyoun modificada. A ocorrência de Cryptosporidium spp. observada foi de 21,4% (21/98 para potros e 18,4% (18/98 para éguas. A ocorrência de Cryptosporidium spp. teve uma associação significativa com a raça e a idade dos animais. A partir dos resultados obtidos, conclui-se neste estudo que potros com idade superior a dois meses e animais da raça Mangalarga foram menos susceptíveis à ocorrência de

  20. Salvage Treatment of Pseudoaneurysm Rupture Hemorrhage Patient Fllowing Pancreaticoduodenectomy%胰十二指肠切除术后假性动脉瘤破裂出血纠误挽治

    Institute of Scientific and Technical Information of China (English)

    梁耀杰; 杜俊东; 焦华波; 涂玉亮; 朱自满; 吴雷超; 吕金勇; 金鑫

    2015-01-01

    Objective To explore new ideas for the salvage treatment of pseudoaneurysm rupture hemorrhage patient following pancreaticoduodenectomy. Methods Clinical data of 1 patient with pseudoaneurysm rupture hemorrhage patient af-ter pancreaticoduodenectomy for Vater's ampullary carcinoma was retrospectively analyzed, and relevant literature was also re-viewed. Results After pancreaticoduodenectomy (3 weeks), the patient's condition was complicated with the burst of the splenic artery pseudoaneurysm rupture, and after celiac artery spring bolt and gelatin sponge embolization surgery, postopera-tive hemorrhagic shock, acute liver and kidney dysfunction occurred, and the patient was admitted to our hospital when the circulatory function became stable. Upon admission he developed hypoalbuminemia, multiple liver abscess, abdominal abscess and empyema and after repeated abscess drainage catheter, intravenous nutritional support, broad-spectrum antibiotic therapy, the patient still had persistent fever, and the relapses made the condition worse. Total parenteral nutrition support was suspen-ded and antibiotics and many other medications, endoscopic gastric jejunostomy enteral nutrition support were given, with the secondary psychological counseling and physical exercise, and the condition gradually improved, the patient was able get out of the bed after 2 months. Sleep, diet and mental condition also returned to normal and 3 months later he was discharged. Conclusion Postoperative treatment of critically ill patients should not over-rely on antibiotics and total parenteral nutrition. Attention should be paid promptly to minimally invasive abscess drainage, and enteral nutrition and psychological counseling should be strengthened and the use of antibiotics and other drugs be limited, all of which may be helpful in the rehabilitation of critically ill patients.%目的:总结探讨胰十二指肠切除术后并发假性动脉瘤破裂出血的诊疗新

  1. Analysis on the Value of Iodine Contrast Medium on the Urologic Disease%碘造影剂对泌尿系疾病的诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    张茵

    2013-01-01

    目的:评价碘造影剂泛影葡胺对泌尿系疾病的诊断价值。方法:回顾静脉肾盂造影患者的资料,2005年~2009年行静脉肾盂造影患者共122例,男性82例,女性40例。对照组122例。结果:造影检查发现,梗阻性肾病73例,多囊肾13例,慢性肾盂肾炎14例,先天性壶腹肾盂16例,先天性单侧双肾盂、双输尿管1例,单侧输尿管狭窄3例,2例因肾盂积水严重,输尿管不显影,无法明确诊断。结论:碘造影剂泛影葡胺价格低廉,使用时简便宜行,适合基层医院开展检查,基本能达到诊断目的。%Objective:To evaluate the value of the Iodine contrast medium meglumine diatrizoate on the Urologic disease .Methods:After Reviewing the information of the Intravenous pyelography sufferers ,from 2005 to 2009 there were totally 122 cases of Intravenous py-elography sufferers,male 82 cases, female 40 cases .control group 122 cases.Result:As a result of the contrast examination ,there were 73 cases of obstructive nephropathy , 13 cases of Polycystic kidney , 14 cases of chronic pyelonephritis , 16 cases of congenital ampulla of pelvis,1 case of congenital unilateral double pelvis and congenital unilateral double ureter ,3 cases of Unilateral ureteral stenosis .For the reason of the serious hydronephrosis ,ureter can't develop ,2 cases were unable to confirm the diagnosis .Conclusion:Iodine contrast medi-um meglumine diatrizoate is cheap and convenient ,Suitable for primary hospital to carry out inspection .It can basically meet the diagnostic purposes.

  2. Pancreaticoblastoma (infantile pancreatic carcinoma): a case report

    International Nuclear Information System (INIS)

    Pancreaticoblastoma is a rare nonfunctioning primary malignant neoplasm of the pancreas occurring in childhood. It arises in the ventral pancreas and is thought to be caused by a disturbance in organogenesis due to failure of the duct of Wirsung to communicate with the duct of Santorini and the ampulla. It is well-demarcated solid and cystic tumor on the basis of the gross morphology. Prognosis is known to be good if the tumor is discovered prior to metastasis. Authors present a case of pancreaticoblastoma in a 3 year-old girl with a brief review of the literatures.

  3. Duodenopancreatectomias: análise de 39 pacientes Pancreaticoduodenectomies: analysis of 39 patients

    Directory of Open Access Journals (Sweden)

    Orlando Jorge Martins Torres

    2007-02-01

    Full Text Available OBJETIVO: Pretendemos neste estudo analisar 39 pacientes submetidos à duodenopancreatectomia. MÉTODO: No período de julho de 1998 a março de 2004, trinta e nove pacientes foram submetidos a duodenopancreatectomia no Hospital Universitário da Universidade Federal do Maranhão. Foram analisados os dados epidemiológicos, o quadro clínico, os métodos radiológicos, as indicações da operação e as complicações encontradas . RESULTADOS: Havia 22 pacientes do sexo masculino (56,4% e 17 pacientes do sexo feminino (43,6% com média de idade de 54,9 anos (variação de 21-82 anos. O exame radiológico mais utilizado foi a tomografia computadorizada. O diagnóstico histológico definitivo revelou adenocarcinoma periampolar em 35 pacientes (89,7%, pancreatite crônica (três pacientes - 7,7% e adenocarcinoma colo-retal (um paciente - 2,6%. O adenocarcinoma periampolar mais freqüente foi o carcinoma ductal do pâncreas (27 pacientes - 69,2%, seguido por carcinoma de papila de Vater ( cinco pacientes - 12,8%, adenocarcinoma duodenal (dois pacientes - 5,1% e carcinoma de via biliar distal (um paciente - 2,6%. As complicações pulmonares foram as mais freqüentes sendo encontradas em cinco pacientes (12,8%, a sepse peritoneal em quatro pacientes (10,2%, fístula pancreática em três pacientes (7,6% e a hemorragia0 intra-abdominal em três pacientes (7,6%. A mortalidade intra-hospitalar em 30 dias foi 10,2 % (quatro pacientes. CONCLUSÃO: A duodenopancreatectomia ainda está associada a morbidade considerável. Entretanto com uma seleção adequada destes pacientes este procedimento pode ser realizado de forma segura com melhores resultados.BACKGROUND: The aim of this study is to analyze 39 patients underwent Whipple's operation. METHOD: In the period from July 1998 to March 2004, thirty-nine patients underwent pancreaticoduodenectomy at University Hospital, Federal University of Maranhão. The diagnosis was made on the basis of computed

  4. Qualitative and quantitative histological changes in ewe oviduct and uterus after X irradiation

    International Nuclear Information System (INIS)

    Experiments were performed to study changes in the epithelium of the oviduct and surface epithelium of the endometrium and endometrial glands of ewes of the Slovak Merino breed after irradiation of the hypothalamo-hypophysial region at a dose of 516.5 mC.kg-1 (2000 R) and after direct exposure of the ovaries to 64.4 mC.kg-1 (250 R); prior to this, the ewes had been laparotomized. The symptoms of irradiation included multiplication of pale cells, an increased occurrence of the subnuclear vacuolization of the surface epithelium, and similar vacuolization in the secretory cells of the endometrial glands. Irradiation of the ovaries induces a marked occurrence of round cells. Irradiation of the head caused a significant increase in the thickness of the epithelium on the border between the infundibulum and the ampulla as well as at the site where the ampulla passes into the isthmus. The thickness of the oviduct epithelium remained unchanged after the irradiation of the ovaries, in comparison with the control group. It was found by a quantitative microscopic analysis that the thickness of surface epithelium did not show any marked changes after irradiation. On the other hand, the thickness of the secretory cells of the endometrial glands changed significantly in both experimental groups of ewes. The change in endometrial thickness was decribed; the change was more significant after irradiation of the ovaries than after irradiation of the hypothalamo-hypophysial region. (author)

  5. Helical CT defecography

    International Nuclear Information System (INIS)

    The purpose of this work is to investigate the possible role of Helical CT defecography in pelvic floor disorders by comparing the results of the investigations with those of conventional defecography. The series analyzed consisted of 90 patients, namely 62 women and 28 men, ranging in age 24-82 years. They were all submitted to conventional defecography, and 18 questionable cases were also studied with Helical CT defecography. The conventional examination was performed during the 4 standard phases of resting, squeezing, Valsalva and straining; it is used a remote-control unit. The parameters for Helical CT defecography were: 5 mm beam collimation, pitch 2, 120 KV, 250 m As and 18-20 degrees gantry inclination to acquire coronal images of the pelvic floor. The rectal ampulla was distended with a bolus of 300 mL nonionic iodinated contrast agent (dilution: 3g/cc). The patient wore a napkin and was seated on the table, except for those who could not hold the position and were thus examined supine. Twenty-second helical scans were performed at rest and during evacuation; multiplanar reconstructions were obtained especially on the sagittal plane for comparison with conventional defecographic images. Coronal Helical CT defecography images permitted to map the perineal floor muscles, while sagittal reconstructions provided information on the ampulla and the levator ani. To conclude, Helical CT defecography performed well in study of pelvic floor disorders and can follow conventional defecography especially in questionable cases

  6. Pancreas Preserving Total Duodenectomy for Complex Duodenal Injury

    Directory of Open Access Journals (Sweden)

    Jai Dev Wig

    2009-07-01

    Full Text Available Context To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Case report Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum. There were no complications attributable to the procedure. Both patients are well on follow up. Conclusion A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

  7. CORRESPONDENCIA

    Directory of Open Access Journals (Sweden)

    Consuelo Restrepo

    2010-06-01

    Full Text Available Letter to the Editor:Given the academic spirit of Colombia Médica, let us make some comments on the article «Unilateral renal agenesis: case review of ambulatory pediatric nephrology clinics in Cali, by Dr. Consuelo Restrepo de Rovetto et al.1As for the assertion «There are no national or local statistics in Colombia to know the frequency, clinical aspects and complications of this anomaly» even when it is true that in our country there is little information on the epidemiological behavior of this type of pathology, we have found in the literature two articles: one published by Zarante et al. in Biomédica in 2010 (published online since 01.09.09, which mentions a prevalence of unilateral renal agenesis of 0.94 per 10,000, in the evaluation of 52,744 births in four Colombian cities2. Another article published by García et al.3 in the same journal in 2003, reported a prevalence of unilateral agenesis or kidney dysplasia of 1.76 per 10,000 births in the evaluation of 5686 births in Bogotá.Additionally, in the results section «Single kidney associated to other pathologies was found in 46.5% cases: occult spina bifida and congenital scoliosis, three cases; anorectal malformations, 3 cases; chromosome syndromes, 2 cases; Klippel-Feil syndrome, two cases; cryptorchidie, 1 case; tricuspid insufficiency, 1 case; pre-auricular appendix in 1 case, and a case of morbid obesity. No patient with myeloid-Vater sequence or meningocele was found», which states that no patients were found with a diagnosis of Vater sequence. We would like to clarify that the term Vater sequence is currently not appropriate and it has been replaced by the term VACTERL association from the acronym vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal malformations, and limb defects4. The term association refers to «the occurrence of multiple idiopathic congenital malformations during blastogenesis»5. Given this definition, and knowing that

  8. Un modelo descriptivo del sistema reproductor hembra del coipo (Myocastor coypus II: los órganos tubulares (A descriptive model of the female reproductive system of coypu (Myocastor coypus II: tubular organs

    Directory of Open Access Journals (Sweden)

    Felipe, A. E.

    2006-03-01

    prominence. The mucous tunic of infundibulum and ampulla had many longitudinal folds with fine secondary and tertiary branches. Folds were low and undivided at the isthmus. The mucosa of the oviducts was covered by high epithelium. The double uterus consisted of two uteri with cavities quite independent from each other. A gross septum separated the cervical canals which still remained separately in the dorsal surface of the cervix. The mucous epithelium of the horns was composed of ciliated cylindrical cells that contained oval nuclei in basal position. There were abundant endometrial glands in the horns. The epithelium of the endocervix was composed of large columnar cells, with a mucus-secreting appearance. All along the uterine horns the lamina propria was composed of a lax connective tissue. The myometrium was very well-developed. The perimetrium was a serous membrane with many longitudinal muscle fibres. The vagina was a tubular organ. The fornix was divided into five cul-de-sacs. The vaginal mucosa was covered by a stratified squamous epithelium. The connective-epithelial junction was notably irregular due to the presence of many connective papillae which projected themselves from the lamina propria into the basal epithelium. The general morphology of the reproductive organs of the Myocastor coypus is typical of the hystricomorph rodents studied.

  9. Bilateral multicystic renal dysplasia with potter sequence: A case with penile agenesis

    International Nuclear Information System (INIS)

    Hereditary renal adysplasia (HRA) is rare autosomal dominant condition. Patients have several other anomalies including Potter facies, thoracic, cardiac, and extremity deformities. The case present dysmorphic facial features such as hypertelorism, prominent epicanthic folds, a flat and broad nose, choanal stenosis, low set ears and a receding chin. He had femoral bowing, hypoplastic right tibia and agenesis of the right foot. He had rich and thin skin. He had also a dysplastic empty scrotum, penile agenesis, and anal atresia. The autopsy revealed pulmonary hypoplasia, ventricular septal defect, bilateral multicystic renal dysplasia, agenesis of ureter and bladder, intraabdominal testicles, and a single umbilical artery. The penile agenesis was first reported, and including the consanguinity in the parents might further delineate the bilateral multicystic HRA. Vater/caudal regression anomalies, Mullerian duct/aplasia, unilateral renal agenesis, and cervicothoracic somite anomalies association and Coloboma, heart anomaly, choanal atresia, retardation, retardation, genital and ear anomalies syndrome has been considered in differential diagnosis. (author)

  10. Risk Factors of Persistent Ectopic Pregnancy after Laparoscopic Conservative Surgery for Tubal Pregnancy%腹腔镜保守性手术后持续性异位妊娠的有关因素分析

    Institute of Scientific and Technical Information of China (English)

    黄晓斌; 柳晓春; 郑玉华; 冯敏清; 罗美玲

    2012-01-01

    Objective To study the risk factors of persistent ectopic pregnancy (PEP) following laparoscopic conservative surgery for tubal pregnancy. Methods Since January 2007 to December 2011, we performed laparoscopic conservative surgery on 2105 patients with tubal pregnancy, 27 of them ( 1. 3% ) developed PEP after the procedure. We analyzed the risk factors of PEP based on the data of these patients. Results Among the 27 patients, 26 were cured with MTX, and the other were cured after a emergency operation for abdominal hemorrhage. Univariate analysis showed that PEP is correlated with preoperative serum levels of p-hCG ( ≥ 4000 U/L) and pregnendione ( ≥ 30 nmol/L) , as well as the site of pregnancy (x2 = 66. 512 , P = 0. 000; x2 = 85. 093 , P=0.000;x2 =9. 918, P = 0. 019). There existed significant difference in the rate of PEP between the patients had the tubal pregnancy at the intramural oviduct and those at the isthmus and ampulla (x = 4. 182, P = 0. 041 ; ;x2 = 4. 992, P = 0. 025 ) . Length of menelipsis, age, size of lesion, history of cesarean section are not related to the incidence of PEP (P > 0. 05 ). Conclusion Preoperative serum levels of β-hCG ( ≥ 4000 U/L) and pregnendione ( ≥30 nmol/L) , as well as the site of pregnancy are risk factors of PEP.%目的 探讨腹腔镜保守性手术后持续性异位妊娠(persistent ectopic pregnancy,PEP)的有关因素. 方法 2007年1月~2011年12月对2105例输卵管妊娠行腹腔镜保守性手术,27例术后发生PEP,发生率1.3%,对腹腔镜保守性手术后PEP的有关因素进行分析. 结果 26例PEP甲氨蝶呤(MTX)药物治疗治愈,1例PEP因腹腔内出血急诊手术治愈.对有关因素进行单因素分析显示,PEP的发生与术前血清β-hCG≥4000 U/L、术前血清孕酮≥30 nmol/L和妊娠部位有关(x2=66.512,P=0.000;x2=85.093,P=0.000;x2=9.918,P=0.019),其中间质部与峡部、壶腹部的PEP发生率有统计学差异(x2 =4.182,P=0.041;x2 =4.992,P =0.025);停经时间

  11. Muusikamaailm / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    2011-01-01

    Muusikasõnumeid mujalt maailmast: BBC Proms - maailma suurim muusikafestival. Arvo Pärdi "Vater unser" kõlas kingitusena paavstile. Lera Auerbachi muusika on jätkuvalt menukas. Preemiaid ja tunnustusi

  12. 卵巢浆液性肿瘤中输卵管上皮的病理形态学观察%Morphologic changes of fallopian tubal epithelium in ovarian serous tumors

    Institute of Scientific and Technical Information of China (English)

    文佳; 史景丽; 沈丹华; 陈云新; 宋秋静

    2012-01-01

    Objectives To study the morphologic changes of fallopian tubal epithelium in patients with ovarian serous epithelial tumors and to explore the relationship between the tubal epithelial changes and tumorigenesis of serous ovarian carcinoma.Methods The fallopian tubes in 79 cases of high-grade serous ovarian carcinoma,12 cases of low-grade serous ovarian carcinoma,16 cases of serous borderline ovarian tumor and 11 cases of non-ovarian benign tumors were serially examined under light microscope.Immunohistochemical study with EnVision method was used to detect the expression of p53 and bcl-2 protein in the fallopian tubal epithelium in all cases.The occurrences of secretory cell outgrowth(SCOUT),p53 signature,serous tubal intraepithelial carcinoma(STIC) and serous invasive carcinoma were analyzed.Results SCOUT in tubal epithelium was observed in 60.8%(48/79) of the high-grade serous carcinoma group,4/12 of the low-grade serous carcinoma group,3/16 of the serous borderline tumor group and 2/11 of the non-ovarian benign tumor group(P =0.001).P53 signature,STIC and serous invasive carcinoma occurred only in the fallopian tubal epithelium of patients with high-grade serous ovarian carcinoma,with the positive rates being 29.1%(23/79),15.2%(12/79) and 44.3%(35/79),respectively.Of the 23 cases with p53 signature,17 cases had solitary lesion and 6 cases involved more than two sites.A total of 33 p53 signature positive foci were found,with 22 foci located at fimbria and 11 at ampulla.Bcl-2 expression was demonstrated in 90.9% of those foci(30/33).Of the 12 patients with STIC,7 cases were solitary and 5 cases involved more than two sites.A total of 18 STIC foci were found,with 16 foci located at fimbria and 2 at ampulla.All of them were positive for bcl-2.Conclusions SCOUT is found in fallopian tubal epithelium in patients with serous ovarian epithelial tumors,especially high-grade serious carcinoma.On the other hand,p53 signature,STIC and invasive serous carcinoma of

  13. Berufstätige Mütter und sozial-emotionale Kompetenzen ihrer Kinder

    OpenAIRE

    Röhr-Sendlmeier, Una M.; Bergold, Sebastian; Jöris, Andreas; Cummings, Anna Verena; Heim, Karin; Johannen, Eva

    2012-01-01

    "Bei 985 vollständigen Familien mit Kindern der 3., 4. und 6. Klassen aus Grundschulen, Hauptschulen, Realschulen und Gymnasien wurde in einer Querschnittsuntersuchung die Beziehung zwischen der Berufstätigkeit der Mutter und sozial- emotionalen Kompetenzen der Kinder untersucht. Die Aufgabenübernahme des Vaters (erfragt vom Vater), das Wohlbefinden und der praktizierte Erziehungsstil der Mutter (erfragt von der Mutter) wurden als vermittelnde Variablen für den postulierten Zusammenhang angen...

  14. A terapêutica endoscópica nas complicações biliares pós-transplante hepático Endoscopic management of biliary complications after liver transplantation

    Directory of Open Access Journals (Sweden)

    Jeany Borges e Silva Ribeiro

    2012-12-01

    cholangiopancreatography due to suspected biliary complications. RESULTS: Fifteen patients were included (10 male, mean age of 49.57 years and 36 endoscopic retrograde cholangiopancreatographies were undertaken (2.4/patient. Biliary stricture was diagnosed in 13 patients and endoscopic treatment was successful in 56% (38,46% still in treatment. Biliary leaks were found in one patient and dysfunction of the hepatobilliary ampulla with choledocholithiasis was diagnosed in one patient, both cured by endoscopic treatment. CONCLUSIONS: Post-liver transplantation biliary complications are relatively common and endoscopic treatment may result in satisfactory outcome. Stenosis was the more frequent complication in this series.

  15. Neoadjuvant chemoradiotherapy for locally advanced rectal cancer low localization

    International Nuclear Information System (INIS)

    The research demonstrates possibility of improvement of direct treatment results after the use of preoperative combined radiotherapy with radio modification for patients with the locally advanced cancer of rectum. Based on the analysis of the results of chemo radiation treatment of 97 patients with tumors of the lower- and medium ampulla localization (T3N0-1M0), in which the radiotherapy was carried out by various modes of exposure. External beam radiotherapy combined with Capecitabine in a daily dose of 850 mg/m2 and a combination of external beam and intracavitary radiotherapy combined with Capecitabine in a daily dose of 850 mg/m2 were compared. The analysis of tolerability showed that preoperative combination of external and intracavitary radiation therapy has shown an acceptable toxicity profile, increase the number of patients transferred in resectable form of disease and the number of sphincter-preserving operations

  16. Optical nerve stimulation for a vestibular prosthesis

    Science.gov (United States)

    Harris, David M.; Bierer, Steven M.; Wells, Jonathon D.; Phillips, James O.

    2009-02-01

    Infrared Nerve Stimulation (INS) offers several advantages over electrical stimulation, including more precise spatial selectivity and improved surgical access. In this study, INS and electrical stimulation were compared in their ability to activate the vestibular branch of the VIIIth nerve, as a potential way to treat balance disorders. The superior and lateral canals of the vestibular system of Guinea pigs were identified and approached with the aid of precise 3-D reconstructions. A monopolar platinum stimulating electrode was positioned near the ampullae of the canals, and biphasic current pulses were used to stimulate vestibular evoked potentials and eye movements. Thresholds and input/output functions were measured for various stimulus conditions. A short pulsed diode laser (Capella, Lockheed Martin-Aculight, Inc., Bothell WA) was placed in the same anatomical position and various stimulus conditions were evaluated in their ability to evoke similar potentials and eye movements.

  17. A Glasgow Tipple-transjugular intrahepatic portosystemic shunt insertion prior to Whipple resection.

    Science.gov (United States)

    Jabbar, Salman A A; Jamieson, Nigel B; Morris, Andrew J; Oien, Karin A; Duthie, Fraser; McKay, Colin J; Carter, Christopher R; Dickson, Euan J

    2016-01-01

    Abdominal surgery performed in patients with significant liver disease and portal hypertension is associated with high mortality rates, with even poorer outcomes associated with complex pancreaticobiliary operations. We report on a patient requiring portal decompression via transjugular intrahepatic portosystemic shunt (TIPS) prior to a pancreaticoduodenectomy. The 49-year-old patient presented with pain, jaundice and weight loss. At ERCP an edematous ampulla was biopsied, revealing high-grade dysplasia within a distal bile duct adenoma. Liver biopsy was performed to investigate portal hypertension, confirming congenital hepatic fibrosis (CHF). A TIPS was performed to enable a pancreaticoduodenectomy. Prophylactic TIPS can be performed for preoperative portal decompression for patients requiring pancreatic resection. A potentially curative resection was performed when abdominal surgery was initially thought impossible. Notably, CHF has been associated with the development of cholangiocarcinoma in only four previous instances, with this case being only the second reported distal bile duct cholangiocarcinoma. PMID:27177892

  18. A Glasgow Tipple—transjugular intrahepatic portosystemic shunt insertion prior to Whipple resection

    Science.gov (United States)

    Jabbar, Salman A.A.; Jamieson, Nigel B.; Morris, Andrew J.; Oien, Karin A.; Duthie, Fraser; McKay, Colin J.; Carter, Christopher R.; Dickson, Euan J.

    2016-01-01

    Abdominal surgery performed in patients with significant liver disease and portal hypertension is associated with high mortality rates, with even poorer outcomes associated with complex pancreaticobiliary operations. We report on a patient requiring portal decompression via transjugular intrahepatic portosystemic shunt (TIPS) prior to a pancreaticoduodenectomy. The 49-year-old patient presented with pain, jaundice and weight loss. At ERCP an edematous ampulla was biopsied, revealing high-grade dysplasia within a distal bile duct adenoma. Liver biopsy was performed to investigate portal hypertension, confirming congenital hepatic fibrosis (CHF). A TIPS was performed to enable a pancreaticoduodenectomy. Prophylactic TIPS can be performed for preoperative portal decompression for patients requiring pancreatic resection. A potentially curative resection was performed when abdominal surgery was initially thought impossible. Notably, CHF has been associated with the development of cholangiocarcinoma in only four previous instances, with this case being only the second reported distal bile duct cholangiocarcinoma. PMID:27177892

  19. Medline Plus

    Full Text Available ... vas deferens, a muscular tube, which propels sperm forward through smooth muscle contractions. The sperm arrive first ... added. From the ampulla, seminal fluid is propelled forward through the ejaculatory ducts toward the urethra, passing ...

  20. Diagnosing & Treating Digestive Tract Disorders Endoscopically

    Medline Plus

    Full Text Available ... either under general anesthesia or under what we call MAC, which is monitored anesthesia care. And that ... it empties through a little nipple that we call the papilla or the ampulla. And we can ...

  1. Cause analysis and treatment countermeasure of postcholecystestomy syndrome%胆囊切除术后综合征原因分析与治疗对策

    Institute of Scientific and Technical Information of China (English)

    熊为民; 邓剑; 丁志平; 陈声飞

    2016-01-01

    目的:探析胆囊切除术后综合征(PCS)的原因与治疗对策。方法35例单纯胆囊切除术患者,对其术后发生PCS的临床资料进行回顾性分析。结果35例患者中,出现PCS原因:胆道因素、胆道外因素及其他因素。胆道因素17例,包括胆道结石5例、胆管扩张3例、胆管狭窄2例、胆道十二指肠瘘1例、胆囊管残留过长4例、胆总管损伤2例;胆道外因素14例,包括缩窄性乳头炎4例、胆汁返流性胃炎4例、上消化道溃疡3例、慢性胰腺炎2例、十二指肠憩室1例;其他因素4例,主要为患者精神紧张及过度劳累所致。手术治疗23例,其中治愈19例、好转2例、无效1例、死亡1例;保守治疗12例,其中治愈9例、好转2例、无效1例。术后随访时间6~36个月,未见复发病例。结论PCS病因复杂,术前应全面检查,术中规范操作,严格探查,避免损伤胆管和电灼误伤等,可有效减少和杜绝术后PCS发生。可根据PCS病因进行对症治疗,并加强患者心理治疗和护理工作,以促进患者身体恢复,提高生活质量。%ObjectiveTo investigate cause and treatment countermeasure of postcholecystestomy syndrome (PCS).MethodsA retrospective analysis was made on clinical data of 35 patients with PCS after single cholecystectomy.ResultsCauses of PCS in the 35 cases included biliary tract factor, outside biliary tract factor and other factor. There were 17 cases with biliary tract factor, including 5 cases with biliary calculi, 3 cases with cholangiectasis, 2 cases with stenosis of bile duct, 1 case with biliary duodenal fistula, 4 cases with long residual cystic duct, and 2 cases with choledochus injury. There were 14 cases with outside biliary tract factor, including 4 cases with constrictive papillitis of vater, 4 cases with bile reflax gastritis, 3 cases with upper digestive tract ulcer, 2 cases with chronic pancreatitis, and 1 case with duodenal diverticulum

  2. Kronos und der walfisch

    Directory of Open Access Journals (Sweden)

    Janez Stanovnik

    2016-02-01

    Full Text Available Nach Hesiod, Theog. 154—210 entmannte Kronos seinen Vater Uranos, als sich dieser Gaia in der Nacht nahte, indem er ihm mit der von seiner Mutter gegebenen Sichel sein Glied abschnitt. Es ist bekannt, daß das Verhältnis zwischen Uranos und Kronos eine Dublette des Verhältnisses zwischen Kronos und seinen Kindern, insbesondere Zeus, ist. Laut der Theogonie hat auch Zeus dasselbe seinem Vater Kronos angetan: er hat ihn mit Honig trunken gemacht und ihn damn im Schlaf gefesselt und entmannt.

  3. The value of abdominal ultrasound in the diagnosis of colon cancer Rentabilidad de la ecografía abdominal en el diagnóstico del cáncer de colon

    Directory of Open Access Journals (Sweden)

    D. Martínez-Ares

    2005-12-01

    Full Text Available Introduction: colon cancer is one of the main causes of cancer death. Diagnosis requires the examination of the entire large bowel by means of radiological or endoscopic techniques. Many patients suspect of colon cancer are referred for colonoscopy but nevertheless this suspicion is not confirmed after endoscopic examination. The objective of this study is the evaluation of the reliability of abdominal ultrasound in the diagnosis of these tumors. Material and method: we selected patients suspect of colon cancer referred to the endoscopy unit for a colonoscopy. An abdominal ultrasound was carried out on all patients prior to the endoscopy. Considering the endoscopic examination as a gold standard, the sensibility, specificity, positive predictive value (PPV and negative predictive value (NPV of the ultrasonography were evaluated. Likewise, a series of analytical and clinical parameters were evaluated, in an attempt to establish associated factors of a colon cancer. The statistical analysis was carried out by means of the statistical package SPSS 12.0 for Windows. Results: 145 patients were included in the study (56.6% males with an average 66.72 years of age (22-89. A cancer was diagnosed in 42 cases (28.9%. In the diagnosis of colon cancer, abdominal ultrasound presents a sensitivity of 79.06%, a specificity of 92.15%, a PPV and a NPV of 80.9% and of 91.2%, respectively. Excluding from the analysis lesions of the rectal ampulla, which cannot be adequately evaluated by means of ultrasound, the figures for sensitivity, specificity, PPV and NPV increase to 91.8, 92.1, 80.9 and 96.9% respectively. The univariate analysis showed that an age over 65 years and the presence of microcytosis are associated to a greater risk of colon cancer while after multivariate analysis only the presence of microcytosis resulted to be an independent predictive factor of cancer. Conclusions: abdominal ultrasound presents high sensitivity, specificity, PPV and NPV in the

  4. Laparoscopic Pancreas-Sparing Subtotal Duodenectomy

    Directory of Open Access Journals (Sweden)

    Ignasi Poves

    2011-01-01

    Full Text Available Context Primary adenocarcinoma of the duodenum is a rare digestive malignancy which is commonly treated by radical surgical resection, pancreaticoduodenectomy being the technique of choice. Complete tumor resection obtaining free margins should be the standard of treatment for primary adenocarcinoma of the duodenum. Segmental duodenal resection is an appropriate operation for selected cases of primary adenocarcinoma of the duodenum of the 3rd and 4th portions of the duodenum. Case report We present the case of a 67-year-old woman suffering from an infra-ampullary large villous polypoid mass affecting the 3rd portion of the duodenum. Multiple endoscopic biopsies did not disclose any malignancy, and abdominal CT and endoscopic ultrasound found no extraduodenal involvement. A 3rd and 4th portion pancreas-sparing duodenectomy was carried out using a totally laparoscopic approach. Intra-operatory duodenoscopy was done to safeguard the papilla of Vater. Recovery was uneventful and the patient was discharged on the 7th postoperative day. The final diagnosis was primary adenocarcinoma of the duodenum (free resection margins. After forty-five months of follow-up, the patient is free of disease. Conclusions We recommend this procedure for treatment of an infra-ampullary benign and pre-malignant duodenal pathology; it can also be a treatment option and an alternative to a pancreaticoduodenectomy in very selected cases of tumors confined to the duodenum. Expertise in both pancreatic surgery and laparoscopic techniques is required.

  5. Radiological biliary tract diagnosis after cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.; Kueper, K.

    1982-01-01

    Fifty-three patients with biliary symptoms were studied at least four years after cholecystectomy by isotope techniques. There was a highly significant correlation between symptoms and disturbances of bile flow, such as dyskinesia or obstruction. There was no correlation with serum enzyme levels such as gamma-GT, alkaline phosphatase, bilirubin or transaminases. Measurements of the diameter of the bile duct on cholangiograms provided no evidence of obstruction up to 15 mm, although a diameter in excess of 10 mm. made obstruction likely. The upper value for 'normal' bile flow derived from hilar flow curves of patients without dyskinesia showed a half value period of 27.5 minutes. The disturbances of flow demonstrated by isotope methods in the presence of typical symptoms, and without other pathological findings, indicate a pre-clinical stage of a partly compensated biliodynamic insufficiency. Where there is no morphological evidence of biliary obstruction, one must assume inflammatory changes round the papilla of Vater; these are frequent even in normal biliary tracts and almost always present after cholecystectomy. Quantitative hepato-biliary scintigraphy is the most reliable method for objective measurement of disturbances of bile flow and make it possible to avoid the vague diagnosis of 'postcholecystectomy syndrome'.

  6. Refractory obstructive jaundice in a child affected with thalassodrepanocytosis: a new endoscopic approach

    Directory of Open Access Journals (Sweden)

    Barresi Luca

    2010-10-01

    Full Text Available Abstract Background Liver involvement, including elevated direct-reacting bilirubin levels, is common in patients with sickle cell disease. Fifty to seventy percent of sickle cell patients have pigmented gallstones due to precipitation of unconjugated bilirubin, and cholelithiasis or choledocholithiasis are common complications. The highest prevalence of these complications occurs in patients with Gilbert's syndrome because of the combined effect of increased bilirubin production and reduced bilirubin-diphosphate-glucuronosyltransferase enzyme activity. Cholelithiasis is also a common complication in patients with thalassemia. Endoscopic removal of choledochal stones does not always resolve the clinical picture, as in cases of dysfunction of the Vater's papilla, increased bile density due to persistently impaired bile flow or distortion of the choledocus due to dilatation, or inflammation secondary to gallstone. Case presentation We report here a case of severe and persistent obstructive jaundice in a child affected with thalassodrepanocytosis and Gilbert's syndrome, previously, and unsuccessfully, treated with endoscopic removal of choledochal stones. Deep and thorough biliary washing, and stenting with a new removable polytetrafluoroethylene (PTFE-covered flared-type stent led to complete resolution of the obstructive jaundice. Conclusions This report shows that an aggressive endoscopic approach in this select category of patients can help resolve the severe complication of hemolytic anemia, thus avoiding surgery.

  7. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Takao Itoi; Fumihide Itokawa; Atsushi Sofuni; Toshio Kurihara; Takayoshi Tsuchiya; Kentaro Ishii; Shujiro Tsuji; Nobuhito Ikeuchi; Fuminori Moriyasu

    2008-01-01

    Endoscopic ultrasonography (EUS)-guided biliary drainage was performed for treatment of patients who have obstructive jaundice in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). In the present study, we introduced the feasibility and outcome of EUS-guided choledochoduodenostomy in four patients who failed in ERCP. We performed the procedure in 2 papilla of Vater, including one resectable case, and 2 cases of cancer of the head of pancreas. Using a curved linear array echoendoscope, a 19 G needle or a needle knife was punctured transduodenally into the bile duct under EUS visualization. Using a biliary catheter for dilation, or papillary balloon dilator, a 7-Fr plastic stent was inserted through the choledochoduodenostomy site into the extrahepatic bile duct. In 3 (75%) of 4 cases, an indwelling plastic stent was placed, and in one case in which the stent could not be advanced into the bile duct, a naso-biliary drainage tube was placed instead. In all cases, the obstructive jaundice rapidly improved after the procedure. Focal peritonitis and bleeding not requiring blood transfusion was seen in one case. In this case, pancreatoduodenectomy was performed and the surgical findings revealed severe adhesion around the choledochoduodenostomy site. Although further studies and development of devices are mandatory, EUS-guided choledochoduodenostomy appears to be an effective alternative to ERCP in selected cases.

  8. Strategic Petroleum Reserve, annual site environmental report for calendar year 1991

    International Nuclear Information System (INIS)

    This report, provided annually in accordance with DOE Order 5400.1, summarizes monitoring data collected to assess Strategic Petroleum Reserve (SPR) impacts on the environment. The report serves as a management tool for mitigating such impacts, thus serving the public interest by ensuring environmentally sound operation of the SPR. Included in this report is a description of each site's environment, an overview of the SPR environmental program, and a recapitulation of special environmental activities and events associated with each SPR site during 1990. The active permits and the results of the environmental monitoring program (i.e., air, surface vater, groundwater, and water discharges) are discussed within each section by site. The quality assurance program is presented which includes results from laboratory and field audits and studies performed internally and by regulatory agencies. In general, no significant adverse environmental impact resulted from any SPR activities during 1990. Environmental areas of concern, such as potential groundwater contamination, are fully addressed in the applicable section by site. The SPR continues to maintain an overall excellent environmental record

  9. Peritonite meconial como diagnóstico diferencial de ascite fetal: relato de caso Meconium peritonitis in the differential diagnosis of fetal ascites: a case report

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    1999-07-01

    include fetal ascites and intra-abdominal calcifications. Evidence suggests that prenatal diagnosis can improve postnatal prognosis. Case Report: R.C.M.S., 22 years, II pregnancy O para, presented ultrasound (12/02/98 with diagnosis of fetal ascites. Investigation for hydrops fetalis was performed and immune and nonimmune causes were excluded. Severe fetal ascites persisted on subsequent ultrasound examinations, without calcifications. Vaginal delivery occurred at 36 weeks (01/02/99, with polyhydramnios. Female neonate weighing 2,670 g, with signs of respiratory distress, abdominal distension and petechiae. Abdominal distension worsened progressively, with palpation of a petrous tumor in the right upper quadrant and elimination of white mucus at rectal examination. Radiological findings (01/04/99 were disseminated abdominal calcifications, intestinal dilatation and absence of gas at rectal ampulla. Exploratory laparotomy was indicated with diagnosis of meconium peritonitis. A giant meconium cyst and ileal atresia were observed and lysis of adhesions and ileostomy were performed. Initial postoperative evolution was satisfactory but was subsequently complicated by sepsis and neonatal death occurred (01/09/99. Conclusion: meconium peritonitis should be remembered at differential diagnosis of fetal ascites. In the present case, surgical indication could be anticipated if prenatal diagnosis were established, with improvement of neonatal evolution.

  10. Inner ear morphological study of guinea pigs with acoustically evoked short latency negative response%声诱发短潜伏期负电位豚鼠的内耳铺片研究

    Institute of Scientific and Technical Information of China (English)

    黄文钦; 李治美; 徐丽; 农东晓; 唐安洲; 覃焕桦; 杨甜

    2012-01-01

    Objective To establish a model of ototoxicity in guinea pigs with acoustically evoked short latency negative response (ASNR) and verify the responsible organ of ASNR based on microscopic characteristics of basal membranes,saccules,utricles and ampulla canalis semicircularis of the inner ear.Methods Total of 45 guinea pigs were employed in the experiment,which were randomly divided into the control group (15 subjects,30 ears) and the deafened group (30 subjects,60 ears). Each animal experienced auditory brainstem response ( ABR ). A quick treatment was employed for deafened group consisting of a subcutaneous injection of kanamycin at a dose of 400 mg/kg followed by jugular vein injection of ethacrynic acid at a dose of 40 mg/kg one hour later.The animals were performed ABR test from 7 to 10 days after the drug administration.The deafened group was further divided into ASNR group and non-ASNR group based on the presence of ASNR.All the guinea pigs were sacrificed after ABR tests.The Corti organ,macula sacculi,macula utriculi and crista ampullaris were observed by light microscope.Results In the deafened group (60 ears),3 subjects died postoperatively,27 subjects (54 ears) provided full data.ASNR was elicited in 19 ears (35.2%,19/54 ),the thresholds of ASNR were from 110 to 125 dBSPL with average of ( 121.7 ±4.5)dBSPL ASNR latency ranges were 1.80-2.08 ms,the average latency of thresholds were ( 1.93 ±0.07) ms.The stretched preparation results:overall hair-cell density of macula saccule,macula utriculi and crista ampullaris decreased in order of normal eontrol group,ASNR group and non-ASNR group.There was no difference between the normal group and ASNR group for cell density of macula saccule.Apart from this,statistical differences were found among other groups.Conclusions The present study evoked ASNR in an olotoxicity guinea pig model which was profound hearing loss with normal saccular function and normal saccular hair cell density.It suggested that ASNR

  11. Percutaneous transhepatic metallic stent insertion for malignant afferent loop obstruction following pancreaticoduodenectomy: a case report

    Directory of Open Access Journals (Sweden)

    Hosokawa Isamu

    2012-07-01

    Full Text Available Abstract Introduction Malignant afferent loop obstruction following pancreaticoduodenectomy is a rare complication and may be fatal if suppurative cholangitis or obstructive jaundice develops. Effective and safe therapeutic strategies for malignant afferent loop obstruction following pancreaticoduodenectomy are scarce at present. Case presentation A 51-year-old Japanese man underwent pancreaticoduodenectomy for carcinoma of the papilla of Vater. Seven months postoperatively, he developed a high-grade fever, jaundice, and right upper abdominal pain. Abdominal contrast-enhanced computed tomography showed afferent loop obstruction and intrahepatic bile duct dilatation due to nodal recurrence. Percutaneous transhepatic biliary drainage was performed, and a self-expanding metallic stent (WallFlex™ duodenal stent was placed across the stricture using the transhepatic route. Conclusions There are surgical and nonsurgical treatments for malignant afferent loop obstruction following pancreaticoduodenectomy. Nonsurgical treatments include either an endoscopic or percutaneous approach to the afferent loop. Of these methods, percutaneous transhepatic insertion of a self-expanding metallic stent is the preferred treatment for malignant afferent loop obstruction following pancreaticoduodenectomy because it is more prompt and less invasive.

  12. The number and profile of reactive NADH-d and NADPH-d neurons of myenteric plexus of six-month-old rats are different in the cecum portions O número de neurônios e a área do perfil neuronal NADH-d e NADPH-d reativos do plexo mioentérico de ratos com seis meses de idade são diferentes nas diferentes porções e regiões do ceco

    Directory of Open Access Journals (Sweden)

    Elizangela A. Silva

    2008-05-01

    Full Text Available Whole-mount preparations were prepared and submitted to NADH-diaphorase and NADPH-diaphorase histochemistry techniques. The myenteric plexus arrangement and the number of neurons were comparatively evaluated among the different portions of the cecum. The neurons from the apical and basal regions were distributed in classes at intervals of 100µm², the means of the corresponding intervals being compared. The ganglia, in both techniques, were often connected by fine bundles, which became thicker in the mesenteric region and in the region next to the cecal ampulla. The number of positive NADH-d neurons was higher than that of NADPH-d neurons in all portions, from both regions. The numbers of reactive NADH-d e NADPH-d neurons were significantly different among the different portions of the cecum, except for the antimesenteric basal and intermediate basal regions, considering the NADH-d neurons. The profile area for the reactive NADH-d e NADPH-d neurons was higher in the apical region than in the basal area. Differences in arrangement, distribution and size of positive NADH-d e NADPH-d neurons in the different cecum portions evidenced the importance of the subdivision of the analyzed organ.Estudaram-se o arranjo do plexo mioentérico, o número de neurônios e a área do perfil do corpo celular (µm² dos neurônios mioentéricos, nas regiões apical e basal do ceco de ratos Wistar com 6 meses de idade. Estas regiões foram subdivididas nas seguintes porções: apical mesentérica (AM; apical intermediária (AI; apical antimesentérica (AA; próximo à ampola cecal (PA; basal intermediária (BI, e basal antimesentérica (BA. Foram montados preparados de membrana que receberam as técnicas histoquímica de NADH-diaforase (NADH-d e NADPH-diaforase (NADPH-d. O arranjo do plexo mioentérico e o número de neurônios foram avaliados comparativamente entre as diferentes porções das regiões do ceco. Os neurônios das regiões apical e basal foram

  13. Hartnäckige Anachronismen

    Directory of Open Access Journals (Sweden)

    Barbara Drinck

    2004-11-01

    Full Text Available Väter sind anders ist die überarbeitete Fassung von Guter Vater – Böser Vater (1997. Uns liegen elf Kapitel vor, die sich mit der Entwicklung des Mannes vom Sohn zum Vater, mit dem Geschlechterverhältnis von Mann und Frau, der Bedeutung des Berufs für den Mann und der männlichen Aggression und Sexualität auseinandersetzen. Der Text basiert auf der orthodox-psychoanalytischen Annahme einer binären Geschlechtsidentität, sein Männlichkeitsbild gründet Petri auf die These von der angeblichen kulturellen Überlegenheit des Mannes, auf populär-evolutionistische Ansichten von der Rolle von Mann und Frau sowie auf die Vorstellung ‚gesunder‘ binärer geschlechtsadäquater Identität, die – wen wundert’s – zwangsläufig in Heterosexualität münde. Über den Nutzen dieser Vater-Studie lässt sich streiten.

  14. Helge Schroth zum 65. Geburtstag

    OpenAIRE

    Pietsch, Torsten

    2014-01-01

    Frau Helga Schroth beging am 15.10.1998 ihren 65. Geburtstag. Sie wurde in Zscheiplitz bei Freyburg im landschaftlich reizvollen Unstruttal geboren. Hier förderte insbesondere ihr Großvater väterlicherseits auf ausgedehnten Wanderungen schon frühzeitig ihr Naturverständnis.

  15. Historisches Rätsel Physik mit Gewehr und Eiern

    Science.gov (United States)

    Loos, Andreas

    2003-11-01

    Es fing schon gut an: Mit zehn Jahren saß der begabte Junge bereits in der Universität, wo ihn kein Geringerer als sein Vater persönlich unterrichtete. Damit schlug dieser zwei Fliegen mit einer Klappe: Sein Sohn lernte etwas Gescheites, und er war zugleich in sicherer Obhut.

  16. Sepp, Brüder

    OpenAIRE

    2009-01-01

    Vater der Brüder war Johann S. (* 24.6.1626 Kaltern/Südtirol [Caldaro/I], † zw. 1679/84 Schlanders/Südtirol [Silandro/I]). Paul (Paolo): * 1649 Kaltern/Südtirol (Caldaro/I), † April 1670 Bozen/Südtirol (Bolzano/I) oder 1692 Kaltern. Sänger, Komponist, Organist.

  17. Hematopoetic prostaglandin D synthase: an ESR1-dependent oviductal epithelial cell synthase.

    Science.gov (United States)

    Bridges, Phillip J; Jeoung, Myoungkun; Shim, Sarah; Park, Ji Yeon; Lee, Jae Eun; Sapsford, Lindsay A; Trudgen, Kourtney; Ko, Chemyong; Gye, Myung Chan; Jo, Misung

    2012-04-01

    Oviductal disease is a primary cause of infertility, a problem that largely stems from excessive inflammation of this key reproductive organ. Our poor understanding of the mechanisms regulating oviductal inflammation restricts our ability to diagnose, treat, and/or prevent oviductal disease. Using mice, our objective was to determine the spatial localization, regulatory mechanism, and functional attributes of a hypothesized regulator of oviductal inflammation, the hematopoietic form of prostaglandin D synthase (HPGDS). Immunohistochemistry revealed specific localization of HPGDS to the oviduct's epithelium. In the isthmus, expression of HPGDS was consistent. In the ampulla, expression of HPGDS appeared dependent upon stage of the estrous cycle. HPGDS was expressed in the epithelium of immature and cycling mice but not in the oviducts of estrogen receptor α knockouts. Two receptor subtypes bind PGD₂: PGD₂ receptor and G protein-coupled receptor 44. Expression of mRNA for Ptgdr was higher in the epithelial cells (EPI) than in the stroma (P cell viability (P < 0.05). Treatment of mice with HQL-79 increased mRNA for chemokine (C-C motif) ligands 3, 4, and 19; chemokine (C-X-C motif) ligands 11 and 12; IL-13 and IL-17B; and TNF receptor superfamily, member 1b (P < 0.02 for each mRNA). Overall, these results suggest that HPGDS may play a role in the regulation of inflammation and EPI health within the oviduct. PMID:22374975

  18. Neonatal handling induces anovulatory estrous cycles in rats

    Directory of Open Access Journals (Sweden)

    Gomes C.M.

    1999-01-01

    Full Text Available Since previous work has shown that stimulation early in life decreases sexual receptiveness as measured by the female lordosis quotient, we suggested that neonatal handling could affect the function of the hypothalamus-pituitary-gonadal axis. The effects of neonatal handling on the estrous cycle and ovulation were analyzed in adult rats. Two groups of animals were studied: intact (no manipulation, N = 10 and handled (N = 11. Pups were either handled daily for 1 min during the first 10 days of life or left undisturbed. At the age of 90 days, a vaginal smear was collected daily at 9:00 a.m. and analyzed for 29 days; at 9:00 a.m. on the day of estrus, animals were anesthetized with thiopental (40 mg/kg, ip, the ovaries were removed and the oviduct was dissected and squashed between 2 glass slides. The number of oocytes of both oviductal ampullae was counted under the microscope. The average numbers for each phase of the cycle (diestrus I, diestrus II, proestrus and estrus during the period analyzed were compared between the two groups. There were no significant differences between intact and handled females during any of the phases. However, the number of handled females that showed anovulatory cycles (8 out of 11 was significantly higher than in the intact group (none out of 10. Neonatal stimulation may affect not only the hypothalamus-pituitary-adrenal axis, as previously demonstrated, but also the hypothalamus-pituitary-gonadal axis in female rats.

  19. Parameters That May Be Used for Predicting Failure during Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Emre Balik

    2013-01-01

    Full Text Available Aim. Endoscopic retrograde cholangiopancreatography (ERCP is frequently used for the diagnosis and treatment of hepatic, biliary tract, and pancreatic disorders. However, failure during cannulation necessitates other interventions. The aim of this study was to establish parameters that can be used to predict failure during ERCP. Methods. A total of 5884 ERCP procedures performed on 5079 patients, between 1991 and 2006, were retrospectively evaluated. Results. Cannulation was possible in 4482 (88.2% patients. For each one-year increase in age, the cannulation failure rate increased by 1.01-fold (. A history of previous hepatic biliary tract surgery caused the cannulation failure rate to decrease by 0.487-fold (. A tumor infiltrating the ampulla, the presence of pathology obstructing the gastrointestinal passage, and peptic ulcer increased the failure rate by 78-, 28-, and 3.47-fold, respectively (. Conclusions.Patient gender and duodenal diverticula do not influence the success of cannulation during ERCP. Billroth II and Roux-en-Y gastrojejunostomy surgeries, a benign or malignant obstruction of the gastrointestinal system, and duodenal ulcers decrease the cannulation success rate, whereas a history of previous hepatic biliary tract surgery increases it. Although all endoscopists had equal levels of experience, statistically significant differences were detected among them.

  20. Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation.

    Science.gov (United States)

    Riordan, R D; Khonsari, M; Jeffries, J; Maskell, G F; Cook, P G

    2004-12-01

    The quality of magnetic resonance cholangiopancreatography (MRCP) images is frequently degraded by high signal from the gastrointestinal tract. The aim of this study is to evaluate pineapple juice (PJ) as an oral negative contrast agent in MRCP. Preliminary in vitro evaluation demonstrated that PJ shortened T(2) relaxation time and hence decreased T(2) signal intensity on a standard MRCP sequence to a similar degree to a commercially available negative contrast agent (ferumoxsil). Electrothermal atomic absorption spectrometry assay demonstrated a high manganese concentration in PJ of 2.76 mg dl(-1), which is likely to be responsible for its T(2) imaging properties. MRCP was subsequently performed in 10 healthy volunteers, before and at 15 min and 30 min following ingestion of 400 ml of PJ. Images were assessed blindly by two Consultant Radiologists using a standard grading technique based on contrast effect (degree of suppression of bowel signal), and image effect (diagnostic quality). There were statistically significant improvements in contrast and image effect between pre and post PJ images. There was particularly significant improvement in visualization of the pancreatic duct, but no significant difference between 15 min and 30 min post PJ images. Visualization of the ampulla, common bile duct, common hepatic and central intrahepatic ducts were also significantly improved at 15 min following PJ. Our results demonstrate that PJ, may be used as an alternative to commercially available negative oral contrast agent in MRCP. PMID:15569640

  1. Reality named endoscopic ultrasound biliary drainage.

    Science.gov (United States)

    Guedes, Hugo Gonçalo; Lopes, Roberto Iglesias; de Oliveira, Joel Fernandez; Artifon, Everson Luiz de Almeida

    2015-10-25

    Endoscopic ultrasound (EUS) is used for diagnosis and evaluation of many diseases of the gastrointestinal (GI) tract. In the past, it was used to guide a cholangiography, but nowadays it emerges as a powerful therapeutic tool in biliary drainage. The aims of this review are: outline the rationale for endoscopic ultrasound-guided biliary drainage (EGBD); detail the procedural technique; evaluate the clinical outcomes and limitations of the method; and provide recommendations for the practicing clinician. In cases of failed endoscopic retrograde cholangiopancreatography (ERCP), patients are usually referred for either percutaneous transhepatic biliary drainage (PTBD) or surgical bypass. Both these procedures have high rates of undesirable complications. EGBD is an attractive alternative to PTBD or surgery when ERCP fails. EGBD can be performed at two locations: transhepatic or extrahepatic, and the stent can be inserted in an antegrade or retrograde fashion. The drainage route can be transluminal, duodenal or transpapillary, which, again, can be antegrade or retrograde [rendezvous (EUS-RV)]. Complications of all techniques combined include pneumoperitoneum, bleeding, bile leak/peritonitis and cholangitis. We recommend EGBD when bile duct access is not possible because of failed cannulation, altered upper GI tract anatomy, gastric outlet obstruction, a distorted ampulla or a periampullary diverticulum, as a minimally invasive alternative to surgery or radiology. PMID:26504507

  2. Constipation: A common problem in childhood

    Directory of Open Access Journals (Sweden)

    Bukarica Svetlana

    2005-01-01

    Full Text Available Introduction Constipation in children is defined as the infrequent and difficult passage of hard stool, not necessarily associated with infrequent stools. All healthy newborns have their first stool within the first 24 to 48 hours after birth. Intestinal transit time increases with age, therapy decreasing the frequency of stooling. Anatomy and Physiology of Anus and Rectum Acquisition of fecal continence requires: normal internal and external anal sphincters, puborectal muscle as well as intact sensory input from both the rectal vault and anal canal. Etiology and Differential Diagnosis During the first year of life, failure to have bowel movement every other day warrants evaluation. During infancy, constipation is usually due to dietary manipulations, malnutrition or some other functional abnormalities. Anatomic causes are found only in 5% of patients. Diagnosis and Therapy Diagnosis relies on history and physical examination. Digital rectal examination usually reveals a shorter anal canal with decreased sphincter tone. The rectal ampulla is dilated and filled with stool. Anorectal manometry is helpful in differentiating functional constipation from aganglionosis or other neurologic problems. Treatment varies depending on the underlying cause. Bowel retraining, aimed at establishing regular daily bowel movement, is of utmost importance in children. The response to treatment is usually dramatic. Conclusion Constipation in children causes anxiety in the family and successful treatment requires persistent reassurance and repeated reevaluation.

  3. Grateloupia tenuis Wang et Luan sp. nov. (Halymeniaceae, Rhodophyta: A New Species from South China Sea Based on Morphological Observation and rbcL Gene Sequences Analysis

    Directory of Open Access Journals (Sweden)

    Ling Yu

    2013-01-01

    Full Text Available Grateloupia tenuis Wang et Luan sp. nov. is a new species described from Lingshui, Hainan Province, South China Sea. Based on the external form and internal structure, combined with rbcL gene sequence analysis, Grateloupia tenuis is distinct from other Grateloupia species as follows: (1 thalli is slippery and cartilaginous in texture; possess fewer branches, relatively slight main axes, and two or three dichotomous branches; (2 cortex is 5-6 layers; medulla is solid when young, but hollow in old branches; reproductive structures are dispersed in main axes of thalli and lower portions of branchlets; exhibits Grateloupia-type auxiliary cell ampullae; (3 the four studied G. tenuis sequences were positioned in a large Grateloupia clade of Halymeniaceae, which included sister group generitype G. filicina with 68 bp differences; G. tenuis was determined to be a sister taxon to the G. catenata, G. ramosissima, G. orientalis, and G. filiformis subclade. The pairwise distances between G. tenuis and these species were 39 to 50 bp. The sequences of G. tenuis differed by 81–108 bp from the sequences of other samples in Grateloupia; there are 114–133 bp changes between G. tenuis and other genera of Halymeniaceae. In final analysis, we considered Grateloupia tenuis Wang et Luan sp. nov. to be a new species of genus Grateloupia.

  4. Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review

    Directory of Open Access Journals (Sweden)

    Vleggaar Frank P

    2009-12-01

    Full Text Available Abstract Background Benign biliary strictures may be a consequence of surgical procedures, chronic pancreatitis or iatrogenic injuries to the ampulla. Stents are increasingly being used for this indication, however it is not completely clear which stent type should be preferred. Methods A systematic review on stent placement for benign extrahepatic biliary strictures was performed after searching PubMed and EMBASE databases. Data were pooled and evaluated for technical success, clinical success and complications. Results In total, 47 studies (1116 patients on outcome of stent placement were identified. No randomized controlled trials (RCTs, one non-randomized comparative studies and 46 case series were found. Technical success was 98,9% for uncovered self-expandable metal stents (uSEMS, 94,8% for single plastic stents and 94,0% for multiple plastic stents. Overall clinical success rate was highest for placement of multiple plastic stents (94,3% followed by uSEMS (79,5% and single plastic stents (59.6%. Complications occurred more frequently with uSEMS (39.5% compared with single plastic stents (36.0% and multiple plastic stents (20,3%. Conclusion Based on clinical success and risk of complications, placement of multiple plastic stents is currently the best choice. The evolving role of cSEMS placement as a more patient friendly and cost effective treatment for benign biliary strictures needs further elucidation. There is a need for RCTs comparing different stent types for this indication.

  5. Colony specificity in Botrylloides leachi. I. Morphological aspects

    Directory of Open Access Journals (Sweden)

    G Zaniolo

    2006-12-01

    Full Text Available We studied colony specificity in the colonial ascidian Botrylloides leachi which, as in other botryllid ascidians, leads to either fusion or non-fusion between contacting colonies. Fusion requires the prior disappearance of contacting tunic cuticles and contact between facing ampullar epithelia. The epithelial cells of the ampullar tip show “pad regions” rich in ribosomes, which contribute to the synthesis of new tunic and cuticle. Blood cells, mainly phagocytes and pigment cells, increase their concentrations inside the ampullar lumen and phagocytes can cross the ampullar epithelium and enter the tunic, where they can contribute to the digestion of tunic cuticles and cells of the ampullar epithelium in order to establish a common circulation. Non-fusion reaction, as studied in the colony allorecognition assay, resembles the subcuticular rejection described in Japanese Botrylloides, characterised by limited tunic fusion, hemocyte leakage, and necrotic spots. Conversely, in the cut surface assay, a more intense cytotoxic reaction is observed along the contact border. In this case, morula cells crowd massively inside the facing ampullae, enter the tunic, and release their vacuolar contents which are probably required for the formation of necrotic spots.

  6. 2. symposium energy crops 2009; 2. Symposium Energiepflanzen 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-27

    Within the meeting '2nd Symposium energy plants 2009', held at 17th to 18th November, 2009, in Berlin (Federal Republic of Germany), the following lectures were held: (1) The bio energy policy of the Federal Government in the area of attention between climatic protection, ecology and economy (Ilse Aigner); (2) Chances and threatens of cultivation of energy plants for a sustainable energy supply (Alois Heissenhuber); (3) Certification as a prerequisite of the global exploration of bio energy (Andreas Feige); (4) A project support in the field of cultivation of energy plants, a review (Andreas Schuette); (5) Results from the investigation of the crop rotation in the EVA network (Armin Vater); (6) Optimisation of the cultivation technology of sorghum millets (Christian Roehricht); (7) The two-culture utilization system - a comparison between ecologic and conventional cultivation (Reinhold Stuelpnagel); (8) Crop rotation with energy plants - Chances and threatens for the plant protection (Baerbel Gerowitt); (9) Efficiency of utilization of water for energy plants (Siegfried Schittenhelm); (10) Utilization of arable food grasses and permanent grassland as a substrate for biogas (Matthias Benke); (11) Economical evaluation of plant fermentation substrates (Dominik Reus); (12) Energy plants as a challenge for the agricultural engineering (Heiner Bruening); (13) Influence of the design of cultivation on the subsequent effects of the cultivation of energy plants (Michael Glemnitz); (14) Energy plants and waters protection - Key aspects and possible options of action (Heike Nitsch); (15) Neophytes as energy plants - Chances and threatens (Werner Kuhn); (16) Manifold in te landscape - extensive cultivation systems with renewable raw materials as an option for nature protection? (Peer Heck); (17) Ecologic aspects of agro forestry systems (Holger Gruenewald); (18) Enhancement of the potential of energy yield of winter wheat (Wolfgang Friedt); (19) Interspersed silphie

  7. Ventriculomegaly with non-CNS anomalies

    International Nuclear Information System (INIS)

    We correlated fetal magnetic resonance (MR) imaging findings with postnatal clinical findings to assess ventriculomegaly with non-CNS anomalies. From 2002 to 2010, 52 fetuses underwent a MRI for evaluation of ventriculomegaly after ultrasonography (US). Ten of the 52 demonstrated anomalies outside the central nervous system (CNS), including trisomy 8, trisomy 18, X-linked hydrocephalus, CHARGE/Potter sequences, VATER association, oral-facial-digital syndrome, esophageal atresia type C, or external auditory canal stenosis. Examinations were performed between 24 and 35 weeks' gestation. MR imaging was performed in a 1.5-tesla unit using a phased-array coil without preparation. Fetal MR imaging showed abnormalities of the kidney, bladder, duodenum, and thumbs but did not permit diagnosis of esophageal atresia type C or craniofacial, anorectal, or skeletal anomalies. Cardiac anomaly was most frequent, but fetal MR imaging did not allow final diagnosis of congenital heart disease. On both US and MR imaging, esophageal atresia type C and anorectal anomaly were undetected; normal rectal signal in a case of anorectal anomaly without urorectal fistula did not lead to suspicion of anomaly. Observation of adducted thumbs on MR imaging is an important sign of X-linked hydrocephalus. The slice area used in this study did not cover polydactyly, which accompanies oral-facial-digital syndrome. US and MR imaging are complementary imaging methods used to evaluate ventriculomegaly. Fetal MR imaging should cover the kidney, bladder, and fingers. Further work is needed to determine the anomalies that can be clearly detected by fetal MR imaging. (author)

  8. Historisches Rätsel Der rastlose Amerikaner

    Science.gov (United States)

    Loos, Andreas

    2004-09-01

    In der Schule, die er mit acht Jahren zum ersten Mal von innen sah, hielt man ihn nicht für allzu helle - schließlich hinkte der Kleine oft hinter der Klasse her. Und es hat etwas Tragisches, wenn der wohl berühmteste Erfinder aller Zeiten und Halter von 2000 Patenten im Alter über seinen Vater sagt: Er dachte, ich sei dumm. Und ich meinte schon fast selbst, ich sei ein Dummkopf.

  9. Väterforschung als Familienforschung

    Directory of Open Access Journals (Sweden)

    Walter Bien

    2004-11-01

    Full Text Available Männer im Übergang zur Vaterschaft von Ariane Schorn ist ein interessantes, empfehlenswertes Buch, das einen wichtigen, bisher wenig beleuchteten Aspekt im Alltag eines Großteils der Bevölkerung umfasst, immerhin sind bzw. werden zwischen70 und 80% aller Männer im Laufe ihres Lebens einmal Vater. Das Buch zeigt eine lebendige, nicht immer einfache Entwicklung in einer schwierigen Zeit der Familientriade.

  10. Endoparasitosen bei Kälbern in Mutterkuhhaltung : Vorkommen sowie haltungsbedingte und genetische Einflüsse

    OpenAIRE

    Jäger, Michael

    2003-01-01

    Ziel der vorliegenden, unter Feldbedingungen durchgeführten Untersuchung an insgesamt 443 Kälbern in Mutterkuhhaltung war, das Vorkommen und die Verbreitung von Endoparasiten bei Kälbern in Mutterkuhhaltung zu bestimmen und den Einfluss der Haltungsform sowie den genetischen Einfluss des Vaters auf die Parasitosen zu untersuchen. Dazu wurden über einen Zeitraum von 17 Wochen nach der Geburt Extensität und Intensität der Ausscheidung verschiedener Parasitenstadien im Kot untersucht. Die nach ...

  11. Zum psychoanalytischen Verständnis der Harry Potter-Entwicklungsromane

    OpenAIRE

    Subkowski, Peter

    2008-01-01

    In dieser Arbeit wird herausgearbeitet wie Harry Potter nach dem traumatisierenden Verlust beider Eltern und der nachfolgenden Vernachlässigung durch seine Verwandten eine exemplarische psychische Entwicklung zu einem reifen Erwachsenen nimmt. Auf der Basis seiner verinnerlichten frühen Mutterliebe erwirbt er dabei über die Identifikation mit seinem Vater und dem väterlichen Freund Dumbledore zunehmend Selbstvertrauen und gewinnt neue Freunde in seiner Peer-Group. Harry durchläuft nach zahlre...

  12. Buchbesprechungen

    OpenAIRE

    1987-01-01

    Kaiser, A & Oubaid, M (Hrsg) (1986) Deutsche Pädagoginnen der Gegenwart. Köln. Aissen-Crewett, M (1986): Kunsttherapie. Köln. Stork, (Hrsg ) (1986) Das Vaterbild in Kontinuität und Wandlung. Zur Rolle und Bedeutung des Vaters aus psycho-pathologischer Betrachtung und in psychoanalytischer Reflektion. Stuttgart. Fichter, M.M. (1985) Magersucht und Bulimie. Berlin. Krampen, G. (1986) Handlungsleitende Kognitionen von Lehrern. Gottingen. Nissen, G. (Hrsg.) (1986) Psychiatrie...

  13. Helical CT cholangiography with multiplanar reformation: utility in patients with extrahepatic biliary obstruction

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases (seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholagiogram with that of operation or invasive cholangiography. In 100% (36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100% (11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7% (all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level and the cause of biliary obstruction and therefore could replace the invasive cholangiography

  14. Marine alien species in Greek Seas: Additions and amendments by 2010

    Directory of Open Access Journals (Sweden)

    A. ZENETOS

    2012-12-01

    Full Text Available An update of the inventory of alien marine species from the coastal and offshore waters of Greece is presented. Records were compiled based on the existing scientific and grey literature, including the HCMR database of Greek alien species (ELNAIS, technical reports, scientific congresses, academic dissertations, websites, and unpublished/personal observations. 47 species were added to the inventory, including 34 invertebrates, one vertebrate (fish, three plants, eight protozoa, and one cyanobacterium. With the new records, the inventory of alien marine species of Greece now includes a total of 237 species (33 macrophytes, 131 invertebrates, 42 vertebrates, two bacteria and 29 protozoans. Among these, the presence of the gastropodHypselodoris infucata, the bivalvesDendrostrea frons and Septifer forskaliand the chondrichthyan Rhizoprionodon acutus is reported here for the first time. Based on molecular analysis, the occurrence of Bulla arabica in Greek waters is confirmed, and the suggestion that previous records of Bulla ampulla in the Mediterranean should be considered as misidentification of B. arabica is further supported. The acclimitization status of earlier records was revised in the light of new data, and thus the fishEnchelycore anatina, Seriola fasciata andTylerius spinosissimus, the red algaeHypnea cornuta and Sarconema scinaioides, the scyphomedusaCassiopea andromeda, the cephalopodSepioteuthis lessoniana, the nudibranchChromodoris annulata and the bivalvesGastrochaena cymbium andPseudochama corbieri were upgraded from casual records to established populations. The increased rate of introductions of warm water species confirms previous findings, which link the rate of introduction in the eastern Mediterranean to climate change.

  15. Electrosensitive spatial vectors in elasmobranch fishes: implications for source localization.

    Directory of Open Access Journals (Sweden)

    Ariel C Rivera-Vicente

    Full Text Available The electrosense of sharks and rays is used to detect weak dipole-like bioelectric fields of prey, mates and predators, and several models propose a use for the detection of streaming ocean currents and swimming-induced fields for geomagnetic orientation. We assessed pore distributions, canal vectors, complementarity and possible evolutionary divergent functions for ampullary clusters in two sharks, the scalloped hammerhead (Sphyrna lewini and the sandbar shark (Carcharhinus plumbeus, and the brown stingray (Dasyatis lata. Canal projections were determined from measured coordinates of each electrosensory pore and corresponding ampulla relative to the body axis. These species share three ampullary groups: the buccal (BUC, mandibular (MAN and superficial ophthalmic (SO, which is subdivided into anterior (SOa and posterior (SOp in sharks. The stingray also has a hyoid (HYO cluster. The SOp in both sharks contains the longest (most sensitive canals with main projections in the posterior-lateral quadrants of the horizontal plane. In contrast, stingray SO canals are few and short with the posterior-lateral projections subsumed by the HYO. There was strong projection coincidence by BUC and SOp canals in the posterior lateral quadrant of the hammerhead shark, and laterally among the stingray BUC and HYO. The shark SOa and stingray SO and BUC contain short canals located anterior to the mouth for detection of prey at close distance. The MAN canals of all species project in anterior or posterior directions behind the mouth and likely coordinate prey capture. Vertical elevation was greatest in the BUC of the sandbar shark, restricted by the hammerhead cephalofoil and extremely limited in the dorsoventrally flattened stingray. These results are consistent with the functional subunit hypothesis that predicts specialized ampullary functions for processing of weak dipole and geomagnetic induced fields, and provides an anatomical basis for future experiments on

  16. Helical CT defecography; La defecografia con Tomografia Computerizzata spirale

    Energy Technology Data Exchange (ETDEWEB)

    Ferrando, R.; Fiorini, G.; Beghello, A.; Cicio, G.R.; Derchi, L.E.; Consigliere, M.; Resasco, M. [Genua Univ., Genua (Italy). Ist. di Radiologia, Cattedra R; Tornago, S. [Genua Univ. Genua (Italy). 2 Clinica Ortopedica

    1999-11-01

    The purpose of this work is to investigate the possible role of Helical CT defecography in pelvic floor disorders by comparing the results of the investigations with those of conventional defecography. The series analyzed consisted of 90 patients, namely 62 women and 28 men, ranging in age 24-82 years. They were all submitted to conventional defecography, and 18 questionable cases were also studied with Helical CT defecography. The conventional examination was performed during the 4 standard phases of resting, squeezing, Valsalva and straining; it is used a remote-control unit. The parameters for Helical CT defecography were: 5 mm beam collimation, pitch 2, 120 KV, 250 m As and 18-20 degrees gantry inclination to acquire coronal images of the pelvic floor. The rectal ampulla was distended with a bolus of 300 mL nonionic iodinated contrast agent (dilution: 3g/cc). The patient wore a napkin and was seated on the table, except for those who could not hold the position and were thus examined supine. Twenty-second helical scans were performed at rest and during evacuation; multiplanar reconstructions were obtained especially on the sagittal plane for comparison with conventional defecographic images. Coronal Helical CT defecography images permitted to map the perineal floor muscles, while sagittal reconstructions provided information on the ampulla and the levator ani. To conclude, Helical CT defecography performed well in study of pelvic floor disorders and can follow conventional defecography especially in questionable cases. [Italian] Scopo di questo lavoro e' ricercare un ruolo per la defeco-TC con apparecchiatura elicoidale nello studio delle malattie del pavimento pelvico confrontandola con i risultati consolidati della defecografia tradizionale. Si sono visionati 90 pazienti, 62 femmine e 28 maschi, con eta' compresa tra 24 e 82 anni, con defecografia tradizionale; di questi, 18 casi con diagnosi dubbia sono stati studiati anche con defeco-TC spirale

  17. Bicarbonate secretion by rabbit proximal colon.

    Science.gov (United States)

    Sullivan, S K; Smith, P L

    1986-10-01

    Stripped segments of proximal colon (1-6 cm distal to the ampulla caecalis coli) were studied in vitro in Ussing chambers under short-circuit conditions using the pH-stat technique. With glucose and HCO3-CO2 present in the serosal bathing solution only, proximal colon alkalinizes the luminal bathing solution at a rate of 2.1 +/- 0.2 mu eq X h-1 X cm-2 (n = 36). With HCO3-CO2 present in the luminal bathing solution alone, proximal colon does not significantly acidify or alkalinize the serosal bathing solution. Addition of glucose (10 mM) to the luminal bathing solution abolished luminal alkalinization. Removal of HCO3 and CO2 from the serosal bathing solution or replacement of O2 with N2 also abolished luminal alkalinization. Acetazolamide (0.1 mM) added to both bathing solutions did not alter the rate of luminal alkalinization. Ion-replacement studies revealed that the alkalinization process was highly dependent on the presence of Na in the bathing solutions and much less dependent on the presence of Cl. Furthermore, ouabain (0.1 mM) significantly reduced luminal alkalinization. As in rabbit ileum, serosal epinephrine (0.1 mM) did not alter luminal alkalinization but increased serosal alkalinization by a Na-dependent mechanism. These results suggest that luminal alkalinization results from a Na-dependent, active transcellular HCO3 transport process and that a Na-dependent HCO3 absorptive process is activated by adrenergic stimuli. PMID:3766731

  18. Resectable adenocarcinomas in the pancreatic head: the retroperitoneal resection margin is an independent prognostic factor

    Directory of Open Access Journals (Sweden)

    Eide Tor J

    2008-01-01

    Full Text Available Abstract Background The retroperitoneal margin is frequently microscopically tumour positive in non-curative periampullary adenocarcinoma resections. This margin should be evaluated by serial perpendicular sectioning. The aim of the study was to determine whether retroperitoneal margin involvement independently predicts survival after pancreaticoduodenectomy within a framework of standardized assessment of the resected specimens. Methods 114 consecutive macroscopically margin-free periampullary adenocarcinomas were examined according to a prospective standardized protocol for histopathologic evaluation. The retroperitoneal margin was assessed by serial perpendicular sectioning. The periampullary cancer origin (pancreas, ampulla, distal bile duct or duodenum was registered prospectively and reevaluated retrospectively. Associations between histopathologic factors were evaluated by Chi-square test, Fisher's exact test, Kruskal-Wallis test, and Mann-Whitney test, as appropriate. Survival curves were calculated by the Kaplan-Meier method and compared using the log-rank test. Associations between histopathologic factors and survival were also evaluated by unadjusted and adjusted Cox regression analysis, including stepwise variable selection, in order to identify factors that independently predict a poor prognosis after periampullary adenocarcinoma resections. Results Microscopic resection margin involvement (R1 resection was present in 40 tumours, of which 32 involved the retroperitoneal margin. Involvement of the retroperitoneal margin independently predicted a poor prognosis (p = 0.010; HR 1.89; CI 1.16–3.08 after presumed curative (R0 and R1 resection. In microscopically curative (R0 resections (n = 74, pancreatic tumour origin was the only factor that independently predicted a poor prognosis (p Conclusion Serial perpendicular sectioning of the retroperitoneal resection margin demonstrates that tumour involvement of this margin independently

  19. Resectable adenocarcinomas in the pancreatic head: the retroperitoneal resection margin is an independent prognostic factor

    International Nuclear Information System (INIS)

    The retroperitoneal margin is frequently microscopically tumour positive in non-curative periampullary adenocarcinoma resections. This margin should be evaluated by serial perpendicular sectioning. The aim of the study was to determine whether retroperitoneal margin involvement independently predicts survival after pancreaticoduodenectomy within a framework of standardized assessment of the resected specimens. 114 consecutive macroscopically margin-free periampullary adenocarcinomas were examined according to a prospective standardized protocol for histopathologic evaluation. The retroperitoneal margin was assessed by serial perpendicular sectioning. The periampullary cancer origin (pancreas, ampulla, distal bile duct or duodenum) was registered prospectively and reevaluated retrospectively. Associations between histopathologic factors were evaluated by Chi-square test, Fisher's exact test, Kruskal-Wallis test, and Mann-Whitney test, as appropriate. Survival curves were calculated by the Kaplan-Meier method and compared using the log-rank test. Associations between histopathologic factors and survival were also evaluated by unadjusted and adjusted Cox regression analysis, including stepwise variable selection, in order to identify factors that independently predict a poor prognosis after periampullary adenocarcinoma resections. Microscopic resection margin involvement (R1 resection) was present in 40 tumours, of which 32 involved the retroperitoneal margin. Involvement of the retroperitoneal margin independently predicted a poor prognosis (p = 0.010; HR 1.89; CI 1.16–3.08) after presumed curative (R0 and R1) resection. In microscopically curative (R0) resections (n = 74), pancreatic tumour origin was the only factor that independently predicted a poor prognosis (p < 0.001; HR 4.71 for pancreatic versus ampullary; CI 2.13–10.4). Serial perpendicular sectioning of the retroperitoneal resection margin demonstrates that tumour involvement of this margin

  20. Malignant biliary obstruction treated with metallic stents

    International Nuclear Information System (INIS)

    Purpose: The outcome of 33 patients with malignant biliary obstruction treated with metallic stents is presented. Materials and methods: Thirty-eight biliary metallic stents were placed in 33 patients with malignant biliary obstruction. They were 52-71 years old (mean = 61.7); 23 were male and 10 were female. The biliary obstruction was caused by biliary carcinoma (n = 16), pancreatic carcinoma (n = 2), hepatoma (n = 2), metastasis in liver (n = 3) and lymph node metastasis (n = 10). Six types and 38 metallic stents were used. After stentering, 3 cases were treated with intrastent brachytherapy, 7 cases treated with external radiotherapy and 2 patients treated with interventional radiology. Patients were followed for 6-28 months, mean 11 months. Results: Stent placement was successful in all 33 cases. The same time, 4 patients were treated with plastic tube for external drainage only. The successful rate was 90%. Twenty-nine patients were placed in one time, 4 cases began with plastic tube which was replaced with metallic stents after 1-2 weeks. Nine had metallic stents and plastic tube, because of complicated obstruction. The external drainage catheters were removed after 15-200 days. Three patients had stents crossing the ampulla. In 28 cases (84.85%), jaundice was reduced satisfactorily while in 5 cases with complicated biliary obstruction, the result was unsatisfactory. The median survival was 7 months. After stentering, 12 cases were treated with locat chemotherapy, brachytherapy or radiotherapy. The median survival period was 10 months. Conclusion: The metallic stent provides good palliative drainage and is well tolerated by patients. It improves the survival rate when combined with radiotherapy, brachytherapy and chemotherapy in patients with malignant biliary obstruction

  1. Vaterschaft nach der Scheidung – Die Perspektive der Väter Fatherhood After Divorce—The Fathers’ Perspective

    Directory of Open Access Journals (Sweden)

    Michael Matzner

    2004-11-01

    Full Text Available Während man in Deutschland die Situation von allein erziehenden Müttern gut erforscht hat, wandte man sich den von ihren Kindern getrennt lebenden Vätern nur äußerst selten zu. Dies ist mehr als erstaunlich, wenn man sich die in die Millionen gehende Zahl betroffener Väter und Kinder vor Augen führt. Allein im Jahr 2000 wurden 95.000 Ehepaare mit minderjährigen Kindern (146.000 geschieden. Bei Gerhard Amendts empirischer Studie handelt es sich um die erste deutschsprachige, als Buch erschienene wissenschaftliche Veröffentlichung zum Thema „Scheidungsväter“. Amendt beantwortet aus der Perspektive der Väter folgende Fragen: Wie sprechen Väter über ihre Scheidung und wie gehen sie mit den Scheidungsfolgen um? Wie verbringen sie die Zeit mit ihren Kindern? Warum brechen manche von ihnen den Kontakt zu den Kindern ab? Der neue Zugang zum Thema Scheidung bzw. Trennung über die Person des Vaters war längst überfällig und bringt neue Perspektiven und Erkenntnisse in die wissenschaftliche Debatte.While the situation of single mothers has been duly researched in Germany, very rarely has attention been given to fathers who live separated from their children. This is truly remarkable when one surveys the number, rising into the millions, of fathers and children affected. In the year 2000 alone, 95,000 married couples with dependant children (146,000 divorced. Gerhard Amendt’s empirical study can be seen as the first German-language, book length, scientific publication on “divorced fathers.” Arendt answers the following questions from the perspective of the fathers: How do fathers talk about divorce and how do they deal with the consequences of divorce? How do they spend time with their children? Why do some of them cut off contact to their children? This new access to the issues of divorce or separation with regard to the father was long overdue and brings new perspectives and realizations to the scientific debate.

  2. Überwachen und Strafen : Armut und Ausgrenzung in Büchners "Woyzeck"

    OpenAIRE

    Reinhard, Nadja

    2013-01-01

    In Georg Büchners Jubiläumsjahr seines 200. Geburtstages sind die 1824-1826 in juristischen Fachzeitschriften publizierten, inzwischen längst vergessenen Gutachten von Georg Büchners Vater Ernst erneut unter dem Titel "Versuchter Selbstmord mit Stecknadeln" veröffentlicht worden. Die depressive Patientin des titelgebenden Berichts gab an, zunächst 30 und später dann 300 Stecknadeln in suizidaler Absicht verschluckt und unbeeinträchtigt wieder ausgeschieden zu haben. Ernst Büchner hielt das ni...

  3. Männlichkeiten : the dark continent (?)

    OpenAIRE

    2008-01-01

    Inhalt: Männlichkeit(en) erforschen. Eine Einführung in das Lehrforschungsprojekt (Sylka Scholz) „Diese Aufgabe ist nun mal das Wichtigste, was ich mache: der Beruf“. Die Bedeutung von Berufsarbeit für die Männlichkeitskonstruktionen ostdeutscher Männer (Manuela Salzwedel, Sylka Scholz) Wie der Vater, so der Sohn? Der Einfluss der Herkunftsfamilien auf berufliche, familiäre und persönliche Orientierungen und Werdegänge der Söhne (Alexandra Amanda Ahammer, Ina Heise, Christine Stamm) Das schwa...

  4. Harry Potter - das Trauma als Motor der psychischen Entwicklung

    OpenAIRE

    Subkowski, Peter

    2004-01-01

    In den Harry Potter-Bänden wird exemplarisch die psychische Entwicklung eines traumatisierten Jungen von der frühen verinnerlichten Mutterliebe über das massive Verlusttrauma zur Zeit der analen Phase und der kumulativen Traumatisierung durch die Vernachlässigung und das Gequältwerden bei seinen Verwandten dargestellt. Über die Identifikation mit seinem Vater und anderen Ersatzvätern erwirbt sich Harry Potter schließlich Selbstvertrauen und gewinnt neue Freunde. Harry durchläuft dab...

  5. Sinfonia

    OpenAIRE

    Lotti, Antonio

    2011-01-01

    Antonio Lotti (1667 – 1740) gehörte zu den angesehensten Musikern seiner Zeit und wurde deshalb vom sächsischen Kurprinzen mit Einverständnis seines Vaters für drei Jahre nach Dresden verpflichtet. Lotti hatte den Auftrag, mit einem italienischen Ensemble italienische Opern in Dresden aufzuführen. August der Starke erteilte am 23. August 1718 von Warschau aus die schriftliche Ordre an den Grafen Wackerbarth, ein neues Opernhaus am Taschenberg zu errichten. Es wurde am 3. September 1719 mit „G...

  6. Sinfonia

    OpenAIRE

    Lotti, Antonio

    2014-01-01

    Antonio Lotti (1667 – 1740) gehörte zu den angesehensten Musikern seiner Zeit und wurde deshalb vom sächsischen Kurprinzen mit Einverständnis seines Vaters für drei Jahre nach Dresden verpflichtet. Lotti hatte den Auftrag, mit einem italienischen Ensemble italienische Opern in Dresden aufzuführen. August der Starke erteilte am 23. August 1718 von Warschau aus die schriftliche Ordre an den Grafen Wackerbarth, ein neues Opernhaus am Taschenberg zu errichten. Es wurde am 3. September 1719 mit „G...

  7. Postmortem perianal findings in children.

    Science.gov (United States)

    McCann, J; Reay, D; Siebert, J; Stephens, B G; Wirtz, S

    1996-12-01

    The postmortem finding of anal dilation or an exposed pectinate line in children who have died under suspicious circumstances continues to raise the concern of possible sexual abuse. The following multicenter, collaborative study was designed to help address that question. Sixty-five subjects, ranging in age from birth to 17 years, were autopsied at three different sites. A standard protocol along with 35-mm cameras were used to record the results. Thirty-eight (58%) subjects were boys, and 27 (42%) were girls. Forty-two (65%) were white, 10 (15%) African-American, five (8%) Asian, three (5%) white Hispanic and five (8%) other. Fifty-seven (88%) were in Tanner stage I of secondary sexual development. Thirty-four (52%) died of natural causes, 26 (40%) from accidental injuries, three (5%) from other causes, and four (6%) as a result of a homicide. Forty-eight subjects (74%) had some dilation of the anal sphincters. In 21 children (32%), the entire anal canal, including the rectal ampulla, could be visualized. In another 21 (32%) subjects, the pectinate line was exposed. Only the outer portion of the anal canal opened in six children (10%), whereas 17 (26%) had no dilatation of the anus. Anal laxity led to flattened skin folds in 50 (77%), a shallow anal canal in 40 (62%), the exposure of both the pectinate line in 38 (59%), and the anal mucosa in 24 (37%). Venous congestion was present in 14 (22%), venous pooling in three (5%), erythema in six (9%), and increased pigmentation in eight (12%). Funneling was found in two (3%). Blood was present in three (5%), and an abrasion was discovered in one (2%). No fissures, lacerations, hemorrhoids, or scars were found in any of the children. Anal orifice size varied with the age of the child, the amount of traction applied to the buttocks, and a history of a CNS injury at the time of death. It is suggested, finally, that anal dilatation alone cannot be used a marker for prior sexual abuse and the exposure of the pectinate line

  8. Falciform ligament abscess from left sided portal pyaemia following malignant obstructive cholangitis

    Directory of Open Access Journals (Sweden)

    Warren Leigh R

    2012-12-01

    Full Text Available Abstract Abscess formation of the falciform ligament is incredibly rare and perplexing when encountered for the first time. It is reported to occur in the setting of cholecystitis and cholangitis, but the pathophysiology is poorly understood. In this case report, we present a 73-year-old man with falciform ligament abscess following cholangitis from an obstructive ampullary carcinoma. The patient was referred to the Royal Adelaide Hospital from a country hospital, with progressive jaundice, anorexia and nausea. Prior to transfer, he deteriorated with cholangitis, dehydration and renal failure. On arrival, his abdomen was exquisitely tender along the course of the falciform ligament. His blood tests revealed an elevated white cell count of 14.9 x 103/μl, bilirubin of 291μmol/l and creatinine of 347 μmol/l. His CA 19-9 was markedly elevated at 35,000 kU/l. A non-contrast computed tomography (CT demonstrated gross biliary dilatation and a collection tracking along the path of the falciform ligament to the umbilicus. The patient was commenced on intravenous antibiotics and underwent an urgent endoscopic retrograde cholangiopancreatogram (ERCP with sphincterotomy and biliary stent drainage. Cholangiogram revealed a grossly dilated biliary tree, with abrupt transition at the ampulla, which on biopsy confirmed an obstructing ampullary carcinoma. Following ERCP, his jaundice and abdominal tenderness resolved. He was optimized over 4 weeks for an elective pancreaticoduodenectomy. At operation, we found abscess transformation of the falciform ligament. Copious amounts of pus and necrotic material was drained. Part of the round ligament was resected along the undersurface of the liver. Histology showed that there was prominent histiocytic inflammation with granular acellular eosinophilic components. The patient recovered slowly but uneventfully. A contrast CT scan undertaken 2 weeks post-operatively (approximately 7 weeks after the initial CT revealed

  9. Malignant biliary obstruction: treatment with interventional radiology

    Institute of Scientific and Technical Information of China (English)

    翟仁友; 钱晓军; 戴定可; 于平

    2003-01-01

    Objective To evaluate the method of palliative drainage by means of metallic indwelling stents or plastic tubes for patients with malignant biliary obstruction. Methods From January 1995 to Febuary 2001, 243 consecutive patients (161 men and 82 women; aged 26-91 years, mean of 61.3 years) with malignant biliary obstruction were treated with transhepatic placement of metallic stents and/or plastic tubes. Among them, 47 patients had pancreatic carcinoma, 98 cholangiocarcinoma, 28 metastatic carcinoma and 60 hepatic carcinoma. 169 stents of nine types were used in this series. After stenting, 47 patients were treated for local tumors. Procedure- and device-related complications were recorded. Patient survival and stent patency rates were calculated with Kaplan-Meier survival analysis.Results One hundred and three patients underwent successfully stent placement for the first time. Others had their stents installed 1-2 weeks after catheterization. Stents were used in 132 patients. Ninety-five patients were treated with a single stent. Seventeen patients had two stents installed for bilateral drainage,20 patients had two stents installed from top to bottom to create stenting of adequate ength, and 12 patients had stents placed across the ampulla. The 2-month mortality rate was 8.64% (21/243). Major complications occurred in two patients (0.8%, 2/243). Minor complications included self-limited bleeding into the drainage tubes and fever. The average patency of the initial stent was 7.5 months and average survival was 9 months. Thirteen patients received brachytherapy in their stents, 15 extra radiation therapy, and 19 intra-arterial infusion chemotherapy. The 47 patients treated for local tumors had an average survival of 11.3 months (log rank 32.8,P<0.001) with an average patency of 9.7 months(log rank 4.7,P<0.05).Conclusion Percutaneous transhepatic bile drainage as a palliative procedure is well tolerated by patients. After stenting, treatment for local tumor may

  10. Photodynamic therapy for gastrointestinal tumors using three a photosensitizers - ALA induced PPIX, Photofrin and MTHPC. A pilot study

    International Nuclear Information System (INIS)

    Photodynamic therapy (PDT) produces localized necrosis with light after prior administration of a photosensitizing drug. As PDT lesions in the gastrointestinal tract heal well, the technique is suitable for repeated endoscopic use. In this study we used PDT to treat benign and malignant gastrointestinal tumors in esophagus, duodenum and rectum in 22 patients, who refused or were not suitable for surgery. Patients were sensitized with 0.15 mg/kg of body weight with mesotetrahydroxyphenylchlorin i.v. m-THPc (2 patients), with 2.0 mg/kg Photofrin i.v. (4 patients) or 60 mg/kg 5-aminolevulinic acid orally ALA (which is converted in vivo to active derivate protoporphyrin IX-PPIX) in fractionated doses (16 patients). Laser treatment was performed 2 days after Photofrin, 2 and 4 days after mTHPc and 4 hours after ALA, using a metal vapour laser (628 nm, 50-150 J/cm2 for ALA and Photofrin, 650 nm and 10-15 J/cm2 for mTHPc). Using ALA, the necrosis was only superficial (up to 1.8 mm depth). Four patients treated with Photofrin showed deeper necrosis, in one case of 8 mm colon cancer complete response, in three cases 1-1.5 cm adenomatous polyps involving the ampulla Vateri 50% longer term reduction in size - seen endoscopically. Two patients with rectal villous adenomas treated with mTHPc showed 60-80% reduction in size (observed endoscopically) within few days after PDT, with better effects for treatment carried out 4 rather than 2 days after the sensitization. In all patients the healing was without any complications. Photofrin and mTHPc work better, but cause cutaneous photosensitivity lasting 12 and 5 weeks, respectively. Better results with ALA are possible when using higher drug doses or modified light dosimetry. PDT is a promising treatment for small localized tumors in patients unsuitable for surgery, but further work is required to optimize the treatment conditions. (authors)

  11. 体外受精取卵日手淫取精失败的取精方法%Research on methods to obtain sperm after failing to obtain sperm by masturbation in oocyte retrieval for in vitro fertilization

    Institute of Scientific and Technical Information of China (English)

    蒲军; 丘彦

    2011-01-01

    目的 研究体外受精取卵日手淫取精失败的取精方法.方法 对120例体外受精取卵日手淫取精失败的临床资料进行回顾分析.结果 120例患者分别采用药物治疗法、性交法、阴茎头震荡刺激法、经直肠输精管壶腹和精囊及前列腺按摩法、经皮穿刺附睾睾丸法5种方法作为手淫取精失败的替代取精法,120例患者全部取精成功.结论 性交法、经皮穿刺附睾睾丸取精法是较满意的两种替代方法.提前冷冻精子是解决体外受精取卵日手淫取精失败的最佳方案.%Objective To research the methods to obtain sperm after failing to obtain sperm by masturbation in oocyte retrieval for in vitro fertilization. Methods To retrospectively analyse the clinical data of 120 patients failing to obtain sperm by masturbation in oocyte retrieval for in vitro fertilization. Results 120 patients adopted 5 methods respectively to obtain sperm for substitution,which including drug treatment,coitus,shaking and stimulating balanus,pressing ampulla of deferent duct and seminal vesicle and prostate per rectum, percutaneous epididymal and testicular sperm aspiration. Conclusion There are two frequently used methods to obtain sperm by coitus and percutaneous epididymal and testicular sperm aspiration for substitution. It is the optimal method to freeze sperm in advance to deal with one patient fail to obtain sperm by masturbation in oocyte retrieval for in vitro fertilization.

  12. Preventing Post-ERCP Pancreatitis: Where Are We?

    Directory of Open Access Journals (Sweden)

    Testoni PA

    2003-01-01

    Full Text Available Acute pancreatitis still represents the most common complication after procedures involving Vater's papilla; the reported incidence of this complication varies from less than 1% up to 40%. Attempts at preventing post-ERCP pancreatitis have been carried out using technical measures, pharmacological prophylaxis, or patient selection. Balloon sphincter of Oddi dilatation, difficult papillary cannulation, pancreatic sphincterotomy and multiple pancreatic duct injections have been found to be risk factors for postprocedure pancreatitis. Therefore, technique-related prevention of post-ERCP pancreatitis includes careful pancreatic duct injection, avoiding cannulation trauma, and maintaining adequate pancreatic drainage after the ERCP procedure. Pancreatic stent placement has been shown to be the most effective technique-related prevention of postprocedure pancreatitis. Apart from technique-related risk factors, operator experience also seems to be a potential risk-factor for post-ERCP/ES complications. The experience of the endoscopist rather than other patient- or technique-related conditions could probably constitute the major risk factor for postprocedure pancreatitis. Pharmacological prevention of pancreatitis after ERCP or sphincterotomy has been the topic of several investigations in recent years but still remains a debated question. Pharmacological prevention has been mainly aimed at either reducing the amount of intrapancreatic enzymes, preventing intra-cellular co-localization of enzymes and lysosomal hydrolases or blocking some steps of the enzyme-activated inflammatory cascade. Somatostatin, octreotide, gabexate mesilate and, more recently, recombinant interleukin-10 have been the most investigated drugs. Somatostatin, gabexate mesilate and recombinant interleukin-10, but not octreotide, have been found to be able to prevent post-ERCP pancreatitis in non-selected cases; however, a strategy of routine pharmacological prophylaxis in all

  13. Laryngo-tracheo-oesophageal clefts

    Directory of Open Access Journals (Sweden)

    Leboulanger Nicolas

    2011-12-01

    Full Text Available Abstract A laryngo-tracheo-esophageal cleft (LC is a congenital malformation characterized by an abnormal, posterior, sagittal communication between the larynx and the pharynx, possibly extending downward between the trachea and the esophagus. The estimated annual incidence of LC is 1/10,000 to 1/20,000 live births, accounting for 0.2% to 1.5% of congenital malformations of the larynx. These incidence rates may however be underestimated due to difficulty in diagnosing minor forms and a high mortality rate in severe forms. A slightly higher incidence has been reported in boys than in girls. No specific geographic distribution has been found. Depending on the severity of the malformation, patients may present with stridor, hoarse cry, swallowing difficulties, aspirations, cough, dyspnea and cyanosis through to early respiratory distress. Five types of laryngo-tracheo-esophageal cleft have been described based on the downward extension of the cleft, which typically correlates with the severity of symptoms: Type 0 laryngo-tracheo-esophageal cleft to Type 4 laryngo-tracheo-esophageal cleft. LC is often associated with other congenital abnormalities/anomalies (16% to 68%, mainly involving the gastro-intestinal tract, which include laryngomalacia, tracheo-bronchial dyskinesia, tracheo-bronchomalacia (mostly in types 3 and 4, and gastro-esophageal reflux disease (GERD. The syndromes most frequently associated with an LC are Opitz/BBB syndrome, Pallister Hall syndrome, VACTERL/VATER association, and CHARGE syndrome. Laryngeal clefts result from failure of fusion of the posterior cricoid lamina and abnormal development of the tracheo-esophageal septum. The causes of the embryological developmental anomalies leading to LC are not known but are thought to be multifactorial. LC appears to be mostly sporadic although some familial cases with suspected autosomal dominant transmission have been reported. The age of diagnosis depends mainly on the severity of

  14. Franz Kafka: Raízes

    Directory of Open Access Journals (Sweden)

    George Bernard Sperber

    1997-11-01

    Full Text Available Der Text versucht den Wurzeln des Schaffens Franz Kafkas nachzugehen, und sucht diese in verschiedenen, konzentrischen und exzentrischen Kreisen. Ein erster un enger Kreis ist der der Familie Kafkas, mit der vorherrschenden Figur des autoritären Vaters. Ein zweiter und weiterer Kreis ist der des Prager Judentums, mit dem ihm auferlegten Außenseitertum, das auch den dritten und noch breiteren Kreis bedingt, und zwar den der deutschsprachigen Bevölkerung Prags am Anfang des Jahrhunderts. Die aus diesen Kreisen sprießenden Wurzeln bedingen das Außenseitertum Kafkas, befähigen ihn aber auch die Rolle des Dichters als Propheten zu übernehmen.

  15. Tratamiento de la coledocolitiasis mediante dilatación con balón de papila. Estudio clínico y funcional manométrico.

    OpenAIRE

    Cisneros Reig, Ignacio

    2008-01-01

    RESUMEN En la actualidad no existe un consenso en el tratamiento de la coledocolitiasis. Durante los últimos años, el avance de las técnicas mínimamente invasivas como la cirugía laparoscópica y la radiología intervencionista ha hecho que sean varias las opciones terapéuticas en el manejo de esta patología. Entre las opciones posibles se encuentra la dilatación con balón de la papila de Vater y el empuje de los cálculos a duodeno. Esta técnica puede ser aplicada a través diferentes abordaj...

  16. 经会阴二维超声对产后女性盆底功能的初步筛查%Preliminary Screening for Pelvic Floor Function in Postpartum Women with the Two-dimensional Transperineal Ultrasonography

    Institute of Scientific and Technical Information of China (English)

    杨粟芬; 赵倩

    2013-01-01

    目的 利用经会阴二维超声对自然分娩女性产后100例常规体检观察膀胱颈、子宫颈及直肠、肛管,探讨经会阴超声初步筛查产后女性盆底功能的价值.方法 对行经阴道超声检查的女性,将腔内探头置于阴道下段及会阴处,观察平静呼吸及乏氏(Valsalva)动作下膀胱颈及子宫颈活动度及直肠形态变化,观察肛管形态及结构,利用彩色多普勒观察肛门括约肌血流分布情况.结果 100例女性经会阴处观察均可清晰显示膀胱颈及宫颈位移、尿道膀胱颈角度、直肠壶腹部活动及肛管回声,并可显示肛管内的血流分布.结论 经会阴二维超声对产后女性盆底的观察可初步筛查产后压力性尿失禁、直肠脱垂及膨出、肛门括约肌损伤,操作简单,具备临床实用价值.%Objective Observation of bladder necks, cervices, rectums and anal canals was made through routine physical examinations of 100 women who had undergone the spontaneous delivery with the two-dimensional transperineal ultrasonography. To investigate the significance of preliminary screening for pelvic floor function in postpartum women with the two-dimensional transperineal ultrasonography. Methods Endo-probe was put in lower areas of vagina and perineum regions of women for transvaginal ultrasound examinations to observe activity of cervix vesicae and cervix uterus, morphology change of recta, and the form and structure of anal tubes under eupnea and Valsalva. Blood distribution in sphincter ani was also observed with color Doppler. Results Displacement of cervix vesicae and cervix uterus, angles of cervix transurethral vesicae, activity in rectal ampulla and anal echo were showed clearly in transperineal examinations of 100 women. Blood distribution in anal tubes can also be revealed well. Conclusion Postpartum pelvic floor observation by transperineal two-dimensional ultrasonography can initially screen postpartum stress urinary incontinence

  17. Uroboros : [aus "Uroboros"] : [luuletused] / Ene Mihkelson ; tlk. Irja Grönholm ja Gisbert Jänicke

    Index Scriptorium Estoniae

    Mihkelson, Ene, 1944-

    2006-01-01

    Sisu: Uroboros : "In der Nacht fragt heimlich jemand Wie heisst du..." ; "Am Meer stand ein Mann mit einer Sense..." ; "An dem Tag als es Kugeln regnete..." ; "Zum Zeitvertrieb ersteigerte ich mir auf einer Auktion ein paar..." ; "Sie hat sich mit der Zeit eingelassen und daraus..." ; Das Feld ; "Mutter ist wieder bei mir obgleich..." ; "Wir waren ein Mädchen Wir redeten..." ; "Als ich vier Jahre alt wurde Da wurde so viel..." ; "Wer ist dein Vater Der Fremde aus der Ferne..." ; "Das letzte Wort Das letzte Das letzte Das allein...". Orig.: Uroboros : "Öö aegu keegi küsib sala Mis su nimi on..." ; "Mere ees seisis vikatiga mees..." ; "Sel päeval kui sadas kuulivihma..." ; "Ajaviiteks ostsin enampakkumisel sõpru..." ; "Ta ajaga läinud on sohki ja sellest..." ; Põld ; "Mu ema on jälle mu juures kuigi..." ; "Meid oli üks türduk Me rääkisime..." ; "Kui olin saanud neljaseks Nii väga kiitis..." ; "Kes on su isa Kaugelt tulnud võõras..." ; "Viimast sõna Viimast Viimast Ainu..."

  18. Arzt und Hobby-Astronom in stürmischen Zeiten Der Büchernachlass des Doktor Johannes Häringshauser, Viertelsmedicus in Mistelbach (1630-1641) in der Melker Stiftsbibliothek.

    Science.gov (United States)

    Davison, Giles; Glaßner, Gottfried

    2009-06-01

    Auf der Suche nach astronomischer Literatur stieß Giles Davison in der Melker Stiftsbibliothek auf den Namen "Doctor Johannes Häringshauser“ als Besitzer seltener und interessanter astronomischer Werke u.a. von Johannes Regiomontan, Georg von Peuerbach, Michael Mästlin, Johannes Kepler und Daniel Sennert. Weitere in den Jahren 2007-2009 durchgeführte Nachforschungen ergaben, dass es sich um den von 1630-1641 in Mistelbach, Niederösterreich, als Landschaftsarzt tätigen Vater des Melker Konventualen und Bibliothekars Sigismund Häringshauser (1631-1698) handelt. Er wurde 1603 als Sohn des aus Magdeburg stammenden Apothekers Johannes Häringshauser geboren und starb 1642 in Mistelbach. Johannes Häringshauser Sen. bekleidete von 1613-1640 eine Reihe wichtiger Ämter in der Wiener Stadtregierung und starb 1647. Der Studienaufenthalt von Dr. Johannes Häringshauser Jun. in Padua (1624-1626) dürfte das Interesse für Astronomie geweckt haben, das sich in seiner in die Bestände der Melker Stiftsbibliothek eingegangenen Privatbibliothek widerspiegelt. Der Großteil der 10 dem Fachbereich der Astronomie und Astrologie zuzuweisenden Titel wurde von ihm in den Jahren 1636 und 1637 erworben.

  19. Vaterschaft nach der Scheidung – Die Perspektive der Väter

    Directory of Open Access Journals (Sweden)

    Michael Matzner

    2004-11-01

    Full Text Available Während man in Deutschland die Situation von allein erziehenden Müttern gut erforscht hat, wandte man sich den von ihren Kindern getrennt lebenden Vätern nur äußerst selten zu. Dies ist mehr als erstaunlich, wenn man sich die in die Millionen gehende Zahl betroffener Väter und Kinder vor Augen führt. Allein im Jahr 2000 wurden 95.000 Ehepaare mit minderjährigen Kindern (146.000 geschieden. Bei Gerhard Amendts empirischer Studie handelt es sich um die erste deutschsprachige, als Buch erschienene wissenschaftliche Veröffentlichung zum Thema „Scheidungsväter“. Amendt beantwortet aus der Perspektive der Väter folgende Fragen: Wie sprechen Väter über ihre Scheidung und wie gehen sie mit den Scheidungsfolgen um? Wie verbringen sie die Zeit mit ihren Kindern? Warum brechen manche von ihnen den Kontakt zu den Kindern ab? Der neue Zugang zum Thema Scheidung bzw. Trennung über die Person des Vaters war längst überfällig und bringt neue Perspektiven und Erkenntnisse in die wissenschaftliche Debatte.

  20. Die Verwendung von fremden Samen im Rahmen der Reproduktionsmedizin

    Directory of Open Access Journals (Sweden)

    Kentenich H

    2007-01-01

    Full Text Available Nach der "Richtlinie über künstliche Befruchtung" der Bundesärztekammer aus dem Jahr 1998 war eine Behandlung mit Spendersamen bei der Behandlung mittels In-vitro-Fertilisation (IVF und intrazytoplasmatischer Spermieninjektion (ICSI auf Antrag möglich, wenn eine Kommission bei der Landesärztekammer dem zugestimmt hatte. Da die grundlegende juristische und psychosoziale Problematik der Verwendung von Spendersamen bei der Insemination und bei der IVF/ICSI-Behandlung gleich ist, hat die Bundesärztekammer in ihren Richtlinien 2006 die Verwendung von fremdem Sperma näher geregelt. Es ergeben sich Auswirkungen für den Samenspender, das Paar und den behandelnden Arzt. Der Arzt muß sich über die rechtlichen Rahmenbedingungen informieren, der Samenspender und das Paar müssen über alle medizinischen, psychosozialen und rechtlichen Konsequenzen informiert, aufgeklärt und beraten werden. Die Identität des Samenspenders muß dokumentiert werden, damit das Kind später den genetischen Vater auf Wunsch identifizieren kann. Eine Behandlung mit Spendersamen bei der alleinstehenden Frau und dem homosexuellen weiblichen Paar scheint nach den Richtlinien der Bundesärztekammer nicht möglich.

  1. 应激性心肌病诊治探讨

    Institute of Scientific and Technical Information of China (English)

    柴文慧; 陈海娟

    2009-01-01

    应激性心肌病(stress cardiomyopathy)是一种由精神刺激所诱发的以左心室不全为主要表现的,伴有影像学与心电图呈一过性改变的一组症候群。该病2006年WHO心肌病指南中分为一种特殊的心肌病;该疾病曾有多种名称,包括:短暂性左心室心尖部气球样变(transient left ventricular apical ballooning),伤心综合征(broker heart syndrome),壶腹心肌病(ampulla cardiomyopathy),应激性心肌病(stress cardiomyopathy)等。此病在临床上与急性心梗非常相似,故认识此病非常重要。

  2. Wandel in der Implementation des Deutschen Embryonenschutzgesetzes

    Directory of Open Access Journals (Sweden)

    Bals-Pratsch M

    2010-01-01

    Full Text Available Das Embryonenschutzgesetz (ESchG bildet seit 1990 die rechtliche Grundlage für die Fortpflanzungmedizin in Deutschland. Die Bundesärztekammer (BÄK hat aus diesem Gesetz (§ 1 Abs. 1 Nr. 3 und 5 die sogenannte Dreierregel herausgelesen. Damit hat sie zwar durch die Begrenzung des Transfers auf 3 Embryonen den Gesundheitsschutz der Frau hervorgehoben, gleichzeitig aber die reproduktiven Rechte der Frau eingeschränkt. Da die Fortschritte in der Reproduktionsmedizin, wie die Blastozystenkultur mit selektivem Transfer oder die Präimplantationsdiagnostik (PID, bei einer konservativen Lesart des ESchG in Deutschland nicht im Interesse der Kinderwunschpaare umgesetzt werden konnten, ist die Diskussion um ein umfassendes Fortpflanzungsmedizingesetz entstanden. Zudem ist die konservative Interpretation des ESchG teilweise durch das in der Länderhoheit befindliche Berufsrecht festgeschrieben worden, falls die entsprechenden Landesärztekammern (LÄK die Richtlinie der BÄK ratifiziert hatten. Gesetze sind aber so formuliert, dass „technische Veränderungen“ (z. B. Blastozystentransfer keine Neukodifikation erfordern, sondern andere Sachverhalte zu anderen rechtlichen Bewertungen führen. Der neue Kommentar des ESchG sowie aktuelle Gerichtsurteile zur Kultivierung von Eizellen und zur Trophoblastbiopsie als frühe Form der Pränataldiagnostik (PND bestätigen die im Gesetz vorhandenen Auslegungsspielräume. – Die Erbrechts- und Unterhaltsansprüche eines Kindes gegenüber seinem genetischen Vater bei der Samenspende können außerhalb eines neuen Fortpflanzungsmedizingesetzes geregelt werden. Das Verbot der Eizellspende und Leihmutterschaft folgen aus dem rechtlichen Status der „Mutter“ eines Kindes als der Frau, die das Kind geboren hat. Mit diesem Hintergrund greift das ESchG mit dem Verbot der Eizellspende in das Reproduktionsrecht von Frauen ein. Abgesehen von diesem Verbot ist mit der von vielen Reproduktionsmedizinern und auch von den

  3. Luise Millerin und Ne'mat - die weiblichen Hauptfiguren von "Kabale und Liebe" und "Afwah wa Araneb" im Vergleich

    Directory of Open Access Journals (Sweden)

    Rascha Muhammad ‘OrabiRasch ‘Abdel ‘Aziz Muhammad ‘Orabi

    2013-10-01

    Full Text Available Dieser Beitrag  verfolgt  das Ziel, die weibliche Hauptfigur im deutschen Drama "Kabale und Liebe" und im arabischen Drama "Afwah wa Araneb" zu charakterisieren und miteinander zu vergleichen. Dabei werden die inneren sowie die zwischenmenschlichen Konflikte dieser beiden Frauen aufgezeigt und verglichen. Es macht sich bemerkbar, wie ähnlich die Schicksale der beiden weiblichen Hauptfiguren sind, die nach den Wertvorstellungen des Vaters oder des Familienoberhauptes leben müssen. Sie können als Musterbeispiele für die damalige Männerherrschaft angesehen werden. Männerherrschaft und Ungleichwertigkeit der Geschlechter - ein Thema, das unser modernes Leben noch immer beschäftigt. Darüber hinaus möchte ich beweisen, dass sich ein vollständiges Bild nur dann ergibt, wenn bei der Betrachtung alle Komponenten, politische, soziologische, psychologische sowie theologische, als Einheit berücksichtigt werden, wobei Luise und Ne'mat jeweils im Blickpunkt stehen sollen. Die gesellschaftliche Funktion des Dramas besteht in der Änderung der Gesellschaft durch Literatur und Drama. Die Untersuchung geht davon aus, dass beide Dramen als literarische Unterstützung der Emanzipation der bürgerlichen oder bäuerlichen Frau betrachtet werden sollen. Beide Dramen passen in jede Zeit. Unseren Jugendlichen sind die damaligen Probleme heute nicht fremd. Zu Zeiten Luises und Ne'mats hofft die junge Generation auf das Ende des Absolutismus, die Auflösung der Standesunterschiede und die Verwirklichung der sozialen Gerechtigkeit. Im arabischen Frühling spielen die Jugendlichen in Ägypten die Hauptrolle bei dem Sturz des diktatorischen Regimes von Husni Mubarak. Sie fordern auch Freiheit, Würde und soziale Gerechtigkeit. Diese Generationenkonflikte gibt es schon immer und wird es immer geben. Sie sind eine wesentliche Voraussetzung für Veränderung und Entwicklung. Schlagwörter: Interkulturalität, Komparatistik, "Kabale und Liebe", "Afwah wa Araneb

  4. Ludwig Feuerbach : la religion de l’Homme

    Directory of Open Access Journals (Sweden)

    Anne Durand

    2009-12-01

    Full Text Available Comment le père de l’athéisme moderne peut-il être en même temps celui qui réaffirme en l’Homme la religion comme conscience de soi ? Il s’agit de montrer en quoi Feuerbach, loin de nier toute réalité à la religion, ne remet en cause que l’existence d’un Dieu personnel et l’immortalité de l’Homme. En effet, il affirme que la religion est propre à l’essence humaine. La philosophie a contrairement à la théologie, pour objet de dévoiler le fondement anthropologique de la religion, c’est-à-dire, l’identité entre la conscience de Dieu et la conscience de soi de l’Homme. L’Homme prend alors conscience de son essence, c’est-à-dire de son appartenance à la communauté humaine. Feuerbach tente donc de dépasser tant l’abstraction théologique que celle de l’individu isolé, unique, pensé par Stirner. L’essence infinie de l’Homme s’exprime socialement au sein d’une communauté humaine et c’est ce qui rend possible une praxis sociale. Ce passage de la croyance en un Dieu personnel à la praxis sociale nécessite de s’interroger sur l’essence de la religion ainsi que sur le caractère anthropologique de la philosophie de Feuerbach.Ludwig Feuerbach (1804-1872, der eine Zeit lang Hegels Schüler und dann Anführer der jungen Hegelianer war, gilt gewöhnlich als Vater des neuzeitlichen Atheismus. Seit der Veröffentlichung der Gedanken über Tod und Unsterblichkeit behauptet Feuerbach die Nichtexistenz Gottes und die Unsterblichkeit des Inviduums. Auch wenn Feuerbach sein Denken in der Diesseitigkeit verankert, hält er daran fest, dass es eine Religion im Sinne von religio gibt. Es handelt sich dabei um eine Religion, die nicht Zugehörigkeit zu einer Kirche ist, sondern Respekt der Menschheit. Religion wird Selbstbewusstsein: Das Individuum ist sich seines unendlichen Wesens als Mensch bewusst. Dieses Paradox gilt es aufzuklären.

  5. Analysis of quality of ....

    OpenAIRE

    Gholamreza Bordbar; Fatemah Shakeri

    2012-01-01

    Selection and appointment of best people in any job is an important decision. In this regard, management of the universities is one of the concerning subjects and respectively, head of departments are also important due to their influence on the performance of faculties. In this paper the quality of competency based selection and appointment of head of departments has been studied considering five dimensions of professional knowledge intellectual and behavioral skills personality characterist...

  6. Analysis of quality of ....

    Directory of Open Access Journals (Sweden)

    Gholamreza Bordbar

    2012-03-01

    Full Text Available Selection and appointment of best people in any job is an important decision. In this regard, management of the universities is one of the concerning subjects and respectively, head of departments are also important due to their influence on the performance of faculties. In this paper the quality of competency based selection and appointment of head of departments has been studied considering five dimensions of professional knowledge intellectual and behavioral skills personality characteristics attitude, insight and honor of people and the gap between present and desired status has been analyzed according to the viewpoints of faculty members of Yazd University. The data has been collected through literature review, interview and questionnaire. The validity of designed questionnaire has been approved by a group of experts. 175 questionnaires have been distributed among faculty members of 30 departments of Yazd University in 2009, out of which, 122 have been completed and returned. The reliability of questionnaire has been computed using Cronbach's alpha as 0.97. The findings imply that at the current status, the dimensions of "personality characteristics" and "professional knowledge" are of most and least concern, respectively. The findings of calculating weighted negative gap in departments imply that less consideration of personality characteristics is the major reason for selection of incompetent head of departments. By ranking elements of this dimension using TOPSIS technique, it has been found that concentration on factors such as challenging, age, resistance against pressure, freshness and sociality and patience could further improve the current status. Therefore, with a proper planning for quality improvement of the elements of the mentioned dimensions, the probable problems and obstacles towards desirable performance of faculties can be rapidly removed.     Keywords : Quality, Competency based selection, Head of department, Yazd

  7. Evolution of definition of competitiveness of products

    Directory of Open Access Journals (Sweden)

    I.A. Aleksandrov

    2010-12-01

    Full Text Available Investigational evolution of definition of competitiveness of products, certainly the stages of his development. Classification of existent approaches is improved in relation to the estimation of competitiveness of products, found out the sources of competitive edges from position of consumer cost, marginal utility, differentiation of products, demand and supply, key competense, marketing categories and ecological approach.

  8. Study of dynamics of level of physical preparedness of students.

    Directory of Open Access Journals (Sweden)

    Коvalenko Y.A.

    2010-12-01

    Full Text Available The dynamics of level of physical preparedness of students is studied in the article. A tendency is marked to the decline of level of physical preparedness of students of 1-3 courses. Methodical recommendations are presented on the improvement of the system of organization of physical education of students of the Zaporizhzhya national university. The dynamics of indexes of physical preparedness of students 1, 2, 3 courses of different years of teaching is studied. Principal reasons of decline of level of physical preparedness of students are certain. There are recommendations the department of physical education in relation to physical preparedness of students.

  9. Use of motivational levers of increase of efficiency of functioning of enterprises of region

    Directory of Open Access Journals (Sweden)

    Pakulin Sergey

    2016-02-01

    Full Text Available The method of increase of efficiency of work of labor collective is developed and approved due to the improvement of socially psychological climate. On the basis of the questionnaire questioning, utilizing separate expert descriptions of mutual relations of people in a collective, the integral index of mutual relations is measured in a collective, measures are then developed for the correction of conduct of his cocks with the purpose of improvement of morally psychological climate

  10. State of the knowledge of flora of hepaticas of Colombia

    International Nuclear Information System (INIS)

    The Colombian hepatic flora is a very rich one. About 60% of all the species of tropical America and one sixth of the world's hepaticas occur in Colombia. The country has more species than the whole of Africa south of the Sahara and almost twice as many as Europe. The new catalogue of the hepaticas of Colombia accepts 840 species (in 36 families and 136 genera): 832 species of Hepaticae and 8 species of Anthocerotae

  11. Legality of use of drones

    OpenAIRE

    Slabá, Tereza

    2015-01-01

    The thesis analyses the legality of the use of drones in warfare based on the examination of three specific case studies. Firstly the use of armed drones in Afghanistan 2001 and 2002, then Pakistan drone strikes ongoing since 2004 and lastly the Yemen case study. A developed legal framework is used to assess the legality of the use of drones. Furthermore, it briefly touches upon the aspects of morality and ethics of the use of the unmanned aerial vehicles in combat.

  12. EXPOSURE OF PRIORITIES OF SOCIO-ECONOMIC DEVELOPMENT OF REGION

    OpenAIRE

    Dikan, V.

    2009-01-01

    The given article examines the questions of socio-economic development of region, the necessity of exposure of priorities of development for providing of strategic management on the basis of integral indicator of quality of life of population is grounded.

  13. Management of supply of inventories of enterprises

    OpenAIRE

    Горбунова, Анна Володимирівна

    2016-01-01

    Peculiarities of supply of inventories under present-day business conditions have been researched. It has been suggested to stipulate in the purchase contract stimulation of a supplier to deliver inventories in time, paying it out certain part of economy, received from avoiding keeping unnecessary inventories.

  14. Strategy of modernization of Sonatrach

    International Nuclear Information System (INIS)

    The problem of modernization of Sonatrach proceeds from an analysis which assumes as fundamentals : technological evolution as a source of competitive advantage, the careful observation of the strategies followed by the main actors of the international oil industry, the evolution of relationship between the State and the state owned enterprise. (Author)

  15. Models and method of determination of the state of organism of employee of enterprise

    OpenAIRE

    ЕВЛАНОВ М.В.; СЕРДЮК Н.Н.

    2015-01-01

    The features of information systems were considered for management by safety of labor on an enterprise, shortcomings of existent models of functional tasks of analysis and prognosis of change of the state of employee of enterprise, are offered models and method which allowing to describe the architectural features of determination of function which is used for description of the state of the employee of enterprise observed in the concrete moment of time. The models and methods of Naive Bayes ...

  16. FACTORS OF RISE OF LEVEL OF SOCIO-ECONOMIC DEVELOPMENT OF ENTERPRISES OF RAILWAY TRANSPORT

    OpenAIRE

    Zorina, O.

    2014-01-01

    In the article the analysis of factors, which affects socio-economic development of railway transport of Ukraine, is definite, priority of basic factors affecting socio-economic development of railway transport of Ukraine is offered, and the spheres of influence of external environment on development of railway transport are selected, the factors of rise of level of socio-economic development of enterprises of railway transport are grounded, influence of social factors on the change of level ...

  17. Assessment of sustainability of logistic activity of Port of Klaipeda

    OpenAIRE

    Kutkaitis, Audrius; Šimanskienė, Ligita; Burgis, Darius

    2014-01-01

    In this article we analyze the relation between sustainable development and logistic activity of sea ports. The assessment of sustainability of development of logistic activity in seaports is important for determining current trends of development, to indicate problematic areas and to develop means of adjusting development according to predetermined goals. The main problem that the article deals with is the complexity of sustainable development assessment that usually requires specific app...

  18. Increasing of Reliability of Converter

    Directory of Open Access Journals (Sweden)

    Trebuňa, F.

    2006-01-01

    Full Text Available The innovative activities in steel production invoke exploitation of new machines with the higher production capacity and productivity of labor. The paper deals with deformation and stress analysis of carrying parts of converter pedestal on the base of which the proposals and supporting measures were made that had the aim to increase reliability of the converter during steel production. This was achieved by lifespan prolongation of anchor and connecting bolts of converter pedestal, by change of stiffness of connected elements as well as by correction of nuts of bolted connections. The realization of structural changes decreased loading amplitudes and consequently the vibrations of pedestal. Solution was verified by numerical and experimental procedures of mechanics.

  19. Prerequisites of Formation of the Mechanism of State Regulation of the System of Commercial Insurance

    Directory of Open Access Journals (Sweden)

    Kuzhelyev Mykhaylo O.

    2014-01-01

    Full Text Available The article analyses establishment of the domestic system of commercial insurance with consideration of genesis of mechanisms of its regulation. It shows that the basis of the state regulation of insurance should be formed by the model of economic and historical process of establishment and development of commercial insurance, allowing to reveal the role of the state in formation of efficient instruments of administration and development of this system. The article establishes that evolution of formation of the state mechanism of administration is a reaction to imperfection of mechanisms of self-regulation of the system of commercial insurance. It argues that the national model of state regulation has specific features of the continental model, which is manifested in the applied forms of regulation. The author tracked formation of the modern mechanism of state regulation of the system of commercial insurance in genesis, which allowed trustworthy establishment of its specific features and prospects of development.

  20. Designing of the System of Strategic Accounting of Industrial Enterprise

    OpenAIRE

    Pilipenko Andrey. A.

    2009-01-01

    The problems of formation of accounting and analytical support of the system of strategic management of enterprises and their associations have been considered. The directions of the use of tools of basic theories and conceptions of management in the profile of elements of the method of accounting have been defined and directions of solution of existing discrepancies between possibilities of accounting as to the formation of information support for the system of management and requirements of...

  1. IMPROVEMENT OF DEVELOPMENT OF TOURISM OF SERBIA

    Directory of Open Access Journals (Sweden)

    Slobodan CEROVIC

    2007-06-01

    Full Text Available Serbia, without doubt, has qualitative and diverse base to develop tourism. Natural attractions as well as attained level of lodging and other capacities point out that numerous types of tourism could be developed, especially if one takes into account landscape diversity as well as natural potentials of Serbia. Previous development of tourism affirms its numerous effects which, in significant manner, have been embedded in economic and social development of Serbia. In that connection, the aim of this work is to point out the necessity of stimulating tourism in Serbia, which would form necessary assumptions for its dynamic role in the development of Serbia’s economy.

  2. FORMATION OF PARENTAL COMPETENCE OF CONDITIONS OF ELEMENTARY SCHOOL

    Directory of Open Access Journals (Sweden)

    B. V. Sergeeva

    2016-03-01

    Full Text Available Article is devoted to a problem of formation of parental competence of younger school students. Results of designing of the maintenance of parental competence of children of younger school age are presented in article. Process of formation of the parental competence of younger school students consisting of 3 blocks is also presented: target, organizational and substantial and estimated and productive, the target block assumes statement of the purpose - formation of parental competence of younger school students and consists of components: motivational and personal (manifestation of interest of parents in successful result of education of younger school students, abilities to empathy, pedagogical reflection, self-checking; Gnostic (existence at parents of knowledge of features of manifestation and formation of the pupil during the different periods of development; communicative and activity (manifestation by parents of abilities to build relationship with the pupil, to stimulate his independence in activity, to apply effective methods of education; competence-based experience (use of the approved and mastered knowledge, skills of education of younger school students in practice of family education; the organizational and substantial, including system methods and forms of formation of parental competence of younger school students; the estimated and productive block of model consists of an assessment of productivity of process of formation of the competence of parents including identification of dynamics of level of parental competence at children of younger school age assuming achievement of sufficient level of parental competence of children of younger school age, and also a condition of formation of parental competence of younger school students. Realization of model of formation of parental competence of children of younger school age of age will be effective at increase of readiness of teachers for formation of pedagogical competence of

  3. MANAGEMENT OF OPERATIONAL EXPENSES AS THE FACTOR OF INCREASE OF ECONOMIC EFFICIENCY OF WORK OF RAILWAYS

    OpenAIRE

    Melnik, V.; Ruban, O.

    2010-01-01

    In the article expedience of formation of a control system by operational expenses of railways from the point of view of maintenance of economic efficiency of their functioning in modern conditions of managing which are characterised by high degree of instability and increase of influence of the crisis phenomena as in national, and on a global scale is proved.

  4. Of Corpse

    OpenAIRE

    Narvaez, Peter

    2003-01-01

    Laughter, contemporary theory suggests, is often aggressive in some manner and may be prompted by a sudden perception of incongruity combined with memories of past emotional experience. Given this importance of the past to our recognition of the comic, it follows that some "traditions" dispose us to ludic responses. The studies in Of Corpse: Death and Humor in Folklore and Popular Culture examine specific interactions of text (jokes, poetry, epitaphs, iconography, film drama) and social conte...

  5. Indexes of estimation of efficiency of the use of intellectual resources of industrial enterprises

    Directory of Open Access Journals (Sweden)

    Audzeichyk Olga

    2015-12-01

    Full Text Available The article researches the theoretical and practical aspects of estimation of intellectual resources of industrial enterprises and proposes the method of estimation of efficiency of the use of intellectual resources.

  6. IMPROVEMENT OF DEVELOPMENT OF TOURISM OF SERBIA

    OpenAIRE

    Cerovic, Slobodan

    2007-01-01

    Serbia, without doubt, has qualitative and diverse base to develop tourism. Natural attractions as well as attained level of lodging and other capacities point out that numerous types of tourism could be developed, especially if one takes into account landscape diversity as well as natural potentials of Serbia. Previous development of tourism affirms its numerous effects which, in significant manner, have been embedded in economic and social development of Serbia. In that connection, the aim ...

  7. Comparative analysis of indexes of physical preparedness of footballers of professional commands of different level

    OpenAIRE

    Shalenko V.V.; Pertsukhov A.A.

    2010-01-01

    This paper deals with results of the research of physical preparedness of professional teams of footballers of different level. The pedagogical testing program of the physical skills level includes control exercised recommended by the scientific-methodical committee of Ukrainian Federation of Football. The article presents indices of physical preparedness of footballers of different playing roles of the top league teams of Ukrainian championship and first league of Ukrainian team championship...

  8. OF INERTIAL PROPERTIES OF SOILS

    Directory of Open Access Journals (Sweden)

    Sargsjan Akop Egishovich

    2012-10-01

    The article describes the motion of the construction foundation slab as a rigid body with six degrees of freedom on the surface of the inertial linearly deformable semi-space. The dynamic mechanical model of the base is presented as six pairs of parallel-connected springs and dampers that characterize the rigidity of the base subjected to ultimate forces (three forces alongside the axes and three moments in relation to the axes.

  9. Ways of modernization of the automated system of crisis management of the Emercom of Russia

    OpenAIRE

    KACHANOV SERGEY A.; AGEEV SERGEY V.; GRACHEV VITALI L.

    2015-01-01

    The principles and the main approaches to the upgrade of software and structure of information provision of automated information management system of the unified state system of prevention and liquidation of emergency situations, as well as ways to increase the level of interaction between the functional subsystems of the unified state system of prevention and liquidation of emergency situations.

  10. Radiosensitivity of carcinoma of esophagus

    International Nuclear Information System (INIS)

    With a detailed graphic reconstruction of radiation effects shown in 11 operation materials of carcinoma of esophagus with preoperative irradiation, histologic analysis of the radiosensitivity was made. Residual cancer lesions in 11 operation specimens contained adenocarcinoma elements. Carcinoma of esophagus belonged to mixed carcinoma (syn. metaplastic cancer). Radioresistant nature resulted from the remnant adenocarcinoma elements. Protruded type (3 cases) showed about 60 % of residual cancer after preoperative irradiation of 40 Gy (Lineac or 60Co.). The residual cancer nests histologically revealed well-differentiated squamous cell carcinoma with a few signet-ring cells, compatible with mucoepidermoid carcinoma. In protruded type, the mixed carcinoma was composed of segmental, disproportioned zonal squamous metaplasia. As its histogenetic origin, a main duct of esophageal gland was suggested. In 9 autopsy cases of esophageal cancer, recurrent lesion within the field of irradiation failed to respond to radiotherapy. In recurrent residual lesions, a higher proportion of adenocarcinoma elements was noticed. Therefore, the cancer part formed by a high rate of metaplasia was markedly responsive to irradiation, whereas increased residue of adenocarcinoma elements was enhanced the radioresistant property. In a middle thoracic esophagus (Im) corresponding to the commonest site of esophageal cancer, the distribution of esohageal glands was in a high density with a constant ratio of density in each age group particularly in male. In age groups with higher incidence of carcinoma of esophagus, esophageal glands markedly increased especially in male, in contrast with the indefinite number and density ratio in female cases. A high density of esophageal glands was noticed in the upper (Iu) and lower (Im) parts of the 2nd physiologic constriction, in proportion to the commonest site of carcinoma of esophagus. (J.P.N.)

  11. Development of generalized dynamic model of oscillations of cylinder case of diesel engine of locomotive

    Directory of Open Access Journals (Sweden)

    Irina YUTKINA

    2014-03-01

    Full Text Available An engineering method of design, worked out by the authors, is considered in the paper. It allows to carry out design of amplitude-frequency specter and vibration loading of cylinder cases of the diesel engine of locomotive with account of cavitation-erosion damage. Offered method of design of parameters of cavitation-erosion damage may be used in design of new structures of diesel engines of locomotives and systems of cooling.

  12. Analysis of Risks and Factors of Formation of the Structure of Financial Capital of Subject of Entrepreneurship

    OpenAIRE

    Rubaha Mariya V.

    2013-01-01

    The article is devoted to analysis of the structure of sources of financing economic subjects, study of commercial and financial risks of formation of the structure of financial capital of subjects of entrepreneurship. The article pays significant attention to calculation of the weighted average cost of capital, degrees of financial and operational leverages and also to assessment of their mutual influence upon results of financial and economic activity of an enterprise. It studies impact of ...

  13. Informatization of trade education of future teacher of physical culture

    OpenAIRE

    Dragnev Y. V.

    2012-01-01

    Resolved, that the informatization of professional education of future teachers of physical culture is one of the most important components of the restructuring of the system of physical education; the defining element of the information society on the basis of introduction of modern information technologies. Is shown, that for successful solution of the problems of informatization of professional education of future teachers of physical culture appropriate to comprehensively carry out resear...

  14. FORMATION OF PARENTAL COMPETENCE OF CONDITIONS OF ELEMENTARY SCHOOL

    OpenAIRE

    B. V. Sergeeva; R. K. Arakelian

    2016-01-01

    Article is devoted to a problem of formation of parental competence of younger school students. Results of designing of the maintenance of parental competence of children of younger school age are presented in article. Process of formation of the parental competence of younger school students consisting of 3 blocks is also presented: target, organizational and substantial and estimated and productive, the target block assumes statement of the purpose - formation of parental competence of youn...

  15. PREPARATION OF HALIDES OF PLUTONIUM

    Science.gov (United States)

    Garner, C.S.; Johns, I.B.

    1958-09-01

    A dry chemical method is described for preparing plutonium halides, which consists in contacting plutonyl nitrate with dry gaseous HCl or HF at an elevated temperature. The addition to the reaction gas of a small quantity of an oxidizing gas or a reducing gas will cause formation of the tetra- or tri-halide of plutonium as desired.

  16. LAW OF CONSERVATION OF WEALTH

    OpenAIRE

    Gopinath VadirajaRao Bangalore

    2005-01-01

    Law of Conservation is a universal Law and applies to mass, energy and wealth alike. When wealth is changed from one form to the other, the value of transferee form of wealth equals value of transferor form of wealth. This leads to inferance that wealth can neither be created nor be destroyed but can be changed from one form to the other. The principle of Double Entry Method of Bookkeeping rests on this Law. We cannot create a debit/credit without corresponding credit/debit and the assets and...

  17. Fundamentals of equations of state

    CERN Document Server

    Eliezer, Shalom; Hora, Heinrich

    2002-01-01

    The equation of state was originally developed for ideal gases, and proved central to the development of early molecular and atomic physics. Increasingly sophisticated equations of state have been developed to take into account molecular interactions, quantization, relativistic effects, etc. Extreme conditions of matter are encountered both in nature and in the laboratory, for example in the centres of stars, in relativistic collisions of heavy nuclei, in inertial confinement fusion (where a temperature of 10 9 K and a pressure exceeding a billion atmospheres can be achieved). A sound knowledg

  18. Thermodynamics of solution of histidine

    International Nuclear Information System (INIS)

    The enthalpies of solution of L-histidine in water at 288.15-318.15 K and 0.003-0.15 mol kg-1 were measured. The enthalpies of solution were found to be independent of the solute molality up to ∼0.1 mol kg-1. Standard enthalpies and heat capacities of solution were computed. Free energies and entropies of solution have been estimated in the temperature range studied using literature solubility data and the results of the present study. The temperature increase was found to result in a pronounced rise of the L-histidine solubility due to the significant increase of the TΔS values. The characteristic temperatures for the thermodynamic properties of histidine aqueous solutions were estimated

  19. Summary of Code of Ethics.

    Science.gov (United States)

    Eklund, Kerri

    2016-01-01

    The Guide to the Code of Ethics for Nurses is an excellent guideline for all nurses regardless of their area of practice. I greatly enjoyed reading the revisions in place within the 2015 edition and refreshing my nursing conscience. I plan to always keep my Guide to the Code of Ethics for Nurses near in order to keep my moral compass from veering off the path of quality care. PMID:27183735

  20. Evaluation of the Effects of

    OpenAIRE

    Deniz Çetinkünar; Meltem Önder

    2012-01-01

    Background and Design: In this study, we aimed to evaluate the effects of a formula composed of millet extract, wheat germ oil, calcium pantothenate and L-cystine in women with diffuse alopecia by using Digital Phototrichogram (Trichoscan). Materials and methods: We evaluated female patients who presented to Gazi University Faculty of Medicine Department of Dermatology between January 2008 and November 2008 with the complaint of diffuse hair loss. Digital phototrichogram was performed in the ...

  1. Irradiation of mutants of rose

    International Nuclear Information System (INIS)

    Radiation-induced Reddish-orange (R) and Pink (P) flowered mutants of the rose cultivar Montezuma were subjected to a second treatment of gamma radiation. Effects of this treatment were recorded on bud-take, growth, survival, flowering and essential oil content. The P mutant was more radiosensitive than the R mutant. The occurrence of certain early flowering and flower yielding plants in the latter mutant proved the efficiency of this technique for inducing genetic variability in garden roses. (author)

  2. Measurement of Spin of Projectiles

    Directory of Open Access Journals (Sweden)

    S. R. Verma

    1989-01-01

    Full Text Available Hitherto the spin of the projectile has been measured with the help of spin loop method (for magnetised projectiles and Multishot Ballistic Synchro method (for magnetised and non-magnetised projectiles. This paper discusses the method of measurement of spinwith a single ballistic synchro picture; the advantage of this method is that it dispenses with elaborate and precise optical alignment, required for Multishot Ballistic Synchro method.

  3. Analysis of voice of citizens

    International Nuclear Information System (INIS)

    The study proposes to apply a multidisciplinary approach to identify the diverse voices of citizens for nuclear regulation for plant O and M in Japan. The degree and the cope of understanding and interest for the nuclear regulation were examined through adoption of questionnaire method. The result of the experimental research was that the strong needs for comprehensive communication opportunity from the viewpoint of citizens to understand the regulation. (author)

  4. Comparative analysis of indexes of physical preparedness of footballers of professional commands of different level

    Directory of Open Access Journals (Sweden)

    Shalenko V.V.

    2010-01-01

    Full Text Available This paper deals with results of the research of physical preparedness of professional teams of footballers of different level. The pedagogical testing program of the physical skills level includes control exercised recommended by the scientific-methodical committee of Ukrainian Federation of Football. The article presents indices of physical preparedness of footballers of different playing roles of the top league teams of Ukrainian championship and first league of Ukrainian team championship. Differences of physical preparedness structure of goalkeepers, defenders, halfbacks and forwards are revealed.

  5. Optimization of a parity of brake forces of automobiles in view of a bias of road

    International Nuclear Information System (INIS)

    In clause it is shown a method optimization of brake of forces in view of a bias road it is established, that in mountain conditions of loss of coupling weight of automobiles than 2-3 times concerning flat conditions therma are more. The degree of use of coupling weight in result use of a regulator of brake forces very much increases also efficiency of brake systems such a kind of automobiles is provided with definition of optimum factor of coupling at which value of loss of coupling weight is provided minimal

  6. Construction of the rating of competitiveness of facilities of light aircraft of Ukrainian and Russian production

    Directory of Open Access Journals (Sweden)

    А.I. Yakovlev

    2010-12-01

    Full Text Available Methodical approaches to determination of level of competitiveness of the small flying machines made in the various countries are considered. The valuation method of coefficients of weightiness of indicators of competitiveness is developed. The market rating of small airplanes of Ukrainian and Russian production is built.

  7. Mechanisms of action of emodepside.

    Science.gov (United States)

    Harder, A; Holden-Dye, L; Walker, R; Wunderlich, F

    2005-10-01

    The research of the class of cyclic octadepsipeptides started at the beginning of the 1990s. PF1022A, the starting material of emodepside, is a natural secondary metabolite of the fungus Mycelia sterilia, which belongs to the microflora of the leaves of Camellia japonica. PF1022A consists of four N-methyl-L-leucins, two D-Iactic acids and two D-phenyllactic acids, which build up a cyclic octadepsipeptide with an alternating L-D-L-configuration. Emodepside is a semisynthetic derivative of PF1022A, which contains a morpholine attached in para position at each of both D-phenyllactic acids. Emodepside is efficacious against a variety of gastrointestinal nematodes. Emodepside binds to a presynaptic latrophilin receptor in nematodes. The following presynaptic signal transduction occurs via activation of Gqalpha protein and phospholipase-Cbeta, which leads to mobilization of diacylglycerol (DAG). DAG then activates UNC-13 and synaptobrevin, two proteins which play an important role in presynaptic vesicle-functioning. This finally leads to the release of a currently unidentified transmitter. The transmitter (or modulator) exerts its effects at the postsynaptic membrane and induces a flaccid paralysis of the pharynx and the somatic musculature in nematodes. PMID:16228263

  8. Problem of mathematical deduction of the existence of black holes

    Directory of Open Access Journals (Sweden)

    Yuan-Shun Chin

    1990-01-01

    Full Text Available The mathematical proof of existence of Black Hole is based on the assumption of mass being independent of speed. Considering the effect of special relativity of the dependence of mass with speed there is no Black hole.

  9. Determination of Basic Factors of Influence and Indexes of Evaluation of Quality of Labour Life of Workers of Industry

    OpenAIRE

    Yastremskaya Elena N.; Stamatin Aleksandr V.

    2012-01-01

    In this paper the factors influencing the quality of working life of workers in industry as an example of mechanical engineering is investigated. The main components of the quality of working life is defined conditions, financial incentives, intangible promotion, social security, state of the environment. The influence of defined components on productivity is proven. The results of research for mechanical engineering of fifth technological structure in Kharkiv region allow to conclude that al...

  10. Optimization of Gas Supply of CHP Sources of Energy

    OpenAIRE

    Odiņeca, T; Zēbergs, V

    2008-01-01

    The article contains reviews the method of optimization of gas supply of CHP sources of energy - the method of calculation of permissible IRR. It is effective for analyzing the projects of CHP plants’ gasification (also in reconstruction of existing boiler houses). IRR is an effective criterion of profitability of gasification, if the forecast of the consumption of gas is precise. Using the method of calculation of permissible IRR it is possible to find the load limits in which CH...

  11. Evaluation of perception of quality of life of disabled athletes

    Directory of Open Access Journals (Sweden)

    Bolach Bartosz

    2014-01-01

    Full Text Available Purpose: To evaluate the perception of quality of life for athletes - disabled, participating in individual and team Paralympic sports. Material: The study involved 32 athletes sports club "Start" in Wroclaw in 2013, engaged in individual sports: swimming, weightlifting, powerlifting (powerlifting and command: wheelchair basketball and volleyball in a sitting position. Results: Studies have proven that sports people with physical disabilities have a positive effect on the quality of their lives. Conclusions: 1. Study aspects of perception of quality of life is a complex issue, but deserves proper attention and appropriate force to study it. 2. Athletes - Disabled involved both individual and team sports, the perception of quality of life is average.

  12. Mechanism of action of probiotics

    Directory of Open Access Journals (Sweden)

    S Hemaiswarya

    2013-02-01

    Full Text Available The modern diet doesn't provide the required amount of beneficial bacteria. Maintenance of a proper microbial ecology in the host is the main criteria to be met for a healthy growth. Probiotics are one such alternative that are supplemented to the host where by and large species of Lactobacillus, Bifidobacterium and Saccharomyces are considered as main probiotics. The field of probiotics has made stupendous strides though there is no major break through in the identification of their mechanism of action. They exert their activity primarily by strengthening the intestinal barrier and immunomodulation. The main objective of the study was to provide a deep insight into the effect of probiotics against the diseases, their applications and proposed mechanism of action.

  13. Ways of improvement of financial provision of industrial development

    Directory of Open Access Journals (Sweden)

    Shemyakina Natalya V.

    2013-03-01

    Full Text Available The article conducts the study of the state of financial provision of industrial development under modern conditions and justifies main ways of improvement and prospects of investment financing of technical development of the production potential. Classical theses and fundamental works of foreign and domestic scientists, statistical indicators and results of author’s studies of the problems of financing of technical development of industry became the methodological basis of the study. Using the conducted analysis of the state of financing the industrial development in Ukraine, potential sources of financial resources of development of the production potential (profit, depreciation, means of financial institutions and leasing, condition of the state financial support of technical development of the industrial sector and taking into account the modern experience of foreign countries, the article justifies main ways of improvement of the financial provision of industrial development. The proposed ways of improvement of financial provision of industrial development are based on: orientation at the modern model with attraction of all potential investment sources; state-private co-financing of investment projects of production development; de-centralisation of the state support through the use of various channels of support of the processes of industrial development; and formation of the market infrastructure of ensuring of financing of the innovation and investment process in industry.

  14. Removal of

    OpenAIRE

    Roohan Rakhshaee; Zahra Zamiraee; Somaieh Baghipour; Mohammad Panahandeh

    2013-01-01

    Background and Objectives: Azolla Filiculoides as a non-living fern was used in a batch system to remove "Basic Blue 3", which is a cationic dye and a carcinogenic agent.Materials and Methods: We used a batch system by applying certain concentrations of dye contaminant and in the presence of a certain amount of adsorbent under optimum conditions. The main groups presenting in the Azolla cell wall were evaluated by acidification and alkalization of Azolla's media and then potentiometric titrat...

  15. Analysis of sedimentation of canals

    Directory of Open Access Journals (Sweden)

    Agunwamba, J.C.,

    2013-03-01

    Full Text Available The dredged canals in the Niger Delta coastal flood plain are being threatened by siltation. This study is limited to those canals in Rivers State of Nigeria, which are under the influence of tidal waves. A total of eight canals were considered with four each from Ekulama and Cawthorne Channel. Different approaches were used to carry out this study, which includes field reconnaissance survey, hydrographic survey, soil sample analysis and collection of all available data and information. The typical bed materials size (D50 is approximately 0.01mm; which gives a settling velocity of 0.09mm/sec using stroke’s law. Hydrographic survey of the canals from 1992 to 1996 revealed an average siltation rate of 2.35m/yr. A regression equation was also derived which relates the cost of dredging to canal area, rate of siltation and average aggregation. A plot of canal centre profile; entrance, middle and end cross sections showing sediment distribution along the canal profile, shows that majority of the particles that form the sediment enter the canal from the rivers. The sedimentation is caused by the reduction in water current, which has average value of 0.0145m/sec. The bathyorographical check on the canals revealed that the sum of the two exterior angles of the canal with the river at the point of connection has to lie within 1800 + 50 for an effective flow that will minimize settlement of particles. In addition, the canals should be constructed to start and terminate on a moving water body, to avoid dead ends. A regression equation was determined which relates the cost of dredging to canal area, rate of siltation and average aggradations.

  16. Formation of the Cycle of Business Processes of Management of Marketing Activity of a Transport Enterprise

    OpenAIRE

    Horielov Dmytro O.; Lavrova Yuliia V.

    2014-01-01

    The article is devoted to problems of organisation of the process of management of marketing activity of an enterprise. It specifies the model of services of a transport enterprise and provides levels of services and their structure: basic, real, expanded, expected and prospective. The article offers to differentiate planning and realisation of the transportation service by its levels, each of which would correspond with a separate business process of management. It reveals specific features ...

  17. The environment of marketing of football clubs of Iraq

    Directory of Open Access Journals (Sweden)

    Michuda Y.P.

    2012-01-01

    Full Text Available Features and conditions of use of marketing in professional football of Iraq are presented, characteristic features of macroenvironment and a microenvironment in which marketing activity of professional football clubs of Iraq is carried out are considered. In research the data of questionnaire 76 experts of Association of football of Iraq (IFA, and also 45 heads of football clubs of the Superleague of Iraq is used. The maintenance and role of environment in formation and functioning of a control system by marketing activity of football clubs of Iraq is defined. Positive and negative factors which define management efficiency marketing of football clubs are revealed.

  18. Direction of use of instruments of classic concept of municipal marketing in development of competitiveness of a city

    Directory of Open Access Journals (Sweden)

    I.M. Budnikevich

    2011-10-01

    Full Text Available The prerequisites of formation of the concept of classical marketing in Ukraine are considered in the paper. The definition of the municipal marketing in the framework of the classical concept is offered. The role of marketing instruments in formation of competitive advantages of the city is determined. The variants of segmentation of city environment and strategies of municipal marketing towards target markets are described. The experience of Dresden (Germany in the field of realization of marketing concept is studied.

  19. Formation of Strategic Maps within the Framework of Realisation of the Process of Administration of Financial Security of a Company

    OpenAIRE

    Sablina Natalia Victorovna; Kuzenko Tatiana Borisovna

    2013-01-01

    The article analyses approaches to the essence of administration of financial security of a company. It justifies expediency of introduction of a system approach to the system of administration of financial security of a company, the original idea of which is a necessity to determine influence of destabilising factors of internal and external environments when identifying the strategic goal of company’s activity. It specifies that one of the modern approaches of effective adaptation to the ch...

  20. Direction of use of instruments of classic concept of municipal marketing in development of competitiveness of a city

    OpenAIRE

    I.M. Budnikevich

    2011-01-01

    The prerequisites of formation of the concept of classical marketing in Ukraine are considered in the paper. The definition of the municipal marketing in the framework of the classical concept is offered. The role of marketing instruments in formation of competitive advantages of the city is determined. The variants of segmentation of city environment and strategies of municipal marketing towards target markets are described. The experience of Dresden (Germany) in the field of realization of ...

  1. Pedagogical terms of realization of program development professionally of important qualities of students of economic specialities by tools of football

    Directory of Open Access Journals (Sweden)

    Maliar E.I.

    2010-04-01

    Full Text Available The article is devoted to the questions of professionally oriented psychophysical preparation of students of higher educational establishments of economic type. In the article the pedagogical terms of effective realization of the program of development professionally of important qualities of future economists are given by the tools of football: rational distributing of educational material during 4th semesters; personality-oriented character of study of students; rational distributing of time on general and special physical preparation; differentiated planning of parameters of the physical loading; complex control of dynamics of physical health, tech-tactical and physical preparedness of students.

  2. METHODS OF IMPROVEMENT OF ACOUSTIC PERFORMANCES OF TURBOFAN ENGINE

    OpenAIRE

    Peleshok, I.; National Aviation University, Kyiv

    2012-01-01

     Nowadays the problem of decreasing of noise of environment is a global problem. The solution of this problem depends on different countries and the culture, economics and policy of it. Nowadays there is no single system of checking of sequences of acting of noise on environment on population and cost of damages. 

  3. Pedagogical conditions of maintenance of integrity of process of socialization-individualization of children-orphans

    OpenAIRE

    Pronina A. N.

    2011-01-01

    Formation of the high-grade person of children of preschool age, without parental support should be carried out in complete process of socialization-individualization that assumes working out of the pedagogical conditions directed on maintenance of interrelation of processes of socialization and an individualization.

  4. Pedagogical conditions of maintenance of integrity of process of socialization-individualization of children-orphans

    Directory of Open Access Journals (Sweden)

    Pronina A. N.

    2011-12-01

    Full Text Available Formation of the high-grade person of children of preschool age, without parental support should be carried out in complete process of socialization-individualization that assumes working out of the pedagogical conditions directed on maintenance of interrelation of processes of socialization and an individualization.

  5. Features of structure of skin of hairy part of head of men at androgenic defluxion

    Directory of Open Access Journals (Sweden)

    Kostilenko Yu.P.

    2009-01-01

    Full Text Available Utilized by us universal innovative method of morphological researches provided the receipt of original information, which not only complement the known facts but also in more depth expose principles of device of skin of hairy part of head of men in a norm and after an androgenic pelade. In the process of androgenic pelade degradation foremost intradermal hair follicles undergo sclerosis. In the reticulated layer of derma degrading hair follicles substituted with connective tissue. Complete loss of hair at an androgenic defluxion, results in compensatory reorganization of skin of hairy part of head, which is expressed in a substitution of hypodermis connecting tissue by fatty tissue, blood vessels formation in all layers of skin of with prevaliation of venous among, and also, in the considerable increase of concentration of sebaceous glands in the reticulated layer of derma. In spite of complete loss of hair at an androgenic pelade, germ epithelial elements, being sources of formation of thin (abortive hairsprings array patterns of which are saved in the skin of hairy part of head, hidden in the layer of sebaceous glands. On the basis of the actual findings in our work revealed, that loss of hairs at an androgenic defluxion filled in due to the physiological hypertrophy of other tissue constituents of skin.

  6. Maintenance and ways of maintainance and strengthening of health of students of institutes of higher

    Directory of Open Access Journals (Sweden)

    Leyfa A.V.

    2009-10-01

    Full Text Available The aim of given study was the basing of substance and experimental testing economy of health by students. The developed substance is built on a base of the rules and foundations general system of sanitary physical training in combination with subsidiary and additional resources. Results of pedagogical experiment testify to effectiveness of developed substance in the economy of health by students.

  7. Mechanism of action of cariprazine.

    Science.gov (United States)

    Stahl, Stephen M

    2016-04-01

    Cariprazine is a new therapeutic agent recently approved for the treatment of both schizophrenia and manic or mixed episodes associated with bipolar disorder, and is under investigation for the treatment of both bipolar depression and major depressive disorder. PMID:26956157

  8. Prevention of retinopathy of prematurity

    OpenAIRE

    João Borges Fortes Filho; Gabriela Unchalo Eckert; Marcia Beatriz Tartarella; Renato Soibelmann Procianoy

    2011-01-01

    Retinopathy of prematurity (ROP) is related to oxygen-regulated vascular endothelial growth factor and to insulin-like growth factor-I. After premature birth, supplemental oxygen induces a retinal hyperoxic condition with vasoconstriction and to a definitive interruption of retinal vasculogenesis. Peripheral ischemia may stimulate retinal neovascularization and the onset of additional ROP-related complications. The natural course of the disease may result in irreversible blindness if not prom...

  9. Fractal dimensionality of cascades of atomic displacements

    International Nuclear Information System (INIS)

    The cascades of opening displacements, formed during irradiation of solids are the most typical process of dissipation of the energy of incident particles and the generation of radiation defects. The aim of the present work is the examination of the energy dependence of the fractal dimensionality of the cascades of atomic displacements in the solid

  10. Kinetics of cyaniding of gold comprising ores

    International Nuclear Information System (INIS)

    Present article is devoted to kinetics of cyaniding process of gold comprising ores. Thus in laboratory conditions the researches on leaching of gold and silver from ores of various deposits of Tajikistan by means of cyaniding were conducted. The results of laboratory researches on cyaniding of ores of various deposits are presented. The flowsheet of cyaniding of gold comprising ores was elaborated.

  11. Implementation of operational concept of air traffic

    OpenAIRE

    О.Є. Луппо; Ю.В. Чинченко

    2008-01-01

     Parameters of air traffic management, which influence safety, efficiency and regularity of flight are considered. Influence of required parameters of full system to total quality of operation of aeronautical system of Ukraine areanalyzed.

  12. Mode of Action of Mycotoxins

    Science.gov (United States)

    Mycotoxins are a structurally disparate group of toxic chemicals. There only common link is that they are all produced by fungi. It is therefore not surprising that their biochemical mechanisms of action are as diverse as their taxonomic origins. The study of biochemical and cellular mechanisms o...

  13. Mode of Action of Glyphosate

    Science.gov (United States)

    Although glyphosate is the most used and studied herbicide in the world, the available information is not enough to fully understand its mode of action. The molecular site of action of glyphosate is the enzyme 5-enolpyruvlyshikimate-3-phosphate synthase (EPSPS). It is the only known compound that ...

  14. Pathophysiology of Retinopathy of Prematurity

    OpenAIRE

    İmren Akkoyun

    2012-01-01

    Retinopathy of prematurity (ROP), an ocular disease characterized by onset of vascular abnormalities in the developing retina, is the major cause of visual impairment and blindness in premature neonates. ROP is a complex multifactorial disease that occurs with microvascular degeneration followed by neovascularization which passing through different stages can progress to retinal detachment. Currently used ablative therapies like cryocoagulation and laser photocoagulation for prolifer...

  15. Features of Formation of the National Income

    OpenAIRE

    Sergey Alexandrovich SURKOV; Ellen G. Trofimova

    2015-01-01

    Significant indicator of economic progress of the country is the specific income per capita. Experts consider such indicator important from the point of view of forecasting of economic development. Influence of various factors is presented in references, but influence of psychological indicators, in particular, influence of personal characteristics of the population isn't considered. On material of the population of various countries of the world features of formation of the national specific...

  16. Analysis of Risks and Factors of Formation of the Structure of Financial Capital of Subject of Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Rubaha Mariya V.

    2013-11-01

    Full Text Available The article is devoted to analysis of the structure of sources of financing economic subjects, study of commercial and financial risks of formation of the structure of financial capital of subjects of entrepreneurship. The article pays significant attention to calculation of the weighted average cost of capital, degrees of financial and operational leverages and also to assessment of their mutual influence upon results of financial and economic activity of an enterprise. It studies impact of factors of external environment on the structure of sources of financing subjects of entrepreneurship, these factors include specific features of operational activity, quality and liquidity of assets, concentration of own capital, stages of the life cycle, level of profitability of operational activity, credit history of a borrower and a necessity to ensure the prospective repayment capacity, and financial mentality of owners and managers of an enterprise. The article also analyses factors of external environment of an enterprise (cost of attraction of financing from different sources, commodity and financial markets situations, state regulation and control over business processes, level of taxation of profit of enterprises and also income of physical persons and legal entities – investors from owning securities that influence the possibilities to attract financial capital and, consequently, prospects of efficient functioning of a subject of entrepreneurship in a long-term prospect.

  17. Influence of mechanical abrasion of carbon adsorbents on aerodynamic resistance of filters of system of ventilation of NPS

    International Nuclear Information System (INIS)

    Influence of mechanical abrasion of granules on aerodynamic resistance of different carbon adsorbents at conditions similar to work of filters AU-1500 is studied. The change of fractional composition of the probed adsorbents by abrasion is determined. The obtained experimental data allow making conclusion about practicability using mixture of adsorbent Norit with different fractional composition for renewal of adsorbers of ventilation system of NPS.

  18. Prospects of development of the market of functional food

    OpenAIRE

    Radosteva, E.; Kalacheva, T.

    2013-01-01

    In article choice tendencies are defined by the population of Perm Krai of food; the basic principles of creation and production of functional food are revealed; the main receptions of transformation of foodstuff in the functional are defined.

  19. The problem of formation of design competence of university students

    OpenAIRE

    Galina; Marina

    2014-01-01

    The article discusses the concept of "design competence" under the implementation of educational standards of the third generation, emphasizes integrative bond formation of design competence with the implementation of project activities in the context of modern educational paradigm.

  20. Significance of irradiation of blood

    International Nuclear Information System (INIS)

    Many reports of fatal GVHD occurring in non-immunocompromised patients after blood transfusion have been published in Japan. One explantation is that transfused lymphocytes were simulated and attack the recipient organs recognized as HLA incompatible. That is so called 'one-way matching'. To reduce the risk of post-transfusion GVHD, one of the most convenient methods is to irradiate the donated blood at an appropriate dose for inactivation of lymphocytes. Because no one knows about the late effect of irradiated blood, it is necessary to make the prospective safety control. (author)

  1. Mode of action of etoxazole.

    Science.gov (United States)

    Nauen, Ralf; Smagghe, Guy

    2006-05-01

    The mode of action of the 2,4-diphenyl-1,3-oxazoline acaricide/insecticide etoxazole has been argued to be moulting inhibition, but experimental results supporting this hypothesis are lacking. This study investigated the effect of etoxazole on chitin biosynthesis in the fall armyworm, Spodoptera frugiperda (Smith) (Lepidoptera: Noctuidae). Etoxazole induced moulting defects in fall armyworm larvae similar, if not identical, to those caused by benzoylphenylureas, a well-known class of insecticidal chitin biosynthesis inhibitors. Furthermore, in contrast to untreated larvae, the chitin content in the integuments of larvae several days after treatment did not differ from that in freshly ecdysed individuals, thus suggesting strong chitin biosynthesis inhibition in vivo. A more detailed investigation of the inhibitory potential by incubating cultured integument pieces from larvae of S. frugiperda with [14C]N-acetyl-D-glucosamine, a radiolabelled chitin precursor, revealed I50 values of 2.95 and 0.071 microM for etoxazole and triflumuron respectively. The incorporation of radiolabel into potassium hydroxide-resistant material was inhibited by etoxazole in a dose-dependent manner. Based on these results, it is concluded that the acaricidal and insecticidal mode of action of etoxazole is chitin biosynthesis inhibition. PMID:16555232

  2. INFLUENCE OF PARAMETERS OF CRYSTALLIZATION ON MODIFYING OF AN ALLOY

    Directory of Open Access Journals (Sweden)

    V. Yu. Stetsenko

    2015-01-01

    Full Text Available It is shown that extent of modifying of an alloy is proportional to overcooling at its hardening, viscosity of fusion and interphase superficial energy of crystals of the leading phase. The key technological parameters of modifying of an alloy are the speed of its hardening, viscosity of fusion and extent of refinement from surface-active elements. Their adsorption on crystals of the leading phase interferes with modifying of an alloy.

  3. FEATURES OF DEFINITION OF TAX BURDEN OF AN ECONOMIC ENTITY

    OpenAIRE

    Sobchenko N. V.; Kuleshova L. V.; Lapina E. N.

    2015-01-01

    The results of an analytical assessment of the developed frame of reference on concepts of tax planning, tax burden, tax burden of the enterprise are presented in article. Tax planning is the most important part of financial planning of the organization. A basis of this process is possibility of each taxpayer to use legislatively resolved means, receptions and ways directed on minimization of tax payments. Minimization of taxes is directed not only on absolute decrease in volumes of tax payme...

  4. Measurement of \

    CERN Document Server

    Aguilar-Arevalo, A A; Bazarko, A O; Brice, S J; Brown, B C; Bugel, L; Cao, J; Coney, L; Conrad, J M; Cox, D C; Curioni, A; Djurcic, Z; Finley, D A; Fleming, B T; Ford, R; Garcia, F G; Garvey, G T; Gonzales, J; Grange, J; Green, C; Green, J A; Hart, T L; Hawker, E; Imlay, R; Johnson, R A; Karagiorgi, G; Kasper, P; Katori, T; Kobilarcik, T; Kourbanis, I; Koutsoliotas, S; Laird, E M; Linden, S K; Link, J M; Liu, Y; Louis, W C; Mahn, K B M; Marsh, W; Mauger, C; McGary, V T; McGregor, G; Metcalf, W; Meyers, P D; Mills, F; Mills, G B; Monroe, J; Moore, C D; Mousseau, J; Nelson, R H; Nienaber, P; Nowak, J A; Osmanov, B; Ouedraogo, S; Patterson, R B; Pavlovic, Z; Perevalov, D; Polly, C C; Prebys, E; Raaf, J L; Ray, H; Roe, B P; Russell, A D; Sandberg, V; Schirato, R; Schmitz, D; Shaevitz, M H; Shoemaker, F C; Smith, D; Soderberg, M; Sorel, M; Spentzouris, P; Spitz, J; Stancu, I; Stefanski, R J; Sung, M; Tanaka, H A; Tayloe, R; Tzanov, M; Van de Water, R G; Wascko, M O; White, D H; Wilking, M J; Yang, H J; Zeller, G P; Zimmerman, E D

    2009-01-01

    MiniBooNE reports the first absolute cross sections for neutral current single \\pi^0 production on CH_2 induced by neutrino and antineutrino interactions measured from the largest sets of NC \\pi^0 events collected to date. The principal result consists of differential cross sections measured as functions of \\pi^0 momentum and \\pi^0 angle averaged over the neutrino flux at MiniBooNE. We find total cross sections of (4.76+/-0.05_{stat}+/-0.40_{sys})*10^{-40} cm^2/nucleon at a mean energy of =808 MeV and (1.48+/-0.05_{stat}+/-0.14_{sys})*10^{-40} cm^2/nucleon at a mean energy of =664 MeV for \

  5. Analysis of the automated systems of planning of spatial constructions

    Directory of Open Access Journals (Sweden)

    М.С. Барабаш

    2004-04-01

    Full Text Available  The article is devoted to the questions of analysis of existing SAPR and questions of development of new information technologies of planning on the basis of integration of programmatic complexes with the use of united informatively-logical model of object.

  6. Probabilistic Models of Analysis of Loan Activity of Internet Banking

    OpenAIRE

    Kondrateva Irina G.; Ostapenko Irina N.

    2012-01-01

    In article the main advantages of electronic banking in comparison with traditional, methods of the analysis of credit activity are considered. The special role is taken to the probabilistic method of analysis of credit activity in the Internet-bank. Modeling of activity of bank on the basis of probabilistic models of credit operations.

  7. Logic of management of strategic problems of the enterprise

    Directory of Open Access Journals (Sweden)

    Ivahnenko Aleksandr Vladimirovich

    2014-12-01

    Full Text Available Problems of management by firm in the conditions of changes are considered, types of strategic problems, logic of constructions of system of strategic management are allocated. Principles of formation of strategy of firm and a strategy choice in conditions not full definiteness are defined.

  8. SOME FISCAL ASPECTS OF EUROPEAN INTEGRATION OF REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Ivan LUCHIAN

    2014-03-01

    Full Text Available European integration of Republic of Moldova requires solvation of many issues, including those relating to fiscal aspects. The main of them are related to the harmonization of tax legislation of the Republic of Moldova to the European and the operation of the shadow economy and tax fraud. This article will be devoted to reflection problems and some ways of resolving them.

  9. FEATURES OF DEFINITION OF TAX BURDEN OF AN ECONOMIC ENTITY

    Directory of Open Access Journals (Sweden)

    Sobchenko N. V.

    2015-12-01

    Full Text Available The results of an analytical assessment of the developed frame of reference on concepts of tax planning, tax burden, tax burden of the enterprise are presented in article. Tax planning is the most important part of financial planning of the organization. A basis of this process is possibility of each taxpayer to use legislatively resolved means, receptions and ways directed on minimization of tax payments. Minimization of taxes is directed not only on absolute decrease in volumes of tax payments, but also on purposeful transfer of business to more favorable conditions of managing. Tax planning is connected with recognition of the right of each taxpayer to apply all legislatively resolved means, receptions and ways to decrease in tax payments. The analysis of a condition of tax burden of an economic entity of real sector of economy is carried out. It is noted, that by means of various techniques of its assessment it is possible to receive contradictory data on dynamics of change of level of tax burden. As one of factors of increasing the efficiency of business activity is optimization of tax payments and implementation of tax planning acts. Importance of realization of tax planning and optimization of tax payments is defined by desire of taxpayers to lower tax burden and explainable aspiration of the state to prevent it

  10. Problems of formation of the financial resources of small businesses

    Directory of Open Access Journals (Sweden)

    Gorbunova Irina Ivanovna

    2014-05-01

    Full Text Available Article is devoted problems of formation of financial resources of small enterprises. In article kinds and sources of financing of small enterprises are analysed, the estimation of influence of external and internal factors on formation of financial resources of small enterprises is given.

  11. Mathematical Modelling of Process of Fluoration of Metal Tungsten

    Directory of Open Access Journals (Sweden)

    Brendakov Roman V.

    2016-01-01

    Full Text Available Wide use of products from metal tungsten in various branches of a national economy is caused by unique properties of this metal. By means of physical and mathematical modelling of process of receiving gaseous hexafluoride of tungsten it is possible to solve a problem of creation of import-substituting technology of processing of metal tungsten. The fluoride technology of processing of tungsten allows to put various coverings and to make products of tungsten of a various form which can't be received by traditional methods. Fluoride technology of processing of tungsten it is possible to present in the form sequences of two processes, process of fluorination of metal tungsten and process of restoration of fluorides of tungsten hydrogen.

  12. Gases of combustion of briquettes of coal of easy ignition

    International Nuclear Information System (INIS)

    Emissions of combustion gasses of the possible atmospheric pollutants of burnt easy coal briquettes are analysed. The measured pollutants are smoke, CO, CO2, NOx, and SO2. The qualitative measurement of smoke was between excellent and without emissions. This shows a good behaviour of the briquettes in relation to this parameter. Emission of gasses shows a decrease when the process was made inside a closed place in comparison to burn a briquette under free-air conditions. Emission of gases in both cases also depends on the slice of the briquette, which is burning in a specific time. The high differences which were get in SO2 emissions lead to the conclusion that the coal briquettes do not have a good homogenisation in relation to the used SO2 materials for the retention of these emissions. The air quality around the burnt briquette was measured emissions. It was found that co concentration. Is bellow maximum allowed by air quality Colombian and EPA (environmental protection agency) regulations for one hour exposition to this gas. Even thought it was taken inside a closed place, which is the condition that produces the highest CO emissions

  13. Stages of Formation of the Strategy of Social Responsibility of Business

    OpenAIRE

    Zatieyshchykova Olha O.

    2014-01-01

    The article studies existing approaches to formulation of stages of the strategy, according to which a list of stages of formation of the strategy of social responsibility (SSR) is formed, including: identification of the mission and vision of SSR, formation of the system of goals of SSR, assessment of influence of factors of external environment, assessment of the level of social responsibility, analysis of alternatives and selection of strategies. The article identifies SSR mission for Ukra...

  14. Prolegomena of a logic of culture

    DEFF Research Database (Denmark)

    Zeller, Jörg

    Considerations about the elements of a logic of culture inspired by Cassirer's philosophy of symbolic forms, his logic of cultural science and Bourdieu's logic of praxis.......Considerations about the elements of a logic of culture inspired by Cassirer's philosophy of symbolic forms, his logic of cultural science and Bourdieu's logic of praxis....

  15. Formation of communication skills of aviation specialists

    OpenAIRE

    Коваленко, Ольга Олександрівна

    2012-01-01

    Culture of the professional communication is the basis of the professional activity. It is spoken about the process of formation of the professional communication culture, where communication, professionalism of the communication are foundation of it in personal oriented studying by means of creative technologies; examined about peculiarities, and defined conditions of formation of professional oral skills culture of future aviation specialists.

  16. Control of quality in the tests of systems of containment of vehicles. Intercomparison of the results of the tests

    International Nuclear Information System (INIS)

    This article tries to offer information on how Central Laboratory of Structures and Materials are made the tests for Marca N of AENOR of the systems of containment of vehicles and its control of external quality. (Author) 15 refs

  17. Primary stage of development of Institute of Nuclear Physics of Uzbekistan Academy of Sciences

    International Nuclear Information System (INIS)

    The history of organization of Institute of Nuclear Physics of Uzbekistan Academy of Sciences and its first ten years of activities is presented. The main nuclear physics facilities(nuclear reactor, cyclotron, gamma rays source) and main research fields(nuclear physics, radiation materials science, neutron activation analysis) are described. The chronological history of main events is presented