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Sample records for jejunal pouch interposition

  1. Construction of a Jejunal Pouch After Total Gastrectomy

    African Journals Online (AJOL)

    food intake and slow the transit. Reconstruction using a jejunal interposition is more complicated and less suitable than the simple classic Roux‑en‑Y reconstruction.[1]. According to several prospective randomized trials and a recent meta‑analysis, the Roux‑en‑Y jejunal pouch reconstruction [Figure 1] appears to be the ...

  2. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Directory of Open Access Journals (Sweden)

    Leila Ghahramani

    2014-03-01

    Full Text Available Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty. In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03. Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. Please cite this article as: Ghahramani L, Yazdani S, Derakhshani S, Rezaianzadeh A, Jalli R, Geramizadeh B, Safarpour AR, Rahimikazerooni S, Hosseini SV. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog. Iran J Med Sci. 2014;39(2:117-122.

  3. The effect of isoperistaltic jejunal interposition upon gastric emptying

    Energy Technology Data Exchange (ETDEWEB)

    Mackie, C.R.; Hall, A.W.; Clark, J.; Wisbey, M.; Baker, P.R.; Cuschieri, A.

    1981-12-01

    Ten patients with severe postgastrectomy-postvagotomy symptoms, all of whom had the features of vasomotor dumping, underwent gastric emptying studies, using a 300 milliliter meal of 15 per cent dextrose labeled with 99mTc-sulphur colloid. Studies were repeated two to 11 months following remedial operative treatment, using a 12.5 to 15.0 centimeter isoperistaltic jejunal interposition. Preoperatively, all patients had rapid gastric emptying with a typical biphasic pattern. Following isoperistaltic interposition, the rate of gastric emptying was similar to that found in control patients. Gastric emptying reverted to a more normal pattern but, as in the preoperative studies, was best described by a double exponential function, consisting of slow and fast components. Analysis of these particular functions suggests the manner in which isoperistaltic interposition modified the underlying disorder of gastric motility.

  4. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-01-01

    Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. PMID:24644380

  5. Interposition of ileal j-pouch for rectum reconstruction in dog.

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-03-01

    The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases.

  6. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    OpenAIRE

    Leila Ghahramani; Saeed Yazdani; Saeed Derakhshani; Abbas Rezaianzadeh; Reza Jalli; Bita Geramizadeh; Ali Reza Safarpour; Salar Rahimikazerooni; Seyed Vahid Hosseini

    2014-01-01

    Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve do...

  7. Endogenous growth hormone and insulin after interposition of a reversed jejunal segment in short bowel syndrome. An experimental study on pigs

    Directory of Open Access Journals (Sweden)

    Papamichail Michail

    2012-08-01

    Full Text Available Abstract Background Interposition of a reversed jejunal loop in short bowel sydrome has previously been investigated in human along with animal models and seemed able to facilitate intestinal adaptation. However, it is unclear if growth hormone and insulin, well known for their implication in short bowel pathophysiology, intervene on this effect. Findings Porcine models were randomly allocated to two cohorts: (1 short bowel (SB group (n = 8 and (2 short bowel reverse jejunal segment (SB-RS group (n = 8. Amongst other parameters serum growth hormone and insulin were measured at baseline, as well as on postoperative day 30 and 60. Conclusion Both endogenous hormones failed to demonstrate significant difference in respect to potential direct effect to mechanisms of enhanced intestinal adaptation in reversed group

  8. Preoperative determination of appropriate cutting line for proximal gastrectomy to avoid postoperative jejunal ulcer.

    Science.gov (United States)

    Takahashi, Naoto; Kashimura, Hirotaka; Nimura, Hiroshi; Watanabe, Atsushi; Yano, Kentaro; Aoki, Hiroaki; Koyama, Tomoki; Sasaki, Toshiyuki; Shida, Atsuo; Mitsumori, Norio; Aoki, Teruaki; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2012-01-01

    Although proximal gastrectomy has become a procedure of choice for patients' early cancer in the upper third of stomach, no clinical guide for optimal gastric resection in order to avoid postoperative jejunal ulcer is available. The aim of this study was to investigate whether determining the distribution of parietal and chief cells of the stomach using Congo red test is clinically relevant. The F-line was defined as a boundary line between fundic and intermediate area of the stomach according to the pathological findings in 29 patients who underwent total gastrectomy for early gastric cancer, whereas the f-line was regarded as a boundary line between intermediate and pyloric area. In the additional 6 patients undergoing vagus-preserving proximal gastrectomy with jejunal pouch interposition, endoscopic Congo red test was preoperatively performed to determine the F-f-line. The distances from the pyloric ring to f-line on the lesser and greater curvatures were variable. Long-term outcomes of proximal gastrectomy guided by preoperative endoscopic Congo red test were favorable. It is suggested that preoperative endoscopic Congo red test is useful to determine the appropriate cutting line in order to avoid postoperative jejunal ulcer after proximal gastrectomy.

  9. Colon interposition

    International Nuclear Information System (INIS)

    Isolauri, J.; Tampere Univ. Central Hospital; Paakkala, T.; Arajaervi, P.; Markkula, H.

    1987-01-01

    Colon interposition was carried out in 12 patients with oesophageal carcinoma and on 38 patients with benign oesophageal disease an average of 71 months before the radiographic examination. Various ischaemic changes including 'jejunization', loss of haustration and stricture formation were observed in 15 cases. In 12 patients one or several diverticula were seen in the colon graft. Reflux was observed in 17 cases in supine position. Double contrast technique in the examination of interposed colon is recommended. (orig.)

  10. Uncut Esophagojejunostomy with Double Jejunal Pouch: An Alternative Reconstruction Method that Improves the Quality of Life of Patients after Total Gastrectomy.

    Science.gov (United States)

    Gong, Jia Qing; Cao, Yong Kuan; Zhang, Guo Hu; Wang, Pei Hong; Luo, Guo De

    2017-04-01

    Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed. Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy. According to the reconstruction methods used, these patients were divided into three groups: UJEA-DJP (n = 63), Roux-en-Y (n = 45), and P-loop with Roux-en-Y esophagojejunostomy (P-RY; n = 52). The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick classification among the three groups were analyzed. We found that UJEA-DJP has advantages over Roux-en-Y and P-RY regarding the time of digestive tract reconstruction, incidence rates for long-term complications, postoperative nutritional index, body weight recovery, and the Visick classification for subjective feelings (p quality of life of patients after surgical procedure.

  11. Long-term comparison of boomerang-shaped jejunal interposition and Billroth-I reconstruction after distal gastrectomy.

    Science.gov (United States)

    Sasaki, Kinro; Miyachi, Kazuhito; Yoda, Norihito; Onodera, Shinichi; Satomura, Hitoshi; Otsuka, Kichiro; Nakajima, Masanobu; Yamaguchi, Satoru; Sunagawa, Masakatsu; Kato, Hiroyuki

    2015-05-01

    Billroth-I (BI) is a simple, physiological method of reconstruction following distal gastrectomy. In actuality, postoperative QOL is by no means favorable due to the high incidence of post-gastrectomy syndrome. The aim of this study is to assess the safety and efficacy of boomerang-shaped jejunal interposition (BJI) after distal gastrectomy. Sixty-six patients with early gastric cancer underwent the BI procedure (n = 33) or BJI (n = 33) after distal gastrectomy, following which they were compared for 5 years. Tumor characteristics, operative details, postoperative complications and complaints, number of meals, and body weight were analyzed. Patients were followed up by endoscopy every 12 months. There were no significant differences in the incidence of postoperative complications. The incidence of heartburn (30 vs. 0 %, P = 0.0009) and oral bitterness (33 vs. 6 %, P = 0.0112) were significantly lower in the BJI cases. Endoscopic findings revealed significantly lower incidences of reflux esophagitis (24 vs. 0 %, P = 0.0051) and remnant gastritis (70 vs. 3 %, P < 0.0001) in the BJI group. The incidence of food stasis was low in both groups (12 vs. 15 %). In the BJI group, 30 patients (90 %) were eating 3 meals/day within 12 months, whereas in the BI group, 16 patients (48 %) were still eating 5 meals/day at 12 months or later. BJI is as safe as BI, but is better in terms of improvement in bile reflux and food intake without stasis. This procedure, therefore, appears to be a useful method for reconstruction after distal gastrectomy.

  12. One-Anastomosis Jejunal Interposition with Gastric Remnant Resection (Branco-Zorron Switch) for Severe Recurrent Hyperinsulinemic Hypoglycemia after Gastric Bypass for Morbid Obesity.

    Science.gov (United States)

    Zorron, Ricardo; Branco, Alcides; Sampaio, Jose; Bothe, Claudia; Junghans, Tido; Rasim, Gyurdzhan; Pratschke, Johann; Guel-Klein, Safak

    2017-04-01

    The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch). Patients with severe symptomatic hyperinsulinemic hypoglycemia refractory to conservative therapy were treated using the technique. The procedure started with resection of the remnant stomach close to pylorus. The alimentary limb was sectioned at 20 cm from the gastrojejunal anastomosis, and the rest of the alimentary limb was resected until the Y-Roux anastomosis. A hand-sutured anastomosis was then performed with the proximal alimentary limb and the remnant antrum. Four patients were successfully submitted to the procedure with reversal of the symptomatology and normalization of insulin levels, postprandial glucose levels, and oral glucose tolerance test, with a mean follow-up of 24.3 months. Mean operative time was 188 min, and patients recovered without postoperative complications. Patients suffering from severe hyperinsulinemic hypoglycemia after gastric bypass may be efficiently treated by this innovative procedure, avoiding extreme surgical therapy such as pancreatectomy or restoring the gastric anatomy, while still maintaining sustained weight loss. Studies with larger series and longer follow-up are still needed to define the role of this therapy in managing this entity.

  13. Ileoanal pouch function is related to postprandial pouch tone

    NARCIS (Netherlands)

    Steens, J.; Bemelman, W. A.; Meijerink, W. J.; Griffioen, G.; van Hogezand, R. A.; Masclee, A. A.

    2001-01-01

    Functional impairments are frequently observed in patients with an ileoanal pouch. Meal ingestion increases pouch tone and motility. Little is known, however, about the influence of meal-stimulated pouch characteristics on pouch function. The aim was to characterize basal and postprandial pouch

  14. Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis

    DEFF Research Database (Denmark)

    Mark-Christensen, A; Erichsen, R; Brandsborg, S

    2018-01-01

    BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulc......BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients......-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved....

  15. The role of pouch compliance measurement in the management of pouch dysfunction

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Molina, María Elena; Norton, Christine

    2010-01-01

    PURPOSE: Ileal pouch anal anastomosis is an established option for patients who require total proctocolectomy and restoration of bowel continuity. However, the functional results are not always good and low pouch compliance has been suggested as one possible cause. We aimed to review the results...... of pouch compliance tests over 11 years to assess whether measuring pouch compliance is a useful diagnostic tool to guide management of pouch dysfunction. METHODS: The results of pouch compliance tests performed between 1996 and 2007 together with the details of symptoms, treatments and outcome were...... reviewed. RESULTS: One hundred and forty-one pouch compliance tests were performed. There was no difference in pouch compliance between those with overt pathology (pouchitis, pelvic sepsis or anastomotic stricture) and those with idiopathic pouch dysfunction. In this second group, there was no difference...

  16. Dysphagia after Colon Interposition Graft for Esophageal Carcinoma

    Directory of Open Access Journals (Sweden)

    C. Spitali

    2012-01-01

    Full Text Available Colon interposition is an established technique for esophageal reconstruction. We describe the case of primary adenocarcinoma arising in a colonic interposition graft that was performed after total esophagectomy for recurrence adenocarcinoma derived from the Barrett esophagus.

  17. Comparative evaluation of two reconstructive methods following laparoscopic assisted subtotal gastrectomy in dogs

    Directory of Open Access Journals (Sweden)

    Bakhtiari Jalal

    2012-12-01

    Full Text Available Abstract Background Laparoscopic gastrectomy is a new and technically challenging surgical procedure with potential benefit. The objective of this study was to investigate clinical and para-clinical consequences following Roux-en-Y and Jejunal Loop interposition reconstructive techniques for subtotal gastrectomy using laparoscopic assisted surgery. Results Following resection of the stomach attachments through a laparoscopic approach, stomach was removed and reconstruction was performed with either standard Roux-en-Y (n = 5 or Jejunal Loop interposition (n = 5 methods. Weight changes were monitored on a daily basis and blood samples were collected on Days 0, 7 and 21 post surgery. A fecal sample was collected on Day 28 after surgery to evaluate fat content. One month post surgery, positive contrast radiography was conducted at 5, 10, 20, 40, 60 and 90 minutes after oral administration of barium sulfate, to evaluate the postoperative complications. There was a gradual decline in body weight in both experimental groups after surgery (P  0.05. Fecal fat content increased in the Roux-en-Y compared to the Jejunal loop interposition technique (P  0.05. Conclusion Roux-en-Y and Jejunal loop interposition techniques might be considered as suitable approaches for reconstructing gastro-intestinal tract following gastrectomy in dogs. The results of this study warrant further investigation with a larger number of animals.

  18. Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis.

    Science.gov (United States)

    Abtar, Houssam Khodor; Mneimneh, Mostapha; Hammoud, Mazen M; Zaaroura, Ahmed; Papas, Yasmina S

    2016-01-01

    Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula), bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.

  19. Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis

    Directory of Open Access Journals (Sweden)

    Houssam Khodor Abtar

    2016-01-01

    Full Text Available Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula, bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.

  20. The role of pouch compliance measurement in the management of pouch dysfunction

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Molina, Maria E; Norton, Christine

    2010-01-01

    in pouch compliance between patients with and without each of the symptoms of increased defaecatory frequency, incontinence and evacuation difficulties. The results of the compliance testing did not influence the clinical decision making on idiopathic pouch dysfunction (p=0.77) nor diverted pouches (p=0...

  1. Peri-Vesical Fat Interposition Flap Reinforcement in High Vesico ...

    African Journals Online (AJOL)

    Background and Aim: The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginal fistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap. Materials and Methods: An interposition flap of peri-vesical ...

  2. Changing your ostomy pouch

    Science.gov (United States)

    Ostomy - pouch change; Colostomy - pouch change ... of surgery you had. You may need your ostomy for just a short time. Or, you may ... it for the rest of your life. The ostomy pouch attaches to your belly, away from your ...

  3. Outcomes After Interpositional Arthroplasty of the First Metatarsophalangeal Joint.

    Science.gov (United States)

    Aynardi, Michael C; Atwater, Lara; Dein, Eric J; Zahoor, Talal; Schon, Lew C; Miller, Stuart D

    2017-05-01

    For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus. All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores. Survivorship of the interpositional arthroplasty procedure was defined as no subsequent surgery on the hallux after the index procedure. Patients were excluded for incomplete records. Complications were recorded. From 2001 to 2014, 183 patients were identified. Of these, 14 were excluded for incomplete data, leaving 169 patients. Of these, 133 had an average follow-up of 62.2 months (range, 24.3 months to 151.2 months). The overall failure rate was 3.8% (5/133). Patient-reported outcome was rated as excellent in 65.4% (87/133) or good in 24.1% (32/133) of patients and fair or poor in 10.5% (14/133) of patients. Of 133 patients, 101 (76%) were able to return to fashionable or regular footwear. The infection rate was 1.5% (2/133). Patient-reported cock-up deformity of the first metatarsophalangeal joint (MTPJ) occurred in 4.5% (6/133) of patients. In addition, 17.3% (23/133) of patients reported metatarsalgia of the second or third MTPJ at the time of final follow-up, and there was no significant difference between interposition types ( P = .441). Interpositional arthroplasty for hallux rigidus was found to have excellent or good results in most patients at a mean follow-up of 62.2 months. Level IV, retrospective case series.

  4. Modulatory effects of taurine on jejunal contractility

    Directory of Open Access Journals (Sweden)

    Q.Y. Yao

    2014-12-01

    Full Text Available Taurine (2-aminoethanesulfonic acid is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism.

  5. Modulatory effects of taurine on jejunal contractility

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y. [Dalian Medical University, Dalian, Liaoning (China)

    2014-10-14

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca{sup 2+} dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism.

  6. Modulatory effects of taurine on jejunal contractility

    International Nuclear Information System (INIS)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y.

    2014-01-01

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca 2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism

  7. Modulatory effects of taurine on jejunal contractility

    Science.gov (United States)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y.

    2014-01-01

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism. PMID:25387674

  8. Thromboxane synthesis inhibitors and postprandial jejunal capillary exchange capacity.

    Science.gov (United States)

    Mangino, M J; Chou, C C

    1988-05-01

    The effects of thromboxane synthesis inhibitors (imidazole and U 63557A; Upjohn) and the cyclooxygenase inhibitor, mefenamic acid, on jejunal capillary filtration coefficients (Kfc) were determined in dogs before and during the presence of predigested food in the jejunal lumen. The jejunal Kfc increased significantly soon after the placement of a predigested test food containing all major constituents of diet. The Kfc remained elevated as long as the food was present in the lumen (15 min). Mefenamic acid (10 mg/kg iv) did not significantly alter resting jejunal Kfc or alter the food-induced increase in Kfc. Imidazole (5.0 mg/min ia) or U 63557A (5.0 mg/kg iv) per se significantly increased jejunal Kfc. Placement of digested food further increased the Kfc to levels significantly higher than those observed before administration of the two thromboxane synthase inhibitors. Production of thromboxane B2 by jejunal tissue was significantly reduced and 6-ketoprostaglandin F1 alpha (the stable hydrolysis product of prostacyclin) production was significantly increased after administration of U 63557A. Our study indicates that the relative production of endogenous thromboxanes and other prostanoids modulates jejunal capillary exchange capacity in the absence or presence of digested food in the jejunal lumen.

  9. Jejunal Diverticular Perforation due to Enterolith

    Directory of Open Access Journals (Sweden)

    Ronaldo Nonose

    2011-08-01

    Full Text Available Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

  10. Modified T-Plate Interpositional Arthroplasty for Temporomandibular Joint Ankylosis: A New and Versatile Option

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    Imran Ahmad

    2015-11-01

    Full Text Available BackgroundThis study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty.MethodsA prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation.ResultsA significant increase in interincisal distance of 32 mm was seen in 12 (92.31% patients in the T-plate interposition group, in 2 (25% cases of the temporalis muscle flap interposition group, and in 1 case (14.28% of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69% of the T-plate interposition group, while as it was observed in 4 (50% cases in the temporalis muscle flap interposition group and 4 (57.14% cases in the condylectomy group, and these differences were statistically significant.ConclusionsOur clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis.

  11. Prolapso jejunal em gastroenteroanastomose

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    Gerson Junqueira Júnior

    Full Text Available The autors report a case of jejunal mucosa prolapse after gastroenteroanastomosis, a rare postoperative complication. In the late postcholecistectomy period the patient had persistent vomit. Upper digestive endoscopy (UDE showed obstruction of the second portion of duodenum, and a gastrojejunal anastomosis was performed. Soon after that, the patient had persistent vomit and upper digestive endoscopy (UDE showed invagination of the jejunal mucosa. She was reoperated, a Roux Y gastrectomy was performed and the patient had a good evolution. The treatment for this complication is basically surgical, which intends to realieve the obstructive symptomatology.

  12. Rapid duodenal and jejunal intubation

    International Nuclear Information System (INIS)

    Nolan, D.J.

    1979-01-01

    A size 12 French radiopaque catheter, 135 cm long, suitable for rapid duodenal and jejunal intubation, is described. Its size and flexibility enable it to be passed with ease through the nose, stomach and duodenum. A guide wire is used to act as a stiffener as the catheter is passed through the stomach. The catheter is suitable for infusing barium directly into the small intestine and for performing hypotonic duodenography. The technique for duodenal and jejunal intubation is discussed. (author)

  13. Viability of a jejunal segment after neovascularization by omentoenteropexy Viabilidade de segmento jejunal neovascularizado por omentoenteropexia

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    Mércia Maria Braga Rocha

    2002-01-01

    Full Text Available Omentoenteropexy was developed as an alternative technique to promote neovascularization in an isolated bowel segment. OBJECTIVE: The aim of the present protocol was to study the long-term viability of an isolated jejunal segment following neovascularization by omentoenteropexy. Long-term survival of a neovascularized bowel segment is an indication that the utilization of this segment as an intestinal graft can be successful. METHODS: To test the proposed surgical technique, 13 Wistar rats were subjected to laparotomy, the jejunum was exposed at 20 cm from the angle of Treitz and a pedicle of greater omentum was isolated. An incision of 6 cm was made along the antimesenteric jejunal border, exposing the submucosa. Omentoenteropexy was performed between the incision of the jejunum and the pedicle of the greater omentum. After seven weeks, the mesentery of the jejunal segment subjected to omentoenteropexy was ligated and isolated from the rest of the jejunum by a complete proximal and distal transversal section. Subsequently, an end-to-end anastomosis was performed to restore the continuity of the bowel. RESULTS: At 10 weeks from the first surgical intervention, the isolated jejunal segment subjected to omentoenteropexy was completely neovascularized and viable. CONCLUSION: No evidence of anatomical or functional intestinal obstruction was observed.A omentoenteropexia foi desenvolvida como uma alternativa para técnica de neovascularização em segmentos intestinais isolados, evidenciando algumas vantagens em relação a utilização de órgãos previamente descritos. OBJETIVO: Avaliar a viabilidade de um segmento jejunal neovascularizado por omentoenteropexia. MÉTODOS: Treze ratos Wistar foram submetidos a laparotomia, com exposição do jejuno vinte centímetros após o ligamento de Treitz e obtenção de um pedículo de omento. Na borda antimesentérica do jejuno foi feita uma incisão de seis centímetros com exposição da submucosa intacta

  14. Failed pelvic pouch substituted by continent ileostomy.

    Science.gov (United States)

    Wasmuth, H H; Tranø, G; Wibe, A; Endreseth, B H; Rydning, A; Myrvold, H E

    2010-07-01

    The long-term failure rate of ileal pouch-anal anastomosis (IPAA) is 10-15%. When salvage surgery is unsuccessful, most surgeons prefer pouch excision with conventional ileostomy, thus sacrificing 40-50 cm of ileum. Conversion of a pelvic pouch to a continent ileostomy (CI, Kock pouch) is an alternative that preserves both the ileal surface and pouch properties. The aim of the study was to evaluate clinical outcome after the construction of a CI following a failed IPAA. During 1984-2007, 317 patients were operated with IPAA at St Olavs Hospital and evaluated for failure, treatment and outcome. Seven patients with IPAA failure had CI. Four patients with IPAA failure referred from other hospitals underwent conversion to CI and are included in the final analysis. Seven patients had a CI constructed from the transposing pelvic pouch and four had the pelvic pouch removed and a new continent pouch constructed from the distal ileum. Median follow up after conversion to CI was 7 years (0-17 years). Two CI had to be removed due to fistulae. One patient needed a revision of the nipple valve due to pouch loosening. At the end of follow-up, 8 of the 11 patients were fully continent. One patient with Crohn's disease had minor leakage. In patients with pelvic pouch failure, the possibility of conversion to CI should be presented to the patient as an alternative to pouch excision and permanent ileostomy. The advantage is the continence and possibly a better body image. Construction of a CI on a new ileal segment may be considered, but the consequences of additional small bowel loss and risk of malnutrition if the Kock pouch fails should be appraised.

  15. Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.

    Science.gov (United States)

    Jayasundara, Jasb; Perera, E; Chandu de Silva, M V; Pathirana, A A

    2017-03-01

    Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.

  16. Glenohumeral kinematics after soft tissue interposition graft and glenoid reaming: A cadaveric study

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    Nickolas G Garbis

    2016-01-01

    Conclusion: Glenohumeral contact pressure is significantly improved with interposition of allograft at time zero compared to an arthritic state. Our findings suggest that concentric reaming did not differ from the arthritic model when compared to normal. These findings favor the use of allograft for interposition as a potential treatment option in patients with glenoid wear.

  17. Transgastrostomy jejunal intubation for enteric alimentation.

    Science.gov (United States)

    McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B

    1982-12-01

    Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

  18. Lesions of the Pouch of Douglas: A Review.

    Science.gov (United States)

    Heller, Debra S

    2016-01-01

    The pouch of Douglas may become occupied by a variety of mass-like lesions, which may be challenging to providers who treat women. These lesions may initially be thought to arise from the uterus or adnexa. We conducted a literature review using a Medline search of the terms "Douglas' pouch," "pouch of Douglas," "cul-de-sac," and "rectouterine pouch." A review of the scope of pouch of Douglas lesions is presented to assist in developing a differential diagnosis if a patient with such a lesion is encountered. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  19. Congenital pouch colon in female subjects

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    Sarin Y

    2007-01-01

    Full Text Available Over a period of 5-year (May 2000 to April 2005 29 patients of congenital pouch colon (CPC were managed by single pediatric surgeon in the Department of Pediatric Surgery of a tertiary hospital. Of these, 11 were girls (M: F: 1.6:1. Detailed anatomy could be studied in nine patients, were included in this study. Age of presentation in female subjects ranged 1 day to 8 years. On examination, eight of the nine patients had single perineal opening suggesting a very high incidence of association of cloaca in female subjects with CPC. Four had short urogenital sinus with colonic pouch opening in the posterior wall of urinary bladder. In other two patients, CPC terminated in short cloaca. Anomalies of mullerian structures such as uterus didelphus and septate vagina ware commonly encountered. Proximal diversion with or without pouch excision was done as the initial preliminary treatment for all those patients who presented in early life. Of the nine girls, two died after the preliminary surgery. Only five patients have undergone definitive surgery. Definitive surgery included abdomino-perineal pull-through of proximal normal colon ( n =2, tubularization of pouch with abdomino- posterior sagittal- pull through ( n =2 and abdomino-posterior sagittal urethra-vaginoanorectoplasty with pull through of tapered pouch colon in one patient. Two of these patients had concomitant bowel vaginoplasty. Three patients with tubularized pouches had constipation and spurious diarrhea. However, good pseudo-continence of bowel was achieved on regular bowel washes. The cosmetic appearance of perineum in all these three patients was acceptable. The patients in whom pouch excision was done had diarrhea and severe perineal excoriation resistant to conservative management.

  20. Ruptured Jejunal Diverticulum Due to a Single-Band Small Bowel Obstruction

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    Rajaraman Durai

    2008-01-01

    Full Text Available Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon. Here we describe a patient with known severe diverticular disease of the large bowel, who presented acutely with abdominal pain and signs of generalised peritonitis. Laparotomy showed ruptured jejunal diverticulosis with a single band over the terminal ileum, causing small bowel obstruction. Spontaneous perforation of a jejunal diverticulum is rare and is usually an intraoperative finding. One should exclude a precipitating cause, such as coexisting distal obstruction, stricture, or a foreign body.

  1. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

    International Nuclear Information System (INIS)

    Macari, M.; Faust, M.; Liang, H.; Pachter, H.L.

    2007-01-01

    Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient

  2. Elderly patient with acute, left lower abdominal pain: perforated jejunal diverticulitis (2010:7b)

    International Nuclear Information System (INIS)

    Franca, Manuela; Certo, Manuela; Varzim, Pedro; Silva, Donzilia; Peixoto, Carlos

    2010-01-01

    An elderly patient with acute, left, lower abdominal pain is described, for whom the diagnosis of perforated jejunal diverticulitis was established by computed tomography (CT). The presence of a jejunal segmental inflammatory process, with or without abscess or perforation, in the setting of jejunal diverticulosis, is very suggestive of jejunal diverticulitis. (orig.)

  3. Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: A treatment for extensive esophagogastric junction cancer

    OpenAIRE

    Ceroni, Marco; Norero, Enrique; Henríquez, Juan Pablo; Viñuela, Eduardo; Briceño, Eduardo; Martínez, Cristian; Aguayo, Gloria; Araos, Fernando; González, Paulina; Díaz, Alfonso; Caracci, Mario

    2015-01-01

    AIM: To review the post-operative morbidity and mortality of total esophagogastrectomy (TEG) with second barrier lymphadenectomy (D2) with interposition of a transverse colon and to determine the oncological outcomes of TEG D2 with interposition of a transverse colon.

  4. Ulcerative Colitis in Colonic Interposition for Esophageal Atresia

    OpenAIRE

    Arshad, Hafiz Muhammad Sharjeel; Tetangco, Eula; Elkhatib, Imad

    2016-01-01

    A 38-year-old male with a history of colonic interposition for esophageal atresia as an infant presented with dysphagia and abdominal pain. On the basis of endoscopy findings, pathology, and response to therapy, he was found to have ulcerative colitis of the colonic conduit.

  5. A surprise case of colonic interposition

    International Nuclear Information System (INIS)

    Law, Robert

    2006-01-01

    Blind nasogastric intubation failure as a result of changes to the normal anatomical pathway is not uncommon. This case report is of fluoroscopically guided intubation in a patient in whom blind intubation failed as a result of what was subsequently found to be a colonic interposition with associated late complications. Fluroscopically guided nasogastric intubation is a safe and effective procedure that should always be considered when blind intubation has failed

  6. Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear

    Directory of Open Access Journals (Sweden)

    Paulo Moraes Agnollitto

    2016-02-01

    Full Text Available Abstract The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma.

  7. A rare cause of acute abdomen: jejunal diverticulosis with perforation.

    Science.gov (United States)

    Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali

    2013-01-01

    Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

  8. 21 CFR 876.5900 - Ostomy pouch and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ostomy pouch and accessories. 876.5900 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5900 Ostomy pouch and accessories. (a) Identification. An ostomy pouch and accessories is a device that consists of a bag that is...

  9. A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

  10. Isolated jejunal perforation following blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Ahmet Pergel

    2012-09-01

    Full Text Available Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare. These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often inadequate for diagnosing this subsetof trauma. For an accurate and timely diagnosis, thepossibility of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta 28-year-old man with isolated jejunal perforation followingblunt abdominal trauma.Key words: Blunt abdominal trauma, isolated jejunal perforation,early diagnosis

  11. Causes and consequences of anterior pharyngeal pouch after total laryngectomy.

    Science.gov (United States)

    Anderson, S; Hogan, D; Panizza, B

    2014-07-01

    To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. A prospective, observational study of 43 patients undergoing total laryngectomy. Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.

  12. Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, W.; Itoi, Eiji; Sato, Kozo [Akita Univ. (Japan). Dept. of Orthopedic Surgery

    2000-12-01

    Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip. (orig.)

  13. On free jejunal and colon transfer for pharyngo-esophageal reconstruction

    International Nuclear Information System (INIS)

    Fukui, Kiyoko; Annraku, Kuniaki; Ikenoya, Shintaro; Makino, Sachio; Ito, Kazuyuki; Takubo, Kenji; Kaji, Shogo

    2013-01-01

    Free jejunal transfer is a common procedure for hypopharyngo-esophageal reconstruction. We reviewed our experience with patients who underwent free jejunal and colon transfer surgery for hypopharyngo-esophageal reconstruction in the last 20 years in our institute. A retrospective review was conducted for 31 cases of reconstruction with free jejunal and colon transfer performed at Japanese Red Cross Matsue Hospital during the period of 20 years from January 1992 to December 2011. The mean age of the patients was 66 years. There were 30 patients with hypopharynx cancer and one patient with larynx cancer. Thirty patients had received preoperative radiotherapy and chemotherapy. The average time of surgery for free jejunal transfer reconstruction was 8.8 hours, including extraction of the hypopharynx, pharynx and cervical esophagus, debridment of pars hemi-cervicalis, and grafting procedure of free jejunum. The most common recipient vessels were the transverse cervical artery and external jugular vein, but recently, vessels of free flaps are often chosen to be anastomosed with the superior thyroid artery and internal jugular vein. The free jejunal and colon grafts for reconstruction took successfully in all patients. The complication rate was 52% (16/31 cases). Complications often occurred in cases of total esophagectomy, recurrence after full-dose chemoradiotherapy, and radiation therapy administered postoperatively. (author)

  14. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Science.gov (United States)

    2010-04-01

    ... implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis...

  15. Colon pouch (Mainz III) for continent urinary diversion.

    Science.gov (United States)

    Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Liatsikos, Evangelos N; Sakelaropoulos, George; Rödder, Kilian; Hohenfellner, Rudolph; Fisch, Margit

    2007-06-01

    To evaluate the use of a continent cutaneous pouch made exclusively of colon (Mainz pouch III), as excellent results with the Mainz pouch III in irradiated patients suggested that the indication for this type of urinary diversion could be extended. The outcome of 24 patients with continent cutaneous urinary diversions using colon segments (Mainz pouch III) was investigated retrospectively. Overall, 22 of the patients had a malignant disease and two a benign disease; 16 had a hysterectomy and pelvic exenteration for gynaecological tumours; two men with a rhabdomyosarcoma of the prostate had a radical cystoprostatectomy; one woman had pelvic exenteration for bladder cancer; one man had a simultaneous rectum resection due to infiltrating rectal cancer, and another a left nephrectomy with cystectomy for concomitant kidney and bladder tumour. Benign indications were hyper-reflexive bladder after polytrauma and two cases of neurogenic bladder dysfunction. Eighteen patients had radiotherapy (32-48 Gy) before the urinary diversion. The mean (range) follow-up was 35 (12-65) months. The mean pouch capacity was 293.8 mL. Three patients died during the follow-up (two from disease progression and one suicide); 20 patients were fully continent, four with reduced pouch capacity (<300 mL) had slight incontinence and are wearing a protective pad (band-aid at the umbilicus). All patients use intermittent self-catheterization (mean catheterization frequency 6.8/day, range 6-12). Complications related to the pouch were one outlet stenosis that required revision. Postoperative pouchograms showed asymptomatic reflux in four patients. None of the patients developed metabolic acidosis or diarrhoea. The Mainz pouch III is an alternative to other types of continent urinary diversion.

  16. Psychological impact of colostomy pouch change and disposal.

    Science.gov (United States)

    McKenzie, Frances; White, Craig A; Kendall, Sally; Finlayson, Aileen; Urquhart, Mary; Williams, Isabel

    This article presents some of the findings from a multicentre cross-sectional correlational study to evaluate the relationship between colostomy pouch change and disposal practices and the patient's psychological wellbeing. Five questionnaires were used in a one-off interview with 86 patients. Patients were assessed at between one and four months postoperatively. Results from the Pouch Change and Disposal questionnaire showed that only 25% of patients found disposal of used appliances the most difficult part of their pouch change and disposal routine. Half felt that their body was out of their control and 33% reported avoiding social and leisure activities due to what was involved in their pouch change and disposal routine. Patients cited several factors, such as minimizing odour and having an appliance that could flush away, as factors which would help them to stop avoiding these activities. Stoma care nurses have a unique opportunity to improve the psychological wellbeing of their patients by considering the aspects of pouch change and disposal that pose the greatest challenge to individuals. Use of a modified version of the Pouch Change and Disposal questionnaire may be a useful tool in identifying those at risk of impaired quality of life.

  17. Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study.

    Science.gov (United States)

    Aneja, Vikas; Raval, Rushik; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

    2016-10-01

    Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ ankylosis. The aim of this series was to evaluate the effectiveness of the temporomyofacial flap in the treatment of TMJ ankylosis as an interpositional gap arthroplasty. A total of 10 cases with unilateral TMJ ankylosis were treated by interpositional gap arthroplasty by pedicled temporalis myofacial flap and evaluated with a follow-up of 6 months to 5 years (Mean 3.3 years) for the functional stability of TMJ. All the patients were successfully treated. There were no signs of recurrence in any patients up to last follow up visit. The result showed that temporalis myofascial flap is a preferable choice for inter-positional gap arthroplasty which proves its versatility as an inter-positional material.

  18. Congenital pouch colon: Increasing association with low anorectal anomalies

    Directory of Open Access Journals (Sweden)

    Pavai Arunachalam

    2009-01-01

    Full Text Available Three cases of type IV congenital pouch colon associated with low anorectal anomaly are reported here. Pouch colon may be a cause of intractable constipation in children operated for low anorectal anomaly. Excellent results can be obtained by exicision of the pouch. The radiological and pathological features of this condition are discussed.

  19. Interposition vein cuffs.

    Science.gov (United States)

    Harris, P; Da Silva, T; How, T

    1996-01-01

    A vein cuff interposed at the distal anastomosis between a prosthetic vascular graft and a recipient infrageniculate artery improves the chances of continued patency of the graft, at least in the short and medium term. The mode of effect appears to be suppression or modification of anastomotic myointimal hyperplasia (MIH). In the event of graft failure the recipient artery and run-off vessels remain free from MIH and their patency is preserved thereby improving the prospects for further vascular reconstruction and limb salvage. The mechanisms by which interposition vein cuffs might modulate MIH are reviewed. Experimental evidence is described to show that the geometry of a cuffed anastomosis promotes a characteristic haemodynamic flow structure with a stable vortex. It is suggested that this vortex exerts greater shear stress upon the wall of the artery than the normal laminar flow observed in conventional anastomoses. High shear stress is known to inhibit MIH.

  20. Sulphomucin expression in ileal pouches: emerging differences between ulcerative colitis and familial adenomatous polyposis pouches.

    LENUS (Irish Health Repository)

    Bambury, Niamh

    2012-02-03

    PURPOSE: We characterized the expression of sialomucin and sulphomucin in pouches fashioned for familial adenomatous polyposis and ulcerative colitis. We correlated sulphomucin expression with bacterial colonization and mucosal inflammation. METHODS: Ethical approval and informed consent were obtained. Mucosal biopsies from 9 patients with familial adenomatous polyposis and 12 with ulcerative colitis were obtained. Sulphomucin levels were assessed by using the high iron-diamine stain. Mucous gel layer composition was correlated with villous height, crypt depth, and total mucosal thickness. Mucous gel layer composition was correlated with acute and chronic inflammatory infiltrates. Colonization by a panel of seven bacterial species (including sulphate reducing bacteria) was established and correlated with sulphomucin levels. RESULTS: High-iron-diamine positivity (i.e., sulphomucin expression) was greater in ulcerative colitis pouch mucous gel (2.083 +\\/- 0.5 vs. 0.556 +\\/- 0.4, P = 0.003). Sulphomucin expression correlated with reduced crypt depth, villous height, and total mucosal thickness. In the ulcerative colitis group, chronic inflammatory infiltrate scores were significantly greater for high-iron-diamine-positive patients. Colonization by sulphate reducing bacteria was increased in high-iron-diamine-positive patients. CONCLUSIONS: Sulphomucin expression is increased in the mucous gel layer of the ulcerative colitis pouch compared with that of the familial adenomatous polyposis pouch. Sulphomucin expression is associated with colonization by sulphate-reducing bacteria and increased chronic inflammation.

  1. Food intake in relation to pouch volume, stoma diameter, and pouch emptying after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1988-01-01

    associated with the change of solid foods consumed (by weight, p = 0.01; by energy content, p = 0.02). The change of pouch volume was negatively associated with the change of energy from beverages (p = 0.005). In conclusion, it seems impossible to tailor the reduction of food intake through adjustments...... of the surgical dimensions, at least within the ranges of our observations. Increased food consumption and decreased energy intake with beverages may be caused by late dilations, or vice versa.......This study investigated possible determinants of food intake change after gastroplastry. Preoperatively and 6 and 12 months postoperatively, 27 morbidly obese patients were prospectively examined with 7-day food registration and radiologic measurement of pouch volume and stoma diameter. Pouch...

  2. Stability of double-row rotator cuff repair is not adversely affected by scaffold interposition between tendon and bone.

    Science.gov (United States)

    Beitzel, Knut; Chowaniec, David M; McCarthy, Mary Beth; Cote, Mark P; Russell, Ryan P; Obopilwe, Elifho; Imhoff, Andreas B; Arciero, Robert A; Mazzocca, Augustus D

    2012-05-01

    Rotator cuff reconstructions may be improved by adding growth factors, cells, or other biologic factors into the repair zone. This usually requires a biological carrier (scaffold) to be integrated into the construct and placed in the area of tendon-to-bone healing. This needs to be done without affecting the constructs mechanics. Hypothesis/ The hypothesis was that scaffold placement, as an interposition, has no adverse effects on biomechanical properties of double-row rotator cuff repair. The purpose of this study was to examine the effect of scaffold interposition on the initial strength of rotator cuff repairs. Controlled laboratory study. Twenty-five fresh-frozen shoulders (mean age: 65.5 ± 8.9 years) were randomly assigned to 5 groups. Groups were chosen to represent a broad spectrum of commonly used scaffold types: (1) double-row repair without augmentation, (2) double-row repair with interposition of a fibrin clot (Viscogel), (3) double-row repair with interposition of a collagen scaffold (Mucograft) between tendon and bone, (4) double-row repair with interposition of human dermis patch (ArthroFlex) between tendon and bone, and (5) double-row repair with human dermis patch (ArthroFlex) placed on top of the repair. Cyclic loading to measure displacement was performed to 3000 cycles at 1 Hz with an applied 10- to 100-N load. The ultimate load to failure was determined at a rate of 31 mm/min. There were no significant differences in mean displacement under cyclic loading, slope, or energy absorbed to failure between all groups (P = .128, P = .981, P = .105). Ultimate load to failure of repairs that used the collagen patch as an interposition (573.3 ± 75.6 N) and a dermis patch on top of the reconstruction (575.8 ± 22.6 N) was higher compared with the repair without a scaffold (348.9 ± 98.8 N; P = .018 and P = .025). No significant differences were found for repairs with the fibrin clot as an interposition (426.9 ± 103.6 N) and the decellularized dermis

  3. Pouch dilatation following laparoscopic adjustable gastric banding: psychobehavioral factors (can psychiatrists predict pouch dilatation?).

    Science.gov (United States)

    Poole, Norman; Al Atar, Ashraf; Bidlake, Louise; Fienness, Alberic; McCluskey, Sara; Nussey, S; Bano, Gal; Morgan, John

    2004-01-01

    Laparoscopic adjustable gastric banding is increasingly being performed in morbidly obese individuals for weight loss. Some patients develop pouch dilatation as a postoperative complication that limits the utility of the procedure. Surgical variables are poor predictors of this complication. 5 patients from a series of 157 who underwent LAGB at a single center developed the condition. Psychiatric and surgical case-notes were analyzed retrospectively for the presence of operationally defined psychiatric disorders and compared to 10 controls from the same population. Cases were significantly more likely to have past or current binge eating, emotionally triggered eating with reduced awareness of the link, a history of affective disorder, reduced sexual functioning and successful preoperative weight loss. No difference between groups was observed for compliance with orlistat, childhood sexual abuse, relationships with parents, history of bulimia nervosa, rate of band inflation or preoperative BMI. Psychological factors may be better predictors of pouch dilatation than biomedical variables. Disordered eating can be an attempt to modulate negative emotions. Pouch dilatation may be a consequence of this eating behavior.

  4. Thromboxane plays a role in postprandial jejunal oxygen uptake and capillary exchange.

    Science.gov (United States)

    Alemayehu, A; Chou, C C

    1990-09-01

    The effects of a thromboxane A2 (TxA2)-endoperoxide receptor antagonist, SQ 29548, on jejunal blood flow, oxygen uptake, and capillary filtration coefficient (Kfc) were determined in anesthetized dogs under resting conditions and during the presence of predigested food in the jejunal lumen in three series of experiments. In series 1, 2.0 micrograms intra-arterial administration of SQ 29548 was found to abolish completely the vasoconstrictor action of graded doses (0.05-2.0 micrograms) of intra-arterial injection of a TxA2-endoperoxide analogue, U44069. SQ 29548 (2.0 micrograms ia) per se did not significantly alter resting jejunal blood flow, oxygen uptake, capillary pressure, or Kfc. Before SQ 29548, placement of food plus bile into the jejunal lumen increased blood flow +42 +/- 9%, oxygen uptake +28 +/- 7%, and Kfc +24 +/- 6%. After SQ 29548, the food placement increased blood flow +37 +/- 8%, oxygen uptake +52 +/- 11%, and Kfc +63 +/- 20%. The food-induced increases in oxygen uptake and Kfc after SQ 29548 were significantly greater than those induced before the blocking of TxA2-endoperoxide receptors by SQ 29548. Our study indicates that endogenous thromboxane does not play a role in regulating jejunal blood flow, capillary filtration, and oxygen uptake under resting conditions. However, it plays a role in limiting the food-induced increases in jejunal oxygen uptake and capillary exchange capacity without influencing the food-induced hyperemia.

  5. Alkaline and non-aqueous proton-conducting pouch-cell batteries

    Science.gov (United States)

    Young, Kwo-hsiung; Nei, Jean; Meng, Tiejun

    2018-01-02

    Provided are sealed pouch-cell batteries that are alkaline batteries or non-aqueous proton-conducing batteries. A pouch cell includes a flexible housing such as is used for pouch cell construction where the housing is in the form of a pouch, a cathode comprising a cathode active material suitable for use in an alkaline battery, an anode comprising an anode active material suitable for use in an alkaline battery, an electrolyte that is optionally an alkaline or proton-conducting electrolyte, and wherein the pouch does not include or require a safety vent or other gas absorbing or releasing system as the anode active material and the cathode active material do not increase the internal atmospheric pressure any more than 2 psig during cycling. The batteries provided function contrary to the art recognized belief that such battery systems were impossible due to unacceptable gas production during cycling.

  6. Tuberculosis Detection by Giant African Pouched Rats

    Science.gov (United States)

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie; Durgin, Amy; Mahoney, Amanda

    2011-01-01

    In recent years, operant discrimination training procedures have been used to teach giant African pouched rats to detect tuberculosis (TB) in human sputum samples. This article summarizes how the rats are trained and used operationally, as well as their performance in studies published to date. Available data suggest that pouched rats, which can…

  7. Microbiology of third and fourth branchial pouch cysts.

    Science.gov (United States)

    Pahlavan, Shane; Haque, Waqar; Pereira, Kevin; Larrier, Deidre; Valdez, Tulio A

    2010-03-01

    To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Retrospective chart and literature review. Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. A total of 11 patients were identified. All patients had left-sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management.

  8. Electroacupuncture at LI11 promotes jejunal motility via the parasympathetic pathway.

    Science.gov (United States)

    Hu, Xuanming; Yuan, Mengqian; Yin, Yin; Wang, Yidan; Li, Yuqin; Zhang, Na; Sun, Xueyi; Yu, Zhi; Xu, Bin

    2017-06-21

    Gastrointestinal motility disorder has been demonstrated to be regulated by acupuncture treatment. The mechanisms underlying the effects of acupuncture stimulation of abdominal and lower limb acupoints on gastrointestinal motility have been thoroughly studied; however, the physiology underlying the effects of acupuncture on the forelimbs to mediate gastrointestinal motility requires further exploration. The aim of this study was to determine whether electroacupuncture (EA) at LI11 promotes jejunal motility, whether the parasympathetic pathway participates in this effect, and if so, which somatic afferent nerve fibres are involved. A manometric balloon was used to observe jejunal motility. The effects and mechanisms of EA at LI11 were explored in male Sprague-Dawley rats with or without drug administration (propranolol, clenbuterol, acetylcholine, and atropine) and with or without vagotomy. Three types of male mice (β 1 β 2 receptor-knockout [β 1 β 2 -/- ] mice, M 2 M 3 receptor-knockout [M 2 M 3 -/- ] mice and wild-type [WT] mice) were also studied by using different EA intensities (1, 2, 4, 6, and 8 mA). A total of 72 rats and 56 mice were included in the study. EA at LI11 increased the contractile amplitude of jejunal motility in the majority of both rats and mice. However, EA at LI11 did not enhance jejunal motility in rats administered atropine, rats that underwent vagotomy, and M 2 M 3 -‍‍/- mice (at all intensities). In WT mice, EA at LI11 significantly increased jejunal motility at all intensities except 1 mA, and a plateau was reached at intensities greater than 4 mA. Our results suggest that EA at LI11 promotes jejunal motility primarily by exciting the parasympathetic pathway, and that Aδ-fibres and C-fibres may play important roles in the process.

  9. Pouch emptying of solid foods after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1985-01-01

    To obtain information on possible determinants of weight loss after horizontal gastroplasty, pouch emptying was prospectively investigated in 27 morbidly obese patients. A scintigraphic method was used. Examinations were carried out every 6 months until 2 years after surgery. Pouch emptying...... was described by means of delay, time until half emptying, mean transit time, and emptying rate. The measures all showed a significant (p less than 0.05) acceleration of pouch emptying during the first 6 months after gastroplasty. Thereafter pouch emptying was unaltered. No significant association could...

  10. Acupuncture at heterotopic acupoints enhances jejunal motility in constipated and diarrheic rats

    Science.gov (United States)

    Qin, Qing-Guang; Gao, Xin-Yan; Liu, Kun; Yu, Xiao-Chun; Li, Liang; Wang, Hai-Ping; Zhu, Bing

    2014-01-01

    AIM: To investigate the effect and mechanism of acupuncture at heterotopic acupoints on jejunal motility, particularly in pathological conditions. METHODS: Jejunal motility was assessed using a manometric balloon placed in the jejunum approximately 18-20 cm downstream from the pylorus and filled with approximately 0.1 mL warm water in anesthetized normal rats or rats with diarrhea or constipation. The heterotopic acupoints including LI11 (Quchi), ST37 (Shangjuxu), BL25 (Dachangshu), and the homotopic acupoint ST25 (Tianshu), and were stimulated for 60 s by rotating acupuncture needles right and left at a frequency of 2 Hz. To determine the type of afferent fibers mediating the regulation of jejunal motility by manual acupuncture, the ipsilateral sciatic A or C fibers of ST37 were inactivated by local application of the A-fiber selective demyelination agent cobra venom or the C fiber blocker capsaicin. Methoctramine, a selective M2 receptor antagonist, was injected intravenously to identify a specific role for M2 receptors in mediating the effect of acupuncture on jejunal motility. RESULTS: Acupuncture at heterotopic acupoints, such as LI11 and ST37, increased jejunal motility not only in normal rats, but also in rats with constipation or diarrhea. In normal rats, manual acupuncture at LI11 or ST37 enhanced jejunal pressure from 7.34 ± 0.19 cmH2O to 7.93 ± 0.20 cmH2O, an increase of 9.05% ± 0.82% (P acupuncture at LI11 or ST37 increased intrajejunal pressure from 8.17 ± 0.31 cmH2O to 9.86 ± 0.36 cmH2O, an increase of 20.69% ± 2.10% (P 0.05), respectively. In contrast, acupuncture ST25, a homotopic acupoint, decreased not only intrajejunal pressure, but also significantly decreased frequency in normal rats and rats with constipation or diarrhea. Following demyelination of Aδ fibers, acupuncture at ST37 again augmented intrajejunal pressure to 121.48% ± 3.06% of baseline. Following capsaicin application for 24 h, acupuncture at ipsilateral ST37 increased

  11. A novel technique for distal fingertip replantation: Polypropylene suture guided interpositional vein graft.

    Science.gov (United States)

    Dadaci, Mehmet; Ince, Bilsev; Altuntas, Zeynep; Bitik, Ozan; Uzun, Hakan; Bilgen, Fatma

    2015-05-04

    Despite current advances in microsurgery, fingertip replantation is still controversial, mainly due to its difficulty and cost. The purpose of this study is to describe a new technique of interposition vein graft guided by polypropylene suture in distal fingertip replantation. A total of eight consecutive Tamai zone 1 fingertip replantations performed by the same author were included. All replantations were performed using interposition vein graft guided by polypropylene suture. This technique involved a vein graft of ∼ 2 cm, with appropriate calibration, obtained from the volar part of the forearm and a 2-0 polyprolene suture passed through the interposition vein graft. Then, a polypropylene suture guide carrying the vein graft was inserted into the artery. The anastomosis was easily performed with the aid of 10-0 or 11-0 nylon in a bloodless medium and without encountering the posterior wall problem. Average surgery time was 2.5 hours (range = 2-3 hours). Among eight Tamai zone 1 replantations, six were successful (75%). There were two replantations lost because of arterial failure. This technique may ease fingertip replantations and increase the success rate for Tamai zone 1 injuries.

  12. Influence of an interpositional spacer on the behaviour of the tibiofemoral joint: a finite element study.

    Science.gov (United States)

    Checa, S; Taylor, M; New, A

    2008-10-01

    Interpositional arthroplasty is considered by many surgeons for the treatment of isolated medial compartment osteoarthritis of the knee. In this procedure, an interpositional spacer is inserted into the medial compartment of the joint with no bone resection and no mechanical fixation. Major problems such as implant dislocation, severe pain or need for revision have been reported post-operatively. In this study, the kinematics of a knee implanted with an interpositional spacer made of either polyurethane or cobalt-chrome during walking, stair ascent and squatting cycles have been predicted and compared to the normal knee using finite element analysis. In addition, articular cartilage stress histories have been examined to obtain distributions of cumulative stress, a measure of the likelihood of articular cartilage degeneration. The insertion of a polyurethane interpositional spacer in the medial side of the knee did not affect knee kinematics as compared to the normal knee, but caused an increase of articular cartilage cumulative contact stress exposures in the medial compartment of the joint. The knee implanted with the Co-Cr spacer exhibited similar trends in knee kinematics, however significantly different ranges of motion were observed during some periods of the activity cycles, specifically during the first half of the walking cycle where lower ranges of motion were predicted. In addition, higher articular cartilage cumulative contact stress exposures were observed in both compartments of the knee. In both cases, cumulative contact stress exposures of the tibial articular cartilage were more affected than those of the femoral articular cartilage. These results suggest implant material as an important parameter in the design phase of interpositional spacers.

  13. Morphology of brood pouch formation in the pot-bellied seahorse Hippocampus abdominalis.

    Science.gov (United States)

    Kawaguchi, Mari; Okubo, Ryohei; Harada, Akari; Miyasaka, Kazuki; Takada, Kensuke; Hiroi, Junya; Yasumasu, Shigeki

    2017-01-01

    The reproductive strategies of vertebrates are diverse. Seahorses (Pisces: Syngnathidae) possess the unique characteristic of male pregnancy; i.e., males, not females, incubate embryos in a specialized structure called a 'brood pouch'. The brood pouch is formed along the ventral midline of the tail. The lumen of the brood pouch is surrounded by loose connective tissue, called pseudoplacenta, and dermis. We visualized and evaluated the morphology of brood pouch formation in Hippocampus abdominalis to gain generalizable insights into this process in seahorses. First, we employed several staining methods to characterize the pseudoplacenta and dermis of the brood pouch of mature male seahorses. The pseudoplacenta is composed mainly of reticular fibers, while the dermis is composed mainly of collagenous fibers. Further observations showed that pouch formation is initiated by linear projections of epithelia on both ventrolateral sides of the body. These projections elongated toward the ventral midline, eventually fused together, and then formed a baggy structure composed of a single dermis layer with neither smooth muscle nor pseudoplacenta. Finally, the pseudoplacenta was formed, together with two layers of dermis and smooth muscle. Thus, a fully developed brood pouch was established. The morphology of the luminal epithelium also changed during pouch formation. We analyzed the localization of C-type lectins as markers; haCTL II was localized in both the outer and luminal epithelia of the brood pouch throughout development in the male seahorse, whereas haCTL IV, which was not detected in the early stage of seahorse development, became localized only in the luminal epithelium as development proceeded. We categorized the processes of brood pouch formation during male seahorse development into three stages: (1) the early stage, characterized by formation of a baggy structure from the primordium; (2) the middle stage, characterized by the differentiation and establishment of

  14. Food intake in relation to pouch volume, stoma diameter, and pouch emptying after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1988-01-01

    This study investigated possible determinants of food intake change after gastroplastry. Preoperatively and 6 and 12 months postoperatively, 27 morbidly obese patients were prospectively examined with 7-day food registration and radiologic measurement of pouch volume and stoma diameter. Pouch...... associated with the change of solid foods consumed (by weight, p = 0.01; by energy content, p = 0.02). The change of pouch volume was negatively associated with the change of energy from beverages (p = 0.005). In conclusion, it seems impossible to tailor the reduction of food intake through adjustments...... emptying was determined as the mean transit time by a scintigraphic method. None of the measured variables was found to influence the change in food intake taking place during the first 6 months, when most of the weight loss was observed. Between 6 and 12 months, the change of stoma diameter was positively...

  15. How I do it: the stapled ileal J pouch at restorative proctocolectomy.

    LENUS (Irish Health Repository)

    Martin, S T

    2011-12-01

    Ileal pouch-anal anastomosis (IPAA) following proctocolectomy is the preferred option for patients with medically refractory ulcerative colitis, indeterminate colitis, and familial adenomatous polyposis. However, it remains a procedure associated with morbidity and mortality. Pelvic sepsis, pouch fistulae, and anastomotic dehiscence predispose to pouch failure. We report our experience with an adaptation for the formation of the stapled ileal J pouch using the GIA™ 100 stapling device (Covidien, Mansfield, Massachusetts, USA). When creating the J pouch, we remove the bevelled plastic protector from the thin fork of the stapling device, allowing the staple line to be completed to the tip of the stapled efferent limb of the pouch, thereby minimizing potential blind ending in the efferent limb and injury to the transverse staple line.

  16. Interposition of the posterior cruciate ligament into the medial compartment of the knee joint on coronal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Su; Yoon, Young Cheol; Park, Ki Jeong; Wang, Joon Ho [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong Keun [Dept. of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    The purpose of our study was to evaluate the overall prevalence and clinical significance of interposition of the posterior cruciate ligament (PCL) into the medial compartment of the knee joint in coronal magnetic resonance imaging (MRI). We retrospectively reviewed 317 consecutive patients referred for knee MRI at our institution between October 2009 and December 2009. Interposition of the PCL into the medial compartment of the knee joint on proton coronal MRI was evaluated dichotomously (i.e., present or absent). We analyzed the interposition according to its prevalence as well as its relationship with right-left sidedness, gender, age, and disease categories (osteoarthritis, anterior cruciate ligament tear, and medial meniscus tear). Prevalence of interposition of PCL into the medial compartment of the knee joint was 47.0% (149/317). There was no right (50.0%, 83/166) to left (43.7%, 66/151) or male (50.3%, 87/173) to female (43.1%, 62/144) differences in the prevalence. There was no significant association between the prevalence and age, or the disease categories. Interposition of the PCL into the medial compartment of the knee joint is observed in almost half of patients on proton coronal MRI of the knee. Its presence is not associated with any particular factors including knee pathology and may be regarded as a normal MR finding.

  17. Prune belly syndrome with pouch colon with scaphoid megalourethra

    African Journals Online (AJOL)

    We here report a rare association of megalourethra with pouch colon with prune belly syndrome. We also provide a newer embryological and prognostic perspective to this association. Keywords: megalourethra, prune belly syndrome pouch colon, scaphoid ...

  18. Breath hydrogen analysis in patients with ileoanal pouch anastomosis

    DEFF Research Database (Denmark)

    Bruun, E; Meyer, J N; Rumessen, J J

    1995-01-01

    The possible influence on functional outcomes of hydrogen production in the ileoanal pouch after restorative proctocolectomy was investigated by means of lactulose H2 breath tests. Eight of 15 patients had significant increases in breath hydrogen after 10 g lactulose. One patient declined...... to participate in further investigations, the remaining seven responders had no evidence of small bowel bacterial overgrowth after glucose H2 breath tests. The ability to produce hydrogen by anaerobic fermentation of lactulose in the pouch was unrelated to the age of the patients or of the pouch. Seven of eight...... responders had successive breath tests after ingestion of lactulose 20 g and wheat starch 100 g. Five of seven had significant increases after lactulose but none after wheat starch. The overall function of the pouch continence, spontaneity of defecation, and 24 hour stool frequency was significantly better...

  19. Sulfate-reducing bacteria colonize pouches formed for ulcerative colitis but not for familial adenomatous polyposis.

    LENUS (Irish Health Repository)

    Duffy, M

    2012-02-03

    PURPOSE: Ileal pouch-anal anastomosis remains the "gold standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. Pouchitis occurs mainly in patients with a background of ulcerative colitis, although the reasons for this are unknown. The aim of this study was to characterize differences in pouch bacterial populations between ulcerative colitis and familial adenomatous pouches. METHODS: After ethical approval was obtained, fresh stool samples were collected from patients with ulcerative colitis pouches (n = 10), familial adenomatous polyposis (n = 7) pouches, and ulcerative colitis ileostomies (n = 8). Quantitative measurements of aerobic and anaerobic bacteria were performed. RESULTS: Sulfate-reducing bacteria were isolated from 80 percent (n = 8) of ulcerative colitis pouches. Sulfate-reducing bacteria were absent from familial adenomatous polyposis pouches and also from ulcerative colitis ileostomy effluent. Pouch Lactobacilli, Bifidobacterium, Bacteroides sp, and Clostridium perfringens counts were increased relative to ileostomy counts in patients with ulcerative colitis. Total pouch enterococci and coliform counts were also increased relative to ileostomy levels. There were no significant quantitative or qualitative differences between pouch types when these bacteria were evaluated. CONCLUSIONS: Sulfate-reducing bacteria are exclusive to patients with a background of ulcerative colitis. Not all ulcerative colitis pouches harbor sulfate-reducing bacteria because two ulcerative colitis pouches in this study were free of the latter. They are not present in familial adenomatous polyposis pouches or in ileostomy effluent collected from patients with ulcerative colitis. Total bacterial counts increase in ulcerative colitis pouches after stoma closure. Levels of Lactobacilli, Bifidobacterium, Bacteroides sp, Clostridium perfringens, enterococci, and coliforms were similar in both pouch groups. Because sulfate-reducing bacteria are

  20. Scintigraphic small intestinal transit time and defaecography in patients with J-pouch

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Simonsen, Jane Angel; Hvidsten, Svend

    2015-01-01

    Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch...... function, mucosal condition and a questionnaire on quality of life (QoL). This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch...... mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365). Median ejection fraction at defaecography (EF) was 49% (3–77) and 62% (17–98) after first and second defecation. Median pouch volume was 223 mL (100–360). A median daily stool frequency of nine (4...

  1. Surgical sterilization of the African giant pouched rats | Werema ...

    African Journals Online (AJOL)

    ... to all principles of surgery. This study has demonstrated the three surgical procedures for African Giant pouched rats as being useful to veterinarians in public/private practice and/or in biomedical research facilities. Keywords: Surgical sterilization, ovariectomy, ovariohysterectomy, orchidectomy, African giant pouched rats ...

  2. Disease course and management strategy of pouch neoplasia in patients with underlying inflammatory bowel diseases.

    Science.gov (United States)

    Wu, Xian-Rui; Remzi, Feza H; Liu, Xiu-Li; Lian, Lei; Stocchi, Luca; Ashburn, Jean; Shen, Bo

    2014-11-01

    To evaluate the disease course and management strategy for pouch neoplasia. Patients undergoing ileal pouch surgery for underlying ulcerative colitis who developed low-grade dysplasia (LGD), high-grade dysplasia, or adenocarcinoma in the pouch were identified. All eligible 44 patients were evaluated. Of the 22 patients with initial diagnosis of pouch LGD, 6 (27.3%) had persistence or progression after a median follow-up of 9.5 (4.1-17.6) years. Family history of colorectal cancer was shown to be a risk factor associated with persistence or progression of LGD (P = 0.03). Of the 12 patients with pouch high-grade dysplasia, 5 (41.7%) had a history of (n = 2, 16.7%) or synchronous (n = 4, 33.3%) pouch LGD. Pouch high-grade dysplasia either persisted or progressed in 3 patients (25.0%) after the initial management, during a median time interval of 5.4 (2.2-9.2) years. Of the 14 patients with pouch adenocarcinoma, 12 (85.7%) had a history of (n = 2, 14.3%) or synchronous dysplasia (n = 12, 85.7%). After a median follow-up of 2.1 (0.6-5.2) years, 6 patients with pouch cancer (42.9%) died. Comparison of patients with a final diagnosis of pouch adenocarcinoma (14, 32.6%), and those with dysplasia (29, 67.4%) showed that patients with adenocarcinoma were older (P = 0.04) and had a longer duration from IBD diagnosis or pouch construction to the detection of pouch neoplasia (P = 0.007 and P = 0.0013). The risk for progression of pouch dysplasia can be stratified. The presence of family history of colorectal cancer seemed to increase the risk for persistence or progression for patients with pouch LGD. The prognosis for pouch adenocarcinoma was poor.

  3. Differences in Ostomy Pouch Seal Leakage Occurrences Between North American and European Residents.

    Science.gov (United States)

    Fellows, Jane; Forest Lalande, Louise; Martins, Lina; Steen, Anne; Størling, Zenia M

    The purpose of this study was to compare experiences and concerns about pouch seal leakage between persons with ostomies residing in North America (Canada and the United States) and Europe (United Kingdom, Netherlands, Sweden, Germany, Belgium, France, and Italy). Differences in reported pouch wear time and accessories used between the 2 groups were also examined. Secondary analysis of data from a cross-sectional study (Ostomy Life Study). Responses from persons residing in European countries (n = 1939) were compared with responses of 1387 individuals residing in North American countries. Persons with an ostomy completed a questionnaire that focused on 4 topics related to the daily use of an ostomy pouching system (pouch seal leakage, ballooning, appearance of pouching system such as color and size of the pouch and whether it is discrete under clothing, and coupling failure of 2-piece pouching systems). Pouch seal leakage was defined as stomal effluent seeping between the skin and the wafer of the ostomy pouching system. Statistical analysis was performed using a proportional odds model including various variable effects. Special attention was given to frequency of pouch seal leakage occurrences. All tests were 2-sided; P values ≤.05 were deemed statistically significant. Participants living in the North American countries indicated they were more likely to experience leakage from the ostomy (odds ratio = 2.610, 95% CI 2.187-3.115; P < .0001). Findings also indicated they were more likely to worry about pouch seal leakage than those in the European countries' data set (odds ratio = 2.722, 95% CI 2.283-3.246; P < .0001). Participants residing in the North American countries had significantly longer wear times than those participants in the European countries (P < .0001, χ test). The use of accessories was associated with a longer pouching system wear time. Study results suggest that participants from the North American countries indicated significantly more

  4. GATA4 Is Sufficient to Establish Jejunal Versus Ileal Identity in the Small IntestineSummary

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    Cayla A. Thompson

    2017-05-01

    Full Text Available Background & Aims: Patterning of the small intestinal epithelium along its cephalocaudal axis establishes three functionally distinct regions: duodenum, jejunum, and ileum. Efficient nutrient assimilation and growth depend on the proper spatial patterning of specialized digestive and absorptive functions performed by duodenal, jejunal, and ileal enterocytes. When enterocyte function is disrupted by disease or injury, intestinal failure can occur. One approach to alleviate intestinal failure would be to restore lost enterocyte functions. The molecular mechanisms determining regionally defined enterocyte functions, however, are poorly delineated. We previously showed that GATA binding protein 4 (GATA4 is essential to define jejunal enterocytes. The goal of this study was to test the hypothesis that GATA4 is sufficient to confer jejunal identity within the intestinal epithelium. Methods: To test this hypothesis, we generated a novel Gata4 conditional knock-in mouse line and expressed GATA4 in the ileum, where it is absent. Results: We found that GATA4-expressing ileum lost ileal identity. The global gene expression profile of GATA4-expressing ileal epithelium aligned more closely with jejunum and duodenum rather than ileum. Focusing on jejunal vs ileal identity, we defined sets of jejunal and ileal genes likely to be regulated directly by GATA4 to suppress ileal identity and promote jejunal identity. Furthermore, our study implicates GATA4 as a transcriptional repressor of fibroblast growth factor 15 (Fgf15, which encodes an enterokine that has been implicated in an increasing number of human diseases. Conclusions: Overall, this study refines our understanding of an important GATA4-dependent molecular mechanism to pattern the intestinal epithelium along its cephalocaudal axis by elaborating on GATA4’s function as a crucial dominant molecular determinant of jejunal enterocyte identity. Microarray data from this study have been deposited into

  5. Elicitation of ostomy pouch preferences

    DEFF Research Database (Denmark)

    Bonnichsen, Ole

    2011-01-01

    Background: Previous studies about patients who have undergone ostomy surgery commonly address the issues of the surgery, complications, preoperative counseling, quality of life, and psychosocial changes following surgery. Only a limited number of studies deal with how technical improvements...... in stoma care would affect patients and, to the author's knowledge, the present study is the first to elicit preferences for potential improvements in ostomy pouches in the form of monetary values. Objective: This article examines and measures Swedish patients' preferences for potential improvements...... in ostomy pouch attributes. The theory, study design, elicitation procedure, and resulting preference structure of the sample is described. Methods: A discrete-choice experiment (DCE) was used to elicit preferences. Respondents were asked to choose between alternatives in choice sets, in which each...

  6. Scintigraphic Small Intestinal Transit Time and Defaecography in Patients with J-Pouch

    Directory of Open Access Journals (Sweden)

    Mie Dilling Kjaer

    2015-10-01

    Full Text Available Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch function, mucosal condition and a questionnaire on quality of life (QoL. This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365. Median ejection fraction at defaecography (EF was 49% (3–77 and 62% (17–98 after first and second defecation. Median pouch volume was 223 mL (100–360. A median daily stool frequency of nine (4–25 was reported and three (14% patients suffered from daytime incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed unspecific inflammation in 19 (90% patients. There was no correlation between transit time, evacuation fraction (EF and pouch function in univariate analysis. However, we found a high body mass index (BMI and a low bowel movement frequency to be associated with a longer transit time by multivariate analysis. Scintigraphic determination of transit time and defaecography are feasible methods in patients with ileal pouch anal anastomosis, but the clinical relevance is yet doubtful.

  7. Electrophysiological response of chicken's jejunal epithelium to increasing levels of T-2 toxin.

    Science.gov (United States)

    Yunus, Agha Waqar; Kröger, Susan; Tichy, Alexander; Zentek, Jürgen; Böhm, Josef

    2013-02-01

    The present investigations were conducted to test the effects of T-2 toxin on electrophysiological variables of jejunal epithelium of chicken. Jejunal segments of broilers were monitored in Ussing chambers in the presence of T-2 toxin at the levels of 0 (negative control), 0 (methanol/vehicle control), 0.1, 1, 5, and 10 μg/ml of buffer. T-2 toxin did not affect basal values of short circuit current (I(sc)), transmural potential difference, or tissue conductivity in the jejunal epithelium. T-2 toxin also did not statistically affect glucose-induced electrophysiological variables during the first 3 min of glucose induction. Compared to the vehicle control, the ouabain-sensitive I(sc) was negatively affected (P = 0.008) only under 5 μg of T-2 toxin/ml. Increasing levels of T-2 toxin negatively affected the ouabain-sensitive I(sc) in a cubic (P = 0.007) fashion. These data indicate that acute exposure to moderate levels of T-2 toxin may progressively impair the cation gradient across the jejunal epithelium.

  8. The effect of ileal interposition surgery on enteroendocrine cell numbers in the UC Davis type 2 diabetes mellitus rat

    DEFF Research Database (Denmark)

    Hansen, Carl Frederik; Vassiliadis, Efstathios; Vrang, Niels

    2014-01-01

    To investigate the short-term effect of ileal interposition (IT) surgery on gut morphology and enteroendocrine cell numbers in the pre-diabetic UC Davis type 2 diabetes mellitus (UCD-T2DM) rat.......To investigate the short-term effect of ileal interposition (IT) surgery on gut morphology and enteroendocrine cell numbers in the pre-diabetic UC Davis type 2 diabetes mellitus (UCD-T2DM) rat....

  9. Rare association of prune belly syndrome with pouch colon

    Directory of Open Access Journals (Sweden)

    M Ragavan

    2011-01-01

    Full Text Available M Ragavan1, U Haripriya1, PV Pradeep1, J Sarvavinothini21Department of Endocrine Surgery, 2Department of Anaesthesia, Narayana Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, IndiaAbstract: Prune belly syndrome is a triad characterized by abdominal wall musculature deficiency, cryptorchidism and urinary tract abnormalities, and is often associated with other anomalies. Although associated anorectal anomalies have been reported with this syndrome, only two cases of pouch colon, a rare type of anorectal malformation, have been reported. We report a case of prune belly syndrome with pouch colon presenting with retention of urine.Keywords: prune belly, triad syndrome, pouch colon, anorectal malformation

  10. Robotic-assisted vesicovaginal fistula repair using an extravesical approach without interposition grafting.

    Science.gov (United States)

    Kelly, Erin; Wu, Maria Y; MacMillan, J Barry

    2018-03-01

    Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center. A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone. The patient underwent a robotic-assisted VVF repair 3 months after presentation, without complication. An abdominal, extravesical approach was used. Operative time was 116 min and repeat CT cystogram showed no evidence of persistent. We have demonstrated that a VVF repair, using a robotic-assisted, extravesical approach without interposition graft placement, can be safe, less invasive and have a successful outcome at 1 year of follow-up.

  11. Elicitation of preferences for improvements in ostomy pouches

    DEFF Research Database (Denmark)

    Bonnichsen, Ole

    This paper attempts to examine and measure ostomates’ preferences for improvements in ostomy pouches. Described are the study design, elicitation procedure and resulting preference structure of the Swedish ostomate sample. The method used to elicit the preferences is a Discrete Choice Experiment...... (DCE), where respondents are asked to choose between alternatives in choice sets. Each alternative is comprised of a number of attributes relating to the adhesive, filter and flexibility of ostomy pouches. The choice between alternatives made by the respondent implies an implicit trade-off between...... the attributes and allows for the estimation of individuals’ Willingness to Pay (WTP) for the attributes of ostomy pouches when cost is included as an attribute. The data consists of 254 ostomates responding to the survey. The respondents have positive WTP for all improvement attributes presented to them...

  12. Recurrent Volvulus of an Ileal Pouch Requiring Repeat Pouchopexy: A Lesson Learnt

    Directory of Open Access Journals (Sweden)

    Pär Myrelid

    2014-01-01

    Full Text Available Introduction. Restorative surgery for ulcerative colitis with ileal pouch anal anastomosis (IPAA is frequently accompanied by complications. Volvulus of the ileal pouch is one of the most rarely reported late complications and to our knowledge no report exists on reoperative surgery for this condition. Case Report. A 58-year-old woman who previously had undergone restorative proctocolectomy due to ulcerative colitis with an IPAA presented with volvulus of the pouch. She was operated with a single row pouchopexy to the presacral fascia. Two months later she returned with a recurrent volvulus. At reoperation, the pouch was found to have become completely detached from the fascia. A new pexy was made by firmly anchoring the pouch with two rows of sutures to the presacral fascia as well as with sutures to the lateral pelvic walls. At follow-up after five months she was free of symptoms. Conclusion. This first report ever on reoperative surgery for volvulus of a pelvic pouch indicates that a single row pouchopexy might be insufficient for preventing retwisting. Several rows seem to be needed.

  13. Restorative proctocolectomy with ileal pouch-anal anastomosis in 203 patients: the Auckland experience.

    Science.gov (United States)

    Neilly, P; Neill, M E; Hill, G L

    1999-01-01

    Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become an established operation for patients with ulcerative colitis and familial adenomatous polyposis (FAP). The results of a 15-year experience with IPAA are reported. Between September 1982 and June 1997, 203 patients had IPAA surgery. From a review of the charts, data were collected on the surgical procedure, the diagnosis and early and late complications. Pouch function was assessed by means of a postal questionnaire. Of the 201 patients (median age of 32 years; 89 women) with complete records, 122 had J pouches, 65 had W pouches and 14 S pouches were constructed. The pre-operative diagnosis in 88% was ulcerative colitis and in 10% it was FAP. During a median follow-up time of 6.1 years the diagnoses were changed for 8% of the patients; in 4% the diagnosis was changed to Crohn's disease. The overall mortality was 1.5% (early = 2, late = 1). The overall morbidity was 62% (early = 17%, late = 52%). The pouch was removed or was non-functional in 9%. All patients with a final diagnosis of Crohn's disease have had their pouch excised. The median stool frequency was 4.0 (range 1.3-8.7) during the day, and 0.7 (range 0-2.1) during the night. The fewer night-time stools (J = 1.0+/-0.6; W = 0.4+/-0.5 P requirement of the W-pouch patients for anti-diarrhoeals (P = 0.004) were offset by the need for two W-pouch patients to pass a catheter to empty their pouches. The type of patients who present for IPAA surgery and the outcomes observed in this series of Auckland patients are similar to those reported from major centres elsewhere.

  14. Pouch Volvulus in Patients Having Undergone Restorative Proctocolectomy for Ulcerative Colitis: A Case Series.

    Science.gov (United States)

    Landisch, Rachel M; Knechtges, Paul M; Otterson, Mary F; Ludwig, Kirk A; Ridolfi, Timothy J

    2018-06-01

    Restorative proctocolectomy with IPAA improves quality of life in patients with medically refractory ulcerative colitis. Although bowel obstruction is common, pouch volvulus is rare and described only in case reports. Diagnosis can be challenging, resulting in delayed care and heightened morbidity. The purpose of this study was to delineate the symptoms and successful management strategies used in patients with IPAA volvulus that result in pouch salvage. This study was a case series. The study was conducted at a tertiary referral center for ulcerative colitis in Milwaukee, Wisconsin. Patients included those with volvulus of the IPAA. Over the study period (2010-2015), 6 patients were diagnosed with IPAA volvulus. The primary outcomes were symptom manifestation, diagnostic practices, and treatment of pouch volvulus. Six patients with ulcerative colitis were identified with pouch volvulus. The majority (n = 4) underwent a laparoscopic pouch creation and had early symptom manifestation after surgery. Complications preceding volvulus included pouch ulceration (n = 5) and pouchitis (n = 4). The most common presenting symptoms of volvulus were abdominal pain (n = 4) and obstipation (n = 4). Multiple imaging modalities were used, but volvulus was most frequently identified by CT scan. Management was primarily operative (n = 5), composed of excision of the pouch (n = 3), pouch-pexy (n = 1), and detorsion with defect closure (n = 1). Both operative and nonoperative treatment with endoscopic detorsion resulted in low morbidity and improved patient symptoms. This single-institution study is limited by its retrospective design and small number of patients. IPAA volvulus is a rare and challenging cause of bowel obstruction in ulcerative colitis. Heralding signs and symptoms, such as pouch ulceration and acute obstipation, should initiate a workup for a twisting pouch. Diagnosis, which is multimodal, must occur early to avert necrosis and allow for preservation of a well

  15. Quality of life and nutritional consequences after aboral pouch reconstruction following total gastrectomy for gastric cancer: randomized controlled trial CCG1101.

    Science.gov (United States)

    Ito, Yuichi; Yoshikawa, Takaki; Fujiwara, Michitaka; Kojima, Hiroshi; Matsui, Takanori; Mochizuki, Yoshinari; Cho, Haruhiko; Aoyama, Toru; Ito, Seiji; Misawa, Kazunari; Nakayama, Hiroshi; Morioka, Yuki; Ishiyama, Akiharu; Tanaka, Chie; Morita, Satoshi; Sakamoto, Junichi; Kodera, Yasuhiro

    2016-07-01

    Total gastrectomy has detrimental effects on postoperative nutritional status and quality of life (QOL), but it is often unavoidable in the treatment of gastric cancer. Roux-en-Y (RY) is the most common reconstruction method following total gastrectomy. Trials to explore other means of reconstruction have been conducted but have failed to identify a method that is globally accepted. Aboral pouch reconstruction (AP), in which an anisoperistaltic jejunal pouch is created in the Y limb of the RY reconstruction, is considered effective and technically feasible. A prospective randomized trial was conducted to compare AP with RY. Gastric cancer patients requiring total gastrectomy for R0 resection were randomly assigned during surgery to receive either RY (n = 51) or AP (n = 49). Postoperative QOL as assessed by the EORTC QLQ-C30 and STO22, body composition, and morbidity were compared between the two reconstruction methods. The physical functioning score of the QLQ-C30 was selected as the primary endpoint. The incidences of postoperative complications were similar between the two groups (29 % in the RY group and 27 % in the AP group). No significant difference was observed in the physical functioning score, and the superiority of AP was demonstrated only for the nausea and vomiting score at 12 months (p = 0.041) and the reflux score at 1 month (p = 0.036). No significant differences were observed in body composition or serum biochemistry. Although AP was safely implemented, no increased benefits in nutritional or QOL-related parameters were observed for this method over RY within 12 months postoperatively.

  16. Jejunal Gastric Heterotopia causing Multiple Strictures and Perforation Peritonitis- A Case Report with Review of Literature.

    Science.gov (United States)

    Vani, M; Nambiar, Ajit; Geetha, K; Kundil, Byju

    2017-03-01

    Gastric heterotopias beyond the ligament of Treitz though rare, should be thought of in the differential diagnosis of polypoid lesions presenting with gastrointestinal bleed or obstructive symptoms especially in children and in the young. Here is a 24-year-old male with multifocal jejunal gastric heterotopias causing multiple strictures and perforation peritonitis. Patient presented with acute abdomen pain and an emergency laparotomy was performed revealing jejunum with multiple strictures and perforation, followed by jejunal resection. On gross examination polypoid mucosa was noted at the stricture sites which showed heterotopic gastric mucosa on microscopy. Jejunal gastric heterotopias are extremely rare with less than ten reported cases and those presenting with multiple strictures are even rarer. To our knowledge this is the second case of jejunal gastric heterotopia presenting with multiple strictures.

  17. A Case of Midgut Volvulus Associated with a Jejunal Diverticulum

    Directory of Open Access Journals (Sweden)

    Joseph Gutowski

    2017-01-01

    Full Text Available Midgut volvulus in adults is a rare entity that may present with intermittent colicky abdominal pain mixed with completely asymptomatic episodes. This small bowel twist may result in complications of obstruction, ischemia, hemorrhage, or perforation. With a midgut volvulus, complications may be life-threatening, and emergent surgical intervention is the mainstay of treatment. This current case involves an 80-year-old woman with intermittent abdominal pain with increasing severity and decreasing interval of time to presentation. A CAT scan revealed mesenteric swirling with possible internal hernia. A diagnostic laparoscopy followed by laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery, and a large jejunal diverticulum. The adhesions were lysed enabling untwisting of the bowel, allowing placement of the small bowel in the correct anatomic position and resection of the jejunal diverticulum. This is a rare case of midgut volvulus with intermittent abdominal pain, associated with jejunal diverticulum managed successfully. A midgut volvulus should be considered in the differential diagnosis of a patient who present with a small bowel obstruction secondary to an internal hernia, especially when a swirl sign is present on the CAT scan.

  18. Jejunal divertikulitis som årsag til akut abdomen

    DEFF Research Database (Denmark)

    Arsic, Ivan; Cuk, Pedja; Nielsen, Michael Festersen

    2014-01-01

    diverticular disease is intravenous fluids and antibiotics. If there is an occurrence of peritonitis as a complication of jejunal diverticulitis, laparatomy may be indicated. Both of the patients received a conservative treatment with intravenous fluids and antibiotics with good response....

  19. Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Rauf Fozia

    2011-09-01

    Full Text Available Abstract Introduction Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation. Case presentation A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery. Conclusion Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction.

  20. Endoscopic Management of Drain Inclusion in the Gastric Pouch after Gastrojejunal Leakage after Laparoscopic Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity (LRYGBP

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2010-01-01

    Patients. All four obese morbidly patients underwent LRYGBP and presented a gastro-jejunal fistula after acute anastomotic leakage. During follow-up endoscopy the drain was found inside the gastric pouch. It was moved into the abdominal cavity. Fistula debit reduced significantly and closed. Results. Gastric leak closure in less than 24 hours was achieved in all, with complete resolution of symptoms. These patients benefited exclusively from endoscopic treatment. Conclusions. Endoscopy is useful and technically feasible in chronic fistulas. This procedure is a less invasive alternative to traditional surgical revision. Other therapeutic strategies can be used such as clips and fibrin glue. Drains should not be placed in contact with the anastomosis or stapled lines. Drain inclusion must be suspected when fistula debit suddenly arises. If so, endoscopy is indicated for diagnostic accuracy. Under endoscopy vision, the drain is gently removed from the gastric reservoir leading to sudden and complete resolution of the fistula.

  1. Bmp signaling mediates endoderm pouch morphogenesis by regulating Fgf signaling in zebrafish

    Science.gov (United States)

    Swartz, Mary E.; McCarthy, Neil; Norrie, Jacqueline L.; Eberhart, Johann K.

    2016-01-01

    The endodermal pouches are a series of reiterated structures that segment the pharyngeal arches and help pattern the vertebrate face. Multiple pathways regulate the complex process of endodermal development, including the Bone morphogenetic protein (Bmp) pathway. However, the role of Bmp signaling in pouch morphogenesis is poorly understood. Using genetic and chemical inhibitor approaches, we show that pouch morphogenesis requires Bmp signaling from 10-18 h post-fertilization, immediately following gastrulation. Blocking Bmp signaling during this window results in morphological defects to the pouches and craniofacial skeleton. Using genetic chimeras we show that Bmp signals directly to the endoderm for proper morphogenesis. Time-lapse imaging and analysis of reporter transgenics show that Bmp signaling is necessary for pouch outpocketing via the Fibroblast growth factor (Fgf) pathway. Double loss-of-function analyses demonstrate that Bmp and Fgf signaling interact synergistically in craniofacial development. Collectively, our analyses shed light on the tissue and signaling interactions that regulate development of the vertebrate face. PMID:27122171

  2. Seahorse Brood Pouch Transcriptome Reveals Common Genes Associated with Vertebrate Pregnancy.

    Science.gov (United States)

    Whittington, Camilla M; Griffith, Oliver W; Qi, Weihong; Thompson, Michael B; Wilson, Anthony B

    2015-12-01

    Viviparity (live birth) has evolved more than 150 times in vertebrates, and represents an excellent model system for studying the evolution of complex traits. There are at least 23 independent origins of viviparity in fishes, with syngnathid fishes (seahorses and pipefish) unique in exhibiting male pregnancy. Male seahorses and pipefish have evolved specialized brooding pouches that provide protection, gas exchange, osmoregulation, and limited nutrient provisioning to developing embryos. Pouch structures differ widely across the Syngnathidae, offering an ideal opportunity to study the evolution of reproductive complexity. However, the physiological and genetic changes facilitating male pregnancy are largely unknown. We used transcriptome profiling to examine pouch gene expression at successive gestational stages in a syngnathid with the most complex brood pouch morphology, the seahorse Hippocampus abdominalis. Using a unique time-calibrated RNA-seq data set including brood pouch at key stages of embryonic development, we identified transcriptional changes associated with brood pouch remodeling, nutrient and waste transport, gas exchange, osmoregulation, and immunological protection of developing embryos at conception, development and parturition. Key seahorse transcripts share homology with genes of reproductive function in pregnant mammals, reptiles, and other live-bearing fish, suggesting a common toolkit of genes regulating pregnancy in divergent evolutionary lineages. © The Author 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Defecation mechanisms after anterior resection with J-pouch-anal and side-to-end anastomosis in dogs.

    Science.gov (United States)

    Willis, S; Hölzl, F; Wein, B; Tittel, A; Schumpelick, V

    2007-02-01

    Colonic J-pouch-anal anastomosis or colonic side-to-end anastomosis is the reconstruction of choice after low anterior resection. However, the mechanisms of defecation after both reconstruction forms are still speculative. Low anterior rectal resections were performed in 12 dogs with six colonic J-pouch-anal (pouch) and six coloanal side-to-end (SE) reconstructions. Four months postoperative stool frequency, intestinal transit time, and neorectal compliance were determined by radiography and barostat. Defecation mechanisms were evaluated radiographically during expulsion of artificial stool. One dog with pouch reconstruction could not be evaluated due to an anastomotic leak, while the others had uncomplicated course. Spontaneous stool frequency was significantly increased with both reconstruction methods (control 2.0+/-0.9, pouch 2.7+/-1.2, SE 3.3+/-0.9 day; panastomosis. Our results show that pouch evacuation is passive and independent from pouch motility. The functional principle of the colonic J-pouch is not its reservoir function but a delay of colonic motility.

  4. Management of ileal pouch prolapse with endoscopic hot snare

    Directory of Open Access Journals (Sweden)

    Xian-rui Wu

    2013-04-01

    Full Text Available Pouch prolapse is a complication following the creation of restorative proctocolectomy. There is a paucity of information in the literature pertaining to its management. An ileal J pouch patient with dyschezia presented to our Pouch Center. Under sedation, pouchos- copy was performed with a gastroscope. We detected an anterior distal pouch mucosal prolapse, 1.5 cm in diameter, blocking the anal canal. The prolapsed mucosa was excised with hot snare under a retroflex view. There was no bleeding or perforation. The entire procedure took 25 minutes. The patient tolerated the procedure well and was discharged home 30 minutes after post-procedural observation. The patient reported the resolution of the dyschezia symptom. The histopathological examination of excised specimen showed small bowel mucosa and sub-mucosa with changes compatible with mucosal prolapse. En- doscopic hot snare appears to be feasible in the management of pouch mucosal prolapse. Resumo: O prolapso da bolsa ileal é uma complicação que pode surgir após a criação da proctoco- lectomia restauradora. As informações na literatura são escassas quanto ao tratamento. Um paciente com bolsa ileal em “J” e apresentando disquezia deu entrada em nosso centro médico. Sob sedação, realizamos uma endoscopia da bolsa ileal. Detectamos uma bolsa distal anterior com prolapso da mucosa, com 1,5 cm de diâmetro, bloqueando o canal anal. O prolapso da mucosa foi retirado com alça diatérmica sob visão retroflexa. Não houve san- gramento ou perfuração. A duração de todo o processo foi de 25 minutos. O paciente tolerou bem o procedimento e recebeu alta após 30 minutos de observação pós-procedimento. O paciente relatou a resolução do sintoma de disquezia. O exame histopatológico do espéci- me extirpado mostrou a mucosa e submucosa do intestino delgado com alterações com- patíveis com o prolapso da mucosa. A alça diatérmica endoscópica parece ser viável no

  5. Palliative Percutaneous Jejunal Stent for Patients with Short Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Satoru Takayama

    2009-04-01

    Full Text Available Gastrointestinal obstruction is a common preterminal event in patients with gastric and pancreatic cancer who often undergo palliative bypass surgery. Although endoscopic palliation with self-expandable metallic stents has emerged as a safe and effective alternative to surgery, experience with this technique remains limited. In particular, a proximal jejunal obstruction requires more technical expertise than a duodenal obstruction. Palliative treatment modalities include both surgical and nonsurgical approaches. In this report, we describe the successful placement of self-expandable metallic stents at the proximal jejunum using a combination of percutaneous endoscopic, intraoperative, and transstomal stenting. Usually endoscopy is not indicated in cases of proximal jejunal obstruction, but some cases may require palliative endoscopy instead of bypass operation.

  6. Perforated Jejunal Diverticula Secondary to a Large Faecolith: A Rare Cause of the Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Peter John Webster

    2014-01-01

    Full Text Available Jejunal diverticula are uncommon and usually asymptomatic. Very rarely, they can lead to acute complications such as bleeding, obstruction, and perforation. This report describes our experience of a case of jejunal diverticula perforation secondary to a large faecolith, with particular focus on the aetiology and management of this rare condition.

  7. Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: A treatment for extensive esophagogastric junction cancer.

    Science.gov (United States)

    Ceroni, Marco; Norero, Enrique; Henríquez, Juan Pablo; Viñuela, Eduardo; Briceño, Eduardo; Martínez, Cristian; Aguayo, Gloria; Araos, Fernando; González, Paulina; Díaz, Alfonso; Caracci, Mario

    2015-10-08

    To review the post-operative morbidity and mortality of total esophagogastrectomy (TEG) with second barrier lymphadenectomy (D2) with interposition of a transverse colon and to determine the oncological outcomes of TEG D2 with interposition of a transverse colon. This study consisted of a retrospective review of patients with a cancer diagnosis who underwent TEG between 1997 and 2013. Demographic data, surgery protocols, complications according to Clavien-Dindo classifications, final pathological reports, oncological follow-ups and causes of death were recorded. We used the TNM 2010 and Japanese classifications for nodal dissection of gastric cancer. We used descriptive statistical analysis and Kaplan-Meier survival curves. A P-value of less than 0.05 was considered statistically significant. The series consisted of 21 patients (80.9% men). The median age was 60 years. The 2 main surgical indications were extensive esophagogastric junction cancers (85.7%) and double cancers (14.2%). The mean total surgery time was 405 min (352-465 min). Interposition of a transverse colon through the posterior mediastinum was used for replacement in all cases. Splenectomy was required in 13 patients (61.9%), distal pancreatectomy was required in 2 patients (9.5%) and resection of the left adrenal gland was required in 1 patient (4.7%). No residual cancer surgery was achieved in 75.1% of patients. A total of 71.4% of patients had a postoperative complication. Respiratory complications were the most frequently observed complication. Postoperative mortality was 5.8%. Median follow-up was 13.4 mo. Surgery specific survival at 5 years of follow-up was 32.8%; for patients with curative surgery, it was 39.5% at 5 years. TEG for cancer with interposition of a transverse colon is a very complex surgery, and it presents high post-operative morbidity and adequate oncological outcomes.

  8. Substrate metabolism in isolated rat jejunal epithelium. Analysis using 14C-radioisotopes

    International Nuclear Information System (INIS)

    Mallet, R.T.

    1986-01-01

    The jejunal epithelium absorbs nutrients from the intestinal lumen and is therefore the initial site for metabolism of these compounds. The purpose of this investigation is to analyze substrate metabolism in a preparation of jejunal epithelium relatively free of other tissues. Novel radioisotopic labelling techniques allow quantitation of substrate metabolism in the TCA cycle, Embden-Meyerhof (glycolytic) pathway, and hexose monophosphate shunt. For example, ratios of 14 CO 2 production from pairs of 14 C-pyruvate, and 14 C-succinate radioisotopes (CO 2 ratios) indicate the probability of TCA cycle intermediate efflux to generate compounds other than CO 2 . With (2,3- 14 C)succinate as tracer, the ratio of 14 C in carbon 4 + 5 versus carbon 2 + 3 of citrate, the citrate labelling ratio, equals the probability of TCA intermediate flux to the acetyl CoA-derived portion of citrate versus flux to the oxaloacetate-derived portion. The principal metabolic substrates for the jejunal epithelium are glucose and glutamine. CO 2 ratios indicate that glutamine uptake and metabolism is partially Na + -independent, and is saturable, with a half-maximal rate at physiological plasma glutamine concentrations. Glucose metabolism in the jejunal epithelium proceeds almost entirely via the Embden-Meyerhof pathway. Conversion of substrates to multi-carbon products in this tissue allows partial conservation of reduced carbon for further utilization in other tissues. In summary, metabolic modeling based on 14 C labelling ratios is a potentially valuable technique for analysis of metabolic flux patterns in cell preparations

  9. Comparison of enterotomy leak pressure among fresh, cooled, and frozen-thawed porcine jejunal segments.

    Science.gov (United States)

    Aeschlimann, Kimberly A; Mann, F A; Middleton, John R; Belter, Rebecca C

    2018-05-01

    OBJECTIVE To determine whether stored (cooled or frozen-thawed) jejunal segments can be used to obtain dependable leak pressure data after enterotomy closure. SAMPLE 36 jejunal segments from 3 juvenile pigs. PROCEDURES Jejunal segments were harvested from euthanized pigs and assigned to 1 of 3 treatment groups (n = 12 segments/group) as follows: fresh (used within 4 hours after collection), cooled (stored overnight at 5°C before use), and frozen-thawed (frozen at -12°C for 8 days and thawed at room temperature [23°C] for 1 hour before use). Jejunal segments were suspended and 2-cm enterotomy incisions were made on the antimesenteric border. Enterotomies were closed with a simple continuous suture pattern. Lactated Ringer solution was infused into each segment until failure at the suture line was detected. Leak pressure was measured by use of a digital transducer. RESULTS Mean ± SD leak pressure for fresh, cooled, and frozen-thawed segments was 68.3 ± 23.7 mm Hg, 55.3 ± 28.1 mm Hg, and 14.4 ± 14.8 mm Hg, respectively. Overall, there were no significant differences in mean leak pressure among pigs, but a significant difference in mean leak pressure was detected among treatment groups. Mean leak pressure was significantly lower for frozen-thawed segments than for fresh or cooled segments, but mean leak pressure did not differ significantly between fresh and cooled segments. CONCLUSIONS AND CLINICAL RELEVANCE Fresh porcine jejunal segments or segments cooled overnight may be used for determining intestinal leak pressure, but frozen-thawed segments should not be used.

  10. Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study

    OpenAIRE

    Aneja, Vikas; Raval, Rushik; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

    2016-01-01

    Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ anky...

  11. Hypoglossal-facial-jump-anastomosis without an interposition nerve graft.

    Science.gov (United States)

    Beutner, Dirk; Luers, Jan C; Grosheva, Maria

    2013-10-01

    The hypoglossal-facial-anastomosis is the most often applied procedure for the reanimation of a long lasting peripheral facial nerve paralysis. The use of an interposition graft and its end-to-side anastomosis to the hypoglossal nerve allows the preservation of the tongue function and also requires two anastomosis sites and a free second donor nerve. We describe the modified technique of the hypoglossal-facial-jump-anastomosis without an interposition and present the first results. Retrospective case study. We performed the facial nerve reconstruction in five patients. The indication for the surgery was a long-standing facial paralysis with preserved portion distal to geniculate ganglion, absent voluntary activity in the needle facial electromyography, and an intact bilateral hypoglossal nerve. Following mastoidectomy, the facial nerve was mobilized in the fallopian canal down to its bifurcation in the parotid gland and cut in its tympanic portion distal to the lesion. Then, a tensionless end-to-side suture to the hypoglossal nerve was performed. The facial function was monitored up to 16 months postoperatively. The reconstruction technique succeeded in all patients: The facial function improved within the average time period of 10 months to the House-Brackmann score 3. This modified technique of the hypoglossal-facial reanimation is a valid method with good clinical results, especially in cases of a preserved intramastoidal facial nerve. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Peripouch Fat Area Measured on MRI Image and Its Association With Adverse Pouch Outcomes.

    Science.gov (United States)

    Gao, Xian Hua; Chouhan, Hanumant; Liu, Gang Lei; Lan, Nan; Remer, Erick; Stocchi, Luca; Ashburn, Jean; Hull, Tracy L; Shen, Bo

    2018-03-19

    There are no published studies on the impact of peripouch fat on pouch outcomes in inflammatory bowel disease (IBD) patients. Patients with pelvic MRI-DIXON scans from our prospectively maintained Pouch Database between 2002 and 2016 were evaluated. Peripouch fat area was measured on MRI-DIXON-F images at the middle height level of the pouch (area M) and the highest level of the pouch (area H). Of all 1863 patients in the database, 197 eligible patients were included in this study. The median of area M was 52.4 cm2, so the 197 patients were classified into 2 groups: group 1 (Area-M Area-M ≥52.4 cm2). Compared with group 1, group 2 was found to have thicker perianal fat, more Caucasian and more males. Group 2 also had a higher Area-H, more weight, height, and body mass index, along with greater age at IBD diagnosis, age at pouch construction and pouch age, and a higher frequency of total pouch complication (86.7% versus 66.7%, P = 0.001), chronic pouch complication (68.4% versus 51.5%, P = 0.016), and chronic antibiotic-refractory pouchitis (16.3% versus 7.1%, P = 0.043). Multivariate logistic analysis showed that Area-M was an independent risk factor for chronic antibiotic-refractory pouchitis (odds ratio [OR]: 1.025; 95% confidence interval [CI]: 1.007-1.042, P = 0.005). The 22 patients with 2 or more pelvic MRI-DIXON scans were further classified into 2 groups by the change from the initial to latest MRI-DIXON scans. Patients with Area-M increase ≥10% and Area-M/height increase ≥10% were found to have shorter pouch survivals than those with increase <10%. A new method was established for measuring peripouch fat using pelvic MRI-DIXON-F image. Our study suggests that accumulation of peripouch fat may be associated with poor outcomes in selected IBD patients suspected of inflammatory or mechanical disorders of the pouch. Whether this association is causal warrants further investigation.

  13. Jejunal Choristoma: A Very Rare Cause of Abdominal Pain in Children

    Directory of Open Access Journals (Sweden)

    T. A. Olajide

    2014-01-01

    Full Text Available Choristoma is development of a normal tissue in an aberrant location. This report describes jejunal salivary choristoma (JSC causing recurring episodes of abdominal discomfort in a 5-year-old girl. Exploratory laporatomy revealed a pale yellow subserosal jejunal lesion. Wedge resection of the lesion and repair of the bowel were performed. The child did well postoperatively and has since that time been free of pain at follow-up. Histopathological examination of the resected lesion revealed salivary gland choriostoma. Literature review (PUBMED search engine revealed no previous report of this rare clinicopathologic entity. We conclude that choriostoma should be considered a possible differential when evaluating abdominal complaint in children.

  14. Lethality of Rendang packaged in multilayer retortable pouch with sterilization process

    Science.gov (United States)

    Praharasti, A. S.; Kusumaningrum, A.; Frediansyah, A.; Nurhikmat, A.; Khasanah, Y.; Suprapedi

    2017-01-01

    Retort Pouch had become a choice to preserve foods nowadays, besides the used of the can. Both had their own advantages, and Retort Pouch became more popular for the reason of cheaper and easier to recycle. General Method usually used to estimate the lethality of commercial heat sterilization process. Lethality value wa s used for evaluating the efficacy of the thermal process. This study aimed to find whether different layers of pouch materials affect the lethality value and to find differences lethality in two types of multilayer retort pouch, PET/Aluminum Foil/Nylon/RCPP and PET/Nylon/Modified Aluminum/CPP. The result showed that the different layer arrangement was resulted different Sterilization Value (SV). PET/Nylon/Modified Aluminum/CPP had better heat penetration, implied by the higher value of lethality. PET/Nylon/Modified Aluminum/CPP had the lethality value of 6,24 minutes, whereas the lethality value of PET/Aluminum Foil/Nylon/RCPP was 3,54 minutes.

  15. A Third Branchial Pouch Cyst Presenting as Stridor in a Child

    OpenAIRE

    Wasson, Joseph; Blaney, Sean; Simo, Ricard

    2007-01-01

    We present a rare case of a third branchial pouch cyst in an 18-month-old child, presenting with stridor and a lateral cervical cystic mass. Differences in the anatomical course of third and fourth branchial cysts, and histological differences between branchial pouch and branchial cleft cysts are discussed.

  16. Clinical surgical Experiences with 51-ileal pouches

    International Nuclear Information System (INIS)

    Puerta, Juan D; Castano, Rodrigo; Arismendi, Ivan R

    2004-01-01

    Restorative proctocolectomy and ileal pouch (IP) has become an established surgery for patients with chronic ulcerative colitis and poliposis syndromes. The authors report the results of 8-year experience of restorative proctocolectomy and IP. Chart review was performed for 51 patients undergoing IP from 1994 through 2002. Preoperative histopathologic diagnoses were ulcerative colitis (n=39), poliposis syndromes (n=10), 2 Crohn diseases and 1 patient with colorectal cancer and extended resection. Information was obtained regarding patient demographics, type and duration of diseases, previous operations, and indications for surgery. Early (within 30 days after surgery) and late complications were noted. Follow-up included an annual function, physical examination, and biopsies of the pouch and anal transitional zone when were indicated. Of the 51 patients (24 women) with mean follow-up time of 44,5 months (range 12 -108 months), histopathologic diagnoses of ulcerative colitis were changed for Crohn's disease in 2 patients. The overall mortality rate was 2% (1 patient) one death was related to perineal sepsis 45 months after ileal pouch. The overall morbidity rate was 65% (73 complications in 33 patients; early 39%; late 49%) the mean hospitalary stance was 8, 9 days (range 6-25 days). Small bowel obstruction, septic complication and reoperation rates were 36%, 22% and 26%, respectively. The most frequent late complication was pouchitis (31,8%). The ileal pouch was removed in 1 patient, and it is functional in 50 (98%). There was a satisfactory index with 82% with excellent-good results, and 16% and 2% with regular and bad results. Restorative proctocolectomy with an IP is a safe procedure, with low mortality and major morbidity rates. Although total morbidity rate is appreciable, functional results generally are good and patient satisfaction is acceptable

  17. A Third Branchial Pouch Cyst Presenting as Stridor in a Child

    Science.gov (United States)

    Wasson, Joseph; Blaney, Sean; Simo, Ricard

    2007-01-01

    We present a rare case of a third branchial pouch cyst in an 18-month-old child, presenting with stridor and a lateral cervical cystic mass. Differences in the anatomical course of third and fourth branchial cysts, and histological differences between branchial pouch and branchial cleft cysts are discussed. PMID:17316513

  18. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    Retrograde jejunal intussusception is a rare disease. A 60‑year‑old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs‑en‑Y. On examination, there was a palpable wax‑like mass on the left‑hand side underneath the umbilicus. Computerized ...

  19. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Retrograde jejunal intussusception is a rare disease. A 60-year-old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs-en-Y. On examination, there was a palpable wax-like mass on the left-hand side underneath the umbilicus.

  20. Jejunal perforation by swallowed ibuprofen caplet | Njoku | Nigerian ...

    African Journals Online (AJOL)

    We present a case of jejunal perforation caused by an unusual foreign body, an ibuprofen caplet in its blister packing believed to be the first of its kind, perforation of the intestine caused by an ingested medication. The patient eventually developed an enterocutaneous fistula through the weak wall of a preexisting incisional ...

  1. The placement of naso-jejunal feeding tube under DSA guidance: its technology and skills

    International Nuclear Information System (INIS)

    Song Laichang; Wang Wenhui; Li Fenqiang; Su Dongjun; Li Bo

    2009-01-01

    Objective: To retrospectively analyze and summarize the manipulation and skills of the placement of naso-jejunal feeding tube under DSA guidance. Methods: After performing the spraying anesthesia of nasopharynx, the naso-jejunal feeding tube, with the help of guide wire and under DSA guidance, was placed into the proximal jejunum by passing it through the nose, pharynx, esophagus, stomach, pylorus and duodenum in order. The procedure was employed in 441 cases. Results: The mean time for performing the procedure was within five minutes. The procedure was successfully accomplished in all 441 cases and no complications occurred in this series. Conclusion: Under DSA guidance the placement of naso- jejunal feeding tube can be safely and quickly carried out with high successful rate and less sufferings to patient. It is worth popularizing this technique in clinical practice. (authors)

  2. An integrin-dependent role of pouch endoderm in hyoid cartilage development.

    Directory of Open Access Journals (Sweden)

    Justin Gage Crump

    2004-09-01

    Full Text Available Pharyngeal endoderm is essential for and can reprogram development of the head skeleton. Here we investigate the roles of specific endodermal structures in regulating craniofacial development. We have isolated an integrinalpha5 mutant in zebrafish that has region-specific losses of facial cartilages derived from hyoid neural crest cells. In addition, the cranial muscles that normally attach to the affected cartilage region and their associated nerve are secondarily reduced in integrinalpha5- animals. Earlier in development, integrinalpha5 mutants also have specific defects in the formation of the first pouch, an outpocketing of the pharyngeal endoderm. By fate mapping, we show that the cartilage regions that are lost in integrinalpha5 mutants develop from neural crest cells directly adjacent to the first pouch in wild-type animals. Furthermore, we demonstrate that Integrinalpha5 functions in the endoderm to control pouch formation and cartilage development. Time-lapse recordings suggest that the first pouch promotes region-specific cartilage development by regulating the local compaction and survival of skeletogenic neural crest cells. Thus, our results reveal a hierarchy of tissue interactions, at the top of which is the first endodermal pouch, which locally coordinates the development of multiple tissues in a specific region of the vertebrate face. Lastly, we discuss the implications of a mosaic assembly of the facial skeleton for the evolution of ray-finned fish.

  3. Early Transcriptomic Changes in the Ileal Pouch Provide Insight into the Molecular Pathogenesis of Pouchitis and Ulcerative Colitis

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yong; Dalal, Sushila; Antonopoulos, Dionysios; Hubert, Nathaniel; Raffals, Laura H.; Dolan, Kyle; Weber, Christopher; Messer, Jeannette S.; Jabri, Bana; Bendelac, Albert; Eren, A. Murat; Rubin, David T.; Sogin, Mitch; Chang, Eugene B.

    2017-01-01

    Background: Ulcerative colitis (UC) only involves the colonic mucosa. Yet, nearly 50% of patients with UC who undergo total proctocolectomy with ileal pouch anal anastomosis develop UC-like inflammation of the ileal pouch (pouchitis). By contrast, patients with familial adenomatous polyposis (FAP) with ileal pouch anal anastomosis develop pouchitis far less frequently. We hypothesized that pathogenic events associated with the development of UC are recapitulated by colonic-metaplastic transcriptomic reprogramming of the UC pouch. Methods: We prospectively sampled pouch and prepouch ileum mucosal biopsies in patients with UC with ileal pouch anal anastomosis 4, 8, and 12 months after their pouch was in continuity. Mucosal samples were also obtained from patients with FAP. Transcriptional profiles of the UC and FAP pouch and prepouch ileum were investigated via RNA sequencing and compared with data from a previously published microarray study. Results: Unlike patients with FAP, subjects with UC exhibited a large set of differentially expressed genes between the pouch and prepouch ileum as early as 4 months after pouch functionalization. Functional pathway analysis of differentially expressed genes in the UC pouch revealed an enhanced state of immune/inflammatory response and extracellular matrix remodeling. Moreover, >70% of differentially expressed genes mapped to published inflammatory bowel diseases microarray data sets displayed directional changes consistent with active UC but not with Crohn's disease. Conclusions: The UC pouch, well before histologic inflammation, already displays a systems-level gain of colon-associated genes and loss of ileum-associated genes. Patients with UC exhibit a unique transcriptomic response to ileal pouch creation that can be observed well before disease and may in part explain their susceptibility to the development of pouchitis.

  4. Microfluidic "Pouch" Chips for Immunoassays and Nucleic Acid Amplification Tests.

    Science.gov (United States)

    Mauk, Michael G; Liu, Changchun; Qiu, Xianbo; Chen, Dafeng; Song, Jinzhao; Bau, Haim H

    2017-01-01

    Microfluidic cassettes ("chips") for processing and analysis of clinical specimens and other sample types facilitate point-of-care (POC) immunoassays and nucleic acid based amplification tests. These single-use test chips can be self-contained and made amenable to autonomous operation-reducing or eliminating supporting instrumentation-by incorporating laminated, pliable "pouch" and membrane structures for fluid storage, pumping, mixing, and flow control. Materials and methods for integrating flexible pouch compartments and diaphragm valves into hard plastic (e.g., acrylic and polycarbonate) microfluidic "chips" for reagent storage, fluid actuation, and flow control are described. We review several versions of these pouch chips for immunoassay and nucleic acid amplification tests, and describe related fabrication techniques. These protocols thus offer a "toolbox" of methods for storage, pumping, and flow control functions in microfluidic devices.

  5. Do right-handed monkeys use the right cheek pouch before the left?

    Directory of Open Access Journals (Sweden)

    Madhur Mangalam

    Full Text Available There can be several factors that are likely to have played a role in the evolution of hand preference in humans and non-human primates, which the existing theories do not consider. There exists a possibility that hand preference in non-human primates evolved from the pre-existing lateralities in more elementary brain functions and behavior, or alternatively, the two coevolved. A basic example can be a hand-mouth command system that could have evolved in the context of ingestion. In the present study, we examined the relationship between lateralities in prehension and mastication processes, that is, hand and cheek pouch usage, in free-ranging bonnet macaques, Macaca radiata. The macaques preferentially used one hand-the 'preferred' hand, to pick up the bananas lying on the ground. Lateralities in hand and cheek pouch usage (for both filling and emptying were positively related with each other, that is, the macaques used the cheek pouch corresponding to the preferred hand predominantly and before the other. Moreover, when the macaques used the non-preferred hand to pick up the bananas, the frequency of contralateral cheek pouch usage was higher than the frequency of ipsilateral cheek pouch usage, that is, the combined structure of hand, mouth, and food did not influence the relationship between laterality in hand usage and laterality in cheek pouch usage. These findings demonstrate laterality in a relatively more involuntary function than those explored previously in any non-human primate species (e.g., facial expressions and manual gestures.

  6. A mouse air pouch model for evaluating the immune response to Taenia crassiceps infection.

    Science.gov (United States)

    Gaspar, Emanuelle B; Sakai, Yuriko I; Gaspari, Elizabeth De

    2014-02-01

    The experimental system of Taenia crassiceps cysticerci infection in BALB/c mice is considered to be the most representative model of cysticercosis. In our work, mice were sacrificed 7 and 30days after infection, and pouch fluid was collected to determine the number of accumulated cells and the concentrations of IFNγ, IL-2, IL-4, IL-6, IL-10 and nitric oxide. The injection of 50 nonbudding cysticerci into normal mouse dorsal air pouches induced a high level of IFNγ and nitric oxide production relative to the parasite load. The air pouch provides a convenient cavity that allows studying the cellular immunological aspects of the T. crassiceps parasite. The nonbudding cysticerci recovered from the air pouches contained cells that can reconstitute complete cysts in the peritoneal cavity of mice. In conclusion, these results demonstrate that the air pouch model is an alternative tool for the evaluation of the immune characteristics of T. crassiceps infection. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. CT-control of the H-graft interposition mesocaval shunt patency

    Energy Technology Data Exchange (ETDEWEB)

    Partanen, P L.K.; Oksala, I

    1984-02-01

    A method for assessing the patency of the H-graft interposition mesocaval shunts by computerized tomography is described. Five patients with such shunts were examined with a 5.5 second CT scanner. After locating the graft a 50 cc bolus of 76% diatrizoate was injected into a cubital vein and 3-4 scans were executed at a preselected level. A distinct vessel like enhancement appeared if the shunt was open. With dynamic CT-scanning the flow can be demonstrated in graphical form as time-density curves.

  8. Jejunal varices diagnosed by capsule endoscopy in patients with post-liver transplant portal hypertension.

    Science.gov (United States)

    Bass, Lee M; Kim, Stanley; Superina, Riccardo; Mohammad, Saeed

    2017-02-01

    Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2.8 g/dL (range 1.8-6.8 g/dL). Upper endoscopy was negative for significant esophageal varices, gastric varices, and bleeding portal gastropathy in all three children. All three patients had significant jejunal varices noted on CE in mid-jejunum. Jejunal varices were described as large prominent bluish vessels underneath visualized mucosa, one with evidence of recent bleeding. The results led to venoplasty of the portal vein in two patients and a decompressive shunt in one patient with resolution of GI bleed and anemia. CE is useful to diagnose intestinal varices in children with portal hypertension and GI bleeding following liver transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. The Kock pouch reconsidered: an alternative surgical technique.

    Science.gov (United States)

    Crawshaw, Alison; Williams, Julia; Woodhouse, Fran

    The psychological impact stoma surgery can have on an individual is well documented within the literature (White and Hunt, 1997; Borwell, 2009; Williams, 2005; Brown, 2005). For many years, surgeons have explored and developed innovations in surgical techniques, in particular restorative procedures with a view of preventing permanent stoma formation; ileal anal pouch (IAP) now being the surgical procedure of choice for treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). However, high morbidity rates are associated with pouch longevity (Castillo et al 2005; Nessar and Wu, 2012) and once removed can lead to a high-output ileostomy with risks of electrolyte imbalance and malabsorption. This then creates the dilemma of whether the Kock pouch (KP) should be offered as a surgical option. This article offers a historical perspective of the KP and its place in the surgical management of UC and FAP. This article also presents results from a recent audit funded by the Ileostomy Association (IA), highlighting how patients manage their KP and the importance of maintaining bowel control and being free of an incontinent stoma as a means of coming to terms with their condition.

  10. Occult Interpositional Rotator Cuff - an Extremely Rare Case of Traumatic Rotator Cuff Tear

    Energy Technology Data Exchange (ETDEWEB)

    Su, Wei Ren; Jou, I Ming [National Cheng Kung University Hospital, Tainan (China); Lin, Cheng Li [Show-Chwan Memorial Hospital, Changhua (China); Chih, Wei Hsing [Chia-Yi Christian Hospital, Chiayi (China)

    2012-01-15

    Traumatic interposition of a rotator cuff tendon in the glenohumeral joint without recognizable glenohumeral dislocation is an unusual complication after shoulder trauma. Here we report the clinical and imaging presentations of a 17-year-old man with trapped rotator cuff tendons in the glenohumeral joint after a bicycle accident. The possible trauma mechanism is also discussed.

  11. Jejunal Replacement of Stomach in Two Children with Total Gastric Necrosis

    Directory of Open Access Journals (Sweden)

    Onder Ozden

    2014-04-01

    Full Text Available Total gastrectomy is an extremely rare procedure in children and experience with its replacement is very limited. We present two patients who had jejunal replacement due to total gastric necrosis. The first patient was a- 2-year-old boy who admitted with a history of caustic ingestion. He was taken operation because of gastric perforation and necrosis. Anastomosis was applied by using jejunal segments. The second patient was an 11-years-old girl who left diaphragmatic hernia and acute gastric volvulus. At laparotomy, Total gastrectomy and Hunt-Lawrence type gastroesophostomy were made. Reconstruction with jejunum is thought as a good option in total gastric necrosis according to our 2 patient experiences. [Cukurova Med J 2014; 39(2.000: 403-407

  12. Gastric pull-up reconstruction combined with free jejunal transfer (FJT) following total pharyngolaryngo-oesophagectomy (PLE).

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Li, Dezhi; Li, Zhengjiang; Wu, Yuehuang; Xu, Zhengang; Liu, Shaoyan

    2015-06-01

    Reconstruction following total pharyngolaryngo-oesophagectomy (PLE) still challenges surgeons because of the extreme length of removed tissue. Gastric pull-up reconstruction, one of the most common reconstructive methods after PLE, has many complications such as anastomotic fistula and gastric necrosis caused by the high anastomotic tension. However, modifications of gastric pull-up reconstruction aiming to reducing the high anastomotic tension have been less reported compared with other aspects with this technique. Here we report a modified gastric pull-up reconstruction combined with free jejunal transfer (FTJ) to reduce the anastomosis tension, and thus to reduce the risk of complications after PLE. Patients underwent a standard surgical procedure including total pharyngolaryngo-oesophagectomy and bilateral internal jugular lymph nodal clearance. A free jejunal graft about 10 cm was harvested and placed in the appropriate position between mobilized stomach and oropharynx. The anastomosis between the free jejunal graft and the gastric tube was created through a stapler. Vascular anastomosis was made between the jejunal artery and the transverse cervical artery, and between the jejunal vein and the internal jugular vein. Hand suturing technique was used in the anastomosis between jejunum and pharynx. None of the patients suffered from any complications such as anastomotic fistula. Both patients resumed early postoperative oral intake. So far, they remain free of tumor recurrence and are in good health for 46 and 18 months, respectively. Considering the tumor status and the patient condition, the gastric pull-up reconstruction combined with FJT after PLE could be a reliable choice. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  13. Prevalence of Methicillin?Resistant Staphylococcus aureus from Equine Nasopharyngeal and Guttural Pouch Wash Samples

    OpenAIRE

    Boyle, A.G.; Rankin, S.C.; Duffee, L.A.; Morris, D.

    2017-01-01

    Background Methicillin?resistant Staphylococcus aureus (MRSA) is recognized as a cause of nosocomial infections in both human and veterinary medicine. Studies that examine the nasopharynx and guttural pouches of the horse as carriage sites for MRSA have not been reported. Hypothesis/Objective MRSA colonizes the nasopharynx and guttural pouch of horses. To determine the prevalence of MRSA in equine nasopharyngeal wash (NPW) and guttural pouch lavage (GPL) samples in a field population of horse...

  14. Interposition of the gallbladder in the common hepatic duct: a rare dangerous anomaly. Case report.

    Science.gov (United States)

    Rosato, L; Ginardi, A; Mondini, G

    2011-01-01

    Anomalies of the gallbladder position in the biliary tract are rare, but they could be very dangerous during cholecystectomy. A 48-year-old man presented with a 2-week history of intermittent epigastric pain, scleral jaundice and elevation of liver function tests. After a magnetic resonance cholangiogram and an endoscopic retrograde cholangiogram with sphincterotomy, he was submitted to laparoscopic cholecystectomy, the conversion to laparotomy was decided for the suspect of gallbladder interposition. The anatomical anomaly was confirmed and a Roux-en-Y hepaticojejunostomy was executed, with end-to-side anastomosis between the confluence of the hepatic ducts and the fourth loop of jejunum, on a biliary stent. This catheter was removed in the tenth postoperative day; after cholangiography and CT abdominal scan the patient was discharged, without complications. The gallbladder interposition is a rare malformation which seems to arise from an embryonic anomaly occurring between the 4th and the 5th week and whose potential causes have not been detected. A similar outcome could be also determined by a Mirizzi syndrome, but in our case it is excluded because intra-operatively there was no inflammatory reaction that could justify the presence of a fistula between the gallbladder and the common hepatic duct. Once the gallbladder interposition is found, the surgical treatment consists in removing the gallbladder itself and the corresponding part of the common hepatic duct. The reconstruction is carried out by a Roux-en-Y hepaticojejunostomy with anastomosis at the hepatic hilum, positioning a biliary stent.

  15. Mannose-specific interaction of Lactobacillus plantarum with porcine jejunal epithelium

    NARCIS (Netherlands)

    Pretzer, G.; Meulen, van der J.; Snel, J.; Meer, van der R.; Kleerebezem, M.; Niewold, Th.; Hulst, M.M.; Smits, M.A.

    2008-01-01

    Host-microorganism interactions in the intestinal tract are complex, and little is known about specific nonpathogenic microbial factors triggering host responses in the gut. In this study, mannose-specific interactions of Lactobacillus plantarum 299v with jejunal epithelium were investigated using

  16. The Jejunal Serosal Patch Procedure: A Successful Technique for ...

    African Journals Online (AJOL)

    Background: The selection of the most appropriate technique for the repair of peptic ulcer perforations, especially when the initial attempt of closure has failed have been the concern of many surgeons. Since the experimental report regarding the jejunal serosal patch procedure by Koboldin in 1963, authors have reported its ...

  17. Laparoscopic pylorus-preserving pancreatoduodenectomy with double jejunal loop reconstruction: an old trick for a new dog.

    Science.gov (United States)

    Machado, Marcel Autran C; Makdissi, Fabio F; Surjan, Rodrigo C T; Machado, Marcel C C

    2013-02-01

    Pancreatoduodenectomy is an established procedure for the treatment of benign and malignant diseases located at the pancreatic head and periampullary region. In order to decrease morbidity and mortality, we devised a unique technique using two different jejunal loops to avoid activation of pancreatic juice by biliary secretion and therefore reduce the severity of pancreatic fistula. This technique has been used for open pancreatoduodenectomy worldwide but to date has never been described for laparoscopic pancreatoduodenectomy. This article reports the technique of laparoscopic pylorus-preserving pancreatoduodenectomy with two jejunal loops for reconstruction of the alimentary tract. After pancreatic head resection, retrocolic end-to-side pancreaticojejunostomy with duct-to-mucosa anastomosis is performed. The jejunal loop is divided with a stapler, and side-to-side jejunojejunostomy is performed with the stapler, leaving a 40-cm jejunal loop for retrocolic hepaticojejunostomy. Finally, end-to-side duodenojejunostomy is performed in an antecolic fashion. This technique has been successfully used in 3 consecutive patients with pancreatic head tumors: 2 patients underwent hand-assisted laparoscopic pylorus-preserving pancreatoduodenectomy, and 1 patient underwent totally laparoscopic pylorus-preserving pancreatoduodenectomy. One patient presented a Grade A pancreatic fistula that was managed conservatively. One patient received blood transfusion. Mean operative time was 9 hours. Mean hospital stay was 7 days. No postoperative mortality was observed. Laparoscopic pylorus-preserving pancreatoduodenectomy with double jejunal loop reconstruction is feasible and may be useful to decrease morbidity and mortality after pancreatoduodenectomy. This operation is challenging and may be reserved for highly skilled laparoscopic surgeons.

  18. Magnetic resonance imaging findings of periosteal interposition in a distal tibial Salter-Harris type I fracture with surgical correlation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nara; Jung, Jee Young; Kang, Ki Ser [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2013-08-15

    The complication of growth disturbance after physeal fracture of the distal tibia has been well recognized. Although irreducible fractures of the physis due to trapped soft tissue, including periosteum, are not common, it could still cause growth disturbances. Therefore, the detection of periosteal interposition with physeal injury on imaging study is important. We present a case of a 10-year-old girl with surgically confirmed periosteal interposition in the distal tibial Salter-Harris type I fracture, through magnetic resonance imaging findings.

  19. Magnetic resonance imaging findings of periosteal interposition in a distal tibial Salter-Harris type I fracture with surgical correlation: A case report

    International Nuclear Information System (INIS)

    Kim, Nara; Jung, Jee Young; Kang, Ki Ser

    2013-01-01

    The complication of growth disturbance after physeal fracture of the distal tibia has been well recognized. Although irreducible fractures of the physis due to trapped soft tissue, including periosteum, are not common, it could still cause growth disturbances. Therefore, the detection of periosteal interposition with physeal injury on imaging study is important. We present a case of a 10-year-old girl with surgically confirmed periosteal interposition in the distal tibial Salter-Harris type I fracture, through magnetic resonance imaging findings.

  20. Oesophageal pouches and diverticula: A pictorial review

    African Journals Online (AJOL)

    through these areas of weaknesses are termed pouches, while persistent ... gradient across the oesophageal lumen, which determines the formation of ... Postero-anterior radiograph of the chest, control view for a barium swallow study in a ...

  1. Duodenal-jejunal bypass sleeve - a potential alternative to bariatric surgery?

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  2. Congenital pouch colon syndrome: A report of 17 cases

    International Nuclear Information System (INIS)

    Bhat, Nisar Ahmad

    2007-01-01

    Congenital pouch syndrome (CPC) is rare condition seen in an association with anorectal malformation that occurs almost exclusively in northern India. We viewed cases seen in our institution to study aspects of clinical presentation, diagnosis, embryogeneis, and management and raise awareness of this relatively frequent entity. From March 2002 to September 2004, 17 neonates/infants (11 males and 6 females) treated for CPC associated with anorectal malformations included 13 with type IV and 4 with type I CPC. Diagnosis was made by a single large air-fluid level on the infantogram occupying more than 50% of the entire abdominal dimension. In all patients, the pouch had fistulous communication with the genitourinary system, and there were other associated anomalies as well. Of 13 patients with pouch colon type IV, 11 neonates underwent laparotomy, ligation of the fistula, excision of the colonic pouch and end colostomy as a stage I procedure. Subsequently, these patients underwent definitive surgery, i.e. abdominal posterior sagittal anorectoplasty (AP-PSARP), with or without covering colostomy. Two of the 4 patients with type I CPC underwent laparotomy, ligation of the fistula and colorrhaphy as a first-stage operation before AP-PSARP. In our series, 4 patients were diagnosed intraoperatively and were treated in accordance with their operative findings. Post-operatively, there were no major complications except wound infection in some patients. There was one death that was not related to surgery. There are variants of the anomaly, but the possibility of CPC needs to be kept in mind as a possible association with anorectal malformations. (author)

  3. Beyond the brotherhood: Skoal Bandits' role in the evolution of marketing moist smokeless tobacco pouches.

    Science.gov (United States)

    Hendlin, Yogi H; Veffer, Jessica R; Lewis, M Jane; Ling, Pamela M

    2017-01-01

    Since 2006, "snus" smokeless tobacco has been sold in the U.S.. However, U.S. Smokeless Tobacco (USST) and Swedish Match developed and marketed pouched moist snuff tobacco (MST) since 1973. Analysis of previously secret tobacco documents, advertisements and trade press. USST partnered with Swedish Match, forming United Scandia International to develop pouch products as part of the "Lotus Project." Pouched MST was not commonly used, either in Sweden or the U.S. prior to the Lotus Project's innovation in 1973. The project aimed to transform smokeless tobacco from being perceived as an "unsightly habit of old men" into a relevant, socially acceptable urban activity, targeting 15-35 year-old men. While USST's initial pouched product "Good Luck," never gained mainstream traction, Skoal Bandits captured significant market share after its 1983 introduction. Internal market research found that smokers generally used Skoal Bandits in smokefree environments, yet continued to smoke cigarettes in other contexts. Over time, pouch products increasingly featured increased flavor, size, nicotine strength and user imagery variation. Marlboro and Camel Snus advertising mirrors historical advertising for Skoal Bandits, designed to recruit new users and smokers subjected to smokefree places. Despite serious efforts, pouched MST marketing has been unable to dispel its association with traditional smokeless tobacco stereotypes as macho and rural. Public education efforts to discourage new users and dual use of MST and cigarettes should emphasize that "new" pouch products are simply repackaging "old" smokeless tobacco.

  4. Influence of storage period on properties of biopolymer packaging materials and pouches

    Directory of Open Access Journals (Sweden)

    Bulut Sandra N.

    2017-01-01

    Full Text Available Bilayer biodegradable films based on pumpkin oil cake (PuOC and zein, as well as pouches made from these materials, were prepared, and the changes of their mechanical, physicochemical and barrier properties were analyzed during four weeks of storage. Heat seal quality of formed pouches and composition of the gas atmosphere in the pouches were also monitored. The results showed that the bilayer film had a thickness of 300 ± 10 (μm, and no its changes were observed during the storage time. The tensile strength of the tested film increased slightly in the third week, but the elongation at break showed a decreasing trend during the whole storage period. The decreases in the moisture content, total soluble matter and swelling of the obtained film, were also observed. After one month of storage, the O2 transmission rate of tested films, increased from 27 to 64 (ml/m2 24h 1 bar, and the CO2 gas transmission rate from 147 to 188 (ml/m2 24h 1 bar. The heat seal strength of the PuOC/Zein pouches decreased during the whole storage period. The percentage of O2 in PuOC/Zein pouches increased up to 7 times during the storage period; however, the percentage of CO2 decreased up to 18 times already after one week, and then remained stable in the rest of the storage period. These results are, to a smaller extent, due to the gas transmission rate through the material, especially for CO2 , and to a greater extent, due to the low heat seal strength, which decreased through the storage period, and probably influenced the content of the gases in the pouches.[Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 46010

  5. Serology of Patients with Ulcerative Colitis After Pouch Surgery Is More Comparable with that of Patients with Crohn's Disease.

    Science.gov (United States)

    Goren, Idan; Yahav, Lior; Tulchinsky, Hagit; Dotan, Iris

    2015-10-01

    The serologic status of patients with ulcerative colitis (UC) who develop postoperative pouchitis was compared with that of patients with Crohn's disease (CD) and unoperated patients with UC. Pouch patients were stratified into normal pouch, acute/recurrent acute pouchitis, and chronic pouchitis/Crohn's-like disease of the pouch groups. Antibodies against glycans associated with CD (anti-Saccharomyces cerevisiae, anti-laminaribioside, anti-chitobioside, and anti-mannobioside carbohydrate antibodies [ASCA, ALCA, ACCA, and AMCA, respectively]) were detected and correlated with type of inflammatory bowel disease and pouch behavior. A total of 501 patients with inflammatory bowel diseases were recruited: 250 (50%) CD, 124 (24.7%) unoperated UC, and 127 (25.3%) UC-pouch. At least 1 positive antibody was detected in 77.6% CD, 52.0% UC-pouch and 33.1% unoperated UC (P ACCA and AMCA prevalence in CD, UC-pouch and unoperated patients with UC were 33.2%, 24.4%, and 16.9% (P = 0.003 for all) and 35.2%, 26.8%, and 7.3%, respectively (P ACCA and AMCA is significantly increased in UC-pouch patients, suggesting that pouch surgery may trigger differential immune responses to glycans. The finding that the serology of UC-pouch patients shares similarities with that of patients with CD supports the notion that those 2 inflammatory bowel diseases share a common pathogenic pathway.

  6. Congenital intrahepatic arterioportal and portosystemic venous fistulae with jejunal arteriovenous malformation depicted on multislice spiral CT

    International Nuclear Information System (INIS)

    Chae, Eun Jin; Goo, Hyun Woo; Yoon, Chong Hyun; Kim, Seong-Chul

    2004-01-01

    We report a symptomatic infant with very rare congenital arterioportal and portosystemic venous fistulae in the liver. Multislice CT after partial transcatheter embolisation revealed not only the complicated vascular architecture of the lesion, but also an incidental jejunal arteriovenous malformation which explained the patient's melena. The patient underwent ligation of the hepatic artery and resection of the jejunal arteriovenous malformation. Postoperative multislice CT clearly demonstrated the success of the treatment. (orig.)

  7. Biomechanical comparison of expanded polytetrafluoroethylene (ePTFE) and PTFE interpositional patches and direct tendon-to-bone repair for massive rotator cuff tears in an ovine model.

    Science.gov (United States)

    McKeown, Andrew Dj; Beattie, Rebekah F; Murrell, George Ac; Lam, Patrick H

    2016-01-01

    Massive irreparable rotator cuff tears are a difficult problem. Modalities such as irrigation and debridement, partial repair, tendon transfer and grafts have been utilized with high failure rates and mixed results. Synthetic interpositional patch repairs are a novel and increasingly used approach. The present study aimed to examine the biomechanical properties of common synthetic materials for interpositional repairs in contrast to native tendon. Six ovine tendons, six polytetrafluoroethylene (PTFE) felt sections and six expanded PTFE (ePTFE) patch sections were pulled-to-failure to analyze their biomechanical and material properties. Six direct tendon-to-bone surgical method repairs, six interpositional PTFE felt patch repairs and six interpositional ePTFE patch repairs were also constructed in ovine shoulders and pulled-to-failure to examine the biomechanical properties of each repair construct. Ovine tendon had higher load-to-failure (591 N) and had greater stiffness (108 N/mm) than either PTFE felt (296 N, 28 N/mm) or ePTFE patch sections (323 N, 34 N/mm). Both PTFE felt and ePTFE repair techniques required greater load-to-failure (225 N and 177 N, respectively) than direct tendon-to-bone surgical repairs (147 N) in ovine models. Synthetic materials lacked several biomechanical properties, including strength and stiffness, compared to ovine tendon. Interpositional surgical repair models with these materials were significantly stronger than direct tendon-to-bone model repairs.

  8. Epidural fat interposition between dura mater and spinous process: a new sign for the diagnosis of spondylolysis on MR imaging of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Sherif, Hanan; Mahfouz, Ahmed-Emad [Department of Radiology, Hamad Medical Corporation, P.O. Box 3050, Doha (Qatar)

    2004-06-01

    The purpose of this study was to assess the diagnostic value of epidural fat interposition between the dura mater and spinous process of L5 as an indirect sign of spondylolysis on mid-sagittal MR imaging of the lumbar spine. Mid-sagittal T1-weighted MR images of the lumbar spine of 85 patients with spondylolysis and 93 patients without pars interarticularis fractures were randomized and evaluated by a masked reader. After a training sample of five cases, the reader was asked to note the presence or absence of epidural fat interposition between the dura mater and spinous process of L5 on the randomized images. The epidural fat interposition between the dura mater and spinous process of L5 was noted in 67 out of the 85 patients with spondylolysis (78.8%) and three of the patients without pars interarticularis fracture (3.2%). The difference was statistically significant (P<0.01). This sign has a specificity of 96.7%, sensitivity of 78.8%, positive predictive value of 95.7%, negative predictive value of 83.3% and accuracy of 88.2% for diagnosis of spondylolysis. Epidural fat interposition between the dura mater and spinous process may be a helpful sign for the diagnosis of spondylolysis on mid-sagittal MR imaging of the lumbar spine. (orig.)

  9. Epidural fat interposition between dura mater and spinous process: a new sign for the diagnosis of spondylolysis on MR imaging of the lumbar spine

    International Nuclear Information System (INIS)

    Sherif, Hanan; Mahfouz, Ahmed-Emad

    2004-01-01

    The purpose of this study was to assess the diagnostic value of epidural fat interposition between the dura mater and spinous process of L5 as an indirect sign of spondylolysis on mid-sagittal MR imaging of the lumbar spine. Mid-sagittal T1-weighted MR images of the lumbar spine of 85 patients with spondylolysis and 93 patients without pars interarticularis fractures were randomized and evaluated by a masked reader. After a training sample of five cases, the reader was asked to note the presence or absence of epidural fat interposition between the dura mater and spinous process of L5 on the randomized images. The epidural fat interposition between the dura mater and spinous process of L5 was noted in 67 out of the 85 patients with spondylolysis (78.8%) and three of the patients without pars interarticularis fracture (3.2%). The difference was statistically significant (P<0.01). This sign has a specificity of 96.7%, sensitivity of 78.8%, positive predictive value of 95.7%, negative predictive value of 83.3% and accuracy of 88.2% for diagnosis of spondylolysis. Epidural fat interposition between the dura mater and spinous process may be a helpful sign for the diagnosis of spondylolysis on mid-sagittal MR imaging of the lumbar spine. (orig.)

  10. Experimental induction of mycotic plaques in the guttural pouches of horses.

    Science.gov (United States)

    Greppi, Maria Carla; Guillot, Jacques; Melloul, Elise; Bourdoiseau, Gilles; Lepage, Olivier; Cadoré, Jean-Luc

    2017-04-01

    Guttural pouch mycosis (GPM) is a rare but potentially life-threatening condition in horses. GPM is caused by a fungal invasion into the mucosal lining of the guttural pouches and, frequently, the associated neurovascular structures. Although several species of fungi have been associated with this disease, Aspergillus spp. appear to be the most common isolated from the guttural pouches. However, it remains unclear which are the predisposing factors leading to the development of the infection. The objectives of the present study were to experimentally reproduce an infection by Aspergillus fumigatus and to follow the natural evolution of the mycosis. Eight guttural pouches from four horses were experimentally infected by endoscopy-guided intrapouch inoculation of A. fumigatus culture. Horses were monitored for clinical signs and development of fungal plaques through endoscopic examination. Mycotic lesions were observed in all the horses and a spontaneous regression was observed within 15-28 days. No development of clinical signs was noticed. In conclusion, we were able to induce the development of mycotic lesions and to observe a natural regression of these lesions without clinical signs. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Partial trapeziectomy and interposition of fascia lata allograft in the operative treatment of thumb base osteoarthritis

    NARCIS (Netherlands)

    Spaans, Anne J.; Weijns, Marieke E.; Braakenburg, Assa; Van Minnen, Leo Paul; Mink Van Der Molen, Aebele B.

    2016-01-01

    Aim: The purpose of this retrospective cohort study was to evaluate the results of fascia lata allograft interposition after partial trapeziectomy in patients with symptomatic first carpometacarpal joint osteoarthritis. Methods and results: Twenty-one patients (22 thumbs) with Eaton-Glickel stage II

  12. Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

    Directory of Open Access Journals (Sweden)

    Manish A Madnani

    2015-01-01

    Full Text Available Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA.

  13. Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report

    Directory of Open Access Journals (Sweden)

    Ching-Wen Huang

    2004-09-01

    Full Text Available Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra-abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile- stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.

  14. Food allergy alters jejunal circular muscle contractility and induces local inflammatory cytokine expression in a mouse model

    Directory of Open Access Journals (Sweden)

    Kovanen Petri T

    2009-05-01

    Full Text Available Abstract Background We hypothesized that food allergy causes a state of non-specific jejunal dysmotility. This was tested in a mouse model. Methods Balb/c mice were epicutaneously sensitized with ovalbumin and challenged with 10 intragastric ovalbumin administrations every second day. Smooth muscle contractility of isolated circular jejunal sections was studied in organ bath with increasing concentrations of carbamylcholine chloride (carbachol. Smooth muscle layer thickness and mast cell protease-1 (MMCP-1 positive cell density were assayed histologically. Serum MMCP-1 and immunoglobulins were quantified by ELISA, and mRNA expressions of IFN-γ, IL-4, IL-6 and TGFβ-1 from jejunal and ileal tissue segments were analyzed with quantitative real-time PCR. Results Ovalbumin-specific serum IgE correlated with jejunal MMCP-1+ cell density. In the allergic mice, higher concentrations of carbachol were required to reach submaximal muscular stimulation, particularly in preparations derived from mice with diarrhoea. Decreased sensitivity to carbachol was associated with increased expression of IL-4 and IL-6 mRNA in jejunum. Smooth muscle layer thickness, as well as mRNA of IFN-γ and TGF-β1 remained unchanged. Conclusion In this mouse model of food allergy, we demonstrated a decreased response to a muscarinic agonist, and increased levels of proinflammatory IL-6 and Th2-related IL-4, but not Th1-related IFN-γ mRNAs in jejunum. IgE levels in serum correlated with the number of jejunal MMCP-1+ cells, and predicted diarrhoea. Overall, these changes may reflect a protective mechanism of the gut in food allergy.

  15. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Nasmyth, D.G.; Johnston, D.; Williams, N.S.; King, R.F.; Burkinshaw, L.; Brooks, K.

    1989-01-01

    Bile acid absorption was investigated using 75 Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches

  16. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Nasmyth, D.G.; Johnston, D.; Williams, N.S.; King, R.F.; Burkinshaw, L.; Brooks, K.

    1989-03-01

    Bile acid absorption was investigated using /sup 75/Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches.

  17. Paradoxical Impact of Ileal Pouch-Anal Anastomosis on Male and Female Fertility in Patients With Ulcerative Colitis.

    Science.gov (United States)

    Pachler, Frederik R; Brandsborg, Søren B; Laurberg, Søren

    2017-06-01

    Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. This was a retrospective registry-based cohort study that was performed over a 30-year period. Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits. All data were prospectively registered. All patients with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis between 1980 and 2010 were identified in Danish national databases. The primary outcomes measured were birth rates in females and males with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis. We included 27,379 patients with ulcerative colitis (12,812 males and 14,567 females); 1544 had ileal pouch-anal anastomosis (792 males and 752 females). Patients with ulcerative colitis have slightly reduced birth rates (males at 40.8 children/1000 years, background population 43.2, females at 46.2 children/1000 years, background population 49.1). After ileal pouch-anal anastomosis, males had increased birth rates at 47.8 children/1000 years in comparison with males with ulcerative colitis without ileal pouch-anal anastomosis (40.5 children/1000 years), whereas females had reduced birth rates at 27.6 children/1000 years in comparison with females with ulcerative colitis without ileal pouch-anal anastomosis (46.8 children/1000 years). Only birth rates were investigated and not fecundability. Furthermore, there is a question about misattributed paternity, but this has previously been shown to be less than 5%. Ulcerative colitis per se has little impact on birth rates in both sexes, but ileal pouch-anal anastomosis surgery leads to a reduction in birth rates in females and an increase in birth rates in males. This has clinical

  18. Effect of the Interposition of Calcium Phosphate Materials on Tendon-Bone Healing During Repair of Chronic Rotator Cuff Tear.

    Science.gov (United States)

    Zhao, Song; Peng, Lingjie; Xie, Guoming; Li, Dingfeng; Zhao, Jinzhong; Ning, Congqin

    2014-08-01

    The current nature of tendon-bone healing after rotator cuff (RC) repair is still the formation of granulation tissue at the tendon-bone interface rather than the formation of fibrocartilage, which is the crucial structure in native tendon insertion and can be observed after knee ligament reconstruction. The interposition of calcium phosphate materials has been found to be able to enhance tendon-bone healing in knee ligament reconstruction. However, whether the interposition of these kinds of materials can enhance tendon-bone healing or even change the current nature of tendon-bone healing after RC repair still needs to be explored. The interposition of calcium phosphate materials during RC repair would enhance tendon-bone healing or change its current nature of granulation tissue formation into a more favorable process. Controlled laboratory study. A total of 144 male Sprague-Dawley rats underwent unilateral detachment of the supraspinatus tendon, followed by delayed repair after 3 weeks. The animals were allocated into 1 of 3 groups: (1) repair alone, (2) repair with Ca5(PO4)2SiO4 (CPS) bioceramic interposition, or (3) repair with hydroxyapatite (HA) bioceramic interposition at the tendon-bone interface. Animals were sacrificed at 2, 4, or 8 weeks postoperatively, and microcomputed tomography (micro-CT) was used to quantify the new bone formation at the repair site. New fibrocartilage formation and collagen organization at the tendon-bone interface was evaluated by histomorphometric analysis. Biomechanical testing of the supraspinatus tendon-bone complex was performed. Statistical analysis was performed using 1-way analysis of variance. Significance was set at P repair, CPS bioceramic significantly increased the area of fibrocartilage at the tendon-bone interface compared with the control and HA groups. Moreover, CPS and HA bioceramics had significantly improved collagen organization. Biomechanical tests indicated that the CPS and HA groups have greater ultimate

  19. Characterization of the upper pouch tracheo-oesophageal fistula in oesophageal atresia.

    Science.gov (United States)

    Summerour, Virginia; Stevens, Paul S; Lander, Anthony D; Singh, Michael; Soccorso, Giampiero; Arul, G Suren

    2017-02-01

    A small proportion of infants with oesophageal atresia (OA) are thought to have a proximal tracheoesophageal fistula (TOF). Failure to recognize these can hamper mobilization of the upper pouch and lead to life-threatening episodes of aspiration once oral feeding starts. We reviewed our experience of upper pouch fistulae to identify characteristic features of proximal TOF. A retrospective review of TOF/OA patient notes and bronchoscopy photographs and videos, identified from our database from 01/01/2006 to 12/31/2015, was performed. Eight (6.1%) infants were identified (M:F 5:3) from a total population of 131 newly diagnosed TOF/OA infants during the period. Their median gestational age was 33 (range 28-39) weeks, and median birth weight was 1647g (range 1100-3400g). Five were initially diagnosed with pure OA and 3 with a distal TOF. All patients underwent rigid bronchoscopy at the initial surgery but only one proximal fistula was identified. The 7 missed proximal fistulae were subsequently found either during on-table oesophagograms for gap assessment (n=2), at the time of thoracotomy when mobilizing the upper pouch (n=3), or during subsequent bronchoscopy for symptoms post OA repair (n=2). Two patients needed a further operation to divide the fistula. Review of the bronchoscopy videos identified four characteristic differences between upper and lower pouch fistulae. Proximal fistulae are found just distal to the vocal cords, are very small, often no more than a pit, do not open and close with ventilation, and are best identified by insufflation of the esophagus. Upper pouch fistulae are relatively easy to miss because of different characteristics compared with H-type or distal fistulae that have not previously been mentioned in the literature. level IV. Copyright © 2016. Published by Elsevier Inc.

  20. Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

    International Nuclear Information System (INIS)

    Fidan, Nurdan; Mermi, Esra Ummuhan; Acay, Mehtap Beker; Murat, Muammer; Zobaci, Ethem

    2015-01-01

    Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum

  1. [Reconstruction of the hypopharynx and cervical esophagus using a free jejunal graft].

    Science.gov (United States)

    Pesko, P; Bumbasirević, M; Knezević, J; Dunjić, M; Djukić, V; Simić, A; Stojakov, D; Sabljak, P; Bjelović, M; Janković, Z; Micev, M; Saranović, D

    2000-01-01

    Extensive malignant tumors of the hypopharynx and cervical esophagus continue to challenge surgeons in respect to both type and extent of resection as well as type of reconstruction. In the period between November 1st, 1996 and November 1st, 1998, at our Department, five patients have been operated due to squamocellular carcinoma of the hypopharynx using a free jejunal graft reconstruction method. The first free jejunal graft operation due to hypopharyngeal carcinoma, at the same time the first operation of this kind ever done in our Country, was performed on November 13th, 1998. There were 4 female and one male patient, average age 47.75 years. Disfagia for solid foods was a leading symptom in all patients (mean duration of 3.5 months) and was always accompanied with weight loss (average of 8 kg for two months). In all patients barium swallow, endoscopy, CT as well as intraoperative endoscopy was performed. Radical surgical procedure was always accompanied with the bilateral modified lympf node neck dissection. As a arterial donor vessel superior thyroid artery was used in all patients. As a venous drainage in three patients a external jugular vein was used and in two facial vein. Reconstruction using a free jejunal graft of approximately 25 cm long was performed in all patients creating upper, oropharingeal, anastomosis end to side and distal, esophageal, end to end (in only one patients side to end) using 3/0 apsorbable sutures. Mean duration of the operation was six hours. The postoperative course in all patients was uneventful. On the 9th postoperative day gastrografin and three days later barium swallow radiography was performed as a standard control study. Regular check ups were done on three, six, nine months, year and two years. On all controls all patients were symptom free and feeling well. It is our opinion that in the patients with isolated carcinoma of the hypopharynx due to low morbidity and mortality rate, free jejunal graft method is the surgical

  2. A Rare Case of Jejunal Arterio-Venous Fistula: Treatment with Superselective Catheter Embolization with a Tracker-18 Catheter and Microcoils

    International Nuclear Information System (INIS)

    Sonnenschein, Martin J.; Anderson, Suzanne E.; Lourens, Steven; Triller, Juergen

    2004-01-01

    Arterio-venous fistulas may develop spontaneously, following trauma or infection, or be iatrogenic in nature. We present a rare case of a jejunal arterio- venous fistula in a 35-year-old man with a history of pancreatic head resection that had been performed two years previously because of chronic pancreatitis. The patient was admitted with acute upper abdominal pain, vomiting and an abdominal machinery-type bruit. The diagnosis of a jejunal arterio-venous fistula was established by MR imaging. Transfemoral angiography was performed to assess the possibility of catheter embolization. The angiographic study revealed a small aneurysm of the third jejunal artery, abnormal early filling of dilated jejunal veins and marked filling of the slightly dilated portal vein (13-14 mm). We considered the presence of segmental portal hypertension. The patient was treated with coil embolization in the same angiographic session. This case report demonstrates the importance of auscultation of the abdomen in the initial clinical examination. MR imaging and color Doppler ultrasound are excellent noninvasive tools in establishing the diagnosis. The role of interventional radiological techniques in the treatment of early portal hypertension secondary to jejunal arterio-venous fistula is discussed at a time when this condition is still asymptomatic. A review of the current literature is included

  3. Morbidity Following Coloanal Anastomosis: A Comparison of Colonic J-Pouch vs Straight Anastomosis.

    Science.gov (United States)

    Brown, Shaun; Margolin, David A; Altom, Laura K; Green, Heather; Beck, David E; Kann, Brian R; Whitlow, Charles B; Vargas, Herschel David

    2018-02-01

    Low rectal tumors are often treated with sphincter-preserving resection followed by coloanal anastomosis. The purpose of this study was to compare the short-term complications following straight coloanal anastomosis vs colonic J-pouch anal anastomosis. Patients were identified who underwent proctectomy for rectal neoplasia followed by coloanal anastomosis in the 2008 to 2013 American College of Surgeons National Surgical Quality Improvement Program database. Demographic characteristics and 30-day postoperative complications were compared between groups. A national sample was extracted from the American College of Surgeons National Surgical Quality Improvement Project database. Inpatients following proctectomy and coloanal anastomosis for rectal cancer were selected. Demographic characteristics and 30-day postoperative complications were compared between the 2 groups. One thousand three hundred seventy patients were included, 624 in the straight anastomosis group and 746 in the colonic J-pouch group. Preoperative characteristics were similar between groups, with the exception of preoperative radiation therapy (straight anastomosis 35% vs colonic J-pouch 48%, p = 0.0004). Univariate analysis demonstrated that deep surgical site infection (3.7% vs 1.4%, p = 0.01), septic shock (2.25% vs 0.8%, p = 0.04), and return to the operating room (8.8% vs 5.0%, p = 0.0006) were more frequent in the straight anastomosis group vs the colonic J-pouch group. Major complications were also higher (23% vs 14%, p = 0.0001) and length of stay was longer in the straight anastomosis group vs the colonic J-pouch group (8.9 days vs 8.1 days, p = 0.02). After adjusting for covariates, major complications were less following colonic J-pouch vs straight anastomosis (OR, 0.57; CI, 0.38-0.84; p = 0.005). Subgroup analysis of patients who received preoperative radiation therapy demonstrated no difference in major complications between groups. This study had those limitations inherent to a

  4. One-stage metatarsal lengthening by allograft interposition: a novel approach for congenital brachymetatarsia.

    Science.gov (United States)

    Giannini, Sandro; Faldini, Cesare; Pagkrati, Stavroula; Miscione, Maria Teresa; Luciani, Deianira

    2010-07-01

    Congenital brachymetatarsia, a shortened metatarsal bone, can be corrected surgically by callus distraction or one-stage lengthening using bone graft. We asked whether one-stage metatarsal lengthening using metatarsal homologous bone graft could improve forefoot function, lead to metatarsal healing, restore metatarsal parabola, and improve cosmetic appearance. We retrospectively reviewed 29 patients (41 feet) in whom we lengthened 50 metatarsals. Surgery consisted of a transverse proximal osteotomy of the metatarsal shaft and interposition of a metatarsal homologous bone graft (average, 13 mm long) fixed with an intramedullary Kirschner wire. Minimum followup was 3 years (mean, 5 years; range, 3-11 years). Bone union was achieved in all cases. The mean preoperative American Orthopaedic Foot and Ankle Society score was 37 points (range, 28-53 points) and the mean postoperative score was 88 points (range, 74-96 points), with an average improvement of 51 points. Radiographically, the mean gain in length was 13 mm (range, 10-15 mm), and the mean percentage increase was 23%. One-stage metatarsal lengthening using interposition of metatarsal homologous bone graft to correct congenital brachymetatarsia has low morbidity for the patient, limited complications, short recovery times, and restores forefoot anatomy. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  5. Vertical augmentation of the posterior atrophic mandible by interpositional grafts in a split-mouth design: a human tomography evaluation pilot study.

    Science.gov (United States)

    Domingues, Eduardo Pinheiro; Ribeiro, Rafael Fernandes; Horta, Martinho Campolina Rebello; Manzi, Flávio Ricardo; Côsso, Maurício Greco; Zenóbio, Elton Gonçalves

    2017-10-01

    Using computed tomography, to compare vertical and volumetric bone augmentation after interposition grafting with bovine bone mineral matrix (GEISTLICH BIO-OSS ® ) or hydroxyapatite/tricalcium phosphate (STRAUMANN ® BONECERAMIC) for atrophic posterior mandible reconstruction through segmental osteotomy. Seven patients received interposition grafts in the posterior mandible for implant rehabilitation. The computed tomography cone beam images were analysed with OsiriX Imaging Software 6.5 (Pixmeo Geneva, Switzerland) in the pre-surgical period (T0), at 15 days post-surgery (T1) and at 180 days post-surgery (T2). The tomographic analysis was performed by a single trained and calibrated radiologist. Descriptive statistics and nonparametric methods were used to analyse the data. There was a significant difference in vertical and volume augmentation with both biomaterials using the technique (P  0.05) in volume change of the graft, bone volume augmentation, or augmentation of the maximum linear vertical distance between the two analysed biomaterials. The GEISTLICH BIO-OSS ® and STRAUMANN ® BONECERAMIC interposition grafts exhibited similar and sufficient dimensional stability and volume gain for short implants in the atrophic posterior mandible. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Section of Paediatric Radiology, Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Piazzale Golgi, 2, 27100, Pavia PV (Italy); Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco [Division of Paediatric Surgery, IRCCS Policlinico S. Matteo, Pavia (Italy); Morbini, Patrizia [Department of Pathology, IRCCS Policlinico S. Matteo, Pavia (Italy)

    2004-09-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  7. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    International Nuclear Information System (INIS)

    Beluffi, Giampiero; Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco; Morbini, Patrizia

    2004-01-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  8. Experience with 32 Pelvic Fracture Urethral Defects Associated with Urethrorectal Fistulas: Transperineal Urethroplasty with Gracilis Muscle Interposition.

    Science.gov (United States)

    Guo, Hailin; Sa, Yinglong; Fu, Qiang; Jin, Chongrui; Wang, Lin

    2017-07-01

    Pelvic fracture urethral defects associated with urethrorectal fistulas are rare and difficult to repair. The aim of this study was to evaluate the efficacy of transperineal urethroplasty with gracilis muscle interposition for the repair of pelvic fracture urethral defects associated with urethrorectal fistulas. We identified 32 patients who underwent transperineal urethroplasty with gracilis muscle interposition to repair pelvic fracture urethral defects associated with urethrorectal fistulas. Patient demographics as well as preoperative, operative and postoperative data were obtained. Mean followup was 33 months (range 6 to 64). The overall success rate was 91% (29 of 32 cases). One-stage repair was successful in 17 of 18 patients (94%) using perineal anastomosis with separation of the corporeal body and in 12 of 14 (86%) using perineal anastomosis with inferior pubectomy and separation of the corporeal body. All 22 patients (100%) without a previous history of repair were successfully treated. However, only 7 of 10 patients (70%) with a previous history of failed urethroplasty and urethrorectal fistula repair were cured. Recurrent urethral strictures developed in 2 cases. One patient was treated successfully with optical internal urethrotomy and the other was treated successfully with tubed perineoscrotal flap urethroplasty. Recurrent urethrorectal fistulas associated with urethral strictures developed in an additional patient. Transperineal urethroplasty with gracilis muscle interposition is a safe and effective surgical procedure for most pelvic fracture urethral defects associated with urethrorectal fistulas. Several other factors may affect its postoperative efficiency. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. The fraction dose absorbed, in humans, and high jejunal human permeability relationship.

    Science.gov (United States)

    Dahan, Arik; Lennernäs, Hans; Amidon, Gordon L

    2012-06-04

    The drug intestinal permeability (P(eff)) measure has been widely used as one of the main factors governing both the rate and/or extent of drug absorption (F(abs)) in humans following oral administration. In this communication we emphasize the complexity behind and the care that must be taken with this in vivo P(eff) measurement. Intestinal permeability, considering the whole of the human intestine, is more complex than generally recognized, and this can lead to misjudgment regarding F(abs) and P(eff) in various settings, e.g. drug discovery, formulation design, drug development and regulation. Setting the adequate standard for the low/high permeability class boundary, the different experimental methods for the permeability measurement, and segmental-dependent permeability throughout the human intestine due to different mechanisms are some of the main points that are discussed. Overall, the use of jejunal P(eff) as a surrogate for extent of absorption is sound and scientifically justified; a compound with high jejunal P(eff) will have high F(abs), eliminating the risk for misclassification as a BCS class I drug. Much more care should be taken, however, when jejunal P(eff) does not support a high-permeability classification; a thorough examination may reveal high-permeability after all, attributable to e.g. segmental-dependent permeability due to degree of ionization or transporter expression. In this situation, the use of multiple permeability experimental methods, including the use of metabolism, which except for luminal degradation requires absorption, is prudent and encouraged.

  10. The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn

    Directory of Open Access Journals (Sweden)

    Zachary Bauman

    2015-01-01

    Full Text Available We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia.

  11. Follow-up of volar plate interposition arthroplasty (Tupper) of the metacarpophalangeal joints in rheumatoid hands: preliminary findings

    DEFF Research Database (Denmark)

    Gøtze, J P; Jensen, Claus Hjorth

    2000-01-01

    We present the results of a three-year follow-up study of 59 interposition volar plate arthroplasties (Tupper) on metacarpophalangeal joints in 13 patients with erosive rheumatoid arthritis. The median age at the time of operation was 60 years (range 45-77). All patients reported lasting pain...

  12. Modified Le Bag Pouch after Radical Cystectomy: Continence, Uro dynamic Results and Morbidity

    International Nuclear Information System (INIS)

    Nassar, O.A.H.

    2010-01-01

    To revaluate ileocolonic pouch for ortho-topic neobladder reconstruction, a cohort of patients with bladder cancer was selected to undergo radical cystectomy and modified Le Bag pouch. Evaluation concentrates on continence and associated morbidity observed on close follow-up. Patients and Methods: A total of 37 patients including 16 females with T2 3 bladder cancer (19 transitional, 15 : squamous and 3 adenocarcinoma) were treated by radical cystectomy and totally detubularized ileocolic neobladder. Post operative morbidity, continence and urodynamic studies were evaluated. Mean time to have full daytime continence was tested against age, gender, postoperative complications, technique of pouch creation either stapler or hand suture and adjuvant irradiation. Results: Cystometry 12 months post surgery showed 493 ml median capacity with basal and maximum reservoir median pressures of 16 and 38 cm H 2 O respectively. Uro-flowmetry had maximum voiding volume of 370ml, voiding time 45s and maximum flow rate of 11.6ml/s. Within the first 2 months post operative 44% were continent by day, 33% by night and 67% had stress incontinence. By 12 months post surgery 89% were continent by day, 73% by night and 27% had stress incontinence. Two years post surgery 94% were continent by day and 81 % had complete day and night control of uri-ne. Urinary leakage was the most frequent early complication (10.8%). Late complications were urinary tract infection (13.5%), metabolic acidosis (13.5%) and reflux (10.8%). Pouch over distension (5.4%) was consistent with bladder neck obstruction. Patient's gender and postoperative morbidity were statistically significant factors to increase the mean time to continence; whereas, age, use of stapler and adjuvant radiotherapy had no significant effect. Conclusion: Modified Le Bag pouch is a simple technique with adequate pouch capacity that offers excellent slowly progressing continence rates with minor morbidity rate. Post operative morbidity and

  13. Endoscopic gastric pouch plication – a novel endoluminal incision free approach to revisional bariatric surgery

    Directory of Open Access Journals (Sweden)

    Virk CS

    2010-04-01

    Full Text Available 10-40% of Roux-en-Y gastric bypass (RYGB patients regain significant weight after Roux-en-Y gastric bypass surgery due to dilation of the pouch and/or the gastrojejunal (GJ anastomosis. Traditional revision surgery is associated with significant morbidity (e.g. post-anastomotic GJ leak where less invasive endoluminal procedures may represent safer alternatives. The present article reports a case of the safe and successful use of endoluminal gastric pouch plication (EGPP using the StomaphyX™ device to correct both a dilated gastric pouch and a dilated gastrojejunostomy in a post-RYGB patient who regained significant weight.

  14. Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique

    Directory of Open Access Journals (Sweden)

    Issam Saliba

    2018-01-01

    Full Text Available Objective: To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S and a new fat interposition total ossicular replacement prosthesis (TORP-F in pediatric and adult patients and to assess the complication and the undesirable outcome. Study design: This is a retrospective study. Methods: This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes’ head as a partial ossicular replacement prosthesis. Results: The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52 compared with 40% in the TORP-S group (n = 29. However, the adult cohort shows 79.3% in the TORP-F group (n = 52 compared with 43.75% in the TORP-S group (n = 25. These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P  = .03. Conclusions: The interposition of a fat graft between the legs of the titanium implants (TORP-F provides superior hearing results compared with a standard procedure (TORP-S in pediatric and adult populations because of its better stability in the oval window niche.

  15. Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique.

    Science.gov (United States)

    Saliba, Issam; Sabbah, Valérie; Poirier, Jackie Bibeau

    2018-01-01

    To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. This is a retrospective study. This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes' head as a partial ossicular replacement prosthesis. The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P  = .03). The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche.

  16. Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound.

    Science.gov (United States)

    Rubin, Jacob A; Shigemoto, Reynsen; Reese, David J; Case, J Brad

    2015-01-01

    A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

  17. Two-staged management for all types of congenital pouch colon

    Directory of Open Access Journals (Sweden)

    Rajendra K Ghritlaharey

    2013-01-01

    Full Text Available Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC. Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 December 2011. Results: CPC comprised of 13.71% (97 of 707 of all anorectal malformations (ARM and 28.19% (97 of 344 of high ARM. Eleven CPC cases (all males were managed with two-staged procedures. Distribution of cases (Narsimha Rao et al.′s classification into types I, II, III, and IV were 1, 2, 6, and 2, respectively. Initial operative procedures performed were window colostomy (n = 6, colostomy proximal to pouch (n = 4, and ligation of colovesical fistula and end colostomy (n = 1. As definitive procedures, pouch excision with abdomino-perineal pull through (APPT of colon in eight, and pouch excision with APPT of ileum in three were performed. The mean age at the time of definitive procedures was 15.6 months (ranges from 3 to 53 months and the mean weight was 7.5 kg (ranges from 4 to 11 kg. Good fecal continence was observed in six and fair in two cases in follow-up periods, while three of our cases lost to follow up. There was no mortality following definitive procedures amongst above 11 cases. Conclusions: Two-staged procedures for all types of CPC can also be performed safely with good results. The most important fact that the definitive procedure is being done without protective stoma and therefore, it avoids stoma closure, stoma-related complications, related cost of stoma closure and hospital stay.

  18. Female sexual function and fertility after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Hor, Thevy; Lefevre, Jeremie H; Shields, Conor; Chafai, Najim; Tiret, Emmanuel; Parc, Yann

    2016-03-01

    A potential complication in women after ileal pouch-anal anastomosis (IPAA) is sexual impairment and reduced fertility. The aim was to evaluate sexual function and fertility after IPAA. All female patients who underwent an IPAA between 2004 and 2013 were retrospectively included. Sexual function, fertility, and continence were explored by the female sexual function index (FSFI), telephonic interview, and Wexner's score. Among 127 women included, 93 responded to the questionnaires (73.2%). Seventy five were sexually active, and 48 (64%) had normal sexual function (FSFI > 26). In univariate analysis, there was a significant relationship between ulcerative colitis (p = 0.0161), age > 40 years (p = 0.01311), number of bowel movements (p = 0.0238), nocturnal pouch activity (p = 0.0094), use of loperamide (p = 0.0283), and existence of sexual dysfunction. After multivariate analysis, age and nocturnal pouch activity were associated with a worse sexual function (p = 0.0235, OR = 3.3 (1.2-9.9) and p = 0.0094, OR = 4.1 (1.4-13.5)). Of 16 patients who wished to have children, 10 (63%) became pregnant without recourse to in vitro fertilization, of whom 3 had two or more pregnancies. In total, there were 13 children born after IPAA. The mean time between the first pregnancy and surgery was 24.8 ± 22 months. At 12 and 24 months after cessation of contraception, 57 and 67% had at least one pregnancy. While sexual function is impaired in a limited number of patients, the impact of surgery can be regarded as modest. Age and nocturnal pouch activity were some independent factors of worse sexual function. The risk of infertility should not preclude consideration of IPAA as a treatment option.

  19. A Case of Extragonadal Teratoma in the Pouch of Douglas and Literature Review.

    Science.gov (United States)

    Kakuda, Mamoru; Matsuzaki, Shinya; Kobayashi, Eiji; Yoshino, Kiyoshi; Morii, Eiichi; Kimura, Tadashi

    2015-01-01

    Mature cystic teratoma is a germ cell tumor of the ovaries and is often observed in clinical practice. However, extragonadal teratomas are rare tumors and have been reported outside the ovaries, (e.g., in the greater omentum). The mechanism underlying the development of extragonadal teratomas remains unknown. We encountered a case of extragonadal teratoma in the pouch of Douglas that appeared to be a parasitic dermoid cyst. From our experience and the literature review, we discuss the potential mechanism leading to the development of extragonadal teratomas. A 41-year-old nonpregnant woman was referred to our department due to myoma and anemia. A 4-cm asymptomatic mass in the pouch of Douglas was observed, and the patient was diagnosed with ovarian mature cystic teratoma. She underwent laparoscopic surgery, and intraoperative findings revealed that the fallopian tube was injured and torn, and a residual small ovary was observed in the left side of the ovary. A tumor measuring approximately 4 cm observed in the pouch of Douglas was extracted without rupturing. The tumor was diagnosed as a parasitic dermoid cyst by macroscopic and histopathological findings. Auto-amputation could be the underlying mechanism that leads to an isolated parasitic dermoid cyst in the pouch of Douglas. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  20. Tubular Adenoma in the Indiana Pouch of a Patient With a History of Bladder Exstrophy

    Directory of Open Access Journals (Sweden)

    Madeleine G. Manka

    2015-09-01

    Full Text Available An increased risk of neoplasm has been noted when bowel segments are used for urinary diversion. Particularly true for ureterosigmoidostomy, colonic adenocarcinoma has rarely been reported following Indiana Pouch diversion. This report describes a 42-year-old woman with a history of bladder exstrophy who developed a polyp in her Indiana Pouch 24 years after its creation. The polyp, found incidentally, was a tubular adenoma with high-grade dysplasia. Due to its malignant potential, the polyp was resected with preservation of the Indiana Pouch. This case highlights the need for lifetime surveillance in urinary reservoir patients who received diversions at a young age.

  1. Increased jejunal prostaglandin E2 concentrations in patients with acute cholera

    NARCIS (Netherlands)

    Speelman, P.; Rabbani, G. H.; Bukhave, K.; Rask-Madsen, J.

    1985-01-01

    Supraphysiologic doses of prostaglandins (PGs) mimic the effect of cholera toxin and cAMP in the small intestine, but not all observations are explicable in terms of the theory that links PGs to cAMP. Because no data exist on endogenous PGs in human cholera we measured PGE2 concentrations in jejunal

  2. Contaminated fistula following J-pouch ileoanal reservoir. Treatment with a collagen sponge containing gentamicin and metronidazole. Case report

    DEFF Research Database (Denmark)

    Nielsen, R; Bülow, Steffen; Moesgaard, F

    1991-01-01

    In a 55-year-old woman, a 1 x 5 cm fistula developed in the ileoanal anastomosis after restorative proctocolectomy with J-pouch ileoanal reservoir and temporary ileostomy for intractable ulcerative colitis. The fistula extended between the pouch and the sacral bone. Lasting closure was achieved b...... by intrafistular placement of a collagen sponge containing gentamicin and soaked in metronidazole solution and pouch drainage through a transanal Foley catheter....

  3. 48 CFR 752.7015 - Use of pouch facilities.

    Science.gov (United States)

    2010-10-01

    ... clause is available from the Post Communication Center at the Embassy or USAID Mission. [49 FR 13259, Apr... paragraphs (a)(1) through (a)(7) of this clause; however, the final decision regarding use of pouch... Name of Post, U.S. Agency for International Development, Washington, DC 20523-0001. (5) Personal mail...

  4. Bacterial fermentation of fructo-oligosaccharides and resistant starch in patients with an ileal pouch-anal anastomosis.

    NARCIS (Netherlands)

    Alles, M.S.; Katan, M.B.; Salemans, J.M.J.I.; Laere, van K.M.J.; Gerichhausen, M.J.W.; Rozendaal, M.J.; Nagengast, F.M.

    1997-01-01

    Patients with large bowel disease may undergo ileal pouch-anal anastomosis, in which the colon is removed and part of the distal ileum is used to construct a pelvic reservoir. Competence of the ileal pouch to ferment carbohydrates is associated with the absence of pouchitis. However, the extent to

  5. The Effect of Combination of Radiation with 5-Fluorouracil on Mouse Jejunal Crypt Cells

    International Nuclear Information System (INIS)

    Huh, Seung Jae; Park, Charn Il

    1985-01-01

    The interaction of radiation and 5-Fluorouracil (5-FU) on mouse jejunal crypt cells was studied using the microcolony survival assay. 150mg/kg of 5-FU was injected intraperitoneally 15 minutes before irradiation and 6 hours after irradiation. Jejunal crypt cells of mouse survived more when 5-FU was given 15 minutes before irradiation than giving it 6 hours after irradiation. The mean lethal doses (Do) of each of irradiation alone group, 5-FU injection group of 15 minutes preceding irradiation, and 5-FU injection group of 6 hours post irradiation were 135, 135, and 114 rad respectively. The dose effect factor (DEF) of each of 5-FU injection groups of 15 minutes preceding irradiation and of 6 hours post irradiation were 1.13 and 1.27

  6. Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft.

    Science.gov (United States)

    Tower, Dyane E; Wood, Ryan W; Vaardahl, Michael D

    2015-01-01

    Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of symptoms after nonoperative treatment, and surgical intervention is commonly used to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints. Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition resection with interposition of a particulate juvenile hyaline cartilaginous allograft (DeNovo(®) NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series were doing well with improved subtalar joint motion and decreased pain, and 1 foot showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Behandling med duodenal-jejunal bypass-sleeve ved svær overvægt

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  8. Proteomic analysis of protein interactions between Eimeria maxima sporozoites and chicken jejunal epithelial cells by shotgun LC-MS/MS.

    Science.gov (United States)

    Huang, Jingwei; Liu, Tingqi; Li, Ke; Song, Xiaokai; Yan, Ruofeng; Xu, Lixin; Li, Xiangrui

    2018-04-04

    Eimeria maxima initiates infection by invading the jejunal epithelial cells of chicken. However, the proteins involved in invasion remain unknown. The research of the molecules that participate in the interactions between E. maxima sporozoites and host target cells will fill a gap in our understanding of the invasion system of this parasitic pathogen. In the present study, chicken jejunal epithelial cells were isolated and cultured in vitro. Western blot was employed to analyze the soluble proteins of E. maxima sporozoites that bound to chicken jejunal epithelial cells. Co-immunoprecipitation (co-IP) assay was used to separate the E. maxima proteins that bound to chicken jejunal epithelial cells. Shotgun LC-MS/MS technique was used for proteomics identification and Gene Ontology was employed for the bioinformatics analysis. The results of Western blot analysis showed that four proteins bands from jejunal epithelial cells co-cultured with soluble proteins of E. maxima sporozoites were recognized by the positive sera, with molecular weights of 70, 90, 95 and 130 kDa. The co-IP dilutions were analyzed by shotgun LC-MS/MS. A total of 204 proteins were identified in the E. maxima protein database using the MASCOT search engine. Thirty-five proteins including microneme protein 3 and 7 had more than two unique peptide counts and were annotated using Gene Ontology for molecular function, biological process and cellular localization. The results revealed that of the 35 annotated peptides, 22 (62.86%) were associated with binding activity and 15 (42.86%) were involved in catalytic activity. Our findings provide an insight into the interaction between E. maxima and the corresponding host cells and it is important for the understanding of molecular mechanisms underlying E. maxima invasion.

  9. Indiana pouch continent urinary reservoir in patients with previous pelvic irradiation

    International Nuclear Information System (INIS)

    Mannel, R.S.; Braly, P.S.; Buller, R.E.

    1990-01-01

    Little information exists on the use of continent urinary reservoirs in patients with previous pelvic irradiation. We report the use of the Indiana pouch urinary reservoir in ten women with a history of pelvic irradiation for cervical cancer, of whom eight underwent a total pelvic exenteration for recurrent pelvic tumor and two had diversion for radiation-induced vesicovaginal fistula. All ten women achieved daytime continence, with a median time between catheterizations of 4.5 hours and a median pouch capacity of 500 mL. There was no evidence of leakage from the reservoir or significant ureteral reflux or obstruction on postoperative radiographic evaluation. No patient has required reoperation or had significant postoperative complications with the technique described

  10. Outcome of Mainz II Pouch Urinary Diversion after Radical ...

    African Journals Online (AJOL)

    bladder cancer is one of the options of continent urinary diversion following radical ... II pouch urinary diversion for muscle‑invasive bladder cancer in our institution ... immunotherapy.[2]. Following RC, there is a need for urinary diversion. Internal urinary diversion by ureterosigmoidostomy was introduced decades ago,.

  11. The influence of dibutyryl adenosine cyclic monophosphate on cell proliferation in the epithelium of the jejunal crypts, the colonic crypts and in colonic carcinomata of rat.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1980-01-01

    1. Cell proliferation in the jejunal crypts, the colonic crypts and in dimethylhydrazine (DMH)-induced adenocarcinomata of rat colon was measured using a stathmokinetic technique. 2. Dibutryl cyclic adneosine monophosphate (dibutyryl cAMP) was found to inhibit cell proliferation in colonic crypts and in colonic adenocarcinomata. 3. Dibutryl cAMP at very high doses was found to inhibit jejunal crypt cell proliferation but at lower doses was found to accelerate jejunal crypt cell proliferation. 4. Neither bilateral adrenalectomy nor chemical sympathectomy was found to abolish the ability of dibutryl cAMP to stimulate jejunal crypt cell proliferation. 5. The present results are difficult to interpret in terms of known hormonal influences on cell proliferation in the tissues examined and of established actions, of these hormones on cyclic nucleotide metabolism in other tissues.

  12. Effect of dietary restriction and subsequent re-alimentation on the transcriptional profile of bovine jejunal epithelium.

    Science.gov (United States)

    Keogh, Kate; Waters, Sinead M; Cormican, Paul; Kelly, Alan K; Kenny, David A

    2018-01-01

    Compensatory growth (CG), an accelerated growth phenomenon which occurs following a period of dietary restriction is utilised worldwide in animal production systems as a management practise to lower feed costs. The objective of this study was to evaluate the contribution of jejunal epithelial to CG in cattle through transcriptional profiling following a period of dietary restriction as well as subsequent re-alimentation induced CG. Sixty Holstein Friesian bulls were separated into two groups; RES and ADLIB, with 30 animals in each. RES animals were offered a restricted diet for 125 days (Period 1) followed by ad libitum feeding for 55 days (Period 2). ADLIB animals had ad libitum access to feed across both periods 1 and 2. At the end of each period, 15 animals from each treatment group were slaughtered, jejunal epithelium collected and RNAseq analysis performed. Animals that were previously diet restricted underwent CG, gaining 1.8 times the rate of their non-restricted counterparts. Twenty-four genes were differentially expressed in RES compared to ADLIB animals at the end of Period 1, with only one gene, GSTA1, differentially expressed between the two groups at the end of Period 2. When analysed within treatment (RES, Period 2 v Period 1), 31 genes were differentially expressed between diet restricted and animals undergoing CG. Dietary restriction and subsequent re-alimentation were associated with altered expression of genes involved in digestion and metabolism as well as those involved in cellular division and growth. Compensatory growth was also associated with greater expression of genes involved in cellular protection and detoxification in jejunal epithelium. This study highlights some of the molecular mechanisms regulating the response to dietary restriction and subsequent re-alimentation induced CG in cattle; however the gene expression results suggest that most of the CG in jejunal epithelium had occurred by day 55 of re-alimentation.

  13. Energy and process substitution in the frozen-food industry: geothermal energy and the retortable pouch

    Energy Technology Data Exchange (ETDEWEB)

    Stern, M.W.; Hanemann, W.M.; Eckhouse, K.

    1981-12-01

    An assessment is made of the possibilities of using geothermal energy and an aseptic retortable pouch in the food processing industry. The focus of the study is on the production of frozen broccoli in the Imperial Valley, California. Background information on the current status of the frozen food industry, the nature of geothermal energy as a potential substitute for conventional fossil fuels, and the engineering details of the retortable pouch process are covered. The analytical methodology by which the energy and process substitution were evaluated is described. A four-way comparison of the economics of the frozen product versus the pouched product and conventional fossil fuels versus geothermal energy was performed. A sensitivity analysis for the energy substitution was made and results are given. Results are summarized. (MCW)

  14. Treatment of giant and large fusiform middle cerebral artery aneurysms with excision and interposition radial artery graft in a 4-year-old child: case report.

    Science.gov (United States)

    Mrak, Goran; Paladino, Josip; Stambolija, Vasilije; Nemir, Jakob; Sekhar, Laligam N

    2014-03-01

    We report an unusual case of complex giant and large fusiform aneurysms not amenable for clipping or coiling in a 4-year-old child managed with aneurysm resection and radial artery interposition graft. A 4-year-old child presented with repeated severe headache and vomiting. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography and digital subtraction angiography showed a giant fusiform aneurysm on the right middle cerebral artery (MCA). Because of the complex shape, endovascular treatment or clip reconstruction was not possible, and a bypass procedure was planned. Right frontotemporal craniotomy and orbitotomy was performed. Two aneurysms involving the M1 segment of the MCA were found in line, 1 giant, and the other large in size. The aneurysms were resected and treated with short radial artery interposition graft, which was narrower than the proximal or distal MCA. The child recovered normally, and the bypass was patent after 1 year. Large fusiform MCA aneurysms may be difficult to treat, but there are treatment options that include a bypass procedure. Resection and short interposition radial artery graft is an excellent but rare treatment option in a very young child. This was a very successful treatment in this child.

  15. Jejunal Perforation: A Rare Presentation of Burkitt’s Lymphoma—Successful Management

    Directory of Open Access Journals (Sweden)

    Samir Ranjan Nayak

    2014-01-01

    Full Text Available Malignant tumors of the small bowel presenting as acute abdomen are a rare occurrence. Burkitt’s lymphoma presenting as a surgical emergency needing emergency laparotomy is an uncommon presentation of this tumor. We present an interesting case of jejunal perforation as a first manifestation of Burkitt’s lymphoma which was successfully managed with surgical resection, high dose chemotherapy, and good supportive care.

  16. Peritonitis by jejunal ulcer perforation in a child: a case report

    Directory of Open Access Journals (Sweden)

    Ndèye Aby Ndoye

    2017-01-01

    Full Text Available Ulcer perforation is a rare cause of peritonitis in children. The cases reported in the literature are caused by peptic ulcer. We report on a case of peritonitis caused by jejunal ulcer perforation, discovered in a girl's abdomen during an acute surgical procedure. The treatment consisted of a resection of the perforation followed by an end-to-end anastomosis. Postoperative period was uneventful.

  17. Quality of ready to serve tilapia fish curry with PUFA in retortable pouches.

    Science.gov (United States)

    Dhanapal, K; Reddy, G V S; Nayak, B B; Basu, S; Shashidhar, K; Venkateshwarlu, G; Chouksey, M K

    2010-09-01

    Studies on the physical, chemical, and microbiological qualities of fresh tilapia meat revealed its suitability for the preparation of ready to eat fish curry packed in retort pouches. Studies on the fatty acid profile of tilapia meat suggest fortification with polyunsaturated fatty acid (PUFA) to increase the nutritional value. Based on the commercial sterility, sensory evaluation, color, and texture profile analysis F(0) value of 6.94 and cook value of 107.24, with a total process time of 50.24 min at 116 °C was satisfactory for the development of tilapia fish curry in retort pouches. Thermally processed ready to eat south Indian type tilapia fish curry fortified with PUFA was developed and its keeping quality studied at ambient temperature. During storage, a slight increase in the fat content of fish meat was observed, with no significant change in the contents of moisture, protein, and ash. The thiobarbituric acid (TBA) values of fish curry significantly increased during storage. Fish curry fortified with 1% cod liver oil and fish curry without fortification (control) did not show any significant difference in the levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), during thermal processing and storage. Sensory analysis revealed that fortification of fish curry with cod liver oil had no impact on the quality. Tilapia fish curry processed at 116 °C and F(0) value of 7.0 (with or without fortification of cod liver oil) was fit for consumption, even after a period of 1-y storage in retort pouch. Tilapia is a lean variety of fish with white flesh and therefore an ideal choice as raw material for the development of ready to serve fish products such as fish curry in retort pouches for both domestic and international markets. Ready to eat thermal processed (116 °C and F(0) value of 7.0) south Indian type tilapia fish curry enriched with PUFA and packed in retort pouch was acceptable for consumption even after a storage period of 1 y at ambient

  18. Jejunal hemorrhage syndrome in a Zebu cow in Brazil

    Directory of Open Access Journals (Sweden)

    Prhiscylla Sadanã Pires

    2015-08-01

    Full Text Available Clostridium perfringens type A has been incriminated as the etiologic agent in jejunal hemorrhage syndrome (JHS, which is a disease that affects dairy cattle. Although this microorganism is considered an important enteropathogen the pathogenesis of JHS is still not clear, and there have been no reports of its occurrence in Brazil so far. The aim of this study was to describe the occurrence of JHS by infection with a C. perfringens type A strain carrying the beta-2 toxin gene in a zebu cow in Brazil, for the first time.

  19. Stability of 2-Alkylcyclobutanones in irradiated retort pouch Gyudon topping during room temperature storage

    International Nuclear Information System (INIS)

    Kitagawa, Yoko; Okihashi, Masahiro; Takatori, Satoshi; Fukui, Naoki; Kajimura, Keiji; Obana, Hirotaka; Furuta, Masakazu

    2016-01-01

    2-Alkylcyclobutanones (ACBs), such as 2-dodecylcyclobutanone (DCB) and 2-tetradecylcylobutanone (TCB) are specific products in the irradiated liquid. Thus, DCB and TCB are suitable for indicators of the irradiation history of food. We previously reported DCB and TCB concentrations in irradiated retort pouch Gyudon topping (instant Gyudon mixes which were made from a beef, onion and soy sauce and could be preserved for a long term at room temperature) after storage for one year. Here, we have evaluated the stability of ACBs preserved in irradiated retort pouch Gyudon topping at room temperature for three years. Although interfering peaks were detected frequently after the storage at room temperature, it was possible for the detection of the irradiation history and there was no apparent decrease of ACBs concentrations in comparison with the one year storage after irradiation. These results concluded that DCB and TCB formed in retort pouch would be stable at room temperature for three years. (author)

  20. Vascularized pedicle jejunal graft for closure of large duodenal defect in a dog.

    Science.gov (United States)

    Massie, Anna; McFadden, Michael

    2016-11-01

    A Labrador retriever dog was presented for intestinal obstruction resulting in devitalization of portions of the duodenum. A severe perforation, accounting for 70% duodenal circumference, was present at the level of the duodenal papilla. A vascularized jejunal graft was used to close the perforation, representing novel utilization of this grafting technique.

  1. Endoscopic management of anastomotic bleeding in the ileal pouch with staples removal and clipping

    Directory of Open Access Journals (Sweden)

    Xian-rui Wu

    2013-01-01

    Full Text Available Objective: Postoperative pouch bleeding is a rare but detrimental complication following ileal pouch surgery. It is usually self-limited, however continuous bleeding requires inter- vention. There is limited published data on its management. Design: Ileoscopy via stoma for loop ileostomy and pouchoscopy via anus for ileal pouch were performed under sedation for the purpose of diagnosis and management of postop- erative bleeding. Results: Ileoscopy demonstrated a large, long blood clot in the lumen of efferent limb, but no sign of active bleeding was identified. Pouchoscopy showed that lumen of pouch body as well as afferent limb was filled with maroon-colored liquid stool. Pouch and neo-terminal ileum mucosa was normal. Two dislodged staples at the anastomotic line with sharp tips towards the lumen were found, with activating bleeding at one site. The staples were re- moved by biopsy forceps, and active bleeding was successfully controlled by the deploy- ment of one endoclip. Conclusions: We reported the first case that postoperative pouch bleeding, which was caused by dislodged staples, was successfully managed by endoscopic removal of the staples com- bined with clipping. Resumo: Objetivo: O sangramento pós-operatório da bolsa ileal é uma complicação rara, mas prejudi- cial após abordagem cirúrgica da bolsa ileal. Esse sangramento é geralmente autolimitado, porém, requer intervenção quando contínuo. Não há dados publicados sobre o tratamento. Método: Ileoscopia através de estoma para ileostomia em alça e endoscopia via ânus para a bolsa ileal foram realizadas sob sedação para diagnóstico e tratamento do sangramento pós-operatório. Resultados: A ileoscopia demonstrou um grande e longo coágulo sanguíneo no lúmen do ramo eferente, mas nenhum sinal de sangramento ativo foi identificado. A endoscopia da bolsa ileal mostrou que os lumens do corpo da bolsa e ramo aferente estavam cheios de fe- zes líquidas de cor marrom. A

  2. [Free tissue transfers with lengthening of vascular pedicle using interpositional vein grafts. About 10 cases].

    Science.gov (United States)

    Yeo, S; Perrot, P; Duteille, F

    2010-04-01

    The realization of free flaps with lack of reliable vessels nearby the loss of substance is a difficult problem for plastic surgeons. We report 10 cases of free tissue transfers with a one-stage technique lengthening the vascular pedicle of the free flap with interpositional vein grafts. Taking into consideration the good results and the low rate of morbidity, the authors emphasize the use of this technique rather than a two-stage procedure. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  3. Giant African Pouched Rats as Detectors of Tuberculosis in Human Sputum: Comparison of Two Techniques for Sputum Presentation

    Science.gov (United States)

    Wray, Alisha M.; Mahoney, Amanda; Weetjens, Bart J.; Cox, Christophe; Jubitana, Maureen; Kazwala, Rudovic; Mfinanga, Godfrey S.; Durgin, Amy; Poling, Alan

    2013-01-01

    Previous studies have shown that pouched rats can detect the presence of "Mycobacterium tuberculosis," which causes tuberculosis, in human sputum samples obtained from clinical facilities. Although pouched rats evaluate sputum samples quickly, preparing the samples is relatively slow. The present study evaluated whether the rats can detect…

  4. Treatment of a Ruptured Anastomotic Esophageal Stricture Following Bougienage with a Dacron-Covered Nitinol Stent

    International Nuclear Information System (INIS)

    Heindel, Walter; Gossmann, Axel; Fischbach, Roman; Michel, Olaf; Lackner, Klaus

    1996-01-01

    A patient suffering from esophagorespiratory fistula after bougienage of a benign stricture at the site of the anastomosis between a jejunal interposition and the esophagus was referred for interventional treatment. A prototype nitinol stent centrally covered with Dacron was implanted under regional anesthesia and fluoroscopic guidance. The self-expanding prosthesis dilated the stenosis completely and closed the fistula, with consequent improvement in respiratory and nutritional status and thus the general quality of life. The patient was able to eat and drink normally until death 3 months later due to progression of his underlying malignant disease

  5. Alterações estruturais na mucosa jejunal de camundongos infectados com Schistosoma mansoni, alimentados com dietas hipo ou hiperprotéicas

    OpenAIRE

    Couto, Janira Lúcia Assumpção; Ferreira, Haroldo da Silva; Rocha, Dinalva Bezerra da; Duarte, Maria Eugênia Leite; Assunção, Monica Lopes; Coutinho, Eridan de Medeiros

    2002-01-01

    The effects of high and low-protein diets on the structure of the jejunal mucosa were studied in Schistosoma mansoni infected mice (morphology and histomorphometry). Weaning male albino mice were infected with 80 cercariae, fed with high (20%) or low-protein (5%) diets and compared to uninfected controls under the same conditions. Mice were sacrificed 12 weeks after infection. Animals submitted to a low-protein diet showed lower weight curves, mainly when infected. In the jejunal mucosa, fing...

  6. Intestinal myoelectric activity and contractile motility in dogs with a reversed jejunal segment after extensive small bowel resection.

    Science.gov (United States)

    Uchiyama, M; Iwafuchi, M; Ohsawa, Y; Yagi, M; Iinuma, Y; Ohtani, S

    1992-06-01

    To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.

  7. Resulting long-term intestinal motility in dogs following construction of a reversed jejunal segment after extensive small bowel resection.

    Science.gov (United States)

    Uchiyama, M; Iwafuchi, M; Ohsawa, Y; Yagi, M; Iinuma, Y; Ohtani, S

    1994-10-01

    To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. The Quechua manta pouch: a caretaking practice for buffering the Peruvian infant against the multiple stressors of high altitude.

    Science.gov (United States)

    Tronick, E Z; Thomas, R B; Daltabuit, M

    1994-08-01

    The manta pouch--a caretaking practice of tightly swaddling and enclosing the infant in a set of cloths and blankets--and other caretaking practices are described for high-altitude resident (> 4,000 m) Quechua mother-infant pairs (N = 14). The manta pouch modifies the microenvironment inside the pouch so that, compared to the ambient environment, the temperature is higher and more stable, the humidity is higher, the partial pressure of O2 is lower, and stimulation levels are reduced. As the infant gets older, the characteristics of the pouch are modified such that the infant is increasingly exposed to ambient conditions. These caretaking practices may benefit the infant by buffering the infant from the multiple ecological stressors of high altitude, but they may also incur costs by exposing the infant to additional microenvironmental stressors (e.g., higher CO2 levels) and by reducing stimulation and limiting infant movement.

  9. Transepithelial transport of PAMAM dendrimers across isolated rat jejunal mucosae in ussing chambers.

    Science.gov (United States)

    Hubbard, Dallin; Ghandehari, Hamidreza; Brayden, David J

    2014-08-11

    Oral delivery remains a challenge for poorly permeable hydrophilic macromolecules. Poly(amido amine) (PAMAM) dendrimers have shown potential for their possible oral delivery. Transepithelial transport of carboxyl-terminated G3.5 and amine-terminated G4 PAMAM dendrimers was assessed using isolated rat jejunal mucosae mounted in Ussing chambers. The 1 mM FITC-labeled dendrimers were added to the apical side of mucosae. Apparent permeability coefficients (Papp) from the apical to the basolateral side were significantly increased for FITC when conjugated to G3.5 PAMAM dendrimer compared to FITC alone. Minimal signs of toxicity were observed when mucosae were exposed to both dendrimers with respect to transepithelial electrical resistance changes, carbachol-induced short circuit current stimulation, and histological changes. [(14)C]-mannitol fluxes were not altered in the presence of 1 mM dendrimers, suggesting that the paracellular pathway was not affected at this concentration in this model. These results give insight into the mechanism of PAMAM dendrimer transepithelial rat jejunal transport, as well as toxicological considerations important for oral drug delivery.

  10. Treatment of pouch stones after augmentation ileocystoplasty in children: is it always bothersome?

    Science.gov (United States)

    Helmy, Tamer E; Elawdy, Mohammed M; AbdelHalim, Ahmed; Orban, Hesham; Nabeeh, Hossam; Dawaba, Mohammed; Hafez, Ashraf T

    2015-01-01

    To report our experience with different approaches for management of pouch stones in children with ileal-based urinary reservoir. Charts of children who underwent ileal-based urinary reservoirs between 2000 and 2009 were retrospectively reviewed. Patients who were diagnosed with reservoir calculi were identified; medical records were reviewed for patients' demographics, diversion details, stone criteria, mode of treatment, perioperative complications, and recurrence rate. We identified 26 children with pouch stones after urinary diversion. There were 11 boys (42%) and 15 girls (58%). Mean age was 11 years (range, 4-16 years). Mean time for diagnosis was 42 months (24-120 months). Pouch stones were asymptomatic in 10 patients (38%). Fifteen cases were postbladder augmentation and 11 cases postcontinent cutaneous diversion. The mean stone size was 4 cm (range, 1-10 cm), and mean Hounsfield Unit was 585 (205-1090). Seventeen children (65%) had positive urine culture result, whereas 9 children were sterile. Seven children (27%) required open poucholithotomy, whereas 19 patients (73%) were managed endoscopically. Percutaneous approach was done in 5 children, whereas urethral access was used in 7 children. Mechanical extraction was performed in 12 cases, and stone disintegration was required in 7 cases. Eight children developed stone recurrence. Mean time for recurrence was 11 months (range, 3-19 months). Six children were after endoscopic disintegration, and all required redo endoscopic extraction. Stone analysis was available in 15 patients (struvite stones in 10 cases and calcium phosphate in 5 cases). Pouch stones are established long-term complication of urinary diversion. Open and endoscopic approaches are valid treatment strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Further studies on the effect of adenosine cyclic monophosphate derivatives on cell proliferation in the jejunal crypts of rat.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1982-01-01

    1. Cell proliferation in the jejunal crypt epithelium of rat was measured using a stathmokinetic technique. 2. Sodium butyrate was found to promote jejunal crypt cell proliferation. 3. N6, O2'-Dibutyryl cyclic adenosine monophosphate (cAMP), N6-monobutyryl-cAMP and N6-monobutyryl-8-bromo-cAMP were found to inhibit cell proliferation when compared to sodium butyrate treated tissues. 4. 8-Chlorophenylthio-cAMP was found to inhibit cell division when compared to untreated animals. 5. O2'-Monobutyryl cAMP and 8-bromo-cAMP were not found to inhibit cell proliferation.

  12. Retrograde Jejuno-Jejunal Intussusception after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Akira Yoneda

    2008-08-01

    Full Text Available An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.

  13. J-pouch ileoanal anastomosis in children and adolescents with ulcerative colitis

    DEFF Research Database (Denmark)

    Wewer, Vibeke; Hesselfeldt, Peter; Qvist, Niels

    2005-01-01

    OBJECTIVES: The aim of this study was to evaluate, over a 10-year period, severe surgical complications, functional outcome, patient satisfaction and impact on social life after colectomy and J-pouch ileoanal anastomosis for children and adolescents

  14. Scintigrapfic evaluation of pouch function in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Hvidsten, Svend; Simonsen, Jane Angel

    by endoscopy and pouch biopsy. Results We included 9 men and 12 women with a median age of 41 yrs [26-68]. Median BMI was 24 [19-36] and follow-up was 932 days [481-3491]. A median daily stool frequency of 8.5 [4-25] was reported and 3 (15%) patients suffered from incontinence. No patients had symptomatic......Introduction The function of an ileal pouch–anal anastomosis (IPAA) has high impact on the patients’ quality of life (QoL), and, hence, objective methods for examination of the function are warranted for a better understanding of the functional result and possible treatment of dysfunction. Studies...... with QoL and pouch function. Method It is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste...

  15. Tissue eosinophilia induced by recombinant human interleukin-5 in the hamster cheek pouch membrane

    Directory of Open Access Journals (Sweden)

    M. Minnicozzi

    1995-01-01

    Full Text Available Interleukin-5 (IL-5 is a cytokine that preferentially effects the development and function of eosinophils, and is considered important in the pathophysiology of allergic inflammation. In this study, we evaluated the ability of recombinant human IL-5 (rHu IL-5 to promote tissue eosinophilia and the importance of this eosinophilia to pathological alterations in vascular function. Repetitive subcutaneous administration for 18 days of rHu IL-5 resulted in a 7-fold increase in the number of eosinophils found in the ipsilateral hamster cheek pouch membrane. The contralateral cheek pouch membrane and peritoneum of these animals showed lesser but significant elevations in the number of eosinophils. In contrast, denatured rHu IL-5 did not elevate eosinophils in these tissues. Through the use of intravital microscopy and fluorometric analysis, rHu IL-5 treated hamster cheek pouch membranes were evaluated for alterations in microvascular permeability, using plasma clearance of FITC-dextran 150 as an index. Despite promoting a prominent tissue eosinophilia, the repetitive subcutaneous injections of rHu IL-5 did not alter the clearance of FITC-dextran 150. Topical application of rHu IL-5 to the cheek pouch, also, had no effect on the clearance of FITC-dextran 150. Immunofluorescence observations using an antibody to the granule protein, eosinophil peroxidase, indicated that the recruited cells had not degranulated. Our results support the importance of IL-5 in the recruitment of tissue eosinophils, but further stimulation is probably required to cause degranulation of these cells and the ensuing tissue damage.

  16. Outcome of Mainz II pouch urinary diversion after radical cystectomy ...

    African Journals Online (AJOL)

    Outcome of Mainz II pouch urinary diversion after radical cystectomy in patients with muscle-invasive bladder cancer: our experience. ... Nine (82%) had a histological diagnosis of transitional cell carcinoma, and two (18%) were squamous cell carcinoma (SCC). Ten (91%) patients had high‑grade disease, whereas only 1 ...

  17. Preserving Duodenal-Jejunal (Foregut) Transit Does Not Impair Glucose Tolerance and Diabetes Remission Following Gastric Bypass in Type 2 Diabetes Sprague-Dawley Rat Model.

    Science.gov (United States)

    Dolo, Ponnie R; Yao, Libin; Li, Chao; Zhu, Xiaocheng; Shi, Linsen; Widjaja, Jason

    2017-11-02

    Possible mechanisms underlying diabetes remission following Roux-en-Y gastric bypass (RYGB) include eradication of putative factor(s) with duodenal-jejunal bypass. The objective of this study is to observe the effects of duodenal-jejunal transit on glucose tolerance and diabetes remission in gastric bypass rat model. In order to verify the effect of duodenal-jejunal transit on glucose tolerance and diabetes remission in gastric bypass, 22 type 2 diabetes Sprague-Dawley rat models established through high-fat diet and low-dose streptozotocin (STZ) administered intraperitoneally were assigned to one of three groups: gastric bypass with duodenal-jejunal transit (GB-DJT n = 8), gastric bypass without duodenal-jejunal transit (RYGB n = 8), and sham (n = 6). Body weight, food intake, blood glucose, as well as meal-stimulated insulin, and incretin hormone responses were assessed to ascertain the effect of surgery in all groups. Oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were conducted three and 7 weeks after surgery. Comparing our GB-DJT to the RYGB group, we saw no differences in the mean decline in body weight, food intake, and blood glucose 8 weeks after surgery. GB-DJT group exhibited immediate and sustained glucose control throughout the study. Glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels were also significantly increased from preoperative level in the GB-DJT group (p transit does not impede glucose tolerance and diabetes remission after gastric bypass in type-2 diabetes Sprague-Dawley rat model.

  18. A case of incisional hernia repair using Composix mesh prosthesis after antethoracic pedicled jejunal flap reconstruction following an esophagectomy.

    Science.gov (United States)

    Yasuda, Atsushi; Yasuda, Takushi; Kato, Hiroaki; Iwama, Mitsuru; Shiraishi, Osamu; Hiraki, Yoko; Tanaka, Yumiko; Shinkai, Masayuki; Imano, Motohiro; Kimura, Yutaka; Imamoto, Haruhiko

    2017-12-01

    An incisional hernia in a case of antethoracic pedicled jejunal flap esophageal reconstruction after esophagectomy is a very rare occurrence, and this hernia was distinctive in that the reconstructed jejunum had passed through the hernial orifice; a standard surgical treatment for such a presentation has not been established. Herein, we describe a case of repair using mesh prosthesis for an atypical and distinctive incisional hernia after antethoracic pedicled jejunal flap esophageal reconstruction. A 77-year-old woman with a history of subtotal esophagectomy who had undergone antethoracic pedicled jejunal flap reconstruction complained of epigastric prominence and discomfort without pain. On examination, she had an abdominal protrusion between the xiphoid process and the umbilicus that contained the small bowel. Computed tomography showed that the fenestration of the abdominal wall that was intentionally created for jejunum pull-up was dehisced in a region measuring 9 × 15 cm and the small intestine protruded through it into the subcutaneous space without strangulation. Because the hernial orifice was too large and the reconstructed jejunum was passing through the hernial orifice in this case, we applied a parastomal hernia repair method that was modified from the inguinal hernia repair using the Lichtenstein technique. After 3 years and 5 months following surgery, the patient has recovered without hernia recurrence or other complications. We consider this to be the first case of repair using Composix mesh prosthesis for repair of an atypical and distinctive incisional hernia after an antethoracic pedicled jejunal flap reconstruction. This method seems to be useful and could potentially be widely adopted as the surgical treatment for this condition.

  19. Label-free vascular imaging in a spontaneous hamster cheek pouch carcinogen model for pre-cancer detection (Conference Presentation)

    Science.gov (United States)

    Hu, Fangyao; Morhard, Robert; Liu, Heather; Murphy, Helen; Farsiu, Sina; Ramanujam, Nimmi

    2016-03-01

    Inducing angiogenesis is one hallmark of cancer. Tumor induced neovasculature is often characterized as leaky, tortuous and chaotic, unlike a highly organized normal vasculature. Additionally, in the course of carcinogenesis, angiogenesis precedes a visible lesion. Tumor cannot grow beyond 1-2 mm in diameter without inducing angiogenesis. Therefore, capturing the event of angiogenesis may aid early detection of pre-cancer -important for better treatment prognoses in regions that lack the resources to manage invasive cancer. In this study, we imaged the neovascularization in vivo in a spontaneous hamster cheek pouch carcinogen model using a, non-invasive, label-free, high resolution, reflected-light spectral darkfield microscope. Hamsters' cheek pouches were painted with 7,12-Dimethylbenz[a]anthracene (DMBA) to induce pre-cancerous to cancerous changes, or mineral oil as control. High resolution spectral darkfield images were obtained over the course of pre-cancer development and in control cheek pouches. The vasculature was segmented with a multi-scale Gabor filter with an 85% accuracy compared with manually traced masks. Highly tortuous vasculature was observed only in the DMBA treated cheek pouches as early as 6 weeks of treatment. In addition, the highly tortuous vessels could be identified before a visible lesion occurred later during the treatment. The vessel patterns as determined by the tortuosity index were significantly different from that of the control cheek pouch. This preliminary study suggests that high-resolution darkfield microscopy is promising tool for pre-cancer and early cancer detection in low resource settings.

  20. The role of the sympathetic nervous system in radiation-induced apoptosis in jejunal crypt cells of spontaneously hypertensive rats

    International Nuclear Information System (INIS)

    Matsuu, Mutsumi; Shichijo; Kazuko; Nakamura, Yasuko; Ikeda, Yuji; Naito, Shinji; Ito, Masahiro; Okaichi, Kumio; Sekine, Ichiro

    2000-01-01

    To evaluate the effect of the sympathetic nervous system on radiation-induced apoptosis in jejunal crypt cells, apoptosis levels were compared in spontaneously hypertensive rats (SHR), animals which are a genetic hyperfunction model of the sympathetic nervous system, and normotensive Wistar-Kyoto rats (WKY). SHR and WKY were exposed to whole body X-ray irradiation at doses from 0.5 to 2 Gy. The apoptotic index in jejunal crypt cells was significantly greater in SHR than in WKY at each time point after irradiation and at each dose. WKY and SHR were treated with reserpine to induce sympathetic dysfunction, and were subsequently exposed to irradiation. Reserpine administration to SHR or WKY resulted in a significant suppression of apoptosis. p53 accumulation was detected in the jejunum in both WKY and SHR after irradiation by Western blotting analysis. There were no significant differences in the levels of p53 accumulation in irradiated intestine between WKY and SHR. These findings suggested that hyperfunction of the sympathetic nervous system is involved in the mechanism of high susceptibility to radiation-induced apoptosis of the jejunal crypt cells. (author)

  1. Adenocarcinoma of the pouch after silastic ring vertical gastroplasty.

    Science.gov (United States)

    Zirak, Christophe; Lemaitre, Jean; Lebrun, Eric; Journé, Stephane; Carlier, Patrick

    2002-10-01

    A 52-year-old woman was admitted because of epigastralgia, anorexia and recently increased vomiting, 2 years after silastic ring vertical gastroplasty. On gastroscopy, a tumor mass was visualized in the pouch near the "neo-pylorus". Biopsies confirmed adenocarcinoma. She underwent total gastrectomy, and has no evidence of recurrence at 1 year. The literature on gastric carcinoma after gastroplasty is reviewed.

  2. Avaliação do Efeito do Transporte no Desempenho de Embalagem Tipo Stand-up Pouch para Produtos Líquidos Evaluation of Transport Effect on the Performance of Stand-Up Pouch Packages for Liquid Products

    Directory of Open Access Journals (Sweden)

    Leda Coltro

    2002-01-01

    Full Text Available Este estudo foi desenvolvido com o objetivo de estimar o efeito do transporte rodoviário no desempenho de embalagem do tipo stand-up pouch tendo folha de alumínio (8µm na estrutura, para o acondicionamento de produtos líquidos. O stand-up pouch foi submetido ao ensaio de simulação de transporte seguindo os padrões adotados na norma ASTM D4728-95, durante 4 horas. A intensidade da vibração randômica e o tempo de ensaio representam uma distância percorrida de aproximadamente 2000km. Como ocorreu falha na estrutura de algumas unidades de embalagem devido a solicitação de vibração, foram feitas avaliações empregando-se microscopia ótica e microscopia eletrônica de varredura dos stand-up pouches antes e após a simulação de transporte a fim de elucidar a causa dos danos. As prováveis causas da falha observada na estrutura podem estar associadas aos seguintes fatores: a características da laminação da estrutura (tipo de material, força de adesão das camadas, etc.; b flexibilidade e características de elasticidade da folha de alumínio; c efeito crítico da solicitação mecânica da embalagem pelo uso da mesma com um produto líquido.The aim of this study was to evaluate the effect of the transport on the performance of stand-up pouch packaging having aluminum foil in the structure, employed for packing liquid products. The stand-up pouch was submitted to transport simulation tests following the standards adopted in the ASTM D4728-95, during 4 hours. The intensity of the random vibration and the test time represent a traveled distance of approximately 2000km. Evaluations of the stand-up pouches were performed before and after the transport simulation employing optical microscopy and scanning electron microscopy, in order to elucidate the cause of possible damages in the structure of the packaging by the vibration request. The probable causes of the observed ruptures in the structure can be associated to the following

  3. An Electrochemical Impedance Spectroscopy Study on a Lithium Sulfur Pouch Cell

    DEFF Research Database (Denmark)

    Stroe, Daniel Loan; Knap, Vaclav; Swierczynski, Maciej Jozef

    2016-01-01

    The impedance behavior of a 3.4 Ah pouch Lithium-Sulfur cell was extensively characterized using the electrochemical impedance spectroscopy (EIS) technique. EIS measurements were performed at various temperatures and over the entire state-of-charge (SOC) interval without applying a superimposed DC...

  4. Jejunal diverticulitis in a healthy 91-year-old man.

    Science.gov (United States)

    Kagolanu, Deepthi Chaitanya; Subhani, Miral; Novick, Daniel; Rizvon, Kaleem

    2018-05-30

    A 91-year-old African American man was admitted with sudden onset diffuse abdominal pain which radiated to the right flank. CT of the abdomen with contrast showed diverticula in the jejunum with adjacent inflammation and microperforation that was contained. Conservative therapy similar to colonic diverticulitis was effective. Although rare, our case highlights the importance of having an early and high suspicion for jejunal diverticulitis when patients present with non-specific abdominal symptoms in order to avoid perforation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses.

    Science.gov (United States)

    Nasreldin, Magda H A; Ibrahim, Eman A; Saad El-Din, Somaia A

    2016-01-01

    Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

  6. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

    Directory of Open Access Journals (Sweden)

    Magda H. A. Nasreldin

    2016-01-01

    Full Text Available Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

  7. Jejunal diverticula with perforation in non steroidal anti inflammatory drug user: A case report

    Directory of Open Access Journals (Sweden)

    Shobhit Gupta

    2017-01-01

    Conclusion: Jejunal diverticula are rare lesions, and their perforation never features in the list of diagnoses for acute abdomen, especially in this part of the world. Further this unique case report opens the doors for further research to prove an assosiation between NSAID use and diverticular perforation which itself is a very rare entity.

  8. Successful conservative management of a rare complication of tracheostomy; extensive posterior tracheal false pouch.

    Science.gov (United States)

    Ha, Jennifer F; Ostwani, Waseem; Green, Glenn

    2016-11-01

    With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant. This was managed successfully with conservative treatment. A former 34-week premature infant was transferred to our pediatrics intensive care unit (PICU) with recurrent episodes of cardiopulmonary arrests due to suspected severe tracheobronchomalacia. The patient has bronchopulomonary dysplasia, severe restrictive lung disease and thoracic insufficiency from skeletal dysplasia requiring tracheostomy tube (TT) at two-month-old and mechanical ventilation. The 3.5 NEO TT was gradually upsized to a 5. The PEEP setting at transfer was 18cmH2O. The direct laryngoscopy and bronchoscopy showed moderate tracheomalacia at the innominate artery with a false pouch in the posterior tracheal wall that was 1.1cm below the tracheostomy stoma. A multi-disciplinary discussion including otolaryngology, PICU, Pulmonary Medicine, and Pediatric Surgery decided on conservative management. The false pouch healed and she was transferred back to referring PICU after a 46-day. Tracheal wall erosion resulting in a pouch formation is a rare complication, but it should be considered in patients with long term tracheostomy with difficulty ventilation and oxygenation with positional change. DLB is a useful tool in its diagnosis and conservative management can be successful. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. An unusual presentation of a malignant jejunal tumor and a different management strategy

    Directory of Open Access Journals (Sweden)

    Parida Dillip K

    2005-01-01

    Full Text Available Abstract Background Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA is discussed. Case presentation A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. Conclusion Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.

  10. Stability of 2-Alkylcyclobutanones in irradiated retort pouch Gyudon topping during room temperature storage

    International Nuclear Information System (INIS)

    Kitagawa, Yoko; Okihashi, Masahiro; Takatori, Satoshi; Fukui, Naoki; Kajimura, Keiji; Obana, Hirotaka; Furuta, Masakazu

    2014-01-01

    2-Alkylcyclobutanones (ACBs), such as 2-dodecylcyclobutanone (DCB) and 2-tetradecylcylobutanone (TCB) are specific products from irradiated lipid. Thus, DCB and TCB are suitable for indicators of the irradiation history of food. The purpose of this study was to clarify the stability of ACBs in food, kept at room temperature for a long period. We evaluated DCB and TCB in irradiated retort pouch Gyudon topping (instant Gyudon mixes which were made from a beef, onion and soy sauce), which could be preserved for a long term at room temperature, after storage for one year. DCB and TCB were detected at doses of 0.6-4.5 kGy in irradiated retort pouch Gyudon topping. The peaks of DCB and TCB were separated from other peaks on the chromatogram with GC-MS. The concentration of DCB and TCB were periodically determined till 12 months later of irradiation. The dose-response curves of DCB and TCB were almost identical with those obtained from the samples after the 12 months storage at room temperature. These results concluded that DCB and TCB formed in retort pouch would stable at room temperature at least 12 months. (author)

  11. The Quechua Manta Pouch: A Caretaking Practice for Buffering the Peruvian Infant against the Multiple Stressors of High Altitude.

    Science.gov (United States)

    Tronick, E. Z.; And Others

    1994-01-01

    Describes the caretaking practices employed by the Peruvian Quechua mountain people, who swaddle infants in cloths and blankets (known as a manta pouch) to protect them from the harsh and frigid environment. The practices of 14 mother-infants pairs are examined in detail, and the benefits and drawbacks of the manta pouch are examined. (MDM)

  12. Jejunal perforation caused by abdominal angiostrongyliasis Perfuração jejunal causada por angiostrongilíase abdominal

    Directory of Open Access Journals (Sweden)

    Jaques WAISBERG

    1999-09-01

    Full Text Available The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.Os autores descrevem caso de angiostrongilíase abdominal em doente adulto que se manifestou como abdômen agudo devido à perfuração de alça jejunal, evento raro, uma vez que esta afecção geralmente envolve o íleo terminal, apêndice, ceco ou cólon ascendente. A doença é causada pelo nematódeo Angiostrongylus costaricensis cujos hospedeiros definitivos são roedores silvestres e os hospedeiros intermediários são caracóis e caramujos. A infecção em humanos é acidental e ocorre pela ingestão de secreção mucóide destes invertebrados presentes em vegetais ou por contato direto com o muco. A angiostrongilíase abdominal é clinicamente caracterizada pela presença de febre prolongada, anorexia, dor no quadrante inferior direito do abdômen e eosinofilia periférica. Embora a doença seja de

  13. Comparison of functional outcome of colonic J-pouch and latero-terminal anastomosis in low anterior resection for rectal cancer.

    Science.gov (United States)

    Marković, Velimir; Dimitrijević, Ivan; Barišić, Goran; Krivokapić, Zoran

    2015-01-01

    Functional results after low anterior resection for rectal cancer are an issue of increasing attention among colorectal surgeons and others interested in this subject. The consensus on ideal reconstruction type has not been achieved to date, although the number of papers on this subject has been published in recent years. We conducted a prospective, parallel group study comparing latero-terminal with colonic J-pouch anastomosis in terms of defecatory function in patients undergoing stapled low colorectal/ coloanal anastomosis. A total of 80 patients were included in this study with either latero-terminal or colonic J-pouch anastomosis. Defecatory function was evaluated using the modified version of MSKCC questionnaire 6, 12 and 24 months after the operation. Fecal continence was evaluated using the Wexner continence score. In both groups, trend towards improvement was registered in all measured variables in all three control intervals. This can apply to bowel frequency, urgency, night soiling, fragmentation and incomplete evacuation. However, the difference was not statistically significant, and when reviewing the trend of results we can note that in the J-pouch group steady state has not been reached even after 24 month control. This trial did not reveal any significant differences in defecatory function 6, 12 and 24 months after low anterior resection (LAR) between patients with a latero-terminal anastomosis and those with colonic J-pouch anastomosis. Our results did not confirm superiority of colonic J-pouch over the latero-terminal anastomosis

  14. Effect of probiotics (Lactobacillus plantarum 299 plus Bifidobacterium Cure21) in patients with poor ileal pouch function: a randomised controlled trial.

    Science.gov (United States)

    Bengtsson, J; Adlerberth, I; Östblom, A; Saksena, P; Öresland, T; Börjesson, L

    2016-09-01

    Poor pouch function after restorative proctocolectomy for ulcerative colitis is a considerable problem. Pouchitis and functional disorders are the most common reasons. Probiotics seem to have a beneficial effect in pouchitis but have not been assessed in functional pouch disorders. The aim was to analyse the effects of probiotics in patients with poor pouch function. Thirty-three patients were randomized to probiotics (Lactobacillus plantarum 299 and Bifidobacterium infantis Cure 21) or placebo in a double blinded, 1:1 fashion. The treatment effect was assessed by the pouch functional score (PFS; 0-15, 15 worst), pouchitis disease activity index (PDAI; 0-18, 18 worst), and levels of four faecal biomarkers of inflammation (calprotectin, lactoferrin, myeloperoxidase [MPO] and eosinophilic cationic protein [ECP]). Thirty-two patients were included (probiotics = 17, placebo = 16). There was no difference in change in the PFS from before to after treatment between the groups (median difference: -1.00, 95% C.I. -3.00 to 0.00, p = 0.119). Furthermore, probiotics had no effect on PDAI (median difference: 0.00, 95% C.I. 0.00-1.00, p = 0.786), or on faecal biomarkers. Significant correlations were observed between PDAI and each of the faecal biomarkers at study start. There were no correlations between PFS or PDAI symptom subscore and the biomarkers. PDAI endoscopic and histologic subscores correlated significantly to each of the biomarkers. The hypothesis that probiotics improves pouch-related dysfunction was not confirmed. Faecal biomarkers could play a future role in the management of pouch patients.

  15. Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia

    Directory of Open Access Journals (Sweden)

    Chih-Cheng Luo

    2010-10-01

    Conclusion: In very proximal high atresia, the extent of tapering is limited by the proximity of the ligament of Treitz. Duodenal derotation provides better access to the high atresia. The results of this limited experience suggest that the DDETJ procedure could provide an alternative therapy in patients with high jejunal atresia.

  16. Carvedilol alleviates adjuvant-induced arthritis and subcutaneous air pouch edema: Modulation of oxidative stress and inflammatory mediators

    International Nuclear Information System (INIS)

    Arab, Hany H.; El-Sawalhi, Maha M.

    2013-01-01

    Rheumatoid arthritis (RA) is a systemic inflammatory disease with cardiovascular complications as the leading cause of morbidity. Carvedilol is an adrenergic antagonist which has been safely used in treatment of several cardiovascular disorders. Given that carvedilol has powerful antioxidant/anti-inflammatory properties, we aimed to investigate its protective potential against arthritis that may add further benefits for its clinical usefulness especially in RA patients with concomitant cardiovascular disorders. Two models were studied in the same rat; adjuvant arthritis and subcutaneous air pouch edema. Carvedilol (10 mg/kg/day p.o. for 21 days) effectively suppressed inflammation in both models with comparable efficacy to the standard anti-inflammatory diclofenac (5 mg/kg/day p.o.). Notably, carvedilol inhibited paw edema and abrogated the leukocyte invasion to air pouch exudates. The latter observation was confirmed by the histopathological assessment of the pouch lining that revealed mitigation of immuno-inflammatory cell influx. Carvedilol reduced/normalized oxidative stress markers (lipid peroxides, nitric oxide and protein thiols) and lowered the release of inflammatory cytokines (TNF-α and IL-6), and eicosanoids (PGE 2 and LTB 4 ) in sera and exudates of arthritic rats. Interestingly, carvedilol, per se, didn't present any effect on assessed biochemical parameters in normal rats. Together, the current study highlights evidences for the promising anti-arthritic effects of carvedilol that could be mediated through attenuation of leukocyte migration, alleviation of oxidative stress and suppression of proinflammatory cytokines and eicosanoids. - Highlights: ► Carvedilol possesses promising anti-arthritic properties. ► It markedly suppressed inflammation in adjuvant arthritis and air pouch edema. ► It abrogated the leukocyte invasion to air pouch exudates and linings. ► It reduced/normalized oxidative stress markers in sera and exudates of arthritic rats

  17. Carvedilol alleviates adjuvant-induced arthritis and subcutaneous air pouch edema: Modulation of oxidative stress and inflammatory mediators

    Energy Technology Data Exchange (ETDEWEB)

    Arab, Hany H., E-mail: hany_h_arab@yahoo.com [Biochemistry Division, Department of Pharmacology and Toxicology, Faculty of Pharmacy, Taif University, Taif (Saudi Arabia); Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo (Egypt); El-Sawalhi, Maha M. [Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo (Egypt)

    2013-04-15

    Rheumatoid arthritis (RA) is a systemic inflammatory disease with cardiovascular complications as the leading cause of morbidity. Carvedilol is an adrenergic antagonist which has been safely used in treatment of several cardiovascular disorders. Given that carvedilol has powerful antioxidant/anti-inflammatory properties, we aimed to investigate its protective potential against arthritis that may add further benefits for its clinical usefulness especially in RA patients with concomitant cardiovascular disorders. Two models were studied in the same rat; adjuvant arthritis and subcutaneous air pouch edema. Carvedilol (10 mg/kg/day p.o. for 21 days) effectively suppressed inflammation in both models with comparable efficacy to the standard anti-inflammatory diclofenac (5 mg/kg/day p.o.). Notably, carvedilol inhibited paw edema and abrogated the leukocyte invasion to air pouch exudates. The latter observation was confirmed by the histopathological assessment of the pouch lining that revealed mitigation of immuno-inflammatory cell influx. Carvedilol reduced/normalized oxidative stress markers (lipid peroxides, nitric oxide and protein thiols) and lowered the release of inflammatory cytokines (TNF-α and IL-6), and eicosanoids (PGE{sub 2} and LTB{sub 4}) in sera and exudates of arthritic rats. Interestingly, carvedilol, per se, didn't present any effect on assessed biochemical parameters in normal rats. Together, the current study highlights evidences for the promising anti-arthritic effects of carvedilol that could be mediated through attenuation of leukocyte migration, alleviation of oxidative stress and suppression of proinflammatory cytokines and eicosanoids. - Highlights: ► Carvedilol possesses promising anti-arthritic properties. ► It markedly suppressed inflammation in adjuvant arthritis and air pouch edema. ► It abrogated the leukocyte invasion to air pouch exudates and linings. ► It reduced/normalized oxidative stress markers in sera and exudates of

  18. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.

  19. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

    International Nuclear Information System (INIS)

    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook

    2017-01-01

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery

  20. Emergency arterial embolization of upper gastrointestinal and jejunal tumors: An analysis of 12 patients with severe bleeding.

    Science.gov (United States)

    Zandrino, F; Tettoni, S M; Gallesio, I; Summa, M

    2017-01-01

    The goal of this study was to retrospectively assess the efficacy of emergency percutaneous transcatheter arterial embolization in patients with severe bleeding due to upper gastrointestinal or jejunal tumor. Twelve patients (7 men, 5 women; mean age, 74 years±14 (SD); range: 54-86 years) with severe bleeding from the upper gastrointestinal tract, with failed endoscopic treatment not eligible for emergency surgery were treated by emergency percutaneous transcatheter arterial embolization. The bleeding cause was gastric tumor in 7 patients, duodenal tumor in 4 patients and jejunal tumor in one patient. Procedure details and follow-up were reviewed. Twelve embolization procedures were performed using various embolic agents. Embolization was achieved and bleeding was stopped in all patients. Five patients underwent surgery within the 30 days following embolization. In the remaining 7 patients, no bleeding occurred at 1 month follow-up in 6 patients and bleeding recurred in one patient at 1 month. In this later patient, endoscopic treatment was successful. The results of our study suggest that transcatheter arterial embolization is safe and effective in patients with severe arterial bleeding due to upper gastrointestinal or jejunal tumor. In some patients, transcatheter arterial embolization can be used as a bridge to surgery. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  1. Prevalence of Methicillin-Resistant Staphylococcus aureus from Equine Nasopharyngeal and Guttural Pouch Wash Samples.

    Science.gov (United States)

    Boyle, A G; Rankin, S C; Duffee, L A; Morris, D

    2017-09-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a cause of nosocomial infections in both human and veterinary medicine. Studies that examine the nasopharynx and guttural pouches of the horse as carriage sites for MRSA have not been reported. MRSA colonizes the nasopharynx and guttural pouch of horses. To determine the prevalence of MRSA in equine nasopharyngeal wash (NPW) and guttural pouch lavage (GPL) samples in a field population of horses. One hundred seventy-eight samples (123 NPW and 55 GPL) from 108 horses. Prospective study. Samples were collected from a convenience population of clinically ill horses with suspected Streptococcus equi subsp. equi (S. equi) infection, horses convalescing from a known S. equi infection, and asymptomatic horses undergoing S. equi screening. Samples were submitted for S. aureus aerobic bacterial culture with mannitol salt broth and two selective agars (cefoxitin CHROMagar as the PBP2a inducer and mannitol salt agar with oxacillin). Biochemical identification of Staphylococcus species and pulsed-field gel electrophoresis (PFGE), to determine clonal relationships between isolates, were performed. Methicillin-resistant Staphylococcus (MRS) was isolated from the nasopharynx of 7/108 (4%) horses. Three horses had MRSA (2.7%), and 4 had MR-Staphylococcus pseudintermedius (MRSP). MRSA was isolated from horses on the same farm. PFGE revealed the 3 MRSA as USA 500 strains. Sampling the nasopharynx and guttural pouch of community-based horses revealed a similarly low prevalence rate of MRSA as other studies sampling the nares of community-based horses. More study is required to determine the need for sampling multiple anatomic sites when screening horses for MRSA. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  2. Effects on the pouch of different digestive tract reconstruction modes assessed by radionuclide scintigraphy

    Science.gov (United States)

    Li, Dong-Sheng; Xu, Hui-Mian; Han, Chun-Qi; Li, Ya-Ming

    2010-01-01

    AIM: To determine the effect of three digestive tract reconstruction procedures on pouch function, after radical surgery undertaken because of gastric cancer, as assessed by radionuclide dynamic imaging. METHODS: As a measure of the reservoir function, with a designed diet containing technetium-99m (99mTc), the emptying time of the gastric substitute was evaluated using a 99mTc-labeled solid test meal. Immediately after the meal, the patient was placed in front of a γ camera in a supine position and the radioactivity was measured over the whole abdomen every minute. A frame image was obtained. The emptying sequences were recorded by the microprocessor and then stored on a computer disk. According to a computer processing system, the half-emptying actual curve and the fitting curve of food containing isotope in the detected region were depicted, and the half-emptying actual curves of the three reconstruction procedures were directly compared. RESULTS: Of the three reconstruction procedures, the half-emptying time of food containing isotope in the Dual Braun type esophagojejunal anastomosis procedure (51.86 ± 6.43 min) was far closer to normal, significantly better than that of the proximal gastrectomy orthotopic reconstruction (30.07 ± 15.77 min, P = 0.002) and P type esophagojejunal anastomosis (27.88 ± 6.07 min, P = 0.001) methods. The half-emptying actual curve and fitting curves for the Dual Braun type esophagojejunal anastomosis were fairly similar while those of the proximal gastrectomy orthotopic reconstruction and P type esophagojejunal anastomosis were obviously separated, which indicated bad food conservation in the reconstructed pouches. CONCLUSION: Dual Braun type esophagojejunal anastomosis is the most useful of the three procedures for improving food accommodation in patients with a pouch and can retard evacuation of solid food from the reconstructed pouch. PMID:20238408

  3. The effects of 5HT3 receptor antagonist granisetron on inflammatory parameters and angiogenesis in the air-pouch model of inflammation.

    Science.gov (United States)

    Maleki-Dizaji, Nasrin; Eteraf-Oskouei, Tahereh; Fakhrjou, Ashraf; Maljaie, Seyyed Hadi; Garjani, Alireza

    2010-09-01

    The antagonists of 5HT(3) receptors have shown impressive efficacy in rheumatoid arthritis, osteoarthritis or fibromyalgia. The mechanistic relationships between 5HT(3) receptors, angiogenesis and sequence of cytokine expression, and leukocyte recruitment during inflammation are not clear. We evaluate the effects of granisetron on inflammatory parameters and angiogenesis in rat air-pouch model. Male Wistar rats were anesthetized, and then 20 ml and 10 ml of sterile air were injected subcutaneously in the back on day 0 and day 3, respectively. On day 6, inflammation was induced by injection of 1 ml of carrageenan 1% into pouches. After 6 and 72 h, the rats were sacrificed; pouch fluid was collected in order to determine exudate volume, the number of accumulated cells and TNFalpha/PGE(2) concentration. Pouches were dissected out and weighed. Angiogenesis of granulomatous tissue was assayed using a hemoglobin kit. Leukocyte accumulation was dose-dependently inhibited by granisetron both at 6 and 72 h after induction of inflammation. All doses of granisetron decreased hemoglobin level in the whole granulation tissue in a bell-shaped manner. Vascular network formation was also inhibited by granisetron. Granisetron increased PGE(2) level at a lower dose (50 microg/pouch) but higher doses (100 and 200 microg/pouch) inhibited the release. At the same time, TNFalpha production was decreased by the lower dose and increased by higher doses of granisetron in a reciprocal fashion. Anti-inflammatory activities of 5HT(3) receptor antagonist, granisetron probably are mediated through modulation of TNFalpha/PGE(2) production and leukocyte infiltration. (c) 2010 Elsevier B.V. All rights reserved.

  4. Pouched Rats’ Detection of Tuberculosis in Human Sputum: Comparison to Culturing and Polymerase Chain Reaction

    Directory of Open Access Journals (Sweden)

    Amanda Mahoney

    2012-01-01

    Full Text Available Setting. Tanzania. Objective. To compare microscopy as conducted in direct observation of treatment, short course centers to pouched rats as detectors of Mycobacterium tuberculosis. Design. Ten pouched rats were trained to detect tuberculosis in sputum using operant conditioning techniques. The rats evaluated 910 samples previously evaluated by smear microscopy. All samples were also evaluated through culturing and multiplex polymerase chain reaction was performed on culture growths to classify the bacteria. Results. The patientwise sensitivity of microscopy was 58.0%, and the patient-wise specificity was 97.3%. Used as a group of 10 with a cutoff (defined as the number of rat indications to classify a sample as positive for Mycobacterium tuberculosis of 1, the rats increased new case detection by 46.8% relative to microscopy alone. The average samplewise sensitivity of the individual rats was 68.4% (range 61.1–73.8%, and the mean specificity was 87.3% (range 84.7–90.3%. Conclusion. These results suggest that pouched rats are a valuable adjunct to, and may be a viable substitute for, sputum smear microscopy as a tuberculosis diagnostic in resource-poor countries.

  5. Li-Ion Pouch Cells for Vehicle Applications — Studies of Water Transmission and Packing Materials

    Directory of Open Access Journals (Sweden)

    Göran Flodberg

    2013-01-01

    Full Text Available This study includes analysis of encapsulation materials from lithium-ion pouch cells and water vapour transmission rate (WVTR measurements. WVTR measurements are performed on both fresh and environmentally stressed lithium-ion pouch cells. Capacity measurements are performed on both the fresh and the environmentally stressed battery cells to identify possible influences on electrochemical performance. Preparation of the battery cells prior to WVTR measurements includes opening of battery cells and extraction of electrode material, followed by resealing the encapsulations and adhesively mounting of gas couplings. A model describing the water diffusion through the thermal welds of the encapsulation are set up based on material analysis of the encapsulation material. Two WVTR equipments with different type of detectors are evaluated in this study. The results from the WVTR measurements show how important it is to perform this type of studies in dry environment and apply a rigorous precondition sequence before testing. Results from modelling confirm that the WVTR method has potential to be used for measurements of water diffusion into lithium-ion pouch cells. Consequently, WVTR measurements should be possible to use as a complement or alternative method to for example Karl Fisher titration.

  6. Effects on the pouch of different digestive tract reconstruction modes assessed by radionuclide scintigraphy

    OpenAIRE

    Li, Dong-Sheng; Xu, Hui-Mian; Han, Chun-Qi; Li, Ya-Ming

    2010-01-01

    AIM: To determine the effect of three digestive tract reconstruction procedures on pouch function, after radical surgery undertaken because of gastric cancer, as assessed by radionuclide dynamic imaging.

  7. Cancer in an unexpected site post pouch surgery for familial adenomatous polyposis (FAP

    Directory of Open Access Journals (Sweden)

    Omar A. Alwahbi

    2018-01-01

    Conclusion: Although the risk of developing adenomas or carcinomas in the ileal pouch post proctocolectomy with IPAA is low it should not be neglected as cancer occurrence or recurrence is unpredictable even with appropriate measures.

  8. Different behaviour of 63Ni and 59Fe during absorption in iron-deficient and iron-adequate jejunal rat segments ex vivo

    International Nuclear Information System (INIS)

    Mueller-Fassbender, M.; Elsenhans, B.; McKie, A.T.; Schuemann, K.

    2003-01-01

    Nickel exhibits low oral toxicity. It shares the absorptive pathways for iron, though there are substantial quantitative differences in handling of both metals. To analyse these differences more closely, jejunal segments from iron-deficient and iron-adequate rats were luminally perfused ex vivo with 59 Fe and 63 Ni at six different concentrations (1-500 μmo1/l) under steady state conditions. 59 Fe over-all absorption increased 2.0-4.6-fold in iron-deficiency at luminal concentrations between 1 and 100 μmol/l, while 63 Ni absorption increased to a much lower extent (2.6-fold at 1 μmol/l and 1.5-fold at higher luminal concentrations). Moreover, there was a 5-7-fold higher concentration for 63 Ni in the jejunal tissue than in the absorbate at luminal concentrations above 50 μmol/l which was not observed at 1 μmol 63 Ni/l and not for 59 Fe. 63 Ni tissue load showed a linear and a saturable fraction. In iron-deficiency the saturable 63 Ni fraction increased 4-fold as compared to only 1.5-fold increments for 59 Fe. Moreover, a substantially higher share of 63 Ni was retained in the jejunal tissue at high as compare to low luminal concentrations after perfusion had been continued without luminal radioactivity. This was not found for 59 Fe and suggests a concentration-dependent block of 63 Ni export across the enterocytes' basolateral membrane. To explain these results one may speculate that 63 Ni may bind more tightly to tissue ligands than 59 Fe due to the higher thermodynamic and kinetic stability of nickel complexes. In particular, nickel may bind to a basolateral population of metal carriers and block its own basolateral transfer in a concentration-dependent manner. Tight 63 Ni binding to non-specific jejunal ligands is responsible for the unaltered high linear fraction of jejunal 63 Ni load in iron-deficient and iron-adequate segments. Binding of 63 Ni to food and tissue ligands in the small intestine may, thus, be a likely explanation for the low oral nickel

  9. Presentation of GIST as jejuno-jejunal intussusception

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2018-03-01

    Full Text Available Gastrointestinal stromal tumours (GISTs are rare tumour. It comprises 0.2% of gastrointestinal tumours and only 0.04% of small intestinal tumours. Usually this tumour is found in people in their 60s.These tumours can be found anywhere in the gastrointestinal tract but most commonly found in the stomach (40–60%. Patients with GISTs usually have vague and nonspecific symptoms. We present a 17year-old with complain of abdominal pain, distension, and few episodes of vomiting. All laboratory investigations were normal. The ultrasonography (USG and computed tomography (CT were suggestive of jejuno-jejunal intussusception. The patient had emergency exploratory laparotomy with resection of the segment with five cm healthy margin, and end to end anastomosis. Patient was discharged after 4 days and remains well. This case report highlights the rarity of GISTs in the concern of age (17 year old, site (Jejunum as well as presentation (intussusception.

  10. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans

    NARCIS (Netherlands)

    Luttikhold, Joanna; Norren, Van Klaske; Rijna, Herman; Buijs, Nikki; Ankersmit, Marjolein; Heijboer, Annemieke C.; Gootjes, Jeannette; Hartmann, Bolette; Holst, Jens J.; Loon, Van Luc J.C.; Leeuwen, Van P.A.M.

    2016-01-01

    Background: Jejunal feeding is preferred instead of gastric feeding in patients who are intolerant to gastric feeding or at risk of aspiration. However, the impact of gastric feeding compared with that of jejunal feeding on postprandial circulating plasma glucose and amino acid concentrations and

  11. Boron neutron capture therapy for the treatment of oral cancer in the hamster cheek pouch model

    International Nuclear Information System (INIS)

    Kreimann, Erica L.; Itoiz, Maria E.; Schwint, Amanda E.; Longhino, Juan; Blaumann, Herman; Calzetta, Osvaldo

    2003-01-01

    We have proposed and validated the hamster cheek pouch model of oral cancer for BNCT studies separately. We herein report the first evidence of the usefulness of BNCT for the treatment of oral cancer in an experimental model. We assessed the response of hamster cheek pouch tumors, precancerous tissue and normal oral tissue to BPA-mediated BNCT employing the thermalized epithermal beam of the RA-6 Reactor at the Bariloche Atomic Center. BNCT leads to complete remission by 15 days post-treatment in 78% of tumors and partial remission in a further 13% of tumors with virtually no damage to normal tissue. (author)

  12. J-pouch versus Roux-en-Y reconstruction after gastrectomy: functional assessment and quality of life (randomized trial

    Directory of Open Access Journals (Sweden)

    Zonca P

    2016-12-01

    Full Text Available Pavel Zonča,1,2 Tomáš Malý,3 Peter Ihnát,1,2 Matus Peteja,1,2 Otakar Kraft,4 Kamil Kuca2,5 1Department of Surgery, University Hospital Ostrava, 2Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, 3Department of Surgery, University Hospital Olomouc, Olomouc, 4Department of Nuclear Medicine, University Hospital Ostrava, Ostrava, 5Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic Purpose: The aim of this study was to evaluate the quality of life and functional emptying of J-pouch versus Roux-en-Y reconstruction after total gastrectomy for malignancy. Methods: This study was designed as a prospective, nonblinded, randomized, parallel clinical trial (Trial Number: MN Ostrava, 200604. With informed consent, patients undergoing gastrectomy for malignancy were randomized to J-pouch or Roux-en-Y reconstruction. The time taken for a test semisolid meal labeled with 99mTc-sulfur colloid to exit the reconstructed parts was measured by dynamic scintigraphy 1 year after resection. Quality of life was measured using the Eypasch questionnaire at the same time as functional emptying assessment. This trial was investigator-initiated. Results: In all, 72 patients were included into the study. The time taken for the test meal to exit the postgastrectomy reconstruction was 16.5±10.0 minutes (mean ± standard deviation in the Roux-en-Y group and 89.4±37.8 minutes in the “J-pouch” group; the difference was statistically significant (P<0.001. Emptying of the J-pouch appeared to be a linear decreasing function compared to the exponential pattern seen in the Roux-en-Y group. The quality of life measurement showed scores of 106±18.8 points (mean ± standard deviation in the Roux-en-Y group compared to 122±22.5 points in the J-pouch group; the difference was statistically significant (P=0.0016. There were no important adverse events. Conclusion: After total gastrectomy, a J-pouch

  13. The effects of probiotics on barrier function and mucosal pouch microbiota during maintenance treatment for severe pouchitis in patients with ulcerative colitis

    NARCIS (Netherlands)

    Persborn, M.; Gerritsen, J.; Wallon, C.; Carlsson, A.; Akkermans, L.M.A.; Soderholm, J.D.

    2013-01-01

    Background A total of 10-15% of patients with an ileoanal pouch develop severe pouchitis necessitating long-term use of antibiotics or pouch excision. Probiotics reduce the risk of recurrence of pouchitis, but mechanisms behind these effects are not fully understood. Aim To examine mucosal barrier

  14. Functional Evaluation of Modified T Pouch as Ileal Neo bladder Ortho topic Reservoir

    International Nuclear Information System (INIS)

    Hammouda, H.M.

    2004-01-01

    We report on the functional results of ortho topic modified T pouch ileal neo bladder, incorporating serous- lined extra mural ileal anti reflux technique for urinary diversion after radical cystectomy. Material and Methods: From September 1998 through November 2001,42 patients of mean age 49 years (range 45-54) having invasive bladder carcinoma underwent radical cystectomy and ortho topic ileal neo bladder urinary diversion, the modified T pouch. Thirty-three patients were males while the remaining 9 were females. The mean follow up was 24 months (range 18-42). Preoperative unior bilateral ureteral dilatation was noted in 13/42 (30.9%) patients). Follow up included clinical examination, laboratory, radiological and uro dynamic investigations. Early postoperative complications were recorded in 3 cases, that were managed conservatively. Day and night continence were achieved in 34/42 (81 %) and 29/42 (69%) patients, night enuresis in 2 (4.8%),while satisfactory day and night continence were noted, respectively. Upper urinary tract (UUT) remained unchanged or improved in all cases. No need for clean intermittent catherization (CIC). No evidence of reflux was detected. Pressure at maximum capacity (average 17 cm H 2 O at 600 ml). Mean flow rate was 17.6 ml/sec (range 15-24). Pelvic cancer recurrence was recorded in 5 patients at mean 24 months, respectively. Modified T pouch has an excellent functional criteria as an ortho topic ileal neo bladder reservoir. It is absolutely indicated in short and/or massively dilated ureter

  15. Quality of life after ileal pouch-anal anastomosis: an evaluation of diet and other factors using the Cleveland Global Quality of Life instrument.

    LENUS (Irish Health Repository)

    Coffey, J C

    2012-02-03

    PURPOSE: Although functional results after ileal pouch-anal anastomosis are excellent, imperfections of function do occur. In this setting, quality-of-life assessment is an invaluable tool in determining overall therapeutic efficacy. We evaluated the impact of dietary restrictions, preoperative diagnosis (ulcerative colitis vs. familial adenomatous polyposis), and pregnancy (after pouch insertion) on quality of life. METHODS: After ethical approval, 64 patients were reviewed (mean age, 31 (range, 15-54) years). Long-term quality of life in patients after ileal pouch-anal anastomosis was assessed using the Cleveland Global Quality of Life instrument or Fazio score. The Cleveland Global Quality of Life score is a novel quality-of-life instrument specifically designed for patients with ileal pouches. Stool frequency and continence were recorded to establish the functional status of this group. RESULTS: Sixty-one patients (95.3 percent) complained of some form of dietary restriction and adopted a fixed dietary regimen. All such patients felt that a breach of this regimen would impinge significantly on their quality of life. Late eating and alcohol were associated with diarrhea, whereas smoking was not. Constipation was infrequently reported. The mean Cleveland Global Quality of Life score of patients with ulcerative colitis (0.81 +\\/- 0.13) was greater than that of patients with ulcerative colitis and a background of pouchitis (0.78 +\\/- 0.16; P = 0.042). Whereas postoperative stool frequency in patients with familial adenomatous polyposis was always higher than the preoperative level (4 vs. 2 movements per day; P = 0.04), the Cleveland Global Quality of Life score of this group was lower than that of ulcerative colitis patients (0.77 vs. 0.81; P = 0.047). The Cleveland Global Quality of Life score of females who had had pregnancies after pouch formation was 0.70, significantly lower (P = 0.039) than that of ulcerative colitis patients, although pouch function was

  16. Type V Pouch Colon, Prune Belly Syndrome, and Congenital Anterior Urethrocutaneous Fistula.

    Science.gov (United States)

    Raj, Prince; Birua, Hirendra

    2017-01-01

    Congenital pouch colon (CPC) or short colon syndrome is a rare type of anorectal malformation(ARM). Type V is the rarest form of CPC. We present a 1-day-old male child with type V CPC with prune belly syndrome and congenital anterior urethrocutaneous fistula (CAUF).

  17. Tendon Interposition and Ligament Reconstruction with ECRL Tendon in the Late Stages of Kienböck’s Disease: A Cadaver Study

    Directory of Open Access Journals (Sweden)

    Nazım Karalezli

    2013-01-01

    Full Text Available Background. The optimal surgical treatment for Kienböck’s disease with stages IIIB and IV remains controversial. A cadaver study was carried out to evaluate the use of coiled extensor carpi radialis longus tendon for tendon interposition and a strip obtained from the same tendon for ligament reconstruction in the late stages of Kienböck’s disease. Methods. Coiled extensor carpi radialis longus tendon was used to fill the cavity of the excised lunate, and a strip obtained from this tendon was sutured onto itself after passing through the scaphoid and the triquetrum acting as a ligament to preserve proximal row integrity. Biomechanical tests were carried out in order to evaluate this new ligamentous reconstruction. Results. It was biomechanically confirmed that the procedure was effective against axial compression and distributed the upcoming mechanical stress to the distal row. Conclusion. Extensor carpi radialis longus tendon has not been used for tendon interposition and ligament reconstruction in the treatment of this disease before. In view of the biomechanical data, the procedure seems to be effective for the stabilization of scaphoid and carpal bones.

  18. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

    OpenAIRE

    Magda H. A. Nasreldin; Eman A. Ibrahim; Somaia A. Saad El-Din

    2016-01-01

    Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a cl...

  19. Urticaria due to polyethylene glycol-3350 and electrolytes for oral solution in a patient with jejunal nodular lymphoid hyperplasia.

    Science.gov (United States)

    Zhang, Hongfeng; Henry, Winoah A; Chen, Lea Ann; Khashab, Mouen A

    2015-01-01

    Both jejunal nodular lymphoid hyperplasia (NLH) and polyethylene glycol (PEG)-3350 hypersensitivity are extremely rare. We describe a 30-year-old female who had previously taken a PEG-3350 bowel preparation without adverse effects, and presented for evaluation of chronic diarrhea. An upper and lower gastrointestinal endoscopy, and small bowel series were scheduled. PEG-3350 and electrolytes for oral solution was prescribed for bowel cleansing. During consumption of the bowel preparation she developed urticarial hypersensitivity. An alternative bowel preparation was used. Colonoscopy and upper endoscopy were normal, but small bowel series revealed innumerable sand-like lucencies in the jejunum. NLH was confirmed on biopsy from antegrade enteroscopy. This is the first case report on the pathological jejunal NLH in association with the PEG-3350 urticarial hypersensitivity. The potential pathophysiological etiology of this association is discussed.

  20. Barium enema and CT findings of Douglas pouch metastasis

    International Nuclear Information System (INIS)

    Miyakawa, Kunihisa; Uchiyama, Nachiko; Iinuma, Hajime; Moriyama, Noriyuki

    1999-01-01

    We retrospectively reviewed barium enema and CT findings of Douglas pouch metastasis in 170 patients. The findings were divided into three types: Anterior compression type, anterior fixed folds type, and stenosis type. Patients with gastric cancer usually showed a stenosis type, especially in those with poorly differentiated adenocarcinoma. Patients with colon and ovary cancer usually showed an anterior compression type. In patients with gastric cancer, those who showed a stenosis type had the most favorable prognosis among these three types. (author)

  1. Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

    Science.gov (United States)

    Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

    1988-01-01

    The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

  2. Further assessment of Monkeypox Virus infection in Gambian pouched rats (Cricetomys gambianus) using in vivo bioluminescent imaging

    Science.gov (United States)

    Falendysz, Elizabeth; Lopera, Juan G.; Faye Lorenzsonn,; Salzer, Johanna S.; Hutson, Christina L.; Doty, Jeffrey; Gallardo-Romero, Nadia; Carroll, Darin S.; Osorio, Jorge E.; Rocke, Tonie E.

    2015-01-01

    Monkeypox is a zoonosis clinically similar to smallpox in humans. Recent evidence has shown a potential risk of increased incidence in central Africa. Despite attempts to isolate the virus from wild rodents and other small mammals, no reservoir host has been identified. In 2003,Monkeypox virus (MPXV) was accidentally introduced into the U.S. via the pet trade and was associated with the Gambian pouched rat (Cricetomys gambianus). Therefore, we investigated the potential reservoir competence of the Gambian pouched rat for MPXV by utilizing a combination of in vivo and in vitro methods. We inoculated three animals by the intradermal route and three animals by the intranasal route, with one mock-infected control for each route. Bioluminescent imaging (BLI) was used to track replicating virus in infected animals and virological assays (e.g. real time PCR, cell culture) were used to determine viral load in blood, urine, ocular, nasal, oral, and rectal swabs. Intradermal inoculation resulted in clinical signs of monkeypox infection in two of three animals. One severely ill animal was euthanized and the other affected animal recovered. In contrast, intranasal inoculation resulted in subclinical infection in all three animals. All animals, regardless of apparent or inapparent infection, shed virus in oral and nasal secretions. Additionally, BLI identified viral replication in the skin without grossly visible lesions. These results suggest that Gambian pouched rats may play an important role in transmission of the virus to humans, as they are hunted for consumption and it is possible for MPXV-infected pouched rats to shed infectious virus without displaying overt clinical signs.

  3. Mesh Migration into the J-Pouch in a Patient with Post-Ulcerative Colitis Colectomy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Asem Ghanim

    2017-01-01

    Full Text Available Mesh repair offers advantages like lower postsurgical pain and earlier return to work. Thus, it has become a widely used treatment option. Here, we present the first case report of a mesh migration into a J-pouch in a patient with history of ulcerative colitis who underwent total abdominal colectomy with J-pouch and ileoanal anastomosis and a subsequent laparoscopic ventral hernia repair with mesh.

  4. Jejunal brush border microvillous alterations in Giardia muris-infected mice: role of T lymphocytes and interleukin-6.

    Science.gov (United States)

    Scott, K G; Logan, M R; Klammer, G M; Teoh, D A; Buret, A G

    2000-06-01

    Intestinal colonization with the protozoan Giardia causes diffuse brush border microvillous alterations and disaccharidase deficiencies, which in turn are responsible for intestinal malabsorption and maldigestion. The role of T cells and/or cytokines in the pathogenesis of Giardia-induced microvillous injury remains unclear. The aim of this study was to assess the role of T cells and interleukin-6 (IL-6) in the brush border pathophysiology of acute murine giardiasis in vivo. Athymic nude (nu(-)/nu(-)) CD-1 mice and isogenic immunocompetent (nu(+)/nu(+)) CD-1 mice (4 weeks old) received an axenic Giardia muris trophozoite inoculum or vehicle (control) via orogastric gavage. Weight gain and food intake were assessed daily. On day 6, segments of jejunum were assessed for parasite load, brush border ultrastructure, IL-6 content, maltase and sucrase activities, villus-crypt architecture, and intraepithelial lymphocyte (IEL) infiltration. Despite similar parasitic loads on day 6, infected immunocompetent animals, but not infected nude mice, showed a diffuse loss of brush border microvillous surface area, which was correlated with a significant reduction in maltase and sucrase activities and a decrease in jejunal IL-6 concentration. In both athymic control and infected mice, jejunal brush border surface area and disaccharidases were high, but levels of tissue IL-6 were low and comparable to the concentration measured in immunocompetent infected animals. In both immunocompetent and nude mice, infection caused a small but significant increase in the numbers of IELs. These findings suggest that the enterocyte brush border injury and malfunction seen in giardiasis is, at least in part, mediated by thymus-derived T lymphocytes and that suppressed jejunal IL-6 does not necessarily accompany microvillous shortening.

  5. Processing of chopped mussel meat in retort pouch

    Directory of Open Access Journals (Sweden)

    Giustino TRIBUZI

    2015-01-01

    Full Text Available Abstract Chopped mussel meat packaged in retort pouches was processed in a laboratory-scale water immersion retort, adapted for processing under overpressure conditions. Retort temperature effects on product yield and on cook value were evaluated by setting the F0 at 7 min. The effects of different pre-treatments (salting and marination on the characteristics of mussels were evaluated after processing at retort temperature of 118 °C and during a whole year of storage at 25 °C. The salted samples showed better yield during storage, while no differences were found for the other physicochemical parameters.

  6. A functional study on small intestinal smooth muscles in jejunal atresia

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    Preeti Tyagi

    2016-01-01

    Full Text Available Aim: The present study was aimed to assess the contractile status of neonatal small intestinal smooth muscle of dilated pre-atretic part of intestinal atresia to resolve debatable issues related to mechanisms of persistent dysmotility after surgical repair. Materials and Methods: A total of 34 longitudinally sectioned strips were prepared from pre-atretic dilated part of freshly excised 8 jejunal atresia type III a cases. Spontaneous as well as acetylcholine- and histamine-induced contractions were recorded in vitro by using organ bath preparations. Chemically evoked contractions were further evaluated after application of atropine (muscarinic blocker, pheniramine (H1 blocker, and lignocaine (neuronal blocker to ascertain receptors and neuronal involvement. Histological examinations of strips were made by using Masson trichrome stain to assess the fibrotic changes. Results: All 34 strips, except four showed spontaneous contractions with mean frequency and amplitude of 5.49 ± 0.26/min and 24.41 ± 5.26 g/g wet tissue respectively. The response to ACh was nearly twice as compared to histamine for equimolar concentrations (100 μM. ACh (100 μM induced contractions were attenuated (by 60% by atropine. Histamine (100 μM-induced contractions was blocked by pheniramine (0.32 μM and lignocaine (4 μM by 74% and 78%, respectively. Histopathological examination showed varying degree of fibrotic changes in muscle layers. Conclusions: Pre-atretic dilated part of jejunal atresia retains functional activity but with definitive histopathologic abnormalities. It is suggested that excision of a length of pre-atretic part and early stimulation of peristalsis by locally acting cholinomimetic or H1 agonist may help in reducing postoperative motility problems in atresia patients.

  7. A functional study on small intestinal smooth muscles in jejunal atresia.

    Science.gov (United States)

    Tyagi, Preeti; Mandal, Maloy B; Gangopadhyay, Ajay N; Patne, Shashikant C U

    2016-01-01

    The present study was aimed to assess the contractile status of neonatal small intestinal smooth muscle of dilated pre-atretic part of intestinal atresia to resolve debatable issues related to mechanisms of persistent dysmotility after surgical repair. A total of 34 longitudinally sectioned strips were prepared from pre-atretic dilated part of freshly excised 8 jejunal atresia type III a cases. Spontaneous as well as acetylcholine- and histamine-induced contractions were recorded in vitro by using organ bath preparations. Chemically evoked contractions were further evaluated after application of atropine (muscarinic blocker), pheniramine (H1 blocker), and lignocaine (neuronal blocker) to ascertain receptors and neuronal involvement. Histological examinations of strips were made by using Masson trichrome stain to assess the fibrotic changes. All 34 strips, except four showed spontaneous contractions with mean frequency and amplitude of 5.49 ± 0.26/min and 24.41 ± 5.26 g/g wet tissue respectively. The response to ACh was nearly twice as compared to histamine for equimolar concentrations (100 μM). ACh (100 μM) induced contractions were attenuated (by 60%) by atropine. Histamine (100 μM)-induced contractions was blocked by pheniramine (0.32 μM) and lignocaine (4 μM) by 74% and 78%, respectively. Histopathological examination showed varying degree of fibrotic changes in muscle layers. Pre-atretic dilated part of jejunal atresia retains functional activity but with definitive histopathologic abnormalities. It is suggested that excision of a length of pre-atretic part and early stimulation of peristalsis by locally acting cholinomimetic or H1 agonist may help in reducing postoperative motility problems in atresia patients.

  8. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers

    OpenAIRE

    Deng-Fu Yang; Jeng-Woei Lee; Hsin-Ming Chen; Yih-Chih Hsu

    2014-01-01

    Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of human oral precancerous lesions. This animal study aimed to assess whether topical methotrexate (MTX) pretreatment could enhance the therapeutic effect of topical ALA-PDT on hamster buccal pouch precancerous lesions. Methods: Twenty hamster buccal pouch precancerous lesions were treated with either topical ALA-PDT with topical MTX pretreatment (topical MTX-ALA-PDT group, n = 10) or topical A...

  9. Sources and severity of self-reported food intolerance after ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Steenhagen, E.; Roos, de N.M.; Bouwman, C.A.; Laarhoven, van C.J.H.M.; Staveren, van W.A.

    2006-01-01

    Data on food intolerance after ileal pouch-anal anastomosis are scarce. The aim of this study was to identify foods causing intolerance and to determine the nature and severity of reported symptoms. Patients from the Dutch Crohn's and Ulcerative Colitis Association were mailed a survey on food

  10. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans: a randomized trial

    NARCIS (Netherlands)

    Luttikhold, Joanna; van Norren, Klaske; Rijna, Herman; Buijs, Nikki; Ankersmit, Marjolein; Heijboer, Annemieke C.; Gootjes, Jeannette; Hartmann, Bolette; Holst, Jens J.; van Loon, Luc Jc; van Leeuwen, Paul Am

    2016-01-01

    Jejunal feeding is preferred instead of gastric feeding in patients who are intolerant to gastric feeding or at risk of aspiration. However, the impact of gastric feeding compared with that of jejunal feeding on postprandial circulating plasma glucose and amino acid concentrations and the associated

  11. Establishment of a tumor neovascularization animal model with biomaterials in rabbit corneal pouch.

    Science.gov (United States)

    Chu, Yu-Ping; Li, Hong-Chuan; Ma, Ling; Xia, Yang

    2018-06-01

    The present animal model of tumor neovascularization most often used by researchers is zebrafish. For studies on human breast cancer cell neovascularization, a new animal model was established to enable a more convenient study of tumor neovascularization. A sodium alginate-gelatin blend gel system was used to design the new animal model. The model was established using rabbit corneal pouch implantation. Then, the animal model was validated by human breast cancer cell lines MCF-7-Kindlin-2 and MCF-7-CMV. The experiment intuitively observed the relationship between tumor and neovascularization, and demonstrated the advantages of this animal model in the study of tumor neovascularization. The use of sodium alginate-gelatin blends to establish tumor neovascularization in a rabbit corneal pouch is a novel and ideal method for the study of neovascularization. It may be a better animal model for expanding the research in this area. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Measuring and assessing the effective in-plane thermal conductivity of lithium iron phosphate pouch cells

    International Nuclear Information System (INIS)

    Bazinski, S.J.; Wang, X.; Sangeorzan, B.P.; Guessous, L.

    2016-01-01

    The objective of this research is to experimentally determine the effective in-plane thermal conductivity of a lithium iron phosphate pouch cell. An experimental setup is designed to treat the battery cell as a straight rectangular fin in natural convection. Thermography and heat sensors were used to collect data that yields the temperature distribution and heat transfer rate of the fin, respectively. One-dimensional fin equations were combined with the experimental data to yield the in-plane thermal conductivity through an iterative process that best-fits the data to the model. The experiment was first calibrated using reference plates of different metals. The fin model predicts the thermal conductivity value well with a correction factor of approximately 7%–9%. Using this experimental method, the in-plane thermal conductivity of the pouch cells is measured at different state of charge (SOC) levels. The in-plane thermal conductivity decreases approximately 0.13 Wm"−"1 °C"−"1 per 10% increase in SOC for the LFP cells. This translates to a 4.2% overall decrease in the thermal conductivity as the cell becomes fully charged. - Highlights: • A method is proposed to measure the in-plane thermal conductivity of a pouch cell. • The thermal conductivity decreases slightly with increase in SOC for the LFP cells. • The fin model predicts the thermal conductivity well with a correction factor.

  13. Functional morphology of the brain of the African giant pouched rat (Cricetomys gambianus Waterhouse, 1840

    Directory of Open Access Journals (Sweden)

    Chikera S. Ibe

    2014-03-01

    Full Text Available A gross morphological study of the brain of the African giant pouched rat (Cricetomys gambianus Waterhouse, 1840 was undertaken in order to document its normal features and assess the structure-function paradigm. The study was conducted by direct observation of 29 adult African giant pouched rats’ brains. In the telencephalon, the cerebral cortex was devoid of prominent gyri and sulci, but the large olfactory bulb and tract relaying impulses to the olfactory cortex were very prominent. The large size of the olfactory bulb correlated with the established sharp olfactory acuity of the rodent. In the mesencephalic tectum, the caudal colliculi were bigger than the rostral colliculi, indicating a more acute sense of hearing than sight. In the metencephalon, the cerebellar vermis, the flocculus and the paraflocculus were highly coiled and, thus, well developed. The myelencephalon revealed a better organised ventral surface than dorsal surface; the cuneate fascicle, the intermediate sulcus and the lateral sulcus were not evident on the dorsal surface, but there were clearly visible pyramids and olivary prominence on the ventral surface. In conclusion, the highly coiled cerebellar vermis, flocculus and paraflocculus, as well as the conspicuous pyramids and olivary prominence are indicative of a good motor coordination and balance in the African giant pouched rat.

  14. Similar Outcome After Colonic Pouch and Side-to-End Anastomosis in Low Anterior Resection for Rectal Cancer

    Science.gov (United States)

    Machado, Mikael; Nygren, Jonas; Goldman, Sven; Ljungqvist, Olle

    2003-01-01

    Objectives To compare a colonic J-pouch or a side-to-end anastomosis after low-anterior resection for rectal cancer with regard to functional and surgical outcome. Summary Background Data: A complication after restorative rectal surgery with a straight anastomosis is low- anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis. Methods: One-hundred patients with rectal cancer undergoing total mesorectal excision and colo-anal anastomosis were randomized to receive either a colonic pouch or a side-to-end anastomosis using the descending colon. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. Results: Fifty patients were randomized to each group. Patient characteristics in both groups were very similar regarding age, gender, tumor level, and Dukes’ stages. A large proportion of the patients received short-term preoperative radiotherapy (78%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height (4 cm), perioperative blood loss (500 ml), hospital stay (11 days), postoperative complications, reoperations or pelvic sepsis rates. Comparing functional results in the 2 study groups, only the ability to evacuate the bowel in <15 minutes at 6 months reached a significant difference in favor of the pouch procedure. Conclusions: The data from this study show that either a colonic J-pouch or a side-to-end anastomosis performed on the descending colon in low-anterior resection with total mesorectal excision are methods that can be used with similar expected functional and surgical results. PMID:12894014

  15. Intestinal Parasites and Anthelmintic Treatments in a Laboratory Colony of Wild-caught African Pouched Rats (Cricetomys ansorgei)

    Science.gov (United States)

    Cullin, Cassandra O; Sellers, Matthew S; Rogers, Erin R; Scott, Kathleen E; Lee, Danielle N; Ophir, Alexander G; Jackson, Todd A

    2017-01-01

    African giant pouched rats (Cricetomys spp.) are large rodents native to subSaharan Africa. Wild-caught pouched rats identified as Cricetomys ansorgei (n = 49) were imported from Tanzania. A survey of gastrointestinal parasitism by fecal flotation revealed the presence of multiple parasites, including Nippostrongylus spp., Heterakis spp., Trichuris spp., Hymenolepis spp., Raillietina spp., and Eimeria spp. Oral self-administered fenbendazole (150 ppm), topical moxidectin (2 mg/kg), pyrantel pamoate (15 mg/kg), piperazine (100 mg/kg daily), and injectable ivermectin (0.25 mg/kg) were used to determine effective treatment options for the gastrointestinal parasites present in the colony. Pyrantel pamoate in a treat vehicle and piperazine in water bottles were easily administered and significantly reduced the numbers of animals shedding Nippostrongylus spp. and Heterakis spp. during the study. Moxidectin and ivermectin were clinically ineffective at reducing fecal egg shedding. Fenbendazole was most effective at clearing infection with Trichuris spp. Although 10 mg/kg praziquantel was ineffective, a single dose of 30 mg/kg praziquantel significantly reduced the number of African pouched rats that shed cestode embryos. A combination treatment may be necessary to successfully treat all parasites present in any given animal. PMID:28935004

  16. Jejuno-jejunal intussusception in a guinea pig (Cavia porcellus

    Directory of Open Access Journals (Sweden)

    Tara J. Fetzer

    2017-09-01

    Full Text Available An approximately four-year-old male castrated guinea pig (Cavia porcellus was presented for painful defecation with a 24-hour history of hyporexia and intermittent episodes of rolling behavior. Upon presentation the patient was quiet, alert, and responsive, and mildly hypothermic. Abdominal palpation revealed an approximately 2-cm long oblong mass within the caudal abdomen. Abdominal radiographs revealed gastric dilation without volvulus and a peritoneal mass effect. The patient was euthanized following gastric reflux of brown malodorous fluid from his nares and oral cavity. A necropsy was performed and revealed a jejuno-jejunal intussusception causing mechanical gastrointestinal ileus, and gastric dilatation without volvulus. While non-obstructive gastrointestinal stasis is common and obstructive ileus is uncommon in guinea pigs, this report shows that intestinal intussusception is a differential in guinea pigs with ileus and gastric dilatation.

  17. Prune belly syndrome with pouch colon and absent dermatome.

    Science.gov (United States)

    Baba, Aejaz A; Hussain, Syed A; Shera, Altaf H; Patnaik, Rekha

    2010-01-01

    Prune belly syndrome (PBS) is a rare congenital constellation of defects in pediatric surgical practice. Although anorectal anomalies have been reported in association with PBS, only few case of pouch colon with PBS has been reported. [1] In addition, our patient had deficient abdominal wall with absent dermatome in left upper quadrant, which has never been reported in the English literature. This association with abdominal wall deficiency and absent dermatome not only strengthens the theory of mesodermal arrest in the etiology of PBS but also points towards a defect in the ectodermal development.

  18. Management of third branchial pouch anomalies - an evolution of a minimally invasive technique.

    Science.gov (United States)

    Wong, Phui Yee; Moore, Andrew; Daya, Hamid

    2014-03-01

    The management of third branchial pouch anomalies has evolved in recent times with the popularisation of the endoscopic diathermy technique to sclerose the pyriform fossa sinus opening. We present our experience in managing 3 children with third branchial pouch anomalies and propose a minimally invasive management algorithm avoiding open neck surgery. Retrospective case review of 3 patients including demographics, mode of presentation, investigations, management and complications. Three children, two male and one female of mean age 9.6 years presented with painful left anterior neck swelling. Axial neck imaging showed a superficial abscess with air locules and a sinus tract leading towards the left pharynx. Diagnosis was confirmed by endoscopic examination of the pyriform fossa revealing a sinus opening. Two patients underwent open excision; one combined with diathermy to the sinus opening. The last patient was diagnosed at his initial presentation and managed with endoscopic diathermy of the sinus opening combined with percutaneous needle aspiration of the neck abscess at the same sitting. One patient had two recurrences, the first after initial open surgery and the second after the first cautery. Two patients developed temporary hoarseness after the procedure, which resolved within two weeks. All patients were free from recurrences at follow-up. Introduction of the technique of endoscopic diathermy to the pyriform fossa sinus opening in children with third branchial pouch anomalies has revolutionised their management avoiding open and potentially morbid surgery. Our algorithm takes this further by advocating percutaneous needle aspiration of the infective component and performing diathermy to the sinus opening at the first presentation. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Subarachnoid pouches of the posterior fossa with syringomyelia

    Energy Technology Data Exchange (ETDEWEB)

    Williams, B [Midland Centre for Neurosurgery and Neurology, Smethwick (UK)

    1979-01-01

    Three men are presented, all of whom were born with difficulty and later developed severe syringomyelia with collapsing cords on air myelography. Each had hydrocephalus and a sizable subarachnoid pouch in the posterior fossa. The clinical features and investigations are presented with a discussion of the aetiology and possible mechanisms concerned in pathogenesis and treatment. All three men had posterior fossa exploration over fifty years after birth, and the first two were also treated by valved ventriculo-atrial shunts. Each patient has improved a little since operation, but no certainly that this was due to surgery has been proved in any case; none has progressed since the last operation.

  20. Report of a Case and Review of Literature of Internal Hernia through Peritoneal Defect in Pouch of Douglas: A Rare Occurrence.

    Science.gov (United States)

    Muthukumar, Vamseedharan; Venugopal, Sarveswaran; Subramaniam, Surees Kumar

    2017-01-01

    Intestinal obstruction attributable to internal hernia as a cause is a rare phenomenon with a reported incidence of 0.6%-5.8%. Internal hernias ensuing as a result of defect in the pouch of Douglas is extremely rare with only six such cases reported so far in the literature. We present a case of 74-year-old posthysterectomy status female who presented with features of intestinal obstruction. Intraoperatively, the site of obstruction was found to be a rent in the peritoneum of the pouch of Douglas through which a loop of ileum was found herniating. The viability of the bowel was confirmed, and the defect was closed. The postoperative course was uneventful. This report presents an extremely rare type of internal hernia caused by defect in the pouch of Douglas and review of the literature so far available.

  1. Biodistribution study with combined administration of BPA and BSH for BNCT in the hamster cheek pouch oral cancer model

    International Nuclear Information System (INIS)

    Garabalino, M A; Heber, E M; Monti Hughes, A; Pzzi, E C C; Molinari, A J; Niggg, D W; Bauer, W; Trivillin, V A; Schwint, A E

    2012-01-01

    We previously proved the therapeutic potential of the chemically non-selective boron compound decahydrodecaborate (GB-10) as a stand-alone boron carrier for BNCT in the hamster cheek pouch oral cancer model with no toxic effects in normal or precancerous tissue. Although GB-10 is not taken up selectively by oral tumor tissue, selective tumor lethality would result from selective aberrant tumor blood vessel damage. Furthermore, BNCT efficacy was enhanced when GB-10 and boronophenylalanine (BPA) were administered jointly. The fact that sodium mercaptoundecahydro-closo-dodecaborate (BSH) is being investigated clinically as a stand-alone boron agent for BNCT of brain tumors and in combination with BPA for recurrent head and neck malignancies makes it a particularly interesting boron compound to explore. Based on the working hypothesis that BSH would conceivably behave similarly to GB-10 in oral cancer, we previously performed biodistribution studies with BSH alone in the hamster cheek pouch oral cancer model. The aim of the present study was to perform biodistribution studies of BSH + BPA administered jointly in the hamster cheek pouch oral cancer model as a starting point to contribute to the knowledge of (BSH+BPA)-BNCT radiobiology and optimize therapeutic efficacy. The right cheek pouch of Syrian hamsters was subjected to topical administration of a carcinogen twice a week for 12 weeks. Once the exophytic tumors, i.e. squamous cell carcinomas, had developed, the animals were used for biodistribution studies with BSH + BPA. Three administration protocols with different proportions of each of the compounds were assessed: 1. BSH, 50 mg 10 B/kg, iv + BPA, 15.5 mg 10 B/kg, ip; 2. BSH, 34.5 mg 10 B/kg, iv + BPA, 31 mg 10 B/kg, ip; 3. BSH, 20 mg 10 B/kg, iv + BPA, 46.5 mg 10 B/kg, ip. Groups of animals were euthanized 4 h after the administration of BSH and 3 h after the administration of BPA. Samples of blood, tumor, precancerous and normal pouch and other tissues with

  2. Autoradiographic images in the hamster cheek pouch oral cancer model

    International Nuclear Information System (INIS)

    Portu, A.; Molinari, A.J.; Schwint, A.; Saint Martin, G.; Thorp, S.; Pozzi, E.C.C.; Curotto, P.

    2013-01-01

    The aim of this work is to summarize the autoradiographic study performed to samples from different protocols of the hamster cheek pouch oral cancer model. The qualitative analysis of histological and autoradiographic images, together with the determination of the boron concentration in the different structures of tumor, premalignant tissue and normal tissue contributed to the knowledge of the microdistribution of boron compounds. Besides, the study led to the optimization of the autoradiography technique applied to BNCT (Boron Neutron Capture Therapy). (author)

  3. A Case of Enlarged Intracranial Translucency in a Fetus with Blake’s Pouch Cyst

    Directory of Open Access Journals (Sweden)

    Ambra Iuculano

    2014-01-01

    Full Text Available The intracranial translucency (IT is a recently introduced marker of open spina bifida (OSB. In this study, we describe a case of a fetus affected by Blake’s pouch cyst which showed alterations of BS/BSOB ratio at the first trimester screening.

  4. Alveolar ridge augmentation by connective tissue grafting using a pouch method and modified connective tissue technique: A prospective study.

    Science.gov (United States)

    Agarwal, Ashish; Gupta, Narinder Dev

    2015-01-01

    Localized alveolar ridge defect may create physiological and pathological problems. Developments in surgical techniques have made it simpler to change the configuration of a ridge to create a more aesthetic and more easily cleansable shape. The purpose of this study was to compare the efficacy of alveolar ridge augmentation using a subepithelial connective tissue graft in pouch and modified connective tissue graft technique. In this randomized, double blind, parallel and prospective study, 40 non-smoker individuals with 40 class III alveolar ridge defects in maxillary anterior were randomly divided in two groups. Group I received modified connective tissue graft, while group II were treated with subepithelial connective tissue graft in pouch technique. The defect size was measured in its horizontal and vertical dimension by utilizing a periodontal probe in a stone cast at base line, after 3 months, and 6 months post surgically. Analysis of variance and Bonferroni post-hoc test were used for statistical analysis. A two-tailed P connective tissue graft proposed significantly more improvement as compare to connective tissue graft in pouch.

  5. Small bowel volvulus with jejunal diverticulum: Primary or secondary?

    Science.gov (United States)

    Shen, Xiao-Fei; Guan, Wen-Xian; Cao, Ke; Wang, Hao; Du, Jun-Feng

    2015-09-28

    Small bowel volvulus, which is torsion of the small bowel and its mesentery, is a medical emergency, and is categorized as primary or secondary type. Primary type often occurs without any apparent intrinsic anatomical anomalies, while the secondary type is common clinically and could be caused by numerous factors including postoperative adhesions, intestinal diverticulum, and/or tumors. Here, we report a rare case of a 60-year-old man diagnosed with small bowel volvulus using multidetector computed tomography (MDCT) angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. This case report includes several etiological factors of small bowel volvulus, and we discuss the possible cause of small bowel volvulus in this patient. We also highlight the importance of MDCT angiography in the diagnosis of volvulus and share our experience in treating this disease.

  6. Visual pigment coexpression in all cones of two rodents, the Siberian hamster, and the pouched mouse.

    Science.gov (United States)

    Lukáts, Akos; Dkhissi-Benyahya, Ouria; Szepessy, Zsuzsanna; Röhlich, Pál; Vígh, Béla; Bennett, Nigel C; Cooper, Howard M; Szél, Agoston

    2002-07-01

    To decide whether the identical topography of short- and middle-wavelength cone photoreceptors in two species of rodents reflects the presence of both opsins in all cone cells. Double-label immunocytochemistry using antibodies directed against short-wavelength (S)-and middle- to long-wavelength (M/L)-sensitive opsin were used to determine the presence of visual pigments in cones of two species of rodents, the Siberian hamster (Phodopus sungorus) and the pouched mouse (Saccostomus campestris) from South Africa. Topographical distribution was determined from retinal whole-mounts, and the colocalization of visual pigments was examined using confocal laser scanning microscopy. Opsin colocalization was also confirmed in consecutive semithin tangential sections. The immunocytochemical results demonstrate that in both the Siberian hamster and the pouched mouse all retinal cones contain two visual pigments. No dorsoventral gradient in the differential expression of the two opsins is observed. The retina of the Siberian hamster and the pouched mouse is the first example to show a uniform coexpression of M and S cone opsins in all cones, without any topographical gradient in opsin expression. This finding makes these two species good models for the study of molecular control mechanisms in opsin coexpression in rodents, and renders them suitable as sources of dual cones for future investigations on the role and neural connections of this cone type.

  7. Towards Sensor-Actuator Coupling in an Automated Order Picking System by Detecting Sealed Seams on Pouch Packed Goods

    Directory of Open Access Journals (Sweden)

    Frank Weichert

    2014-10-01

    Full Text Available In this paper, a novel concept of coupling the actuators of an automated order picking system for pouch packed goods with an embedded CCD camera sensor by means of image processing and machine learning is presented. The picking system mechanically combines the conveyance and singularization of a still-connected chain of pouch packed goods in a single machinery. The proposed algorithms perform a per-frame processing of the captured images in real-time to detect the sealed seams of the ongoing pouches. The detections are used to deduce cutting decisions in order to control the system’s actuators, namely the drive pulley for conveyance and the cutting device for the separation. Within this context, two controlling strategies are presented as well which specify the interaction of the sensor and the actuators. The detection is carried out by two different marker detection strategies: enhanced Template Matching as a heuristic and Support Vector Machines as a supervised classification based concept. Depending on the employed marker, detection rates of almost 100% with a calculation time of less than 40 ms are possible. From a logistic point of view, sealed seam widths of 20 mm prove feasible.

  8. Preliminary study of tissue concentrations of penicillin after local administration into the guttural pouches in four healthy horses.

    Science.gov (United States)

    Kendall, A; Mayhew, I G; Petrovski, K

    2016-08-01

    Treatment of subclinical carriers of Streptococcus equi subsp. equi with a gelatine-penicillin formulation deposited in the guttural pouch has been empirically proposed, but data on local tissue penicillin concentrations after treatment are lacking. We analysed tissue levels of penicillin after administration into the guttural pouches of four healthy horses. Two horses received local treatment with gelatine-penicillin and two horses received local treatment with an intramammary formulation of penicillin. Tissues were harvested for analysis either 12 or 24 h later. Results indicate that local treatment may be effective, but more research on optimal drug formulations in a larger sample size is warranted. © 2016 Australian Veterinary Association.

  9. Prune belly syndrome with pouch colon and absent dermatome

    Directory of Open Access Journals (Sweden)

    Baba Aejaz

    2010-01-01

    Full Text Available Prune belly syndrome (PBS is a rare congenital constellation of defects in pediatric surgical practice. Although anorectal anomalies have been reported in association with PBS, only few case of pouch colon with PBS has been reported. [1] In addition, our patient had deficient abdominal wall with absent dermatome in left upper quadrant, which has never been reported in the English literature. This association with abdominal wall deficiency and absent dermatome not only strengthens the theory of mesodermal arrest in the etiology of PBS but also points towards a defect in the ectodermal development.

  10. Duodenal-jejunal bypass liner implantation provokes rapid weight loss and improved glycemic control, accompanied by elevated fasting ghrelin levels

    NARCIS (Netherlands)

    Koehestanie, P.; Dogan, K.; Berends, F.; Janssen, I.; Wahab, P.J.; Groenen, M.; Müller, M.R.; Wit, de N.J.W.

    2014-01-01

    Background and study aims: Endoscopic implantation of a duodenal-jejunal bypass liner (DJBL) is a novel bariatric technique to induce weight loss and remission of type 2 diabetes mellitus. Placement of the DJBL mimics the bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. In this

  11. Refractory cytopenias secondary to copper deficiency in children receiving exclusive jejunal nutrition.

    Science.gov (United States)

    Jacobson, Amanda E; Kahwash, Samir B; Chawla, Anjulika

    2017-11-01

    Copper deficiency is a known cause of anemia and neutropenia that is easily remedied with copper supplementation. Copper is primarily absorbed in the stomach and proximal duodenum, so patients receiving enteral nutrition via methods that bypass this critical region may be at increased risk for copper deficiency. In pediatrics, postpyloric enteral feeding is increasingly utilized to overcome problems related to aspiration, severe reflux, poor gastric motility, and gastric outlet obstruction. However, little is known about the prevalence of copper deficiency in this population. We describe three pediatric patients receiving exclusive jejunal feeds who developed cytopenias secondary to copper deficiency. © 2017 Wiley Periodicals, Inc.

  12. Using Trained Pouched Rats to Detect Land Mines: Another Victory for Operant Conditioning

    Science.gov (United States)

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie W.; Bach, Harvard; Sully, Andrew

    2011-01-01

    We used giant African pouched rats ("Cricetomys gambianus") as land mine-detection animals in Mozambique because they have an excellent sense of smell, weigh too little to activate mines, and are native to sub-Saharan Africa, and therefore are resistant to local parasites and diseases. In 2009 the rats searched 93,400 m[superscript 2] of…

  13. Effects of propionyl-L-carnitine on ischemia-reperfusion injury in hamster cheek pouch microcirculation.

    Science.gov (United States)

    Lapi, Dominga; Sabatino, Lina; Altobelli, Giovanna Giuseppina; Mondola, Paolo; Cimini, Vincenzo; Colantuoni, Antonio

    2010-01-01

    Propionyl-l-carnitine (pLc) exerts protective effects in different experimental models of ischemia-reperfusion (I/R). The aim of the present study was to assess the effects of intravenously and topically applied pLc on microvascular permeability increase induced by I/R in the hamster cheek pouch preparation. The hamster cheek pouch microcirculation was visualized by fluorescence microscopy. Microvascular permeability, leukocyte adhesion to venular walls, perfused capillary length, and capillary red blood cell velocity (V(RBC)) were evaluated by computer-assisted methods. E-selectin expression was assessed by in vitro analysis. Lipid peroxidation and reactive oxygen species (ROS) formation were determined by thiobarbituric acid-reactive substances (TBARS) and 2'-7'-dichlorofluorescein (DCF), respectively. In control animals, I/R caused a significant increase in permeability and in the leukocyte adhesion in venules. Capillary perfusion and V(RBC) decreased. TBARS levels and DCF fluorescence significantly increased compared with baseline. Intravenously infused pLc dose-dependently prevented leakage and leukocyte adhesion, preserved capillary perfusion, and induced vasodilation at the end of reperfusion, while ROS concentration decreased. Inhibition of nitric oxide synthase prior to pLc caused vasoconstriction and partially blunted the pLc-induced protective effects; inhibition of the endothelium-derived hyperpolarizing factor (EDHF) abolished pLc effects. Topical application of pLc on cheek pouch membrane produced the same effects as observed with intravenous administration. pLc decreased the E-selectin expression. pLc prevents microvascular changes induced by I/R injury. The reduction of permeability increase could be mainly due to EDHF release induce vasodilatation together with NO. The reduction of E-selectin expression prevents leukocyte adhesion and permeability increase.

  14. Effects of propionyl-L-carnitine on ischemia-reperfusion injury in hamster cheek pouch microcirculation.

    Directory of Open Access Journals (Sweden)

    Dominga Lapi

    2010-10-01

    Full Text Available Background and Purpose Propionyl-L-carnitine (pLc exerts protective effects in different experimental models of ischemia-reperfusion (I/R. The aim of the present study was to assess the effects of intravenously and topically applied pLc on microvascular permeability increase induced by I/R in the hamster check pouch preparation. Methods The hamster check pouch microcirculation was visualized by fluorescence microscopy. Microvascular permeability, leukocyte adhesion to venular walls, perfused capillary length and capillary red blood cell velocity (VRBC were evaluated by computer-assisted methods. E-selectin expression was assessed by in vitro analysis. Lipid peroxidation and reactive oxygen species (ROS formation were determined by thiobarbituric acid-reactive substances (TBARS and 2’-7’-dichlorofluorescein (DCF, respectively. Results In control animals, I/R caused a significant increase in permeability and in the leukocyte adhesion in venules. Capillary perfusion and VRBC decreased. TBARS levels and DCF fluorescence significantly increased compared with baseline. Intravenously infused pLc dose-dependently prevented leakage and leukocyte adhesion, preserved capillary perfusion and induced vasodilation at the end of reperfusion, while ROS concentration decreased. Inhibition of nitric oxide synthase prior to pLc caused vasoconstriction and partially blunted the pLc-induced protective effects; inhibition of the endothelium-derived hyperpolarizing factor (EDHF abolished pLc effects. Topical application of pLc on check pouch membrane produced the same effects as observed with intravenous administration. pLc decreased the E-selectin expression. Conclusions pLc prevents microvascular changes induced by I/R injury. The reduction of permeability increase could be mainly due to EDHF release induce vasodilatation together with NO. The reduction of E-selectin expression prevents leukocyte adhesion and permeability increase.

  15. Dietary non-esterified oleic Acid decreases the jejunal levels of anorectic N-acylethanolamines

    DEFF Research Database (Denmark)

    Diep, Thi Ai; Madsen, Andreas N; Krogh-Hansen, Sandra

    2014-01-01

    mice respond to dietary fat (olive oil) by reducing levels of anorectic NAEs, and 3) whether dietary non-esterified oleic acid also can decrease levels of anorectic NAEs in mice. We are searching for the fat sensor in the intestine, which mediates the decreased levels of anorectic NAEs. METHODS: Male...... of anorectic NAEs in mice. CONCLUSIONS: These results suggest that the down-regulation of the jejunal level of anorectic NAEs by dietary fat is not restricted to rats, and that the fatty acid component oleic acid, in dietary olive oil may be sufficient to mediate this regulation. Thus, a fatty acid sensor may...

  16. Congenital cheek teratoma with temporo-mandibular joint ankylosis managed with ultra-thin silicone sheet interpositional arthroplasty.

    Science.gov (United States)

    Bhatnagar, Ankur; Verma, Vinay Kumar; Purohit, Vishal

    2013-01-01

    Primary cheek teratomas are rare with joint ankylosis (TMJA). The fundamental aim in the treatment of TMJA is the successful surgical resection of ankylotic bone, prevention of recurrence, and aesthetic improvement by ensuring functional occlusion. Early treatment is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of child. Inter-positional arthroplasty with ultra-thin silicone sheet was performed. Advantages include short operative time, less foreign material in the joint space leading to negligible foreign body reactions and least chances of implant extrusion. Instead of excising a large bony segment, a thin silicone sheet was interposed and then sutured ensuring preservation of mandibular height. Aggressive post-operative physiotherapy with custom made dynamic jaw exerciser was used to prevent recurrence.

  17. Internal hernia through the pouch of douglas after hysterectomy: A case report

    International Nuclear Information System (INIS)

    Yang, Dong Jin; Cho, Seung Hyun; Shin, Hyun Woong; Kim, Tae Eun; Kim, Byung Young; Kim, Hee Jin

    2012-01-01

    Internal hernia is a rare cause of small bowel obstruction. Among the different types of internal hernias, the pelvic hernia is extremely rare. We report the radiographic findings of a patient with a Douglas pouch hernia presenting with closed loop obstruction at the anterior aspect of the distal rectum. The patient was a 60 year old female, who had undergone a hysterectomy 20 years prior, for treatment of a uterine myoma

  18. Endoscopic Removal of a Giant Gastric Bezoar in a Gastric pouch Diverticulum

    Science.gov (United States)

    2017-08-15

    the bezoar was noted to be hard , requiring a tooth forcep to penetrate the outer shell. This maneuver was followed by transection of the bezoars into...of the grinding mechanism. Our patient had multiple risk factors to include post-surgical anatomy of gastric pouch, compounded by formation of a...It should be noted that certain phytobezoars (eg. Persimmons) are often resistant to chemical dissolution because of their hard consistency

  19. Use of a laparoscopic specimen retrieval pouch to facilitate removal of intact or fragmented cystic calculi from standing sedated horses: 8 cases (2012-2015).

    Science.gov (United States)

    Katzman, Scott A; Vaughan, Betsy; Nieto, Jorge E; Galuppo, Larry D

    2016-08-01

    OBJECTIVE To evaluate the use of a laparoscopic specimen retrieval pouch for removal of intact or fragmented cystic calculi from standing horses. DESIGN Retrospective case series. ANIMALS 8 horses (5 geldings and 3 mares) with cystic calculi. PROCEDURES Physical examination and cystoscopic, ultrasonographic, and hematologic evaluations of urinary tract function were performed for each horse. A diagnosis of cystic calculus was made on the basis of results of cystoscopy and ultrasonography. Concurrent urolithiasis or other urinary tract abnormalities identified during preoperative evaluation were recorded. Horses were sedated and placed in standing stocks, and the perineum was aseptically prepared. Direct access to the urinary bladder was gained in geldings via perineal urethrotomy or in mares by a transurethral approach. Calculi were visualized endoscopically, manipulated into the retrieval pouch, and removed intact or fragmented (for larger calculi). RESULTS For 4 geldings and 1 mare, fragmentation was necessary to facilitate calculus removal. Mean duration of surgery was 125 minutes, and trauma to the urinary bladder and urethra was limited to areas of hyperemia and submucosal petechiation. No postoperative complications were encountered for any horse. When lithotripsy was required, the retrieval pouch provided an effective means of stabilizing calculi and containing the fragments for removal. CONCLUSIONS AND CLINICAL RELEVANCE Use of the laparoscopic specimen retrieval pouch was an effective, minimally traumatic method for retrieving cystic calculi from standing horses. The pouch protected the urinary bladder and urethra from trauma during calculus removal and allowed for stabilization, containment, and fragmentation of calculi when necessary.

  20. The LPS-induced neutrophil recruitment into rat air pouches is mediated by TNFα: likely macrophage origin

    Directory of Open Access Journals (Sweden)

    C-D. Arreto

    1997-01-01

    Full Text Available The role of resident cells during the lipopolysaccharide (LPS-induced neutrophil recruitment into rat air pouches was investigated. In this model, LPS (Escherichia coli, O55: B5 strain; 2–2000 ng induced a dose– and time-dependent neutrophil recruitment accompanied by the generation of a tumour necrosis factor-α (TNFα-like activity. Dexamethasone (0.05–5 mug and cycloheximide (6 ng, injected 2 h before LPS into the pouches, inhibited the neutrophil recruitment and the generation of the TNFα-like activity, while the H1-receptor antagonist mepyramine (1 and 4 mg/kg, i.p., 0.5 h before LPS and the PAF-receptor antagonist WEB 2170 (0.05 and 1 mg/kg, i.p., 0.5 h before LPS had no effect. Purified alveolar macrophages (AM were used to replenish the pouches of cycloheximide-treated recipient rats. AM provided by PBS-treated animals led to the recovery of the LPS-induced neutrophil recruitment and of the TNFα-like formation contrasting with those from cycloheximide-treated animals (1 mg/kg, i.p.. When delivered in situ, liposome-encapsulated clodronate, a macrophage depletor, significantly impaired both the LPSinduced neutrophil recruitment and the TNFα-like activity. An anti-murine TNFα polyclonal antibody (0.5 h before LPS was also effective. These results emphasize the pivotal role of macrophages for LPS-induced neutrophil recruitment via the formation of TNFα.

  1. Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses : A systematic review

    NARCIS (Netherlands)

    Derks, Laura S M; Veenstra, Hidde J.; Oomen, Karin P Q; Speleman, Lucienne; Stegeman, Inge

    2016-01-01

    Objectives To systematically review the current literature on treatment of third and fourth branchial pouch sinuses with endoscopic cauterization, including chemocauterization and electrocauterization, in comparison to surgical treatment. Data Sources PubMed, Embase, and the Cochrane Library. Review

  2. Tunguska, 1908: the gas pouch and soil fluidization hypothesis

    Science.gov (United States)

    Nistor, I.

    2012-01-01

    The Siberian taiga explosion of 30 June 1908 remains one of the great mysteries of the 20th century: millions of trees put down over an area of 2200 km2 without trace of a crater or meteorite fragments. Hundred years of failed searches have followed, resulting in as many flawed hypothesis which could not offer satisfactory explanations: meteorite, comet, UFO, etc. In the author's opinion, the cause is that the energy the explorers looked for was simply not there! The author's hypothesis is that a meteoroid encountered a gas pouch in the atmosphere, producing a devastating explosion, its effects being amplified by soil fluidization.

  3. Electrocautery-induced localized colonic injury elicits increased levels of pro-inflammatory cytokines in small bowel and decreases jejunal alanine absorption.

    Science.gov (United States)

    Barada, Kassem; Mourad, Fadi H; Noutsi, Bakiza; Saadé, Nayef E

    2015-01-01

    Colitis is associated with functional abnormalities in proximal non-inflamed gut areas, but animal models to study small bowel dysfunction in colitis have limitations. This study aims to determine small intestinal alanine absorption and cytokine expression in a novel model of colonic ulceration induced by electro-cautery. A descending colon ulcer was induced in rats by a bipolar electro-cautery probe. Ulcer score was determined using Satoh's criteria. Jejunal alanine absorption was measured immediately and at different time intervals post ulcer induction. Levels of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) protein and m-RNA were determined in mucosal scrapings obtained from the colon, duodenum, jejunum and ileum at various time intervals after colonic ulcer induction. The mean ulcer score was 3 up to 48h, followed by healing by 96h post ulcer induction. Small bowel histology was normal throughout. Jejunal alanine absorption was reduced by 12-34% immediately and up to 72h after cautery and returned to normal at 96h. IL-1 and TNF-α mRNA increased significantly in the colon, duodenum, jejunum and ileum 3h post electro-cautery and returned to normal at 48h, while that of IL-6 increased significantly at 48h post ulcer induction. Similarly, IL-1, IL-6 and TNF-α protein levels increased in the duodenum, jejunum, ileum and colon up to 48h post ulcer induction. Electrically induced localized colonic injury increased production of pro-inflammatory cytokines in non-inflamed segments of the small intestine and was associated with derangements of jejunal absorptive function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Treatment of postparotidectomy Frey syndrome with the interposition of temporalis fascia and sternocleidomastoid flaps.

    Science.gov (United States)

    Dai, Xiao-Ming; Liu, Hua; He, Jia; Tu, Min-Song; Yu, Li-Fu; Liu, Liu

    2015-05-01

    This study was performed to evaluate the effectiveness of overlapping the temporalis fascia flaps (TFFs) and the sternocleidomastoid muscle flaps (SCMFs) as physical barriers to treat established Frey syndrome and concavity after parotidectomy. We retrospectively reviewed 17 patients who underwent corrective procedures with simultaneous TFF and SCMF interposition for the treatment of Frey syndrome. The affected areas of the cheek skin were identified with starch-iodine tests. The facial contours of the patients were classified as bilaterally symmetric (BS), with a slightly shallow (SS) contour on the surgical side, or with a conspicuously shallow (CS) contour on the surgical side. The sample was followed up for a mean of 22 months. The average area of gustatory-sweating positive skin was reduced from 12.80 to 1.32 square centimeters postoperatively. The facial asymmetry secondary to parotidectomy was greatly improved. The authors concluded that this technique was efficacious in ameliorating Frey syndrome and facial concavity secondary to parotidectomy. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Serotonin receptors influencing cell proliferation in the jejunal crypt epithelium and in colonic adenocarcinomas.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1986-01-01

    Serotonin has previously been shown to stimulate cell proliferation in the jejunal crypt epithelium and in colonic tumours. The original classification of serotonin receptors into D and M groups was not conductive to the understanding of these observations. The more recent classification of serotonin receptors into 5HT1 and 5HT2 groups is considered in this report. On the balance of evidence it appears that similar receptors mediate the response to serotonin in the two tissues under consideration and that these receptors resemble those of the 5HT1 group. Such receptors are usually positively linked to adenylate cyclase.

  6. Combination therapies in adjuvant with topical ALA-mediated photodynamic therapy for DMBA-induced hamster buccal pouch premalignant lesions

    Science.gov (United States)

    Yang, Deng-Fu; Hsu, Yih-Chih

    2012-03-01

    In Taiwan, oral cancer has becomes the fastest growth male cancer disease due to the betel nut chewing habit combing with smoking and alcohol-drinking lifestyle of people. In order to eliminate the systemic phototoxic effect of 5-aminolevulinic acid (ALA), this study was designed to use a topical ALA-mediated PDT for treatment of DMBA-induced hamster buccal pouch precancerous lesions. DMBA was applied to one of the buccal pouches of hamsters thrice a week for 10 to 12 weeks. Cancerous lesions were induced and proven by histological examination. These DMBA-induced cancerous lesions were used for testing the efficacy of topical ALA-mediated PDT. Before PDT, fluorescence spectroscopy was used to determine when ALA reached its peak level in the lesional epithelial cells after topical application of ALA gel. We found that ALA reached its peak level in precancerous lesions about 2.5 hrs after topical application of ALA gel. The cancerous lesions in hamsters were then treated with topical ALA -mediated PDT with light exposure dose of 150 J/cm2 using LED 635 nm fiber-guided light device. Visual examination demonstrated that adjuvant topical ALA -mediated PDT group has shown better therapeutic results in compared to those of non-adjuvant topical ALA-mediated PDT group for DMBA-induced hamster buccal pouch precancerous lesions.

  7. The effect of experimental gastric dilatation-volvulus on adenosine triphosphate content and conductance of the canine gastric and jejunal mucosa.

    Science.gov (United States)

    Peycke, Laura E; Hosgood, Giselle; Davidson, Jacqueline R; Tetens, Joanne; Taylor, H Wayne

    2005-07-01

    The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experimentally induced for 120 min followed by decompression, derotation, and reperfusion for 90 min. Group 3 had GDV experimentally induced for 210 min. Gastric (fundus and pylorus) and jejunal tissue was taken at 0, 120, and 210 min from all of the dogs. Tissue was analyzed for ATP concentration, mucosal conductance, and microscopic changes. The ATP concentration in the fundus did not change significantly from baseline in group 2, but decreased significantly below baseline at 210 min in group 3. The ATP concentration in the jejunum decreased significantly below baseline in groups 2 and 3 at 120 min, remaining significantly decreased in group 3 but returning to baseline at 210 min in group 2. Mucosal conductance of the fundus did not change significantly in any dog. Mucosal conductance of the jejunum increased at 120 min in groups 2 and 3, and became significantly increased above baseline at 210 min. The jejunal mucosa showed more profound cellular changes than the gastric mucosa. The jejunum showed substantial decreases in ATP concentration with an increase in mucosal conductance, suggesting cell membrane dysfunction. Dogs sustaining a GDV are likely to have a change in the activity of mucosal cells in the jejunum, which may be important in the pathophysiology of GDV.

  8. A Multifactorial Analysis of Reconstruction Methods Applied After Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Oktay Büyükaşık

    2010-12-01

    Full Text Available Aim: The aim of this study was to evaluate the reconstruction methods applied after total gastrectomy in terms of postoperative symptomology and nutrition. Methods: This retrospective study was conducted on 31 patients who underwent total gastrectomy due to gastric cancer in 2. Clinic of General Surgery, SSK Ankara Training Hospital. 6 different reconstruction methods were used and analyzed in terms of age, sex and postoperative complications. One from esophagus and two biopsy specimens from jejunum were taken through upper gastrointestinal endoscopy from all cases, and late period morphological and microbiological changes were examined. Postoperative weight change, dumping symptoms, reflux esophagitis, solid/liquid dysphagia, early satiety, postprandial pain, diarrhea and anorexia were assessed. Results: Of 31 patients,18 were males and 13 females; the youngest one was 33 years old, while the oldest- 69 years old. It was found that reconstruction without pouch was performed in 22 cases and with pouch in 9 cases. Early satiety, postprandial pain, dumping symptoms, diarrhea and anemia were found most commonly in cases with reconstruction without pouch. The rate of bacterial colonization of the jejunal mucosa was identical in both groups. Reflux esophagitis was most commonly seen in omega esophagojejunostomy (EJ, while the least-in Roux-en-Y, Tooley and Tanner 19 EJ. Conclusion: Reconstruction with pouch performed after total gastrectomy is still a preferable method. (The Medical Bulletin of Haseki 2010; 48:126-31

  9. Surgery for nonobese type 2 diabetic patients: an interventional study with duodenal-jejunal exclusion.

    Science.gov (United States)

    Geloneze, Bruno; Geloneze, Sylka R; Fiori, Carla; Stabe, Christiane; Tambascia, Marcos A; Chaim, Elinton A; Astiarraga, Brenno D; Pareja, Jose Carlos

    2009-08-01

    A 24-week interventional prospective trial was performed to compare the benefits of open duodenal-jejunal exclusion surgery (GJB) with a matched control group on standard medical care. One-hundred eighty patients were screened for the surgical approach. Twelve patients accepted to be operated and presented the full eligibility criteria for surgery that includes overweight BMI (25-29.9 kg/m2), T2DM diagnosis for less than 15 years, insulin-treated patients, no history of major complications, preserved beta-cell function, and absence of autoimmunity. A matched control group (CG) of patients whom refused surgical treatment was placed to receive standard care. Patients had age of 50 (5) years, time of diagnosis 9 years (range, 3 to 15 years), time of insulin usage 6 months (range, 3 to 48 months), fasting glucose (FG), 9.8 (2.5) mg/dL, and glycated hemoglobin (A1C) 8.90 (2.12)%. At 24 weeks after surgery, patients experienced greater reductions on FG (14% vs. 7% on CG), A1C (from 8.78 to 7.84 in GJB-p<0.01 and 8.93 to 8.71 in CG; p<0.05 between groups) and reductions on average daily insulin requirement (93% vs. 29%, p<0.01). Ten patients stopped insulin usage in GJB but they remain taking oral medications. No differences were observed in both groups regarding BMI, body distribution and composition, blood pressure, and lipids. In conclusion, duodenal-jejunal exclusion was an effective treatment for nonobese T2DM subjects. GJB was superior to standard care in achieving better glycemic control along with reduction in insulin requirements.

  10. Teaching giant african pouched rats to find landmines: operant conditioning with real consequences.

    Science.gov (United States)

    Poling, Alan; Weetjens, Bart J; Cox, Christophe; Beyene, Negussie; Bach, Håvard; Sully, Andrew

    2010-01-01

    Giant African pouched rats recently have been used as mine-detection animals in Mozambique. To provide an example of the wide range of problems to which operant conditioning procedures can be applied and to illustrate the common challenges often faced in applying those procedures, this manuscript briefly describes how the rats are trained and used operationally. To date, the rats have performed well and it appears they can play a valuable role in humanitarian demining.

  11. Using Trained Pouched Rats (Cricetomys Gambianus) to Detect Land Mines: Another Victory for Operant Conditioning

    Science.gov (United States)

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie W.; Bach, Harvard; Sully, Andrew

    2011-01-01

    We used giant African pouched rats ("Cricetomys gambianus") as land mine-detection animals in Mozambique because they have an excellent sense of smell, weigh too little to activate mines, and are native to sub-Saharan Africa, and therefore are resistant to local parasites and diseases. In 2009 the rats searched 93,400 m[superscript 2] of…

  12. Temporary Relocation of the Testes in Anteromedial Thigh Pouches Facilitates Delayed Primary Scrotal Wound Closure in Fournier Gangrene With Extensive Loss of Scrotal Skin-Experience With 12 Cases.

    Science.gov (United States)

    Okwudili, Obi Anselm

    2016-03-01

    To share our experience on the use of temporary testicular thigh pouches to facilitate scrotal wound closure in Fournier gangrene with extensive loss of scrotal skin. Patients seen over a 10-year period who had extensive (>50%) loss of scrotal skin precluding delayed primary closure of the residual scrotal skin over the testes were documented. Patients had serial debridement as required with scrotal wound dressing until healthy granulation tissue was achieved. The testes were placed temporarily in anteromedial thigh pouches to allow for scrotal wound closure. In the postoperative period, the testes were gradually massaged back into the residual scrotal pouch, thus acting as natural tissue expanders. Mean patient age was 38.1 ± 10.0 years. Mean duration of admission was 24.4 ± 4.7 days. Identified predisposing factors were ischiorectal fossa abscess in 2 patients and urethral stricture in 1 patient. The rest were idiopathic. Mean Fournier gangrene severity index was 6.0 ± 1.3. Mean number of debridements was 2.3 ± 0.5. There was no mortality. The residual scrotal pouches expanded sufficiently over time (3-8 months) to accommodate the testes. Normal testicular volume was maintained in all patients. Mean testicular volume was 19.0 ± 3.2 cm. Follow-up was for 14.8 ± 9.7 months. Temporarily relocating the testes in anteromedial thigh pouches facilitates scrotal wound closure in Fournier gangrene with extensive loss of scrotal skin and obviates the need for specialized reconstructive surgery.

  13. Influência do ácido ascórbico em anastomoses e alças jejunais íntegras de rato Influence of ascorbic acid on anastomotic and jejunal resistance in rat

    Directory of Open Access Journals (Sweden)

    Andy PETROIANU

    2001-01-01

    Full Text Available Racional - O efeito do ácido ascórbico sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Objetivo - Comparar a resistência cicatricial de anastomoses e de segmentos íntegros jejunais de ratos submetidos a administração de vitamina C, em distintos períodos pós-operatórios. Método - Foram estudados 50 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em dois grupos (n = 25: Grupo I - controle; Grupo II - administração de vitamina C oral, 100 mg/kg. Avaliaram-se as pressões de ruptura anastomótica e do segmento íntegro jejunal nos 3º, 5º, 7º, 21º e 28º dias pós-operatórios. Resultados - Os ratos que receberam vitamina C apresentaram uma pressão de ruptura anastomótica maior nos 5º, 7º e 28º dias pós-operatórios. O mesmo ocorreu com as pressões de ruptura do segmento íntegro jejunal dos ratos. Conclusões - A vitamina C aumentou a resistência das anastomoses jejunais dos ratos, tanto no pós-operatório imediato, quanto no tardio. Além disso, a resistência final dos segmentos jejunais íntegros dos ratos submetidos a administração de vitamina C foi significativamente maior do que no Grupo Controle.Backgroud - The effects of vitamin C on anastomotic healing process are controversial. Objective - To compare the jejunal anastomotic tension and in the upright segment in different postoperative periods. Method - Fifty male rats weighing 250 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into two groups (n = 25. Group I - control, Group II - oral administration of vitamin C (100 mg/kg. The anastomotic and the upright segment resistance was determined by using bursting pressure test on the 3rd, 5th , 7th , 21st and 28th postoperative days

  14. Modeling Lithium Ion Battery Safety: Venting of Pouch Cells; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Santhanagopalan, Shriram.; Yang, Chuanbo.; Pesaran, Ahmad

    2013-07-01

    This report documents the successful completion of the NREL July milestone entitled “Modeling Lithium-Ion Battery Safety - Complete Case-Studies on Pouch Cell Venting,” as part of the 2013 Vehicle Technologies Annual Operating Plan with the U.S. Department of Energy (DOE). This work aims to bridge the gap between materials modeling, usually carried out at the sub-continuum scale, and the

  15. Topical photosan-mediated photodynamic therapy for DMBA-induced hamster buccal pouch early cancer lesions: an in vivo study

    Science.gov (United States)

    Hsu, Yih-Chih; Chang, Walter Hong-Shong; Chang, Junn-Liang; Liu, Kuang-Ting; Chiang, Chun-Pin; Liu, Chung-Ji; Chen, Chih-Ping

    2011-03-01

    Oral cancer has becomes the most prominent cancer disease in recent years in Taiwan. The reason is the betel nut chewing habit combing with smoking and alcohol-drinking lifestyle of people results in oral cancer becomes the fastest growth incident cancer amongst other major cancer diseases. In previous studies showed that photosan, haematoporphyrin derivative (HPD), has demonstrated effective PDT results on human head and neck disease studies. To avoid the systemic phototoxic effect of photosan, this study was designed to use a topical photosan-mediated PDT for treatment of DMBA-induced hamster buccal pouch cancerous lesions. DMBA was applied to one of the buccal pouches of hamsters thrice a week for 10 to 12 weeks. Cancerous lesions were induced and proven by histological examination. These DMBA-induced cancerous lesions were used for testing the efficacy of topical photosan-mediated PDT. Before PDT, fluorescence spectroscopy was used to determine when photosan reached its peak level in the lesional epithelial cells after topical application of photosan gel. We found that photosan reached its peak level in cancerous lesions about 13.5 min after topical application of photosan gel. The cancerous lesions in hamsters were then treated with topical photosan-mediated PDT (fluence rate: 600 mW/cm2; light exposure dose 200 J/cm2) using the portable Lumacare 635 nm fiber-guided light device. Visual examination demonstrated that topical photosan-mediated PDT was an applicable treatment modality for DMBA-induced hamster buccal pouch cancerous lesions.

  16. J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results.

    Science.gov (United States)

    Okkabaz, Nuri; Haksal, Mustafa; Atici, Ali Emre; Altuntas, Yunus Emre; Gundogan, Ersin; Gezen, Fazli Cem; Oncel, Mustafa

    2017-11-01

    To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. Seventy four patients were randomized. Reservoir creation was withdrawn in 17 (23%) patients, mostly related to reach problem (n = 11, 64.7%). Anastomotic leakage rate was significantly higher in j-pouch group (8 [27.6%] vs. 0, p = 0.004). Stoma closure could not be achieved in 16 (28.1%) patients. Life quality and functional outcomes, measured 4, 8 and 12 months after the stoma reversal, were similar. Colonic j-pouch and side-to-end anastomosis are similar regarding perioperative measures including operation time, rates of postoperative complications, reoperation and 30-day mortality, and hospitalization period except anastomotic leak rate, which is higher in j-pouch group. Postoperative aspects are not different in patients receiving either technique including functional outcomes and life quality for the first year after stoma closure. In our opinion, both techniques may be preferred during the daily practice while performing laparoscopic surgery; but surgeons may be aware of a possibly higher anastomotic leak rate in case of a j-pouch. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Effect of gamma-radiation on migration of additives in laminated flexible plastic pouches

    International Nuclear Information System (INIS)

    Variyar, Prasad S.; Rao, B.Y.K.; Alur, M.D.; Thomas, Paul

    2000-01-01

    Effect of gamma-radiation (7.5 kGy) on migration of chemical constituents from laminated (LDP/Nylon/EAA) plastic pouches into water as simulant was studied. The compounds migrating into water were concentrated, separated on TLC and analyzed using GC/MS. Some of the migrant compounds identified were p-toluene sulfonamide, di-n-butyl phthalate, di-isobutyl phthalate, hexadecanoic acid and lyxononitrile. The non-irradiated control sample did not show the presence of any of these compounds. (author)

  18. Determination of the behavior and performance of commercial Li-Ion pouch cells by means of isothermal calorimeter

    DEFF Research Database (Denmark)

    Khan, Mohammad Rezwan; Swierczynski, Maciej Jozef; Kær, Søren Knudsen

    2016-01-01

    In this experiment-based research, there is an attempt to determine the evolution of surface temperature distribution, thermal behaviour and performance of a battery cell at the same time. The pouch type commercial test cell has a 13Ah capacity and Lithium Titanate Oxide (LTO) based anode...

  19. Hand-assisted hybrid laparoscopic-robotic total proctocolectomy with ileal pouch--anal anastomosis.

    Science.gov (United States)

    Morelli, Luca; Guadagni, Simone; Mariniello, Maria Donatella; Furbetta, Niccolò; Pisano, Roberta; D'Isidoro, Cristiano; Caprili, Giovanni; Marciano, Emanuele; Di Candio, Giulio; Boggi, Ugo; Mosca, Franco

    2015-08-01

    Few studies have reported minimally invasive total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). We herein report a novel hand-assisted hybrid laparoscopic-robotic technique for patients with FAP and UC. Between February 2010 and March 2014, six patients underwent hand-assisted hybrid laparoscopic-robotic total proctocolectomy with IPAA. The abdominal colectomy was performed laparoscopically with hand assistance through a transverse suprapubic incision, also used to fashion the ileal pouch. The proctectomy was carried out with the da Vinci Surgical System. The IPAA was hand-sewn through a trans-anal approach. The procedure was complemented by a temporary diverting loop ileostomy. The mean hand-assisted laparoscopic surgery (HALS) time was 154.6 (±12.8) min whereas the mean robotic time was 93.6 (±8.1) min. In all cases, a nerve-sparing proctectomy was performed, and no conversion to traditional laparotomy was required. The mean postoperative hospital stay was 13.2 (±7.4) days. No anastomotic leakage was observed. To date, no autonomic neurological disorders have been observed with a mean of 5.8 (±1.3) bowel movements per day. The hand-assisted hybrid laparoscopic-robotic approach to total proctocolectomy with IPAA has not been previously described. Our report shows the feasibility of this hybrid approach, which surpasses most of the limitations of pure laparoscopic and robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages.

  20. Zyflamend reduces LTB4 formation and prevents oral carcinogenesis in a 7,12-dimethylbenz[alpha]anthracene (DMBA)-induced hamster cheek pouch model.

    Science.gov (United States)

    Yang, Peiying; Sun, Zheng; Chan, Diana; Cartwright, Carrie A; Vijjeswarapu, Mary; Ding, Jibin; Chen, Xiaoxin; Newman, Robert A

    2008-11-01

    Aberrant arachidonic acid metabolism, especially altered cyclooxygenase and 5-lipoxygenase (LOX) activities, has been associated with chronic inflammation as well as carcinogenesis in human oral cavity tissues. Here, we examined the effect of Zyflamend, a product containing 10 concentrated herbal extracts, on development of 7,12-dimethylbenz[alpha]anthracene (DMBA)-induced inflammation and oral squamous cell carcinoma (SCC). A hamster cheek pouch model was used in which 0.5% DMBA was applied topically onto the left cheek pouch of male Syrian golden hamsters either three times per week for 3 weeks (short term) or 6 weeks (long term). Zyflamend was then applied topically at one of three different doses (25, 50 and 100 microl) onto the left cheek pouch three times for 1 week (short-term study) or chronically for 18 weeks. Zyflamend significantly reduced infiltration of inflammatory cells, incidence of hyperplasia and dysplastic lesions, bromodeoxyuridine-labeling index as well as number of SCC in a concentration-dependent manner. Application of Zyflamend (100 microl) reduced formation of leukotriene B(4) (LTB(4)) by 50% compared with DMBA-treated tissues. The reduction of LTB(4) was concentration dependent. The effect of Zyflamend on inhibition of LTB(4) formation was further confirmed with in vitro cell-based assay. Adding LTB(4) to RBL-1 cells, a rat leukemia cell line expressing high levels of 5-LOX and LTA(4) hydrolase, partially blocked antiproliferative effect of Zyflamend. This study demonstrates that Zyflamend inhibited LTB(4) formation and modulated adverse histopathological changes in the DMBA-induced hamster cheek pouch model. The study suggests that Zyflamend might prevent oral carcinogenesis at the post-initiation stage.

  1. Effect of indirect ohmic heating on quality of ready-to-eat pineapple packed in plastic pouch

    Directory of Open Access Journals (Sweden)

    Hoang Pham

    2014-06-01

    Full Text Available Ready-to-eat fruits packed in sealed containers are highly perishable due to their intrinsic characteristics and lack of full thermal process. Ohmic heating has the advantages of rapid liquid heating through electrical current. The aim of this research was to investigate the effect of indirect ohmic heating on pH, total soluble solids, polyphenol oxidase activity, color and texture of ready-to-eat pineapple packed in a polypropylene pouch with 1% calcium chloride and 0.3% ascorbic acid packing solution. The pre-packed sample in a pouch was placed in the ohmic heating jar filled with 0.5% sodium chloride ohmic heating solution which was then ohmic heated at different voltage gradients (20, 30, 40 V/cm, to different packing solution temperatures (60, 70, 80°C for 60s. Samples were kept at 4°C for quality measurement. It was found that browning index of ready-to-eat pineapple treated with 20 V/cm at 80°C, 30 V/cm at 70°C and 80°C, 40 V/cm at 80°C did not change during 12 days cold storage (p>0.05. Polyphenol oxidase was inactivated when the temperature of the pineapple was 62°C or higher. After 10 days at 4°C, the pineapple heated with 30 V/cm at 70°C had much higher firmness than the un-heated sample kept at the same storage condition. Indirect ohmic heating of pre-packed ready-to-eat pineapple in polypropylene pouch with 30 V/cm at 70°C packing solution temperature for 60s could be used as minimal heating methods to maintain the quality of ready-to-eat fruits in 12 days at 4°C.

  2. Pouchitis-Associated Iritis (Uveitis Following Total Proctocolectomy and Ileal Pouch-to-Anal Anastomosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    2001-01-01

    Full Text Available A 26-year-old woman with ulcerative colitis treated with a proctocolectomy and ileal pouch-to-anal anastomosis developed an erosive and ulcerative pouchitis. Although no ophthalmological manifestations were present before the staged surgical procedures, iritis developed after appearance of the pouchitis. Both conditions subsequently resolved with oral corticosteroids and metronidazole.

  3. Improved cell line IPEC-J2, characterized as a model for porcine jejunal epithelium.

    Directory of Open Access Journals (Sweden)

    Silke S Zakrzewski

    Full Text Available Cell lines matching the source epithelium are indispensable for investigating porcine intestinal transport and barrier properties on a subcellular or molecular level and furthermore help to reduce animal usage. The porcine jejunal cell line IPEC-J2 is established as an in vitro model for porcine infection studies but exhibits atypically high transepithelial resistances (TER and only low active transport rates so that the effect of nutritional factors cannot be reliably investigated. This study aimed to properly remodel IPEC-J2 and then to re-characterize these cells regarding epithelial architecture, expression of barrier-relevant tight junction (TJ proteins, adequate TER and transport function, and reaction to secretagogues. For this, IPEC-J2 monolayers were cultured on permeable supports, either under conventional (fetal bovine serum, FBS or species-specific (porcine serum, PS conditions. Porcine jejunal mucosa was analyzed for comparison. Main results were that under PS conditions (IPEC-J2/PS, compared to conventional FBS culture (IPEC-J2/FBS, the cell height increased 6-fold while the cell diameter was reduced by 50%. The apical cell membrane of IPEC-J2/PS exhibited typical microvilli. Most importantly, PS caused a one order of magnitude reduction of TER and of trans- and paracellular resistance, and a 2-fold increase in secretory response to forskolin when compared to FBS condition. TJ ultrastructure and appearance of TJ proteins changed dramatically in IPEC-J2/PS. Most parameters measured under PS conditions were much closer to those of typical pig jejunocytes than ever reported since the cell line's initial establishment in 1989. In conclusion, IPEC-J2, if cultured under defined species-specific conditions, forms a suitable model for investigating porcine paracellular intestinal barrier function.

  4. Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection.

    Science.gov (United States)

    Mehrvarz, Shaban; Towliat, Seyed Mohsen; Mohebbi, Hassan Ali; Derakhshani, Saieed; Abavisani, Mahdi

    2013-01-01

    The tendency towards sphincter preserving for low rectal cancers with low anterior resection, has led to the technique of straight coloanal anastomosis (SCAA) or colonic J-pouch anal anastomosis (CPAA). The aim of our study was to compare functional outcomes, complication rates and quality of life (QoL) after LAR with either a straight or colonic J pouch anastomosis. In 88 patients with rectal tumors located in lower third, who were candidate for LAR with coloanal anastomosis. They were divided for reconstruction using either SCAA (n= 47) or CPAA (n= 41) from January 2007 to May 2009. Functional results were assessed after closure of temporary loop ileostomy, 6 months postoperatively. Quality of life (QoL) was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. The two groups were matched for gender, age, and preoperative chemotherapy and radiotherapy. There were no significant differences between the SCAA and CPAA groups relative to anastomotic leakage. Among patients with CPAA, the mean of 24 hours bowel movements, daytime bowel movements, incontinence scores, and incidence of urgency were significantly lower than those in the SCAA group. Also, patients with a CPAA had a significantly better quality of life. CPAA provided not only better functional results than SCAA, but also improved quality of life, thus may be the better choice.

  5. Definitive management of isolated esophageal atresia: Experience at NICH Karachi

    Directory of Open Access Journals (Sweden)

    Jan Iftikhar

    2006-01-01

    Full Text Available Background: Definitive treatment of isolated esophageal atresia (IEA is still controversial. A study was conducted to review cases of IEA in our department with a view to evaluate the long term results of definitive surgery in these patients. Materials and Methods: Nine consecutive patients with IEA were included in the study. All babies initially underwent cervical esophagostomy and feeding gastrostomy. One baby also had anorectal atresia and needed a colostomy. In 6 babies, end esophagostomy was performed while in 3 babies, lateral esophagostomy was performed. Of the 6 babies with end esophagostomy, two underwent jejunal Interpositioning, two had serial extra-thoracic lengthening and two reverse gastric tube interpositiong. Three babies with lateral esophagostomy were planned for delayed primary repair. Results: Both babies with jejunal interpositiong initially did well; serious gastro-esophageal reflux occurred in one baby who needed antireflux surgery. At 6 years follow-up both children had redundant Jejunum. Recurrent Respiratory tract infection remained a problem in one child while other is doing well. Of the two babies with extrathoracic lengthening it was possible to perform end to end anastomosis in one baby but in the other extrathoracic lengthening did not work and gastric transpositioning was performed. Of the two babies with reverse gastric tube interpositioning one developed esophageal stenosis at the site of anastomosis and is on serial dilatations. Other died due to anastomotic leak and mediastinitis. In all the three babies with lateral esophagostomy spontaneous lengthening of esophagus was noted. End to end anastomosis was possible in two of these babies who are doing well. One is waiting definitive surgery. Number of complications, hospital stay and cost of surgery was least in patients with lateral esophagostomy. Conclusion: Various methods of definitive treatment have been proposed for isolated esophageal atresia but each

  6. Establishment of a rat and guinea pig aortic interposition graft model reveals model-specific patterns of intimal hyperplasia.

    Science.gov (United States)

    Gregory, Elaine K; Vercammen, Janet M; Flynn, Megan E; Kibbe, Melina R

    2016-12-01

    Although the aortic interposition bypass model has been widely used to evaluate biomaterials for bypass grafting, there is no comprehensive description of the procedure or of the distribution of intimal hyperplasia that results. The objectives of this study were to (1) review and summarize approaches of aortic interposition grafting in animal models, (2) determine the pertinent anatomy for this procedure, (3) validate this model in the rat and guinea pig, and (4) compare the distribution of intimal hyperplasia that develops in each species. A literature search was performed in PubMed from 1980 to the present to analyze the use of anesthesia, anticoagulation, antiplatelet agents, graft material, suture, and anastomotic techniques. Using 10-week-old male Sprague-Dawley rats and Hartley guinea pigs, we established pertinent aortic anatomy, developed comparable models, and assessed complications for each model. At 30 days, the graft and associated aorta were explanted, intimal formation was assessed morphometrically, and cellularity was assessed via nuclear counting. We reviewed 30 articles and summarized the pertinent procedural findings. Upon establishing both animal models, key anatomic differences between the species that affect this model were noted. Guinea pigs have a much larger cecum, increased retroperitoneal fat, and lack the iliolumbar vessels compared with the rat. Surgical outcomes for the rat model included a 53% technical success rate and a 32% technical error rate. Surgical outcomes for the guinea pig model included a 69% technical success rate and a 31% technical error rate. These two species demonstrated unique distribution of intimal hyperplasia at 30 days. Intimal hyperplasia in the rat model was greatest at two areas, the proximal graft (5400 μm 2 ; P guinea pig model developed similar intimal hyperplasia throughout the graft (4500-5100 μm 2 ; P guinea pig, and describe a unique distribution of intimal formation that results in both species

  7. Effects of aqueous cinnamon extract on chemically-induced carcinoma of hamster cheek pouch mucosa

    Directory of Open Access Journals (Sweden)

    Samah K. Ezzat

    2017-12-01

    Full Text Available This study aimed to investigate the effects of aqueous cinnamon extract (ACE on 7, 12-Dimethylbenz[a]anthracene (DMBA-induced oral carcinogenesis in hamster cheek pouch (HCP mucosa. Sixty male Syrian hamsters were randomly divided into six equal groups. The hamsters of groups I, II and III received no treatment, DMBA and ACE respectively, for 16 weeks. Groups IV and V were handled as group II and concomitantly treated with ACE for the same period and additionally group V received ACE for other 16 weeks after the stoppage of DMBA application. Group VI hamsters were handled as group III and additionally received DMBA for other 16 weeks after the stoppage of ACE supplementation. Hamsters of each group were euthanized according to the experimental schedule. The buccal pouches were and prepared for H&E stain, PAS reagent, CD3 and PDGF immunohistochemical reactivity. All groups showed dysplastic changes with varying degrees except groups I and III. Deep invasive carcinomas were recorded in 90% of the samples of group II, 60% of group IV, 50% of group V and 40% of group VI. From the previous results, it can be concluded that ACE has the potentiality preventing oral cancer initiation better than inhibiting oral cancer progression.

  8. Effect of Glucagon-like Peptide 2 on Tight Junction in Jejunal Epithelium of Weaned Pigs though MAPK Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Changsong Yu

    2014-05-01

    Full Text Available The glucagon-like peptide 2 (GLP-2 that is expressed in intestine epithelial cells of mammals, is important for intestinal barrier function and regulation of tight junction (TJ proteins. However, there is little known about the intracellular mechanisms of GLP-2 in the regulation of TJ proteins in piglets’ intestinal epithelial cells. The purpose of this study is to test the hypothesis that GLP-2 regulates the expressions of TJ proteins in the mitogen-activated protein kinase (MAPK signaling pathway in piglets’ intestinal epithelial cells. The jejunal tissues were cultured in a Dulbecco’s modified Eagle’s medium/high glucose medium containing supplemental 0 to 100 nmol/L GLP-2. At 72 h after the treatment with the appropriate concentrations of GLP-2, the mRNA and protein expressions of zonula occludens-1 (ZO-1, occludin and claudin-1 were increased (p<0.05. U0126, an MAPK kinase inhibitor, prevented the mRNA and protein expressions of ZO-1, occludin, claudin-1 increase induced by GLP-2 (p<0.05. In conclusion, these results indicated that GLP-2 could improve the expression of TJ proteins in weaned pigs’ jejunal epithelium, and the underlying mechanism may due to the MAPK signaling pathway.

  9. The benefits of a laparoscopic approach in ileal pouch anal anastomosis formation: a single institutional retrospective case-matched experience.

    LENUS (Irish Health Repository)

    Kelly, J

    2010-06-01

    A laparoscopic approach to ileoanal pouch formation is novel. By using prospectively gathered data, laparoscopic and open restorative proctocolectomy procedures in mucosal ulcerative colitis (UC) and familial adenomatous polyposis (FAP) patients were compared using a case-matched design.

  10. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers

    Directory of Open Access Journals (Sweden)

    Deng-Fu Yang

    2014-09-01

    Conclusion: We conclude that topical MTX-pretreatment can increase intracellular PpIX production in hamster buccal pouch precancerous lesions and significantly improves the outcomes of the precancerous lesions treated with topical ALA-PDT.

  11. A Case Report of Ridge Augmentation using Onlay Interpositional Graft: An Approach to Improve Prosthetic Prognosis of a Deficit Ridge

    Directory of Open Access Journals (Sweden)

    Devanand Shetty

    2014-01-01

    Full Text Available Background: Periodontal therapy has developed beyond the scope of the treatment of periodontal pathoses. Periodontal plastic surgery consists of the reconstructive procedures designed to enhance the both function and esthetics. Deficient ridges pose a severe problem to the restorative dentist in restoring the natural form, function and esthetics of the prosthesis replacing the natural dentition. Depending upon the severity, location of these defects and the prosthetic option chosen, hard and soft tissue ridge augmentation or non-surgical approach or a combination may help to address them. The present clinical report describes a soft tissue ridge augmentation of a localized ridge defect in maxillary aesthetic region using onlay interpositional graft followed by fixed partial denture.

  12. Autoradiographic investigations on the question of diurnal variations of cell proliferation in the jejunal crypt epithelia of mice

    International Nuclear Information System (INIS)

    Herterich, G.C.

    1982-01-01

    In this work the question was investigated whether the proliferation activity of the crypt epithelia of the small intestine of mice is subject to diurnal variations. The results published so far to settle this question are contradictory. The flow rate at the beginning and end of the S phase was measured as a function of daytime for the jejunal crypt epithelia of mice following a double labelling with 3-H and 14-C-TdR. The quotient of the cell flow rate in and out of the S phase is supposed to be = 1 over the whole day if there are no diurnal variations. The method of measurements of the cell flow rate was chosen above all because the quotient is largely independent of the variation from animal to animal. The experiments provided dues as to the presence of deviations of the quotient of cell flow rate at the end and beginning of the S phase and of the mitotic index from the daily mean value. However, on account of the relatively large statistical variations of the values at the different daytimes it is not possible to state clearly whether the cell proliferation of the jejunal epithelium is subject to diurnal variations. Should there be such variations, then they are not large at any rate. (orig./MG) [de

  13. The role of the defaecating pouchogram in the assessment of evacuation difficulty after restorative proctocolectomy and pouch-anal anastomosis

    NARCIS (Netherlands)

    Stellingwerf, M. E.; Maeda, Y.; Patel, U.; Vaizey, C. J.; Warusavitarne, J.; Bemelman, W. A.; Clark, S. K.

    2016-01-01

    Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not

  14. Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly Utilidad de la biopsia yeyunal en el estudio de la malabsorción intestinal en el anciano

    Directory of Open Access Journals (Sweden)

    B. Lobo

    2004-04-01

    Full Text Available Background: small bowel structure and function are not different between elderly people and young people. Thus, in principle it is advisable to perform diagnostic investigation of elderly patients as well as younger patients when they present with symptoms suggestive of intestinal malabsorption. A key test for the etiologic diagnosis of intestinal malabsorption, jejunal biopsy, has not been specifically examined to assess its usefulness and risk of complications in this advanced age patients. Aim: to establish the usefulness of jejunal biopsy with the Watson's capsule in the elderly patients with suspected intestinal malabsorption. Patients: patients older than 65 years referred to our Unit for performance of a jejunal biopsy from 1996 to 2001 for suspicion of intestinal malabsorption. Results: forty-seven patients were included. Appropriate biopsy sample was obtained in 45 cases, although in 3 patients a second try was required. Histologic findings: partial villous atrophy in 10 cases (22.2%, complete villous atrophy in 5 cases (11.1%, intraepithelial lymphocytosis in 5 cases (11.1%, and single cases of intestinal lymphangiectasia, amyloidosis, unspecific jejunitis, and Whipple's disease. Histology was normal in 19 cases (42%. Definitive diagnosis was celiac disease in 14 patients, bacterial overgrowth in 3, jejunitis in 3, Whipple's disease in 1, lymphangiectasia in 1, atrophic gastritis in 3, amyloidosis in 1, and ischemic colitis in 1. Jejunal biopsy achieved an etiologic diagnosis in 20 patients. There were no cases of perforations or bleeding. Conclusion: jejunal biopsy is a useful and safe test for the etiologic diagnosis of intestinal malabsorption in elderly patients.Fundamento: la estructura y función del intestino delgado en el anciano sano y en el joven no difieren. Por este motivo ante la sospecha clínica de malabsorción intestinal en el anciano siempre deben realizarse las pruebas necesarias para identificar su causa. Una prueba

  15. Closure of leak at the tip of the “J” after ileal pouch-anal anastomosis using a novel over-the-scope clipping system

    Directory of Open Access Journals (Sweden)

    Lei Lian

    2014-04-01

    Full Text Available Objective: leaks from the body or the tip of the J-pouch can occur after restorative proctocolecotmy. Although it may follow an indolent clinical course, it often requires surgical repair or pouch revision. Here we describe a novel endoscopic approach to close the leak at the tip of the J pouch. Design: pouchoscopy was performed under sedation and endoscopic over-the-scope clipping system was used for the management of a leak from the tip of a J-pouch. Results: under sedation, a pouchoscopy was performed and the deep tip of “J” leak was detected with a guidewire, along with water-contrasted pouchogram. The contained cavity from the leak was cleaned with hydrogen peroxide and 50% dextrose. Debridement of the epithelialized mouth of the leak was performed with an endoscopic cytology brush. Then endoscopic over-the-scope clipping system was used and the leak defect was completely closed. There was no bleeding or perforation. The entire procedure took 25 min. The patient continued to do well and reported resolution of the low back pain symptom. Conclusion: we reported the first case in the literature that a leak from the tip of a J-pouch was endoscopically occluded using a novel over-the-scope clipping system. Resumo: Objetive: vazamentos do corpo da bolsa e da extremidade da bolsa ileal em J podem ocorrer após proctocolectomia restauradora. Embora possam apresentar um curso clínico indolente, muitas vezes requerem procedimentos abdominais. Desenho: endoscopia da bolsa ileal foi realizada sob sedação e clipagem endoscópica usando o sistema “over-the-scope” foi utilizada para fechar um vazamento na extremidade da bolsa ileal em “J”. Resultados: sob sedação, uma endoscopia de bolsa ileal foi realizada e a extremidade profunda do vazamento da bolsa ileal em “J” foi detectada com um fio-guia. A cavidade que continha o vazamento foi limpa com peróxido de hidrogênio e 50% de dextrose. Desbridamento da borda epitelizada do

  16. Laparoscopic restorative total proctocolectomy with ileal pouch anal anastomosis for familial adenomatous polyposis.

    Science.gov (United States)

    Palanivelu, C; Jani, Kalpesh; Sendhilkumar, K; Parthasarathi, R; Senthilnathan, P; Maheshkumar, G

    2008-01-01

    Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review the literature on the topic. This is a case series of 15 patients who underwent restorative proctocolectomy with ileo-anal pouch anastomosis for familial adenomatous polyposis between 2000 and 2007. The salient operative steps are described. There were 9 males and 6 females, 32 to 52 years of age, with an average age of 44.8 years. The median body mass index was 21.5 (range, 17 to 28). Rectal cancer was already present in 4 patients at the time of diagnosis. The median operating time was 225 minutes. Mean blood loss was 60 mL, with none of the patients requiring perioperative blood transfusion. None of the surgeries required conversion to the open approach. Bowel function resumed on the second postoperative day in 12 patients and on the third postoperative day in 3 patients. The median hospital stay was 8 days. Postoperatively, there was no mortality and no serious morbidity. Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis is a feasible surgery for familial adenomatous polyposis, and considering its cosmetic benefit, is a desirable option for this group of predominantly young patients.

  17. Alveolar ridge augmentation by connective tissue grafting using a pouch method and modified connective tissue technique: A prospective study

    Directory of Open Access Journals (Sweden)

    Ashish Agarwal

    2015-01-01

    Full Text Available Background: Localized alveolar ridge defect may create physiological and pathological problems. Developments in surgical techniques have made it simpler to change the configuration of a ridge to create a more aesthetic and more easily cleansable shape. The purpose of this study was to compare the efficacy of alveolar ridge augmentation using a subepithelial connective tissue graft in pouch and modified connective tissue graft technique. Materials and Methods: In this randomized, double blind, parallel and prospective study, 40 non-smoker individuals with 40 class III alveolar ridge defects in maxillary anterior were randomly divided in two groups. Group I received modified connective tissue graft, while group II were treated with subepithelial connective tissue graft in pouch technique. The defect size was measured in its horizontal and vertical dimension by utilizing a periodontal probe in a stone cast at base line, after 3 months, and 6 months post surgically. Analysis of variance and Bonferroni post-hoc test were used for statistical analysis. A two-tailed P < 0.05 was considered to be statistically significant. Results: Mean values in horizontal width after 6 months were 4.70 ± 0.87 mm, and 4.05 ± 0.89 mm for group I and II, respectively. Regarding vertical heights, obtained mean values were 4.75 ± 0.97 mm and 3.70 ± 0.92 mm for group I and group II, respectively. Conclusion: Within the limitations of this study, connective tissue graft proposed significantly more improvement as compare to connective tissue graft in pouch.

  18. Exogenous transforming growth factor-β1 enhances smooth muscle differentiation in embryonic mouse jejunal explants.

    Science.gov (United States)

    Coletta, Riccardo; Roberts, Neil A; Randles, Michael J; Morabito, Antonino; Woolf, Adrian S

    2017-01-13

    An ex vivo experimental strategy that replicates in vivo intestinal development would in theory provide an accessible setting with which to study normal and dysmorphic gut biology. The current authors recently described a system in which mouse embryonic jejunal segments were explanted onto semipermeable platforms and fed with chemically defined serum-free media. Over 3 days in organ culture, explants formed villi and they began to undergo spontaneous peristalsis. As defined in the current study, the wall of the explanted gut failed to form a robust longitudinal smooth muscle (SM) layer as it would do in vivo over the same time period. Given the role of transforming growth factor β1 (TGFβ1) in SM differentiation in other organs, it was hypothesized that exogenous TGFβ1 would enhance SM differentiation in these explants. In vivo, TGFβ receptors I and II were both detected in embryonic longitudinal jejunal SM cells and, in organ culture, exogenous TGFβ1 induced robust differentiation of longitudinal SM. Microarray profiling showed that TGFβ1 increased SM specific transcripts in a dose dependent manner. TGFβ1 proteins were detected in amniotic fluid at a time when the intestine was physiologically herniated. By analogy with the requirement for exogenous TGFβ1 for SM differentiation in organ culture, the TGFβ1 protein that was demonstrated to be present in the amniotic fluid may enhance intestinal development when it is physiologically herniated in early gestation. Future studies of embryonic intestinal cultures should include TGFβ1 in the defined media to produce a more faithful model of in vivo muscle differentiation. Copyright © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons, Ltd. Copyright © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons, Ltd.

  19. Serological and molecular characterization of leptospira serovar Kenya from captive African giant pouched rats (Cricetomys gambianus) from Morogoro Tanzania

    NARCIS (Netherlands)

    Machang'u, R. S.; Mgode, G. F.; Assenga, J.; Mhamphi, G.; Weetjens, B.; Cox, C.; Verhagen, R.; Sondij, S.; Goris, M. G.; Hartskeerl, R. A.

    2004-01-01

    Two identical leptospiral isolates coded Sh9 and Sh25 obtained from the urine of captive African giant pouched rats (Cricetomys gambianus), destined for use as biodetector of antipersonnel landmines were typed as serovar Kenya using cross-agglutination absorption test and DNA fingerprinting with the

  20. Claudin-4 Undergoes Age-Dependent Change in Cellular Localization on Pig Jejunal Villous Epithelial Cells, Independent of Bacterial Colonization

    Directory of Open Access Journals (Sweden)

    J. Alex Pasternak

    2015-01-01

    Full Text Available Newborn piglets are immunologically naïve and must receive passive immunity via colostrum within 24 hours to survive. Mechanisms by which the newborn piglet gut facilitates uptake of colostral cells, antibodies, and proteins may include FcRn and pIgR receptor-mediated endocytosis and paracellular transport between tight junctions (TJs. In the present study, FcRn gene (FCGRT was minimally expressed in 6-week-old gut and newborn jejunum but it was expressed at significantly higher levels in the ileum of newborn piglets. pIgR was highly expressed in the jejunum and ileum of 6-week-old animals but only minimally in neonatal gut. Immunohistochemical analysis showed that Claudin-5 localized to blood vessel endothelial cells. Claudin-4 was strongly localized to the apical aspect of jejunal epithelial cells for the first 2 days of life after which it was redistributed to the lateral surface between adjacent enterocytes. Claudin-4 was localized to ileal lateral surfaces within 24 hours after birth indicating regional and temporal differences. Tissue from gnotobiotic piglets showed that commensal microbiota did not influence Claudin-4 surface localization on jejunal or ileal enterocytes. Regulation of TJs by Claudin-4 surface localization requires further investigation. Understanding the factors that regulate gut barrier maturation may yield protective strategies against infectious diseases.

  1. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans

    DEFF Research Database (Denmark)

    Luttikhold, Joanna; van Norren, Klaske; Rijna, Herman

    2016-01-01

    and the associated endocrine response in vivo in humans remains largely unexplored. OBJECTIVE: We compared the impact of administering enteral nutrition as either gastric feeding or jejunal feeding on endocrine responses in vivo in humans. DESIGN: In a randomized, crossover study design, 12 healthy young men (mean...... and a greater postprandial incremental AUC for GLP-1 and cholecystokinin (all P young men results in similar postprandial plasma amino acid and glucose concentrations....... However, the endocrine response differs substantially, with higher peak plasma cholecystokinin, PYY, GLP-1, and GLP-2 concentrations being attained after jejunal feeding. This effect may result in an improved anabolic response, greater insulin sensitivity, and an improved intestinotropic effect...

  2. Plasma prolactin concentrations during lactation, pouch young development and the return to behavioural oestrus in captive koalas (Phascolarctos cinereus).

    Science.gov (United States)

    Ballantyne, K; Anderson, S T; Mucci, A; Nicolson, V; Johnston, S D

    2015-05-29

    Plasma prolactin (PRL) concentrations in captive koalas during lactation were determined by serial blood sampling. PRL concentrations were low (1.3 ± 0.1 ng mL-1; n = 5) during early lactation until pouch young (PY) began to emerge from the pouch (around Day 130) before significantly (P < 0.05) increasing between Day 161 and Day 175 (5.3 ± 1.0 ng mL-1). A significant (P < 0.001) peak in PRL (7.7 ± 0.6 ng mL-1) coincided with maturing young between Day 189 and Day 231. All females failed to exhibit any signs of oestrous behaviour until Day 268.8 ± 8.5 (n = 4), some 102 ± 19 days before PY were weaned following achieving target weights of 2.5-2.7 kg. Throughout lactation, plasma LH concentrations were relatively high (range 4.9-8.7 ng mL-1) and LH responses to exogenous gonadotrophin-releasing hormone were observed in all koalas at all times during lactation.

  3. Videoradiography of free jejunal grafts for rehabilitation of speech in laryngectomized patients

    International Nuclear Information System (INIS)

    Pokieser, P.; Grasl, M.C.; Schima, W.; Uranitsch, K.; Piza-Katzer, H.; Niederle, B.; Ehrenberger, K.; Ekberg, O.; Tscholakoff, D.

    1995-01-01

    In laryngectomized patients a tracheo-esophageal artificial fistula can be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographic examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspiration. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time during the examination, this was a sign of aspiration hazard. To avoid aspiration, the vertex of the speech siphon should be higher than the level of the hypopharyngeal anastomosis. (orig.)

  4. Effect of corn replacement with graded levels of wheat screening and enzyme supplementation on performance, blood lipids, viscosity and jejunal histomorphology of finisher broilers

    Energy Technology Data Exchange (ETDEWEB)

    Mazhari, M.; Golian, A.; Kermanshahi, H.

    2015-07-01

    An experiment was carried out to study the effect of corn replacement with five levels of wheat screening (0, 150, 300, 450 and 600 g/kg of diet) with (0.5 g/kg of diet) or without xylanase-glucanase enzyme on performance, blood lipids, viscosity and jejunal histomorphology of finisher broilers (25-42 days of age). Five hundred day-old Ross-308 male broiler chicks were fed by a standard commercial diet up to 24 days of age, then randomly assigned to 10 diets. Each diet was fed to five groups of ten chicks each. There was not significant differences in body weight gain (BWG), feed intake, and feed conversion ratio of birds fed with different levels of wheat screening (WS), whereas enzyme increased (p<0.05) BWG. Different levels of WS and enzyme did not have a significant effect on relative weights of carcass, breast, thigh, and abdominal fat of broilers. Relative weights of gizzard, pancreas, small and large intestine, and relative length of jejunum and jejunal and ileal viscosity were increased (p<0.05) by WS, while were decreased (p<0.05) by enzyme. The serum cholesterol level decreased (p<0.05) by increasing levels of WS. Jejunal histomorphological observations showed (p<0.05) shorter and thicker villus and lower crypt depth by increasing levels of WS, while addition of enzyme to the diets, affected (p<0.05) reversely to these parameters. The results showed that the addition of wheat screening up to an inclusion level of 600 g/kg of diet had no adverse effect on broiler performance in the finisher (25-42 d) phases whereas decreased serum cholesterol levels, increased viscosity and villus atrophy. The dietary administration of exogenous enzyme improved performance parameters and decreased viscosity and villus atrophy of broiler jejunum. (Author)

  5. Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

  6. Abdominoperineal pull-through with simultaneous extravesical detrussoraphy: An alternative surgical technique for congenital pouch colon with high-grade vesicoureteric reflux

    Directory of Open Access Journals (Sweden)

    Monika Bawa

    2018-01-01

    Full Text Available Congenital pouch colon (CPC is frequently associated with vesicoureteric reflux (VUR. These patients require long-term antibiotic prophylaxis and/or an additional surgical intervention for the management of the refluxing system. We propose a single-stage alternative approach in these patients. Two patients diagnosed to have CPC underwent pouch excision and an end colostomy at birth. Further evaluation revealed high-grade reflux in both the patients. At 6 months of age, definitive abdominoperineal pull-through (APPT surgery along with extravesical detrusorrhaphy was performed. In the follow-up at 1 year, they are thriving well with no urinary complaints. Micturating cystourethrogram revealed complete resolution of VUR. This approach takes the advantage of the anesthesia for APPT and offers a relatively simple and quick solution for the refluxing system, thus, enabling the stoppage of antibiotic prophylaxis and obviating the need for a future endoscopy/surgery.

  7. Comparsion of light dose on topical ALA-mediated photodynamic therapy for DMBA-induced hamster buccal pouch premalignant lesions

    Science.gov (United States)

    Yang, Deng-Fu; Tseng, Meng-Ke; Liu, Chung-Ji; Hsu, Yih-Chih

    2012-03-01

    Oral cancer has becomes the most prominent male cancer disease due to the local betel nut chewing habit combing with smoking and alcohol-drinking lifestyle. In order to minimize the systemic phototoxic effect of 5-aminolevulinic acid (ALA), this study was designed to use a topical ALA-mediated PDT for treatment of DMBA-induced hamster buccal pouch cancerous lesions. DMBA was applied to one of the buccal pouches of hamsters thrice a week for 8 to 10 weeks. Precancerous lesions were induced and proven by histological examination. These DMBA-induced cancerous lesions were used for testing the efficacy of topical ALA -mediated PDT. We found that ALA reached its peak level in cancerous lesions about 2.5 hrs after topical application of ALA gel. The precancerous lesions in hamsters were then treated with topical ALA -mediated PDT with light exposure dose of 75 and 100 J/cm2 using LED 635 nm Wonderlight device. It is suggesting that optimization of the given light dose is critical to the success of PDT results.

  8. Topical chlorophyll-pheophytin derivative-mediated photodynamic therapy for DMBA-induced hamster buccal pouch premaligant lesions: an in vivo study

    Science.gov (United States)

    Hsu, Yih-Chih; Chiang, Chung-Pin; Chen, Jian Wen; Lee, Jeng-Woei; How, Mon-Hsin

    2010-02-01

    In Taiwan, oral cancer has become a prominent cancer because of its highest annual increase rate among all cancer diseases. Betel quid chewing habit is a major risk factor for oral precancerous and cancerous lesions and there are more than two million people who have this habit in Taiwan. Our previous studies showed that chlorophyll-pheophytin derivative (CPD)-mediated PDT is very effective for killing of SCC-4 cell lines in vitro. In order to decrease the systemic phototoxic effect of CPD, this study was designed to use a topical CPD-mediated PDT for treatment of DMBA-induced hamster buccal pouch precancerous lesions. DMBA was applied to one of the buccal pouches of hamsters thrice a week for 8 to 10 weeks. Precancerous lesions of moderate to severe dysplasia were induced and proven by histological examination. These induced precancerous lesions were used for testing the efficacy of topical CPD-mediated PDT. Before PDT, fluorescence spectroscopy was used to determine when CPD reached its peak level in the lesional epithelial cells after topical application of CPD gel. We found that CPD reached its peak level in precancerous lesions about 1 hour (range, 0 to 30 hours) after topical application of CPD gel. The precancerous lesions in hamsters were then treated with topical CPD-mediated PDT (fluence rate: 200 mW/cm2; light exposure dose 100 J/cm2) using the portable WonderLight LED 635 nm fiber-guided light device once or twice a week. Visual and histological examination demonstrated that topical CPD-mediated PDT was partially effective treatment modality for DMBA-induced hamster buccal pouch precancerous lesions.

  9. Coverage of Gingival Fenestration Using Modified Pouch and Tunnel Technique: A Novel Approach

    Directory of Open Access Journals (Sweden)

    Sunil Pendor

    2013-01-01

    Full Text Available Gingival fenestration defects are a rare phenomenon. Gingival fenestration means the exposure of the tooth due to loss of the overlying bone and gingiva. Though treatment of mucosal fenestration occurring in association with chronic periapical inflammation has been reported previously, the occurrence and treatment of gingival fenestration have not been documented in great detail. This report describes the occurrence of a gingival fenestration that developed secondarily to a gutka chewing habit. Treatment of the fenestration along with coverage of an adjacent recession defect in a single-step procedure using a pouch and tunnel technique is described.

  10. The effect of experimental gastric dilatation-volvulus on adenosine triphosphate content and conductance of the canine gastric and jejunal mucosa

    OpenAIRE

    Peycke, Laura E.; Hosgood, Giselle; Davidson, Jacqueline R.; Tetens, Joanne; Taylor, H. Wayne

    2005-01-01

    The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experim...

  11. Rapid promotion and progression of fibrovascular polyps by inflammation and/or hyperplasia in hamster check pouch: implications for carcinogenesis assay.

    Science.gov (United States)

    McGaughey, C; Jensen, J L

    1983-03-01

    Tumor initiation by topical application of 7,12-dimethylbenz[a]anthracene (DMBA) in dimethyl sulfoxide (DMSO) followed by topical application of retinyl acetate (RA), ethylphenylpropiolate, or acetic acid in DMSO at inflammatory and hyperplasiogenic dose regimens caused the rapid promotion of fibrovascular polyps with dysplastic epithelium in hamster cheek pouch. Such lesions did not occur in control animals initiated with DMBA followed by application of DMSO only, where inflammation was also minimal. At the dose regimen employed, RA caused obvious cytotoxicity and tissue destruction. With EPP and AA, there was no histological evidence of tissue destruction. At dose regimens resulting in minimal inflammation and no apparent cytotoxicity, RA promoted almost no polyps, but a higher yield of other tumor types. Thus, inflammation and/or hyperplasia apparently exerted a strong polyp-promoting and progressive influence. This and other differences between the tumorigenic responses of hamster-pouch mucosa and mouse skin suggest that the former supplement the latter in carcinogenic risk assessment.

  12. Leiomyosarcoma of inferior vena cava involving bilateral renal veins: Surgical challenges and reconstruction with upfront saphenous vein interposition graft for left renal vein outflow

    Directory of Open Access Journals (Sweden)

    Rishi Nayyar

    2010-01-01

    Full Text Available Leiomyosarcoma of inferior vena cava (IVC involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.

  13. Sodium borocaptate (BSH) for Boron Neutron Capture Therapy (BNCT) in the hamster cheek pouch oral cancer model: boron biodistribution at 9 post administration time-points

    International Nuclear Information System (INIS)

    Garabalino, M.A.; Heber, E.M.; Monti, Hughes A.; Molinari, A.J.; Pozzi, E.C.C.; Trivillin, V.A.; Schwint, Amanda E.

    2011-01-01

    The therapeutic success of Boron Neutron Capture Therapy (BNCT) depends centrally on boron concentration in tumor and healthy tissue. We previously demonstrated the therapeutic efficacy of boronophenylalanine (BPA) and sodium decahydrodecaborate (GB-10) as boron carriers for BNCT in the hamster cheek pouch oral cancer model. Given the clinical relevance of sodium mercaptoundecahydro-closo-dodecaborate (BSH) as a boron carrier, the aim of the present study was to expand the ongoing BSH biodistribution studies in the hamster cheek pouch oral cancer model. In particular, we studied 3 additional post-administration time-points and increased the sample size corresponding to the time-points evaluated previously, to select more accurately the post-administration time at which neutron irradiation would potentially confer the greatest therapeutic advantage. BSH was dissolved in saline solution in anaerobic conditions to avoid the formation of the dimer BSSB and its oxides which are toxic. The solution was injected intravenously at a dose of 50 mg 10 B/kg (88 mg BSH / kg). Different groups of animals were killed humanely at 7, 8, and 10 h after administration of BSH. The sample size corresponding to the time-points 3, 4, 6, 9 and 12 h was increased. Samples of blood, tumor, precancerous tissue, normal pouch tissue, cheek mucosa, parotid gland, palate, skin, tongue, spinal cord marrow, brain, liver, kidney, spleen and lung were processed for boron measurement by Optic Emission Spectroscopy (ICP-OES). Boron concentration in tumor peaked to 24-34 ppm, 3-10 h post-administration of BSH, with a spread in values that resembled that previously reported in other experimental models and human subjects. The boron concentration ratios tumor/normal pouch tissue and tumor/blood ranged from 1.3 to 1.8. No selective tumor uptake was observed at any of the time points evaluated. The times post-administration of BSH that would be therapeutically most useful would be 5, 7 and 9 h. The

  14. The hamster cheek pouch: an immunologically privileged site suitable to the study of granulomatous infections A bolsa jugal do hamster: um local imunologicamente privilegiado, apropriado para o estudo das ¡nfecções granulomatosas

    Directory of Open Access Journals (Sweden)

    M. S. P. de Arruda

    1995-08-01

    Full Text Available The hamster check pouch is an invagination of oral mucosa, characterized histologically as skin-like. In this paper we describe anatomical, histological and embriological features of the pouch and coment on the pouch as an immunologically privileged site since it lacks lymphatic drainage and has few Langerhans cells. We present the review from literature and our observations after inoculation in the pouch of mycobacteriae (BCG, Mycobacterium tuberculosis and Mycobacterium leprae and a fungus (Paracoccidioides brasiliensis. Lesions in the pouch were granulomatous but smaller and long lasting; even granulomatous, the reaction was inefficient to control the proliferation of agents compared with inoculation in other sites, except for BCG. Appearance of immunity was also delayed or absent and, when it was detected, a sharp decrease in number of agents in pouch lesions was observed. These observations make the pouch an interesting site for the study of the role of immune system in infeccious diseases and in granuloma formation.A bolsa jugal do hamster (BJH é uma invaginação da mucosa oral, caracterizada histologicamente como semelhante a pele. Nesse estudo nós descrevemos algumas de suas características anatômicas, histológicas e embriológicas e comentamos sobre sua propriedade como local imunologicamente privilegiado, considerando a ausência de drenagem linfática e o reduzido número de células de Langerhans. Apresentamos também os resultados obtidos quando da inoculação de micobacterias (BCG, Mycobacterium tuberculosis e Mycobacterium leprae e do fungo Paracoccidioides brasiliensis na bolsa jugal. Comparada com as lesões provocadas em outras localizações e, à exceção do BCG, as lesões induzidas na bolsa são menores e de maior duração e, mesmo quando granulomatosas, incapazes de controlar a multiplicação do agente; nos casos em que houve o desenvolvimento da resposta imune, ele se fez tardiamente e foi acompanhado pela redu

  15. Tissue response and wound healing after placement of two types of bioengineered grafts containing vital cells in submucosal maxillary pouches: an experimental pilot study in rabbits.

    Science.gov (United States)

    Bornstein, Michael M; Reichart, Peter A; Buser, Daniel; Bosshardt, Dieter D

    2011-01-01

    This pilot study evaluated the wound healing and tissue response after placement of two different skin substitutes in subgingival mucosal pouches in rabbits. Four rabbits were selected to receive a commercially available skin substitute consisting of a collagen matrix with fibroblasts and an epithelial layer (test membrane 1) and a prototype device consisting of a collagen matrix with fibroblasts only (test membrane 2). In each rabbit, two horizontal incisions were made in the buccal alveolar mucosa of the maxilla bilaterally to create submucosal pouches. Three pouches in each animal were filled with either the test 1 or test 2 membranes, and one pouch was left without a membrane (sham-operated control). All rabbits were sacrificed after a healing period of 4 weeks, and histologic samples were prepared and examined. After a healing period of 1 month, both tested membranes were still visible in the sections. Test membrane 1 was still bilayered, contained inflammatory cells in its center, and was encapsulated by a thick fibrous tissue. Numerous ectopic calcifications were evident in the collagenous part of the membrane and in association with some basal epithelial cells. Test membrane 2 was also encapsulated in fibrous tissue, with inflammatory cells present only between the fibrous encapsulation and the remnants of the membrane. For test membrane 2, no calcifications were visible. Test membrane 1 seemed to be more resistant to degradation, but there was also a more pronounced inflammatory reaction in comparison to test membrane 2, especially in the vicinity of the keratinocytes. The significance of the ectopic calcifications, along with that of the resorption or degradation processes of both tested membranes, must be evaluated in future experimental studies, with different time points after implantation examined.

  16. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers.

    Science.gov (United States)

    Yang, Deng-Fu; Lee, Jeng-Woei; Chen, Hsin-Ming; Hsu, Yih-Chih

    2014-09-01

    Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of human oral precancerous lesions. This animal study aimed to assess whether topical methotrexate (MTX) pretreatment could enhance the therapeutic effect of topical ALA-PDT on hamster buccal pouch precancerous lesions. Twenty hamster buccal pouch precancerous lesions were treated with either topical ALA-PDT with topical MTX pretreatment (topical MTX-ALA-PDT group, n = 10) or topical ALA-PDT alone (topical ALA-PDT group, n = 10). The intracellular protoporphyrin IX (PpIX) level in another 12 precancerous lesions (n = 6 for either the topical MTX-ALA or topical ALA group) was monitored by fluorescence spectroscopy. The intracellular PpIX reached its peak level in precancerous lesions 6.5 hours and 2.5 hours after topical ALA application for the topical MTX-ALA group (5.63-fold higher in the lesion than in the normal mucosa) and topical ALA group (2.42-fold higher in the lesion than in the normal mucosa), respectively. The complete response rate of precancerous lesions was 80% for the topical MTX-ALA-PDT group and 70% for the topical ALA-PDT group. In addition, the topical MTX-ALA-PDT group required a significantly lower mean treatment number (2.1 ± 0.6) to achieve complete response than the topical ALA-PDT group (4.4 ± 1.3, p topical MTX-ALA-PDT group had a lower recurrence rate (12.5%) than the topical ALA-PDT group (28.6%). We conclude that topical MTX-pretreatment can increase intracellular PpIX production in hamster buccal pouch precancerous lesions and significantly improves the outcomes of the precancerous lesions treated with topical ALA-PDT. Copyright © 2014. Published by Elsevier B.V.

  17. Surface temperature evolution and the location of maximum and average surface temperature of a lithium-ion pouch cell under variable load profiles

    DEFF Research Database (Denmark)

    Goutam, Shovon; Timmermans, Jean-Marc; Omar, Noshin

    2014-01-01

    This experimental work attempts to determine the surface temperature evolution of large (20 Ah-rated capacity) commercial Lithium-Ion pouch cells for the application of rechargeable energy storage of plug in hybrid electric vehicles and electric vehicles. The cathode of the cells is nickel...

  18. Successful endoscopic treatment of fecalith blocking sinus in a patient with ileal pouch-anal anastomosis

    Directory of Open Access Journals (Sweden)

    Jessica Ma

    2014-07-01

    Full Text Available Background: Ulcerative colitis patients who underwent restorative proctocolectomy with ileal pouch-anal anastomosis can develop various mechanical complications. Among them is presacral sinus resulting from chronic anastomotic leak. Methods: We present a symptomatic patient with a large fecalith blocking the sinus which was successfully treated with Doppler ultrasound guided endoscopic needle knife sinusotomy along with fecalith extraction. Results: A 67-year-old female presented with a 4-month history of perianal pain and urgency. Pouchocopy showed a 3-cm deep wide-mouthed anastomotic sinus, the orifice of which was blocked by a large hard fecalith. Removal of the fecalith using RothNet, Tripod, or Basket were made but failed. Then needle knife was applied to cut the orifice to enlarge the opening of the sinus. One month later, the patient returned and the fecalith was successfully removed with two Baskets and two Rothnets. Six months after fecalith extraction, pouchoscopy showed a compartalized distal pouch sinus with two cavities, which was treated by two sessions of Doppler ultrasound guided endoscopic needle knife sinusotomy. Six months following the treatment, the sinus was completed healed. The patient tolerated all procedures well without any complication. Conclusion: Fecalith blocking pouch anastomotic sinus is a rare complication in patients with restorative proctocolectomy. In our case, this surgical complication was successfully treated with a carefully planned, stepwise endoscopy approach. Resumo: Experiência: Pacientes com colite ulcerativa tratados por proctocolectomia restauradora com anastomose bolsa ileal-anal podem ser acometidos por diversas complicações mecânicas. Entre elas, cita-se o seio pré-sacral resultante de vazamento crônico pela anastomose. Métodos: Apresentamos uma paciente sintomática com um grande fecálito bloqueando o seio, com tratamento bem-sucedido com sinusotomia por bisturi-agulha guiado por

  19. Impact of Tab Location on Large Format Lithium-Ion Pouch Cell Based on Fully Coupled Tree-Dimensional Electrochemical-Thermal Modeling

    International Nuclear Information System (INIS)

    Samba, Ahmadou; Omar, Noshin; Gualous, Hamid; Capron, Odile; Van den Bossche, Peter; Van Mierlo, Joeri

    2014-01-01

    This paper presents extensive three-dimensional (3D) simulations of large LiFPO 4 pouch cells. 3D simulations of the Li-ion battery behavior are highly nonlinear and computationally demanding. Coupling electrochemical modeling to thermal models represents an important step towards accurate simulation of the Li-ion battery. Non-uniform temperature, potential and current density through the battery induce non-uniform use of the active material and can have a negative impact on cell performance and lifetime. Different pouch cell designs, with different tab locations, have been investigated in term of performance, current density, potential and heat distributions. The model is first validated with experimental data at different current discharge rates. Afterwards, the electrochemical, thermal and electrical behaviors over each cell design under high discharge rate (4 I t ) are compared between configurations. It has been shown that the designs with symmetrical configurations show uniform potential and current density gradient, which minimize the ohmic heat and lead to more uniform active material utilization and temperature distributions across the cell surface.Introduction

  20. Enhanced Contaminated Human Remains Pouch: initial development and preliminary performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Iseli, A.M.; Kwen, H.D.; Ul-Alam, M.; Balasubramanian, M.; Rajagopalan, S.

    2011-11-07

    The objective is to produce a proof of concept prototype Enhanced Contaminated Human Remains Pouch (ECHRP) with self-decontamination capability to provide increased protection to emergency response personnel. The key objective was to decrease the concentration of toxic chemicals through the use of an absorbent and reactive nanocellulose liner. Additionally, nanomaterials with biocidal properties were developed and tested as a 'stand-alone' treatment. The setting was a private company research laboratory. The main outcome measures were production of a functional prototype. A functional prototype capable of mitigating the threats due to sulfur mustard, Soman, and a large variety of liquid and vapor toxic industrial chemicals was produced. Stand-alone biocidal treatment efficacy was validated. The ECHRP provides superior protection from both chemical and biological hazards to various emergency response personnel and human remains handlers.

  1. Inhibitory effects of Zengshengping fractions on DMBA-induced buccal pouch carcinogenesis in hamsters.

    Science.gov (United States)

    Guan, Xiao-Bing; Sun, Zheng; Chen, Xiao-Xin; Wu, Hong-Ru; Zhang, Xin-Yan

    2012-01-01

    Zengshengping (ZSP) tablets had inhibitory effects on oral precancerous lesions by reducing the incidence of oral cancer. However, the severe liver toxicity caused by systemic administration of ZSP limits the long-term use of this anti-cancer drug. The purpose of this study was to evaluate the tumor inhibitory effects due to the topical application of extracts from ZSP, a Chinese herbal drug, on 7, 12-dimethlbenz(a)anthracene (DMBA) induced oral tumors in hamsters. The study also investigated the anti-cancer mechanisms of the ZSP extracts on oral carcinogenesis. DMBA (0.5%) was applied topically to the buccal pouches of Syrian golden hamsters (6 - 8 weeks old) three times per week for six weeks in order to induce the development of oral tumors. Different fractions of ZSP were either applied topically to the oral tumor lesions or fed orally at varying dosages to animals with oral tumors for 18 weeks. Tumor volume was measured by histopathological examination. Tumor cell proliferation was evaluated by counting BrdU labeled cells and by Western blotting for mitogen-activated protein kinase (MAPK) protein levels. The protein levels of apoptosis marker Caspase-3 and regulator Bcl-2 protein were also measured by Western blotting. Topical application of DMBA to the left pouch of hamsters induced oral tumor formation. Animals treated with DMBA showed a loss in body weight while animals treated with ZSP maintained normal body weights. Both the ZSP n-butanol fraction and water fraction significantly reduced tumor volume by 32.6% (P oral tumor lesions and reduced the expression level of MAPK. In addition, ZSP promoted tumor cell apoptosis by increasing Caspase-3 expression but decreasing Bcl-2 protein production. The n-butanol and water fractions of ZSP are effective at inhibiting tumor cell proliferation and stimulating apoptosis in oral cancer suggesting that these fractions have chemopreventive effects on DMBA induced oral carcinogenesis.

  2. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  3. A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia

    NARCIS (Netherlands)

    Gallo, Gabriele; Zwaveling, S; Van Der Zee, David C.; Bax, Klaas N.; De Langen, Zacharias J.; Hulscher, Jan B F

    2015-01-01

    Purpose When restoration of the anatomical continuity in case of long gap esophageal atresia (LGEA) is not feasible, esophageal replacement surgery becomes mandatory. The aim of this paper is to critically compare the experience of two tertiary referral centers in The Netherlands performing either

  4. Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses: A systematic review.

    Science.gov (United States)

    Derks, Laura S M; Veenstra, Hidde J; Oomen, Karin P Q; Speleman, Lucienne; Stegeman, Inge

    2016-01-01

    To systematically review the current literature on treatment of third and fourth branchial pouch sinuses with endoscopic cauterization, including chemocauterization and electrocauterization, in comparison to surgical treatment. PubMed, Embase, and the Cochrane Library. We conducted a systematic search. Studies reporting original study data were included. After assessing the directness of evidence and risk of bias, studies with a low directness of evidence or a high risk of bias were excluded from analysis. Cumulative success rates after initial and recurrent treatments were calculated for both methods. A meta-analysis was conducted comparing the success rate of electrocauterization and surgery. A total of 2,263 articles were retrieved, of which seven retrospective and one prospective article were eligible for analysis. The cumulative success rate after primary treatment with cauterization ranged from 66.7% to 100%, and ranged from 77.8% to 100% after a second cauterization. The cumulative success rate after the first surgical treatment ranged from 50% to 100% and was 100% after the second surgical attempt. Meta-analysis on electrocauterization showed a nonsignificant risk ratio of 1.35 (95% confidence interval: 0.78-2.33). The effectiveness of cauterization in preventing recurrence seems to be comparable to surgical treatment. However, we suggest endoscopic cauterization as the treatment of choice for third and fourth branchial pouch sinuses because of the lower morbidity rate. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Heterotopic ossification of the elbow after closed reduction and retrograde intramedullary nailing for radial neck fracture treated by anconeus interposition.

    Science.gov (United States)

    Sreenivas, T; Menon, Jagdish; Nataraj, A R

    2013-12-01

    Heterotopic ossification around the elbow can lead to considerable functional disability. We describe a case of a 42-year-old man who developed heterotopic ossification of his elbow after closed reduction of the elbow dislocation and radial neck fracture and retrograde intramedullary nailing for radial neck fracture. During the follow-up after initial surgery, movements of the elbow were gradually deteriorated and diagnosed as heterotopic ossification of the elbow. Implant removal, radial head excision along with heterotopic mass, and also interposition of the anconeus muscle resulted in improvement of his elbow mobility. At 18 months of follow-up, patient had elbow flexion arc of 15°-110°, 70° of supination, and 50° of pronation without recurrence of heterotopic ossification. The uniqueness of this case lies in the treatment of heterotopic ossification of the elbow to prevent its recurrence, which was developed after retrograde intramedullary nailing for radial neck fracture following closed reduction.

  6. Technique of Robotic-assisted Total Proctocolectomy with Lymphadenectomy and Ileal Pouch-Anal Anastomosis for Transverse Colitic Cancer of Ulcerative Colitis, Using the Single Cart Position.

    Science.gov (United States)

    Hanai, Tsunekazu; Maeda, Koutarou; Masumori, Koji; Katsuno, Hidetoshi; Matsuoka, Hiroshi

    2015-11-01

    Robotic surgery offers advantages for operating in a narrow space such as inside the pelvis. We report on the technique of robotic-assisted laparoscopic total proctocolectomy with lymphadenectomy and ileal pouch-anal anastomosis for ulcerative colitis with transverse colitic cancer, using the single cart position. A 46-year-old female patient was diagnosed with colitic cancer of the transverse colon during the surveillance of ulcerative colitis. Six port sites were used. Mobilization of the left-sided colon through to the rectum and mobilization of the transverse colon with lymphadenectomy around the middle colic artery were performed using the robotic surgical system. After rectal mobilization was conducted near the anus, the right side of the colon was mobilized and the ileum resected laparoscopically. Thereafter, a mucosectomy of the proctorectum was carried out through a trans-anal approach, and a hand-sewn J-pouch was performed. Finally, a diverting ileostomy was constructed through the right lower abdomen. The operative time was 460 minutes, including the console time of 361 minutes. The amount of blood loss was 76 g. The patient was discharged on postoperative day nine. Pathological results demonstrated that the depth of the lesion was T3, and the positive lymph node was 1 of 115 retrieved lymph nodes. There were no complications or mortality. Robotic-assisted total proctocolectomy and lymphadenectomy with ileal pouch-anal anastomosis for transverse colitic cancer of ulcerative colitis was performed safely using the single cart position.

  7. [Observation on alpha-SMA during Erigeron Breviscapus (Vant) Hand-Mazz obstructs the evolution of carcinogenesis of golden hamster cheek pouch].

    Science.gov (United States)

    Zhou, C T; Zhang, S L; Ding, R Y; Hua, L; Zhong, W J

    2000-06-01

    To observe dynamically that Erigeron Breviscapus (Vant) Hand-Mazz (HEr) affects the expression of alpha-smooth muscle actin (alpha-SMA). To discuss the probable mechanism of obstructing leukoplakia carcinogenesis of this medicine. 120 golden hamsters were randomly divided into model group (48), HEr group (48) and control group (6). HEr was applied to obstruct the evolution of carcinogenesis of golden hamster cheek pouch. Immunohistochemistry was used to detect the expression level of alpha-SMA with cheek pouch specimen that besmears DMBA in 4-9 weeks. Results were compared with model group. Vessel density dyed with alpha-SMA continuously of HEr group was 65.76 significantly higher than that of model group 42.12 (P<0.001). High classification cases in HEr group were much more than model group when cases were divided into five groups as follow: 100%, 50%, 20%, 10%, 3% (P<0.01). HEr can raise the expression level of alpha-SMA exactly during the evolution of leukoplakia carcinogenesis of golden hamster, which shows that this medicine obstructs carcinogenesis by keeping the normal physiological function of vascular myoepithelial cell and integrity of vascular basement membrane.

  8. A characterization of anaerobic colonization and associated mucosal adaptations in the undiseased ileal pouch.

    LENUS (Irish Health Repository)

    Smith, F M

    2012-02-03

    INTRODUCTION: The resolution of pouchitis with metronidazole points to an anaerobic aetiology. Pouchitis is mainly seen in patients with ulcerative colitis pouches (UCP). We have recently found that sulphate reducing bacteria (SRB), a species of strict anaerobe, colonize UCP exclusively. Herein, we aimed to correlate levels of different bacterial species (including SRB) with mucosal inflammation and morphology. METHODS: Following ethical approval, fresh faecal samples and mucosal biopsies were taken from 9 patients with UCP and 5 patients with familial adenomatous polyposis pouches (FAPP). For the purposes of comparison, faecal samples and mucosal biopsies were also taken from the stomas of 7 of the 9 patients with UC (UCS). Colonization by four types of strict anaerobes (SRB, Clostridium perfringens, Bifidobacteria and Bacteroides) as well as by three types of facultative anaerobes (Enterococci, Coliforms and Lactobacilli) was evaluated. Inflammatory scores and mucosal morphology were assessed histologically in a blinded fashion by a pathologist. RESULTS: In general, strict anaerobes predominated over facultative in the UCP (P = 0.041). SRB were present in UCP exclusively. Even after exclusion of SRB from total bacterial counts, strict anaerobes still predominated. In the UCS, facultative anaerobes predominated. Strict and facultative anaerobes were present at similar levels in the FAPP. Enterococci were present at significantly reduced levels in the UCP when compared with the UCS (P = 0.031). When levels of SRB and other anaerobic species were individually correlated with mucosal inflammation and morphology, no trends were observed. CONCLUSION: We have previously identified that SRB exclusively colonize UCP. In addition we have now identified a novel increase in the strict\\/facultative anaerobic ratio within the UCP compared to UCS. These stark differences in bacterial colonization, however, appear to have limited impact on mucosal inflammation or morphology.

  9. Comparative evaluation of antiproliferative, antiangiogenic and apoptosis inducing potential of black tea polyphenols in the hamster buccal pouch carcinogenesis model

    Directory of Open Access Journals (Sweden)

    Prathiba Duvuru

    2007-01-01

    Full Text Available Abstract Background To evaluate the relative chemopreventive efficacy of two black tea polyphenols, Polyphenon-B [P-B] and BTF-35 on 7,12-dimethylbenz [a]anthracene (DMBA-induced hamster buccal pouch (HBP carcinogenesis. Methods Hamsters were divided into 6 groups. The right buccal pouches of animals in groups 1–3 were painted with 0.5% of DMBA three times a week for 14 weeks. While hamsters in group 1 received no further treatment, animals in groups 2 and 3 received diet containing 0.05% P-B and BTF-35 respectively, four weeks before DMBA painting that was continued until the end of the experiments. Animals in groups 4 and 5 were given P-B and BTF-35 alone respectively as in groups 2 and 3. Group 6 animals served as the untreated control. All the animals were sacrificed after 18 weeks. The expression of p21, cyclin D1, glutathione S-transferase pi (GST-P, nuclear factor kappa B (NF-κB, Bcl-2, Bax, cytochrome C, caspase-3, caspase-9, poly(ADP-ribose polymerase (PARP, cytokeratins and vascular endothelial growth factor (VEGF was analysed by RT-PCR, immunohistochemical and Western blot analyses. Results DMBA treated animals developed buccal pouch carcinomas that displayed increased expression of p21, cyclin D1, GST-P, NF-κB, cytokeratins, VEGF and Bcl-2 with decreased expression of Bax, cytochrome C, caspase-3, caspase-9, and PARP. Dietary administration of both P-B and BTF-35 reduced the incidence of DMBA-induced HBP carcinomas by modulating markers of cell proliferation, cell survival, tumour infiltration, angiogenesis, and apoptosis. Conclusion The results of the present study provide a mechanistic basis for the chemopreventive potential of black tea polyphenols. The greater efficacy of BTF-35 in inhibiting HBP carcinogenesis and modulating multiple molecular targets may have a potential role in the prevention of oral cancer.

  10. Absent upper blind Pouch in a case of tracheo-esophageal fistula

    Directory of Open Access Journals (Sweden)

    Man Mohan Harjai

    2015-01-01

    Full Text Available A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation, which is difficult even in expert hand. We present a newborn with suspected tracheo-esophageal fistula that was diagnosed intraoperatively to have absent upper blind pouch of the esophagus and on autopsy found to have laryngeal atresia with absent vocal cords and a common aerodigestive tract continuing distally with trachea. The neonate was ventilated with endotracheal tube (ETT placement which in retrospect we came to know that it was in the esophagus. The neonate also had associated multiple congenital anomalies of VACTERL association. The importance of teamwork between neonatologist, pediatric surgeon, anesthesiologist, and radiologist is highlighted for diagnosis and management of such rare cases.

  11. Soft tissue reinforcement interposition flaps in hypospadias repair

    Directory of Open Access Journals (Sweden)

    Singh R

    2007-01-01

    Full Text Available Purpose: To discuss the role and mechanism of action of soft tissue reinforcement interposition flaps (STRIFs in hypospadias repairs (reinforced hypospadiac urethroplasties. Materials and Methods: Between 2000-2005, 120 consecutive hypospadiacs (distal 85, mid 20, proximal 15, who underwent primary reinforced urethroplasties employing different types of STRIFs, were retrospectively analyzed. The STRIFs were highly vascular soft tissue pedicled flaps (devoid of epithelium interposed between neo-urethras and the covering skin to reinforce the neo-urethras against fistula formation. The STRIFs were harvested, without much donor site deformity, from: preputial skin, penile skin and scrotal skin by de-epithelialization. Those from Buck′s fascia, corpus spongiosum and tunica vaginalis are STRIFs without epithelium anyway, therefore do not need de-epithelialization. Redo urethroplasties and micropenises were not included. Seven patients were excluded because they had incomplete follow-up. The remaining 113 (distal 84, mid 17, proximal 12 were followed up for nine to 40 months for number, size, location, spontaneous closure and persistence of urethro-cutaneous fistula (UCF, and other complications with regard to the severity of hypospadias, method of neourethral re-construction, types of STRIFs employed and skin cover used. A total of 158 STRIFs and 124 skin covers were used in 113 hypospadiac urethroplasties. Results: The first surgery was curative in 74 (65% of 113 patients. In the remaining 39 (35%, various complications included 12 urethro-cutaneous fistulas (UCFs, 10 urethral strictures, six cases each of penile torsion and meatal stenosis and five cases each of superficial necrosis and poor cosmesis. Of these 39 patients, 25 (64% recovered with conservative treatment and 14 (36% required re-operation, i.e. UCFs and strictures in four cases each and penile torsion, meatal stenosis and dog-ears in two cases each. All the 12 UCFs were single

  12. Histochemical characterization of glycoproteins present in jejunal and colonic goblet cells of pigs on different diets. A biopsy study using chemical methods and peroxidase-labelled lectins.

    Science.gov (United States)

    Moré, J; Fioramonti, J; Bénazet, F; Buéno, L

    1987-01-01

    We examined the glycoprotein composition of intestinal goblet cells in jejunal and colonic biopsies obtained from pigs on different diets. Paraffin sections were stained both chemically and with the following horseradish-peroxidase conjugated lectins: Canavalia ensiformis (Con-A), Limulus polyphemus (LPA), Lotus tetragonolobus (LTA), Arachis hypogaea (PNA), Ricinus communis (RCA1), Glycine max (SBA) and Triticum vulgaris (WGA). Using chemical staining procedures, only small quantitative differences were noted between the two organs. With respect to lectin staining, the mucus of the jejunum was characterized by the absence of Con-A binding sites, and colonic mucus consistently exhibited an absence of SBA affinity. After dietary modifications, O-acetyl sialic acid reactivity was lowered in the jejunum but was enhanced in the colon. In the jejunum, the glycoproteins became neuraminidase susceptible, whereas the colon became characterized by the absence of neutral mucins. The affinity for the tested lectins after the different diets was variable, but the most striking effects were observed after the fibreless diet (milk alone). Our data suggest the existence of marked regional variations in goblet-cell mucus and indicate significant differences between the glycoprotein components of the jejunal and colonic mucosa. Furthermore, the biosynthesis of mucins in both regions was altered by even only short-term feeding modifications.

  13. Direct microvascular monitoring of a free autologous jejunal flap using microendoscopy: a case report

    Directory of Open Access Journals (Sweden)

    Hopper Colin

    2006-09-01

    Full Text Available Abstract Background Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many technical developments of free flap monitoring have now reached clinical application, very few are considered to be reliable and non-invasive for early recognition of flap failure. Case presentation We used microendoscopic technique for microvascular monitoring of free autologous jejunal flap by the direct visualisation of the flow of erythrocytes through the capillary vasculature on both the mucosal and serosal surfaces. Blood flow was seen to be pulsatile, with individual erythrocytes visible in the capillaries. The best view was obtained when the scope was focussed directly on the capillary rather than the graft surface. The view of the unstained mucosal surface was bland apart from the fine capillary loops which were seen to fill with each pulsatile event. The microendoscopic examination of the serosal surface revealed much larger calibre vessels with obvious blood flow. Conclusion The microendoscopic monitoring technique is simple and safe with direct visualisation of blood flow. The technique may also be useful for the monitoring of other free bowel transplants.

  14. Boron biodistribution for BNCT in the hamster cheek pouch oral cancer model: Combined administration of BSH and BPA

    Energy Technology Data Exchange (ETDEWEB)

    D.W. Nigg; William Bauer; Various Others

    2014-06-01

    Sodium mercaptoundecahydro-closo-dodecaborate (BSH) is being investigated clinically for BNCT. We examined the biodistribution of BSH and BPA administered jointly in different proportions in the hamster cheek pouch oral cancer model. The 3 assayed protocols were non-toxic, and showed preferential tumor boron uptake versus precancerous and normal tissue and therapeutic tumor boron concentration values (70–85 ppm). All 3 protocols warrant assessment in BNCT studies to contribute to the knowledge of (BSH+BPA)-BNCT radiobiology for head and neck cancer and optimize therapeutic efficacy.

  15. Congenital pouch colon in a girl associated with bilateral atresia of cervix uteri and uterus didelphys.

    Science.gov (United States)

    Chadha, Rajiv; Puri, Manju; Saxena, Rahul; Agarwala, Surendrakumar; Puri, Archana; Choudhury, Subhasis Roy

    2013-04-01

    This report describes a girl with congenital pouch colon (CPC), uterus didelphys with septate vagina, and a cloacal anomaly. The girl underwent cloacal reconstruction at the age of 15 months. Subsequently, at puberty, the child had primary amenorrhea with severe cyclic abdominal pain due to endometriosis of both the uteruses and adnexal cysts with hematometra and hematosalpinx. Laparotomy with removal of both uteri and the left fallopian tube was performed. Both uteri had atresia of the cervix uteri. This report emphasizes the need for comprehensive evaluation and a long-term management strategy for associated gynecologic anomalies in girls with CPC, especially with regard to patency of the outflow tract.

  16. Short-term morbidity and quality of life from a randomized clinical trial of close rectal dissection and total mesorectal excision in ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Bartels, S. A. L.; Gardenbroek, T. J.; Aarts, M.; Ponsioen, C. Y.; Tanis, P. J.; Buskens, C. J.; Bemelman, W. A.

    2015-01-01

    Posterior rectal dissection during ileal pouch-anal anastomosis (IPAA) can be performed in the total mesorectal excision (TME) or close rectal dissection (CRD) plane. The aim of this study was to compare morbidity and quality of life (QoL) in patients having TME or CRD during proctectomy followed by

  17. Inhibitory effect of vitamin D-binding protein-derived macrophage activating factor on DMBA-induced hamster cheek pouch carcinogenesis and its derived carcinoma cell line.

    Science.gov (United States)

    Toyohara, Yukiyo; Hashitani, Susumu; Kishimoto, Hiromitsu; Noguchi, Kazuma; Yamamoto, Nobuto; Urade, Masahiro

    2011-07-01

    This study investigated the inhibitory effect of vitamin D-binding protein-derived macrophage-activating factor (GcMAF) on carcinogenesis and tumor growth, using a 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced hamster cheek pouch carcinogenesis model, as well as the cytocidal effect of activated macrophages against HCPC-1, a cell line established from DMBA-induced cheek pouch carcinoma. DMBA application induced squamous cell carcinoma in all 15 hamsters of the control group at approximately 10 weeks, and all 15 hamsters died of tumor burden within 20 weeks. By contrast, 2 out of the 14 hamsters with GcMAF administration did not develop tumors and the remaining 12 hamsters showed a significant delay of tumor development for approximately 3.5 weeks. The growth of tumors formed was significantly suppressed and none of the hamsters died within the 20 weeks during which they were observed. When GcMAF administration was stopped at the 13th week of the experiment in 4 out of the 14 hamsters in the GcMAF-treated group, tumor growth was promoted, but none of the mice died within the 20-week period. On the other hand, when GcMAF administration was commenced after the 13th week in 5 out of the 15 hamsters in the control group, tumor growth was slightly suppressed and all 15 hamsters died of tumor burden. However, the mean survival time was significantly extended. GcMAF treatment activated peritoneal macrophages in vitro and in vivo, and these activated macrophages exhibited a marked cytocidal effect on HCPC-1 cells. Furthermore, the cytocidal effect of activated macrophages was enhanced by the addition of tumor-bearing hamster serum. These findings indicated that GcMAF possesses an inhibitory effect on tumor development and growth in a DMBA-induced hamster cheek pouch carcinogenesis model.

  18. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  19. Development of an Advanced Two-Dimensional Thermal Model for Large size Lithium-ion Pouch Cells

    International Nuclear Information System (INIS)

    Samba, Ahmadou; Omar, Noshin; Gualous, Hamid; Firouz, Youssef; Van den Bossche, Peter; Van Mierlo, Joeri; Boubekeur, Tala Ighil

    2014-01-01

    In this work, a LiFePO4/graphite lithium-ion pouch cell with a rated capacity of 45Ah has been used and a two dimensional thermal model is developed to predict the cell temperature distribution over the surface of the battery, this model requires less input parameters and still has high accuracy. The used input parameters are the heat generation and thermal properties. The ANSYS FLUENT software has been used to solve the models. In addition, a new estimation tool has been developed for estimation of the thermal model parameters. Furthermore, the thermal behavior of the proposed battery has been investigated at different environmental conditions as well as during the abuse conditions. Thermal runaway is investigated in depth by the model

  20. The role of the defaecating pouchogram in the assessment of evacuation difficulty after restorative proctocolectomy and pouch-anal anastomosis.

    Science.gov (United States)

    Stellingwerf, M E; Maeda, Y; Patel, U; Vaizey, C J; Warusavitarne, J; Bemelman, W A; Clark, S K

    2016-08-01

    Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not well understood. We aimed to evaluate the role of defaecating pouchography in an attempt to assess the mechanism of evacuation difficulty in pouch patients. All RPC patients who had had a defaecating pouchogram for evacuation difficulty at one hospital between 2006 and 2014 were retrospectively reviewed. The findings and features were correlated with the symptoms. Demographic, clinical and radiological variables were analysed. Eighty-seven [55 (63%) female] patients aged 47.6 ± 12.5 years (mean standard ± SD) were identified. Thirty-five had a mechanical outlet obstruction and 52 had no identified mechanical cause to explain the evacuation difficulty. The mean age of these 52 [33 (63%) female] patients was 48.2 ± 13 years. Of these 52 patients, significantly more used anti-diarrhoeal medication (P = 0.029), complained of a high frequency of defaecation (P = 0.005), experienced a longer time to the initiation of defaecation (P = 0.049) and underwent pouchoscopy (P = 0.003). Biofeedback appeared to improve the symptoms in 7 of 16 patients with a nonmechanical defaecatory difficulty. The most common findings on defaecating pouchography included residual barium of more than 33% after an attempted evacuation (46%, n = 24), slow evacuation (35%, n = 18) and mucosal irregularity (33%, n = 17). Correlation between radiological features and symptoms showed a statistically significant relationship between straining, anal pain, incontinence and urgency with patterns of anismus or pelvic floor descent or weakness seen on the defaecating pouchogram. Symptoms of incomplete evacuation, difficulty in the initiation of defaecation, high defaecatory frequency and

  1. Letting the ‘cat’ out of the bag: pouch young development of the extinct Tasmanian tiger revealed by X-ray computed tomography

    Science.gov (United States)

    Spoutil, Frantisek; Prochazka, Jan; Black, Jay R.; Medlock, Kathryn; Paddle, Robert N.; Knitlova, Marketa; Hipsley, Christy A.

    2018-01-01

    The Tasmanian tiger or thylacine (Thylacinus cynocephalus) was an iconic Australian marsupial predator that was hunted to extinction in the early 1900s. Despite sharing striking similarities with canids, they failed to evolve many of the specialized anatomical features that characterize carnivorous placental mammals. These evolutionary limitations are thought to arise from functional constraints associated with the marsupial mode of reproduction, in which otherwise highly altricial young use their well-developed forelimbs to climb to the pouch and mouth to suckle. Here we present the first three-dimensional digital developmental series of the thylacine throughout its pouch life using X-ray computed tomography on all known ethanol-preserved specimens. Based on detailed skeletal measurements, we refine the species growth curve to improve age estimates for the individuals. Comparison of allometric growth trends in the appendicular skeleton (fore- and hindlimbs) with that of other placental and marsupial mammals revealed that despite their unique adult morphologies, thylacines retained a generalized early marsupial ontogeny. Our approach also revealed mislabelled specimens that possessed large epipubic bones (vestigial in thylacine) and differing vertebral numbers. All of our generated CT models are publicly available, preserving their developmental morphology and providing a novel digital resource for future studies of this unique marsupial. PMID:29515893

  2. Enteroscopic Tattooing for Better Intraoperative Localization of a Bleeding Jejunal GIST Facilitates Minimally Invasive Laparoscopically-assisted Surgery.

    Science.gov (United States)

    Iacob, Razvan; Dimitriu, Anca; Stanciulea, Oana; Herlea, Vlad; Popescu, Irinel; Gheorghe, Cristian

    2016-03-01

    We present the case of a 63-year-old man that was admitted for melena and severe anemia. Upper GI endoscopy and colonoscopy failed to identify the lesion responsible for bleeding, and enteroCT scan was also non-contributive to the diagnosis. Capsule endoscopy indicated possible jejunal bleeding but could not indicate the source of bleeding, recommending anterograde enteroscopy. Single balloon enteroscopy identified a 2 cm submucosal tumour in the distal part of the jejunum, with a macroscopic appearance suggesting a gastrointestinal stromal tumour (GIST). The tumor location was marked using SPOT tattoo and subsequently easily identified by the surgeon and resected via minimally invasive laparoscopic-assisted approach. Histological and immunohistochemical analysis indicated a low risk GIST. The unusual small size of the GIST as a modality of presentation, with digestive bleeding and anemia and the ability to use VCE/enteroscopy to identify and mark the lesion prior to minimally invasive surgery, represent the particularities of the presented case.

  3. Effects of grinding method, particle size, and physical form of the diet on gastrointestinal morphology and jejunal glucose transport in laying hens.

    Science.gov (United States)

    Röhe, I; Ruhnke, I; Knorr, F; Mader, A; Boroojeni, F Goodarzi; Löwe, R; Zentek, J

    2014-08-01

    Several studies illustrated that the structure of feed, i.e., the particle size, particle-size distribution, and the physical form of the diet, affects the avian gastrointestinal function and health leading to changes in productive performance. However, investigations concerning the effects of feeding differently processed diets on laying hens are limited and primarily concentrated on bird performance. The current study examines the effect of feed processing on the gastrointestinal morphology and on the jejunal glucose transport of laying hens. In 8 replicates, a total of 384 hens (Lohmann Brown) aged 20 wk were randomly allocated to 8 different groups and fed over a period of 21 d in a 3-factorial design. Diets differed in 1) grinding method, either hammer or roller mill; 2) physical form, either mash or expandate; and 3) particle size, either coarsely or finely ground. During the experimental trial, the laying performance of each feeding group was recorded daily and the feed intake and BW determined weekly. After slaughtering, the weights of the pancreas, proventriculus, gizzard, and small intestine were measured. Villus lengths and crypt depths of the duodenum, jejunum, and ileum were determined. The jejunal electrogenic glucose transport was studied in Ussing chambers. Hens that received mash instead of expandate had higher proventriculus (P = 0.011), gizzard (P feeding of coarsely instead of finely ground diets led to higher gizzard weights (P hens showed longer duodenal (P hens had higher glucose transport rates than expandate-fed hens (P feeding of coarsely ground as well as mash diets had stimulating effects on the development of the gastrointestinal organs. Moreover, the feeding of mash influenced the intestinal microstructure of the epithelium that was accompanied by higher glucose transport capacities. © Poultry Science Association Inc.

  4. Effects of Duodenal-Jejunal Exclusion and New Bilio-Pancreatic Diversion on Blood Glucose in Rats with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Weng, Shan Geng; Zhang, Bin; Wang, Xiaojian; Chen, Hao

    2017-08-01

    The current study aimed to investigate the effects of duodenal-jejunal bypass (DJB), new bilio-pancreatic diversion (NBPD), and duodenal-jejunal exclusion (DJE) on blood glucose in rats with type 2 diabetes mellitus (T2DM). Male Sprague Dawley rats were fed with high glucose, high fat food, and intraperitoneally injected with streptozotocin to establish a T2DM animal model. T2DM rats were randomly assigned into 4 groups: a sham group (n = 8), DJB group (n = 9), NBPD group (n = 10), and DJE group (n = 10). Body weight, 2-h postprandial glucose, oral glucose tolerance, fasting serum bile acid, 2-h postprandial serum bile acid, fasting insulin, 2-h postprandial insulin (INS), fasting glucagon-like peptide-1 (GLP-1), and 2-h postprandial GLP-1 were measured before and after surgery. Six weeks after surgery, the 2-h postprandial glucose in the DJB (16.1 ± 6.7 mmol/L) and NBPD (19.5 ± 5.7 mmol/L) groups decreased significantly compared to the sham group (25.8 ± 4.9 mmol/L) (P  0.05). Four weeks after surgery, fasting serum bile acid in the DJB group (60.6 ± 11.4 μmol/L) and NBPD group (54.4 ± 7.64 μmol/L) was significantly higher than that in the sham group (34.3 ± 6.98 μmol/L; P  0.05). Body weight remained stable after surgery in all 4 groups (P > 0.05). NBPD plays a major role in the therapy of T2DM with DJB. NBPD may significantly increase fasting serum bile acid in T2DM rats, an action that may be one of the mechanisms underlying the therapeutic effects of DJB on T2DM.

  5. Dietary turmeric modulates DMBA-induced p21ras, MAP kinases and AP-1/NF-κB pathway to alter cellular responses during hamster buccal pouch carcinogenesis

    International Nuclear Information System (INIS)

    Garg, Rachana; Ingle, Arvind; Maru, Girish

    2008-01-01

    The chemopreventive efficacy of turmeric has been established in experimental systems. However, its mechanism(s) of action are not fully elucidated in vivo. The present study investigates the mechanism of turmeric-mediated chemoprevention in 7,12-dimethylbenz(a)anthracene (DMBA)-induced hamster buccal pouch (HBP) carcinogenesis at 2, 4, 6, 10 and 12 weeks. Dietary turmeric (1%) led to decrease in DMBA-induced tumor burden and multiplicity, and enhanced the latency period in parallel, to its modulatory effects on oncogene products and various cellular responses during HBP tumorigenesis. DMBA-induced expression of ras oncogene product, p21 and downstream target, the mitogen-activated protein kinases were significantly decreased by turmeric during HBP carcinogenesis. Turmeric also diminished the DMBA-induced mRNA expression of proto-oncogenes (c-jun, c-fos) and NF-κB, leading to decreased protein levels and in further attenuation of DMBA-induced AP-1/NF-κB DNA-binding in the buccal pouch nuclear extracts. Besides, buccal pouch of hamsters receiving turmeric diet showed significant alterations in DMBA-induced effects: (a) decrease in cell proliferation (diminished PCNA and Bcl2 expression), (b) enhanced apoptosis (increased expression of Bax, caspase-3 and apoptotic index), (c) decrease in inflammation (levels of Cox-2, the downstream target of AP-1/NF-κB, and PGE2) and (d) aberrant expression of differentiation markers, the cytokeratins (1, 5, 8, and 18). Together, the protective effects of dietary turmeric converge on augmenting apoptosis of the initiated cells and decreasing cell proliferation in DMBA-treated animals, which in turn, is reflected in decreased tumor burden, multiplicity and enhanced latency period. Some of these biomarkers are likely to be helpful in monitoring clinical trials and evaluating drug effect measurements

  6. An unexpected resident in the ileum detected during robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal Studer pouch formation: Taenia saginata parasite.

    Science.gov (United States)

    Canda, Abdullah Erdem; Asil, Erem; Balbay, Mevlana Derya

    2011-02-01

    A case of moving ileal Taenia saginata parasites is presented with demonstrative images. We came across the parasites surprisingly while performing robot-assisted laparoscopic radical cystoprostatectomy with intracorporeal Studer pouch urinary diversion. We recommend stool sample evaluation in the preoperative period for possible presence of intestinal parasitic diseases, particularly in patients with bladder cancer who are admitted from areas with an increased incidence of intestinal parasitic diseases, before opening the bowel segments during surgery to perform radical cystectomy and urinary diversion.

  7. Protective Effects of Vitamin E on Methotrexate-Induced Jejunal Mucosal Damage in Rats.

    Science.gov (United States)

    Burcu, Busra; Kanter, Mehmet; Orhon, Zeynep Nur; Yarali, Oguzhan; Karabacak, Rukiye

    2016-04-01

    To investigate the possible protective effects of Vitamin E (Vit E) on oxidative stress and jejunal damage in the rat intestinal mucosa after methotrexate (MTX)-induced enterotoxicity. Rats were divided into 3 groups: control, MTX, and MTX+ Vit E; each group contained 8 animals. The control group was given physiological serum in addition to sunflower oil for 3 days. The second group was given sunflower oil with intragastric tube daily, followed by MTX injection (20 mg/kg intraperitoneally). To the third group, starting 3 days before injection, Vit E was given dissolved in sunflower oil (600 mg/kg orally) in addition to MTX injection. Four days after MTX injection the anesthetized rats were sacrificed, and the tissue samples obtained from their jejunums were investigated for histological and biochemical analysis. Vit E treatment significantly decreased the elevated tissue malondialdehyde levels and increased the reduced glutathione peroxidase and superoxide dismutase activities in comparison to the MTX-treated group. MTX treatment caused severe histopathological injury including mucosal erosions, inflammatory cell infiltration, necrosis, hemorrhage, and villous congestion. Vit E treatment significantly attenuated the severity of intestinal injury caused by MTX via inhibiting induced nitric oxide synthase levels and NF-κB p65 activation. Because of its reconstructing and antioxidant effects, Vit E pretreatment may have protective effects in the intestinal tissue of MTX-treated rats.

  8. Therapeutic effect of recombinant human interleukin-11 and curcumin on jejunal damage in mice after neutron irradiation

    International Nuclear Information System (INIS)

    Chang Gongmin; Peng Ruiyun; Gao Yabing; Wang Shuiming; Li Yang; Xu Xinping; Wang Lifeng; Dong Ji; Zhao Li

    2010-01-01

    Objective: To explore the therapeutic effect of recombinant human interleukin (rhIL-11) and curcumin on jejunal damage in mice after neutron irradiation. Methods: 140 male BALB/c mice were randomly divided into 4 groups: 20 mice in healthy control group, 60 mice in mere irradiation group, 30 mice in IL-11 treatment group and 30 mice in curcumin treatment group. The mere irradiation group mice were wholly exposed to 3 Gy neutron irradiation. The treatment groups mice were imtraperitoneally injected with rhIL-11 at the dosage of 500 μg·kg -1 ·d -1 and ourcumin of 200 mg·kg -1 ·/ -1 through enterocoelia once a day for a d after irradiation. The mortality of the mice were observed. The mice in the control and mere irradiation groups were killed 6 h, 1, 3, and 6 d post-irradiation, respectively, and the mice of the 2 treatment groups were killed 3 and 6 d post-irradiation, respectively and the samples of jujunum were colleted. HE staining, argyrophilic of nucleolar organizer staining, Feulgen staining, and image analysis were used to observe the pathology and levels of argyrophilic proteins and DNA. Results: The mice in the mere irradiation group all died at 5 d post-irradiation, while 2 mice in the IL-11 treatment group and 3 in the curcumin group survived. Large area necrosis and exfoliation were found in the intestinal epithelial mucosa of the mere irradiated group mice since 6 h to 3 d after irradiation. Crypt cell regeneration was seen occasionally found 3 days later and much more 5 days later. Crypt cell regeneration was obviously found in the intestinal epithelial mucosa and lots of new villi were observed 5 d after irradiation in both treatment groups, however, the amounts of crypt cells and new villi of the curcumin treatment group were less than those of the IL-11 treatment group. The contents of AgNOR and DNA in the intestinal epithelial cells 5 days after irradiation of the 2 treatment groups were all significantly higher than those of the mere

  9. A paper sheet phantom for scintigraphic planar imaging. Usefulness of pouch-laminated paper source

    International Nuclear Information System (INIS)

    Takaki, Akihiro; Soma, Tsutomu; Murase, Kenya; Teraoka, Satomi; Murakami, Tomonori; Kojima, Akihiro; Matsumoto, Masanori

    2007-01-01

    In order to perform experimental measurements for evaluation of imaging device's performance, data acquisition technique, and clinical images on scintigraphic imaging, many kinds of phantoms are employed. However, since these materials are acrylic and plastic, the thickness and quality of those materials cause attenuation and scatter in itself. We developed a paper sheet phantom sealed with a pouch laminator, which can be a true radioactive source in air. In this study, the paper sheet phantom was compared to the acrylic liver phantom, with the thickness of 2 cm, which is commercially available. The results showed that although some scatter counts were contained within the image of the acrylic liver phantom, there were few scattered photons in the paper sheet phantom image. Furthermore, this laminated paper sheet phantom made handling of the source and its waste easier. If the paper sheet phantom will be designed more sophisticatedly, it becomes a useful tool for planar imaging experiments. (author)

  10. Magnetic resonance imaging appearance of the flexor carpi radialis tendon after harvest in ligamentous reconstruction tendon interposition arthroplasty

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Fish, Jon R.; Ritchie, Eric R.; Tran, Hoang N.; Ingari, John V.; Campbell, Scot E.; Grayson, David E.; Sanders, Timothy G.; Mundis, Gregory; Lehman, Thomas P.

    2006-01-01

    To determine whether the post-harvest magnetic resonance (MR) imaging appearance of flexor carpi radialis (FCR) tendons, harvested during ligamentous reconstruction tendon interposition (LRTI) of the thumb carpometacarpal (CMC) joint arthroplasty, is consistent with tendon regeneration. Operative reports and patient medical records for all patients undergoing LRTI arthroplasty between 1995 and 2003 at our institution were reviewed. MR images of the patients' forearms and wrists were obtained and interpreted by two musculoskeletal radiologists. Using the flexor carpi ulnaris (FCU) tendon as an internal standard, the extent of FCR tendon regeneration was expressed as a percentage by dividing the volume of regenerated FCR tendon by the volume of the FCU tendon. Fourteen patients who had the full thickness of the FCR tendon harvested and who were available for MR imaging were identified and included in the study. At least partial regeneration of the FCR tendon occurred in 11 of the 14 patients (79%). Of these, 2 patients (14%), demonstrated complete, or nearly complete regeneration. Partial regeneration of the FCR tendon was seen in 9 of the 14 patients (64%). In 3 patients (21%), there was no appreciable regeneration of the FCR tendon. Among patients who underwent full-thickness harvest of the FCR tendon for LRTI arthroplasty of the first CMC joint, the follow-up MR imaging appearance of the flexor carpi radialis tendon was consistent with tendon regeneration in 79% of those examined. (orig.)

  11. The Waterfall Fascia Lata Interposition Arthroplasty “Grika Technique” as Treatment of Posttraumatic Osteoarthritis of the Elbow in a High-Demand Adult Patient: Validity and Reliability

    Directory of Open Access Journals (Sweden)

    Giuseppe Rollo

    2018-01-01

    Full Text Available Introduction. The elbow interposition arthroplasty is a very common procedure performed mainly on active young patients who need great functionality and for whom total joint replacement is contraindicated and arthrodesis is noncompliant. We are going to demonstrate a case of a 34-year-old male suffering from malunion of the distal humerus, elbow stiffness, and manifest signs of arthrosis of the dominant limb, treated with the IA Grika technique at a 5-year follow-up. Patients and Methods. The chosen criteria to evaluate the injured side and the uninjured side during the clinical and radiological follow-up were the objective function and related quality of life, measured by the Mayo Elbow Performance Score (MEPS, and postoperative complications. To assess flexion and supination forces and elbow muscular strength, a hydraulic dynamometer was used. Results. At a 5-year follow-up, the results were excellent as during the first year. Conclusions. The Grika technique is a valid and feasible option in the treatment of elbow injuries.

  12. Totally Transanal Laparo-Endoscopic Single-Site ProctoColectomy-Ileoanal J-Pouch (TLPC-J: An Experimental Study of a Novel Approach

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Vahdad

    2015-09-01

    Full Text Available Background: The natural orifice transluminal endoscopic surgery (NOTES has become a commonly considered novel approach in the surgical field. The NOTES provide possibility of operation through the natural orifice and decreases the intentional puncture of the systemic organ and subsequent complications. Totally transanal laparo-endoscopic single-site proctoColectomy-Ileoanal J-Pouch (TLPC-J is a novel method in minimally invasive surgery for total colectomy. The main goal of this study is to perform this new method on an animal model, to assess probable complication and to resolve probable issues by using patients that are candidate for total colectomy. Method: Five dogs were prepared in lithotomy position. The TLPC-I procedure consists of endorectal technique with full thickness rectal dissection starting 1 cm orally from the dentate line above the peritoneal reflection and the proximal bowel was replaced into the abdominal cavity. Afterwards, the TriPort system was inserted in the anal canal and mesentrial resection of the total colon, mobilization of a distal ileal segment and intracorporeal suture of an ileal J-loop was accomplished by this system. An incision in the J-loop was conducted transanally. The J-pouch was created with an Endo-GIA® and sutured to the rectal wall. Results: All animals survived and passed stool with clear post operation situation. There was no infection in site of anastomosis. Conclusion: The TLPC-I provides the possibility of surgery without abdominal wall incision and decreases post operation complication such as pain, abdominal wound infection and wound dehiscence. This technique increases the quality of life and surgeons can discharge the patients early.

  13. Early development of the longsnout seahorse Hippocampus reidi (Syngnathidae) within the male brood pouch.

    Science.gov (United States)

    Novelli, B; Otero Ferrer, F; Socorro, J A; Molina Domínguez, L

    2018-04-16

    Fertilized and unfertilized eggs and embryos of the longsnout seahorse Hippocampus reidi were collected at different stages of development and provided the basis for a description of morphological development from fertilization until release from the paternal pouch. Images of fertilized eggs, as well as their rupture after a few minutes in seawater are reported for the first time. The yolk sac transitioned from ovoid to spherical shape and was reabsorbed progressively until release. The tail began rising from the surface of the deuteroplasm while embryos were in the egg envelope. Embryos lacked a primordial fin fold and developed some species characteristics, such as rays in the dorsal fin, before resorption of the yolk sac. At release, juvenile seahorses were in an advanced stage of development even if they lacked important adult characteristics, such as ring plates and coronet. The tail was not prehensile in juveniles at release; a small caudal fin was present, although this fin is lost in adults. This article is protected by copyright. All rights reserved.

  14. Abductor pollicis longus tendon interposition for arthrosis of the first carpo-metacarpal joint. Long-term results.

    Science.gov (United States)

    Lied, Line; Bjørnstad, Kari; Woje, Ann K N; Finsen, Vilhjalmur

    2016-02-01

    We performed an interposition arthroplasty using the abductor pollicis longus tendon for arthrosis in the basal joint of the thumb that needed surgery from 1995 to 2010. In 2001 47 patients (55 thumbs) were reviewed after 3.5 (1-5) years. The pain relief was excellent in 32 thumbs, and 25 patients improved their ability to perform daily tasks. Mobility was well preserved. Key pinch and grip strengths averaged 78% and 89%, respectively, of those in unaffected hands. We have now re-examined all 33 available patients (36 thumbs) 11-14 years after surgery. Fourty one of the originally examined patients were still alive. Seven were too ill to attend a follow-up and one refused. The remainder were examined in a fashion as similar as possible to that at the original review. The patients' subjective estimations of pain during the last week and satisfaction with the cosmetic and general results were recorded on visual analogue scales. The patients' ability to perform various activities of daily living were recorded and they completed the Disability of the arm, shoulder and hand (DASH) questionnaire. The mobility of the wrist and abduction of the thumb of the operated hands were recorded with a goniometer. Grip and pinch strength were measured and new radiographs were obtained. Key pinch strength had increased significantly over the last 10 years. The mobility was still good, except for thumb abduction, which had decreased with time. The median DASH score had fallen from 28 to 20 between the two reviews. There was insignificant further median loss of distance between the scaphoid and the metacarpal since the earlier review. The good results of this procedure found soon after surgery are maintained long-term.

  15. Effects of babassu nut oil on ischemia/reperfusion-induced leukocyte adhesion and macromolecular leakage in the microcirculation: Observation in the hamster cheek pouch

    Directory of Open Access Journals (Sweden)

    Barbosa Maria do

    2012-11-01

    Full Text Available Abstract Background The babassu palm tree is native to Brazil and is most densely distributed in the Cocais region of the state of Maranhão, in northeastern Brazil. In addition to the industrial use of refined babassu oil, the milk, the unrefined oil and the nuts in natura are used by families from several communities of African descendants as one of the principal sources of food energy. The objective of this study was to evaluate the effects of babassu oil on microvascular permeability and leukocyte-endothelial interactions induced by ischemia/reperfusion using the hamster cheek pouch microcirculation as experimental model. Methods Twice a day for 14 days, male hamsters received unrefined babassu oil (0.02 ml/dose [BO-2 group], 0.06 ml/dose [BO-6 group], 0.18 ml/dose [BO-18 group] or mineral oil (0.18 ml/dose [MO group]. Observations were made in the cheek pouch and macromolecular permeability increase induced by ischemia/reperfusion (I/R or topical application of histamine, as well as leukocyte-endothelial interaction after I/R were evaluated. Results The mean value of I/R-induced microvascular leakage, determined during reperfusion, was significantly lower in the BO-6 and BO-18 groups than in the MO one (P Conclusions Our findings suggest that unrefined babassu oil reduced microvascular leakage and protected against histamine-induced effects in postcapillary venules and highlights that these almost unexploited nut and its oil might be secure sources of food energy.

  16. Sexual Function and Body Image are Similar after Laparoscopy-Assisted and Open Ileal Pouch-Anal Anastomosis

    DEFF Research Database (Denmark)

    Kjaer, Mie Dilling; Laursen, Stig Borbjerg; Qvist, Niels

    2014-01-01

    BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is performed in patients with ulcerative colitis and familial adenomatous polyposis where the majority of patients are sexually active. Laparoscopic surgery is becoming the preferred technique for most colorectal interventions, and we examined posto...... better body image among laparoscopy-treated women, the two surgical techniques seem equal with respect to postoperative sexual function....... postoperative sexual function and body image compared to those after open surgery IPAA. METHODS: Patients treated with IPAA in the period from October 2008 to March 2012 were included. Evaluation of sexual function, body image, and quality of life was performed using the Female Sexual Function Index (FSFI......), the International Index of Erectile Function (IIEF), the Body Image Questionnaire (BIQ), and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). RESULTS: We included 72 patients (38 laparoscopy-assisted and 34 open). Response rate was 74 %. There were no differences in demographics, functional outcome...

  17. A prospective study of personality as a predictor of quality of life after pelvic pouch surgery.

    Science.gov (United States)

    Weinryb, R M; Gustavsson, J P; Liljeqvist, L; Poppen, B; Rössel, R J

    1997-02-01

    Surgeons often "know" preoperatively which patients will achieve good postoperative quality of life (QOL). This intuition is probably based on impressions of the patient's personality. The present aim was to examine whether preoperative personality traits predict postoperative QOL. In 53 patients undergoing pelvic pouch surgery for ulcerative colitis the relationship between preoperative personality traits, and surgical functional outcome and QOL was examined at a median of 17 months postoperatively. Personality assessment instruments (KAPP and KSP), and specific measures of alexithymia were used. Postoperatively, the Psychosocial Adjustment to Illness Scale (PAIS), and surgical functional outcome scales were used. Using multiple correlation/regression, analysis lack of alexithymia, poor frustration tolerance, anxiety proneness, and poor socialization (resentment over childhood and present life situation) were found to predict poor postoperative QOL. The findings suggest personality traits, in addition to surgical functional outcome, to be important for the patient's postoperative QOL.

  18. Phytic acid decreases deoxynivalenol and fumonisin B1-induced changes on swine jejunal explants

    Directory of Open Access Journals (Sweden)

    Elisângela Olegário da Silva

    2014-01-01

    Full Text Available The purpose of the present study was to investigate the effects of phytic acid (IP6 on morphological and immunohistochemical parameters on intestinal explants exposed to deoxynivalenol (DON and fumonisin B1 (FB1. The jejunal explants were exposed for 4 h to different treatments: control, DON (10 μM, DON plus 2.5 mM or 5 mM IP6, FB1 (70 μM, and FB1 plus 2.5 mM or 5 mM IP6. Both mycotoxins induced significant intestinal lesions and decreased villi height. The presence of 2.5 mM and 5 mM IP6 significantly inhibited the morphological changes caused by the mycotoxins. DON induced a significant increase in caspase-3 (83% and cyclooxygenase-2 (71.3% expression compared with the control. The presence of 5 mM IP6 induced a significant decrease in caspase-3 (43.7% and Cox-2 (48% expression compared with the DON group. FB1 induced a significant increase in caspase-3 expression (47% compared to the control, whereas IP6 induced no significant change in this expression. A significant decrease in cell proliferation was observed when explants were exposed to 5 mM of IP6 in comparison with the DON and FB1 groups. The present data provide evidence that phytic acid modulates the toxic effects induced by DON and FB1 on intestinal tissue.

  19. Boron neutron capture therapy (BNCT) translational studies in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration of the RA-6 nuclear reactor

    International Nuclear Information System (INIS)

    Monti Hughes, Andrea; Trivillin, Veronica A.; Schwint, Amanda E.; Longhino, Juan; Boggio, Esteban; Medina, Vanina A.; Martinel Lamas, Diego J.; Garabalino, Marcela A.; Heber, Elisa M.; Pozzi, Emiliano C.C.; Itoiz, Maria E.; Aromando, Romina F.; Nigg, David W.

    2017-01-01

    Boron neutron capture therapy (BNCT) is based on selective accumulation of B-10 carriers in tumor followed by neutron irradiation. We demonstrated, in 2001, the therapeutic effect of BNCT mediated by BPA (boronophenylalanine) in the hamster cheek pouch model of oral cancer, at the RA-6 nuclear reactor. Between 2007 and 2011, the RA-6 was upgraded, leading to an improvement in the performance of the BNCT beam (B2 configuration). Our aim was to evaluate BPA-BNCT radiotoxicity and tumor control in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration. We also evaluated, for the first time in the oral cancer model, the radioprotective effect of histamine against mucositis in precancerous tissue as the dose-limiting tissue. Cancerized pouches were exposed to: BPA-BNCT; BPA-BNCT + histamine; BO: Beam only; BO + histamine; CONTROL: cancerized, no-treatment. BNCT induced severe mucositis, with an incidence that was slightly higher than in ''B1'' experiments (86 vs 67%, respectively). BO induced low/moderate mucositis. Histamine slightly reduced the incidence of severe mucositis induced by BPA-BNCT (75 vs 86%) and prevented mucositis altogether in BO animals. Tumor overall response was significantly higher in BNCT (94-96%) than in control (16%) and BO groups (9-38%), and did not differ significantly from the ''B1'' results (91%). Histamine did not compromise BNCT therapeutic efficacy. BNCT radiotoxicity and therapeutic effect at the B1 and B2 configurations of RA-6 were consistent. Histamine slightly reduced mucositis in precancerous tissue even in this overly aggressive oral cancer model, without compromising tumor control. (orig.)

  20. Boron neutron capture therapy (BNCT) translational studies in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration of the RA-6 nuclear reactor

    Energy Technology Data Exchange (ETDEWEB)

    Monti Hughes, Andrea; Trivillin, Veronica A.; Schwint, Amanda E. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); National Research Council (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Longhino, Juan; Boggio, Esteban [Bariloche Atomic Center, CNEA, Department of Nuclear Engineering, San Carlos de Bariloche, Province Rio Negro (Argentina); Medina, Vanina A.; Martinel Lamas, Diego J. [National Research Council (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Pontifical Catholic University of Argentina (UCA), Laboratory of Tumoral Biology and Inflammation, School of Medical Sciences, Institute for Biomedical Research (BIOMED CONICET-UCA), Ciudad Autonoma de Buenos Aires (Argentina); Garabalino, Marcela A.; Heber, Elisa M.; Pozzi, Emiliano C.C. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); Itoiz, Maria E. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); UBA, Department of Oral Pathology, Faculty of Dentistry, Ciudad Autonoma de Buenos Aires (Argentina); Aromando, Romina F. [UBA, Department of Oral Pathology, Faculty of Dentistry, Ciudad Autonoma de Buenos Aires (Argentina); Nigg, David W. [Idaho National Laboratory, Idaho Falls (United States)

    2017-11-15

    Boron neutron capture therapy (BNCT) is based on selective accumulation of B-10 carriers in tumor followed by neutron irradiation. We demonstrated, in 2001, the therapeutic effect of BNCT mediated by BPA (boronophenylalanine) in the hamster cheek pouch model of oral cancer, at the RA-6 nuclear reactor. Between 2007 and 2011, the RA-6 was upgraded, leading to an improvement in the performance of the BNCT beam (B2 configuration). Our aim was to evaluate BPA-BNCT radiotoxicity and tumor control in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration. We also evaluated, for the first time in the oral cancer model, the radioprotective effect of histamine against mucositis in precancerous tissue as the dose-limiting tissue. Cancerized pouches were exposed to: BPA-BNCT; BPA-BNCT + histamine; BO: Beam only; BO + histamine; CONTROL: cancerized, no-treatment. BNCT induced severe mucositis, with an incidence that was slightly higher than in ''B1'' experiments (86 vs 67%, respectively). BO induced low/moderate mucositis. Histamine slightly reduced the incidence of severe mucositis induced by BPA-BNCT (75 vs 86%) and prevented mucositis altogether in BO animals. Tumor overall response was significantly higher in BNCT (94-96%) than in control (16%) and BO groups (9-38%), and did not differ significantly from the ''B1'' results (91%). Histamine did not compromise BNCT therapeutic efficacy. BNCT radiotoxicity and therapeutic effect at the B1 and B2 configurations of RA-6 were consistent. Histamine slightly reduced mucositis in precancerous tissue even in this overly aggressive oral cancer model, without compromising tumor control. (orig.)

  1. Quantitative evaluation of bile diversion surgery utilizing /sup 99m/Tc HIDA scintigraphy

    International Nuclear Information System (INIS)

    Wickremesinghe, P.C.; Dayrit, P.Q.; Manfredi, O.L.; Fazio, R.A.; Fagel, V.L.

    1983-01-01

    This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by /sup 99m/Tc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative /sup 99m/Tc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to 45%. /sup 99m/Tc HIDA scintigraphy is useful in evaluating patients before and after bile diversion surgery, and demonstrates the quantitative decrease in enterogastric reflux after such surgery

  2. Performance and Ageing Robustness of Graphite/NMC Pouch Prototypes Manufactured through Eco-Friendly Materials and Processes.

    Science.gov (United States)

    Loeffler, Nicholas; Kim, Guk-T; Passerini, Stefano; Gutierrez, Cesar; Cendoya, Iosu; De Meatza, Iratxe; Alessandrini, Fabrizio; Appetecchi, Giovanni B

    2017-09-22

    Graphite/lithium nickel-manganese-cobalt oxide (NMC), stacked pouch cells with nominal capacity of 15-18 Ah were designed, developed, and manufactured for automotive applications in the frame of the European Project GREENLION. A natural, water-soluble material was used as the main electrode binder, thus allowing the employment of H 2 O as the only processing solvent. The electrode formulations were developed, optimized, and upscaled for cell manufacturing. Prolonged cycling and ageing tests revealed excellent capacity retention and robustness toward degradation phenomena. For instance, above 99 % of the initial capacity is retained upon 500 full charge/discharge cycles, corresponding to a fading of 0.004 % per cycle, and about 80 % of the initial capacity is delivered after 8 months ageing at 45 °C. The stacked soft-packaged cells have shown very reproducible characteristics and performance, reflecting the goodness of design and manufacturing. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Endoscopic third ventriculostomy is a safe and effective procedure for the treatment of Blake's pouch cyst

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Brusius

    2013-08-01

    Full Text Available OBJECTIVE: Blake's pouch cyst (BPC is a midline cystic malformation of the posterior fossa, within Dandy-Walker's complex (DWC, often associated with hydrocephalus. Endoscopic third ventriculostomy (ETV has been an alternative to conventional methods for BPC treatment. This study aimed at reporting our experience with ETV in a series of patients with BPC. METHODS: Of 33 patients diagnosed with midline posterior fossa cyst, 26 met the protocol criteria for DWC, and eight subjects with BPC were selected (aged one month to two years old. All cases were treated with ETV. RESULTS: Five patients were male; and three were prenatally diagnosed. They had hydrocephalus and motor deficiencies. Motor assessment at a five-year follow-up yielded normal findings. All patients improved, and only one had residual cognitive dysfunction, despite overall neurological improvement. There were no complications. CONCLUSIONS: ETV was a safe and effective procedure, reducing risks and morbidity associated with open surgery and shunt-related problems.

  4. Case report of severe Cushing's syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration.

    Science.gov (United States)

    Hammami, Muhammad M; Duaiji, Najla; Mutairi, Ghazi; Aklabi, Sabah; Qattan, Nasser; Abouzied, Mohei El-Din M; Sous, Mohamed W

    2015-09-09

    Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing's syndrome. Aortic dissection has been reported in three patients with Cushing's syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. An adult male with metastatic medullary thyroid cancer presented with hyperglycemia, hypernatremia, hypokalemia, hypertension, acne-like rash, and diabetes insipidus (urine volume >8 L/d, osmolality 190 mOsm/kg). Serum cortisol, adrenocorticoitropic hormone, dehydroepiandrostenedione sulfate, and urinary free cortisol were elevated 8, 20, 4.4, and 340 folds, respectively. Pituitary imaging was normal. Computed tomography scan revealed jejunal intussusception and incidental abdominal aortic dissection. Sorafenib treatment was associated with Cushing's syndrome remission, elevated progesterone (>10 fold), normalization of dehydroepiandrostenedione sulfate, but persistently elevated cortisol concentration. Newly-developed proximal lower limb weakness and decreased salivation were associated with elevated ganglionic neuronal acetylcholine receptor (alpha-3) and borderline P/Q type calcium channel antibodies. Extreme cortisol concentration may have contributed to aortic dissection and suppressed antidiuretic hormone secretion; which combined with hypokalemia due cortisol activation of mineralocorticoid receptors, manifested as diabetes insipidus. This is the first report of paraneoplastic dysautonomia and jejunal intussusception in medullary thyroid cancer, they may be related to medullary thyroid cancer's neuroendocrine origin and metastasis, respectively. Remission of Cushing's syndrome without measurable reduction in cortisol concentration suggests a novel cortisol-independent mechanism of action or assay cross-reactivity. Normalization of dehydroepiandrostenedione

  5. [Histologic study on impeding leukoplakia carcinogenesis of golden hamster cheek pouch about Erigeron breviscapus (Vant) Hand-Mazz].

    Science.gov (United States)

    Zhou, C T; Zhong, W J; Hua, L; Hu, H F; Jin, Z G

    2000-06-01

    To observe the effect of Erigeron breviscapus (Vant) Hand Mazz (HEr) in impeding oral leukoplakia carcinogenesis, and to seek effective Chinese herb medicine that can impede precarcinoma of oral mucosas. 132 golden hamsters were randomly divided into model group (60 animals), HEr group (60 animals), and control group 12 animals. Salley's leukoplakia carcinogenesis model of golden hamster cheek pouch was used in this study. HEr was injected into the stomach to impede evolution of carcinogenesis. Pathological specimens were observed via naked eye and light microscope between model group and HEr group. Results were compared. Observation via naked-eye showed that leukoplakia rate of HEr group (18.2%) was lower than that of model group (27.3%). Observation via light microscope showed that carcinogenesis rate descended one fold and displasia rate descended 0.4 fold in HEr group. HEr has exact effect in impeding leukoplakia carcinogenesis.

  6. HIV enteropathy: HAART reduces HIV-induced stem cell hyperproliferation and crypt hypertrophy to normal in jejunal mucosa.

    Science.gov (United States)

    Batman, Philip A; Kapembwa, Moses S; Belmonte, Liliana; Tudor, Gregory; Kotler, Donald P; Potten, Christopher S; Booth, Catherine; Cahn, Pedro; Griffin, George E

    2014-01-01

    To analyse the structural and kinetic response of small intestinal crypt epithelial cells including stem cells to highly active antiretroviral therapy (HAART). Crypt size and proliferative activity of transit and stem cells in jejunal mucosa were quantified using morphometric techniques. Crypt length was measured by counting the number of enterocytes along one side of a number of crypts in each biopsy specimen and the mean crypt length was calculated. Proliferating crypt cells were identified with MIB-1 monoclonal antibody, and the percentage of crypt cells in proliferation was calculated at each cell position along the length of the crypt (proliferation index). Data were obtained from 9 HIV-positive test patients co-infected with microsporidia, 34 HIV-positive patients receiving HAART and 13 control cases. Crypt length was significantly greater in test patients than in controls, but crypt length in patients receiving HAART was normal. The proliferation index was greater in test subjects than in controls in stem and transit cell compartments, and was decreased in patients treated with HAART only in the stem cell region of the crypt. Villous atrophy in HIV enteropathy is attributed to crypt hypertrophy and encroachment of crypt cells onto villi. HAART restores normal crypt structure by inhibition of HIV-driven stem cell hyperproliferation at the crypt bases.

  7. Assessment of Root Morphological Traits of 16 Tropical and Four Temperate Maize Cultivars for Nitrogen Efficiency in Short-Term Nutrient Solution Experiments with the Cigar Roll and Growth Pouch Methods

    Energy Technology Data Exchange (ETDEWEB)

    Saifu, S.; Schulte auf' m Erley, G.; Horst, W. J. [Institute for Plant Nutrition, Leibniz University of Hannover (Germany)

    2013-11-15

    Genotypic differences in N efficiency of maize have been reported by many authors. One of the reasons responsible for genotypic differences in N efficiency is differences in N uptake efficiency after anthesis. Continuous root growth and N uptake activity are responsible for the high N uptake efficiency of N-efficient genotypes. This study was conducted mainly to identify root parameters which could be used as secondary selection traits for genotypic differences in N efficiency of maize established in field experiments. The specific objective of the first experiment was to establish a relationship between root parameters with genotypic differences in N efficiency in the field, and to identify root traits to be used as secondary selection criteria for N efficiency. Four temperate and 16 tropical genotypes were grown in low-N nutrient solution with a cigar roll and a growth pouch culture for 9 and 10 days, respectively. In the cigar roll experiment individual root fractions (adventitious, seminal and primary root fractions) and in growth pouch experiment root distribution and root branching angle were of primary interest. Genotypic differences were found in most of the root traits, but the differences were not clear cut between N-efficient and inefficient genotypes with few exceptions. The N-efficient genotypes had the highest percentage of root length in the deepest (>20 cm) interval in the growth pouch, which also positively correlated with N uptake after anthesis and grain yield. The N-efficient genotypes also had a high percentage of roots in the root branching angle interval of 60-90{sup o}. It was concluded that the high N uptake efficiency of N-efficient genotypes might be related to a higher percentage of roots growing downwards (high branching angle) and a high percentage of root length in deeper soil layers enabling them to exploit nitrate in the subsoil more efficiently. These two root parameters were found promising to use as selection criteria for N

  8. Increased cholinergic contractions of jejunal smooth muscle caused by a high cholesterol diet are prevented by the 5-HT4 agonist – tegaserod

    Directory of Open Access Journals (Sweden)

    Shaffer Eldon

    2006-02-01

    Full Text Available Abstract Background Excess cholesterol in bile and in blood is a major risk factor for the respective development of gallbladder disease and atherosclerosis. This lipid in excess negatively impacts the functioning of other smooth muscles, including the intestine. Serotonin is an important mediator of the contractile responses of the small intestine. Drugs targeting the serotonin receptor are used as prokinetic agents to manage intestinal motor disorders, in particular irritable bowel syndrome. Thus, tegaserod, acting on 5-HT4 receptor, ideally should obviate detrimental effects of excessive cholesterol on gastrointestinal smooth muscle. In this study we examined the effect of tegaserod on cholesterol-induced changes in the contractile responses of intestinal smooth muscle. Methods The effects of a high cholesterol (1% diet on the in vitro contractile responses of jejunal longitudinal smooth muscle from Richardson ground squirrels to the cholinergic agonist carbachol were examined in the presence or absence of tetrodrodotoxin (TTX. Two groups of animals, fed either low (0.03% or high cholesterol rat chow diet, were further divided into two subgroups and treated for 28 days with either vehicle or tegaserod. Results The high cholesterol diet increased, by nearly 2-fold, contractions of the jejunal longitudinal smooth muscle elicited by carbachol. These cholinergic contractions were mediated by muscarinic receptors since they were blocked by scopolamine, a muscarinic receptor antagonist, but not by the nicotinic receptor antagonist, hexamethonium. Tegaserod treatment, which did not affect cholinergic contractions of tissues from low cholesterol fed animals, abrogated the increase caused by the high cholesterol diet. With low cholesterol diet TTX enhanced carbachol-evoked contractions, whereas this action potential blocker did not affect the augmented cholinergic contractions seen with tissues from animals on the high cholesterol diet. Tegaserod

  9. A smart mobile pouch as a biomechanical energy harvester towards self-powered smart wireless power transfer applications.

    Science.gov (United States)

    Chandrasekhar, Arunkumar; Alluri, Nagamalleswara Rao; Sudhakaran, M S P; Mok, Young Sun; Kim, Sang-Jae

    2017-07-20

    A Smart Mobile Pouch Triboelectric Nanogenerator (SMP-TENG) is introduced as a promising eco-friendly approach for scavenging biomechanical energy for powering next generation intelligent devices and smart phones. This is a cost-effective and robust method for harvesting energy from human motion, by utilizing worn fabrics as a contact material. The SMP-TENG is capable of harvesting energy in two operational modes: lateral sliding and vertical contact and separation. Moreover, the SMP-TENG can also act as a self-powered emergency flashlight and self-powered pedometer during normal human motion. A wireless power transmission setup integrated with SMP-TENG is demonstrated. This upgrades the traditional energy harvesting device into a self-powered wireless power transfer SMP-TENG. The wirelessly transferred power can be used to charge a Li-ion battery and light LEDs. The SMP-TENG opens a wide range of opportunities in the field of self-powered devices and low maintenance energy harvesting systems for portable and wearable electronic gadgets.

  10. Morbidity and Functional Outcomes following Free Jejunal Flap Reconstruction for Head and Neck Cancer.

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Qu, Dong; Wang, Jian; Li, Dezhi; Zhang, Bin; Xu, Zhengang; Liu, Shaoyan

    2017-01-01

    To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients. 8 patients died of tumor recurrence and 2 patients died of other reasons (cerebrovascular disease and respiratory disease, respectively). The 1-year, 2-year, and 3-year survival rates were 70.5, 49.4, and 33.8%, respectively. 83.3% of all patients could tolerate soft chewable foods, such as cooked vegetables, fish, hamburger, and small pieces of meat. 2 patients with early stenosis at upper anastomotic sites were with good swallowing function; while 2 patients with early stenosis at lower anastomotic sites were found to have difficulty in oral diet. 2 (11.1%) patients with larynx-preserving pharyngo-esophagectomy showed no compromise in speech. Only 2 (11.1%) patients underwent primary tracheoesophageal puncture for inserting an indwelling voice prosthesis for speech, and both patients achieved functional tracheoesophageal speech. The remaining 14 (77.8%) patients with total PLE did not resume functional speech. Postoperative barium swallow examination is helpful to predict long-term anastomotic stenosis. Good functional swallow rehabilitation is achieved following FJF reconstruction after total PLE or a larynx-preserving procedure. However, the speech outcomes are not satisfactory. It raises the demand of enhancement of functional recovery so that quality of life can be improved for these patients in China. © 2017 S. Karger AG, Basel.

  11. Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature Reconstrução da via biliar após lesão iatrogênica, proposta de nova técnica: estudo em cães e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Eduardo Crema

    2007-06-01

    Full Text Available PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg, were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg. Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os

  12. Temporomandibular joint arthroplasty for osteoarthrosis: A series of 24 patients that received a uni- or bilateral inter-positional silicone sheet.

    Science.gov (United States)

    Boutault, F; Cavallier, Z; Lauwers, F; Prevost, A

    2018-06-01

    To evaluate mid-term results from using a silicone sheet for inter-positional arthroplasty in moderate or severe cases of osteoarthrosis of the temporo-mandibular joint (TMJ). To also determine any remaining indications from this method. This retrospective study included patients that underwent surgery between 2008 and 2016. Pre- and post-operative mouth opening (MO), according to inter-incisal distance (mm) and pain score (PS: 0=no pain to 4=very severe pain) were recorded for 24 patients. Patients were divided according to thickness of the silicone sheet (group A: 1.0 mm, group B: 1.5 mm). The cohort included 22 females (92%). Mean age at surgery was 55 years±13 (26-80). Mean length of follow-up was 26 months±24 (6-80). Mean improvement in MO was 8.2 mm (+33%) and of PS was 1.7 (-68%). MO was not improved for two patients and worsened for one. PS score improved for all patients. No statistical difference was found between groups A and B. There was also a tendency for degradation of outcomes over time. The poor reputation of prosthetic discoplasty was not as evident in our series, even though anatomical and functional status seemed to deteriorate over time. This is because total-joint prosthetic replacement is often proposed instead. However, for elderly or fragile patients that have severe pain, and regarding cost-benefit aspects, conventional arthroplasty can still be discussed, especially since French national health-care insurance does not yet support TMJ prosthetic replacement for osteoarthrosis. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. State of charge estimation for lithium-ion pouch batteries based on stress measurement

    International Nuclear Information System (INIS)

    Dai, Haifeng; Yu, Chenchen; Wei, Xuezhe; Sun, Zechang

    2017-01-01

    State of charge (SOC) estimation is one of the important tasks of battery management system (BMS). Being different from other researches, a novel method of SOC estimation for pouch lithium-ion battery cells based on stress measurement is proposed. With a comprehensive experimental study, we find that, the stress of the battery during charge/discharge is composed of the static stress and the dynamic stress. The static stress, which is the measured stress in equilibrium state, corresponds to SOC, this phenomenon facilitates the design of our stress-based SOC estimation. The dynamic stress, on the other hand, is influenced by multiple factors including charge accumulation or depletion, current and historical operation, thus a multiple regression model of the dynamic stress is established. Based on the relationship between static stress and SOC, as well as the dynamic stress modeling, the SOC estimation method is founded. Experimental results show that the stress-based method performs well with a good accuracy, and this method offers a novel perspective for SOC estimation. - Highlights: • A State of Charge estimator based on stress measurement is proposed. • The stress during charge and discharge is investigated with comprehensive experiments. • Effects of SOC, current, and operation history on battery stress are well studied. • A multiple regression model of the dynamic stress is established.

  14. Endosonographic and manometric assessment of the anal sphincters after ileal pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Ciesielski, A.; Bielecki, K.; Baczuk, L.; Tarnowski, W.

    2003-01-01

    Background. The aim of this study was to compare endosonography and manometry of the anal sphincters in patients after ileal pouch-anal anastomosis (IPAA). Patients and methods. Ten patients aged between 23 and 50 years with IPAA performed for ulcerative colitis were examined with anal endosonography (AES) and manometry. Results. AES visualised abnormal image of the internal anal sphincter (IAS) in 9 patients (90%). Defects of the external anal sphincter (EAS) and puborectalis muscle (PR) were shown in 4 patients (40%). In 5 patients (50%) correlation between endosonographic and manometric assessment for the all analysed muscles: IAS, EAS and PR was found. In 4 cases (40%) both methods correlated with the evaluation of the EAS only and in 1 patient (10%) no correlation was found. Correlation between both methods for the IAS was found in half of the patients (50%) while in the evaluation of the EAS and PR dynamic activity, it was found in 9 cases (90%). Conclusions. Anal endosonography and manometry allow us to assess the morphology as well as the function of the anal sphincters in patients with IPAA. The methods mentioned above show high correlation in the assessment of the EAS function (9 cases; 90%) whereas in the case of IAS, manometry frequently (5 patients; 50%) does not confirm endosonografically detected defects. (author)

  15. A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy

    Directory of Open Access Journals (Sweden)

    Ramazan Karabulut

    2015-01-01

    Full Text Available Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

  16. Storage in high-barrier pouches increases the sulforaphane concentration in broccoli florets.

    Directory of Open Access Journals (Sweden)

    Yoshio Makino

    Full Text Available Sulforaphane is a phytochemical that is usually found in cruciferous vegetables and is known to have a depressive effect on gastric cancer. Preliminary investigations showed that the sulforaphane concentration in broccoli (Brassica oleracea var. italica florets increased under anoxia. Therefore, in the present study, we examined the effect of different atmospheric conditions on the sulforaphane concentration in broccoli and also tested whether there are concurrent effects on the concentration of ethanol, which is an unfavorable byproduct of fermentation. The sulforaphane concentration in broccoli florets was significantly elevated by 1.9- to 2.8-fold after 2 d of storage under hypoxia at ca. 0% O2 and ca. 24% CO2 at 20°C, whereas no such increase was observed following storage under normoxia at ca. 0% O2 without CO2 at 20°C. Furthermore, after 2 d, the sulforaphane concentration under hypoxia was 1.6- to 2.3-fold higher than that under normoxia. These results suggest that storage under hypoxia with high CO2 levels can elevate the sulforaphane concentration in broccoli florets. However, the elevated sulforaphane concentration could not be maintained beyond 2 d. There was no significant difference in the concentration of ethanol between florets that were stored under hypoxia with/without CO2 or normoxia at 2 d. However, the ethanol concentrations inside the pouches significantly increased between 2 d and 7 d. These findings indicate that the quality of broccoli florets can be improved through storage under hypoxia with high CO2 levels at 20°C for 2 d.

  17. Storage in high-barrier pouches increases the sulforaphane concentration in broccoli florets.

    Science.gov (United States)

    Makino, Yoshio; Nishimura, Yuto; Oshita, Seiichi; Mizosoe, Takaharu; Akihiro, Takashi

    2018-01-01

    Sulforaphane is a phytochemical that is usually found in cruciferous vegetables and is known to have a depressive effect on gastric cancer. Preliminary investigations showed that the sulforaphane concentration in broccoli (Brassica oleracea var. italica) florets increased under anoxia. Therefore, in the present study, we examined the effect of different atmospheric conditions on the sulforaphane concentration in broccoli and also tested whether there are concurrent effects on the concentration of ethanol, which is an unfavorable byproduct of fermentation. The sulforaphane concentration in broccoli florets was significantly elevated by 1.9- to 2.8-fold after 2 d of storage under hypoxia at ca. 0% O2 and ca. 24% CO2 at 20°C, whereas no such increase was observed following storage under normoxia at ca. 0% O2 without CO2 at 20°C. Furthermore, after 2 d, the sulforaphane concentration under hypoxia was 1.6- to 2.3-fold higher than that under normoxia. These results suggest that storage under hypoxia with high CO2 levels can elevate the sulforaphane concentration in broccoli florets. However, the elevated sulforaphane concentration could not be maintained beyond 2 d. There was no significant difference in the concentration of ethanol between florets that were stored under hypoxia with/without CO2 or normoxia at 2 d. However, the ethanol concentrations inside the pouches significantly increased between 2 d and 7 d. These findings indicate that the quality of broccoli florets can be improved through storage under hypoxia with high CO2 levels at 20°C for 2 d.

  18. A new species of pouched octopus, Cistopus Gray, 1849 (Cephalopoda: Octopodidae) from the southwest coast of India.

    Science.gov (United States)

    Sreeja, Vijayamma; Norman, Mark D; Kumar, Appukuttannair Biju

    2015-12-16

    Octopuses of the genus Cistopus Gray, 1849 are commercially valuable catches in the cephalopod fisheries of India. The primary and unique diagnostic character of this genus is the possession of eight small mucous pouches embedded in the oral faces of the webs between the bases of each arm. Historically only a single species of Cistopus, C. indicus, had been reported from Indian waters. In reviewing the octopod fauna off the Kerala coast, we have detected three species of Cistopus, of which one is described here as a new species. Cistopus platinoidus sp. nov. is distinct from Cistopus species described to date (C. indicus, C. taiwanicus and C. chinensis) on the basis of sucker counts, the number and position of enlarged suckers in males, and presence/absence of a calamus. Our studies of catch composition of Kerala octopod fisheries indicate a higher diversity of target species than previously suspected, including a number of undescribed species. Taxonomic resolution and collation of biological and distributional data are required for effective monitoring and management of these valuable fisheries.

  19. Carcinogenic effects of MGP-7 and B(a)P on the Hamster Cheek Pouch

    Energy Technology Data Exchange (ETDEWEB)

    Brandon, J.L.; Conti, C.J.; Goldstein, L.S.; DiGiovanni, J.; Gimenez-Conti, I.B. [University of Texas MD Anderson Cancer Center, Smithville, TX (United States). Dept. of Carcinogenesis

    2009-10-15

    This study was performed to examine the carcinogenic effects of benzo(a)pyrene (B(a)P) and manufactured gas plant (MGP) residues on the hamster cheek pouch (HCP). Syrian hamsters were treated topically with a suspension of 2%, 10%, or 20% B(a)P or 50% or 100% MGP-7 (a mixture of residues from 7 MGP sites) in mineral oil for eight (short-term study) and sixteen, twenty, twenty-eight, and thirty-two weeks (long-term study). The short-term study showed that B(a)P induced p53 protein accumulation, indicative of genotoxic damage, as well as increased cell proliferation, hyperplasia, and inflammation, which is usually associated with promotional activity. In contrast, the MGP-7 presented only marginal p53 accumulation and induction of BrdU incorporation. In the long-term experiments, animals treated with 2% and 10% of B(a)P continued to show p53 protein accumulation as well as hyperplasia and increased cell proliferation and inflammation. By thirty weeks, all the animals treated with B(a)P had a 100% incidence of squamous cell carcinoma (SCC). Animals treated with 50% and 100% MGP-7 showed only weak hyperplasia and a low proliferation rate and accumulation of p53 protein through thirty-two weeks. Benzo(a)pyrene was highly carcinogenic when used at adequate doses. Manufactured gas plant residue, however, was not carcinogenic in this model.

  20. Novel double-stapling technique for distal oesophageal resection and oesophago-jejunal anastomosis.

    Science.gov (United States)

    Gentilli, Sergio; Portigliotti, Luca; Davoli, Fabio; Roncon, Alberto; Rena, Ottavio; Oldani, Alberto

    2016-01-01

    The restoration of the digestive tract by performing an esophago-jejunal anastomosis (EJA) is a crucial step of the total gastric and distal esophagus surgical resection for esophago-gastric junction (EGJ) cancer. We have already ideated and tested on a cadaver model an innovative technique which could be useful to minimize the risk of complications related to the phase of securing the anvil of the circular stapler prior to perform the EJA. This surgical technique was derived from the well-known "double-stapling Knight and Griffen" one that was described for the rectal resection. We used the following described technique in 20 patients with EGJ cancer and it is efficient, reliable, safe, easy to learn and easy to perform. From August 2014 to May 2015, 20 patients (14 male and 6 female) underwent surgery for esophagogastric junction cancer: In all patients a distal esophageal resection and total gastrectomy was performed. Through the trans-hiatal access, the free margins of the esophageal stump were suspended and the anvil of a circular stapler on a new dedicated and registered support bar was inserted into the lumen. Subsequently, the linear suturing stapler is closed over the bar and then fired to suture the distal stump of the esophagus; after the confirmation of a negative margin, the bar is retracted and the push-rod of the anvil is pulled out through the linear suture. Finally, the anastomosis is performed with the classic technique by using a circular stapler. No postoperative mortality occurred; postoperative course has been uneventful for 18 patients. One patient developed anastomotic fistula that has been treated conservatively with endoscopic prothesis, removed after 20 days. One patient developed in 3 POD myocardial infarction Mean Hospital stay has been 14 days (range 7-20 days). The aim of our new procedure is the insertion the anvil of a common circular stapler without handsewn securing; this is to reduce the technical difficulties related to the hand

  1. Large format lithium ion pouch cell full thermal characterisation for improved electric vehicle thermal management

    Science.gov (United States)

    Grandjean, Thomas; Barai, Anup; Hosseinzadeh, Elham; Guo, Yue; McGordon, Andrew; Marco, James

    2017-08-01

    It is crucial to maintain temperature homogeneity in lithium ion batteries in order to prevent adverse voltage distributions and differential ageing within the cell. As such, the thermal behaviour of a large-format 20 Ah lithium iron phosphate pouch cell is investigated over a wide range of ambient temperatures and C rates during both charging and discharging. Whilst previous studies have only considered one surface, this article presents experimental results, which characterise both surfaces of the cell exposed to similar thermal media and boundary conditions, allowing for thermal gradients in-plane and perpendicular to the stack to be quantified. Temperature gradients, caused by self-heating, are found to increase with increasing C rate and decreasing temperature to such an extent that 13.4 ± 0.7% capacity can be extracted using a 10C discharge compared to a 0.5C discharge, both at -10 °C ambient temperature. The former condition causes an 18.8 ± 1.1 °C in plane gradient and a 19.7 ± 0.8 °C thermal gradient perpendicular to the stack, which results in large current density distributions and local state of charge differences within the cell. The implications of these thermal and electrical inhomogeneities on ageing and battery pack design for the automotive industry are discussed.

  2. Duodenum inclusion in alimentary transit for preventing or correcting nutritional deficiencies resulting from Roux-en-y gastric bypass in obesity treatment.

    Science.gov (United States)

    Ceneviva, Reginaldo

    2016-01-01

    Nutritional and metabolic complications can develop after Roux-en-Y gastric bypass (RYGB) when there is an exaggerated response to the anatomical and functional changes or when there is inadequate nutritional supplementation. Severe malnutrition is rare, but deficiencies of vitamin B12, iron, calcium and thiamin, metabolic bone disease and gallstones are common after RYGB. Shortage of vitamin B12, iron, calcium and also cholelithiasis are caused at least partially by excluding the duodenum and proximal jejunum from food transit. We designed a new procedure, with the maintenance of the duodenum and proximal jejunum in the gastrointestinal transit through interposition of jejunal loop, as a primary operation to prevent such deficiencies or as corrective surgery for severe malnutrition after RYGB with failure in responding to conservative treatment. Complicações nutricionais e metabólicas podem se desenvolver após a derivação gástrica em Y de Roux (DGYR) quando há uma resposta exagerada às mudanças anatômicas e funcionais ou quando há suplementação nutricional inadequada. A desnutrição grave é rara, mas deficiências de vitamina B12, ferro, cálcio e tiamina, doença óssea metabólica e cálculos biliares são comuns após a DGYR. Dessas deficiências mencionadas, a de vitamina B12, de ferro, de cálcio e também a colelitíase, são causadas, ao menos parcialmente, pela exclusão do duodeno e jejuno proximal. Um novo procedimento com a manutenção do duodeno e do jejuno proximal no trânsito gastrointestinal, mediante interposição de alça jejunal, foi idealizado como operação primária para prevenir essas deficiências ou como cirurgia corretiva de desnutrição grave após DGYR com falha na resposta a exaustivas tentativas de tratamento conservador.

  3. Esvaziamento gástrico e jejunal proximal em ratos submetidos ou não à gastrectomia parcial com reconstrução do trânsito intestinal em Y de Roux ou a Billroth II Gastric and proximal jejunum emptying in rats submitted or not to partial gastrectomy with Roux-en Y or Billroth II reconstruction

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    Flavio José Garani

    1997-03-01

    Full Text Available Estudou-se os efeitos da reconstrução gastrojejunal em Y de ROUX (YR ou a BILLROTH II (BII no esvaziamento gástrico (EG e jejunal proximal de líquido nutriente. Constitui-se quatro grupos de dez ratos Wistar machos: simulado (grupo I, antrectomia em YR (grupo II, gastrectomia subtotal em YR (grupo III e antrectomia a BII (grupo IV. O EG e jejunal proximal foram avaliados no sétimo dia de pós-operatório, 60 minutos após a introdução gástrica de ovo cru mexido marcado com Tc99m. Após esse tempo, retirou-se separadamente o estômago, intestino proximal e restante do intestino, seguindo-se da quantificação do radioisótopo presente em cada segmento, numa câmara de ionização. O EG foi mais rápido nos animais gastrectomizados do que naqueles sem gastrectomia (α The aim of this study was to determine the effects of ROUX-EN-Y or BILLROTH II gastrojejunostomy in gastric and proximal jejunal emptying of nutrient liquid meal. Four groups of ten WISTAR rats were used: sham {group I, antrectomy and ROUX-EN-Y gastrojejunostomy (group II, subtotal gastrectomy and ROUX-EN-Y gastrojejunostomy (group III and antrectomy and BILLROTH II gastrojejunostomy (group IV. The gastric and proxima! jejunal emptying were measured one week after surgery, 60 minutes after gastric introduetion of 1 ml of 99mTc labeled uncooked scrainbled egg. Afler this interval the stomach, proximal intestine, small bowell remaining and colon of each rat were excised and placed in separate containers. The absolute amounts of the radionuclide present in each segment was determined in an ionization camera. The relative amounts was calculated and compared. The gastric emplying Ín ROUX-EN-Y antrectomy group was faster than sham group and slower than ROUX-EN-Y subtotal gastrectomy group (∞ < 0,05, but didn't present a significant difference in relation to antrectomy BILLROTH II group. The ROUX limb emptying (groups II and III was not significantly different than efferent loop

  4. Mucormicosis yeyunal en paciente con linfoma de Hodgkin Jejunal mucormycosis in a patient with Hodgkin's lymphoma

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    B. Madrigal

    2008-08-01

    Full Text Available Comunicamos un caso de mucormicosis intestinal en un hombre de 46 años de edad, diagnosticado de enfermedad de Hodgkin clásica, estadio IV-B. Durante la primera fase de la quimioterapia, sufrió una hemorragia digestiva masiva secundaria a una úlcera yeyunal por zigomicosis tipo mucor, diagnosticada por biopsia endoscópica. El paciente fue tratado con antifúngicos y resección quirúrgica del intestino afectado. En la cirugía, se apreció una doble perforación yeyunal cubierta. El estudio anatomopatológico de la pieza confirmó el diagnóstico previo. Tras un año de seguimiento, el paciente está recuperado y su linfoma de Hodgkin en remisión completa. Tras una extensa revisión de la literatura, según nuestro conocimiento, este es el segundo caso publicado en la literatura de mucormicosis intestinal en un paciente con linfoma de Hodgkin.We report a case of intestinal mucormycosis in a 46-year-old male diagnosed with classical Hodgkin's disease, IV-B stage. During the first phase of chemotherapy he had a massive digestive bleeding event secondary to a jejunal ulcer, and zygomicosis mucor-type was diagnosed by endoscopic biopsy. The patient was treated with antifungal drugs and surgical resection of the intestine involved. At surgery a double covered perforation of the jejunum was seen. Pathological examination confirmed the previous diagnosis. After one year of follow-up the patient is doing well, and his lymphoma is on remission. To our best knowledge this is the second case of intestinal mucormycosis in a patient with Hodgkin's lymphoma reported in the medical literature.

  5. Effects of external pressure on the performance and ageing of single-layer lithium-ion pouch cells

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    Mussa, Abdilbari Shifa; Klett, Matilda; Lindbergh, Göran; Lindström, Rakel Wreland

    2018-05-01

    The effects of external compression on the performance and ageing of NMC(1/3)/Graphite single-layer Li-ion pouch cells are investigated using a spring-loaded fixture. The influence of pressure (0.66, 0.99, 1.32, and 1.98 MPa) on impedance is characterized in fresh cells that are subsequently cycled at the given pressure levels. The aged cells are analyzed for capacity fade and impedance rise at the cell and electrode level. The effect of pressure distribution that may occur in large-format cells or in a battery pack is simulated using parallel connected cells. The results show that the kinetic and mass transport resistance increases with pressure in a fresh cell. An optimum pressure around 1.3 MPa is shown to be beneficial to reduce cyclable-lithium loss during cycling. The minor active mass losses observed in the electrodes are independent of the ageing pressure, whereas ageing pressure affects the charge transfer resistance of both NMC and graphite electrodes and the ohmic resistance of the cell. Pressure distribution induces current distribution but the enhanced current throughput at lower pressures cell does not accelerate its ageing. Conclusions from this work can explain some of the discrepancies in non-uniform ageing reported in the literature and indicate coupling between electrochemistry and mechanics.

  6. Myeloid Heme Oxygenase-1 Regulates the Acute Inflammatory Response to Zymosan in the Mouse Air Pouch

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    Rita Brines

    2018-01-01

    Full Text Available Heme oxygenase-1 (HO-1 is induced by many stimuli to modulate the activation and function of different cell types during innate immune responses. Although HO-1 has shown anti-inflammatory effects in different systems, there are few data on the contribution of myeloid HO-1 and its role in inflammatory processes is not well understood. To address this point, we have used HO-1M-KO mice with myeloid-restricted deletion of HO-1 to specifically investigate its influence on the acute inflammatory response to zymosan in vivo. In the mouse air pouch model, we have shown an exacerbated inflammation in HO-1M-KO mice with increased neutrophil infiltration accompanied by high levels of inflammatory mediators such as interleukin-1β, tumor necrosis factor-α, and prostaglandin E2. The expression of the degradative enzyme matrix metalloproteinase-3 (MMP-3 was also enhanced. In addition, we observed higher levels of serum MMP-3 in HO-1M-KO mice compared with control mice, suggesting the presence of systemic inflammation. Altogether, these findings demonstrate that myeloid HO-1 plays an anti-inflammatory role in the acute response to zymosan in vivo and suggest the interest of this target to regulate inflammatory processes.

  7. Quality and shelf life of buffalo meat blocks processed in retort pouches.

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    Devadason, I Prince; Anjaneyulu, A S R; Mendirtta, S K; Murthy, T R K

    2014-12-01

    The shelf life of buffalo meat blocks processed in 3-ply retort pouches at Fo = 12.13 in a stock sterilizer were evaluated at 15 days interval for physico-chemical, microbiological and sensory attributes for a period of 3 months. The pH of the product was 6.28 at 0 day and a gradual decline was noticed during storage. Texture of the product as indicated by shear force values had decreased slowly. The residual nitrite content had significantly declined from 82.67 ppm at 0 day to 45.00 ppm on 90th day of storage. The TBARS values were 0.24 and 0.67 mg malonaldehyde/kg, respectively at 0 day and 90 days of storage. Tyrosine value had significantly increased from 0.37 mg/100 g at 0 day to 0.58 mg/100 g during storage. Free aminoacid content increased gradually from an initial level of 124.32 to 217.51 at 90(th) day of storage. The SDS-PAGE hydrolysis pattern showed barely discernible 205 KDa protein and presence of subfragments in the molecular range of 63 KDa to 29 KDa protein. The sensory studies indicated that the products were well acceptable up to a period of 90 days. As the storage period increased pH, reidual nitrite, sensory attributes declined significantly and TBARS value, tyrosine value and free aminoacid content significantly increased. Mesophillic aerobes and anerobes were found to be absent. The shelf life study indicated that the products were well acceptable up to a period of 90 days based on the assessment of physico-chemical, microbiological and sensory attributes.

  8. Effects of fasting at different stages of lighting regimen on the proliferation of jejunal epithelial cells during rat pup weaning.

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    Soares, Maria Albertina de Miranda; Okada, Monica A; Ayub, Cristina Lucia Sant'Ana C; Gomes, José Rosa

    2009-07-01

    The lifespan of intestinal epithelial cells is predetermined by the process of cell proliferation that occurs constantly in the crypt. The control of this process involves some endogenous factors, such as hormones, as well as exogenous factors, like food and natural light variations. These last two exogenous factors seem to be the major modulators of the cell proliferation process. Fasting treatment was conducted to assess the role of food and its effect on the metaphase index (MI) of the intestinal epithelium at different times and periods (light and dark) of the day. The effects of short- (5 hr) and long-term (25 hr) fasting on the MI in the jejunal epithelium of young rats were investigated at 09:00 h, 15:00 hr, 21:00 hr, and 02:00 hr using the arrested metaphases method. The present study demonstrates that 5 hr and 25 hr of fasting treatment decrease the MI at 09:00 hr. It was observed from MI analysis that there is an interaction between the fed/fasted status of the animal and the different times of the day. This result suggests that during the transition from youth to adulthood, the control of MI by the light/dark cycle seems to be more pronounced as compared with control by food intake at some periods of the day, although at other times food had a greater impact on the MI.

  9. Estudo comparativo entre ressecção do trapézio e interposição tendinosa com e sem ligamentoplastia no tratamento da artrose carpometacarpiana do polegar Comparative study between trapezium resection and tendon interposition with and without ligament plasty in the management of carpometacarpal arthrosis of the thumb

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    Arlindo Gomes Pardini Junior

    2008-03-01

    Full Text Available OBJETIVOS: O tratamento da artrose da base do polegar tem sido tema de grande controvérsia. Numerosas cirurgias têm sido descritas, como ressecção isolada do trapézio, ressecção com interposição com e sem reforço ligamentar, artrodese e artroplastias. O objetivo deste trabalho foi o de comparar os resultados das duas técnicas mais utilizadas nesse tratamento. MÉTODOS: Foi realizado estudo prospectivo a fim de comparar os resultados cirúrgicos de ressecção do trapézio com interposição tendinosa (tenoartroplastia - 22 casos e tenoartroplastia associada a ligamentoplastia - 24 casos. A avaliação objetiva foi feita através das medidas de oponência, dos movimentos da articulação metacarpofalangiana, da força de pinça e de preensão, da medida radiográfica da distância entre a base do 1º metacarpiano e o escafóide e do ângulo entre o 1º e o 2º metacarpianos. A avaliação subjetiva foi realizada através do questionário DASH, uma escala analógico-digital para avaliar a dor e a satisfação do paciente. RESULTADOS E CONCLUSÃO: Após a aplicação dos critérios descritos e usada análise estatística pelo teste t de Student, os autores concluem não haver vantagens da reconstrução ligamentar sobre a simples interposição tendinosa na artrose carpometacarpiana do polegar.OBJECTIVES: Treating arthrosis in the base of the thumb has been a highly controverted subject. Many surgeries have been described, such as the isolated trapezium resection; resection with interposition with and without ligament plasty, arthrodesis, and arthroplasties. The purpose of this paper is to compare the two techniques which are the most used in this treatment. METHODS: A prospective study has been made to compare the surgical results between the trapezium resection with tendon interposition (tendon arthroplasty - 22 cases - and tendon arthroplasty associated to ligament plasty - 24 cases. Objective evaluation was done by measuring

  10. Hamster (Mesocricetus auratus cheek pouch as an experimental model to investigate human skin and keloid heterologous graft Bolsa jugal no hamster (Mesocricetus auratus como modelo experimental de investigação de enxertos heterólogos de pele humana e quelóide

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    Bernardo Hochman

    2004-12-01

    Full Text Available To describe the integration process of grafts of total human skin and keloid in hamster (Mesocricetus auratus cheek pouch, whose sub-epithelium is naturally an "Immunologically Privileged Site". Fragments of human normal skin and keloid from the breast region of mulatto female patients were transplanted into the cheek pouch subepithelium in situ. Surgical procedure and grafted pouches for microscopic exam at several time points of the transplantation were standardized. The integration of grafted fragments of human skin and keloid was seen in late periods (84 days since the microscopic assessment showed the presence of blood vases within the conjunctive tissue of grafted fragments. It was also possible to see among the grafted fragments the epithelium, the appearing of early cellular infiltrated, epithelial secretion of keratin, the presence of melanocytes, and delayed changes on the aspect of collagen fibers of conjunctive tissue. Pooled results allow to define hamster cheek pouch sub-epithelium as an experimental model to investigating heterologous graft physiology of human total skin and keloid with epithelium.Descrever a integração dos enxertos de pele total humana e quelóide na bolsa jugal do hamster (Mesocricetus auratus, cujo subepitélio é, naturalmente, um "Local de Privilégio Imunológico". Foram transplantados fragmentos, de pele humana normal e de quelóide, obtidos da região mamária de pacientes pardas, no subepitélio da bolsa jugal in situ. O procedimento operatório, e de preparo das bolsas enxertadas para exame microscópico em vários períodos de transplante, foi padronizado. Verificou-se a integração dos fragmentos enxertados de pele humana e de quelóide em períodos tardios (84 dias, uma vez que a avaliação microscópica revelou a presença de vasos sangüíneos no tecido conjuntivo dos fragmentos enxertados. Foi também possível observar, nos fragmentos enxertados, o epitélio, o aparecimento de infiltrado

  11. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis.

    Science.gov (United States)

    Yetisir, Fahri; Sarer, Akgün Ebru; Acar, Hasan Zafer; Osmanoglu, Gokhan; Özer, Mehmet; Yaylak, Faik

    2016-01-01

    Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU) with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF) to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

  12. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis

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    Fahri Yetisir

    2016-01-01

    Full Text Available Introduction. We report the management of a septic Open Abdomen (OA patient by the help of negative pressure therapy (NPT and abdominal reapproximation anchor (ABRA system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S with confounding factor of mild acute pancreatitis (AP. Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR. There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

  13. Development of functional canned and pouched tuna products added inulin for commercial production.

    Science.gov (United States)

    Rueangwatcharin, U; Wichienchot, S

    2015-08-01

    Four formulas of canned tuna in spring water and tuna in mayonnaise and pouched tuna in salad cream and tuna in thousand island cream with added inulin were developed for commercial production. The effects of the addition of a prebiotic (inulin, Orafti®-HP) on the color and sensory properties of these products were studied. For inulin concentrations studied (3, 5, 7 and 10 %, w/w) caused more intensed yellow and red colors. Hedonic sensory values of tuna packed in spring water and in mayonnaise showed no significant differences (p > 0.05) among products with different inulin addition levels (3, 5, 7 and 10 %, w/w) in terms of color, flavor, sweetness and overall characteristics. However, when packed in thousand island cream, significant differences (p < 0.05) in color and overall characteristics were found when inulin was added higher than 7 %. Tuna in salad cream showed significant differences (p < 0.05) in color, flavor, sweetness and overall characteristics at higher than 7 % inulin. The panelists showed acceptable overall liking scores at upto 7 % inulin of all tuna products. The thermal sterilization process resulted in approximately 20 % decrease in final inulin content. The calculated residual fructans of finished products at shelf life of 3 years were 3.01, 2.78, 2.90 and 2.84 % for tuna in spring water, tuna in mayonnaise, tuna in thousand island and tuna in salad cream, respectively. Considering formula cost in a commercial production and the recommended daily intake (RDI) of inulin in the finished product at end of shelf life (≥3 g/d), an addition of 5 % inulin for tuna in spring water and 7 % inulin for tuna in mayonnaise, tuna in thousand island and tuna in salad cream are recommended.

  14. Adhesions after laparoscopic and open ileal pouch-anal anastomosis surgery for ulcerative colitis.

    Science.gov (United States)

    Hull, T L; Joyce, M R; Geisler, D P; Coffey, J C

    2012-02-01

    Emerging evidence suggests that a laparoscopic approach to colorectal procedures generates fewer adhesions. Even though laparoscopic ileal pouch-anal anastomosis (IPAA) is a lengthy procedure, the prospect of fewer adhesions may justify this approach. The aim of this study was to assess abdominal and adnexal adhesion formation following laparoscopic versus open IPAA in patients with ulcerative colitis. A diagnostic laparoscopy was performed at time of ileostomy closure. All abdominal quadrants and the pelvis were video recorded systematically and graded offline. The incisional adhesion score (IAS; range 0-6) and total abdominal adhesion score (TAS; range 0-10) were calculated, based on the grade and extent of adhesions. Adnexal adhesions were classified by the American Fertility Society (AFS) adhesion score. A total of 43 patients consented to participate, of whom 40 could be included in the study (laparoscopic 28, open 12). Median age was 38 (range 20-61) years. There was no difference in age, sex, body mass index, American Society of Anesthesiologists grade and time to ileostomy closure between groups. The IAS was significantly lower after laparoscopic IPAA than following an open procedure: median (range) 0 (0-5) versus 4 (2-6) respectively (P = 0·004). The TAS was also significantly lower in the laparoscopic group: 2 (0-6) versus 8 (2-10) (P = 0·002). Applying the AFS score, women undergoing laparoscopic IPAA had a significantly lower mean(s.d.) prognostic classification score than those in the open group: 5·2(3·7) versus 20·0(5·6) (P = 0·023). Laparoscopic IPAA was associated with significantly fewer incisional, abdominal and adnexal adhesions in comparison with open IPAA. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  15. The neem limonoids azadirachtin and nimbolide inhibit hamster cheek pouch carcinogenesis by modulating xenobiotic-metabolizing enzymes, DNA damage, antioxidants, invasion and angiogenesis.

    Science.gov (United States)

    Priyadarsini, Ramamurthi Vidya; Manikandan, Palrasu; Kumar, Gurram Harish; Nagini, Siddavaram

    2009-05-01

    The neem tree has attracted considerable research attention as a rich source of limonoids that have potent antioxidant and anti-cancer properties. The present study was designed to evaluate the chemopreventive potential of the neem limonoids azadirachtin and nimbolide based on in vitro antioxidant assays and in vivo inhibitory effects on 7,12-dimethylbenz[a]anthracene (DMBA)-induced hamster buccal pouch (HBP) carcinogenesis. Both azadirachtin and nimbolide exhibited concentration-dependent anti-radical scavenging activity and reductive potential in the order: nimbolide > azadirachtin > ascorbate. Administration of both azadirachtin and nimbolide inhibited the development of DMBA-induced HBP carcinomas by influencing multiple mechanisms including prevention of procarcinogen activation and oxidative DNA damage, upregulation of antioxidant and carcinogen detoxification enzymes and inhibition of tumour invasion and angiogenesis. On a comparative basis, nimbolide was found to be a more potent antioxidant and chemopreventive agent and offers promise as a candidate agent in multitargeted prevention and treatment of cancer.

  16. Vimentin and laminin are altered on cheek pouch microvessels of streptozotocin-induced diabetic hamsters

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    Jemima Fuentes R Silva

    2011-01-01

    Full Text Available OBJECTIVE: Normal endothelial cells respond to shear stress by elongating and aligning in the direction of fluid flow. Hyperglycemia impairs this response and contributes to microvascular complications, which result in deleterious effects to the endothelium. This work aimed to evaluate cheek pouch microvessel morphological characteristics, reactivity, permeability, and expression of cytoskeleton and extracellular matrix components in hamsters after the induction of diabetes with streptozotocin. METHODS: Syrian golden hamsters (90-130 g were injected with streptozotocin (50 mg/kg, i.p. or vehicle either 6 (the diabetes mellitus 6 group or 15 (the diabetes mellitus 15 group days before the experiment. Vascular dimensions and density per area of vessels were determined by morphometric and stereological measurements. Changes in blood flow were measured in response to acetylcholine, and plasma extravasation was measured by the number of leakage sites. Actin, talin, α-smooth muscle actin, vimentin, type IV collagen, and laminin were detected by immunohistochemistry and assessed through a semiquantitative scoring system. RESULTS: There were no major alterations in the lumen, wall diameters, or densities of the examined vessels. Likewise, vascular reactivity and permeability were not altered by diabetes. The arterioles demonstrated increased immunoreactivity to vimentin and laminin in the diabetes mellitus 6 and diabetes mellitus 15 groups. DISCUSSION: Antibodies against laminin and vimentin inhibit branching morphogenesis in vitro. Therefore, laminin and vimentin participating in the structure of the focal adhesion may play a role in angiogenesis. CONCLUSIONS: Our results indicated the existence of changes related to cell-matrix interactions, which may contribute to the pathological remodeling that was already underway one week after induction of experimental diabetes.

  17. Aspectos técnicos da interposição ileal com gastrectomia vertical como possível opção ao tratamento do diabetes mellitus tipo 2 Technical aspects of ileal interposition with sleeve gastrectomy as a possible option for the treatment of type 2

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    Aureo Ludovico de Paula

    2010-06-01

    Full Text Available INTRODUÇÃO: Há evidências que os melhores resultados em termos de resolução do diabetes mellitus tipo 2 (DM2 em pacientes obesos mórbidos são atingidos com as derivações biliopancreáticas, em especial o duodenal switch. Essas operações caracterizam-se por redução do estômago através de gastrectomia e o rápido trânsito dos alimentos para o íleo distal, através de expressiva derivação de segmentos do intestino delgado. A idéia da realização da técnica aqui apresentada baseou-se nestes princípios. MÉTODO: Os procedimentos são habitualmente realizados por via laparoscópica após pneumoperitônio com 12 a 15 mmHg e seis trocárteres. O paciente é inicialmente posicionado em proclive de 30º com o cirurgião à direita. Inicia-se a gastrectomia vertical tendo como referência anatômica a trifurcação distal do vago anterior. A desvascularização da grande curvatura é realizada e se estende até o ângulo esofagogástrico. Com um calibrador intra-gástrico de 20 mm posicionado ao longo da pequena curvatura gástrica inicia-se a ressecção gástrica no antro com grampeador linear e adicionalmente é feita uma sutura contínua. Para a realização da interposição ileal na altura do jejuno proximal o ângulo duodenojejunal é identificado e o jejuno seccionado 20 a 30 cm à jusante com grampeador linear. O ceco é identificado e o íleo distal seccionado a 30 cm no sentido proximal. Um segmento de 150 a 170 cm de íleo é medido em sentido proximal e seccionado com grampeador linear. O segmento de íleo é interposto de forma isoperistáltica no jejuno proximal previamente seccionado. Em seguida, são realizadas três enteroanastomoses: a primeira íleo-ileal próxima ao ceco; outra próxima ao ângulo duodenojejunal; a terceira íleo-jejunal. O procedimento pode também ser feito com interposição ileal na primeira porção do duodeno. CONCLUSÃO: Esta técnica demonstrou-se segura, com baixa morbidade e

  18. Immunohistochemical study of jejunal graft mucosa cell populations during the initial adaptation phase in the host body in rats.

    Science.gov (United States)

    Tóth, Stefan; Jonecová, Zuzana; Varga, Ján; Staško, Pavel; Kovalčinová, Barbora; Maretta, Milan; Leško, Dušan; Veselá, Jarmila

    2013-10-01

    The character of the changes in cell populations within the jejunal graft mucosa during the initial adaptation phase in the host body was investigated. 24 adult male Wistar rats underwent intestinal heterotopic allotransplantation. Aorto-aortal and porto-caval anastomoses were performed using the end-to-side microsurgery technique. Graft tissues were compared to the intestinal tissues of the recipients. This study demonstrates that: (1) Distinct injury to the graft mucosa 1h after transplantation was accompanied by significant reduction in numbers of epithelial secretory cell populations. The injury was more intense in the mesenteric portion. Six hours after transplantation the graft mucosa was covered by a continuous epithelium, but the number of goblet and Paneth cells was found to be less than 30% of that in the recipient epithelium. (2) In comparison with recipients, myeloperoxidase-positive cell numbers increased significantly in the graft mucosa 1 h after transplantation. In the epithelial layer, denudation and destruction of villi was associated with a significant reduction in intraepithelial lymphocyte numbers. A significant decrease in mucosal mast cell numbers was detected 6 h after transplantation. They attained only 10% of the number found in the recipients. (3) Time-dependent changes in the graft mucosa revealed that CD163-positive cells increased significantly in the graft mucosa during 6 h after transplantation and reached the level found in the recipients. In contrast, the myeloperoxidase-positive cell population significantly decreased in the graft mucosa within the initial 6 h. Copyright © 2013 Elsevier GmbH. All rights reserved.

  19. The Antarctic holothurian genus Echinopsolus Gutt, 1990 (Dendrochirotida, Cucumariidae): brood pouches, spermatozoa, spermatozeugmata and taxonomic implications.

    Science.gov (United States)

    Bohn, Jens Michael; Heß, Martin

    2014-07-29

    An examination of seven Antarctic brooding cucumariid and psolid holothurian species revealed a variety of characters all of them have in common: (1) All are gonochoric. (2) A genital papilla is present on the oral disc (permanent and digitiform in males). (3) Females brood their offspring in five anterior interradial brood pouches that are situated at the transition of body to introvert. (4) Multiple spermatozoa are always bundled to bunch-like spermato-zeugmata. (5) The spermatozoa have a fusiform head and a hollow cylinder-like mid-piece encircling the anterior end of the flagellum. This combination of characters so far is unique, and indicates a close relationship based on common origin. As a consequence, we unite all species sharing this set of synapomorphies in the genus Echinopsolus Gutt, 1990. The herewith included species are: E. acanthocola Gutt, 1990, E. acutus (Massin, 1992) comb. nov., E. charcoti (Vaney, 1906) comb. nov., E. koehleri (Vaney, 1914) comb. nov., E. mollis (Ludwig & Heding, 1935) comb. nov., E. parvipes Massin, 1992 and E. splendidus (Gutt, 1990) comb. nov.. Because the current assignment of Echinopsolus to the family Psolidae can not be retained, the genus is tranferred to the family Cucumariidae, as relationships to taxa within this family are obvious. The peculiar spermatozoa and spermato-zeugmata of all Echinopsolus species are described using light- and electron-microscopical techniques and the results are evaluated and discussed concerning their taxonomy and phylogeny. 

  20. [A case report: anomaly of the fourth branchial pouch with recurring cervical abscesses. Cauterization with trichloroacetic acid closed the fistula opening and cured the patient].

    Science.gov (United States)

    Stenquist, Monika; Juhlin, Claes; Aström, Gunnar; Friberg, Ulla

    2003-04-24

    A fourth branchial pouch sinus is a rare congenital anomaly, which in a 13-year-old girl presented clinically as recurrent deep cervical abscesses. The location of the majority of these anomalies is the left side of the neck (90%). Radiological and endoscopic investigations verified the diagnosis. The internal orifice located at the apex of the pyriform sinus could facilitate contamination by infectious pharyngeal secretions and lead to abscess recurrence. Traditionally, the recommended treatment is radical surgery. It can, however, be technically difficult to excise the whole fistula tract. In this patient we used a non-invasive treatment modality; chemocauterization with 40% trichloroacetic acid (TCA). After three treatments the fistula was closed. To date (month no. 15) there has been no abscess recurrence. TCA chemocauterization seems to be a safe first-line treatment for patients with pyriform sinus fistulas.

  1. The Dorsoulnar Artery Perforator Adipofascial Flap in the Treatment of Distal Radioulnar Synostosis

    Directory of Open Access Journals (Sweden)

    Alessia Pagnotta

    2017-01-01

    Full Text Available Posttraumatic radioulnar synostosis (RUS is a rare event following forearm fractures. Consequences are disabling for patients who suffer from functional limitation in forearm pronosupination. Distal RUS are even more rare and more difficult to treat because of high recurrence rates. The patient we describe in this paper came to our attention with a double distal RUS recurrence and a Darrach procedure already performed. We performed a radical excision of RUS and interposition with a vascularized dorsoulnar artery (DUA adipofascial perforator flap. Four years after surgery, the patient shows the same complete range of motion in pronosupination, and MRI confirms that the flap is still in place with signs of vascularization. Simple synostosis excision has been proven ineffective in many cases. Interposition is recommended after excision, and biological material interposition seems to be more effective than foreign material. Surgeons are increasingly performing vascularized interposition, and the results are very encouraging.

  2. Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication

    International Nuclear Information System (INIS)

    Fasulakis, Stephen; Andronikou, Savvas

    2003-01-01

    Balloon dilatation of the oesophagus in children has been performed predominantly for treating strictures, which are the result of primary repair of oesophageal atresia, interposition surgery or restrictive Nissen's fundoplication. Reports of the use of this technique for alternative causes of stricture are few. To report our experience and success with balloon dilatation of strictures due to caustic ingestion, achalasia, oesophagitis, congenital stenosis, and epidermolysis bullosa (EB) and to make comparisons with our treatment of patients with primary repair of oesophageal atresia (OA), as well as with reports in the English language literature. Retrospective review of fluoroscopically guided balloon oesophageal dilatation procedures in 19 patients over a 5-year period, and comparison of those performed for OA repair complications with those due to other diseases. The average radiation dose, per procedure, was calculated by a medical physicist. Ten patients had strictures as a result of primary repair of OA. Three patients had stricture as a result of EB, two from achalasia, two from caustic injury, one due to an oesophageal web and one from reflux oesophagitis. Our results show that the technique can also be curative for the last group and that it may be used intermittently to alleviate symptoms in ongoing diseases. We have not experienced any complications and have also calculated that, even with prolonged use of multiple procedures, the radiation exposure is comparable to other radiological techniques. Patients with alternative causes for oesophageal stricture may be treated to resolution within 2 years using balloon dilatation. Ongoing diseases such as EB require ongoing dilatation, but balloon dilatation of strictures has been successful in alleviating swallowing difficulty. Patients with stricture from OA repair sometimes need ongoing dilatation. Radiation exposure for multiple procedures, over an extended period, is comparable to that from a single

  3. Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication

    Energy Technology Data Exchange (ETDEWEB)

    Fasulakis, Stephen [Royal Children' s Hospital, Melbourne (Australia); Andronikou, Savvas [Royal Children' s Hospital, Melbourne (Australia); Department of Paediatric Radiology, Red Cross Children' s Hospital, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa)

    2003-10-01

    Balloon dilatation of the oesophagus in children has been performed predominantly for treating strictures, which are the result of primary repair of oesophageal atresia, interposition surgery or restrictive Nissen's fundoplication. Reports of the use of this technique for alternative causes of stricture are few. To report our experience and success with balloon dilatation of strictures due to caustic ingestion, achalasia, oesophagitis, congenital stenosis, and epidermolysis bullosa (EB) and to make comparisons with our treatment of patients with primary repair of oesophageal atresia (OA), as well as with reports in the English language literature. Retrospective review of fluoroscopically guided balloon oesophageal dilatation procedures in 19 patients over a 5-year period, and comparison of those performed for OA repair complications with those due to other diseases. The average radiation dose, per procedure, was calculated by a medical physicist. Ten patients had strictures as a result of primary repair of OA. Three patients had stricture as a result of EB, two from achalasia, two from caustic injury, one due to an oesophageal web and one from reflux oesophagitis. Our results show that the technique can also be curative for the last group and that it may be used intermittently to alleviate symptoms in ongoing diseases. We have not experienced any complications and have also calculated that, even with prolonged use of multiple procedures, the radiation exposure is comparable to other radiological techniques. Patients with alternative causes for oesophageal stricture may be treated to resolution within 2 years using balloon dilatation. Ongoing diseases such as EB require ongoing dilatation, but balloon dilatation of strictures has been successful in alleviating swallowing difficulty. Patients with stricture from OA repair sometimes need ongoing dilatation. Radiation exposure for multiple procedures, over an extended period, is comparable to that from a single

  4. Jejunal gluconeogenesis associated with insulin resistance level and its evolution after Roux-en-Y gastric bypass.

    Science.gov (United States)

    Gutierrez-Repiso, Carolina; Garcia-Serrano, Sara; Moreno-Ruiz, Francisco J; Alcain-Martinez, Guillermo; Rodriguez-Pacheco, Francisca; Garcia-Fuentes, Eduardo

    2017-04-01

    Intestinal gluconeogenesis (GNG) may play an important role in glucose homeostasis, but there is little information about the condition in humans. To study the relationship between intestinal GNG and insulin resistance, its association with the evolution of morbidly obese patients after bariatric surgery, and the effect of insulin and or leptin. Regional university hospital, Malaga (Spain). Jejunal mRNA expression of genes involved in GNG was analyzed in 3 groups of morbidly obese patients who underwent Roux-en-Y gastric bypass: with low insulin resistance (MO-low-IR), with high insulin resistance (MO-high-IR), and with type 2 diabetes treated with metformin (MO-metf-T2D). Also, intestinal epithelial cells (IEC) from MO-low-IR were incubated with different doses of insulin and or leptin. In MO-high-IR, glutaminase, phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6 Pase), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1 α), and sterol regulatory element-binding proteins 1 c (SREBP-1 c) expressions were significantly higher than in MO-low-IR. In MO-metf-T2 D, only PEPCK was significantly lower than in MO-high-IR. In IEC, an incubation with a high glucose and insulin dose produced an increase of PEPCK and SREBP-1 c, and a decrease of glutaminase, fructose 1,6-bisphosphatase (FBPase), and PGC-1 α expression. At high doses of leptin, G6 Pase and FBPase were significantly increased. The improvement of insulin resistance 3 months after bariatric surgery was positively associated with high G6 Pase and FBPase expression. mRNA expression of genes involved in GNG is increased in the jejunum of MO-high-IR, and regulated by insulin and or leptin. High mRNA expression of genes involved in GNG is associated with a better evolution of insulin resistance after bariatric surgery. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  5. A new multi-purpose NIM module

    International Nuclear Information System (INIS)

    Dong Binjiang; Wang Congrong; Du Chunxiang.

    1992-01-01

    The authors briefly state the function, character and main technique performance of a new multi-purpose NIM interposition (NI01) developed recently. This interposition uses 8031 single-chip microprocessors as the kernel and is multi-purpose, reliable and convenient. Especially, it is suitable for training teaching and scientific researching

  6. Design and characterization of a novel neutron shield for BNCT in an experimental model of oral cancer in the hamster cheek pouch at RA-3

    International Nuclear Information System (INIS)

    Pozzi, E.C.C.; Curotto, P.; Monti Hughes, A.; Nigg, D.W.; Schwint, A.E.; Trivillin, V.A.; Thorp, S.I.

    2013-01-01

    Our research group at the Radiation Pathology Division of the Department of Radiobiology (National Atomic Energy Commission) has previously demonstrated the therapeutic efficacy of different BNCT protocols to treat oral cancer in an experimental hamster cheek pouch model. In particular, to perform studies in this experimental model at the thermal facility constructed at RA-3, we designed and constructed a shielding device for thermal neutrons, to be able to expose the cheek pouch while minimizing the dose to the rest of the body. This device allowed for the irradiation of one animal at a time. Given the usage rate of the device, the aim of the present study was to design and construct an optimized version of the existing shielding device that would allow for the simultaneous irradiation of 2 animals at the thermal facility of RA-3. Taking into account the characteristics of the neutron source and preliminary biological assays, we designed the shielding device for the body of the animal, i.e. a rectangular shaped box with double acrylic walls. The space between the walls contains a continuous filling of 6Li 2 CO 3 (95% enriched in 6Li), approximately 6 mm thick. Two small windows interrupt the shield at one end of the box through which the right pouch of each hamster is everted out onto an external acrylic shelf for exposure to the neutron flux. The characterization of the shielding device showed that the neutron flux was equivalent at both irradiation positions confirming that we were able to design and construct a new shielding device that allows for the irradiation of 2 animals at the same time at the thermal facility of RA-3. This new version of the shielding device will reduce the number of interventions of the reactor operators, reducing occupational exposure to radiation and will make the procedure more efficient for researchers. In addition, we addressed the generation of tritium as a product of the capture reaction in lithium. It was considered as a

  7. Simplification of total mesorectal excision with colonic J-pouch anal anastomosis for middle and lower rectal cancer. One surgeon's experience

    International Nuclear Information System (INIS)

    Kusunoki, Masato; Inoue, Yasuhiro; Yanagi, Hidenori

    2008-01-01

    The introduction of total mesorectal excision (TME) has dramatically improved local control of rectal cancer. Yet, despite its complexity, there is no clear technical explanation of this procedure in the text references. Thus, we attempted to simplify the TME procedure according to its original concept. Our procedure has three principles: posterolateral dissection, which is helpful for performing complete TME with autonomic nerve preservation; detachment of the hiatal ligament, which enables mobilization of the whole mesorectum and transection of the distal rectum just above the anal canal; and colonic J-pouch anal anastomosis to support fecal continence. We evaluated our modified TME, focusing on one surgeon's experience. Between 1993 and 2006, 164 patients underwent modified TME, performed by one surgeon (M.K.). Intraoperative blood loss and operating time were both significantly lower than for conventional resection (P<0.01), and the rate of anastomotic leakage was less than 1%. Modified TME combined with radiotherapy or chemotherapy, or both, also improved prognosis considerably. We have succeeded in simplifying the original TME procedure and improved its outcome even further, based on our familiarity with its anatomyoriented elements. (author)

  8. Longitudinal evaluation of efficacy, safety and nutritional status during one-year treatment with the duodenal-jejunal bypass liner.

    Science.gov (United States)

    Riedel, Nina; Laubner, Katharina; Lautenbach, Anne; Schön, Gerhard; Schlensak, Matthias; Stengel, Rainer; Eberl, Thomas; Dederichs, Frank; Aberle, Jens; Seufert, Jochen

    2018-03-09

    The endoscopic duodenal-jejunal bypass liner (DJBL) represents a novel temporary endoscopic approach for treatment of obesity-associated type 2 diabetes. Recent results from the German DJBL registry confirmed substantial positive metabolic effects of the DJBL in type 2 diabetes. However, the last Food and Drug Administration trial was stopped due to a high occurrence of hepatic abscesses (3.5%). Here, we analyzed time courses of development of co-morbidities, nutritive changes, and occurrence of adverse events during the 1-year treatment phase with the DJBL in the German DJBL registry. Sixty-six patients from the registry were analyzed for efficacy, safety, and nutritional status. Patient data sets were analyzed at implantation, 3 and 6 months after implantation, and at explantation visits. Weight, body mass index, glycated hemoglobin, and low-density lipoprotein cholesterol primarily declined during the first 3 months after implantation, whereas systolic and diastolic blood pressure were predominantly reduced during the second half of the treatment phase. Severe DJBL-associated side effects were mainly documented at the explantation visit (intestinal obstruction [1.7%], dislocation [1.7%], and liver abscess [1.7%]). Measurements of serum concentrations of ferritin, albumin, vitamin B12, folic acid, 25-hydroxyvitamin D3 (25 OH-Vit-D3), and calcium provided suggestive evidence of a possible decrease of nutritional absorption of vitamins and trace elements by the DJBL. The DJBL demonstrates high efficacy with substantial improvement of all parameters of the metabolic syndrome and the potential for reduction of comedications in overweight patients with type 2 diabetes. These registry results are important to optimize recommendations for adaptation of concomitant medication, surveillance of adverse events, nutritional status and supplementation, and adaptation of the implantation period of the DJBL. Copyright © 2018 American Society for Bariatric Surgery. Published by

  9. Influência da vitamina C e da hidrocortisona sobre a tensão anastomótica jejunal em ratos

    Directory of Open Access Journals (Sweden)

    Petroianu Andy

    2000-01-01

    Full Text Available O efeito da vitamina C e da hidrocortisona sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Dessa forma, o presente trabalho teve o objetivo de comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. Foram estudados 40 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em quatro grupos (n=10: Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica nos 5 º e 21º dias pós-operatórios. Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a uma pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dias pós-operatórios. Os resultados deste trabalho sugerem que a vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros 5 dias pós-operatórios. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

  10. Oesophageal elongation with traction sutures (FOKER procedure in a newborn baby with long-gap oesophageal atresia (LGEA: Maybe too early, maybe too dangerous?

    Directory of Open Access Journals (Sweden)

    Holger Till

    2013-01-01

    Full Text Available In children with long gap oesophageal atresia (LGEA, the FOKER technique (oesophageal elongation with traction sutures has been criticized for its high complication rate. We advocate analysing such problems to increase the safety in the future. The present case report will focus on timing. A female newborn (3000 g with LGEA (gap of 5 cm was delivered in an outward hospital. On day two of life, she received traction sutures on both pouches. By day five, all sutures had torn out, and a primary anastomosis was attempted. However, it leaked severely. Thus, on day ten, the oesophagus was approached from the neck converting the proximal end into a spit fistula and closing the distal end blindly. Furthermore, the gastro-oesophageal (GE- junction was wrapped with a Teflon sling. When the baby arrived in our institution, she suffered from cavernous oesophageal masses extending from the thoracic inlet down to the diaphragm and fistulas draining them into the neck as well as into the right lung. Moreover, the Teflon sling had dislodged allowing for GE-reflux. In several stages, the oesophageal remnants were resected without any complications. Finally, Prof. Alaa Hamza performed a colonic interposition, which is working well today. In conclusion, the present case aims to caution paediatric surgeons to apply traction sutures for oesophageal elongation in newborns with LGEA.

  11. Use of atropine to reduce mucosal eversion during intestinal resection and anastomosis in the dog.

    Science.gov (United States)

    Agrodnia, Marta; Hauptman, Joe; Walshaw, Richard

    2003-01-01

    To determine whether atropine altered the degree of mucosal eversion during jejunal resection and anastomosis in the dog. Part I: Prospective, blinded, randomized, controlled study using a therapeutic dose (0.04 mg/kg systemic) of atropine. Part II: Prospective, unblinded, assigned, controlled study using a pharmacologic (0.04 mg/kg local arterial) dose of atropine. Part I: Twenty-two young adult female Beagle dogs used during a nonsurvival third-year veterinary student surgical laboratory (small intestinal resection and anastomosis). Part II: Ten young adult female Beagle dogs used immediately after completion of a nonsurvival third-year veterinary student orthopedic surgical laboratory. Part I: Dogs were randomly assigned to receive either atropine (0.04 mg/kg), or an equal volume of saline, given intramuscularly (premedication) and again intravenously prior to intestinal resection. Part II: In each dog, atropine (0.04 mg/kg)/saline was alternately given in the proximal/distal jejunum. Part I: There was no clinically or statistically significant difference between systemic atropine and saline solution on the degree of jejunal mucosal eversion after resection. Part II: There was a statistically significant decrease in jejunal mucosal eversion with atropine compared with saline solution when injected into a local jejunal artery. Systemic atropine (0.04 mg/kg) does not alter the degree of jejunal mucosal eversion during resection and anastomosis. Jejunal intraarterial atropine (0.04 mg/kg) reduced jejunal mucosal eversion during resection and anastomosis. The clinical usefulness and consequences of jejunal arterial atropine administration to reduce mucosal eversion remain to be determined. Copyright 2003 by The American College of Veterinary Surgeons

  12. Detection of Trichomonas Vaginalis Infection in Male Non-gonococcal Urethritis Patients by InPouch TV Culture and Polymerase Chain Reaction

    Institute of Scientific and Technical Information of China (English)

    YAO Zhiyuan(姚志远); ZHENG Heyi(郑和义); CAO Jingjiang(曹经江)

    2002-01-01

    Objective: To study the prevalence of Trichomonas vaginalis(TV) infection in Chinese male patients with nongonococcalurethritis (NGU), to evaluate the sensitivity and specificity ofurine-based and urethral swab polymerase chain reaction(PCR) detection, to set up a method for non-invasive detectionof male TV infection. Method: One hundred and five male NGU patients wereselected from a Beijing STD clinic. Two urethral swabs wereobtained from each patient, one for the InPouch TV culturesystem and the other for PCR. In addition, one first void urinespecimen was collected for PCR detection. Culture wasconsidered the "gold standard". The sensitivity, specificity,positive predictive value (PPV) and negative predictive value(NPV) of the two PCR detections were compared to cultureresults. Results: The prevalence of urine-based PCR and urethralswab PCR detection was 3.81% (4/105) and 4.76% (5/105)respectively. Compared to culture, the sensitivity, specificity,PPV and NPV were 80%, 100%, 100% and 99% for urine-based PCR and 80%, 99%, 80% and 99% for urethral swabPCR.Conclusion: TV is one of the etiological agents in male NGU,with a 4.76% prevalence of infection in our study. The urine-based PCR detection has higher sensitivity and specificity andprovides a noninvasive method more feasible in practice.

  13. A multilayer electro-thermal model of pouch battery during normal discharge and internal short circuit process

    International Nuclear Information System (INIS)

    Chen, Mingbiao; Bai, Fanfei; Song, Wenji; Lv, Jie; Lin, Shili

    2017-01-01

    Highlights: • 2D network equivalent circuit considers the interplay of cell units. • The temperature non-uniformity Φ of multilayer model is bigger than that of lumped model. • The temperature non-uniformity is quantified and the reason of non-uniformity is analyzed. • Increasing the thermal conductivity of the separator can effectively relieve the heat spot effect of ISC. - Abstract: As the electrical and thermal characteristic will affect the batteries’ safety, performance, calendar life and capacity fading, an electro-thermal coupled model for pouch battery LiFePO_4/C is developed in normal discharge and internal short circuit process. The battery is discretized into many cell elements which are united as a 2D network equivalent circuit. The electro-thermal model is solved with finite difference method. Non-uniformity of current distribution and temperature distribution is simulated and the result is validated with experiment data at various discharge rates. Comparison of the lumped model and the multilayer structure model shows that the temperature non-uniformity Φ of multilayer model is bigger than that of lumped model and shows more precise. The temperature non-uniformity is quantified and the reason of non-uniformity is analyzed. The electro-thermal model can also be used to guide the safety design of battery. The temperature of the ISC element near tabs is the highest because the equivalent resistance of the external circuit (not including the ISC element) is the smallest when the resistance of cell units is small. It is found that increasing the thermal conductivity of integrated layer can effectively relieve the heat spot effect of ISC.

  14. Diabetes Is Reversed in a Murine Model by Marginal Mass Syngeneic Islet Transplantation Using a Subcutaneous Cell Pouch Device.

    Science.gov (United States)

    Pepper, Andrew R; Pawlick, Rena; Gala-Lopez, Boris; MacGillivary, Amanda; Mazzuca, Delfina M; White, David J G; Toleikis, Philip M; Shapiro, A M James

    2015-11-01

    Islet transplantation is a successful β-cell replacement therapy for selected patients with type 1 diabetes mellitus. Although high rates of early insulin independence are achieved routinely, long-term function wanes over time. Intraportal transplantation is associated with procedural risks, requires multiple donors, and does not afford routine biopsy. Stem cell technologies may require potential for retrievability, and graft removal by hepatectomy is impractical. There is a clear clinical need for an alternative, optimized transplantation site. The subcutaneous space is a potential substitute, but transplantation of islets into this site has routinely failed to reverse diabetes. However, an implanted device, which becomes prevascularized before transplantation, may alter this equation. Syngeneic mouse islets were transplanted subcutaneously within Sernova Corp's Cell Pouch (CP). All recipients were preimplanted with CPs 4 weeks before diabetes induction and transplantation. After transplantation, recipients were monitored for glycemic control and glucose tolerance. Mouse islets transplanted into the CP routinely restored glycemic control with modest delay and responded well to glucose challenge, comparable to renal subcapsular islet grafts, despite a marginal islet dose, and normoglycemia was maintained until graft explantation. In contrast, islets transplanted subcutaneously alone failed to engraft. Islets within CPs stained positively for insulin, glucagon, and microvessels. The CP is biocompatible, forms an environment suitable for islet engraftment, and offers a potential alternative to the intraportal site for islet and future stem cell therapies.

  15. Dietary Lactobacillus rhamnosus GG Supplementation Improves the Mucosal Barrier Function in the Intestine of Weaned Piglets Challenged by Porcine Rotavirus.

    Directory of Open Access Journals (Sweden)

    Xiangbing Mao

    Full Text Available Lactobacillus rhamnosus GG (LGG has been regarded as a safe probiotic strain. The aim of this study was to investigate whether dietary LGG supplementation could alleviate diarrhea via improving jejunal mucosal barrier function in the weaned piglets challenged by RV, and further analyze the potential roles for apoptosis of jejunal mucosal cells and intestinal microbiota. A total of 24 crossbred barrows weaned at 21 d of age were assigned randomly to 1 of 2 diets: the basal diet and LGG supplementing diet. On day 11, all pigs were orally infused RV or the sterile essential medium. RV infusion increased the diarrhea rate, increased the RV-Ab, NSP4 and IL-2 concentrations and the Bax mRNA levels of jejunal mucosa (P<0.05, decreased the villus height, villus height: crypt depth, the sIgA, IL-4 and mucin 1 concentrations and the ZO-1, occludin and Bcl-2 mRNA levels of jejunal mucosa (P<0.05, and affected the microbiota of ileum and cecum (P<0.05 in the weaned pigs. Dietary LGG supplementation increased the villus height and villus height: crypt depth, the sIgA, IL-4, mucin 1 and mucin 2 concentrations, and the ZO-1, occludin and Bcl-2 mRNA levels of the jejunal mucosa (P<0.05 reduced the Bax mRNA levels of the jejunal mucosa (P<0.05 in weaned pigs. Furthermore, dietary LGG supplementation alleviated the increase of diarrhea rate in the weaned pigs challenged by RV (P<0.05, and relieve the effect of RV infection on the villus height, crypt depth and the villus height: crypt depth of the jejunal mucosa (P<0.05, the NSP4, sIgA, IL-2, IL-4, mucin 1 and mucin 2 concentrations of jejunal mucosa (P<0.05, the ZO-1, occludin, Bax and Bcl-2 mRNA levels of the jejunal mucosa (P<0.05, and the microbiota of ileum and cecum (P<0.05 in the weaned pigs challenged by RV. These results suggest that supplementing LGG in diets alleviated the diarrhea of weaned piglets challenged by RV via inhibiting the virus multiplication and improving the jejunal mucosal barrier

  16. Performance improvements of pouch-type flexible thin-film lithium-ion batteries by modifying sequential screen-printing process

    International Nuclear Information System (INIS)

    Kang, Kun-Young; Lee, Young-Gi; Shin, Dong Ok; Kim, Jin-Chul; Kim, Kwang Man

    2014-01-01

    A pouch-type flexible thin-film lithium-ion battery is fabricated by sequential screen-printing (wet) processes to produce consecutive layers of a current collector, positive and negative electrodes, and a gel polymer electrolyte. Optimum conditions of each process are determined by adjusting the paste or slurry compositions to achieve lower surface resistance of each layer (current collector and electrodes) and higher ionic conductivity of the gel polymer electrolyte. The fabricated flexible thin-film lithium-ion battery (5.5 × 5.5 cm 2 , 325 μm thick) shows superior electrochemical performance, including an energy density of 292.3 Wh L −1 based on electrode size (4.0 × 4.0 cm 2 ), an initial discharge capacity of 2.5 mAh cm −2 per electrode area, and capacity retention ratio of over 68% at the 50th cycle. To further improve the battery performance, the wet processes are modified by adopting hybrid (dry-wet) processes, which mainly consist of the formation of metallic current collector layers (Al and Cu) using a thermal evaporator and another optimized gel polymer electrolyte, to achieve an energy density of 332.8 Wh L −1 and capacity retention ratio of 84% at the 50th cycle. Cell flexibility is also confirmed by stable open circuit voltages after the system is subjected to several hundred iterations of bending, stretching, and even folding. There is the possibility that the suggested wet and dry-wet processes can be expanded to a high-speed mass-production roll-to-roll process

  17. Processamento térmico de purê de banana (Musa cavendishii, Lamb. em embalagens flexíveis esterilizáveis Thermal processing of banana puree (Musa cavendishii, Lamb. in retortale pouches

    Directory of Open Access Journals (Sweden)

    Celso Duarte CARVALHO FILHO

    1997-12-01

    Full Text Available O objetivo deste trabalho foi estabelecer as condições de processo térmico de purê de banana, variedade "nanica", em bolsas esterilizáveis porção individual (130 x 170mm. Os frutos foram selecionados, aquecidos a 98°C/5min. para inativação enzimática, separadas as sementes e fibras num despolpador com malha de 0,08cm de diâmetro e depois o purê foi embalado nas bolsas sob um vácuo de 25mmHg, resultando em média 2,7ml de ar residual por bolsa. Em seguida as bolsas foram processadas sem agitação e em posição horizontal numa autoclave horizontal, a 115°C/158KPa, com imersão total de água quente. O tempo de manutenção do processo foi de 7,5min. Inicialmente foi utilizado o Clostridium butyricum como microrganismo alvo do processo, entretanto, observou-se que esta bactéria apresentara uma resistência térmica em purê de banana (pH 4,6 um pouco menor que o valor estimado para o Clostridium botulinum, D115=0,183min. e D115=0,236min respectivamente, sendo assim, o C. botulinum foi escolhido como microrganismo alvo da esterilização do produto. O valor de F121,1°C aplicado foi de 0,64min. para causar 12 reduções decimais, calculado segundo PFLUG (1985 para um pH de 4,6, e verificado pelo método geral. Este valor somente foi considerado para a fase de aquecimento, deixando a letalidade do resfriamento (0,34min., que foi realizada com água à temperatura ambiente, como segurança de processo. Nos testes de penetração de calor foram encontrados os valores médio de fh=6,8min; jh=0,48; fc=17,4min. e jc=1,3 demonstrando assim, que o produto é altamente condutivo. Nenhuma alteração no produto nem nas embalagens foi notada após a aplicação do ensaio de esterilidade comercial em 36 bolsas processadas contendo purê de banana, confirmando assim, a eficácia do tratamento térmico aplicado.The aim of this work was to establish thermal processing conditions for banana puree in retor pouches (130 x 170mm. The fruits were

  18. Mouldy feed, mycotoxins and Shiga toxin - producing Escherichia coli colonization associated with Jejunal Hemorrhage Syndrome in beef cattle

    Directory of Open Access Journals (Sweden)

    Masson Luke

    2011-06-01

    Full Text Available Abstract Background Both O157 and non-O157 Shiga toxin - producing Escherichia coli (STECs cause serious human disease outbreaks through the consumption of contaminated foods. Cattle are considered the main reservoir but it is unclear how STECs affect mature animals. Neonatal calves are the susceptible age class for STEC infections causing severe enteritis. In an earlier study, we determined that mycotoxins and STECs were part of the disease complex for dairy cattle with Jejunal Hemorrhage Syndrome (JHS. For STECs to play a role in the development of JHS, we hypothesized that STEC colonization should also be evident in beef cattle with JHS. Aggressive medical and surgical therapies are effective for JHS, but rely on early recognition of clinical signs for optimal outcomes suggesting that novel approaches must be developed for managing this disease. The main objective of this study was to confirm that mouldy feeds, mycotoxins and STEC colonization were associated with the development of JHS in beef cattle. Results Beef cattle developed JHS after consuming feed containing several types of mycotoxigenic fungi including Fusarium poae, F. verticillioides, F. sporotrichioides, Penicillium roqueforti and Aspergillus fumigatus. Mixtures of STECs colonized the mucosa in the hemorrhaged tissues of the cattle and no other pathogen was identified. The STECs expressed Stx1 and Stx2, but more significantly, Stxs were also present in the blood collected from the lumen of the hemorrhaged jejunum. Feed extracts containing mycotoxins were toxic to enterocytes and 0.1% of a prebiotic, Celmanax Trademark, removed the cytotoxicity in vitro. The inclusion of a prebiotic in the care program for symptomatic beef calves was associated with 69% recovery. Conclusions The current study confirmed that STECs and mycotoxins are part of the disease complex for JHS in beef cattle. Mycotoxigenic fungi are only relevant in that they produce the mycotoxins deposited in the feed. A

  19. Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.

    Science.gov (United States)

    Cousty, M; Tricaud, C; De Beauregard, T; Picandet, V; Bizon-Mercier, C; Tessier, C

    2016-01-09

    The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques. British Veterinary Association.

  20. Sexuality and fertility outcomes after hand sewn versus stapled ileal pouch anal anastomosis for ulcerative colitis.

    Science.gov (United States)

    Harnoy, Yann; Desfourneaux, Véronique; Bouguen, Guillaume; Rayar, Michel; Meunier, Bernard; Siproudhis, Laurent; Boudjema, Karim; Sulpice, Laurent

    2016-01-01

    Ileal pouch anal anastomosis (IPAA) may alter sexuality and fertility in women. The laparoscopic approach seems to reduce infertility rates in women after IPAA. However, the impact of hand sewn versus stapled IPAA on sexuality and fertility has never been assessed in patients with ulcerative colitis (UC). The objective of this study was to analyze the impact of the IPAA technique on sexuality and fertility in UC. All UC patients who underwent an IPAA between May 1996 and April 2011 were included. The patients answered mailed questionnaires including sexuality validated questionnaires and fertility questionnaires. The risk factors of sexual dysfunction were explored. A total of 135 patients were included. Eighty-eight patients (65%) answered the questionnaires. Their mean age and follow-up were 37.2 ± 13.4 y and 109.7 ± 57.5 mo. The rates of female and male sexual dysfunction were 50% and 29%, respectively. Intestinal transit disorders were identified as risk factors in both men and women and anastomotic stricture in women sexual dysfunction, in univariate analyses. The IPAA technique did not impact sexual function in women but there was a trend for less erectile dysfunction after hand sewn IPAA (16.7% versus 44.4%). The fertility rate was 47% in women and 75% in men, with a trend for a better fertility in women after hand sewn IPAA (P = 0.07). In this preliminary study, the hand sewn or stapled IPAA technique did not impact the sexuality or fertility outcomes of UC patients, but there was a trend for better female fertility and male erectile function after hand sewn IPAA. Intestinal transit disorders contributed to male and female sexual dysfunction after IPAA. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Mesonia hippocampi sp. nov., isolated from the brood pouch of a diseased Barbour's Seahorse (Hippocampus barbouri).

    Science.gov (United States)

    Kolberg, Judy; Busse, Hans-Jürgen; Wilke, Thomas; Schubert, Patrick; Kämpfer, Peter; Glaeser, Stefanie P

    2015-07-01

    An orange-pigmented, Gram-staining-negative, rod-shaped bacterium, designated 96_Hippo_TS_3/13(T) was isolated from the brood pouch of a diseased seahorse male of the species Hippocampus barbouri from the animal facility of the University of Giessen, Germany. Phylogenetic analyses based on the nearly full-length 16S rRNA gene sequence placed strain 96_Hippo_TS_3/13(T) into the monophyletic cluster of the genus Mesonia within the family Flavobacteriaceae. However, the strain shared only 92.2-93.8% sequence similarity to type strains of species of the genus Mesonia, with highest sequence similarity to the type strain of Mesonia aquimarina. Cellular fatty acid analysis showed a Mesonia-typical fatty acid profile including several branched and hydroxyl fatty acids with highest amounts of iso-C15 : 0 (40.9%) followed by iso-C17 : 0 3-OH (14.8%). In the polyamine pattern, sym-homospermidine was predominant. The diagnostic diamino acid of the peptidoglycan was meso-diaminopimelic acid. The quinone system contained exclusively menaquinone MK-6. The only identified compound in the polar lipid profile was phosphatidylethanolamine present in major amounts. Additionally, major amounts of an unidentified aminolipid and two unidentified lipids not containing a phosphate group, an amino group or a sugar residue were detected. The genomic G+C content of strain 96_Hippo_TS_3/13(T) was 30 mol%. Based on genotypic, chemotaxonomic and physiological characterizations we propose a novel species of the genus Mesonia, Mesonia hippocampi sp. nov., with strain 96_Hippo_TS_3/13(T) ( = CIP 110839T =  LMG 28572(T) = CCM 8557(T)) as the type strain. An emended description of the genus Mesonia is also provided.

  2. Genome-Wide Linkage and Association Analysis Identifies Major Gene Loci for Guttural Pouch Tympany in Arabian and German Warmblood Horses

    Science.gov (United States)

    Metzger, Julia; Ohnesorge, Bernhard; Distl, Ottmar

    2012-01-01

    Equine guttural pouch tympany (GPT) is a hereditary condition affecting foals in their first months of life. Complex segregation analyses in Arabian and German warmblood horses showed the involvement of a major gene as very likely. Genome-wide linkage and association analyses including a high density marker set of single nucleotide polymorphisms (SNPs) were performed to map the genomic region harbouring the potential major gene for GPT. A total of 85 Arabian and 373 German warmblood horses were genotyped on the Illumina equine SNP50 beadchip. Non-parametric multipoint linkage analyses showed genome-wide significance on horse chromosomes (ECA) 3 for German warmblood at 16–26 Mb and 34–55 Mb and for Arabian on ECA15 at 64–65 Mb. Genome-wide association analyses confirmed the linked regions for both breeds. In Arabian, genome-wide association was detected at 64 Mb within the region with the highest linkage peak on ECA15. For German warmblood, signals for genome-wide association were close to the peak region of linkage at 52 Mb on ECA3. The odds ratio for the SNP with the highest genome-wide association was 0.12 for the Arabian. In conclusion, the refinement of the regions with the Illumina equine SNP50 beadchip is an important step to unravel the responsible mutations for GPT. PMID:22848553

  3. Streamline three-dimensional thermal model of a lithium titanate pouch cell battery in extreme temperature conditions with module simulation

    Science.gov (United States)

    Jaguemont, Joris; Omar, Noshin; Martel, François; Van den Bossche, Peter; Van Mierlo, Joeri

    2017-11-01

    In this paper, the development of a three-dimensional (3D) lithium titanium oxide (LTO) pouch cell is presented to first better comprehend its thermal behavior within electrified vehicle applications, but also to propose a strong modeling base for future thermal management system. Current 3D-thermal models are based on electrochemical reactions which are in need for elaborated meshing effort and long computational time. There lacks a fast electro-thermal model which can capture voltage, current and thermal distribution variation during the whole process. The proposed thermal model is a reduce-effort temperature simulation approach involving a 0D-electrical model accommodating a 3D-thermal model to exclude electrochemical processes. The thermal model is based on heat-transfer theory and its temperature distribution prediction incorporates internal conduction and heat generation effect as well as convection. In addition, experimental tests are conducted to validate the model. Results show that both the heat dissipation rate and surface temperature uniformity data are in agreement with simulation results, which satisfies the application requirements for electrified vehicles. Additionally, a LTO battery pack sizing and modeling is also designed, applied and displays a non-uniformity of the cells under driving operation. Ultimately, the model will serve as a basis for the future development of a thermal strategy for LTO cells that operate in a large temperature range, which is a strong contribution to the existing body of scientific literature.

  4. THE FEATURES OF TIBIOFIBULAR INJURY IN PATENTS WITH ANKLE FRACTURES

    Directory of Open Access Journals (Sweden)

    N. F. Fomin

    2010-01-01

    Full Text Available The role of interposition of soft tissues into tibiofibular syndesmosis is analyzed as a cause of unsatisfactory outcomes in the ankle joint pronation fracture treatment. The study is based on clinical (452 patients and experimental material (36 experiments including unfixed anatomic objects. The elevator for minimal invasive operative elimination of interposition of stumps of distal tibiofibular syndesmosis anterior and posterior ligaments is developed and tested.

  5. 袋鼠和海马

    Institute of Scientific and Technical Information of China (English)

    曹志明

    1989-01-01

    The kangaroo is a strange animal. It lives in Australia. The motherhas a pouch (育儿袋). She keeps her babies in the pouch. The babieswill live there happily for a long time. In the pouch there are breasts(乳房). There they drink milk and sleep warmly. The babies will notleave the pouch until they are 8 months old.

  6. EVOLUÇÃO DA FIBROSE BILIAR SECUNDÁRIA EM RATOS TRATADOS MEDIANTE DERIVAÇÃO BÍLIO-DUODENAL OU BÍLIO-JEJUNAL COM AL��A DE ROUX MEDINDO 5, 10 E 15 CM

    Directory of Open Access Journals (Sweden)

    Pandolfi Jr. H.

    2001-01-01

    Full Text Available A modalidade de derivação bílio-digestiva empregada no tratamento da colestase extra-hepática crônica pode influenciar na reparação das lesões hepáticas. Avaliou-se o desempenho das derivações bílio-duodenal e bílio-jejunal em Y de Roux com alça exclusa de diferentes comprimentos na reparação das lesões morfológicas e funcionais do fígado de ratos com fibrose biliar secundária. Foram utilizados ratos Wistar, com 15 dias de obstrução biliar, alocados em 5 grupos de 6 animais. O grupo OB caracterizou as alterações da fibrose biliar. Os animais remanescentes foram tratados mediante derivação com o duodeno (grupo DBD, e com o jejuno, em alça exclusa de 5cm (grupo DBJ5, 10cm (grupo DBJ10 e 15cm (grupo DBJ15, sendo reavaliados 3 meses depois. Outros 6 animais foram submetidos à intervenção simulada e considerados grupo controle (IS. Todos animais foram submetidos à avaliação morfométrica do fígado, análise bioquímica do sangue e microbiológica da bile, estudo da função mitocondrial hepática e verificação do peso úmido do fígado e do baço. Na análise estatística adotou-se o nível de significância de 5%. Houve aumento significativo do peso estimado, em g/Kg de peso corporal, dos ductos biliares, da fibrose e dos hepatócitos nos animais do grupo OB (medianas de 1,30; 10,03 e 37,0 em relação aos animais controles (IS (medianas de 0,03; zero e 29,37. Após tratamento, ocorreu regressão significativa do peso estimado dos ductos biliares e da fibrose, com valores medianos de 0,22 e 0,22 para o grupo DBD, 0,45 e 3,31 para o grupo DBJ5 e 0,22 e 5,0 para o grupo DBJ15. Houve regressão significativa do peso estimado dos hepatócitos apenas nos grupos derivados com o jejuno, com valores medianos de 31,93; 24,46 e 28,52. Ocorreu aumento significativo do peso úmido do fígado e do baço no grupo OB (medianas em g/Kg de peso corporal de 49,85 e 5,71 em relação ao grupo IS (30,0 e 3,04. Houve regress

  7. Non-invasive characterization of normal and pathological tissues through dynamic infrared imaging in the hamster cheek pouch oral cancer model

    Science.gov (United States)

    Herrera, María. S.; Monti Hughes, Andrea; Salva, Natalia; Padra, Claudio; Schwint, Amanda; Santa Cruz, Gustavo A.

    2017-05-01

    Biomedical infrared thermography, a non-invasive and functional imaging method, provides information on the normal and abnormal status and response of tissues in terms of spatial and temporal variations in body infrared radiance. It is especially attractive in cancer research due to the hypervascular and hypermetabolic activity of solid tumors. Moreover, healthy tissues like skin or mucosa exposed to radiation can be examined since inflammation, changes in water content, exudation, desquamation, erosion and necrosis, between others, are factors that modify their thermal properties. In this work we performed Dynamic Infrared Imaging (DIRI) to contribute to the understanding and evaluation of normal tissue, tumor and precancerous tissue response and radiotoxicity in an in vivo model, the hamster cheek pouch, exposed to Boron Neutron Capture Therapy. In this study, we particularly focused on the observation of temperature changes under forced transient conditions associated with mass moisture transfer in the tissue-air interface, in each tissue with or without treatment. We proposed a simple mathematical procedure that considerers the heat transfer from tissue to ambient through convection and evaporation to model the transient (exponential decay o recover) thermal study. The data was fitted to determined the characteristic decay and recovery time constants of the temperature as a function of time. Also this model allowed to explore the mass flux of moisture, as a degree of evaporation occurring on the tissue surface. Tissue thermal responses under provocation tests could be used as a non-invasive method to characterize tissue physiology.

  8. Post-voiding residual urine and capacity increase in orthotopic urinary diversion: Standard vs modified technique

    Directory of Open Access Journals (Sweden)

    Bančević Vladimir

    2010-01-01

    Full Text Available Background/Aim. Ever since the time when the first orthotopic urinary diversion (pouch was performed there has been a constant improvement and modification of surgical techniques. The aim has been to create a urinary reservoir similar to normal bladder, to decrease incidence of postoperative complications and provide an improved life quality. The aim of this study was to compare postvoiding residual urine (PVR and capacity of the pouch constructed by standard or modified technique. Methods. In this prospective and partially retrospective clinical study we included 79 patients. In the group of 41 patients (group ST pouch was constructed using 50-70 cm of the ileum (standard technique. In the group of 38 patients (group MT pouch was constructed using 25-35 cm of the ileum (modified technique. Postoperatively, PVR and pouch capacity were measured using ultrasound in a 3-, 6- and 12-month period. Results. Postoperatively, an increase in PVR and pouch capacity was noticed in both groups. Twelve months postoperatively, PVR was significantly smaller in the group MT than in the group ST [23 (0-90 mL vs 109 (0-570 mL, p < 0,001]. In the same period the pouch capacity was significantly smaller in the MT group than in the ST group [460 (290-710 mL vs 892 (480-2 050 mL, p < 0.001]. Conclusion. Postoperatively, an increase in PVR and pouch capacity was noticed during a 12-month period. A year following the operation the pouch created from a shorter ileal segment reached capacity of the 'normal' bladder with small PVR. The pouch created by standard technique developed an unnecessary large PVR and capacity.

  9. A randomized comparison of horizontal and vertical banded gastroplasty: what determines weight loss?

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Dissing, I

    1989-01-01

    Pouch volume, stoma diameter, and pouch emptying rate were measured postoperatively and after 6 months in 45 morbidly obese patients who had been assigned to either horizontal gastroplasty (HGP) or vertical banded gastroplasty (VBGP) after pretreatment with diet alone. Pouch volume and stoma...

  10. Function and expression of cystic fibrosis transmembrane conductance regulator after small intestinal transplantation in mice.

    Directory of Open Access Journals (Sweden)

    Penghong Song

    Full Text Available The secretion function of intestinal graft is one of the most important factors for successful intestinal transplantation. Cystic fibrosis transmembrane conductance regulator (CFTR mediates HCO3(- and Cl(- secretions in intestinal epithelial cells. In this study, we made investigation on the expression and function of CFTR in an experimental model of murine small intestinal transplantation. Heterotopic intestinal transplantations were performed in syngeneic mice. The mRNA and protein expressions of CFTR were analyzed by real time PCR and western blot. Murine intestinal mucosal HCO3(- and Cl(- secretions were examined in vitro in Ussing chambers by the pH stat and short circuit current (I(sc techniques. The results showed that forskolin, an activator of CFTR, stimulated jejunal mucosal epithelial HCO3(- and Cl(- secretions in mice, but forskolin-stimulated HCO3(- and Cl(- secretions in donor and recipient jejunal mucosae of mice after heterotopic jejunal transplantation were markedly decreased, compared with controls (P<0.001. The mRNA and protein expression levels of CFTR in donor and recipient jejunal mucosae of mice were also markedly lower than those in controls (P<0.001, and the mRNA and protein expression levels of tumor necrosis factor α (TNFα were markedly increased in donor jejunal mucosae of mice (P<0.001, compared with controls. Further experiments showed that TNFα down-regulated the expression of CFTR mRNA in murine jejunal mucosa. In conclusion, after intestinal transplantation, the function of CFTR was impaired, and its mRNA and protein expressions were down-regulated, which may be induced by TNFα.

  11. Spatiotemporal maps reveal regional differences in the effects on gut motility for Lactobacillus reuteri and rhamnosus strains.

    Science.gov (United States)

    Wu, R Y; Pasyk, M; Wang, B; Forsythe, P; Bienenstock, J; Mao, Y-K; Sharma, P; Stanisz, A M; Kunze, W A

    2013-03-01

    Commensal bacteria such as probiotics that are neuroactive acutely affect the amplitudes of intestinal migrating motor complexes (MMCs). What is lacking for an improved understanding of these motility effects are region specific measurements of velocity and frequency. We have combined intraluminal pressure recordings with spatiotemporal diameter maps to analyze more completely effects of different strains of beneficial bacteria on motility. Intraluminal peak pressure (PPr) was measured and video recordings made of mouse ex vivo jejunum and colon segments before and after intraluminal applications of Lactobacillus rhamnosus (JB-1) or Lactobacillus reuteri (DSM 17938). Migrating motor complex frequency and velocity were calculated. JB-1 decreased jejunal frequencies by 56% and 34% in colon. Jejunal velocities increased 171%, but decreased 31% in colon. Jejunal PPr decreased by 55% and in colon by 21%. DSM 17938 increased jejunal frequencies 63% and in colon 75%; jejunal velocity decreased 57%, but increased in colon 146%; jejunal PPr was reduced 26% and 12% in colon. TRAM-34 decreased frequency by 71% and increased velocity 200% for jejunum, but increased frequency 46% and velocity 50% for colon; PPr was decreased 59% for jejunum and 39% for colon. The results show that probiotics and other beneficial bacteria have strain and region-specific actions on gut motility that can be successfully discriminated using spatiotemporal mapping of diameter changes. Effects are not necessarily the same in colon and jejunum. Further research is needed on the detailed effects of the strains on enteric neuron currents for each gut region. © 2013 Blackwell Publishing Ltd.

  12. 'Sequential' Boron Neutron Capture Therapy (BNCT): A Novel Approach to BNCT for the Treatment of Oral Cancer in the Hamster Cheek Pouch Model

    International Nuclear Information System (INIS)

    Molinari, Ana J.; Pozzi, Emiliano C.C.; Hughes, Andrea Monti; Heber, Elisa M.; Garabalino, Marcela A.; Thorp, Silvia I.; Miller, Marcelo; Itoiz, Maria E.; Aromando, Romina F.; Nigg, David W.; Quintana, Jorge; Santa Cruz, Gustavo A.; Trivillin, Veronica A.; Schwint, Amanda E.

    2011-01-01

    In the present study we evaluated the therapeutic effect and/or potential radiotoxicity of the novel 'Tandem' Boron Neutron Capture Therapy (T-BNCT) for the treatment of oral cancer in the hamster cheek pouch model at RA-3 Nuclear Reactor. Two groups of animals were treated with 'Tandem BNCT', i.e. BNCT mediated by boronophenylalanine (BPA) followed by BNCT mediated by sodium decahydrodecaborate (GB-10) either 24 h (T-24h-BNCT) or 48 h (T-48h-BNCT) later. A total tumor dose-matched single application of BNCT mediated by BPA and GB-10 administered jointly ((BPA + GB-10)-BNCT) was administered to an additional group of animals. At 28 days post-treatment, T-24h-BNCT and T-48h-BNCT induced, respectively, overall tumor control (OTC) of 95% and 91%, with no statistically significant differences between protocols. Tumor response for the single application of (BPA + GB-10)-BNCT was 75%, significantly lower than for T-BNCT. The T-BNCT protocols and (BPA + GB-10)-BNCT induced reversible mucositis in dose-limiting precancerous tissue around treated tumors, reaching Grade 3/4 mucositis in 47% and 60% of the animals respectively. No normal tissue radiotoxicity was associated to tumor control for any of the protocols. 'Tandem' BNCT enhances tumor control in oral cancer and reduces or, at worst, does not increase, mucositis in dose-limiting precancerous tissue.

  13. Cytoskeleton remodling and alterations in smooth muscle contractility in the bovine jejunum during the early stage of Cooperia oncophora infection

    Science.gov (United States)

    Gastrointestinal nematodes of the genus Cooperia are arguably the most important parasites of cattle. We characterized the bovine jejunal transcriptome in response to C. oncophora infection using RNA-seq technology. Approximately 71% of the 25,670 bovine genes were detected in the jejunal transcript...

  14. Vasectomy occlusion techniques for male sterilization.

    Science.gov (United States)

    Cook, L A; Vliet, H; Pun, A; Gallo, M F

    2004-01-01

    Vasectomy is an increasingly popular and effective family planning method. A variety of vasectomy techniques are used worldwide including various vas occlusion techniques (excision and ligation, thermal or electrocautery, and mechanical and chemical occlusion methods), vas irrigation and fascial interposition. Vasectomy guidelines largely rely on information from observational studies. Ideally, the choice of vasectomy techniques should be based on the best available evidence from randomized controlled trials. The objective of this review was to compare the effectiveness, safety, acceptability and costs of vasectomy techniques for male sterilization. We searched the computerized databases the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Popline and LILACS. In addition, we searched the reference lists of relevant articles and book chapters. We included randomized controlled trials and controlled clinical trials comparing vasectomy techniques. We assessed all titles and abstracts located in the literature searches and two reviewers independently extracted articles identified for inclusion. Data were presented in the text of the review. Outcome measures include contraceptive efficacy, safety, discontinuation, and acceptability. Two trials compared vas occlusion with clips versus a conventional vasectomy technique; both were of poor quality. Neither trial found a difference between the two groups with regard to the primary outcome of failure to reach azoospermia. Four trials examined vas irrigation: three compared water irrigation with no irrigation and one compared water irrigation with euflavine. All of the trials were of poor quality. None of the trials found a significant difference between the groups with respect to the primary outcome of time to azoospermia. However, one trial found that the median number of ejaculations to azoospermia was significantly lower in the euflavine group compared to the water irrigation group. The one trial

  15. Laboratory investigations of African Pouched Rats (Cricetomys gambianus) as a potential reservoir host species for Monkeypox Virus

    Science.gov (United States)

    Hutson, Christina L.; Nakazawa, Yoshinori J.; Self, Joshua; Olson, Victoria A.; Regnery, Russell L.; Braden, Zachary; Weiss, Sonja; Malekani, Jean; Jackson, Eddie; Tate, Mallory; Karem, Kevin L.; Rocke, Tonie E.; Osorio, Jorge E.; Damon, Inger K.; Carroll, Darin S.

    2015-01-01

    Monkeypox is a zoonotic disease endemic to central and western Africa, where it is a major public health concern. Although Monkeypox virus (MPXV) and monkeypox disease in humans have been well characterized, little is known about its natural history, or its maintenance in animal populations of sylvatic reservoir(s). In 2003, several species of rodents imported from Ghana were involved in a monkeypox outbreak in the United States with individuals of three African rodent genera (Cricetomys, Graphiurus, Funisciurus) shown to be infected with MPXV. Here, we examine the course of MPXV infection in Cricetomys gambianus (pouched Gambian rats) and this rodent species’ competence as a host for the virus. We obtained ten Gambian rats from an introduced colony in Grassy Key, Florida and infected eight of these via scarification with a challenge dose of 4X104 plaque forming units (pfu) from either of the two primary clades of MPXV: Congo Basin (C-MPXV: n = 4) or West African (W-MPXV: n = 4); an additional 2 animals served as PBS controls. Viral shedding and the effect of infection on activity and physiological aspects of the animals were measured. MPXV challenged animals had significantly higher core body temperatures, reduced activity and increased weight loss than PBS controls. Viable virus was found in samples taken from animals in both experimental groups (C-MPXV and W-MPXV) between 3 and 27 days post infection (p.i.) (up to 1X108pfu/ml), with viral DNA found until day 56 p.i. The results from this work show that Cricetomys gambianus (and by inference, probably the closely related species, Cricetomys emini) can be infected with MPXV and shed viable virus particles; thus suggesting that these animals may be involved in the maintenance of MPXV in wildlife mammalian populations. More research is needed to elucidate the epidemiology of MPXV and the role of Gambian rats and other species.

  16. Laboratory Investigations of African Pouched Rats (Cricetomys gambianus as a Potential Reservoir Host Species for Monkeypox Virus.

    Directory of Open Access Journals (Sweden)

    Christina L Hutson

    Full Text Available Monkeypox is a zoonotic disease endemic to central and western Africa, where it is a major public health concern. Although Monkeypox virus (MPXV and monkeypox disease in humans have been well characterized, little is known about its natural history, or its maintenance in animal populations of sylvatic reservoir(s. In 2003, several species of rodents imported from Ghana were involved in a monkeypox outbreak in the United States with individuals of three African rodent genera (Cricetomys, Graphiurus, Funisciurus shown to be infected with MPXV. Here, we examine the course of MPXV infection in Cricetomys gambianus (pouched Gambian rats and this rodent species' competence as a host for the virus. We obtained ten Gambian rats from an introduced colony in Grassy Key, Florida and infected eight of these via scarification with a challenge dose of 4X104 plaque forming units (pfu from either of the two primary clades of MPXV: Congo Basin (C-MPXV: n = 4 or West African (W-MPXV: n = 4; an additional 2 animals served as PBS controls. Viral shedding and the effect of infection on activity and physiological aspects of the animals were measured. MPXV challenged animals had significantly higher core body temperatures, reduced activity and increased weight loss than PBS controls. Viable virus was found in samples taken from animals in both experimental groups (C-MPXV and W-MPXV between 3 and 27 days post infection (p.i. (up to 1X108 pfu/ml, with viral DNA found until day 56 p.i. The results from this work show that Cricetomys gambianus (and by inference, probably the closely related species, Cricetomys emini can be infected with MPXV and shed viable virus particles; thus suggesting that these animals may be involved in the maintenance of MPXV in wildlife mammalian populations. More research is needed to elucidate the epidemiology of MPXV and the role of Gambian rats and other species.

  17. Evidence for the involvement of 5-lipoxygenase products in ethanol-induced intestinal plasma protein loss

    International Nuclear Information System (INIS)

    Beck, I.T.; Boyd, A.J.; Dinda, P.K.

    1988-01-01

    In this study the authors investigated whether the products of 5-lipoxygenase (5-LO) were involved in the jejunal microvascular injury induced by intraluminal ethanol (ETH). A group of rabbits was given orally a selective inhibitor of 5-LO in two 10-mg doses, 24, and 2 h before the experiments. A jejunal segment was perfused with a control solution (control segment) and an adjacent segment with an ETH-containing solution (ETH-perfused segment). In a series of experiments, they measured 5-LO activity of the jejunal segments of both groups using the generation of leukotriene B 4 (LTB 4 ) as an index. In a second series of experiments, they determined the ETH-induced intraluminal protein loss, which was taken as a measure of mucosal microvascular damage. The ETH-induced increase in protein loss was significantly lower in the treated than in the untreated group. These findings suggest that products of 5-LO are involved in the ETH-induced jejunal microvascular injury

  18. Appendicitis with Intraluminal Air

    International Nuclear Information System (INIS)

    Fernandez, Alfredo; Ramirez, Sandra M; Rodriguez, Cesar A; Uriza, Luis F

    2010-01-01

    The presentation of acute appendicitis with intraluminal air is an uncommon presentation. Ultrasound is a widely used and accepted to establish the diagnosis of appendicitis, but its performance is limited in situations where there is interposition of air. Inflamed appendix which presents with distension by gas can be source of error in ultrasound to establish a false negative diagnosis. In this article we present three patients with appendicitis where the interposition of intraluminal air hid their diagnostic by ultrasound. In all three cases the definitive diagnosis was established by computed tomography and surgical confirmation.

  19. Adhesive capsulitis of the shoulder: MR arthrography

    International Nuclear Information System (INIS)

    Kim, Hyun Jeong; Han, Tae Il; Lee, Kwang Won; Choi, Youn Seon; Kim, Dae Hong; Han, Hyun Young; Song, Mun Kab; Kwon, Soon Tae

    2001-01-01

    Adhesive capsulitis is a clinical syndrome involving pain and decreased joint motion caused by thickening and contraction of the joint capsule. The purpose of this study is to describe the MR arthrographic findings of this syndrome. Twenty-nine sets of MR arthrographic images were included in the study. Fourteen patients had adhesive capsulitis diagnosed by physical examination and arthrography, and their MR arthrographic findings were compared with those of 15 subjects in the control group. The images were retrospectively reviewed with specific attention to the thickness of the joint capsule, volume of the axillary pouch (length, width, height(depth)), thinkness of the coracohumeral ligament, presence of extra-articular contrast extravasation, and contrst filling of the subcoracoid bursa. Mean capsular thickness measured at the inferior portion of the axillary pouch was 4.1 mm in patients with adhesive capsulitis and 1.5 mm in the control group. The mean width of the axillary pouch was 2.5 mm in patients and 9.5 mm in controls. In patients, the capsule was significantly thicker and the axillary pouch significantly narrower than in controls (p<0.05). Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch (sensitivity 93%, specificity 80%) and a pouch narrower than 3.5 mm (sensitivity 93%, specificity 100%) were useful criteria for the diagnosis of adhesive capsulitis. In patients with this condition, extra-articular contrast extravasation was noted in six patients (43%) and contrast filling of the subcoracoid bursa in three (21%). The MR arthrographic findings of adhesive capsulitis are capsular thickening, a low-volume axillary pouch, extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa. Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch and a pouch width of less than 3.5 mm are useful diagnostic imaging characteristics

  20. Determining Permissible Oxygen and Water Vapor Transmission Rate for Non-Retort Military Ration Packaging

    Science.gov (United States)

    2011-11-01

    OXYGEN AND WATER VAPOR TRANSMISSION RATE FOR NON- RETORT MILITARY RATION PACKAGING by Danielle Froio Alan Wright Nicole Favreau and Sarah...ANSI Std. Z39.18 RETORT STORAGE SHELF LIFE RETORT POUCHES SENSORY ANALYSIS OXYGEN CRACKERS PACKAGING SENSORY... Packaging for MRE. (a) MRE Retort Pouch Quad-Laminate Structure; (b) MRE Non- retort Pouch Tri-Laminate Structure

  1. “Sequential” Boron Neutron Capture Therapy (BNCT): A Novel Approach to BNCT for the Treatment of Oral Cancer in the Hamster Cheek Pouch Model

    Energy Technology Data Exchange (ETDEWEB)

    Ana J. Molinari; Emiliano C. C. Pozzi; Andrea Monti Hughes; Elisa M. Heber; Marcela A. Garabalino; Silvia I. Thorp; Marcelo Miller; Maria E. Itoiz; Romina F. Aromando; David W. Nigg; Jorge Quintana; Gustavo A. Santa Cruz; Veronica A. Trivillin; Amanda E. Schwint

    2011-04-01

    In the present study we evaluated the therapeutic effect and/or potential radiotoxicity of the novel “Tandem” Boron Neutron Capture Therapy (T-BNCT) for the treatment of oral cancer in the hamster cheek pouch model at RA-3 Nuclear Reactor. Two groups of animals were treated with “Tandem BNCT”, i.e. BNCT mediated by boronophenylalanine (BPA) followed by BNCT mediated by sodium decahydrodecaborate (GB-10) either 24 h (T-24h-BNCT) or 48 h (T-48h-BNCT) later. A total tumor dose-matched single application of BNCT mediated by BPA and GB-10 administered jointly [(BPA + GB-10)-BNCT] was administered to an additional group of animals. At 28 days post-treatment, T-24h-BNCT and T-48h-BNCT induced, respectively, overall tumor control (OTC) of 95% and 91%, with no statistically significant differences between protocols. Tumor response for the single application of (BPA + GB-10)-BNCT was 75%, significantly lower than for T-BNCT. The T-BNCT protocols and (BPA + GB-10)-BNCT induced reversible mucositis in dose-limiting precancerous tissue around treated tumors, reaching Grade 3/4 mucositis in 47% and 60% of the animals respectively. No normal tissue radiotoxicity was associated to tumor control for any of the protocols. “Tandem” BNCT enhances tumor control in oral cancer and reduces or, at worst, does not increase, mucositis in dose-limiting precancerous tissue.

  2. Different flavonoids present in the micronized purified flavonoid fraction (Daflon 500 mg) contribute to its anti-hyperpermeability effect in the hamster cheek pouch microcirculation.

    Science.gov (United States)

    Paysant, J; Sansilvestri-Morel, P; Bouskela, E; Verbeuren, T J

    2008-02-01

    This study evaluated microcirculatory effects of the flavonoid substances that constitute the micronized purified flavonoid fraction (MPFF) (Daflon 500 mg) in comparison to diosmin. In groups of 3 male hamsters, oral treatment with MPFF or diosmin (15 min before anesthesia) did not alter blood pressure. At 10 or 30 mg/kg, both MPFF and diosmin significantly decreased the leaky sites caused by ischemia/reperfusion (I/R) (30 min) in the hamster cheek pouch; the effect was significantly higher with MPFF (39+/-1% and 52+/-1%, respectively) than diosmin (18+/-1% and 37+/-3%, respectively). Eight groups of 3 hamsters each were treated with the components of MPFF. Diosmetin only decreased the number leaky sites at 30 mg/kg (decrease: 15+/-2%). The decrement at 10 and 30 mg/kg averaged at: 17+/-3% and 44+/-1%, respectively, for hesperidin; 19+/-1% and 46+/-2%, respectively, for linarin; and 30+/-1% and 44+/-1%, respectively, for isorhoifolin. Hesperidin, linarin, and isorhoifolin each displayed an anti-leakage effect comparable to or greater than diosmin. MPFF decreases permeability more than any of its single constituents, suggesting that the flavonoids present in its formulation have a synergistic action. These results illustrate that MPFF is more potent than single diosmin in this model of hyperpermeability and that each of the flavonoid substances present in MPFF contribute to its action.

  3. Influence of MAP and Multi-layer Flexible Pouches on Clostridium Count of Smoked Kutum Fish (Rutilus frisii kutum

    Directory of Open Access Journals (Sweden)

    Nazanin Zand

    2016-11-01

    Full Text Available In this study the effect of different concentrations of three gas mixture (carbon dioxide, nitrogen, oxygen, and also vacuum conditions and flexible multi-layer films were evaluated on Clostridium count of smoked kutum fish (Rutilus frisii kutum at ambient condition (T= 25 0C. Ordinary condition as control packaging were compared with four types of modified atmosphere packaging: (N270%+ CO230%, (N230% + CO270%, (45%CO2+ 45%N2+10%O2 and vacuum conditions, in this project. Smoked kutum fish were packaged into 3 kinds of flexible pouches {3- layers(PET(12/AL(12/LLD(100, 4-layers (PET(12/AL(7/ PET(12/LLD(100, and 3-layer (PET(12/AL(7/LLD(100}. Packed samples were performed microbial tests (Clostridium count, in different times during 60 days, with 15 treatment ,3 run, statistical analysis and comparison of data, were done by software SAS (Ver:9/1 and Duncan’s new multiple range test, with confidence level of 95% (P <0.05 . The shelf life of Samples (according to Clostridium count were reported in 4-layers , under conditions 1,2,3 and vacuum conditions, 60,58,45,40 days, in 3-layers (AL:12, under conditions 1,2,3 were 55,50,40 days and in vacuum conditions were about 35 days, with 3- layers(AL:7, under conditions 1,2,3 and vacuum conditions 45,40,35, 30 days. Clostridium count showed that increasing CO2 concentration prolonged shelf life. During the period of this experiment Clostridium count of samples in various conditions, had significant level. According to these results could be concluded the best condition belonged to treatment under modified atmosphere CO2 70% and also 4- layer container due to the thickness (131 μ, low permeability of water vapor in this 4-layer container and anti-microbial effect of more percentage of CO2.

  4. Left atrial accessory appendages, diverticula, and left-sided septal pouch in multi-slice computed tomography. Association with atrial fibrillation and cerebrovascular accidents.

    Science.gov (United States)

    Hołda, Mateusz K; Koziej, Mateusz; Wszołek, Karolina; Pawlik, Wiesław; Krawczyk-Ożóg, Agata; Sorysz, Danuta; Łoboda, Piotr; Kuźma, Katarzyna; Kuniewicz, Marcin; Lelakowski, Jacek; Dudek, Dariusz; Klimek-Piotrowska, Wiesława

    2017-10-01

    The aim of this study is to provide a morphometric description of the left-sided septal pouch (LSSP), left atrial accessory appendages, and diverticula using cardiac multi-slice computed tomography (MSCT) and to compare results between patient subgroups. Two hundred and ninety four patients (42.9% females) with a mean of 69.4±13.1years of age were investigated using MSCT. The presence of the LSSP, left atrial accessory appendages, and diverticula was evaluated. Multiple logistic regression analysis was performed to check whether the presence of additional left atrial structures is associated with increased risk of atrial fibrillation and cerebrovascular accidents. At least one additional left atrial structure was present in 51.7% of patients. A single LSSP, left atrial diverticulum, and accessory appendage were present in 35.7%, 16.0%, and 4.1% of patients, respectively. After adjusting for other risk factors via multiple logistic regression, patients with LSSP are more likely to have atrial fibrillation (OR=2.00, 95% CI=1.14-3.48, p=0.01). The presence of a LSSP was found to be associated with an increased risk of transient ischemic attack using multiple logistic regression analysis after adjustment for other risk factors (OR=3.88, 95% CI=1.10-13.69, p=0.03). In conclusion LSSPs, accessory appendages, and diverticula are highly prevalent anatomic structures within the left atrium, which could be easily identified by MSCT. The presence of LSSP is associated with increased risk for atrial fibrillation and transient ischemic attack. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Detection of Campylobacter in Stool and Determination of Significance by Culture, Enzyme Immunoassay, and PCR in Developing Countries

    Science.gov (United States)

    Platts-Mills, James A.; Liu, Jie; Gratz, Jean; Mduma, Esto; Amour, Caroline; Swai, Ndealilia; Taniuchi, Mami; Begum, Sharmin; Peñataro Yori, Pablo; Tilley, Drake H.; Lee, Gwenyth; Shen, Zeli; Whary, Mark T.; Fox, James G.; McGrath, Monica; Kosek, Margaret; Haque, Rashidul

    2014-01-01

    Campylobacter is a common bacterial enteropathogen that can be detected in stool by culture, enzyme immunoassay (EIA), or PCR. We compared culture for C. jejuni/C. coli, EIA (ProSpecT), and duplex PCR to distinguish Campylobacter jejuni/C. coli and non-jejuni/coli Campylobacter on 432 diarrheal and matched control stool samples from infants in a multisite longitudinal study of enteric infections in Tanzania, Bangladesh, and Peru. The sensitivity and specificity of culture were 8.5% and 97.6%, respectively, compared with the results of EIA and 8.7% and 98.0%, respectively, compared with the results of PCR for C. jejuni/C. coli. Most (71.6%) EIA-positive samples were positive by PCR for C. jejuni/C. coli, but 27.6% were positive for non-jejuni/coli Campylobacter species. Sequencing of 16S rRNA from 53 of these non-jejuni/coli Campylobacter samples showed that it most closely matched the 16S rRNA of C. hyointestinalis subsp. lawsonii (56%), C. troglodytis (33%), C. upsaliensis (7.7%), and C. jejuni/C. coli (2.6%). Campylobacter-negative stool spiked with each of the above-mentioned Campylobacter species revealed reactivity with EIA. PCR detection of Campylobacter species was strongly associated with diarrhea in Peru (odds ratio [OR] = 3.66, P < 0.001) but not in Tanzania (OR = 1.56, P = 0.24) or Bangladesh (OR = 1.13, P = 0.75). According to PCR, Campylobacter jejuni/C. coli infections represented less than half of all infections with Campylobacter species. In sum, in infants in developing country settings, the ProSpecT EIA and PCR for Campylobacter reveal extremely high rates of positivity. We propose the use of PCR because it retains high sensitivity, can ascertain burden, and can distinguish between Campylobacter infections at the species level. PMID:24452175

  6. MRI diagnosis of trapped periosteum following incomplete closed reduction of distal tibial Salter-Harris II fracture

    International Nuclear Information System (INIS)

    Raman, Subha; Wallace, E.C.

    2011-01-01

    Irreducible fracture of the distal tibial physis due to interposed soft tissue including periosteum is well documented in the orthopedic literature but is uncommon. This condition has been associated with subsequent growth disturbance and requires open reduction. There are very few prior reports of MRI depiction of soft tissue interposition and none of periosteal interposition in the distal tibial physis. This is a relatively common location of physeal injury and related growth disturbance. We present a case of periosteum trapped in the distal tibial physis, diagnosed on MRI, in a Salter-Harris II fracture and its management implications. (orig.)

  7. Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child

    Energy Technology Data Exchange (ETDEWEB)

    Chun, K.A. [The Catholic University of Korea Uijongbu St. Mary' s Hospital, Department of Radiology, Uijongbu, Kyunggi-Do 480-130 (Korea); University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States); Morcuende, J. [University of Iowa Hospitals and Clinics, Department of Orthopaedic Surgery, Iowa City (United States); El-Khoury, G.Y. [University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States)

    2004-12-01

    In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

  8. Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child

    International Nuclear Information System (INIS)

    Chun, K.A.; Morcuende, J.; El-Khoury, G.Y.

    2004-01-01

    In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

  9. Defect in assimilation following combined radiation and chemotherapy in patients with locally unresectable pancreatic carcinoma

    International Nuclear Information System (INIS)

    Barkin, J.S.; Kalser, M.H.; Thomsen, S.; Redlhammer, D.

    1982-01-01

    The relative contributions of high-dose irradiation and/or chemotherapy to the nutritional problems of patients with inoperable pancreatic carcinoma were evaluated by study of pancreatic exocrine function and jejunal function and morphologic findings in ten patients before and after treatment. Nutrient assimilation studies included determination of serum carotene levels, D-xylose absorption and fat absorption. Crosby capsule biopsy specimen of jejunal mucosa were evaluated with light microscopy. Fat assimilation was the only parameter of nutritional function to significantly worsen after therapy. Low serum carotene levels present in the patients before therapy remained low but did not significantly change after treatment. D-xylose absorption and the morphologic structure of the jejunal mucosa were normal before and after treatment. These findings support the previous observations that the nutritional problems of the patient with inoperable pancreatic carcinoma are due to pancreatic insufficiency and that high dose irradiation and chemotherapy can exacerbate the pancreatic insufficiency but do not produce jejunal dysfunction. Therefore, it is suggested that pancreatic exocrine replacement therapy may improve the nutritional status of these patients

  10. Utility of barium studies for patients with recurrent weight gain after Roux-en-Y gastric bypass

    International Nuclear Information System (INIS)

    Wang, B.; Levine, M.S.; Rubesin, S.E.; Williams, N.N.; Dumon, K.; Raper, S.

    2015-01-01

    Aim: To determine the utility of barium studies for detecting abnormalities responsible for recurrent weight gain after gastric bypass surgery. Methods: A computerized search identified 42 patients who had undergone barium studies for recurrent weight gain after gastric bypass and 42 controls. The images were reviewed to determine the frequency of staple-line breakdown and measure the length/width of the pouch and gastrojejunal anastomosis. A large pouch exceeded 6 cm in length or 5 cm in width and a wide anastomosis exceeded 2 cm. Records were reviewed for the amount of recurrent weight gain and subsequent weight loss after additional treatment. Results: Staple-line breakdown was present in 6/42 patients (14%) with recurrent weight gain. When measurements were obtained, 13/35 patients (37%) with recurrent weight gain had a large pouch, three (9%) had a wide anastomosis, and four (11%) had both, whereas 22/42 controls (52%) had a large pouch, one (2%) had a wide anastomosis, and two (5%) had both. Ten patients (24%) with recurrent weight gain underwent staple-line repair (n = 3) or pouch/anastomosis revision (n = 7). These 10 patients had a mean weight loss of 38.1 lbs versus a mean loss of 8.6 lbs in 19 patients managed medically. Conclusion: Only 14% of patients with recurrent weight gain after gastric bypass had staple-line breakdown, whereas 57% had a large pouch, wide anastomosis, or both. Not all patients with abnormal anatomy had recurrent weight gain, but those who did were more likely to benefit from surgical intervention than from medical management. - Highlights: • Only 14% of patients with recurrent weight gain after gastric bypass had GGFs. • The majority of patients with recurrent weight gain had a large pouch/wide GJA. • Many patients without recurrent weight gain also had a large pouch/wide GJA. • Those with weight gain and a large pouch/wide GJA are likely to benefit from surgery

  11. Imaging active lymphocytic infiltration in coeliac disease with iodine-123-interleukin-2 and the response to diet

    Energy Technology Data Exchange (ETDEWEB)

    Signore, A.; Chianelli, M.; Annovazzi, A.; Rossi, M.; Greco, M.; Ronga, G.; Picarelli, A. [Nuclear Medicine Unit (Nu.M.E.D. Group) and Gastroenterology Unit, Department of Clinical Sciences, University of Rome ' ' La Sapienza' ' (Italy); Maiuri, L. [Inst. of Paediatrics, Children' s Hospital Posilipon, University ' ' Federico II' ' , Naples (Italy); Britton, K.E. [Dept. of Nuclear Medicine, St. Bartholomew' s Hospital, London (United Kingdom)

    2000-01-01

    Coeliac disease is diagnosed by the presence of specific antibodies and a jejunal biopsy showing mucosal atrophy and mononuclear cell infiltration. Mucosal cell-mediated immune response is considered the central event in the pathogenesis of coeliac disease, and untreated coeliac patients show specific features of T-cell activation in the small intestine. Here we describe the use of iodine-123-interleukin-2 scintigraphy in coeliac patients as a non-invasive tool for detection of lymphocytic infiltration in the small bowel and its use for therapy follow-up, and we demonstrate the specificity of binding of labelled-IL2 to activated lymphocytes by ex-vivo autoradiography of jejunal biopsies. {sup 123}I-IL2 was administered i.v. [74 MBq (2 mCi)], and gamma camera images were acquired after 1 h. Ten patients were studied with {sup 123}I-IL2 scintigraphy at diagnosis and seven were also investigated after 12-19 months of gluten-free diet. Results were expressed as target-to-background radioactivity ratios in six different bowel regions before and after the diet. At the time of diagnosis all patients showed a significantly higher bowel uptake of {sup 123}I-IL2 than normal subjects (P<0.003 in all regions). A significant correlation was found between jejunal radioactivity and the number of IL2R+ve lymphocytes per millimetre of jejunal mucosa as detected by immunostaining of jejunal biopsy (r{sup 2}=0.66; P=0.008). Autoradiography of jejunal biopsies confirmed that labelled-IL2 only binds to activated T-lymphocytes infiltrating the gut mucosa. After 1 year of the diet, bowel uptake of {sup 123}I-IL2 significantly decreased in five out of six regions (P<0.03), although two patients still had a positive IL2 scintigraphy in one region. We conclude that {sup 123}I-IL2 scintigraphy is a sensitive non-invasive technique for assessing in vivo the presence of activated mononuclear cells in the bowel of patients affected by coeliac disease. Unlike jejunal biopsy, this method provides

  12. Neo bladder long term follow-up

    International Nuclear Information System (INIS)

    Fakhr, I.; Mohamed, A. M.; Moustafa, A.; Al-Sherbiny, M.; Salama, M.

    2013-01-01

    One of the commonest forms of orthotopic bladder substitution for bladder cancer surivors, used in our institute, is the use of ileocecal segment. Sometimes, the need for Indiana pouch heterotropic continent diversion arises. Aim: To compare the long-term effect of orthotopic ileocecal bladder and heterotropic Indiana pouch following radical cystectomy in bladder cancer patients. Patients and methods: Between January 2008 and December 2011, 91 patients underwent radical cystectomy/anterior pelvic exentration and ortho topic ileocecal bladder reconstruction (61 patients) and Indiana pouch (30 patients), when orthotopic diversion could not be technically or oncologically feasible. Results: Convalescence was uneventful in most patients. All minor and major urinary leakage cases, in both diversions groups, where successfully conservatively treated. Only one patient in the ileocecal group with major urinary leak required re-exploration with successful revision of uretro-colonic anastomosis. Only one patient in the Indiana pouch group had accidentally discovered sub-centimetric stone, which was simply expelled. The overall survival proportion of ileocecal group was 100% compared to 80% in the Indiana pouch group (p < 0.001). The disease free survival proportion of ileocecal group was 90.8% compared to 80% in the Indiana pouch group (p = 0.076). Effective comparative daytime and nighttime urinary continence as well as renal function deterioration were not statistically significant between both reconstruction types. Conclusion: Both ileocecal bladder and Indiana pouch are safe procedures in regard to long-term effects over kidney function following radical cystectomy

  13. Outcomes After Patch Use in Rotator Cuff Repair.

    Science.gov (United States)

    Steinhaus, Michael E; Makhni, Eric C; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

    2016-08-01

    To provide a comprehensive review of clinical outcomes and retear rates after patch use in rotator cuff repair, and to determine the differences between available graft types and techniques. A systematic review was conducted from database (PubMed, Medline, Scopus, Embase) inception to January 2015 for English-language articles reporting outcome data with 9 months' minimum follow-up. Studies were assessed by 2 reviewers who collected pertinent data, with outcomes combined to generate frequency-weighted means. Twenty-four studies met the inclusion criteria. The frequency-weighted mean age was 61.9 years with 35.4 months' follow-up. The mean improvements in postoperative range of motion in the forward elevation, abduction, external rotation, and internal rotation planes were 58.6°, 66.2°, 16.6°, and 16.1°, respectively, and postoperative abduction strength improved by 3.84 kg. American Shoulder and Elbow Surgeons, University of California-Los Angeles, Constant, Penn, and Oxford scores improved by 39.3, 10.7, 40.8, 34.4, and 17.6, respectively. Augmentation and interposition techniques showed similar improvements in range of motion, strength, and patient-reported outcomes (PROs), whereas xenografts showed less improvement in PROs compared with other graft types. Studies reported improvements in pain and activities of daily living (ADLs), with greater than 90% overall satisfaction, although few patients (13%) were able to return to preinjury activity. Whereas interposition and augmentation techniques showed similar improvements in pain and ADLs, xenografts showed less improvement in ADLs than other graft types. The overall retear rate was 25%, with rates of 34% and 12% for augmentation and interposition, respectively, and rates of 44%, 23%, and 15% for xenografts, allografts, and synthetic grafts, respectively. We report improvements in clinical and functional outcomes, with similar results for augmentation and interposition techniques, whereas xenografts showed

  14. Duodenal-jejunal bypass surgery up-regulates the expression of the hepatic insulin signaling proteins and the key regulatory enzymes of intestinal gluconeogenesis in diabetic Goto-Kakizaki rats.

    Science.gov (United States)

    Sun, Dong; Wang, Kexin; Yan, Zhibo; Zhang, Guangyong; Liu, Shaozhuang; Liu, Fengjun; Hu, Chunxiao; Hu, Sanyuan

    2013-11-01

    Duodenal-jejunal bypass (DJB), which is not routinely applied in metabolic surgery, is an effective surgical procedure in terms of type 2 diabetes mellitus resolution. However, the underlying mechanisms are still undefined. Our aim was to investigate the diabetic improvement by DJB and to explore the changes in hepatic insulin signaling proteins and regulatory enzymes of gluconeogenesis after DJB in a non-obese diabetic rat model. Sixteen adult male Goto-Kakizaki rats were randomly divided into DJB and sham-operated groups. The body weight, food intake, hormone levels, and glucose metabolism were measured. The levels of protein expression and phosphorylation of insulin receptor-beta (IR-β) and insulin receptor substrate 2 (IRS-2) were evaluated in the liver. We also detected the expression of key regulatory enzymes of gluconeogenesis [phosphoenoylpyruvate carboxykinase-1 (PCK1), glucose-6-phosphatase-alpha (G6Pase-α)] in small intestine and liver. DJB induced significant diabetic improvement with higher postprandial glucagons-like peptide 1, peptide YY, and insulin levels, but without weight loss. The DJB group exhibited increased expression and phosphorylation of IR-β and IRS-2 in liver, up-regulated the expression of PCK1 and G6Pase-α in small intestine, and down-regulated the expression of these enzymes in liver. DJB is effective in up-regulating the expression of the key proteins in the hepatic insulin signaling pathway and the key regulatory enzymes of intestinal gluconeogenesis and down-regulating the expression of the key regulatory enzymes of hepatic gluconeogenesis without weight loss. Our study helps to reveal the potential role of hepatic insulin signaling pathway and intestinal gluconeogenesis in ameliorating insulin resistance after metabolic surgery.

  15. Single-dose-response curves of murine gastrointestinal crypt stem cells

    International Nuclear Information System (INIS)

    Masuda, K.; Withers, H.R.; Mason, K.A.; Chen, K.Y.

    1977-01-01

    Dose-response curves for the reproductive capacity of crypt stem cells of murine colonic, jejunal, and gastric mucosae exposed in situ to multifractionated gamma ray exposures were analyzed and single-dose-survival curves of these cells were constructed. The following conclusions were drawn: (1) The single-dose-response curves bend downward over a dose range of approximately 200 to 1500 rad; (2) cell death seems to be due to nonrepairable damage at doses less than 250 rad for colon, and 220 rad for jejunum; (3) there are 21, 110, and 140 stem cells per crypt of gastric, colonic, and jejunal mucosa, respectively; and (4) jejunal stem cells are the most radiosensitive and gastric mucosal stem cells are the most resistant

  16. Effect of different binders on the physico-chemical, textural, histological, and sensory qualities of retort pouched buffalo meat nuggets.

    Science.gov (United States)

    Devadason, I Prince; Anjaneyulu, A S R; Babji, Y

    2010-01-01

    The functional properties of 4 binders, namely corn starch, wheat semolina, wheat flour, and tapioca starches, were evaluated to improve the quality of buffalo meat nuggets processed in retort pouches at F(0) 12.13. Incorporation of corn starch in buffalo meat nuggets produced more stable emulsion than other binders used. Product yield, drip loss, and pH did not vary significantly between the products with different binders. Shear force value was significantly higher for product with corn starch (0.42 +/- 0.0 Kg/cm(3)) followed by refined wheat flour (0.36 +/- 0.010 Kg/cm(3)), tapioca starch (0.32 +/- 0.010 Kg/cm(3)), and wheat semolina (0.32 +/- 0.010 Kg/cm(3)). Type of binder used had no significant effect on frying loss, moisture, and protein content of the product. However, fat content was higher in products with corn starch when compared to products with other binders. Texture profile indicated that products made with corn starch (22.17 +/- 2.55 N) and refined wheat flour (21.50 +/- 0.75 N) contributed firmer texture to the product. Corn starch contributed greater chewiness (83.8 +/- 12.51) to the products resulting in higher sensory scores for texture and overall acceptability. Products containing corn starch showed higher sensory scores for all attributes in comparison to products with other binders. Panelists preferred products containing different binders in the order of corn starch (7.23 +/- 0.09) > refined wheat flour (6.48 +/- 0.13) > tapioca starch (6.45 +/- 0.14) > wheat semolina (6.35 +/- 0.13) based on sensory scores. Histological studies indicated that products with corn starch showed dense protein matrix, uniform fat globules, and less number of vacuoles when compared to products made with other binders. The results indicated that corn flour is the better cereal binder for developing buffalo meat nuggets when compared to all other binders based on physico-chemical and sensory attributes.

  17. Schwann cell seeded guidance tubes restore erectile function after ablation of cavernous nerves in rats.

    Science.gov (United States)

    May, F; Weidner, N; Matiasek, K; Caspers, C; Mrva, T; Vroemen, M; Henke, J; Lehmer, A; Schwaibold, H; Erhardt, W; Gänsbacher, B; Hartung, R

    2004-07-01

    Dissection of the cavernous nerves eliminates spontaneous erections. We evaluated the ability of Schwann cell seeded nerve guidance tubes to restore erections after bilateral cavernous nerve resection in rats. Sections (5 mm) of the cavernous nerve were excised bilaterally, followed by immediate bilateral microsurgical reconstruction. In 10 animals per group (20 study nerves) reconstruction was performed by genitofemoral nerve interposition, interposition of silicone tubes or interposition of silicone tubes seeded with homologous Schwann cells. As the control 10 animals (20 study nerves) underwent sham operation (positive control) and bilateral nerve ablation (without reconstruction) was performed in a further 10 (negative control). Erectile function was evaluated 3 months postoperatively by relaparotomy, electrical nerve stimulation and intracavernous pressure recording. After 3 months neurostimulation resulted in an intact erectile response in 90% (18 of 20) of Schwann cell grafts, while treatment with autologous nerves (30% or 6 of 20) or tubes only (50% or 10 of 20) was less successful (p Schwann cell grafts compared to results in the other treatment groups (p Schwann cell grafts. Schwann cell seeded guidance tubes restore erectile function after the ablation of cavernous nerves in rats and they are superior to autologous nerve grafts.

  18. Thirty-Day Hospital Readmission After Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis for Chronic Ulcerative Colitis at a High-Volume Center.

    Science.gov (United States)

    McKenna, Nicholas P; Mathis, Kellie L; Khasawneh, Mohammad; Shariq, Omair; Dozois, Eric J; Larson, David W; Lightner, Amy L

    2017-11-01

    Ileal pouch anal anastomosis (IPAA) is associated with a high 30-day hospital readmission rate. Risk factors and etiology of readmission remain poorly defined. We sought to determine the 30-day hospital readmission rate following IPAA at a high-volume center and identify any modifiable perioperative factors. A retrospective review of all patients undergoing two- or three-stage IPAA for chronic ulcerative colitis at our institution between 2002 and 2013 was performed. Analysis was performed on rate of readmission, readmission diagnosis, intervention performed upon readmission, and risk factors for readmission. Thirty-day primary and secondary readmission rates after IPAA were 20.3% (n = 185) and 2.1% (n = 19), respectively. The leading etiologies for readmission included partial small bowel obstruction/ileus (n = 52, 21.9%), pelvic sepsis (n = 43, 18.1%), dehydration (n = 42, 17.7%), and venous thromboembolism (n = 31, 13.1%). While the majority of readmissions were managed medically (n = 119, 65.4%), 19.2% (n = 35) required radiologic intervention and 15.3% (n = 28) required a return to the operating room. On univariate analysis, younger age (p = 0.03) and female sex (p = 0.04) had a significantly increased risk of readmission. On multivariable analysis, BMI ≥ 30 (OR 0.51; 95% CI, 0.25-0.97, p = 0.04) was protective of readmission. Thirty-day hospital readmission following IPAA remains a common problem. Preventable etiologies of readmission include dehydration and venous thromboembolism (VTE). Future quality improvement efforts should focus on education regarding stoma output and extended VTE prophylaxis to decrease hospital readmission rates following IPAA.

  19. Colonic mucin secretion related to non-contractile motility in the dog

    International Nuclear Information System (INIS)

    Skioedebrand, C.G.; Margulis, A.R.; Hattner, R.S.; Hartmeyer, J.; Stoughton, J.A.

    1981-01-01

    In 8 dogs a colonic pouch with fistula was surgically created. Mucin secretion was measured by washing mucus out of the pouch and then, after a number of chemical steps, by determining the turbidity with spectrophotometry. The movement of tantalum particles insufflated into the canine rectum during periods of absence of contractions was correlated with mucus secretion in the pouch. Correlations were made after parenteral injection of secretin which increased movement of tantalum particles and production of mucin, and after injection of glucagon, which stopped movement of the particles and decreased mucin secretion in the pouch. Movement of tantalum was also observed when the particles were insufflated into the canine rectum on top of an applied layer of water-soluble jelly. (Auth.)

  20. Radiologic findings and weight loss following gastroplasty for morbid obesity

    Energy Technology Data Exchange (ETDEWEB)

    Miskowiak, J.; Fleckenstein, P.; Andersen, B.

    Gastroplasty aimed at treatment of morbid obesity creates a small proximal pouch and a narrow stoma to the remainder of the stomach. In 11 consecutive obese patients subjected to gastroplasty radiologic examinations of the stomach were performed before operation and one week, 3 and 12 months postoperatively. All stomachs were normal before operation. A significant decrease in pouch area and increase in stoma diameter were registered over the observation period. There were no statistically significant correla