Sample records for healing iatrogenic gastric

  1. Rebamipide May Be Comparable to H2 Receptor Antagonist in Healing Iatrogenic Gastric Ulcers Created by Endoscopic Mucosal Resection: A Prospective Randomized Pilot Study

    Kim, Yu Jin; Lee, Sang Kil; Kim, Jie Hyun; Lee, Yong Chan


    Endoscopic mucosal resection (EMR) results in the formation of iatrogenic gastric ulcers and the optimal treatments for such ulcers are still unclear. We aimed to evaluate the efficacy of rebamipide in the management of EMR-induced ulcers by comparing it with an H2 receptor antagonist. After EMR, patients were randomly assigned into either rebamipide or famotidine groups. All patients received a one-week lansoprazole 30 mg q.d. therapy followed by three-week famotidine (20 mg b.i.d.) or rebamipide (100 mg t.i.d.) therapy. Four weeks after the treatments, ulcer sizes, stages, bleeding rates, and ulcer-related symptoms were compared using endoscopy and a questionnaire. A total of 63 patients were enrolled in this study. Finally, 51 patients were analyzed, 26 in rebamipide and 25 in famotidine group. Baseline characteristics were not significantly different between the two groups. Four weeks after EMR, the two groups were comparable in terms of ulcer reduction ratio (P=0.297), and ulcer stage (P=1.000). Moreover, no difference was observed with regard to ulcer-related symptoms, drug compliance, adverse drug event rates, and bleeding rates. Our data suggest that rebamipide is not inferior to famotidine in healing iatrogenic gastric ulcers, and could be a therapeutic option in the treatment of such ulcers. PMID:20358002

  2. Risk factors of delayed ulcer healing after gastric endoscopic submucosal dissection.

    Lim, Joo Hyun; Kim, Sang Gyun; Choi, Jeongmin; Im, Jong Pil; Kim, Joo Sung; Jung, Hyun Chae


    Although post-endoscopic submucosal dissection (ESD) iatrogenic ulcer is known to heal faster than peptic ulcer, some iatrogenic ulcers show delayed healing. The aim of this study was to clarify risk factors of delayed ulcer healing after gastric ESD. We retrospectively reviewed medical records of all patients who had ESD for gastric neoplasms (866 adenomas and 814 early gastric cancers) between January 2005 and February 2011. Of 1680 subjects, 95 had delayed ulcer healing in 3-month follow-up. Multivariate analysis showed that diabetes (OR 1.743; 95% CI 1.017-2.989, p = 0.043), coagulation abnormality (OR 3.195; 95% CI 1.535-6.650, p = 0.002), specimen size greater than 4 cm (OR 2.999; 95% CI 1.603-5.611, p = 0.001), and electrocoagulation (OR 7.149; 95% CI 1.738-29.411, p = 0.006) were revealed to be independent risk factors of delayed ulcer healing. Meanwhile, persistent Helicobacter pylori infection was not related to the delayed ulcer healing. Large iatrogenic ulcer by ESD with massive hemostasis, especially in patients with diabetes mellitus or coagulation abnormalities, tends to take more than 3 months to heal. For such cases, initial dosage increment of PPI or addition of other anti-ulcer agents after ESD may be beneficial.

  3. Clopidogrel delays gastric ulcer healing in rats.

    Luo, Jiing-Chyuan; Huo, Teh-Ia; Hou, Ming-Chih; Lin, Hsiao-Yi; Li, Chung-Pin; Lin, Han-Chieh; Chang, Full-Young; Lee, Fa-Yauh


    Clopidogrel is not safe enough for the gastric mucosa in patients with high risk of peptic ulcer. This study aimed to explore if clopidogrel delays gastric ulcer healing and elucidate the involved mechanisms. Gastric ulcer was induced in rats and the ulcer size, mucosal epithelial cell proliferation of the ulcer margin, expression of growth factors [epidermal growth factor (EGF), basic fibroblast growth factor] and their receptors, and signal transduction pathways for cell proliferation were measured and compared between the clopidogrel-treated group and untreated controls. For the in vitro part, rat gastric mucosal epithelial cell line (RGM-1 cells) was used to establish EGF receptor over-expressed cells. Cell proliferation and molecular change under EGF treatment (10ng/ml) with and without clopidogrel (10(-6)M) were demonstrated. Ulcer size was significantly larger in the clopidogrel-treated group compared to the control and mucosal epithelial cell proliferation of the ulcer margin was significantly decreased in the clopidogrel-treated group (Pulcer-induced gastric epithelial cell proliferation and ulcer-stimulated expressions of EGF receptor and phosphorylated extracellular signal-regulated kinase (PERK) at the ulcer margin (Pgastric ulcer healing in rats via inhibiting gastric epithelial cell proliferation, at least by inhibition of the EGF receptor-ERK signal transduction pathway.

  4. Non-healing gastric ulcer associated with Candida infection

    Ramaswamy K


    Full Text Available Candida bezoars of the stomach usually occur after gastric surgery. We report a small Candida mass occurring on a non-healing gastric ulcer in a 40-year-old male non-smoker. The ulcer healed with fluconazole and withdrawal of the proton pump inhibitor.

  5. EP4 agonist alleviates indomethacin-induced gastric lesions and promotes chronic gastric ulcer healing

    Guang-Liang Jiang; Wha Bin Im; Yariv Donde; Larry A Wheeler


    AIM: To investigate EP4-selective agonist effect on indomethacin-induced gastric lesions and on the spontaneous healing of chronic gastric ulcers. METHODS: In a mouse model of gastric bleeding with high dose of indomethacin (20 mg/kg), an EP4-selective agonist was administered orally. Stomach lesions and gastric mucous regeneration were monitored. In a mouse model of chronic gastric ulcer induced by acetic acid, EP4 agonist effect on the healing of chronic gastric ulcer was evaluated in the presence or absence of low dose indomethacin (3 mg/kg). In cultured human gastric mucous cells, EP4 agonist effect on indomethacininduced apoptosis was assessed by flow cytometry. RESULTS: The EP4-selective agonist reduced high dose indomethacin-induced acute hemorrhagic damage and promoted mucous epithelial regeneration. Low-dose indomethacin aggravated ulcer bleeding and inflammation, and delayed the healing of the established chronic gastric ulcer. The EP4 agonist, when applied locally, not only offset indomethacin-induced gastric bleeding and inflammation, but also accelerated ulcer healing. In the absence of indomethacin, the EP4 agonist even accelerated chronic gastric ulcer healing and suppressed inflammatory cell infiltration in the granulation tissue. In vitro , the EP4 agonist protected human gastric mucous cells from indomethacin-induced apoptosis. CONCLUSION: EP4-selective agonist may prevent indomethacin-induced gastric lesions and promote healing of existing and indomethacin-aggravated gastric ulcers, via promoting proliferation and survival of mucous epithelial cells.

  6. Effect of omeprazole and cimetidine on healing of chronic gastric ulcers and gastric acid secretion in rats

    Poulsen, Steen Seier


    The effect of omeprazole and cimetidine on healing of chronic gastric ulcers and gastric acid secretion was investigated in rats. The effect of three doses of omeprazole given orally once daily for 25 days was investigated. In controls median ulcer healing was 19.6% after 25 days. Omeprazole...... increased median ulcer healing from 36% at 145 mumole/kg/day to 80% at 580 mumole/kg/day. Basal and pentagastrin stimulated gastric acid secretion decreased dose-dependently by nearly 90% at a dose of 580 mumole/kg/day 22-24 hr after the last dose of omeprazole. Cimetidine given twice daily, in a dose...... that initially inhibits gastric acid secretion by 95%, reduced acid secretion by only 50% 11 hr after the last dose. Median ulcer healing after treatment with cimetidine for 25 days was 41%. This study demonstrates that omeprazole has a more long-acting inhibitory effect on gastric acid secretion compared...

  7. Effect of ranitidine on healing of experimentally induced gastric ulcers in ponies.

    MacAllister, C G; Sangiah, S


    Thirty young ponies were examined endoscopically for evidence of gastric ulceration. Seven ponies had noninduced gastric ulcers present at the initial examination and were eliminated from the study. In an attempt to induce gastric ulcers experimentally, flunixin meglumine (1.1 mg/kg of body weight, IM, q 8 h) was administered for 7 days to the 23 ponies with endoscopically normal gastric mucosa. During the 7 days of flunixin administration, 11 ponies developed gastric ulcers that were appropriate for study. The 11 ponies were randomly allotted to 2 groups. Group-A (n = 5) and group-B (n = 6) ponies received ranitidine (4.4 mg/kg, PO, q 8 h) and corn syrup, respectively, until ulcers healed or for a maximum of 40 days. General anesthesia was induced every 3 to 5 days for visual evaluation of ulcer healing by use of a video endoscope. The earliest complete healing of gastric lesions observed in a corn syrup-treated pony was at 17 days. At 40 days, 3 of 5 and 3 of 6 ponies of the ranitidine and corn syrup-treated groups, respectively, had healed ulcers. Results of this study indicate that: noninduced gastric ulcers may be common in young ponies, flunixin meglumine may be effective in inducing gastric ulcers for gastric healing studies in young ponies, and ranitidine (4.4 mg/kg, q 8 h) is not significantly effective in accelerating healing of experimentally induced gastric ulcers in ponies under conditions of this study.

  8. [The Influence of Glucocorticoids on the Healing Processes in the Gastric Mucosa].

    Podvigina, T T; Filaretova, L P


    In this review, we analyzed the data of literature about the glucocorticoid influences on the gastric erosion and ulcer healing. The data show that multiple injections of glucocorticoids at pharmacological doses delay gastric erosion and ulcer healing. However, according to experimental results endogenic glucocorticoids, on the contrary, play significant role in maintenance of gastric mucosal integrity. Thus, glucocorticoids may have dual effect on healing of gastric injury: contribute to healing process or delay them. The initial glucocorticoid action is physiological and consists in a participation in healing processes what is considered as component gastroprotective action of these hormones. During a long-lasting action of glucocorticoids, the physiological effect can be transformed into pathological one, delaying erosion and ulcer healing, and this contributes to the ulcerogenic action of glucocorticods.

  9. Stable gastric pentadecapeptide BPC 157 heals rat colovesical fistula.

    Grgic, Tihomir; Grgic, Dora; Drmic, Domagoj; Sever, Anita Zenko; Petrovic, Igor; Sucic, Mario; Kokot, Antonio; Klicek, Robert; Sever, Marko; Seiwerth, Sven; Sikiric, Predrag


    To establish the effects of BPC 157 on the healing of rat colovesical fistulas, Wistar Albino male rats were randomly assigned to different groups. BPC 157, a stable gastric pentadecapeptide, has been used in clinical applications-specifically, in ulcerative colitis-and was successful in treating both external and internal fistulas. BPC 157 was provided daily, perorally, in drinking water (10µg/kg, 12ml/rat/day) until sacrifice or, alternatively, 10µg/kg or 10ng/kg intraperitoneally, with the first application at 30min after surgery and the last at 24h before sacrifice. Controls simultaneously received an equivolume of saline (5.0ml/kg ip) or water only (12ml/rat/day). Assessment (i.e., colon and vesical defects, fistula leaking, fecaluria and defecation through the fistula, adhesions and intestinal obstruction as healing processes) took place on days 7, 14 and 28. Control colovesical fistulas regularly exhibited poor healing, with both of the defects persisting; continuous fistula leakage; fecaluria and defecation through the fistula; advanced adhesion formation; and intestinal obstruction. By contrast, BPC 157 given perorally or intraperitoneally and in µg- and ng-regimens rapidly improved the whole presentation, with both colon and vesical defects simultaneously ameliorated and eventually healed. The maximal instilled volume was continuously raised until it reached the values of healthy rats, there were no signs of fecaluria and no defecation through the fistula, there was counteraction of advanced adhesion formation or there was an intestinal obstruction. In conclusion, BPC 157 effects appear to be suited to inducing full healing of colocutaneous fistulas in rats.

  10. Effect of sialoadenectomy and synthetic human urogastrone on healing of chronic gastric ulcers in rats

    Poulsen, Steen Seier; Nexø, Ebba


    The effect of extirpation of the submandibular glands, an exocrine organ for epidermal growth factor/urogastrone (EGF/URO), and the effect of oral administration of synthetic human (EGF/URO) on healing of chronic gastric ulcers in rats has been investigated. Removal of the submandibular glands...... delayed healing of chronic gastric ulcers when examined after 50, 100, and 200 days. Oral administration of synthetic human EGF/URO stimulated gastric ulcer healing when examined after 25 and 50 days of treatment. The effect of synthetic human EGF/URO was comparable with that of cimetidine. The combined...... administration of synthetic human EGF/URO and cimetidine further increased healing of gastric ulcers compared with administration of each substance. Neither synthetic human EGF/URO, nor removal of the submandibular glands had any influence on gastric acid secretion. This study showed that the submandibular...

  11. Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori-infected patients without atrophic gastritis.

    Chen, Li-Wei; Chang, Liang-Che; Hua, Chung-Ching; Hsieh, Bor-Jen; Chen, Shuo-Wei; Chien, Rong-Nan


    Gastric epithelial hyper-proliferation was reported in patients with Helicobacter pylori (H. pylori)-infected gastric mucosa with intestinal metaplasia (IM) changes. In patients with gastric ulcer (GU) and IM, the GU may have a different healing rate in comparison to patients without IM. This study aimed to compare the difference in GU healing between H. pylori-infected patients with IM and those without IM. We retrospectively analyzed patients at the Keelung Chung Gung Memorial Hospital during the period from March 2005 to January 2011. The inclusion criteria were: 1) endoscopic findings of GU and biopsy histological examination plus rapid urease test indicating H. pylori infection; 2) gastric IM adjacent to a GU but with no atrophic gastritis changes; 3) patients receiving H. pylori eradication triple therapy and 8 weeks of maintenance therapy with a proton pump inhibitor; and 4) patients receiving follow-up endoscopy within the 3(rd) and the 4(th) months after treatment. In total, 327 patients with GU and H. pylori infection (136 with IM and 191 without IM) were included. Patients with IM had a higher GU healing rate than those without IM (91.9% vs. 84.3%, P = 0.040). Multivariate logistical regression analysis revealed that failure of H. pylori eradication (Odds = 4.013, 95% CI: 1.840-8.951, P gastric IM (Odds = 0.369, 95% CI: 0.168-0.812, P = 0.013) were the predictors of non-healing GU following treatment. Patient with gastric IM change may have a higher GU healing rate than those without gastric IM. However, successful H. pylori eradication is a more important factor for GU healing than gastric IM.

  12. Effects of the Ethyl Acetate Fraction of Alchornea triplinervia on Healing Gastric Ulcer in Rats

    Clélia A. Hiruma-Lima


    Full Text Available Alchornea triplinervia (Spreng. Muell. Arg (Euphorbiaceae is a medicinal plant commonly used by people living in the Cerrado region of Brazil to treat gastrointestinal ulcers. We previously described the gastroprotective action of methanolic extract (ME of Alchornea triplinervia and the ethyl acetate fraction (EAF in increasing of prostaglandin E2 (PGE2 gastric levels in the mucosa. In this work we evaluated the effect of EAF in promoting the healing process in rats with acetic acid-induced gastric ulcers. In addition, toxicity was investigated during treatment with EAF. After 14 days of treatment with EAF, the potent stimulator of gastric cell proliferation contributed to the acceleration of gastric ulcer healing. Upon immunohistochemical analysis, we observed a pronounced expression of COX-2, mainly in the submucosal layer. The 14-day EAF treatment also significantly increased the number of neutrophils in the gastric mucosa regeneration area. The EAF induced angiogenesis on gastric mucosa, observed as an increase of the number of blood vessels supplying the stomach in rats treated with EAF. Oral administration for 14 days of the ethyl acetate fraction from Alchornea triplinervia accelerated the healing of gastric ulcers in rats by promoting epithelial cell proliferation, increasing the number of neutrophils and stimulation of mucus production. This fraction, which contained mainly phenolic compounds, contributed to gastric mucosa healing.

  13. Effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality: A clinical observation study.

    Yang, Rui-Qi; Mao, Hua; Huang, Li-Yun; Su, Pei-Zhu; Lu, Min


    To evaluate the effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality. Forty-eight patients diagnosed with gastric ulcer between June 2014 and February 2016 were randomly allocated to the combination therapy group or monotherapy group. The former received hydrotalcite combined with esomeprazole, and the latter received esomeprazole alone, for 8 wk. Twenty-four healthy volunteers were recruited and acted as the healthy control group. Endoscopic ulcer healing was observed using white light endoscopy and narrow band imaging magnifying endoscopy. The composition of collagen fibers, amount of collagen deposition, expression of factor VIII and TGF-β1, and hydroxyproline content were analyzed by Masson staining, immunohistochemistry, immunofluorescent imaging and ELISA. Following treatment, changes in the gastric microvascular network were statistically different between the combination therapy group and the monotherapy group (P gastric ulcer healing quality in terms of improving microvascular morphology, degree of structure maturity and function of regenerated mucosa.

  14. Importance of luminal and mucosal zinc in the mechanism of experimental gastric ulcer healing.

    Opoka, W; Adamek, D; Plonka, M; Reczynski, W; Bas, B; Drozdowicz, D; Jagielski, P; Sliwowski, Z; Adamski, P; Brzozowski, T


    Zinc has been reported to exert a gastroprotective action against various experimental gastric lesions suggesting that this trace element is involved in the integrity of the gastric mucosa. Compounds containing zinc, such as polaprezinc, were developed in Japan and used as an antiulcer drugs in the treatment of human peptic ulcer disease. However, the precise mechanism of Zn(2+) containing compounds and their effects on mucosal integrity, gastroprotection and ulcer healing remain unclear. We have determined the efficacy of zinc hydroaspartate, a compound containing Zn(2+), in the mechanism of gastric secretion and ulcer healing in rats with chronic gastric ulcers induced by acetic acid (initial ulcer area = 28 mm(2)). Rats with gastric ulcers were randomized into two groups: A) with gastric fistulas (GF) and B) without gastric fistulas and received a daily treatment with zinc hydroaspartate (32-130 mg/kg-d i.g.) for 3, 7 and 14 days. At the termination of each treatment, the area of gastric ulcers were examined by planimetry, the gastric blood flow (GBF) at ulcer margin was assessed by laser Doppler flowmetry and H(2)-gas clearance methods. The venous blood was withdrawn for a measurement of plasma gastrin levels by radioimmunoassay (RIA). The concentration of Zn(2+) in the gastric juice and mucosa at the ulcer margin were determined by differential pulse anodic stripping voltammetry (DPASV) and flame atomic absorption spectrometry (FAAS) methods and the gastric biopsy samples were taken for histopathological assessment of the quality of ulcer healing. The ulcers healed gradually, with the ulcer area in the vehicle control rats being diminished by 15%, 48% and 78% upon ulcer induction at 3, 7 and 14 days, respectively. Zinc hydroaspartate dose-dependently inhibited the area of gastric ulcer, the dose reducing this area by 50% (ID(50)) being about 60 mg/kg-d. The mucosal concentration of Zn(2+) significantly was unchanged from the baseline immediately after ulcer

  15. Effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing in rats

    Kallaya Eamlamnam; Suthiluk Patumraj; Naruemon Visedopas; Duangporn Thong-Ngam


    AIM: To compare the effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing.METHODS: Male Spraque-Dawley rats (n=48) were divided into four groups. Group1 served as control group,group 2 as gastric ulcer group without treatment, groups 3 and 4 as gastric ulcer treatment groups with sucralfate and Aloe vera. The rats from each group were divided into 2 subgroups for study of leukocyte adherence, TNF-α and IL-10 levels and gastric ulcer healing on days 1 and 8 after induction of gastric ulcer by 20% acetic acid. RESULTS: On day 1 after induction of gastric ulcer, the leukocyte adherence in postcapillary venule was significantly (P< 0.05) increased in the ulcer groups when compared to the control group. The level of TNF-αwas elevated and the level of IL-10 was reduced. In the ulcer groups treated with sucralfate and Aloe vera,leukocyte adherence was reduced in postcapillary venule.The level of IL-10 was elevated, but the level of TNF-αhad no significant difference. On day 8, the leukocyte adherence in postcapillary venule and the level of TNF-αwere still increased and the level of IL-10 was reduced in the ulcer group without treatment. The ulcer treated with sucralfate and Aloe vera had lower leukocyte adherence in postcapillary venule and TNF-α level. The level of IL-10 was still elevated compared to the ulcer group without treatment. Furthermore, histopathological examination of stomach on days 1 and 8 after induction of gastric ulcer showed that gastric tissue was damaged with inflammation. In the ulcer groups treated with sucralfate and Aloe vera on days 1 and 8, gastric inflammation was reduced, epithelial cell proliferation was enhanced and gastric glands became elongated. The ulcer sizes were also reduced compared to the ulcer group without treatment.CONCLUSION: Administration of 20% acetic acid can induce gastric inflammation, increase leukocyte adherence in postcapillary venule and TNF-α level

  16. Angiogenesis in gastric mucosa: an important component of gastric erosion and ulcer healing and its impairment in aging.

    Tarnawski, Andrzej S; Ahluwalia, Amrita; Jones, Michael K


    Angiogenesis (also referred to as neovascularization-formation of new blood vessels from existing vessels) is a fundamental process essential for healing of tissue injury and ulcers because regeneration of blood microvessels is a critical requirement for oxygen and nutrient delivery to the healing site. This review article updates the current views on angiogenesis in gastric mucosa following injury and during ulcer healing, its sequential events, the underlying mechanisms, and the impairment of angiogenesis in aging gastric mucosa. We focus on the time sequence and ultrastructural features of angiogenesis, hypoxia as a trigger, role of vascular endothelial growth factor signaling (VEGF), serum response factor, Cox2 and prostaglandins, nitric oxide, and importin. Recent reports indicate that gastric mucosa of aging humans and experimental animals exhibits increased susceptibility to injury and delayed healing. Gastric mucosa of aging rats has increased susceptibility to injury by a variety of damaging agents such as ethanol, aspirin, and other non-steroidal anti-inflammatory drugs because of structural and functional abnormalities including: reduced gastric mucosal blood flow, hypoxia, reduced expression of vascular endothelial growth factor and survivin, and increased expression of early growth response protein 1 (egr-1) and phosphatase and tensin homolog (PTEN). Until recently, postnatal neovascularization was assumed to occur solely through angiogenesis sprouting of endothelial cells and formation of new blood vessels from pre-existing blood vessels. New studies in the last decade have challenged this paradigm and indicate that in some tissues, including gastric mucosa, the homing of bone marrow-derived endothelial progenitor cells to the site of injury can also contribute to neovascularization by a process termed vasculogenesis.

  17. Iatrogenic neurology.

    Sposato, Luciano A; Fustinoni, Osvaldo


    Iatrogenic disease is one of the most frequent causes of hospital admissions and constitutes a growing public health problem. The most common type of iatrogenic neurologic disease is pharmacologic, and the central and peripheral nervous systems are particularly vulnerable. Despite this, iatrogenic disease is generally overlooked as a differential diagnosis among neurologic patients. The clinical picture of pharmacologically mediated iatrogenic neurologic disease can range from mild to fatal. Common and uncommon forms of drug toxicity are comprehensively addressed in this chapter. While the majority of neurologic adverse effects are listed and referenced in the tables, the most relevant issues are further discussed in the text.

  18. The role of methylglyoxal-modified proteins in gastric ulcer healing.

    Takagi, T; Naito, Y; Oya-Ito, T; Yoshikawa, T


    Methylglyoxal is a reactive dicarbonyl compound produced from cellular glycolytic intermediates that reacts nonenzymatically with proteins to form products such as argpyrimidine at arginine residues. Abnormal accumulation of methylglyoxal and methylglyoxal-derived advanced glycation end products (AGEs) occurs under hyperglycemic conditions and has been implicated in endothelium dysfunction, arterial stiffening, and microvascular complications in diabetes. However, the role of methylglyoxal in the healing process of diabetic gastric ulcers has not been fully investigated. Recently, methylglyoxal modification of peroxiredoxin-VI was found to be associated with delayed healing of diabetic gastric ulcers. Thus, inhibition of methylglyoxal modification might have therapeutic potential for the treatment of such ulcers. In this review, we present what is currently known regarding the role of methylglyoxal in the healing of diabetic gastric ulcers.

  19. Healing, Antioxidant and Cytoprotective Properties of Indigofera truxillensis in Different Models of Gastric Ulcer in Rats


    The present study evaluated the antiulcerogenic activity and mechanisms of the aqueous (AqF 100 mg/kg) and ethyl acetate (AcF 50 mg/kg) fractions from Indigofera truxillensis leaves. This dose was selected to assess its activity on ulcer healing and its action on gastric acid and mucus secretion, prostaglandin production and antioxidant enzyme activity (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione reductase (GSH-Rd)). Gastric ulcer was induced by absolute ethano...

  20. Solcoseryl in prevention of stress-induced gastric lesions and healing of chronic ulcers.

    Konturek, S J; Drozdowicz, D; Pytko-Polonczyk, J; Brzozowski, T; Bielański, W


    Solcoseryl, a deproteinized extract of calf blood, protects the gastric mucosa against various topical irritants and enhances the healing of chronic gastric ulcerations but the mechanisms of these effects have been little studied. This study was designed to elucidate the active principle in Solcoseryl and to determine the role of prostaglandins (PG) and polyamines in the antiulcer properties of this agent. Using both, the radioimmunoassay and radioreceptor assay, EGF-like material was detected in Solcoseryl preparation. Solcoseryl given s.c. prevented the formation of stress-induced gastric lesions and this was accompanied by an increase in the generation of PGE2 in the gastric mucosa. Similar effects were obtained with EGF. Pretreatment with indomethacin, to suppress mucosal generation of prostaglandins (PG), greatly augmented stress-induced gastric ulcerations and antagonized the protection exerted by both Solcoseryl and EGF. Solcoseryl, like EGF, enhanced the healing of chronic gastro-duodenal ulcerations. This effect was abolished by the pretreatment with difluoromethylornithine, an inhibitor of ornithine decarboxylase, the key enzyme in the biosynthesis of polyamines. The healing effects of Solcoseryl and EGF was also reduced by prednisolone which decreased the angiogenesis in the granulation tissue in the ulcer area. These results indicate that Solcoseryl 1. contains EGF-like material, 2. displays the protective and ulcer healing effects similar to those of EGF and involving both PG and polyamines and 3. acts via similar mechanism as does EGF.

  1. The Probiotic Mixture VSL#3 Accelerates Gastric Ulcer Healing by Stimulating Vascular Endothelial Growth Factor

    Dharmani, Poonam; De Simone, Claudio; Chadee, Kris


    Studies assessing the effect and mechanism of probiotics on diseases of the upper gastrointestinal tract (GI) including gastric ulcers are limited despite extensive work and promising results of this therapeutic option for other GI diseases. In this study, we investigated the mechanisms by which the probiotic mixture VSL#3 (a mixture of eight probiotic bacteria including Lactobacilli, Bifidobacteria and Streptococcus species) heals acetic acid induced gastric ulcer in rats. VSL#3 was administered orally at low (6×109 bacteria) or high (1.2×1010 bacteria) dosages from day 3 after ulcer induction for 14 consecutive days. VSL#3 treatments significantly enhanced gastric ulcer healing in a dose-dependent manner. To assess the mechanism(s) whereby VSL#3 exerted its protective effects, we quantified the gene expression of several pro-inflammatory cytokines, protein and expression of stomach mucin-Muc5ac, regulatory cytokine-IL-10, COX-2 and various growth factors. Of all the components examined, only expression and protein production of VEGF was increased 332-fold on day 7 in the ulcerated tissues of animals treated with VSL#3. Predictably, animals treated with VEGF neutralizing antibody significantly delayed gastric ulcer healing in VSL#3 treated animals. This is the first report to demonstrate high efficacy of the probiotic mixture VSL#3 in enhancing gastric ulcer healing. Probiotic efficacy was effective at higher concentrations of VSL#3 by specifically increasing the expression and production of angiogenesis promoting growth factors, primarily VEGF. PMID:23484048

  2. Quality of healing of gastric ulcers: Natural products beyond acid suppression.

    Kangwan, Napapan; Park, Jong-Min; Kim, Eun-Hee; Hahm, Ki Baik


    Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors (PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process. However, in spite of these advancements, some patients have suffered from recurrence or intractability in spite of continuous anti-ulcer therapy. A new concept of the quality of ulcer healing (QOUH) was initiated that considers the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. Although several gastroprotection provided these achievements of the QOUH, which PPI or other acid suppressants did not accomplish, we found that gastroprotection that originated from natural products, such as a newer formulation from either Artemisia or S-allyl cysteine from garlic, were very effective in the QOUH, as well as improving clinical symptoms with fewer side effects. In this review, we will introduce the importance of the QOUH in ulcer healing and the achievements from natural products.

  3. Gastric cytoprotection beyond prostaglandins: cellular and molecular mechanisms of gastroprotective and ulcer healing actions of antacids.

    Tarnawski, Andrzej; Ahluwalia, Amrita; Jones, Michael K


    This article updates current views on gastric mucosal defense, injury, protection and ulcer healing with a focus on mucosal protective and ulcer healing actions of antacids. The gastric mucosa is continuously exposed to a variety of noxious factors, both endogenous such as: 0.1N hydrochloric acid, pepsin, bile acids, lysolecithin, H. pylori toxins and exogenous such as NSAIDs, ethanol and others. Gastric mucosal integrity is maintained by pre-epithelial, epithelial and post-epithelial defense mechanisms permitting the mucosa to withstand exposure to the above damaging factors. When mucosal defense is weakened or overwhelmed by injurious factors, injury develops in the form of erosions or ulcers. In the late 1970s Andre Robert and coworkers discovered that microgram amounts of a prostaglandin E2 analog protects the gastric mucosa against a variety of ulcerogenic and necrotizing agents - even such strong inducers of injury as 100% ethanol and boiling water. They proposed a new concept of cytoprotection. Subsequently, other compounds, such as sulfhydryls, sucralfate and epidermal growth factor were shown to exert protective action on gastric mucosa. Additionally, some antacids have been shown to exert a potent mucosal protective action against a variety of injurious factors and accelerate healing of erosions and gastric ulcers. These actions of antacids, especially hydrotalcite - the newest and the most extensively studied antacid - are due to activation of prostaglandin synthesis; binding to and inactivation of pepsin, bile acids and H. pylori toxins; induction of heat shock proteins; and, activation of genes encoding growth factors and their receptors.

  4. The effect of sequential therapy with lansoprazole and ecabet sodium in treating iatrogenic gastric ulcer after endoscopic submucosal dissection: a randomized prospective study.

    Ahn, Ji Yong; Choi, Chang Hwan; Lee, Jang Wook; Park, Sung Jin; Kim, Jeong Wook; Chang, Sae Kyung; Han, Seung Bong


    Ecabet sodium (ES) is a new non-systemic anti-ulcer agent belonging to the category of gastroprotective agents. In this study we aimed to compare the efficacy of a combination therapy with lansoprazole (LS) followed by ES with LS alone in treating endoscopic submucosal dissection (ESD)-induced iatrogenic gastric ulcers. Patients diagnosed with gastric adenomas or early gastric cancer were randomly divided into either the LS group (30 mg once daily for 4 weeks; n = 45) or the LS + ES group (LS 30 mg once daily for one week followed by ES 1500 mg twice daily for 3 weeks; n = 45). Four weeks after ESD, a follow-up endoscopy was conducted to evaluate the proportions of ulcer reduction and ulcer stages in the two groups. In all, 79 patients were included in the final analyses. Both treatment modalities were well-tolerated in most patients, with a drug compliance of over 80%. There were no significant differences between the two groups in terms of the proportions of ulcer reduction (0.9503 ± 0.1215 in the LS group vs 0.9192 ± 0.0700 in the LS + ES group, P = 0.169) or ulcer stage (P = 0.446). The prevalence of adverse events related to drugs and bleeding were also similar between the two groups. Sequential therapy with LS + ES is as effective as LS alone against ESD-induced gastric ulcers. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  5. L-Theanine healed NSAID-induced gastric ulcer by modulating pro/antioxidant balance in gastric ulcer margin.

    Chatterjee, Sirshendu; Chatterjee, Ananya; Roy, Surmi; Bera, Biswajit; Bandyopadhyay, Sandip K


    L-Theanine is a unique non-protein-forming amino acid present in tea [Camellia sinensis (L.) O. Kuntze]. In the present work, we evaluated the healing effect of L-theanine on NSAID (indomethacin)-induced gastric ulcer. Histology of the stomach tissues revealed maximum ulceration on the third day after indomethacin administration (18 mg/kg, single dose p.o.) which was accompanied by increased lipid peroxidation; protein carbonylation; Th1 cytokine synthesis, and depletion of thiol, mucin, prostaglandin (PG) E, Th2 cytokine synthesis; and total antioxidant status in mice. L-Theanine healed gastric ulcer at a dose of 10 mg/kg b.w. but aggravated the ulcerated condition at a higher dose of 40 mg/kg b.w. At 10 mg/kg b.w., L-theanine significantly alleviated the adverse oxidative effect of indomethacin through enhanced synthesis of PGE2 by modulation of cyclo-oxygenase-1 and 2 [COX-1 and COX-2] expression, Th1/Th2 cytokine balance, and restoration of cellular antioxidant status at the gastric ulcer margin. The present study revealed for the first time the dose-dependent biphasic effect of a natural neuroprotective agent, L-theanine, on gastric ulcer disease.

  6. Expression and activities of three inducible enzymes in the healing of gastric ulcers in rats

    Jin-Sheng Guo; Chi-Hin Cho; Wei-Ping Wang; Xi-Zhong Shen; Chuen-Lung Cheng; Marcel Wing Leung Koo


    AIM: To explore the roles of nitric oxide synthase (NOS),heme oxygenase (HO) and cyclooxygenase (COX) in gastric ulceration and to investigate the relationships of the expression and activities of these enzymes at different stages of gastric ulceration.METHODS: Gastric ulcers (kissing ulcers) were induced by luminal application of acetic acid. Gastric tissue samples were obtained from the ulcer base, ulcer margin, and nonulcerated area around the ulcer margin at different time intervals after ulcer induction. The mRNA expression and protein levels of inducible and constitutive isoforms of NOS,HO and COX were analyzed with RT-PCR and Western blotting methods. The activities of the total NOS, inducible NOS (iNOS), HO, and COX were also determined.RESULTS: Differential expression of inducible iNOS, HO-1and COX-2 and enzyme activities of NOS, HO and COX were found in the gastric ulcer base. High iNOS expression and activity were observed on day 1 to day 3 in severely inflamed ulcer tissues. Maximum expressions of HO-1 and COX-2 and enzyme activities of HO and COX lagged behind that of iNOS,and remained at high levels during the healing phase.CONCLUSION: The expression and activities of inducible NOS, HO-1 and COX-2 are found to be correlated to different stages of gastric ulceration. Inducible NOS may contribute to ulcer formation while HO-1 and COX-2 may promote ulcer healing.

  7. [Melatonin as a therapeutic factor in gastric ulcer healing under experimental diabetes].

    Magierowski, Marcin; Jasnos, Katarzyna; Brzozowska, Iwona; Drozdowicz, Danuta; Sliwowski, Zbigniew; Nawrot, Elizbieta; Szczyrk, Urszula; Kwiecień, Sławomir


    Melatonin (N-acetyl-5-methoxytryptamine) is a hormon secreted mostly by the pineal gland in the brain which maintains the body's circadian rhythm. Interestingly, this indol derivative is produced by enterochromaffin-like cells (ECL) in the gastrointestinal tract (GIT) in amount about 400 fold greater than detected in the pinealocytes. Previous studies revealed that melatonin exerts beneficial action against acute gastric damage induced by stress ethanol, aspirin and ischemia-reperfusion. Hyperglycemia, which is the main symptom of diabetes mellitus, is known to induce mitochondrial dysfunction and endoplasmic reticulum stress, both promoting the generation of reactive oxygen species (ROS). ROS were shown to exhibit higher activity than molecular oxygen under basal conditions due to unpaired electron in its outermost shell of electrons. ROS lead to damage of cellular proteins, nucleic acids and membrane polyunsaturated fatty lipids. In this study, we induced diabetes mellitus by the application of strep. tozocin in presence of gastric ulcers. Male Wistar rats were used in this model. 9 days after gastric ulcers and diabetes mellitus induction, groups of rats were treated with saline or melatonin (20 mg/kg i.g.). At the termination of the experiment, rats were anesthetized, abdomen was opened and gastric blood flow (GBF) was measured. Stomachs were removed for determination of gastric ulcers area by planimetry. Tissue samples were collected for biochemical assays. We demonstrated that melatonin significantly accelerates gastric ulcers healing with and without coexistence of diabetes mellitus. This effect was accompanied by increase of GBF level. Moreover, we observed an increase in superoxide dismutase (SOD) activity and an decrease in lipid peroxidation products concentration within gastric tissue homogenates of animals treated with melatonin, as compared with control group. Melatonin application accelerates gastric ulcers healing with and without presence of

  8. Healing, antioxidant and cytoprotective properties of Indigofera truxillensis in different models of gastric ulcer in rats.

    Luiz-Ferreira, Anderson; Cola, Maira; Barbastefano, Victor; de-Faria, Felipe Meira; Almeida, Ana Beatriz A de; Farias-Silva, Elisângela; Calvo, Tamara Regina; Hiruma-Lima, Clélia A; Vilegas, Wagner; Souza-Brito, Alba Regina M


    The present study evaluated the antiulcerogenic activity and mechanisms of the aqueous (AqF 100 mg/kg) and ethyl acetate (AcF 50 mg/kg) fractions from Indigofera truxillensis leaves. This dose was selected to assess its activity on ulcer healing and its action on gastric acid and mucus secretion, prostaglandin production and antioxidant enzyme activity (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione reductase (GSH-Rd)). Gastric ulcer was induced by absolute ethanol. Antisecretory action, mucus and prostaglandin production, healing and antioxidant enzyme activities were evaluated for both fractions. AqF and AcF significantly inhibited the gastric mucosal damage caused by ethanol. This effect was statistically significant at 100 and 50 mg/kg compared with the vehicle. Neither fraction interfered with gastric secretion. AcF increased the PGE(2) production, and both fractions increased mucus production. l-NAME did not alter the gastroprotection exerted by the fractions, but N-ethylmaleimide attenuated only AcF. In the ischemia/reperfusion model both fractions inhibited the mucosal damage. AcF increased SOD, GSH-Px and GSH-Rd activity, but AqF increased only SOD and GSH-Px. In the acetic acid-induced ulcer model AcF only accelerated ulcer healing. These results showed that Indigofera truxillensis acted as a gastroprotective agent, stimulating protective factors and antioxidants enzymes.

  9. Healing, Antioxidant and Cytoprotective Properties of Indigofera truxillensis in Different Models of Gastric Ulcer in Rats

    Wagner Vilegas


    Full Text Available The present study evaluated the antiulcerogenic activity and mechanisms of the aqueous (AqF 100 mg/kg and ethyl acetate (AcF 50 mg/kg fractions from Indigofera truxillensis leaves. This dose was selected to assess its activity on ulcer healing and its action on gastric acid and mucus secretion, prostaglandin production and antioxidant enzyme activity (superoxide dismutase (SOD, glutathione peroxidase (GSH-Px and glutathione reductase (GSH-Rd. Gastric ulcer was induced by absolute ethanol. Antisecretory action, mucus and prostaglandin production, healing and antioxidant enzyme activities were evaluated for both fractions. AqF and AcF significantly inhibited the gastric mucosal damage caused by ethanol. This effect was statistically significant at 100 and 50 mg/kg compared with the vehicle. Neither fraction interfered with gastric secretion. AcF increased the PGE2 production, and both fractions increased mucus production. l-NAME did not alter the gastroprotection exerted by the fractions, but N-ethylmaleimide attenuated only AcF. In the ischemia/reperfusion model both fractions inhibited the mucosal damage. AcF increased SOD, GSH-Px and GSH-Rd activity, but AqF increased only SOD and GSH-Px. In the acetic acid-induced ulcer model AcF only accelerated ulcer healing. These results showed that Indigofera truxillensis acted as a gastroprotective agent, stimulating protective factors and antioxidants enzymes.

  10. Iatrogenic disease

    Nikkels, PGJ


    Injury is a feature of all medical practice, but it is perhaps nowhere more accepted as an unavoidable consequence of therapy than in obstetric and neonatal medicine. Treatment is usually benefi cial, but therapeutic procedures may sometimes result in adverse side effects or cause iatrogenic damage.

  11. Somatic pain sensitivity during formation and healing of acetic acid-induced gastric ulcers in conscious rats.

    Yarushkina, Natalya; Bogdanov, Anatoly; Filaretova, Ludmila


    A classical feature of visceral pain is its referring to somatic locations. Gastric ulcer is a source of visceral pain. In the present study we investigated whether gastric ulcers may trigger the changes in somatic nociception. For this aim somatic pain sensitivity was estimated under conditions of gastric ulcer development and healing. Gastric ulcers were induced by luminal application of 60% acetic acid under surgical conditions. Control rats were subjected to the same surgical procedure, but with the application of saline instead of the acid. Somatic pain sensitivity (tail flick latency), plasma corticosterone level, adrenal and thymus weight were investigated under conditions of the formation and the healing of gastric ulcers. The application of the acid resulted in the formation of kissing gastric ulcers, the increase of somatic pain sensitivity (the decrease of tail flick latency) as well as the appearance of typical signs of chronic stress: long-lasting increase of plasma corticosterone level, adrenal gland hypertrophy and thymus gland involution. Natural healing of gastric ulcers was accompanied by restoration of pain sensitivity as well as attenuation of the signs of chronic stress. Delay of ulcer healing by the daily indomethacin administration (2 mg/kg, s.c.) prevented the restoration of somatic pain sensitivity. The results suggest that chronic gastric ulcers may trigger somatic hypersensitivity.

  12. Impact of Helicobacter pylori on the healing process of the gastric barrier

    Mnich, Eliza; Kowalewicz-Kulbat, Magdalena; Sicińska, Paulina; Hinc, Krzysztof; Obuchowski, Michał; Gajewski, Adrian; Moran, Anthony P; Chmiela, Magdalena


    AIM To determine the impact of selected well defined Helicobacter pylori (H. pylori) antigens on gastric barrier cell turnover. METHODS In this study, using two cellular models of gastric epithelial cells and fibroblasts, we have focused on exploring the effects of well defined H. pylori soluble components such as glycine acid extract antigenic complex (GE), subunit A of urease (UreA), cytotoxin associated gene A protein (CagA) and lipopolysaccharide (LPS) on cell turnover by comparing the wound healing capacity of the cells in terms of their proliferative and metabolic activity as well as cell cycle distribution. Toxic effects of H. pylori components have been assessed in an association with damage to cell nuclei and inhibition of signal transducer and activator of transcription 3 (STAT3) phosphorylation. RESULTS We showed that H. pylori GE, CagA and UreA promoted regeneration of epithelial cells and fibroblasts, which is necessary for effective tissue healing. However, in vivo increased proliferative activity of these cells may constitute an increased risk of gastric neoplasia. In contrast, H. pylori LPS showed a dose-dependent influence on the process of wound healing. At a low concentration (1 ng/mL) H. pylori LPS accelerated of healing epithelial cells, which was linked to significantly enhanced cell proliferation and MTT reduction as well as lack of alterations in cell cycle and downregulation of epidermal growth factor (EGF) production as well as cell nuclei destruction. By comparison, H. pylori LPS at a high concentration (25 ng/mL) inhibited the process of wound repair, which was related to diminished proliferative activity of the cells, cell cycle arrest, destruction of cell nuclei and downregulation of the EGF/STAT3 signalling pathway. CONCLUSION In vivo H. pylori LPS driven effects might lead to the maintenance of chronic inflammatory response and pathological disorders on the level of the gastric mucosal barrier. PMID:27672275

  13. Evidence of gastric ulcer healing activity of Maytenus robusta Reissek: In vitro and in vivo studies.

    da Silva, Luisa Mota; Boeing, Thaise; Somensi, Lincon Bordignon; Cury, Benhur Judah; Steimbach, Viviane Miranda Bispo; Silveria, Alessandro Conrado de Oliveira; Niero, Rivaldo; Cechinel Filho, Valdir; Santin, José Roberto; de Andrade, Sérgio Faloni


    Maytenus robusta Reissek (Celastraceae) is traditionally used in Brazilian folk medicine to treat gastric ulcer, as a substitute for M. ilicifolia, which is almost extinct. The gastroprotective properties of M. robusta were demonstrated previously using only preventive approaches, such as acute gastric ulcer models. However, the healing effect of M. robusta in gastric ulcers remains unclear. The current study was carried out to investigate the healing effectiveness of M. robusta hydroalcoholic extract (HEMR) from aerial parts in the acetic acid-induced chronic ulcer model and to determine its effect on cell proliferation, scavenging free radicals, and inflammatory and oxidative damage. To evaluate the healing properties of HEMR in vivo, chronic gastric ulcer was induced in rats by 80% acid acetic. Next, different groups of animals (n=6) were treated orally with vehicle (water plus 1% tween, 1 ml/kg), omeprazole (20mg/kg), or HEMR (1-10mg/kg), twice daily for 7 days. At the end of the treatment, the total ulcer area (mm(2)) was measured and a sample of gastric tissue was taken for histological and histochemical analysis. Evaluation of GSH and LOOH levels, GST, SOD, CAT and MPO activity was also performed at the site of the lesion. In parallel, radical scavenging activity, cytoprotective effect, and cell proliferation activity in fibroblasts (L929 cells) were determined by in vitro trials. The antisecretory properties were evaluated using the pylorus ligature model in rats, and the anti-Helicobacter pylori activity was determined in vitro. Acute toxicity was evaluated by relative organ weight and biochemical parameters in serum. The prokinetic properties were also evaluated in mice. Oral administration of HEMR (10mg/kg) reduced the gastric ulcer area by 53%, compared to the vehicle group (120.0 ± 8.3mm(2)), the regeneration of gastric mucosa was evidenced in histological analysis. Moreover, HEMR treatment increased gastric mucin content and reduced oxidative stress

  14. Ellagic acid facilitates indomethacin-induced gastric ulcer healing via COX-2 up-regulation

    Ananya Chatterjee; Sirshendu Chatterjee; Smita Das; Arpita Saha; Subrata Chattopadhyay; Sandip K. Bandyopadhyay


    The mechanism of indomethacin-induced gastric ulcer healing by ellagic acid (EA) in experimental mice model is described in our study.Ulcer index (UI) and myeloperoxidase (MPO) activity of the stomach tissues showed maximum ulceration on the third day after indomethacin (18 mg/kg,single dose) administration.Preliminary observation of UI and MPO activity suggests that EA possesses ulcer-healing activity.Other anti-ulcer parameters such as the levels of prostaglandin E2,cyclooxygenase (COX) 1 and 2 enzymes,anti-inflammatory cytokines [interleukin (IL)-4 and -5J,pro-angiogenic factors,e.g.vascular endothelial growth factor,hepatocyte growth factor (HGF),and endothelial growth factor (EGF) were down-regulated by indomethacin.EA (7 mg/kg/day) treatment for 3 days shifted the indomethacin-induced pro-inflammatory biochemical parameters to the healing side.These activities were correlated with the ability of EA to alter the COX-2-dependent healing pathways.The ulcer-healing activity of EA was,however,compromised by pre-administration of the specific COX-2 inhibitor,celecoxib,and NS-398.Taken together,these results suggested that the EA treatment accelerates ulcer healing by inducing IL-4,EGF/HGF levds and enhances COX-2 expression.

  15. Iatrogenic gastric fistula due to inappropriate placement of intercostal drainage tube in a case of traumatic diaphragmatic hernia.

    Rege S


    Full Text Available A 26-year-old, 30 weeks primigravida presented with a gastric fistula through a left intercostal drain, which was inserted for drainage of suspected haemopneumothorax following minor trauma. It was confirmed to be a diaphragmatic hernia, with stomach and omentum as its contents. On exploratory laparotomy, disconnection of the tube and fistulous tract, with reduction of herniated contents and primary suturing of stomach was carried out. Diaphragmatic reconstruction with polypropylene mesh was also carried out. Post-operative recovery was uneventful with full lung expansion by 3rd postoperative day. Patient was asymptomatic at follow-up 6 months.

  16. Iatrogenic meningitis

    Eduardo Genaro Mutarelli


    Full Text Available Iatrogenic meningitis can be caused by a number of mechanisms. The recent case reports of fungal meningitis after application of epidural methylprednisolone caused warning in the medical community. Cases were caused by contaminated lots of methylprednisolone from a single compounding pharmacy. Several medications can cause meninigitis by probable hypersensitivity mechanism. Neurologists should be alert to the recent description of the use of lamotrigine and development of aseptic meningitis.

  17. Clopidogrel inhibits angiogenesis of gastric ulcer healing via downregulation of vascular endothelial growth factor receptor 2.

    Luo, Jiing-Chyuan; Peng, Yen-Ling; Chen, Tseng-Shing; Huo, Teh-Ia; Hou, Ming-Chih; Huang, Hui-Chun; Lin, Han-Chieh; Lee, Fa-Yauh


    Although clopidogrel does not cause gastric mucosal injury, it does not prevent peptic ulcer recurrence in high-risk patients. We explored whether clopidogrel delays gastric ulcer healing via inhibiting angiogenesis and to elucidate the possible mechanisms. Gastric ulcers were induced in Sprague Dawley rats, and ulcer healing and angiogenesis of ulcer margin were compared between clopidogrel-treated rats and controls. The expressions of the proangiogenic growth factors and their receptors including basic fibroblast growth factor (bFGF), bFGF receptor (FGFR), vascular endothelial growth factor (VEGF), VEGFR1, VEGFR2, platelet-derived growth factor (PDGF)A, PDGFB, PDGFR A, PDGFR B, and phosphorylated form of mitogenic activated protein kinase pathways over the ulcer margin were compared via western blot and reverse transcription polymerase chain reaction. In vitro, human umbilical vein endothelial cells (HUVECs) were used to elucidate how clopidogrel inhibited growth factors-stimulated HUVEC proliferation. The ulcer sizes were significantly larger and the angiogenesis of ulcer margin was significantly diminished in the clopidogrel (2 and 10 mg/kg/d) treated groups. Ulcer induction markedly increased the expression of phosphorylated form of extracellular signal-regulated kinase (pERK), FGFR2, VEGF, VEGFR2, and PDGFRA when compared with those of normal mucosa. Clopidogrel treatment significantly decreased pERK, FGFR2, VEGF, VEGFR2, and PDGFRA expression at the ulcer margin when compared with those of the respective control group. In vitro, clopidogrel (10(-6)M) inhibited VEGF-stimulated (20 ng/mL) HUVEC proliferation, at least, via downregulation of VEGFR2 and pERK. Clopidogrel inhibits the angiogenesis of gastric ulcer healing at least partially by the inhibition of the VEGF-VEGFR2-ERK signal transduction pathway. Copyright © 2015. Published by Elsevier B.V.

  18. Endothelin-1, an ulcer inducer, promotes gastric ulcer healing via mobilizing gastric myofibroblasts and stimulates production of stroma-derived factors.

    Nishida, Tsutomu; Tsuji, Shingo; Kimura, Arata; Tsujii, Masahiko; Ishii, Syuji; Yoshio, Toshiyuki; Shinzaki, Shinichiro; Egawa, Satoshi; Irie, Takanobu; Yasumaru, Masakazu; Iijima, Hideki; Murata, Hiroaki; Kawano, Sunao; Hayashi, Norio


    Endothelin (ET)-1 is a potent inducer of peptic ulcers. The roles of ET-1 in ulcer healing, however, have remained unclear, and these were investigated in mice. Gastric ulcers were induced in mice by serosal application of acetic acid. Three days later, mice were given a neutralizing ET-1 antibody or nonimmunized serum. The ulcer size, amount of fibrosis and myofibroblasts, and localization of ET-1 and ET(A/B) receptors were analyzed. To elucidate the mechanisms underlying the effects of ET-1, we examined the proliferation, migration, and release of growth and angiogenic factors in gastric myofibroblasts with or without ET-1. The expression of prepro-ET-1 (an ET-1 precursor) and ET-converting enzyme-1 was examined in gastric myofibroblasts using RT-PCR. Immunoneutralization of ET-1 delayed gastric ulcer healing. The areas of fibrosis and myofibroblasts were smaller in the anti-ET-1 antibody group than in the control. ET-1 was expressed in the gastric epithelium, myofibroblasts, and other cell types. ET(A) receptors, but not ET(B) receptors, were present in myofibroblasts. ET-1 increased proliferation and migration of gastric myofibroblasts. ET-1 stimulated the release of hepatocyte growth factor, VEGF, PGE(2), and IL-6 from gastric myofibroblasts. mRNA for prepro-ET-1 and ET-converting enzyme-1 was also expressed. ET-1 promotes the accumulation of gastric myofibroblasts and collagen fibrils at gastric ulcers. ET-1 also stimulates migration and proliferation of gastric myofibroblasts and enhances the release of growth factors, angiogenic factors, and PGE(2). Thus ET-1 has important roles not only in ulcer formation but also in ulcer healing via mobilizing myofibroblasts and inducing production of stroma-derived factors.

  19. Enhancement of gastric ulcer healing and angiogenesis by cochinchina Momordica seed extract in rats.

    Kang, Jung Mook; Kim, Nayoung; Kim, Bongcheol; Kim, Joo-Hyon; Lee, Bong-Yong; Park, Ji Hyun; Lee, Mi Kyoung; Lee, Hye Seung; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung


    Cochinchina momordica seed is the dried ripe seed of Momordica cochinchinensis, a perennial vine. The antiulcer effect of an extract from cochinchina momordica seeds (SK-MS10) was evaluated in a rat model of acetic acid-induced gastric ulcers. Gastric ulcers were produced by subserosal injection of acetic acid. SK-MS10 (200 mg/kg) or vehicle was administered orally once per day for 14 days after the acetic acid injection. The stomach was removed and the ulcer size measured at day 7 and 14 of the treatment. Expression of vascular endothelial growth factor (VEGF) was assessed by real-time RT-PCR and Western blot analysis. In addition, the microvasculature density (MVD) adjacent to the ulcer margin was examined by immunohistochemistry. The treatment with SK-MS10 for 7 and 14 days significantly accelerated ulcer healing and increased the expression of mRNA (at day 7) as well as VEGF protein (at day 14) compared to the vehicle-treated rats. The MVD for factor VIII was also higher in the SK-MS10 treatment group compared to the vehicle-treated rats; however, these differences were not statistically significant. These results suggest that SK-MS10 treatment accelerates the healing of gastric ulcers via upregulation of VEGF and angiogenesis in an acetic acid rat model.

  20. Effect of Jianweiyuyang granule on gastric ulcer recurrence and expression of VEGF mRNA in the healing process of gastric ulcer in rats

    Xing-Ping Dai; Jia-Bang Li; Zhao-Qian Liu; Xiang Ding; Cheng-Hui Huang; Bing Zhou


    AIM: To investigate the effect of Jianweiyuyang (JWYY)granule on gastric ulcer recurrence and its mechanism in the treatment of gastric ulcer in rats.METHODS: Gastric ulcer in rats was induced according to Okeba's method with minor modification and the recurrence model was induced by IL-1β. The expression of vascular endothelial growth factor mRNA (VEGF mRNA) was examined by reverse transcription polymerase chain reaction in gastric ulcer and microvessel density (MVD) adjacent to the ulcer margin was examined by immunohistochemistry.RESULTS: MVD was higher in the JWYY treatment group (14.0±2.62) compared with the normal, model and ranitidine treatment groups (2.2±0.84, 8.8±0.97, 10.4±0.97) in rats (P<0.01). The expression level of VEGF mRNA in gastric tissues during the healing process of JWYY treatment group rats significantly increased compared with other groups (normal group: 0.190±0.019, model group: 0.642±0.034,ranitidine group: 0.790±0.037, P<0.01).CONCLUSION: JWYY granules can stimulate angiogenesis and enhance the expression of VEGF mRNA in gastric ulcer rats. This might be the mechanism for JWYY accelerating the ulcer healing, and preventing the recurrence of gastric ulcer.

  1. A comparison of roxatidine acetate and ranitidine in gastric ulcer healing.

    Judmaier, G


    A randomised multicentre double-blind study was conducted to compare the efficacy and safety of roxatidine acetate 75 mg twice daily and ranitidine 150 mg twice daily in 295 patients with endoscopically confirmed gastric ulcers. Substantial reductions in ulcer diameters and healing rates of 85.6 and 88.2% for roxatidine acetate and ranitidine, respectively, were obtained after 8 weeks of treatment. There was no difference in healing rates between smokers and non-smokers in either group. The relief of day and night-time epigastric pain was comparable for both treatment groups, as was antacid tablet consumption, with the majority of patients pain-free at the end of the study. The incidence of side effects was low, with 3 patients treated with roxatidine acetate, compared with 4 ranitidine-treated patients, reporting adverse reactions. There were no clinically significant changes in laboratory values. The present study suggests that 8 weeks of treatment with roxatidine acetate 75 mg twice a day produces effective and safe acute management of gastric ulcers which is comparable to that seen with ranitidine.

  2. A comparison of roxatidine acetate 150 mg once daily and 75 mg twice daily in gastric ulcer healing.

    Rösch, W


    In 363 outpatients with endoscopically confirmed gastric ulcers the efficacy and safety of roxatidine acetate 150 mg at night was compared to 75 mg twice daily. After 8 weeks' treatment substantial reductions in gastric ulcer diameter were obtained in addition to healing rates of 83.7 and 86% for the twice daily and night-time dosing, respectively. Daily reductions in day and night-time epigastric pain were obtained with no significant differences between treatment groups for pain scores or antacid tablet consumption. Furthermore, cigarette smoking did not influence the healing rates produced by either treatment schedule. 26 patients reported 32 adverse reactions and 5 patients discontinued treatment because of side effects, although only 1 of these was a severe reaction. The present data suggest that a single night-time dose of roxatidine acetate 150 mg is as safe and effective as the twice daily dose regimen for the management of acute gastric ulceration.

  3. Role of TFF in healing of stress-induced gastric lesions

    Shi-Nan Nie; Hai-Chen Sun; Zhao-Shen Li; Xiao-Ming Qian; Xue-Hao Wu; Shi-Yu Yang; Wen-Jie Tang; Bao-Hua Xu; Fang Huang; Xin Lin; Dong-Yan Sun


    AIM: To determine the changes of pS2 and ITF of TFF expression in gastric mucosa and the effect on ulcer healing of pS2, ITF to Water-immersion and restraint stress (WRS)in rats.METHODS: Wistar rats were exposed to single or repeated WRS for 4 h every other day for up to 6 days. Gastric mucosal blood flow (GMBF) was measured by LDF-3 flowmeter and the extent of gastric mucosal lesions were evaluated grossly and histologically. Expression of pS2 and ITF mRNA was determined by RT-PCR. Immunohistochemistry was used to further detect the expression of pS2 and ITF.RESULTS: WRS applied once produced numerous gastric mucosal erosions, but the number of these lesions gradually declined and GMBF restored at 2, 4, 8 h after stress. The area of gastric mucosal lesion was reduced by 64.9 % and GMBF was increased by 89.8 % at 8 h. The healing of stress-induced ulcerations was accompanied by increased expression of pS2 (0.51±0.14 vs0.77±0.11, P<0.01) and ITF (0.022±0.001 vs 0.177±0.010, P<0.01). The results were demonstrated further by immunohistochemistry of pS2(0.95±0.11 vs1.41±0.04, P<0.01) and ITF (0.134±0.001 vs 0.253±0.01,P<0.01). With repeated WRS, adaptation to this WRS developed, the area of gastric mucosal lesions was reduced by 22.0 % after four consecutive WRS. This adaptation to WRS was accompanied by increased GMBF (being increased by 94.2 %), active cell proliferation in the neck region of gastric glands, and increased expression of pS2 (0.37±0.02 vs 0.77±0.01, P<0.01) and ITF (0.040±0.001 vs0.372±0.010, P<0.01). The result was demonstrated further by immunohistochemistry of pS2 (0.55±0.04 vs 2.46±0.08, P<0.01) and ITF (0.134±0.001 vs0.354±0.070,P<0.01).CONCLUSION: TFF may not only participate in the early phase of epithelial repair known as restitution(maked by increased cell migration),but also play an important role in the subsequent, protracted phase of glandular renewal(made by cell proliferation).

  4. Gastric ulcer healing effect of wild honey and its combination with Turmeric (Curcuma domestica Val.) Rhizome on male Wistar rats

    I Ketut Adnyana; Joseph I.Sigit; Larasati A.Kusumawardani


    Gastric ulcer is a common disorder in human at any ages.In this research,the antiulcer activity of wild honey produced by Apis dorsata,alone or in combination with Turmeric Rhizome,was evaluated in healing acute gastric ulcer.Male Wistar albino rats (150-250 g) were induced ulcers with aspirin at 405 mg/kg BW and ethanol.Antiulcer evaluation was done based on the gastric acidity,numbers and diameter of ulcers,ulcer index,healing ratio,histological examinations,and body weight.The results showed that the groups given honey alone,turmeric alone,and combination of turmeric-honey displayed significant ulcer healing compared to the control group.Ulcers in the group administered with combination of turmeric-wild honey was different significantly from the turmeric alone and wild honey alone groups with increased body weight in that group.The result showed that wild honey (2125 mg/kg BW) had the greatest activity in healing ulcers among other groups.The combination of turmeric-wild honey had a good activity in healing ulcers and increased the body weight of the group.

  5. Role of activation of 5'-adenosine monophosphate-activated protein kinase in gastric ulcer healing in diabetic rats.

    Baraka, Azza M; Deif, Maha M


    The potential utility of 5'-adenosine monophosphate-activated protein kinase (AMPK)-activating agents, such as metformin, in inducing angiogenesis, could be a promising approach to promote healing of gastric ulcers complicated by diabetes mellitus. The aim of the present study was to assess the effect of a drug that activates AMPK, namely metformin, in gastric ulcer healing in streptozotocin-induced diabetic rats. Forty male Wistar albino rats were made diabetic by intraperitoneal (i.p.) streptozotocin injection and 10 rats were injected i.p. by a single dose of physiological saline. Six weeks following streptozotocin or saline injection, gastric ulcers were induced by serosal application of acetic acid. Three days after acetic acid application, rats were divided into group 1 (nondiabetic control), group 2 (streptozotocin-injected rats), groups 3-5 (streptozotocin-injected rats treated with metformin or metformin and an inhibitor of AMPK, namely compound C or pioglitazone) for 7 days following acetic acid application. Administration of metformin, but not pioglitazone, resulted in a significant decrease in the gastric ulcer area, a significant increase in epithelial regeneration assessed histologically, a significant increase in the number of microvessels in the ulcer margin, a significant increase in gastric vascular endothelial growth factor concentration and gastric von Willebrand factor as well as a significant increase in gastric phospho-AMPK. Compound C, an inhibitor of AMPK, blocked metformin-induced changes in assessed parameters suggesting that the effect of metformin was mediated mainly through activation of AMPK. Our results suggest the feasibility of a novel treatment strategy, namely drugs activating AMPK, for patients in whom impairment of ulcer healing constitutes a secondary complication of diabetes mellitus. Copyright © 2011 S. Karger AG, Basel.

  6. Nerve growth factor injected into the gastric ulcer base incorporates into endothelial, neuronal, glial and epithelial cells: implications for angiogenesis, mucosal regeneration and ulcer healing.

    Tanigawa, T; Ahluwalia, A; Watanabe, T; Arakawa, T; Tarnawski, A S


    A previous study has demonstrated that locally administered growth factors such as epidermal growth factor, basic fibroblast growth factor and hepatocyte growth factor can accelerate healing of experimental gastric ulcers in rats. That study indicates that locally administered growth factors can exert potent biological effects resulting in enhanced gastric ulcers healing. However, the fate of injected growth factors, their retention and localization to specific cellular compartments have not been examined. In our preliminary study, we demonstrated that local injection of nerve growth factor to the base of experimental gastric ulcers dramatically accelerates ulcer healing, increases angiogenesis - new blood vessel formation, and improves the quality of vascular and epithelial regeneration. Before embarking on larger, definitive and time sequence studies, we wished to determine whether locally injected nerve growth factor is retained in gastric ulcer's tissues and taken up by specific cells during gastric ulcer healing. Gastric ulcers were induced in anesthetized rats by local application of acetic acid using standard methods; and, 60 min later fluorescein isothiocyanate-labeled nerve growth factor was injected locally to the ulcer base. Rats were euthanized 2, 5 and 10 days later. Gastric specimens were obtained and processed for histology. Unstained paraffin sections were examined under a fluorescence microscope, and the incorporation of fluorescein isothiocyanate-labeled nerve growth factor into various gastric tissue cells was determined and quantified. In addition, we performed immunostaining for S100β protein that is expressed in neural components. Five and ten days after ulcer induction labeled nerve growth factor (injected to the gastric ulcer base) was incorporated into endothelial cells of blood vessels, neuronal, glial and epithelial cells, myofibroblasts and muscle cells. This study demonstrates for the first time that during gastric ulcer healing

  7. Black Tea and Theaflavins Assist Healing of Indomethacin-Induced Gastric Ulceration in Mice by Antioxidative Action

    Biplab Adhikary


    Full Text Available The healing activities of black tea (BT and the theaflavins (TF against the indomethacin-induced stomach ulceration were studied in a mouse model. Indomethacin (18 mg/kg, p.o. administration induced maximum ulceration in the glandular portion of the gastric mucosa on the 3rd day, accompanied by increased lipid peroxidation and protein oxidation, depletion of thiol-defense and mucin, as well as reduced expressions of cyclooxygenases (COX and prostaglandin (PG E synthesis in the gastric tissues, and plasma total antioxidant status of mice. Treatment with BT (40 mg/kg, TF (1 mg/kg, and omeprazole (3 mg/kg produced similar (74%–76% ulcer healing, as revealed from the histopathological studies. Treatment with all the above samples reversed the adverse oxidative effects of indomethacin significantly. BT and TF also enhanced the PGE synthesis by augmenting the expressions of COX 1 and 2, but did not modulate acid secretion.

  8. Enhancement of Gastric Ulcer Healing and Angiogenesis by Hepatocyte Growth Factor Gene Mediated by Attenuated Salmonella in Rats.

    Ha, Xiaoqin; Peng, Junhua; Zhao, Hongbin; Deng, Zhiyun; Dong, Juzi; Fan, Hongyan; Zhao, Yong; Li, Bing; Feng, Qiangsheng; Yang, Zhihua


    The present study developed an oral hepatocyte growth factor (HGF) gene therapy strategy for gastric ulcers treatment. An attenuated Salmonella typhimurium that stably expressed high HGF (named as TPH) was constructed, and the antiulcerogenic effect of TPH was evaluated in a rat model of gastric ulcers that created by acetic acid subserosal injection. From day 5 after injection, TPH (1 × 10⁹ cfu), vehicle (TP, 1 × 10⁹ cfu), or sodium bicarbonate (model control) was administered orally every alternate day for three times. Then ulcer size was measured at day 21 after ulcer induction. The ulcer area in TPH-treated group was 10.56 ± 3.30 mm², which was smaller when compared with those in the TP-treated and model control groups (43.47 ± 4.18 and 56.25 ± 6.38 mm², respectively). A higher level of reepithelialization was found in TPH-treated group and the crawling length of gastric epithelial cells was significantly longer than in the other two groups (P ulcer granulation tissues of the TPH-treated rats was 39.9 vessels/mm², which was greater than in the TP-treated and model control rats, with a significant statistical difference. These results suggest that TPH treatment significantly accelerates the healing of gastric ulcers via stimulating proliferation of gastric epithelial cells and enhancing angiogenesis on gastric ulcer site.

  9. Gastroprotective and ulcer healing effects of Piptadeniastrum Africanum on experimentally induced gastric ulcers in rats.

    Ateufack, Gilbert; Domgnim Mokam, Elisabeth Carol; Mbiantcha, Marius; Dongmo Feudjio, Rostand Breuil; David, Nana; Kamanyi, Albert


    Gastric peptic ulcer is one of the common disorders of gastrointestinal tract, which occur due to an imbalance between the offensive and defensive factors. It is an illness that affects a considerable number of people worldwide. This study was conducted to evaluate the antiulcerogenic and antiulcer effects and recognize the basic mechanism of action of Piptadeniastrum africanum stem bark extracts. The aqueous and methanol extracts of Piptadeniastrum africanum were administered at the doses 125, 250 and 500 mg/kg to evaluate their effects on gastric ulcer induced by the HCl/ethanol mixture, indomethacin and acetic acid in Wistar strain male adult rats, aged between 12 and 16 weeks and weighing between 180 and 220 g. Ranitidine, Maalox and Misoprostol were used as standard drugs. Histopathological examination and nitric oxide level were performed to evaluate the basic mechanism of action of Piptadeniastrum africanum. Phytochemical screening was carried out to identify known phytochemicals present in these extracts. The aqueous and methanol extracts of stem bark of Piptadeniastrum africanum significantly inhibited (p gastric ulceration induced by HCl/ethanol to the percentages of inhibition of 81.38; 98.75 and 100 % for the aqueous extract and then 75.83, 89.76 and 96.52 % for the methanol extract, and with the Indomethacin-induced ulcers, aqueous and methanol extracts of bark of Piptadeniastrum africanum reduce significantly (p gastric lesions in rats, with percentage of cure 35.75; 52.33 and 98.58 % for the aqueous extract, and 33.7; 51.97; and 65.93 to the methanol extract. The results revealed a significant reduction of ulcerated surface in both extracts and increase of nitric oxide (NO) level with methanol extract. When compared to methanol extract, aqueous extract showed more pronounced effects, corresponding to percentages of healing of 59. 92; 84.12 and 59.65 % for the aqueous extract; and 70.43; 55.49 and 57.59 % for the methanol extract in the ulcer

  10. Piper umbellatum L.: A medicinal plant with gastric-ulcer protective and ulcer healing effects in experimental rodent models.

    da Silva Junior, Iberê Ferreira; Balogun, Sikiru Olaitan; de Oliveira, Ruberlei Godinho; Damazo, Amílcar Sabino; Martins, Domingos Tabajara de Oliveira


    Piper umbellatum L. (Piperaceae) is a shrub found in the Amazon, Savannah and Atlantic Forest region of Brazil. It is widely used in folk medicine in many countries primarily for the treatment of gastric disorders. The aim of this study was to evaluate the gastroprotective and anti-ulcer effects of hydroethanolic extract of P. umbellatum (HEPu) leaves in experimental rodents. In addition, the anti-Helicobacter pylori activity of the extract was assessed. The leaves of P. umbellatum were macerated in 75% (1:3w/v) hydroethanolic solution to obtain HEPu. The gastroprotective and ulcer healing activities of HEPu were evaluated using acidified ethanol (acute) and acetic acid (chronic) gastric ulcer models in rodents. The anti-H. pylori activity was evaluated by in vitro broth microdilution assay using H. pylori cagA(+) and vacA(+) strain. The probable mechanism of action of HEPu was evaluated by determining gastric secretory parameters, antioxidant enzyme (catalase), non-protein sulfhydryl (glutathione) and malondialdehyde levels in gastric tissue, including pro-inflammatory (IL-1β, TNF-a, IL -17, RANTES, IFN-γ and MIP-2) and anti-inflammatory (IL-10) cytokines. HEPu demonstrated potent gastroprotection against acute ulcer induced by acidified ethanol and excellent healing effect of the chronic ulcer induced by acetic acid. The gastroprotective activity in acidified ethanol is partly attributed to the antioxidant mechanisms, while anti-secretory, anti-inflammatory and regeneration of the gastric mucosa are evoked as part of its antiulcer mechanism of action. The gastric ulcer healing of HEPu also involves restoration of the altered cytokines levels to near normal. However, it has no in vitro anti-H. pylori activity. The results of this study showed that HEPu possesses preventive and curative effects in experimental models of gastric ulcers in animals. These effects are partially dependent on antioxidant, antisecretory, anti-inflammatory and mucosa regeneration. It is

  11. Gallic Acid Enriched Fraction of Phyllanthus emblica Potentiates Indomethacin-Induced Gastric Ulcer Healing via e-NOS-Dependent Pathway

    Ananya Chatterjee


    Full Text Available The healing activity of gallic acid enriched ethanolic extract (GAE of Phyllanthus emblica fruits (amla against the indomethacin-induced gastric ulceration in mice was investigated. The activity was correlated with the ability of GAE to alter the cyclooxygenase- (COX- dependent healing pathways. Histology of the stomach tissues revealed maximum ulceration on the 3rd day after indomethacin (18 mg/kg, single dose administration that was associated with significant increase in inflammatory factors, namely, mucosal myeloperoxidase (MPO activity and inducible nitric oxide synthase (i-NOS expression. Proangiogenic parameters such as the levels of prostaglandin (PG E2, vascular endothelial growth factor (VEGF, hepatocyte growth factor (HGF, von Willebrand Factor VIII, and endothelial NOS (e-NOS were downregulated by indomethacin. Treatment with GAE (5 mg/kg/day and omeprazole (3 mg/kg/day for 3 days led to effective healing of the acute ulceration, while GAE could reverse the indomethacin-induced proinflammatory changes of the designated biochemical parameters. The ulcer healing activity of GAE was, however, compromised by coadministration of the nonspecific NOS inhibitor, N-nitro-L-arginine methyl ester (L-NAME, but not the i-NOS-specific inhibitor, L-N6-(1-iminoethyl lysine hydrochloride (L-NIL. Taken together, these results suggested that the GAE treatment accelerates ulcer healing by inducing PGE2 synthesis and augmenting e-NOS/i-NOS ratio.

  12. Gallic Acid Enriched Fraction of Phyllanthus emblica Potentiates Indomethacin-Induced Gastric Ulcer Healing via e-NOS-Dependent Pathway.

    Chatterjee, Ananya; Chatterjee, Sirshendu; Biswas, Angshuman; Bhattacharya, Sayanti; Chattopadhyay, Subrata; Bandyopadhyay, Sandip K


    The healing activity of gallic acid enriched ethanolic extract (GAE) of Phyllanthus emblica fruits (amla) against the indomethacin-induced gastric ulceration in mice was investigated. The activity was correlated with the ability of GAE to alter the cyclooxygenase- (COX-) dependent healing pathways. Histology of the stomach tissues revealed maximum ulceration on the 3rd day after indomethacin (18 mg/kg, single dose) administration that was associated with significant increase in inflammatory factors, namely, mucosal myeloperoxidase (MPO) activity and inducible nitric oxide synthase (i-NOS) expression. Proangiogenic parameters such as the levels of prostaglandin (PG) E(2), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), von Willebrand Factor VIII, and endothelial NOS (e-NOS) were downregulated by indomethacin. Treatment with GAE (5 mg/kg/day) and omeprazole (3 mg/kg/day) for 3 days led to effective healing of the acute ulceration, while GAE could reverse the indomethacin-induced proinflammatory changes of the designated biochemical parameters. The ulcer healing activity of GAE was, however, compromised by coadministration of the nonspecific NOS inhibitor, N-nitro-L-arginine methyl ester (L-NAME), but not the i-NOS-specific inhibitor, L-N6-(1-iminoethyl) lysine hydrochloride (L-NIL). Taken together, these results suggested that the GAE treatment accelerates ulcer healing by inducing PGE(2) synthesis and augmenting e-NOS/i-NOS ratio.

  13. Iatrogenic nutritional deficiencies.

    Young, R C; Blass, J P


    This article catalogs the nutritional deficiencies inadvertently introduced by certain treatment regimens. Specifically, the iatrogenic effects on nutrition of surgery, hemodialysis, irradiation, and drugs are reviewed. Nutritional problems are particularly frequent consequences of surgery on the gastrointestinal tract. Gastric surgery can lead to deficiencies of vitamin B12, folate, iron, and thiamine, as well as to metabolic bone disease. The benefits of small bowel bypass are limited by the potentially severe nutritional consequences of this procedure. Following bypass surgery, patients should be monitored for signs of possible nutritional probems such as weight loss, neuropathy, cardiac arrhythmias, loss of stamina, or changes in mental status. Minimal laboratory tests should include hematologic evaluation, B12, folate, iron, albumin, calcium, phosphorus, alkaline phosphatase, transaminases, sodium, potassium, chloride, and carbon dioxide levels. Roentgenologic examination of the bone should also be obtained. Loss of bone substance is a major consequence of many forms of treatment, and dietary supplementation with calcium is warranted. Patients undergoing hemodialysis have shown carnitine and choline deficiencies, potassium depletion, and hypovitaminosis, as well as osteomalacia. Chronic drug use may alter intake, synthesis, absorption, transport, storage, metabolism, or excretion of nutrients. Patients vary markedly in the metabolic effects of drugs, and recommendations for nutrition must be related to age, sex, reproductive status, and genetic endowment. Moreover, the illness being treated can itself alter nutritional requirements and the effect of the treatment on nutrient status. The changes in nutritional levels induced by use of estrogen-containing oral contraceptives (OCs) are obscure; however, the effects on folate matabolism appear to be of less clinical import than previously suggested. Reduction in pyridoxine and serum vitamin B12 levels has been

  14. Impairment by 5-fluorouracil of the healing of gastric lesions in rats: effect of lafutidine, a histamine H2 receptor antagonist, mediated by capsaicin-sensitive afferent neurons.

    Murashima, Yukiko; Kotani, Tohru; Hayashi, Shusaku; Komatsu, Yoshino; Nakagiri, Akari; Amagase, Kikuko; Takeuchi, Koji


    We investigated the influence of 5-fluorouracil (5-FU), an anti-tumor agent, on the healing of gastric lesions generated by 0.6 M HCl in rats and the effect of lafutidine, a histamine H(2) receptor antagonist, on the impaired healing. Animals fasted for 18 h were given 1 ml of 0.6 M HCl p.o., fed normally from 1 h later, and killed 1-96 h thereafter. 5-FU was given i.v. twice, 1 h and 24 h after the HCl. The gastric lesions healed spontaneously within 96 h. Although it decreased acid secretion, 5-FU markedly delayed the healing. Lafutidine, but not cimetidine, given p.o. immediately after each dosing of 5-FU significantly reversed the delay in healing by 5-FU, and this effect was attenuated by the chemical ablation of capsaicin-sensitive afferent neurons. Capsaicin also significantly reversed the delay in healing. The mucosal application of 50 mM HCl did not affect gastric mucosal blood flow (GMBF) in the normal stomach, but significantly increased it in the stomach damaged by 0.6 M HCl. The increases in GMBF were attenuated by 5-FU; however, the co-administration of lafutidine significantly restored the response. In addition, 5-FU inhibited both cell proliferation and migration in rat gastric epithelial cells (RGM1) in vitro. These results suggest that 5-FU delayed the healing of gastric lesions generated by 0.6 M HCl, probably through the inhibition of cell migration and proliferation, as well as the impairment of GMBF, and lafutidine reversed the delay in healing, mainly through the amelioration of the GMBF response mediated by capsaicin-sensitive afferent neurons.

  15. Healing

    Ventres, William B.


    My personal ethos of healing is an expression of the belief that I can and do act to heal patients while I attend to the traditional goals of medicine. The 7 supporting principles that inform my ethos are dignity, authenticity, integrity, transparency, solidarity, generosity, and resiliency. I invite others, including medical students, residents, and practicing physicians, to reflect and discover their own ethos of healing and the principles that guide their professional growth. A short digital documentary accompanies this essay for use as a reflective prompt to encourage personal and professional development. PMID:26755787

  16. High-mobility group box 1 inhibits gastric ulcer healing through Toll-like receptor 4 and receptor for advanced glycation end products.

    Nadatani, Yuji; Watanabe, Toshio; Tanigawa, Tetsuya; Ohkawa, Fumikazu; Takeda, Shogo; Higashimori, Akira; Sogawa, Mitsue; Yamagami, Hirokazu; Shiba, Masatsugu; Watanabe, Kenji; Tominaga, Kazunari; Fujiwara, Yasuhiro; Takeuchi, Koji; Arakawa, Tetsuo


    High-mobility group box 1 (HMGB1) was initially discovered as a nuclear protein that interacts with DNA as a chromatin-associated non-histone protein to stabilize nucleosomes and to regulate the transcription of many genes in the nucleus. Once leaked or actively secreted into the extracellular environment, HMGB1 activates inflammatory pathways by stimulating multiple receptors, including Toll-like receptor (TLR) 2, TLR4, and receptor for advanced glycation end products (RAGE), leading to tissue injury. Although HMGB1's ability to induce inflammation has been well documented, no studies have examined the role of HMGB1 in wound healing in the gastrointestinal field. The aim of this study was to evaluate the role of HMGB1 and its receptors in the healing of gastric ulcers. We also investigated which receptor among TLR2, TLR4, or RAGE mediates HMGB1's effects on ulcer healing. Gastric ulcers were induced by serosal application of acetic acid in mice, and gastric tissues were processed for further evaluation. The induction of ulcer increased the immunohistochemical staining of cytoplasmic HMGB1 and elevated serum HMGB1 levels. Ulcer size, myeloperoxidase (MPO) activity, and the expression of tumor necrosis factor α (TNFα) mRNA peaked on day 4. Intraperitoneal administration of HMGB1 delayed ulcer healing and elevated MPO activity and TNFα expression. In contrast, administration of anti-HMGB1 antibody promoted ulcer healing and reduced MPO activity and TNFα expression. TLR4 and RAGE deficiency enhanced ulcer healing and reduced the level of TNFα, whereas ulcer healing in TLR2 knockout (KO) mice was similar to that in wild-type mice. In TLR4 KO and RAGE KO mice, exogenous HMGB1 did not affect ulcer healing and TNFα expression. Thus, we showed that HMGB1 is a complicating factor in the gastric ulcer healing process, which acts through TLR4 and RAGE to induce excessive inflammatory responses.

  17. High-mobility group box 1 inhibits gastric ulcer healing through Toll-like receptor 4 and receptor for advanced glycation end products.

    Yuji Nadatani

    Full Text Available High-mobility group box 1 (HMGB1 was initially discovered as a nuclear protein that interacts with DNA as a chromatin-associated non-histone protein to stabilize nucleosomes and to regulate the transcription of many genes in the nucleus. Once leaked or actively secreted into the extracellular environment, HMGB1 activates inflammatory pathways by stimulating multiple receptors, including Toll-like receptor (TLR 2, TLR4, and receptor for advanced glycation end products (RAGE, leading to tissue injury. Although HMGB1's ability to induce inflammation has been well documented, no studies have examined the role of HMGB1 in wound healing in the gastrointestinal field. The aim of this study was to evaluate the role of HMGB1 and its receptors in the healing of gastric ulcers. We also investigated which receptor among TLR2, TLR4, or RAGE mediates HMGB1's effects on ulcer healing. Gastric ulcers were induced by serosal application of acetic acid in mice, and gastric tissues were processed for further evaluation. The induction of ulcer increased the immunohistochemical staining of cytoplasmic HMGB1 and elevated serum HMGB1 levels. Ulcer size, myeloperoxidase (MPO activity, and the expression of tumor necrosis factor α (TNFα mRNA peaked on day 4. Intraperitoneal administration of HMGB1 delayed ulcer healing and elevated MPO activity and TNFα expression. In contrast, administration of anti-HMGB1 antibody promoted ulcer healing and reduced MPO activity and TNFα expression. TLR4 and RAGE deficiency enhanced ulcer healing and reduced the level of TNFα, whereas ulcer healing in TLR2 knockout (KO mice was similar to that in wild-type mice. In TLR4 KO and RAGE KO mice, exogenous HMGB1 did not affect ulcer healing and TNFα expression. Thus, we showed that HMGB1 is a complicating factor in the gastric ulcer healing process, which acts through TLR4 and RAGE to induce excessive inflammatory responses.

  18. Healing mechanisms of the hydroalcoholic extract and ethyl acetate fraction of green tea (Camellia sinensis (L.) Kuntze) on chronic gastric ulcers.

    Borato, Débora Gasparin; Scoparo, Camila Toledo; Maria-Ferreira, Daniele; da Silva, Luísa Mota; de Souza, Lauro Mera; Iacomini, Marcello; Werner, Maria Fernanda de Paula; Baggio, Cristiane Hatsuko


    Green tea is an infusion of unfermented leaves of Camellia sinensis (L.) Kuntze (Theaceae), traditionally used for the treatment of obesity, hypercholesterolemia, and gastric complaints. This study evaluated the mechanisms involved in the gastric ulcer healing of the hydroalcoholic extract from green tea (GEt), its ethyl acetate fraction, (GEAc) and epigallocatechin gallate (EGCG) using the model of acetic acid-induced gastric ulcer in rats. The chronic gastric ulcer was induced by application of 80 % acetic acid on serosal mucosa of rats. After 7 days of oral treatment with GEt and GEAc, the ulcer area, mucin content, inflammatory parameters (MPO and NAG), and antioxidant system (GSH and LOOH levels, SOD and GST activities) were evaluated. In vitro, the scavenging activity of GEt and GEAc were also measured. The antisecretory action was studied on the pylorus ligature method in rats. Oral treatment with GEt and GEAc reduced significantly the gastric ulcer area induced by acetic acid. The gastric ulcer healing was accompanied by increasing of mucin content, restoration of GSH levels and SOD activity, and reduction of MPO and LOOH levels. In addition, GEt and GEAc reduced the DPPH free radicals in vitro. Furthermore, the oral treatment of animals with GEt and GEAc did not alter the gastric acid secretion or cause signs of toxicity. Collectively, these results showed that GEt had a pronounced antiulcer effect, possibly through maintenance of mucin content and reduction of inflammation and oxidative stress. In addition, the compounds present in its ethyl acetate fraction could be responsible for the extract activity.

  19. Herbal Remedy: An Alternate Therapy of Nonsteroidal Anti-Inflammatory Drug Induced Gastric Ulcer Healing

    Ananya Chatterjee


    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are one of the most commonly used therapeutic drug groups used worldwide for curing an array of health problems like pain, inflammation, cardiovascular complications, and many other diseases, but they may cause different side effects including gastroduodenal disorders. So, there is a growing interest and need to search for nontoxic, antiulcer formulations from medicinal plants to treat NSAIDs induced gastric ulcer. Extensive research has reported on many natural plants like Camellia sinensis, Phyllanthus emblica, Myristica malabarica, Piper betle, Picrorhiza kurroa, and so forth, and their active constituents reduced NSAIDs induced gastric ulcer via their antioxidative as well as immunomodulatory activity. Therefore, use of herbal formulations in daily life may prevent NSAIDs induced gastric ulceration and other side effects.

  20. Managing iatrogenic tracheal injuries

    A. Goonasekera C


    Full Text Available We present three cases of iatrogenic tracheal injury. Two patients suffered acute tracheal injuries during anesthesia/surgery, one was managed surgically and the other conservatively. The third case is a delayed tracheal injury presenting as a fistula. The reasons for surgical vs conservative management of tracheal injuries and preventive measures are discussed.

  1. Proper muscle layer damage affects ulcer healing after gastric endoscopic submucosal dissection.

    Horikawa, Yohei; Mimori, Nobuya; Mizutamari, Hiroya; Kato, Yuhei; Shimazu, Kazuhiro; Sawaguchi, Masayuki; Tawaraya, Shin; Igarashi, Kimihiro; Okubo, Syunji


    Endoscopic submucosal dissection (ESD) is the established therapy for superficial gastrointestinal neoplasms. However, management of the artificial ulcers associated with ESD has become important and the relationship between ulcer healing factors and treatment is still unclear. We aimed to evaluate ESD-related artificial ulcer reduction ratio at 4 weeks to assess factors associating with ulcer healing after ESD that may lead to optimal treatment. Between January 2009 and December 2013, a total of 375 lesions fulfilled the expanded criteria for ESD. We defined ulcer reduction rate Ulcer reduction rate was significantly correlated with factors related to the ESD procedure (i.e. procedure time, submucosal fibrosis, and injury of the proper muscle layer, in univariate analysis. Multivariate logistic regression analysis showed that submucosal fibrosis (F2) (P = 0.03; OR, 16.46; 95% CI, 1.31-206.73) and injury of the proper muscle layer (P = 0.01; OR, 4.27; 95% CI, 2.04-8.92) were statistically significant predictors of delayed healing. This single-center retrospective study indicated that ESD-induced artificial ulcer healing was affected by submucosal fibrosis and injury of the proper muscle layer, which induced damage to the muscle layer. Therefore, the preferable pharmacotherapy can be determined on completion of the ESD procedure. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  2. Healing Potential of Picrorhiza kurroa (Scrofulariaceae rhizomes against indomethacin-induced gastric ulceration: a mechanistic exploration.

    Bandyopadhyay Sandip K


    Full Text Available Abstract Background The present study was undertaken to evaluate the potential of the rhizomes of the Indian medicinal plant, Picrorhiza kurroa in healing indomethacin-induced acute stomach ulceration in mice and examine its capacity to modulate oxidative stress and the levels of prostaglandin (PGE2 and EGF during the process. Methods Male swiss albino mice, ulcerated with indomethacin (18 mg/kg, p. o., single dose were treated up to 7 days with different doses of the methanol extract of P. kurroa rhizomes (designated as PK. The healing capacity of the most effective dose of PK (20 mg/kg, p. o. × 3 d was compared with that of omeprazole (Omez (3 mg/kg, p. o. × 3 d. The effects of the drug-treatment for one and three days on the biochemical parameters were assessed by comparing the results with that of untreated mice of the 1st and 3rd day of ulceration. The stomach tissues of the mice were used for the biochemical analysis. Results The macroscopic indices revealed maximum ulceration on the 3rd day after indomethacin administration, which was effectively healed by PK. Under the optimized treatment regime, PK and Omez reduced the ulcer indices by 45.1% (P P Compared to the ulcerated untreated mice, those treated with PK for 3 days showed decreased the levels of thiobarbituric acid reactive substances (TBARS (32.7%, P P P 2 (21.4%, P P P P P P P Conclusion PK (20 mg/kg, p. o. × 3 days could effectively heal indomethacin-induced stomach ulceration in mice by reducing oxidative stress, and promoting mucin secretion, prostaglandin synthesis and augmenting expressions of cyclooxygenase enzymes and growth factors.

  3. Ethanolic extract of roots from Arctium lappa L. accelerates the healing of acetic acid-induced gastric ulcer in rats: Involvement of the antioxidant system.

    da Silva, Luisa Mota; Allemand, Alexandra; Mendes, Daniel Augusto G B; Dos Santos, Ana Cristina; André, Eunice; de Souza, Lauro Mera; Cipriani, Thales Ricardo; Dartora, Nessana; Marques, Maria Consuelo Andrade; Baggio, Cristiane Hatsuko; Werner, Maria Fernanda


    We evaluate the curative efficacy of the ethanolic extract (EET) of roots from Arctium lappa (bardana) in healing of chronic gastric ulcers induced by 80% acetic acid in rats and additionally studies the possible mechanisms underlying this action. Oral administration of EET (1, 3, 10 and 30mg/kg) reduced the gastric lesion area in 29.2%, 41.4%, 59.3% and 38.5%, respectively, and at 10mg/kg promoted significant regeneration of the gastric mucosa, which was confirmed by proliferating cell nuclear antigen immunohistochemistry. EET (10mg/kg) treatment did not increase the gastric mucus content but restored the superoxide dismutase activity, prevented the reduction of glutathione levels, reduced lipid hydroperoxides levels, inhibited the myeloperoxidase activity and reduced the microvascular permeability. In addition, EET reduced the free radical generation and increased scavenging of 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals in vitro. Furthermore, intraduodenal EET (10 and 30mg/kg) decreased volume and acidity of gastric secretion. Total phenolic compounds were high in EET (Folin-Ciocalteau assay) and the analysis by liquid chromatography-mass spectrometry revealed that the main compounds present in EET were a serie of hydroxycinnamoylquinic acid isomers. In conclusion, these data reveal that EET promotes regeneration of damaged gastric mucosa, probably through its antisecretory and antioxidative mechanisms.

  4. Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared With Intact Capsules for Marginal Ulceration Following Roux-en-Y Gastric Bypass.

    Schulman, Allison R; Chan, Walter W; Devery, Aiofe; Ryan, Michele B; Thompson, Christopher C


    Marginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) frequently are prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small-bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules [OCs]) might be absorbed more easily than intact capsules (ICs). We compared time to ulcer healing, number of endoscopic procedures, and use of health care for patients with marginal ulceration who received PPIs in OC vs IC form. We performed a retrospective study of 164 patients diagnosed with marginal ulceration who underwent RYGB at the Brigham and Women's Hospital from 2000 through 2015. Patients received high-dose PPIs and underwent repeat endoscopy every 3 months until ulcer healing was confirmed. We used time-to-event analysis with a Cox proportional hazards model to evaluate the association between mode of PPI administration and time to ulcer healing, in addition to Cox multivariate regression analysis. Total charge (procedural and maintenance) was determined by comparison of categorized charges incurred from time of ulcer diagnosis to resolution. The primary outcome was time to healing of marginal ulceration in RYGB patients receiving high-dose PPIs in OC vs IC form. A total of 162 patients were included (115 received OC and 49 received IC). All patients were followed up until ulcer healing was confirmed. The median time to ulcer healing was 91.0 days for the OC group vs 342.0 days for the IC group (P < .001). OC was the only independent predictor of time to ulcer healing (P < .001) when we controlled for known risk factors. The number of endoscopic procedures (P = .02) and overall health care utilization (P = .05) were lower in the OC than the IC group. Patients with marginal ulceration after RYGB who

  5. Iatrogenic Tumor Implantation

    Ying Ma; Ping Bai


    Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy. It involves desquamation and dissemination of tumor cells that develop into a local recurrence or distant metastasis from the tumor under treatment. The main clinical feature of the condition is nodules at the operation's porous channel or incision, which is easily diagnosed in accordance with the case history. Final diagnosis can be made based on pathological examination. Tumor implantation may occur in various puncturing porous channels, including a laparoscopic port, abdominal wall incision, and perineal incision, etc. Besides a malignant tumor,implantation potential exists with diseases, such as a borderline tumor and endometriosis etc. Once a tumor implantation is diagnosed, or suspected, surgical resection is usually conducted.During the diagnosis and treatment of diseases, avoiding and reducing iatrogenic implantation and dissemination has been regarded as an important principle for surgical treatment of tumors. In a clinical practice setting, if possible, excisional biopsy should be employed, if a biopsy is needed. Repeated puncturing should be avoided during a paracentesis. In a laparoscopic procedure, the tissue is first put into a sample bag and then is taken out from the point of incision. After a laparoscopic procedure, the peritoneum, abdominal muscular fasciae, and skin should be carefully closed, and/or the punctured porous channel be excised. In addition, the sample/tissue should be rinsed with distilled water before surgical closure of the abdominal cavity,allowing the exfoliated tumor cells to swell and rupture in the hypo-osmolar solution. Then surgical closure can be conducted following a change of gloves and equipment. The extent of hysteromyomectomy should as far as possible be away from the uterine cavity. The purpose of this study is to make clinicians aware of the possibility of tumor implantation

  6. Iatrogenic Lens Injuries

    Ümit Kamış


    Full Text Available During intraocular surgery, undesired damages of various etiology may occur in adjacent tissues. One of these tissues is the crystalline lens, which may be traumatized both in anterior segment and posterior segment surgeries, and when damaged, it usually causes marked decrease in visual acuity. The leading causes of iatrogenic lens injuries are intravitreal injection, laser iridotomy, phakic intraocular lens implantation, anterior chamber paracentesis, and vitreoretinal surgery. When crystalline lens damage occurs, its negative effect on visual function may be eliminated by performing cataract surgery intraoperatively or in elective conditions. (Turk J Ophthalmol 2012; 42: Supplement 27-30

  7. [Exceptional iatrogenic ureteral rupture].

    Martínez-Vieira, Almudena; Valera-Sánchez, Zoraida; Sousa-Vaquero, José María; Palacios-González, Carmen; García-Poley, Antonio; Bernal-Bellido, Carmen; Alamo-Martínez, José María; Millán-López, Ana; Blanco-Domínguez, Manuel; Galindo-Galindo, Antonio


    Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used.

  8. Iatrogenic causes of infertility.

    Schoysman, R; Segal, L


    The Authors review the list of the iatrogenic causes of infertility. In their opinion the more delicate the structure, the more heavy the price paid to clumsy or erroneous investigation. Such eventual incompetence may lead to further damage of the already existing situation. The Authors however look at the future with relative optimism: incidents become rarer, specialists in gynecology and infertility pay more attention to the delicacy of genital structures and there is an encouraging tendency to refer to infertility specialists those cases who need adequate work-up of their condition.

  9. Severe iatrogenic nostril stenosis

    Ali Ebrahimi


    Full Text Available Nostril stenosis (narrowing of the nasal inlet is an uncommon deformity which results in aesthetic and breathing discomfort in patients. The literature review shows that trauma, infection, iatrogenic insults and congenital lesions are major causes of stenosis. Nowadays, rhinoplasty is one of most popular aesthetic surgeries which may have complications such as bleeding, swelling, bruising, asymmetry, obstruction of nasal airways. We present a 30-year-old female patient, who complained about breathing and aesthetic difficulties due to external nasal valve obstruction and nasal deformity. Past medical history showed that the patient had undergone three unsuccessful rhinoplasty surgeries with aesthetic goals.

  10. Iatrogenic psoas abscess. Case report

    Bernstein, Inge Thomsen; Hansen, B J


    A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

  11. Hydroethanolic extract of Baccharis trimera promotes gastroprotection and healing of acute and chronic gastric ulcers induced by ethanol and acetic acid.

    Dos Reis Lívero, Francislaine Aparecida; da Silva, Luisa Mota; Ferreira, Daniele Maria; Galuppo, Larissa Favaretto; Borato, Debora Gasparin; Prando, Thiago Bruno Lima; Lourenço, Emerson Luiz Botelho; Strapasson, Regiane Lauriano Batista; Stefanello, Maria Élida Alves; Werner, Maria Fernanda de Paula; Acco, Alexandra


    Ethanol is a psychoactive substance highly consumed around the world whose health problems include gastric lesions. Baccharis trimera is used in folk medicine for the treatment of gastrointestinal disorders. However, few studies have evaluated its biological and toxic effects. To validate the popular use of B. trimera and elucidate its possible antiulcerogenic and cytotoxic mechanisms, a hydroethanolic extract of B. trimera (HEBT) was evaluated in models of gastric lesions. Rats and mice were used to evaluate the protective and antiulcerogenic effects of HEBT on gastric lesions induced by ethanol, acetic acid, and chronic ethanol consumption. The effects of HEBT were also evaluated in a pylorus ligature model and on gastrointestinal motility. The LD50 of HEBT in mice was additionally estimated. HEBT was analyzed by nuclear magnetic resonance, and a high-performance liquid chromatography fingerprint analysis was performed. Oral HEBT administration significantly reduced the lesion area and the oxidative stress induced by acute and chronic ethanol consumption. However, HEBT did not protect against gastric wall mucus depletion and did not alter gastric secretory volume, pH, or total acidity in the pylorus ligature model. Histologically, HEBT accelerated the healing of chronic gastric ulcers in rats, reflected by contractions of the ulcer base. Flavonoids and caffeoylquinic acids were detected in HEBT, which likely contributed to the therapeutic efficacy of HEBT, preventing or reversing ethanol- and acetic acid-induced ulcers, respectively. HEBT antiulcerogenic activity may be partially attributable to the inhibition of free radical generation and subsequent prevention of lipid peroxidation. Our results indicate that HEBT has both gastroprotective and curative activity in animal models, with no toxicity.

  12. Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy

    Oliver J. Ziff


    Full Text Available Colonoscopy is widely accepted as the gold-standard screening technique for detecting malignancies in the distal gastrointestinal tract in patients with symptoms suggestive of colon cancer. However, this procedure is not without risk, including colonic perforation. We report a patient who was managed conservatively after colonoscopy induced perforation. Eighteen months after appearing to make a full recovery, he presented with an upper gastrointestinal bleed. Oesophago-gastro-duodenoscopy (OGD revealed large gastric fundal varices and computed tomography (CT revealed splenic vein thrombosis. The ensuing left-sided (sinistral hypertension explains the development of the fundal varices in the presence of normal liver function. At surgery, a persistent abscess cavity was identified and cultures from this site grew Streptococcus anginosus. Curative splenectomy was performed and the patient made a full recovery. We advocate more prompt operative intervention in selected cases of iatrogenic colonic perforation with primary repair to prevent late complications.

  13. EAU guidelines on iatrogenic trauma.

    Summerton, Duncan J; Kitrey, Noam D; Lumen, Nicolaas; Serafetinidis, Efraim; Djakovic, Nenad


    The European Association of Urology (EAU) Trauma Guidelines Panel presents an updated iatrogenic trauma section of their guidelines. Iatrogenic injuries are known complications of surgery to the urinary tract. Timely and adequate intervention is key to their management. To assess the optimal evaluation and management of iatrogenic injuries and present an update of the iatrogenic section of the EAU Trauma Guidelines. A systematic search of the literature was conducted, consulting Medline and the Cochrane Register of Systematic reviews. No time limitations were applied, although the focus was on more recent publications. The expert panel developed statements and recommendations. Statements were rated according to their level of evidence, and recommendations received a grade following a rating system modified from the Oxford Centre for Evidence-based Medicine. Currently, only limited high-powered studies are available addressing iatrogenic injuries. Because the reporting of complications or sequelae of interventions is now increasingly becoming a standard requirement, this situation will likely change in the future. This section of the trauma guidelines presents an updated overview of the treatment of iatrogenic trauma that will be incorporated in the trauma guidelines available at the EAU Web site (http://www. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  14. The renin-angiotensin system and its vasoactive metabolite angiotensin-(1-7) in the mechanism of the healing of preexisting gastric ulcers. The involvement of Mas receptors, nitric oxide, prostaglandins and proinflammatory cytokines.

    Pawlik, M W; Kwiecien, S; Ptak-Belowska, A; Pajdo, R; Olszanecki, R; Suski, M; Madej, J; Targosz, A; Konturek, S J; Korbut, R; Brzozowski, T


    The inhibition of angiotensin-converting enzyme (ACE) or the blockade of angiotensin (Ang) AT-1 receptors affords protection against acute gastric mucosal injury, but whether the major metabolite of renin-angiotensin system (RAS), Ang-(1-7), accelerates the healing process of preexisting gastric ulcers remains unknown. Previous studies documented that Ang-(1-7) acting via its own Mas receptor exerts vascular responses opposing those of Ang II. We studied the effects of the Ang-(1-7)/Mas receptor axis on the healing rate of acetic-acid-induced gastric ulcers with or without the blockade of Mas receptors by A 779 and compared it with the effects of activation and blockade of the AT-1 receptor by the treatment with Ang II and losartan, respectively, the inhibition of ACE by lisinopril, the NO/cNOS inhibition by L-NAME and inhibition of prostaglandin/COX system by indomethacin in the presence of Ang-(1-7). Additionally, ex vivo metabolism of Ang I in gastric tissue was assessed by LC/MS method. At day 9 after ulcer induction, the area of these ulcers and the accompanying changes in total gastric blood flow (GBF) were determined as were gastric mucosal blood flow (GMBF) at ulcer margin and gastric oxygen uptake (GVO2). The gastric mucosal expression of mRNAs for constitutive nitric oxide synthase (cNOS), superoxide dismutase (SOD), and pro-inflammatory cytokines interleukin 1β (IL-1β) and tumor necrosis factor alpha (TNF-α) and plasma level of both cytokines were determined by RT-PCR and ELISA. The 9 days treatment with Ang II dose-dependently increased the area of gastric ulcers and this effect was accompanied by a significant fall in the GBF, GVO2 and GMBF at ulcer margin. In contrast, treatment with Ang-(1-7) which produced a significant rise in the luminal content of NO significantly reduced the area of gastric ulcer and significantly increased the GBF, GVO2 and the GMBF at ulcer margin. Similar GMBF changes and significant reduction the area of gastric ulcer was

  15. Iatrogenic addiction and its treatment.

    Walker, L


    Iatrogenic addictions, in contrast to illicit drug addictions, are commonly maintained for years before being brought to the attention of mental health professionals. Typically, by the time treatment is sought, both the physiological addiction and its related psychological problems have encapsulated the patient's life-style. The case histories described here illustrate some of the problems which typify treatment of the iatrogenically drug-dependent patient. Psychotherapeutic strategies utilizing life review, assertion training, and didactic teaching of alternative pain relief methods are often useful. The use of methadone for brief or more extended periods is sometimes helpful as an adjunct to psychotherapy.

  16. The Effects of Administration of Mangosteen Pericap's Ethanolic Extract and Xanthone on Angiogenesis of Gastric Ulcer Healing in Wistar Rats Observed Through the Increase in the level of NO and VEGF and CD-31 Expressions

    Ika Kustiyah Oktaviyanti


    Full Text Available BACKGROUND: NSAIDs can cause gastric ulcer or may delay the healing of it. Upon exposure to indomethacin, gastric ulcer can occur due to oxidants. Mangosteen rind contains xanthone, which is a natural antioxidant. Administration of this antioxidant may increase angiogenesis that can accelerate healing of gastric ulcer. METHODS: This study used an experimental method with randomized post test control only design using Wistar rats. The rats were put on fasting for 24 hours, then a single dose of 30mg/kg body weight (BW Indomethacine was given. The rats were divided into control group and treatment group. The treatment group was further divided into two subgroups: one group was given a daily 200 mg/kg BW mangosteen pericap extract, and the other group was given 35 mg/kg BW Xanthone. Both the control group and treatment group were decapitated on the 3rd day, 6th day and 12th day, respectively. After decapitation, the stomach of each rat was taken and divided into two portions, one portion was used for NO examination by ELISA, and the other portion for hispathological examination and immunohistochemical analysis for assessing CD 31 and VEGF expressions. RESULTS: Administration of mangoosteen pericap and xanthone could accelerate healing of gastric ulcers as compared with the control, as shown by the decrease in the severity level of the ulcers. Mangoosteen pericap and xanthone could also increase NO, VEGF expression, and CD-31 as compared with the control, especially on the 3rd day of treatment. Explanation of this finding might be that the antioxidants contained in the mangoosteen pericap or in xanthone could bind with radical superoxide and accelerate release of free NO. The increase of NO caused increase of VEGF and CD-31 that could accelerate angiogenesis, which eventually could accelerate healing of the gastric ulcers. CONCLUSIONS: The effect of mangosteen pericap's extract and xanthone can improve healing of gastric ulcers by increasing nitric

  17. Stable gastric pentadecapeptide BPC 157 heals cysteamine-colitis and colon-colon-anastomosis and counteracts cuprizone brain injuries and motor disability.

    Klicek, R; Kolenc, D; Suran, J; Drmic, D; Brcic, L; Aralica, G; Sever, M; Holjevac, J; Radic, B; Turudic, T; Kokot, A; Patrlj, L; Rucman, R; Seiwerth, S; Sikiric, P


    Stable gastric pentadecapeptide BPC 157 was suggested to link inflammatory bowel disease and multiple sclerosis, and thereby, shown to equally counteract the models of both of those diseases. For colitis, cysteamine (400 mg/kg intrarectally (1 ml/rat)) and colon-colon anastomosis (sacrifice at day 3, 5, 7, and 14) were used. BPC 157 (10 μg/kg, 10 ng/kg) was applied either intraperitoneally once time daily (first application immediately after surgery, last at 24 hours before sacrifice) or per-orally in drinking water (0.16 μg/ml/12 ml/day till the sacrifice) while controls simultaneously received an equivolume of saline (5 ml/kg) intraperitoneally or drinking water only (12 ml/day). A multiple sclerosis suited toxic rat model, cuprizone (compared with standard, a several times higher regimen, 2.5% of diet regimen + 1 g/kg intragastrically/day) was combined with BPC 157 (in drinking water 0.16 μg or 0.16 ng/ml/12 ml/day/rat + 10 μg or 10 ng/kg intragastrically/day) till the sacrifice at day 4. In general, the controls could not heal cysteamine colitis and colon-colon anastomosis. BPC 157 induced an efficient healing of both at the same time. Likewise, cuprizone-controls clearly exhibited an exaggerated and accelerated damaging process; nerve damage appeared in various brain areas, with most prominent damage in corpus callosum, laterodorsal thalamus, nucleus reunions, anterior horn motor neurons. BPC 157-cuprizone rats had consistently less nerve damage in all damaged areas, especially in those areas that otherwise were most affected. Consistently, BPC 157 counteracted cerebellar ataxia and impaired forelimb function. Thereby, this experimental evidence advocates BPC 157 in both inflammatory bowel disease and multiple sclerosis therapy.

  18. 幽门螺杆菌抑制大鼠乙酸胃溃疡愈合的机制%Mechanism of Helicobacter Pylori Inhibiting the Healing of Acetic Acid-Induced Gastric Ulcer in Rats

    李成军; 夏立丁; 金丽; 王国忠


    目的 研究幽门螺杆菌抑制大鼠乙酸胃溃疡愈合的机制.方法 用幽门螺杆菌感染Wistar大鼠,4周后复制出乙酸胃溃疡模型,在溃疡模型复制后的3、8、16天测定胃窦部黏膜G细胞、D细胞的数目、胃液量和pH.结果 Hp+乙酸溃疡组G细胞数目、胃液量高于乙酸溃疡组(P<0.01);D细胞的数目和pH低于乙酸溃疡组(P<0.01).结论 幽门螺杆菌通过增加胃酸分泌抑制溃疡愈合.%Objective To study the mechanism of Helicobacter Pylori inhibiting the healing of acetic acid - induced gastric ulcer in rats. Methods Rats were infected with Helicobacter Pylori and the model of acetic acid gastric ulcer was replicated at 4 weeks after in-fection. Amount of G cell and D cell in mucosa of gastric antrum, quantity of gastric juice and pH were measured at the 3rd,Sth, 16th day after the model was replicated. Results When the group of Hp + acetic acid ulcer compared with the group of acetic acid ulcer, the number of G cell, quantity of gastric juice increased (P < 0.01), and the number of D cell and pH decreased (P < 0.01). Conclusion Helicobacter Pylori inhibits ulcer healing through increasing gastric acid secretion.

  19. Study of the effect of Frankincense extraction on ulcer healing quality in gastric ulcerated rats%乳香提取物对大鼠乙酸胃溃疡愈合质量的影响研究

    梅武轩; 曾常春


    Objective It is to explore the effect of Frankincense extraction on ulcer healing quality in gastric ulcerated rats, and to explore the application value of pathology and optical coherence tomography ( OCT ) device for the ulcer healing quality study. Methods The rat model of chronic gastric ulcer was established by acetic acid, then they were randomly divided into four groups, fed with normal saline, frankincense extracts and omeprazole and so on respectively. The thickness of regenerative mucosa was dynamic observed by pathology and OCT technology. Results The thickness of regenerative mucosa of frankincense extract group was significantly thicker than that of other groups, OCT could dynamic observed the submucosa tissue ulcer healing. Conclusion Frankincense extract can improve the regeneration of mucosal ulcers maturity structure, improve the quality of ulcer healing, OCT has a certain value for determining their quality? Of healing.%目的 讨乳香提取物对大鼠乙酸胃溃疡愈合质量的影响及OCT技术应用于溃疡愈合质量研究的价值.方法 冰醋酸制备大鼠慢性胃溃疡模型,随机分为4组,分别灌服生理盐水、乳香提取物、奥美拉唑等.用病理及OCT技术对再生黏膜厚度进行动态观察.结果 香提取物组再生黏膜厚度增加,OCT可以检测到溃疡病灶黏膜下层组织的愈合过程.结论 香提取物能提高溃疡再生黏膜结构成熟度,提高溃疡愈合质量,OCT对愈合质量的研究具有一定的价值.

  20. Risk of infection by iatrogenic asplenia

    Slanina, J.; Wannenmacher, M.; Heidemann, S.


    A retrospective evaluation of the data of all patients with Hodgkin's disease (collective of Freiburg) treated between 1964 and 1977 was made in order to find out if there was an increased risk of infection after a diagnostic laparotomy with splenectomy (LS). Among a total number of 592 patients, 277 had been submitted to LS (since 1969). 185 patients had a total remission, 130 of them after primary LS, 34 after secondary LS, and 21 without any treatment of the spleen. An inquiry conducted by means of a questionnaire showed no differences between the compared groups as to the frequency of not septic infections such as pulmonary tuberculosis, angina tonsillaris, pyodermia, sinusitis, complications in wound healing, urinary tract infections, and infections of the intestine. However, there was a significant increase of unspecific pneumonias and herpes zoster manifestations after (long-term observation) secondary LS. There were no differences regarding the frequency of febrile and not febrile colds, but after LS, the colds had a longer and more severe course. - The analysis of the cause of death in the 277 patients who died showed a lethal septicaemia in seven cases. All these patients had been submitted to LS. In three of these patients, a recurrence was proved or could not be excluded, four presented as total remission with respect to Hodgkin's disease. - These results and the communications of literature permit to conclude that the iatrogenic asplenia represents an additional immunological risk. They suggest a further reduction of the indication for LS, the criteria of which are discussed.

  1. [Iatrogenic evolutive skull fracture (author's transl)].

    Villarejo, F; Pascual Castroviejo, I; Dabdoub, C; Bordes, M; Jover, P


    A case of growing skull fracture secondary to a maxilofacial operation is reported. Frequency, clinical symptoms, phisiopathology and treatment of growing skull fractures are reviewed and the rarity of the iatrogenic mechanism is stressed.

  2. Iatrogenics in Orthodontics and its challenges

    Barreto, Gustavo Mattos; Feitosa, Henrique Oliveira


    ABSTRACT Introduction: Orthodontics has gone through remarkable advances for those who practice it with dignity and clinical quality, such as the unprecedented number of patients treated of some type of iatrogenic problems (post-treatment root resorptions; occlusal plane changes; midline discrepancies, asymmetries, etc). Several questions may raise useful reflections about the constant increase of iatrogenics. What is causing it? Does it occur when dentists are properly trained? In legal terms, how can dentists accept these patients? How should they be orthodontically treated? What are the most common problems? Objective: This study analyzed and discussed relevant aspects to understand patients with iatrogenic problems and describe a simple and efficient approach to treat complex cases associated with orthodontic iatrogenics. PMID:27901237

  3. Infantile iatrogenic cushing′s syndrome

    Katar Selahattin


    Full Text Available High potency or/and extended use of topical corticosteroids, particularly in children, may cause suppression of the hypothalamopituitary-adrenal axis. However, iatrogenic Cushing′s syndrome in infantile age group is very rare and only a few patients have been reported to date in the literature. Here, we report a case of iatrogenic Cushing′s syndrome in a 6-month-old male child whose parents have admitted to the hospital for overweight and skin fragility.

  4. Iatrogenics in Orthodontics and its challenges

    Gustavo Mattos Barreto; Henrique Oliveira Feitosa


    ABSTRACT Introduction: Orthodontics has gone through remarkable advances for those who practice it with dignity and clinical quality, such as the unprecedented number of patients treated of some type of iatrogenic problems (post-treatment root resorptions; occlusal plane changes; midline discrepancies, asymmetries, etc). Several questions may raise useful reflections about the constant increase of iatrogenics. What is causing it? Does it occur when dentists are properly trained? In legal ter...

  5. Contemporary pharmacotherapy and iatrogenic pathology

    Trailović D.R.


    Full Text Available During the past few decades, the pharmaceutical industry has developed into a powerful human activity highly influencing modern medicine. Thousands of synthetic therapeuticals have been developed, and these formulations enabled the successful treatment of many diseases, some of which were considered incurable. An increase in drug consumption followed the development of the pharmaceutical industry and the introduction of synthetic drugs. The widespread use of new medicals enabled the collection of data confirming their effectiveness, but also more and more data concerning side and unwanted effects were reported. Frequent side/unwanted effect reports gave rise to development of iatrogenic pathology, a new branch of clinical pathology. The knowledge of the possible unwanted effects of drugs on macro organisms did not enable the effective withdrawal of such formulations from the market. At the beginning, the reports concerning unwanted effects were not verealed. Consequently some potentially harmful formulations were used for years without methodical analyses of their side/unwanted effects. Some potentially dangerous formulations are still on the market such as drugs containing ulcerogenic, hepatotoxic, nephrotoxic substances as well as those inducing bone marrow aplasia. The administration of these potentially dangerous formulations is understandable in the case of clear therapeutic indications allowing no alternatives. In these cases the risk of harmful side effects is greatly overwhelmed by the risk from the primary disease. Otherwise the administration of the potentially harmful drug is unjustified, especially if the indication is not a disease. Many potentially harmful drugs are formulated for use in healthy animals, recommended as growth, laying and milk stimulators, those allowing higher speed and strength in sport and racing horses, estrus inducers and suppressors. The misuse or maluse medication is highly present in sport horses daily

  6. Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization

    Yildiz, Altan; Oezer, Caner; Egilmez, Hulusi; Duce, Meltem Nass; Apaydin, Demir F.; Yalcinoglu, Orhan [Department of Radiology, Faculty of Medicine, Mersin University (Turkey)


    The presence of pneumocephalus without a history of intracranial or intrathecal procedures is a significant radiographic finding. Although pneumocephalus means a violation of the dural barrier or the presence of infection, intravascular pneumocephalus is different from intraparenchymal pneumocephalus and its benign nature must be known in the presence of intravenous catheterization. Herein, we present a case of iatrogenic intravascular pneumocephalus with CT findings. To our knowledge, there are only a few reported cases of iatrogenic intravascular pneumocephalus in the literature. Careful intravenous catheterization and diagnosis of the condition on imaging helps to prevent unnecessary treatment procedures. (orig.)

  7. MRI of the stomach: a pictorial review with a focus on oncological applications and gastric motility.

    Sheybani, Arman; Menias, Christine O; Luna, Antonio; Fowler, Kathryn J; Hara, Amy Kiyo; Silva, Alvin C; Yano, Motoyo; Sandrasegaran, Kumar


    The purpose of this pictorial review is to demonstrate gastric pathology seen on magnetic resonance imaging (MRI) and discuss the essential MRI sequences for the evaluation of benign and malignant gastric pathologies. Common tumors of the stomach, polyposis syndromes, iatrogenic conditions, as well as other conditions of the stomach will be reviewed. The utility of MRI in the evaluation of patients with gastric malignancies and disorders of gastric motility will also be discussed.

  8. Iatrogenic injury to the inferior alveolar nerve

    Hillerup, Søren


    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assess...

  9. 阿司匹林对大鼠胃溃疡愈合的影响和机制%Effect of aspirin on gastric ulcer healing in rat and mechanisms

    李成军; 马丹丹; 祝友朋; 王国忠


    目的 探讨阿司匹林对胃溃疡愈合的影响和机制.方法 用乙酸诱导大鼠胃溃疡,8 d后随机分为模型组、盐水组、阿司匹林组.用组织学方法检测溃疡形态、肉芽组织中毛细血管数;用氢气清除法检测溃疡边缘胃黏膜血流;用免疫组化方法检测表皮生长因子(EGF)、血管内皮生长因子(VEGF)在胃黏膜中的表达并检测其积分光密度.结果 阿司匹林组的溃疡面积高于模型和盐水对照组(P<0.05);阿司匹林组的毛细血管数和胃黏膜血流低于模型和盐水组(P<0.01);阿司匹林组的EGF和VEGF积分光密度低于模型和盐水组(P<0.01).结论 阿司匹林通过抑制EGF和VEGF的表达抑制溃疡愈合.%Objective To explore the effect of aspirin on gastric ulcer and mechanisms. Methods The gastric ulcers were induced with acetic acid in rats and the rats were randomly divided into model control, saline control and aspirin groups after 8 day. Ulcerative appearance and the number of capillaries in granulation tissue were detected through histological method. Gastric mucosal blood flow on the ulcerative margin was detected by hydrogen gas clearance technique. The expressions of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in gastric mucosa were detected through immunohistochemical method, and than integral optical density were detected. Results The ulcerative area in aspirin group was increased compared with those of model or saline control groups ( P < 0. 05 ); The number of capillaries and the gastric mucosal blood flow in aspirin group were decreased compared with those of model or saline control groups (P <0. 01 ). The integral optical density of EGF and VEGF in aspirin group was decreased compared with those of model or saline control groups (P < 0. 01 ). Conclusions Aspirin inhibit the ulcer healing by inhibiting the expressions of EGF and VEGF.

  10. Iatrogenic disease in the elderly: risk factors, consequences, and prevention

    Sompol Permpongkosol


    Full Text Available Sompol PermpongkosolDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandAbstract: The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.Keywords: iatrogenic disease, elderly, risk factors, prevention

  11. Metabolism of oral trefoil factor 2 (TFF2) and the effect of oral and parenteral TFF2 on gastric and duodenal ulcer healing in the rat

    Poulsen, Steen Seier; Thulesen, J; Christensen, L


    Trefoil factors (TFFs) are peptides produced by mucus-secreting cells in the gastrointestinal tract. A functional association between these peptides and mucus, leading to stabilisation of the viscoelastic gel overlying the epithelia, has been suggested. Both oral and parenteral administration of ...... of the peptides increase the resistance of the gastric mucosa....

  12. Manuka Honey Exerts Antioxidant and Anti-Inflammatory Activities That Promote Healing of Acetic Acid-Induced Gastric Ulcer in Rats

    Almasaudi, Saad B.; Al-Hindi, Rashad R.; Abdel-dayem, Umama A.; Ali, Soad S.; Saleh, Rasha M.; Al Jaouni, Soad K.


    Gastric ulcers are a major problem worldwide with no effective treatment. The objective of this study was to evaluate the use of manuka honey in the treatment of acetic acid-induced chronic gastric ulcers in rats. Different groups of rats were treated with three different concentrations of honey. Stomachs were checked macroscopically for ulcerative lesions in the glandular mucosa and microscopically for histopathological alterations. Treatment with manuka honey significantly reduced the ulcer index and maintained the glycoprotein content. It also reduced the mucosal myeloperoxidase activity, lipid peroxidation (MDA), and the inflammatory cytokines (TNF-α, IL-1β, and IL-6) as compared to untreated control group. In addition, honey-treated groups showed significant increase in enzymatic (GPx and SOD) and nonenzymatic (GSH) antioxidants besides levels of the anti-inflammatory cytokine IL-10. Flow cytometry studies showed that treatment of animals with manuka honey has normalized cell cycle distribution and significantly lowered apoptosis in gastric mucosa. In conclusion, the results indicated that manuka honey is effective in the treatment of chronic ulcer and preservation of mucosal glycoproteins. Its effects are due to its antioxidant and anti-inflammatory properties that resulted in a significant reduction of the gastric mucosal MDA, TNF-α, IL-1β, and IL-6 and caused an elevation in IL-10 levels. PMID:28250794

  13. [Principle histoclinical forms of iatrogenic eruptions].

    Duperrat, B


    The staggering multiplication of chemotherapy and polychemotherapy, in addition to artificial substances introduced into foodstuffs (such as saccharin in certain so-called fruit juices), has resulted in innumerable visceral and cutaneous disorders. Confining ourselves to "iatrogenic" rashes, the mechanism of which is far from being a single entity, we have riviewed the six most common varieties: recurrent fixed pigmented erythema, in which stovarsol has given way to the sulphaguanidines; pigmentogenic rashes with the renewed use of amiodarone; eczema and erythrodermia which may be due to any drug, with or without the influence of the sun; iatrogenic lichens, atebrine having provided all types; bullous conditions, sometimes the final stage of the previous group; finally, Lyell's syndrome. Our aim was to study skin biopsies in all these problems, in order to attempt to discover typical lesions.

  14. Diagnosis and management of iatrogenic endoscopic perforations

    Paspatis, Gregorios A; Dumonceau, Jean-Marc; Barthet, Marc


    This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures. Main recommendations 1 ESGE recommends that each...... center implements a written policy regarding the management of iatrogenic perforation, including the definition of procedures that carry a high risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 In the case of an endoscopically identified...... perforation after an endoscopic procedure should be carefully evaluated and documented, possibly with a computed tomography (CT) scan, in order to prevent any diagnostic delay. 4 ESGE recommends that endoscopic closure should be considered depending on the type of perforation, its size, and the endoscopist...

  15. 氯吡格雷对乙酸诱导大鼠胃溃疡愈合的影响及机制%Effect and mechanism of clopidogrel on the healing of acetic acid-induced gastric ulcer in rats

    周海娟; 顾磊; 张玉


    Objective To identify the effect of clopidogrel on the gastric ulcer healing in experimental rats and to explore the underlying mechanisms from the aspect of angiogenesis. Methods Acetic acid was introduced into the serosal surface of the gastic bodies to induce ulcers in 22 rats,then they were divided into model (n = 6) ,clopidogrel (n = 8) and normal saline (n = 8) group. The effects of clopidogrel on the healing of gastric ulcer,on microvessel density (MVD) at the bottom of ulcers,on the protein expression of endostatin (ES) and vascular endothelial growth factor-A165 (VEGF-A165) in gastric mucosa were observed. Results Ten days after ulcer inducton,the ulcer area in clopidogrel group and NS group were (11 ± 3.07) mm2 and (7 ± 1. 85) mm2 respectively, with significant difference (P = 0. 023 0). The MVD in clopidogrel group was significantly lower than that in NS group (P = 0.011 4). The VEGF-A165 concentration of gastric mucosa in clopidogrel group was significantly lower than that in NS group (P <0.01). The ES concentration of gastric mucosa in clopidogrel group was significantly higher than that in NS group (P < 0. 01). The MVD at the bottom of ulcers was positively correlated with the concentration of VEGF-A165 ( r = 0.688 8, P = 0.003 2) , while negatively correlated with the concentration of ES ( r = - 0.767 1,P = 0.000 5). Conclusions Clopidogrel can signifficantly delay the healing of gastric ulcer in experimental rats, where inhibiting of angiogenesis at the bottom of ulcers by regulating the expression of VEGF-A165 and ES in gastric mucosa might involve in the mechanism.%目的 明确氯吡格雷对实验性大鼠胃溃疡愈合的影响,并从微血管形成的角度探讨其延缓胃溃疡愈合的机制.方法 以乙酸性大鼠胃溃疡模型为基础,将22只大鼠分为模型组(n=6)、氯吡格雷组(n=8)和生理盐水组(n=8),观察氯吡格雷对胃溃疡愈合的影响,及对溃疡底部微血管密度(microvessel density,MVD)、胃黏膜

  16. Iatrogenic urological triggers of autonomic dysreflexia

    Liu, N; Zhou, M; Biering-Sørensen, F


    Med search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood...... dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other...

  17. Medicolegal aspects of iatrogenic root perforations

    Tsesis, I; Rosen, E; Bjørndal, L


    AIM: To retrospectively analyze the medico-legal aspects of iatrogenic root perforations (IRP) that occurred during endodontic treatments. METHODOLOGY: A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of IRP following root canal...... treatment (p root perforation is a complication of root canal treatment and may result in tooth extraction...... and in legal actions against the treating practitioner. Mandibular molars are more prone to medico-legal claims related to root perforations. The patient should be informed of the risks during RCT and should get information on alternative treatments and their risks and prognosis...

  18. Iatrogenic traumatic brain injury during tooth extraction.

    Troxel, Mark


    An 8 yr old spayed female Yorkshire terrier was referred for evaluation of progressive neurological signs after a routine dental prophylaxis with tooth extractions. The patient was circling to the left and blind in the right eye with right hemiparesis. Neurolocalization was to the left forebrain. MRI revealed a linear tract extending from the caudal oropharynx, through the left retrobulbar space and frontal lobe, into the left parietal lobe. A small skull fracture was identified in the frontal bone through which the linear tract passed. Those findings were consistent with iatrogenic trauma from slippage of a dental elevator during extraction of tooth 210. The dog was treated empirically with clindamycin. The patient regained most of its normal neurological function within the first 4 mo after the initial injury. Although still not normal, the dog has a good quality of life. Traumatic brain injury is a rarely reported complication of extraction. Care must be taken while performing dental cleaning and tooth extraction, especially of the maxillary premolar and molar teeth to avoid iatrogenic damage to surrounding structures.

  19. Update on strategies limiting iatrogenic hypoglycemia.

    Bonaventura, Aldo; Montecucco, Fabrizio; Dallegri, Franco


    The prevalence of type 2 diabetes mellitus (T2DM) is increasing all over the world. Targeting good glycemic control is fundamental to avoid the complications of diabetes linked to hyperglycemia. This narrative review is based on material searched for and obtained via PubMed up to April 2015. The search terms we used were: 'hypoglycemia, diabetes, complications' in combination with 'iatrogenic, treatment, symptoms.' Serious complications might occur from an inappropriate treatment of hyperglycemia. The most frequent complication is iatrogenic hypoglycemia that is often associated with autonomic and neuroglycopenic symptoms. Furthermore, hypoglycemia causes acute cardiovascular effects, which may explain some of the typical symptoms: ischemia, QT prolongation, and arrhythmia. With regards to the latter, the night represents a dangerous period because of the major increase in arrhythmias and the prolonged period of hypoglycemia; indeed, sleep has been shown to blunt the sympatho-adrenal response to hypoglycemia. Two main strategies have been implemented to reduce these effects: monitoring blood glucose values and individualized HbA1c goals. Several drugs for the treatment of T2DM are currently available and different combinations have been recommended to achieve individualized glycemic targets, considering age, comorbidities, disease duration, and life expectancy. In conclusion, according to international guidelines, hypoglycemia-avoiding therapy must reach an individualized glycemic goal, which is the lowest HbA1c not causing severe hypoglycemia and preserving awareness of hypoglycemia. © 2015 The authors.

  20. Spontaneous globe luxation in iatrogenic Cushing syndrome.

    Ortega-Evangelio, Leticia; Navarrete-Sanchis, Javier; Williams, Basil K; Tomas-Torrent, Juan Miguel


    We report a rare case of spontaneous eyeball luxation associated with exophthalmos due to iatrogenic Cushing syndrome (CS). The normalization of serum hormones led to the regression of the picture. A 64-year-old man presented with spontaneous globe luxation of the left eye after a 6-month history of bilateral, painless, and slowly progressive exophthalmos. The patient had been receiving weekly infusions of methylprednisone over the previous 6 months. His best-corrected visual acuity (BCVA) at presentation was 20/40 in the right eye and 20/20 in the left eye. The patient demonstrated full extraocular motility. The intraocular pressure (IOP) was elevated in the right eye (24 mHg) and normal in the left eye (18 mmHg). Exophthalmometry demonstrated bilateral proptosis with measurements of 27 mm in the right eye and 28 mm in the left eye. Computed tomography scan of the brain and orbits revealed increased orbital and cervical fat. Clinical, radiographic and serologic findings ruled out potential diagnoses including orbital metastasis, thyroid orbitopathy, carotid-cavernous fistula, and idiopathic orbital pseudotumor. Clinical suspicion of iatrogenic CS was high, and additional serologic testing confirmed the diagnosis. Exophthalmos is an uncommon sign of CS, but to our knowledge, this is the first reported case of spontaneous globe luxation secondary to CS. In our case, normalization of cortisol was sufficient to resolve the clinical symptoms and eliminated the need for surgical intervention such as orbital decompression surgery.

  1. Changes of trefoil factor 3 in hypophysis during healing of experimental gastric ulcer in rats%大鼠实验性胃溃疡自愈期间垂体三叶因子3的变化

    张小俊; 吕洋; 张文静; 张静; 邵素霞; 吴靖芳


    目的 通过观察大鼠实验性胃溃疡形成和愈合过程中垂体和血清三叶因子3(TFF3)的改变,探讨垂体TFF3在实验性胃溃疡愈合中的作用. 方法 以免疫组织化学染色检测溃疡组(42只)、盐水组(21只)和正常组(6只)大鼠垂体TFF3蛋白的表达;RT-PCR检测TFF3mRNA的转录;酶联免疫吸附测定(ELISA)法检测血清TFF3含量变化,原位杂交技术显示TFF3mRNA的定位. 结果 大鼠实验性胃溃疡自愈期间TFF3免疫反应阳性物质存在于腺垂体部分细胞和神经垂体,而TFF3 mRNA仅存在于腺垂体.与对照组相比,溃疡第1~6天,腺垂体内阳性信号平均吸光度值明显增大,6d达高峰,10d略有下降,14d复增高,23d下降,但仍高于对照组(P<0.01或P<0.05);神经垂体TFF3平均吸光度值在2~23d高水平波动,14d达高峰(P<0.01或P<0.05).RT-PCR显示,各组垂体均检测到TFF3 mRNA转录,溃疡组TFF3/GAPDH吸光度比值在溃疡2~ 23d均高于对照组(P<0.01或P<0.05);血清TFF3含量在溃疡组明显高于正常组(p<0.01). 结论 垂体TFF3在溃疡期间高表达,可能通过释放入血发挥促进溃疡愈合的作用.%Objective To explore the function of trefoil factor 3(TFF3) during the self-healing of experimental gastric ulcer in rats,and to observe the changes of TFF3 in hypophysis and blood serum. Methods The expression and changes of TFF3 peptide and mRNA in hypophysis at 42 gastric ulcer, 21 saline and 6 normal rats were detected by immunohistochemical SP and RT-PCR methods respectively. The content of TFF3 peptide of blood serum in different phase was detected by EL1SA. In situ hibridazation method (ISH) was used to detect the location of TFF3 mRNA in hypophysis. Results TFF3 immunoreactive profiles were mainly located in some cells of adenohypophysis ( AP) ,and neurohypophysis (NP) ,but TFF3 mRNA only in some cells of AP by ISH. The average absorbance( AA ) values increased from the day 1 to 6 after gastric ulcer

  2. Post tubal ligation syndrome or iatrogenic hydrosalpinx.

    Gregory, M G


    The purpose of this case report is as follows: to attempt to establish an association between the observed increase in hydrosalpinx and the phenomenal increase in surgical sterilization; to present a credible etiology for iatrogenic hydrosalpinx; and to discuss the pathogenesis of a disease process henceforth referred to as post tubal ligation syndrome. A 36-year-old white woman was admitted to Park View Hospital in Nashville, Tennessee on January 7, 1981 for evaluation of continuous lower abdominal pain, abdominal pressure, and dyspareunia for several months. The woman had 2 children who were delivered vaginally. An abdominal tubal ligation was performed for sterilization when she was 27, and vaginal hysterectomy, with anterior and posterior colporrhaphy, was done for symptomatic pelvic relaxation at age 33. Physical examination showed tenderness without palpable masses in the pelvic adnexal areas. Laboratory studies were within normal limits. On January 9, 1981, the patient underwent exploratory laparotomy, and bilateral salpingo-oophorectomy. She was found to have bilateral hydrosalpinx. Historically, hydrosalpinx has been considered an intermediary step in pelvic inflammatory disease. Iatrogenic hydrosalpinx is, in essence, initiated by an initial insult, e.g., tubal ligation, fulguration, or application of a mechanical clip or band. Theoretically, single point interruption of a fallopian tube should produce no ill effects. The popularity and success of tubal ligation attest to single point interruption of an otherwise normal fallopian tube as an innocuous procedure. A schematic drawing is provided of the same tube insulted a 2nd time and consequently the situation is prefactory to development of hydrosalpinx, i.e., a tube lined with secretory epithelium is closed at both ends. Secretion within this closed system will produce dilatation. This "2nd" insult to the normal fallopian tube, post tubal ligation, may take 1 of several forms. The symptoms of iatrogenic

  3. [Traumatic and iatrogenic lesions of abdominal vessels].

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H


    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  4. [Necrotizing enterocolitis. Pathogenesis and iatrogenic factors].

    Obladen, M


    Following clinical observations, measurements of osmolarity of liquid drugs, and determination of blood loss due to sampling in very low birthweight infants, the following hypothesis on iatrogenic factors contributing to the pathogenesis of necrotizing enterocolitis is proposed: Due to diagnostic blood sampling during intensive care, premature infants may become severely anemic. Therefore their intestinal perfusion is reduced, causing hypoxia and hypoperfusion in the submucosa. Especially in infants with oral feeding and hyperosmolar medication, mechanical factors, hyperosmolarity and infection can affect the mucosa from the luminal side. Simultaneous hypoperfusion and hyperosmolar load may contribute to the pathogenesis of necrotizing enterocolitis. This hypothesis, which needs experimental verification, explains the different incidence of the disease in different hospitals.

  5. Iatrogenic Digital Compromise with Tubular Dressings

    Corre, Kenneth A


    Full Text Available Objective: This case report describes a digit amputation resulting from an improperly applied tubular dressing. The safe application of digital tubular dressings, and the rationale behind it, is detailed to raise emergency physician (EP awareness.Methods: We present a case report of a recent iatrogenic-induced digit ischemia caused by improperly applied tube gauze. We review the literature on the subject and the likely sources of poor outcomes presented. The proper application of tubular gauze dressings is then outlined.Conclusion: EPs and emergency department personnel must be educated on the safe application of tubular gauze dressings to avoid dire outcomes associated with improper applications.[WestJEM. 2009;10:190-192.

  6. A Retrospective Review of Iatrogenic Skin and Soft Tissue Injuries

    Tae Geun Lee


    Full Text Available BackgroundEven though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department.MethodsA retrospective clinical review was performed from April 2006 to November 2010. In total, 196 patients (116 females and 80 males were referred to the plastic surgery department for the treatment of iatrogenic injuries. We analyzed the types and anatomic locations of iatrogenic complications, along with therapeutic results.ResultsAn extravasation injury (65 cases, 37.4% was the most common iatrogenic complication in our study sample, followed by splint-induced skin ulceration, dopamine-induced necrosis, prefabricated pneumatic walking brace-related wounds and elastic bandage-induced wounds. Among these, prefabricated pneumatic walking brace-related complication incidence increased the most during the 5-year study period.ConclusionsThe awareness of the very common iatrogenic complications and its causes may allow physicians to reduce their occurrence and allow for earlier detection and referral to a plastic surgeon. We believe this is the first study to analyze iatrogenic complications referred to a plastic surgery department in a hospital unit.

  7. Iatrogenic oesophageal perforation during placement of an endoscopic vacuum therapy device.

    Halliday, Edwin; Patel, Anant; Hindmarsh, Andrew; Sujendran, Vijay


    Endoscopic vacuum-assisted closure (VAC) is increasingly being used as a means of managing perforations or anastomotic leaks of the upper gastrointestinal (GI) tract. Published outcomes are favourable, with few mentions of complications or morbidity. We present a case in which the management of a gastric perforation with endoscopic vacuum therapy was complicated by cervical oesophageal perforation. The case highlights the risks of such endoscopic therapeutic procedures and is the first report in the literature to describe significant visceral injury during placement of a VAC device for upper GI perforation. Iatrogenic oesophageal perforation is an inherent risk to upper GI endoscopy and the risk increases in therapeutic endoscopic procedures. Complications may be reduced by management under a multidisciplinary team in a centre with specialist upper GI services. There is no doubt that the endoscopic VAC approach is becoming established practice, and training in its use must reflect its increasingly widespread adoption.

  8. Steroid-induced iatrogenic disease after treating for pseudothrombocytopenia.

    Sharma, A; Pinto Pereira, Lexley M; Capildeo, K; Charles, K; Teelucksingh, S


    Pseudothrombocytopenia, a spontaneous in vitro occurrence after the addition of anticoagulant to blood, causes clumping of platelets resulting in a spurious observation of low platelet counts (pseudothrombocytopenia. Failure to recognize this phenomenon may lead to debilitating iatrogenic disease.

  9. Iatrogenic diaphragmatic hernia in infants: Potentially catastrophic when overlooked

    Yousef El-Gohary


    Full Text Available Acquired diaphragmatic hernias are a rare occurrence. They can result from blunt, penetrating or inadvertent iatrogenic injury. When overlooked they can potentially be catastrophic. We report a case of iatrogenic diaphragmatic hernia in a six-month old infant presenting with acute respiratory distress as a result of strangulated bowel herniating into the left hemithorax caused from a traumatic chest tube insertion in the neonatal period.

  10. Inhalational Steroids and Iatrogenic Cushing’s Syndrome

    A.V, Raveendran


    Bronchial asthma (BA) and Allergic rhinitis (AR) are common clinical problems encountered in day to day practice, where inhalational corticosteroids (ICS) or intranasal steroids (INS) are the mainstay of treatment. Iatrogenic Cushing syndrome (CS) is a well known complication of systemic steroid administration. ICS /INS were earlier thought to be safe, but now more and more number of case reports of Iatrogenic Cushing syndrome have been reported, especially in those who are taking cytochrome P450 (CYP 450) inhibitors. Comparing to the classical clinical features of spontaneous Cushing syndrome, iatrogenic Cushing syndrome is more commonly associated with osteoporosis, increase in intra-ocular pressure, benign intracranial hypertension, aseptic necrosis of femoral head and pancreatitis, where as hypertension, hirsuitisum and menstrual irregularities are less common. Endocrine work up shows low serum cortisol level with evidence of HPA (hypothalamo-pituitary-adrenal) axis suppression. In all patients with features of Cushing syndrome with evidence of adrenal suppression always suspect iatrogenic CS. Since concomitant administration of cytochrome P450 inhibitors in patients on ICS/INS can precipitate iatrogenic CS, avoidance of CYP450 inhibitors, its dose reduction or substitution of ICS are the available options. Along with those, measures to prevent the precipitation of adrenal crisis has to be taken. An update on ICS-/INS- associated iatrogenic CS and its management is presented here. PMID:25674177

  11. Foreign body gingivitis: An iatrogenic disease

    Daley, T.D.; Wysocki, G.P. (Univ. of Western Ontario, London (Canada))


    Gingival biopsy specimens from eight patients exhibiting a localized, erythematous, or mixed erythematous/leukoplakic gingivitis that was refractory to conventional periodontal therapy were examined histologically and by energy-dispersive X-ray microanalysis. Histologic examination revealed variable numbers of small, usually subtle, sometimes equivocal, and occasionally obvious foci of granulomatous inflammation. Special stains for fungi and acid-fast bacilli were consistently negative. In all cases, the granulomatous foci contained particles of foreign material that were often inconspicuous and easily overlooked during routine histologic examination. Energy-dispersive X-ray microanalysis of these foreign particles disclosed Ca, Al, Si, Ti, and P in most lesions. However, other elements such as Zr, V, Ag, and Ni were found only in specific biopsy specimens. By comparing the elemental analyses, clinical features, and history of the lesions, strong evidence for an iatrogenic source of the foreign material was found in one case, and good evidence in five cases. In the remaining two patients, the source of the foreign particles remains unresolved.

  12. Mesenteric infarction due to iatrogenic polycythemia.

    Skoog, Katrina; Carmelle-Elie, Marie; Ferguson, Kevin


    Polycythemia vera is defined as a chronic myeloproliferative disorder characterized by increased red blood cell count. There have been no reports on mesenteric thrombosis resulting from iatrogenic polycythemia. We present a patient with a history of non-small cell lung cancer undergoing maintenance oral chemotherapy on tarceva and adjunctive use of procrit. The patient presented to our emergency department with an acute abdomen and was found to have ischemic bowel from unmonitored procrit, which lead to hyperviscosity of blood and mesenteric infarction. The patient remained intubated with ventilator support. He refused a tracheostomy. He continued on feeding through the J port of the nasojejunal tube. His white cell count, and hematocrit and creatinine levels remained normal. Procrit use and chemotherapy were not restarted. He was transferred to a subacute nursing facility for further treatment. Procrit and other erythropoiesis stimulating drugs can cause significant morbidity and mortality with an increased risk of cardiovascular events, gastrointestinal bleeding, thromboembolism and stroke. This case report suggests that without closely monitoring hematocrit levels, epoetin may also be associated with an increased risk of mesenteric infarction.

  13. Iatrogenic causes of salivary gland dysfunction

    Schubert, M.M.; Izutsu, K.T.


    Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts).

  14. Identification and Management of Iatrogenic Aortocoronary Dissection

    Shao-Ping Nie, MD, PhD, FESC, FSCAI


    Full Text Available Iatrogenic aortocoronary dissection (IACD is a rare but potentially life-threatening complication during coronary catheterizations. Although the incidence was relatively low, the dissection often leads to procedure failure with increased risk of myocardial infarction and death. IACD is mainly caused by disruption of intima at the ostia of left or right coronary artery during interventional procedures, and appears as luminal filling defects or persistence of contrast (“extraluminal cap” or intimal tear outside the coronary lumen. Dissection could disseminate antegradely and lead to subtotal or total occlusion of the coronary lumen. Similarly, it could extend retrogradely into the sinus of Valsalva and cusp, or even the ascending aorta, aortic arch, or descending aorta, leading to hemodynamic collapse. Early identification and prompt management is crucial to the prognosis of patients with IACD. Immediate bail-out stenting should be performed as rapidly as possible in most cases of severe dissection, even when significant propagation has already occurred. Surgery should only be considered when stenting failed to seal the dissection and the patients had hemodynamic compromise.

  15. Deep anterior lamellar keratoplasty for the management of iatrogenic keratectasia occurring after hexagonal keratotomy

    Paras Mehta


    Full Text Available Iatrogenic keratectasia has been reported subsequent to refractive surgery or trauma. Hexagonal keratotomy (HK is a surgical incisional technique to correct hyperopia. A number of complications have been reported following this procedure, including irregular astigmatism, wound healing abnormalities and corneal ectasia. When visual acuity is poor because of ectasia or irregular astigmatism and contact lens fitting is not possible, penetrating or lamellar keratoplasty can be performed. Since incisions in refractive keratotomy are set at 90-95% depth of cornea, intraoperative microperforations are known to occur and lamellar keratoplasty may become difficult. We describe deep anterior lamellar keratoplasty (DALK used to successfully manage keratectasia after HK. Pre DALK vision was 20/400 and post DALK vision was 20/30 two months after surgery. This report aims to show improved visual outcome in corneal ectasia secondary to HK. DALK can be a procedure of choice with proper case selection.

  16. Interdisciplinary Approach for Management of Iatrogenic Internal Root Resorption: A Case Report.

    Ramazani, Mohsen; Asgary, Saeed; Zarenejad, Nafiseh; Mehrani, Javad


    For management of a symptomatic maxillary lateral incisor with dull pain on chewing, suppurative sinus tract, defective metal-ceramic crown and iatrogenic internal root resorption, an interdisciplinary approach was taken. Two-visit nonsurgical treatment with calcium-enriched mixture (CEM) cement, replacement of metal-ceramic crown with all-ceramic crown and corrective periodontal plastic surgery were included in the treatment plan. Six-month and one-year follow-ups revealed complete resolution of signs and symptoms and radiographic healing. This case report highlights the importance of adequate cooling during crown preparation to preserve the pulp vitality and prevent internal resorptive lesions and also the profound sealing ability and biocompatibility of CEM cement.

  17. Classiifcation of iatrogenic bile duct injur y

    Wan-Yee Lau; Eric C.H. Lai


    BACKGROUND: Iatrogenic bile duct injury continues to be an important clinical problem, resulting in serious morbidity, and occasional mortality, to patients. The ease of management, operative risk, and outcome of bile duct injuries vary considerably, and are highly dependent on the type of injury and its location. This article reviews the various classiifcation systems of bile duct injury. DATA SOURCES: A Medline, PubMed database search was performed to identify relevant articles using the keywords"bile duct injury", "cholecystectomy", and “classiifcation”. Additional papers were identiifed by a manual search of the references from the key articles. RESULTS: Traditionally, biliary injuries have been classiifed using the Bismuth's classiifcation. This classiifcation, which originated from the era of open surgery, is intended to help the surgeons to choose the appropriate technique for the repair, and it has a good correlation with the ifnal outcome after surgical repair. However, the Bismuth's classiifcation does not encompass the whole spectrum of injuries that are possible. Bile duct injury during laparoscopic cholecystectomy tends to be more severe than those with open cholecystectomy. Strasberg’s classiifcation made Bismuth’s classiifcation much more comprehensive by including various other types of extrahepatic bile duct injuries. Our group, Bergman et al, Neuhaus et al, Csendes et al, and Stewart et al have also proposed other classiifcation systems to complement the Bismuth's classiifcation. CONCLUSIONS:None of the classiifcation system is universally accepted as each has its own limitation. Hopefully, a universally accepted comprehensive classiifcation system will be published in the near future.

  18. 携带SPK1基因的重组腺病毒对犬酒精性胃溃疡愈合的影响%Effect of sphingosine kinase-1 gene recombinant adenovirus on healing of gastric ulcer induced by alcohol in experimental dogs

    郭强; 张凯; 孔庆龙; 唐平; 张修礼; 孙刚


    Objective To study the therapeutic effect of Ad-sphingosine kinase-l(SPKl) gene on alcohol-induced gastric ulcers. Methods A dog model of alcohol-induced gastric ulcer was established. Adenovirus carrying green fluorescent protein(GFP) was prepared and used as a control to observe the distribution of GFP in gastric wall of dogs. Ulcer healing was observed under an electronic gastroscope 7,14, 21 and 28d respectively, after the drugs were given Ad-GFP or Ad-SPKl. SPK1 protein expression in gastric tissue was detected by Western blot. Activity of cellular SPK.1 was assayed with γ -P32 ATP incorporation method. Expression of CD34 was detected with immunohistochemical method and microvessel density(MVD) was calculated. Results Adenovirus could effectively mediate the expression of GFP and SPK1 in gastric mucosa cells. Adenovirus-mediated Ad-SPKl gene transfer promoted the healing of gastric ulcer under electronic gastroscope. The MVD was significantly higher in Ad-SPKl group than in control group(P<0.05). Conclusion Ad-SPKl can promote gastric mucosa repair and new vascular formation, thus accelerating the healing of ulcers in experimental dogs.%目的 探讨基因药物Ad-SPK1对酒精性胃溃疡的治疗作用.方法 建立酒精诱导的实验犬胃溃疡模型,制备携带绿色荧光蛋白(GFP)基因的腺病毒作为对照,观察GFP在犬胃壁中的分布,分别于给药后7、14、21、28d电子胃镜下观察溃疡的愈合情况,取胃溃疡组织进行Western blot检测SPK1蛋白的表达和γ-P32掺入法检测SPK酶活性和免疫组化检测CD34表达和MVD计数.结果 腺病毒能有效介导GFP和SPK1基因在胃溃疡黏膜层细胞表达.电子内镜下可见腺病毒介导的SPK1基因转移能促进胃溃疡愈合.微血管密度计数结果显示,Ad-SPK1组的微血管密度计数值明显高于对照组AdGFP组(P<0.05).结论 Ad-SPK1可促进实验犬胃溃疡黏膜上皮修复和溃疡面血管增生,加快溃疡愈合.

  19. Iatrogenic Uterine Diverticulum in Pregnancy After Robotic-assisted Myomectomy.

    DeStephano, Christopher C; Jernigan, Amelia M; Szymanski, Linda M


    Uterine diverticula are rare outpouchings of the uterus associated with abnormal uterine bleeding, pelvic pain, dysmenorrhea, and adverse obstetric events. At the time of cesarean delivery at 36 5/7 weeks' gestation during the patient's first pregnancy and 36 6/7 weeks during the second pregnancy, a fundal iatrogenic uterine diverticulum at the site of a prior robotic-assisted myomectomy was noted. The outpouching communicated with the endometrial cavity and was extremely attenuated, palpably 2 to 3 mm thick. Further research is needed to determine the incidence of iatrogenic uterine diverticulum after robotic myomectomy and whether these malformations increase the risk of adverse obstetric outcomes.

  20. Post-thyroidectomy iatrogenic Horner's syndrome with heterochromia


    Purpose To present a case of iatrogenic Horner's syndrome seen together with the heterochromia in the post-thyroidectomy period. Methods A 23-year-old female patient was admitted to our clinic with complaints of low vision in the eye and difference in eye color that developed over the past two years. In the left eye, myosis and minimal ptosis (∼1 mm) was detected, and the color of the iris was lighter than the right eye. Results The pre-diagnosis of left iatrogenic Horner's syndrome was final...

  1. Iatrogenic skin injury in the neonatal intensive care unit.

    Sardesai, Smeeta R; Kornacka, Maria K; Walas, Wojciech; Ramanathan, Rangasamy


    Although neonatal care has become more and more meticulous with significant changes in technology in the neonatal intensive care unit (NICU) in the past 50 years, iatrogenic cutaneous injuries continue to occur. Although the incidence of severe injuries is decreasing because the more difficult procedures are being replaced by improved techniques, skin injuries have not yet been completely eliminated. However, the nature and causes of cutaneous injuries have changed, and the injuries are frequent but generally minor. The major risk factors are low birth weight, gestational age, length of stay, a central venous line, mechanical ventilation, and support with continuous positive airway pressure. The rate of iatrogenic events is about 57% at gestational ages of 24-27 weeks, compared with 3% at term. There are no current comprehensive reviews of iatrogenic cutaneous injury. The purpose of this review is to describe the iatrogenic cutaneous injuries that may occur in the newborns as a consequence of perinatal and postnatal medical procedures. With increased survival of extremely-low-birth-weight (ELBW) infants and changing modes of management in the NICU, neonatologists must make every effort to recognize injuries and prevent their occurrence in the NICU.

  2. A Retrospective Review of Iatrogenic Skin and Soft Tissue Injuries

    Tae Geun Lee


    Full Text Available Background Even though the quality of medical and surgical care has improved remarkablyover time, iatrogenic injuries that require surgical treatment including injuries caused by castand elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequentlyoccur. The goal of this study was to estimate the incidence and analyze the distribution ofiatrogenic injuries referred to our department.Methods A retrospective clinical review was performed from April 2006 to November 2010. Intotal, 196 patients (116 females and 80 males were referred to the plastic surgery departmentfor the treatment of iatrogenic injuries. We analyzed the types and anatomic locations ofiatrogenic complications, along with therapeutic results.Results An extravasation injury (65 cases, 37.4% was the most common iatrogeniccomplication in our study sample, followed by splint-induced skin ulceration, dopamineinducednecrosis, prefabricated pneumatic walking brace-related wounds and elasticbandage-induced wounds. Among these, prefabricated pneumatic walking brace-relatedcomplication incidence increased the most during the 5-year study period.Conclusions The awareness of the very common iatrogenic complications and its causes mayallow physicians to reduce their occurrence and allow for earlier detection and referral to aplastic surgeon. We believe this is the first study to analyze iatrogenic complications referredto a plastic surgery department in a hospital unit.

  3. Healing Architecture

    Folmer, Mette Blicher; Mullins, Michael; Frandsen, Anne Kathrine


    The project examines how architecture and design of space in the intensive unit promotes or hinders interaction between relatives and patients. The primary starting point is the relatives. Relatives’ support and interaction with their loved ones is important in order to promote the patients healing...... process. Therefore knowledge on how space can support interaction is fundamental for the architect, in order to make the best design solutions. Several scientific studies document that the hospital's architecture and design are important for human healing processes, including how the physical environment...... architectural and design solutions in order to improve quality of interaction between relative and patient in the hospital's intensive unit....

  4. Gastric carcinogenesis

    Ismail Gomceli; Baris Demiriz; Mesut Tez


    Gastric cancer is the second most common cancer worldwide and the second most common cause of cancer-related deaths.Despite complete resection of gastric cancer and lymph node dissection,as well as improvements in chemotherapy and radiotherapy,there are still 700 000 gastric cancer-related deaths per year worldwide and more than 80% of patients with advanced gastric cancer die of the disease or recurrent disease within 1 year after diagnosis.None of the treatment modalities we have been applying today can influence the overall survival rates:at present,the overall 5-year relative survival rate for gastric cancer is about 28%.Cellular metaplasia due to chronic inflammation,injury and repair are the most documented processes for neoplasia.It appears that chronic inflammation stimulates tumor development and plays a critical role in initiating,sustaining and advancing tumor growth.It is also evident that not all inflammation is tumorigenic.Additional mutations can be acquired,and this leads to the cancer cell gaining a further growth advantage and acquiring a more malignant phenotype.Intestinalization of gastric units,which is called "intestinal metaplasia";phenotypic antralization of fundic units,which is called "spasmolytic polypeptide-expressing metaplasia"; and the development directly from the stem/progenitor cell zone are three pathways that have been described for gastric carcinogenesis.Also,an important factor for the development of gastrointestinal cancers is peritumoral stroma.However,the initiating cellular event in gastric metaplasia is still controversial.Understanding gastric carcinogenesis and its precursor lesions has been under intense investigation,and our paper attempts to high-light recent progress in this field of cancer research.

  5. Iatrogenic tension pneumothorax in children: two case reports

    Mayordomo-Colunga Juan


    Full Text Available Abstract Introduction Two cases of iatrogenic tension pneumothorax in children are reported. Case presentations Case 1: A 2-year-old boy with suspected brain death after suffering multiple trauma suddenly developed intense cyanosis, extreme bradycardia and generalized subcutaneous emphysema during apnea testing. He received advanced cardiopulmonary resuscitation and urgent bilateral needle thoracostomy. Case 2: A diagnostic-therapeutic flexible bronchoscopy was conducted on a 17-month-old girl, under sedation-analgesia with midazolam and ketamine. She very suddenly developed bradycardia, generalized cyanosis and cervical, thoracic and abdominal subcutaneous emphysema. Urgent needle decompression of both hemithoraces was performed. Conclusion In techniques where gas is introduced into a child's airway, it is vital to ensure its way out to avoid iatrogenic tension pneumothorax. Moreover, the equipment to perform an urgent needle thoracostomy should be readily available.

  6. Iatrogenic Cushing's syndrome in children following nasal steroid.

    Oluwayemi, Isaac Oludare; Oduwole, Abiola Olufunmilayo; Oyenusi, Elizabeth; Onyiriuka, Alphonsus Ndidi; Abdullahi, Muhammad; Fakeye-Udeogu, Olubunmi Benedicta; Achonwa, Chidozie Jude; Kouyate, Moustapha


    Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. We report two cases of iatrogenic Cushing's syndrome in two Nigerian children following intranasal administration of aristobed-N (Betamethasone + Neomycin) given at a private hospital where the children presented with feature of adenoidal hypertrophy. Two months into treatment children were noticed to have developed clinical and laboratory features of iatrogenic Cushing's syndrome with critical adrenal suppression. Serum cortisol (at presentation): 1(st) patient: 12nmol/L (reference range 240-618), 2(nd) 1.69nmol/L. Serum cortisol (3 months after weaning off steroid): 343.27 nmol/L (within normal range for the first patient; second patient newly presented and has just begun steroid weaning off process. The serum cortisol level one month into weaninig off process was 128 nmol/L). Unsupervised topical steroid administration in children can cause adrenal suppression with clinical features of Cushing's syndrome.

  7. Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage?

    Mario Visconti


    Full Text Available Proton pump inhibitors (PPIs are the most potent drugs for reducing gastric acid secretion; so, since their release in the late 1980s, they have been recommended as the first therapeutic choice for many gastroesophageal diseases, risk reduction in or healing of non-steroidal anti-inflammatory drugs-associated ulcer disease and stress ulcer prophylaxis in intensive care unit patients. Thus PPIs account for a significant proportion of pharmaceutical health-care expenditure. Much of this high expenditure results from overuse of PPIs in account of inappropriate indications or prolongation of therapies for excessive time compared to real need. PPIs overutilization occurs in all medical care settings: in the majority of hospitalized patients with low risks for gastrointestinal bleeding, in patients healed at discharge from hospital, in outpatients in ambulatory practice. However potential adverse effects associated with PPIs therapy have been described, including enteric (especially by Clostridium difficile in elderly patients and pneumonia infections, nutritional deficiencies, rebound acid hypersecretion, acute interstitial nephritis, gastric neoplasms, bone fractures. Caution is required for some coprescription, particularly with clopidogrel.

  8. Iatrogenic nocturnal eneuresis- an overlooked side effect of anti histamines?

    D Italiano


    Full Text Available Nocturnal enuresis is a common disorder in childhood, but its pathophysiological mechanisms have not been fully elucidated. Iatrogenic nocturnal enuresis has been described following treatment with several psychotropic medications. Herein, we describe a 6-year-old child who experienced nocturnal enuresis during treatment with the antihistamine cetirizine. Drug rechallenge was positive. Several neurotransmitters are implicated in the pathogenesis of nocturnal enuresis, including noradrenaline, serotonin and dopamine. Antihistamine treatment may provoke functional imbalance of these pathways resulting in incontinence.

  9. Human prion diseases: surgical lessons learned from iatrogenic prion transmission.

    Bonda, David J; Manjila, Sunil; Mehndiratta, Prachi; Khan, Fahd; Miller, Benjamin R; Onwuzulike, Kaine; Puoti, Gianfranco; Cohen, Mark L; Schonberger, Lawrence B; Cali, Ignazio


    The human prion diseases, or transmissible spongiform encephalopathies, have captivated our imaginations since their discovery in the Fore linguistic group in Papua New Guinea in the 1950s. The mysterious and poorly understood "infectious protein" has become somewhat of a household name in many regions across the globe. From bovine spongiform encephalopathy (BSE), commonly identified as mad cow disease, to endocannibalism, media outlets have capitalized on these devastatingly fatal neurological conditions. Interestingly, since their discovery, there have been more than 492 incidents of iatrogenic transmission of prion diseases, largely resulting from prion-contaminated growth hormone and dura mater grafts. Although fewer than 9 cases of probable iatrogenic neurosurgical cases of Creutzfeldt-Jakob disease (CJD) have been reported worldwide, the likelihood of some missed cases and the potential for prion transmission by neurosurgery create considerable concern. Laboratory studies indicate that standard decontamination and sterilization procedures may be insufficient to completely remove infectivity from prion-contaminated instruments. In this unfortunate event, the instruments may transmit the prion disease to others. Much caution therefore should be taken in the absence of strong evidence against the presence of a prion disease in a neurosurgical patient. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have devised risk assessment and decontamination protocols for the prevention of iatrogenic transmission of the prion diseases, incidents of possible exposure to prions have unfortunately occurred in the United States. In this article, the authors outline the historical discoveries that led from kuru to the identification and isolation of the pathological prion proteins in addition to providing a brief description of human prion diseases and iatrogenic forms of CJD, a brief history of prion disease nosocomial transmission

  10. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sirmahan Cakarer, Muhsin Cifter, Cuneyt Korhan Oral


    Full Text Available Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  11. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sabri Cemil Isler, Sabit Demircan, Merva Soluk, Cetin Kasapoglu, Cuneyt Korhan Oral


    Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  12. Embolis cutis medicamentosa, a rare preventable iatrogenic complication

    Manjunath Kavya,


    Full Text Available Embolis cutis medicamentosa is an uncommon iatrogenic complication characterised by variable degree of skin and tissue necrosis, likely to follow intramuscular injection. Intense pain and purplish discoloration of overlying skin, with or without reticulate pattern subsequently followed by tissue necrosis and scarring is highly specific for this syndrome. It has also been reported following intravenous, intra-articular and subcutaneous injections. Herein we are reporting two cases of this rare preventable entity.

  13. Hereditary Diffuse Gastric Cancer

    ... Hereditary Diffuse Gastric Cancer Request Permissions Hereditary Diffuse Gastric Cancer Approved by the Cancer.Net Editorial Board , 11/2015 What is hereditary diffuse gastric cancer? Hereditary diffuse gastric cancer (HDGC) is an inherited ...

  14. Expression patterns of transforming growth factor-beta and its receptors in gastric mucosa of patients with refractory gastric ulcer

    Shou-Chuan Shih; Chung-Liang Chien; Kwang-Wen Tseng; Shee-Chan Lin; Chin-Roa Kao; Sun-Yen Chou; Horng-Yuan Wang; Wen-Hsiung Chang; Cheng-Hsin Chu; Tsang-En Wang


    AIM: Transforming growth factor-β (TGF-β) plays a regulatory role in tissue repair. In a previous study, we found that TGF-β and its receptors were expressed in gastric mucosa of patients with well-healed gastric ulcers, as demonstrated by immunohistochemistry. To further characterize the role of TGF-β and its receptors in repairing gastric ulcers, we investigated the expression patterns of TGF-β and its receptors in gastric mucosa by in situ hybridization and reverse transcriptase-polymerase chain reaction (RT-PCR).METHODS: Seventy-four patients with endoscopically proven gastric ulcers were eligible for participation in this study. All patients had routine biopsies on initial endoscopy and were then treated for 12 wk with an H2 blocker. Repeat endoscopy was then performed. There were 8 patients with poorly healed ulcers, and biopsies were taken from the margin of the residual ulcers. These tissue samples, along with biopsy of gastric mucosa near the original ulcers from 8 randomly selected patients with well-healed ulcers were examined for TGF-β and TGF-β receptor Ⅱ mRNA by RT-PCR and in situ hybridization, as well as immunohistochemistry.RESULTS: TGF-β and TGF-β receptor Ⅱ were strongly expressed in tissues from patients with well-healed ulcers.Four of the 8 patients with poor healing had low or absent expression of TGF-β or TGF-β receptor Ⅱ mRNA. All cases positive by RT-PCR assay were confirmed by in situ hybridization as well as immunohistochemistry.CONCLUSION: It is suggested that TGF-β and its receptors are important for gastric ulcer healing. These results may have implications for further investigation of the healing process and in predicting response to therapy.

  15. Prevention of Iatrogenic Anemia in Critical and Neonatal Care.

    Jakacka, Natalia; Snarski, Emilian; Mekuria, Selamawit


    Iatrogenic anemia caused by diagnostic blood sampling is a common problem in the intensive care unit, where continuous monitoring of blood parameters is very often required. Cumulative blood loss associated with phlebotomy along with other factors render this group of patients particularly susceptible to anemia. As it has been proven that anemia in this group of patients leads to inferior outcomes, packed red blood cell transfusions are used to alleviate possible threats associated with low hemoglobin concentration. However, the use of blood components is a procedure conferring a set of risks to the patients despite improvements in safety. Iatrogenic blood loss has also gained particular attention in neonatal care, where cumulative blood loss due to samples taken during the first week of life could easily equal or exceed circulating blood volume. This review summarizes the current knowledge on the causes of iatrogenic anemia and discusses the most common preventive measures taken to reduce diagnostic blood loss and the requirement for blood component transfusions in the aforementioned clinical situations.

  16. Contribution of optical coherence tomography imaging in management of iatrogenic coronary dissection

    Barber-Chamoux, Nicolas, E-mail: [Department of Cardiology, Gabriel Montpied University Hospital, Clermont-Ferrand (France); Souteyrand, Géraud; Combaret, Nicolas [Department of Cardiology, Gabriel Montpied University Hospital, Clermont-Ferrand (France); ISIT, CaVITI, CNRS (UMR-6284), Auvergne University, Clermont-Ferrand (France); Ouedraogo, Edgar; Lusson, Jean René [Department of Cardiology, Gabriel Montpied University Hospital, Clermont-Ferrand (France); Motreff, Pascal [Department of Cardiology, Gabriel Montpied University Hospital, Clermont-Ferrand (France); ISIT, CaVITI, CNRS (UMR-6284), Auvergne University, Clermont-Ferrand (France)


    Iatrogenic coronary dissection is a rare but potentially serious complication of coronary angiography and angioplasty. Treatment with angioplasty guided only by angiography is often difficult. Optical coherence tomography imaging seems to be an interesting technique to lead the management of iatrogenic coronary dissection. Diagnosis can be made by optical coherence tomography; it can also eliminate differential diagnosis. Furthermore, this technique can guide safely the endovascular treatment. - Highlights: • Iatrogenic coronary dissection remains a challenging problem in angiography. • Endocoronary imaging is helpful for the diagnosis of iatrogenic coronary dissection. • OCT is a safe option to manage the endovascular treatment of coronary dissection.

  17. Iatrogenic Cushing's Syndrome Due to Topical Ocular Glucocorticoid Treatment.

    Fukuhara, Daisuke; Takiura, Toshihiko; Keino, Hiroshi; Okada, Annabelle A; Yan, Kunimasa


    Iatrogenic Cushing's syndrome (CS) is a severe adverse effect of systemic glucocorticoid (GC) therapy in children, but is extremely rare in the setting of topical ocular GC therapy. In this article, we report the case of a 9-year-old girl suffering from idiopathic uveitis who developed CS due to topical ocular GC treatment. She was referred to the ophthalmology department with a complaint of painful eyes, at which time she was diagnosed with bilateral iridocyclitis and started on a treatment of betamethasone sodium phosphate eye drops. Six months after the initiation of topical ocular GC treatment, she was referred to our pediatric department with stunted growth, truncal obesity, purple skin striate, buffalo hump, and moon face. Because her serum cortisol and plasma adrenocorticotropic hormone levels were undetectable, she was diagnosed with iatrogenic CS. After the doses of topical ocular GC were reduced, the clinical symptoms of CS were improved. The fact that the amount of topical ocular GC with our patient was apparently less than that of similar previous cases tempted us to perform genetic analysis of her NR3C1 gene. We found that our patient had a single heterozygous nucleotide substitution in the 3' untranslated region of the NR3C1 gene, which may explain why she developed CS. However, additional investigations are required to determine if our findings can be extrapolated to other patients. In conclusion, clinicians should be aware that even extremely low doses of topical ocular steroid therapy can cause iatrogenic CS. Copyright © 2017 by the American Academy of Pediatrics.

  18. [Gastric cancer].

    Belén Fraile, M; Serra Bartual, M; Segarra Sánchez, J; Richart Rufino, M J


    Gastric cancer represents a disorder which incidence has come down last years. Its etiology is unknown, but diet is the principal determinant risk of suffering it. Clinic history is not much useful, because in the early stage symptoms can fail and in the late stage are inespecific. Election diagnosis is endoscopy. Surgery is the only curative treatment. By these features, it would be useful to left under vigilance to: a) patients 40 years older with dispepsia; b) patients following gastric operations; c) patients with disorders presenting aclorhidria. The authors report a clinic case that can be of frequent presentation in primary assistance.

  19. Gastric angiogenesis and Helicobacter pylori infection

    I. D. Pousa

    Full Text Available The formation of new blood vessels seen in conditions commonly associated with Helicobacter pylori (H. pylori infection, including gastritis, peptic ulcer, and gastric carcinoma, prompts consideration of a potential relationship between mucosal colonization by this organism and the angiogenic process. H. pylori directly or indirectly damages endothelial cells, which induces a number of changes in the microvasculature of the gastric mucosa. In H. pylori-associated conditions, that is, in gastritis, peptic ulcer and gastric carcinoma, there is an increased concentration of angiogenic factors, and subsequently a formation of new blood vessels. However, this early angiogenesis -which is activated to repair the gastric mucosa- is subsequently inhibited in patients with peptic ulcer, and ulcer healing is thus delayed. This may be due to the antiproliferative action of this organism on endothelial cells. While the angiogenic process becomes inhibited in infected patients with peptic ulcer, it remains seemingly active in those with gastritis or gastric cancer. This fact is in support of the notion suggested by various studies that peptic ulcer and gastric cancer are mutually excluding conditions. In the case of gastric cancer, neoangiogenesis would enhance nutrient and oxygen supply to cancer cells, and thus tumor growth and metastatic spread.

  20. Iatrogenic mid-root perforation of fused teeth

    Vijay Kumar


    Full Text Available Fusion is defined as a union between the dentin and/or enamel of two or more distinct dental sprouts that occurs at any stage of the dental organ. Its prevalence ranges from 0.5%-2.5% in the primary dentition alone and 0.1%-1% of the primary as well as the permanent dentition. These fused teeth can cause various problems such as caries, periodontal disease, abnormal eruption, impaction or an ectopic eruption of an adjacent tooth and reported in the literature. However this paper documented an unusual case of iatrogenic root perforation of fused permanent lower anterior teeth during inter maxillary fixation.

  1. Radiofrequency Ablation for Iatrogenic Thyroid Artery Pseudoaneurysm: Initial Experience.

    Jun, Ye Kyeong; Jung, So Lyung; Byun, Ho Kyun; Baek, Jung Hwan; Sung, Jin Yong; Sim, Jung Suk


    Eight iatrogenic thyroid pseudoaneurysms (ITPAs) after thyroid biopsy are reported. The mean ITPA diameter was 7.2 mm (range 4 to 12 mm). Ultrasound (US)-guided compression was initially performed at the neck of the ITPA in all cases. Among them, 4 ITPAs persisted (50%) in which radiofrequency (RF) ablation was performed. Mean RF ablation time and power were 13.5 seconds (range 5 to 24 seconds) and 20 W (range 10 to 50 W), respectively. All 4 cases were treated with RF ablation without any complications.

  2. Surgical replacement of iatrogenically prolapsed penis in a dromedary camel

    S.A.T. Al-Qubati


    Full Text Available Prolapse of the penis through an iatrogenic incision on the right side of the preputial base in a five year old dromedary camel was handled surgically and the organ was successfully replaced into the preputial cavity. The condition occurred as a result of draining an abscess at the base of the prepuce by a quack about eight months earlier. The reason to report this case lies in its peculiarity that although the penis remained outside the preputial cavity for about eight months exposed to the external environment, yet no complications pertaining to its fragile tissue and urination occurred during this long period as seen in cases of paraphimosis.

  3. Iatrogenic Penile Glans Amputation: Major Novel Reconstructive Procedure

    Rami Nasr


    Full Text Available Circumcision is a very common urological practice. Even though it is relatively safe, it is not a complication-free procedure. We describe a patient that underwent a neonatal circumcision complicated by iatrogenic complete glans amputation. Reconstructive repair of a neoglans using a modified traditional method was used. Postoperative followup to 90 days is illustrated. Despite being a simple procedure, circumcision in unprofessional hands can have major complication impacting the emotional and sexual life of patients. Surgical reconstruction is possible with varying satisfactory results.

  4. Iatrogenic granulomas of the prostate and the urinary bladder

    Sørensen, Flemming Brandt; Marcussen, N


    In 1059 patients who had transurethral resections (TUR) of the prostate 8 cases (0.8%) with nonspecific granulomas were found. In another group of 280 patients treated by TUR for tumours of the urinary bladder 5 cases (1.8%) had granulomatous lesions in the resectates. The granulomas were observed...... was observed in the granulomas. The findings are compared to previously reported cases of iatrogenic granulomas in the prostate, the urinary bladder and other organs. It is concluded that the granulomas arise as a local reaction to previous surgery, maybe involving hypersensitivity to locally altered collagen....

  5. Gastric lipoma

    Zameer M


    Full Text Available We report a 12-year-old-boy with gastric lipoma. Upper gastrointestinal (GI endoscopy with biopsy and abdominal computed tomogram (CT scan revealed the diagnosis. Open surgical excision of the mass with stomach preservation was done. The clinical presentation and management are discussed and the literature reviewed here. This is the sixth pediatric case reported in the English literature.

  6. Infectious prion diseases in humans: cannibalism, iatrogenicity and zoonoses.

    Haïk, Stéphane; Brandel, Jean-Philippe


    In contrast with other neurodegenerative disorders associated to protein misfolding, human prion diseases include infectious forms (also called transmitted forms) such as kuru, iatrogenic Creutzfeldt-Jakob disease and variant Creutzfeldt-Jakob disease. The transmissible agent is thought to be solely composed of the abnormal isoform (PrP(Sc)) of the host-encoded prion protein that accumulated in the central nervous system of affected individuals. Compared to its normal counterpart, PrP(Sc) is β-sheet enriched and aggregated and its propagation is based on an autocatalytic conversion process. Increasing evidence supports the view that conformational variations of PrP(Sc) encoded the biological properties of the various prion strains that have been isolated by transmission studies in experimental models. Infectious forms of human prion diseases played a pivotal role in the emergence of the prion concept and in the characterization of the very unconventional properties of prions. They provide a unique model to understand how prion strains are selected and propagate in humans. Here, we review and discuss how genetic factors interplay with strain properties and route of transmission to influence disease susceptibility, incubation period and phenotypic expression in the light of the kuru epidemics due to ritual endocannibalism, the various series iatrogenic diseases secondary to extractive growth hormone treatment or dura mater graft and the epidemics of variant Creutzfeldt-Jakob disease linked to dietary exposure to the agent of bovine spongiform encephalopathy.

  7. Endovascular Management of Iatrogenic Native Renal Arterial Pseudoaneurysms

    Sildiroglu, Onur; Saad, Wael E.; Hagspiel, Klaus D.; Matsumoto, Alan H.; Turba, Ulku Cenk, E-mail: [University of Virginia Health System, Department of Radiology (United States)


    Purpose: Our purpose was to evaluate iatrogenic renal pseudoaneurysms, endovascular treatment, and outcomes. Methods: This retrospective study (2003-2011) reported the technical and clinical outcomes of endovascular therapy for renal pseudoaneurysms in eight patients (mean age, 46 (range 24-68) years). Renal parenchymal loss evaluation was based on digital subtraction angiography and computed tomography. Results: We identified eight iatrogenic renal pseudoaneurysm patients with symptoms of hematuria, pain, and hematoma after renal biopsy (n = 3), surgery (n = 3), percutaneous nephrolithotomy (n = 1), and endoscopic shock-wave lithotripsy (n = 1). In six patients, the pseudoaneurysms were small-sized (<20 mm) and peripherally located and were treated solely with coil embolization (n = 5). In one patient, coil embolization was preceded by embolization with 500-700 micron embospheres to control active bleeding. The remaining two patients had large-sized ({>=}50 mm), centrally located renal pseudoaneurysms treated with thrombin {+-} coils. Technical success with immediate bleeding cessation was achieved in all patients. There were no procedure-related deaths or complications (mean follow-up, 23.5 (range, 1-67) months). Conclusions: Treatment of renal pseudoaneurysms using endovascular approach is a relatively safe and viable option regardless of location (central or peripheral) and size of the lesions with minimal renal parenchymal sacrifice.

  8. Frequency of Iatrogenic Changes Caused from Overhang Restorations

    Boteva E.


    Full Text Available Overhangs from different restorations are an iatrogenic error with different results, short and long term consequences related to bone changes and periodontal diseases. Amalgam “tattoos”, idiopathic subgingival hypertrophy, marginal periodontitis and bone reductions in the intradental septum are major problems. The aim of the present study is to evaluate the frequency of traumatic restorations in distal teeth and clinical criteria, related to the x-ray findings. Evaluating criteria, for repairing the overhangs or for replacement of the restorations, is also a goal. Three hundred and sixteen - 316 patients from both sexes, 632 dental x-rays with 948 distal teeth and 632 restorations, at least two radiographs for each patient, were analyzed. Overhangs are classified in three groups: small, middle and large. In the criteria bone changes from the overhangs are analyzed separately from the existing or nonexisting bone changes from a generalized periodontal diseases. The frequency of iatrogenic changes in this cohort group is 10.6% from 632 restored teeth. This is a relatively small number compared with the other published studies. These overhangs are on distal teeth in sound teeth arches which makes them difficult for corrections. The evaluated criteria for replacement based on x-ray findings and clinical experience includes: operative and nonoperative corrections, restoration replacement, perio- and endo-therapy and follow up terms for secondary caries.

  9. Iatrogenic Cushing syndrome caused by ocular glucocorticoids in a child.

    Messina, Maria Francesca; Valenzise, Mariella; Aversa, Salvatore; Arrigo, Teresa; De Luca, Filippo


    A boy aged 7.6 years presented to our Unit of Paediatric Endocrinology for evaluation of obesity. Progressive weight gain (10 kg) started 6 months earlier after an accidental penetrating orbital injury on the right eye. During this period the child has been treated with oral betamethasone (0.5 mg/day) for 1 month and dexamethasone 2% ocular drops (2 hourly by day) for 6 months. Physical examination showed he was 113.5 cm in height (-1.5 SD), weight 36.0 kg, blood pressure 110/90 mmHg (90th centile), body mass index 28 (+5 SD), truncal obesity, buffalo hump, "moon-face", increased lanugo hair and supraclavicular fullness. Endocrinological work-up revealed undetectable levels of basal adrenocorticotropic hormone (ACTH), basal and ACTH-stimulated cortisol and 24 h urine excretion cortisol, confirming the diagnosis of iatrogenic Cushing syndrome. The abrupt withdrawal of ocular glucocorticoids by the parents evoked two adrenal crises; 4 months later the patient recovered. In conclusion, we would alert doctors that every formulation of glucocorticoids, no ocular drops excluded, can determine severe systemic side effects and iatrogenic Cushing syndrome.

  10. Iatrogenic displacement of tumor cells to the sentinel node after surgical excision in primary breast cancer

    Tvedskov, Tove F; Jensen, Maj-Britt; Kroman, Niels;


    Isolated tumor cells (ITC) are more common in the sentinel node (SN) after needle biopsy of a breast cancer, indicating iatrogenic displacement of tumor cells. We here investigate whether similar iatrogenic displacement occurs after surgical excision of a breast tumor. We compared the incidence...

  11. Iatrogenic illness in the paediatric intensive care unit at Gharian teaching hospital, Libya.

    Ismail, A M; Shedeed, S A


    The aim of this prospective follow-up study wasto determine the incidence and risk factors of iatrogenic illness and the outcome among cases admitted to the paediatric intensive care unit in ateaching hospital in Libya. The incidence of iatrogenic complications was 22.9% among 423 cases admitted over a 1-year period. Human error (18.4%) followed by machine defects (4.5%) were the most common causes of complications. The overall mortality rate was 7.6% and was significantly higher in iatrogenic cases than others (13.4% versus 5.8%). Paediatric risk of mortality (PRISM) score was a good predictor of risk of iatrogenic illness. Both mortality and occurrence of iatrogenic illness were significantly associated with: higher PRISM score, use of mechanical ventilation, higher bed occupancy rate in the unit, presence of respiratory and neurological diseases, prolonged duration of stay in the intensive care unit and younger age of the child.

  12. Gastric Sleeve Surgery

    ... A Week of Healthy Breakfasts Shyness Gastric Sleeve Surgery KidsHealth > For Teens > Gastric Sleeve Surgery Print A ... buying healthy food ) continue Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  13. Iatrogenia em Medicina Intensiva Iatrogenic in Intensive Care Medicine

    Rafael Canineu


    Full Text Available JUSTIFICATIVA E OBJETIVOS: Define-se iatrogenia ou afecções iatrogênicas como decorrentes da intervenção médica, correta ou não e justificada ou não, da qual resultam conseqüências prejudiciais ao paciente. Os cuidados em Medicina Intensiva apresentam desafios substanciais com relação à segurança do paciente. O objetivo deste artigo foi apresentar uma breve revisão da literatura sobre a iatrogenia em seus conceitos e termos básicos e suas taxas de prevalência em Medicina Intensiva. CONTEÚDO: A Medicina Intensiva fornece subsídios que melhoram a morbidade e a mortalidade, mas que também se associam a riscos significativos de eventos adversos e erros graves; as iatrogenias podem ser diminuídos com monitoração adequada ou podem ser rotuladas como agravante esperado, idiopatia e se perpetuarem no anonimato CONCLUSÕES: É fundamental reconhecer a necessidade do constante aprendizado, reciclagem e consciência da susceptibilidade ao erro; neste contexto, o respeito pelo ser humano deve nortear a conduta profissional.BACKGROUND AND OBJECTIVES: Iatrogenic conditions was due of the medical, correctly intervention or not, justified or not, which harmful consequences to the patient. The cares in Intensive Care Medicine present substantial challenges with relation to the security of the patient. The objective of this article is to make one brief revision of literature on the iatrogenic in its concepts and basic terms and its taxes prevalence in Intensive Care Medicine. CONTENTS: Intensive Care Medicine supplies subsidies that improve the morbidity and mortality, but that also the significant risks of adverse events and serious errors associate. The Iatrogenic can be minimized with the adequate monitorization or can be friction as waited aggravation, idiopathic and if to perpetuate in the anonymity. CONCLUSIONS: It is basic to recognize the necessity of the constant learning and recycling and conscience of the susceptibilities to the

  14. Is Iatrogenic Cushing s a New Form of Child Neglect?

    Habip Almis


    Full Text Available Child abuse is an increasingly important issue. One of the main types of abuse is child neglect, that is, behavior in which the child is knowingly or unknowingly injured. In this article; we report a case of iatrogenic Cushing%u2019s syndrome due to clobetasol 17-propionate treatment that was used inappropriately, in order to discuss whether or not this is a form of child neglect. It is one of the basic tasks of families to protect the health of the child and learn how to treat that child when he or she is ill. We believe that by being adequately informed by the health professionals, families may reduce the risk of child neglect.

  15. Influência do octreotide subcutâneo na cicatrização de sutura gástrica em ratos Effect of octreotide administered subcutaneously on the healing of gastric sutures in rats

    Paula Suzin Trubian


    Full Text Available RACIONAL: Octreotide, análogo sintético da somatostatina, é potente inibidor da secreção gástrica, intestinal e pancreática. Reduz fluxo sangüíneo esplâncnico, acelera esvaziamento gástrico e prolonga tempo de trânsito intestinal, estimulando a absorção de água e eletrólitos. Freqüentemente é utilizado no tratamento das fístulas digestivas pela sua capacidade de reduzir o débito da fístula, porém a redução do fluxo sangüíneo poderia interferir negativamente na cicatrização. OBJETIVO: Avaliar a influência do octreotide na cicatrização de sutura gástrica em ratos. MÉTODOS: Foram utilizados 39 ratos Wistar machos, divididos em dois grupos, controle e octreotide, subdivididos em 4 e 7 dias, de acordo com o dia da morte do animal. Todos foram submetidos à gastrotomia e fechamento com pontos seromusculares interrompidos. Os animais do grupo octreotide receberam dose única diária do medicamento por via subcutânea. O grupo controle recebeu solução salina a 0,9%. Foram determinados o percentual de colágeno maduro e imaturo, pela técnica de picrosirius-red F3BA. O cálculo do índice de maturação do colágeno e determinação da força de ruptura (FRT e força máxima de tração (FMT, foi testada em tensiômetro computadorizado. Utilizou-se para análise estatística, os testes t de Student e Kruskal-Wallis com nível de significância de PBACKGROUND: Octreotide, a somatostatin synthetic analogue, is a potent inhibitor of gastric intestinal and pancreatic secretions. It also inhibits many trophic and anabolics hormones, decreases splanchnic blood flow, accelerates gastric emptying and prolongs intestinal transit time, increasing the absorption of water and electrolytes. AIM: Evaluate the effects of octreotide on gastric sutures in rats. METHODS: Thirty-nine male adult Wistar rats were used, divided into control group and octreotide group. They were further subdivided into two subgroups, according to the day they

  16. Gastric infarction following gastric bypass surgery

    Do, Patrick H; Kang, Young S; Cahill, Peter


    Gastric infarction is an extremely rare occurrence owing to the stomach’s extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition. PMID:27200168

  17. Wound Healing and Care

    ... Right Sport for You Healthy School Lunch Planner Wound Healing and Care KidsHealth > For Teens > Wound Healing and Care Print A A A What's in ... mouth, or sunken eyes. There's good news about wound healing when you're a teen: Age is on ...

  18. Saliva and wound healing

    Brand, H.S.; Ligtenberg, A.J.M.; Veerman, E.C.I.; Ligtenberg, A.J.M.; Veerman, E.C.I.


    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In

  19. Saliva and wound healing

    Brand, H.S.; Ligtenberg, A.J.M.; Veerman, E.C.I.; Ligtenberg, A.J.M.; Veerman, E.C.I.


    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In

  20. The effects of antidepressants on gastric ulcer

    Mehmet Latif Güneş


    Full Text Available In their daily practice, psychiatrists often experience gastriccomplaints in patients beside psychiatric disorders.Peptic ulcer is one of the diseases, which accompanyto psychiatric disorders including mainly depression. Itis shown that antidepressants can inflame the bleedingsincluding gastrointestinal (GI bleedings, while they havepositive effect on ulcer healing. In this review, studies,which conducted about the positive or negative effects ofantidepressant drugs on ulcer treatment were examined.Accordingly; it was found that opipramol, amitriptyline,imipramine that of tricyclic antidepressants was found tobe helpful in healing of the ulcer. It was stated that SelectiveSerotonin Reuptake Inhibitors generally inflamedulcers, exceptionally fluvoxamine and fluoxetine reducedulcer; moclobemide that of monoamine-oxidase inhibitorand tianeptine and mirtazapine that of atypical antidepressantshad positive effect in ulcer healing. To be carefulin choosing the appropriate antidepressant in psychiatricpatients with gastric ulcer is important in the prognosisof both ulcer and depression.Key words: peptic ulcer; depression; antidepressant drugs

  1. 健胃愈疡片修复内镜治疗术后“医源性溃疡”%Jianweiyuyang Pills Repair the Iatrogenic Ulcer after “the Endoscopic Therapy”

    王昌雄; 王巧明; 宋力伟; 庄永卫; 徐磊; 尚惺杰


    Objective:To compare the clinical value of taking Jianweiyuyang pills and Rabeprazole capsules to repaire the iatrogenic ulcer after the Endoscopic therapy.Method:The patients who used the iatrogenic ulcer after the treatment of argon plasma coagulation,endoscopic mucosal resection and endoscopic submucosal dissection, let them take Jianweiyuyang pills and Rabeprazole capsules to make a clinical control treatment. Then drug efficacy were observed.Result:Two groups of patients during treatment did not be found complications such as gastric antrum mucosa hemorrhage, perforation. In Jianweiyuyang pills group, after 1 month of the last treatment review, there were 48 cases (90.6%) showed red ulcer scars (S1 period). After 3 month of the surgery review,there were 52 cases (98.1%) showed white ulcer scars (S1 period). EUS appears as Sc of 50 cases (94.3%) after 6 month of the surgery.In Rabeprazole capsules group, after 1 month of the last treatment review,there were 47 cases (94.0%) showed red ulcer scars (S1 period). After 3 month of the surgery review, there were 45 cases (90.0%) showed white ulcer scars (S1 period). EUS appears as Sc of 40 cases (80.0%)after 6 month of the surgery.The quality of ulcer healing of Jianweiyuyang pills group with stage Sc was better than Rabeprazole capsules group, the difference was statistically significant (P<0.05). Conclusion:Short-term efficacy is quite of treating the Iatrogenic ulcer by taking Jianweiyuyang pills or Rabeprazole capsules. Long-term effects (the Sc period of ulcer healing quality) of taking Jianweiyuyang pills is better than Rabeprazole capsules . The author believes that Jianweiyuyang pills is an ideal drug for treating the artificial ulcer, and can be a selection for clinical application.%目的:比较健胃愈疡片和雷贝拉唑胶囊修复内镜治疗术后“医源性溃疡”的临床价值。方法:对内镜下应用氩等离子凝固疗法(APC)、内镜黏膜切除术(EMR)、

  2. Flexibility in Men's Sexual Practices in Response to Iatrogenic Erectile Dysfunction after Prostate Cancer Treatment

    Gary W. Dowsett, PhD


    Conclusions: Flexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115–120.

  3. Massive thoracoabdominal aortic thrombosis in a patient with iatrogenic Cushing syndrome.

    Kim, Dong Hun; Choi, Dong-Hyun; Lee, Young-Min; Kang, Joon Tae; Chae, Seung Seok; Kim, Bo-Bae; Ki, Young-Jae; Kim, Jin Hwa; Chung, Joong-Wha; Koh, Young-Youp


    Massive thoracoabdominal aortic thrombosis is a rare finding in patients with iatrogenic Cushing syndrome in the absence of any coagulation abnormality. It frequently represents an urgent surgical situation. We report the case of an 82-year-old woman with massive aortic thrombosis secondary to iatrogenic Cushing syndrome. A follow-up computed tomography scan showed a decreased amount of thrombus in the aorta after anticoagulation therapy alone.

  4. Massive Thoracoabdominal Aortic Thrombosis in a Patient with Iatrogenic Cushing Syndrome

    Kim, Dong Hun; Choi, Dong Hyun; Lee, Young Min; Kim, Bo Bae; Ki, Young Jae; Kim, Jin Hwa; Chung, Joong Wha; Koh, Young Youp [Chosun University School of Medicine, Gwangju (Korea, Republic of); Kang, Joon Tae; Chae, Seung Seok [Dept. of nternal Medicine, Mokpo Jung-Ang General Hospital, Mokpo (Korea, Republic of)


    Massive thoracoabdominal aortic thrombosis is a rare finding in patients with iatrogenic Cushing syndrome in the absence of any coagulation abnormality. It frequently represents an urgent surgical situation. We report the case of an 82-year-old woman with massive aortic thrombosis secondary to iatrogenic Cushing syndrome. A follow-up computed tomography scan showed a decreased amount of thrombus in the aorta after anticoagulation therapy alone.

  5. Iatrogenic Rectal Injury During Radical Prostatectomy: Is Colostomy Inevitable End?

    Ramazan Topaktas


    Full Text Available Aim: Radical prostatectomy (RP is the gold standard treatment method for localized prostate cancer, because of its high oncological success. Iatrogenic rectal injury (IRI during RP is rarely seen, but it may causes serious complications because of the close anatomic relationship between the prostate and rectum. Aim is to present our series about management of IRI without colostomy. Material and Method: Between June 1999 and June 2013, radical retropubic prostatectomy (RRP was performed to 372 patients by a single surgeon. 10 cases (%2,6 were complicated by a rectal injury during RRP. Instant rectal closure was performed in 3 layers without a diverting colostomy, at the time of surgery. Omental vascular flap was placed between rectum and vesicourethral anastomosis. Results: The clinical stages of IRI cases were T1c, T2a and T2c in 2, 3 and 5 patients, respectively. Their preoperative Gleason scores were 6, 7 and 8 in 3, 5 and 2 patient, respectively. None of the 10 had undergone previous prostatic or rectal surgery, or received preoperative radiotherapy or hormonal therapy. Discussion: Instant diagnosis and rectal wall closures by three layers are essential for successful repair. Our technique seems as a safe, minimal invasive and highly effective option for the management of IRI.

  6. Acupuncture-induced haemothorax: a rare iatrogenic complication of acupuncture.

    Karavis, Miltiades Y; Argyra, Erifili; Segredos, Venieris; Yiallouroy, Aneza; Giokas, Georgios; Theodosopoulos, Thedosios


    This paper reports a rare iatrogenic complication of acupuncture-induced haemothorax and comments on the importance and need for special education of physicians and physiotherapists in order to apply safe and effective acupuncture treatment. A 37-year-old healthy woman had a session of acupuncture treatments for neck and right upper thoracic non-specific musculoskeletal pain, after which she gradually developed dyspnoea and chest discomfort. After some delay while trying other treatment, she was eventually transferred to the emergency department where a chest X-ray revealed a right pneumothorax and fluid collection. She was admitted to hospital and a chest tube inserted into the right hemithorax (under ultrasound guidance) drained 800 mL of bloody fluid (haematocrit (Hct) 17.8%) in 24 h and 1200 mL over the following 3 days. Her blood Hct fell from 39.0% to 30.8% and haemoglobin from 12.7 to 10.3 g/dL. The patient recovered completely and was discharged after 9 days of hospitalisation. When dyspnoea, chest pain and discomfort occur during or after an acupuncture treatment, the possibility of secondary (traumatic) pneumo- or haemopneumothorax should be considered and the patient should remain under careful observation (watchful waiting) for at least 48 h. To maximise the safety of acupuncture, specific training should be given for the safe use of acupuncture points of the anterior and posterior thoracic wall using dry needling, trigger point acupuncture or other advanced acupuncture techniques.

  7. War, traffic and iatrogenic injuries of D3 duodenal segment

    Ignjatović Dragan


    Full Text Available Background. Injuries of the duodenum at the level of aortomesenteric clamp (segment D3 are with a high incidence of death due to the development of fistula and peritonitis. In three successfully managed cases, we applied the biliary surgery method. Case reports. All three cases were with the injuries of D3 duodenal segment. The first patient suffered from the blast perforation of duodenum at the level of the aortomesenteric clamp which occurred at the 7th day after the injury. The second patient suffered from the duodenal injury caused in a traffic accident. The third patient suffered from an iatrogenic injury at the beginning of D3 duodenal segment inflicted during ureterolithotomy. The described surgical procedure included basically the suture to narrow the site of the injury, then lateroterminal anastomosis with the Roux-en-Y jejunal flexure and, finally, the placement of a silicone prosthesis starting from the duodenum through the site of injury and the Roux-en-Y out. Octreotide and the total parenteral nutrition were administered to the patients postoperatively. Conclusion. The use of the releasing silicone prosthesis in all three patients provided the repair of the site of the injury with anastomosed Reux-en-Y jejunum.

  8. Iatrogenic Pulmonary Nodule in a Heart Transplant Recipient

    Atul C. Mehta


    Full Text Available A 58-year-old female with a history of non-Hodgkin lymphoma and end-stage nonischemic cardiomyopathy from Adriamycin toxicity underwent orthotic heart transplantation during June 2013. She developed shortness of breath in September 2013 and was suspected to have invasive pulmonary aspergillosis. A flexible bronchoscopy (FB with a transbronchial biopsy (TBBx was performed. She was found to have a focal lung nodule in the same location at the site of the TBBx on day 13 after the FB. Spontaneous resolution of the nodule was confirmed on the computed tomography (CT scan of chest performed at 3 months. We believe that this nodule was as a consequence of the TBBx. Formation of a peripheral pulmonary nodule (PPN following a TBBx is occasionally encountered among the recipients of the lung transplantation. To our knowledge, this is the first case of TBBx producing a pulmonary nodule in a heart transplant recipient. Physicians caring for the patients with heart transplantation should be cognizant of the iatrogenic nature of such nodule to avoid unnecessary diagnostic work-up.

  9. Iatrogenic bile duct injuries from biliar y tract surger y

    Umar Ali; Zhen-Hua Ma; Cheng-En Pan; Qing-Yong Ma


    BACKGROUND:Cholecystectomy is the most commonly performed procedure in general surgery. However, bile duct injury is a rare but still one of the most common complications. These injuries sometimes present variably after primary surgery. Timely detection and appropriate management decrease the morbidity and mortality of the operation. METHODS:Five cases of iatrogenic bile duct injury (IBDI) were managed at the Department of Surgery, First Afifliated Hospital, Xi'an Jiaotong University. All the cases who underwent both open and laparoscopic cholecystectomy had persistent injury to the biliary tract and were treated accordingly. RESULTS: Recovery of the patients was uneventful. All patients were followed-up at the surgical outpatient department for six months to three years. So far the patients have shown good recovery. CONCLUSIONS:In cases of IBDI it is necessary to perform the operation under the supervision of an experienced surgeon who is specialized in the repair of bile duct injuries, and it is also necessary to detect and treat the injury as soon as possible to obtain a satisfactory outcome.

  10. Iatrogenic displacement of impacted third molar. Case report

    Konstantinos TSIKLAKIS


    Full Text Available Peri-operative complications may occur during the surgical extraction of impacted mandibular third molars such as the iatrogenic displacement of the whole tooth or a tooth fragment in to the adjacent anatomical structures. The purpose of this case report is to present the diagnosis and treatment planning, as well as the surgical management required for the removal of a 3rd molar displaced in the soft tissues of the floor of the mouth. A 38-year old male patient presented to the Dental School, complaining of pain around the left submandibular area that started three months after the extraction of the impacted mandibular left third molar. At the radiographic examination the tooth was detected in the soft tissues of the floor of the mouth and in close proximity to the lingual plate. It is noteworthy that the patient was under the assumption that the tooth had been extracted successfully. Radiographically the tooth appeared at an 180° turnaround from its original position. Surgical extraction of the displaced third molar took place under local anaesthesia. No post-operative complications were reported. Thorough clinical and radiographic examination, as well as competency at surgical procedures are prerequisites for the appropriate surgical management of impacted third molars.

  11. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin


    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  12. Iatrogenic bile duct injuries: Etiology, diagnosis and management

    Beata Jab(l)o(n)ska; Pawe(l) Lampe


    Iatrogenic bile duct injuries (IBDI) remain an important problem in gastrointestinal surgery. They are most frequently caused by laparoscopic cholecystectomy which is one of the commonest surgical procedures in the world. The early and proper diagnosis of IBDI isvery important for surgeons and gastroenterologists,because unrecognized IBDI lead to serious complications such as biliary cirrhosis, hepatic failure and death.Laboratory and radiological investigations play an important role in the diagnosis of biliary injuries. There are many classifications of IBDI. The most popularand simple classification of IBDI is the Bismuth scale.Endoscopic techniques are recommended for initial treatment of IBDI. When endoscopic treatment is not effective, surgical management is considered.Different surgical reconstructions are performed in patients with IBDI. According to the literature, Rouxen-Y hepaticojejunostomy is the most frequent surgical reconstruction and recommended by most authors.In the opinion of some authors, a more physiological and equally effective type of reconstruction is endto-end ductal anastomosis. Long term results are the most important in the assessment of the effectiveness of IBDI treatment. There are a few classifications for the long term results in patients treated for IBDI;the Terblanche scale, based on clinical biliary symptoms,is regarded as the most useful classification. Proper diagnosis and treatment of IBDI may avoid many serious complications and improve quality of life.

  13. Endovascular management for significant iatrogenic portal vein bleeding.

    Kim, Jong Woo; Shin, Ji Hoon; Park, Jonathan K; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu-Bo


    Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4-240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.

  14. Role of ARPC2 in Human Gastric Cancer

    Jun Zhang


    Full Text Available Gastric cancer continues to be the second most frequent cause of cancer deaths worldwide. However, the exact molecular mechanisms are still unclear. Further research to find potential targets for therapy is critical and urgent. In this study, we found that ARPC2 promoted cell proliferation and invasion in the human cancer cell line MKN-28 using a cell total number assay, MTT (3-(4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2-H-tetrazolium bromide assay, cell colony formation assay, migration assay, invasion assay, and wound healing assay. For downstream pathways, CTNND1, EZH2, BCL2L2, CDH2, VIM, and EGFR were upregulated by ARPC2, whereas PTEN, BAK, and CDH1 were downregulated by ARPC2. In a clinical study, we examined the expression of ARPC2 in 110 cases of normal human gastric tissues and 110 cases of human gastric cancer tissues. ARPC2 showed higher expression in gastric cancer tissues than in normal gastric tissues. In the association analysis of 110 gastric cancer tissues, ARPC2 showed significant associations with large tumor size, lymph node invasion, and high tumor stage. In addition, ARPC2-positive patients exhibited lower RFS and OS rates compared with ARPC2-negative patients. We thus identify that ARPC2 plays an aneretic role in human gastric cancer and provided a new target for gastric cancer therapy.

  15. Impact of Annexin A3 expression in gastric cancer cells.

    Yu, S Y; Li, Y; Fan, L Q; Zhao, Q; Tan, B B; Liu, Y


    Annexin A3 participates in various biological processes, including tumorigenesis, drug resistance, and metastasis. The aim of this study was to investigate the expression of Annexin A3 in gastric cancer and its relationship with cell differentiation, migration, and invasion of gastric cancer cells. Annexin A3 expression in gastric cancer tissues was detected by quantitative real-time PCR and Western blotting. The proliferation of gastric cancer cells was measured by the MTT assay. Cell migration and invasion were determined via wound healing and transwell assays, respectively. Knock down of endogenous Annexin A3 in gastric cancer BGC823 cells was performed using siRNA technology. The expression of Annexin A3 was significantly upregulated in gastric cancer tissues, and negatively correlated with the differentiation degree. Silencing of endogenous Annexin A3 suppressed the proliferation, migration, and invasion of BGC823 cells. Additionally, the expression of p21, p27, TIMP-1, and TIMP-2 was upregulated, and the expression of PCNA, cyclin D1, MMP-1, and MMP-2 decreased in cells treated with Annexin A3-siRNA. Annexin A3 was upregulated in gastric cancer cells. Deletion of endogenous Annexin A3 significantly inhibited gastric cancer cell proliferation, migration, and invasion.

  16. The healing Buddha.

    Chen, Thomas S N; Chen, Peter S Y


    The iconography of the healing Buddha embraces two healing traditions, symbolized by the healing stone lapis lazuli from Central Asia and by the myrobalan fruit from the ayurvedic medicine of ancient India. The first mention of the healing Buddha is in Buddhist texts of the first century BC, and the earliest extant icons date from the fourth century AD. This suggests the cult of the healing Buddha was a relatively late development in the history of Buddhism. Worshippers sought his help in alleviating spiritual, mental and physical suffering, as well as for medical cures. In China followers believed he was also a cosmic Buddha, to whom one appealed for longevity and protection from disasters. This form of faith-based healing remains vibrant in China, Japan and Tibet to this day.

  17. Feasibility of the maxillary sinus ultrasonic study in patients with iatrogenic sinusitis

    S. D. Varzhapetyan


    Full Text Available Objective: to study the effectiveness of ultrasonic diagnostic imaging in the diagnostics of the iatrogenic maxillary sinusitis. Materials and Methods. 68 (100.0% patients of iatrogenic maxillary sinusitis undergone Sonographic Study in B-mode (ultrasonic diagnostic apparatus FCUSON X 500, ATSmod.539 (SIEMENS, USA. For this purpose, we used linear sensors with a working surface of 37 mm long with 7.10 MHz frequency regime. The findings were compared with the results of clinical (rhinoscopy, sinus lavage through perforation, diagnostic puncture and radiological (cone-beam computed tomography examination. The results were recorded according The accuracy of the two-dimensional sonography in the detection of pathological formations (polyps, cysts, foreign bodies, iatrogenic and inflammatory origin in the sinus was detected as lower than in clinical methods. Sensitivity of the two-dimensional sonography was 8.3%, specificity – 95.4% overall accuracy – 64.7%. Informativity of the cone beam tomography in the detection of exudation, effusion and thickening of the sinus mucosa during sinus iatrogenic sinusitis was detected as lower than in sonography. The sensitivity of the two-dimensional sonography in the detection of exudation in the sinus with iatrogenic maxillary sinus was 96.8%, specificity – 91.7% overall accuracy – 94.1%. The sensitivity of the cone beam tomography to thicken (sclerotic changes mucosa was 37.5%, specificity – 92.8%, accuracy – 52.9%. Conclusions. Feasibility of the ultrasound sonography in patients with iatrogenic sinusitis is less than in computer tomography. Maxillary sinuses sonography in addition to CT will improve the quality of the examination in patients with iatrogenic maxillary sinusitis.

  18. Iatrogenic genitourinary fistula: an 18-year retrospective review of 805 injuries.

    Raassen, Thomas J I P; Ngongo, Carrie J; Mahendeka, Marietta M


    Genitourinary fistula poses a public health challenge in areas where women have inadequate access to quality emergency obstetric care. Fistulas typically develop during prolonged, obstructed labor, but providers can also inadvertently cause a fistula when performing obstetric or gynecological surgery. This retrospective study analyzes 805 iatrogenic fistulas from a series of 5,959 women undergoing genitourinary fistula repair in 11 countries between 1994 and 2012. Injuries fall into three categories: ureteric, vault, and vesico-[utero]/-cervico-vaginal. This analysis considers the frequency and characteristics of each type of fistula and the risk factors associated with iatrogenic fistula development. In this large series, 13.2 % of genitourinary fistula repairs were for injuries caused by provider error. A range of cadres conducted procedures resulting in iatrogenic fistula. Four out of five iatrogenic fistulas developed following surgery for obstetric complications: cesarean section, ruptured uterus repair, or hysterectomy for ruptured uterus. Others developed during gynecological procedures, most commonly hysterectomy. Vesico-[utero]/-cervico-vaginal fistulas were the most common (43.6 %), followed by ureteric injuries (33.9 %) and vault fistulas (22.5 %). One quarter of women with iatrogenic fistulas had previously undergone a laparotomy, nearly always a cesarean section. Among these women, one quarter had undergone more than one previous cesarean section. Women with previous cesarean sections are at an increased risk of iatrogenic injury. Work environments must be adequate to reduce surgical error. Training must emphasize the importance of optimal surgical techniques, obstetric decision-making, and alternative ways to deliver dead babies. Iatrogenic fistulas should be recognized as a distinct genitourinary fistula category.




    Wound healing is a basic, highly complex, logical and well orchestrated physiologic process of interaction of various speciic molecules and cells in normal tissue function and structure restoration. In essence, genetically deined and by reined physical and chemical forces driven process, in most living beings wound healing leads to imperfect but suficient tissue repair. Some rare exceptions in wound healing, like salamander or human fetus, that can achieve complete and perfect regeneration pr...

  20. Factors Affecting Wound Healing

    Guo, S.; DiPietro, L A


    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

  1. Stomach (Gastric) Cancer Prevention

    ... Treatment Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Prevention (PDQ®)–Patient Version What is ... to keep cancer from starting. General Information About Stomach Cancer Key Points Stomach (gastric) cancer is a ...

  2. Self-healing materials.

    Hager, Martin D; Greil, Peter; Leyens, Christoph; van der Zwaag, Sybrand; Schubert, Ulrich S


    Self-healing materials are able to partially or completely heal damage inflicted on them, e.g., crack formation; it is anticipated that the original functionality can be restored. This article covers the design and generic principles of self-healing materials through a wide range of different material classes including metals, ceramics, concrete, and polymers. Recent key developments and future challenges in the field of self-healing materials are summarised, and generic, fundamental material-independent principles and mechanism are discussed and evaluated.

  3. Gastric tube ulcer perforating the pericardium after subtotal esophagectomy.

    Nikolić, Igor; Stancić-Rokotov, Dinko; Macan, Jasna Spicek; Korusić, Andelko; Mikecin, Verica; Duzel, Viktor


    Subtotal esophagectomy with retrosternal transposition of the gastric tube to the neck was performed in a 62-year-old patient with squamous cell carcinoma of the proximal third of the esophagus. He developed a salivatory fistula in the early postoperative period that healed spontaneously. Five months later, the patient developed partial stenosis of the esophagogastric anastomosis which required recervicotomy and excision, after numerous failed dilatation attempts. Eighteen months later, the patient presented to the hospital for severe pain in the upper abdomen. Clinical work-up revealed pericardial perforation by the gastric tube ulcer necessitating emergent surgery and gastric tube removal. We present a patient who developed both early and late complications of subtotal esophagectomy with gastric tube transposition as well as a review of the literature.

  4. Prevention of acute gastric mucosal lesions by Solcoseryl.

    Brzozowski, T; Radecki, T; Sendur, R; Gustaw, P; Konturek, S J


    Solcoseryl, a deproteinized extract from calf blood containing various biologically active substances, has been reported to promote the healing of skin wounds and gastric ulceration In this study, the gastroprotective effects of Solcoseryl vis-a-vis acute gastric mucosal damage were examined in rats. Solcoseryl significantly reduced the formation of acute lesions induced by intragastric application of absolute ethanol or acidified taurocholate and by water immersion and restraint stress, but failed to affect those caused by acidified aspirin. Since Solcoseryl did not offer protection in the absence of mucosal prostaglandins (PG) e.g. in aspirin-induced gastric damage, it is likely that PG may be involved in the observed gastroprotective activity of the drug. Solcoseryl failed to affect gastric acid or pepsin secretion, but increased mucosal blood flow. Thus PG generated by Solcoseryl might contribute to the maintenance of the observed mucosal microcirculation and the prevention of lesion formation by corrosive substances and stress conditions.

  5. Epidemiology of gastric cancer

    Crew, Katherine D.; Neugut, Alfred I.


    The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has...

  6. Gastric lymphoma

    Sravani Padala


    Full Text Available Gastrointestinal lymphomas represent 5-20% of extra nodal lymphomas and mainly occur in the stomach and small intestine. Clinical findings are not specific, thus often determining a delay in the diagnosis. Imaging features at conventional and cross-sectional imaging must be known by the radiologist since he/she plays a pivotal role in the diagnosis and disease assessment, thus assisting in the choice of the optimal treatment to patients. This review focuses on the wide variety of imaging presentation of esophageal, gastric, and small and large bowel lymphoma presenting their main imaging appearances at conventional and cross-sectional imaging, mainly focusing on computed tomography and magnetic resonance, helping in the choice of the best imaging technique for the disease characterization and assessment and the recognition of potential complications. Gastrointestinal tract is the most common extra nodal site involved by lymphoma. Although lymphoma can involve any part of the gastrointestinal tract .The most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. [Int J Res Med Sci 2016; 4(6.000: 2481-2486

  7. Stages of Gastric Cancer

    ... liver cancer . The following stages are used for gastric cancer: Stage 0 (Carcinoma in Situ) In stage 0 , abnormal cells are ... check-ups. Treatment Options by Stage Stage 0 (Carcinoma in ... Stage I Gastric Cancer Treatment of stage I gastric cancer may ...

  8. Effects of glutamine on wound healing.

    Kesici, Ugur; Kesici, Sevgi; Ulusoy, Hulya; Yucesan, Fulya; Turkmen, Aygen U; Besir, Ahmet; Tuna, Verda


    Studies reporting the need for replacing amino acids such as glutamine (Gln), hydroxymethyl butyrate (HMB) and arginine (Arg) to accelerate wound healing are available in the literature. The primary objective of this study was to present the effects of Gln on tissue hydroxyproline (OHP) levels in wound healing. This study was conducted on 30 female Sprague Dawley rats with a mean weight of 230 ± 20 g. Secondary wounds were formed by excising 2 × 1 cm skin subcutaneous tissue on the back of the rats. The rats were divided into three equal groups. Group C (Control): the group received 1 ml/day isotonic solution by gastric gavage after secondary wound was formed. Group A (Abound): the group received 0·3 g/kg/day/ml Gln, 0·052 g/kg/day/ml HMB and 0·3 g/kg/day/ml Arg by gastric gavage after secondary wound was formed. Group R (Resource): the group received 0·3 g/kg/day/ml Gln by gastric gavage after secondary wound was formed. The OHP levels of the tissues obtained from the upper half region on the 8th day and the lower half region on the 21st day from the same rats in the groups were examined. Statistical analysis was performed using the statistics program SPSS version 17.0. No statistically significant differences were reported with regard to the OHP measurements on the 8th and 21st days (8th day: F = 0·068, P = 0·935 > 0·05; 21st day: F = 0·018, P = 0·983 > 0·05). The increase in mean OHP levels on the 8th and 21st days within each group was found to be statistically significant (F = 1146·34, P = 0·000 wound healing negatively and who do not have large tissue loss at critical level, Gln, Arg and HMB support would not be required to accelerate secondary wound healing. © 2013 The Authors. International Wound Journal © 2013 Inc and John Wiley & Sons Ltd.

  9. Saliva and wound healing

    Brand, H.S.; Veerman, E.C.I.


    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival

  10. Saliva and wound healing

    Brand, H.S.; Veerman, E.C.I.


    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival

  11. [Early diagnosis of gastric cancer, a utopian idea? (author's transl)].

    Seifert, E


    In order to improve the prognosis of gastric cancer it is necessary to discover the lesions at an early stage of the disease. Early gastric cancer has an excellent prognosis with a postoperative survival rate of 77 to 99%. Since 1970 we have diagnosed 76 cases of early gastric cancer and the percentage of early cancer out of all gastric cancers increased from 10 to 23%. This improvement is based on selected examinations of high-risk patients, on better diagnostic methods and on our better knowledge of macroscopic and histological appearance. In particular, the use of snare biopsy in protruding lesions and the implementation of continuous endoscopic-bioptic follow-up of all gastric ulcers until complete healing is achieved have improved the accuracy of histological verification. In 16 out of 76 cases of early gastric cancer a multicentric growth was observed. The diagnosis of gastric cancer at an early stage is not an utopian idea. It is reality when we pay attention to the aspects mentioned before.

  12. Factors Affecting Wound Healing

    Guo, S.; DiPietro, L.A.


    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  13. Severe lactic acidosis after an iatrogenic propylene glycol overdose.

    Zosel, Amy; Egelhoff, Elizabeth; Heard, Kennon


    . Although the patient's outcome was death, his lactic acidosis was treated successfully with fomepizole and CVVH. Clinicians should be aware that an iatrogenic overdose of lorazepam may result in severe propylene glycol toxicity, which may be treated with fomepizole and CVVH.

  14. Relationship between trefoil factor 1 expression and gastric rnucosa injuries and gastric cancer

    Jian-Lin Ren; Jin-Yan Luo; Ya-Pi Lu; Lin Wang; Hua-Xiu Shi


    AIM: To determine whether trefoil factor 1 (TFF1) is associated with mucosa healing and carcinoma suppression, we assess the expression of trefoil factor 1 in normal and pathologic gastric mucosa.METHODS: TFF1 in normal and pathologic gastric mucosa was assessed by immunohistochemical method, and the average positive A was estimated by Motic Images Advanced 3.0 software.RESULTS: Increased TFF1 was detected in gastritis, gastric ulcer and duodenal ulcer compared with normal mucosa. The same result could be seen in multiple and compound ulcer compared with simple ulcer. There was no significant difference between gastric ulcer and duodenal ulcer, gastritis and simple ulcer respectively. Increased TFF1 was detected in the peripheral mucosa of the gastric adenocarcinoma compared with normalmucosa. The expression of TFF1 in gastric adenocarcinoma was related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma, the weaker the expression of TFF1. There was no TFF1 expressed in low-differentiated adenocarcinoma. The expression of TFF1 in middle and highly differentiated adenocarcinoma was a little lower than that in normal mucosa. But there was no significant difference. No TFF1 was assessed in esophageal squamous carcinoma and peripheral tissue. There was no significant difference between male and female.CONCLUSION: The expression of TFF1 was higher in gastritis and peptic ulcer than that in normal mucosa, and was also higher in multiple and compound ulcer than in simple ulcer. It seems that TFF1 plays a role in gastric mucosa protection and epithelial restitution. Increased expression of TFF1 in peripheral tissue suggests that TFFLis associated with mechanism of carcinoma suppression and differentiation. Decreased expression of TFF1 in carcinoma and its relativity to the differentiation suggests that TFF1 is related to gland and cell destruction of carcinoma.

  15. Endovascular treatment of iatrogenic penetrating trauma of the carotid artery: case report

    Eduardo Lichtenfels


    Full Text Available Carotid trauma demands early diagnosis and treatment. Open repair may be technically challenging if the trauma is at the base of the neck. We present a case of iatrogenic penetrating carotid trauma caused by insertion of a hemodialysis catheter. Treatment was accomplished by placement of a covered stent-graft in the common carotid artery, covering the puncture site. This case suggests that placement of a covered stent-graft is a good option for treatment of iatrogenic injury to the carotid artery.

  16. Hypothalamic-Pituitary-Adrenal Suppression and Iatrogenic Cushing's Syndrome as a Complication of Epidural Steroid Injections

    Joyce Leary


    Full Text Available Epidural steroid injections are well accepted as a treatment for radicular back pain in appropriate candidates. While overall incidence of systemic side effects has not been well established, at least five biochemically proven cases of iatrogenic Cushing's Syndrome have been reported as complications of epidural steroid treatment. We present an additional case of iatrogenic Cushing's Syndrome and adrenal suppression in a middle-aged woman who received three epidural steroid injections over a four-month period. We review this case in the context of previous cases and discuss diagnostic and management issues.

  17. Iatrogenic aortic pseudoaneurysm following anterior thoracic spine surgery masquerading as chronic infection

    Goni Vijay


    Full Text Available 【Abstract】Late vascular complications involving aorta are rare but devastating adversities following anterior thoracic spine operations are present. The current article describes our experience with one such patient who had an iatrogenic pseudoaneurysm of the thoracic aorta, mimick- ing infection. The patient was treated successfully follow- ing concomitant efforts by multidisciplinary experts with shunting. We wish to highlight upon the significance of recognizing the possible sinister consequences of a dan- gerously prominent spinal implant and the role of a suspi- cious surgeon in identifying these menacing complications at the right time. Key words: Fractures, bone; Aorta, thoracic; Aneurysm, false; Iatrogenic disease

  18. Iatrogenic cushing syndrome to facial nerve palsy: via intracranial tuberculoma-an interesting journey.

    Chakrabarti, Subrata


    Isolated Facial nerve palsy is a less common neurological manifestation of intracranial tuberculoma. Again, tuberculoma can arise following development of Cushing syndrome after prolonged intake of steroids due to origin of immunosuppressed state. Thus exogenous steroid administration leading to iatrogenic Cushing Syndrome which again causing tuberculoma, with facial nerve palsy developing as a manifestation of tuberculoma is not unnatural but definitely a unique scenario. The author reports an interesting case where a patient developed left sided facial palsy following development of intracranial tuberculoma from iatrogenic Cushing syndrome after longterm intake of Dexamethasone as a treatment for low back pain. This situation is rarely reported before.

  19. Iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus:A rare injury

    Kumar Vishal; R.H.H.Arjun; Aggarwal Sameer; John Rakesh; Kishan Rama


    Complications following supracondylar fracture of humerus are well-known.Pre-and post-operative complications have been documented in the literature.Neurovascular injury due to fracture fragments following this type of fracture is described,Iatrogenic brachial artery during surgical treatment of this fracture is unknown to the literature.So we report a rare case of iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus and try to create awareness to the surgeons that such injuries can occur with improper operative techniques.

  20. Undetected iatrogenic lesions of the anterior femoral shaft during intramedullary nailing: a cadaveric study

    Shepherd Lane


    Full Text Available Abstract Background The incidence of undetected radiographically iatrogenic longitudinal splitting in the anterior cortex during intramedullary nailing of the femur has not been well documented. Methods Cadaveric study using nine pairs of fresh-frozen femora from adult cadavers. The nine pairs of femora underwent a standardized antegrade intramedullary nailing and the detection of iatrogenic lesions, if any, was performed macroscopically and by radiographic control. Results Longitudinal splitting in the anterior cortex was revealed in 5 of 18 cadaver femora macroscopically. Anterior splitting was not detectable in radiographic control. Conclusion Longitudinal splitting in the anterior cortex during intramedullary nailing of the femur cannot be detected radiographically.

  1. Oral CPSI-2364 Treatment Prevents Postoperative Ileus in Swine without Impairment of Anastomotic Healing

    Tim O. Vilz


    Full Text Available Background: Postoperative ileus (POI is an iatrogenic complication of abdominal surgery, mediated by a severe inflammation of the muscularis externa (ME. We demonstrated that orally applicated CPSI-2364 prevents POI in rodents by blockade of p38 MAPK pathway and abrogation of NO production in macrophages. In the present experimental swine study we compared the effect of orally and intravenously administered CPSI-2364 on POI and examined CPSI-2364 effect on anastomotic healing. Methods: CPSI-2364 was administered preoperatively via oral or intravenous route. POI was induced by intestinal manipulation of the small bowel. ME specimens were examined by quantitative PCR for CCL2 chemokine gene expression and myeloperoxidase activity. Functional analyzes included measurement of ileal smooth-muscle ex vivo contractility, in vivo intestinal and colonic transit. Furthermore, anastomotic healing of a rectorectostomy after CPSI-2364 treatment was assessed by perianastomotic hydroxyproline concentration, a histochemically evaluated healing score and anastomotic bursting pressure (ABP. Results: CPSI-2364 abolished inflammation of the ME and improved postoperative smooth muscle contractility and intestinal transit independently of its application route. Hydroxyproline concentration and ABP measurement revealed no wound healing disturbances after oral or intravenous CPSI-2364 treatment whereas histological scoring demonstrated delayed anastomotic healing after intravenous treatment. Conclusion: CPSI-2364 effectively prevents POI in swine independently of its application route. Impairment of anastomotic healing could be observed after intravenous but not oral preoperative CPSI-2364 treatment. Subsumed, an oral preoperative administration of CPSI-2364 appears to be a safe and efficient strategy for prophylaxis of POI.

  2. Saliva and wound healing.

    Brand, Henk S; Ligtenberg, Antoon J M; Veerman, Enno C I


    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In addition, saliva contains several proteins which play a role in the different stages of wound healing. Saliva contains substantial amounts of tissue factor, which dramatically accelerates blood clotting. Subsequently, epidermal growth factor in saliva promotes the proliferation of epithelial cells. Secretory leucocyte protease inhibitor inhibits the tissue-degrading activity of enzymes like elastase and trypsin. Absence of this protease inhibitor delays oral wound healing. Salivary histatins in vitro promote wound closure by enhancing cell spreading and cell migration, but do not stimulate cell proliferation. A synthetic cyclic variant of histatin exhibits a 1,000-fold higher activity than linear histatin, which makes this cyclic variant a promising agent for the development of a new wound healing medication. Conclusively, recognition of the many roles salivary proteins play in wound healing makes saliva a promising source for the development of new drugs involved in tissue regeneration.

  3. Efeito do extrato aquoso de Orbignya phalerata (babaçu na cicatrização do estômago em ratos: estudo morfológico e tensiométrico Effect of watery extract of Orbignya phalerata (babassu in the gastric healing in rats: morfologic and tensiometric study

    Clelma Pires Batista


    apenas quanto à coaptação das bordas, favorecendo o sub-grupo GO de sete dias (p-0,000. CONCLUSÃO: O extrato aquoso do mesocarpo de Orbignya phalerata, na dose e via de acesso utilizadas, favoreceu a coaptação das bordas da gastrorrafia nos animais mortos no 7º dia do período pós-operatório.INTRODUCTION: The large use of plants in the prevention and treatment of different diseases is a milenar practice. In Brazil due to it's rich flora there is a huge material for research and use in popular medicine. The babassu (Orbignya phalerata is a native tree from North of the Brazil and has a high concentration at the State of Maranhão. The powder of it's mesocarp is known as amid, and has been used as meal and medication due to the known activity against antiflammatory reaction, pain, pyrexia and immunomodulation. PURPOSE: To analyze the effect of mesocarp of Orbignya phalerata (babassu in gastric wound healing in rats under morphologic and tensiometric aspects. METHOD: Forty Wistar rats, male, adults were submitted to a longitudinal incision of 1 cm in the gastric body and sutured with separated stitches of polypropilene 6.0. After this common procedure the animals were allocated in the aleatory way in two groups Orbignya (GO and Control (GC with 20 animals each one. In the GO was used intraperitoneal doses of 50mg/kh of Orbignya phalerata extract and in the GC water 1ml/Kg. Each group was divided in two subgroups of ten rats according to the period of death, at 3rd and 7th post-operative days. After the death, the abdominal cavity was evaluated and the stomach withdrawn. For the comparative analysis between the groups the macroscopic and histological parameters of wound healing were utilized. RESULTS: There were no abscess, fistulae and haematom in the animals of the study. Abdominal adhesions were observed in both groups of the animals at 3rd and 7th post-operative days. Dehiscence of the gastrorraphy was identified in one 3rd day rat of subgroups GO. The

  4. Healing Childhood Trauma Worldwide

    Kuban, Caelan


    Millions of the world's children are exposed to traumatic events and relationships every day. Whatever the cause, this overwhelming stress produces a host of unsettling symptoms and reactions. The author highlights six practical principles that undergird healing interventions.

  5. Biomimetic Self-Healing


    as well as the storage and delivery of liquid reagents, new materials have been developed with extended longevity that are capable of restoring...may involve high-temperature curing. The capsule Figure 3. Autonomous self-healing rubber. Reproduced with permis- sion from the CNRS image bank ...EPON 828; diglycidyl ether of bisphenol A (DGEBA)) matrix embedded with 1st gen- eration Grubbs catalyst.[64] Upon crack damage, the liquid healing

  6. Diabetes and wound healing

    Svendsen, Rikke; Irakunda, Gloire; Knudsen List, Karoline Cecilie; Sønderstup-Jensen, Marie; Hölmich Rosca, Mette Maria


    Diabetes is a disease where the glucose level in the blood is high, due to either insulin resistance, impaired insulin sensitivity or no insulin production. The high glucose level causes several complications, one of them being an impaired wound healing process, which might lead to chronic wounds, ulcers. Several factors play a role in the development of ulcers, and recent research indicates that microRNA might play a significant role in skin development and wound healing. The purpose of this...

  7. Iatrogenic surgical microscope skin burns: A systematic review of the literature and case report.

    Lopez, Joseph; Soni, Ashwin; Calva, Daniel; Susarla, Srinivas M; Jallo, George I; Redett, Richard


    Cutaneous burns associated with microscope-use are perceived to be uncommon adverse events in microsurgery. Currently, it is unknown what factors are associated with these iatrogenic events. In this report, we describe the case of a 1-year-old patient who suffered a full thickness skin burn from a surgical microscope after a L4-S1 laminectomy. Additionally, we present a systematic review of the literature that assessed the preoperative risk, outcome, and management of iatrogenic microscope skin burns. Lastly, a summary of the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database of voluntary adverse events was reviewed and analyzed for clinical cases of microscope thermal injuries. The systematic literature review identified only seven articles related to microsurgery-related cutaneous burns. From these seven studies, 15 clinical cases of iatrogenic skin burns were extracted for analysis. The systematic review of the FDA MAUDE database revealed only 60 cases of cutaneous burns associated with surgical microscopes since 2004. Few cases of microscope burns have been described in the literature; this report is, to our knowledge, one of the first comprehensive reports of this iatrogenic event in the literature. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  8. Iatrogenic vascular injuries in Sweden. A nationwide study 1987-2005.

    Rudström, H; Bergqvist, D; Ogren, M; Björck, M


    To study the epidemiology of vascular injuries, with special focus on iatrogenic vascular injuries (IVIs) and time-trends. From the Swedish national vascular registry, Swedvasc, prospectively registered data on vascular injuries during 1987-2005 were analysed and cross-referenced for mortality against the population registry. Of 1853 injuries, 48% were caused by iatrogenic, 29% penetrating and 23% blunt trauma. In the three groups median age was 68, 35 and 40 years, respectively. The annual incidence of procedures for vascular injuries increased from 1.2-1.6 per 100 000 inhabitants and the proportion of IVIs increased from 41 to 51%, during the period. Mortality was higher after IVI (4.9%) compared to non-IVI (2.5%). Patients with IVI also had more co-morbidities; 58% cardiac disease, 44% hypertension, and 18% renal dysfunction. Among 888 IVIs, right femoral arterial injury was the most frequent (37%). The most common vascular reconstruction was direct suture (39%) followed by by-pass or interposition graft (19%, of which prosthetics were used in over half the cases). Endovascular repair increased from 4.6% to 15% between 1987 and 2005. Vascular injuries, in particular iatrogenic ones, appear to be increasing. Iatrogenic injuries affect vulnerable patients with co-morbidities and are associated with a high mortality.

  9. Protected stent retriever thrombectomy prevents iatrogenic emboli in new vascular territories

    Klinger-Gratz, Pascal P. [Bern University Hospital and University of Bern, Department of Diagnostic and Interventional Neuroradiology, Inselspital, Freiburgstrasse 10, Bern (Switzerland); University of Basel, Department of Radiology, Basel (Switzerland); Schroth, Gerhard; Gralla, Jan; Weisstanner, Christian; Verma, Rajeev K.; Mordasini, Pasquale; Kellner-Weldon, Frauke; Hsieh, Kety; El-Koussy, Marwan [Bern University Hospital and University of Bern, Department of Diagnostic and Interventional Neuroradiology, Inselspital, Freiburgstrasse 10, Bern (Switzerland); Jung, Simon [Bern University Hospital and University of Bern, Department of Diagnostic and Interventional Neuroradiology, Inselspital, Freiburgstrasse 10, Bern (Switzerland); Bern University Hospital and University of Bern, Department of Neurology, Inselspital, Bern (Switzerland); Heldner, Mirjam R.; Fischer, Urs; Arnold, Marcel; Mattle, Heinrich P. [Bern University Hospital and University of Bern, Department of Neurology, Inselspital, Bern (Switzerland)


    Diagnostic tools to show emboli reliably and protection techniques against embolization when employing stent retrievers are necessary to improve endovascular stroke therapy. The aim of the present study was to investigate iatrogenic emboli using susceptibility-weighted imaging (SWI) in an open series of patients who had been treated with stent retriever thrombectomy using emboli protection techniques. Patients with anterior circulation stroke examined with MRI before and after stent retriever thrombectomy were assessed for iatrogenic embolic events. Thrombectomy was performed in flow arrest and under aspiration using a balloon-mounted guiding catheter, a distal access catheter, or both. In 13 of 57 patients (22.8 %) post-interventional SWI sequences detected 16 microemboli. Three of them were associated with small ischemic lesions on diffusion-weighted imaging (DWI). None of the microemboli were located in a new vascular territory, none showed clinical signs, and all 13 patients have been rated as Thrombolysis in Cerebral Infarction (TICI) 2b (n = 3) or 3 (n = 10). Retrospective reevaluation of the digital subtraction angiography (DSA) detected discrete flow stagnation nearby the iatrogenic microemboli in four patients with a positive persistent collateral sign in one. Our study demonstrates two things: First, SWI seems to be more sensitive to detect emboli than DWI and DSA and, second, proximal or distal protected stent retriever thrombectomy seems to prevent iatrogenic embolization into new vascular territories during retraction of the thrombus, but not downstream during mobilization of the thrombus. Both techniques should be investigated and refined further. (orig.)

  10. Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide

    Skov, M; Main, K M; Sillesen, Ida Blok


    A recent case of iatrogenic Cushing's syndrome and complete suppression of the pituitary-adrenal-axis in a patient with cystic fibrosis (CF) and allergic bronchopulmonary aspergillosis treated with itraconazole as an antifungal agent, and budesonide as an anti-inflammatory agent led to a systematic...

  11. Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide

    Skov, M; Main, K M; Sillesen, Ida Blok


    A recent case of iatrogenic Cushing's syndrome and complete suppression of the pituitary-adrenal-axis in a patient with cystic fibrosis (CF) and allergic bronchopulmonary aspergillosis treated with itraconazole as an antifungal agent, and budesonide as an anti-inflammatory agent led to a systemat...

  12. A Case of Iatrogenic Subclavian Artery Injury Successfully Treated with Endovascular Procedures

    Yamagami, Takuji; Yoshimatsu, Rika; Tanaka, Osamu; Miura, Hiroshi; Kawahito, Yutaka; Oka, Katsuhiko; Yaku, Hitoshi; Nishimura, Tsunehiko


    We report a case of a life-threatening massive hemothorax caused by iatrogenic injury of the right subclavian artery. The patient was successfully treated with placement of a covered stent. During the procedure, occlusion balloon catheters rapidly controlled the massive bleeding. PMID:23555430

  13. Gastric syphilis - Case report*

    Guimarães, Tais Ferreira; Novis, Camila Freitas Lobo; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José


    Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described. PMID:27828649

  14. Gastrin and Gastric Cancer

    Waldum, Helge L.; Sagatun, Liv; Mjønes, Patricia


    Gastric cancer although occurring in reduced frequency is still an important disease, partly because of the bad prognosis when occurring in western countries. This decline in occurrence may mainly be due to the reduced prevalence of Helicobacter pylori (Hp) infection, which is the most important cause of gastric cancer. There exist many different pathological classifications of gastric carcinomas, but the most useful seems to be the one by Lauren into intestinal and diffuse types since these types seldom transform into the other and also have different epidemiology. During the nearly 30 years that have passed since the groundbreaking description of Hp as the cause of gastritis and gastric cancer, a continuous search for the mechanism by which Hp infection causes gastric cancer has been done. Interestingly, it is mainly atrophic gastritis of the oxyntic mucosa that predisposes to gastric cancer possibly by inducing hypoacidity and hypergastrinemia. There are many arguments in favor of an important role of gastrin and its target cell, the enterochromaffin-like cell, in gastric carcinogenesis. The role of gastrin in gastric carcinogenesis implies caution in the long-term treatment with inhibitors of gastric acid secretion inducing secondary hypergastrinemia, in a common disease like gastroesophageal reflux disease. PMID:28144230

  15. The role of iatrogenic disease of cattle in admission to veterinary hospital

    Giulia Sala


    Full Text Available Iatrogenic diseases are due to negligence or malpractice (Pezza et al.,2008. In human medicine, these conditions are widely described (Weingart et al., 2000, mostly for insurance issues related to hospitalization, while in veterinary medicine are reported only occasional case reports. 4155 clinical records related to cattle admitted to the Clinic for Ruminants and Swine of the University of Milan between 2005 and 2017 were analyzed. Clinical cases that required admission because of an iatrogenic related disease were selected for this study. For case selection, 3 experienced veterinarians examined the clinical records, cross-compared the selection and pick 114 cases (2,7%. The iatrogenic diseases were primarily caused by farmers (93% than veterinary practitioner (7%. Iatrogenic diseases were caused mostly by erroneous administration of drugs (47,4%, excessive traction at birth (17,5%, improper milk or colostrum administration, frequently performed by oroesophageal tubing (16,7% or by forced administration using a nipple bottle (12,3%. As verified by our study, farmers often performs medical, nursing and zootechnical procedures without adequate competences and sometimes choose medical treatment for sick animals without professional consultation of veterinarians.The veterinarian rule is fundamental in farmer education. Clinicians, especially in some professional branches as neonatology, should be more responsible of their assignments, avoiding delegation of specific procedures to unskilled staff. The importance of communication in improving management and health in dairy farms has been recently demonstrated (Jansen and Lam, 2012; Jansen et al., 2010. Effective communication has a key role in dairy herd health and communication strategies are required to support diseases control programs (Lievaart et al., 2008. More attention to iatrogenic issue may have a positive impact on animal and public health. Moreover, a decrease of unnecessary and injurious

  16. Protective Effect of Flos Lonicerae against Experimental Gastric Ulcers in Rats: Mechanisms of Antioxidant and Anti-Inflammatory Action

    Jung-Woo Kang


    Full Text Available Flos Lonicerae is one of the oldest and most commonly prescribed herbs in Eastern traditional medicine to treat various inflammatory diseases. In the present study, we investigated the effects of ethyl acetate fraction of Flos Lonicerae (GC-7101 on experimental gastric ulcer models and its mechanisms of action in gastric ulcer healing. The pharmacological activity of GC-7101 was investigated in rats on HCl/EtOH, indomethacin, water immersion restraint stress induced acute gastric ulcer, and acetic-acid-induced subchronic gastric ulcer. To determine its gastroprotective mechanisms, gastric wall mucus secretion, mucosal PGE2, mucosal NO content, nuclear translocation of NF-κB, mRNA expression of inflammatory cytokines, lipid peroxidation and glutathione content, and superoxide dismutase and catalase activities were measured. GC-7101 significantly attenuated development of acute gastric ulcer and accelerated the healing of acetic-acid-induced subchronic gastric ulcer. In HCl/EtOH-induced gastric ulcer, GC-7101 markedly enhanced gastric wall mucus content which was accompanied by increased mucosal PGE2 and NO production. Furthermore, treatment of GC-7101 exhibited anti-inflammatory and antioxidant activities as evidenced by decreased myeloperoxidase activity, NF-κB translocation, inflammatory cytokines mRNA expression, and lipid peroxidation and increased glutathione content and superoxide dismutase and catalase activities. These results demonstrated that GC-7101 possesses strong antiulcerogenic effect by modulating oxidative stress and proinflammatory mediators.

  17. In vivo transplantation of bone marrow mesenchymal stem cells accelerates repair of injured gastric mucosa in rats

    CHANG Qing; YAN Li; WANG Chang-zheng; ZHANG Wen-hui; HU Ya-zhuo; WU Ben-yan


    Background Adult stem cells provide a promising alternative for the treatment of injured tissues.We aimed to investigate the effect of in vivo transplantation of bone marrow mesenchymal stem cells (BMMSCs) on injured gastric mucosa in rats.Methods The gastric ulcer in rats was induced by indomethacin.BMMSCs from male rats,labeled with the fluorescent cell linker 5,6-carboxyfluorescein diacetate succinimidyl ester (CFDA SE),were transplanted into the female rats via tail vein injection.The healing process of gastric ulcers was monitored by HE staining.The protein levels of vascular endothelial growth factor (VEGF) and the epidermal growth factor receptor (EGFR) in the injured gastric mucosa were determined by immunohistochemistry.Results At 48 and 72 hours after BMMSCs transplantation,the CFDA SE labeled cells were found scattered in the injured gastric mucosa,but not in the gastric mucosa of control rats.At 72 hours after BMMSCs transplantation,the mean ulcer index was 12.67±2.16 in the BMMSCs transplanted group and 17.33±1.97 in vehicle-treated controls (P <0.01).Both VEGF and EGFR protein expression levels were significantly higher in the gastric section from the rats that received BMMSCs transplantation as compared to rats without BMMSCs transplantation.Conclusion Autologous BMMSCs transplantation can accelerate gastric ulcer healing in injured gastric mucosa in a rodent model.

  18. Gastroprotective and ulcer healing effects of essential oil of Hyptis martiusii Benth. (Lamiaceae.

    Germana Freire Rocha Caldas

    Full Text Available Hyptis martiusii Benth. is an aromatic plant found in abundance in northeastern Brazil that is used in ethnomedicine to treat gastric disorders. The aim of this study was to elucidate the mechanisms of action involved in the gastroprotection of the essential oil of Hyptis martiusii (EOHM and to evaluate its healing capacity. Wistar rats were exposed to different protocols and subsequently were treated with 1% Tween-80 aqueous solution (negative control, pantoprazole, carbenoxolone, N-acetylcysteine (depending on the specificity of each model or EOHM. The antisecretory activity (basal or stimulated was determined using the pyloric ligature method. The gastroprotective action of nitric oxide and sulphydryl groups (-SH groups, as well as the quantification of adherent mucus and the levels of malondialdehyde and -SH groups in gastric mucosa, were evaluated using ethanol-induced gastric ulcer model. The healing ability was evaluated using the acetic acid-induced gastric ulcer model and histological and immunohistochemical analysis (HE, PAS and PCNA. EOHM (400 mg/kg reduced the volume and acidity of gastric secretion stimulated by histamine and pentagastrin. The gastroprotective effect of EOHM involves the participation of endogenous sulfhydryl groups. EOHM increased mucus production (54.8%, reduced levels of MDA (72.5% and prevented the depletion of -SH groups (73.8% in the gastric mucosa. The treatment with EOHM reduced in 70.3% the gastric lesion area, promoting significant regeneration of the gastric mucosa, as confirmed by histological analysis and analysis of proliferating cell nuclear antigen. The results show that gastroprotective effect of EOHM is mediated by cytoprotective and antioxidant mechanisms and by their antisecretory activity, and suggest that the essential oil of Hyptis martiusii is a promising candidate for the treatment of gastric ulcers.

  19. Indigofera suffruticosa Mill as new source of healing agent: Involvement of prostaglandin and mucus and heat shock proteins


    Ethnopharmacological relevance: Indigofera suffruticosa is specie typical of the Cerrado or Brazilian savannah; it is a member of the Fabaceae family - in folkmedicine is used for gastric disorders, infection and inflammation.Aim of the study: Ethyl acetate fraction (AcF) and aqueous fraction (AqF) of the methanolic extract of I. suffruticosa leaves were evaluated against acute gastric ulcer. The AcF fraction was selected to assess its activity in ulcer healing and its gastroprotective effect...

  20. "Gastric cytoprotection" is still relevant.

    Szabo, Sandor


    Although Andre Robert's historic article on "gastric cytoprotection" in 1979 introduced this new name and concept, gastroprotective drugs (e.g. sofalcone, sucralfate), which prevent and/or accelerate healing of gastric ulcers without inhibiting acid secretion, were known in Japan before or around that time. But since Robert's studies were solely focused on prostaglandins (PG), they became the center of gastrointestinal research for more than 30 years. As endogenous products, PG were implicated in mediating the gastroprotective effect of other drugs such as sofalcone and sucralfate, despite that the cyclooxygenase inhibitor indomethacin diminished but never abolished gastroprotection by other drugs. Another group of endogenous substances, that is, sulfhydryls (SH), investigated in parallel with PG, also seem to play a mechanistic role in gastroprotection, especially since SH alkylators like N-ethylmaleimide counteract virtually any form of gastroprotection. In Robert's terms of "prevention of chemically induced acute mucosal lesions," so far no single mechanism could explain the beneficial effects of diverse protective agents, but I argue that these two endogenous substances (i.e. PG, SH), in addition to histamine, are the main mechanistic mediators of acute gastroprotection: PG and histamine, because as mediators of acute inflammation, they increase vascular permeability (VP), and SH scavenge free radicals. This is contrary to the search for a single mechanism of action, long focused on enhanced secretion of mucus and/or bicarbonate that may contribute but cannot explain all forms of gastroprotection. Nevertheless, based on research work of the last 30 years, in part from our lab, a new mechanistic explanation of gastroprotection may be formulated: it's a complex but orderly and evolution-based physiologic response of the gastric mucosa under pathologic conditions. Namely, one of the first physiologic defense responses of any organ is inflammation that starts with

  1. Wound healing in urology.

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves


    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment.

  2. Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma

    Francesco A. Polistina


    Full Text Available Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.

  3. Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma

    Polistina, Francesco A.; Costantin, Giorgio; Settin, Alessandro; Lumachi, Franco; Ambrosino, Giovanni


    Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree. PMID:21103208

  4. Stomach (Gastric) Cancer Screening

    ... Gastric Cancer Treatment Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening (PDQ®)–Patient Version What is ... from the . There is no standard or routine screening test for stomach cancer. Several types of screening tests have been ...

  5. Epidemiology of gastric cancer

    Katherine D Crew; Alfred I Neugut


    The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.

  6. Gastric bypass surgery

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  7. Obesity and gastric cancer.

    Li, Qiang; Zhang, Jun; Zhou, Yongning; Qiao, Liang


    Obesity is an important public health problem worldwide. It increases the risk of many chronic diseases such as diabetes and cardiovascular diseases. Meanwhile, obesity is a major risk factor for several types of cancer including gastric cancer. Possible mechanisms linking obesity with gastric cancer may include obesity associated gastro-oesophageal reflux, insulin resistance, altered levels of adiponectin, leptin, ghrelin, and an abnormally increased blood level of insulin-like growth factor (IGF). Helicobacter pylori (H. pylori) infection is a well-recognized risk factor for peptic ulcer and gastric cancer. Recent studies have revealed an increased prevalence of H. pylori infection in obese patients, providing another clue for the increased incidence of gastric cancer in obese population. If this connection can be confirmed in animal models and a large cohort of patients, then eradicating H. pylori together with life style modification in obese individuals may help prevent the development of gastric cancer in the increasingly obese population.

  8. Effect of antisecretory agents and vagotomy on healing of "chronic" cysteamine-induced duodenal ulcers in rats

    Poulsen, Steen Seier


    Penetrated cysteamine-induced duodenal ulcers in rats have a very prolonged course of healing. In this study, it was investigated how much the healing of these ulcers is accelerated by some treatments. The treatments included omeprazole, cimetidine, and truncal vagotomy. In addition, the effect...... of omeprazole and cimetidine on gastric acid secretion was investigated in chronic gastric fistula rats. After 25 days of treatment, significantly more rats in the treated groups had healed ulcers than in the control group. There was little further improvement up to 100 days of treatment, and the difference...... between treated and untreated groups decreased. The morphology of healing ulcers in treated and untreated rats was also compared. In controls, there was a simultaneous regeneration of mucosa and the submucosal Brunner's glands from the edges of the ulcer, the slow proliferation rate of the latter probably...

  9. Acute Intrathoracic Gastric Volvulus due to Diaphragmatic Hernia: A Rare Emergency Easily Overlooked

    Hyung Hun Kim


    Full Text Available Acute intrathoracic gastric volvulus occurs when the stomach undergoes organoaxial torsion in the chest due to either concomitant enlargement of the hiatus or a diaphragmatic hernia. Iatrogenic diaphragmatic hernia can occur after hiatal hernia repair and other surgical procedures, such as nephrectomy, esophagogastrectomy and splenopancreatectomy. We describe a 49-year-old woman who presented to our emergency department with acute moderate epigastric soreness and vomiting. She had undergone extensive gynecologic surgery including splenectomy 1 year before. The chest radiograph obtained in the emergency department demonstrated an elevated gastric air-fluid level in the left lower lung field. An urgent gastroscopy showed twisted structural abnormality of the stomach body. A computed tomography scan demonstrated the distended stomach, located in the left lower hemithorax through a left diaphragmatic defect. Emergent transthoracic repair was performed. Postoperative recovery was uneventful, and the patient did not experience any pain or difficulty with eating.

  10. Bone healing in 2016

    Buza, John A.; Einhorn, Thomas


    Summary Delayed fracture healing and nonunion occurs in up to 5–10% of all fractures, and can present a challenging clinical scenario for the treating physician. Methods for the enhancement of skeletal repair may benefit patients that are at risk of, or have experienced, delayed healing or nonunion. These methods can be categorized into either physical stimulation therapies or biological therapies. Physical stimulation therapies include electrical stimulation, low-intensity pulsed ultrasonography, or extracorporeal shock wave therapy. Biological therapies can be further classified into local or systemic therapy based on the method of delivery. Local methods include autologous bone marrow, autologous bone graft, fibroblast growth factor-2, platelet-rich plasma, platelet-derived growth factor, and bone morphogenetic proteins. Systemic therapies include parathyroid hormone and bisphosphonates. This article reviews the current applications and supporting evidence for the use of these therapies in the enhancement of fracture healing. PMID:27920804

  11. The Efficacy of Fucoidan on Gastric Ulcer

    Mohammad Juffrie


    Full Text Available Hyperacidity causes gastric injury, and in severe situations, ulcer could develop. The growth factors known asthe basic fibroblast growth factor (bFGF and the epidermal growth factor (EGF have been recognized to promoteulcer healing. Fucoidan is extracted from a brown seaweed of Okinawa called Mozuku or Cladosiphon okamuranus.Fucoidan is effective for the healing of gastric ulcers by inducing epithelial cells to produce growth factors. The aimof this study is to explore the efficacy of fucoidan in patient who suffered by gastric ulcer. A randomized control trialdouble blind was conducted to 33 eligible samples. By using four-blocks random samples were divided into fucoidanand placebo groups. 100 mg of fucoidan was given to the fucoidan group and 100 mg of glucose was given to theplacebo group. Due to ethical reasons, for both groups were given a proton pump inhibitor. There was no differencein the age category between the fucoidan group (mean: 46.23 ± 14.8 years and the placebo group (mean: 46.18 ± 18.4years (p: 0.28. There was also no difference in sex between the fucoidan group (female: 10/33; male 7/33 and theplacebo group (female: 7/33; male: 9/33; p: 0.38. According to the SAKITA and MIWA criterias 32 patients fulfilledA1 which indicate active severe ulcer, and 1 patient fulfilled A2 which indicate active moderate ulcer. Most of theulcers were gastric ulcer. There was a significant improvement of the grade of ulcer in fucoidan group (94% (16/17compared to placebo group (37.5% (6/16,p: 0.005. There was a significant reduction of abdominal pain after 5 daysin the fucoidan group, compared to the placebo group (p: 0.04. Vomiting tends to decrease in day 6 of the fucoidangroup however its proportion is similar with that of the placebo group (p: 0.9. Fucoidan is effective for ulcer healingand reducing ulcer symptoms.Key words : fucoidan, gastric ulcer, anti-peptic activity

  12. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

    Kufner, Sebastian, E-mail: [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Cassese, Salvatore; Groha, Philipp; Byrne, Robert A. [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Schunkert, Heribert; Kastrati, Adnan [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Ott, Ilka; Fusaro, Massimiliano [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany)


    Background: The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. A strategy of percutaneous transluminal angioplasty (PTA) with covered stent (CS) may represent a valuable alternative to open surgery. However, systematic evaluations of CS in this setting represent a scientific gap. In the present study, we investigate the procedural and clinical outcomes associated with PTA and CS implantation to repair iatrogenic injuries of peripheral arteries. Methods: All patients undergoing PTA with CS for endovascular repair of iatrogenic injuries of peripheral arteries between August 2010 and July 2013 at our Institution were retrospectively analyzed. The primary endpoint was the technical success. Secondary endpoints were in-hospital mortality and cumulative death, target lesion revascularization (TLR), amputation and major stroke at 12-month follow-up. Results: During the period of observation, a total of 30 patients underwent PTA with either self-expandable (43.3%) or balloon-expandable CS (56.7%) for iatrogenic injuries of peripheral arteries. Injuries consisted of perforation/rupture (76.7%), arteriovenous fistula (16.7%) and pseudoaneurysm (6.7%) of iliac–femoral arteries. Technical success was achieved in all cases. Median follow-up was 409 days [210–907]. The incidence of in-hospital mortality was 10.0%. At 12-month follow-up, the incidence of death, TLR, amputation and major stroke was 20.0%, 17.0%, 3.3% and 6.7%, respectively. Conclusion: The use of covered stents for endovascular repair of iatrogenic injuries of peripheral arteries shows a high technical success and may be alternative to surgery. Further studies with larger populations are needed to confirm these preliminary findings. - Highlights: • The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. • Percutaneous transluminal angioplasty with


    S. I. Artiukhova


    Full Text Available Summary. The article presents data on the development of technology and qualitative research, bio-products «Healing-1». One of the promising directions in food biotechnology is the development of new integrated starter-based consortia of microorganisms, which have higher activity compared with cultures prepared using pure cultures. So it was interesting studies on the development of new biotechnology and bio-based microbial consortium of lactic acid bacteria. Based on the analysis of biotechnological properties of native cultures created a new consortium of microorganisms containing lactic acid streptococci and bacilli, allowing the maximum extent possible to implement the physiological, biochemical and technological potential of microorganisms. Scientifically substantiated and experimentally developed a new biotechnology production of bioproducts «Healing-1», obtained on the basis of microbial consortium with broad spectrum antimicrobial activity. Experimentally investigated quality parameters of organic food «Healing-1» using a new microbial consortium as freshly prepared and during storage. Found that antagonistic activity of microflora bio «Healing-1» with respect to pathogenic and conditionally pathogenic bacteria, as well as its resistance to substances in the gastrointestinal tract of man is more pronounced compared to bioproducts obtained using a separate starter, members of the microbial consortium. It should be noted a more pronounced synthesis of exopolysaccharides in bioproduct «Healing-1», which leads to increased viscosity of the system and improves the consistency of bio. New bioproducts have good organoleptic characteristics and contain a high number of viable cells of lactic acid bacteria. High stability and survival of lactic acid bacteria during storage. In the study of attacked proteins bioproducts digestive proteinases «in vitro» found that the fermentation of milk microbial consortium increases the digestibility

  14. Healing the nations

    Karl Dortzbach


    Full Text Available This article gives the motivations, methodology and some results of a study done in Christian healing interventions in African contexts of� stress and violence. Healing in community has been viewed through the prism of �shalom�. Shalom occurs when people who are in a� right� relationship with God� and� each other enjoy and share together the resources of the earth� in ways� that� show Christ� is Lord of all creation. Charts are given showing� the various kinds of community needs, ways to intervene, and some indications of ways to evaluate the interventions.

  15. The effect of immunonutrition (glutamine, alanine on fracture healing

    Abdullah Küçükalp


    Full Text Available Background: There have been various studies related to fracture healing. Glutamine is an amino acid with an important role in many cell and organ functions. This study aimed to make a clinical, radiological, and histopathological evaluation of the effects of glutamine on fracture healing. Methods: Twenty rabbits were randomly allocated into two groups of control and immunonutrition. A fracture of the fibula was made to the right hind leg. All rabbits received standard food and water. From post-operative first day for 30 days, the study group received an additional 2 ml/kg/day 20% L-alanine L-glutamine solution via a gastric catheter, and the control group received 2 ml/kg/day isotonic via gastric catheter. At the end of 30 days, the rabbits were sacrificed and the fractures were examined clinically, radiologically, and histopathologically in respect to the degree of union. Results: Radiological evaluation of the control group determined a mean score of 2.5 according to the orthopaedists and 2.65 according to the radiologists. In the clinical evaluation, the mean score was 1.875 for the control group and 2.0 for the study group. Histopathological evaluation determined a mean score of 8.5 for the control group and 9.0 for the study group. Conclusion: One month after orally administered glutamine–alanine, positive effects were observed on fracture healing radiologically, clinically, and histopathologically, although no statistically significant difference was determined.

  16. Quality of peptic ulcer healing induced by lansoprazole and roxatidine.

    Fujino, M A; Morozumi, A; Kobayashi, K; Ueda, F; Suzuki, Y; Uchida, N; Tachikawa, H; Sano, S; Ohtsuka, H; Yamamoto, Y


    This study reports preliminary results of a controlled, multicenter trial on the quality of ulcer healing induced by lansoprazole (LPZ) or roxatidine (R) in gastric ulcer (GU) or duodenal ulcer (DU) patients. Group A received LPZ 30 mg q.d. and group B received R 75 mg b.i.d. All drugs were given for 8 weeks in GU and for 6 weeks in DU. Endoscopy and gastric biopsy were performed to detect Helicobacter pylori before and on completion of treatment. The healing rates of groups A and B were 100 and 69.2%, respectively, in GU and 100 and 70.0%, respectively, in DU. This difference (p < 0.01) was significant between the two groups in GU. There was no significant difference between the two groups in the S2 stage shift rate in GU and DU. The H. pylori clearance rates of groups A and B were 33.3 and 20.0%, respectively, in GU and 62.5 and 33.3%, respectively, in DU. The differences in treatment response (healing rates and S2 shift rates) between the LPZ group and the R group may be related to the differences in suppression of acid secretion and in bactericidal effects on H. pylori.

  17. Local steroid injection into the artificial ulcer created by endoscopic submucosal dissection for gastric cancer: prevention of gastric deformity.

    Mori, H; Rafiq, K; Kobara, H; Fujihara, S; Nishiyama, N; Kobayashi, M; Himoto, T; Haba, R; Hagiike, M; Izuishi, K; Okano, K; Suzuki, Y; Masaki, T


    Endoscopic submucosal dissection (ESD) of large gastric lesions results in an extensive artificial ulcer that can lead to marked gastric deformity. The aim of the current study was to evaluate therapeutic efficacy in the prevention of gastric deformity of local triamcinolone acetonide (TCA) injection into the extensive artificial ulcer following ESD. A total of 45 patients who were diagnosed with early gastric cancer were enrolled. Patients were randomly assigned by the sealed-envelope randomization method to either local TCA injections (n = 21) or sham-control (n = 20) groups. Two clips were placed at the two maximum outer edges of the artificial ulcer after the lesion had been resected (Day 0). Local TCA injections were performed on postoperative Day 5 and Day 12. The distance between the two clips was measured by endoscopic measuring forceps on Days 5, 12, 30, and 60. Granulation formation and gastric deformity were evaluated by visual analog scale (VAS) on Days 30 and 60. Local TCA injection did not alter clip-to-clip distance on postoperative Day 60, and formation of flat granulation tissue over the ulcer was followed by regenerative mucosa without any gastric deformity. The sham-control group showed significant shortening of clip-to-clip distance compared with the local steroid-injected group and protruded forms of granulation tissue with mucosal convergence. Histological evaluation revealed prominent growth of neovessels, swelling, and marked increases in endothelial cells in the local steroid-injected group compared with the sham-control group. Local steroid injection into the floor of a post-ESD artificial ulcer promotes the formation of granulation tissue at an early stage of the healing process leading to regeneration of gastric mucosa without mucosal convergence or gastric deformity. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Review: African medicinal plants with wound healing properties.

    Agyare, Christian; Boakye, Yaw Duah; Bekoe, Emelia Oppong; Hensel, Andreas; Dapaah, Susana Oteng; Appiah, Theresa


    Wounds of various types including injuries, cuts, pressure, burns, diabetic, gastric and duodenal ulcers continue to have severe socio-economic impact on the cost of health care to patients, family and health care institutions in both developing and developed countries. However, most people in the developing countries, especially Africa, depend on herbal remedies for effective treatment of wounds. Various in vitro and in vivo parameters are used for the evaluation of the functional activity of medicinal plants by using extracts, fractions and isolated compounds. The aim of the review is to identify African medicinal plants with wound healing properties within the last two decades. Electronic databases such as PubMed, Scifinder(®) and Google Scholar were used to search and filter for African medicinal plants with wound healing activity. The methods employed in the evaluation of wound healing activity of these African medicinal plants comprise both in vivo and in vitro models. In vivo wound models such as excision, incision, dead space and burn wound model are commonly employed in assessing the rate of wound closure (contraction), tensile strength or breaking strength determination, antioxidant and antimicrobial activities, hydroxyproline content assay and histological investigations including epithelialisation, collagen synthesis, and granulation tissue formation. In in vitro studies, single cell systems are mostly used to study proliferation and differentiation of dermal fibroblasts and keratinocytes by monitoring typical differentiation markers like collagen and keratin. In this study, 61 plants belonging to 36 families with scientifically demonstrated or reported wound healing properties were reviewed. Various plant parts including leaves, fruits, stem bark and root extracts of the plants are used in the evaluation of plants for wound healing activities. Although, a variety of medicinal plants for wound healing can be found in literature, there is a need for the

  19. Genomic dysregulation in gastric tumors.

    Janjigian, Yelena Y; Kelsen, David P


    Gastric cancer is among the most common human malignancies and the second leading cause of cancer-related death. The different epidemiologic and histopathology of subtypes of gastric cancer are associated with different genomic patterns. Data suggests that gene expression patterns of proximal, distal gastric cancers-intestinal type, and diffuse/signet cell are well separated. This review summarizes the genetic and epigenetic changes thought to drive gastric cancer and the emerging paradigm of gastric cancer as three unique disease subtypes.

  20. Gastric conduit perforation.

    Patil, Nilesh; Kaushal, Arvind; Jain, Amit; Saluja, Sundeep Singh; Mishra, Pramod Kumar


    As patients with carcinoma of the esophagus live longer, complications associated with the use of a gastric conduit are increasing. Ulcers form in the gastric conduit in 6.6% to 19.4% of patients. There are a few reports of perforation of a gastric conduit in the English literature. Almost all of these were associated with serious complications. We report a patient who developed a tension pneumothorax consequent to spontaneous perforation of an ulcer in the gastric conduit 7 years after the index surgery in a patient with carcinoma of the gastroesophageal junction. He responded well to conservative management. Complications related to a gastric conduit can be because of multiple factors. Periodic endoscopic surveillance of gastric conduits should be considered as these are at a higher risk of ulcer formation than a normal stomach. Long term treatment with proton pump inhibitors may decrease complications. There are no guidelines for the treatment of a perforated gastric conduit ulcer and the management should be individualized.

  1. Familial gastric cancer

    Bresciani Cláudio


    Full Text Available BACKGROUND: Familial aggregation of gastric cancer has pointed out to a possible hereditary and genetic factor involved in the carcinogenesis of this disease. The diffuse type gastric cancer patients are frequently younger and the tumor has locally infiltrative growth pattern early in its development. Observation of families with frequent early onset gastric cancer has led to the identification of a novel gene implicated in gastric cancer susceptibility: CDH1/E-cadherin. Diffuse familiar gastric cancer is defined as any family presenting: two first-degree relatives with diffuse gastric cancer, one of them with age under 50 years or at least 3 first-degree relatives irrespective age of onset. CASE REPORT: The family reported by us does not fit in any of the classification proposed. The precise identification of these families by clinical and molecular tools is of great importance. The case reported is an example of a family that probably is a form of hereditary gastric cancer not yet fully understood. CONCLUSION: Soon there will be new criteria, possibly including genetic and molecular characteristics.

  2. Sleep-disordered breathing as a delayed complication of iatrogenic vocal cord trauma.

    Faiz, Saadia A; Bashoura, Lara; Kodali, Lavanya; Hessel, Amy C; Evans, Scott E; Balachandran, Diwakar D


    A case of a 55-year-old woman with iatrogenic vocal cord trauma and sleep-related symptoms is reported. In particular, this case highlights sleep-disordered breathing as a delayed complication after iatrogenic vocal cord trauma. The patient developed acute stridor from a contralateral vocal cord hematoma following vocal fold injection for right vocal cord paralysis. Acute respiratory symptoms resolved with oxygen, steroids, and nebulized therapy, but nocturnal symptoms persisted and polysomnography revealed sleep-related hypoventilation and mild obstructive sleep apnea. Positive pressure therapy was successfully used to ameliorate her symptoms and treat sleep-disordered breathing until her hematoma resolved. In addition to the typically acute respiratory symptoms that may result from vocal cord dysfunction, sleep-disordered breathing may also present as a significant subacute or chronic problem. Management of the acute respiratory symptoms is relatively well established, but clinicians should be alert for more subtle nocturnal symptoms that may require further study with polysomnography.

  3. Iatrogenic Creutzfeldt-Jakob disease following human growth hormone therapy: case report

    Caboclo Luís Otávio Sales Ferreira


    Full Text Available We report the case of a 41-year-old man with iatrogenic Creutzfeldt-Jakob disease (CJD acquired after the use of growth hormone (GH obtained from a number of pituitary glands sourced from autopsy material. The incubation period of the disease (from the midpoint of treatment to the onset of clinical symptoms was rather long (28 years. Besides the remarkable cerebellar and mental signs, the patient exhibited sleep disturbance (excessive somnolence from the onset of the symptoms, with striking alteration of the sleep architecture documented by polysomnography. 14-3-3 protein was detected in the CSF, and MRI revealed increased signal intensity bilaterally in the striatum, being most evident in diffusion-weighted (DW-MRI sequences. This is the second case of iatrogenic CJD associated with the use of GH reported in Brazil.

  4. Topical-steroid-induced iatrogenic Cushing syndrome in the pediatric age group: A rare case report

    Ashish Tiwari


    Full Text Available Cushing syndrome, a systemic disorder, is the result of abnormally high blood level of cortisol or other glucocorticoids. The most common cause of Cushing syndrome is prolonged exogenous administration of glucocorticoid hormones. Prolonged use of topical corticosteroids, particularly in children, may cause Cushing syndrome and suppression of the hypothalamopituitory-adrenal axis, which is less common than that of oral or parenteral route. However, iatrogenic Cushing syndrome in the infantile age group due to topical steroid is very rare and only a few patients have been reported to date in the literature. Here we report a case of iatrogenic Cushing syndrome due to topical steroid application in a 5-month-old female child admitted to the hospital for repeated episodes of fever and cough.

  5. Topical-steroid-induced iatrogenic Cushing syndrome in the pediatric age group: A rare case report.

    Tiwari, Ashish; Goel, Manjusha; Pal, Pankaj; Gohiya, Poorva


    Cushing syndrome, a systemic disorder, is the result of abnormally high blood level of cortisol or other glucocorticoids. The most common cause of Cushing syndrome is prolonged exogenous administration of glucocorticoid hormones. Prolonged use of topical corticosteroids, particularly in children, may cause Cushing syndrome and suppression of the hypothalamopituitory-adrenal axis, which is less common than that of oral or parenteral route. However, iatrogenic Cushing syndrome in the infantile age group due to topical steroid is very rare and only a few patients have been reported to date in the literature. Here we report a case of iatrogenic Cushing syndrome due to topical steroid application in a 5-month-old female child admitted to the hospital for repeated episodes of fever and cough.

  6. [Iatrogenic extravasations of cytotoxic or hyperosmolar aqueous solutions. Value of surgical emergency by aspiration and lavage].

    Lambert, F; Couturaud, B; Arnaud, E; Champeau, F; Revol, M; Servant, J M


    Iatrogenic extravasations are characterized by their unpredictable course, the possible repercussions of functional, cosmetic and psychological sequelae, and the absence of a therapeutic consensus. The authors present the protocol used in Hôpital Saint-Louis, based on a synthesis of current procedures, consisting of emergency conservative surgical aspiration and lavage, performed in a context of close collaboration with oncolosits, intensive care physicians and radiologists. From 1994 to March 1997, fifteen patients were operated following extravasation during seven chemotherapeutic protocols, three radiographic examinations with injection of contrast agents and five resuscitation procedures. This simple protocol, applied systematically, achieved cure without cutaneous or functional sequelae in all patients. Aspiration-lavage during the first twelve hours therefore constitutes the treatment of choice of iatrogenic extravasation with cytotoxic or hyperosmolar aqueous solutions.

  7. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases

    Hillerup, Søren


    The aims of this study were threefold: (1) to describe iatrogenic lesions to oral branches of the trigeminal nerve, signs and symptoms, and functional status, (2) to report on a simple neurosensory examination method, and (3) to discuss means of prevention of iatrogenic injury. The etiology...... and functional status of 449 injuries to oral branches collected over 18 years were retrospectively reviewed. A simple scheme of a clinical neurosensory examination was applied to enable a quantified rating of the perception. Injury to the lingual nerve (n = 261) is not only the most prevalent type of lesion...... was affected more frequently and severely than other oral branches of the trigeminal nerve. The female gender was overrepresented in incidence of injured nerves but no difference was found in the severity of affection between females and males. All grades of loss of neurosensory functions were found...

  8. Iatrogenic neonatal type B aortic dissection: comprehensive MRI-based diagnosis and follow-up

    Geiger, Julia; Markl, M. [University Hospital Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Stiller, B.; Arnold, R. [University Hospital Freiburg, Department of Congenital Heart Disease and Pediatric Cardiology, Freiburg (Germany); Schlensak, C. [University Hospital Freiburg, Department of Cardiovascular Surgery, Freiburg (Germany)


    Neonatal aortic dissection is rare and most frequently iatrogenic. Decision making and appropriate imaging are highly challenging for pediatric cardiologists and radiologists. We present MRI and echocardiographic findings in the follow-up at 6 months of age of a boy with a conservatively treated iatrogenic neonatal aortic dissection (type B). To evaluate the morphology of the aortic arch and descending aorta, we carried out multidirectional time-resolved three-dimensional flow-analysis and contrast-enhanced MR angiography (CE-MRA). The MRI and Doppler echocardiographic results were closely comparable. Three-dimensional visualization helped assess details of blood flow acceleration and alteration caused by the dissection, and played a key role in our deciding not to treat surgically. (orig.)

  9. Acute iatrogenic polycythemia induced by massive red blood cell transfusion during subtotal abdominal colectomy

    David Chiapaikeo


    Full Text Available A 46 year old man was transfused ten units of packed red blood cells during subtotal colectomy after intraoperative point-of-care testing values demonstrated hemoglobin values less than seven grams per deciliter (g/dL. A post-operative hemoglobin analyzed in a standard hematologic laboratory revealed a hemoglobin value of 27.8 g/dL. He underwent emergent red blood cell depletion therapy which decreased his hemoglobin to 7.5 g/dL. The physiologic consequences of iatrogenic polycythemia caused by massive transfusion during major abdominal surgery must take into account the fluid shifts that interplay between the osmotic load, viscosity of blood, and postoperative third spacing of fluid. Treatment of acute iatrogenic polycythemia can be effectively accomplished by red blood cell depletion therapy. However, fluid shifts caused by massive transfusion followed by rapid red cell depletion produce a unique physiologic state that is without a well-described algorithm for management.

  10. Iatrogenic visual aura: a case report and a brief review of the literature.

    Buture, Alina; Khalil, Modar; Ahmed, Fayyaz


    Iatrogenic migraine aura following transseptal catheterization has only rarely been reported in the literature. We report the case of a 60-year-old female who presented with new onset of migraine with visual aura 1 day after transseptal cryoballoon catheter ablation for atrial fibrillation. The patient had a 5-year history of typical migraine without aura and had never experienced visual aura before the cardiac intervention. The neurological examination, fundoscopy, and blood tests were normal. The magnetic resonance imaging of the brain showed small vessel ischemia without evidence of vessel ischemic changes in the occipital lobes and large blood vessel disease. A change in the characteristics of existing migraine could occur following an iatrogenic episode, which in this case was catheter ablation for atrial fibrillation. A new onset of aura is considered an indication for a brain scan as it may signify underlying new pathology.

  11. Fibronectin and wound healing.

    Grinnell, F


    I have tried to briefly review the evidence (summarized in Table II) indicating that fibronectin is important in cutaneous wound healing. Fibronectin appears to be an important factor throughout this process. It promotes the spreading of platelets at the site of injury, the adhesion and migration of neutrophils, monocytes, fibroblasts, and endothelial cells into the wound region, and the migration of epidermal cells through the granulation tissue. At the level of matrix synthesis, fibronectin appears to be involved both in the organization of the granulation tissue and basement membrane. In terms of tissue remodeling, fibronectin functions as a nonimmune opsonin for phagocytosis of debris by fibroblasts, keratinocytes, and under some circumstances, macrophages. Fibronectin also enhances the phagocytosis of immune-opsonized particles by monocytes, but whether this includes phagocytosis of bacteria remains to be determined. In general, phagocytosis of bacteria has not appeared to involve fibronectin. On the contrary, the presence of fibronectin in the wound bed may promote bacterial attachment and infection. Because of the ease of experimental manipulations, wound healing experiments have been carried out on skin more frequently than other tissues. As a result, the possible role of fibronectin has not been investigated thoroughly in the repair of internal organs and tissues. Nevertheless, it seems reasonable to speculate that fibronectin plays a central role in all wound healing situations. Finally, the wound healing problems of patients with severe factor XIII deficiencies may occur because of their inability to incorporate fibronectin into blood clots.

  12. Microdeformation in wound healing.

    Wiegand, Cornelia; White, Richard


    Mechanical forces greatly influence cellular organization and behavior. Cells respond to applied stress by changes in form and composition until a suitable state is reestablished. However, without any mechanical stimuli cells stop proliferating, discontinue migration, go into cell-cycle arrest, and eventually die. Hence, one can assume that pathologies closely depending on cell migration like cancer or atherosclerosis might be governed by biophysical parameters. Moreover, mechanical cues will have fundamental effects in wound healing. Especially negative pressure wound therapy has the potential to endorse wound healing by induction of both macrodeformation (wound contraction) and microdeformation (tissue reactions at microscopic level). So far, the capacity for researchers to study the link between mechanical stimulation and biological response has been limited by the lack of instrumentation capable of stimulating the tissue in an appropriate manner. However, first reports on application of micromechanical forces to wounds elucidate the roles of cell stretch, substrate stiffness, and tissue deformation during cell proliferation and differentiation. This review deals with their findings and tries to establish a link between the current knowledge and the questions that are essential to clinicians in the field: What is the significance of mirodeformations for wound healing? Does "dead space" impede propagation of mechanical cues? How can microdeformations induce cell proliferation? What role do fibroblasts, myofibroblasts, and mesenchymal stem cells play in chronic wounds with regard to micromechanical forces? © 2013 by the Wound Healing Society.

  13. Healing Invisible Wounds

    Adams, Erica J.


    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual…

  14. Phytochemicals in Wound Healing

    Thangapazham, Rajesh L.; Sharad, Shashwat; Radha K Maheshwari


    Significance: Traditional therapies, including the use of dietary components for wound healing and skin regeneration, are very common in Asian countries such as China and India. The increasing evidence of health-protective benefits of phytochemicals, components derived from plants is generating a lot of interest, warranting further scientific evaluation and mechanistic studies.

  15. Healing Invisible Wounds

    Adams, Erica J.


    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual…

  16. Iatrogenic subclavian artery pseudoaneurysm close to the origin of the vertebral artery: an endovascular strategy

    XU Gao-feng; Dae Chul Suh


    Subclavian artery pseudoaneurysm that induced from central venous catheterization through the internal jugular vein is relatively uncommon. However, the management of subclavian artery pseudoaneurysm remains a challenge because of their non-compressibility of deep locality and relationship to important surrounding anatomy, such as the origin of vertebral artery. In this paper, the authors report a patient with larger iatrogenic subclavian arterial pseudoaneurysm near the origin of vertebral artery, that was treated successfully by endovascular covered stent and coils.

  17. Endoscopic Diagnosis and Management of Iatrogenic Cervical Esophageal Perforation in Extremely Premature Infants

    Wen-Jue Soong


    Full Text Available Blind oro-(naso-pharyngeal suction and feeding catheter intubation are very common practices in pediatric critical care. However, these simple procedures may produce unexpected complications in friable tiny patients. We encountered 3 extremely premature infants in whom cervical esophageal perforation and further submucosal excavation were caused by traumatic catheter injury and subsequently led to catastrophes. These episodes of iatrogenic trauma were all successfully diagnosed early, documented and managed with the aid of ultrathin flexible endoscopy.

  18. Gastric Duplication Cyst Causing Gastric Outlet Obstruction

    Muna Al Shehi


    Full Text Available This is a case report of a newborn baby with gastric duplication cyst presented with non-bilious vomiting and upper abdominal distension. The diagnosis was suspected clinically and established by ultrasonography and computed tomography. The cyst was completely excised with uneventful recovery.

  19. Self-healing supramolecular nanocomposites

    Liu, Z.


    The aim of this thesis is to execute a bottom-up design of the intrinsically self-healing nanocomposites. We briefly introduced the self-healing materials in chapter 1, covering classification and basic self-healing mechanism. In chapter 2, we have synthesized polyborosiloxane (PBS) according to th

  20. Self-healing supramolecular nanocomposites

    Liu, Z.


    The aim of this thesis is to execute a bottom-up design of the intrinsically self-healing nanocomposites. We briefly introduced the self-healing materials in chapter 1, covering classification and basic self-healing mechanism. In chapter 2, we have synthesized polyborosiloxane (PBS) according to

  1. Reversing gastric mucosal alterations during ethanol-induced chronic gastritis in rats by oral administration of Opuntia ficus- indica mucilage

    Ricardo Vázquez-Ramírez; Marisela Olguín-Martínez; Carlos Kubli-Garfias; Rolando Hernández-Mu(n)oz


    AIM: To study the effect of mucilage obtained from cladodes of Opuntia ficus-indica (Cactaceae) on the healing of ethanol-induced gastritis in rats.METHODS: Chronic gastric mucosa injury was treated with mucilage (5 mg/kg per day) after it was induced by ethanol. Lipid composition, activity of 5'-nucleotidase (a membrane-associated ectoenzyme) and cytosolic activities of lactate and alcohol dehydrogenases in the plasma membrane of gastric mucosa were determined.Histological studies of gastric samples from the experimental groups were included.RESULTS: Ethanol elicited the histological profile of gastritis characterized by loss of the surface epithelium and infiltration of polymorphonuclear leukocytes.Phosphatidylcholine (PC) decreased and cholesterol content increased in plasma membranes of the gastric mucosa. In addition, cytosolic activity increased while the activity of alcohol dehydrogenases decreased. The administration of mucilage promptly corrected these enzymatic changes. In fact, mucilage readily accelerated restoration of the ethanol-induced histological alterations and the disturbances in plasma membranes of gastric mucosa, showing a univocal anti-inflammatory effect.The activity of 5'-nucleotidase correlated with the changes in lipid composition and the fluidity of gastric mucosal plasma membranes.CONCLUSION: The beneficial action of mucilage seems correlated with stabilization of plasma membranes of damaged gastric mucosa. Molecular interactions between mucilage monosaccharides and membrane phospholipids,mainly PC and phosphatidylethanolamine (PE), may be the relevant features responsible for changing activities of membrane-attached proteins during the healing process after chronic gastric mucosal damage.

  2. Percutaneous Ultrasound-Guided Thrombin Injection in Iatrogenic Arterial Pseudoaneurysms: Effectiveness and Complications

    Koh, Young Hwan [Boramae Hospital, Seoul (Korea, Republic of); Kim, Hak Soo; Kim, Hyung Sik; Min, Seung Kee [Gachon Medical School, Incheon (Korea, Republic of)


    To evaluate and describe the efficacy and side effects of a percutaneous thrombin injection under ultrasonography guidance for the treatment of iatrogenic pseudo aneurysms Eighteen consecutive iatrogenic pseudo aneurysm cases were treated with a thrombin injection. The thrombin was injected into the pseudo aneurysm cavity using a 22-gauge needle under ultrasonographic guidance. The causes of the pseudo aneurysms are as follows: post coronary angiography (9 cases), percutaneous coronary balloon angioplasty (5 cases), cerebral angiography (1 case), transhepatic chemo embolization (1 case), percutaneous trans femoral arterial stent insertion (1 case) and bone marrow aspiration for a marrow transplant (1 case). Only one case required a secondary thrombin injection due to recurrent flow in the pseudo aneurysm lumen, which was detected at the follow up Doppler ultrasound. Other seventeen cases were successfully treated on the first trial. There were no technical failures or complication related to the procedure. The average amount of thrombin injected was 733 IU. Nine out of 18 treated patients (50%) showed mild reactions to the thrombin including mild fever (4 cases), chilling sensation (3 cases), a chilling sensation with mild dyspnea (1 case), mild chest discomfort (1 case) after the thrombin injection. All these side effects were transient and improved several hours later. All the iatrogenic pseudo aneurysms were treated successfully with an ultrasound-guided percutaneous thrombin injection. There was a high rate of hypersensitivity to the bovine thrombin, which precaution should be taken to prevent more serious side effects

  3. Virally mediated cervical cancer in the iatrogenically immunocompromised: applications for psychoneuroimmunology.

    Jensen, Sally E; Lehman, Brandy; Antoni, Michael H; Pereira, Deidre B


    Oncogenic or high-risk (HR) human papillomavirus (HPV) infection is implicated in the pathogenesis of a number of cancers, including cervical cancer. HPV infected individuals who are immunocompromised secondary to acquired (e.g., human immunodeficiency virus [HIV]) or iatrogenic (e.g., systemic lupus erythematosus [SLE] patients and organ and hematopoeitic stem cell transplant recipients undergoing immunosuppressive therapy) immune deficiency are particularly at risk for HPV-initiated cervical neoplasia and cancer. Psychoneuroimmunologic (PNI) research has demonstrated that psychosocial factors such as stress, pessimism, and sleep quality may play a role in the promotion of HPV-mediated cervical neoplasia in HIV-positive women. However, no research to our knowledge has examined PNI mechanisms of HPV-mediated cervical neoplasia and cancer in women who are undergoing iatrogenic immunosuppressive therapy for the treatment of autoimmune disease or the prevention of graft-rejection. This article reviews the PNI mechanisms that may underlie the promotion of HPV-mediated cervical neoplasia and applies this model to HPV-infected women who are iatrogenically immunosuppressed, an understudied population at-risk for cervical cancer. Female transplant recipients, one such group, may provide a unique paradigm in which to explore further PNI mechanisms of HPV-mediated cervical neoplasia.

  4. Novel oesophago-gastro-duodenal stenting for gastric leaks after laparoscopic sleeve gastrectomy.

    Liu, Shirley Yuk-Wah; Wong, Simon Kin-Hung; Ng, Enders Kwok-Wai


    The management of gastric leak after laparoscopic sleeve gastrectomy (LSG) can be complex and challenging. Whilst operative interventions are mostly complicated and reserved for unstable or refractory cases, endoscopic self-expandable metal stenting (SEMS) is increasingly preferred as a safer treatment option. Yet, SEMS carries the problems of frequent stent migration and inconsistent healing as ordinary SEMS is designed mainly for stenotic disease. We hereby present two cases of early and chronic post-LSG leakage that were respectively failed to be treated by surgery and ordinary SEMS but were successfully managed by a dedicated extra-long oesophago-gastro-duodenal stent. In oesophago-gastro-duodenal stenting, the characteristics of extra-long stent length allow total gastric exclusion between the mid-oesophagus and the first part of duodenum to prevent stent migration and to equalise high pressure gradient within the gastric sleeve to promote fistula healing.

  5. Helicobacter pyloriand gastric cancer


    May 12, 2009 ... This process may result in sloughing off of epithelial cells and compensatory cell ... Nardone G, Rocco A, Malfertheiner P. Review article: Helicobacter pylori and molecular events in precancerous gastric lesions. Aliment.

  6. Diet after gastric banding

    ... helps people who have a gastric band stay satisfied longer. This includes things like salad with grilled ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  7. Survey of Current Practices among Members of CAG in the Follow-Up of Patients Diagnosed with Gastric Ulcer

    Niall P Breslin


    Full Text Available INTRODUCTION: Guidelines recommend a policy of endoscopic follow-up of all gastric ulcers until healing. Analysis of data from the Alberta Endoscopy Project indicates that fewer than 50% of patients diagnosed with benign gastric ulcer had undergone a repeat procedure. The practice and attitudes of physician members of the Canadian Association of Gastroenterology (CAG on the follow-up of such patients were assessed.

  8. Gastric volvulus in childhood.

    Karande T


    Full Text Available Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.

  9. Endoscopic Submucosal Dissection (ESD) and Related Techniques as Precursors of "New Notes" Resection Methods for Gastric Neoplasms.

    Goto, Osamu; Takeuchi, Hiroya; Kitagawa, Yuko; Yahagi, Naohisa


    Endoscopic full-thickness resection for subepithelial tumors is one of the more attractive proposed methods for less-invasive transluminal surgery but remains challenging in terms of safety and feasibility. Currently, laparoscopic endoscopic cooperative surgery is thought to be a more clinically acceptable approach. In targeting cancers, however, more advanced nonexposure techniques are required to avoid the risk of iatrogenic tumor seeding. By combining these techniques with possible regional lymphadenectomy using sentinel node navigation surgery, an ideal minimally invasive, function-preserving gastric resection can be achieved even in possible node-positive cancers. Further development for this type of advanced endoscopic surgery is expected.

  10. CT of Gastric Emergencies.

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M


    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls.

  11. Familial Gastric Cancers

    Setia, Namrata; Clark, Jeffrey W.; Duda, Dan G.; Hong, Theodore S.; Kwak, Eunice L.; Mullen, John T.


    Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%–3% cases. Of these, hereditary diffuse gastric cancer is the most recognized predisposition syndrome. Although rare, the less commonly known syndromes also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes require a multidisciplinary effort involving oncologists, surgeons, genetic counselors, biologists, and pathologists. This article reviews the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. Implications for Practice: Although the majority of gastric adenocarcinomas are sporadic with many of those related to chronic Helicobacter pylori infection, approximately 10% of the cases show familial aggregation, and a specific hereditary cause is determined in 1%–3% cases. This review describes the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. Ultimately, a better understanding of the biology of these conditions should allow early identification and intervention as part of a multidisciplinary approach involving oncologists, surgeons, genetic counselors, and pathologists. PMID:26424758

  12. Applied Literature for Healing,

    Susanna Marie Anderson


    Full Text Available In this qualitative research study interviews conducted with elite participants serve to reveal the underlying elements that unite the richly diverse emerging field of Applied Literature. The basic interpretative qualitative method included a thematic analysis of data from the interviews yielding numerous common elements that were then distilled into key themes that elucidated the beneficial effects of engaging consciously with literature. These themes included developing a stronger sense of self in balance with an increasing connection with community; providing a safe container to engage challenging and potentially overwhelming issues from a stance of empowered action; and fostering a healing space for creativity. The findings provide grounds for uniting the work being done in a range of helping professions into a cohesive field of Applied Literature, which offers effective tools for healing, transformation and empowerment. Keywords: Applied Literature, Bibliotherapy, Poetry Therapy, Arts in Corrections, Arts in Medicine

  13. Self-healing polymers

    Klein, Daniel J. (Inventor)


    A three dimensional structure fabricated from a self-healing polymeric material, comprising poly(ester amides) obtained from ethylene glycol, azelaic acid and 1,1-aminoundecanoic acid, wherein polymeric material has a melt index above 2.5 g/10 min. as determined by ASTM D1238 at C. and 2.16kg, impact resistance and ductility sufficient to resist cracking and brittle fracture upon impact by a 9 mm bullet fired at a temperature of about C. at subsonic speed in a range from about 800 feet/sec to about 1000 feet/sec. It has been determined that the important factors necessary for self-healing behavior of polymers include sufficient impact strength, control of the degree of crystallinity, low melting point and the ability to instantly melt at impacted area.

  14. Are proton pump inhibitors the first choice for acute treatment of gastric ulcers? A meta analysis of randomized clinical trials

    Ward Alexandra


    Full Text Available Abstract Background Gastric ulcers are a frequent problem in the United States. Proton pump inhibitors have been shown to increase healing rates and improve clinical symptoms. The objective of this study is to compare gastric ulcer healing rates for patients treated with a proton pump inhibitor (PPI (omeprazole, rabeprazole, pantoprazole, or lansoprazole, an histamine 2- receptor antagonist (ranitidine or placebo. Methods A literature search was conducted to identify randomized, controlled clinical trials that included a PPI in at least one treatment arm and assessed the gastric ulcer healing rates endoscopically. The healing rates were estimated for each treatment at specific time points, and Rate Ratios (RR and 95% confidence intervals (CI were estimated for each trial. Results Sixteen trials met the inclusion criteria: four compared a PPI versus placebo, nine compared a PPI versus ranitidine (no trials of rabeprazole versus ranitidine met the inclusion criteria, and three compared a newer PPI (lansoprazole, pantoprazole or rabeprazole versus omeprazole. In relation to ranitidine, the pooled RR of PPIs (lansoprazole, omeprazole and pantoprazole was 1.33 (95% CI 1.24 to 1.42 at four weeks. In each trial, greater improvement in the studied clinical symptoms was found with the newer PPIs (rabeprazole, pantoprazole and lansoprazole when compared to omeprazole. Conclusion In this study treatment with PPIs resulted in higher healing rates than ranitidine or placebo. This evidence suggests that the first choice for gastric ulcer treatment for the greater relief of symptoms is one of the newer PPIs.

  15. Effects of administration of a proton pump inhibitor before endoscopic submucosal dissection for differentiated early gastric cancer with ulcer.

    Myung, Yu Sik; Hong, Su Jin; Han, Jae Pil; Park, Kyung Woo; Ko, Bong Min; Lee, Moon Sung


    In ulcerative early gastric cancer, improvement and exacerbation of ulceration repeat as a malignant cycle. Moreover, early gastric cancer combined with ulcer is associated with a low curative resection rate and high risk of adverse events. The aim of this study was to investigate the ulcer healing rate and clinical outcomes with the administration of a proton pump inhibitor before endoscopic submucosal dissection for differentiated early gastric cancer with ulcer. A total of 136 patients with differentiated early gastric cancer with ulcer who met the expanded indications for endoscopic submucosal dissection were reviewed between June 2005 and June 2014. Eighty-one patients were given PPI before endoscopic submucosal dissection and 55 patients were not given PPI. The complete ulcer healing rate was significantly different between the two groups (59.3 % vs. 23.6 %, P ulceration. The calculated accuracy for whether complete healing of the ulcer after PPI administration can differentiate mucosal from submucosal invasion was 75.3 %. Administration of PPI before ESD in differentiated EGC meeting the expanded criteria is effective to heal the ulcer lesion and reduce the mean procedure time. Complete healing of the ulcer after PPI administration suggests mucosal cancer.


    S. I. Artiukhova; T. T. Tolstoguzova


    Summary. The article presents data on the development of technology and qualitative research, bio-products «Healing-1». One of the promising directions in food biotechnology is the development of new integrated starter-based consortia of microorganisms, which have higher activity compared with cultures prepared using pure cultures. So it was interesting studies on the development of new biotechnology and bio-based microbial consortium of lactic acid bacteria. Based on the analysis of biotechn...

  17. Ganoderma lucidum Pharmacopuncture for the Treatment of Acute Gastric Ulcers in Rats

    Jae-Heung Park


    Full Text Available Objectives: The gastric ulcer is a common disorder of the stomach and duodenum. The basic physiopathology of a gastric ulcer results from an imbalance between some endogenous aggressive and cytoprotective factors. This study examined whether Ganoderma lucidum pharmacopuncture (GLP would provide protection against acute gastric ulcers in rats. Methods: Sprague-Dawley rats were divided randomly into 4 groups of 8 rats each: normal, control, normal saline (NP and GLP groups. The experimental acute gastric ulcer was induced by using an EtOH/HCl solution and the normal group received the same amount of normal saline instead of ethanol. The NP and the GLP groups were treated once with injections of saline and GLP, respectively. Two local acupoints were used: CV12 (中脘 which is the alarm point of the Stomach Meridian, and ST36 (足三里, which is the sea point of the Stomach Meridian. The stomachs from the rats in each group were collected and analyzed for gross appearance and histology. Also, immunohistochemistry staining for BAX, Bcl-2 and TGF-β1 was performed. Results: Histological observations of the gastric lesions in the control group showed comparatively extensive damage of the gastric mucosa and necrotic lesions had penetrated deeply into the mucosa. The lesions were long, hemorrhagic, and confined to the glandular portions. The lesions were measured microscopically by using the clear depth of penetration into the gastric mucosal surface. The length and the width of the ulcer were measured and the inhibition percentage was calculated. Wound healing of the acute gastric ulcer was promoted by using GLP, and significant alterations of indices in gastric mucosa were observed. Such protection was shown by gross appearance, histology and immunohistochemistry staining for BAX, Bcl-2 and TGF-β1. Conclusion: These results suggest that GLP administered at CV12 and ST36 can provide significant protection to the gastric mucosa against an ethanol

  18. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

    Abdulrahman Al-Hussaini


    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  19. Efficacy of omeprazole paste in the treatment and prevention of gastric ulcers in horses.

    Andrews, F M; Sifferman, R L; Bernard, W; Hughes, F E; Holste, J E; Daurio, C P; Alva, R; Cox, J L


    Equine gastric ulcer syndrome (EGUS) is very common among performance horses, with a reported prevalence of approximately 90% in racehorses, and also > 50% in foals. Omeprazole, an acid pump inhibitor 5 times more potent than ranitidine, has been used with great success to treat EGUS. This multicentre study of Thoroughbred racehorses with endoscopically verified gastric ulcers was designed to demonstrate the efficacy of an equine oral paste formulation of omeprazole in the treatment and prevention of recurrence of EGUS. Of the 100 horses entered into the study, 25 were sham-dosed for the full 58 days of the study. The remaining 75 horses all received omeprazole paste, 4 mg/kg bwt/day once daily for 28 days. At Day 28, 25 of treated horses continued on this dosing regimen while 25 received a half dose (2 mg/kg bwt once daily) and 25 horses were sham-dosed. By Day 28, gastric ulcers were completely healed in 77% of omeprazole-treated horses, while 92% were significantly (P < 0.01) improved. In contrast, 96% of the sham-dosed horses still had gastric ulcers at Day 28. The improvement was maintained in horses that continued on either a full dose or half dose of omeprazole paste until Day 58. However, in those horses that were removed from omeprazole treatment at Day 28, the incidence and severity of the gastric ulcers at the end of the study were similar to those horses that did not receive the omeprazole paste. This study demonstrates that omeprazole paste, 4 mg/kg bwt per os, once daily, is highly effective in healing gastric ulcers in Thoroughbred racehorses and that either a full dose or half dose of omeprazole paste effectively prevents the recurrence of EGUS. The study also indicates that gastric ulcers in untreated horses did not demonstrate a significant rate of spontaneous healing.

  20. Social facilitation of wound healing.

    Detillion, Courtney E; Craft, Tara K S; Glasper, Erica R; Prendergast, Brian J; DeVries, A Courtney


    It is well documented that psychological stress impairs wound healing in humans and rodents. However, most research effort into influences on wound healing has focused on factors that compromise, rather than promote, healing. In the present study, we determined if positive social interaction, which influences hypothalamic-pituitary-adrenal (HPA) axis activity in social rodents, promotes wound healing. Siberian hamsters received a cutaneous wound and then were exposed to immobilization stress. Stress increased cortisol concentrations and impaired wound healing in isolated, but not socially housed, hamsters. Removal of endogenous cortisol via adrenalectomy eliminated the effects of stress on wound healing in isolated hamsters. Treatment of isolated hamsters with oxytocin (OT), a hormone released during social contact and associated with social bonding, also blocked stress-induced increases in cortisol concentrations and facilitated wound healing. In contrast, treating socially housed hamsters with an OT antagonist delayed wound healing. Taken together, these data suggest that social interactions buffer against stress and promote wound healing through a mechanism that involves OT-induced suppression of the HPA axis. The data imply that social isolation impairs wound healing, whereas OT treatment may ameliorate some effects of social isolation on health.

  1. The Advantages of Traditional Chumash Healing

    James D. Adams


    Full Text Available Chumash healing has been practiced in California for ∼13 000 years. Chumash healers treat their patients with prayer, laughter, dreaming, phytotherapy, aromatherapy, healing ceremonies and other techniques. Healing involves first healing the spirit, then healing the body. Chumash people still maintain their unique identity. Chumash Healers still practice the ancient healing arts in California. This lecture is a brief introduction to Chumash Healing.

  2. Misdiagnosis and management of iatrogenic pseudoaneurysm of vertebral artery after Harms technique of C1-C2 fixation

    MIN Li; SONG Yue-ming; XIE Xiao-dong; WANG Chao-hua; LIU Li-min


    Harms technique of C1-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury (VAI) rate.But considering the unique and variable anatomy of atlantoaxial complex,iatrogenic VAI will result in catastrophic consequences and provides particular surgical challenges for surgeons.To our knowledge,comparing with iatrogenic VAI in the screw hole,iatrogenic VAI in the "open space" is much rarer during the Harms technique of C1-C2 fixation.In this article,we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C1-C2 fixation.This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compression was initially misdiagnosed as VAI by pedicle screw perforation.It can be concluded that intraoperative or postoperative computed angiography is very helpful to diagnose the exact site of VAI and the combination of endovascular coil occlusion as well as external local compression can further prevent bleeding and abnormal vertebral artery flow in the pseudoaneurysm.However,patients treated require further follow-up to confirm that there is no recurrence of the pseudoaneurysm.

  3. Gastric cancer: basic aspects.

    Resende, Carlos; Thiel, Alexandra; Machado, José C; Ristimäki, Ari


    Gastric cancer (GC) is a world health burden, ranging as the second cause of cancer death worldwide. Etiologically, GC arises not only from the combined effects of environmental factors and susceptible genetic variants but also from the accumulation of genetic and epigenetic alterations. In the last years, molecular oncobiology studies brought to light a number of genes that are implicated in gastric carcinogenesis. This review is intended to focus on the recently described basic aspects that play key roles in the process of gastric carcinogenesis. Genetic variants of the genes IL-10, IL-17, MUC1, MUC6, DNMT3B, SMAD4, and SERPINE1 have been reported to modify the risk of developing GC. Several genes have been newly associated with gastric carcinogenesis, both through oncogenic activation (GSK3β, CD133, DSC2, P-Cadherin, CDH17, CD168, CD44, metalloproteinases MMP7 and MMP11, and a subset of miRNAs) and through tumor suppressor gene inactivation mechanisms (TFF1, PDX1, BCL2L10, XRCC, psiTPTE-HERV, HAI-2, GRIK2, and RUNX3). It also addressed the role of the inflammatory mediator cyclooxygenase-2 (COX-2) in the process of gastric carcinogenesis and its importance as a potential molecular target for therapy.

  4. Therapeutic effect of low molecular weight chitosan containing sepia ink on ethanol-induced gastric ulcer in rats.

    Zhang, Wei; Liu, Kang; Li, Lei; Li, Yingxin; Sui, Xianxian; Rao, Yinzhu; Wu, Jiahao; Wu, Qiuping


    To evaluate the role of low molecular chitosan containing sepia ink (LMCS) in ethanol-induced (5 ml/kg) gastric ulcer in rats. Animals were divided into four groups (n = 12): normal group (Normal), negative control group (Con), experiment group (LMCS) and positive control Omeprazole group (OMZ). Gastric empty rate was detected in the first 7 days. Rats were sacrificed at 7, 14 and 21 day for histology and ELISA detections. Gastric empty was no significant differences among the groups (P > 0.05). Histological observation showed gastric mucosal LMCS treated had better healing effect. Hydroxyproline (Hyp) was significantly increased from 7 day (P gastric mucosa tissue repair, exert significant influences on oxidative and antioxidant enzyme activities and neutrophil infiltration.

  5. Fluticasone furoate induced iatrogenic Cushing syndrome in a pediatric patient receiving anti-retroviral therapy

    S A A van den Berg


    Full Text Available We present a case of iatrogenic Cushing’s syndrome, induced by treatment with fluticasone furoate (1–2 dd, 27.5 μg in each nostril in a pediatric patient treated for congenital HIV. The pediatric patient described in this case report is a young girl of African descent, treated for congenital HIV with a combination therapy of Lopinavir/Ritonavir (1 dd 320/80 mg, Lamivudine (1 dd 160 mg and Abacavir (1 dd 320 mg. Our pediatric patient presented with typical Cushingoid features (i.e. striae of the upper legs, full moon face, increased body and facial hair within weeks after starting fluticasone furoate therapy, which was exacerbated after increasing the dose to 2 dd because of complaints of unresolved rhinitis. Biochemical analysis fitted iatrogenic Cushing’s syndrome, with a repeatedly low cortisol (<0.03 μM, ref 0.14–0.60 μM and low ACTH (9 pg/mL, ref 9–52 pg/mL without signs of adrenal insufficiency. No other biochemical abnormalities that could point to adrenal or pituitary dysfunction were detected; electrolytes, thyroid and gonadal function, and IGF-1 were within the normal range. Pharmacogenetic analysis revealed that the pediatric patient carried the CYP3A4 *1B/*1G and CYP3A5 *3/*3 genotype (associated with a partial and complete loss of enzyme activity, respectively which is associated with the development of iatrogenic Cushing’s syndrome in patients treated for HIV due to the strong inhibition of CYP3 enzymes by Ritonavir. Upon discontinuation of fluticasone treatment, the pediatric patient improved both clinically and biochemically with normalisation of cortisol and ACTH within a couple of weeks.

  6. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    Goltz, J.P.; Kickuth, R. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik; Bastuerk, P.; Hoppe, H.; Triller, J. [Universitaetsspital Bern (Switzerland). Inst. fuer Diagnostische, Interventionelle und Paediatrische Radiologie


    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  7. Treatment Option Overview (Gastric Cancer)

    ... liver cancer . The following stages are used for gastric cancer: Stage 0 (Carcinoma in Situ) In stage 0 , abnormal cells are ... check-ups. Treatment Options by Stage Stage 0 (Carcinoma in ... Stage I Gastric Cancer Treatment of stage I gastric cancer may ...

  8. General Information about Gastric Cancer

    ... liver cancer . The following stages are used for gastric cancer: Stage 0 (Carcinoma in Situ) In stage 0 , abnormal cells are ... check-ups. Treatment Options by Stage Stage 0 (Carcinoma in ... Stage I Gastric Cancer Treatment of stage I gastric cancer may ...

  9. Iatrogenic central retinal artery occlusion after carotid body tumor embolization and excision

    Rangel, Carlos M.


    Full Text Available Objective: To report a case of iatrogenic central retinal artery occlusion after embolization and surgical resection of carotid body paraganglioma.Methods: Case report Results: One adult female patient presented with persistent unilateral visual loss after embolization with Embosphere and Contour microparticles of carotid body tumor. Fluorescein angiography revealed intraluminal microspheres in the central retinal artery ramifications. OCT revealed intraretinal spherical, hyporeflective particles with posterior shadowing. Conclusions: Central retinal artery occlusion should be assessed as a possible complication after surgical repair of head and neck paragangliomas.

  10. Neo-liberal Governing of “Radicals”: Danish Radicalization Prevention Policies and Potential Iatrogenic Effects

    Lasse Lindekilde


    Full Text Available The Danish government’s counter-radicalization Action Plan of 2009 had intended and unintended effects. Primarily targeting Danish Muslims, it employs neoliberal governmentality approaches of governance through individual support and response, information and knowledge, empowerment, surveillance and intervention, and anti-discrimination. It aims to prevent radicalization by transforming, shaping, and disciplining illiberal and violence-prone “radicals” into active, liberal citizens. Prolonged fieldwork and in-depth interviews with seventeen Muslims from a targeted milieu reveal skepticism about the effectiveness of the measures. Implementation of the action plan in practice may yield iatrogenic effects.

  11. Stent graft repair of iatrogenic femoral arteriovenous fistula: a useful therapeutic approach in a hostile groin.

    De Martino, Randall R; Nolan, Brian W; Powell, Richard J; Walsh, Daniel B; Stone, David H


    The incidence of iatrogenic femoral arteriovenous fistulas (IFAVF) has increased in contemporary practice. We herein report the case of a 55-year-old obese woman with significant surgical comorbidities who sustained an IFAVF between the superficial femoral artery (SFA) and the femoral vein. Given her substantial risk factors, she was treated with a SFA stent-graft (iCast 6 x 22 mm) using a contralateral endovascular approach. She remains asymptomatic at 15 months with ongoing resolution of the AVF. This report highlights the utility of stent-graft repair of an IFAVF in high surgical risk patients or in those with ''hostile'' anatomy.

  12. Combined endovascular intervention and percutaneous thrombin injection in the treatment of iatrogenic pseudoaneurysm. Case report.

    Gabriel, M; Juszkat, R; Pukacki, F; Waliszewski, K


    One of the basic techniques of treatment of iatrogenic pseudoaneurysms is percutaneous thrombin injection. Unfortunately, success rate of this treatment can be limited in cases associated with extensive damage to arterial wall. Our paper presents one case of combined treatment involving endovascular occlusion of the entry to the false aneurysm and percutaneous thrombin injection into the pseudoaneurysm chamber. In our opinion this technique can be successfully applied in patients with contraindications for compression therapy, surgical intervention or failure of traditional injection due to large entry, multiple arterial wall damage or accompanying arteriovenous fistula.

  13. Parathyroid hormone and bone healing

    Ellegaard, M; Jørgensen, N R; Schwarz, P


    , no pharmacological treatments are available. There is therefore an unmet need for medications that can stimulate bone healing. Parathyroid hormone (PTH) is the first bone anabolic drug approved for the treatment of osteoporosis, and intriguingly a number of animal studies suggest that PTH could be beneficial...... in the treatment of fractures and could thus be a potentially new treatment option for induction of fracture healing in humans. Furthermore, fractures in animals with experimental conditions of impaired healing such as aging, estrogen withdrawal, and malnutrition can heal in an expedited manner after PTH treatment...

  14. Music Healing Rituals in Thailand

    Bussakorn Binson


    Full Text Available This paper discusses the music healing rituals from North, Northeast and Southern Thailand. In general, these healing rituals bring together supportive elements from the family, the community and spiritual entities with the shaman as a conductor. Shaman utilizes music in corporate the community as a whole including elicits the support from the spiritual entitles. Traditional music healing process played the role as enticement to recruit spirits, distract the patients from experiencing unpleasant in their body. Even in today’s modern society these healing rituals have persisted, as they are inseparable from these regions’ animistic beliefs system.

  15. Innovation and wound healing.

    Harding, Keith


    Innovation in medicine requires unique partnerships between academic research, biotech or pharmaceutical companies, and health-care providers. While innovation in medicine has greatly increased over the past 100 years, innovation in wound care has been slow, despite the fact that chronic wounds are a global health challenge where there is a need for technical, process and social innovation. While novel partnerships between research and the health-care system have been created, we still have much to learn about wound care and the wound-healing processes.


    郭冬丽; 宁佩芳; 袁媛


    Objective: To study the dynamic change and its diagnostic significance of MG7 expression in the process of gastric cancer development. Methods: The expression level of antigen MG7 was determined by immunohistochemistry method in 406 cases of gastric mucosa. The classification of intestinal metaplasia of gastric mucosa was determined by histochemistry method in 82 cases. Results: The positive rate of MG7 expression in normal gastric mucosa, intestinal metaplasia and dysplasia of gastric mucosa and gastric cancer were increased gradually (P<0.01). The positive rate of MG7 expression in superficial gastritis, atrophic gastritis and gastric cancer were increased on sequence (P<0.01). The positive rate of antigen MG7 expression in type Ⅲ intestinal metaplasia of gastric mucosa had significant difference,compared with that in type Ⅰ an Ⅱ intestinal metaplasia (P<0.05). Conclusion: MG7 antigen had close relationship with gastric cancer. Type Ⅲ intestinal metaplasia, atrophic gastritis and dysplasia should be followed up in order to improve the early detection of gastric cancer. MG7 antigen had great clinical value in the dynamic follow-up of gastric precursors.

  17. Immunotherapy in gastric cancer.

    Matsueda, Satoko; Graham, David Y


    Gastric cancer is the second most common of cancer-related deaths worldwide. In the majority of cases gastric cancer is advanced at diagnosis and although medical and surgical treatments have improved, survival rates remain poor. Cancer immunotherapy has emerged as a powerful and promising clinical approach for treatment of cancer and has shown major success in breast cancer, prostate cancer and melanoma. Here, we provide an overview of concepts of modern cancer immunotherapy including the theory, current approaches, remaining hurdles to be overcome, and the future prospect of cancer immunotherapy in the treatment of gastric cancer. Adaptive cell therapies, cancer vaccines, gene therapies, monoclonal antibody therapies have all been used with some initial successes in gastric cancer. However, to date the results in gastric cancer have been disappointing as current approaches often do not stimulate immunity efficiently allowing tumors continue to grow despite the presence of a measurable immune response. Here, we discuss the identification of targets for immunotherapy and the role of biomarkers in prospectively identifying appropriate subjects or immunotherapy. We also discuss the molecular mechanisms by which tumor cells escape host immunosurveillance and produce an immunosuppressive tumor microenvironment. We show how advances have provided tools for overcoming the mechanisms of immunosuppression including the use of monoclonal antibodies to block negative regulators normally expressed on the surface of T cells which limit activation and proliferation of cytotoxic T cells. Immunotherapy has greatly improved and is becoming an important factor in such fields as medical care and welfare for human being. Progress has been rapid ensuring that the future of immunotherapy for gastric cancer is bright.

  18. Ganoderma Lucidum Pharmacopuncture for Teating Ethanol-induced Chronic Gastric Ulcers in Rats

    Jae-Heung Park


    Full Text Available Objectives: The stomach is a sensitive digestive organ that is susceptible to exogenous pathogens from the diet. In response to such pathogens, the stomach induces oxidative stress, which might be related to the development of both gastric organic disorders such as gastritis, gastric ulcers, and gastric cancer, and functional disorders such as functional dyspepsia. This study was accomplished to investigate the effect of Ganoderma lucidum pharmacopuncture (GLP on chronic gastric ulcers in rats. Methods: The rats were divided into 4 groups of 8 animals each: the normal, the control, the normal saline (NP and the GLP groups. In this study, the modified ethanol gastritis model was used. The rats were administrated 56% ethanol orally every other day. The dose of ethanol was 8 g/kg body weight. The normal group received the same amount of normal saline instead of ethanol. The NP and the GLP groups were treated with injection of saline and GLP respectively. The control group received no treatment. Two local acupoints CV12 (中脘 and ST36 (足三里 were used. All laboratory rats underwent treatment for 15 days. On last day, the rats were sacrificed and their stomachs were immediately excised. Results: Ulcers of the gastric mucosa appeared as elongated bands of hemorrhagic lesions parallel to the long axis of the stomach. In the NP and GLP groups, the injuries to the gastric mucosal injuries were not as severe as they were in the control group. Wound healings of the chronic gastric ulcers was promoted by using GLP and significant alterations of the indices in the gastric mucosa were observed. Such protection was demonstrated by gross appearance, histology and immunehistochemistry staining for Bcl-2-associated X (BAX, B-cell lymphoma 2 (Bcl-2 and Transforming growth factor-beta 1 (TGF-β1. Conclusion: These results suggest that GLP at CV12 and ST36 can provide significant protection to the gastric mucosa against an ethanol induced chronic gastric ulcer.

  19. Healing agent for self-healing cementious material

    Jonkers, H.M.


    The invention provides a process for the production of a cementious material. The process comprises mixing cement starting materials and a particulate healing agent to provide the cementious material. The healing agent comprises coated particles, wherein the coated particles comprise bacterial mater

  20. A prospective multicentre observational study of adverse iatrogenic events and substandard care preceding intensive care unit admission (PREVENT).

    Garry, D A; McKechnie, S R; Culliford, D J; Ezra, M; Garry, P S; Loveland, R C; Sharma, V V; Walden, A P; Keating, L M


    We examined the current incidence, type, severity and preventability of iatrogenic events associated with intensive care unit admission in five hospitals in England. All unplanned adult admissions to intensive care units were prospectively reviewed over a continuous six-week period. In the week before admission, 76/280 patients (27%) experienced 104 iatrogenic events. The majority of iatrogenic events were categorised as medical (37%), drug (17%) or nursing events (17%). Seventy-seven per cent of the events were considered preventable and 80% caused or contributed to admission. Eleven events were thought to have contributed to a patient's death. The mean (SD) age of patients who had an event was greater (63 (21) years) than those who had not (57 (19) years, p = 0.023), and they had a longer median (IQR [range]) intensive care stay, 4 (1-8 [0-29]) days vs 3 (1-5 [0-20]) days, respectively, p = 0.043.

  1. MYC and gastric adenocarcinoma carcinogenesis

    Danielle Queiroz Calcagno; Mariana Ferreira Leal; Paulo Pimentel Assumpcao; Marilia de Arruda Cardoso Smith; Rommel Rodriguez Burbano


    MYC is an oncogene involved in cell cycle regulation, cell growth arrest, cell adhesion, metabolism, ribosome biogenesis, protein synthesis, and mitochondrial function. It has been described as a key element of several carcinogenesis processes in humans. Many studies have shown an association between MYC deregulation and gastric cancer. MYC deregulation is also seen in gastric preneoplastic lesions and thus it may have a role in early gastric carcinogenesis. Several studies have suggested that amplification is the main mechanism of MYC deregulation in gastric cancer. In the present review, we focus on the deregulation of the MYC oncogene in gastric adenocarcinoma carcinogenesis, including its association with Helicobacter pylori (H pylori) and clinical applications.

  2. Precordial skin burns after endoscopic submucosal dissection for gastric tube cancer.

    Miyagi, Motoshi; Yoshio, Toshiyuki; Hirasawa, Toshiaki; Ishiyama, Akiyoshi; Yamamoto, Yorimasa; Tsuchida, Tomohiro; Fujisaki, Junko; Igarashi, Masahiro


    Endoscopic submucosal dissection (ESD) is useful as a minimally invasive treatment option for early gastric cancer. ESD is also used in the management of postoperative remnant gastric cancers in the stomach and gastric tube cancers. Perforation and delayed bleeding have been the main complications of ESD reported in the management of gastric tube cancer. However, in the current literature, there is no description of precordial skin burns caused by electrical coagulation. While we treated 22 patients with gastric tube cancers by ESD from 2005 to 2014, we experienced five skin burns in four patients after ESD. We retrospectively analyzed clinical characteristics of precordial skin burn as a complication of ESD. All skin burns occurred in patients reconstructed using a presternal route, whose incidence of precordial skin burn was 55.6%. In all cases, lesions were located in the upper or middle third of gastric tubes irrespective of their direction. Skin burn developed on postoperative day (POD) 1 or POD 2, taking 4-7 days to heal and was accompanied by high fever in 60% of cases. The present study suggests that when carrying out ESD for gastric tube cancer using the presternal route, it is necessary to consider the occurrence of a precordial skin burn as a possible complication. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  3. Humor's healing potential.

    Seaward, B L


    In the past three decades the medical world has begun to take more serious notice of the healing power of humor and the positive emotions associated with it. Humor and laughter are currently being employed by psychotherapists and other care givers as tools to promote and maintain health, as well as intervention and rehabilitation tools for a host of maladies and illnesses related to stress and life-style. Although this empirical medical approach is relatively new, the study of humor has revealed a complex psychological phenomenon. Senses of humor have been categorized in types associated with personality. Humor has many styles and can be found in almost any situation, on any occasion. Theories of humor include the superiority theory, the incongruity theory, the release/relief theory, and the divinity theory. Laughter has many clinical benefits, promoting beneficial physiological changes and an overall sense of well-being. Humor even has long-term effects that strengthen the effectiveness of the immune system. In healthcare, humor therapy can help relieve stress associated with disease and illness. It serves as a diversionary tactic, a therapeutic tool for disorders such as depression, and a coping mechanism. It also is a natural healing component for care givers trying to cope with the stress and personal demands of their occupations.


    N. Hamdulay*, Z. Attaurrahaman , V. Shende and M. Lawar


    Full Text Available Trichosanthes dioica Roxb (family: Cucurbitaceae, commonly known as “Sespadula” in English and “Parwal” in Hindi and is widely grown throughout India. The leaves of this plant have also been used in traditional system of medicine for overcoming problems like constipation, fever, skin infection, wound healing and also in gastric ulcer. In the present study Aqueous extract of leaves of Trichosanthes dioica Roxb was evaluated for its antiulcer activity against; 1 Aspirin plus pylorus ligation model and, 2 Ethanol/HCl-induced ulcer in wistar rats. Ranitidine (100 mg/kg was used as the standard drug. Different groups of rats (n=6 in each group were given two doses (250 and 500 mg/kg of T.dioica extract. Phytochemical analysis of the extract was also done. Phytochemical results revealed presence of tannins, saponins, triterpenoids, flavanoids. Thus only T.dioica extract (500 mg/kg significantly (p<0.001 reduced the ulcer index in all the models used. The extract also significantly (p<0.001 increased the pH of gastric acid while at the same time reduced the volume of gastric juice, free and total acidities. Also it showed significant (p<0.05 reduction in pepsin activity. In conclusion, the present study provides preliminary data on antiulcer potential of Trichosanthes dioica leaves and supports the traditional use of the plant for the treatment of gastric ulcer.

  5. Bio-sheet graft therapy for artificial gastric ulcer after endoscopic submucosal dissection: an animal feasibility study.

    Kwon, Chang-Il; Kim, Gwangil; Ko, Kwang Hyun; Jung, Yunho; Chung, Il-Kwun; Jeong, Seok; Lee, Don Haeng; Hong, Sung Pyo; Hahm, Ki Baik


    Various bio-sheet grafts have been attempted either to accelerate healing of artificial ulcers or to prevent adverse events after endoscopic submucosal dissection (ESD), but neither prospective nor mechanistic studies were available. To evaluate the substantial effect of a bio-sheet graft on artificial ulcer healing and its feasibility as an endoscopic treatment modality. Preclinical, in vivo animal experiment and proof-of-concept study. Animal laboratory. Three mini-pigs, Sus scrofa, mean age 14 months. Multiple ulcers sized 2.5 cm in diameter were generated by ESD in 3 mini-pigs and were assigned randomly into the following 3 groups; control group, bio-sheet group, or combination (bio-sheet plus drug) group. Bio-sheet grafts or bio-sheet plus drug combinations were applied on the artificial ulcers immediately after the ESD. Feasibility and efficacy of endoscopic bio-sheet graft therapy for the management of artificial ulcers and the evaluation of healing conditions based on histology changes in the remaining gastric bed tissues harvested from the stomachs. Thirty-three ESD specimens were obtained. On an image analysis of the ratio of healed area in the remaining gastric bed tissue compared with the matched dissected gastric mucosa, the control group showed the most significant improvement in healing activity among the 3 groups (P ulcer tissue was significantly attenuated in bio-sheet and combination groups (P gastric acid attack as reflected in the attenuated inflammation on the ulcer beds, unexpected delayed ulcer healing was noted in the bio-sheet graft group because of its physical hindrance of the healing process. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  6. Quality of life after iatrogenic bile duct injury: a case control study.

    Hogan, Aisling M


    OBJECTIVE: To compare quality of life (QOL) of patients following iatrogenic bile duct injuries (BDI) to matched controls. SUMMARY BACKGROUND DATA: BDI complicate approximately 0.3% of all cholecystectomy procedures. The literature regarding impact on quality of life is conflicted as assessment using clinical determinants alone is insufficient. METHODS: The medical outcomes study short form 36 (SF-36), a sensitive tool for quantification of life quality outcome, was used. The study group of iatrogenic BDI was compared with an age- and sex-matched group who underwent uncomplicated cholecystectomy. Telephone questionnaire using the SF-36 quality of life tool was administered to both groups at a median postoperative time of 12 years 8 months (range, 2 months -20 years). RESULTS: Seventy-eight patients were referred with BDI but due to mortality (n = 10) and unavailability (n = 6) 62 participated. The age- and sex-matched control cohort had undergone uncomplicated cholecystectomy (n = 62). Comparison between groups revealed that 7 of 8 variables examined were statistically similar to those of the control group (physical functioning, role physical, bodily pain, general health perceptions, vitality and social functioning, and mental health index). Mean role emotional scores were slightly worse in the BDI group (46 vs. 50) but the significance was borderline (P = 0.045). Subgroup analysis by method of intervention for BDI did not demonstrate significant differences. CONCLUSION: Quality of life of surviving patients following BDI compares favorably to that after uncomplicated laparoscopic cholecystectomy.

  7. Managing iatrogenic trigeminal nerve injury: a case series and review of the literature.

    Renton, T; Yilmaz, Z


    This study describes the management of 216 patients with post-traumatic iatrogenic lingual nerve injuries (LNIs; n=93) and inferior alveolar nerve injuries (IANI; n=123). At initial consultation, 6% IANI and 2% LNI patients had undergone significant resolution requiring no further reviews. Reassurance and counselling was adequate management for 51% IANI and 55% LNI patients. Systemic or topical medication was offered as pain relief to 5% of patients. Additional cognitive behaviour therapy (CBT) was offered to 8% of patients. Topical 5% lidocaine patches reduced pain and allodynia in 7% of IANI patients, most often used without any other form of management. A small percentage of IANI patients (4%) received a combination of therapies involving CBT, surgery, medication and 5% lidocaine patches. Exploratory surgery improved symptoms and reduced neuropathic area in 18 LNI and 15 IANI patients resulting in improved quality of life. In conclusion, the authors suggest a more diverse and perhaps holistic strategy for management of patients with iatrogenic trigeminal nerve injuries and recommend pragmatic assessment criteria for measurement of treatment success in these patients.

  8. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

    Murali Mothilal


    Full Text Available Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound. Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient. Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial. Keywords: Iatrogenic, ulnar nerve palsy

  9. Conventional mesh repair of a giant iatrogenic bilateral diaphragmatic hernia with an enterothorax

    Lingohr P


    Full Text Available Philipp Lingohr,1 Thomas Galetin,2 Boris Vestweber,2 Hanno Matthaei,1 Jörg C Kalff,1 Karl-Heinz Vestweber2 1Department of Surgery, University of Bonn, Bonn, Germany; 2Department of Surgery, Klinikum Leverkusen, Leverkusen, Germany Purpose: Diaphragmatic hernias (DHs are divided into congenital and acquired hernias, most of which are congenital. Among acquired DHs, up to 80% are left-sided, only a few iatrogenic DHs have been reported, and bilateral hernias are extremely rare. For diagnostic reasons, many DHs are overlooked by ultrasonography or X-ray and are only recognized at a later stage when complications occur. Methods: In 2009, we performed three partial diaphragm replacements in our clinic for repairing DHs using a PERMACOL™ implant. Results: As all patients had uneventful postoperative courses and the clinical outcomes were very good, we present one special case of a 65-year-old male with a giant iatrogenic bilateral DH with an enterothorax. Conclusion: We see a good indication for diaphragm replacements by using a PERMACOL™ implant for fixing especially DHs with huge hernial gaps and in cases with fragile tissue. Keywords: bilateral diaphragmatic hernia, enterothorax, conventional hernia repair, PERMACOL™, biological implant, diaphragm replacement, mesh repair

  10. Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

    Ozturk, Hakan; Karaaslan, Serap


    Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

  11. Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study.

    Linder, T; Mulazimoglu, S; El Hadi, T; Darrouzet, V; Ayache, D; Somers, T; Schmerber, S; Vincent, C; Mondain, M; Lescanne, E; Bonnard, D


    To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. Multicentre retrospective study in eight tertiary referral hospitals over 17 years. Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery. © 2016 John Wiley & Sons Ltd.

  12. Clinical Application of Six Current Classification Systems for Iatrogenic Bile Duct Injuries after Cholecystectomy.

    Velidedeoglu, Mehmet; Arikan, Akif Enes; Uludag, Sezgin Server; Olgun, Deniz Cebi; Kilic, Fahrettin; Kapan, Metin


    Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively. We described type of injury for each patient according to current six different classifications. 9 patients underwent definitive biliary reconstruction. Bismuth, Strasberg-Bismuth, Stewart-Way and Neuhaus classifications do not consider vascular involvement, Siewert system does, but only for the tangential lesions without structural loss of duct and lesion with a structural defect of hepatic or common bile duct. Siewert, Neuhaus and Stewart-Way systems do not discriminate between lesions at or above bifurcation of the hepatic duct. The Hannover classification may resolve the missing aspects of other systems by describing additional vascular involvement and location of the lesion at or above bifurcation.

  13. Iatrogenic facial nerve palsy "Prevention is better than cure": Analysis of four cases

    Rakesh Kumar


    Full Text Available Iatrogenic facial nerve palsy in mastoid surgery is considered a crime or a taboo in the present scenario of medical science. But one has to accept the fact that every otologist encounters this entity at some point in his/her career. Hence it is of prime importance to be equipped to detect and to manage these cases. The obvious and disfiguring facial deformity it causes makes this a dreaded complication. Our article here discusses our experience in managing four cases of iatrogenic facial palsy. The etiology in all the cases was mastoidectomy for cholesteatoma. The detection of the site and repair was performed by the same surgeon in all cases. The facial nerve was transected completely in three cases, and in one case there was partial loss (>50% of fibers. Cable nerve grafting was utilized in three patients. There was grade 4 improvement in three patients who underwent cable nerve grafting, and one patient had grade 2 recovery after end-to-end anastomosis. A good anatomical knowledge and experience with temporal bone dissection is of great importance in preventing facial nerve injury. If facial nerve injury is detected, it should be managed as early as possible. An end-to-end anastomosis provides better results in final recovery as opposed to cable nerve grafting for facial nerve repair.

  14. Iatrogenic bleb formation and hypotony maculopathy following pterygium surgery with Mitomycin-C

    Saeed Shokouhi-Rad


    Full Text Available Purpose: To report a case of late iatrogenic bleb formation and hypotony maculopathy after pterygium surgery applying Mitomycin C (MMC. Case Report: A 66-year-old man presented with an elevated, bleb-like, fluid-filled, cystic lesion on the nasal sclera of the right eye. The patient had undergone pterygium surgery with a combination of conjunctival autograft and adjuvant intraoperative MMC 0.02% four years before. The sclera seemed fistulized at the site of surgery and a thin layer of conjunctiva completely covered the lesion. A scleral patch graft was secured over the fistula with sutures, followed by excision of the thinned, avascular conjunctiva and advancement of the healthy adjacent conjunctiva to cover the patch graft. One month later, a small bleb re-appeared adjacent to the scleral patch graft and IOP was 2 mmHg. Argon-laser treatment of the bleb was tried to induce scarring and reduction of bleb size, and was highly effective. After one week, IOP was increased to 8 mmHg. The clinical features remained stable four months after initial presentation. Conclusion: Pterygium surgery using adjuvant MMC may result in late iatrogenic bleb formation and hypotony maculopathy. This complication can be successfully corrected surgically using a scleral patch graft combined with argon laser treatment over the inadvertent bleb.

  15. Management of a Small Paracentral Corneal Perforation Using Iatrogenic Iris Incarceration and Tissue Adhesive

    Akira Kobayashi


    Full Text Available Background: Surgical intervention for corneal perforation is indicated when the anterior chamber does not reform within a short period of time. Herein, we report the successful management of a small paracentral corneal perforation using autologous iris incarceration and tissue adhesive. Case: A 41-year-old man developed a small paracentral corneal perforation (0.5 mm in size in the right eye, while the treating physician attempted to remove the residual rust ring after removal of a piece of metallic foreign body. Observations: The eye was initially managed with a bandage soft contact lens to ameliorate the aqueous leakage; however, without success. Iatrogenic iris incarceration of the wound was first induced, followed by application of cyanoacrylate tissue adhesive to the perforated site. As a result, the anterior chamber was immediately reformed and maintained. Complete corneal epithelialization of the perforation was achieved in 2 months without visual compromises. Conclusions: Cyanoacrylate tissue adhesive with iatrogenic incarceration of the autologous iris was effective in treating this type of small corneal perforation. This technique is simple and potentially useful for small paracentral corneal perforations outside the visual axis and without good apposition.

  16. Iatrogenic anemia in intensive care unit%ICU医源性贫血

    许峰; 党红星


    ICU患者中不同程度的存在急慢性贫血,除自身原发病外,可因各种检查、治疗引起.针对医源性贫血的发生原因进行预防,加强管理,制定合理的输血方案,在保证患者必要检查治疗的基础上,最大限度地减少医源性贫血的发生,有助于改善预后.%Acute and chronic anemias are frequently seen in patients of ICU.Besides the underlying diseases,anemia can also be induced by the examination and treatment.In this paper,the reasons of iatrogenic anemia were analyzed.On the base of the essential diagnosis and treatment,it is helpful to improve the prognosis of ICU patients by strengthening the administration of blood collection.The risk of iatrogenic anemia could be minimized by making a reasonable project of blood transfusion.

  17. ‘Growing mushroom on the back’ following minimally invasive spine fixation: The theory of iatrogenic compartment syndrome revisited

    M.J. Asha, MSc, MRCS


    Full Text Available The authors report a case of lumbar para-spinal muscle herniation following percutaneous thoraco-lumbar pedicle screw fixation. This is suggested to be due to subclinical iatrogenic increase in the intra-compartmental pressure. The possibility of ‘Iatrogenic paraspinal compartment syndrome’ following minimally invasive spine techniques has been discussed previously by other authors. Nevertheless, no such case has been reported so far in the literature. The awareness of this potential complication might be helpful for spinal surgeons for early detection and management.

  18. Effects of corn oil on the volatile fatty acids in horses with induced gastric ulcers

    José Martínez A


    Full Text Available Objetive. To determine the influence of corn oil on the volatile fatty acids (VFA concentrations in the gastric juice in horses with phenylbutazone (PBZ induced gastric ulcers and Correlate the gastroscopic findings with the VFA concentrations. Materials and methods. 15 horses were allotted in 3 groups. Group I (control received placebo during first 6 days (induction period and was treated with sucralfate for 2 weeks (treatment period. Groups II and III received PBZ during the induction phase. After 6 days, horses from group II received 70 mL of corn oil /100 kg of body weight/ po, twice a day, for 2 weeks and horses from group III received 90 mL of corn oil/100 kg of body weight/ po, twice a day, for 2 weeks. All horses were examined by gastroscopy at days 0, 7 and 21. The lesions were recorded and classified according to the number and severity. Samples from gastric fluid were taken to measure the concentrations of the acetic, propionic, butyric and lactic acids. Results. Both PBZ protocols produced lesions in the both non-glandular and glandular areas of the stomach. All the treatments produced healing of the injured mucosa glandular. Neither of the two corn oil treatments affected healing of the gastric ulcers located in the non-glandular area. Conclusions. The concentrations of acetic and butyric acids were highest in the gastric juice. The corn oil and sucralfate did not lead to differences in the concentration of acetic acid and butyric acid.

  19. Our Pathway toward Healing Racism

    Honour, Robert


    In this article, Robert Honour, Training and Staff Development Manager, at the Fairfax, Virginia, Department of Family Services (DFS), reports on the outcome of "Healing Racism" training at his organization. Participants in "Healing Racism Institutes" are transforming relationships and creating an organizational culture that…

  20. Self-Healing Laminate System

    Beiermann, Brett A. (Inventor); Keller, Michael W. (Inventor); White, Scott R. (Inventor); Sottos, Nancy R. (Inventor)


    A laminate material may include a first flexible layer, and a self-healing composite layer in contact with the first flexible layer. The composite layer includes an elastomer matrix, a plurality of first capsules including a polymerizer, and a corresponding activator for the polymerizer. The laminate material may self-heal when subjected to a puncture or a tear.

  1. Clinical aspects of tendon healing

    J.C.H.M. van der Meulen (Jacques)


    textabstractWe know that healing of a tendon wound takes place by an invasion of fibreblasts from the surrounding tissues; the tendon itself has no intrinsic healing capacity. lt was Potenza (1962) who proved that a traumatic suture of the tendons within their sheath is followed by disintegration of

  2. Clinical aspects of tendon healing

    J.C.H.M. van der Meulen (Jacques)


    textabstractWe know that healing of a tendon wound takes place by an invasion of fibreblasts from the surrounding tissues; the tendon itself has no intrinsic healing capacity. lt was Potenza (1962) who proved that a traumatic suture of the tendons within their sheath is followed by disintegration of

  3. Cell therapy for wound healing.

    You, Hi-Jin; Han, Seung-Kyu


    In covering wounds, efforts should include utilization of the safest and least invasive methods with goals of achieving optimal functional and cosmetic outcome. The recent development of advanced wound healing technology has triggered the use of cells to improve wound healing conditions. The purpose of this review is to provide information on clinically available cell-based treatment options for healing of acute and chronic wounds. Compared with a variety of conventional methods, such as skin grafts and local flaps, the cell therapy technique is simple, less time-consuming, and reduces the surgical burden for patients in the repair of acute wounds. Cell therapy has also been developed for chronic wound healing. By transplanting cells with an excellent wound healing capacity profile to chronic wounds, in which wound healing cannot be achieved successfully, attempts are made to convert the wound bed into the environment where maximum wound healing can be achieved. Fibroblasts, keratinocytes, adipose-derived stromal vascular fraction cells, bone marrow stem cells, and platelets have been used for wound healing in clinical practice. Some formulations are commercially available. To establish the cell therapy as a standard treatment, however, further research is needed.

  4. Self-healing biomaterials(3)

    Brochu, Alice B. W.; Craig, Stephen L.; Reichert, William M.


    The goal of this review is to introduce the biomaterials community to the emerging field of self-healing materials, and also to suggest how one could utilize and modify self-healing approaches to develop new classes of biomaterials. A brief discussion of the in vivo mechanical loading and resultant failures experienced by biomedical implants is followed by presentation of the self-healing methods for combating mechanical failure. If conventional composite materials that retard failure may be considered zeroth generation self-healing materials, then taxonomically-speaking, first generation self-healing materials describe approaches that “halt” and “fill” damage, whereas second generation self-healing materials strive to “fully restore” the pre-failed material structure. In spite of limited commercial use to date, primarily because the technical details have not been suitably optimized, it is likely from a practical standpoint that first generation approaches will be the first to be employed commercially, whereas second generation approaches may take longer to implement. For self-healing biomaterials the optimization of technical considerations is further compounded by the additional constraints of toxicity and biocompatibility, necessitating inclusion of separate discussions of design criteria for self-healing biomaterials. PMID:21171168

  5. Effects of gastric pacing on gastric emptying and plasma motilin

    Min Yang; Dian-Chun Fang; Qian-Wei Li; Nian-Xu Sun; Qing-Lin Long; Jian-Feng Sui; Lu Gan


    AIM: To invertigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level.METHODS: Ten healthy Mongrel dogs were divided into:experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope-99m Tc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs.RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35±2.99 min to 79.42±l.91 min (P<0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64,94±l.75 min (P<0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCⅢ (interdigertive myoelectrical complex, IMCⅢ) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29±9.81 pg/ml vs 242.09±17,22 pg/ml; P<0.01). But plasma motilin concentration (212.55±11.20 pg/ml; P<0.02) was decreased significantly after a long-term treatment with gastric pacing.Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r=0.867, P<0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r=-0.733, P<0,04).CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying

  6. Lesão iatrogênica de vias biliares Iatrogenic bile duct injuries

    Guilherme Brasileiro de Aguiar


    Full Text Available OBJETIVO: O objetivo do presente estudo foi avaliar os casos de lesões iatrogênicas de vias biliares tratados na clínica cirúrgica do Hospital Getúlio Vargas - HGV nos últimos oito anos. MÉTODO: Foi realizada análise retrospectiva dos prontuários dos pacientes internados no HGV, com hipótese diagnóstica de lesão iatrogênica de vias biliares. Foram incluídos pacientes com lesões provenientes do próprio serviço e de outras instituições. Os prontuários foram revisados e obtidas as seguintes variáveis: procedência do paciente, idade, sexo, data da cirurgia inicial, sintomas, tempo de evolução, valores da bilirrubina, fosfatase alcalina, AST e ALT, TAP, creatinina, além da cirurgia realizada para correção da lesão, complicações, permanência hospitalar e condições do paciente na alta hospitalar. RESULTADOS: Foram confirmados 10 casos de lesão iatrogênica de vias biliares. Todos os paciente eram do sexo feminino, com idades variando entre 18 e 49 anos. Os sinais ou sintomas mais freqüentes foram icterícia, colúria e dor abdominal. Em relação à terapêutica cirúrgica, a hepático-jejunostomia em "Y" de Roux foi o procedimento mais empregado. CONCLUSÕES: As lesões iatrogênicas das vias biliares ainda representam um desafio para os cirurgiões e sua ocorrência está mais relacionada a procedimentos realizados em hospitais não especializados, por cirurgiões sem treinamento adequado. A principal medida a ser adotada é a prevenção da lesão. Após sua ocorrência, esta deve ser corrigida em hospitais com equipe médica treinada.BACKGROUND: The objective of this study was to evaluate the cases of iatrogenic lesions of the biliary tract treated in the surgical clinic at Getulio Vargas Hospital - GVH during the last eight years. METHODS: A retrospective analysis of the patients' charts admitted with the diagnosis of iatrogenic lesions of the biliary tract was performed. Patients with iatrogenic lesions

  7. In vivo wound healing and antiulcer properties of white sweet potato (Ipomoea batatas

    Daniele Hermes


    Full Text Available The potential of tuber flour of Ipomoea batatas (L. Lam. cv. Brazlândia Branca (white sweet potato as wound healing and antiulcerogenic agent was investigated in vivo in animal model. Excision on the back of Wistar rats was performed to induce wounds that were topically treated with Beeler’s base containing tuber flour of white sweet potato at 2.5%. Number of cells undergoing metaphase and the degree of tissue re-epithelialization were investigated 4, 7 and 10 days post-treatment. The protective effect of aqueous suspension of tuber flour (75 and 100 mg/kg animal weight on gastric mucosa of Wistar rats was also studied by using the ethanol-induced ulceration model. Ointment based on white sweet potato at 2.5% effectively triggered the healing of cutaneous wound as attested by the increased number of cells undergoing metaphase and tissue re-epithelialization regardless the time of wound treatment. Tuber flour potentially prevented ethanol-induced gastric ulceration by suppressing edema formation and partly protecting gastric mucosa wrinkles. Crude extracts also exhibited potential as free radical scavengers. The results from animal model experiments indicate the potential of tuber flour of white sweet potato to heal wounds.

  8. Gastric and non-gastric signals in electrogastrography.

    Kaiho, T; Shimoyama, I; Nakajima, Y; Ochiai, T


    Electrogastrography (EGG) is the cutaneous recording of gastric myoelectrical activity, and the dominant frequency reflects the rhythm of the gastric slow wave. Ambulatory EGG is contaminated with a large amount of motion artifacts, and it is unclear how much of the signals comprising the dominant frequency originates from non-gastric sources. The aim of the present study was to evaluate the pattern of gastric and non-gastric signals in the dominant frequency histogram (DFH) obtained from long-term ambulatory EGG recordings. Ten normal controls and five post-gastrectomy patients participated in the present study. Twenty-four hour ambulatory EGG was recorded under normal daily conditions. The DFH of normal controls showed two distinctive peaks, and that of the post-gastrectomy patients, a single peak. The common peak at approximately 1.5 cpm was seen in both DFHs, and the peak at 3 cpm was seen only in the DFH of normal controls. Thus, the common peak was thought to be a product of non-gastric origin. In conclusion, the dominant frequency consists of gastric and non-gastric components which have a specific distribution pattern in the DFH. These findings quantified the contribution of gastric and non-gastric signals to the dominant frequencies in long-term ambulatory EGG.

  9. Gastric Calcifying Fibrous Tumour

    Tan Attila


    Full Text Available Intramucosal gastric tumours are most commonly found to be gastrointestinal stromal tumours or leiomyomas (smooth muscle tumours; however, a variety of other uncommon mesenchymal tumours can occur in the stomach wall. A rare benign calcifying fibrous tumour is reported and the endoscopic appearance, ultrasound findings and morphology are documented. A review of the literature found only two similar cases.

  10. Folk Medicine, Folk Healing

    Mustafa SEVER


    Full Text Available Folk medicine and folk healing may be defined codified, regulated, taught openly and practised widely, and benefit from thousands of years of experience. On the other hand, it may be highly secretive, mystical and extremely localized, with knowledge of its practices passed on orally. Folk medicine and traditional medical practices emerged as a result of the reactions of primitive men against natural events and their ways of comparing and exchanging the medical practices of relevant communities with their own practices. Magic played an important role in shaping the practices. Folk medicine is the solutions developed by societies against material and moral disorders starting from the mythic period until today. Folk healer, on the other hand, is the wisest and the most respectable person in the society, in terms of materiality and morale. This person has the power of identifying and curing the diseases, disorders, consequently the origin of these diseases and disorders, and the skill of using various drugs for the treatment of the diseases and disorders or applying the practices with the help of information and practices acquired from the tradition. The Turks having rich and deep rooted culture. The Turkısh folk medicine and folk healing that contain rich cultural structure in themselves survive until today by being fed by different sources. Before Islam, the Turks used to believe that there were white and black possessors, ancestors’ spirits (arvaks and their healthy and peaceful life depended on getting on with these spirits. They also believed that diseases were caused when they could no more keep in with possessors and spirits, or when they offended and annoyed them. In such an environment of belief, the visible diseases caused by material reasons were generally cured with products obtained from plants, mines and animals in the region or drugs that were made out of their combinations. On the other hand, in invisible diseases associated with

  11. Synthetic Self-Healing Methods

    Bello, Mollie [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    Given enough time, pressure, temperature fluctuation, and stress any material will fail. Currently, synthesized materials make up a large part of our everyday lives, and are used in a number of important applications such as; space travel, under water devices, precise instrumentation, transportation, and infrastructure. Structural failure of these material scan lead to expensive and dangerous consequences. In an attempt to prolong the life spans of specific materials and reduce efforts put into repairing them, biologically inspired, self-healing systems have been extensively investigated. The current review explores recent advances in three methods of synthesized self-healing: capsule based, vascular, and intrinsic. Ideally, self-healing materials require no human intervention to promote healing, are capable of surviving all the steps of polymer processing, and heal the same location repeatedly. Only the vascular method holds up to all of these idealities.

  12. The Flexibility Hypothesis of Healing.

    Hinton, Devon E; Kirmayer, Laurence J


    Theories of healing have attempted to identify general mechanisms that may work across different modalities. These include altering expectations, remoralization, and instilling hope. In this paper, we argue that many forms of healing and psychotherapy may work by inducing positive psychological states marked by flexibility or an enhanced ability to shift cognitive sets. Healing practices may induce these states of cognitive and emotional flexibility through specific symbolic interventions we term "flexibility primers" that can include images, metaphors, music, and other media. The flexibility hypothesis suggests that cognitive and emotional flexibility is represented, elicited, and enacted through multiple modalities in healing rituals. Identifying psychological processes and cultural forms that evoke and support cognitive and emotional flexibility provides a way to understand the cultural specificity and potential efficacy of particular healing practices and can guide the design of interventions that promote resilience and well-being.

  13. Self-healing composites: A review

    Wang, Yongjing; Pham, Duc Truong; Ji, Chunqian


    Self-healing composites are composite materials capable of automatic recovery when damaged. They are inspired by biological systems such as the human skin which are naturally able to heal themselves. This paper reviews work on self-healing composites with a focus on capsule-based and vascular healing systems. Complementing previous survey articles, the paper provides an updated overview of the various self-healing concepts proposed over the past 15 years, and a comparative analysis of healing...

  14. Self-healing composites: A review

    Yongjing Wang; Duc Truong Pham; Chunqian Ji


    Self-healing composites are composite materials capable of automatic recovery when damaged. They are inspired by biological systems such as the human skin which are naturally able to heal themselves. This paper reviews work on self-healing composites with a focus on capsule-based and vascular healing systems. Complementing previous survey articles, the paper provides an updated overview of the various self-healing concepts proposed over the past 15 years, and a comparative analysis of healing...

  15. Murine models of human wound healing.

    Chen, Jerry S; Longaker, Michael T; Gurtner, Geoffrey C


    In vivo wound healing experiments remain the most predictive models for studying human wound healing, allowing an accurate representation of the complete wound healing environment including various cell types, environmental cues, and paracrine interactions. Small animals are economical, easy to maintain, and allow researchers to take advantage of the numerous transgenic strains that have been developed to investigate the specific mechanisms involved in wound healing and regeneration. Here we describe three reproducible murine wound healing models that recapitulate the human wound healing process.

  16. Unveiling Cebuano Traditional Healing Practices

    ZachiaRaiza Joy S. Berdon


    Full Text Available This study aims to identify the features of Cebuano’s traditional healing practices. Specifically, it also answers the following objectives: analyze traditional healing in Cebuano’s perspectives, explain the traditional healing process practiced in terms of the traditional healers’ belief, and extrapolate perceptions of medical practitioners toward traditional healing. This study made use of qualitative approach, among five traditional healers who performed healing for not less than ten years, in the mountain barangays of Cebu City. These healers served as the primary informants who were selected because of their popularity in healing. The use of open-ended interview in local dialect and naturalistic observation provided a free listing of their verbatim accounts were noted and as primary narratives. Participation in the study was voluntary and participants were interviewed privately after obtaining their consent. The Cebuano traditional healing practices or “panambal” comprise the use of “himolso” (pulse-checking, “palakaw” (petition, “pasubay” (determining what causes the sickness and its possible means of healing, “pangalap” (searching of medicinal plants for “palina” (fumigation, “tayhop” (gentle-blowing, “tutho” (saliva-blowing,“tuob” (boiling, “orasyon” (mystical prayers, “hilot” (massage, and “barang” (sorcery. Though traditional with medical science disapproval, it contributes to a mystical identity of Cebuano healers, as a manifestation of folk Catholicism belief, in order to do a good legacy to the community that needs help. For further study, researchers may conduct further the studies on the: curative effects of medicinal plants in Cebu, psychological effect pulsechecking healed persons by the mananambal, and unmasking the other features of traditional healing.

  17. Reversing gastric mucosal alterations during ethanol-induced chronic gastritis in rats by oral administration of Opuntia ficus-indica mucilage

    Vázquez-Ramírez, Ricardo; Olguín-Martínez, Marisela; Kubli-Garfias, Carlos; Hernández-Muñoz, Rolando


    AIM: To study the effect of mucilage obtained from cladodes of Opuntia ficus-indica (Cactaceae) on the healing of ethanol-induced gastritis in rats. METHODS: Chronic gastric mucosa injury was treated with mucilage (5 mg/kg per day) after it was induced by ethanol. Lipid composition, activity of 5’-nucleotidase (a membrane-associated ectoenzyme) and cytosolic activities of lactate and alcohol dehydrogenases in the plasma membrane of gastric mucosa were determined. Histological studies of gastric samples from the experimental groups were included. RESULTS: Ethanol elicited the histological profile of gastritis characterized by loss of the surface epithelium and infiltration of polymorphonuclear leukocytes. Phosphatidylcholine (PC) decreased and cholesterol content increased in plasma membranes of the gastric mucosa. In addition, cytosolic activity increased while the activity of alcohol dehydrogenases decreased. The administration of mucilage promptly corrected these enzymatic changes. In fact, mucilage readily accelerated restoration of the ethanol-induced histological alterations and the disturbances in plasma membranes of gastric mucosa, showing a univocal anti-inflammatory effect. The activity of 5’-nucleotidase correlated with the changes in lipid composition and the fluidity of gastric mucosal plasma membranes. CONCLUSION: The beneficial action of mucilage seems correlated with stabilization of plasma membranes of damaged gastric mucosa. Molecular interactions between mucilage monosaccharides and membrane phospholipids, mainly PC and phosphatidylethanolamine (PE), may be the relevant features responsible for changing activities of membrane-attached proteins during the healing process after chronic gastric mucosal damage. PMID:16865772



    Objective To observe the expression and distribution of myofibroblasts in the healing process of bile duct and discuss its function and significance in the process of iatrogenic biliary stricture formation. Methods A model of trauma-repair of bile duct in the dog was made . The anastomosis tissues on week 1,3 and month 3,6 after operation were studied with TEM and immunohistochemical SP staining of SMA. Results Myofibroblasts functioned actively and lasted for the whole process, extracellular matrix overdeposited. SMA staining was observed in myofibroblasts and highly expressed from 1 week to 6 months after operation. The consequence easily leaded to scar contracture and anastomoctic stenosis. Conclusion Myofibroblast is the main cause of scar contracture of bile duct.

  19. Wound healing and the effect of pineal gland and melatonin

    Jacek Drobnik


    Full Text Available Wound healing is a complex phenomenon that is controlled by local and general regulatory mechanisms. The aim of the paper is to analyze recently-published data devoted to the regulation of wound repair by melatonin. The effect of melatonin has been reported in different wound types healed with various mechanisms. The action of the pineal indoleamine is dependent on the used dose, time of application and target organ. Moreover, melatonin influences different phases of wound repair such as inflammation, by regulating the release of inflammatory mediators, cell proliferation and migration, by influencing angiogenesis, and the proliferation of fibroblasts, as well as the synthesis phase, by regulating collagen and glycosaminoglycan accumulation in the wounded milieu. Thus, healing of the skin wound, myocardial infarction, bone fractures and gastric ulcer is influenced by melatonin. In patients with low levels of melatonin (elderly or β-blocker treated patients, its regulatory effects are expected to be impaired. Thus, the need for melatonin supplementation in those patients is postulated in the study. [J Exp Integr Med 2012; 2(1.000: 3-14

  20. Incidence and management of bleeding complications after gastric bypass surgery in the morbidly obese.

    Heneghan, Helen M; Meron-Eldar, Shai; Yenumula, Panduranga; Rogula, Tomasz; Brethauer, Stacy A; Schauer, Philip R


    Bleeding after gastric bypass can be a life-threatening event and challenging to manage. With an increase in the number of bariatric procedures performed in recent years, it is important to be cognizant of the frequency, presentation, and management of this complication. The purpose of the present study was to evaluate the incidence and management of bleeding complications after gastric bypass surgery. A review of prospectively maintained bariatric surgery databases was conducted at 2 tertiary bariatric units. All patients who presented with gastrointestinal and intra-abdominal bleeding after gastric bypass during a 10-year period were identified, and their charts were reviewed. A total of 4466 patients who underwent gastric bypass during the 10-year period had reliable morbidity data available and were included in the present study. Of the 4466 patients, 42 (.94%) experienced a bleeding complication postoperatively. Of these patients, 20 (47.6%) had undergone previous abdominal surgery. Bleeding occurred in the early postoperative period (bleeding from the staple lines, iatrogenic visceral injury, or mesenteric vessel bleeding. Early postoperative bleeding required operative intervention to achieve hemostasis in 43%. Late postoperative bleeding (n = 12) were usually secondary to marginal ulceration and warranted surgical intervention in 33.3%. Previously undiagnosed bleeding diatheses were identified in 14.3%. Gastrointestinal bleeding after gastric bypass, although infrequent, is a difficult clinical scenario. Nonoperative management is feasible for hemodynamically stable patients. Surgical intervention is merited for patients with hemodynamic compromise, those who do not respond to transfusion, and those in whom the bleeding source cannot be adequately identified nonoperatively. Copyright © 2012 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Effects of celecoxib on acid-challenged gastric mucosa of rats: comparison with metamizol and piroxicam.

    Berenguer, Bettina; Alarcón De La Lastra, Catalina; Motilva, Virginia; La Casa, Carmen; Herrerias, Juan Manuel; Pozo, David; Calero, María José Martin


    Selective COX-2 inhibitors have been shown to produce fewer gastrointestinal adverse reactions than classical NSAIDs. Nevertheless, these new agents may worsen and delay the healing of experimentally induced gastric ulcers in animals. In this study, we compared the effects of a selective COX-2 inhibitor (celecoxib), a preferential COX-1 inhibitor (piroxicam), and a nonnarcotic analgesic (metamizol) on normal gastric mucosa of rats and, on the other hand, in a setting of preexisting acute gastric lesions induced by 0.6 N hydrochloric acid. Under normal conditions, only piroxicam produced appreciable gastric lesions. However, after acid challenge the three assayed drugs induced significant macroscopic and microscopic damage. Myeloperoxidase activity as an index of neutrophil infiltration was elevated with celecoxib and piroxicam on normal gastric mucosa. On inflamed mucosa, celecoxib augmented enzymatic activity at the lower dose, which was parallelled by an increase in the interleukin 1beta level. Acid instillaton produced a significant rise in PGE2 content at 7 hr. Drug treatment after acid challenge decreased prostaglandin values in all cases, although to a lesser extent than after single drug dose administration. COX-2 mRNA expression was visible 1 hr after acid application, whereas COX-2 protein could only be detected at 7 hr. Piroxicam increased both expression levels. All NSAIDs enhanced transforming growth factor alpha and epidermal growth factor receptor immunoreactivity around the acid-induced lesions. It is concluded that selective COX-2 inhibitors, like conventional NSAIDs, impair the healing of gastric damage, and therefore special attention should be paid in patients with gastric pathologies.

  2. Protective effect ofLuffa acutangula extracts on gastric ulceration in NIDDM rats:Role of gastric mucosal glycoproteins and antioxidants

    B P Pimple; P V Kadam; M J Patil


    Objective:To study the comparative gastroprotective effect ofLuffa acutangula methanolic extract(LAM) and aqueous extract(LAW) on typeII diabetes rats.Methods:Streptozotocin(65 mg/kg,i.p.) along with nicotinamide(120 mg/kg,i.p.) was used to induce non insulin dependent diabetes mellitus(NIDDM) in rats.A daily oral dose of aspirin(200 mg/kg,i.p.) was administered for initial seven days to induce gastric ulcerations in the diabetic rats.LAM andLAW were administered orally in the doses of100,200 and400 mg/kg once daily for21 days.Glibenclamide and ranitidine were used as standards for comparing the antidiabetic and antiulcer effect respectively.Results:LAM significantly(P<0.01) increased mucosal glycoprotein and antioxidant enzyme level in gastric mucosa of diabetic rats thanLAW(P <0.05).LAM was efficient inreversing the delayed healing of gastric ulcer in diabetic rats close to the normal level.LAM exhibited better ulcer healing effect than glibenclamide andLAW, because of its both antihyperglycemic and mucosal defensive actions.Conclusions:Thus,LAM is proved to be a better alternative for treating gastric ulcers co-occurring with diabetes.

  3. Ulcer healing properties of different extracts of Origanum majorana in streptozotocin-nicotinamide induced diabetic rats

    BP Pimple


    Full Text Available Objective: The aim of the present investigation was to evaluate the ulcer healing properties of different extracts of Origannum majorana, viz., hydrodistilled volatile oil (OMO, methanolic (OMM and aqueous extract (OMW in streptozotocin-nicotinamide induced diabetic rats. Methods: All the extracts were administered in different doses (100, 200 and 400 mg/kg, p.o. to investigate the ulcer healing potential. Streptozotocin (STZ; 65 mg/kg, i.p. along with nicotinamide (120 mg/kg, i.p. was used to induce non-insulin dependent diabetes mellitus in rats. Aspirin (200 mg/kg, i.p. was administered for initial 7 d to induce gastric ulcerations in the diabetic rats. Various biochemical markers of blood and tissue origin were estimated to compare the ulcer healing potential of these extracts. Results: The OMO and OMM exhibited dose dependent significant (P<0.01 ulcer healing property than the OMW. Additionally, the antidiabetic property of OMO and OMM was better than OMW. Conclusions: The OMO and OMM of Origanum majorana leaves can prove to be beneficial in the concomitant treatment of gastric ulcers and diabetes.

  4. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit


    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  5. 医源性气胸28例临床分析%The prevention of iatrogenic pneumothorax



    Objective To investigate the reasons and preventive measures of iatrogenic pneumothorax. Methods Retrospective analysis was done in 28 cases suffering from iatrogenic pneumothorax diagnosed from October 1998 to December 2008. Results The reasons of iatrogenic pneumothorax were various, but mainly related to improper operation. Conclusion Rigorous and normative operations and timely treatments are critical to prevent the iatrogenic pneumothorax.%目的 探讨医源性气胸的发生原因及预防措施.方法 对1998年10月至2008年12月我院诊治的28例医源性气胸患者进行回顾性分析.结果 医源性气胸的发生原因较多,但主要与医务人员操作不当有关.结论 严谨规范的操作技巧和恰当及时的处置是预防医源性气胸的关键.

  6. Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital.

    Thomas, Arun Z


    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  7. Genetics Home Reference: hereditary diffuse gastric cancer

    ... Health Conditions hereditary diffuse gastric cancer hereditary diffuse gastric cancer Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Hereditary diffuse gastric cancer (HDGC) is an inherited disorder that greatly increases ...

  8. Oral administration of synthetic human urogastrone promotes healing of chronic duodenal ulcers in rats

    Poulsen, Steen Seier; Nexø, Ebba


    effective than cimetidine alone. These results show that a combination of an agent inhibiting gastric acid secretion and the cytoprotective and growth-stimulating peptide EGF/URO seems to be more effective with regard to duodenal ulcer healing than individual administration of the two substances. Synthetic......The effect of oral administration of synthetic human epidermal growth factor/urogastrone (EGF/URO) on healing of chronic duodenal ulcers induced by cysteamine in rats was investigated and compared with that of cimetidine, a H2-receptor antagonist. After 25 and 50 days of treatment, synthetic human...... EGF/URO significantly increased healing of chronic duodenal ulcers to the same extent as cimetidine. Combined treatment with synthetic human EGF/URO and cimetidine for 25 days was more effective than synthetic human EGF/URO given alone, whereas combined treatment for 50 days was significantly more...

  9. Interior design and healing architecture

    Mogensen, Jeppe; Poulsen, Søren Bolvig; Hansen, Allan Grutt


    Hospital design is today influenced by the design concept healing architecture, stating that the patients’ healing process is promoted through accommodating physical surroundings. However, despite the increasing amount of research in the field of healing architecture, research on interior design....... Through a mixed-method study, 43 patients from the outpatient-lung department at Hospital Vendsyssel, Denmark were presented with different types of furniture and materials and were asked about their preferences. Additional questions on their experience of the hospital interior were asked to guide...

  10. Progress in corneal wound healing.

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh


    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  11. Progress in corneal wound healing

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh


    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  12. Gene therapy for gastric diseases.

    Fumoto, Shintaro; Nishi, Junya; Nakamura, Junzo; Nishida, Koyo


    Gene therapy for gastric cancer and gastric ulcer is a rationalized strategy since various genes correlate with these diseases. Since gene expressions in non-target tissues/cells cause side effects, a selective gene delivery system targeted to the stomach and/or cancer must be developed. The route of vector transfer (direct injection, systemic, intraperitoneal, gastric serosal surface and oral administration) is an important issue which can determine efficacy and safety. Strategies for cancer...

  13. Epidemiological characteristics of gastric cancer

    Šipetić Sandra B.; Tomić-Kundaković Slađana; Vlajinac Hristina D.; Maksimović Nataša; Knežević Anita; Kisić Darija


    Introduction. Gastric cancer was the third most common cancer worldwide in 2000, accounting for approximately 876 000 new cases or 9% of the global cancer burden. Epidemiological characteristics As a result of changes in diet, the incidence of gastric cancer has decreased in most countries. Now days, consumption of fresh vegetables and fruits is increasing in regard to canned food. In addition to unhealthy diet, the main risk factors for gastric cancer are H. pylori infection, alcohol consump...

  14. Hereditary diffuse gastric cancer

    van der Post, Rachel S; Vogelaar, Ingrid P; Carneiro, Fátima


    Germline CDH1 mutations confer a high lifetime risk of developing diffuse gastric (DGC) and lobular breast cancer (LBC). A multidisciplinary workshop was organised to discuss genetic testing, surgery, surveillance strategies, pathology reporting and the patient's perspective on multiple aspects......, including diet post gastrectomy. The updated guidelines include revised CDH1 testing criteria (taking into account first-degree and second-degree relatives): (1) families with two or more patients with gastric cancer at any age, one confirmed DGC; (2) individuals with DGC before the age of 40 and (3...... the high mortality associated with invasive disease, prophylactic total gastrectomy at a centre of expertise is advised for individuals with pathogenic CDH1 mutations. Breast cancer surveillance with annual breast MRI starting at age 30 for women with a CDH1 mutation is recommended. Standardised endoscopic...

  15. Iatrogenic stigma in outpatient treatment for Hansen's disease (leprosy) in Brazil.

    White, Cassandra


    This paper explores how iatrogenic stigma, or stigma that is produced through a patient's encounter with physicians or with biomedicine in general, might emerge in outpatient treatment for Hansen's disease, or leprosy. Based on in-depth interviews with people affected by Hansen's disease and observations conducted at several public health clinics in Rio de Janeiro, Brazil, this research identified several aspects of the biomedical encounter that generated or contributed to stigma, either felt or enacted. Also noted in the research were positive examples of techniques used by physicians and health care workers for minimizing or circumventing stigma. The paper touches upon several topics, such as culturally mediated responses to medication side effects and communication between health care workers and patients, that might be salient or useful for health educators and others who are attempting to reduce health-related stigma.

  16. Iatrogenic Lower Extremity Subcutaneous Emphysema after Prolonged Robotic-Assisted Hysterectomy

    Monica Hagan Vetter


    Full Text Available Subcutaneous emphysema is a known complication of carbon dioxide insufflation, an essential component of laparoscopy. The literature contains reports of hypercarbia, pneumothorax, or pneumomediastinum. However, isolated lower extremity subcutaneous emphysema remains a seldom-reported complication. We report a case of unilateral lower extremity subcutaneous emphysema following robotic-assisted hysterectomy, bilateral salpingooophorectomy, staging, and anterior/posterior colporrhaphy for carcinosarcoma and vaginal prolapse. On postoperative day 1, the patient developed tender crepitus and bruising of her right ankle. Radiography confirmed presence of subcutaneous air. Vital signs and laboratory findings were unremarkable. Her symptoms spontaneously improved over time, and she was discharged in good condition on day 2. In stable patients with postoperative extremity swelling or pain with crepitus on exam, the diagnosis of iatrogenic subcutaneous emphysema must be considered.

  17. Orthopaedic surgeon's nightmare: iatrogenic fractures of talus and medial malleolus following tibial nailing

    Sanjay Meena; Vivek Trikha; Pramod Saini; Rakesh Kumar; Buddhadev Chowdhary


    Intramedullary interlocking nailing is the gold standard for treatment of tibial shaft fractures.The growing use of intramedullary nailing has resulted in an increased number of tibial nailing in daily clinical practice.Despite adequate surgeon experience,tibial nailing is not without complications if proper techniques are not followed.A case of iatrogenic talar neck and medial malleolus fractures during intramedullary nailing of tibia in a 24-year-old male is reported.It is believed to be caused by forceful hammering of insertion zig with foot dorsiflexed.To the best of our knowledge,no such case has been reported in the literature.It is possible to reduce the risk of this complication by adoption of preventive measures.

  18. How Should Physicians Help Gender-Transitioning Adolescents Consider Potential Iatrogenic Harms of Hormone Therapy?

    Steensma, Thomas D; Wensing-Kruger, S Annelijn; Klink, Daniel T


    Counseling and treatment of transgender youth can be challenging for mental health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. Is a gender identity diagnosis helpful? What is the right time to treat, and should the adolescent's age matter in decision making? In this article, we discuss these questions in light of a case in which an adolescent wishes to pursue hormone therapy. Our analysis focuses on the importance of balanced decision making when counseling and treating adolescents with nonconforming gender identities. We argue that clinicians' communicating appropriate expectations about the effectiveness and limitations of hormone therapy and the risks of psychological and physical iatrogenic effects is critical. © 2017 American Medical Association. All Rights Reserved.


    Kononenko, O A; Stakhovskiy, E O; Vukalovych, P S; Voylenko, O A; Stakhovskiy, O E; Vitruk, Yu V; Chepurnatiy, M V


    Clinical analysis was conducted in 74 oncological patients, in whom 103 iatrogenic injuries of ureter (IIU) were revealed and for which they were treated in Scientific-nvestigative Department of Plastic and Reconstructive Oncourology. Restoration of renal and ureteric function were noted in terms up to 6 mo, in these terms were revealed all complications, caused by recurrence of obstruction. Late follow-up results of III were positive in 95.2% patients, unsatisfactory result was revealed in 3 (4.8%) patients, what have demanded conduction of surgical secondary correction of urodynamics. Quality of life after restoration operative treatment have improved in 31.70%patients in comparison of such before the operation.


    Stakhovskyi, E O; Vukalovych, P S; Voylenko, O A; Stakhovskyi, O E; Vitruk, Yu V; Kononenko, O A


    Results of examination and treatment of 119 patients for oncological diseases were analyzed, in whom iatrogenic injury of ureter (IIU) have occurred. Remission of oncological diseases plastic operations were performed in 48 (40.3%) patients, reconstructive - in 23 (19.3%), restoration - in 3 (2.5%); while a progress - palliative nephrostomy in 41 (34.5%) patients. In 4 (3.4%) patients dynamical observation was conducted. The method of operative treatment was selected, taking into account efficacy of treatment of oncological diseases; mechanism of IIU; level of obstruction and irreversibility of changes in wall of ureter; character of injury (one-sided, bilateral, injury of ureter of a single kidney); anatomo-functional changes of upper and lower urinary ways; the patient state severity.


    G. LUCA


    Full Text Available Introduction: The principles lying at the basis of a balanced dental occlusion cannot be analyzed separately, but only if considering the teeth (and, implicitly, dental occlusion as integrated into the masticatory system, which includes the masticatory muscles, the temporo-mandibu‑ lary joint and the maxillary bones. Scope: The scope of the present study was to correlate and establish the interde‑ pendence between the morpholgically-incorrect prosthetic works and the tissular and functional damages suffered by the neighbouring structures, as a result of some incor‑ rectly-made prosthetic works. Also, the study aims at iden‑ tifying the factors and limits responsible for a prolongued maintenance of such irreversible pathological modificati‑ ons within an asymptomatic zone for the patient. Materials and method: The working hypothesis of the present inves‑ tigation started from the analysis of the various objective signs, versus the morphology of the incorrectly performed prosthetic works. The study, initiated as early as 2009, in a private stomatological clinics (DentEstet, Bucuresti, includes a number of 500 patients (250 women and 250 men, selected among the patients having addressed the stomatological office from various reasons (not always related to the prosthetic pathology of the cases here under investigation. Included in the study have been only the patients with fixed prosthetic works associated with one or several of the previously described objective signs, potentially induced by the iatrogeneicity of the prosthetic works. Results: The pathological effects of the iatrogenic works here under analysis, upon both the antagonistic and prosthetic support teeth, may be clinically identified during a minute examination performed prior to produ‑ cing irreversible final effects (abrasions, fractures, dental mobility, etc.. Such noxious effects of the iatrogenic pros‑ thetic works appear as a false masticatory comfort and as a

  2. Iatrogenic effects of photoprotection recommendations on skin cancer development, vitamin D levels, and general health.

    Reddy, Kavitha K; Gilchrest, Barbara A


    Ultraviolet (UV) radiation is an established carcinogen that causes skin cancers and other cutaneous photodamage. Vitamin D is produced in the skin after UV exposure and may also be obtained from dietary and supplemental sources. The effect of recommendations for UV protection, as well as for very large vitamin D supplements, and possible adverse effects of both are explored. Current evidence supports the conclusion that protection from UV radiation reduces the incidence of skin cancers and photodamage, but generally does not compromise vitamin D status or lead to iatrogenic disease. Conversely, risks of maintaining very high vitamin D levels have not been adequately studied. Vitamin D obtained from diet and supplements is functionally identical to that produced after UV exposure, and is a more reliable and quantifiable source of the vitamin.

  3. Iatrogenic fracture of the superomedial orbital rim during frontal trephine irrigation.

    Angel, Douglas; Zener, Rebecca; Rotenberg, Brian W


    Frontal sinus trephination (FST) has numerous applications in the treatment of acute and chronic sinus disease. This procedure involves making an incision at the medial aspect of the supraorbital rim and then drilling the sinus's anterior table. Placement of a frontal trephine allows for irrigation of the frontal recess in order to evacuate the frontal sinus in a minimally invasive manner. Orbital injury is a rare complication of FST. We present a case of previously unreported orbital compartment syndrome secondary to iatrogenic fracture of the superomedial orbital rim as a complication of frontal trephine irrigation. We also review the literature on the applications of FST and its associated complications, and we discuss orbital compartment syndrome as a complication of sinus surgery.

  4. Antegrade deligation of iatrogenic distal ureteric obstruction utilising a high pressure balloon dilatation technique.

    Rajendran, Simon


    BACKGROUND: Iatrogenic trauma is the leading cause of ureteric injury with an incidence in abdominal and pelvic surgery varying between 0.4 and 2.5%. CASE: We report a case of ureteric obstruction caused by a haemostatic clip. There was associated rupture of the ureter proximal to the clip with intra-peritoneal leakage of urine. The patient was unfit for surgery and was managed by a novel procedure of endoluminal balloon deligation. CONCLUSION: Ureteric injuries are rare but potentially serious complications. They require prompt diagnosis and management depends on the patients\\' clinical condition, extent of injury and interval from injury to diagnosis. We have successfully demonstrated a new technique to treat ureteric obstruction caused by a haemostatic clip with associated ureteral rupture in a patient unfit for surgery.

  5. Preventing Cushing: Iatrogenic Cushing Syndrome due to Ritonavir-Fluticasone Interaction.

    Tiruneh, Fasil; Awan, Ahmad; Didana, Abiot; Doshi, Saumil


    Ritonavir is commonly used in low doses to boost plasma levels of protease inhibitors in patients with human immunodeficiency virus (HIV) infections. It is also a potent inhibitor of cytochrome P450. We present a 50-year-old African American male with past medical history of HIV on highly active antiretroviral therapy (HAART), which also included ritonavir and long standing asthma that has been treated with inhaled fluticasone, who presented with back pain. He had central obesity, prominent abdominal striae and wasted extremities on physical examination. Laboratory tests showed low morning serum cortisol and suboptimal cosyntropin test consistent with adrenal insufficiency. Computed tomography (CT) of the spine showed a fracture of inferior endplate of the lumbar (L3) vertebra. The cause of osteoporosis is believed to be iatrogenic Cushing syndrome caused by enhanced levels of inhaled fluticasone effects secondary to inhibition of cytochrome P450. The patient was managed surgically and fluticasone was discontinued.

  6. Iatrogenic injury to the inferior alveolar nerve: etiology, signs and symptoms, and observations on recovery.

    Hillerup, S


    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assessing tactile, thermal, and positional perception as well as two-point discrimination and pain. In 48 patients with IAN injuries of differing etiologies who did not undergo surgery, 32 patients with injury associated with third molar surgery exhibited significant spontaneous improvement of sensory function. Recovery improvement of sensory function was insignificant in the patients with other etiologies. In most patients the level of sensory perception was such that microsurgical repair was only occasionally indicated. Four patients had microsurgical repair; the outcome was favourable in three. IAN injuries associated with third molar surgery, other dento-alveolar surgery or implant surgery occur sufficiently often to render prevention a key issue.

  7. Iatrogenic aspergillus infection of the central nervous system in a pregnant woman

    Lokuhetty Menaka


    Full Text Available A healthy postnatal woman succumbed to fulminant iatrogenic Aspergillus infection of the central nervous system, following accidental inoculation into the subarachnoid space at spinal anesthesia, during an outbreak of Aspergillus meningitis in Sri Lanka. Autopsy revealed extensive Aspergillus meningitis and culture confirmed Aspergillus fumigatus. The thalamic parenchyma in the brain was invaded by fungal hyphae producing necrotizing angitis with thrombosis, thalamic infarcts and fungal abscesses. The directional growth of fungal hyphae from the extra-luminal side of blood vessels towards the lumen favored extension from the brain parenchyma over hematogenous spread. The spinal parenchyma was resistant to fungal invasion in spite of the heavy growth within the spinal meninges and initial inoculation at spinal level. Modulation of the immune response in pregnancy with depression of selective aspects of cell-mediated immunity probably contributed to rapid spread within the subarachnoid space, to involve the brain parenchyma leading to clinical deterioration and death.

  8. Rett syndrome and gastric perforation.

    Shah, Malay B; Bittner, James G; Edwards, Michael A


    Rett Syndrome is associated with decreased peristaltic esophageal waves and gastric dysmotility, resulting in swallowing difficulties and gastric dilation. Rarely, gastric necrosis and perforation occur. Our case represents the third reported case of gastric necrosis and perforation associated with Rett Syndrome. A 31-year-old female after 11 hours of intermittent emesis and constant, sharp abdominal pain presented with evidence of multiorgan system failure including hypovolemic shock, metabolic acidosis, coagulopathy, and hepatorenal failure. A chest radiograph revealed intra-abdominal free air necessitating emergent laparotomy. During exploration, a severely dilated, thin-walled stomach with an area of necrosis and gross perforation was noted. Wedge resection of the necrotic tissue and primary closure were performed. Despite aggressive perioperative resuscitation and ventilation support, the patient died 3 hours postoperatively secondary to refractory shock and hypoxemia. Severe gastric dilation can occur with Rett Syndrome and may cause gastric necrosis and perforation. Prolonged elevated gastric pressures can decrease perfusion and may contribute to perforation. Timely decompression via percutaneous endoscopic or surgical gastrostomy could decrease the risk of perforation particularly when significant gastric distention is present. Consideration of gastric necrosis and perforation in patients with Rett Syndrome may lead to earlier intervention and decreased mortality.

  9. Helicobacter pylori in gastric carcinogenesis

    Hyo; Jun; Ahn; Dong; Soo; Lee


    Gastric cancer still is a major concern as the third most common cancer worldwide, despite declining rates of incidence in many Western countries. Helicobacter pylori(H. pylori) is the major cause of gastric carcinogenesis, and its infection insults gastric mucosa leading to theoccurrence of atrophic gastritis which progress to intestinal metaplasia, dysplasia, early gastric cancer, and advanced gastric cancer consequently. This review focuses on multiple factors including microbial virulence factors, host genetic factors, and environmental factors, which can heighten the chance of occurrence of gastric adenocarcinoma due to H. pylori infection. Bacterial virulence factors are key components in controlling the immune response associated with the induction of carcinogenesis, and cag A and vac A are the most well-known pathogenic factors. Host genetic polymorphisms contribute to regulating the inflammatory response to H. pylori and will become increasingly important with advancing techniques. Environmental factors such as high salt and smoking may also play a role in gastric carcinogenesis. It is important to understand the virulence factors, host genetic factors, and environmental factors interacting in the multistep process of gastric carcinogenesis. To conclude, prevention via H. pylori eradication and controlling environmental factors such as diet, smoking, and alcohol is an important strategy to avoid H. pylori-associated gastric carcinogenesis.

  10. Epigenetic alterations in gastric carcinogenesis

    In-Seon CHOI; Tsung-Teh WU


    Gastric cancer is believed to result in part from the accumulation of multiple genetic alterations leading to oncogene overexpression and tumor suppressor loss. Epigenetic alterations as a distinct and crucial mechanism to silence a variety of methylated tissue-specific and imprinted genes, have been extensively studied in gastric carcinoma and play important roles in gastric carcinogenesis. This review will briefly discuss the basic aspects of DNA methylation and CpG island methylation, in particular the epigenetic alterations of certain critical genes implicated in gastric carcinogenesis and its relevance of clinical implications.

  11. Nutrition and Gastric Cancer

    Carlo La Vecchia; Silvia Franceschi


    The reasons for the worldwide decline in stomach cancer incidence and mortality rates are not fully understood, but dietary changes are clearly implicated. While the possible mechanisms of gastric carcinogenesis and the impact of Helicobacter pylori eradication remain open to debate, at least two practical recommendations – to increase fruit and vegetable intake, and to reduce consumption of salt – are already supported by epidemiological evidence. These dietary recommend...

  12. Laparoscopic reconstruction of iatrogenic-induced lower ureteric strictures: Does timing of repair influence the outcome?

    George P Abraham


    Full Text Available Context: Influence of timing of repair on outcome following laparoscopic reconstruction of lower ureteric strictures Aims: To assess the influence of timing of repair on outcome following laparoscopic reconstruction of lower ureteric strictures in our adult patient population. Settings and Design: Single surgeon operative experience in two institutes. Retrospective analysis. Materials and Methods: All patients were worked up in detail. All patients underwent cystoscopy and retrograde pyelography prior to laparoscopic approach. Patients were categorised into two groups: early repair (within seven days of inciting event and delayed repair (after two weeks. Operative parameters and postoperative events were recorded. Postprocedure all patients were evaluated three monthly. Follow-up imaging was ordered at six months postoperatively. Improvement in renal function, resolution of hydronephrosis and unhindered drainage of contrast through the reconstructed unit on follow-up imaging was interpreted as a satisfactory outcome. Statistical Analysis Used: Mean, standard deviation, equal variance t test, Mann Whitney Z test, Aspin-Welch unequal variance t test. Results: Thirty-six patients (37 units, 36 unilateral and 1 simultaneous bilateral underwent laparoscopic ureteral reconstruction of lower ureteric stricture following iatrogenic injury - 21 early repair (Group I and 15 delayed repair (Group II. All patients were hemodynamically stable at presentation. Early repair was more technically demanding with increased operation duration. There was no difference in blood loss, operative complications, postoperative parameters, or longterm outcome. Conclusions: In hemodynamically stable patients, laparoscopic repair of iatrogenically induced lower ureteric strictures can be conveniently undertaken without undue delay from the inciting event. Compared to delayed repairs, the procedure is technically more demanding but morbidity incurred and outcome is at par.

  13. and Gastric Cancers

    Sebahattin Celik


    Full Text Available Purpose. To examine the relationship between esophageal and gastric cancers commonly seen in Van Lake region and the traditional eating habits of the geography. Materials and Methods. Esophageal and gastric cancer cases, who underwent surgery between January 1, 2012, and December 31, 2013, were examined. Pathology reports of the patients and presence of Helicobacter pylori (HP were recorded. Surveys were filled by face to face meeting or telephone call. Control group was created with randomly selected individuals without any cancer diagnosis having age, gender, and socioeconomic characteristics similar to patient group. All data were analyzed using SAS.9.3 statistical programme. Results. Compared with the control group, herby cheese consumption (a component of eating habits and smoking were significantly higher in the patient group (P<0.001. Tandoor exposure is compared in terms of female gender, and significant difference was found between the groups (P=0.0013. As a result of the analysis with logistic regression more than 150 gr of herby cheese consumption per day was found to increase the cancer risk (odds ratio 1.017; 95% CI: 1.012–1.022. Conclusion. A high consumption of herby cheese, cooking bread on tandoor, and heavy smoking were seen to be important risk factors for esophageal and gastric cancers.

  14. Tricholithobezoar Causing Gastric Perforation

    Juliana Santos Valenciano


    Full Text Available A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.

  15. Chemotherapy for gastric cancer

    Javier Sastre; Jose Angel García-Saenz; Eduardo Díaz-Rubio


    Metastatic gastric cancer remains a non-curative disease.Palliative chemotherapy has been demonstrated to prolong survival without quality of life compromise. Many single-agents and combinations have been confirmed to be active in the treatment of metastatic disease. Objective response rates ranged from 10-30% for single-agent therapy and 30-60% for polychemotherapy. Results of phase Ⅱ and Ⅲ studies are reviewed in this paper as well as the potential efficacy of new drugs. For patients with localized disease, the role of adjuvant and neoadjuvant chemotherapy and radiation therapy is discussed.Most studies on adjuvant chemotherapy failed to demonstrate a survival advantage, and therefore, it is not considered as standard treatment in most centres. Adjuvant immunochemotherapy has been developed fundamentally in Korea and Japan. A meta-analysis of phase Ⅲ trials with OK-432 suggested that immunochemotherapy may improve survival of patients with curatively resected gastric cancer. Based on the results of US Intergroup 0116study, postoperative chemoradiation has been Accepted as standard care in patients with resected gastric cancer in North America. However, the results are somewhat confounded by the fact that patients underwent less than a recommended D1 lymph node dissection and the pattern of recurrence suggested a positive effect derived from local radiotherapy without any effect on micrometastatic disease.Neoadjuvant chemotherapy or chemoradiation therapy remains experimental, but several phase Ⅱstudies are showing promising results. Phase Ⅲ trials are needed.

  16. Diet and gastric cancer

    Šipetić Sandra B.


    Full Text Available The aim of this case-control study, conducted in Serbia during the period 1998-2000, was to investigate whether diet was associated with the development of gastric cancer. The case group consisted of 131 patients with histologically confirmed gastric cancer, and the control group of 131 patients with orthopedics diseases and injuries. Cases and controls were individually matched by age (±± 2 years, gender, and place of residence. On the basis of multivariate logistic regression analysis, following factors were found as independent risk factors for gastric cancer: more frequent consumption of high-fat milk [Odds ratio (OR =1.45, 95% confidence interval (CI = 0.99-2.16]; mutton, lamb and/or calf meat (OR = 2.46, 95% CI = 1.11-5.47, sugar (OR = 2.13, 95% CI = 1.43-3.18, semi-white bread (OR = 2.09, 95% CI = 1.25-3.50, and salting food (OR = 5.72, 95% CI = 2.63-12.42. Factors found as protective were: more frequent consumption of margarine (OR = 0.41, 95% CI = 0.25-0.69, „other“ cheeses (OR = 0.47, 95% CI = 0.29 - 0.77, and fish (OR = 0.39, 95% CI = 0.19-0.76.

  17. The gastroprotective effect of Memora nodosa roots against experimental gastric ulcer in mice



    Full Text Available ABSTRACT Memora nodosa is popularly known as "caroba" and widely found in the Cerrado regions of Brazil. In traditional medicine, the leaves and stems are used for the healing of external ulcer and the roots for abdominal pain. This study investigated the effect of ethanolic roots extract of Memora nodosa (EMN on the gastric mucosa of mice. In the indomethacin induced gastric ulcer model, the treatments of the animals with EMN at doses of 100, 300 and 1000 mg/kg, p.o., markedly reduced the index of lesions. In the gastric ulcer models induced by ethanol and cold restraint-stress the previous treatment with EMN at dose of 300 mg/kg showed 69% and 43% of protection, respectively. Seven days after food-restriction, the animals treated with EMN (300 mg/kg p.o. showed reduction in the index of lesion by 65% as compared to control group. The intraduodenal administration of EMN (300 mg/kg did not alter the gastric acid secretion parameters. The treatment with EMN (300 mg/kg p.o. did not alter glutathione levels (GSH, but showed an increase of adhered gastric mucus as compared to the control group with lesion. These results showed that EMN has gastroprotective activity probably due with an increase of adhered gastric mucus.

  18. A Zinc Morpholine Complex Prevents HCl/Ethanol-Induced Gastric Ulcers in a Rat Model.

    Salama, Suzy M; Gwaram, Nura Suleiman; AlRashdi, Ahmed S; Khalifa, Shaden A M; Abdulla, Mahmood A; Ali, Hapipah M; El-Seedi, Hesham R


    Zinc is a naturally occurring element with roles in wound healing and rescuing tissue integrity, particularly in the gastrointestinal system, where it can be detected in the mucosal and submucosal layers. Zinc chelates are known to have beneficial effects on the gastrointestinal mucosa and in cases of gastric ulcer. We synthesized complexes of zinc featuring a heterocyclic amine binding amino acids then investigated their ability to enhance the gastric self-repair. Zinc-morpholine complex, Zn(L)SCN, namely showed strong free-radical scavenging, promotion of the DNA and RNA polymerases reconstruction and suppression of cell damage. The complex's mode of action is proposed to involve hydrogen bond formation via its bis(thiocyanato-k)zinc moiety. Zn(L)SCN complex had potent effects on gastric enzymatic activity both in vitro and in vivo. The complex disrupted the ulcerative process as demonstrated by changes in the intermediate metabolites of the oxidative pathway - specifically, reduction in the MDA levels and elevation of reduced glutathione together with an attenuation of oxidative DNA damage. Additionally, Zn(L)SCN restored the gastric mucosa, inhibited the production of pro-inflammatory cytokines (IL-6, TNF and the caspases), and preserved the gastric mucous balance. Zn(L)SCN thus exhibited anti-oxidative, anti-inflammatory and anti-apoptotic activities, all of which have cytoprotective effects on the gastric lining.

  19. PFTK1 Promotes Gastric Cancer Progression by Regulating Proliferation, Migration and Invasion.

    Yang, Lei; Zhu, Jia; Huang, Hua; Yang, Qichang; Cai, Jing; Wang, Qiuhong; Zhu, Junya; Shao, Mengting; Xiao, Jinzhang; Cao, Jie; Gu, Xiaodan; Zhang, Shusen; Wang, Yingying


    PFTK1, also known as PFTAIRE1, CDK14, is a novel member of Cdc2-related serine/threonine protein kinases. Recent studies show that PFTK1 is highly expressed in several malignant tumors such as hepatocellular carcinoma, esophageal cancer, breast cancer, and involved in regulation of cell cycle, tumors proliferation, migration, and invasion that further influence the prognosis of tumors. However, the expression and physiological significance of PFTK1 in gastric cancer remain unclear. In this study, we analyzed the expression and clinical significance of PFTK1 by Western blot in 8 paired fresh gastric cancer tissues, nontumorous gastric mucosal tissues and immunohistochemistry on 161 paraffinembedded slices. High PFTK1 expression was correlated with the tumor grade, lymph node invasion as well as Ki-67. Through Cell Counting Kit (CCK)-8 assay, flow cytometry, colony formation, wound healing and transwell assays, the vitro studies demonstrated that PFTK1 overexpression promoted proliferation, migration and invasion of gastric cancer cells, while PFTK1 knockdown led to the opposite results. Our findings for the first time supported that PFTK1 might play an important role in the regulation of gastric cancer proliferation, migration and would provide a novel promising therapeutic strategy against human gastric cancer.

  20. CT examinations of healing fractures

    Nutz, V.; Uexkuell-Gueldenband, V. v.


    The CT appearances of healing fractures were studied following tibial osteotomy in a dog. Traditional radiological investigations and CT were carried out until healing was complete; CT showed callus on the ninth day, whereas radiographs only showed it after 19 days. After 32 days, callus filled nearly the entire medullary cavity. Similar observations were made in several human situations. CT demonstrates interposed material in the fracture very clearly, even if there is marked callus formation within the fracture.

  1. [Specificities in children wound healing].

    Sanchez, J; Antonicelli, F; Tuton, D; Mazouz Dorval, S; François, C


    Children have specific characteristics of wound healing. The aim of this study was to describe the specific clinical characteristics of wounds healing in children and to present the current knowledge on the specific mechanisms with regard to infant age. The tissue insult or injury in fetus can heal without scar, mainly due to reduced granulation tissue associated to diminished or even no inflammatory phase, modified extracellular matrix such as the concentration of hyaluronic acid in amniotic liquid, expression and arrangement of collagen and tenascin. Thickness of children skin is a serious negative factor in case of trauma, whereas poor co-morbidities and efficient growth tissue mechanisms are beneficial to good evolution, even in cases of extensive damage and loss of tissue. The subsequent tissue mechanical forces, wound healing during childhood, spanning from the age of 2 until the end of puberty, is associated with more hypertrophic scars, both in duration and in intensity. Consequently, unnecessary surgery has to be avoided during this period when possible, and children with abnormal or pathologic wound healing should benefit from complementary treatments (hydration, massage, brace, silicone, hydrotherapy…), which represent efficient factors to minimize tissue scarring. After wound healing, the growth body rate can be responsible for specific complications, such as contractures, alopecia, and scar intussusceptions. Its evolutionary character implies the need of an attentive follow-up until adult age. Psychologic repercussions, as a consequence of pathologic scars, must be prevented and investigated by the surgeon.

  2. Primary Closure versus Gastric Resection for Perforated Gastric ...

    Surgical Scales: Primary Closure versus Gastric Resection for. Perforated Gastric ... best choice? Minor or ... current practice is reserved mostly for Johnson Type I and IV ulcers .... if gastrectomy is indicated and even if the patient is fit for major ...

  3. Effect of zinc acexamate and ranitidine on chronic gastric lesions in the rat.

    Navarro, C; Escolar, G; Bravo, M L; Jiménez, E; Bulbena, O


    Using the rat as an experimental model we have studied the healing of chronic gastric lesions and the modifications of these lesions by antiulcer agents. Gastric injuries were induced by submucosal injection of 0.05 ml of 5% acetic acid. Placebo, ranitidine (RNT) or zinc acexamate (ZAC) were administered orally. The evolution of gastric injuries was macro- and microscopically evaluated at 6, 12 and 21 days after acetic acid injection. The administration of either RNT (30 mg/kg) or ZAC (200 mg/kg) was followed by a marked improvement of the healing process with respect to control groups. The size of experimental ulcers at 21 days was 3.1 +/- 0.8 mm2 for the control group, 1.8 +/- 1.1 mm2 for RNT-treated animals and 0.3 +/- 0.6 mm2 for ZAC-treated rats (p less than 0.05, vs. control). A similar tendency was observed when lesions were microscopically analyzed. Indices of microscopical lesions (0-6) at 21 days were 3.8 +/- 0.8 for the control group, 3.0 +/- 0.8 for rats receiving RNT and 2.3 +/- 0.4 for rats receiving ZAC (p less than 0.05, vs. control). The statistical analysis of the distribution of microscopical indices of lesions showed significant differences in favour of ZAC at days 6 (p less than 0.01) and 21 (p less than 0.05). Our study indicates that the evolution of gastric damage induced by acid acetic injection was consistently better in rats treated with ZAC than in those receiving RNT. Data obtained in our experiments suggest that the blockade of H2 receptors does not guarantee the optimal healing of chronic gastric lesions induced in rats.


    Wang, Guozhong; Li, Chengjun; Fan, Xichao; Li, Bo; Xiao, Wei; Jin, Li


    To explore the ettect and mechanisms of bone marrow mesenchymal stem cells (BMSCs) on healing quality of acetic acid-induced gastric ulcer. Forty-eight clean grade male Wistar rats were used to establish the model of gastric ulcer with acetic acid and were randomly divided into 3 groups after 3 days of modeling, 16 rats each group. After the abdominal cavity was open and stomach was pulled out, no treatment was given in group A, 150 µL phosphate buffered saline (PBS) and 150 µL BMSCs at passage 4+PBS (1 x 10(8) cells/100 µL) were injected into the gastric wall surrounding the ulcer at 5 different points in groups B and C respectively. After 10 days, the ulcer area was measured, the mucosal thickness and the number of dilated glands were tested in the regenerative mucosa by histological method. And the expression of vascular endothelial growth factor (VEGF) was detected at ulcerative margin by immunohistochemical method. The ulcer area in group C was significantly smaller than that of groups A and B (P 0.05). HE staining showed that group C had thicker regenerative gastric mucosa, less dilated glands, and more regular mucosal structure than groups A and B, showing significant differences in regenerative gastric mucosa thickness and dilated glands number (P 0.05). Immunohistochemical staining showed that the positive expression of VEGF in the ulcer margin mucosa of group C was significantly higher than that of groups A and B. The integral absorbance (IA) value of VEGF expression in group C was significantly higher than that in groups A and B (P 0.05). BMSCs can accelerate ulcer healing by the secretion of VEGF, and improve the quality of ulcer healing.

  5. Misoprostol inhibits gastric mucosal release of endogenous prostaglandin E2 and thromboxane B2 in healthy volunteers

    Mertz-Nielsen, A; Eskerod, O; Bukhave, K


    Prostaglandin analogues of the E-series theoretically offer the ideal antiulcer drugs. Peptic ulcer healing with prostaglandin analogues is, however, no better than would be predicted from their ability to inhibit gastric acid secretion and they are less effective than histamine H2 receptor...... antagonists in preventing ulcer relapse. It could be that prostaglandin analogues inhibit gastric mucosal synthesis or release of endogenous eicosanoids, thereby abrogating their own effects. This study, therefore, examined how a single therapeutic dose (200 micrograms) of misoprostol, a synthetic analogue...... of prostaglandin E1, influences gastric mucosal release of endogenous prostaglandin E2 (PGE2), thromboxane B2 (TXB2), and chemotactic leukotriene B4 (LTB4) during basal conditions and in response to gastric luminal acidification (0.1 M HCl; 5 ml/min for 10 minutes). Nine healthy volunteers were studied in a single...

  6. Recapitulating Human Gastric Cancer Pathogenesis: Experimental Models of Gastric Cancer

    Ding, Lin; El Zaatari, Mohamad


    Overview Gastric cancer has been traditionally defined by the Correa paradigm as a progression of sequential pathological events that begins with chronic inflammation [1]. Infection with Helicobacter pylori (H. pylori) is the typical explanation for why the stomach becomes chronically inflamed. Acute gastric inflammation then leads to chronic gastritis, atrophy particularly of acid-secreting parietal cells, metaplasia due to mucous neck cell expansion from trans-differentiation of zymogenic cells to dysplasia and eventually carcinoma [2]. The chapter contains an overview of gastric anatomy and physiology to set the stage for signaling pathways that play a role in gastric tumorigenesis. Finally, the major known mouse models of gastric transformation are critiqued in terms of the rationale behind their generation and contribution to our understanding of human cancer subtypes. PMID:27573785

  7. Roxatidine acetate in the long term maintenance of gastric ulcers.

    Börsch, G


    A non-comparative multicentre study of 78 patients with healed gastric ulcers who had received roxatidine acetate was conducted to determine the ulcer recurrence rates during 6 months' maintenance therapy with roxatidine acetate 75 mg at night. Gastric ulcer relapses occurred in 35% of patients, representing a worst possible outcome estimate, with no significant differences between smokers and non-smokers although heavy smoking appeared to increase the rate of relapse. The incidence of epigastric pain did not significantly increase over the duration of therapy and while some patients complained of mild pain at the start of the trial all subjects had endoscopically confirmed healed ulcers. The consumption of antacids for symptom relief was low, reaching an average of 0.75 tablets a day which was insufficient to influence intragastric pH. Continuous poor appetite and pyrosis were reported by about 5% of subjects. Of 2 patients who complained of mild to moderate side effects, 1 discontinued treatment. In addition, there were no clinically significant changes in haematological and biochemical variables. Thus, maintenance therapy with roxatidine acetate 75 mg at night is safe and generally effective in preventing symptomatic relapse.

  8. Motility and chemotaxis mediate the preferential colonization of gastric injury sites by Helicobacter pylori.

    Eitaro Aihara


    Full Text Available Helicobacter pylori (H. pylori is a pathogen contributing to peptic inflammation, ulceration, and cancer. A crucial step in the pathogenic sequence is when the bacterium first interacts with gastric tissue, an event that is poorly understood in vivo. We have shown that the luminal space adjacent to gastric epithelial damage is a microenvironment, and we hypothesized that this microenvironment might enhance H. pylori colonization. Inoculation with 106 H. pylori (wild-type Sydney Strain 1, SS1 significantly delayed healing of acetic-acid induced ulcers at Day 1, 7 and 30 post-inoculation, and wild-type SS1 preferentially colonized the ulcerated area compared to uninjured gastric tissue in the same animal at all time points. Gastric resident Lactobacillus spp. did not preferentially colonize ulcerated tissue. To determine whether bacterial motility and chemotaxis are important to ulcer healing and colonization, we analyzed isogenic H. pylori mutants defective in motility (ΔmotB or chemotaxis (ΔcheY. ΔmotB (10(6 failed to colonize ulcerated or healthy stomach tissue. ΔcheY (10(6 colonized both tissues, but without preferential colonization of ulcerated tissue. However, ΔcheY did modestly delay ulcer healing, suggesting that chemotaxis is not required for this process. We used two-photon microscopy to induce microscopic epithelial lesions in vivo, and evaluated accumulation of fluorescently labeled H. pylori at gastric damage sites in the time frame of minutes instead of days. By 5 min after inducing damage, H. pylori SS1 preferentially accumulated at the site of damage and inhibited gastric epithelial restitution. H. pylori ΔcheY modestly accumulated at the gastric surface and inhibited restitution, but did not preferentially accumulate at the injury site. H. pylori ΔmotB neither accumulated at the surface nor inhibited restitution. We conclude that bacterial chemosensing and motility rapidly promote H. pylori colonization of injury sites

  9. Refractory ulcer of reconstructed gastric tube after esophagectomy: a case report.

    Okamura, Yuki; Takeno, Shinsuke; Takahashi, Yoshiaki; Moroga, Toshihiko; Yamashita, Shin-ichi; Kawahara, Katsunobu


    We report a case in which rabeprazole cured gastric tube ulcer after esophagectomy for esophageal squamous cell carcinoma (ESCC). A 47-year-old Japanese man was referred to our hospital with refractory ulcer of the reconstructed gastric tube one year after esophagectomy for ESCC. The ulcer proved refractory to healing by the administration of omeprazole or lansoprazole, or eradication of Helicobacter pylori after examinations concerning ischemia, acid over-secretion and H. pylori infection. Finally, metabolizer type was examined for proton pump inhibitors (PPIs), revealing the patient as a hetero-extensive metabolizer for the CYP2C19 genotype. This suggested sensitivity to rabeprazole, but resistance to omeprazole and lansoprazole. The refractory ulcer was subsequently cured after changing the PPI to rabeprazole. Examination of PPI metabolizer type might thus be important, along with an investigation of ischemia, acid secretion and H. pylori infection in the treatment of refractory gastric tube ulcer after esophagectomy.

  10. Mouse Models of Gastric Cancer

    Timothy C. Wang


    Full Text Available Animal models have greatly enriched our understanding of the molecular mechanisms of numerous types of cancers. Gastric cancer is one of the most common cancers worldwide, with a poor prognosis and high incidence of drug-resistance. However, most inbred strains of mice have proven resistant to gastric carcinogenesis. To establish useful models which mimic human gastric cancer phenotypes, investigators have utilized animals infected with Helicobacter species and treated with carcinogens. In addition, by exploiting genetic engineering, a variety of transgenic and knockout mouse models of gastric cancer have emerged, such as INS-GAS mice and TFF1 knockout mice. Investigators have used the combination of carcinogens and gene alteration to accelerate gastric cancer development, but rarely do mouse models show an aggressive and metastatic gastric cancer phenotype that could be relevant to preclinical studies, which may require more specific targeting of gastric progenitor cells. Here, we review current gastric carcinogenesis mouse models and provide our future perspectives on this field.

  11. Supersaturation in human gastric fluids.

    Bevernage, Jan; Hens, Bart; Brouwers, Joachim; Tack, Jan; Annaert, Pieter; Augustijns, Patrick


    The current study reports on supersaturation, precipitation and excipient mediated precipitation inhibition of five poorly soluble drugs (loviride, glibenclamide, itraconazole, danazol, and etravirine) in human and simulated gastric fluids. Upon induction of supersaturation in human gastric fluids (HGFs), simulated gastric fluid (SGF), and fasted state simulated gastric fluid (FaSSGF) using a solvent shift method, supersaturation and precipitation were assessed as a function of time. In addition, the precipitation inhibitory capacity of three polymers (Eudragit® E PO, HPMC-E5, and PVP K25) was investigated. Supersaturation in human gastric fluids was observed for all model compounds, but proved to be relatively unstable (fast precipitation), except for itraconazole. Only modest excipient-mediated stabilizing effects on supersaturation were observed using HPMC-E5 and Eudragit® E PO whereas PVP K25 exerted no effect. In contrast to SGF, the observed precipitation behavior in FaSSGF was similar to the behavior in human gastric fluids. The present study demonstrates that supersaturation stability of drugs in human gastric fluids is in general inferior to supersaturation stability in intestinal fluids. As the potential for excipient mediated precipitation inhibition in gastric fluids was only limited, our data suggest that supersaturation should preferably be targeted to the intestine. Copyright © 2012 Elsevier B.V. All rights reserved.


    季加孚; 张霁; 寿成超; 王怡; 徐光炜


    Objective: To determine the prevalence of Mycoplasma hyorhinis in archived paraffin-embedded gastric cancer tissue. Methods: The antigen recognized by anti-tumor monoclonal antibody PD4 was identified as P40 (a specific Mycoplasma hyorhinis protein). We constructed a tissue-microarray of high density containing 105 gastric cancer samples, 101 non-tumor margin samples and 62 benign gastric disease samples for detecting Mycoplasma hyorhinis using Immunohistochemistry. Results: The infection rate of M. hyorhinis was 54.1%(53/98) in gastric cancer samples, 51.7%(45/87) in non-tumor margin samples and 15.8%(9/57) in benign disease samples. The difference in infection rate between gastric cancer and benign gastric disease has statistical significance (P=0.001). Highly differentiated adenocarcinomas have a greater chance (84.6%) to be infected with M. hyorhinis than poorly differentiated ones (45.5%)(P<0.05. Conclusion: The infection rate of M. yorhinis was higher in gastric cancer than in other tastric diseases, which suggests the association between Mycoplasma infection and gastric cancer. Whether M. hyorhinis has oncogenic potential needs to be elucidated.

  13. Involvement of cyclooxygenase-1 and cyclooxygenase-2 activity in the therapeutic effect of ghrelin in the course of ethanol-induced gastric ulcers in rats.

    Warzecha, Z; Ceranowicz, P; Dembinski, M; Cieszkowski, J; Ginter, G; Ptak-Belowska, A; Dembinski, A


    Previous studies have shown that treatment with ghrelin exhibits protective and therapeutic effects in the gut. Aim of our present investigation was to examine the influence of ghrelin administration on the healing of ethanol-induced gastric ulcers and determine the role of cyclooxygenase-1 and cyclooxygenase-2 in this effect. Our studies were performed on male Wistar rats. Gastric ulcers were induced by intragastric administration of 75% ethanol. Ghrelin alone or in combination with cyclooxygenase inhibitors was administered twice, 1 and 13 hours after ethanol application. Cyclooxygenase-1 (COX-1) inhibitor (SC-560, 10 mg/kg/dose) or COX-2 inhibitor (celecoxib, 10 mg/kg/dose) were given 30 min prior to ghrelin. Twelve or 24 hours after administration of ethanol, rats were anesthetized and experiments were terminated. The study revealed that administration of ethanol induced gastric ulcers in all animals and this effect was accompanied by the reduction in gastric blood flow and mucosal DNA synthesis. Moreover induction of gastric ulcer by ethanol significantly increased mucosal expression of mRNA for COX-2, IL-1β and TNF-α. Treatment with ghrelin significantly accelerated gastric ulcer healing. Therapeutic effect of ghrelin was associated with significant reversion of the ulcer-evoked decrease in mucosal blood flow and DNA synthesis. Ghrelin administration also caused the reduction in mucosal expression of mRNA for IL-1β and TNF-α. Addition of SC-560 slightly reduced the therapeutic effect of ghrelin in the healing of ethanol-induced ulcer and the ulcer area in rats treated SC-560 plus ghrelin was significantly smaller than that observed in rats treated with saline or SC-560 alone. Pretreatment with celecoxib, a COX-2 inhibitor, abolished therapeutic effect of ghrelin. We concluded that treatment with ghrelin increases healing rate of gastric ulcers evoked by ethanol and this effect is related to improvement in mucosal blood flow, an increase in mucosal cell

  14. Role of peroxisome proliferator-activated receptors alpha and gamma in gastric ulcer: An overview of experimental evidences

    Lekha; Saha


    Peroxisome proliferator-activated receptors(PPARs) are ligand-activated transcription factors belonging to the nuclear hormone receptor superfamily. Three subtypes, PPARα, PPARβ/δ, and PPARγ, have been identifiedso far. PPARα is expressed in the liver, kidney, small intestine, heart, and muscle, where it activates the fatty acid catabolism and control lipoprotein assembly in response to long-chain unsaturated fatty acids, eicosanoids, and hypolipidemic drugs(e.g., fenofibrate). PPARβ/δ is more broadly expressed and is implicated in fatty acid oxidation, keratinocyte differentiation, wound healing, and macrophage response to very low density lipoprotein metabolism. This isoform has been implicated in transcriptional-repression functions and has been shown to repress the activity of PPARα or PPARγ target genes. PPARγ1 and γ2 are generated from a single-gene peroxisome proliferator-activated receptors gamma by differential promoter usage and alternative splicing. PPARγ1 is expressed in colon, immune system(e.g., monocytes and macrophages), and other tissues where it participates in the modulation of inflammation, cell proliferation, and differentiation. PPARs regulate gene expression through distinct mechanisms: Liganddependent transactivation, ligand-independent repression, and ligand-dependent transrepression. Studies in animals have demonstrated the gastric antisecretory activity of PPARα agonists like ciprofibrate, bezafibrate and clofibrate. Study by Pathak et al also demonstrated the effect of PPARα agonist, bezafibrate, on gastric secretion and gastric cytoprotection in various gastric ulcer models in rats. The majority of the experimental studies is on pioglitazone and rosiglitazone, which are PPARγ activators. In all the studies, both the PPARγ activators showed protection against the gastric ulcer and also accelerate the ulcer healing in gastric ulcer model in rats. Therefore, PPARα and PPARγ may be a target for gastric ulcer therapy

  15. Epigenetic mechanisms in gastric cancer.

    Gigek, Carolina Oliveira; Chen, Elizabeth Suchi; Calcagno, Danielle Queiroz; Wisnieski, Fernanda; Burbano, Rommel Rodriguez; Smith, Marilia Arruda Cardoso


    Cancer is considered one of the major health issues worldwide, and gastric cancer accounted for 8% of total cases and 10% of total deaths in 2008. Gastric cancer is considered an age-related disease, and the total number of newly diagnosed cases has been increasing as a result of the higher life expectancy. Therefore, the basic mechanisms underlying gastric tumorigenesis is worth investigation. This review provides an overview of the epigenetic mechanisms, such as DNA methylation, histone modifications, chromatin remodeling complex and miRNA, involved in gastric cancer. As the studies in gastric cancer continue, the mapping of an epigenome code is not far for this disease. In conclusion, an epigenetic therapy might appear in the not too distant future.

  16. Effect of sucralfate on gastric emptying in duodenal ulcer patients

    Petersen, J.M.; Caride, V.J.; Prokop, E.K.; Troncale, F.; McCallum, R.W.


    Duodenal ulcer (DU) patients may have accelerated gastric emptying (GE) suggesting that there is an increase in unbuffered gastric acid reaching the duodenum contributing to DU disease. Aluminum-containing antacids were shown to delay GE. The authors' aim was to investigate whether another aluminum-containing compound, Sucralfate, affects GE in normal and DU patients. Nine normal volunteers and 10 patients with documented DU disease were studied. For each test the subject ingested a meal composed of chicken liver Tc-99m-S-C mixed with beef stew and eaten with 4 oz. of water labelled with of III-in-DTPA. On two separate days, subjects received 1 gram of Sucralfate (190 mg of aluminum per gram) or placebo in a randomized double-blind fashion one hour prior to the test meal. GE of liquids and solids in normal subjects was not significantly changed by Sucralfate. Sucralfate in the DU patients significantly slowed liquid emptying in the initial 40 min and solid food throughout the study compared to placebo (p<0.05). This paper summarizes that; GE of solids but not liquids is accelerated in DU patients compared to normal subjects; and sucralfate delays GE of both liquid and solid components of a meal in DU patients but has no effect on GE in normals. The authors conclude that a slowing of gastric emptying possibly mediated by aluminum ions, may be one mechanism by which Sucralfate enhances healing and decreases recurrence of DU.

  17. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Kurtkaya-Yapicier Ozlem


    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  18. Pathology and Genetics of Syndromic Gastric Polyps

    Brosens, Lodewijk A A; Wood, Laura D; Offerhaus, G Johan; Arnold, Christina A; Lam-Himlin, Dora; Giardiello, Francis M; Montgomery, Elizabeth A


    Gastric polyps are found in 1% to 4% of patients undergoing gastroscopy. The vast majority are sporadic, but some gastric polyps indicate an underlying syndrome. Gastric polyps can manifest in each of the gastrointestinal polyposis syndromes, including the recently described gastric adenocarcinoma a

  19. Self-healing materials with microvascular networks.

    Toohey, Kathleen S; Sottos, Nancy R; Lewis, Jennifer A; Moore, Jeffrey S; White, Scott R


    Self-healing polymers composed of microencapsulated healing agents exhibit remarkable mechanical performance and regenerative ability, but are limited to autonomic repair of a single damage event in a given location. Self-healing is triggered by crack-induced rupture of the embedded capsules; thus, once a localized region is depleted of healing agent, further repair is precluded. Re-mendable polymers can achieve multiple healing cycles, but require external intervention in the form of heat treatment and applied pressure. Here, we report a self-healing system capable of autonomously repairing repeated damage events. Our bio-inspired coating-substrate design delivers healing agent to cracks in a polymer coating via a three-dimensional microvascular network embedded in the substrate. Crack damage in the epoxy coating is healed repeatedly. This approach opens new avenues for continuous delivery of healing agents for self-repair as well as other active species for additional functionality.

  20. [Wound healing and wound dressing].

    Eitel, F; Sklarek, J


    This review article intends to discuss the clinical management of wounds in respect to a pathophysiological background. Recent results of research in the field of wound healing are demonstrated. Wound healing can be seen as aseptic inflammatory response to a traumatic stimulus. The activation of the clotting cascade by the trauma induces a sequence of humoral and cellular reactions. Platelets, granulocytes and macrophages are activated stepwisely. In the first phase of wound healing the wounded tissue area will be prepared for phagocytosis by enzymatic degradation of ground substance and depolymerisation of protein macromolecules (wound edema). Following the phagocytic microdebridement mesenchymal cells proliferate and produce matrix substance. Microcirculation within the traumatized area will be restored by angiogenesis, macroscopically observed as new formed granulation tissue. This leads to the wound healing phase of scar tissue formation. In this complexity of reactions naturally many possibilities of impairment are given. The most common complication during wound healing is the infection. It can be seen as self reinforcing process. The therapy of the impairment of wound healing consists in the disruption of the specific vicious circle, in the case of an osseus infection that would be a macrodebridement (that is necrectomy) and biomechanical stabilization. The surgical management of wounds principally consists in ensuring an undisturbed sequence of the healing process. This can be done by the wound excision that supports the phagocytic microdebridement. A further possibility is to avoid overwhelming formation of edema by eliminating the traumatic stimulus, by immobilization of the injured region and by ensuring a physiological microenvironment with a primary suture if possible. There are up to the present no drugs available to enhance cell proliferation and to regulate wound healing but it seems that experimental research is successful in characterizing


    Ida Bagus Putra Pramana


    Full Text Available The mechanism of wound healing is a complex mechanism and involves a variety of cells. Injury is defined as a disruption of normal structure and function. Various types of growth factors and cytokines such as platelet derived growth factor and transforming growth factor beta involved in the mechanism of wound healing. There are four phases of wound healing mechanisms : hemostasis, inflammatory, proliferative, and remodeling. Diabetic ulcers is one major complication, occurring in 15% of patients with diabetes mellitus (DM and as much as 84% of patients with diabetic ulcers require amputation action. In DM patients there is a failure in normal wound healing mechanisms. Various histopathological studies showed elongation phase of inflammation in patients with diabetes mellitus, thus inhibiting the formation of granulation tissue. Increased blood sugar levels will lower the expressin of perlecan, increased advanced glycation endproducts, decreased the formation of nitric oxide (by ± 67%, changes in the structure and function of fibroblasts and increased activity of matrix metalolproteinases, it will cause distruption of the normal wound healing mechanisms. (MEDICINA 2012;43:49-53.

  2. Hindlimb unloading alters ligament healing

    Provenzano, Paolo P.; Martinez, Daniel A.; Grindeland, Richard E.; Dwyer, Kelley W.; Turner, Joanne; Vailas, Arthur C.; Vanderby, Ray Jr


    We investigated the hypothesis that hindlimb unloading inhibits healing in fibrous connective tissue such as ligament. Male rats were assigned to 3- and 7-wk treatment groups with three subgroups each: sham control, ambulatory healing, and hindlimb-suspended healing. Ambulatory and suspended animals underwent surgical rupture of their medial collateral ligaments, whereas sham surgeries were performed on control animals. After 3 or 7 wk, mechanical and/or morphological properties were measured in ligament, muscle, and bone. During mechanical testing, most suspended ligaments failed in the scar region, indicating the greatest impairment was to ligament and not to bone-ligament insertion. Ligament testing revealed significant reductions in maximum force, ultimate stress, elastic modulus, and low-load properties in suspended animals. In addition, femoral mineral density, femoral strength, gastrocnemius mass, and tibialis anterior mass were significantly reduced. Microscopy revealed abnormal scar formation and cell distribution in suspended ligaments with extracellular matrix discontinuities and voids between misaligned, but well-formed, collagen fiber bundles. Hence, stress levels from ambulation appear unnecessary for formation of fiber bundles yet required for collagen to form structurally competent continuous fibers. Results support our hypothesis that hindlimb unloading impairs healing of fibrous connective tissue. In addition, this study provides compelling morphological evidence explaining the altered structure-function relationship in load-deprived healing connective tissue.

  3. Healing texts and healing techniques in indigenous Balinese medicine.

    McCauley, A P


    Case histories of three prominent Balinese healers illustrate various ways that indigenous medical texts are used in healing. Most healers employ mantras, spells and inscriptions from the texts because they believe them to have innate power which can heal. A smaller group of healers are literate in the archaic language used in the palm-leaf medical manuscripts. However, their use of these manuscripts often differs from the literal and unambiguous way that Westerners read medical documents. An examination of Balinese medical manuscripts, in the context of the conventions of Balinese literature, demonstrates the use of these texts to align the body with the macrocosm and to reaffirm the beliefs of the ancestors.

  4. Wound healing: an overview of acute, fibrotic and delayed healing.

    Diegelmann, Robert F; Evans, Melissa C


    Acute wounds normally heal in a very orderly and efficient manner characterized by four distinct, but overlapping phases: hemostasis, inflammation, proliferation and remodeling. Specific biological markers characterize healing of acute wounds. Likewise, unique biologic markers also characterize pathologic responses resulting in fibrosis and chronic non-healing ulcers. This review describes the major biological processes associated with both normal and pathologic healing. The normal healing response begins the moment the tissue is injured. As the blood components spill into the site of injury, the platelets come into contact with exposed collagen and other elements of the extracellular matrix. This contact triggers the platelets to release clotting factors as well as essential growth factors and cytokines such as platelet-derived growth factor (PDGF) and transforming growth factor beta (TGF-beta). Following hemostasis, the neutrophils then enter the wound site and begin the critical task of phagocytosis to remove foreign materials, bacteria and damaged tissue. As part of this inflammatory phase, the macrophages appear and continue the process of phagocytosis as well as releasing more PDGF and TGF beta. Once the wound site is cleaned out, fibroblasts migrate in to begin the proliferative phase and deposit new extracellular matrix. The new collagen matrix then becomes cross-linked and organized during the final remodeling phase. In order for this efficient and highly controlled repair process to take place, there are numerous cell-signaling events that are required. In pathologic conditions such as non-healing pressure ulcers, this efficient and orderly process is lost and the ulcers are locked into a state of chronic inflammation characterized by abundant neutrophil infiltration with associated reactive oxygen species and destructive enzymes. Healing proceeds only after the inflammation is controlled. On the opposite end of the spectrum, fibrosis is characterized by

  5. Follow up through Endoscopical – Histological Studies and Helicobacter Pylori Infections in Patients Suffering from Gastric Ulcers

    Marcos Félix Osorio Pagola


    Full Text Available Background: Endoscopic follow up of gastric ulcers until healing has a great important due to the possibility of a new proliferation. The commonest chronic infection worldwide is caused by Helicobacter pylori and it is associated to gastro duodenal diseases. Objective: To determine the endoscopic-biopsic follow up and to set the frequency of infection due to Helicobacter pylori in those patients who suffer from gastric ulcers. Methods: observational, descriptive and prospective study carried out at the University Hospital “Arnaldo Milián Castro”. It included 96 gastric ulcer sufferers diagnosed endoscopically and who fulfilled with the selection criteria. Endoscopy and biopsy of the gastric mucosa was done for the histological study of the gastric ulcers and for the diagnosis of infection due to Helicobacter pylori through hematoxiline-eosine and giemsa stains respectively. Results: 89 patients (92,7 % healed their ulcers in the first three months of follow up and 5 patients underwent a histological diagnosis of malignant ulcers (5,2 %. Surgery was done on the two patients whose ulcers did not heal. (2,1 %. 67,7 % had been infected with the bacteria. There was a greater frequency of patients infected with Helicobacter pylori, either with benign or malignant ulcus (93,8 % y 6,2 % respectively. Conclusions: the follow up of benign ulcers was good , almost all of them healed in a three-month follow up. 5 patients suffered from malignant ulcers, being 2 of them diagnosed in their second endoscopy. More than half of the patients were infected with Helicobacter pylori.

  6. Innominate vein repair after iatrogenic perforation with central venous catheter via mini-sternotomy—Case report

    Juan A. Siordia


    Conclusion: The case presented in this report suggests a new approach to replace the traditional complete median sternotomy in attempts to repair the innominate vein. The mini-sternotomy approach provides sufficient visualization of the vessel and surrounding structures with minimal post-operative complications and healing time.

  7. Iatrogenic vitamin D toxicity in an infant--a case report and review of literature.

    Ketha, Hemamalini; Wadams, Heather; Lteif, Aida; Singh, Ravinder J


    Public concern over vitamin D deficiency has led to widespread use of over the counter (OTC) vitamin D (-D3 or -D2) supplements, containing up to 10,000 IU/unit dose (400 IU=10μg). Overzealous use of such supplements can cause hypercalcemia due to vitamin D toxicity. Infants are particularly vulnerable to toxicity associated with vitamin D overdose. OTC supplements are not subject to stringent quality control regulations from FDA and high degree of variability in vitamin D content in OTC pills has been demonstrated. Other etiologies of vitamin D induced hypercalcemia include hyperparathyroidism, granulomatous malignancies like sarcoidosis and mutations in the CYP24A1 gene. The differential diagnosis of hypercalcemia should include iatrogenic and genetic etiologies. C24-hydroxylation and C3-epimerization are two important biochemical pathways via which 25-hydroxyvitamin D3 (25(OH)D3) is converted to its metabolites, 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) or its C3 epimer, 3-epi-25-OH-D3 respectively. Mutations in the CYP24A1 gene cause reduced serum 24,25(OH)2D3 to 25(OH)D3 ratio (D3), hypercalcemia, hypercalciuria and nephrolithiasis. Studies in infants have shown that 3-epi-25(OH)D3 can contribute 9-61.1% of the total 25(OH)D3. Therefore, measurements of parathyroid hormone (PTH) and vitamin D metabolites 25(OH)D3, 1,25(OH)2D3, 3-epi-25(OH)D3 and 24,25(OH)2D3 are useful to investigate whether the underlying cause of vitamin D toxicity is iatrogenic versus genetic. Here we report a case of vitamin D3 associated toxicity in a 4-month-old female who was exclusively breast-fed and received an oral liquid vitamin D3 supplement at a dose significantly higher than recommended on the label. The vitamin D3 content of the supplement was threefold higher (6000 IU of D/drop) than listed on the label (2000 IU). Due to overdosing and higher vitamin D3 content, the infant received ∼50,000 IU/day for two months resulting in severe hypercalcemia, hypercalciuria and

  8. Iatrogenic cushing syndrome secondary to a probable interaction between voriconazole and budesonide.

    Jones, Whitney; Chastain, Cody A; Wright, Patty W


    Oral budesonide is commonly used for the management of Crohn's disease given its high affinity for glucocorticoid receptors and low systemic activity due to extensive first-pass metabolism through hepatic cytochrome P450 (CYP) 3A4. Voriconazole, a second-generation triazole antifungal agent, is both a substrate and potent inhibitor of CYP isoenzymes, specifically CYP2C19, CYP2C9, and CYP3A4; thus, the potential for drug-drug interactions with voriconazole is high. To our knowledge, drug-drug interactions between voriconazole and corticosteroids have not been specifically reported in the literature. We describe a 48-year-old woman who was receiving oral budesonide 9 mg/day for the management of Crohn's disease and was diagnosed with fluconazole-resistant Candida albicans esophagitis; oral voriconazole 200 mg every 12 hours for 3 weeks was prescribed for treatment. Because the patient experienced recurrent symptoms of dysphagia, a second 3-week course of voriconazole therapy was taken. Seven weeks after originally being prescribed voriconazole, she came to her primary care clinic with elevated blood pressure, lower extremity edema, and weight gain; she was prescribed a diuretic and evaluated for renal dysfunction. At a follow-up visit 6 weeks later with her specialty clinic, the patient's blood pressure was elevated, and her physical examination was notable for moon facies, posterior cervical fat pad prominence, and lower extremity pitting edema. Iatrogenic Cushing syndrome due to a drug-drug interaction between voriconazole and budesonide was suspected, and voriconazole was discontinued. Budesonide was continued as previously prescribed for her Crohn's disease. On reevaluation 2 months later, the patient's Cushingoid features had markedly regressed. To our knowledge, this is the first published case report of iatrogenic Cushing syndrome due to a probable interaction between voriconazole and oral budesonide. In patients presenting with Cushingoid features who

  9. Iatrogenic keratoconjunctivitis sicca in a dog Ceratoconjuntivite seca iatrogênica em cão

    Denise Eliza de Almeida


    Full Text Available Qualitative and quantitative abnormalities in primary components of the tear can alter the dynamics of the lacrimal film, compromising its function. Lipids, an aqueous fraction and mucoproteins constitute the lacrimal film. Keratoconjunctivitis sicca (KCS is a disease commonly diagnosed in dogs. It is characterized by the deficiency of the aqueous fraction in the lacrimal film that results in dryness, inflammation of the conjunctive and cornea with progressive corneal illness and reduction of vision and pain. Due to the significant contribution of the third eyelid lacrimal gland to the production of the aqueous fraction of the lacrimal film, the removal of this gland when prolapsed is an important cause of iatrogenic keratoconjuctivitis sicca. This paper describes a clinical case of iatrogenic keratoconjuctivitis sicca in a 10 month-old Boston Terrier which was caused by the removal of the third eyelid lacrimal gland due to its prolapse.Anormalidades quali-quantitativas em componentes primários da lágrima podem alterar a dinâmica do filme lacrimal, comprometendo sua função. O filme lacrimal é composto por lipídios, uma fração aquosa e por mucoproteínas. A ceratoconjuntivite seca (CCS é uma enfermidade freqüentemente diagnosticada em cães, caracterizada pela deficiência da fração aquosa do filme lacrimal, resultando em dessecação e inflamação da conjuntiva e córnea, dor, doença corneana progressiva e redução da visão. Devido à contribuição significativa da glândula da terceira pálpebra na produção da porção aquosa do filme lacrimal, a remoção desta glândula, quando prolapsada, constitui-se em importante causa de CCS iatrogênica. Este trabalho relata um caso clínico de ceratoconjuntivite seca iatrogênica, em um cão da raça Boston Terrier de 10 meses de idade, causada pela remoção cirúrgica da glândula lacrimal da terceira pálpebra, quando esta encontrava-se prolapsada.

  10. A fatal iatrogenic right vertebral injury after transoral odontoidectomy and posterior cervical stabilization for a type II odontoid fracture.

    Scalici, Edoardo; Indorato, Francesca; Portelli, Francesca; Savì, Tommaso; Maresi, Emiliano; Busardò, Francesco P


    The authors present a singular case of an iatrogenic right vertebral artery injury, involving a 67 year-old man, who reported a type II odontoid fracture (Anderson and D'Alonzo Classification) and posterior atlantoaxial dislocation following a road traffic accident. A small injury involving the right vertebral artery occurred as a consequence of transoral odontoidectomy and posterior cervical stabilization. It was caused by bone spicules of spinal origin and their presence was confirmed by the histological section of the right vertebral artery at the level of C1-C2. The case confirms how iatrogenic vertebral artery injuries during cervical spine surgery may be potentially lethal, especially where complications arise some days after surgery.

  11. Immediate bail-out TAP-stenting for the treatment of iatrogenic aortocoronary dissection involving left main bifurcation

    Edmundo Patricio Lopes Lao; Shao-Ping Nie; Chang-Sheng Ma


    Iatrogenic aortocoronary dissection is a rare but potentially disastrous complication of percutaneous coronary intervention. The left main dissection extending into distal bifurcation involving both the left anterior descending and left circumflex is a complex and vital complication, which is classified as Eshtehardi Type II dissection. We presented a case of iatrogenic left main coronary artery dissection with upcoming closure of both major branches, which was successfully managed by immediate bail-out TAP-stenting. The 77-year-old patient was discharged without any complication, and 1-year follow-up indicated stent patency and favorable clinical result. Immediate bail-out stenting is a feasible and reasonable initial management for this lethal complication.

  12. [Role of animal gastric Helicobacter species in human gastric pathology].

    Pozdeev, O K; Pozdeeva, A O; Pozdnyak, A O; Saifutdinov, R G


    Animal Helicobacter species other than Helicobacter pylori are also able to cause human gastritis, gastric ulcers, and MALT lymphomas. Animal Helicobacter species are presented with typical spiral fastidious microorganisms colonizing the gastric mucosa of different animals. Bacteria initially received their provisional name Helicobacter heilmannii, and out of them at least five species colonizing the gastric mucosa of pigs, cats, and dogs were isolated later on. A high proportion of these diseases are shown to be zoonotic. Transmission of pathogens occurs by contact. The factors of bacterial pathogenicity remain little studied.

  13. Molecular pathology of wound healing.

    Kondo, Toshikazu; Ishida, Yuko


    Skin-wound healing is an orchestrated biological phenomena consisting of three sequential phases, inflammation, proliferation, and maturation. Many biological substances are involved in the process of wound repair, and this short and simplified overview of wound healing can be adopted to determine wound vitality or wound age in forensic medicine. With the development of genetically engineered animals, essential molecules for skin-wound healing have been identified. Especially, cytokines, and growth factors are useful candidates and markers for the determination of wound vitality or age. Moreover, bone marrow-derived progenitor cells would give significant information to wound age determination. In this review article, some interesting observations are presented, possibly contributing to the future practice of forensic pathologists. Copyright © 2010. Published by Elsevier Ireland Ltd.

  14. Minimally Displaced Distal Radius Fracture Treated with Closed Reduction and Percutaneous Fixation Resulting in an Iatrogenic Galeazzi Lesion.

    Compagnone, Luce; Ghazal, Rakan; Canavese, Federico


    Galeazzi fracture in skeletally immature patients is a relatively uncommon injury. No previously published case has been associated with an iatrogenic mechanism. Here, we report a case of a 10-year-old boy with a minimally displaced distal radius fracture evolving into a Galeazzi lesion after unnecessary surgical treatment. Unnecessary surgical procedure associated with poor knowledge of bone growth and physiology contributed significantly to the reported condition.

  15. The clinical curative effect of transurethral resection of the ejaculatory duct for iatrogenic ejaculatory duct obstruction after prostatic hyperthermia

    Liang-Yun Zhao; Xiang-An Tu; Chun-Hua Deng


    @@ Dear Sir, I am a urologic doctor from Urology Department of The First Affiliated Hospital of Sun Yat-Sen University of Medical Science. Recently our group find there are some patients diagnosed with iatrogenic ejaculatory duct obstruction (EDO) after prostatic hyperthermia.This finding showed it was dangerous that some nullibreeding patients of prostatitis were treated with prostatic hyperthermia, which could induce EDO and urethrostenosis.

  16. Iatrogenic Bidirectional Dissection of the Right Coronary Artery and the Ascending Aorta: The Worst Nightmare for an Interventional Cardiologist

    Dahdouh, Ziad; Roule, Vincent; Lognoné, Thérèse; Sabatier, Rémi; Bignon, Mathieu; Malcor, Guillaume; Lemaitre, Adrien; Blanchart, Katrien; Wain-Hobson, Julien; Saplacan, Vladimir; Cutone, Fabio; Buklas, Dimitrios; Ivascau, Calin; Massetti, Massimo; Grollier, Gilles


    Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the pr...

  17. A Novel Type of Ureteral Stents in the Treatment of a Bilateral Iatrogenic Transaction of the Ureters

    Ernesto Mazza


    Full Text Available This report illustrates the case of a patient who suffered an iatrogenic complete injury of both ureters after a complex surgical procedure to remove a large sacral chordoma. Ureteral recanalization was achieved with two removable, autoexpandable, and polytetrafluoroethylene covered nitinol stents. To our knowledge, we describe the first application of this type of stents to treat a bilateral ureteral transection. Despite the bad general conditions of the patient, the ureteral stents successfully restored and maintained the bilateral ureteral continuity.

  18. Comparison of solcoseryl and epidermal growth factors (EGF) in healing of chronic gastroduodenal ulcerations and mucosal growth in rats.

    Konturek, S J; Brzozowski, T; Dembinski, A; Warzecha, A; Drozdowicz, D


    Solcoseryl, a deproteinized extract of calf blood, and EGF, produced by salivary glands, have been shown to enhance the healing of peptic ulcerations, but the mechanism of this effect is unknown. Since both solcoseryl and EGF have been reported to stimulate cell proliferation, we designed the study to compare the ulcer healing and growth promoting actions of these two agents in the same animals. Gastric and duodenal ulcerations were produced by serosal application of 100% acetic acid on an area of 13.8 mm2 of gastric and duodenal wall, respectively. In the control animals, 7 days after ulcer induction, the mean ulcer area was reduced to 7.1 +/- 1.2 mm2 in the stomach, and to 6.1 +/- 0.8 mm2 in the duodenum. After 14 days all ulcers were healed, both in the stomach and duodenum. Oral administration of solcoseryl (10 ml/kg-day) or EGF (30 micrograms/kg-day) for 7 days after ulcer induction resulted in a significant reduction in the ulcer area in the stomach, and to a greater extent in the duodenum. This enhancement of ulcer healing by solcoseryl was accompanied by a significant increase in the weight of the duodenal mucosa and the total contents of DNA and RNA after 7 days of treatment, and in the weight and nucleic acid contents in both the gastric and duodenal mucosa after 14 days of treatment. EGF also increased the weights and the nucleic acid contents in gastric and duodenal mucosa, but this was significant only after 14 days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Gastric Ulcers Syndrome in Donkeys

    Abelardo Morales Briceño


    Full Text Available This study aimed to describe gastric ulcer in donkeys. 10 donkeys (Equus asinus were studied in Bodonal de la Sierra, Badajoz-Extremadura, Spain. They were referred for necropsy and dead due to non-digestive causes. 4 males and 6 females were examined. The ages were classified of 4-16 years old. The stomach and gastric mucosa was evaluated for classified Merrit, 2003. Samples of gastric tissue were collected. The samples fixed in formalin were processed by conventional histological techniques and examined by histopathology. None of the donkeys presented clinical signs for gastric ulcers syndrome. Of the 10 donkeys studied, 10% had Grade 0; 30% Grade 1; 40% Grade 2; 10% Grade 3; and 10% Grade 4. In 30% (3/10 parasites such as Gasterophilus sp. were observed. The histological slices revealed severe damage on the gastric mucosa, a loss of continuity of the gastric mucosa with corium exposure, and subchorionic edema with parakeratotic hyperkeratosis, together with a mixed lymphoplasmocytic mononuclear infiltrate. In conclusion, we reported gastric ulcers syndrome in donkeys in Spain.

  20. Photodynamic therapy of gastric cancer

    Kharnas, Sergey S.; Kuzin, N. M.; Zavodnov, Victor Y.; Sclyanskaya, Olga A.; Linkov, Kirill G.; Loschenov, Victor B.; Meerovich, Gennadii A.; Torshina, Nadezgda L.; Stratonnikov, Alexander A.; Steiner, Rudolf W.


    Photodynamic therapy (PDT) with the use of laser endoscopic spectrum analyzer (LESA-5), the spectral-analyzing video-imaging system, Kr laser and various types of catheters for different tumor localizations, and Phthalocyanine aluminum photosensitizers in patients with gastric cancer was discussed. PDT was carried out in fifteen patients with gastric cancer. There were the following indications for PDT: early gastric cancer (3 patients), malignant stenosis of the cardia or pyloric portion of the stomach (4 patients), cancer of gastric stump with stenosis of gastrojejunal anastomosis (1 patient), preoperative treatment of patients with large but probably resectable gastric tumor size (7 patients). Usually we used 3 - 4 seances of laser treatment 10 - 30 minutes long. Concentration of photosensitizer in normal and malignant tissue was controlled by LESA-5. Treatment was monitored by spectral-analyzing video- imaging system in fluorescent light. The results show high efficiency of PDT especially in patients with early gastric cancer (necrosis of all tumor mass, i.e. complete regression of tumor). For all other patients we obtained partial regression of gastric cancer.

  1. Socio-demographic and clinical features of Irish iatrogenic hepatitis C patients: a cross-sectional survey.

    McKenna, Olivia


    BACKGROUND: A discrete sub-group of iatrogenically-acquired hepatitis C virus (HCV)-infected individuals exists in the Irish population on whom limited current research data is available. The aim of this study was to establish a current profile of the socio-demographic and clinical characteristics of the Irish iatrogenic hepatitis C population and to determine factors predicting symptoms experienced. METHODS: An anonymous, national, cross-sectional survey was conducted to explore this populations\\' self-reported health and social attributes. Data were collected on 290 respondents. RESULTS: Mean time since infection was 26 years. Eighty-four percent (n = 237) of respondents were female (mean age = 55.9 +\\/- 9.6 years). Hepatic and extra-hepatic symptoms were common (62% and 99% respectively). Fatigue and pain were frequent complaints while 89% reported diagnosed co-morbid disease. On logistic regression, female gender, age and co-morbid disease emerged as independent predictors of self-reported symptoms. CONCLUSION: This study describes the current status of the iatrogenically infected patient cohort in Ireland, adding to existing knowledge regarding the clinical course and consequences of HCV infection. Changing healthcare needs were shown by comparison with earlier surveys in this same population, in terms of disease progression, development of co-morbid disease and ageing.

  2. Extrahepatic Pseudoaneurysms and Ruptures of the Hepatic Artery in Liver Transplant Recipients: Endovascular Management and a New Iatrogenic Etiology

    Saad, Wael E. A., E-mail:; Dasgupta, Niloy; Lippert, Allison J.; Turba, Ulku C.; Davies, Mark G. [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States); Kumer, Sean [University of Virginia Health System, Division of Solid Organ Transplantation, Department of Surgery (United States); Gardenier, Jason C.; Sabri, Saher S.; Park, Auh-Whan [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States); Waldman, David L. [University of Rochester Medical Center, Department of Imaging Sciences (United States); Schmitt, Timothy [University of Virginia Health System, Division of Solid Organ Transplantation, Department of Surgery (United States); Matsumoto, Alan H.; Angle, John F. [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States)


    To characterize extrahepatic pseudoaneurysm regarding incidence and etiology and determine the effectiveness of endovascular management. A retrospective audit of 1,857 liver transplants in two institutions was performed (1996-2009). Recipients' demographics, clinical presentation, transplant type, biliary anastomosis, and presence of biliary endoprostheses were noted. Pseudoaneurysms were classified into iatrogenic (associated with biliary endoprosthesis or angioplasty) or spontaneous extrahepatic pseudoaneurysms. Spontaneous and iatrogenic pseudoaneurysms were compared for time from transplant, presenting symptoms, location in the arterial anatomy, and 3-month graft survival. Arterial patency and 6-month graft survival were calculated. Twenty pseudoaneurysms were found (1.1 %, 20/1,857): 9 (0.5 % of transplants, 9/1,857) were spontaneous and 11 (0.6 % of transplants, 11/1,857) were 'iatrogenic' (due to minimally invasive procedures: 4 angioplasty and 7 biliary endoprostheses). Sixty percent (12/20) underwent endovascular management (4 coil embolization and 8 stent-grafts). Technical success was 83 % (10/12) with a mean arterial patency of 70 % (follow-up mean, 4.9; range, 0-18 months). The 1-, 3-, and 6-month graft survival was 70, 40, and 35 %, respectively. Due to minimally invasive procedures, posttransplant extrahepatic pseudoaneurysms are no longer an exclusive complication of the transplant surgery itself. Endovascular management is effective to stabilize patients but has not improved historic postsurgical graft survival.

  3. Healing particles in self-healing thermal barrier coatings

    Derelioglu, Z.; Anusuya Ponnusami, S.; Turteltaub, S.; Van der Zwaag, S.; Sloof, W.G.


    Crack healing in ceramic thermal barrier coatings (TBCs) may be realized by embedding Mo-Si based particles in the thermal barrier coating. Upon cracking, these particles are exposed to oxygen that permeates through the top layer and the crack gap is filled with SiO2 which is produced from oxidation

  4. Self-healing of polymer modified concrete

    Abd_Elmoaty M. Abd_Elmoaty


    Full Text Available Self healing phenomenon of concrete has been observed in traditional, fibrous, self compacting concrete. This phenomenon occurred mainly due to the presence of unhydrated cement particles in the presence of water. Mechanism of polymer in concrete depends on creating a layer and net of polymer around cement particles which enhances the properties of polymer modified concrete. This mechanism may affect the self healing of this type of concrete. This work aims to study the presence of the self healing phenomenon in polymer modified concrete and the related parameters. An experimental investigation on self healing of polymer modified concrete was undertaken. In this research work, effect of polymer type, polymer dose, cement content, cement type, w/cm ratio and age of damage were studied. The healing process extended up to 60 days. Ultrasonic pulse velocity measurements were used to evaluate the healing process. Results indicated that, the self healing phenomenon existed in polymer modified concrete as in traditional concrete. The increase of polymer dose increases the healing degree at the same healing time. This increase depends on polymer type. Also, the decrease of w/cm ratio reduces the self healing degree while the use of Type V Portland cement improves the self healing process compared with Type I Portland cement. Cement content has an insignificant effect on healing process for both concrete with and without polymer. In addition, the increase of damage age decreases the efficiency of self healing process.

  5. Anti-ulcer and wound healing activities of Sida corymbosa in rats.

    John-Africa, Lucy Binda; Yahaya, Tijani Adeniyi; Isimi, Christianah Yetunde


    There are strong beliefs in the efficacy of traditional medical systems worldwide. Many herbs have been acclaimed to possess antiulcer effects and could be unexplored sources of new lead compounds. Sida corymbosa R. E. Fries (Malvaceae) is used in Northern Nigeria to treat ulcers and wounds. This work aimed to investigate the usefulness of Sida corymbosa in treatments of stomach ulcers and wounds in traditional medicine. Effect of the aqueous extract was determined on gastric ulceration, rate of wound healing and inflammation using ethanol-induced and diclofenac-induced ulceration, wound excision model and albumin-induced inflammation respectively in rats. The study demonstrated the anti-ulcer activity of Sida corymbosa as the extract (250, 500 and 1000 mg/kg) showed a dose-dependent, significant (PSida corymbosa on surgically created incisions produced an increase in the rate of healing of the wounds. The extract of Sida corymbosa exhibited a significant (P Sida corymbosa has constituents with the ability to reduce the severity of haemorrhagic gastric lesions, promote wound healing and reduce inflammation. These actions may be attributed to any one of the active constituents or as a result of synergistic effects of these phytoconstituents. This study validates the use of the plant in traditional medicine for the treatment of stomach ulcers and wounds.

  6. Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations

    Wang, Z.; Chen, J.; Shi, H.; Zhou, K.; Sun, H. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Li, X., E-mail: [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Pan, J.; Zhang, X.; Liu, W.; Yang, N.; Jin, Z. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China)


    Aim: To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs). Materials and methods: A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin ({beta}-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed. Results: A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred. Conclusion: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.

  7. MRI findings on iatrogenic spinal infection following various pain management procedures

    Kim, Yu Jin; Lee, Jee Young; Kim, Bong Man [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Min, Sang Hyuk [Dept. of Orthopedic Surgery, Dankook University Hospital, Cheonan (Korea, Republic of)


    The aim of this study was to investigate and report magnetic resonance imaging (MRI) findings of iatrogenic spinal infection (ISI). We retrospectively reviewed the clinical and MRI findings on 18 patients diagnosed with ISI. The MRI findings were evaluated for the number of spinal segments showing inflammation in the longitudinal span and affected vertebral bodies and discs, the presence of abscess in the epidural or paravertebral space, paravertebral myositis, and skip lesions. Among the 18 patients, the range of the longitudinal span of spinal inflammation was 2-11 (mean = 5.84) vertebral segments. 17 of the 18 patients had three or more contiguous vertebral segments. The osteomyelitis and disc destruction was apparent in 77.8% and 66.7% of the patients, and 78% of patients with osteomyelitis showed involvement of one or two vertebrae; 91.7% of patients with disc destruction showed involvement of single disc. The incidence of epidural or paravertebral abscesses, and paravertebral myositis were 88.9%, and 94.4%. There were no spinal skip lesions. MRI findings of those are wide longitudinal span of infection, involvement of no more than one or two vertebral bodies and a single disc, large abscesses, extensive myositis and no skip lesions, can be a useful ISI-diagnostic tool.

  8. Iatrogenic Inflammatory Fibrosis of Hard Palate in a 13-Year-Old Female Patient

    Shanthan Mettu


    Full Text Available Palatal swellings are rare in children and the incidence differs from that of the adult counterparts. When the palatal swellings do arise in children, they usually are palatal abscess from periapical region, and few cases like pleomorphic adenoma in young adults have also been reported. But inflammatory fibrosis of palate in children is a rare occurrence. Inflammatory fibrosis is formation of excess fibrous connective tissue in an organ or tissue, as a reparative or reactive process. This report describes an unusual case of iatrogenic inflammatory fibrosis on the palate due to extraction of tooth number 22 in a 13-year-old female patient. The patient presented with a single large well-circumscribed oval palatal swelling that was soft, fluctuant, not fixed, and nontender. Surgical excision of the lesion was done and it was sent for histopathological assessment. The biopsy showed fibrous tissue with collagen fibers, spindle shaped fibroblasts, neovascularization, RBCs, chronic inflammatory cells, and traces of salivary gland and nerve tissue.

  9. Urethrolysis with Martius labial fat pad graft for iatrogenic bladder outlet obstruction.

    Carey, Jeffrey M; Chon, Joanna K; Leach, Gary E


    This article evaluates treatment outcomes of urethrolysis with the Martius labial fat pad graft for patients with outlet obstruction after incontinence surgery. A total of 23 women were diagnosed with iatrogenic bladder outlet obstruction by urinary retention, urodynamic criteria, physical examination findings, and/or temporal relation of voiding dysfunction to anti-incontinence surgery. The urodynamic definition of female outlet obstruction was a maximum flow rate 20 cm of water. Surgical treatment consisted of urethrolysis with complete circumferential urethral mobilization. A Martius labial fat pad graft was used to circumferentially wrap the urethra. No concurrent resuspension procedures were performed. Procedure efficacy was determined by retrospective review and phone interview. Mean patient age was 55 years (range, 37 to 85 years). Mean postoperative follow-up time was 15 months (maximum, 44 months). All patients related voiding dysfunction symptoms to their anti-incontinence surgery. In all, 17 of 23 (74%) patients had preoperative urinary retention requiring catheterization, and 63% of patients met urodynamic criteria for obstruction. After urethrolysis with a Martius labial fat pad graft, 20 of 23 (87%) patients had complete resolution of their obstruction; 3 patients required persistent catheterization. Postoperative stress incontinence was reported by 6 of 23 (13%) patients. Urodynamically documented detrusor instability occurred in 6 of 23 (26%) patients with de novo detrusor instability occurring in 3 of 15 (20%) patients.


    Stakhovskiy, E O; Vukalovych, P S; Voylenko, O A; Stakhovskiy, O E; Vitruk, Yu V; Kononenko, O A


    Basing on analysis of the examination and treatment results in 53 patients, suffering iatrogenic injury of ureter (IIU), the indications for ureteric reconstruction using intestinal segment were the ureter long irreversible changes, while renal function preserved. A segmental ureteric plasty was done in 8 (15.1%) patients, a subtotal one--in 16 (30.2%), total--in 14 (26.4%), and bilateral--in 15 (28.3%). With the objective to prevent the bladder-intestinal reflux occurrence a distal part of the intestinal transplant was modeled. In 35 (66%) patients 2 - 3 cm of distal part of intestinal mucosa were turned out with the wrap formation. In 18 (34%) patients the creation of antireflux wrap was added by its modeling in a kind of intraileal plasty with formation of two separate channels in the intestinal-bladder anastomosis region. While performance of intraileal plasty of the bladder-intestinal reflux have occurred in 2 (11.1%) patients, and after procedure with the wrap formation--in 13 (37.1%).

  11. Iatrogenic Anetoderma of Prematurity: A Case Report and Review of the Literature

    Laura Maffeis


    Full Text Available Anetoderma is a skin disorder characterized by focal loss of elastic tissue in the mid dermis, resulting in localized areas of macular depressions or pouchlike herniations of skin. An iatrogenic form of anetoderma has been rarely described in extremely premature infants and has been related to the placement of monitoring devices on the patient skin. Because of the increasing survival of extremely premature infants, it is easy to foresee that the prevalence of anetoderma of prematurity will increase in the next future. Although it is a benign lesion, it persists over time and can lead to significant aesthetic damage with need for surgical correction. Sometimes the diagnosis can be difficult, especially when the atrophic lesions become evident after discharge. Here, we report on a premature infant born at 24 weeks of gestation, who developed multiple anetodermic patches of skin on the trunk at the sites where electrocardiographic electrodes were previously applied. The knowledge of the disease can encourage a more careful management of the skin of extremely premature babies and aid the physicians to diagnose the disease when anetoderma patches are first encountered later in childhood.

  12. Iatrogenic Spinal Cord Injury in a Trauma Patient with Ankylosing Spondylitis.

    Maarouf, Ahmad; McQuown, Colleen M; Frey, Jennifer A; Ahmed, Rami A; Derrick, Lisa


    The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients. To describe an iatrogenic injury resulting from the use of a rigid spinal board and advocate for the use of alternative immobilization methods or no immobilization at all. We present our case here of a 68-year-old male with a history of AS. The patient was ambulatory on scene after a low speed car accident, but immobilized with a rigid backboard by paramedics. He developed back pain and paraplegia suddenly when the backboard was lifted for transport to the hospital. A CT scan revealed an extension fraction of T10 to T11 with involvement of the posterior column. Emergency spinal fusion was performed. Patient died of complications in the hospital. This case shows that spinal immobilization should be avoided in cases of ambulatory patients without a clear indication. Alternative transport methods such as vacuum mattresses should be considered when spinal immobilization is indicated, especially for patients with predispositions to spinal injury, particularly AS, to maintain the natural alignment of the spinal curvature.

  13. Limitation of imaging in identifying iatrogenic aortic coarctation following thoracic endovascular aortic repair.

    Thakkar, Rajiv N; Thomaier, Lauren; Qazi, Umair; Verde, Franco; Malas, Mahmoud B


    A 21-year-old male suffered blunt trauma from a motor vehicle accident causing thoracic aorta tear. The smallest available stent graft was deployed. Definitive repair was later performed using a 22 × 22 × 116 mm Talent Thoracic Stent Graft. The postoperative course was uneventful. Seventeen months later, he presented with dizziness, chest pain, acute renal failure, malignant hypertension, and troponin elevation. Computed tomography (CT) angiogram and transesophageal echocardiogram did not reveal any dissection, stent stenosis or collapse. Cardiac catheterization showed normal coronary arteries but a 117 mm Hg gradient across the stent graft. Iatrogenic coarctation of the aorta was confirmed with a second measurement during arch angiogram. A Palmaz stent was deployed over the distal end of the previous stent graft with complete resolution of symptoms and gradual normalization of kidney function. This case report demonstrates a need for wider availability and selecting appropriate stent graft in treating traumatic aortic injuries in young patients. It is the first case report of the inability of current imaging modalities in confirming stent collapse. Pressure gradient is a useful tool in confirming stent collapse when clinical scenario does not match CT findings.

  14. Endosurgical repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy.

    Lesley, W S


    A 56-year-old woman with right-sided trigeminal neuralgia (TN), who underwent technically uneventful percutaneous balloon rhizotomy, developed significant bilateral pulsatile tinnitus on the first post-operative day. Although the patient reported significantly improved neuralgia, auscultation revealed a right facial bruit. Magnetic resonance angiography (MRA) of the face and brain demonstrated prominent right facial and jugular venous vascularity. Catheter angiography confirmed the suspected facial arteriovenous fistula (AVF). A transarterial approach was used to explore the AVF which arose from a laceration of the right internal maxillary artery and which fistulized directly with the pterygoid venous plexus. Endosurgical repair utilizing three non-fibered platinum coils was done under conscious sedation at the same setting as the diagnostic angiogram. Angiographically, the fistula was obliterated, and the patient's bruit and tinnitus immediately resolved. Follow-up MRA at 3.5 months was normal, and, the patient had no clinical symptoms of recurrent AVF. In conclusion facial AVF can complicate percutaneous trigeminal rhizotomy. Iatrogenic facial AVF can be repaired via an endovascular approach.

  15. Hybrid Interventional Treatment of Iatrogenic Innominate Artery Aneurysm in a Child.

    Paczkowski, Konrad; Haponiuk, Ireneusz; Chojnicki, Maciej; Brzezińska-Rajszys, Grażyna


    An iatrogenic aneurysm of an innominate artery is an extremely rare complication, especially in children. Nevertheless, this pathology was diagnosed in a child given palliative care with chronic respiratory insufficiency and a history of encephalitis requiring permanent ventilation at home via a tracheal tube.A nine-year-old girl with colitis ulcerosa and a history of hemorrhagic encephalitis, with chronic home ventilation therapy, was admitted in an emergency setting because of massive bleeding from the upper respiratory tract and the area surrounding the tracheotomy. Repeated tamponade with topically applied thrombin, and administration of tranexamid acid and cyclonamine appeared ineffective Because of a life-threatening condition and unknown origin of massive bleeding, the child was referred for cardiac catheterization with aortography before qualifying for surgery, with the option of alternative interventional treatment. An alternative option with PTFE-coated stent direct implantation into the brachiocephalic trunk from a peripheral vascular approach was performed. The girl was discharged home after a short recovery. Her chronic home ventilation was continued without additional problems.Stenting of a brachiocephalic trunk aneurysm with a PTFE-coated stent appeared to be a safe and effective treatment of massive bleeding from the respiratory tract, with its main advantage of avoiding the risk of a classic surgical approach in a palliatively treated patient.

  16. Glycemic goals in diabetes: trade-off between glycemic control and iatrogenic hypoglycemia.

    Cryer, Philip E


    The selection of a glycemic goal in a person with diabetes is a compromise between the documented upside of glycemic control-the partial prevention or delay of microvascular complications-and the documented downside of glycemic control-the recurrent morbidity and potential mortality of iatrogenic hypoglycemia. The latter is not an issue if glycemic control is accomplished with drugs that do not cause hypoglycemia or with substantial weight loss. However, hypoglycemia becomes an issue if glycemic control is accomplished with a sulfonylurea, a glinide, or insulin, particularly in the setting of absolute endogenous insulin deficiency with loss of the normal decrease in circulating insulin and increase in glucagon secretion and attenuation of the sympathoadrenal response as plasma glucose concentrations fall. Then the selection of a glycemic goal should be linked to the risk of hypoglycemia. A reasonable individualized glycemic goal is the lowest A1C that does not cause severe hypoglycemia and preserves awareness of hypoglycemia, preferably with little or no symptomatic or even asymptomatic hypoglycemia, at a given stage in the evolution of the individual's diabetes.

  17. Self-healing epoxy composites: preparation, characterization and healing performance

    Reaz A. Chowdhury


    Full Text Available Low velocity impact damage is common in fiber reinforced composites, which leads to micro-crack and interfacial debonding, where damage is microscopic and invisible. The concept of self-healing composites can be a way of overcoming this limitation and extending the life expectancy while expanding their usage in structural applications. In the current study, extrinsic self-healing concept was adopted using urea-formaldehyde microcapsules containing room temperature curing epoxy resin system (SC-15 as the healing agent prepared by in situ polymerization. Microcapsules were characterized using Fourier transform infrared spectroscopy (FTIR for structural analysis. Size and shape of microcapsules were studied using optical microscopy and scanning electron microscopy (SEM. Size of the microcapsules was between 30 and 100 μm. Thermal characterization was carried out using thermogravimetric analysis. Microcapsules were thermally stable till 210 °C without any significant decomposition. Fiber reinforced composite fabrication was carried out in three different steps. In the first step, epoxy resin was encapsulated in urea-formaldehyde shell material, which was confirmed by FTIR analysis. In the next step, encapsulation of amine hardener was achieved by vacuum infiltration method. These two different microcapsules were added with epoxy at 10:3 ratio and composite fabrication was done with hand layup method. Finally, healing performance was measured in terms of low velocity impact test and thermoscopy analysis. Low velocity impact test with 30 J and 45 J impact loads confirmed the delamination and micro-crack in composite materials and subsequent healing recovery observed in terms of damaged area reduction and restoration of mechanical properties.

  18. Serological assessment of gastric mucosal atrophy in gastric cancer

    Bornschein Jan


    Full Text Available Abstract Background Non-invasive tools for gastric cancer screening and diagnosis are lacking. Serological testing with the detection of pepsinogen 1 (PG1, pepsinogen 2 (PG2 and gastrin 17 (G17 offers the possibility to detect preneoplastic gastric mucosal conditions. Aim of this study was to assess the performance of these serological tests in the presence of gastric neoplasia. Methods Histological and serological samples of 118 patients with gastric cancer have been assessed for tumor specific characteristics (Laurén type, localisation, degree of mucosal abnormalities (intestinal metaplasia, atrophy and serological parameters (PG1, PG2, PG1/2-ratio, G17, H. pylori IgG, CagA status. Association of the general factors to the different serological values have been statistically analyzed. Results Patients with intestinal type gastric cancer had lower PG1 levels and a lower PG1/2-ratio compared to those with diffuse type cancer (p = 0.003. The serum levels of PG2 itself and G17 were not significantly altered. H. pylori infection in general had no influence on the levels of PG1, PG2 and G17 in the serum of gastric cancer patients. There was a trend towards lower PG1 levels in case of positive CagA-status (p = 0.058. The degree of both intestinal metaplasia and atrophy correlated inversely with serum levels for PG1 and the PG1/2-ratio (p Conclusions Glandular atrophy and a positive CagA status are determinant factors for decreased pepsinogen 1 levels in the serum of patients with gastric cancer. The serological assessment of gastric atrophy by analysis of serum pepsinogen is only adequate for patients with intestinal type cancer.

  19. High Temperature Self-Healing Metallic Composite

    Kutelia, E. R.; Bakhtiyarov, S. I.; Tsurtsumia, O. O.; Bakhtiyarov, A. S.; Eristavi, B.


    This work presents the possibility to realize the self healing mechanisms for heterogeneous architectural metal/ceramic high temperature sandwich thermal barrier coating systems on the surfaces refractory metals by analogy of wound healing in the skin.

  20. Gastric metastasis from primary lung adenocarcinomamimicking primary gastric cancer

    Min Ji Kim; Ji Hyung Hong; Eun Su Park; Jae Ho Byun


    Gastric metastases from lung adenocarcinoma arerare. Because gastric metastasis grossly resemblesadvanced gastric cancer, it is difficult to diagnose gastricmetastasis especially when the histology of the primarylung cancer is adenocarcinoma. We describe a case ofgastric metastasis from primary lung adenocarcinomamimicking Borrmann type Ⅳ primary gastric cancer.A 68-year-old man with known lung adenocarcinomawith multiple bone metastases had been experiencingprogressive epigastric pain and dyspepsia over one year.Esophagogastroduodenoscopy revealed linitis plasticalikelesions in the fundus of the stomach. Pathologicexamination revealed a moderately differentiatedadenocarcinoma with submucosal infiltration. Positiveimmunohistochemical staining for thyroid transcriptionfactor-1 (TTF-1) and napsin A (Nap-A) confirmed thatthe metastasis was pulmonary in origin. The patienthad been treated with palliative chemotherapy for thelung cancer and had lived for over fifteen months afterthe diagnosis of gastric metastasis. Clinicians should beaware of the possibility of gastric metastasis in patientswith primary lung adenocarcinoma, and additionalimmunohistochemical staining for Nap-A as well as TTF-1may help in differentiating its origin.

  1. What gastric cancer proteomic studies show about gastric carcinogenesis?

    Leal, Mariana Ferreira; Wisnieski, Fernanda; de Oliveira Gigek, Carolina; do Santos, Leonardo Caires; Calcagno, Danielle Queiroz; Burbano, Rommel Rodriguez; Smith, Marilia Cardoso


    Gastric cancer is a complex, heterogeneous, and multistep disease. Over the past decades, several studies have aimed to determine the molecular factors that lead to gastric cancer development and progression. After completing the human genome sequencing, proteomic technologies have presented rapid progress. Differently from the relative static state of genome, the cell proteome is dynamic and changes in pathologic conditions. Proteomic approaches have been used to determine proteome profiles and identify differentially expressed proteins between groups of samples, such as neoplastic and nonneoplastic samples or between samples of different cancer subtypes or stages. Therefore, proteomic technologies are a useful tool toward improving the knowledge of gastric cancer molecular pathogenesis and the understanding of tumor heterogeneity. This review aimed to summarize the proteins or protein families that are frequently identified by using high-throughput screening methods and which thus may have a key role in gastric carcinogenesis. The increased knowledge of gastric carcinogenesis will clearly help in the development of new anticancer treatments. Although the studies are still in their infancy, the reviewed proteins may be useful for gastric cancer diagnosis, prognosis, and patient management.

  2. Efficacy of additional treatment with azathioprine in a patient with prednisolone-dependent gastric sarcoidosis.

    Murata, Masaki; Sugimoto, Mitsushige; Yokota, Yoshihiro; Ban, Hiromitsu; Inatomi, Osamu; Bamba, Shigeki; Kushima, Ryoji; Andoh, Akira


    Gastric sarcoidosis with noncaseating granuloma is rare. Although corticosteroid produces a dramatic clinical response, it is unknown whether azathioprine show efficacy in prednisolone-dependent cases. Here, we report a case of gastric sarcoidosis in a 25-year-old man with severe epigastlargia. Gastroendoscopy revealed multiple map-like ulcerations. Histological examination showed multiple noncaseating granulomatous lesions in gastric mucosa, which were incompatible with diagnoses of Crohn's disease or tuberculosis. He was started on prednisolone at 30 mg/d, and his symptoms improved within 7-d. The prednisolone was gradually tapered by 5 mg every 2-wk, but oral azathioprine at 50 mg was added after symptoms recurred at tapered dose of 10 mg. Endoscopy 4-wk later showed healing ulcers, and, lymphocytic infiltration was absent. The efficacy of additional azathioprine in gastric sarcoidosis is not well defined. Here, we report a case of prednisolone-dependent gastric sarcoidosis that improved after additional azathioprine, and also review the literature concerning the treatment, especially for prednisolone-dependent cases.

  3. The diminished expression of proangiogenic growth factors and their receptors in gastric ulcers of cirrhotic patients.

    Jiing-Chyuan Luo

    Full Text Available OBJECTIVES: The pathogenesis of the higher occurrence of peptic ulcer disease in cirrhotic patients is complex. Platelets can stimulate angiogenesis and promote gastric ulcer healing. We compared the expressions of proangiogenic growth factors and their receptors in the gastric ulcer margin between cirrhotic patients with thrombocytopenia and those of non-cirrhotic patients to elucidate possible mechanisms. METHODS: Eligible cirrhotic patients (n = 55 and non-cirrhotic patients (n = 55 who had gastric ulcers were enrolled. Mucosa from the gastric ulcer margin and non-ulcer areas were sampled and the mRNA expressions of the proangiogenic growth factors (vascular endothelial growth factor [VEGF], platelet derived growth factor [PDGF], basic fibroblast growth factor [bFGF] and their receptors (VEGFR1, VEGFR2, PDGFRA, PDGFRB, FGFR1, FGFR2 were measured and compared. Platelet count and the expressions of these growth factors and their receptors were correlated with each other. RESULTS: The two groups were comparable in terms of gender, ulcer size and infection rate of Helicobacter pylori. However, the cirrhotic group were younger in age, had a lower platelet count than those in the non-cirrhotic group (p0.5, p<0.001. CONCLUSIONS: Our findings implied that diminished activity of proangiogenic factors and their receptors may contribute to the pathogenesis of gastric ulcers in cirrhotic patients.

  4. Wound healing: part II. Clinical applications.

    Janis, Jeffrey; Harrison, Bridget


    Treatment of all wounds requires adequate wound bed preparation, beginning with irrigation and débridement. Complicated or chronic wounds may also require treatment adjuncts or specialized wound healing products. An extensive body of research and development has introduced novel wound healing therapies and scar management options. In this second of a two-part continuing medical education series on wound healing, the reader is offered an update on current wound healing technologies and recommendations for obtaining optimal outcomes.

  5. Chemokine Regulation of Angiogenesis During Wound Healing

    Bodnar, Richard J.


    Significance: Angiogenesis plays a critical role in wound healing. A defect in the formation of a neovasculature induces ulcer formation. One of the challenges faced by the clinician when devising strategies to promote healing of chronic wounds is the initiation of angiogenesis and the formation of a stable vasculature to support tissue regeneration. Understanding the molecular factors regulating angiogenesis during wound healing will lead to better therapies for healing chronic wounds.

  6. Nutritional Aspects of Gastrointestinal Wound Healing

    Mukherjee, Kaushik; Sandra L Kavalukas; Barbul, Adrian


    Significance: Although the wound healing cascade is similar in many tissues, in the gastrointestinal tract mucosal healing is critical for processes such as inflammatory bowel disease and ulcers and healing of the mucosa, submucosa, and serosal layers is needed for surgical anastomoses and for enterocutaneous fistula. Failure of wound healing can result in complications including infection, prolonged hospitalization, critical illness, organ failure, readmission, new or worsening enterocutaneo...

  7. Wound Healing Devices Brief Vignettes

    Anderson, Caesar A.; Hare, Marc A.; Perdrizet, George A.


    Significance: The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications.

  8. Plasma Proteins and Wound Healing


    an iron donor for proline hydroxylase synthesis. Hapto- globin also may prevent retardation of wound healing caused by infection by reducing the...dans le syndrome degression et la croissance tissulaire. Expos. Annu. Biochim. Med., 1970, 30: 149. JEEEAY, H. The metabolism of scrum proteins—III

  9. Effect of centrally administered oxytocin on gastric and duodenal ulcers in rats%脑室注射催产素对大鼠胃和十二指肠溃疡的作用

    Mohammed ASAD; Deepak Gopal; Kallasam KOUMARAVELOU; Benny K ABRAHAM; Sadashivam VASU; Subramanian RAMASWAMY


    AIM: To investigate the effect of centrally administered oxytocin and its receptor antagonist, atosiban, on gasuic acid secretion and on experimentally induced gastric and duodenal ulcers. METHODS: The acute gastric ulcer models, such as pylorus ligation, indomethacin-induced and ethanol-induced gastric ulcers were used. Chronic gastric ulcers were induced by acetic acid and duodenal ulcers by cysteamine HC1. RESULTS: In pylorus ligated rats, oxytocin ( 10 μg/kg, icv) showed signifi cant antisecretory and antiulcer activity (P<0.01 ). However, it aggravated the ethanol-induced gastric ulcers and did not show any effect on indomethacin-induced gas tric ulcers. Oxytocin increased gastric ulcer healing in acetic acid-induced chronic gastric ulcers. The effect of oxytocin was reversed by atosiban (10 μg/kg, icy), a selective oxytocin receptor antagonist. Atosiban when given alone increased gastric acid secretion and ulcer index in pylorus-ligated rats and also aggravated acetic acid-induced chronic gastric ulcers. It seems the antiul cer activity of oxytocin was due to its anti-secretory ef fect. CONCLUSION: Centrally administered oxytocin possesses gastric anti-secretory and anti-ulcer activity and oxytocin antagonist, atosiban, is pro-ulcerogenic in rats.

  10. [Cancer of the gastric stump].

    Rojas Bravo, F; Montero, L


    627 cases of gastric cancer treated surgically during the last 5 years, at the Hospital Nacional "Edgardo Rebagliati Martins" from Instituto Peruano de Seguridad Social (Lima-Perú) were revised. 4 of the patients had been operated before of hemigastrectomy or antrectomy with pyloroplasty for peptic ulcer. The time between the first operation and diagnosis of cancer of the gastric stump was more than 20 years. 3 of these cases were able to be resected. The international incidence of cancer in the gastric stump is 1.1% to 9.2% according to different authors. The risk is higher after 15 years. In the pathogenesis are advocated the lower gastric acidity, biliary reflux, the presence of bacteria, the formation of nitrosamines, intestinal metaplasia, etc. Is necessary to perform periodic endoscopic survey in patients who were treated surgically of peptic ulcer with antrectomy or hemigastrectomy with more than 15 years of evolution.

  11. Gastric tissue biopsy and culture

    ... results may be due to: Stomach (gastric) cancer Gastritis , when the lining of the stomach becomes inflamed ... Saunders; 2012:chap 3. Feldman M, Lee EL. Gastritis. In: Feldman M, Friedman LS, Brandt LJ, eds. ...

  12. Retrograde Jejuno-gastric Intussusception

    Sumitoj Singh


    Full Text Available Retrograde jejuno-gastric intussusception is a rare complication following gastric surgery. We present a case of retrograde jejuno-gastric intussusception in a 42-year-old female who presented with upper abdominal pain, vomiting and swelling in left hypochondruim. Intussusception was suspected on ultrasound of the abdomen and later confirmed with computed tomography scan. At laparotomy, efferent loop was intussuscepting into stomach. This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be suspected in a patient with the previous history of gastric surgery as it is a rare complication. Early diagnosis and management can prevent further complications like bowel gangrene and its associated morbidity and mortality.

  13. [Gastric mesenchymal tumours (GIST)].

    Spivach, Arrigo; Fezzi, Margherita; Sartori, Alberto; Belgrano, Manuel; Rimondini, Alessandra; Cuttin-Zernich, Roberto; Covab, Maria Assunta; Bonifacio, Daniela; Buri, Luigi; Pagani, Carlo; Zanconati, Fabrizio


    The incidence of gastrointestinal stromal tumours (GIST) has increased in recent years. A number of authors have attempted to define the actual nature of these tumours. Immunohistochemistry highlighting the positivity of tyrosine-kinase (CD117/c-Kit) has revealed the difference between gastrointestinal stromal tumours and other mesenchymal tumours and, therefore, the possibility of medical rather than surgical therapy. We retrospectively reviewed 19 patients affected by primary gastric GIST, who underwent surgery in recent years with subsequent follow-up. Gastroscopy and gastrointestinal tract radiography were used not only to obtain the diagnosis but also to establish the size, density, contours, ulceration, regional lymphadenopathy, mesenteric infiltration and the presence of metastases. The aim of this study was to evaluate the roles of endoscopy and radiology in this pathology and the advantages and limitations of each individual technique.

  14. Ultrasound stimulation of maxillofacial bone healing

    Schortinghuis, J; Stegenga, B; Raghoebar, GM; de Bont, LGM


    A substantial part of the maxillofacial surgery practice deals with maxillofacial bone healing. In the past decades, low-intensity ultrasound treatment has been shown to reduce the healing time of fresh fractures of the extremities up to 38%, and to heal delayed and non-unions up to 90% and 83%, res

  15. News in wound healing and management

    Gottrup, Finn; Jørgensen, Bo; Karlsmark, Tonny


    -TNFalpha) and Lactobacillus plantarum cultures have also been successfully used in hard to heal, atypical wounds. Knowledge on influencing factors as smoking and biofilm on the healing process has also been improved. Smoking results in delayed healing and increased risk of postoperative infection, whereas the role of biofilm...

  16. Early Attempts to Eradicate Helicobacter pylori after Endoscopic Resection of Gastric Neoplasm Significantly Improve Eradication Success Rates

    Huh, Cheal Wung; Youn, Young Hoon; Jung, Da Hyun; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin


    Purpose After endoscopic resection (ER) of gastric tumors, eradication of Helicobacter pylori (H. pylori) infection is advised to reduce metachronous recurrence. Optimal timing of such therapy (yet to be established) was investigated herein, examining early active and late scarring stages of post-ER iatrogenic ulcers. Materials and Methods Analysis included 514 patients who received proton-pump inhibitor (PPI)-based triple therapy for H. pylori eradication after ER for gastric neoplasms between January 2008 and June 2015. Clinicopathologic characteristics, particularly the timing of triple therapy, were used to compare eradication rates, assigning patients to early- (≤2 weeks), intermediate- (2–8 weeks), and late-phase (≥8 weeks) treatment groups. Results H. pylori eradication rates differed significantly by timing of triple therapy after ER (early, 90.0%; intermediate, 76.2%, late, 72.4%; p ulcer, and duration of therapeutic regimen. Early initiation of H. pylori eradication was also identified as a significant independent predictor of eradication success in multivariate analysis (Odds ratio = 3.67, 95% CI 2.18–6.16; p <.001). Conclusion In patients undergoing ER of gastric tumors, early post-ER attempts at eradication of H. pylori offer the best chance of eradication success. PMID:27588679

  17. [Ocular metastasis heralding gastric adenocarcinoma].

    Chekrine, T; Tawfiq, N; Bouchbika, Z; Benchakroun, N; Jouhadi, H; Sahraoui, S; Benider, A


    Ocular metastasis is a rare presenting feature of gastric adenocarcinoma. We report a 48-year-old woman who presented with a decrease in visual acuity of the right eye leading to the discovery of an ocular metastasis. Diagnostic work-up identified a gastric adenocarcinoma with pulmonary metastases. She received four cycles of chemotherapy combining epirubicin, cisplatin and fluorouracil. The patient died 6 months after the diagnosis of respiratory failure.

  18. DBGC: A Database of Human Gastric Cancer.

    Wang, Chao; Zhang, Jun; Cai, Mingdeng; Zhu, Zhenggang; Gu, Wenjie; Yu, Yingyan; Zhang, Xiaoyan


    The Database of Human Gastric Cancer (DBGC) is a comprehensive database that integrates various human gastric cancer-related data resources. Human gastric cancer-related transcriptomics projects, proteomics projects, mutations, biomarkers and drug-sensitive genes from different sources were collected and unified in this database. Moreover, epidemiological statistics of gastric cancer patients in China and clinicopathological information annotated with gastric cancer cases were also integrated into the DBGC. We believe that this database will greatly facilitate research regarding human gastric cancer in many fields. DBGC is freely available at

  19. Folk healing: a description and synthesis.

    Ness, R C; Wintrob, R M


    All societies have developed ways of dealing with physical and mental illness, defined as folk healing systems. The authors review the systems of folk healing that have evolved in different cultural groups in the United States. They describe the faith healing practices of fundamentalist Christian groups, the belief in rootwork among white and black people in the southeastern United States, curanderismo among Mexican-Americans, and espiritismo among Americans from Puerto Rico. Most believers in folk healing also go to physicians for medical care. The authors argue that physicians should familiarize themselves with patients' folk healing beliefs in order to serve them more effectively.

  20. Photobiomodulation in promoting wound healing: a review.

    Kuffler, Damien P


    Despite diverse methods being applied to induce wound healing, many wounds remain recalcitrant to all treatments. Photobiomodulation involves inducing wound healing by illuminating wounds with light emitting diodes or lasers. While used on different animal models, in vitro, and clinically, wound healing is induced by many different wavelengths and powers with no optimal set of parameters yet being identified. While data suggest that simultaneous multiple wavelength illumination is more efficacious than single wavelengths, the optimal single and multiple wavelengths must be better defined to induce more reliable and extensive healing of different wound types. This review focuses on studies in which specific wavelengths induce wound healing and on their mechanisms of action.

  1. Sigmund Freud: pioneer in energy healing.

    Edwards, Stephen D; Edwards, David J


    Energy healing is a popular contemporary term for forms of healing that facilitate a natural healing process through harmonizing, rebalancing, and releasing energy flow disturbed or blocked by disease and illness. Biographical evidence indicates that Freud used physical, suggestive, and radiant forms of energy healing, and that his personal life, metapsychology, and psychoanalysis were founded on dynamic, energetic experiences and conceptualizations. Analysis of Freud's life and work leads to the conclusion that in experience, theory, and practice, Freud typified the traditional role of therapist and was a pioneer in modern forms of energy healing.

  2. Silencing of glutathione peroxidase 3 through DNA hypermethylation is associated with lymph node metastasis in gastric carcinomas.

    Dun-Fa Peng

    Full Text Available Gastric cancer remains the second leading cause of cancer-related death in the world. H. pylori infection, a major risk factor for gastric cancer, generates high levels of reactive oxygen species (ROS. Glutathione peroxidase 3 (GPX3, a plasma GPX member and a major scavenger of ROS, catalyzes the reduction of hydrogen peroxide and lipid peroxides by reduced glutathione. To study the expression and gene regulation of GPX3, we examined GPX3 gene expression in 9 gastric cancer cell lines, 108 primary gastric cancer samples and 45 normal gastric mucosa adjacent to cancers using quantitative real-time RT-PCR. Downregulation or silencing of GPX3 was detected in 8 of 9 cancer cell lines, 83% (90/108 gastric cancers samples, as compared to non-tumor adjacent normal gastric samples (P<0.0001. Examination of GPX3 promoter demonstrated DNA hypermethylation (≥ 10% methylation level determined by Bisulfite Pyrosequencing in 6 of 9 cancer cell lines and 60% of gastric cancer samples (P = 0.007. We also detected a significant loss of DNA copy number of GPX3 in gastric cancers (P<0.001. Treatment of SNU1 and MKN28 cells with 5-Aza-2' Deoxycytidine restored the GPX3 gene expression with a significant demethylation of GPX3 promoter. The downregulation of GPX3 expression and GPX3 promoter hypermethylation were significantly associated with gastric cancer lymph node metastasis (P = 0.018 and P = 0.029, respectively. We also observed downregulation, DNA copy number losses, and promoter hypermethylation of GPX3 in approximately one-third of tumor-adjacent normal gastric tissue samples, suggesting the presence of a field defect in areas near tumor samples. Reconstitution of GPX3 in AGS cells reduced the capacity of cell migration, as measured by scratch wound healing assay. Taken together, the dysfunction of GPX3 in gastric cancer is mediated by genetic and epigenetic alterations, suggesting impairment of mechanisms that regulate ROS and its possible involvement in

  3. Once-Daily Bedtime Dose of Roxatidine and Ranitidine in Acute Duodenal Ulcer: A Combined Assessment of Acid Inhibitory Activity and Healing Rate.

    Savarino, Vincenzo; Mela, Giuseppe Sandro; Zentilin, Patrizia; Mele, Maria Raffaella; Vigneri, Sergio; Termini, Rosanna; Di Mario, Francesco; Ferrana, Marina; Malesci, Alberto; Belicchi, Monica


    This study was carried out in order to compare the antisecretory effect of a single bedtime dose of roxatidine 150 mg and ranitidine 300 mg and to assess the relationship between the degree and the duration of acid suppression and the healing rates obtained in duodenal ulcer patients treated with the above regimens. Sixty-three patients with endoscopically proven ulcer underwent 24-h gastric pH-metry on day 0, day 1, and day 28 of treatment with both roxatidine and ranitidine. Ulcer healing was checked endoscopically after 4 weeks of therapy. RESULTS: Eight patients did not complete the study, leaving 55 patients eligible for final analysis, 28 in the roxatidine group and 27 in the ranitidine group. Duodenal ulcers were healed in 24--28 (85%) patients of the former and in 22--27 (81%) patients of the latter group (p minus sign NS). Gastric pH was significantly higher (p roxatidine and ranitidine. There was also do difference between the two active treatments. The pattern of gastric acidity significantly differed (p roxatidine 150 mg and ranitidine 300 mg was able to heal more than 80% of duodenal ulcers within 4 weeks of treatment. The lack of tolerance to H2-blockers in duodenal ulcer patients contributes to this good result. The antisecretory effect of H2-antagonists is reduced in nonresponder patients with respect to responder patients and this is mainly due to an impaired control of nocturnal acidity.

  4. Immediate and late management of iatrogenic ureteric injuries: 28 years of experience

    El Abd, Ahmed S.; El-Abd, Shawky A.; El-Enen, Mohamed Abo; Tawfik, Ahmed M.; Soliman, Mohamed G.; Abo-Farha, Mohamed; Gamasy, Abd-El Naser El; El-Sharaby, Mahmoud; El-Gamal, Samir


    Objective To evaluate the long-term results after managing intraoperative and late-diagnosed cases of iatrogenic ureteric injury (IUI), treated endoscopically or by open surgery. Patients and methods Patients immediately diagnosed with IUI were managed under the same anaesthetic, while those referred late had a radiological assessment of the site of injury, and endoscopic management. Open surgical procedures were used only for the failed cases with previous diversion. Results In all, 98 patients who were followed had IUI after gynaecological, abdominopelvic and ureteroscopic procedures in 60.2%, 14.3% and 25.5%, respectively. The 27 patients diagnosed during surgery were managed immediately, while in the late-referred 71 patients ureteroscopic ureteric realignment with stenting was successful in 26 (36.6%). Complex open reconstruction with re-implantation or ureteric substitution, using bladder-tube or intestinal-loop procedures, was used in 27 (60%), 16 (35.5%) and two (4.5%) patients of the late group, respectively. A long-term radiological follow-up with a mean (range) of 46.6 (24.5–144) months showed recurrent obstruction in 16 (16.3%) patients managed endoscopically and reflux in six (8.3%) patients. Three renal units only (3%) were lost in the late-presenting patients. Conclusion Patients managed immediately had better long-term results. More than a third of the late-diagnosed patients were successfully managed endoscopically with minimal morbidity. Open reconstruction by an experienced urologist who can perform a complex substitutional procedure was mandatory to preserve renal units in the long-term. PMID:26609443

  5. Efficacy and safety of percutaneous treatment of iatrogenic femoral artery pseudoaneurysm by biodegradable collagen injection.

    Hamraoui, Karim; Ernst, Sjef M P G; van Dessel, Pascal F H M; Kelder, Johannes C; ten Berg, Jurriën M; Suttorp, Maarten Jan; Jaarsma, Wybren; Plokker, Thijs H W


    OBJECTIVES; The goal of this study was to assess the safety and efficacy of femoral artery pseudoaneurysm (FAP) closure by collagen injection. BACKGROUND; The FAP is an infrequent but troublesome complication after percutaneous transfemoral catheter procedures. If ultrasound-guided compression repair (UGCR) fails, vascular surgery is indicated. We have developed a less invasive method to close FAPs percutaneously by injecting collagen and, thus, inducing clotting within the aneurysm. Via a 9F needle or 11F sheath, a biodegradable adhesive bovine collagen is injected percutaneously into the FAP, guided by angiography from the contralateral site. From 1993 to 2000, compression and UGCR had failed to obliterate 110 FAPs. These patients have been treated by collagen injection. Mean age of the patients was 65.6 +/- 10.2 years (range: 32 to 85 years), and 50% were women. Immediate closure of the FAP was achieved in 107/110 patients (97.3%) without any complication or adverse effect. In one patient the collagen could not be applied due to unfavorable anatomy. One patient needed a second session of collagen injection. In one patient too much collagen was inserted, which resulted in external compression of the artery, and surgical intervention was required. The overall success rate was 108/110 (98%, 95% confidence interval: 93.5% to 99.8%). Among the patients with successful procedures, there were no recurrences during six months follow-up. The percutaneous treatment of iatrogenic FAP, by injection with collagen, is an effective and safe strategy. This method provides an excellent therapeutic alternative to the traditional surgical management.

  6. Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts.

    Guha, Daipayan; Heary, Robert F; Shamji, Mohammed F


    OBJECT Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability. METHODS A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed. RESULTS A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%). CONCLUSIONS Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.

  7. Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease.

    Jauniaux, E; Jurkovic, D


    entirely iatrogenic.

  8. Iatrogenic retractile quadriceps fibrosis within children in Benin: Epidemiological, clinical, therapeutical aspects

    A S Gbenou


    Full Text Available Background: In tropical countries, iatrogenic retractile quadriceps fibrosis (IRQF, the cause of walking handicap in children, is often the result of intraquadricipital injection of quinine salts. The aim of this review was to analyse the epidemiological, clinical, therapeutic aspects and outcome of IRQF in children admitted in three hospitals in Benin Republic. Patients and Methods: It was a 10-year retrospective, descriptive and analytic survey of IRQF, involving 81 children aged from 8 months to 15 years. Iterative mobilization of the knee (IMK or modified distal quadriceps plasty by Thompson-Payr′s technique (MDQTPT, with a POP on the knee in flexion position, was performed with additional functional rehabilitation. The results were evaluated on knee flexion gain and walking quality. Data were processed using Epi Info 3.2 software. Results: Patients′ average age was 7.60 years. Children of 6-10 years were most affected; sex ratio was 1.02. Lesions were unilateral (71.6% and bilateral (28.4%. The knees′ stiffness was in flexion (10.57%, rectitude (64.42% and recurvatum (25%. The amyotrophy of the thigh was found in 79.42 %. The IMK was successful in eight cases (7.69 % and the MDQTPT was done in 98 cases (94.23% associated with femoral osteotomy in 13 cases (12.50%. In post-surgical period, skin necrosis and fractures occurred respectively in 15.31% and 5.10%. Results were good in 92.31% of cases. Conclusions: IRQF in children do exist in our settings. The treatment that is based on MDQTPT associated to rehabilitation leads to acceptable outcome.

  9. Ultrasonic incisions produce less inflammatory mediator response during early healing than electrosurgical incisions.

    Bindu Nanduri

    Full Text Available As the use of laparoscopic surgery has become more widespread in recent years, the need has increased for minimally-invasive surgical devices that effectively cut and coagulate tissue with reduced tissue trauma. Although electrosurgery (ES has been used for many generations, newly-developed ultrasonic devices (HARMONIC® Blade, HB have been shown at a macroscopic level to offer better coagulation with less thermally-induced tissue damage. We sought to understand the differences between ES and HB at a microscopic level by comparing mRNA transcript and protein responses at the 3-day timepoint to incisions made by the devices in subcutaneous fat tissue in a porcine model. Samples were also assessed via histological examination. ES-incised tissue had more than twice as many differentially-expressed genes as HB (2,548 vs 1,264 respectively, and more differentially-expressed proteins (508 vs 432 compared to control (untreated tissue. Evaluation of molecular functions using Gene Ontology showed that gene expression changes for the energized devices reflected the start of wound healing, including immune response and inflammation, while protein expression showed a slightly earlier stage, with some remnants of hemostasis. For both transcripts and proteins, ES exhibited a greater response than HB, especially in inflammatory mediators. These findings were in qualitative agreement with histological results. This study has shown that transcriptomics and proteomics can monitor the wound healing response following surgery and can differentiate between surgical devices. In agreement with clinical observations, electrosurgery was shown to incur a greater inflammatory immune response than an ultrasonic device during initial iatrogenic wound healing.

  10. Self-healing composites: A review

    Yongjing Wang


    Full Text Available Self-healing composites are composite materials capable of automatic recovery when damaged. They are inspired by biological systems such as the human skin which are naturally able to heal themselves. This paper reviews work on self-healing composites with a focus on capsule-based and vascular healing systems. Complementing previous survey articles, the paper provides an updated overview of the various self-healing concepts proposed over the past 15 years, and a comparative analysis of healing mechanisms and fabrication techniques for building capsules and vascular networks. Based on the analysis, factors that influence healing performance are presented to reveal key barriers and potential research directions.

  11. Protective effects of pentadecapeptide BPC 157 on gastric ulcer in rats

    Xiao-Chang Xue; Yong-Jie Wu; Ming-Tang Gao; Wen-Guang Li; Ning Zhao; Zeng-Lu Wang; Chun-Jie Bao; Zhen Yan; Ying-Qi Zhang


    AIM: To investigate the protective effects of gastric pentadecapeptide BPC 157 on acute and chronic gastric ulcers in rats and to compare the results in therapy of human gastric ulcers by different administration methods.METHODS: Gastric pentadecapeptide BPC 157 was administered (initial single or continuous administration) into rats either intragastrically or intramuscularly before (induced acute gastric ulcer) or after (induced chronic gastric ulcer) the applications of inducing agents, and each animal was sacrificed to observe the protective effects of BPC 157 on gastric ulcers.RESULTS: Both intramuscular (im) and intragastric (ig) administration of BPC 157 could apparently reduce the ulcer area and accelerate the healing of induced ulcer in different models and the effect of im administered BPC 157 was better than that of ig. The rats treated with higher dosages (400 ng/kg, 800 ng/kg) of BPC 157 (im and ig) showed significantly less lesion (P<0.01 vs excipient or saline control), the inhibition ratio of ulcer formation varied between 45.7% and 65.6%, from all measurements except 400 ng/kg BPC 157 in pylorus ligation induced model (P<0.05),in which the inhibition rate was 54.2%. When im administered (800 ng/kg BPC 157) in three models, the inhibition ratio of ulcer formation was 65.5%, 65.6% and 59.9%, respectively, which was better than that of famotidine (its inhibition rate was 60.8%, 57.2% and 34.3%,respectively). Continuous application of BPC 157 (in chronic acetate induced gastric ulcer) could accelerate rebuilding of glandular epithelium and formation of granulation tissue (P<0.05 at 200 ng/kg and P<0.01 at 400 ng/kg and 800 ng/kg vs excipient or saline control).CONCLUSION: Both im and ig administered gastric pentadecapeptide BPC 157 can apparently ameliorate acute gastric ulcer in rats and antagonize the protracted effect of acetate challenge on chronic ulcer. The effect of im administration of BPC 157 is better than that of ig, and the effective

  12. Evaluation of the morphological changes of gastric mucosa induced by a low concentration of acetic acid using a rat model.

    Nakao, Ken-ichiro; Ro, Ayako; Kibayashi, Kazuhiko


    Oral ingestion of concentrated acetic acid causes corrosive injury of the gastrointestinal tract. To assess the effects of a low concentration of acetic acid on gastric mucosa, we examined the gastric mucosal changes in rats at 1 and 3 days after the injection of 5% or 25% acetic acid into the gastric lumen. The area of the gastric ulcerative lesions in the 25% acetic acid group was significantly larger than that in the 5% acetic acid group. The lesion area was reduced significantly at 3 days after injection in the 5% acetic acid group, whereas no significant difference in lesion area was observed at 1 and 3 days in the 25% acetic acid group. Histologically, corrosive necrosis was limited to the mucosal layer in the 5% acetic acid group, whereas necrosis extended throughout the gastric wall in the 25% acetic acid group. At 3 days post-injection, the 25% acetic acid group showed widespread persistent inflammation, whereas the 5% acetic acid group showed widespread appearance of fibroblasts indicative of a healing process. These results indicate that a low concentration of acetic acid damages the gastric mucosa and that the degree of mucosal damage depends on the concentration of acetic acid.

  13. RABEX-5 is upregulated and plays an oncogenic role in gastric cancer development by activating the VEGF signaling pathway.

    Wang, Shuang; Lu, Aixia; Chen, Xiangming; Wei, Lin; Ding, Jiqiang


    RABEX-5, a guanine-nucleotide exchange factor (GEF) for RAB-5, is implicated in tumorigenesis and in the development of certain human cancers. Here, we report that RABEX-5 promotes tumor growth and the metastatic ability of gastric cancer cells both in vitro and in vivo. Expression of RABEX-5 is significantly higher in gastric cancer tissues and is associated with tumor size and lymph node metastasis. In addition, targeted silencing of RABEX-5 reduced gastric cancer cell proliferation and colony formation in vitro via the induction of a G0/G1 phase arrest, and stimulated gastric cancer cell apoptosis. Knockdown of RABEX-5 also inhibited wound healing, migration and the invasive abilities of gastric cancer cells. The results of in vivo animal experiments were also consistent with these in vitro findings. Silencing of RABEX-5 led to decreased expression of VEGF. These results indicate that RABEX-5 is upregulated and plays an oncogenic role in gastric cancer development by activating the VEGF signaling pathway.

  14. Self-Healing anticorrosive coatings

    Nesterova, Tatyana

    to steel substrates, and subjected to salt spray exposure and reverse impact testing. Neither of the tests revealed any drawbacks from addition of microcapsules to an epoxy coating in a concentration up to 50 vol %. On the contrary, the results of the impact test has shown that addition of microcapsules......Self-healing anticorrosive coatings are multi-component so-called smart materials, which have been proposed as a way to long-lasting corrosion protection of steel structures. The presently most promising technology route is based on microcapsules, filled with active healing agents, and has been...... means of separation were investigated. Capsules with a mean diameter less than 150 µm were obtained using a steel sieve coated with a fluoropolymer coating. These smaller capsules were used in further investigation as model capsules. A range of microcapsule-containing coatings was formulated, applied...

  15. Gastronomy healing after transgastric peritoneoscopy

    Donatsky, Anders Meller; Andersen, Luise; Nielsen, Ole Lerberg


    INTRODUCTION: Reliable closure and infection prevention are the main barriers for implementation of pure transgastric peritoneoscopy. The primary aim of this study was to assess healing of over the scope clip (OTSC) closed gastrotomies. MATERIALS AND METHODS: Pure transgastric peritoneoscopy...... were allowed 14 POD of follow-up, and 4 pigs were allowed 28 POD of follow-up. Survival was achieved in 6 of the 7 animals; 1 pig was euthanized due to diffuse peritonitis. Based on our definition, full-thickness healing had only been achieved in a single pig allowed 28 POD. With respect to clinical...... adhering to the per protocol definition. Endoscopic ultrasonography-guided access was difficult. It lacks reproducibility and needs refinement. Despite a combined decontamination regimen, infectious complications still occurred....

  16. Vasculogenic Cytokines in Wound Healing

    Victor W. Wong


    Full Text Available Chronic wounds represent a growing healthcare burden that particularly afflicts aged, diabetic, vasculopathic, and obese patients. Studies have shown that nonhealing wounds are characterized by dysregulated cytokine networks that impair blood vessel formation. Two distinct forms of neovascularization have been described: vasculogenesis (driven by bone-marrow-derived circulating endothelial progenitor cells and angiogenesis (local endothelial cell sprouting from existing vasculature. Researchers have traditionally focused on angiogenesis but defects in vasculogenesis are increasingly recognized to impact diseases including wound healing. A more comprehensive understanding of vasculogenic cytokine networks may facilitate the development of novel strategies to treat recalcitrant wounds. Further, the clinical success of endothelial progenitor cell-based therapies will depend not only on the delivery of the cells themselves but also on the appropriate cytokine milieu to promote tissue regeneration. This paper will highlight major cytokines involved in vasculogenesis within the context of cutaneous wound healing.

  17. The healing of fractured bones

    Bacon, G.E. [Central Electricity Generating Board, Cheltenham (United Kingdom)


    A method utilising neutron beams of width 1 mm, used on D1B (2.4 A) and D20 (1.3 A) to study the healing of fractured bones is presented. It is found that the callus bone uniting the fractured tibia of a sheep, whose healing had been encouraged by daily mechanical vibration over a period of three months, showed no trace of the large preferential vertical orientation of the apatite crystals which is characteristic of the normal bone. Nevertheless the bone had regained about 60% of its mechanical strength and the callus bone, although not oriented, was well crystallized. It is considered that the new monochromator for D20, expected to give increased intensity at 2.5 A, will be of considerable advantage. (author). 2 refs.

  18. Current management of wound healing

    Gottrup, F; Karlsmark, T


    in the next decade. It is the hope that increasing parts of the new knowledge from basic wound healing research will be implemented in daily clinical practice. The development of new treatment products will also continue, and especially new technologies with combined types of dressing materials or dressing...... containing active substances will be accentuated. Further developments in the management structure and education will also continue and consensus of treatment guidelines, recommendations and organization models will hopefully be achieved....

  19. Epstein-Barr virus in gastric carcinomas and gastric stump carcinomas: a late event in gastric carcinogenesis.

    Hausen, A zur; Rees, van B.P.; Beek, van J.; Craanen, M.E.; Bloemena, E.; Offerhaus, GJ; Meijer, C.J.L.M.; Brule, van den AJ


    BACKGROUND: To determine at what stage during gastric carcinogenesis Epstein-Barr virus (EBV) enters the gastric epithelial cells, the presence of EBV was investigated in two pathogenetically related but distinct forms of adenocarcinoma of the stomach-gastric carcinoma of the intact stomach (GCIS)

  20. Epstein-Barr virus in gastric carcinomas and gastric stump carcinomas: a late event in gastric carcinogenesis.

    Hausen, A zur; Rees, van B.P.; Beek, van J.; Craanen, M.E.; Bloemena, E.; Offerhaus, GJ; Meijer, C.J.L.M.; Brule, van den AJ


    BACKGROUND: To determine at what stage during gastric carcinogenesis Epstein-Barr virus (EBV) enters the gastric epithelial cells, the presence of EBV was investigated in two pathogenetically related but distinct forms of adenocarcinoma of the stomach-gastric carcinoma of the intact stomach (GCIS) a

  1. Treatment Options by Stage (Gastric Cancer)

    ... Cancer Prevention Stomach Cancer Screening Research Gastric Cancer Treatment (PDQ®)–Patient Version General Information About Gastric Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  2. Drugs Approved for Stomach (Gastric) Cancer

    ... Ask about Your Treatment Research Drugs Approved for Stomach (Gastric) Cancer This page lists cancer drugs approved ... that are not listed here. Drugs Approved for Stomach (Gastric) Cancer Cyramza (Ramucirumab) Docetaxel Doxorubicin Hydrochloride 5- ...

  3. Your diet after gastric bypass surgery

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed the way your ...

  4. Honey for Wound Healing, Ulcers, and Burns; Data Supporting Its Use in Clinical Practice

    Noori Al-Waili


    Full Text Available The widespread existence of unhealed wounds, ulcers, and burns has a great impact on public health and economy. Many interventions, including new medications and technologies, are being used to help achieve significant wound healing and to eliminate infections. Therefore, to find an intervention that has both therapeutic effect on the healing process and the ability to kill microbes is of great value. Honey is a natural product that has been recently introduced in modern medical practice. Honey's antibacterial properties and its effects on wound healing have been thoroughly investigated. Laboratory studies and clinical trials have shown that honey is an effective broad-spectrum antibacterial agent. This paper reviews data that support the effectiveness of natural honey in wound healing and its ability to sterilize infected wounds. Studies on the therapeutic effects of honey collected in different geographical areas on skin wounds, skin and gastric ulcers, and burns are reviewed and mechanisms of action are discussed. (Ulcers and burns are included as an example of challenging wounds. The data show that the wound healing properties of honey include stimulation of tissue growth, enhanced epithelialization, and minimized scar formation. These effects are ascribed to honey's acidity, hydrogen peroxide content, osmotic effect, nutritional and antioxidant contents, stimulation of immunity, and to unidentified compounds. Prostaglandins and nitric oxide play a major role in inflammation, microbial killing, and the healing process. Honey was found to lower prostaglandin levels and elevate nitric oxide end products. These properties might help to explain some biological and therapeutic properties of honey, particularly as an antibacterial agent or wound healer. The data presented here demonstrate that honeys from different geographical areas have considerable therapeutic effects on chronic wounds, ulcers, and burns. The results encourage the use of honey

  5. Stress in gastrointestinal tract and stable gastric pentadecapeptide BPC 157. Finally, do we have a solution?

    Sikiric, Predrag; Seiwerth, Sven; Rucman, Rudolf; Drmic, Domagoj; Stupnisek, Mirjana; Kokot, Antonio; Sever, Marko; Zoricic, Ivan; Zoricic, Zoran; Batelja, Lovorka; Ziger, Tihomil; Vlainic, Josipa; Rasic, Zarko; Bencic, Martina Lovric


    Selye's syndrome produced by diverse nocuous agents and "response to damage as such" means Selye's stress triad in stress coping response to reestablish homeostasis. Logically, from the gastrointestinal tract viewpoint, such organoprotective/healing response implies the angiogenic growth factors that commonly signify the healing. Thereby, the gastric pentadecapeptide BPC 157-organoprotection (huge range of beneficial effects) signifies the Selye's stress concept/stress coping response implemented in and from gastrointestinal tract, and BPC 157 as an integrative mediator that integrates the adaptive bodily response to stress. In clinical trials without side effects, LD1 was not achieved, BPC 157 healing in gastrointestinal tract, and particularly the healing of the extra-gastrointestinal tissues (i.e., skin/tendon/ligament/muscle/bone; nerve; cornea/ brain) were referred throughout its integrative capabilities (i.e., ulcerative colitis/multiple sclerosis model equally counteracted), native in gastrointestinal tract, stability in human gastric juice (and thereby, strong efficacy and applicability), its relevance for dopamine-system function (and thereby, counteracting effects of dopamine-system dysfunction and over-function, centrally and peripherally (mucosa maintenance); interaction with serotonin- and GABA-system)), afforded cytoprotection/adaptive cytoprotection/organoprotection (and thereby, beneficial effects on gastric and whole intestinal tract lesions and adaptation, wounds and fistulas healing, blood vessels, somatosensory neurons, NSAIDs-side effects (including also pancreas, liver, brain lesions, and blood disturbances, prolonged bleeding, thrombocytopenia, thrombosis)). Further, we combine such gut-brain axis and the NO-system where BPC 157 counteracts complications of either L-NAME application (i.e., various lesions aggravation, hypertension) or L-arginine application (i.e., hypotension, prolonged bleeding, thrombocytopenia). Also, BPC 157 particularly

  6. Pearl extract enhances the migratory ability of fibroblasts in a wound healing model.

    Li, Yi-Chen; Chen, Chi-Ruei; Young, Tai-Horng


    For 2000 years, traditional Chinese medicine has been used as a remedy for general health improvement, including the fight against aging. Pearl powder has recently been used as a health food that has antioxidant, antiaging, antiradioactive, and tonic activities for cells; it is also applied to cure aphthous ulcer, gastric ulcer, and duodenal ulcer on clinical therapy. In addition, the mother of pearl, nacre, could enhance the cell adhesion and tissue regeneration of skin fibroblasts. Fibroblast is regarded as indispensable in the processes of wound healing. Therefore, the effect of pearl extract (PL) on fibroblasts is investigated in this study. PL is produced by a room temperature super extraction system (Taiwan patent no. I271 220). DMEM medium containing PL (300 μg/mL) was used to examine the effect of migration-promoting potential on human fibroblast cell line or human primary fibroblast cells in a wound healing model in vitro. Medium containing PL (300 μg/mL) demonstrated that the migratory cell numbers of fibroblasts were three times more than that without PL, and mRNA expression of collagen type III was higher than in collagen type I in fibroblasts. It revealed a migration-promoting potential of human fibroblasts in a wound healing model in vitro. The present study found that the migration-promoting effect in PL, which could be a supplement in cell culture. These data suggest PL could be useful for enhancing the wound healing of fibroblasts.

  7. Treatment of gastric ulcers and diarrhea with the Amazonian herbal medicine sangre de grado.

    Miller, M J; MacNaughton, W K; Zhang, X J; Thompson, J H; Charbonnet, R M; Bobrowski, P; Lao, J; Trentacosti, A M; Sandoval, M


    Sangre de grado is an Amazonian herbal medicine used to facilitate the healing of gastric ulcers and to treat gastritis, diarrhea, skin lesions, and insect stings. This study was designed to evaluate the gastrointestinal applications. Gastric ulcers were induced in rats by brief serosal exposure of the fundus to acetic acid (80%). Sangre de grado was administered in drinking water at 1:1,000 and 1:10,000 dilutions from the postoperative period to day 7. Guinea pig ileum secretory responses to capsaicin, electrical field stimulation, and the neurokinin-1 (NK-1) agonist [Sar(9),Met(O(2))(11)]substance P were examined in Ussing chambers. Sangre de grado facilitated the healing of experimental gastric ulcer, reducing myeloperoxidase activity, ulcer size, and bacterial content of the ulcer. The expression of proinflammatory genes tumor necrosis factor-alpha, inducible nitric oxide synthase (iNOS), interleukin (IL)-1beta, IL-6, and cyclooxygenase-2 was upregulated by ulcer induction but reduced by sangre de grado treatment, particularly iNOS and IL-6. In Ussing chambers, sangre de grado impaired the secretory response to capsaicin but not to electrical field stimulation or the NK-1 agonist. We conclude that sangre de grado is a potent, cost-effective treatment for gastrointestinal ulcers and distress via antimicrobial, anti-inflammatory, and sensory afferent-dependent actions.

  8. Gastric Lipase Secretion in Children with Gastritis

    Krystyna Sztefko; Krzysztof Fyderek; Andrzej Zając; Andrzej Wędrychowicz; Iwona Rogatko; Tomasik, Przemyslaw J


    Gastric lipase is one of the prepancreatic lipases found in some mammalian species and in humans. Our knowledge of the hormonal regulation of gastric lipase secretion in children and adolescents is still very limited. The aim of this study was to compare the activity of human gastric lipase (HGL) in gastric juice in healthy adolescents and in patients with gastritis. The adolescents were allocated to three groups: the first including patients with Helicobacter pylori gastritis (HPG; n = 10), ...

  9. Multifactorial etiology of gastric cancer.

    Zabaleta, Jovanny


    The prevalence of gastric cancer is associated with several factors including geographical location, diet, and genetic background of the host. However, it is evident that infection with Helicobacter pylori (H. pylori) is crucial for the development of the disease. Virulence of the bacteria is also important in modulating the risk of the disease. After infection, H. pylori gains access to the gastric mucosa and triggers the production of cytokines that promote recruitment of inflammatory cells, probably involved in tissue damage. Once the infection is established, a cascade of inflammatory steps associated with changes in the gastric epithelia that may lead to cancer is triggered. H. pylori-induced gastritis and H. pylori-associated gastric cancer have been the focus of extensive research aiming to discover the underlying mechanisms of gastric tissue damage. This research has led to the association of host genetic components with the risk of the disease. Among these is the presence of single nucleotide polymorphisms (SNPs) in several genes, including cytokine genes, which are able to differentially modulate the production of inflammatory cytokines and then modulate the risk of gastric cancer. Interestingly, the frequency of some of these SNPs is different among populations and may serve as a predictive factor for gastric cancer risk within that specific population. However, the role played by other genetic modifications should not be minimized. Methylation of gene promoters has been recognized as a major mechanism of gene expression regulation without changing the primary structure of the DNA. Most DNA methylation occurs in cytosine residues in CpG dinucleotide, but it can also be found in other DNA bases. DNA methyltransferases add methyl groups to the CpG dinucleotide, and when this methylation level is too high, the gene expression is turned off. In H. pylori infection as well as in gastric cancer, hypermethylation of promoters of genes involved in cell cycle

  10. Embolotherapy for Gastric Variceal Bleeding from Pseudoaneurysm of Short Gastric Artery: A Case Report

    Yang, Jae Han; Kim, Young Dae; Kim, Dong Hyun [Chosun University, Gwangju (Korea, Republic of)


    The complications of pancreatitis, such as pseudocyst or abscesses, are well known to radiologists. Yet formation of a pseudoaneurysm of the short gastric artery is an uncommon complication of acute pancreatitis. It is also very rare for a psuedoaneurysm of the short gastric artery to cause splenic vein occlusion and the final result is gastric varices. We report here on a case that showed the dramatic effect of embolotherapy for a pseudoaneurysm of the short gastric artery that caused gastric variceal bleeding


    E. Yu. D'yakonovax


    Full Text Available Acute gastric dilatation is a rare surgical condition in children, which often results from blunt abdominal trauma. This condition is characterized by the gut-brain connection disorder or gastric muscular layer damage, which results in atony. Gradual gastric stretching with fluid contents and gases in the end leads to the development of various types of intestinal obstruction. When conservative measures are not sufficient (in rare cases, it is reasonable to resort to operative intervention. Several cases of such a pathology have been published around the world. This condition has been observed not only at the blunt abdominal trauma, but also at lesions of central and peripheral nervous systems and in patients with anorexia nervosa and bulimia in the event of excessive food consumption. The article presents a clinical case study and a follow-up analysis of a child with posttraumatic acute gastric dilatation. The authors describe clinical manifestations, pathogenesis and diagnostic algorithm, which allowed establishing this rare diagnosis. Along with the conventional drugs and intensive care measures, the treatment involved a complex of mini-invasive endosurgical and endoscopic manipulations, including laparoscopic jejunostomy, which was performed in order to provide long-term enteral feeding. The clinical case study demonstrated that the use of diagnostic laparoscopy helps to establish nature of the gastric damage correctly and formulate the following optimal treatment tactics on the basis of the obtained data. 

  12. Endoscopic Aspects of Gastric Syphilis

    Mariana Souza Varella Frazão


    Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.

  13. Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: Visualization with optical coherence tomography

    Khan, Muhammad A. [Department of Cardiology, Manchester Heart Centre, Manchester Royal Infirmary, M13 9WL Manchester (United Kingdom); Prati, Francesco [Interventional Cardiology, San Giovanni Hospital, Via dell’Amba Aradam 8, 00184 Rome (Italy); El-Omar, Magdi, E-mail: [Department of Cardiology, Manchester Heart Centre, Manchester Royal Infirmary, M13 9WL Manchester (United Kingdom)


    Iatrogenic coronary ostial stenosis following aortic valve replacement (AVR) occurs in up to 3.4% of cases and usually presents within the first 6 months following surgery. We present the case of an 85 year old man who developed an acute coronary syndrome 2 months following AVR. Coronary angiography revealed a severe de novo lesion in the left main stem, which, on optical coherence tomography, was shown to be due to severe intimal hyperplasia. The most likely underlying mechanism is vessel wall trauma caused by the rigid tip cannula used for administration of cardioplegia solution. Surgeons should be aware of this possibility when administering this solution via the antegrade approach.

  14. Iatrogenic Cushing Syndrome from Interaction Between Ritonavir and Oral Budesonide During Direct Acting Antiviral Hepatitis C Therapy.

    Yeoh, Sern Wei


    Direct acting antiviral (DAA) regimens containing ritonavir have been developed to treat hepatitis C, with fewer side effects than that by interferon-based regimens. However prescribers must be aware of drug-drug interactions. There are multiple reports of iatrogenic Cushing syndrome (CS) caused by ritonavir, when used to treat human immunodeficiency virus, increasing the bioavailability of exogenous steroids by inhibiting cytochrome p450 enzymes in the liver and gut wall and thus reducing steroid metabolism. We herein report a novel scenario of CS due to interaction between ritonavir for hepatitis C treatment and oral budesonide for autoimmune hepatitis.

  15. Gastric residual volume (GRV) and gastric contents measurement by refractometry.

    Chang, Wei-Kuo; McClave, Stephen A; Hsieh, Chung-Bao; Chao, You-Chen


    Traditional use of gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, is inaccurate and cannot differentiate components of the gastric contents (gastric secretion vs delivered formula). The use of refractometry and 3 mathematical equations has been proposed as a method to calculate the formula concentration, GRV, and formula volume. In this paper, we have validated these mathematical equations so that they can be implemented in clinical practice. Each of 16 patients receiving a nasogastric tube had 50 mL of water followed by 100 mL of dietary formula (Osmolite HN, Abbott Laboratories, Columbus, OH) infused into the stomach. After mixing, gastric content was aspirated for the first Brix value (BV) measurement by refractometry. Then, 50 mL of water was infused into the stomach and a second BV was measured. The procedure of infusion of dietary formula (100 mL) and then water (50 mL) was repeated and followed by subsequent BV measurement. The same procedure was performed in an in vitro experiment. Formula concentration, GRV, and formula volume were calculated from the derived mathematical equations. The formula concentrations, GRVs, and formula volumes calculated by using refractometry and the mathematical equations were close to the true values obtained from both in vivo and in vitro validation experiments. Using this method, measurement of the BV of gastric contents is simple, reproducible, and inexpensive. Refractometry and the derived mathematical equations may be used to measure formula concentration, GRV, and formula volume, and also to serve as a tool for monitoring the gastric contents of patients receiving nasogastric feeding.

  16. Rabbit gastric ulcer models: comparison and evaluation of acetic acid-induced ulcer and mucosectomy-induced ulcer.

    Maeng, Jin Hee; Lee, Eunhye; Lee, Don Haeng; Yang, Su-Geun


    In this study, we examined rabbit gastric ulcer models that can serve as more clinically relevant models. Two types of ulcer model were studied: acetic acid-induced ulcers (AAU) and mucosal resection-induced ulcers (MRU). For AAU, rabbit gastric mucosa was exposed by median laparotomy and treated with bottled acetic acid. MRU was examined as a model for endoscopic mucosal resection (EMR). Normal saline was injected into the submucosal layer and the swollen mucosa was resected with scissors. Endoscopic mucosal resection (EMR) is frequently performed for treatment of early gastric cancers. This procedure inevitably leads to ulcers and bleeding. Bleeding control is the major concern in endoscopic mucosectomy, and some endoscopic hemostatic agents are currently under clinical and preclinical studies. MRU was developed as a model for these induced ulcers and the evaluation of the healing process. The clinical relevancy of those models was compared with that of rat models. Progressive healing was observed for 7 days based on histology. Rabbit models demonstrate round, deep ulcers with clear margins and well-defined healing stages that were difficult to define in rat models.

  17. Computed tomography findings of acute gastric volvulus

    Millet, Ingrid; Orliac, Celine; Alili, Chakib; Taourel, Patrice [Hopital Lapeyronie, Department of Radiology, Montpellier (France); Guillon, Francoise [University Hospital of Montpellier, Department of Surgery, Montpellier (France)


    To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. (orig.)

  18. Gene therapy for gastric cancer: A review

    Chao Zhang; Zhan-Kui Liu


    Gastric cancer is common in China, and its early diagnosis and treatment are difficult. In recent years great progress has been achieved in gene therapy, and a wide array of gene therapy systems for gastric cancer has been investigated. The present article deals with the general principles of gene therapy and then focuses on how these principles may be applied to gastric cancer.

  19. Worldwide practice in gastric cancer surgery

    Brenkman, Hylke Jf; Haverkamp, Leonie; Ruurda, Jelle P; van Hillegersberg, Richard


    AIM: To evaluate the current status of gastric cancer surgery worldwide. METHODS: An international cross-sectional survey on gastric cancer surgery was performed amongst international upper gastro-intestinal surgeons. All surgical members of the International Gastric Cancer Association were invited

  20. Gastric cytoprotection and honey intake in albino rats.

    Alagwu, E A; Nneli, R O; Egwurugwu, J N; Osim, E E


    Beneficial effect of honey has been widely reported particularly on wound healings, gastrointestinal disorders and as antibacterial agent. However, there is paucity of report on its cytoprotective effect on the gastric mucosa despite its common usage worldwide including Nigeria. This study was therefore carried out to evaluate the effect of this widely consumed substance on gastric mucosa using animal model and also to explore possible mechanism of its action on the gastric mucosa .Twenty male adult albino rats of Wistar strain, weighing between 210-220g were used in the experiment. They were randomly assigned into two groups, the control group and the honey-fed (test) group, each containing ten rats. The Control group was fed on normal rat feed and water while the test group was fed on normal rat feed with honey added to its drinking water (1ml of honey for every initial 10ml of water for each rat daily) for twenty two weeks. After twenty two weeks the rats were weighed after being starved overnight. They were anaesthetized with urethane (0.6ml/100g body weight). Gastric ulceration was induced using 1.5ml acid-alcohol prepared from equivolume of 0.1NHCl and 70% methanol introduced into the stomach via a portex cannula tied and left in place following an incision made on the antral-pyloric junction of the stomach. The acid-alcohol was allowed to stay for 1hr. After 1hr, laparatomy was performed and the stomach isolated, cut open along the greater curvature, rinsed with normal saline and fastened in place with pins on a dissecting board for ulcer examination and scores. The result obtained showed mean ulcer scores of 14.5+/-0.70 for the control group and 1.6+/-0.11 for the test group. The result showed that honey significantly reduced ulcer scores as well as caused scanty haemorrhage in the test group compared with increased ulcer scores and multiple haemorrhage in the control group. It is therefore concluded that honey intake offered cytoprotection on the gastric