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Sample records for terminal ileal lipoma

  1. Midgut pain due to an intussuscepting terminal ileal lipoma: a case report.

    LENUS (Irish Health Repository)

    Abbasakoor, Noormuhammad O

    2010-01-01

    ABSTRACT: INTRODUCTION: The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1. CASE PRESENTATION: A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 x 2.5 x 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up. CONCLUSION: This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.

  2. Lipoma

    Science.gov (United States)

    ... of superficial subcutaneous lipomas. The Journal of Clinical Aesthetic Dermatology. 2014;7:46. Lipoma Symptoms & causes Diagnosis & ... Discovery's Edge Magazine Search Publications Training Grant Positions Education Mayo Clinic College of Medicine and Science Mayo ...

  3. ISOLATED SMALL TERMINAL ILEAL ULCERS: THE DIAGNOSTIC UTILITY OF ENDOSCOPIC BIOPSIES

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    Kavya Harika

    2015-07-01

    Full Text Available The aim of this study was to determine the diagnostic utility of endoscopic biopsies in isolated terminal ileal ulcers. Though a large number of terminal ileal biopsies are being performed frequently, the value added to diagnostic possibility is not clear, and there are few published data on the diagnostic value of TI biopsies. Hence, this study was performed to obtain objective data on this subject, as there are currently few data available in the literature. This observational study group included a total of 61 men and women with indication for colonoscopy and terminal ileal biopsy. Patients in whom the colonoscopy revealed isolated terminal ileal ulcers of size < 1 cm were includ ed in the study. In the study, Terminal ileal mucosa with non - specific changes was identified, in 78.7% . Majority 29.5% were between 31 - 40years of age, predominantly men.

  4. The analysis of factors associated with progression of isolated terminal ileal lesions.

    Directory of Open Access Journals (Sweden)

    Zhang Fangbin

    Full Text Available To assess the factors associated with the progression of isolated terminal ileal lesions (ITILs at colonoscopy in Chinese patients.Patients diagnosed with ITILs were enrolled. The ileoscopy was performed by two experienced gastroenterologists every 52 weeks. A logistic regression analysis was used to elucidate the factors associated with Crohn's disease (CD and mucosal healing. A log rank test was used to assess the differences of the cumulative proportion of CD and mucosal healing in different groups at different times.(1 A total of 34 patients were included and no patient had taken nonsteroidal anti-inflammatory drug in the last 6 months; eight (23.5% patients had a clinical diagnosis of CD, 14 (41.2% patients achieved mucosal healing, and 12 (35.3% patients showed no significant changes in the lesions at last follow-up. (2 The logistic regression analysis showed that only abdominal pain was a factor in the ITIL disease outcomes. (3 The cumulative proportion of CD in the abdominal pain group after 3 years was statistically higher than that in the non-abdominal pain group (42.7% vs. 6.2%, χ2 = 10.129, P = 0.001. However, the cumulative proportion of mucosal healing in the non-abdominal pain group was statistically higher than that in the abdominal pain group (73.3% vs. 5.6%, χ2 = 5.225, P = 0.022. (4 The numbers of lesions observed on the initial colonoscopy exams and the initial histologic findings were not related to the ITIL disease outcomes.Clinical symptoms may be related to ITIL disease outcomes. Patients with abdominal pain had a high likelihood of CD, whereas those without abdominal pain had a high likelihood of mucosal healing.

  5. The analysis of factors associated with progression of isolated terminal ileal lesions.

    Science.gov (United States)

    Fangbin, Zhang; Weiwei, Hao; Wugan, Zhao; Cong, Zheng; Yanjun, Chu; Feng, Xu

    2014-01-01

    To assess the factors associated with the progression of isolated terminal ileal lesions (ITILs) at colonoscopy in Chinese patients. Patients diagnosed with ITILs were enrolled. The ileoscopy was performed by two experienced gastroenterologists every 52 weeks. A logistic regression analysis was used to elucidate the factors associated with Crohn's disease (CD) and mucosal healing. A log rank test was used to assess the differences of the cumulative proportion of CD and mucosal healing in different groups at different times. (1) A total of 34 patients were included and no patient had taken nonsteroidal anti-inflammatory drug in the last 6 months; eight (23.5%) patients had a clinical diagnosis of CD, 14 (41.2%) patients achieved mucosal healing, and 12 (35.3%) patients showed no significant changes in the lesions at last follow-up. (2) The logistic regression analysis showed that only abdominal pain was a factor in the ITIL disease outcomes. (3) The cumulative proportion of CD in the abdominal pain group after 3 years was statistically higher than that in the non-abdominal pain group (42.7% vs. 6.2%, χ2 = 10.129, P = 0.001). However, the cumulative proportion of mucosal healing in the non-abdominal pain group was statistically higher than that in the abdominal pain group (73.3% vs. 5.6%, χ2 = 5.225, P = 0.022). (4) The numbers of lesions observed on the initial colonoscopy exams and the initial histologic findings were not related to the ITIL disease outcomes. Clinical symptoms may be related to ITIL disease outcomes. Patients with abdominal pain had a high likelihood of CD, whereas those without abdominal pain had a high likelihood of mucosal healing.

  6. Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum

    Energy Technology Data Exchange (ETDEWEB)

    Hoskins, W.J.; Burke, T.W.; Weiser, E.B.; Heller, P.B.; Grayson, J.; Park, R.C.

    1987-02-01

    Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland. All patients had previously undergone an abdominal operation and three patients had irradiation utilizing extended fields. In all cases, right hemicolectomy and extended ileal resection were performed with primary anastamosis of the ileum to the ascending colon or the transverse colon. Operating time averaged 4 1/2 hr utilizing hand closure anastomoses and 2 1/2 hr with stapled anastomoses. All patients received postoperative hyperalimentation and six of eight patients received preoperative hyperalimentation. One operative death occurred in a patient with intestinal perforation who required multiple resections. The remaining seven patients experienced no serious complications and had rapid return of bowel function. Our experience indicates that wide ileal resection with right hemicolectomy and primary reanastomosis is an acceptable alternative to intestinal bypass for the treatment of severe irradiation injury, especially when performed with gastrointestinal stapling devices.

  7. Lipoma y Lipomatosis Lipoma and Lipomatosis

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    L Huczak

    2007-03-01

    Full Text Available Los lipomas son tumores benignos compuestos por células grasas. Ellos son los tumores mesenquimales más comunes. Se encuentran en el tejido subcutáneo y menos frecuente en órganos internos. Usualmente presentan poca dificultad de diagnóstico y morbilidad. Los lipomas típicamente se desarrollan como masas elásticas discretas en el tejido subcutáneo y tejidos blandos profundos en el adulto. Muchos signos cutáneos y algunos síndromes son anatómicamente muy complejos y pueden estar asociados con un lipoma subyacente. Recientemente un número de nuevas entidades y variantes han sido descriptas. Su reconocimiento es importante para evitar el diagnósitco fallido y terapias inapropiadas. Lipoma condroide, miolipoma y lipoma pleomórfico de células ahusadas puramente cutáneo, son neoplasias biológicamente benignas que pueden simular sarcomas morfológicamente. El advenimiento de las investigaciones moleculares y citogenéticas de las neoplasias lipomatosas tienden a contribuir más al entendimiento de la biología de aquéllas y guiar a la modificación de los esquemas de clasificación convencional.Lipomas are benign tumors componed of mature fat cells. They are the most common benign mesenchymal tumor. Lipomas are found in the subcutaneous tissues and, less commonly, in internal organs. They usually present with little difficulty in diagnosis or morbidity. Lipomas typically develop as discrete rubbery masses in the subcutaneous tissues of the trunk and proximal extremity. Are the most common neoplasms of subcutaneous and deep soft tissues in adults. Most cutaneous signatures and someone syndromes are anatomically more complex and can associated with an underlying lipoma. In recent years a number of "new" entities and variants have been described. Their recognition is important to avoid diagnostic pitfalls and inappropriare therapy. Chondroid lipoma, myolipoma, and purely cutaneous spindle-cell/pleomorphic lipoma are biologically benign

  8. Lipoma endobrônquico Endobronchial lipoma

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    Antônio Mauro Bof

    2005-12-01

    Full Text Available Os lipomas são neoplasias benignas compostas basicamente de tecido adiposo e podem se localizar em várias partes do corpo. O caso relatado é de uma paciente que procurou o serviço médico com queixa de pneumonias de repetição. Após a propedêutica diagnóstica, que incluiu radiografia simples de tórax e tomografia computadorizada de tórax, suspeitou-se que havia uma lesão endobrônquica com densidade de gordura. A hipótese diagnóstica era a presença de um lipoma endobrônquico como responsável pelo quadro clínico da paciente, que foi confirmada após tratamento cirúrgico. Os objetivos deste trabalho são relatar o caso de um lipoma endobrônquico e fazer uma revisão da literatura.Lipomas are benign neoplasms composed primarily of adipose tissue and may be located in various parts of the body. The case reported is that of a patient who sought medical assistance complaining of recurring pneumonia. After diagnostic procedures, including chest X-ray and computed tomography scan of the chest, endobronchial lesion with fat density was suspected. The diagnostic hypothesis was endobronchial lipoma. This hypothesis was confirmed after surgical intervention. The aim of this study was to report this case of endobronchial lipoma and to review the available literature on the subject.

  9. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

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    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  10. Intraoral Lipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    L. K. Surej Kumar

    2014-01-01

    Full Text Available Lipomas are rare in oral and maxillofacial regions although they are the most common tumours of mesenchymal origin in human body. The etiology remains unclear. Various different theories explain the pathogenesis of this adipose tissue tumour and also different histological variants of oral lipoma have been given in literature. A case of intraoral lipoma occurring in mental region in a 77-year-old male is reported along with review of the literature. Wide surgical excision was performed and two-year followup showed excellent healing without any recurrence. Lipomas are benign soft tissue neoplasm of mature adipose tissue seen as a common entity in the head and neck region. Intraoral lipomas are a rare entity which may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. It is mandatory for a clinician to diagnose intraoral lipomas using latest diagnostic methods and conservatively treat them without causing much discomfort.

  11. Laryngeal lipoma: a rare cause of dysphonia.

    Science.gov (United States)

    Nada, Garrouche; Omezzine, Jerbi Saida; Maher, Dhifallah; Nouha, Ben Hamida; Hssine, Hamza

    2017-01-01

    Lipomas are the most common mesenchymal tumors. Laryngeal lipomas represent 1% of all lipomas but unlike other locations may cause life-threatening symptoms by obstruction of the respiratory tract. In this study, the case of a 32-year old woman with laryngeal lipoma is discussed. The lesion was detected on the left aryepiglottic fold, presented as a stalked and dynamic mass of 2 centimeters diameter. The imaging aspects of laryngeal lipoma cases, clinical evaluation, and approaches to treatment will be discussed.

  12. Quantified terminal ileal motility during MR enterography as a potential biomarker of Crohn's disease activity: a preliminary study

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    Menys, Alex; Atkinson, David; Ahmed, Asia; Punwani, Shonit; Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); Odille, Freddy [INSERM U947, Nancy University, Nancy (France); Novelli, Marco; Rodriguez-Justo, Manuel; Proctor, Ian [University College London, Histopathology, London (United Kingdom); Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); University College London Hospital, Department of Specialist Radiology, London (United Kingdom)

    2012-11-15

    To compare quantified terminal ileal (TI) motility during MR enterography (MRE) with histopathological severity of acute inflammation in Crohn's disease. A total of 28 Crohn's patients underwent MRE and endoscopic TI biopsy. Axial and coronal TrueFISP, HASTE and post-gadolinium VIBE images were supplemented by multiple coronal TrueFISP cine motility sequences through the small bowel volume. TI motility index (MI) was quantified using validated software; an acute inflammation score (eAIS; 0-6) was assigned to the biopsy. Two observers qualitatively scored mural thickness, T2 signal, contrast enhancement and perimural oedema (0-3) to produce an activity score (aMRIs) based on anatomical MRI. The association among the MI, eAIS and aMRIs was tested using Spearman's rank correlation. Wilcoxon rank sum test compared motility in subjects with and without histopathological inflammation. Mean MI and mean eAIS were 0.27 (range 0.06-0.55) and 1.5 (range 0-5), respectively. There was a significant difference in MI between non-inflamed (mean 0.37, range 0.13-0.55) and inflamed (mean 0.19, range 0.06-0.44) TI, P = 0.002, and a significant negative correlation between MI and both eAIS (Rho = -0.52, P = 0.005) and aMRIs (R = -0.7, P < 0.001). Quantified TI motility negatively correlates with histopathological measures of disease activity and existing anatomical MRI activity biomarkers. (orig.)

  13. Studies on pudendal nerve terminal motor latency in patients after ileal J-pouch-anal anastomosis for ulcerative colitis and adenomatous coli in childhood.

    Science.gov (United States)

    Tomita, Ryouichi; Igarashi, Seigo; Koshinaga, Tugumichi; Fujisaki, Shigeru; Kusafuka, Takeshi

    2009-01-01

    To clarify the neurological function with respect to external anal sphincter (EAS) muscles in child patients with or without soiling after ileal J pouch anal anastomosis (IPAA), we examined the terminal motor latency in the pudendal motor nerves (PNTML). A total of nine patients after IPAA for UC (7 cases) and AC (2 cases) were studied (6 males and 3 females, 10 to 15 with a mean age of 13.8 years). Patients one year after IPAA with soiling were also subdivided by the see page of mucous and/or stool group A (5 cases); rare soiling with loose stool, group B (4 cases); occasional soiling (1 time per 2 or 3 days). However, all patients showed continence 2 years after IPAA (Group C). Group D served as controls without gastrointestinal symptoms and digestive diseases and consisted of 12 subjects (8 males and 4 females aged 12 to 16 years old with a mean age of 14.8 years). Examinations were performed 1 and 2 years after ileostomy closure. Bilateral (left-sided and right-sided) PNTML tests were performed on all patients in order to measure the latency of the response in the bilateral EAS muscle following digitally directed transrectal pudendal nerve stimulation. 1) Values of the PNTML at the right-sided of the PN: The conduction delay in group B was the longest, followed by groups A, C, and D. Moreover, significant differences in PNTML were noted between groups A and B, between groups A and D, between groups B and C, and between groups B and D (p motor nerves.

  14. Distal ileal stenosing subserosal lipoma: A case report | Emmanuel ...

    African Journals Online (AJOL)

    There was stenosis affecting the distal 30cm of the ileum.The wall of the stenosed part of ileum had intramural fat at the sub-serosal locale. Histology confirmed the presence of sheets of matured adipocytes between the muscularispropria and serosa.Patient condition improved and was discharged seven days after surgery.

  15. An obstructing endobronchial lipoma simulating COPD

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Gottlieb, Magnus; Christensen, Merete

    2014-01-01

    Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essentia...

  16. Chondroid Lipoma of the Right Thigh

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    Rosy Setiawati

    2012-07-01

    Full Text Available Chondroid lipoma is a rare and unusual benign soft tissue lesion. Although there have been several reports of the imaging findings of chondroid lipoma, very few described the radiographic calcification or ossification in a chondroid lipoma. We present a case of chondroid lipoma with adipose tissue and ossified components on plain radiography and MRI images. Correlation of imaging findings and pathological examination is provided to confirm the diagnosis.

  17. Giant Retroperitoneal Lipoma in an Infant

    African Journals Online (AJOL)

    2010-06-29

    Jun 29, 2010 ... 33. Giant Retroperitoneal Lipoma in an Infant. A. M. Mohammad, A. A. Yakubu. INTRODUCTION. Lipomas are the most common soft tissue tumors that are encountered in clinical practice. Lipoma of the abdominal cavity, a benign neoplasm of mature fat cells usually presents as an asymptomatic abdominal.

  18. Giant lipomas of the hand

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    Gokce Yildiran

    2015-04-01

    Conclusion: Giant lipomas of the hand are very rare and may cause compressions and other complications. Thus, they require a careful preoperative evaluation in order to make a proper differential diagnosis. [Hand Microsurg 2015; 4(1.000: 8-11

  19. Intramuscular lipoma: a review of the literature

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    Shane McTighe

    2014-12-01

    Full Text Available Lipomas are the most common type of soft tissue mesenchymal tumors. They are typically located subcutaneously and consist of mature fatty tissue. When they occur under the enclosing fascia, they are called deep-seated lipomas. Infrequently, lipomas can arise inside the muscle and are called intramuscular lipomas. Intramuscular lipomas have been commonly investigated and categorized in the same group as other deep-seated and superficial lipomatous lesions. Their clinical, histological and imaging characteristics may resemble well-differentiated liposarcomas, further adding to the difficulties in the differential diagnosis. This article summarizes the available literature and describes the typical epidemiological, pathological and clinical features of intramuscular lipomas, as well as delineating their treatment and prognosis.

  20. Subacromial lipoma causing shoulder impingement syndrome.

    Science.gov (United States)

    Sucuoglu, Hamza; Akgun, Kenan

    2017-01-01

    Subacromial lipoma represents a rare cause of subacromial impingement syndrome (SIS). A 49-year-old male patient presented to clinic with progressive right shoulder pain and limited movement, ongoing for approximately 1 month. Magnetic resonance imaging (MRI) revealed a lesion, compatible with lipoma, extending through subacromial space and pressing on supraspinatus muscle. After histopathological verification of lipoma, mass was excised. Postoperatively, patient completed 1 month physical therapy and rehabilitation program. Patient was free of pain at 4-month follow-up. Subacromial lipoma should be included in differential diagnosis of SIS for patients unresponsive to conservative treatment; MRI is very useful to determine precise etiology and inform surgical treatment.

  1. Retroperitoneal lipoma arising from the urinary bladder

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    Hisato Kobayashi

    2009-07-01

    Full Text Available Retroperitoneal benign lipomas are extremely rare and represent about 2.9% of all primary retroperitoneal tumors. About 80% of the tumors in the retroperitoneal cavities are malignant neoplasms. We experienced a case of a retroperitoneal lipoma simulating an ovarian mature cystic teratoma. A diagnosis was correctly made by magnetic resonance imaging (MRI prior to surgery, and a total tumorectomy was performed. The retroperitoneal lipoma was recognized to have arisen from the urinary bladder. Histological sections revealed a tumor consisting of typical adipose cells without atypia. These types of lipomas should be carefully followed-up because they often recur and undergo malignant transformations.

  2. Endoscopically removed giant submucosal lipoma

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    Jovanović Ivan

    2007-01-01

    Full Text Available Background. Although uncommon, giant submucosal colon lipomas merit attention as they are often presented with dramatic clinical features such as bleeding, acute bowel obstruction, perforation and sometimes may be mistaken for malignancy. There is a great debate in the literature as to how to treat them. Case report. A patient, 67-year old, was admitted to the Clinic due to a constipation over the last several months, increasing abdominal pain mainly localized in the left lower quadrant accompanied by nausea, vomiting and abdominal distension. Physical examination was unremarkable and the results of the detailed laboratory tests and carcinoembryonic antigen remained within normal limits. Colonoscopy revealed a large 10 cm long, and 4 to 5 cm in diameter, mobile lesion in his sigmoid colon. Conventional endoscopic ultrasound revealed 5 cm hyperechoic lesion of the colonic wall. Twenty MHz mini-probe examination showed that lesion was limited to the submucosa. Since polyp appeared too large for a single transaction, it was removed piecemeal. Once the largest portion of the polyp has been resected, it was relatively easy to place the opened snare loop around portions of the residual polyp. Endoscopic resection was carried out safely without complications. Histological examination revealed the common typical histological features of lipoma elsewhere. The patient remained stable and eventually discharged home. Four weeks later he suffered no recurrent symptoms. Conclusion. Colonic lipomas can be endoscopically removed safely eliminating unnecessary surgery.

  3. Oral lipomas: A report of two cases

    African Journals Online (AJOL)

    McRoy

    2014-03-30

    Mar 30, 2014 ... palate, floor of the mouth and the buccal vestibule. The present report is of two patients; a 70 year old female who presented with a lipoma on the right sublingual region of 5 years duration and a 55 year old female who presented with lipoma on the right buccal mucosa of 2 years duration. CASE REPORTS.

  4. Rectal Lipoma Associated with Genital Prolapse

    African Journals Online (AJOL)

    intestine. We present the case of a 58‑year‑old post‑menopausal lady presenting with rectal bleeding and utero‑vaginal prolapse. The prolapsing mass was excised, and histopathological examination diagnosed the lesion to be a lipoma. Keywords: Mature adipocytes, Rectal bleeding, Rectal lipoma, Utero‑vaginal prolapse.

  5. Retropharyngeal spindle cell/plemorphic lipoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Kyung; Hwang, Seung Bae; Chung, Gyung Ho; Hong, Ki Hwang; Jang, Kyu Yun [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2013-06-15

    Spindle cell/pleomorphic lipoma is an uncommon benign adipose tissue tumor most frequently arising from the subcutaneous tissue of the back, shoulder, head and neck, and extremities. The deep cervical spaces are the rarely affected locations. Herein we report on the imaging findings of spindle cell/pleomorphic lipoma involving the retropharyngeal space in an elderly woman.

  6. Deep intermuscular spindle-cell lipoma

    African Journals Online (AJOL)

    East and Central African Journal of Surgery Vol. 2, No.1. Deep intermuscular spindle-cell lipoma. L N Gakuu MMed(Surg). Senior Lecturer. Department of Orthopaedic Surgery, University of Nairobi, Nairobi, Kenya. Key Words: lipoma ... Dissection was by separation of muscle planes up to the anterior aspect of the.

  7. A Rare Case of Spindle Cell Lipoma of Nose

    African Journals Online (AJOL)

    Spindle cell lipoma is a benign lipomatous tumor which constitutes about 1.5% of all adipocyte tumors. It was first described by Enzinger and. Harvey in 1975. Similar to other kinds of lipomas, 75% of spindle cell lipomas are found in the subcutaneous tissue of back, shoulder, and neck. A spindle cell lipoma in face.

  8. Huge Tongue Lipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Damghani

    2015-03-01

    Full Text Available Introduction: Lipomas are among the most common tumors of the human body. However, they are uncommon in the oral cavity and are observed as slow growing, painless, and asymptomatic yellowish submucosal masses. Surgical excision is the treatment of choice and recurrence is not expected.    Case Report: The case of a 30-year-old woman with a huge lipoma on the tip of her tongue since 3 years, is presented. She had difficulty with speech and mastication because the tongue tumor was filling the oral cavity. Clinical examination revealed a yellowish lesion, measuring 8 cm in maximum diameter, protruding from the lingual surface. The tumor was surgically excised with restoration of normal tongue function and histopathological examination of the tumor confirmed that it was a lipoma.   Conclusion:  Tongue lipoma is rarely seen and can be a cause of macroglossia. Surgical excision for lipoma is indicated for symptomatic relief and exclusion of associated malignancy.

  9. Lipoma arborescens: diagnosis and image; Lipoma arborescens: diagnostico e imagem

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Marcela; Len, Claudio Arnaldo; Terreri, Maria Teresa Ramos Ascencao [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Setor de Reumatologia Pediatrica; Fernandes, Artur da Rocha Correa [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Hilario, Maria Odete Esteves [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Alergia, Imunologia e Reumatologia]. E-mail: odetehilario@terra.com.br

    2004-08-01

    Lipoma arborescens is an intraarticular lesion of unknown etiology, consisting of a chronic villous fat proliferation of the synovial membrane. The disease has occasionally been associated with diabetes mellitus, degenerative diseases, juvenile rheumatoid arthritis and also rheumatoid arthritis. The diagnosis relies on magnetic resonance imaging evaluation and synovial biopsy. We report a case of a 8-year-old girl with a two year history of bilateral swelling of the knees and elbows. The patient had improvement of the arthritis after starting treatment with conventional drugs. (author)

  10. Lipoma Intraóseo

    OpenAIRE

    Fernández Martínez, J.J.; Herruzo Gallego, F.; Corbella Garcia, G.; Massons Albareda, J.

    1990-01-01

    Se comunica un caso clínico de Lipoma Intraóseo de tibia con diagnóstico anatomopatológico confirmado, que constituye en la revisión bibliográfica el número 35. Se realiza, a propósito de este caso clínico, el estudio de otras lesiones con las que es obligado establecer el diagnóstico diferencial. The authors describe a medical case of Intrabone Tibial Lypoma with anatomical-patology confirmed that constitutes in the bibliografical revision numbe r 35. They realize, ab...

  11. Interhemispheric Lipoma, Callosal Anomaly, and Malformations of Cortical Development: A Case Series

    NARCIS (Netherlands)

    Niwa, Tetsu; de Vries, Linda S.|info:eu-repo/dai/nl/072995408; Manten, GTR|info:eu-repo/dai/nl/261633325; Lequin, Maarten; Cuppen, Inge; Shibasaki, Jun; Aida, Noriko

    Intracranial lipomas are rare congenital malformations. The most common type of intracranial lipoma is the interhemispheric lipoma, which is frequently associated with callosal anomalies such as hypogenesis or agenesis of the corpus callosum. In contrast, interhemispheric lipomas are less often

  12. Lipoma or hemangioma: A diagnostic dilemma?

    Directory of Open Access Journals (Sweden)

    K Vinay Kumar Reddy

    2015-01-01

    Full Text Available Lipomas and hemangiomas are well-known benign lesions of the body. However, their occurrence in the oral cavity is rare. Lipoma accounts for 1-4% of benign neoplasms of mouth affecting predominantly the buccal mucosa, floor of mouth and tongue. Hemangiomas occur mostly on the lips, buccal mucosa, tongue, and palate. Lipomas when superficially placed show yellowish surface discoloration and hemangiomas usually have reddish blue to deep blue color. Here, we report an unusual case of benign tumor occurring in the buccal vestibule.

  13. Torsion of a giant mesenteric lipoma

    Energy Technology Data Exchange (ETDEWEB)

    Wolko, Jonathan D.; Rosenfeld, David L.; Lazar, Michael J.; Underberg-Davis, Sharon J. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, P.O. Box 19, New Brunswick, NJ 08903-0019 (United States)

    2003-01-01

    Mesenteric lipoma is a rare benign neoplastic condition that can grow to be very large and mimic other midgut fatty tumors. These benign tumors can cause various gastrointestinal symptoms such as obstruction and abdominal pain. We report the case of a 9-year-old boy who presented with a small bowel obstruction caused by torsion of a large mesenteric lipoma. This is an important but unusual tumor and should be considered in the differential of fatty lesions within the mesentery. (orig.)

  14. Transmural thoracic lipoma: CT and MRI features.

    Science.gov (United States)

    Labuski, M R; Hopper, K D

    1993-01-01

    Lipomas are common benign neoplasms of the chest wall. However, their extension from the pleural space through the ribs into the superficial tissues of the chest wall has been described only twice previously, both by computed tomography (CT). A case is presented of a transmural chest wall lipoma diagnosed by MRI with CT correlation. The advantages of MRI in the diagnosis of these unique neoplasms are described.

  15. Large Parosteal Lipoma without Periosteal Changes

    Directory of Open Access Journals (Sweden)

    Shimpo Aoki, MD, PhD

    2015-01-01

    Full Text Available Summary: Parosteal lipoma is a rare tumor, accounting for approximately 0.3% of all lipomas. Bony lesions are often found in patients with this tumor (59.2%, making the differential diagnosis of malignant tumors important. Our case was a 64-year-old male patient who complained of a 25 × 15-cm mass on his right thigh that had grown rapidly over a 2-month period. On magnetic resonance imaging, a high-intensity lesion was observed on the surface of the femur beneath the vastus medialis muscle on T1 and T2 images, with low intensity on a T1 fat suppression image. No significant bony changes were detected. During total tumor resection, the tumor was found on the femur with tight continuity, with tiny areas of spiculation palpable on the bone surface. The exact tumor size was 18 × 13 × 6 cm. The pathological diagnosis was lipoma, the same result as in the former open biopsy. This case was the largest parosteal lipoma of the femur reported without periosteal changes. In cases of deep parosteal lipomas, the detection of rapidly progressive and growing pseudotumors with ossification or chondromatous changes implies malignancy. A preoperative biopsy is mandatory and must be followed by careful planning and preparation for handling in malignant cases. Plastic surgeons should therefore keep the diagnosis of parosteal lipoma in mind to provide appropriate (not too much or too little surgical treatment.

  16. Lipomas y compresión nerviosa Lipomas and nerve compresion

    Directory of Open Access Journals (Sweden)

    P. Casteleiro Roca

    2010-03-01

    Full Text Available Los lipomas son los tumores de tejidos blandos más frecuentes del organismo, pudiéndose presentar en cualquier localización. Habitualmente son asintomáticos, pero en ocasiones pueden producir clínica de compresión nerviosa. El objetivo de nuestro trabajo es revisar nuestra experiencia en el tratamiento de lipomas que producen compresión nerviosa. Ante la presencia de clínica de compresión nerviosa junto con tumoración de crecimiento lento debemos sospechar el diagnóstico de lipoma. Es muy importante la planificación quirúrgica adecuada, ayudada por las pruebas de imagen tipo Resonancia Nuclear Magnética (RNM, puesto que las estructuras nerviosas pueden estar incluidas en el lipoma.Lipomas are the most frequent soft tissues tumours of the body, and they can be located everywhere. They are usually asymptomatic, but uncommonly they can produce nerve compression. Our objective is to review our experience in the treatment of nerve compression syndromes caused by lipomas. Lipomas must be suspected when an slow growth tumour is present with nerve compression syndrome. It's very important an appropriate surgical planning, supported by image (NMR, because nerves can be included in the lipoma.

  17. Lipoma

    Science.gov (United States)

    ... Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.mhmedical.com/book. ... Dermatology. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://accessmedicine.mhmedical.com/book. ...

  18. A clinicopathological study of lipomas of the head and neck ...

    African Journals Online (AJOL)

    Background: Lipoma of the head and neck region are fairly common. Methods: This twelve year retrospective study evaluated thirty-nine cases of head and neck lipomas in Nigerians. Results: They constituted 14.4% of benign tumours of the head and neck region and 17.6% of total body lipomas seen within the study ...

  19. Giant lipoma of the right gluteal region | Adebayo | Journal of ...

    African Journals Online (AJOL)

    Lipomas are the most common benign mesenchymal tumors and can arise in any location where fat is found. They could present as a tiny swelling or as an enormous mass in a body region. When they are more than 10 cm in their widest dimension or greater than 1 kg in weight, they are called giant lipomas. Giant lipomas ...

  20. Atypical, polyarticular lipoma arborescens in a child

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    Semnic Robert

    2016-01-01

    Full Text Available Introduction. Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. Case Outline. We report a case of a 12-year-old boy with symmetric involvement of the bicipitoradial bursae, synovial sheaths of extensor compartments of both hands and medial ankles. The diagnosis of polyarticular lipoma arborescens was proposed on magnetic resonance (MR imaging and this diagnosis was histologically proven after biopsy of the bursae and later by open surgery of the synovial sheath of the right ankle tendons. Literature search was performed and twelve cases with polyarticular involvement were analyzed. Lipoma arborescens commonly involves suprapatellar recess of the knee and very rarely other joints or bursae. Histological analysis revealed an accompanying non-necrotizing granulomatous synovial inflammation. Conclusion. Polyarticular lipoma arborescens is a rare entity and symmetrical involvement of the joints other than the knees is exceedingly rare. MR imaging plays a significant role in the diagnostic protocol, and the characteristic fatty signal on MR imaging is highly suggestive of lipoma arborescens.

  1. Infiltrating lipoma of the chin: Report of a rare case

    Directory of Open Access Journals (Sweden)

    S. N. Santhosh Kumar

    2014-01-01

    Full Text Available Lipoma, also known as universal tumor or ubiquitous tumor, can occur anywhere in the body, its incidence being 0.1-5% of all head and neck neoplasms. They are benign neoplasms composed of mature adipocytes. There are various types of lipoma based on the constituent tissue type and location of the lipoma. Though lipomas are slow growing and seldom invade adjacent tissue, some variants do exhibit infiltrative behavior. Here, a case of infiltrating type of lipoma of the chin region is presented, which had suddenly increased size in the last 1 year, which led the patient to seek surgical treatment.

  2. Treatment of lipoma by injection lipolysis

    Directory of Open Access Journals (Sweden)

    Soni Nanda

    2011-01-01

    Full Text Available Injection lipolysis or lipodissolve is the practice of injecting phosphatidyl choline/ sodium deoxycholate (PDC/DC compounds in the subcutaneous fat. Though this practice is being used extensively for nonsurgical contouring of body and dissolving localized collections of excess fat, it′s use as a treatment modality for lipomas needs further evaluation. We present a case where this technique was used for treating a lipoma, with no recurrence after 9 months of follow up. Injection lipolysis as a treatment modality for lipomas needs to be evaluated for safety and efficacy in trials on larger population. This could prove to be a very valuable adjunct to the current practice of excision, if done by a trained person in a properly selected patient. Also the side effects and the controversies regarding this procedure have been discussed in detail in the present paper.

  3. Lipoma in oral mucosa: Two case reports

    Directory of Open Access Journals (Sweden)

    Ali Tavakoli Hoseini

    2010-01-01

    Full Text Available Lipoma is a common tumor of soft tissue. Its location on the oral mucosa is rare, representing 1% to 5% of benign oral tumors although it is the most mesenchymal tumor of the trunk and proximal por-tions of extremities. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, and floor of the mouth are among the common locations. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumor. Other benign connective tissue lesions such as granular cell tumor, neurofibroma, traumatic fibroma and salivary gland lesions (mucocele and mixed tumor might be included in differential diagnosis. We present two cases of oral lipoma in unusual locations: one in junction of soft and hard palate and the other in tongue. Both were rare in the literature.

  4. Undiagnosed intracranial lipoma associated with sudden death

    Directory of Open Access Journals (Sweden)

    Carlos Durão

    2017-03-01

    Full Text Available Intracranial lipomas represent less than 0.1% of all intracranial tumors. They are usually located in the callus area and often asymptomatic. This paper presents a sudden death case after an episode of convulsions on a 39 years old woman with a history of migraines and seizures since adolescence. The autopsy revealed the presence of an undiagnosed massive brain lipoma (60 × 35 mm associated with atrophy of the corpus callosum. Although very rare and seldom malignant these may be associated with seizures and sudden death.

  5. Infraclavicular subpectoral lipoma causing thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Stefano Elia

    2015-01-01

    Conclusion: Although benign soft tissue tumors infraclavicular subpectoral lipomas may exert pressure on neurovascular surrounding structures during their progressive expansion and cause TOS. Therefore, a thorough preoperative study by radiological imaging such as MRI or neurophysiological test should always be performed in order to prevent unintentional lesions of the involved axillo-subclavicular plexus and plan correct surgical procedure.

  6. Rectal Lipoma Associated with Genital Prolapse

    African Journals Online (AJOL)

    mass. She underwent vaginal hysterectomy with pelvic floor repair. This was ... Departments of Surgical Gastroenterology, 1Pathology, 2Microbiology, Sree Narayana Institute of Medical Sciences,. 3Dermatology and ... Keywords: Mature adipocytes, Rectal bleeding, Rectal lipoma, Utero‑vaginal prolapse. Access this article ...

  7. Transmural intrathoracic lipoma with intraspinal extension.

    Science.gov (United States)

    Jain, Vishesh; Singal, Arbinder K; Gupta, Arun K; Bhatnagar, Veereshwar

    2007-12-01

    A rare case of transmural dumbbell intrathoracic lipoma with intraspinal extension is reported. Preoperative diagnosis was possible with a computed tomographic scan and fine-needle aspiration cytology. Complete excision was curative. The chest wall defect was repaired with Prolene mesh. Only one similar case has been previously reported in the English literature.

  8. MR imaging findings of intraosseous lipoma

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    Park, Young Chan; Lee, Young Hwan; Jung, Kyung Jae; Sung, Nak kwan; Chung, Duck Soo; Kim, Ok Dong [School of Medicine, Catholic University of Taegu-Hyosung, Taegu (Korea, Republic of); Lee, Jongmin [School of Medicine, Kyungpllk National University, Taegu (Korea, Republic of); Cho, Kil Ho [College of Medicine, Yeungnam University, Taegu (Korea, Republic of)

    2000-09-01

    To evaluate the MR imaging findings of intraosseous lipoma. The MR imaging findings of 12 cases of intraosseous lipoma were retrospectively analyzed with regard to internal signal intensity, enhancement patterns, the presence of calcification and the status of the margin. The findings relating to these last two features were compared with those of plain films and CT. Six tumors were located in the calcaneus, three in the tibia, two in the ilium, and one in the carpal lunate. A fat component was clearly identified in all cases, but no lesion was purely fatty. Cyst formation was noted in four cases, and hyperintense portions different from the cystic area were seen on T2WI in ten. Contrast enhancement was observed in four patients, and although plain film and CT images revealed, in all cases, the presence of calcification, in two cases this was not demonstrated y MRI. In all cases, however, MRI showed well-defined tumoral margins. MRI clearly depicts fat and other components related to the involutional changes occurring in cases of intraosseous lipoma. The information these images provide is useful for the diagnosis and histologic classification of intraosseous lipoma. (author)

  9. Large Lipoma of the Larynx: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Khorsandi Ashtiani

    2010-10-01

    Full Text Available Fewer than 15% of lipomas occur in the head and neck. Lipomas of the larynx are very rare benign laryngeal tumors (0.6%. To date less than 100 case of laryngeal lipoma have been reported in the literature.Clinical manifestation include progressive horseness, dyspnea, and even dysphagia. In the direct exam smooth or pedunculated mass is seen in the larynx and sometimes if tumor is large enough a mass palpated in the neck. In the computed tomography (CT low attenuation mass is seen. Treatment of laryngeal lipoma consists of endoscopic removal or external surgical approach depending on tumor size. The authors present a case of laryngeal lipoma that involved the true vocal cord. The following is a report of a single case of laryngeal lipoma, Including esteroboscopy, radiologic and intraoperative finding as well as review of the literature.

  10. Frontal parosteal lipoma with thickening of diploic space

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Morishita

    2015-09-01

    Full Text Available Parosteal lipoma is a rare benign tumor that is composed mainly of benign mature lipocytes, and it has an intimate association with the underlying affected bone. Parosteal lipoma involving the head and neck is very rare, and there are only two reported cases of parosteal lipoma of the skull in English literature. This paper reports a rare case of frontal parosteal lipoma in a young child with a hard enlargement of the forehead region after blunt trauma. Computed tomography revealed a large soft tissue mass and an osseous projection of the unilateral frontal bone. The pathology report identified lipoma and thickening of diploic space of the frontal bone. Here, we present a new case of parosteal lipoma in the frontal region.

  11. Intrasynovial lipoma causing trigger wrist and carpal tunnel syndrome.

    Science.gov (United States)

    Imai, Shinji; Kodama, Narihito; Matsusue, Yoshitaka

    2008-01-01

    Triggering of the flexor tendon at the wrist is rare. We report a case of intrasynovial lipoma that caused a trigger wrist. As far as we know it is unique in that the intrasynovial lipoma simultaneously caused carpal tunnel syndrome. The massive tenosynovitis and adhesion of flexors tendons after the locking of the intrasynovial lipoma may have resulted from inflammation caused by attrition within the carpal tunnel.

  12. CT manifestations of ileal dysgenesis

    Energy Technology Data Exchange (ETDEWEB)

    Oberhelman, Amy P.; Herman, Thomas E.; McAlister, William H. [St. Louis Children' s Hospital, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Department of Radiology, St. Louis, MO (United States); Keating, James P. [St. Louis Children' s Hospital, Mallinckrodt Department of Pediatrics, Washington University School of Medicine, Division of Gastroenterology, St. Louis, MO (United States); Rollins, Michael D.; Dillon, Patrick A. [St. Louis Children' s Hospital, Department of Surgery, Washington University School of Medicine, St. Louis, MO (United States)

    2007-02-15

    Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly. (orig.)

  13. Mesenteric lipoma causing recurrent intestinal obstruction

    African Journals Online (AJOL)

    2013-01-12

    Jan 12, 2013 ... Nigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue 4. Abstract. Although lipoma is a common tumor found in almost all parts of the body, that occurring in the mesentery of the gut is a rarity. A 29‑year‑old man presented in our center with a 10‑year history of recurrent central colicky ...

  14. Giant right groin lipoma mimicking inguinal hernia.

    Science.gov (United States)

    Gerych, Igor; Ivankiv, Taras; Ogurtsov, Oleksii; Kalynovych, Nazar

    2015-01-01

    Groin lipoma is a rare condition. Such localization may lead to erroneous interpretation of inguinal hernia diagnosis. In case of incorrect diagnosis, there is clinically high risk for development of intraoperative complications. The medical history of 70-year old female patient P., who has been hospitalized at Surgical Department No.1 of Danylo Halytsky Lviv National Medical University (Surgical Department of Lviv Regional Clinical Hospital), was processed retrospectively. Medical case history totals approximately 20 years. Examination in the right groin revealed a tumor falling to the right labia lip: soft, elastic, moderately painful, passive and active reduction into the abdominal cavity was impossible, and the "cough impulse" symptom was negative. CT correctly diagnosed giant right groin lipoma, which was intraoperatively confirmed. Lipoma in the groin may be treated as inguinal hernia. Thus, for the accurate verification of correct diagnosis, it is necessary to perform a follow-up examination involving computer tomography (CT) and nuclear magnetic resonance imaging (NMRI). Copyright © 2015. Published by Elsevier Ltd.

  15. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult

    African Journals Online (AJOL)

    Lipomas of the gastrointestinal tract (GIT) are rare (1:600 necropsies).[1] Owing to recent advances in endoscopy and modern imaging techniques such as computed tomography (CT) scan and magnetic resonance imaging, more cases are being diagnosed and treated. However, duodenal lipomas are very rare with lesser ...

  16. Rectal lipoma associated with genital prolapse | Krishnan | Annals of ...

    African Journals Online (AJOL)

    We present the case of a 58‑year‑old post‑menopausal lady presenting with rectal bleeding and utero‑vaginal prolapse. The prolapsing mass was excised, and histopathological examination diagnosed the lesion to be a lipoma. Keywords: Mature adipocytes, Rectal bleeding, Rectal lipoma, Utero‑vaginal prolapse ...

  17. Total proctocolectomy and ileal - anal pouch

    Science.gov (United States)

    ... activities, and most types of work. Alternative Names Restorative proctocolectomy; Ileal-anal resection; Ileal-anal pouch; J- ... by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, ...

  18. Hepatic lipomas and steatosis: an association beyond chance.

    Science.gov (United States)

    Martin-Benitez, Gregorio; Marti-Bonmati, Luis; Barber, Carmen; Vila, Rocio

    2012-04-01

    To determine if hepatic lipomas have a higher prevalence of liver steatosis than other benign hepatic lesions. Ninety-two benign hepatic lesions were analyzed with magnetic resonance (MR) imaging. There were 6 lipomas and 86 benign non-lipomatous lesions, including 55 hemangiomas, 23 focal nodular hyperplasias (FNH) and 8 adenomas. All studies included a chemical shift T1-weighted sequence (in-phase and opposed-phase) in order to evaluate the presence of steatosis. A statistically significant relationship (Fischer's Exact Test, p=0.019) between hepatic lipomas and steatosis was demonstrated. Fifty percent of hepatic lipomas associated steatosis, while this association was present in only 9% of the non-lipomatous lesions. Lipomas have a significantly greater association with steatosis when compared to nonlipomatous lesions. This relationship may be related to a common insuline resistance mechanism. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Canine lipomas treated with steroid injections: clinical findings.

    Directory of Open Access Journals (Sweden)

    Barbara Lamagna

    Full Text Available Lipomas are common benign tumours of fat cells. In most cases, surgical excision is curative and simple to perform; however, such a procedure requires general anaesthesia and may be associated with delayed wound healing, seroma formation and nerve injury in deep and intramuscular tumours. The objective of this study was to evaluate treatment of subcutaneous, subfascial or intermuscular lipomas using intralesional steroid injections in dogs. Fifteen dogs presenting with lipomas were selected for treatment with ultrasound-guided intralesional injection of triamcinolone acetonide at a dose of 40 mg/mL. Nine subcutaneous and subfascial tumours showed a complete regression. The other lipomas decreased in diameter, achieving, in some cases, remission of discomfort and regression of lameness. Steroid injection was a relatively safe and effective treatment for lipomas in dogs; only six dogs experienced polyuria/polydipsia for about 2 weeks post-treatment.

  20. Lipoma en lengua: aportación de un caso Lingual Lipoma: contribution of one case

    Directory of Open Access Journals (Sweden)

    J. Orozco Ariza

    2009-10-01

    Full Text Available Los tumores de la cavidad oral y estructuras adyacentes son parte importante de la odonto-estomatología por el papel que el profesional de la cavidad bucal juega en el diagnóstico y tratamiento de estas lesiones. Los lipomas son neoplasias benignas de células adiposas, sumamente raras en la cavidad oral. La mucosa bucal, lengua y piso de boca son algunos de los sitios más comunes. La presentación clínica típica es la de una lesión tumoral asintomática, submucosa de color amarillo. La eliminación quirúrgica es el tratamiento de elección, rara vez se observan recurrencia. Se presenta caso clínico de lipoma en lengua en paciente femenino de 23 años de edad, que compromete línea media de cara dorsal de lengua a nivel de tercio medio y posterior.Tumors in the oral cavity and the adjacent structures are an important part of the stomatology because of the role that the oral cavity professional plays in the diagnosis and treatment of these lesions. Lipomas are benign neoplasias made up of adipose cells, extremely rare in the oral cavity. The buccal mucosa, tongue and floor of the mouth are some of the most common sites for these lipomas. The typical clinical case includes a painless tumor and a yellow sub mucosa. The chosen treatment is surgical removal. Recurrences are very rare. We present the clinical case of a 23 year old female with lingual lipoma that endangers the mid line of the dorsal tongue at the middle third.

  1. Giant retroperitoneal lipoma: a case report Lipoma gigante do retroperitônio: relato de caso

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Real Martinez

    2003-12-01

    Full Text Available BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.RACIONAL: O lipoma é a neoplasia mesenquimal mais freqüente, raramente localizada no retroperitônio. Na maioria das vezes, o diagnóstico diferencial pré-operatório com os lipossarcomas de baixo grau de malignidade é difícil de ser estabelecido. OBJETIVO: Apresentar um caso de lipoma gigante retroperitoneal em mulher de 32 anos que há 2 anos apresentava história de dor e tumor abdominal palpável. A ultra-sonografia abdominal e o enema opaco mostraram grande massa localizada no retroperitônio, que deslocava o ceco e o cólon ascendente. A laparotomia mostrou tumor encapsulado com 20 x 13 x 10 cm e 3.400 g de peso. O estudo histopatológico mostrou presença de lipoma retroperitonial. A paciente encontra-se bem, sem recidiva da doença, 17 anos após a cirurgia.

  2. Intrathoracic lipoma masquerading as subclavian artery trauma.

    LENUS (Irish Health Repository)

    Munro, P T

    2012-02-03

    A 58 year old man was admitted to the accident and emergency department following an industrial accident in which he sustained a three part fracture dislocation of his right humerus. Chest radiography revealed a large mass in the right upper hemithorax and, when the patient became hypotensive, an emergency thoracotomy was performed. The mass was found to be a massive intrathoracic lipoma. This case shows how preexisting intrathoracic lesions may be mistaken for subclavian or great vessel trauma following violent shoulder girdle injury. The differential diagnosis of traumatic and non-traumatic intrathoracic mass lesions in chest radiography should be considered carefully.

  3. COMPLICATIONS OF ORTHOTOPIC ILEAL RESERVOIRS

    African Journals Online (AJOL)

    groupe Ill (8 cas) une poche de Kock a ete realisee avec des ureteres directement implantes dans la boucle afférente au-dessus de la valve ileale construite de mamelon d'intussusception. Dans tous les types de reservoirs nous avons employe 45 centimetres de l'ileon. En preoperatoire tous sauf quatre ureteres etaient ...

  4. COMPLICATIONS OF ORTHOTOPIC ILEAL RESERVOIRS ...

    African Journals Online (AJOL)

    The patients were divided into three groups: in Group I (22 cases) a W neobladder was fashioned with the uretero-ileal anastomosis done by creating extramural serosally lined tunnels. In Group II (12 cases) a Camey II pouch was done with ureteroileal anastomosis by direct end-to-end anastomosis in four and by Le Duc ...

  5. An incidentaloma at ileal intubation.

    LENUS (Irish Health Repository)

    Donnellan, Fergal

    2012-02-01

    The authors report the case of a primary small bowel lymphoma discovered incidentally in a 33-year-old male following ileal intubation at colonoscopy. The patient subsequently underwent curative treatment with chemotherapy. This case not only highlights the importance of routine ileoscopy but also the successful use of chemotherapy in a disease for which the optimal treatment modality has not been well characterized.

  6. Lipomas – a health condition that cannot be ignored

    Directory of Open Access Journals (Sweden)

    Robert Sitarz

    2016-12-01

    Full Text Available Background . Lipomas are the most common forms of benign soft tissue tumors. They occur as various-sized lumps that rarely transform into malignant tumors. They form as a result of a focal hypertrophy of adipose cells and are usually located subcutaneously. Generally, they are palpable through the covering tissues, soft to the touch, round or oval, painless, usually movable and covered with unchanged skin. They remain mostly asymptomatic and therefore are ignored by both patients and general practitioners. Nevertheless, growing lipomas may cause problems, mainly esthetic. However, in advanced stages, their surgical removal may even require general anesthesia. Objectives. The aim of the study was to present the results of surgical treatment of subcutaneous lipomas. Moreover, there were presented the most frequent symptoms and problems relating to growing lipomas. Material and methods . There are presented three cases of patients treated surgically due to advanced subcutaneous lipomas in the Department of Surgical Oncology of the Medical University in Lublin. Results . The patients’ medical condition remained undiagnosed and untreated for a long time. As a result, patients experienced troublesome symptoms and eventually required surgical intervention. The performed operations eased their suffering and improved their quality of life. Conclusions . Although lipomas are mostly benign, their diagnosis should be confirmed by a doctor. A full physical examination performed on a regular basis should be a strict standard, as this enables detection of even early stage lipomas.

  7. CT findings of the lipomas in the neck

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyuk Po; Chung, Ho Son; Cho, Jae Ho; Kim, Sun Yong; Park, Bok Hwan; Kim, Hong Jin [Yeung Nam University Hospital, Daegu (Korea, Republic of)

    1991-07-15

    Ordinary lipomas are the most common neoplasm of mesenchymal origin. About 13% of them arise in the head and neck region, especially in the posterior neck. More than 80% of lipomas are ordinary lipoma, and histologically they are composed of mature fat. CT scan provides a definite diagnosis of lipoma in virtually all cases due to their characteristic finding: a homogenous, well-defined low-attenuation mass that usually measures between -65 to -125 HU. The authors reviewed the clinical and CT characteristics of 14 cases of lipoma in the neck. The results were as follows: 1. A palpable neck mass was the most common symptom having a variable duration (months to years) 2. The age distribution of the patients was from 29 to 64 years, and the 6th decade was the most commonly affected. Men (12 cases) were more common than women (2 cases). 3. The most common location of the lipoma was the subcutaneous layer of the posterior neck. 4. Ten cases were ordinary lipoma, and CT scan showed a well-defined capsule in 8 of them. 5. Four cases were multiple symmetrical lipomatosis, and CT showed an irregular margin to the adjacent muscle without evidence of encapsulation suggesting a local infiltrating nature.

  8. Large oral lipoma: Case report and literature review in Iran

    Directory of Open Access Journals (Sweden)

    Ahmad Motagi

    2012-01-01

    Full Text Available Lipoma is a benign mesenchymal tumor of fat with uncertain pathogenesis. Although the most common mesenchymal neoplasm in trunk and proximal portions of the extremities, it is rarely seen in the oral cavity. Oral lipomas are clinically soft, smooth-surfaced nodular masses that mostly are less than 3 cm in size. Typically the tumor is asymptomatic unless bitten or become noticeable because of their size. The buccal mucosa and buccal vestibule are the most common intraoral sites and account for 50% of all cases. Reported here is a relatively large lipoma of buccal mucosa that was treated surgically under local anesthesia. In an 18-month postsurgical follow up no complication or recurrence has occurred. This case will also be compared to intraoral lipomas reported in Iranian population. As lipomas are usually smaller than 3 cm in diameter, lipoma with the size reported, is of clinical importance. Since the large lipomas are in differential diagnosis with other, even malignant, mesenchymal, or salivary gland tumors. Thus, this case report recommends clinical awareness in diagnosis of large intraoral soft tissue lesions.

  9. A case of endobronchial lipoma mimicking bronchial asthma

    Directory of Open Access Journals (Sweden)

    Sevket Ozkaya

    2009-05-01

    Full Text Available Sevket Ozkaya1, Hasan Demir1, Serhat Findik21Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, TurkeyAbstract: Endobronchial lipoma is a rare neoplasm of the tracheobronchial tree and it may cause irreversible pulmonary damage due to recurrent pneumonia. Rarely, it may mimic bronchial asthma. We present a 53-year-old woman with an endobronchial lipoma, which had been treated as a bronchial asthma for four years. She also had developed recurrent pneumonia three times.Keywords: endobronchial lipoma, asthma, radiology, bronchoscopy

  10. Chondroid lipoma of the trunk: MRI appearance and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Boets, An; Mieghem, Isabelle M.Van; Breuseghem, Iwan Van [Catholic University Leuven Radiology, University Hospitals, Leuven (Belgium); Sciot, Raf [Catholic University Leuven, Pathology, University Hospitals, Leuven (Belgium)

    2004-11-01

    Chondroid lipoma is a rare tumour of adipose tissue, bearing a strikingly close pathologic resemblance to myxoid liposarcoma and extraskeletal myxoid chondrosarcoma. Unlike these malignant tumours, chondroid lipoma has a non-aggressive behaviour and does not require radical treatment. Although repeatedly reported in the proximal extremities and limb girdles, this rare entity may less frequently be observed in the trunk. We describe the imaging findings of a chondroid lipoma in the trunk and provide a discussion on the radiologic-pathologic correlation and differential diagnosis. (orig.)

  11. Intraoral lipoma: Review of literature and case report

    Directory of Open Access Journals (Sweden)

    Mahendra Raj

    2012-01-01

    Full Text Available Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. The aim of this paper is to present the importance of diagnosis and treatment of intraoral lipoma. Clinicians must be able to recognize rare lesions, like intraoral lipomas, to provide appropriate treatment, thereby ensuring comfort and quality of life for the patient.

  12. Como Lo Hago Yo: Lipomas Medulares

    Science.gov (United States)

    Portillo, Santiago

    2014-01-01

    Basados en la experiencia de 82 casos; en 5% se observaron anomalías pélvicas asociadas. En los menores de 3 años el motivo de consulta (85%) fue la tumoración. En los mayores de 3 años (42%) tenía problemas neurológicos. Solo el 24% preocupados por la tumoración. El objetivo de la cirugía es desanclar la médula y no remover la totalidad del lipoma. El lipoma de filum es el que es mas simple para operar. Aún cuando la escuela francesa propone operar solamente cuando hay síntomas favorezco cirugía preventiva. Favorezco una segunda cirugía si hay signos de anclaje postoperatorio, aún cuando observamos empeoramiento postoperatorio motor en 2.5% de los operados y urológico a largo plazo en 6% de los operados. PMID:24791218

  13. Lipoma-like hibernoma: an atypical lipoma/well-differentiated liposarcoma mimicker

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    Reis-Filho Jorge S.

    2002-01-01

    Full Text Available Hibernomas are benign lipomatous tumors which show differentiation toward brown fat. Recently, unusual variants have been described, including myxoid, spindle cell, and lipoma-like variants. Lipoma-like hibernoma (LLH is characterized by mature univacuolated adipocytic cells with rare admixed multivacuolated brown fat-like cells, which may resemble lipoblasts, leading to a misdiagnosis of atypical lipoma/well-differentiated liposarcoma (AL/WDLS. We herein report a case of LLH arising on the anterior aspect of the left thigh of a 17-year-old female. A marginal excision was performed. The patient was discharged and remains well four months after surgery. Histological examination showed a lobulated neoplasm composed of univacuolated mature adipose cells admixed with small vessels and occasional mast cells. Scattered islands of brown fat-like cells accounting for less than 10% of the neoplasm were found. Sometimes these cells presented indented and scalloped nuclei, resembling lipoblasts. A final diagnosis of LLH was made based on the presence of focal areas with typical hibernoma morphology, and the lack of atypical hyperchromatic stromal cells. Pathologists must be aware of the typical histological findings of LLH, not to confuse it with AL/WDLS.

  14. A large left atrial lipoma combined with coronary artery disease.

    Science.gov (United States)

    Liu, Yun; Zheng, Xiaomei; Du, Yu; Zhu, Zhicheng; Wang, Tiance; Xu, Rihao; Li, Dan; Liu, Kexiang

    2017-08-22

    Primary benign tumors of the heart are extremely rare and usually difficult to diagnose for their asymptomatic signs. A 66-year-old woman was admitted for shortness of breath caused by a large left atrial lipoma combined with coronary artery disease. Next, we successfully performed simultaneous curative surgery for the large cardiac lipoma and coronary artery bypass grafting with a "starfish" and no cardiopulmonary bypass was used.The patient was discharged on the eighth postoperative day in a good condition, and has remained asymptomatic at the 5-month follow-up. Lipomas are rare and difficult to diagnose, while computed tomography and computed tomography angiography can give us very important clues. Surgery is necessary. We can introduce a "starfish"to the operationand the cardiopulmonary bypass is unnecessary for the left lipoma with coronary artery disease.

  15. Lipomatosis and true lipomas of the ileocecal valve

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, P.; Eide, T.J.; Westgaard, T.; Gauperaa, T.

    1981-12-01

    Two patients with lipomatosis and two patients with true lipoma of the ileocecal valve are described. The symptomatology, radiological appearances, pathological findings and treatment are discussed. True lipomas of the ileocecal valve should be differentiated from the more commonly occurring lipomatosis or lipohyperplasia. The rare true lipomas have a demarcating capsule around the fatty tissue and are confined to only one of the ileocecal lips. The lipomatosis, on the other hand, is characterized by a diffuse fatty deposition in the submucosa of the valve with no encapsulation. Lipomatosis as well as true lipomas may appear as rounded, smoothly outlined and sharply demarcated masses on barium enema examination. Occasionally, these filling defects may present problems of differential diagnosis with respect to malignant involvement of the ileocecal region. A correct preoperative diagnosis, however, is important to prevent unnecessary or too radical surgical treatment.

  16. Cerebellopontine angle lipomas: magnetic resonance imaging findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Rafael S. [Clinica de Diagnostico por Imagem Multi-Imagem, Rio de Janeiro, RJ (Brazil); Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Dept. de Radiologia; Brito, Cecilia Castelo Branco [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Fac. de Medicina; Carvalho, Gustavo A. [Clinica Bambina, Rio de Janeiro, RJ (Brazil). Dept. de Neurocirurgia; Hospital Silvestre, Rio de Janeiro, RJ (Brazil); Domingues, Romeu C. [Clinicas CDPI e Multi-Imagem, Rio de Janeiro RJ (Brazil); Gasparetto, Emerson L. [Clinicas CDPI e Multi-Imagem, Rio de Janeiro RJ (Brazil)

    2009-07-01

    Vestibular schwannomas and meningiomas are the most common lesions of the cerebellopontine angle (CPA), accounting for approximately 85-90% of the tumors seen in this location. Lipomas are rare at this topography, representing about 0.15% of the CPA lesions. These tumors are mal developmental masses that arise from abnormal differentiation of the meninx primitive. Clinically, CPA lipomas can cause slowly progressive neurological symptoms and signs affecting cranial nerves or brain stem. Because these lesions usually are strongly attached to the surrounding structures, any surgical attempts of complete resection can result in neural or vascular damage, reinforcing the importance of the pre-operative imaging diagnosis. Although the CT findings of CPA lipomas can be typical, the magnetic resonance (MR) imaging, especially the fat suppression sequences, had improved the identification of these lesions. We aimed to report two patients with a CPA lipoma, emphasizing the MR imaging findings. (author)

  17. Lipoma of the Colon with Overlying Hyperplastic Epithelium

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    Jasim M Radhi

    1997-01-01

    Full Text Available Lipomas of the colon are submucosal nonepithelial tumours covered by intact or eroded mucosa. A large colonic lipoma present in close proximity to an area of diverticulitis is presented. The lining mucosa in this case exhibited hyperplastic changes, reminiscent of those seen in hyperplastic polyps. The significance of such mucosal changes are highlighted because adenomatous or even carcinomatous transformation, though rare, remains possible.

  18. Giant lipoma arising from deep lobe of the parotid gland

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    Hsu Ying-Che

    2006-06-01

    Full Text Available Abstract Background Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. Case presentation A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 × 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. Conclusion Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.

  19. Spontaneous ileal perforation complicating low anorectal malformation

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    TiJesuni Olatunji

    2015-01-01

    Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

  20. Gut luminal endogenous protein: implications for the determination of ileal amino acid digestibility in humans.

    Science.gov (United States)

    Moughan, Paul J; Rutherfurd, Shane M

    2012-08-01

    The true ileal digestibility assay provides the most informative measure of digestibility to assess bioavailability of amino acids in foods for humans. To determine 'true' estimates of ileal amino acid digestibility, requires that endogenous amino acids present in digesta at the terminal ileum be quantified. The amounts of endogenous amino acids in ileal digesta can be determined after feeding an animal or human a protein-free diet (traditional approach) or by various methods after giving a protein-containing diet. When the protein-free method has been applied with adult human subjects an overall mean value (three separate studies) for endogenous ileal nitrogen flow of 800 mg N/d has been reported. This value is considerably lower than a comparable value obtained after feeding protein of 1852 mg N/d (mean of four separate studies), and thus endogenous ileal N and amino acids should be measured under conditions of protein alimentation. There is some confusion concerning the terminology used to define digestibility, with the term "true" digestibility having different adopted meanings. Here, true amino acid digestibility is defined as apparent amino acid digestibility corrected for the basal amino acid losses determined after giving either a protein-free or a protein-containing diet. Basal losses should be determined at a defined dry-matter and protein intake. The protein-free diet approach to determining endogenous amino acids is considered unphysiological and basal losses refer to ileal endogenous amino acid flows associated with digesta dry-matter flow, and not including "specific" effects of dietary factors such as non starch polysaccharides and anti nutritional factors. Arguments are advanced that the enzyme hydrolysed protein/ultra filtration method may be suitable for routine application with a cannulated pig model, to obtain physiologically-valid basal estimates of ileal endogenous amino acids to allow calculation of true ileal amino acid digestibility in the

  1. Acute necrotizing enterocolitis of preterm piglets is characterized by dysbiosis of ileal mucosa-associated bacteria.

    Science.gov (United States)

    Azcarate-Peril, M Andrea; Foster, Derek M; Cadenas, Maria B; Stone, Maria R; Jacobi, Sheila K; Stauffer, Stephen H; Pease, Anthony; Gookin, Jody L

    2011-01-01

    Investigation of bacteria involved in pathogenesis of necrotizing enterocolitis (NEC) is limited by infant fragility, analysis restricted to feces, use of culture-based methods, and lack of clinically-relevant animal models. This study used a unique preterm piglet model to characterize spontaneous differences in microbiome composition of NEC-predisposed regions of gut.  Preterm piglets (n=23) were cesarean-delivered and nurtured for 30 hours over which time 52% developed NEC. Bacterial DNA from ileal content, ileal mucosa, and colonic mucosa were PCR amplified, subjected to terminal restriction fragment length polymorphism (TRFLP) analysis and targeted 16S rDNA qPCR.  Preterm ileal mucosa was specifically bereft in diversity of bacteria compared to ileal content and colonic mucosa. Preterm ileum was restricted to representation by only Proteobacteria, Firmicutes, Cyanobacteria and Chloroflexi. In piglets with NEC, ileal mucosa was uniquely characterized by increases in number of Firmicutes and diversity of phyla to include Actinobacteria and uncultured bacteria. Five specific TRFLP profiles, corresponding in closest identity to Clostridium butyricum, C. neonatale, C. proteolyticum, Streptomyces spp., and Leptolyngbya spp., were significantly more prevalent or observed only among samples from piglets with NEC. Total numbers of Clostridium spp. and C. butyricum were significantly greater in samples of NEC ileal mucosa but not ileal content or colonic mucosa. These results provide strong support for ileal mucosa as a focus for investigation of specific dysbiosis associated with NEC and suggest a significant role for Clostridium spp., and members of the Actinobacteria and Cyanobacteria in the pathogenesis of NEC in preterm piglets.

  2. Intraosseous lipoma: radiological findings Lipoma intra-ósseo: achados radiológicos

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    Özgür Öztekin

    2008-04-01

    Full Text Available OBJECTIVE: Intraosseous lipomas may be less rare lesions than previously suggested in the literature. They have frequently been misdiagnosed as other benign bone lesions. A combination of computed tomography, magnetic resonance imaging and radiography is essential for decreasing misdiagnosis rates. MATERIALS AND METHODS: This retrospective study presents ten cases of intraosseous lipoma. The patients' ages ranged from 25 to 80 years, and six of them were female. Six patients presented with bone pain, whereas four patients were asymptomatic with incidentally discovered lesions. The involved bones were: femur (four patients, tibia (two patients, calcaneus (one patient, sacrum (one patient, iliac bone (one patient, navicular bone (one patient. All of the patients were assessed by means of conventional radiography, computed tomography and magnetic resonance imaging of the affected region. RESULTS: In all of the cases, plain films revealed well-defined lytic lesions. Both computed tomography and magnetic resonance imaging were quite useful in demonstrating fat within the femur. The histologic pattern of all tumors was that of mature adipose tissue. CONCLUSION: Intraosseous lipoma is a well-defined entity that may develop with varying presentations. Plain radiographs alone cannot establish the diagnosis of this lesion. However, both computed tomography and magnetic resonance imaging are quite useful methods in these cases.OBJETIVO: Lipomas intra-ósseos podem ser lesões menos raras do que anteriormente sugerido na literatura. Freqüentemente têm sido erroneamente diagnosticados como outras lesões ósseas benignas. A combinação de tomografia computadorizada, ressonância magnética e radiografia é essencial para reduzir as taxas de erro diagnóstico. MATERIAIS E MÉTODOS: Este estudo retrospectivo apresenta dez casos de lipoma intra-ósseo. As idades dos pacientes variavam entre 25 e 80 anos, e seis deles eram do sexo feminino. Seis pacientes

  3. Lipoma en lengua: aportación de un caso Lingual Lipoma: contribution of one case

    OpenAIRE

    J. Orozco Ariza; M. Fonseca Ricaurte; A. Díaz Caballero

    2009-01-01

    Los tumores de la cavidad oral y estructuras adyacentes son parte importante de la odonto-estomatología por el papel que el profesional de la cavidad bucal juega en el diagnóstico y tratamiento de estas lesiones. Los lipomas son neoplasias benignas de células adiposas, sumamente raras en la cavidad oral. La mucosa bucal, lengua y piso de boca son algunos de los sitios más comunes. La presentación clínica típica es la de una lesión tumoral asintomática, submucosa de color amarillo. La eliminac...

  4. Lipoma do ângulo pontocerebelar: relato de caso Lipoma of the cerebellopontine angle: case report

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    WALTER JOSÉ FAGUNDES-PEREYRA

    2000-09-01

    Full Text Available Os lipomas do ângulo pontocerebelar são tumores muito raros. Em geral são assintomáticos, achados fortuitos em autópsia, tomografia computadorizada (TC de crânio ou ressonância nuclear magnética do encéfalo. Os autores apresentam o caso de paciente, feminina, branca, 14 anos, há três anos com diminuição da audição à esquerda e há um ano com cefaléia, tipo hemicrânia à esquerda. A TC de crânio evidenciou lesão hipodensa, sem captação de contraste, no ângulo pontocerebelar esquerdo. A paciente foi submetida a cirurgia por via retrossigmóidea para abordagem da lesão, que se apresentou de coloração amarelada, característica de tecido adiposo. Tendo em vista o envolvimento de estruturas nervosas (VII e VIII nervos cranianos, optou-se pela exérese parcial da lesão. A paciente evoluiu com melhora da cefaléia, sem piora do déficit auditivo. Após três anos de seguimento, mantém o quadro estável. Conclui-se que os lipomas do ângulo pontocerebelar, quando assintomáticos, podem ser tratados conservadoramente. Entretanto aqueles associados a sintomatologia persistente e progressiva devem ser operados. A exérese total ou parcial vai depender do envolvimento ou não das estruturas neurovasculares adjacentes.Lipoma of the cerebellopontine angle is a very rare tumor. We report the case of a 14-years-old female, with left side deafness during three years, associated with headache. CT scan showed an hypodense mass, without enhancement at the cerebellopontine angle. The patient was treated surgically by left retrosigmoid approach. The lesion involved the eighth and seventh cranial nerves and only a partial removal was performed. The postoperative course was uneventful. She had no more headache; the deafness of the left side remained unchanged. Asymptomatic lipoma of the cerebellopontine angle can be treated conservatively, although those with progressive symptoms should be treated surgically, with total or partial remove

  5. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  6. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Directory of Open Access Journals (Sweden)

    Jewon Jeong

    2015-01-01

    Full Text Available We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  7. Delineation of Chondroid Lipoma: An Immunohistochemical and Molecular Biological Analysis

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    Ronald S. A. de Vreeze

    2011-01-01

    Full Text Available Aims. Chondroid lipoma (CL is a benign tumor that mimics a variety of soft tissue tumors and is characterized by translocation t(11;16. Here, we analyze CL and its histological mimics. Methods. CL (n=4 was compared to a variety of histological mimics (n=83 for morphological aspects and immunohistochemical features including cyclinD1(CCND1. Using FISH analysis, CCND1 and FUS were investigated as potential translocation partners. Results. All CLs were strongly positive for CCND1. One of 4 myoepitheliomas, CCND1, was positive. In well-differentiated lipomatous tumors and in chondrosarcomas, CCND1 was frequently expressed, but all myxoid liposarcomas were negative. FISH analysis did not give support for direct involvement of CCND1 and FUS as translocation partners. Conclusions. Chondroid lipoma is extremely rare and has several and more prevalent histological mimics. The differential diagnosis of chondroid lipomas can be unraveled using immunohistochemical and molecular support.

  8. Lipoma arborescens of the subdeltoid bursa: a case report.

    Science.gov (United States)

    Teusink, Matthew; El-Khoury, Georges; Buckwalter, Joseph

    2010-01-01

    Lipoma arborescens is a benign, diffuse villous proliferation of the synovium characterized by replacement of the subsynovial tissue by mature adipocytes. Its etiology is unknown and fewer than 100 cases have been reported. It resembles other collections of subsynovial fat, the only difference being its large size and villous macroscopic appearance. It typically presents in patients in their fifth through seventh decades of life. It is most commonly monoarticular and most frequently affects the suprapatellar pouch of the knee. There have been reports of involvement of the hip, shoulder, wrist, elbow, ankle, and associated bursae. To our knowledge there have been only three previous cases of lipoma arborescens of the subdeltoid bursa in the literature. We report on a case of unilateral lipoma arborescens of the subdeltoid bursa in an elderly patient presenting as a shoulder mass.

  9. Fermented Infant Formula Increases Ileal Protein Digestibility and Reduces Ileal Proteolytic Activity Compared with Standard and Hydrolyzed Infant Formulas in Piglets.

    Science.gov (United States)

    Abrahamse, Evan; Huybers, Sylvie; Alles, Martine S; Renes, Ingrid B; Knol, Jan; Bouritius, Hetty; Ludwig, Thomas

    2015-07-01

    An infant formula that contained milk fermented by the bacteria Bifidobacterium breve and Streptococcus thermophilus (Lactofidus) was reported to alleviate functional digestive symptoms in infants. It was hypothesized that improved protein digestibility of the fermented infant formula could contribute to this effect. The aim of this study was to evaluate the protein digestibility of a specific fermented (FF), a standard (SF), and an extensively hydrolyzed protein (HF) formula. Four-week-old piglets (n = 7) were fitted with a T-cannula at the terminal ileum and received each formula in a Latin square design. FF, SF, and HF contained 11.7%, 9.3%, and 11.9% (w/w) crude protein; 1.5%, 5.4%, and 5.6% (w/w) fiber; and had a casein/whey ratio of 60:40, 50:50, and 0:100 per kilogram of powder, respectively. Ileal digesta were collected and analyzed for amino acids and proteolytic activity. FF had a significantly higher apparent ileal crude protein digestibility (92.1% ± 1.0%) than SF and HF (84.4% ± 1.0% and 83.9% ± 0.9%, respectively). FF also had a significantly higher dry matter digestibility than SF and HF. The ileal crude protein flow of FF was significantly lower than that of SF and HF. The ileal flow of FF total proteolytic activity was significantly lower than that of SF but not significantly different from that of HF (412 ± 163 kU/8 h vs. 1530 ± 163 and 703 ± 156 kU/8 h, respectively). The FF in piglets had a significantly higher apparent ileal crude protein digestibility than the SF and HF and displayed lower ileal proteolytic activity than the SF. Both effects may contribute to the alleviation of functional gastrointestinal symptoms reported in infants fed fermented infant milk formula. © 2015 American Society for Nutrition.

  10. Heel lipoma mimicking plantar fasciitis in a ballroom dancer.

    Science.gov (United States)

    Taweel, Nicholas R; Raikin, Steven M

    2015-01-01

    The present case illustrates a lipoma as an unusual cause of heel pain. A 64-year-old female ballroom dancer presented with 8 months of pain that was unresponsive to previous treatment of plantar fasciitis. Magnetic resonance imaging revealed a heel lipoma. Her pain was fully resolved after surgical excision. Soft tissue tumors should be included in the differential diagnosis of heel pain, especially when symptoms and treatment response do not follow the typical course of plantar fasciitis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Lipoma gástrico: relato de caso

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    Daniel Dongiu Kim

    Full Text Available We report a case of gastric lipoma, a rare benign stomach tumor. There are approximately 200 cases previously described in literature. A male, 62-year-old patient with no clinical complaint presented a tumor lesion in the stomach antrum found in a routine upper endoscopy. A surgical resection (subtotal gastrectomy was done and the histological examination showed submucosal lipoma without signs of malignancy. This report points to the growth of routine examination in the current clinical practice and the dilemma brought by overdiagnosis.

  12. Giant gastric lipoma mimicking well-differentiated liposarcoma ...

    African Journals Online (AJOL)

    Nuclei were sometimes large, slightly irregular, but without hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed no MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization. The diagnosis of lipoma was made. Twelve months ...

  13. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult

    African Journals Online (AJOL)

    Hizawa K, Kawasaki M, Kouzuki T, Aoyagi K, Fujishima M. Unroofing technique for the endoscopic resection of a large duodenal lipoma. Gastrointest Endosc 1999;49:391‑2. New features on the journal's website. Optimized content for mobile and hand-held devices. HTML pages have been optimized of mobile and other ...

  14. An infrequent cause of total lung collapse: Endobronchial lipoma

    African Journals Online (AJOL)

    Fahd Ahmed Suhail

    2014-06-21

    Jun 21, 2014 ... Abstract Endobronchial lipomas are rare benign tumors of the lung. The reported case was a. 46-year-old man who came to our center for follow up of endobronchial lesion and contracted it. 5years ago. A fibrobronchoscopy failed to reach the lesion due to narrowing in the upper respiratory tract and the ...

  15. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient

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    Melda Misirlioglu

    2017-01-01

    Full Text Available Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location.

  16. Intramedullary holocord lipoma in an athlete: case report.

    Science.gov (United States)

    Razack, N; Jimenez, O F; Aldana, P; Ragheb, J

    1998-02-01

    Holocord intradural lipoma extending from the cervical to the lumbar spine is an exceedingly rare condition. An extensive review of the literature revealed that only eight other cases have been reported, and none occurred during the contemporary magnetic resonance imaging era. A case of holocord intradural lipoma that was partially resected with the aid of carbon dioxide laser and intraoperative ultrasound is reported. The intimate relationship of the lipoma to the nerve roots and the absence of a distinct plane between tumor and spinal cord precluded a complete resection of this tumor. At 7 months postoperatively, the patient's dysesthetic pain had resolved almost completely. Proprioception in the lower extremities had improved significantly to the point that the patient was able to walk without a cane and his preoperative Romberg's sign had disappeared. Extensive intradural intramedullary spinal lipomas can present in adulthood with symptoms of myelopathy as well as nonradicular pain. We encourage early surgical debulking of the tumor to prevent further progression of symptoms and to offer the possibility of neurological improvement.

  17. Subacromial impingement syndrome caused by a voluminous subdeltoid lipoma.

    Science.gov (United States)

    Murray, Jean-Christophe; Pelet, Stéphane

    2014-01-01

    Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

  18. An infrequent cause of total lung collapse: Endobronchial lipoma

    African Journals Online (AJOL)

    Fahd Ahmed Suhail

    2014-06-21

    Jun 21, 2014 ... Radiology;. Total lung collapse. Abstract Endobronchial lipomas are rare benign tumors of the lung. The reported case was a. 46-year-old man who came to our center for follow up of endobronchial ... 2014 Alexandria University Faculty of Medicine. ... attacks may induce sufficient nuclear atypia to suggest.

  19. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult ...

    African Journals Online (AJOL)

    PN Wichendu, A Dodiyi-Manuel ... remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in countries where access to endoscopy and modern imaging techniques poses a challenge.

  20. Giant lipoma: an unusual cause of carpal tunnel syndrome | Jalan ...

    African Journals Online (AJOL)

    Carpal tunnel syndrome, in its idiopathic form, is an extremely common entrapment neuropathy in the clinical practice however secondary compressive causes are rare. Among secondary causes, tumors are even rarer. Although lipomas are the most common soft tissue tumor in the body, <5% of the benign tumors of the ...

  1. Carpal tunnel syndrome caused by lipoma: a case report | Sbai ...

    African Journals Online (AJOL)

    . A lipoma of the hand causing a carpal tunnel syndrome by compression of the median nerve is exceptional. We report the case of a 70-year-old female presenting with a carpal tunnel syndrome. A compression of the median nerve by a ...

  2. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Murray

    2014-01-01

    Full Text Available Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

  3. Hemangiosarcoma within an intermuscular lipoma in a golden retriever dog.

    Science.gov (United States)

    Leriquier, Claire; Benoit-Biancamano, Marie-Odile; Lacoste, Hugues; Herndon, Gregory D

    2017-10-01

    A subcutaneous mass on the right pelvic limb of an 11-year-old neutered male golden retriever dog was surgically excised. A hemangiosarcoma included within an intermuscular lipoma was diagnosed upon histopathological examination. To the authors' knowledge, this is the first case report of this nature in a dog.

  4. Gastric lipoma: a new case and a review of the literature; Lipoma gastrico: un nuevo caso y revision bibliografica

    Energy Technology Data Exchange (ETDEWEB)

    Juan, F.; Gallego, J. I.; Gomez, C.; Guirau, M. D. [Hospital General Universitario de Alicante (Spain)

    2001-07-01

    We report a case of gastric lipoma discovered incidentally during abdominal ultrasound. We review the literature concerning this unusual disease, stressing clinical and diagnostic aspects, especially the ultrasonographic features and computed tomographic findings, as well as the different therapeutic options. (Author) 11 refs.

  5. Lump on Back: A Rare Case of Parosteal Lipoma of Scapula

    Directory of Open Access Journals (Sweden)

    Ankit Balani

    2014-01-01

    Full Text Available Lipomas are benign tumors of mature adipose tissue which can occur in subcutaneous, intramuscular, intermuscular, parosteal, and intraosseous compartments. Parosteal lipoma is a rare type of lipoma, accounting for less than 0.1% of primary bone neoplasms and 0.3% of all lipomas. Parosteal lipomas commonly arise in the femur and extremities. Around 150 cases have been reported in English literature with scapula being a rare site of involvement. They are known to be associated with underlying bony changes like focal cortical hyperostosis, pressure erosion of the underlying bone, and bowing deformity or with underlying osteochondroma. We report a rare case of a parosteal lipoma arising in the scapula with a bony excrescence in a 38-year-old male.

  6. Lipoma of corpus callosum associated with dysraphic lesions and trisomy 13

    Energy Technology Data Exchange (ETDEWEB)

    Wainwright, H.; Bowen, R.; Radcliffe, M. [Univ. of Cape Town Medical School (South Africa)

    1995-05-22

    We report on a further case of corpus callosal lipoma and frontal cranial defects. Most cases in the literature of corpus callosal lipoma in association with {open_quotes}dysraphic{close_quotes} lesions have been frontal in location. Malformation of the corpus callosum is said to be associated with 50% of these lipomas. Trisomy 13 was confirmed by the 13q14 cosmid probe on paraffin-embedded liver tissue. 19 refs., 5 figs.

  7. Pleomorphic lipoma lacking mature fat component in extensive myxoid stroma: a great diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Lin Xu-Yong

    2012-11-01

    Full Text Available Abstract Pleomorphic lipoma is a relatively uncommon entity, and is considered as a variant of spindle cell lipoma. Histologically, spindle cell lipoma/pleomorphic lipoma consists of varying quantity of mature fat, bland spindle cells and ropey collagen. In addition, pleomorphic lipoma is characterized by multinucleate giant cells, which possess the “floret-like” nuclei and marked pleomorphism. So, in contrast to spindle cell lipoma, pleomorphic lipoma is more easily misdiagnosed as a malignant tumor. Herein, we report a peculiar case of pleomorphic lipoma occurring in axilla with entirely devoid of mature fat in a 71-year-old male. The histopathological findings demonstrated the tumor was made up of bland spindle cells admixed with scattered “floret-like” cells and irregular ropey collagen in an extensive myxoid stroma. Immunostaining showed that the tumor was positive for the Vimentin, Bcl-2 and CD34, and was negative for S-100, desmin, CD68, and α–SMA. Although no fat component was found in the whole section, the tumor was still diagnosed as a pelomprphic lipoma. To our knowledge, this is the third reported case of pelomprphic lipoma which entirely lacked lipomatous component. Because of the existence of atypical multinucleate giant cells and lack of mature fat, this tumor may be easily misdiagnosed nonlipomatous lesions, such as myxoid fibrosarcoma, giant cell fibroblastoma. So, it is necessary to pay careful attention to the histological spectrum of pleomorphic lipoma, including the tumor with devoid of fat, and it should be kept in mind that pelomprphic lipoma still can be diagnosed even if lacking lipomatous component. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1967123180611361

  8. Endogenous ileal losses of nitrogen and amino acids in pigs and piglets fed graded levels of casein.

    Science.gov (United States)

    Mariscal-Landín, Gerardo; De Souza, Tércia C Reis

    2006-12-01

    In order to determine ileal losses of nitrogen (N) and amino acids (AA) and the coefficients of apparent and true ileal digestibility (AID, TID) of N and AA from casein in piglets and pigs, two experiments were conducted. In Experiment 1, 24 piglets were used. The piglets were weaned at 17 days of age, weighing 6.4 kg and cannulated at terminal ileum. Ileal digesta was collected at 28-29 and 35-36 days of age in period 1 and 2, respectively. Feed intake was 150 and 300 g x d(-1) during the first and second period. In Experiment 2, 16 castrates weighing 52.5 kg and cannulated at terminal ileum were used. The intake level of digestible energy was 2.5 times their maintenance requirement. The experiment lasted 7 days and ileal digesta was collected on day 6-7. Treatments consisted of four levels of N from casein: 8, 16, 24 and 32 g N x kg(-1) feed, respectively. Results showed that N level did not increase N or AA ileal losses. In piglets, N and AA ileal losses were similar between periods, except for period 2, where losses per kg DMI were about 47 and 64% higher for glycine and proline, respectively (p piglets were compared, piglets had higher (p piglets in period 2 for N, methionine, glutamic acid, glycine and proline. With exception of glycine in pigs, all values for TID of N and AA of casein were superior to 0.90. Piglets had higher TID of N, leucine, isoleucine, valine and phenylalanine. These results showed that piglets have higher ileal losses than pigs.

  9. Pedunculated Cecal Lipoma Causing Colo-Colonic Intussusception: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Stefanos Atmatzidis

    2012-01-01

    Full Text Available Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy. We present a very rare case of a 34-year-old female patient with symptomatic pedunculated cecal lipoma causing intermittent colo-colonic intussusception. Despite adequate imaging studies, definite preoperative diagnosis was not established and the patient underwent exploratory laparotomy. Intraoperatively, intussusception of the cecum into the ascending colon was found and right hemicolectomy was performed. Macroscopic assessment of the resected specimen showed the presence of a giant cecal pedunculated polypoid tumor with features of lipoma, causing intussusception. Histopathological examination confirmed the diagnosis of pedunculated cecal lipoma.

  10. Nasopalpebral lipoma-coloboma syndrome: clinical, radiological, and histopathological description of a novel sporadic case.

    Science.gov (United States)

    Chacon-Camacho, Oscar F; Lopez-Martinez, Monica S; Vázquez, Johanna; Nava-Castañeda, Angel; Martin-Biasotti, Fernando; Piña-Aguilar, Raul E; Iñiguez-Soto, Marisol; Acosta-García, Job; Zenteno, Juan C

    2013-06-01

    Nasopalpebral lipoma-coloboma syndrome is an extremely uncommon autosomal dominant condition characterized by congenital upper eyelid and nasopalpebral lipomas, colobomata of upper and lower eyelids, telecanthus, and maxillary hypoplasia. A few familial and sporadic cases of this malformation syndrome have been previously reported. Here, the clinical, radiological, and histopathological features of a sporadic Mexican patient with the nasopalpebral lipoma-coloboma syndrome are described. To our knowledge, this is the first time that craniofacial 3D computed tomography imaging was used for a detailed assessment of the facial lipoma. Copyright © 2013 Wiley Periodicals, Inc.

  11. The role of flexible hollow core carbon dioxide lasers in resection of lumbar intraspinal lipomas.

    Science.gov (United States)

    Desai, Sohum Kiran; Paulson, David; Thompson, Bobbye Jo; Patterson, Joel; Mohanty, Aaron

    2012-10-01

    The authors assess the role of flexible hollow core CO2 laser system (Omniguide system) in resection of intraspinal lipomas. Eight patients with intraspinal lipomas were operated using an Omniguide laser system over a 22-month period. The age range varied between 6 months and 16 years. All of them had lipoma of the conus medullaris associated with lumbar subcutaneous lipoma. Two of these had previous surgery with resection of the subcutaneous part of the lipoma; in one of them, a partial resection of the conus medullaris lipoma had also been performed. In six, there were no obvious motor or sensory deficits whereas two had gross neurologic deficits, with the deficits occurring in one after the previous decompression. Resection of the conus lipoma, untethering of the spinal cord, and reconstruction of the decompressed conus was performed in all aided with Omniguide laser system. The power settings of the laser system ranged from 4 to 8 W. Subtotal to near-total resection was achieved in all. None of the patients developed any new motor or sensory deficits. Three had postoperative CSF leaks which initially required reoperation with graft resuturing and subsequently placement of lumboperitoneal shunt. One child with preexisting neurologic deficits improved in power over the next 12 months. Flexible CO2 laser system was precise and convenient in decompressing the conus lipomas and untethering of the cord in lumbar spinal lipomas.

  12. Xanthelasma and lipoma in Leonardo da Vinci's Mona Lisa.

    Science.gov (United States)

    Dequeker, Jan; Muls, Erik; Leenders, Kathleen

    2004-08-01

    The painting Mona Lisa in the Louvre, Paris, by Leonardo da Vinci (1503-1506), shows skin alterations at the inner end of the left upper eyelid similar to xanthelasma, and a swelling of the dorsum of the right hand suggestive of a subcutaneous lipoma. These findings in a 25-30 year old woman, who died at the age of 37, may be indicative of essential hyperlipidemia, a strong risk factor for ischemic heart disease in middle age. As far as is known, this portrait of Mona Lisa painted in 1506 is the first evidence that xanthelasma and lipoma were prevalent in the sixteenth century, long before the first description by Addison and Gall in 1851.

  13. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

    OpenAIRE

    Jean-Christophe Murray; Stéphane Pelet

    2014-01-01

    Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right sh...

  14. Ileal ganglioneuromatosis in a piglet: histopathological and immunohistochemical studies.

    Science.gov (United States)

    Quiroga, M A; Lozada, M I; Madariaga, G; Cappucio, J A; Machuca, M A; Barrales, H; Perez, E M; Perfumo, C J

    2014-11-01

    Ganglioneuromatosis (GNM) is a rare condition characterized by the benign proliferation of ganglion cells, nerve fibres and supporting cells of the enteric nervous system. Necropsy examination of a female piglet weighing 4 kg revealed a well-demarcated 20 cm segment of terminal ileum with thickening of the wall. Microscopically, the lamina propria was infiltrated by enteric glial cells and large ganglion cells. Within the submucosal and muscular layers, aggregates of neurons were interlaced by Schwann cells and enteric glial cells arranged in concentric rings. Immunohistochemically, the neurons were weakly labelled for S-100 and neuron-specific enolase, Schwann cells expressed S-100 and vimentin and enteric glial cells expressed glial fibrillary acidic protein and S-100. Pathological and immunohistochemical findings supported the diagnosis of ileal GNM. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Intracranial lipoma with extracranial extension through foramen ovale in a patient with encephalocraniocutaneous lipomatosis syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Fitoz, S. [Atatuerk Sitesi, Hayri Cecen S., Ankara (Turkey); Department of Radiology, University of Ankara School of Medicine, Ankara (Turkey); Atasoy, C.; Erden, I.; Akyar, S. [Department of Radiology, University of Ankara School of Medicine, Ankara (Turkey)

    2002-02-01

    We present CT and MR features of a large intracranial lipoma located in the left sphenocavernosal region in a patient with a history of spinal intradural lipoma excision. The lipomatous lesion surrounded the internal carotid artery and trigeminal nerve and extended extracranially into the infratemporal region through a smoothly dilated foramen ovale. (orig.)

  16. A case of recurrent lipoma in the sole with long-term follow-up

    Directory of Open Access Journals (Sweden)

    Kazunori Yasumura

    2016-06-01

    Full Text Available We report a rare lipoma in the sole detected at 18 months of age. The lipoma recurred repeatedly and he underwent a third excision at 10 years of age. Although recurrence was clear at 18 years of age, no growth has been observed over the last 8 years.

  17. Primary Mesenteric Lipoma Causing Closed Loop Bowel Obstruction: A Case Report

    Directory of Open Access Journals (Sweden)

    Heong-Ieng Wong

    2005-03-01

    Full Text Available Primary mesenteric lipoma is rare, with fewer than 50 cases described in English-language literature, and those causing bowel obstructions are even more uncommon. The long stalk of the lipoma that caused secondary volvulus and rapid ischemic change in our patient is worth reporting because of its rarity and distinctive picture in emergency abdominal computed tomography.

  18. Spindle cell lipoma of the spermatic cord – a report with review of ...

    African Journals Online (AJOL)

    A case of spindle cell lipoma of the spermatic cord is reported in a 60-year old Saudi male who presented with a one-year history of painless, firm, right testicular mass provisionally diagnosed as a testicular tumour. The final diagnosis of spindle cell lipoma of the cord was made following histopathology of the excised ...

  19. Imaging of lipoma of the corpus callosum and intracranial dermoids in the Goldenhar syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Beltinger, C.; Saule, H.

    1988-01-01

    With increased frequency lipoma of the corpus callosum and intracranial dermoids have been recognized to be associated with oculoauriculovertebral dysplasia (Goldenhar syndrome). We report an additional case of lipoma of the corpus callosum in a newborn with Goldenhar syndrome. Sonographic, roentgenographic and computertomographic features of these intracranial lesions are discussed and the literature is reviewed.

  20. Synchronous Lipoma arborescens of bilateral wrist: An extremely rare manifestation and a new perspective on etiopathogenesis

    Directory of Open Access Journals (Sweden)

    Bal Chander

    2015-01-01

    Full Text Available Lipoma arborescens is a rare lesion wherein abnormal proliferation of adipocytes in the subsynovial region is seen. Whether it is neoplastic or not is still not entirely clear. Usually, Lipoma arborescens is seen unilaterally around knee joint but it can also be seen around tendon sheaths or bursa in adults. Multiple lesions are also reported. Involvement of wrist is extremely rare. We are presenting a case with bilateral wrist involvement by Lipoma arborescens which to the best of our knowledge is first one in English literature. There are a host of co-morbid/associated conditions reported with Lipoma arborescens out of which chronic irritation and inflammation appears to be most significant. We are proposing a novel perspective on etiopathogenesis of Lipoma arborescens based on extant understanding of cellular differentiation and information gleaned from fetal autopsies. The new perspective also explains the predilection for knee joint.

  1. Oral lipoma extending superiorly from mandibular gingivobuccal fold to gingiva: a case report and analysis of 207 patients with oral lipoma in Japan.

    Science.gov (United States)

    Taira, Yukio; Yasukawa, Kazuo; Yamamori, Iku; Iino, Mitsuyoshi

    2012-01-01

    Lipoma is relatively uncommon in the oral cavity. Among the intraoral regions, lipoma involving the gingiva or gingivobuccal fold is relatively infrequent. We report the case of a patient with lipoma extending superiorly from the mandibular gingivobuccal fold to the gingiva. In addition to the case report, we retrospectively reviewed 207 patients with intraoral lipoma reported in Japan from 1987 to 2004. The most frequent site of development was the buccal mucosa (40.6%), followed by the tongue (17.9%), lip (12.6%), gingiva (8.7%), oral floor (6.8%), gingivobuccal fold and palate (4.8%), and others (3.9%). Occurrence tended to be more frequent in males (57.5%) than in females (42.5%). Relative to age, frequency peaked among patients in the 7th (27.3%) and 6th decades (25.1%), respectively, followed in descending order by the 5th (14.8%) and 8th decades (13.1%). The majority of patients (86.3%) were at least 40 years. The most frequent size was 10-19 mm (37.5%), followed by 0-9 mm (27.8%) and 20-29 mm (14.6%), and tumors 30 mm or larger were relatively infrequent. Histopathological types in order of descending frequency were lipomas (69.0%), fibrolipomas (27.4%), and others (3.5%). The male:female ratio was 1.7:1 for lipoma and 1:1.6 for fibrolipoma.

  2. Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity.

    Science.gov (United States)

    De Franco, Antonio; Di Veronica, Alessandra; Armuzzi, Alessandro; Roberto, Italia; Marzo, Manuela; De Pascalis, Barbara; De Vitis, Italo; Papa, Alfredo; Bock, Enrico; Danza, Francesco M; Bonomo, Lorenzo; Guidi, Luisa

    2012-02-01

    To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity. This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis. MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P<.0001 for both), the 33 patients with a CDAI of at least 150 (P<.032 and P<.0074, respectively), and the 26 patients with an SES-CD of at least 1 (P<.0001 and P<.002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%). Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD. © RSNA, 2011

  3. [Infusion of ileal juice by distal stoma].

    Science.gov (United States)

    Kunzle, J E; Ziliotto, A; De Araujo Filho, A A

    1976-01-01

    The authors present a simple and practical method to avoid the ileal juice expoliation in patients with ileostomy after intestinal resection. In the cases presented, after the resection, stomies were performed of the proximal and distal portions of the intestine, in relation to the extirpated segment. The juice collected in the proximal stomy was infused in the distal stomy, simulating that way the physiologic intestinal transit.

  4. Type-selective muscular degeneration promotes infiltrative growth of intramuscular lipoma

    Directory of Open Access Journals (Sweden)

    Ishizawa Michihito

    2004-06-01

    Full Text Available Abstract Background Intramuscular lipoma is a relatively common benign neoplasm that is occasionally described as an infiltrating lipoma. Typical benign tumors show a clear margin, however, the infiltrative growth pattern of this lipoma mimics that of a malignant tumor. Although its growth has an effect on muscle bundles and it is known to never metastasize, the mechanism of infiltrative growth is not well understood. Previously, little attention has been paid to pathogenic features of muscle fibers around an intramuscular lipoma. Methods In the present study, we focused on pathologic changes of the surrounding skeletal muscles especially to the degenerative features of involving muscular types, and evaluate the role of type-selective muscular degeneration for the infiltrative growth of intramuscular lipomas. Following a review of the medical records in our institute, 17 lesions containing muscle tissues in their specimens (15 infiltrating lipomas, 2 well-circumscribed lipomas were analyzed immunohistochemically. The tumor from the most recent case was also subjected to ultrastructural analysis. Two cases of the traumatic muscle damage were also evaluated as the control experiments. Results These analyses revealed type-selective muscle involution in 11 of 17 intramuscular lipomas and in 10 of 11 of the infiltrative type, with an involving pattern that resembled that of a neurogenic or myogenic disorder. Immunoreactivity to cathepsin-D, a lysosomal catabolic enzyme, was increased in the involved muscle fibers. Subsarcolemmal vacuoles in the muscle fibers of the peripheral areas were also positive for cathepsin-D, while degenerative findings were not visually apparent in these areas. Ultrastructural analysis revealed degenerative changes in those fibers. Neither positive staining for cathepsin-D nor type-selective atrophy was detected in the sections of traumatic muscle damage. Conclusions Our findings suggest that type-selective muscular

  5. Posttraumatic lipoma: analysis of 10 cases and explanation of possible mechanisms.

    Science.gov (United States)

    Copcu, Eray; Sivrioglu, Nazan S

    2003-03-01

    Trauma and lipoma are the most frequently met occurrences in clinical routine. Although lipomas are well-known fatty tumors both clinically and pathologically, the precise etiology is still unknown. Generally, posttraumatic lipomas are known as "pseudolipoma," which describes herniation of deeper fat through Scarpa's layer secondary to trauma. Here we present 10 patients with lipoma secondary to blunt trauma in different anatomical sites. To correlate trauma and lipoma relationships and to discuss the possible pathogenetic mechanism by reviewing literature. Ten patients (12 lipomas) after blunt trauma were presented, and data of patients were reviewed. Ultrasonography and/or nuclear magnetic resonance were employed for diagnosis in addition to physical examination. All tumors were verified by histopathologic examinations. Patients were followed for a minimum of 6 months. The average age was 34. Four of the lesions (12 altogether) were located on an upper extremity, 5 on a lower extremity, 2 on the trunk, and 1 on the neck. Excision of tumors and primary closure were performed in 92% of the lesions, and only one liposuction was performed. Aesthetic results were achieved in all patients. There were no complications and recurrences. The effect of blunt trauma on fat tissue may be explained by different theories. We summarized possible mechanisms into two groups according to our observations and review of the literature: The first was related to mature adiposities and mainly a mechanical effect, and the second was differentiations of the preadipocytes to lipoma by the promoting factors. We speculate that only traumas that serve as a cause of fat necrosis may trigger the formation of the lipoma, and local inflammation secondary to fat necrosis may affect adipocytes and promote new formation of lipoma.

  6. MRI Findings of Synovial Lipoma Arborescens of the Hip: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Jin; Park, Chan Sub; Kim, Mi Sung; Park, Noh Hyuck; Park, Jai Hyung; Yi, Sang Yeop [Myoungji Hospital, Kwandong University College of Medicine, Seoul (Korea, Republic of); Park, Sung Il [Shinchon Severance Hospital, Yonsei University School of Medicine, Seoul (Korea, Republic of)

    2010-12-15

    Lipoma arborescens is a rare intra-articular lesion consisting of villous lipomatous proliferation of the synovium that tends to occur in the knee joint, especially in the suprapatellar pouch. The lesion has been observed in other locations, including the glenohumeral joint, subdeltoid bursa, hip, and elbow. We report a case of a lipoma arborescens of a unilateral hip joint in a 34-year-old man. MRI and a whole body bone scan were performed. In addition, a surgical synovectomy was performed and microscopic examination of the tumor revealed multiple variable-sized villous masses composed of mature fat tissue and lined by synovial cells which confirmed the diagnosis of lipoma arborescens

  7. Bilateral lipoma arborescens of the knee in a child: a case report.

    Science.gov (United States)

    Cil, Akin; Atay, O Ahmet; Aydingöz, Ustün; Tetik, Onur; Gedikoğlu, Gökhan; Doral, M Nedim

    2005-09-01

    We report a case of childhood lipoma arborescens of both knee joints who had been erroneously diagnosed to have initially acute rheumatic fever and subsequently oligoarticular juvenile rheumatoid arthritis. She had taken anti-inflammatory medication for 8 years without remission of the effusion. Magnetic resonance imaging (MRI) and synovectomy revealed the diagnosis of lipoma arborescens. Lipoma arborescens should be kept in mind in the differential diagnosis of refractory chronic joint effusion and synovial hypertrophy in the childhood period, and MRI yields the correct diagnosis in this setting.

  8. A case of multiple lipomas coexisting with angiolipomas: Familial multiple lipomatosis or a distinct entity?

    Directory of Open Access Journals (Sweden)

    Funda Tamer

    2016-10-01

    Full Text Available Familial multiple lipomatosis and familial multiple angiolipomatosis are both rare and autosomal-dominantly inherited diseases. Familial multiple lipomatosis is characterized by multiple lipomas on the trunk and extremities, while familial multiple angiolipomatosis presents with multiple angiolipomas. Hereby, we present a 50-year-old Caucasian male patient with both multiple lipomas and angiolipomas on his trunk, arms and thighs with a family history of similar subcutaneous lesions. As multiple lipomas and angiolipomas coexist in the same patient, we suggest that this condition should be nominated as a distinct entity rather than a traditional familial multiple lipomatosis case.

  9. Superficial intraoral lipoma in a geriatric edentulous male: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Priya Sahni

    2014-01-01

    Full Text Available Lipoma is a common tumor of the soft tissues. Its location on the oral mucosa is infrequent, representing 1 to 5% of all benign oral tumors although it is the most frequently occurring mesenchymal tumor of the trunk and proximal portions of extremities. Lipoma of the oral cavity is seen mainly on the buccal mucosa, tongue, and floor of the mouth. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium generally remains intact. The purpose of the present case report is to discuss a lipoma on the left buccal mucosa of an elderly male with a brief review of literature.

  10. Spindle Cell Lipoma Occurring in the Buccal Mucosa: An Unusual Location of This Benign Lipomatous Neoplasm

    Directory of Open Access Journals (Sweden)

    Noala Vicensoto Moreira Milhan

    2015-01-01

    Full Text Available Spindle cell lipoma is a benign lipomatous neoplasm, which rarely occurs in the oral cavity. The aims of this paper are to report a case of spindle cell lipoma located in buccal mucosa and discuss the main clinical, histological, and immunohistochemical findings of this entity. Thus, we report a 4-year history of an asymptomatic smooth surface nodule in an elderly Caucasian man with clinical hypothesis of fibroma. The histopathological examination showed spindle cells, mature adipose tissue, and many mast cells in a stroma of connective tissue presenting ropey collagen fibers bundles. After immunohistochemical analysis, the final diagnosis was spindle cell lipoma.

  11. Asynchronous abdomino-parasacral resection of a giant pelvic lipoma protruding to the left buttock

    Directory of Open Access Journals (Sweden)

    Masanori Sato

    2014-01-01

    CONCLUSION: The asynchronous abdomino-parasacral approach with several turnings of the patient's body and plastic bag packing of the tumor were advantageous to manage en bloc resection of the giant pelvic lipoma presented in this case study.

  12. Diagnostic problems in fine needle aspiration cytology of fat necrosis within a subcutaneous lipoma

    OpenAIRE

    Kavishwar Vikas; Rupani Asha; Amarapurkar Anjali; Anchinmane Vyankatesh

    2008-01-01

    Fat necrosis in subcutaneous lipomas is very unusual and has been reported only occasionally. Literature regarding fine needle aspiration cytology of such a lesion is lacking although fat necrosis is well described in the breast. We came across a case of a large subcutaneous lipoma in the anterior abdominal wall with a well encapsulated area of fat necrosis. The aspiration smears showed an unusual picture which was misinterpreted as the fragments of the hydatid cyst wall. They were actually e...

  13. Lipoma of the Uterine Corpus: Exceptional Eventuality Combined with an Ovarian Thecoma

    Directory of Open Access Journals (Sweden)

    R. Vilallonga

    2009-01-01

    Full Text Available Uterine lipomas are very uncommon with symptoms that are similar to leiomyomas. Their diagnosis is always histological although some radiological methods may suggest their existence prior to surgery. They are sometimes associated with endometrial pathology, but there are no previous reported cases related to ovarian thecoma. Their prognosis is excellent. Clinical, radiological, morphologic, and immunohistochemical findings are shown which correspond to uterine lipoma associated with endometrial polyps and ovarian thecoma.

  14. Postsurgical recurrence of ileal Crohn's disease: an update on risk factors and intervention points to a central role for impaired host-microflora homeostasis.

    LENUS (Irish Health Repository)

    Cunningham, Michael F

    2010-07-01

    A pressing need exists to identify factors that predispose to recurrence after terminal ileal resection for Crohn\\'s disease (CD) and to determine effective prophylactic strategies. This review presents an up-to-date summary of the literature in the field and points to a role for bacterial overproliferation in recurrence.

  15. Ileal brake activation: Macronutrient-specific effects on eating behavior?

    NARCIS (Netherlands)

    Avesaat, M. van; Troost, F.J.; Ripken, D.; Hendriks, H.F.; Aam, M.

    2015-01-01

    BACKGROUND: Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown. OBJECTIVE: The objective of

  16. Typhoid ileal perforation: Analysis of morbidity and mortalityin 89 ...

    African Journals Online (AJOL)

    Typhoid ileal perforation is still prevalent in many developing countries. Despite the advances in The management, the outcome in children is still very poor. To determine the morbidity and mortality of childhood typhoid ileal perforation in a tertiary referral centre in southeast Nigeria Retrospective evaluation of 89 children ...

  17. LIPOMA ARBORESCENS: RARE CASE OF ROTATOR CUFF TEAR ASSOCIATED WITH THE PRESENCE OF LIPOMA ARBORESCENS IN THE SUBACROMIAL-SUBDELTOID AND GLENOHUMERAL BURSA.

    Science.gov (United States)

    Benegas, Eduardo; Neto, Arnaldo Amado Ferreiro; Teodoro, Daniel Sabatini; da Silva, Marcos Vinícius Muriano; de Oliveira, Augusto Medaglia; Filippi, Renée Zon; de Santis Prada, Flávia

    2012-01-01

    Lipoma arborescens is a rare intra-articular disease that is usually monoarticular and is characterized by extensive proliferation of the synovial villi and hyperplasia of the subsynovial fat. The synovial tissue is progressively replaced by mature fat cells in the synovial membrane. The present study reports a case of a rare condition of lipoma arborescens that was simultaneously intra-articular (glenohumeral joint) and in the subacromial-subdeltoid bursa, in association with a torn supraspinatus tendon. The clinical, histological and radiographic presentations and treatment are discussed here. The description of this case includes radiographic and magnetic resonance evaluations and pathological examination. Although lipoma arborescens is a rare condition, it should be taken into consideration in cases presenting synovial hyperproliferation and synovial fat replacement.

  18. A case of lipoma of lateral anterior neck treated with surgical enucleation

    Directory of Open Access Journals (Sweden)

    Francesco Grecchi

    2012-01-01

    Full Text Available Lipoma arise in almost 50% of all soft tumours. The neck lipomas are rare tumours that may present as painless masses with slow growth, in the lateral portions of the neck. Some lipomas, such as the one studied in our case, grow deep in the subcutaneous tissue, in close contact with muscles. Here, we report a case of lipoma extending from pre-tragal region up to the ascending branch of the mandible in a 62 year old man, treated with enucleation. The inferior margin of lipoma involved the pharyngeal and the superior margin was achieved by the top of the skull base. The mass of lipoma caused breathing difficulties in the patient, preventing regular sleep. No complication was recorded in the post-operative period and no further surgery was performed. The complete resolution after one year′s follow-up, together with the rarity of the anatomical site, makes this case worthy of description. A correct diagnosis facilitated removal of this lesion with a surgical method.

  19. A case report of an intermuscular lipoma: presentation, pathophysiology, differential diagnosis.

    Science.gov (United States)

    Kaeser, Martha A; Smith, Linda W; Kettner, Norman W

    2010-09-01

    The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described. The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness. The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass. Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment. Copyright © 2010 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  20. Lipomas of the Brachial Plexus: A Case Series and Review of the Literature.

    Science.gov (United States)

    Graf, Alexander; Yang, Kai; King, David; Dzwierzynski, William; Sanger, James; Hettinger, Patrick

    2017-10-01

    Lipomas are common benign tumors. When they develop in proximity to peripheral nerves, they can cause neurologic symptoms secondary to mass effect. Previous reports have shown symptom resolution after removal of lipomas compressing various upper extremity peripheral nerves. However, brachial plexus lipomas are relatively rare. Our multidisciplinary experience with brachial plexus lipoma resection is reviewed in the largest case series to date. A retrospective chart review of all patients undergoing resection of brachial plexus lipomatous tumors between 2006 and 2016 was performed. Patient demographic data, diagnostic imaging, clinical presentation, operative details, surgical pathology, and clinical outcomes were reviewed. Twelve brachial plexus lipomatous tumors were resected in 11 patients: 10 lipomas, 1 hibernoma, and 1 atypical lipomatous tumor. The most common tumor location was supraclavicular (50%), followed by axillary (42%), and proximal medial arm (8%). The most common brachial plexus segment involved was the upper trunk (50%), followed by posterior cord (25%), lateral pectoral nerve (8%), lower trunk (8%), and proximal median nerve (8%). Most patients presented with an enlarging painless mass (58%). Of the patients who presented with neurologic symptoms, symptoms resolved in the majority (80%). Brachial plexus lipomas are rare causes of compression neuropathy in the upper extremity. Careful resection and knowledge of brachial plexus anatomy, which may be distorted by the tumor, are critical to achieving a successful surgical outcome with predictable symptom resolution. Finally, surveillance magnetic resonance imaging may be warranted for atypical lesions.

  1. A case of asymptomatic ileal duplication cyst associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Hülya İpek

    2017-07-01

    Full Text Available Duplications of the alimentary tract are infrequent anomalies. They are most frequently located in the terminal ileum, and majority of them became symptomatic before the age of 2. Presenting symptoms may include abdominal mass, intestinal obstruction, intussusception, rectal bleeding, and abdominal pain. Preoperative diagnosis is usually difficult, intra-abdominal duplications are usually diagnosed during surgical explorations of above complications. We presented a 12-year-old girl with asymptomatic ileal duplication cyst associated with non-complicated acute appendicitis, whose imaging studies at admission were compatible with complicated perforated appendicitis.

  2. Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report

    Directory of Open Access Journals (Sweden)

    Amelio Gianfranco

    2009-12-01

    Full Text Available Abstract Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should always raise suspicion of a lumbar hernia. Ultrasound and computed tomography may confirm the diagnosis. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results.

  3. Non-febrile Seizure Associated with Pericallosal Lipoma

    Directory of Open Access Journals (Sweden)

    Mehmet Davutoglu

    2008-12-01

    A 6-year-old girl with an unexplained headache was admitted to the Pediatric Outpatient Clinic with complaints of non-febrile seizure. Her seizure was a complex-partial type. Biochemical tests for seizure etiology did not reveal any specific cause. Electroencephalography (EEG revealed typical epileptic activity. Magnetic resonance imaging (MRI gave images of a mass approximately 1 cm in diameter in the vicinity of corpus callosum splenium. Her seizures were kept under control with carbamazepine (400 mg/day and indicators of neuromotor development were found to be normal throughout 24-month period of follow up. Even though it is a rare condition, pericallosal lipoma should also be taken into account in the differential diagnosis of non-febrile seizures in children.

  4. Presentación de caso de un Lipoma Calcificado

    Directory of Open Access Journals (Sweden)

    Pedro Rafael Casado Méndez

    2015-12-01

    Full Text Available El adipoma o lipoma es el tumor de partes blandas más frecuente en la población, pero sus complicaciones resultan ser de tal rareza que apenas el dos porciento de ellos las sufre. Se presentó el caso de un paciente masculino, de 53 años de edad, con antecedentes de una masa tumoral en la región mamilar derecha de más o menos seis años de evolución, que se mostró asintomático, pero que le preocupaba el tumor que le ha estado creciendo. Se le realizó examen físico completo y radiografía de tórax en dos vistas, resultando sugestivo de proceso tumoral de carácter neoplásico. El caso fue  remitido a la consulta de cirugía general, donde se le practicó Tomografía Axial Computarizada, no conclusiva, pero que sugirió proceso oncoproliferativo del tipo rabdomiosarcoma. El paciente fue intervenido quirúrgicamente mediante incisión losángica y se logró la exéresis total del tumor, que se envió para estudio anatomopatológico. Se envió pieza quirúrgica que, al ser seccionada a la mitad, se mostró de color blanco-nácar y consistencia dura y firme. El estudio reveló un lipoma calcificado. El pacientes fue dado de alta con reconsulta al mes, donde se le dio alta definitiva.

  5. Ileal Augmentation Cystoplasty Combined with Ileal Ureter Replacement After Radical Treatment for Cervical Cancer.

    Science.gov (United States)

    Jeong, In Gab; Han, Kyung-Sik; Park, Sang Hyun; Song, Sang Hoon; Song, Geehyun; Park, Hyung Keun; Choo, Myung-Soo; Hong, Bumsik

    2016-05-01

    This study reviewed the outcomes for patients who underwent simultaneous bladder and ureter reconstructive surgery using the ileum after radical treatment for cervical cancer. The medical records of seven patients who underwent augmentation ileocystoplasty with ileal ureter replacement between September 2006 and May 2013 were reviewed. Data on indications for surgery, underlying urologic comorbidities, type of ureteral replacement, postoperative complications, and changes in renal function were obtained. The median age of the patients was 56 years. The primary tumor was cervical cancer in all the patients, and the majority of the patients (4/7, 57.1 %) were previously treated with radical hysterectomy plus radiotherapy. Ileal ureter replacement was performed on 11 renal units, and bilateral ileal ureter substitution was performed for four patients, with the largest ureteral defect being 15 cm. The median length of the ileum used for augmentation and ureter substitution was 30 cm (range 15-40 cm), and the median hospital stay was 23 days (range 18-47 days). The overall rate of major complications (grade ≥3) was 57.1 % (4 of 7 patients). The median preoperative and immediate postoperative serum creatinine levels were respectively 1.2 mg/dL and 0.9 mg/dL. During a mean follow-up duration of 38 months, none of the patients experienced deterioration of renal function after surgery. Ileal ureter substitution combined with augmentation ileocystoplasty is a useful surgical technique for bridging long ureteral defects caused by ureteric stenosis from surgery, radiotherapy, or both for pelvic tumors in contracted low-compliance bladders.

  6. Bricker's ileal conduit urinary diversion with a simple non-refluxing uretero ileal anastomosis

    DEFF Research Database (Denmark)

    Bernstein, I T; Bennicke, K; Rørdam, P

    1991-01-01

    Fifty consecutive patients had ileal conduits constructed with a technically and quick simple antireflux ureteroileal anastomosis. Complications related to the ureteral implantation were studied retrospectively, and at follow-up (8 months-12 years later, median 3 years) conduit dysfunction and ur...... from 300 to 420 mumol/l. Partial ureteral reflux was present in three (2 patients) of 33 ureters studied and minimal conduit dysfunction was found in 8 patients. In conclusion we find this method of urinary diversion to be quick, easy, and safe.......Fifty consecutive patients had ileal conduits constructed with a technically and quick simple antireflux ureteroileal anastomosis. Complications related to the ureteral implantation were studied retrospectively, and at follow-up (8 months-12 years later, median 3 years) conduit dysfunction...... and ureteral reflux were assessed in 18 patients out of the 25 patients who were still alive. Early complications and signs of late upper urinary tract deterioration were similar to those found after other operative techniques had been used. One patient had a postoperative urinary leak from the uretero ileal...

  7. Parosteal lipoma - a case report: conventional radiology, CT and MRI; Lipoma parosteal - relato de um caso: radiologia convencional, tomografia computadorizada e ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Silvio Cavalcanti [Pernambuco Univ., Recife, PE (Brazil). Hospital das Clinicas]|[Instituto Materno Infantil de Pernambuco, Recife, PE (Brazil); Nascimento, Edilene Cristina do; Silva, Ivone Martins da [Pernambuco Univ., Recife PE (Brazil). Hospital das Clinicas. Servico de Radiologia

    1996-03-01

    The authors report a case parosteal lipoma, a rare benign tumor, associated with exostosis, in proximal radius. The diagnosis aspects in conventional radiology, computed tomography and magnetic resonance imaging are presented, as well as a review of the medical literature about the case. (author). 7 refs., 3 figs.

  8. An ileal Crohn's disease gene signature based on whole human genome expression profiles of disease unaffected ileal mucosal biopsies.

    Directory of Open Access Journals (Sweden)

    Tianyi Zhang

    Full Text Available Previous genome-wide expression studies have highlighted distinct gene expression patterns in inflammatory bowel disease (IBD compared to control samples, but the interpretation of these studies has been limited by sample heterogeneity with respect to disease phenotype, disease activity, and anatomic sites. To further improve molecular classification of inflammatory bowel disease phenotypes we focused on a single anatomic site, the disease unaffected proximal ileal margin of resected ileum, and three phenotypes that were unlikely to overlap: ileal Crohn's disease (ileal CD, ulcerative colitis (UC, and control patients without IBD. Whole human genome (Agilent expression profiling was conducted on two independent sets of disease-unaffected ileal samples collected from the proximal margin of resected ileum. Set 1 (47 ileal CD, 27 UC, and 25 Control non-IBD patients was used as the training set and Set 2 was subsequently collected as an independent test set (10 ileal CD, 10 UC, and 10 control non-IBD patients. We compared the 17 gene signatures selected by four different feature-selection methods to distinguish ileal CD phenotype with non-CD phenotype. The four methods yielded different but overlapping solutions that were highly discriminating. All four of these methods selected FOLH1 as a common feature. This gene is an established biomarker for prostate cancer, but has not previously been associated with Crohn's disease. Immunohistochemical staining confirmed increased expression of FOLH1 in the ileal epithelium. These results provide evidence for convergent molecular abnormalities in the macroscopically disease unaffected proximal margin of resected ileum from ileal CD subjects.

  9. Mielopatia compressiva por lipoma de células fusiformes infiltrativo em cão Compressive myelopathy by infiltrative spindle cell lipoma in a dog

    Directory of Open Access Journals (Sweden)

    Rosmarini Passos dos Santos

    2013-05-01

    Full Text Available Relata-se um caso de lipoma de células fusiformes infiltrativo diagnosticado em cadela com sinais neurológicos de ataxia proprioceptiva, reação postural ausente no membro pélvico direito, paraparesia fracamente ambulatória e dor à palpação sobre as vértebras torácicas craniais. A mielografia demonstrou compressão extradural do lado direito sobre a quinta vértebra torácica. À necropsia foi observado neoplasma que invadia o canal vertebral na quarta e quinta vértebras torácicas com compressão acentuada da medula espinhal. Microscopicamente, foram observados adipócitos neoplásicos bem diferenciados, com áreas de células fusiformes, diagnosticado como lipoma de células fusiformes infiltrativo. A avaliação por imuno-histoquímica, com anticorpo anti-CD34, revelou positividade principalmente nas áreas fusiformes do lipoma.A female dog was referred presenting neurological signs of proprioceptive ataxy, proprioceptive deficit in the right pelvic limb, mild ambulatory paresis and spinal pain during the palpation in thoracic vertebrae. It was observed a right extradural compression of spinal cord over fourth and fifth thoracic vertebrae by spinal myelography. During necropsy evaluation, it was observed a neoplasm which infiltrated in the spinal canal in the fourth and fifth thoracic vertebrae with marked compression of the spinal cord. Microscopically there were well differentiated neoplasic adipocytes, with areas of spindle cells, diagnosed as infiltrative spindle cell lipoma. The immunohistochemical staining revealed positive CD34 cells mainly in the areas of spindle cells lipoma.

  10. Lipoma arborescens arising in the extra-articular bursa of the knee joint

    Science.gov (United States)

    Minami, Shinji; Miyake, Yusuke; Kinoshita, Hirofumi

    2016-01-01

    Lipoma arborescens arising in the extra-articular bursa of the knee joint is extremely rare. We describe an 11-year-old boy who complained of a gradual swelling mass of the lateral knee joint. Magnetic resonance imaging (MRI) showed a high signal intensity tumor on T1- and T2-weighted images with a thickened septa and nodular lesion that showed low signal intensity. The radiologist suggested the possible differential diagnosis of well-differentiated liposarcoma. At operation, the tumor was found under the iliotibial tract and was not in contact with the knee joint. Histopathologically, this lesion was diagnosed as lipoma arborescens arising in the extra-articular bursa of the knee joint. On MRI, the appearance of lipoma arborescens arising in the extra-articular bursa of the knee joint differed from that of conventional intra-articular lipoma arborescens. In this report, we describe a case of extra-articular lipoma arborescens of the knee joint bursa and discuss the diagnosis and etiology. PMID:27382924

  11. Giant inframuscular lipoma disclosed 14 years after a blunt trauma: A case report

    Directory of Open Access Journals (Sweden)

    Nigri Giuseppe

    2008-09-01

    Full Text Available Abstract Introduction Lipoma is the most frequent benign tumor of the soft tissue. This lesion is often asymptomatic except in cases of enormous masses compressing nervous-vascular structures. Although the diagnosis is mostly clinical, imaging tools are useful to confirm the adipose nature of the lesion and to define its anatomic border. Sometimes, lipomas may be the result of a previous trauma, such as in this patient. Case presentation A 45-year-old man presented at our institution with a giant hard firm mass in the upper external quadrant of the right buttock disclosed after a weight loss diet. Subsequent magnetic resonance imaging showed a giant adipose mass developed beneath the large gluteal muscle and among the fibers of the medium and small gluteal muscles. When questioned on his medical history, the patient reported a blunt trauma of the lower back 14 years earlier. He underwent surgery and histological examination confirmed a giant lipoma. Conclusion Lipomas might result from a previous trauma. It is hypothesized that the trigger mechanism is activated by cytokine and growth factors released after the trauma. We herein present an exceptional case of a giant post-traumatic lipoma which caused a painful compression on the right sciatic nerve.

  12. Treatment for Intramuscular Lipoma Frequently Confused with Sarcoma: A 6-Year Restrospective Study and Literature Review

    Directory of Open Access Journals (Sweden)

    Hyun Ho Han

    2014-01-01

    Full Text Available Introduction. Intramuscular lipoma is a very rare form of lipoma, known to be categorized as an infiltrating lipoma due to its tendencies to infiltrate the muscle or the synovium. Contrary to other subcutaneous lipomas, even after surgical removal, the rate of local recurrence ranges at a high rate from 50∼80% and differential diagnosis with liposarcoma is very difficult. Patients and Methods. A retrospective chart review was conducted for a total of 27 patients. Before performing a surgery based on the types of mass, a radiologic imaging study was performed. An intraoperative frozen biopsy was performed on every patient and the results were compared. The progress was monitored every 3 to 6 months for recurrence or struggles with rehabilitation. Results. There were 13 male and 14 female patients with an average age of 54.6. The average tumor size was 8.2 cm (1.1 cm∼31.6 cm. Excision was performed using a wide excision. All 27 individuals were initially diagnosed as intramuscular lipoma; however, 1 of the patients was rediagnosed as liposarcoma in the final checkup. The patients had an average of 3 years and 1 month of follow-up and did not suffer recurrences. Conclusion. Thus, it is essential that a frozen biopsy is performed during the surgery in order to identify its malignancy. And a wide excision like malignant tumor operation is a principle of treatment.

  13. Kock Continent Ileal Urinary Reservoirの臨床経験

    OpenAIRE

    松島, 正浩; Boyd, Stuart D.; Lieskovsky, Gary; Skinner, Donald G.

    1986-01-01

    From July 1985 through January 1986, 43 patients underwent urinary diversion that included creation of a continent reservoir from an ileal segment, according to the method described originally by Kock. An important modification included removal of a narrow strip of mesentery for 8 cm along the afferent and efferent limbs of the pouch to allow adequate ileal intussusception and fixation of the nipple valves to prevent reflux and to ensure continence. A strip of PGA mesh serves as a collar to f...

  14. Pseudomembranous colitis associated with changes in an ileal conduit.

    Science.gov (United States)

    Shortland, J R; Spencer, R C; Williams, J L

    1983-01-01

    A case of antibiotic associated pseudomembranous colitis following total cystectomy is reported, in which there was involvement of the ileal conduit. The small bowel remaining in situ was uninvolved. Bacteriological studies revealed Clostridium difficile and the toxin in both colon and ileal conduit. Relevant publications concerning pathogenesis are discussed, in relation to the unusual site described in this case. Epidemiological evidence is reviewed which suggests that isolation of patients with pseudomembranous colitis is a logical course of action. Images PMID:6619315

  15. The influence of copper concentration and source on ileal microbiota.

    Science.gov (United States)

    Pang, Y; Patterson, J A; Applegate, T J

    2009-03-01

    Copper is normally supplemented in poultry diets as a growth promotant and antimicrobial. However, there are conflicting reports about the growth benefits and little information about how Cu affects the microbiota in the intestinal tract of poultry. Therefore, in vitro and in vivo experiments were conducted with broilers to determine the effects of Cu source and supplementation on ileal microbiota. The influence of Cu on growth of lactobacilli and Escherichia coli in media inoculated with ileal contents was determined in the first study. When Cu sulfate pentahydrate was supplemented to the cultures, quadratic increases in lactobacilli to graded concentrations of Cu up to 125 mg/kg and quadratic decreases in E. coli up to 250 mg/kg of Cu were observed after 24 h of incubation at 37 degrees C. However, when tribasic Cu chloride (TBCC) was supplemented, neither linear nor quadratic responses to graded concentrations of dietary Cu were observed on number of lactobacilli or number of E. coli. The effects of Cu and Cu source on ileal microbiota and growth performance in broiler chickens were determined in the second study. Bird performance was not affected by Cu source or concentration. The bacterial culture enumeration results revealed that supplementation with 187.5 mg/kg of Cu from Cu sulfate pentahydrate and TBCC had no effect on number of ileal lactobacilli of birds. The denaturing gradient gel electrophoresis analyses of ileal microbial communities revealed that neither Cu supplementation nor source had effects on the number of bacterial species predominant in the ileal digesta or associated with the ileal mucosa. Supplementation with TBCC supplementation significantly increased the similarity coefficients of microbiota in the ileal mucosa compared with cross-products of all individuals. This suggests that TBCC may alter the intestinal microbiota, yet this shift had no effect on bird performance.

  16. Single-Access Laparoscopic Surgery for Ileal Disease

    Directory of Open Access Journals (Sweden)

    Mohamed Moftah

    2012-01-01

    Full Text Available Aim. Single-access laparoscopic surgery (SALS can be effective for benign and malignant diseases of the ileum in both the elective and urgent setting. Methods. Ten consecutive, nonselected patients with ileal disease requiring surgery over a twelve month period were included. All had a preoperative abdominopelvic computerized tomogram. Peritoneal access was achieved via a single transumbilical incision and a “surgical glove port” utilized as our preferred access device. With the pneumoperitoneum established, the relevant ileal loop was located using standard rigid instruments. For ileal resection, anastomosis, or enterotomy, the site of pathology was delivered and addressed extracorporeally. Result. The median (range age of the patients was 42.5 (22–78 years, and the median body mass index was 22 (20.2–28 kg/m2. Procedures included tru-cut biopsy of an ileal mesenteric mass, loop ileostomy and ileotomy for impacted gallstone extraction as well as ileal (=3 and ileocaecal resection (=4. Mean (range incision length was 2.5 (2–5 cm. All convalescences were uncomplicated. Conclusions. These preliminary results show that SALS is an efficient and safe modality for the surgical management of ileal disease with all the advantages of minimal access surgery and without requiring a significant increase in theatre resource or cost or incurring extra patient morbidity.

  17. [Diaphragmatic lipoma needed to distinguish from Bochdalek hernia; report of a case].

    Science.gov (United States)

    Naomi, Akira; Oyamatsu, Yoshinori; Narita, Kunio; Nakayama, Masato; Maeda, Shouki

    2014-09-01

    A 69-year-old woman had been followed up for an abnormal shadow on the left diaphragm at a nearby hospital, which showed gradual increase in size and she was referred to our hospital for treatment. Chest computed tomography(CT) showed a dome-shaped and homogeneous mass with smooth surface on the left diaphragm. CT showed 50×60 mm hypodense mass and partly interrupted diaphragm. Magnetic resonance imaging( MRI) revealed fat signal intensity on both T1 and T2 weighted image and fat suppressed T1 image. Bochdalek hernia or diaphragm lipoma was suggested and surgery was done. Yellowish round tumor on the diaphragm was resected. The omentum was easily separated from the tumor. Histopathological finding revealed the lipoma cell invading into striated muscle of diaphragm, and the tumor was diagnosed as a mature lipoma originated from diaphragm.

  18. Diagnostic problems in fine needle aspiration cytology of fat necrosis within a subcutaneous lipoma

    Directory of Open Access Journals (Sweden)

    Kavishwar Vikas

    2008-01-01

    Full Text Available Fat necrosis in subcutaneous lipomas is very unusual and has been reported only occasionally. Literature regarding fine needle aspiration cytology of such a lesion is lacking although fat necrosis is well described in the breast. We came across a case of a large subcutaneous lipoma in the anterior abdominal wall with a well encapsulated area of fat necrosis. The aspiration smears showed an unusual picture which was misinterpreted as the fragments of the hydatid cyst wall. They were actually enlarged, nonnucleate, single adipocytes showing laminations, along with calcification and paucity of inflammation. Histopathology confirmed the diagnosis of fat necrosis within the lipoma. Such lesions can be mistaken on radiology for malignancy.

  19. Determination of basal ileal endogenous losses and standardized ileal digestibility of amino acids in barley fed to growing pigs

    DEFF Research Database (Denmark)

    Spindler, Hanna Katharina; Mosenthin, Rainer; Rosenfelder, Pia

    2016-01-01

    BackgroundBasal ileal endogenous amino acid (AA) losses (IAAend) and standardized ileal digestibility (SID) values of cereal grains, such as barley, are apparently underestimated when determined according to the nitrogen (N)-free method. Regression analysis between the dietary apparent ileal...... digestible content (cAID) and total crude protein (CP) and AA can be considered as alternative approach to obtain more accurate values for IAAend and SID of AA in cereal grains.MethodsEight hulled barley genotypes were used, with barley being the only source of CP and AA in the assay diets. The diets...... to tabulated values. Moreover, these SID values were greater than those reported in literature, based on correction of apparent ileal digestibility (AID) of CP and AA for their IAAend values. Summarized, the results of the present regression analysis indicate greater IAAend in barley-based diets compared...

  20. Determination of basal ileal endogenous losses and standardized ileal digestibility of amino acids in barley fed to growing pigs

    DEFF Research Database (Denmark)

    Spindler, Hanna Katharina; Mosenthin, Rainer; Rosenfelder, Pia

    2016-01-01

    digestible content (cAID) and total crude protein (CP) and AA can be considered as alternative approach to obtain more accurate values for IAAend and SID of AA in cereal grains.MethodsEight hulled barley genotypes were used, with barley being the only source of CP and AA in the assay diets. The diets......BackgroundBasal ileal endogenous amino acid (AA) losses (IAAend) and standardized ileal digestibility (SID) values of cereal grains, such as barley, are apparently underestimated when determined according to the nitrogen (N)-free method. Regression analysis between the dietary apparent ileal...... to tabulated values. Moreover, these SID values were greater than those reported in literature, based on correction of apparent ileal digestibility (AID) of CP and AA for their IAAend values. Summarized, the results of the present regression analysis indicate greater IAAend in barley-based diets compared...

  1. Subdeltoid lipoma: a case with symptoms mimicking glenohumeral instability and subacromial impingement.

    Science.gov (United States)

    Ui, Michimasa; Ogawa, Kiyohisa

    2010-06-09

    Lipoma is the most frequently occurring benign soft tissue tumor in the shoulder and the axillary region in middle-aged and older persons, yet few such lipoma cases have been associated with clinical symptoms. A 38-year-old right-handed man presented with an enlarged feeling and a painful back-and-forth popping in his left shoulder. Although moderate tenderness of the subacromial bursa and bicipital groove existed, an obvious impingement sign was absent. Also not evidenced were signs of neurological deficits, limited range of motion, or any physical findings suggestive of instability. Magnetic resonance imaging showed a homogenous tumor in the subdeltoid that was isointense relative to the subcutaneous fat and fluid collection in the hypertrophic subacromial bursa. As the tumor was considered from the clinical and imaging findings to be attributable to all clinical symptoms, it was resected en bloc with a satisfactory result. Histopathologically, the tumor showed typical features of a simple lipoma. To our knowledge, the present case is the first of a subdeltoid intermuscular lipoma of which mechanism developing symptoms was preoperatively surmised from imaging. The symptom-mimicking shoulder instability was assumed to be produced by the back-and-forth snapping of the lipoma beneath the deltoid muscle. The mechanism for developing the subacromial impingement-like symptom was surmised to derive from the middle deltoid fibers pressuring the lipoma to push up into the subacromial space. This case is presented to emphasize the careful reading of imaging in considering the pathomechanism of the attributing symptoms. Copyright 2010, SLACK Incorporated.

  2. Complications arising from a misdiagnosed giant lipoma of the hand and palm: a case report

    Directory of Open Access Journals (Sweden)

    Pagonis Thomas

    2011-11-01

    Full Text Available Abstract Introduction Lipomas are benign tumors which may appear in almost any human organ. Their diagnosis rate in the hand region is not known. Case Presentation We present the case of a 63-year-old Greek Caucasian woman with a giant lipoma of the hand and palm which was not initially diagnosed. After repeated surgical decompression of the carpal tunnel the patient was referred with persisting symptoms of median and ulnar nerve compression and a prominent mass of her left palm and thenar eminence. Clinical examination, magnetic resonance imaging, nerve conduction study and biopsy, revealed a giant lipoma in the deep palmar space (8.0 × 4.0 × 3.75 cm, which was also infiltrating the carpal tunnel. She had already undergone two operations for carpal tunnel syndrome with no relief of her symptoms and she also ended up with a severed flexor pollicis longus tendon. Definitive treatment was performed by marginal resection of the lipoma and restoration of the flexor pollicis longus with an intercalated graft harvested from the palmaris longus. Thirty months after surgery the patient had a fully functional hand without any neurological deficit. Conclusion Not all lipomas of the wrist and hand are diagnosed. Our report tries to emphasize the hidden danger of lipomas in cases with carpal tunnel symptoms. The need for a high index of suspicion in conjunction with good clinical evaluation and the use of appropriate investigative studies is mandatory in order to avoid unnecessary operations and complications. Marginal excision of these tumors is restorative.

  3. Lipoma arborescens: caso raro de ruptura do manguito rotador associado à presença de lipoma arborescens na bursa subacromial-subdeltoidea e glenoumeral Lipoma arborescens: rare case of rotator cuff tear associated with the presence of lipoma arborescens in the subacromial-subdeltoid and glenohumeral bursa

    Directory of Open Access Journals (Sweden)

    Eduardo Benegas

    2012-01-01

    Full Text Available Lipoma arborescens é uma condição rara de moléstia intra-articular, usualmente monoarticular, caracterizada por extensa proliferação dos vilos sinoviais e hiperplasia da gordura subsinovial. O tecido sinovial é progressivamente substituído por células maduras de gordura na membrana sinovial. O presente trabalho é o relato de caso de uma condição rara de lipoma arborescens tanto intra-articular (glenoumeral como da bursa subacromial-subdeltoide além de ruptura do tendão do supraespinhoso. As apresentações clínicas, histológicas e radiográficas assim como o tratamento são discutidos no presente estudo. A apresentação do caso contempla também a avaliação radiográfica, ressonância magnética e exame patológico. Apesar do lipoma arborescens ser uma condição rara, tal hipótese deve ser considerada frente a um caso com hiperproliferação sinovial e lipossubstituição da sinovial.Lipoma arborescens is a rare intra-articular disease that is usually monoarticular and is characterized by extensive proliferation of the synovial villi and hyperplasia of the subsynovial fat. The synovial tissue is progressively replaced by mature fat cells in the synovial membrane. The present study reports a case of a rare condition of lipoma arborescens that was simultaneously intra-articular (glenohumeral joint and in the subacromial-subdeltoid bursa, in association with a torn supraspinatus tendon. The clinical, histological and radiographic presentations and treatment are discussed here. The description of this case includes radiographic and magnetic resonance evaluations and pathological examination. Although lipoma arborescens is a rare condition, it should be taken into consideration in cases presenting synovial hyperproliferation and synovial fat replacement.

  4. Neutral detergent fiber increases endogenous ileal losses but has no effect on ileal digestibility of amino acids in growing pigs.

    Science.gov (United States)

    Mariscal-Landín, Gerardo; Reis de Souza, Tércia Cesária; Bayardo Uribe, Alejandro

    2017-02-01

    Two experiments were conducted to determine the effect of neutral detergent fiber (NDF) on endogenous amino acids and protein ileal losses; and also apparent ileal digestibility (AID), and standardized ileal digestibility (SID) of amino acids and crude protein. Sixteen barrows were fed four protein-free diets containing graded NDF levels in Experiment 1. NDF was a mixture of sugarcane bagasse and corn leaves (SBCL). Twenty-four barrows were fed diets with soybean protein concentrate (SPC) or casein as protein sources and SBCL or corncobs (CC) as NDF sources in Experiment 2. In Experiment 1, a linear increase (P protein ileal losses was observed with increased NDF levels, except for arginine, histidine, methionine and proline. In Experiment 2, protein (P Protein and NDF sources significantly affected (P protein, which was higher in casein diets (92.8%) and CC diets (92.7%). NDF source had no effect (P > 0.05) on SID of amino acids. Overall, this study showed that NDF increased endogenous amino acid and protein ileal losses, but did not affect ileal digestibility of amino acids. © 2016 Japanese Society of Animal Science.

  5. Colonic intussusception in descending colon: An unusual presentation of colon lipoma.

    Science.gov (United States)

    Bagherzadeh Saba, Reza; Sadeghi, Amir; Rad, Neda; Safari, Mohammad Taghi; Barzegar, Farnoush

    2016-12-01

    Lipomas of the colon are relatively rare benign soft tissue tumors derived from mature adipocytes of mesenchymatic origin. During colonoscopy, surgery or autopsy they are generally discovered incidentally. Most cases are asymptomatic, with a small tumor size, and do not need any special treatment. However, in the cases with larger in size of tumor some symptoms such as anemia, abdominal pain, constipation, diarrhea, bleeding, or intussusception may be presented. We reported a 47-year-old woman with colonic intussusception in the descending colon caused by colonic lipoma and diagnosed after surgical exploration for obstructive colonic mass.

  6. Lipoma arborescens associated with osseous/chondroid differentiation in subdeltoid bursa.

    Science.gov (United States)

    Kim, Ryuh Sup; Kim, Young Tae; Choi, Jong Min; Shin, Sang Hyun; Kim, Yeo Ju; Kim, Lucia

    2013-07-01

    Lipoma arborescens (LA) is a rare benign lesion of unknown etiology. It is characterized histologically by villous proliferation of the synovial membrane and diffuse replacement of the subsynovial tissue by mature fat cells. This condition affects the knee joint most commonly. Cases involving other locations including glenohumeral joint,[1] hip,[2] elbow,[3] hand[4] and ankle[5] have been rarely described. Involvement of the subdeltoid bursa has also been reported, but to date no case has described LA with osseous/chondroid differentiation of this bursa. Another significant finding in our case was the coexistence of LA with intermuscular lipoma, SLAP lesion and labral cyst.

  7. [Development of lipoma following a single cupping massage - a case report].

    Science.gov (United States)

    Schumann, Stefan; Lauche, Romy; Hohmann, Claudia; Zirbes, Thomas; Dobos, Gustav; Saha, Felix Joyonto

    2012-01-01

    The cupping massage is a form of bloodless cupping. This type of cupping is particularly used to treat muscular tension and musculoskeletal pain, such as chronic neck pain; however the data records on mechanisms and potential side effects are not satisfactory. In a study on the effectiveness of cupping massage in patients with chronic neck pain, one patient showed a formation of a lipoma in the cupping area after the first treatment session. Because of the short time interval between therapy and development of the lipoma, a primary cause is not realistic. This adverse event has not been described in the literature before, and the present report describes the case in summary.

  8. Endoscopic resection of large colonic lipomas assisted by a prototype single-use endoloop device

    Directory of Open Access Journals (Sweden)

    Ahmad Khosravi Khorashad

    2011-01-01

    Full Text Available Colonic lipomas are benign adipose tumors that do not usually cause symptoms. Giant colonic lipoma (GCL is an uncommon finding at endoscopy which may lead to iron deficiency anemia (IDA with or without macroscopic ulceration. The choice of therapeutic procedure to treat symptomatic GCLs has been controversial. A case of GCL presented with occult bleeding and IDA is reported in this article. IDA resolved following the successful removal of the GCL by a combination of endoloop ligation and snare cautery technique.

  9. [Obscure digestive bleeding by ileal carcinoid tumor].

    Science.gov (United States)

    Nelly Manrique, María; Frisancho, Oscar; Zumaeta, Eduardo; Palomino, Américo; Rodriguez, César

    2011-01-01

    The patient is an 82 year-old female with a history of osteoarthritis, hypothyroidism and anemia for 14 years (receiving blood transfusions). She was admited to our hospital with a nine months history of malaise, anorexia, fatigue and weakness, associated with intermitten episodes of abdominal pain. She was diagnosed anemia and occult blood positive stools. Physical examination revealed a patient in generally fair condition, obese, with mild edema of lower limbs, no changes in the evaluation of chest, cardiovascular, abdomen, etc. Laboratory data was unremarkable, except for iron deficiency anemia. The upper endoscopy showed duodenal ulcer scar, fundic polyposis and chronic gastritis. Colonoscopy revealed some diverticula, a small sessile polyp and internal hemorrhoids. The diagnosis of obscure gastrointestinal bleeding was made. The CT scan of the abdomen showed gallstones and fatty liver; a radiograph of intestinal transit detected a lesion apparently protruded intestinal loop for distal jejunum; enteroscopy was performed (with one team ball) anterograde and retrograde achieving assess distal jejunum and distal ileum without observing any injuries. The study of capsule endoscopy showed a polypoid tumor intestinal with evidence of having bleeding. Surgery detected the tumor in proximal ileum. The surgical specimen findings showed three tumors 0.7 mm, 10 mm and 15 mm on the proximal ileum. The microscopic examination revealed that these lesions were neuroendocrine tumors (carcinoid). The Ileal carcinoid tumor may rarely presented with obscure gastrointestinal bleeding.

  10. Evidence for validity of ileal digestibility coefficients in monogastrics.

    Science.gov (United States)

    Columbus, Daniel; de Lange, Cornelis F M

    2012-08-01

    Measures of amino acid (AA) digestibility are used widely to estimate bioavailability of AA in feed and food ingredients for monogastric animals. In principle, the digestibility assay is simpler than in vivo assessments of AA bioavailability and allows for simultaneous estimation of the bioavailability of all AA in an experimental diet. It is generally assumed that absorption of intact AA in the hindgut of monogastrics is minimal, even though colonocytes do contain AA transporters and have been shown to absorb AA. This assumption is supported by the observation that infusion of AA into the hindgut does not improve nitrogen balance in monogastrics. In addition, growth performance of monogastrics is more highly correlated with ileal than faecal AA digestibility. Therefore, ileal digestibility coefficients provide better estimates of AA bioavailability than faecal digestibility coefficients. Measures of apparent ileal digestibility (AID) of AA are confounded with endogenous gut AA losses (EAAL). The curvilinear increase in AID of AA with increasing dietary AA level has been attributed to the relatively large contribution of EAAL to total ileal AA flows at low dietary AA levels. Subtracting basal EAAL from total ileal AA flows yields standardized ileal digestibility (SID) coefficients that appear to be more additive than AID coefficients in mixtures of feed ingredients. An implicit assumption when using SID AA coefficients in diet formulation is that the post-absorptive utilization of AA is not influenced by the dietary protein source. This assumption appears inappropriate when using feed or food ingredients that have been over-heated, induce large amounts of EAAL, or contain substantial amounts of fermentable fibre. Improved understanding of processes that contribute to the discrepancy between bioavailability and ileal digestibility will allow a more effective use of AA digestibility coefficients in diet formulation.

  11. Radiculopathy in the setting of lumbar nerve root compression due to an extradural intraforaminal lipoma: a report of 3 cases.

    Science.gov (United States)

    Loriaux, Daniel B; Adogwa, Owoicho; Gottfried, Oren N

    2015-07-01

    A true adult spinal lipoma is an exceedingly rare cause of lumbar compression neuropathy. Only 5 cases of true extradural intraforaminal lipomas have been documented in the medical literature. The diagnostic criteria and treatment guidelines for this specific lipoma have yet to be established. This report features 3 histologically confirmed cases of extradural intraforaminal spinal lipomas that recently presented to the authors' practice. In addition, the literature was surveyed to include the 5 previously reported cases of true adult extradural intraforaminal spinal lipomas. The consistency in presentation, response to surgical intervention, and postoperative recovery in these 8 cases supports surgical intervention at the time of diagnosis. The authors' findings support elevated clinical suspicion, efficient diagnosis based on MRI, and early surgical intervention for this rare pathological entity. All cases presented in this report were symptomatic and occurred in the absence of other significant pathologies such as general spinal epidural lipomatosis, intradural lesions, tethering, or severe degenerative stenosis or herniated discs. The clinical, neuroradiological, and histological findings characteristic of a true adult extradural intraforaminal lipoma are emphasized to differentiate this lesion from the more common etiologies for lumbar compression neuropathy. Heightened awareness and clinical suspicion for the focal, foraminal spinal lipoma as a cause of radiculopathy symptoms will enable more efficient diagnosis and treatment.

  12. The value of fat-suppressed T2 or STIR sequences in distinguishing lipoma from well-differentiated liposarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Galant, J. [Servicio de Radiodiagnostico, Hospital Universitario San Juan de Alicante, Ctra. Nacional 332 Alicante-Valencia s/n, 03550 San Juan de Alicante (Spain); Resonancia Magnetica del Sureste, Murcia (Spain); Marti-Bonmati, L. [Department of Radiology, Hospital Universitario Dr. Peset, Valencia (Spain); Saez, F. [Department of Radiology, Hospital Cruces de Baracaldo, Vizcaya (Spain); Soler, R. [Department of Radiology, Hospital Juan Canalejo, A Coruna (Spain); Alcala-Santaella, R. [Department of Traumatology, Hospital Universitario San Juan de Alicante, Ctra. Nacional 332 Alicante-Valencia s/n, 03550 San Juan de Alicante (Spain); Navarro, M. [Servicio de Radiodiagnostico, Hospital Universitario San Juan de Alicante, Ctra. Nacional 332 Alicante-Valencia s/n, 03550 San Juan de Alicante (Spain)

    2003-02-01

    The objective of this study was to evaluate the diagnostic value of fat-suppressed T2-weighted (FS-T2) images or short tau inversion recovery (STIR) imaging in distinguishing lipoma from lipoma-like subtype of well-differentiated liposarcoma. Spin-echo T1-weighted and STIR or fat-suppression T2-weighted sequences were performed in 60 lipomas and 32 lipoma-like well-differentiated liposarcomas, histologically proven, looking for thick septa or nodules in T1-weighted images and linear, nodular, or amorphous hyperintensities on FS-T2/STIR sequences. Fourteen lipomas (23.3%) showed thick septa and/or nodules on T1, whereas on FS-T2 or STIR sequences only seven (11.7%) displayed hyperintense nodules and/or septa. All well-differentiated liposarcomas contained these signs on FS-T2 or STIR sequences. The presence of hyperintense septa or nodules in a predominantly lipomatous tumor on FS-T2/STIR sequences helps to differentiate malignant tumors from lipomas. Employing the presence of hyperintense nodules and/or septa as criteria of malignancy specificity was 76.6% and sensitivity 100%. Overdiagnoses of well-differentiated liposarcoma can occur due to the presence of non-lipomatous areas within lipomas. (orig.)

  13. Digestibilidade ileal aparente e verdadeira de aminoácidos de farinhas de carne e ossos para suínos Apparent and true ileal digestibility of meat and bone meals amino acids for swine

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Pozza

    2004-10-01

    Full Text Available O experimento foi conduzido com o objetivo de determinar a digestibilidade ileal aparente e verdadeira dos aminoácidos de seis diferentes farinhas de carne e ossos. Foram utilizados 12 suínos mestiços, machos castrados, com peso médio inicial de 52,5 ± 5,1 kg. Os animais foram previamente submetidos à cirurgia para implantação de cânula "T" simples no íleo terminal, e, após 20 dias de recuperação, foram distribuídos em um delineamento experimental de blocos ao acaso, com seis tratamentos, quatro repetições e um animal por unidade experimental. Ao término das duas primeiras repetições, os tratamentos foram redistribuídos para evitar que o mesmo animal recebesse a mesma dieta em duas repetições consecutivas. Os tratamentos consistiram de uma dieta isenta de proteína à base de açúcar, amido, óleo e casca de arroz, tendo como única fonte protéica as farinhas de carne e ossos. Os coeficientes de digestibilidade ileal aparente da lisina, treonina e metionina, das diferentes farinhas de carne e ossos variaram de 54,87 a 74,80; 62,62 a 81,19 e 72,35 a 85,46%, respectivamente, e a variação entre os coeficientes de digestibilidade ileal verdadeira foram de 57,00 a 76,08; 66,26 a 83,07 e 73,76 a 86,39%, respectivamente, para a lisina, treonina e metionina. As farinhas de carne e ossos apresentaram grande variação, em função das diferentes amostras, quanto aos coeficientes de digestibilidade ileal aparentes e verdadeiros dos aminoácidos.The experiment was carried out to determine the apparent and true ileal digestibility of amino acids from six different meat and bone meals. Twelvecrossbred swines, castrated males, averaging 52.5 ± 5.1 kg initial weight, were used. The animals were previously submitted to the simple T canula surgery implantation at the terminal ileum and, after twenty days of recovery period, they were allotted to a randomized blocks design, with six treatments, four replicates and one animal per

  14. A ‘giant’ intraluminal lipoma presenting with intussusception in an adult: a case report

    Directory of Open Access Journals (Sweden)

    Ongom Peter A

    2012-10-01

    Full Text Available Abstract Introduction Intussusception is an uncommon cause of intestinal obstruction in adults. It usually presents with typical features of intestinal obstruction, and is associated with the presence of a ‘lead point’ for the invaginated portion. This ‘lead point’ is rarely an intraluminal, submucosal lipoma. Case presentation We describe the case of a 64-year-old African-Ugandan woman of Bantu ethnicity who presented with features of intestinal obstruction secondary to intussusception. She was treated operatively. A left colocolonic invagination was found with the interssusceptum having a giant polyp. A left hemicolectomy was performed. A histopathological examination revealed a polypoid, submucosal lipoma. Conclusions In resource-rich countries, most cases of colonic intraluminal polyps are detected through colonoscopy during routine medical check-ups. With limited resources in our region, many tumors present as intestinal obstructions secondary to intussusception. Even then, most are associated with adenomas and malignancies. Rarely are polypoid, submucosal lipomas found. In our patient’s case a polyp of 9.5cm at its widest dimension is of particular interest. A lesson to learn is that the differential diagnosis for intussusceptions in resource-poor countries should be broadened to include submucosal lipomas.

  15. Lumbosacral lipoma investigated by conventional radiography, ultrasound and direct coronal mode CT-scanning.

    Science.gov (United States)

    Hageman, G; Veiga-Pires, J A; de Graaff, R; vd Beek, R; Probst, F; Ramos, L

    1982-06-01

    The authors describe a case of lipoma of the lumbosacral region, associated with meningocele in an infant and advocate the utilization of CT scanning in direct coronal mode (DCM) and ultrasound (US) as means of diagnosis of the extension and geography of the lesion and differential diagnosis. The surgical management is also indicated.

  16. Intra-articular lipoma with osteochondroid metaplasia in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, F.Y.I. [Dept. of Orthopaedic Surgery, College of Physicians and Surgeons of Columbia University, New York, NY (United States); Orthopaedic Oncology Unit and Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Keel, S.B. [Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Gebhardt, M.C. [Orthopaedic Oncology Unit and Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Rosenthal, D.I. [Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2001-04-01

    We describe a case of lipoma with osteochondroid metaplasia in the knee joint. Although the location of the lesion and radiographic findings were unusual, computed tomography and magnetic resonance imaging were useful in characterizing adipose, cartilaginous and osseous tissue components within the lesion. (orig.)

  17. Lipoma arborescens of the knee: a rare tumour in a black woman. A ...

    African Journals Online (AJOL)

    It weighed 520g and histology showed clusters of adipocytes with abundant pale cytoplasm as well as clusters of collagen fibres with elongated nuclei and bipolar cytoplasmic processes consistent with lipoma arborescens (LA). There is no recurrence at three years of regular follow-up. On the sheer size of this rare lesion, ...

  18. Frontonasal Dysplasia with Lipoma of the Corpus Callosum in a 6 ...

    African Journals Online (AJOL)

    Lipoma of the corpus callosum is a rare slow growing benign lesion that rarely gives any symptoms, Hence, the diagnosis is most often incidental during radiological work up on imaging modalities such as. computed tomography (CT) and magnetic resonance imaging (MRI). It hardly requires surgery. However rarely ...

  19. Anatomic and functional characteristics of the rat ileal pouch.

    Science.gov (United States)

    Chen, Chiung-Nien; McVay, Laila D; Batlivala, Zubin S; Hendren, Samantha K; Swain, Gary P; Salzman, Nita; Williams, Noel N; Rombeau, John L

    2002-04-01

    The definitive operation for chronic ulcerative colitis (UC) and familial adenomatous polyposis is total proctocolectomy with ileal pouch-anal anastomosis (IPAA). Mild inflammation (pouchitis) is omnipresent in pouches and becomes severe in 50% of UC patients with IPAA. The etiology of pouchitis is likely due to combined genetic, microbial, and immunologic factors. Epithelial cell exposure to surgical trauma and/or to changes in intestinal bacterial composition may account for the inflammatory infiltrate. Progress in understanding pouchitis is restricted by the lack of suitable animal models. An ileal pouch-rectal anastomosis [IPRA] in rats was developed to reproduce a model of human IPAA and clinical, gross and histologic criteria were determined. Many shared features with human ileal pouch were observed. IPRA is an important in vivo model to study mechanisms of repair, defense and immunity that may contribute to pouchitis.

  20. The importance of early diagnosis of large lipomas in the maxillofacial region

    Directory of Open Access Journals (Sweden)

    Matheus Furtado de Carvalho

    2011-03-01

    Full Text Available El lipoma es un tumor benigno compuesto por la proliferación de células adiposas maduras entremezcladas con el tejido conectivo fibroso, los vasos sanguíneos y/o músculos, delimitado por una fina cápsula. Aunque representa un neoplasma del mesénquima muy común del cuerpo humano, tiene raras ocurrencias en la cavidad bucal. Presenta variables clínicas e histopatológicas que no alteran su pronóstico. La patogénesis sigue siendo incierta aunque algunos autores consideran que los trastornos hereditarios y endocrinos son causas posibles. Ocurre con una mayor prevalencia en las personas obesas, aunque su metabolismo es totalmente independiente del metabolismo normal de los lípidos corporales. El diagnóstico clínico del lipoma bucal está relacionado con una masa nodular, blanda, asintomática, de superficie plana, sin ulceración y de crecimiento limitado. El continuo crecimiento de la lesión pudiera crear dificultad al masticar, al hablar, en la adaptación dental y cambio en la estética facial del paciente requiriendo la escisión de la lesión. Presentar una revisión de la literatura y de los casos clínicos de un estudio retrospectivo de 61 casos de lipomas diagnosticados en el servicio de patología entre 1978 y 2009 entre los 10 573 informes hechos durante ese mismo período. Se enfatizan los casos especiales de lipomas grandes de la región maxilofacial y la importancia del diagnóstico temprano de estas lesiones. Un cirujano dental debe ser capaz de diagnosticar los lipomas en una etapa temprana en el área maxilofacial para evitar un crecimiento masivo de estas lesiones.

  1. [Biliary endoprosthesis causing ileal perforation--a case report].

    Science.gov (United States)

    Kosiński, Robert; Olędzki, Szymon; Modrzejewski, Andrzej

    2015-10-01

    We experienced ileal perforation caused by dislocated biliary endoprosthesis in 59 years old female patient. The endoprosthesis was implanted due to biliary fistula after laparoscopic cholecystectomy 2 years before the perforation. It seems that endoprosthesis dislocation and the perforation were the result of too long stay of endoprosthesis. After the surgical management and the removal of the prosthesis patient was cured. Although ileal perforation caused by dislocated biliary endoprosthesis is rare, clinicians should be aware of the possibility of its occurrence. © 2015 MEDPRESS.

  2. Sexual Function after Non-Nerve-Sparing Radical Cystoprostatectomy: A Comparison between Ileal Conduit Urinary Diversion and Orthotopic Ileal Neobladder Substitution

    Directory of Open Access Journals (Sweden)

    M.A Asgari

    2013-07-01

    Full Text Available Objective To compare the erectile function (EF and sexual desire (SD in men after radical cystoprostatectomy (RCP who had either an ileal conduit urinary diversion or orthotropic ileal neobladder substitution. Materials and Methods Eighty one sexually active men with bladder cancer were enrolled in this prospective study. After RCP according to patients' preferences they underwent either ileal conduit urinary diversion (n = 41 or orthotropic ileal neobladder substitution (n = 40. EF and SD were assessed using International Index of Erectile Function (IIEF questionnaire. Patients were assessed at 4-week before surgery and were followed up at 1, 6, and 12-month postoperatively using the same questionnaire. Results Postoperatively the EF and SD domains deteriorated significantly in both groups, but in a small proportion of the patients submitted to ileal neobladder they gradually improved with time (P = 0.006. At 12-month postoperative period, 4 (9.8% and 14 (35.0% patients in ileal conduit and ileal neobladder groups were able to achieve erections hard enough for vaginal penetration and maintained their erection to completion of intercourse, respectively (P = 0.006. Among patients in the ileal conduit and ileal neobladder groups, additional 4 (9.8% and 7 (17.1% patients were able to get some erection, but were unable to maintain their erection to completion of intercourse (P = 0.02. At 12-month follow up period 24.4% of the ileal conduit and 45.0% of the ileal neobladder patients rated their sexual desire very high or high (P = 0.01. Conclusion When performed properly, orthotopic ileal neobladder substitution after RCP offers better long-term results in terms of EF and SD.

  3. Surgical technique of the transoral approach to remove a lipoma of the buccal fat pad.

    Science.gov (United States)

    Brucoli, Matteo; Arcuri, Francesco; Borello, Giovanni; Benech, Arnaldo

    2011-11-01

    In 1727, Heister (Compendium anatomicum. Altdorf, Guill, Koleshii: editio tertia 1727: 134, table VIII and figs. 36-37) described the buccal fat pad (BFP) as an independent anatomic structure of the face; in 1801, Bichat (Anatomie generale appliquee a la physiologie et a la medecine. Paris, France: Brosson, Gabon et Cie Libraires, 1801:60) reported his fatty histologic finding. According to the literature, several pathologic tumorous conditions can arise from BFP, such as lipoma, lipoblastomatosis, liposarcoma, hemangioma, arteriovenous malformation, and nodular fasciitis; all of which are rare. After a revision of the English literature performed through PubMed between 1948 and 2008, we found 10 cases of lipomas arising from the BFP (7 cases are simple subtype, 2 are spindle cell lipoma, and 1 is fibrolipoma). The aims of this study were to introduce our clinical report of this rare pathologic entity, describe the surgical technique of the transoral approach, and discuss the potential pitfalls regarding the preoperative diagnosis and the close interrelation among the BFP, the facial buccal branches (FBBs), and the parotid duct (PD). A 43-year-old man was referred to the Maxillofacial Unit of the Novara Major Hospital with a 6-month history of a painless swelling in the right cheek. Clinical examination revealed a clearly visible, tender, slightly fluctuant mass, situated anterior to the masseter muscle and extended to the submandibular region. The patient underwent an ultrasound, a computed tomography, and a magnetic resonance imaging. Under general anesthesia with nasotracheal intubation, the patient underwent intraoral resection of BFP lipoma. The 2 major areas of discussion are the potential pitfall regarding the preoperative diagnosis and the close anatomic interrelation among the BFP, the FBB, and the PD. First, the spindle cell lipoma, one of the most common BFP lipoma variant, can be histologically and clinically similar to a well-differentiated liposarcoma

  4. Morbidity following Ileal Conduit Urinary Diversion in a Welsh ...

    African Journals Online (AJOL)

    In view of the high complication rate, especially in patients with a long life expectancy and benign conditions, objective guidelines regarding the choice of urinary diversion will help surgeons in decision making, patient selection and counseling. Keywords: Ileal conduit diversion, complications, urinary diversion, morbidity, ...

  5. Typhoid ileal perforation in children in Benin city | Osifo | African ...

    African Journals Online (AJOL)

    Background: Typhoid ileal perforation is a common complication of typhoid fever, a multi-systemic infection, which is endemic in many developing countries. Objective: This study reviews and compares the incidence, morbidity and mortality at the University of Benin Teaching Hospital with other referral centres located in ...

  6. Typhoid Ileal Perforation: A Review of a Rural District Hospital ...

    African Journals Online (AJOL)

    Background: Enteric fever is endemic in developing countries and frequently complicates with ileal perforation. Surgical intervention for the perforation is the usual treatment but attendant rate of postoperative complications high. It is unclear what the spec- trum of enteric fever perforations is in rural hospital practice in Kenya ...

  7. Original Article Morbidity following Ileal Conduit Urinary Diversion in ...

    African Journals Online (AJOL)

    2008-04-11

    Apr 11, 2008 ... *true post—surgical deterioration of renal function. PATIENTS AND METHODS. Out of 92 patients subjected to ileal ... incontinence in 19 (22.6%), interstitial cystitis in 8 (9.5%) and other benign conditions in 3 .... renal stones in 6 and stones in the kidney and ureter in one patient. One of these patients.

  8. Intraosseous Lipoma of the Maxilla in a Patient with Henoch-Schönlein Purpura: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Soysal Baş

    2017-12-01

    Full Text Available Intraosseous lipomas are rare benign tumors of the bone that are mostly seen in the metaphysis of long bones and the calcaneus. Intraosseous lipomas are generally asymptomatic, and surgically removed when they are symptomatic or cause cosmetic concerns. Intraosseous lipomas of the maxillary bone have rarely been reported. In this report, we present a case of maxillary intraosseous lipoma in an 11-year-old girl with Henoch-Schönlein purpura-a rare case reported for the first time in the literature.

  9. Increasing digesta viscosity using carboxymethylcellulose in weaned piglets stimulates ileal goblet cell numbers and maturation.

    Science.gov (United States)

    Piel, Christelle; Montagne, Lucile; Sève, Bernard; Lallès, Jean-Paul

    2005-01-01

    Intestinal mucin, a family of glycoproteins secreted by goblet cells, is the main constituent of the mucus protecting the gastrointestinal tract. For optimal mucosal protection, both the quantitative and qualitative characteristics of mucin are essential. To evaluate how viscosity influences ileal apparent digestibility and mucin biology, a highly viscous nonfermentable soluble polysaccharide, carboxymethylcellulose (CMC), was fed to weaned piglets for 15 d. The ileal crude mucin concentration was determined by ethanol precipitation, and changes in goblet cell subtypes were analyzed by the histochemistry of ileal and colonic tissues. As expected, CMC increased the viscosity of ileal digesta and the moisture of feces (P digestibility of dry matter, organic matter, nitrogen, and minerals. The number of total ileal goblet cells per villus also was higher (+30%, P piglets fed CMC increased the ileal mucin output and numbers and maturation of goblet cells in ileal villi without effects on the apparent digestibility of the diet.

  10. Artemisia supplementation differentially affects the mucosal and luminal ileal microbiota of diet-induced obese mice.

    Science.gov (United States)

    Wicks, Shawna; Taylor, Christopher M; Luo, Meng; Blanchard, Eugene; Ribnicky, David M; Cefalu, William T; Mynatt, Randall L; Welsh, David A

    2014-01-01

    The gut microbiome has been implicated in obesity and metabolic syndrome; however, most studies have focused on fecal or colonic samples. Several species of Artemisia have been reported to ameliorate insulin signaling both in vitro and in vivo. The aim of this study was to characterize the mucosal and luminal bacterial populations in the terminal ileum with or without supplementation with Artemisia extracts. Following 4 wk of supplementation with different Artemisia extracts (PMI 5011, Santa or Scopa), diet-induced obese mice were sacrificed and luminal and mucosal samples of terminal ileum were used to evaluate microbial community composition by pyrosequencing of 16 S rDNA hypervariable regions. Significant differences in community structure and membership were observed between luminal and mucosal samples, irrespective of diet group. All Artemisia extracts increased the Bacteroidetes to Firmicutes ratio in mucosal samples. This effect was not observed in the luminal compartment. There was high interindividual variability in the phylogenetic assessments of the ileal microbiota, limiting the statistical power of this pilot investigation. Marked differences in bacterial communities exist depending on the biogeographic compartment in the terminal ileum. Future studies testing the effects of Artemisia or other botanical supplements require larger sample sizes for adequate statistical power. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Sleep and quality of life in people with ileal conduit.

    Science.gov (United States)

    Cavdar, Ikbal; Temiz, Zeynep; Ozbas, Ayfer; Can, Gulbeyaz; Tarhan, Fatih; Findik, Ummu Yildiz; Kutlu, Fatma Yasemin; Akyuz, Nuray

    2016-12-01

    The aim of this study was to determine the sleep quality and the association between sleep quality and quality of life in people with ileal conduit. A descriptive and cross-sectional design was adopted. The study sample comprised 111 people with ileal conduit operated on in urology clinics in a state hospital between January 2011 and May 2014. Six months after the operation, they were called by telephone to participate in the study. Data for the study were collected using a questionnaire form, the Pittsburgh Sleep Quality Index (PSQI) and the Stoma Quality of Life Scale (SQLS). The mean ± SD total PSQI score of the people with ileal conduit was 10.20 ± 2.95, mean total score of SQLS was 43.63 ± 7.21, mean Work/Social Function domain score was 37.27 ± 5.80 and mean Stoma Function domain score was 50.0 ± 12.56. The total sleep quality had a low degree of negative correlation with total SQLS score, a medium degree of negative correlation with Work/Social Function (r = -0.327, p  .001). People using a night drainage system had higher sleep quality. This study determined that quality of life and sleep deteriorate in people with ileal conduit. The quality of life decreases when the sleep quality is poor, and decreased quality of life affects quality of sleep in people with ileal conduit.

  12. Lipoma del cuerpo calloso con crisis convulsiva que ocasiona broncoaspiración alimentaria mortal Lipoma of the corpus callosum with seizure which causes fatal alimentary aspiration

    OpenAIRE

    J. Lucena; E. Barrero; M. Salguero; A. Rico; M. Blanco; R. Marín; F. Heredia; F.F. Cruz-Sánchez

    2004-01-01

    Los lipomas del cuerpo calloso representan hasta el 5% de las malformaciones, tumorales o no, del cuerpo calloso. Actualmente son considerados malformaciones congénitas en lugar de verdaderas neoplasias. La mayoría son sintomáticos, pero algunos se asocian a síntomas neurológicos inespecíficos como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se expone el caso de un varón de 42 años que fallece por broncoaspiración alimentaria secundaria a crisis convulsiva. El estudio neuropa...

  13. Lipoma de la mano, clínica y quirúrgicamente un tumor menospreciado Hand lipoma, surgical and clinically an understimated tumor

    Directory of Open Access Journals (Sweden)

    C. Morales

    2011-12-01

    Full Text Available Los lipomas suponen el 16 % de los tumores de tejidos blandos que se originan en la mano. Tienen una presentación clínica particular debido a la complejidad anatomofuncional de la zona. Analizamos 14 pacientes con diagnóstico clínico de lipoma en mano, 64.3 % de ellos de sexo femenino, con edad promedio de 44.1 años. La localización fue: en la vaina flexora digital 33.3 %, medio palmar (musculatura tenar principalmente 40 %, muñeca dorsal (incluido interóseo 20 % y antebraquial 6.7 %. La disminución de la función de la mano y/o de la muñeca fue la principal sintomatología de los pacientes (66.7 %. Las alteraciones funcionales producidas incluyeron: dedo en gatillo, alteraciones de la flexión y de la pinza, seguidos de dolor en 26.7 % y alteraciones de la sensibilidad en 26.7 %. Síndrome de túnel del carpo en 20 %. En 26.7 % la queja fue cosmética. La escisión resolvió la sintomatología en todos los casos. El seguimiento promedio fue de 15.8 meses, sin ningún caso de recurrencia y solamente se presentó una complicación menor. El estudio por imagen solo fue necesario en 1 caso de esta serie; la certeza mediante diagnóstico clínico fue del 93 %.Lipomas account for the 16 % of all the soft tissue hand tumors. Their clinical presentation is particular, due to the anatomical and functional complexity of the hand. We analyze 14 patients with the clinical diagnosis of hand lipoma, 64.3 % female, with medium age 44.1 years old. The localization was: digital flexor sheath 33.3 %, midpalmar (thenar muscles mainly 40 %, dorsal wrist (including interosseus muscle 20 % and antebrachial 6.7 %. The decrease in hand or wrist function was the main symptom (66.7 %. The functional impairments include: trigger finger, flexion and grip impairment, followed by pain, sensitivity alterations and cosmesis in 26.7 %. The carpal tunnel syndrome presented in 20 %. The surgical excision solved the symptoms in all cases. The mean follow-up was 15

  14. Hemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral re fl ux.

    Science.gov (United States)

    Fujimura, Tetsuya; Minowada, Shigeru; Kishi, Hiroichi; Hamasaki, Kimihisa; Saito, Kiyoshi; Kitamura, Tadaichi

    2005-10-01

    A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral reflux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral reflux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection.

  15. Fermentable non-starch polysaccharides increases the abundance of Bacteroides-Prevotella-Porphyromonas in ileal microbial community of growing pigs.

    Science.gov (United States)

    Ivarsson, E; Roos, S; Liu, H Y; Lindberg, J E

    2014-11-01

    Most plant-origin fiber sources used in pig production contains a mixture of soluble and insoluble non-starch polysaccharides (NSP). The knowledge about effects of these sources of NSP on the gut microbiota and its fermentation products is still scarce. The aim of this study was to investigate effects of feeding diets with native sources of NSP on the ileal and fecal microbial composition and the dietary impact on the concentration of short-chain fatty acids (SCFA) and lactic acid. The experiment comprised four diets and four periods in a change-over design with seven post valve t-cecum cannulated growing pigs. The four diets were balanced to be similar in NSP content and included one of four fiber sources, two diets were rich in pectins, through inclusion of chicory forage (CFO) and sugar beet pulp, and two were rich in arabinoxylan, through inclusion of wheat bran (WB) and grass meal. The gut microbial composition was assessed with terminal restriction fragment (TRF) length polymorphism and the abundance of Lactobacillus spp., Enterobacteriaceae, Bacteroides-Prevotella-Porphyromonas and the β-xylosidase gene, xynB, were assessed with quantitative PCR. The gut microbiota did not cluster based on NSP structure (arabinoxylan or pectin) rather, the effect was to a high degree ingredient specific. In pigs fed diet CFO, three TRFs related to Prevotellaceae together consisted of more than 25% of the fecal microbiota, which is about 3 to 23 times higher (P<0.05) than in pigs fed the other diets. Whereas pigs fed diet WB had about 2 to 22 times higher abundance (P<0.05) of Megasphaera elsdenii in feces and about six times higher abundance (P<0.05) of Lactobacillus reuteri in ileal digesta than pigs fed the other diets. The total amount of digested NSP (r=0.57; P=0.002), xylose (r=0.53; P=0.004) and dietary fiber (r=0.60; P=0.001) in ileal digesta were positively correlated with an increased abundance of Bacteroides-Prevotella-Porphyromonas. The effect on SCFA was

  16. Intracranial lipomas (lipomatous hamartomas): Clinical and computerized tomographic findings in 9 cases

    Energy Technology Data Exchange (ETDEWEB)

    Riffel, B.; Thron, A.

    1981-11-01

    By computed tomography intracranial lipomas can be detected in nearly 0.1% of the cases, including very small lesions. The tumorlike malformation should be classified as a hamartoma, e.g. as a maldifferentiation of primarily non-neoplastic tissue. The preferential location is the midline region; a pathogenetic relation to dysraphic disorders is possible. 7 of the 9 cases presented have a lipomatous hamartoma of the corpus callosum or show involvement of this region; in 5 cases additional lipomatous nodules of the ventricular chorioid plexus could be demonstrated uni- or bilaterally. In agreement with the literature, epilepsy and mental disturbances are frequent also in our cases of lipoma of the corpus callosum. A callosal disconnection syndrome could not be demonstrated in the two patients thoroughly examined. Clinical and CT-findings are discussed with regard to pathogenesis and pathological significance of this complex malformation.

  17. Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

    Science.gov (United States)

    Galvez, Carlos; Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

    2016-08-01

    Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy.

  18. Lipoma Arborescens: Review of an Uncommon Cause for Swelling of the Knee

    Directory of Open Access Journals (Sweden)

    M. De Vleeschhouwer

    2016-01-01

    Full Text Available Lipoma arborescens is a rare cause of chronic monoarticular arthritis, with only a few cases reported in the literature. It is most commonly seen in the knee, but cases in other joints such as the wrist, shoulder, and elbow have also been described. It is a benign condition, in which the subsynovial tissue is replaced diffusely by mature fat cells. We describe a case involving the knee and discuss the symptoms, diagnosis, and treatment.

  19. Multifocal Dysembryoplastic Neuroepithelial Tumour with Intradural Spinal Cord Lipomas: Report of a Case

    Directory of Open Access Journals (Sweden)

    Richard D. White

    2011-01-01

    Full Text Available We report a case of temporal lobe epilepsy and incomplete Brown-Sequard syndrome of the thoracic cord. Computed tomography and magnetic resonance (MR imaging showed multiple supratentorial masses with the classical radiological appearances of multifocal dysembryoplastic neuroepithelial tumour (DNET. Spinal MR imaging revealed intradural lipomas, not previously reported in association with multifocal DNET. Presentation and imaging findings are discussed along with classification and natural history of the tumour.

  20. The Use of Radiation Therapy in the Management of Selected Patients with Atypical Lipomas

    Directory of Open Access Journals (Sweden)

    Josephine Kang

    2013-01-01

    Full Text Available Background and Objectives. Atypical lipomas are uncommon, slow-growing benign tumors. While surgery has been the primary treatment modality, we have managed some patients with radiation (RT as a component of the treatment and have reported their outcomes in this study. Methods. A retrospective review of all cases of extremity and trunk atypical lipomas in The Sarcoma Database at the study institution was conducted. Results. Thirteen patients were identified. All patients underwent surgical resection at initial presentation and received pre- or postoperative radiation for subtotal resection (n=2, local recurrence (n=8, or progressive disease (n=3. The median total radiation dose was 50 Gy. Median followup was 65.1 months. All patients treated with RT remained free of disease at the last followup. No grade 3 or higher late toxicity from radiation was observed. No cases of tumor dedifferentiation occurred. Conclusion. For recurrent or residual atypical lipomas, a combination of reexcision and RT can provide long-term local control with acceptable morbidity. For recurrent tumors, pre-op RT of 50 Gy appears to be an effective and well-tolerated management approach.

  1. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma

    Directory of Open Access Journals (Sweden)

    Tiziana Casiraghi

    2016-01-01

    Full Text Available Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions. Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%; since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  2. New understanding of dorsal dysraphism with lipoma (lipomyeloschisis): radiologic evaluation and surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Naidich, T.P. (Northwestern Univ., Chicago, IL); McLone, D.G.; Mutluer, S.

    1983-06-01

    The spinal anomaly designated dorsal dysraphism with lipoma (lipomyeloschisis) consists of skin-covered, focal spina bifida; focal partial clefting of the dorsal half of the spinal cord; continuity of the dorsal cleft with the central canal of the cord above (and occasionally below) the cleft; deficiency of the dura underlying the spina bifida; deep extension of subcutaneous lipoma through the spina bifida and the dural deficiency to insert directly into the cleft on the dorsal half of the cord; variable cephalic extension of lipoma into the contiguous central canal of the cord; and variable ballooning of the subarachnoid space to form an associated meningocele. The variable individual expressions of the anomaly are best understood by reference to their archetypal concept. Careful analysis of radiographic and surgical findings in human lipomyeloschisis and correlation with an animal model of lipomyeloschisis indicate that plain spine radiographs and high-resolution metrizamide computed tomographic myelography successfully delineate the precise anatomic derangements associated with lipomyeloschisis and provide the proper basis for planning surgical therapy of this condition.

  3. Ileal microbiota composition of broilers fed various commercial diet compositions.

    Science.gov (United States)

    van der Hoeven-Hangoor, E; van der Vossen, J M B M; Schuren, F H J; Verstegen, M W A; de Oliveira, J E; Montijn, R C; Hendriks, W H

    2013-10-01

    Microbiota plays a role in the release and absorption of nutrients from feed components, thereby affecting digesta composition and moisture content of the excreta. The objective of the current study was to determine the effects of 5 different diets varying in ingredients (medium-chain fatty acids, nonstarch polysaccharides, and starch) on the microbiota composition of ileal digesta of broiler chickens and excreta DM content. Each treatment was repeated 6 times in cages each containing 18 Ross 308 broilers, with growth performance measured from 0 to 34 d of age and excreta DM and ileal microbiota composition analyzed at 34 d of age. Microbiota composition was evaluated using a novel ribosomal RNA microarray technology containing 370 different probes covering various genera, groups of microbial species, and individual species of the chicken gut microbiota, of which 321 had a signal above the background threshold. Replacing part of the animal fat and soybean oil in the wheat-based diet with medium-chain fatty acids (MCFA; 0.3% C10 and 2.7% C12) improved feed efficiency compared with the other dietary treatments. This coincided with a suppression of gram-positive bacteria belonging to the phylum of the Firmicutes, including Lactobacillus species, and species belonging to the family of the Enterococcaceae and Micrococcaceae, whereas the gram-negative bacteria belonging to the family of the Enterobacteriaceae were promoted. None of the other diets used in the present study notably changed the ileal digesta bacteria composition. Excreta DM content was not affected by dietary treatment. The variation between individual birds per dietary treatment was more pronounced than variation caused by feed composition, with the exception of the digesta microbiota of the birds fed the MCFA diet. It is concluded that a diet with MCFA significantly changes the ileal microbiota composition, whereas the effect of the other diets on the composition of the microbiota and excreta DM content

  4. Cavernous lymph angioma of the ileal mesentery; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joung Sook; Chang, Young Woong; Koo, Chul Hoe [Chun Cheon Medical Center, Chuncheon (Korea, Republic of)

    1989-06-15

    Lymph angiomas are benign tumors of the lymphatic vessels and classified into three kinds; simple, cavenous and cystic type. They occur mainly in children, most commonly as cystic hygromas in the neck but rarely in the abdominal cavity as lymph angiomas in the mesentery and small intestine. We have experienced an unusual case of cavernous lymph angioma of ileal mesentery demonstrated chiefly as solid mass in ultrasonography and CT and report the case briefly with reviewing the literature.

  5. Id2 deletion attenuates Apc-deficient ileal tumor formation

    Directory of Open Access Journals (Sweden)

    Kyoko Biyajima

    2015-08-01

    Full Text Available The expression level of inhibitor of DNA binding 2 (Id2 is increased in colorectal carcinomas and is positively correlated with poor prognosis. However, the functional significance of Id2 in intestinal tumorigenesis has not been fully defined using genetic approaches. Here, we show that Id2 promotes ileal tumor initiation in Apc-deficient mice. Expression of Id2 was stimulated by Wnt signaling through the enhancer region of the Id2 promoter at the early stage of tumorigenesis in Apc+/Δ716 (ApcΔ716 mice. Genetic depletion of Id2 in ApcΔ716 mice caused ∼80% reduction in the number of ileal polyps, but had little effect on tumor size. Notably, the lack of Id2 increased the number of apoptotic cells in the normal crypt epithelium of the mice. Furthermore, DNA microarray analysis revealed that the expression level of Max dimerization protein 1 (Mxd1, known as a c-Myc antagonist, was specifically increased by Id2 deletion in the ileal intestinal epithelium of ApcΔ716 mice. In contrast, the protein level of c-Myc, but not the mRNA level, was decreased by loss of Id2 in these mice. These results indicate that loss of Id2 inhibits tumor initiation by up-regulation of Mxd1 and down-regulation of c-Myc in ApcΔ716 mice.

  6. Ileal neuroendocrine tumors and heart: not only valvular consequences.

    Science.gov (United States)

    Calissendorff, Jan; Maret, Eva; Sundin, Anders; Falhammar, Henrik

    2015-04-01

    Ileal neuroendocrine tumors (NETs) often progress slowly, but because of their generally nonspecific symptoms, they have often metastasized to local lymph nodes and to the liver by the time the patient presents. Biochemically, most of these patients have increased levels of whole blood serotonin, urinary 5-hydroxyindoleacetic acid, and chromogranin A. Imaging work-up generally comprises computed tomography or magnetic resonance imaging and somatostatin receptor scintigraphy, or in recent years positron emission tomography with 68Ga-labeled somatostatin analogs, allowing for detection of even sub-cm lesions. Carcinoid heart disease with affected leaflets, mainly to the right side of the heart, is a well-known complication and patients routinely undergo echocardiography to diagnose and monitor this. Multitasking surgery is currently recognized as first-line treatment for ileal NETs with metastases and carcinoid heart disease. Open heart surgery and valve replacement are advocated in patients with valvular disease and progressive heart failure. When valvulopathy in the tricuspid valve results in right-sided heart failure, a sequential approach, performing valve replacement first before intra-abdominal tumor-reductive procedures are conducted, reduces the risk of bleeding. Metastases to the myocardium from ileal NETs are seen in heart metastases are detected, with the addition of diuretics and fluid restriction in cases of heart failure. Myocardial metastases are rarely treated by surgical resection.

  7. Ileal Crohn's disease: MRI with endoscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Gallego, Jose C., E-mail: josecarlos.gallego.ojea@sergas.es [Department of Radiology, Hospital A. Marcide, Ferrol (Spain); Echarri, Ana I. [Department of Gastroenterology, Hospital A. Marcide, Ferrol (Spain); Porta, Ana [Department of Radiology, Hospital A. Marcide, Ferrol (Spain); Ollero, Virginia [Department of Gastroenterology, Hospital A. Marcide, Ferrol (Spain)

    2011-11-15

    Purpose: To evaluate activity staging of Crohn's disease (CD) measured with MR-enterography using ileoscopy as reference standard. Materials and methods: A prospective study was made of 61 patients with CD. All patients underwent MR-enterography and ileoscopy. MRI activity was measured by means of an ad hoc developed score, as well as by analysis of the imaging findings, and was compared with the SES-CD score obtained via ileoscopy. Examinations were performed using a 1.0 T scanner. Results: MRI score discriminates between active and inactive disease with an area under the ROC curve of 0.941. Overall correlation with the standard reference SES-CD score was moderate to strong (Spearman's r = 0.62 p < 0.001). Agreement between both methods in staging patients with ileal CD as inactive, mild or moderate to severe was good (Cohen's {kappa} = 0.60). Differences in means of the MRI activity scores of the three groups showed statistical significance (p < 0.01). Conclusions: The MRI score is a reliable predictor of activity in ileal CD and can stage patients in a way comparable to endoscopy. 1.0 T scans are valid for performing radiological evaluation of ileal Crohn's disease.

  8. Successful emergency enterectomy for bleeding ileal varices in a patient with liver cirrhosis.

    Science.gov (United States)

    Ueda, Junji; Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Mizuguchi, Yoshiaki; Shimizu, Tetsuya; Matsumoto, Satoshi; Kakinuma, Daisuke; Ishikawa, Yoshinori; Kanda, Tomoharu; Akimaru, Koho; Teranishi, Nobuhisa; Naito, Zenya; Tajiri, Takashi

    2006-08-01

    We report a rare case of bleeding ileal varices successfully treated with emergency enterectomy. A 72-year old woman with hepatic cirrhosis due to hepatitis C was admitted to our hospital because of anemia and hematochezia. An endoscopic examination showed no evidence of bleeding in the upper and lower gastrointestinal tracts. Angiographic studies of portal hemodynamics revealed extravasation from the ileal varices and total occlusion of the portal vein due to portal thrombus. This made it difficult to remove the ileal varices using interventional radiology. Therefore, the patient underwent emergency enterectomy for the ileal varices. No further gastrointestinal bleeding occurred during the 1-year follow-up.

  9. Effects of corn gluten feed inclusion at graded levels in a corn-soybean diet on the ileal and fecal digestibility of growing pigs

    Science.gov (United States)

    2014-01-01

    Background This study aimed to determine the effect of the inclusion of corn gluten feed (CGF) on the apparent and standardized ileal digestibility of protein and amino acids and the apparent ileal and total tract digestibility of energy in growing pigs. The study was performed using 16 barrows (weight, 45.3 ± 4.5 kg) that were fitted with a T cannula at the terminal ileum. There were four treatments: a corn-soybean diet without CGF and three corn-soybean diets containing increasing levels of CGF (65, 130, and 195 g/kg). Data were analyzed according to a randomized complete block design, four blocks with four pigs each (one pig per treatment). The trend of the response (linear or quadratic) was determined using orthogonal contrasts, and when a linear effect was determined, a linear equation was obtained. Results The results showed that the inclusion up to 195 g/kg of CGF in the corn-soybean diet did not diminish the ileal digestibility (apparent and standardized) of protein and amino acids (P > 0.05), except that of phenylalanine, cystine, and proline. A linear decrease (P digestibility of phenylalanine (0.011 and 0.015 percentage units, respectively), cystine (0.048 and 0.043 percentage units, respectively), and proline (0.045 and 0.047 percentage units, respectively) was noted. Similarly, ileal digestibility of dry matter and energy were adversely affected (reduced by 0.028 and 0.025 percentage units, respectively, per gram of CGF increment in the diet). A significant (P digestibility with increase in CGF amount in the diet was observed for energy (0.027 percentage units), dry matter (0.027 percentage units), crude protein (0.020 percentage units), and neutral detergent fiber (0.041 percentage units) per gram of CGF added to the diet. Conclusion CGF did not affect the ileal digestibility of protein and most amino acids but reduced the ileal and total tract digestibility of energy. PMID:25279142

  10. Twin studies reveal specific imbalances in the mucosa-associated microbiota of patients with ileal Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Willing, B.; Halfvarson, J.; Dicksved, J.; Rosenquist, M.; Jarnerot, G.; Engstrand, L.; Tysk, C.; Jansson, J. K

    2008-08-15

    Large inter-individual variation in the composition of the intestinal microbiota between unrelated individuals has made it challenging to identify specific aspects of dysbiosis that lead to Crohn's disease. To reduce variations in exposure during establishment of the gut flora and influence of genotype, we studied the mucosaassociated microbiota of monozygotic twin pairs that were discordant (n=6) or concordant (n=4) for Crohn's disease. DNA was extracted from biopsies collected from 5 locations between the ileum and rectum. Bacterial 16S ribosomal RNA genes were amplified and community composition assessed by terminal-restriction fragment length polymorphism, cloning and sequencing and quantitative real-time PCR. The microbial compositions at all biopsy locations for each individual were similar, regardless of disease state, but there were differences between individuals. In particular, individuals with predominantly ileal Crohn's had a dramatically lower abundance (P<0.001) of Faecalibacterium prausnitzii and increased abundance (P<0.03) of Escherichia coli compared to healthy co-twins and those with Crohn's localized in the colon. This dysbiosis was significantly correlated to the disease phenotype rather than genotype. The reduced abundance of F. prausnitzii and increased abundance of E. coli are indicative of an ileal Crohn's disease phenotype, distinct from colonic Crohn's disease and the relative abundances of these specific bacterial populations are promising biomarker candidates for differential diagnosis of Crohn's and eventually customized treatment.

  11. THE EFFECT OF BODY WEIGHT OF PIGS ON TRUE AND APPARENT ILEAL AMINO ACIDS DIGESTIBILITY OF RYE

    Directory of Open Access Journals (Sweden)

    Nitrayová

    2013-02-01

    Full Text Available It is generally accepted that the ability of pigs to digest protein increases with age. However, it has been shown that small pigs excreted more endogenous nitrogen (N than large pigs. Consequently, the apparent amino acids (AA digestibility may be lower in young pigs while true digestibility, which is corrected for endogenous losses, may be comparable with that found in older pigs. To test this hypothesis, six cannulated piglets (mean body weight 20.6 kg fitted with a simple T-cannula at terminal ileum were used to estimate apparent and true digestibilities of AA and of total N in a rye-based diet (96 % rye. The digestibility study was repeated on the same pigs fed the same diet when they reached mean body weight 61.7 kg. The apparent ileal digestibilities of total AA and total N were significantly higher in heavier pigs than in piglets. Except for methionine and phenylalanine, the apparent digestibilities of individual AA showed a similar pattern. In contrast, there was no significant difference between piglets and heavier pigs for the true ileal digestibility of total N. True digestibility of most AA was lower in heavier pigs than in piglets, the differences for total and some individual AA being significant. The present results suggest that the higher apparent digestibility values found in heavier pigs as compared to piglets are due to the confounding effect of endogenous N losses rather than the better ability of older pigs to digest protein.

  12. Dietary supplementation with Astragalus polysaccharide enhances ileal digestibilities and serum concentrations of amino acids in early weaned piglets.

    Science.gov (United States)

    Yin, F G; Liu, Y L; Yin, Y L; Kong, X F; Huang, R L; Li, T J; Wu, G Y; Hou, Yongqing

    2009-07-01

    Two experiments were conducted to evaluate the effects of dietary supplementation with Astragalus polysaccharide (APS) on growth performance, apparent ileal digestibilities (AID) of amino acids (AA), and their serum concentrations in early weaned piglets. In Exp. 1, 60 pigs were weaned at 21 days of age (BW 7.35 +/- 0.23 kg) and allocated to three treatments (20 pigs/treatment), representing supplementing 0.0% (control), 0.02% colistin (antibiotic), or 0.1% APS to a corn- and soybean meal-based diet. Average daily gain (ADG), average daily feed intake (ADFI), and feed/gain ratio (F/G) were measured weekly. Blood samples were obtained from five pigs selected randomly from each treatment for the measurement of serum free AA concentrations on days 7, 14, and 28. In Exp. 2, 12 pigs were weaned at 21 day of age (BW 7.64 +/- 0.71 kg), assigned to three treatment groups as in Exp. 1, and surgically fitted with a simple T-cannula at the terminal ileum. Ileal digesta samples were obtained for the measurement of AID of AA on days 7, 14 and 28. Dietary APS did not affect ADFI, but enhanced (P digestive and absorptive function and regulate AA metabolism to beneficially increase the entry of dietary AA into the systemic circulation, which provide a mechanism to explain the growth-promoting effect of APS in early weaned piglets.

  13. LIPOMA CEREBRAL EN CUERPO CALLOSO: HALLAZGO INCIDENTAL EN PACIENTE CON EVENTO CEREBROVASCULAR

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    Gloria Cárcamo-Portillo

    2016-07-01

    Full Text Available Los lipomas intracraneales son lesiones infrecuentes y benignas que representan el 0,03 al 0,08% de todas las masas intracraneales. Estos se encuentran relacionados a un defecto de la línea media debido a un mal cierre del tubo neural; lo que conlleva a una mala diferenciación y una persistencia anormal de la meninge primitiva con posterior diferenciación al tejido adiposo. La mitad de los casos permanecen asintomáticos y son diagnosticados como un hallazgo incidental en los estudios imagenológicos. Sin embargo, otros casos se asocian a sintomatología neurológica como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se presenta el caso de una paciente de 46 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2; que cursa con sintomatología de Evento Cerebrovascular Isquémico por lo que le realizan –una Tomografía Computarizada (TC y una Resonancia Magnética (RM. En el reporte se describen múltiples infartos a nivel del hemisferio cerebral izquierdo mientras que al nivel de la línea media se observó una imagen compatible con lipoma cerebral que afectaba el rostro, la rodilla y la porción anterior del cuerpo calloso. La identificación de este hallazgo fue incidental. Palabras claves: Lipoma Cerebral; Cuerpo Calloso; Resonancia Magnética; Accidente Cerebrovascular. (Fuente: DeCS BIREME.

  14. Bilateral Tarsal Tunnel Syndrome Due To Bilateral Lipoma: A Case Report

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    C. Eren CANSÜ, İstemi YÜCEL, Kutay ÖZTURAN

    2010-11-01

    Full Text Available Tarsal tunnel syndrome is an entrapment neuropathy of posterior tibial nerve under the flexorretinaculum. Patients generally present with paresthesias on the plantar side of foot and fingersand in the distal kruris.The causes of tarsal tunnel syndrome are space occupying lesions within or around the tunnelwhich exert pressure to the nerve, ankle deformities, systemic illnesses, trauma or lesions ofthe nerve itself.In this study a case of tarsal tunnel syndrome due to bilateral lipoma which was treated surgicallyis presented.

  15. [Lipoma as the cause of intussusception of the rectum in a 46-year-old woman].

    Science.gov (United States)

    Sørensen, Jeanette; Nygaard, Helene

    2013-03-04

    We present a case with a 46-year-old woman who had experienced six days of abdominal pain and some days of anal bleeding. She had no prior medical history. At the clinical examination it was found that she had a soft abdomen, but there was tenderness in the lower part. A computed tomography showed an intussusception of the sigmoideum into the rectum. An oncological resection was performed, since it could not at the time of the operation be determined if it was a malignant proces. The histology showed a benign submucosal lipoma.

  16. The importance of early diagnosis of large lipomas in the maxillofacial region

    OpenAIRE

    Matheus Furtado de Carvalho; Thiago Pinheiro Junqueira; Rafael Reis de Souza; Hermínia Marques Capistrano; Maria das Graças Afonso Miranda Chaves

    2011-01-01

    El lipoma es un tumor benigno compuesto por la proliferación de células adiposas maduras entremezcladas con el tejido conectivo fibroso, los vasos sanguíneos y/o músculos, delimitado por una fina cápsula. Aunque representa un neoplasma del mesénquima muy común del cuerpo humano, tiene raras ocurrencias en la cavidad bucal. Presenta variables clínicas e histopatológicas que no alteran su pronóstico. La patogénesis sigue siendo incierta aunque algunos autores consideran que los trastornos hered...

  17. Dysphagia Caused by Spindle Cell Lipoma of Hypopharynx: Presentation of Clinical Case and Literature Review

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    Alberto Peña-Valenzuela

    2012-01-01

    Full Text Available Spindle cell lipoma of the hypopharynx is an extremely rare entity. Here, we present the first case of this lesion originated in the cricopharyngeal region, with symptoms of chronic progressive dysphagia, which can be confused with other pathologies; endoscopic and magnetic resonance imaging (MRI evaluation are the methods of choice for its diagnostic approach. The best therapeutic approach is endoscopic resection with rapid recovery and few complications. Long-term followup is recommended, either endoscopic or imaging, given that it can be confused with an undiagnosed liposarcoma; additionally, its long-term behavior is unknown.

  18. Typhoid ileal perforation in children in Benin city

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    Osifo Osarumwense

    2010-01-01

    Full Text Available Background: Typhoid ileal perforation is a common complication of typhoid fever, a multi-systemic infection, which is endemic in many developing countries. Objective: This study reviews and compares the incidence, morbidity and mortality at the University of Benin Teaching Hospital with other referral centres located in areas with similar socioeconomic and population status. Materials and Methods: The incidence, morbidity and mortality of typhoid ileal perforation in children treated among Edo People at the University of Benin Teaching Hospital, Nigeria, in the period from 1993 to 2007 were retrospectively studied and compared with centres in localities of similar socioeconomic and population status. Results: Twelve children, all of middle class parents who resided in suburban community with poor water supply and substandard sewage disposal, accounted for 70.6% patients with typhoid ileal perforation managed over 15 years while 29.4% occurred in adults. The children comprised seven males and five females (M/F ratio 1.4:1, aged between five and 13 (average 9 years. This number seen over 15 years in this centre was extremely low when compared with other referral centres; as many as 191 patients were seen over 10 months in one of the centres. The few patients seen were traced to cultural beliefs in Benin City, which influenced proper sewage disposal by the about four million Edo people, especially those living in rural areas. Consequently, no child from the rural area with clean natural water supply or urban areas with pipe born water supply where sewages are disposed of properly had typhoid perforation. Unacceptably high morbidity (100% and mortality (75% due to late referrals were recorded in comparison with other centres. Conclusion: Proper sewage disposal may have influenced the low incidence in this centre but early referral is advocated so as to reduce the high associated morbidity and mortality.

  19. Malignancy risk prediction for primary jejunum-ileal tumors

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    MARQUES Ruy Garcia

    2000-01-01

    Full Text Available This work is aimed at identifying factors associated with primary jejunum-ileal tumors malignancy, defining a prediction model with sensitivity, specificity and accuracy to distinguish malign from benign neoplasms. These tumors are rare, have highly unspecific presentation and, frequently, are diagnosed late. We reviewed the charts of 42 patients with primary jejunum-ileal tumors treated in the Department of General Surgery of Rio de Janeiro State University Hospital, Rio de Janeiro, RJ, Brazil, from 1969 to 1998. We performed bivariate analyses, based on chi² test, searching associations between tumors malignancy and demographic and clinical variables. Then logistic regression was employed to consider the independent effect of variables previously identified on malignancy risk. The malign tumors included 11 adenocarcinomas, 7 leiomyosarcomas, 5 carcinoids and 4 lymphomas; the benign tumors included 10 leiomyomas, 2 hamartomas, and single cases of adenoma, multiple neurilemoma and choristoma. The bivariate analyses indicated the association between malignancy and palpable abdominal mass (P = 0.003, period from signs and symptoms onset to diagnosis (P = 0.016, anemia (P = 0.020, anorexia (P = 0.003, abdominal pain (P = 0.031, weight loss (P = 0.001, nausea and vomit (P = 0.094, and intestinal obstruction (P = 0.066; no association with patients demographic characteristics were found. In the final logistic regression model, weight loss, anemia and intestinal obstruction were statistically associated with the dependent variable of interest. Based only on three variables -- weight loss, anemia and intestinal obstruction -- the model defined was able to predict primary jejunum-ileal tumors malignancy with sensitivity of 85.2%, specificity of 80.0%, and accuracy of 83.3%.

  20. The effect of N-acetyl-L-cysteine on the viscosity of ileal neobladder mucus.

    NARCIS (Netherlands)

    Schrier, B.P.; Lichtendonk, W.J.; Witjes, J.A.

    2002-01-01

    N-acetyl-L-cysteine (NAC) proved to be an effective mucolytic in pulmonary secretions. Our goal was to investigate the in vitro effect of NAC on viscosity of ileal neobladder mucus. The urine of a patient with an ileal neobladder was collected during the first 7 days postoperatively and stored in a

  1. Ileal Mucosal and Fecal Pancreatitis Associated Protein Levels Reflect Severity of Salmonella Inflection in Rats

    NARCIS (Netherlands)

    Ampting, van M.T.J.; Rodenburg, G.C.H.; Vink, C.; Kramer, E.; Schonewille, A.; Keijer, J.; Meer, van der R.; Bovee-Oudenhoven, I.M.J.

    2009-01-01

    Background Microbial infections induce ileal pancreatitis-associated protein/regenerating gene III (PAP/RegIII) mRNA expression. Despite increasing interest, little is known about the PAP/RegIII protein. Therefore, ileal mucosal PAP/RegIII protein expression, localization, and fecal excretion were

  2. Sustitución ureteral bilateral con asa ileal

    OpenAIRE

    CASTILLO C,OCTAVIO A; Amorós Torres,Araceli; Velarde R,Laura; Navas M,María del Carmen; López-Fontana,Gastón

    2012-01-01

    Introducción: La sustitución ureteral por un asa de íleon desfuncionalizada fue descrita hace más de 2 siglos y continúa siendo una alternativa terapéutica en la actualidad. Esta serie describe la técnica de sustitución ureteral bilateral con íleon. Objetivo: Presentar 4 casos de sustitución ureteral ileal bilateral realizados en nuestro centro, indicaciones de la técnica quirúrgica, complicaciones y revisión de la literatura. Material y Método: Presentamos 4 casos de lesión ureteral bilatera...

  3. Perforated ileal duplication cyst with haemorrhagic pseudocyst formation

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Im Kyung; Kim, Bong Soo; Kim, Heung Chul; Lee, In Sun; Hwang, Woo Chul [Department of Radiology, College of Medicine, Hallym University (Korea); Namkung, Sook [Department of Radiology, College of Medicine, Hallym University (Korea); Department of Radiology, Chuncheon Sacred Heart Hospital, 153 Kyo-dong, Chuncheon, Kangwon-do, 200-704 (Korea)

    2003-07-01

    Duplication cysts of the gastrointestinal tract are rare congenital abnormalities. Ectopic gastric mucosa, which can be found in duplications, may cause peptic ulceration, gastrointestinal bleeding or perforation. We report a 1-year-old boy with a perforated ileal duplication cyst with haemorrhagic pseudocyst formation caused by peptic ulceration of the duplication cyst. It presented a snowman-like appearance consisting of a small, thick-walled, true enteric cyst and a large, thin-walled haemorrhagic pseudocyst on US and CT. It is an unusual manifestation of a duplication cyst, which has not been reported in the English language literature. (orig.)

  4. Ileal ulcer in asymptomatic individuals. Is this Crohn?

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    Carlos Henrique Marques dos Santos

    2012-06-01

    Full Text Available The endoscopic finding of ileal ulcers, alone or in small number, is not usual, but when it occurs in asymptomatic patients, an impasse may be generated regarding the action to be taken, since the medical literature is unclear as to how to proceed in this situation. OBJECTIVE: Evaluate patients with ileal ulcers, single or in a small number, asymptomatic, and their follow-up. METHODS: The author reports a series of asymptomatic cases (23 patients of ulcers - single or in small number - found in colonoscopy exams performed for other reasons than typical clinical manifestations of Crohn's disease. RESULTS: Most patients were not treated and remained asymptomatic during the follow-up period. CONCLUSIONS: The patients remained asymptomatic and without treatment in most cases, and, considering the small number of cases and the short observation time, this study does not allow to conclude that this is the best practice in case of asymptomatic patients with ileal ulcer.O achado endoscópico de úlceras ileais, isoladas ou em pequeno número, não é frequente, mas quando ocorre em pacientes assintomáticos pode gerar um impasse quanto à conduta a ser tomada, já que a literatura médica não é clara quanto a como se proceder nessa situação. OBJETIVO: Avaliar pacientes que apresentaram úlceras ileais solitárias ou em pequena quantidade, assintomáticos e a evolução clínica dos mesmos. MÉTODOS: O autor relata uma série de casos (23 pacientes assintomáticos que apresentaram úlceras ileais únicas ou em pequeno número em colonoscopias realizadas por outros motivos que não manifestações clínicas típicas de doença de Crohn. RESULTADOS: A maioria dos pacientes não foi tratada e permaneceu assintomática pelo período de acompanhamento. CONCLUSÕES: Os pacientes permaneceram assintomáticos e sem tratamento em sua maioria, salientando-se o reduzido número de casos e o curto tempo de observação, de modo a não permitirem a este estudo

  5. Effect of xylanases on ileal viscosity, intestinal fiber modification, and apparent ileal fiber and nutrient digestibility of rye and wheat in growing pigs

    DEFF Research Database (Denmark)

    Lærke, Helle Nygaard; Arent, Susan; Dalsgaard, Søren

    2015-01-01

    AID of arabinoxylan by 91% to 107% (P Enzyme addition did not affect AID of nutrients in any of the experiments except for a higher starch and crude fat digestibility of fine wheat with enzyme addition (P ...Two experiments were performed to study the effect of xylanase on ileal extract viscosity, in vivo fiber solubilization and degradation, and apparent ileal digestibility (AID) of fiber constituents, OM, CP, starch, and crude fat in rye and wheat in ileal-cannulated pigs. In Exp. 1, coarse rye...... with or without a combination of xylanase from Bacillus subtilis and Trichoderma reesei were fed to 6 ileal-cannulated barrows (initial BW 33.6 ± 0.5 kg) for 1 wk according to a 6 × 6 Latin square design with a 2 × 3 factorial arrangement of enzyme and cereal matrix. Chromic oxide (0.2%) was used as an inert...

  6. Percutaneous transhepatic obliteration of stomal variceal hemorrhage from an ileal conduct: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seung Hyun; Lee, Shin Jae; Won, Jong Yun; Park, Sung Il; Lee, Do Yun; Kim, Man Deuk [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Do Young [Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Variceal bleeding is an unusual complication of ileal conduits. We report a case in which recurrent stomal variceal hemorrhage from an ileal conduit for bladder cancer was successfully treated by percutaneous transhepatic obliteration (PTO) using microcoils and N-butyl cyanoacrylate. Therefore, PTO can be one treatment option to prevent recurrent stomal variceal bleeding from ileal conduits.

  7. The importance of early diagnosis of large lipomas in the maxillofacial region Importancia del diagnóstico precoz de los lipomas de células grandes en la región maxilofacial

    Directory of Open Access Journals (Sweden)

    Matheus Furtado de Carvalho

    2011-03-01

    Full Text Available El lipoma es un tumor benigno compuesto por la proliferación de células adiposas maduras entremezcladas con el tejido conectivo fibroso, los vasos sanguíneos y/o músculos, delimitado por una fina cápsula. Aunque representa un neoplasma del mesénquima muy común del cuerpo humano, tiene raras ocurrencias en la cavidad bucal. Presenta variables clínicas e histopatológicas que no alteran su pronóstico. La patogénesis sigue siendo incierta aunque algunos autores consideran que los trastornos hereditarios y endocrinos son causas posibles. Ocurre con una mayor prevalencia en las personas obesas, aunque su metabolismo es totalmente independiente del metabolismo normal de los lípidos corporales. El diagnóstico clínico del lipoma bucal está relacionado con una masa nodular, blanda, asintomática, de superficie plana, sin ulceración y de crecimiento limitado. El continuo crecimiento de la lesión pudiera crear dificultad al masticar, al hablar, en la adaptación dental y cambio en la estética facial del paciente requiriendo la escisión de la lesión. Presentar una revisión de la literatura y de los casos clínicos de un estudio retrospectivo de 61 casos de lipomas diagnosticados en el servicio de patología entre 1978 y 2009 entre los 10 573 informes hechos durante ese mismo período. Se enfatizan los casos especiales de lipomas grandes de la región maxilofacial y la importancia del diagnóstico temprano de estas lesiones. Un cirujano dental debe ser capaz de diagnosticar los lipomas en una etapa temprana en el área maxilofacial para evitar un crecimiento masivo de estas lesiones.Lipoma is a benign tumor composed of proliferation of mature fat cells interspersed by fibrous connective tissue, blood vessels and muscles, delimited by a thin capsule. Although it represents a mesenchymal neoplasm most common human body, are rare occurrences in the oral cavity. Presents clinical and histopathological variables that do not alter their

  8. Giant congenital melanocytic nevus (bathing trunk nevus associated with lipoma and neurofibroma: Report of two cases

    Directory of Open Access Journals (Sweden)

    Bhagwat P

    2009-01-01

    Full Text Available Giant congenital melanocytic nevi are rare and occur in about one out of every 2,00,000 to 5,00,000 births. There is a significant association between bathing trunk nevus and neurofibromatosis and lipomatosis. Apart from this, association of bathing trunk nevus with abnormalities like spina bifida occulta, meningocele, club foot and hypertrophy or atrophy of deeper structures of a limb, have been described. We are herewith reporting two cases of bathing trunk nevi. In our first case, an eight-year-old girl presented with a bathing trunk nevus studded with multiple, large nodules. Histopathological examination of the biopsy taken from one nodule revealed features of both neurofibroma and lipoma. To the best of our knowledge, features of both these hamartomas in one nodule of a single patient are probably not reported in the literature. In our second case, a 12-year-old girl presented with bathing trunk nevus and she had spina bifida occulta. She also had lipoma in the lesion of bathing trunk nevus. Both of our patients had satellite melanocytic nevi over the face, forearm, upper back and legs. Our second patient, in addition, had small melanocytic nevi over the medial canthus and sclerocorneal junction of the right eye. By the time this girl presented to us, the melanocytic nevus started fading in color and it had become brownish. We are reporting these cases for their peculiarities and for their rare features.

  9. Endoscopic resection of forehead lipoma: A subperiosteal single-portal approach

    Directory of Open Access Journals (Sweden)

    Terence Goh L

    2008-01-01

    Full Text Available Forehead lumps which are commonly excised for cosmetic reasons, are done through a traditional open excision technique. In the Asian population, open excision commonly results in a pigmented scar which tends not to fade with time and this can be a concern to some patients. The aims of this paper are to describe an endoscopically assisted technique of surgery, with emphasis on the subperiosteal, single-portal approach; to review the outcome of the surgery, and to define the indications for its use. Materials and Methods: We describe here a case series of ten patients, in whom a minimally invasive technique was employed for the removal of a forehead lipoma via an endoscopic, single-portal, subperiosteal approach. Results: The patients′ age ranged from 26 to 54 years and the dimensions of the masses removed ranged from 1.0 x 0.5 cm to 3.0 x 3.0 cm. All were confirmed by histological examination to be lipomata. The patients were followed up for an average period of nine months. There were no residual masses or recurrences and no complications of nerve damage. All the patients were very satisfied with their ′scar less′ operations. Conclusions: Endoscopic excision of forehead lipomas through a single-port approach is both safe and reliable. It is indicated in patients who are prone to scarring or who are concerned with a forehead scar.

  10. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

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    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  11. Cellular angiofibroma: analysis of 25 cases emphasizing its relationship to spindle cell lipoma and mammary-type myofibroblastoma

    NARCIS (Netherlands)

    Flucke, U.E.; Krieken, J.H. van; Mentzel, T.

    2011-01-01

    Cellular angiofibroma represents a rare benign mesenchymal tumor, occurring mainly in the superficial soft tissue of the genital region. The involvement of 13q14 in some cases confirmed the morphological suggested link with spindle cell lipoma and mammary-type myofibroblastoma. We analyzed the

  12. Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect

    Directory of Open Access Journals (Sweden)

    V. Insinga

    2014-06-01

    Full Text Available Intestinal atresia type III B (apple peel and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

  13. Reduced Paneth cell α-defensins in ileal Crohn's disease

    Science.gov (United States)

    Wehkamp, Jan; Salzman, Nita H.; Porter, Edith; Nuding, Sabine; Weichenthal, Michael; Petras, Robert E.; Shen, Bo; Schaeffeler, Elke; Schwab, Matthias; Linzmeier, Rose; Feathers, Ryan W.; Chu, Hiutung; Lima, Heriberto; Fellermann, Klaus; Ganz, Tomas; Stange, Eduard F.; Bevins, Charles L.

    2005-01-01

    The pathogenesis of Crohn′s disease (CD), an idiopathic inflammatory bowel disease, is attributed, in part, to intestinal bacteria that may initiate and perpetuate mucosal inflammation in genetically susceptible individuals. Paneth cells (PC) are the major source of antimicrobial peptides in the small intestine, including human α-defensins HD5 and HD6. We tested the hypothesis that reduced expression of PC α-defensins compromises mucosal host defenses and predisposes patients to CD of the ileum. We report that patients with CD of the ileum have reduced antibacterial activity in their intestinal mucosal extracts. These specimens also showed decreased expression of PC α-defensins, whereas the expression of eight other PC products either remained unchanged or increased when compared with controls. The specific decrease of α-defensins was independent of the degree of inflammation in the specimens and was not observed in either CD of the colon, ulcerative colitis, or pouchitis. The functional consequence of α-defensin expression levels was examined by using a transgenic mouse model, where we found changes in HD5 expression levels, comparable to those observed in CD, had a pronounced impact on the luminal microbiota. Thus, the specific deficiency of PC defensins that characterizes ileal CD may compromise innate immune defenses of the ileal mucosa and initiate and/or perpetuate this disease. PMID:16330776

  14. The effect of partial ileal bypass on plasma lipoproteins.

    Science.gov (United States)

    Moore, R B; Buchwald, H; Varco, R L

    1980-09-01

    Plasma lipids and lipoprotein cholesterol concentrations were determined before and at 3 months and 1 year after partial ileal surgery in 28 male survivors of first myocardial infarction (eight normolipidemic subjects and eight type II-A, two type II-B, eight type IV and two type V hyperlipoproteinemic subjects). All subjects had marked reductions in plasma total cholesterol (average 45% and 33% in the type V subjects and 37% and 31% in the other 26 subjects at 3 months and 1 year after surgeryyy). Except for the two type V subjects, all had even more marked reductions in low-density lipoprotein (LDL)-cholesterol than in the total plasma cholesterol, averaging 51% at 3 months and 49% at 1 year after surger. There were no significant changes in high-density lipoprotein (HDL)-cholesterol levels. The hypertriglyceridemic subjects had marked reductions in plasma triglycerides and very low density lipoprotein-cholesterol, whereas the normotriglyceridemic subjects (normals and II-A) had slight increases in these two measurements after surgery. Partial ileal bypass tends to normalize elevated plasma lipid and lipoprotein levels and results in a maximal lowering in LDL-cholesterol concentrations without altering the HDL-cholesterol level.

  15. Parastomal hernias after radical cystectomy and ileal conduit diversion

    Directory of Open Access Journals (Sweden)

    Timothy F. Donahue

    2016-07-01

    Full Text Available Parastomal hernia, defined as an “incisional hernia related to an abdominal wall stoma”, is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%–76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates.

  16. ⁶⁸Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors.

    Science.gov (United States)

    Calissendorff, Jan; Sundin, Anders; Falhammar, Henrik

    2014-09-01

    Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by (68)Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All (68)Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients' activity of daily life. (68)Ga-DOTA-TOC-PET/CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of (68)Ga-DOTA-TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs.

  17. Comparative ileal amino acid digestibility of distillers' grains for growing pigs

    Directory of Open Access Journals (Sweden)

    Olayiwola Adeola

    2016-12-01

    Full Text Available The objective of the experiment reported here was to investigate and compare the amino acid (AA digestibility of distillers' dried grains (DDG, distillers' dried grains with solubles (DDGS, high protein distillers' dried grains (HP-DDG, and high protein distillers' dried grains with solubles (HP-DDGS in growing pigs. Five semi-purified diets consisting of DDG, DDGS, HP-DDG, HP-DDGS, and nitrogen-free diet (NFD were fed to pigs fitted with simple T-cannula for 5 observations per diet. Endogenous losses of AA at the terminal ileum of pigs that received the NFD were used to calculate standardized ileal digestibility (SID of AA from apparent ileal digestibility (AID of AA. The AID of Lys in DDGS was lower (P < 0.05 than that in DDG, which was also lower (P < 0.05 than that in HP-DDG. There were no differences in AID of Met among DDG, DDGS and HP-DDGS, but was greater (P < 0.05 in HP-DDG than in DDG or DDGS. The AID of Thr in HP-DDG was greater (P < 0.05 than that in DDGS but not different from that in DDG or HP-DDGS. The branched-chain AA Ile and Leu had greater (P < 0.05 AID in HP-DDG than in DDG, DDGS or HP-DDGS, and there was no difference among DDG, DDGS, and HP-DDGS. The AID of Trp in DDG and DDGS or HP-DDG and HP-DDGS were not different, but the AID of Trp in HP-DDGS was greater (P < 0.05 than that of DDGS. The greatest SID of the indispensable AA was in HP-DDG. Except for Arg and Lys in which DDG had greater (P < 0.05 digestibility, there was no difference between DDG and DDGS in the SID of the indispensable AA. The SID of Lys in DDG was greater (P < 0.05 than that of DDGS but there was no difference between that of DDG and HP-DDGS. Only His, Ile, and Met had lower (P < 0.05 SID in HP-DDGS than HP-DDG within the indispensable AA. The SID of Ala, Asp, Cys, Glu, Gly, Ser and Tyr were lower (P < 0.05 in DDGS than in HP-DDG. There SID of dispensable AA in DDG was not different from that of HP-DDGS. The current study provided

  18. A simple prognostic scoring system for typhoid ileal perforation peritonitis.

    Science.gov (United States)

    Singh, Hemant; Mishra, Arpan; Sharma, Dhananjaya; Somashekar, Uday

    2010-10-01

    The increasing awareness of the worse than expected outcome after typhoid ileal perforation (TIP) prompted us to prospectively prognosticate patients with the help of the Jabalpur prognostic score (JPS), a simplified scoring system for peptic perforation peritonitis (PPP). Eighty-two consecutive patients with TIP were studied from May 2005 to August 2008 in the Department of Surgery, NSCB Government Medical College, Jabalpur (MP), India. Six parameters used in the JPS were recorded: age, heart rate, mean blood pressure, serum creatinine, any co-morbid illness and perforation-operation interval. JPS correlated with morbidity and mortality in TIP patients and, as the score increased, so did the morbidity and mortality. Survivors had a significantly lower mean score (3.86 ± 2.23) than non-survivors (7.94 ± 3.6; P PPP patients. JPS can be easily modified for TIP (JPS-TIP) and can be easily used for its prognostication.

  19. Torsion of a giant mesocolic lipoma in a child with Bannayan-Riley-Ruvalcaba syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Laguna, Benjamin A. [University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Iyer, Ramesh S.; Rudzinski, Erin R.; Roybal, Jessica L.; Stanescu, A.L. [Seattle Children' s Hospital, Department of Radiology, M/S MA.7.220, 4800 Sand Point Way NE, PO Box 5371, Seattle, WA (United States)

    2015-03-01

    A 6-year-old boy with Bannayan-Riley-Ruvalcaba syndrome (BRRS) presented to the emergency department with periumbilical abdominal pain for 12 h. A contrast-enhanced abdominal and pelvis CT examination revealed significant interval change in the size and appearance of a previously seen hypoattenuating right mesocolic fatty mass suggestive for lipoma, first observed 5 months prior. This lesion demonstrated new enhancing internal septations, a thickened capsule, interval development of adjacent mesenteric fat stranding and engorgement of the mesenteric vessels. Given the short follow-up interval and acute clinical presentation, imaging findings were suggestive for torsion. We present this case for the unusual imaging findings as well as to highlight the differential diagnosis for abdominal fat containing lesions by imaging in patients with BRRS and other hamartomatous syndromes. (orig.)

  20. Lipoma intramuscular del músculo deltoides: Presentación de cuatro casos

    OpenAIRE

    Nieto López, Daniel; Canillas del Rey, F.M.; Hernán Prado, Miguel Ángel; Durán Giménez-Rico, Pablo

    2001-01-01

    Describimos cuatro casos de lipoma intramuscular del músculo deltoides en cuatro pacientes, dos mujeres y dos varones con una edad media de 62 años. Dos están situados en el lado derecho y dos en el izquierdo. Las tumoraciones tienen un tamaño que oscila entre 5 y 8 centímetros, produciendo un cuadro clínico de dolor y limitación funcional del hombro. En tres de los cuatro pacientes se realiza tratamiento definitivo con extirpación quirúrgica de la tumoración. Con un seguimiento mínimo de año...

  1. Giant cervical lipoma excision under cervical epidural anesthesia: A viable alternative to general anesthesia.

    Science.gov (United States)

    Singh, Ram Pal; Shukla, Aparna; Verma, Satyajeet

    2011-01-01

    The technique of Cervical Epidural Anesthesia (CEA) was first described by Dogliotti in 1933 for upper thoracic procedures. Administration of local anesthetic into cervical epidural space results in anesthesia of the neck, upper extremity, and upper thoracic region. CEA provides high-quality analgesia and anesthesia of above dermatomes and, at the same time, it has favorable effect on hemodynamic variable by blocking sympathetic innervation of the heart. CEA is not practiced routinely because of its potential complications. We selected this technique of CEA for excision of giant cervical lipoma on the back of the neck in an adult patient, as the patient was unwilling for general anesthesia. CEA was induced with 10 ml of 1% lignocaine-adrenaline mixture administered into C7-T1 space through 18G Tuohy needle. Our patient maintained vital parameters throught the procedure. The added advantage of epidural anesthesia was that the patient was awake and comfortable throughout the procedure.

  2. The natural history and management of patients with congenital deficits associated with lumbosacral lipomas.

    Science.gov (United States)

    Tu, Albert; Hengel, Ross; Cochrane, D Douglas

    2016-04-01

    Many patients with lumbosacral lipoma are asymptomatic; however, a significant proportion will have neurological deficits present at birth. Implication of these deficits with respect to natural history and management are not well understood. A retrospective review of all infants with lumbosacral lipoma seen at BCCH between 1997 and 2013 was carried out. The study population was stratified on the presence of a congenital, non-progressive deficit and subdivided on treatment approach. The subsequent developments of deficits resulting in untethering procedures were recorded. Of the 44 infants in this study, 24 patients had no neurologic deficit while 20 patients had a fixed, non-progressive deficit evident at birth. Ten of 24 patients without a neurological deficit at birth underwent a prophylactic untethering with 3 eventually requiring repeat untethering after, on average, 62.7 months. Eleven of 14 asymptomatic, monitored patients required untethering for clinical deterioration. Two required a second untethering procedure after 48.7 months. Ten of 20 infants with congenital deficits present at birth underwent prophylactic untethering, and 4 required further surgery after 124 months. Ten patients underwent observation with 8 eventually requiring surgery. Two required repeat untethered after 154 months. The complication rates and operative burden for patients are similar whether prophylactic or delayed surgery is performed. The presence of congenital neurologic deficit does not affect the likelihood of deterioration in patients managed expectantly; prophylactic detethering of these patients did not prevent delayed neurologic deterioration. Comparing the need for repeat surgery in prophylactically untethered patients with initial untethering of patients operated upon at the time of deterioration, prophylactic untethering may confer a benefit with respect to subsequent symptomatic tethering if complication rates are low. However, in a setting with multidisciplinary

  3. Ileo-ileal knot: a rare case of acute strangulated intestinal obstruction

    Science.gov (United States)

    Taniguchi, Kohei; Iida, Ryo; Watanabe, Tomohiko; Nitta, Masahiko; Tomioka, Masao; Uchiyama, Kazuhisa; Takasu, Akira

    2017-01-01

    ABSTRACT Strangulated intestinal obstruction is one of the most common types of acute abdomen and requires urgent surgical treatment. Herein, we report a very rare case of strangulated intestinal obstruction caused by an ileo-ileal knot. An 80-year-old woman was admitted to our hospital with suspicion of strangulation ileus and underwent emergency laparotomy after investigation by exploratory single-port laparoscopy. During surgery, a small bowel gangrene caused by an ileo-ileal knot was found. The gangrenous segment was resected, and primary anastomosis was performed. Post-operative recovery was uneventful except for a minor wound infection. Our extensive search of the literature found only 7 case reports of ileo-ileal knot including ours. An ileo-ileal knot should be considered in the differential diagnosis of acute intestinal obstruction, because this rare phenomenon requires urgent surgical treatment; and some complications should be considered during or after surgery. PMID:28303069

  4. Gross and true ileal digestible amino acid contents of several animal body proteins and their hydrolysates.

    Science.gov (United States)

    Cui, J; Chong, B; Rutherfurd, S M; Wilkinson, B; Singh, H; Moughan, P J

    2013-07-01

    Amino acid compositions of ovine muscle, ovine myofibrillar protein, ovine spleen, ovine liver, bovine blood plasma, bovine blood globulins and bovine serum albumin and the amino acid compositions and in vivo (laboratory rat) true ileal amino acid digestibilities of hydrolysates (sequential hydrolysis with Neutrase, Alcalase and Flavourzyme) of these protein sources were determined. True ileal amino acid digestibility differed (Pprotein hydrolysates. The ovine myofibrillar protein and liver hydrolysates were the most digestible, with a mean true ileal digestibility across all amino acids of 99%. The least digestible protein hydrolysate was bovine serum albumin with a comparable mean true ileal digestibility of 93%. When the digestible amino acid contents were expressed as proportions relative to lysine, considerable differences, across the diverse protein sources, were found in the pattern of predicted absorbed amino acids. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Initial Series of Four-Arm Robotic Completely Intracorporeal Ileal Ureter.

    Science.gov (United States)

    Chopra, Sameer; Metcalfe, Charles; Satkunasivam, Raj; Nagaraj, Shalini; Becker, Carlee; de Castro Abreu, Andre Luis; Azhar, Raed A; Gill, Inderbir; Desai, Mihir; Aron, Monish; Berger, Andre

    2016-04-01

    Ileal ureter formation has been found to be a suitable treatment option for long, chronic ureteral strictures not amendable to less invasive forms of repair. Minimally invasive surgical techniques for this condition have been investigated. We report the first series of robotic completely intracorporeal ileal ureter using a four-arm robotic technique. Three patients underwent this procedure, including one patient with a solitary kidney. All procedures were performed effectively with a median operative time of 450 minutes (range: 420-540) and median estimated blood loss of 100 mL (range: 50-200). Postoperatively, one patient suffered volvulus and subsequent necrosis of small bowel and ileal ureter, which required re-operation and small bowel resection, including the ileal ureter. The other two patients report no surgical complications to date. This early series represents preliminary technical procedure feasibility. Further experience is necessary.

  6. The pelvic ileal reservoir: an experimental assessment of its function compared with that of normal rectum.

    Science.gov (United States)

    Cranley, B; McKelvey, S T

    1982-08-01

    The function of the 3-loop pelvic ileal reservoir as an alternative to total proctocolectomy and ileostomy is assessed experimentally in dogs and compared with normal rectum under identical conditions. No difference was found between the pelvic ileal reservoir and normal rectum in their ability to maintain continence. The efficiency of evacuation, however, is significantly better in normal rectum (P less than 0.01). Observations made over a prolonged period of time suggest that frequency of defecation, tenesmus and incomplete evacuation are persistent problems with an ileal reservoir. The results of the experiments concur with clinical findings that satisfactory continence may be achieved by using the ileal reservoir but that it does not possess the ability of normal rectum to evacuate completely. Hence the frequent need for self-catheterization.

  7. Terminating supervision.

    Science.gov (United States)

    Levendosky, Alytia A; Hopwood, Christopher J

    2017-03-01

    The focus of this paper is on the termination of clinical supervision. Although clinical supervision is considered the backbone of most mental health training programs, it gets relatively little theoretical or empirical attention. The termination of supervision has received even less attention. In this paper, we describe an approach to terminating supervision in our treatment team, which integrates intensive assessment with a relational perspective in a clinical science training program (Levendosky & Hopwood, 2016). We describe our established conceptual framework, review empirical evidence, and provide verbatim examples from final supervision meetings on our team to elaborate the importance of conceptualizing individual differences across trainees and parallels between supervision and psychotherapy dynamics. We conclude by emphasizing the need for research on supervision in general and supervision termination in particular. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Two cases of patients with renal transplants presenting with anuria due to an infarcted ileal conduit.

    Science.gov (United States)

    Coxon, Jonathan P; Jones, Chris R

    2002-10-01

    Transplanting kidneys into patients with an ileal conduit has become acceptable practice, and is usually well tolerated. We present the cases of two such patients who later presented as emergencies with anuria due to infarction of the ileal conduit. Both required operative intervention, and in both cases the renal function returned to its pre-operative level. The cases illustrate an important differential diagnosis of anuria in this group of transplant patients.

  9. Apparent ileal digestibility of amino acids and metabolisable energy value in grains for broilers

    OpenAIRE

    S. PERTTILÄ; J. VALAJA; T. JALAVA

    2008-01-01

    Using ileal digestible amino acids in feed optimising will intensify feed protein utilizing and decrease nitrogen excretion to the environment. The study determined the apparent ileal digestibility (AID) coefficients of amino acids in barley, wheat, oats, triticale, maize, and dehulled oats in the diets of 180 Ross broiler chickens (aged 2435 days). The birds were fed semi-purified diets that contained grain as the sole protein source and chromium-mordanted straw as an indigestible marker. Th...

  10. Azoreductase and nitroreductase activity of bacteria in feces from patients with an ileal reservoir.

    Science.gov (United States)

    Rafii, F; Ruseler-Van Embden, J G; Asad, Y F

    1997-01-01

    Azoreductase and nitroreductase activities of bacteria in feces of five patients with ileal reservoirs were evaluated, both at the onset of symptoms of pouchitis and following recovery after treatment with drugs. All stool samples tested had bacteria with azoreductase and nitroreductase activities. Azoreductase and nitroreductase activities were higher after recovery than during attacks of pouchitis. During reestablishment of the normal microflora in the ileal reservoirs after pouchitis, the anaerobic bacteria increased and the aerobic bacteria decreased.

  11. Apparent and standardized ileal nutrient digestibility of broiler diets containing varying levels of raw full-fat soybean and microbial protease.

    Science.gov (United States)

    Erdaw, Mammo M; Perez-Maldonado, Rider A; Iji, Paul A

    2017-01-01

    Although soybean meal (SBM) is excellent source of protein in diets for poultry, it is sometimes inaccessible, costly and fluctuates in supply. The SBM can partially be replaced by full-fat SBM, but the meals prepared from raw full-fat soybean contain antinutritional factors. To avoid the risk of antinutritional factors, heat treatment is always advisable, but either excessive or under heating the soybean could negatively affect the quality. However, the potential for further improvement of SBM by supplementing with microbial enzymes has been suggested by many researchers. The objective of this study was to evaluate the performance and ileal nutrient digestibility of birds fed on diets containing raw soybeans and supplemented with microbial protease. A 3 × 2 factorial, involving 3 levels of raw full-fat soybean (RFFS; 0, 45 or 75 g/kg of diet) and 2 levels of protease (0 or 15,000 PROT/kg) was used. The birds were raised in a climate-controlled room. A nitrogen-free diet was also offered to a reference group from day 19 to 24 to determine protein and amino acid flow at the terminal ileum and calculate the standardized ileal digestibility of nutrients. On days 10, 24 and 35, body weight and feed leftover were recorded to calculate the body weight gain (BWG), feed intake (FI) and feed conversion ratio (FCR). On day 24, samples of ileal digesta were collected at least from two birds per replicate. When RFFS was increased from 0 to 75 g/kg of diet, the content of trypsin inhibitors was increased from 1747 to 10,193 trypsin inhibitors unit (TIU)/g of diets, and feed consumption of birds was also reduced (P diets. This study showed that some commercial SBM could be replaced by RFFS in broiler diets, without markedly compromising productivity. The AID and SID of CP and lysine were slightly improved by dietary supplementation of microbial protease.

  12. Crohn's disease in the ileal pouch after total colectomy for ulcerative colitis: findings on pouch enemas in six patients.

    Science.gov (United States)

    Wagner-Bartak, Nicolaus A; Levine, Marc S; Rubesin, Stephen E; Laufer, Igor; Rombeau, John L; Lichtenstein, Gary R

    2005-06-01

    The purpose of this study was to describe our experience with six patients who developed Crohn's disease in the ileal pouch or distal ileum after a total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis. Pouch enemas showed characteristic findings of Crohn's disease, including nodularity, thickened folds, ulceration, cobblestoning, strictures, sinus tracks, and fistulas to the perianal region and vagina. It is important for radiologists to be aware of the findings of Crohn's disease in the ileal pouch and distal ileum on radiographic studies of the pouch after total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis because of the implications for patient management.

  13. Ileoanal anastomosis with proximal ileal reservoir: an experimental study.

    Science.gov (United States)

    Schraut, W H; Block, G E

    1982-03-01

    Endorectal ileoanal anastomosis with proximal interposition of an ileal reservoir was evaluated experimentally in dogs as an approach to retain sphincteric control of defecation after proctocolectomy. Two months after the operative procedure, eight animals with a reservoir had four to eight semisolid stools per day and were continent. In contrast, six animals with straight ileoanal anastomosis were incontinent with 10 to 14 evacuations per day. Motility studies demonstrated a reduction of propulsive peristalsis within the undistended reservoir, which is considered the responsible factor for increased intestinal transit time and reduced stool frequency. Filling of the reservoir to capacity elicited strong peristaltic contractions, which may assure a more complete evacuation of the reservoir during defecation. Reservoir capacity increased substantially (150% to 200%) within 2 months but only to a minor degree thereafter, indicating that the reservoir does not dilate progressively into an atonic viscus. Motility patterns remained unaltered as the reservoir became more complaint with time. Mucosal alterations (flattening of villi, submucosal inflammation) were detected in the reservoir but did not result in nutritional defects within an observation period of 1 year.

  14. Measurement of true ileal phosphorus digestibility in meat and bone meal for broiler chickens.

    Science.gov (United States)

    Mutucumarana, R K; Ravindran, V; Ravindran, G; Cowieson, A J

    2015-07-01

    An experiment was conducted to estimate true ileal phosphorus (P:) digestibility of 3 meat and bone meal samples (MBM-1, MBM-2: , and MBM-3:) for broiler chickens. Four semipurified diets were formulated from each sample to contain graded concentrations of P. The experiment was conducted as a completely randomized design with 6 replicates (6 birds per replicate) per dietary treatment. A total of 432 Ross 308 broilers were assigned at 21 d of age to the 12 test diets. The apparent ileal digestibility coefficient of P was determined by the indicator method, and the linear regression method was used to determine the true P digestibility coefficient. The apparent ileal digestibility coefficient of P in birds fed diets containing MBM-1 and MBM-2 was unaffected by increasing dietary concentrations of P (P > 0.05). The apparent ileal digestibility coefficient of P in birds fed the MBM-3 diets decreased with increasing P concentrations (linear, P birds fed the MBM-1 and MBM-2 diets, ileal endogenous P losses were estimated to be 0.049 and 0.142 g/kg DM intake (DMI:), respectively. In birds fed the MBM-3 diets, endogenous P loss was estimated to be negative (-0.370 g/kg DMI). True ileal P digestibility of MBM-1, MBM-2, and MBM-3 was determined to be 0.693, 0.608, and 0.420, respectively. True ileal P digestibility coefficients determined for MBM-1 and MBM-2 were similar (P < 0.05), but were higher (P < 0.05) than that for MBM-3. Total P and true digestible P contents of MBM-1, MBM-2, and MBM-3 were determined to be 37.5 and 26.0; 60.2 and 36.6; and 59.8 and 25.1 g/kg, respectively, on an as-fed basis. © 2015 Poultry Science Association Inc.

  15. Vegetable cells in urinary samples of patients with bricker ileal conduit.

    Science.gov (United States)

    Planinšek, Tanja; Kladnik, Aleš; Pohar-Marinšek, Ziva; Fležar, Margareta Strojan

    2014-02-01

    During routine cytopathological evaluation of urines for malignant cells we have occasionally noticed vegetable cells that were only present in patients with Bricker ileal conduit. We wanted to identify the means and sources of contamination of urinary samples from these patients. During the period between May and November 2010, 637 urinary samples were routinely evaluated for malignant cells. Among them were 13 urinary samples from Bricker ileal conduit which we rescreened. We prepared all urinary samples by membrane filtration and stained them according to Papanicolaou. Subsequently, we prepared samples from ostomy adhesives made by Coloplast and by ConvaTec which are used to secure the ostomy bag onto urostomy. We also took samples from different constituents (hydrocolloids) of ostomy adhesives. On the cytopathological review, we found vegetable cells along with intestinal mucosa cells in urinary samples of seven patients with Bricker ileal conduit. With the light microscopic examination of the samples prepared from different ostomy adhesives, we found vegetable cells only in Coloplast adhesives. In preparations of hydrocolloids, we found vegetable cells only in guar gum. They were morphologically identical to those found in urine samples of patients with Bricker ileal conduit and in Sensura and Sensura Xpro (Coloplast) ostomy adhesives. We determined that the origin of vegetable cells in urines from Bricker ileal conduit is the ostomy adhesive. The vegetable cells differ from human intestinal epithelial cells regarding size, shape, and color so it is difficult to misinterpret them as dysplastic cells. Copyright © 2013 Wiley Periodicals, Inc.

  16. The effect of N-acetyl-L-cysteine on the viscosity of ileal neobladder mucus.

    Science.gov (United States)

    Schrier, B P; Lichtendonk, W J; Witjes, J A

    2002-05-01

    N-acetyl-L-cysteine (NAC) proved to be an effective mucolytic in pulmonary secretions. Our goal was to investigate the in vitro effect of NAC on viscosity of ileal neobladder mucus. The urine of a patient with an ileal neobladder was collected during the first 7 days postoperatively and stored in a refrigerator. After precipitation, the urine was decanted. The residue was stirred to a homogeneous suspension. To samples of 4.5 ml mucus, 0.5 ml NAC 10% was added. To the control sample, 0.5 ml water was added. The samples were incubated in a water bath at 37 degrees C for 5, 30 and 60 min. Viscosity was measured in the Bohlin VOR Rheometer. The viscosity of the ileal neobladder mucus decreased quickly after incubating with NAC 10%. Viscosity increased slightly after I h of incubation. The viscosity in the control sample was higher than in the other incubated samples. NAC was found to decrease the viscosity of ileal neobladder mucus, supporting the in vivo experience that NAC can be useful in patients with an ileal neobladder to facilitate the evacuation of mucus by decreasing viscosity.

  17. 'Low sodium' diuresis and ileal loss in patients with ileostomies: effect of desmopressin.

    Science.gov (United States)

    Sutters, M; Carmichael, D J; Unwin, R J; Sozi, C; Hunter, M; Calam, J; Lightman, S L; Peart, W S

    1991-01-01

    Patients with ileostomies show an early diuresis when sodium restricted; this, together with an obligatory ileal sodium loss, predisposes them to severe salt and water depletion. The role of arginine vasopressin in this circumstance and whether it is natriuretic, or antinatriuretic, is unclear. There is also controversy over its likely effect on small bowel fluid reabsorption. We have examined the effect of the non-pressor (V2) synthetic vasopressin analogue 1-deamino-8-D-arginine (desmopressin) on renal and ileal sodium and water excretion in ileostomy patients during acute adaptation to a low sodium diet. Patients were studied on two separate occasions (nonrandomised) with and without the administration of desmopressin (0.75 micrograms intramuscular, three times a day). In eight subjects without desmopressin there was pronounced diuresis on the first low sodium day, associated with a fall in renal sodium excretion and no change in ileal output or composition. In five (of the original) subjects with desmopressin there was pronounced antidiuresis, no change in renal sodium excretion, and no change in ileal output or composition. In both studies rises in plasma renin activity and salivary aldosterone concentration lagged behind the early decline in renal sodium excretion. We have confirmed the phenomenon of 'low sodium' diuresis after sodium restriction in ileostomy patients and shown that it can be prevented by desmopressin. Desmopressin has no direct or indirect effect on renal sodium excretion or ileal fluid and electrolyte loss in humans. PMID:2060872

  18. Risk of ileal pouch neoplasms in patients with familial adenomatous polyposis

    Science.gov (United States)

    Tajika, Masahiro; Niwa, Yasumasa; Bhatia, Vikram; Tanaka, Tsutomu; Ishihara, Makoto; Yamao, Kenji

    2013-01-01

    Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis (FAP). However, adenomas may develop in the ileal pouch mucosa over time, and even carcinoma in the pouch has been reported. We therefore reviewed the prevalence, nature, and treatment of adenomas and carcinoma that develop after proctocolectomy in the ileal pouch mucosa in patients with FAP. In 25 reports that were reviewed, the incidence of adenomas in the ileal pouch varied from 6.7% to 73.9%. Several potential factors that favor the development of pouch polyposis have been investigated, but many remain controversial. Nevertheless, it seems certain that the age of the pouch is important. The risk appears to be 7% to 16% after 5 years, 35% to 42% after 10 years, and 75% after 15 years. On the other hand, only 21 cases of ileal pouch carcinoma have been recorded in the literature to date. The diagnosis of pouch carcinoma was made between 3 to 20 years (median, 10 years) after pouch construction. Although the risk of malignant transformation in ileal pouches is probably low, it is not negligible, and the long-term risk cannot presently be well quantified. Regular endoscopic surveillance, especially using chromoendoscopy, is recommended. PMID:24187452

  19. Grynfeltt Hernia: A Deceptive Lumbar Mass with a Lipoma-Like Presentation

    Directory of Open Access Journals (Sweden)

    Jonathan R. Zadeh

    2015-01-01

    Full Text Available The Grynfeltt-Lesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro- and intraperitoneal structures through the upper lumbar triangle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. In order to avoid that outcome, it is advisable to electively repair Grynfeltt hernias in patients without significant contraindications to surgery. Due to the limited number of lumbar hernioplasties performed, there has not been a large study that definitively identifies the best repair technique. It is generally accepted that abdominal hernias such as these should be repaired by tension-free methods. Both laparoscopic and open techniques are described in modern literature with unique advantages and complications for each. We present the case of an unexpected Grynfeltt hernia diagnosed following an attempted lipoma resection. We chose to perform an open repair involving a combination of fascial approximation and dual-layer polypropylene mesh placement. The patient’s recovery was uneventful and there has been no evidence of recurrence at over six months. Our goal herein is to increase awareness of upper lumbar hernias and to discuss approaches to their surgical management.

  20. Spindle cell lipoma of the head and neck: CT and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Wook [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Ajou University School of Medicine, Department of Radiology, Suwon (Korea, Republic of); Kim, Hyung-Jin; Kim, Hye Jung; Cha, Ji Hoon; Kim, Sung Tae [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Jinna [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2013-01-15

    Spindle cell lipoma (SCL) is an uncommon benign lipomatous tumor, most commonly occurring in the posterior neck and shoulder. The purpose of this study was to investigate the CT and MR imaging features of SCL in the head and neck. CT (n = 5) and MR (n = 3) images of seven patients (five men and two women; mean age, 54 years) with surgically proven SCL in the head and neck were retrospectively reviewed. The location and morphologic characteristics of SCL were documented as well. Six lesions were well-defined and located in the subcutaneous fat of the posterior neck (n = 4), anterior neck (n = 1), and buccal space (n = 1). One lesion was ill-defined and located deeply in the supraclavicular fossa, infiltrating the adjacent shoulder muscles. Intratumoral fat was identified in five lesions in various amounts. Compared with the adjacent subcutaneous fat, intratumoral fat was slightly hyperattenuated on CT scans and slightly hypointense on T1-weighted MR images. In five of six lesions in which postcontrast CT and/or MR images were obtained, significant enhancement was seen in the nonadipose component of the lesion. Various components of the adipose and nonadipose tissues may cause difficulty differentiating between SCL and other adipocytic tumors including liposarcoma radiologically. Although nonspecific, the radiologist should know the various imaging features of SCL, because the tumor can be cured by simple excision. (orig.)

  1. Terminal Ballistics

    CERN Document Server

    Rosenberg, Zvi

    2012-01-01

    This book covers the important issues of terminal ballistics in a comprehensive way combining experimental data, numerical simulations and analytical modeling. The first chapter reviews the experimental equipment which are used for ballistic tests and the diagnostics for material characterization under impulsive loading conditions. The second chapter covers essential features of the codes which are used for terminal ballistics such as the Euler vs. Lagrange schemes and meshing techniques, as well as the most popular material models. The third chapter, devoted to the penetration mechanics of rigid penetrators, brings the update of modeling in this field. The fourth chapter deals with plate perforation and the fifth chapter deals with the penetration mechanics of shaped charge jets and eroding long rods. The last two chapters discuss several techniques for the disruption and defeating of the main threats in armor design. Throughout the book the authors demonstrate the advantages of numerical simulations in unde...

  2. ILEAL DIGESTIBILITY OF AMINO ACIDS IN WHEAT GERM - A BY-PRODUCT OF THE MILL INDUILEAL DIGESTIBILITY OF AMINO ACIDS IN WHEAT GERM - A BY-PRODUCT OF THE MILL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Matej Brestenský

    2013-02-01

    Full Text Available The 6 cannulated gilts, with initial body weight (BW 34.8 ± 0.7 kg, fitted with ileal T-cannula in terminal ileum were used for estimation apparent (AID and standardized (SID ileal digestibility of nitrogen (N and amino acids (AA in wheat germs. Animals were fed twice a day with tested diet in two equal doses at daily rate of 75 - 80 g.kg - 0.75. Water was offered ad libitum. The test feed was the only source of protein in the diet. After the 14 d postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed an experimental diet, on d 7 we collected ileal digesta continuously for 24 h. Chromium oxide (Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculated AID and SID of AA and N using analytic estimated values of N, Cr2O3, and AA. The SID of AA in wheat germs ranged from 86.6 % (tyrosine to 97.6 % (proline (P < 0.05. Ileal digestibility for lysine

  3. Giant ileal inflammatory fibroid polyp: a rare cause of intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Daniel Cury Ogata

    2012-09-01

    Full Text Available Ileal inflammatory fibroid polyp is a rare non-neoplastic lesion of the gastrointestinal tract. Intussusception caused by an inflammatory fibroid polyps is uncommon. The authors report a case of a 75 year-old female patient presenting with ileal obstruction due to intussusception of a polypoid lesion. The patient underwent surgical treatment and histopathology confirmed the diagnosis.Os pólipos fibroides inflamatórios são raras lesões não neoplásicas do trato gastrointestinal e a intussuscepção devido a essa entidade é incomum. Os autores relatam um caso de paciente do sexo feminino, 75 anos, que apresentou obstrução ileal devido a uma intussuscepção por lesão polipoide. A paciente foi submetida a tratamento cirúrgico, sendo diagnosticado pólipo fibroide inflamatório do íleo.

  4. Isolated ileal perforation in infancy: a lethal initial presentation of Hirschsprung’s disease

    Directory of Open Access Journals (Sweden)

    Fadi Iskandarani

    2017-06-01

    Full Text Available A rare case of ileal perforation, as a fatal initial presentation of total colonic aganglionosis (TCA in infancy is reported. A 10-week-old boy, was brought to the emergency department with symptoms of complicated intestinal obstruction. He looked ill, was lethargic, markedly dehydrated and had a severely distended abdomen. An abdominal X-ray revealed multiple air fluid levels seen in a distended small intestine. During exploratory laparotomy the ileum was massively dilated with distal segment perforation. Ileal perforation repair was performed. A totally collapsed microcolon was identified. Biopsies were taken from the high rectum, sigmoid and hepatic flexure. Appendectomy and ileostomy were performed. All biopsies, as well as the appendix, showed absence of ganglion cells. Despite this procedure the patient progressively deteriorated and later died due to sepsis. Ileal perforation in infants is a rare, but potentially fatal initial presentation of TCA. Early detection is essential to prevent life-threatening complications.

  5. Ileal adhesion of virulent E. coli LF82 is not enhanced in Crohn’s disease

    DEFF Research Database (Denmark)

    Jensen, Rikke S.; Fink, Lisbeth Nielsen; Pedersen, Susanne Brix

    2011-01-01

    Adherent-invasive Escherichia coli (AIEC) comprise a new group of E. coli species named from their distinctive ability to adhere to and invade the intestinal epithelium. The AIEC strains have been associated to the ileal mucosa in Crohn’s disease (CD), and the impact of AIEC in the pathogenesis....... A second purpose was to assess the probiotic efficacy of E. coli Nissle 1917 (ECN) in averting LF82 adhesion to ileal mucosa. Ileal and colonic specimens were obtained from patients with CD ileitis and controls (n¼10). A model was developed to investigate bacterial adhesion to intestinal biopsies...... and comprised: 1) incubation of tissue (inclusive of mucous) with 107 bacteria or buffer for 1 hour, 2) removal of non-adhered bacteria by extensive washing, and 3) absolute quantification of tissue-adhered LF82 and indigenous E. coli by a pre-validated assay including quantitative real-time PCR. Selective...

  6. GATA4 Is Sufficient to Establish Jejunal Versus Ileal Identity in the Small Intestine.

    Science.gov (United States)

    Thompson, Cayla A; Wojta, Kevin; Pulakanti, Kirthi; Rao, Sridhar; Dawson, Paul; Battle, Michele A

    2017-05-01

    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. To test this hypothesis, we generated a novel Gata4 conditional knock-in mouse line and expressed GATA4 in the ileum, where it is absent. 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. 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 NCBI Gene Expression Omnibus (http://www.ncbi.nlm.nih.gov/geo) and are

  7. Robot-assisted intracorporeal ileal conduit: Marionette technique and initial experience at Roswell Park Cancer Institute.

    Science.gov (United States)

    Guru, Khurshid; Seixas-Mikelus, Stéfanie A; Hussain, Abid; Blumenfeld, Aaron J; Nyquist, John; Chandrasekhar, Rameela; Wilding, Gregory E

    2010-10-01

    To present our technique and initial experience with patients who underwent robot-assisted intracorporeal creation of ileal conduit and to compare them with patients who underwent extracorporeal ileal diversion after robot-assisted radical cystectomy. Twenty-six patients diagnosed with invasive transitional cell carcinoma of the bladder underwent a robot-assisted radical cystectomy with bilateral extended pelvic lymphadenectomy with ileal conduit diversion. Total intracorporeal ileal conduit creation was performed in the last 13 patients. Operative data and short-term outcomes between the 2 groups were assessed. The novel surgical technique for intracorporeal ileal conduit will be presented. The intracorporeal group (IC) included 2 female and 11 male patients (mean age 71 years). The extracorporeal group (EC) included 4 female and 9 male patients (mean age 66 years). No significant differences were noted between the groups in terms of patient age, BMI, sex, prior surgery, or pathologic stage. Overall operative time and intraoperative complications were similar. No significant differences were noted between the 2 groups in terms of diversion time or estimated blood loss. There were 4 complications recorded in IC patients, including nonspecific colitis, small bowel obstruction requiring exploratory laparotomy with lysis of adhesions, a urine leak that eventually resolved but required a temporary nephrostomy tube, and a fever of unknown origin that resolved without intervention. Robot-assisted intracorporeal ileal conduit can be accomplished safely with acceptable operative times even during early experience. Larger series with favorable results will be required to add this new paradigm to minimally invasive surgery for bladder cancer. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Surgical treatment for lumbar hyperlordosis after resection of a spinal lipoma associated with spina bifida: A case report.

    Science.gov (United States)

    Sato, Tatsuya; Yonezawa, Ikuho; Onda, Shingo; Yoshikawa, Kei; Takano, Hiromitsu; Shimamura, Yukitoshi; Okuda, Takatoshi; Kaneko, Kazuo

    2017-09-01

    A hyperlordosis deformity of the lumbar spine is relatively rare, and surgical treatment has not been comprehensively addressed. In this case report, we describe the clinical presentation, surgical treatment, and medium-term follow-up of a patient presenting with a progressive lumbar hyperlordosis deformity after resection of a spinal lipoma associated with spina bifida. The patient was a 20-year-old woman presenting with a progressive hyperlordosis deformity of the lumbar spine associated with significant back pain (visual analog pain score of 89/100 mm), but with no neurological symptoms. The lumbar lordosis (LL), measured on standing lateral view radiographs, was 114°, with a sagittal vertical axis (SVA) of -100 mm. The patient had undergone excision of a lipoma, associated with spina bifida of the lumbar spine, at 7 months of age.She was first evaluated at our hospital at 18 years of age for progressive spinal deformity and lumbago. An in situ fusion, from T5 to S1, using pedicle screws with bone graft obtained from the iliac crest, was performed. Postoperatively, the LL decreased to 93°, and the SVA decreased to -50 mm. The decision to not correct the hyperlordosis deformity fully was intentional. Seven years and 1 month postsurgery, the patient had no limitations in standing and walking and reported a pain score of 8/100 mm; there was no evidence of a loss of correction. Lumbar hyperlordosis after resection of a spinal lipoma associated with spina bifida is rare. Posterior fixation provided an effective treatment in this case. As the lumbar hyperlordosis deformity is often high, correction can be difficult. In this case, although the correction and fusion were performed in situ, there was no progression of either the deformity or the lumbago. Early detection remains an essential component of effective treatment, allowing correction when the spinal deformity is easily reversible.

  9. Jejuno-ileal diverticulitis with localized perforation: CT and US findings

    Energy Technology Data Exchange (ETDEWEB)

    Grana, Lucia [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: lu_rx@hotmail.com; Pedraja, Inigo [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: ipedraja@yahoo.es; Mendez, Ramiro [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: rmendez.hcsc@salud.madrid.org; Rodriguez, Ricardo [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: rrodriguez.hcsc@salud.madrid.org

    2009-08-15

    Purpose: To describe the computed tomography and ultrasound findings of five cases of small bowel diverticulitis with localized perforation. Material and methods: Our database, from April 2003 to August 2007, was reviewed and five cases of small bowel diverticulitis were identified. Results: Jejuno-ileal diverticulitis with covered perforation usually presents as wall thickening of a small bowel loop and an adjacent inflammatory mass containing air bubbles. Conclusion: Small bowel diverticula are rare and mostly asymptomatic. They become clinically relevant when complications arise, such as diverticulitis. The symptoms of jejuno-ileal diverticulitis are non-specific and the diagnosis is performed mainly by imaging studies.

  10. Standardized ileal digestibility of amino acids in eight genotypes of barley fed to growing pigs

    DEFF Research Database (Denmark)

    Spindler, H K; Mosenthin, R; Rosenfelder, Pia

    2016-01-01

    To determine chemical composition, physical characteristics and standardized ileal digestibility (SID) of CP and amino acids (AA) in eight current hulled barley genotypes, an experiment with growing pigs has been conducted. These genotypes included Yool, Campanile, Lomerit, Travira, Anisette...... compared to Yool and Campanile. Standardized ileal digestibility of Lys, Met and Trp (Pdigestible content (cSID) of CP and AA. Furthermore, SID and cSID of CP and most AA linearly decreased (P......digestibility of CP and some AA and cSID of CP and most AA decreased linearly with increasing TW (P

  11. Percutaneous Nephrolithotomy, Ileal Conduit- Lithotripsy and Litholapaxy for a Neglected Encrusted Ureteral Stent

    Directory of Open Access Journals (Sweden)

    Andrés Gutierrez

    2017-11-01

    Full Text Available Urolithiasis can result as a complication of urinary diversión, favored by urinary stasis, intestinal mucus, urinary tract bacteriuria, the metabolic derangements and the presence of foreign bodies. We present a 52- year-old male who underwent radical cystectomy with construction of a Bricker uretero-ileostomy. 5 years later he was found with a forgotten ureteral stent, a 6 cm calculi occupying the whole ileal conduit and a 13 mm calculi in the left renal pelvis. We present our experience in the successful endourological management of an encrusted neglected ureteral stent in an ileal conduit, achieving a stone-free status without complications.

  12. Myofibroblastoma of the Female Breast with Admixed but Distinct Foci of Spindle Cell Lipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Hazem A. H. Ibrahim

    2013-01-01

    Full Text Available Mammary myofibroblastoma (MFB is a rare benign spindle neoplasm that affects both sexes with a male predominance. It can exhibit a wide range of histological patterns. We report a case of epithelioid/spindle MFB of the female breast with admixed, but distinct, foci of spindle cell lipoma. Whilst all the spindle cells within the tumour expressed CD34, AR, ER, BCL2, and CD10, only those within the myofibroblastoma expressed desmin and only those within the lipomatous areas expressed S100. This finding, to our knowledge, is a novel one that has not been reported before.

  13. Myofibroblastoma of the female breast with admixed but distinct foci of spindle cell lipoma: a case report.

    Science.gov (United States)

    Ibrahim, Hazem A H; Shousha, Sami

    2013-01-01

    Mammary myofibroblastoma (MFB) is a rare benign spindle neoplasm that affects both sexes with a male predominance. It can exhibit a wide range of histological patterns. We report a case of epithelioid/spindle MFB of the female breast with admixed, but distinct, foci of spindle cell lipoma. Whilst all the spindle cells within the tumour expressed CD34, AR, ER, BCL2, and CD10, only those within the myofibroblastoma expressed desmin and only those within the lipomatous areas expressed S100. This finding, to our knowledge, is a novel one that has not been reported before.

  14. Chemical composition and standardized ileal digestibility of protein and amino acids from blue mussel, starfish, and fish silage in pigs

    DEFF Research Database (Denmark)

    Nørgaard, Jens Vinther; Petersen, Jens Kjerulf; Tørring, Ditte Bruunshøj

    2015-01-01

    fish silage from farmed salmon was also included in theexperiment. The standardized ileal digestibility (SID) of crude protein (CP) and amino acids(AA) was evaluated in a Latin square design with pigs (initial weight 39.3 kg) fitted with asimple T-cannula in the terminal ileum. Diets contained 131......Mussels cultured on lines for nine months and harvested in March were boiled to removeshells and processed into a dry meal or a silage acidified by formic acid. Starfish mealwas prepared from starfish caught in May, and a starfish juice fraction was obtained bypressing fresh starfish. Commercial......–162 g CP/kg and 5 g chromicoxide/kg. Endogenous losses of protein and AA were estimated by feeding an N-free diet.On a dry matter (DM) basis, mussel meal contained 605 g, mussel silage 575 g, starfish meal700 g, starfish juice 393 g, and fish silage 776 g CP/kg. The ratio of AA to CP ranged from0...

  15. Terminal ballistics

    CERN Document Server

    Rosenberg, Zvi

    2016-01-01

    This book comprehensively discusses essential aspects of terminal ballistics, combining experimental data, numerical simulations and analytical modeling. Employing a unique approach to numerical simulations as a measure of sensitivity for the major physical parameters, the new edition also includes the following features: new figures to better illustrate the problems discussed; improved explanations for the equation of state of a solid and for the cavity expansion process; new data concerning the Kolsky bar test; and a discussion of analytical modeling for the hole diameter in a thin metallic plate impacted by a shaped charge jet. The section on thick concrete targets penetrated by rigid projectiles has now been expanded to include the latest findings, and two new sections have been added: one on a novel approach to the perforation of thin concrete slabs, and one on testing the failure of thin metallic plates using a hydrodynamic ram.

  16. True ileal amino acid digestibility of goat and cow milk infant formulas

    NARCIS (Netherlands)

    Rutherfurd, S.M.; Darragh, A.J.; Hendriks, W.H.; Prosser, C.G.; Lowry, D.

    2006-01-01

    Goat milk is used as an alternative to cow milk for the production of infant formulas. However, little is known about the protein quality and, specifically, about the digestible AA pattern of goat milk formulas compared with their cow milk counterparts. In this study, the true ileal AA digestibility

  17. Pouch Failures Following Ileal Pouch-anal Anastomosis for Ulcerative Colitis

    DEFF Research Database (Denmark)

    Mark-Christensen, Anders; Erichsen, Rune; Brandsborg, Søren

    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...... with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980-2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation. We used Cox proportional hazards regression to explore the association....... high-volume 2.30, 95% CI: 1.26-4.20) were also associated with a higher risk of failure. The risk of failure was not associated with calendar year, primary sclerosing cholangitis, synchronous colectomy, or laparoscopy. CONCLUSION: In a cohort of patients with ulcerative colitis and ileal pouch...

  18. Screening of Viral Pathogens from Pediatric Ileal Tissue Samples after Vaccination

    Directory of Open Access Journals (Sweden)

    Laura Hewitson

    2014-01-01

    Full Text Available In 2010, researchers reported that the two US-licensed rotavirus vaccines contained DNA or DNA fragments from porcine circovirus (PCV. Although PCV, a common virus among pigs, is not thought to cause illness in humans, these findings raised several safety concerns. In this study, we sought to determine whether viruses, including PCV, could be detected in ileal tissue samples of children vaccinated with one of the two rotavirus vaccines. A broad spectrum, novel DNA detection technology, the Lawrence Livermore Microbial Detection Array (LLMDA, was utilized, and confirmation of viral pathogens using the polymerase chain reaction (PCR was conducted. The LLMDA technology was recently used to identify PCV from one rotavirus vaccine. Ileal tissue samples were analyzed from 21 subjects, aged 15–62 months. PCV was not detected in any ileal tissue samples by the LLMDA or PCR. LLMDA identified a human rotavirus A from one of the vaccinated subjects, which is likely due to a recent infection from a wild type rotavirus. LLMDA also identified human parechovirus, a common gastroenteritis viral infection, from two subjects. Additionally, LLMDA detected common gastrointestinal bacterial organisms from the Enterobacteriaceae, Bacteroidaceae, and Streptococcaceae families from several subjects. This study provides a survey of viral and bacterial pathogens from pediatric ileal samples, and may shed light on future studies to identify pathogen associations with pediatric vaccinations.

  19. Requirement of standardized ileal digestible valine to lysine ratio for 8- to 14-kg pigs

    DEFF Research Database (Denmark)

    Assadi Soumeh, Elham; van Milgen, Jaap; Sloth, Niels Morten

    2015-01-01

    The objective was to define the Val requirement for weaned piglets in the context of reducing the dietary protein content. A dose–response experiment was conducted to estimate the standardized ileal digestible (SID) Val to Lys ratio required to support the optimum growth of post-weaned piglets...

  20. Multiple angiomatous proliferations of ileal stoma following Campylobacter enteritis. Effect of laser photocoagulation

    NARCIS (Netherlands)

    Meuwissen, S. G.; Willig, A. P.; Hausman, R.; Starink, T. M.; Mathus-Vliegen, E. M.

    1986-01-01

    Multiple polypoid sessile tumors arose at the tip of the ileal stoma of a 37-year-old man, who previously underwent proctocolectomy for ulcerative colitis. The lesions developed shortly after a well-established gastrointestinal infection with Campylobacter jejuni with mucosal ulceration. The

  1. Functional changes associated with short and long lateral ileal reservoirs in a canine model.

    Science.gov (United States)

    Stelzner, M; Fonkalsrud, E W

    1993-03-01

    Colectomy and endorectal ileal pull-through with ileal reservoir (PTR) have become a standard operative procedure for severe ulcerative colitis and familial polyposis coli. Satisfactory results have been reported with a number of different reservoir designs; however, the optimal reservoir size and configuration remain controversial. Two groups of five dogs each, undergoing colectomy and PTR with construction of either 5-cm-long or 18-cm-long lateral ileal reservoirs, were studied to compare defecatory patterns, intestinal transit, and reservoir emptying. Three months postoperatively, dogs with long ileal reservoirs demonstrated a higher stool frequency and made more unsuccessful attempts at defecation. Evacuation of viscous polyethylene glycol solution from the long reservoirs was prolonged during the first hour compared with short reservoirs. Two of the five long reservoirs showed mucosal ulcerations on postmortem examination, whereas none were present in any of the short pouches. Increases in stool water content and subsequent reduction of urine volumes as well as a prolongation in oroanal transit times occurred to a similar degree in both groups. It is concluded that short lateral isoperistaltic reservoirs empty more effectively than do long reservoirs.

  2. 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

  3. Neuropatía compresiva del ciático secundaria a lipoma de muslo: Caso clínico

    Directory of Open Access Journals (Sweden)

    A.F. Pineda-Restrepo

    2014-06-01

    Full Text Available La neuropatía compresiva del nervio ciático es una patología poco frecuente, atribuible a diferentes etiologías. Una causa poco habitual es la compresión extrínseca por tumores de tejidos blandos, como puede ser un lipoma. Presentamos un caso de neuropatía compresiva del nervio ciático a causa de un lipoma en la cara posterior del muslo. Ante la presencia de clínica compresiva del nervio ciático es importante realizar una adecuada evaluación clínica del paciente, así como las pruebas complementarias de imagen y electromiografía que sean necesarias para guiar de una forma acertada el tratamiento. Debemos tener siempre en cuenta que además de las causas comunes de compresión, existen otras causas más infrecuentes que pueden provocar neuropatías compresivas.

  4. Progressive bilateral lipoma arborescens of the knee complicated by juvenile spondyloarthropathy: a case report and review of the literature.

    Science.gov (United States)

    Xue, Jing; Alario, Anthony J; Nelson, Scott D; Wu, Huaxiang

    2013-10-01

    To report an unusual case of lipoma aborescens (LA) presented in a patient with treatment-responsive juvenile spondyloarthropathy (JSPA) and to summarize the clinical manifestations, therapy and prognosis of LA by literature review. We report an atypical case of a 17-year-old patient with an initial presentation of juvenile spondyloarthropathy, whose inflammatory condition was improved successfully by traditional anti-rheumatic drugs and an anti-TNF alpha agent but developed progressive swelling of bilateral knees. Lipoma arborescens were diagnosed in each knee by synovial biopsy obtained by arthroscopic surgery. Fifty-one cases of LA have been reported and are reviewed in detail. Clinically, LA could present as monoarthritis or oligoarthritis. The lateral compartment of the knee is the most common site of involvement. Several cases were reported as a comorbidity of inflammatory diseases, but were not improved by anti-inflammatory therapy. Most patients were diagnosed by classic MRI and biopsy findings. The lesions can be managed by open or arthroscopic surgery, but a minority of the cases may have reoccurrence in the same or opposite joint. LA is a very rare lesion of the synovial and bursal tissue with an unknown etiology. It is considered to be a benign proliferation of the synovial fat associated with trauma, degenerative or inflammatory conditions. LA should be considered as a secondary or comorbid condition in inflammatory arthropathies if other joints respond well to intensive therapy and one or more do not. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Prolonged hypervolemic hemodilution decreases functional capillary density of ileal mucosa in pigs revealed by sidestream dark-field imaging.

    Science.gov (United States)

    Turek, Zdenek; Cerny, Vladimir; Parizkova, Renata; Samek, Jindrich; Oberreiter, Martin

    2011-10-01

    Hemodilution changes the physical properties of blood by reducing its hematocrit and blood viscosity. We tested whether prolonged hypervolemic hemodilution (HHD) impairs functional capillary density (FCD) of ileal mucosa in healthy mechanically-ventilated pigs and if there is any correlation between changes in FCD of ileal and sublingual mucosas during HHD. Sixteen domestic female pigs were anesthetized, mechanically-ventilated, and randomly assigned to the HHD (20 ml/(kg∙h) Hartmann's solution for 3 h) or fluid restrictive (5 ml/(kg∙h) Hartmann's solution for 3 h) group. Microcirculations of sublingual and ileal mucosas via ileostomy were visualized using sidestream dark-field (SDF) imaging at baseline conditions (t=0 h) and at selected time intervals of fluid therapy (t=1, 2, and 3 h). A significant decrease of ileal FCD (285 (278-292) cm/cm(2)) in the HHD group was observed after the third hour of HHD when compared to the baseline (360 (350-370) cm/cm(2)) (P<0.01). This trend was not observed in the restrictive group, where the ileal mucosa FCD was significantly higher after the third hour of fluid therapy as compared to the HHD group (P<0.01). No correlation between microhemodynamic parameters obtained from sublingual and ileal mucosas was found throughout the study. Prolonged HHD established by crystalloid solution significantly decreased ileal villus FCD when compared to restrictive fluid regimen. An inappropriate degree of HHD can be harmful during uncomplicated abdominal surgery.

  6. A tertiary experience of ileal-ureter substitution: Contemporary indications and outcomes.

    Science.gov (United States)

    Gomez-Gomez, Enrique; Malde, Sachin; Spilotros, Marco; Shah, P J; J Greenwell, Tamsin; Ockrim, Jeremy L

    2016-06-01

    Complex ureteric stricture disease in contemporary practice is typically related to prior pelvic surgery, radiotherapy, or complicated, repeated retrograde stone surgery, although outcomes in this group have not been well studied. The aim of this study was to report medium-term outcomes with ileal-ureter substitution for complex ureteric stricture disease. All patients who had undergone ureteric reconstructive surgery using small bowel over a 5 year period between 2010 and 2015 were identified from the theatre database and their case notes reviewed. Data were collected on aetiology of ureteric stricture, prior surgery or radiotherapy, baseline renal function and comorbidity. Postoperative complications were recorded using the Clavien-Dindo classification, and overall outcome and need for further intervention were documented. Nine patients underwent ileal-ureter substitution for complex ureteric stricture disease over this period, with four having bilateral ileal interpositions. Median age was 48 years (38-62 years) with a median follow-up of 17 months (1-40 months). Simple untailored ileal segments and refluxing anastomoses were used in all cases. One case of anastomotic leak and restricture required reintervention, but all others had favourable outcomes with no stricture and no requirement for further intervention. Two patients reported recurrent cystitis following surgery but there was no deterioration in renal function in any patient, with no metabolic complications reported. Ileal-ureter substitution surgery is a valuable option for selected patients with complex, difficult-to-treat ureteric defects that cannot be bridged by other methods. Simple onlay techniques do not seem to affect renal or metabolic function. Avoiding the extra complexity of tailored and tunnelled anastomoses may reduce the potential morbidity and reintervention rate in patients with challenging surgical fields.

  7. First-ever Reported Obstructing Ureteral Nephrogenic Adenoma in a Child and Subsequent Robotic-assisted Laparoscopic Ileal Ureter.

    Science.gov (United States)

    Koenig, Joel F; Rensing, Adam; Austin, Paul F; Vricella, Gino

    2016-08-01

    To report the first known case of a completely intracorporeal robotic-assisted laparoscopic ileal ureter in the pediatric population, a 12-year-old boy with near-complete replacement of his right ureter with nephrogenic adenoma and resulting debilitating renal colic. Intracorporeal robotic-assisted laparoscopic ileal ureter was performed without complication. A detailed description of our surgical technique is included. The patient had improvement in hydronephrosis and complete resolution of renal colic symptoms with minimal incisional length compared to traditional laparotomy. Intracorporeal robotic-assisted laparoscopic ileal ureter provides the benefits of minimally invasive surgery when complete ureteral replacement is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Robot-Assisted Laparoscopic Partial Colpectomy and Intracorporeal Ileal Conduit Urinary Diversion (Bricker for Cervical Adenocarcinoma Recurrence

    Directory of Open Access Journals (Sweden)

    Jennifer Uzan

    2015-01-01

    Full Text Available Ileal conduit urinary diversion (Bricker is a standard surgical open procedure. The Da Vinci robot allowed precision for this surgical procedure, especially for intracorporeal suturing. Meanwhile, few reports of robot-assisted laparoscopic ileal conduit diversion (Bricker are described in the literature. We report the case of a 69-year-old patient with a vaginal recurrence of cervical adenocarcinoma associated with vesicovaginal fistula treated by robot-assisted laparoscopic partial colpectomy and ileal conduit urinary diversion (Bricker. The robot-assisted laparoscopic procedure followed all surgical steps of the open procedure. Postoperative period was free of complications.

  9. Three dosimetry models of lipoma arborescens treated by {sup 90}Y synovectomy

    Energy Technology Data Exchange (ETDEWEB)

    O’Doherty, Jim, E-mail: jim.odoherty@kcl.ac.uk [Department of Medical Physics-Nuclear Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom and Division of Imaging Sciences, PET Imaging Centre at St. Thomas’ Hospital, King' s College London, London SE1 7EH (United Kingdom); Clauss, Ralf [Department of Nuclear Medicine, Royal Surrey County Hospital, Guildford GU2 7XX (United Kingdom); Scuffham, James [Department of Medical Physics-Nuclear Medicine, Royal Surrey County Hospital, Guildford GU2 7XX (United Kingdom); Khan, Aman [Department of Rheumatology, Royal Surrey County Hospital, Guildford GU2 7XX (United Kingdom); Petitguillaume, Alice; Desbrée, Aurélie [Service de Dosimétrie Interne, Institut de Radioprotection et de Sûreté Nucléaire, 92260 Fontenay-aux-Roses (France)

    2014-05-15

    Purpose: Lipoma arborescens (LA) is a benign intra-articular lipomatous proliferation of the synovial membrane. This extremely rare condition has previously been treated by intra-articular{sup 90}Y radiosynoviorthesis but dosimetry literature on this form of radionuclide therapy is nonexistent. The authors detail methodology for successful treatment of LA and provide for the first time estimates of radiation dosimetry. The authors also analyze the biodistribution of the radiopharmaceutical over the course of the patient's treatment through sequential imaging. Methods: A patient with bilateral LA underwent intracavity injection of{sup 90}Y citrate colloid to the right and left knee joint spaces (181 and 198 MBq, respectively). SPECT/CT datasets were acquired over 9 days to quantify the biodistribution and kinetics of the radiopharmaceutical. Radiation dosimetry was performed using the MIRD schema (through OLINDA software), a custom voxel-based method, and a direct Monte Carlo calculation (OEDIPE). Results: Follow-up MRI showed marked reduction in LA size in both knees. Mean absorbed doses to the LA were 21.2 ± 0.8 and 42.9 ± 2.3 Gy using OLINDA, 8.1 ± 0.3 and 16.7 ± 0.5 Gy using voxel based methodology, and 8.2 ± 0.3 and 15.7 ± 0.5 Gy for OEDIPE in the right and left LA, respectively. Distribution of the radiopharmaceutical within the joint space alters over the imaging period, with less than 1% of the remaining activity having moved posteriorly in the knee cavity. No uptake was detected outside of the joint space after assessment with whole-body scintigraphy. Conclusions: An activity of approximately 185 MBq successfully relieved clinical symptoms of LA. There was good correlation between direct Monte Carlo and voxel based techniques, but OLINDA was shown to overestimate the absorbed dose to the tumor. Accurate dosimetry may help select an activity more tailored to the specific size and location of the LA.

  10. Ileal digestibility and endogenous flow of minerals and amino acids: responses to dietary phytic acid in piglets.

    Science.gov (United States)

    Woyengo, Tofuko A; Cowieson, Aaron J; Adeola, Olayiwola; Nyachoti, Charles M

    2009-08-01

    Effects of phytic acid (PA) on ileal mineral and amino acid (AA) digestibilities and ileal endogenous AA flow in piglets were investigated. Seven ileal-cannulated weanling pigs were fed a casein-maize starch-based diet with PA (as sodium phytate) at 0, 5, 10 or 20 g/kg in 4 x 4 Latin square design with three added columns to give seven observations per treatment. The basal diet was formulated to meet National Research Council energy and AA requirements for piglets. The respective digestibility and endogenous lysine loss were determined by indicator and homoarginine methods. The apparent ileal digestibility (AID) of Na, K and P was linearly and quadratically reduced (P 0.05) endogenous AA losses. The results suggest that PA has limited effect on the digestibility and endogenous losses of AA in piglets, but can reduce AID of Mg and Na partly by increasing endogenous losses of these minerals as evidenced by their negative AID values.

  11. Technique Selection of Bricker or Wallace Ureteroileal Anastomosis in Ileal Conduit Urinary Diversion: A Strategy Based on Patient Characteristics

    National Research Council Canada - National Science Library

    Liu, Longfei; Chen, Minfeng; Li, Yuan; Wang, Long; Qi, Fan; Dun, Jingeng; Chen, Jinbo; Zu, Xiongbing; Qi, Lin

    2014-01-01

    ... (Bricker and Wallace anastomosis) used in ileal conduit (IC) diversion. Patients who underwent IC diversion after radical cystectomy for transitional cell carcinoma between January 2009 and December 2011 were prospectively collected...

  12. 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....

  13. Marked Differences in Mucosal Immune Responses Induced in Ileal versus Jejunal Peyer's Patches to Mycobacterium avium subsp. paratuberculosis Secreted Proteins following Targeted Enteric Infection in Young Calves.

    Science.gov (United States)

    Facciuolo, Antonio; Gonzalez-Cano, Patricia; Napper, Scott; Griebel, Philip J; Mutharia, Lucy M

    2016-01-01

    In cattle, Mycobacterium avium subsp. paratuberculosis infection is primarily mediated through M cells overlying Peyer's patches (PP) in the ileum. The capacity of M. avium subsp. paratuberculosis to invade ileal PP (IPP) versus discrete PP in the jejunum (JPP) and subsequent differences in mucosal immune responses were investigated. Intestinal segments were surgically prepared in both mid-jejunum, containing two JPPs, and in terminal small intestine containing continuous IPP. M. avium subsp. paratuberculosis (109 CFU) was injected into the lumen of half of each intestinal segment when calves were 10-14 days-old and infection confirmed 1-2 months later by PCR and immunohistochemistry. Thirteen recombinant M. avium subsp. paratuberculosis proteins, previously identified as immunogenic, were used to analyze pathogen-specific B- and T-cell responses in PP and mesenteric lymph nodes. IgA plasma cell responses to 9 of 13 recombinant proteins were detected in JPP but not in IPP. Secretory IgA reacting in ELISA with 9 of the 13 recombinant proteins was detected in luminal contents from both jejunal and ileal segments. These observations support the conclusion that pathogen-specific IgA B cells were induced in JPP but not IPP early after a primary infection. The presence of secretory IgA in intestinal contents is consistent with dissemination of IgA plasma cells from the identified mucosa-associated immune induction sites. This is the first direct evidence for M. avium subsp. paratuberculosis uptake by bovine JPP and for local induction of pathogen-specific IgA plasma cell responses after enteric infection. We also provide evidence that bacterial invasion of IPP, a primary B lymphoid tissue, provides a novel strategy to evade induction of mucosal immune responses. Over 60% of PPs in the newborn calf small intestine is primary lymphoid tissue, which has significant implications when designing oral vaccines or diagnostic tests to detect early M. avium subsp. paratuberculosis

  14. Is this a mediastinal tumor? A case of Morgagni hernia complicated with intestinal incarceration mistaken for the mediastinal lipoma previously.

    Science.gov (United States)

    Komatsu, Teruya; Takahashi, Yutaka

    2013-01-01

    Morgagni's hernia is a congenital herniation of abdominal viscera into the thoracic cavity through a retrosternal diaphragmatic defect. We present a case of incarcerated Morgagni hernia in a 69-year-old woman. Three years previously, she had undertaken a video-assisted thoracoscopic resection (VATS) of a mediastinal mass, which had been mistaken for a lipoma. Following the primary repair of the hernia at emergency laparotomy, the patient was discharged home uneventfully. Irrespective of the radiologically characteristic findings of our case, the possibility of Morgagni hernia had not been entertained at the first operation. Thorough exploration around the diaphragm at the first VATS operation could have revealed the Morgagni hernia, ultimately avoiding the hernia-related complication such as an incarceration. Morgagni hernia as a differential diagnosis in case of anterior mediastinal mass should not be missed. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  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. Robotic Assisted Laparoscopic Prostatectomy in Men with Proctocolectomy and Restorative Ileal Pouch-Anal Anastomosis

    Directory of Open Access Journals (Sweden)

    Michael Leapman

    2014-01-01

    Full Text Available We conducted a retrospective chart review of robotic prostatectomies done by a single surgeon between 2003 and 2012. During that time period, we identified two patients within the year 2012, with ileal pouch-anal anastomosis (IPPA who also underwent robotic prostatectomies. The demographics and postoperative characteristics of the two patients were assessed. In both patients, prostatectomy, bilateral nerve sparing, and pelvic lymphadenectomy were successfully performed and the integrity of ileal pouch was maintained. There was a mean surgical time of 144.5 minutes, and an average estimated blood loss was 125 mL. Both patients were discharged on the second day postoperatively. In both patients there was a Gleason upgrade to 3 + 4, with negative margins, and preservation of fecal and urinary continence by their six-month followup. Owing to surgical modifications, these two surgeries represent the first successful robotic prostatectomies in patients with a J-pouch.

  17. Robotic assisted laparoscopic prostatectomy in men with proctocolectomy and restorative ileal pouch-anal anastomosis.

    Science.gov (United States)

    Leapman, Michael; Kwon, Young Suk; Collingwood, Shemille A; Chin, Edward; Katsigeorgis, Maria; Hobbs, Adele R; Samadi, David B

    2014-01-01

    We conducted a retrospective chart review of robotic prostatectomies done by a single surgeon between 2003 and 2012. During that time period, we identified two patients within the year 2012, with ileal pouch-anal anastomosis (IPPA) who also underwent robotic prostatectomies. The demographics and postoperative characteristics of the two patients were assessed. In both patients, prostatectomy, bilateral nerve sparing, and pelvic lymphadenectomy were successfully performed and the integrity of ileal pouch was maintained. There was a mean surgical time of 144.5 minutes, and an average estimated blood loss was 125 mL. Both patients were discharged on the second day postoperatively. In both patients there was a Gleason upgrade to 3 + 4, with negative margins, and preservation of fecal and urinary continence by their six-month followup. Owing to surgical modifications, these two surgeries represent the first successful robotic prostatectomies in patients with a J-pouch.

  18. Influence of forage inclusion in the diet on ileal and total tract digestibility

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Carlson, Dorthe; Lærke, Helle Nygaard

    2012-01-01

    throughout the whole experiment. The intake of forages was low and quite variable and on average accounted for only 10 to 12% of the DMI. Ileal digestibility of protein estimated by collection from the T-cannula was higher (P = 0.031) than the digestibility estimated by the slaughter technique indicating......The present investigation aimed to study the ileal and total tract digestibility of 3 forages (clover–grass, clover–grass silage, and fi eld pea (Pisum sativum)–barley (Hordeum vulgare) silage) supplemented to a basal diet. A total of 24 pigs, adapted to eating forages by supplementing a basal feed...... some separation of the digesta collected from the T-cannula. The forages had, as expected, a lower total tract DM and energy digestibility than the basal diet (P digestibility than the 2 silages (60 vs. 48%; P

  19. Ileal atresia and multiple jejunal perforations in a premature neonate with gestational alloimmune liver disease

    Directory of Open Access Journals (Sweden)

    Ryan M. McAdams, MD

    2017-04-01

    Full Text Available Recovery after surgical repair of an ileal atresia with or without intestinal perforation requires prolonged exposure to parenteral nutrition (PN that may lead to PN-associated liver disease. Early liver failure and cholestasis out of proportion for PN exposure may be a harbinger for gestational alloimmune liver disease (GALD, a potentially life-threatening condition that often requires liver transplant if not treated in a timely manner. This case report presents a premature neonate with ileal atresia and multiple jejunal perforations who developed liver failure and was later determined to have GALD. Recognition of clinical and laboratory findings consistent with GALD is essential to promote early treatment, which can enhance neonatal outcomes and impact future pregnancies.

  20. Patent vitellointestinal duct with prolapsed (intussusceptions of proximal and distal ileal loop: A case report

    Directory of Open Access Journals (Sweden)

    Dinesh D. Mundada

    2015-02-01

    Full Text Available A wide variety of anomalies may occur as a result of the vitellointestinal duct (VID failing to obliterate completely. VID is well known because of its various complication and presentation most commonly due to Meckel's diverticulum. Small bowel prolapsed through patent VID is one of the rare presentations that have been reported. We are reporting a case of patent VID through which proximal and distal ileal segment had been intussuscepted and prolapsed through umbilicus.

  1. Ureteric catheterization via an ileal conduit: technique and retrieval of a JJ stent

    Energy Technology Data Exchange (ETDEWEB)

    Wah, T.M.; Kellett, M.J. E-mail: mjkellett@bigwig.net

    2004-11-01

    Retrograde ureteric catheterization of a patient with an ileal conduit is difficult, because guide wires and catheters coil in the conduit. A modified loopogram, using a Foley catheter as a fulcrum through which catheters can be advanced to the ureteric anastomosis, is described. This technique was used to remove a JJ stent, which had been inserted previously across a stricture in one ureter, the stent crossing from one kidney to the other.

  2. Optimum standardized ileal digestible tryptophan to lysine ratio for pigs weighing 7–14 kg

    DEFF Research Database (Denmark)

    Nørgaard, Jan Værum; Pedersen, Trine Friis; Assadi Soumeh, Elham

    2015-01-01

    The objective of the present study was to evaluate the optimum ratio of standardized ileal digestible (SID) Trp to Lys for pigs after weaning. A total of 96 female pigs were allocated to 1 of 6 diets containing 0.13, 0.15, 0.17, 0.19, 0.21, and 0.23 SID Trp:Lys, with 16 individually housed pigs...

  3. Ileal digestibility of sunfl ower meal, pea, rapeseed cake, and lupine in pigs

    DEFF Research Database (Denmark)

    Nørgaard, Jan Værum; Fernández, José Adalberto; Jørgensen, Henry

    2012-01-01

    .05) for soybean meal and pea compared to sunfl ower meal, rapeseed cake, and lupine. The SID of Lys and His were lowest (P digestible protein source relative to sunfl ower......The standardized ileal digestibility (SID) of CP and AA was evaluated in soybean (Glycine max) meal, sunfl ower (Helianthus annuus) meal, rapeseed cake, and fi eld pea (Pisum sativum) using 10 pigs and in lupine (Lupinus angustifolius) using 7 pigs. Pigs were fi tted with either a T...

  4. Effect of different soybean meal type on ileal digestibility of amino acid in weaning pigs.

    Science.gov (United States)

    Kim, Dong Hyuk; Heo, Pil Seung; Jang, Jae Cheol; Jin, Song Shan; Hong, Jin Su; Kim, Yoo Yong

    2015-01-01

    An experiment was conducted to evaluate apparent (AID) and standardized (SID) ileal digestibilities of crude protein (CP) and amino acids (AA) with 6 soybean products in weaning pigs. A total of 14 weaning barrows with an initial body weight of 6.54 ± 0.34 kg were fitted with T-cannula at the distal ileum and allotted to 7 diets containing various soybean products. The soybean products used in the experiment were conventional soybean meal (CSBM), SBM fermented by Aspergillus oryzae GB-107 (FSBMA), SBM fermented by Bacillus subtilis PP6 (FSBMB), UV sterilized SBM fermented by Bacillus subtilis PP6 (UVFSBMB), SBM containing Bacillus subtilis PP6 (PSBM), and soy protein concentrate (SPC). Six corn-based diets were used and each of soybean products was added. All diets contained 5.0 g/kg of chromic oxide as an indigestible indicator and an N-free diet was used to measure basal endogenous losses of CP and AAs. Ileal CP digestibility did not differ by different soybean products. However, SIDs of Ile, Phe and Val were improved in pigs fed the FSBMB, UVFSBMB and SPC diets and the pigs fed the FSBMA diet showed higher SIDs of Phe and Val compared with those fed the CSBM diet (P Pro, Ser, and Tyr compared with PSBM diet (P < 0.05). However, there was no response of UV-sterilization on the FSBMB in the SIDs of AAs. These results suggest that SIDs of AAs could be improved by the supplementation of fermented soybean products in the diet for weaning pigs but fermentation with Bacillus subtilis is more efficient in improving ileal AA digestibility than that with Aspergillus oryzae. Furthermore, probiotics supplementation in the CSBM and UV-sterilization of the FSBMB had no effects on chemical composition and ileal AA digestibility.

  5. Ileal atresia and multiple jejunal perforations in a premature neonate with gestational alloimmune liver disease

    OpenAIRE

    McAdams, Ryan M.

    2017-01-01

    Recovery after surgical repair of an ileal atresia with or without intestinal perforation requires prolonged exposure to parenteral nutrition (PN) that may lead to PN-associated liver disease. Early liver failure and cholestasis out of proportion for PN exposure may be a harbinger for gestational alloimmune liver disease (GALD), a potentially life-threatening condition that often requires liver transplant if not treated in a timely manner. This case report presents a premature neonate with il...

  6. Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder.

    Science.gov (United States)

    Kim, Kwang Hyun; Yoon, Hyun Suk; Yoon, Hana; Chung, Woo Sik; Sim, Bong Suk; Ryu, Dong-Ryeol; Lee, Dong Hyeon

    2016-01-01

    To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder. From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis. Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046). At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002). At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis. Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. However, the incidence of metabolic acidosis decreased to less than 20% 1 year after surgery, and diabetes was an independent risk factor during this period.

  7. Ileal duplication mimicking intestinal intussusception: a congenital condition rarely reported in adult.

    Science.gov (United States)

    Li, Bing-Lu; Huang, Xin; Zheng, Chao-Ji; Zhou, Jiao-Lin; Zhao, Yu-Pei

    2013-10-14

    Intestinal duplication is an uncommon congenital condition in young adults. A 25-year-old man complained of chronic, intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected appendicitis. Abdominal discomfort and pain, suggestive of intestinal obstruction, recurred after operation. A tubular mass was palpable in the right lower quadrant. Computed tomography enterography scan identified suspicious intestinal intussusception, while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower quadrant. On exploratory laparotomy, a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal valve. Ileectomy was performed along with the removal of the duplication disease, and the end-to-end anastomosis was done to restore the gastrointestinal tract continuity. Pathological examination showed ileal duplication with ectopic gastric mucosa. The patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.

  8. 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.

  9. Robotic Assisted Radical Cystoprostatectomy and Intracorporeal Ileal Conduit Urinary Diversion for a Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Peter A. Caputo

    Full Text Available ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen; identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours. Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient

  10. Adaptation of Intestinal and Bile Acid Physiology Accompany the Metabolic Benefits Following Ileal Interposition in the Rat.

    Science.gov (United States)

    Zhao, Ping; Wendt, Donna; Goodin, Sean Z; Ravichandran, Shwetha; Chouinard, Tara E; Strader, April D

    2017-08-31

    Ileal interposition recapitulates many of the metabolic improvements similar to Roux-en-Y gastric bypass. We aimed to determine whether the metabolic improvements seen following ileal interposition were conferred solely by the interposed segment by examining changes in neighboring intestinal segments as well as the composition of the bile acid pool. Adult male rats were treated with either sham or ileal interposition surgeries. Glucose tolerance tests, body composition analysis, polymer chain reaction, enzyme-linked immunosorbent assay, and mass spectrometry were done after the surgeries. This study showed that ileal interposition improved glucose tolerance and enhanced both fasting and glucose-stimulated GLP-1 secretion in diabetic rats. Total bile acid pool was similar between groups but the composition favored glycine-conjugation in rats with ileal interposition. Insulin secretion was highly correlated with the 12-alpha-hydroxylase index of activity. The interposed ileum exhibited an increase in mRNA for preproglucagon and peptide YY; however, the bile acid transporter, apical sodium bile acid transporter, was dramatically reduced compared to sham rats. The interposed segment becomes jejunized in its new location as indicated by an increase in Glut2 and Pepck mRNA, genes predominantly synthesized within the jejunum. Ileal relocation alone can significantly alter the bile acid pool to favor a more insulin-sensitive metabolism in association with intestinal wide alterations in mRNA for a variety of genes. Ileal interposition may confer metabolic improvement via both the interposed segment and the associated intestinal changes in all segments of the intestine, including the colon.

  11. Apparent and standardized ileal nutrient digestibility of broiler diets containing varying levels of raw full-fat soybean and microbial protease

    Directory of Open Access Journals (Sweden)

    Mammo M. Erdaw

    2017-10-01

    Full Text Available Abstract Background Although soybean meal (SBM is excellent source of protein in diets for poultry, it is sometimes inaccessible, costly and fluctuates in supply. The SBM can partially be replaced by full-fat SBM, but the meals prepared from raw full-fat soybean contain antinutritional factors. To avoid the risk of antinutritional factors, heat treatment is always advisable, but either excessive or under heating the soybean could negatively affect the quality. However, the potential for further improvement of SBM by supplementing with microbial enzymes has been suggested by many researchers. The objective of this study was to evaluate the performance and ileal nutrient digestibility of birds fed on diets containing raw soybeans and supplemented with microbial protease. Methods A 3 × 2 factorial, involving 3 levels of raw full-fat soybean (RFFS; 0, 45 or 75 g/kg of diet and 2 levels of protease (0 or 15,000 PROT/kg was used. The birds were raised in a climate-controlled room. A nitrogen-free diet was also offered to a reference group from day 19 to 24 to determine protein and amino acid flow at the terminal ileum and calculate the standardized ileal digestibility of nutrients. On days 10, 24 and 35, body weight and feed leftover were recorded to calculate the body weight gain (BWG, feed intake (FI and feed conversion ratio (FCR. On day 24, samples of ileal digesta were collected at least from two birds per replicate. Results When RFFS was increased from 0 to 75 g/kg of diet, the content of trypsin inhibitors was increased from 1747 to 10,193 trypsin inhibitors unit (TIU/g of diets, and feed consumption of birds was also reduced (P < 0.05. Increasing RFFS level reduced the BWG from hatch 0 to 10 d (P < 0.01 and hatch to 24 d (P < 0.05. The BWG of birds from hatch to 35 was not significantly (P = 0.07 affected. Feed intake was also reduced (P < 0.05 during 0 to 35 d. However, protease supplementation improved (P < 0.05 the BWG and

  12. Investigating the effect of dietary calcium levels on ileal endogenous amino acid losses and standardized ileal amino acid digestibility in broilers and laying hens.

    Science.gov (United States)

    Adedokun, S A; Pescatore, A J; Ford, M J; Ao, T; Jacob, J P

    2017-10-25

    Two studies were conducted to evaluate the effect of dietary Ca levels (low, 1% and high, 3%) on ileal endogenous amino acid losses (IEAAL) and standardized ileal amino acid digestibility (SIAAD) in broilers (BR) and laying hens (LH) fed nitrogen-free diets (NFD) and distiller's dried grain with solubles (DDGS)-based diets. A total of 384 male Cobb 500 BR and 288 LH were used in a completely randomized design (CRD) with 16 (BR) or 12 (LH) replicate cages with 6 birds/replicate. IEAAL and apparent ileal digestibility (AID) of AA were analyzed using the GLM procedure of SAS appropriate for a CRD while SIAAD values were analyzed using the GLM procedure of SAS appropriate for a 2 × 2 factorial arrangement of treatments. For BR, IEAAL and N losses (mg/kg of dry matter intake, DMI) were higher (P < 0.05) when NFD with high Ca level was fed (total AA was 39%, N was 35% higher). For most of the AA, AID was higher (P < 0.05) in BR fed DDGS-based diet with high Ca level. High dietary Ca resulted in higher (P < 0.05) SIAAD for all the AA except for Arg, Lys, Met, Cys, and Tyr. For LH, AID of AA was higher (P < 0.05) for the DDGS diet with high Ca level in 13 of the 18 AA evaluated. There was interaction (P < 0.05) between diet Ca level and correction method on LH SIAAD values for Thr, Asp, Gly, and Ser. The SIAAD values for 8 AA were higher (P < 0.05) in birds on high Ca DDGS diet. Correction with low Ca NFD resulted in higher (P < 0.05) SIAAD values for all the AA. Result from this study showed that high Ca increased total IEAAL in BR by 39% but decreased same by 27% in LH. Finally, SIAAD values were increased in BR fed high Ca DDGS-based diet while SIAAD value in LH was lower when correction was done using values from high Ca-NFD fed birds. © 2017 Poultry Science Association Inc.

  13. Involvement of endoplasmic reticulum stress in inflammatory bowel disease: a different implication for colonic and ileal disease?

    Directory of Open Access Journals (Sweden)

    Sara Bogaert

    Full Text Available BACKGROUND: Endoplasmic reticulum (ER stress has been suggested to play a role in inflammatory bowel disease (IBD. The three branches (ATF6, IRE1 and PERK of the unfolded protein response (UPR have different roles and are not necessarily activated simultaneously. METHODOLOGY/PRINCIPAL FINDINGS: Expression of UPR-related genes was investigated in colonic and ileal biopsies of 23 controls, 15 ulcerative colitis (UC and 54 Crohn's disease (CD patients. This expression was confirmed at protein level in colonic and ileal samples of five controls, UC and CD patients. HSPA5, PDIA4 and XBP1s were significantly increased in colonic IBD at mRNA and/or protein levels, indicating activation of the ATF6 and IRE1 branch. Colonic IBD was associated with increased phosphorylation of EIF2A suggesting the activation of the PERK branch, but subsequent induction of GADD34 was not observed. In ileal CD, no differential expression of the UPR-related genes was observed, but our data suggested a higher basal activation of the UPR in the ileal mucosa of controls. This was confirmed by the increased expression of 16 UPR-related genes as 12 of them were significantly more expressed in ileal controls compared to colonic controls. Tunicamycin stimulation of colonic and ileal samples of healthy individuals revealed that although the ileal mucosa is exhibiting this higher basal UPR activation, it is still responsive to ER stress, even more than colonic mucosa. CONCLUSIONS/SIGNIFICANCE: Activation of the three UPR-related arms is seen in colonic IBD-associated inflammation. However, despite EIF2A activation, inflamed colonic tissue did not increase GADD34 expression, which is usually involved in re-establishment of ER homeostasis. This study also implies the presence of a constitutive UPR activation in healthy ileal mucosa, with no further activation during inflammation. Therefore, engagement of the UPR differs between colon and ileum and this could be a factor in the

  14. Intermodal freight terminals : terminal business planning

    NARCIS (Netherlands)

    Nijkamp, Peter; Wiegmans, Bart W.

    2000-01-01

    The main purpose of this paper is to provide a framework for existing- and newly proposedinter-modal freight terminals in their business planning process. This framework is importantfor constructing- and improving the central terminal service portfolio of handling (loading,discharging, and

  15. Identification of novel HMGA2 fusion sequences in lipoma: evidence that deletion of let-7 miRNA consensus binding site 1 in the HMGA2 3' UTR is not critical for HMGA2 transcriptional upregulation.

    Science.gov (United States)

    Wang, Xiaoke; Hulshizer, Rachael L; Erickson-Johnson, Michele R; Flynn, Heather C; Jenkins, Robert B; Lloyd, Ricardo V; Oliveira, Andre M

    2009-08-01

    Lipoma is a benign tumor composed of mature adipocytes and one of the most common mesenchymal tumors seen in adults. Rearrangement of HMGA2 in chromosome band 12q15 has been found in approximately 60-70% of ordinary lipomas with cytogenetic abnormalities. Herein, we report two novel HMGA2 fusion sequences in lipomas with chromosome 12 rearrangements. Cytogenetic studies showed 12q abnormalities in both cases, and fluorescence in situ hybridization (FISH) confirmed the involvement of HMGA2 in each instance. Rapid amplification of cDNA ends (RACE) PCR experiments revealed that one lipoma contained a fusion of the HMGA2 3' untranslated region (UTR) to a genomic area downstream of the DYRK2 locus on 12q15; the second lipoma showed a fusion of the HMGA2 3' UTR to a genomic sequence upstream of the DCN locus on 12q21. In both instances the breakpoint on HMGA2 occurred downstream to let-7 miRNA (microRNA) consensus binding site (CBS) 1. These two and several other previously reported tumors containing HMGA2 3' UTR rearrangements show breakpoints after let-7 miRNA CBS 1, which suggests that the elimination of this miRNA binding site is not critical for driving HMGA2 transcriptional upregulation.

  16. Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer.

    Science.gov (United States)

    Kim, Kwang Hyun; Yoon, Hyun Suk; Yoon, Hana; Chung, Woo Sik; Sim, Bong Suk; Lee, Dong Hyeon

    2016-07-01

    Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.

  17. Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder.

    Directory of Open Access Journals (Sweden)

    Kwang Hyun Kim

    Full Text Available To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder.From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR <50ml/min. The presence of metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis.Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046. At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002. At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis.Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. However, the incidence of metabolic acidosis decreased to less than 20% 1 year after surgery, and diabetes was an independent risk factor during this period.

  18. Alteration of the ileal microbiota of weanling piglets by the growth-promoting antibiotic chlortetracycline.

    Science.gov (United States)

    Rettedal, Elizabeth; Vilain, Sébastien; Lindblom, Stacy; Lehnert, Kelly; Scofield, Clay; George, Sajan; Clay, Sharon; Kaushik, Radhey S; Rosa, Artur J M; Francis, David; Brözel, Volker S

    2009-09-01

    Antibiotics such as chlortetracycline (CTC) have been used to promote growth of pigs for decades, but concerns over increased antibiotic-resistant infections in humans have prompted the development of alternative strategies. Developing alternatives to antibiotic growth promoters (AGPs) could be informed by information on the mechanisms of growth promotion, notably, how AGPs affect the microbial populations of the gastrointestinal tract. Pigs from three sows were aseptically delivered by cesarean section. Six piglets were distributed to each of two foster mothers until weaning, when piglets were fed a diet with or without 50 mg/kg CTC for 2 weeks. The ileal bacterial microbiota was characterized by using a cultivation-independent approach based on DNA extraction, PCR amplification, cloning, and sequencing of the 16S rRNA gene pool. The ileal and mucosal communities of these growing pigs were dominated by Lactobacillus bacteria, various members of the family Clostridiaceae, and members of the poorly known genus Turicibacter. Overall, CTC treatment resulted in three shifts: a decrease in Lactobacillus johnsonii, an increase in L. amylovorus, and a decrease in Turicibacter phylotypes. The composition of the microbiota varied considerably between individual pigs, as revealed by shared operational taxonomic units (OTUs) and similarity (SONS) analysis (theta(YC) values). While the observed variation between untreated pigs obscured the possible effect of CTC, integral-LIBSHUFF and SONS analyses of pooled libraries indicated a significant shift due to CTC in both the lumen and the mucosa, with some OTUs unique to either treated or control ileum. DOTUR analysis revealed little overlap between control and treated communities at the 3% difference level, indicating unique ileal communities in the presence of CTC.

  19. A comparative study between open and laparoscopic approach in radical cystectomy with orthotopic ileal neobladder.

    Science.gov (United States)

    Mateo, E; García-Tello, A; Ramón de Fata, F; Romero, I; Núñez-Mora, C; Angulo, J C

    2015-03-01

    Probably, laparoscopic radical cystectomy with ileal neobladder and neovesicourethral anastomosis is one of the most complex procedures in minimally invasive surgery. Prospective study carried out in 72 patients surgically treated for invasive bladder neoplasia between January 2008 and October 2013. Patients were undergone to radical cystectomy with ileal neobladder (open approach in 33 patients and laparoscopic approach in 39). The study assessed comparatively surgical outcomes, continence rate and postoperative complications. Mean age was 63.5±9 years (64.3 open vs. 62.7 laparoscopic, P=.46) mean surgery time 323.6±78.7 minutes (321.3 vs. 326.5, P=.77), average hospital stay 14.8 days±8,1 (16.2 vs. 13.6, P=.2), transfusion rate 40.3% (66.7% vs. 17.9%, P<.0001) and complications rate 47.2% (63.6% vs. 33.3%, P=.01). Major complications were reported in 29.1% of cases (39.4% open vs. 20,5% laparoscopic, P=.07). With a mean follow-up rate of 42.5±19.2 months (range 15-70), 50 (69.4%) patients remain alive and free of disease. Continence was evaluated in these patients: total continence rate was 38% (50% vs. 27%, P=.09) and diurnal continence rate 58% (70.8% vs. 46.1%, P=.07). Self-catheterization rate was 8% (4.2% vs. 11.5%, P=.67). Total incontinence rate was 34% (25% vs. 42.3%, P=.19). According to our experience, transfusion rate, number and severity of complications are lower in laparoscopic cystectomy with ileal neobladder. No statistically significant impact on operative time and on hospital stay was observed. In patients undergone to laparoscopic approach, continence rate is lower but not statistically significant. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Ileal, colonic and total tract nutrient digestibility in dogs (Canis familiaris) compared with total tract digestibility in mink (Neovison vison)

    DEFF Research Database (Denmark)

    Tjernsbekk, Maria Therese; Tauson, Anne-Helene; Ahlstrøm, Øystein

    2014-01-01

    Mink (Neovison vison) was studied as a model for the determination of ileal crude protein (CP) and amino acid (AA) digestibility in dogs (Canis familiaris). Apparent ileal digestibility (AID) and apparent colonic digestibility (ACD) in dogs and apparent total tract digestibility (ATTD) in dogs...... and mink were measured for dry matter (DM), main nutrients and AA. Standardised ileal digestibility (SID) of CP and AA in dogs was calculated. Twelve dogs and 12 mink divided into three groups were fed one out of three diets differing in CP digestibility. In dogs, AID of CP was lower (74.4%) than ATTD (83.......5%) (p Digestibility of AA followed the same pattern, and, except for Thr and Ser, ATTD in mink was very close to SID in dogs. Also, AID was close to ATTD in mink for several AA. High correlations were...

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  1. kmsl Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  2. kbrl Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  3. ksfb Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  4. kpsc Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  5. kely Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  6. ksyr Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  7. katw Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  8. kama Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  9. kpae Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  10. kmli Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  11. kokc Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  12. kjst Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  13. kgup Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  14. padl Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  15. klit Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  16. kalb Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  17. kact Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  18. kink Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  19. kshv Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  20. pajn Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  1. kpna Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  2. ktph Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  3. ksux Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  4. kcon Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  5. khio Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  6. konp Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  7. kpnc Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  8. kmlu Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  9. kgsp Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  10. kgpt Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  11. kflo Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  12. keri Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  13. kcid Terminal Aerodrome Forecast

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    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  14. ksaf Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  15. kcvg Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  16. ptya Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  17. katl Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  18. kmth Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  19. Obstruction of an ileal urinary conduit in an incarcerated right inguinal hernia

    Science.gov (United States)

    Weston, PMT

    2015-01-01

    We present the case of a 72-year-old man with a history of anuria from his ileal conduit 15 months following its formation. That conduit had become incarcerated in a right-sided ingunial hernia. The patient presented with anuria and an acute kidney injury. A clincal diagnosis of an incarcerated hernia was made, and he was taken to theatre for reduction and repair of the hernia. On removal of the conduit from the hernial sac, it began to drain immediately. He made a full recovery, with normalisation of his renal function. PMID:26491738

  20. Apparent ileal digestibility of amino acids and metabolisable energy value in grains for broilers

    Directory of Open Access Journals (Sweden)

    S. PERTTILÄ

    2008-12-01

    Full Text Available Using ileal digestible amino acids in feed optimising will intensify feed protein utilizing and decrease nitrogen excretion to the environment. The study determined the apparent ileal digestibility (AID coefficients of amino acids in barley, wheat, oats, triticale, maize, and dehulled oats in the diets of 180 Ross broiler chickens (aged 24–35 days. The birds were fed semi-purified diets that contained grain as the sole protein source and chromium-mordanted straw as an indigestible marker. The AID coefficients of the nutrients were assessed using the slaughter technique, and the apparent metabolisable energy (AME was determined using total excreta collection. The ileal digestibility of the dry matter and organic matter were the highest in maize. The AME of maize was higher than that of other cereals. The ileal digestibility of crude protein was higher in wheat than that in barley, oats and dehulled oats. The AME of wheat was similar to that of barley and oats but lower than that of triticale and dehulled oats. The amino acid AID was highest in wheat (0.86 and triticale (0.85 and lowest in oats (0.79 and barley 0.77. The average amino acid AID was 0.81 in dehulled oats. The threonine AID was the same in all tested ingredients. The lysine, methionine, and cystine AID coefficients were 0.81, 0.79, and 0.71 respectively for barley; 0.86, 0.84, and 0.38 respectively for oats; 0.87, 0.86, and 0.53 respectively for dehulled oats; 0.84, 0.90, and 0.66 respectively for maize; 0.89, 0.88, and 0.77 respectively for triticale; and 0.87, 0.85, and 0.71 respectively for wheat. Results indicated that AME –values of domestic grains (barley, oats and wheat are in the same level. Especially, low AME value of wheat needs further investigation.;

  1. Protein digestibility evaluations of meat and fish substrates using laboratory, avian, and ileally cannulated dog assays.

    Science.gov (United States)

    Faber, T A; Bechtel, P J; Hernot, D C; Parsons, C M; Swanson, K S; Smiley, S; Fahey, G C

    2010-04-01

    Meat and fish serve as important protein sources in the companion animal diet; however, limited protein digestibility data are available for assessing protein digestibility differences among good-quality protein sources. Beef loin, pork loin, chicken breast, pollock fillet, and salmon fillet were evaluated for composition, protein digestibility, and AA bioavailability using the immobilized digestive enzyme assay, cecectomized rooster assay, and ileally cannulated dog assay. Pollock contained the greatest amount of CP, total essential AA (TEAA), and total nonessential AA (TNEAA; DM basis; 96.9, 38.6, and 50.3%, respectively). Salmon contained the next greatest amounts (92.8, 36.4, and 44.6%), followed by chicken (90.3, 36.1, 43.2%). Beef had the least CP content (82.7%), but had slightly greater TEAA and TNEAA concentrations (33.9, 42.0%) compared with pork (86.2, 33.6, 41.3%). Immobilized digestive enzyme assay values were greatest for pollock fillet (0.71) and least for chicken breast (0.52). Beef loin, pork loin, and salmon fillet were similar (0.63, 0.62, and 0.64, respectively). Standardized TEAA and TNEAA digestibility coefficients, evaluated using the cecectomized rooster assay, were greatest (P protein source. No significant differences (P > 0.05) were found in ileal digestibility of protein. Values ranged from 88.9% for chicken to 90.5% for pork loin and pollock fillet. Ileal TEAA and TNEAA coefficients were not different among test substrates, with values between 91.7 and 92.7%, and 88.8 and 90.4%, respectively. Total tract CP apparent digestibility values ranged from 94.4 to 94.8%, with no differences noted among treatments. Despite marked differences in composition and predicted and standardized digestibility values, when the protein sources were added to diets at a concentration of approximately 30% (25% of total energy intake), no differences in test protein substrates were noted in either ileal or total tract nutrient digestibility.

  2. Nodular liver lesions associated with chronic home hyperalimentation after massive enterectomy for ileal carcinoma.

    Science.gov (United States)

    Kemeny, M M

    1987-06-01

    A case of an ileal carcinoma involving the entire midgut treated with a massive enterectomy of the small bowel distal to the ligament of Treitz, the right colon, and part of the transverse colon is discussed. After 1 year on home hyperalimentation, hepatic nodules were seen on CT scans; metastases could not be proven. At 3 years a hepatic wedge resection was performed, multiple areas of necrosis and fibrosis were found, but no carcinoma. This case is presented as an example of an alternative in treatment for this type of carcinoma and to illustrate the problems of differential diagnosis of liver defects on the CT scan in patients on longterm hyperalimentation.

  3. Synchronous association of rectal adenocarcinoma and three ileal carcinoids: a case report.

    LENUS (Irish Health Repository)

    McHugh, Seamus M

    2012-02-01

    BACKGROUND: Synchronous midgut carcinoids with gastrointestinal adenocarcinoma are a rare but recognised association. CASE PRESENTATION: The patient, a 74 year old woman, underwent anterior resection for a low rectal adenocarcinoma. Intra-operatively 3 serosal deposits of tumour were noted in the distal ileum. Histology revealed these to be ileal carcinoids. CONCLUSION: During resection of a gastrointestinal tumour, a thorough inspection of the abdominal cavity should be undertaken to investigate the possibility of metastatic secondaries or a synchronous tumour as is reported in this case.

  4. Patient-posture and Ileal-intubation during colonoscopy (PIC): a randomized controlled open-label trial.

    Science.gov (United States)

    Ahammed, Sk Mahiuddin; Das, Kshaunish; Sarkar, R; Dasgupta, J; Bandopadhyay, S; Dhali, G K

    2014-06-01

    Patient's posture change is commonly employed by a colonoscopist to achieve complete examination. We studied whether patient's posture (left-lateral decubitus vs supine) influenced the success rate of ileal intubation. In this prospective open-label randomized study performed in the Endoscopy Suite of a tertiary-care center, all adult outpatients referred for colonoscopy, in whom cecal intubation was achieved and who satisfied predefined inclusion criteria, were randomized to undergo ileal intubation in either of the above two postures. Colonoscopy (EC-201 WL, Fujinon) was performed after overnight poly-ethylene-glycol preparation, under conscious sedation and continuous pulse-oxymetry monitoring. After confirming cecal intubation, patients were randomized for ileal intubation. Success was defined by visualization of ileal mucosa or villi (confirmed by digital photography) and was attempted until limited by pain and/or time of ≥ 6 min. Of 320 eligible patients, 217 patients (150 males) were randomized, 106 to left-lateral decubitus and 111 to supine posture. At baseline, the two groups were evenly matched. Successful ileal intubation was achieved in 145 (66.8 %) patients overall, significantly higher in the supine posture (74.8 % versus 58.5 %; P = 0.014). On multivariate analysis, supine posture (P = 0.02), average/good right-colon preparation (P < 0.01), non-thin-lipped ileocecal (IC) valve (P < 0.001) and younger age (P = 0.02) were independent predictors of success. Positive ileal findings were recorded in 13 (9 %) patients. Ileoscopy is more successful in supine than in left-lateral decubitus posture. Age, bowel preparation and type of IC valve also determine success.

  5. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    Directory of Open Access Journals (Sweden)

    Bicaj Besnik X

    2011-09-01

    Full Text Available Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

  6. Intermodal freight terminals : terminal business planning

    OpenAIRE

    Nijkamp, Peter; Bart W Wiegmans

    2000-01-01

    The main purpose of this paper is to provide a framework for existing- and newly proposedinter-modal freight terminals in their business planning process. This framework is importantfor constructing- and improving the central terminal service portfolio of handling (loading,discharging, and transhipping) and storage of containerised cargo. Supportive activities (e.g. administration, customs) are taken into account as well.In particular, its aim is to investigate whether business planning offer...

  7. Estimation of the optimum standardized ileal digestible total sulfur amino acid to lysine ratio in late finishing gilts fed low protein diets supplemented with crystalline amino acids.

    Science.gov (United States)

    Ma, Wenfeng; Zhu, Jinlong; Zeng, Xiangfang; Liu, Xutong; Thacker, Philip; Qiao, Shiyan

    2016-01-01

    A total of 90 gilts were used to investigate the effects of various standard ileal digestible (SID) total sulfur amino acid (TSAA) to lysine (Lys) ratios on the performance and carcass characteristics of late finishing gilts receiving low crude protein (CP) diets supplemented with crystalline amino acids (CAA). Graded levels of crystalline methionine (Met) (0, 0.3, 0.5, 0.8 or 1.1 g/kg) were added to the basal diet to produce diets providing SID TSAA to Lys ratios of 0.48, 0.53, 0.58, 0.63 or 0.68. At the termination of the experiment, 30 gilts (one pig per pen) with an average body weight (BW) of 120 kg were killed to evaluate carcass traits. Increasing the SID TSAA to Lys ratio increased average daily gain (ADG) (linear and quadratic effect, P gilts. No effects were obtained for carcass traits. The optimum SID TSAA to Lys ratios to maximize ADG as well as to minimize FCR and SUN levels were 0.57, 0.58 and 0.53 using a linear-break point model and 0.64, 0.62 and 0.61 using a quadratic model. © 2015 Japanese Society of Animal Science.

  8. Neurological function of the puborectalis muscle in patients with or without soiling after ileal J-pouch-anal anastomosis for ulcerative colitis in childhood.

    Science.gov (United States)

    Tomita, Ryouichi

    2014-11-01

    To clarify the puborectalis muscle (PM) function in pediatric patients with soiling after ileal J-pouch-anal anastomosis (IPAA) for ulcerative colitis, the author examined the neurological functions of the PM. Twelve patients 3 months after IPAA were studied (average age 13.6 years). Five patients showed soiling every day (group A1) and 7 patients showed soiling 2 to 3 days per week (Group A2). All patients 1.5 years after IPAA showed continence (group B). Twenty subjects served as a control (Group C; average age 13.5 years). Right, left and posterior sides of the sacral nerve terminal motor latency (SNTML) were measured by magnetic stimulation. On the right, left and posterior sides, patients in group A1 exhibited significant prolongation of the SNTML compared with patients in groups A2, B and C (P<.05 each). Group A2 exhibited significant prolongation compared with groups B and C (P<.05 each). There were no significant differences of the SNTML between right and left sides, between right and posterior sides and between left and posterior sides in groups A1, A2, B and C. The SNTML of the PM demonstrates significant latency in those children who have early post-IPAA soilage. The neurological function of the PM potentially injured during an operation may recover, and correlates with normalization of continence. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Clinical outcome of patients with familial hypercholesterolemia and coronary artery disease undergoing partial ileal bypass surgery

    Directory of Open Access Journals (Sweden)

    Jaqueline Scholz Issa

    2000-07-01

    Full Text Available Familial hypercholesterolemia is characterized by high serum levels of total cholesterol and LDL-cholesterol. It may be homozygous or heterozygous. In homozygous patients, LDL-cholesterol levels range from 500 to 1000mg/dL and coronary artery disease is precocious, usually manifesting itself between the 2nd and 3rd decades of life. The diagnosis is often made by the presence of xanthoma tuberosum and tendinous xanthomas that appear between the 1st and 2nd decades of life. The use of high doses of statins or even unusual procedures (apheresis, partial ileal bypass surgery, liver transplantation, gene therapy, or both, is necessary for increasing survival and improving quality of life, because a reduction in cholesterol levels is essential for stabilizing the coronary artery disease and reducing xanthomas. We report our experience with 3 patients with xanthomatous familial hypercholesterolemia and coronary artery disease, who underwent partial ileal bypass surgery. Their follow-up over the years (approximately 8 years showed a mean 30% reduction in total cholesterol, with a significant reduction in the xanthomas and stabilization of the coronary artery disease.

  10. Non-refluxing ileal ureter replacement using intussuscepted nipple valve--an experimental study in dogs.

    Science.gov (United States)

    Tsukamoto, T

    1996-04-01

    Although the vast accumulation of data from the continent urinary reservoir clearly proves that intussusception of the ileum is a reliable procedure for preventing urine reflux, few reports have appeared on the application of this technique to ileal replacement of the ureter. In an effort to determine if the nipple valve created by the intussuscepted ileum can prevent urine reflux in the ileal ureter, an experimental study was done using five dogs. I performed ureteral replacement using a newly developed procedure to secure the nipple valve in place. All dogs were followed for 6 months and evaluated by blood urea nitrogen (BUN), creatinine (Cr), serum electrolyte, urine culture, intravenous urogram (IVU), cystogram, and urodynamic studies. No significant differences were notable between the preoperative and 6-month postoperative values of BUN, Cr, and serum electrolytes in all dogs. Only one of the dogs, which showed extussusception of the nipple valve, demonstrated the reflux. IVUs and Whitaker flow studies did not confirm any urinary outflow obstruction. Furthermore, during the pressure studies, the nipple valve prevented transmission of the increased intravesical pressure to the upper urinary tract. I believe that the intussuscepted ileum can be secured by our procedure and can prevent reflux even though it is incorporated into the urinary system itself.

  11. Apparent and standardized ileal digestibility of amino acids in diverse barley cultivars fed to growing pigs.

    Science.gov (United States)

    Wang, Hongliang; Ma, Xiaokang; Xu, Xiao; Shi, Meng; Piao, Xiangshu

    2017-12-01

    The objectives of this study were to determine the chemical composition, ileal amino acid (AA) digestibility of barley varieties and to develop equations to predict the AA digestibility based on the chemical characteristics of individual barley. A wide selection of nine barley varieties in the main growing regions of China was used in the experiment. Ten crossbred pigs (30.9 ± 1.8 kg) were allotted to a 6 × 10 Youden Square. The treatments included a nitrogen-free diet and nine barley test diets. Considerable variation was observed in the content of neutral detergent fiber, acid detergent fiber, crude protein (CP) and all AAs among the barley samples. The standardized ileal digestibility (SID) of indispensable AAs with the exception of arginine, phenylalanine and threonine were different (P digestibility of CP and AAs among barley varieties. It is difficult to predict the SID of most of the amino acids in barely based upon chemical characteristics. © 2017 Japanese Society of Animal Science.

  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. Stimulating effects of sorbitol and L-xylose on rat ileal Ca transport in vitro.

    Science.gov (United States)

    Lacour, B; Ohan, J; Aznag, A; Drüeke, T B

    1995-01-01

    The direct effect of sorbitol and L-xylose on net intestinal calcium transport was compared to that of lactose, by determining unidirectional steady state calcium fluxes in segments of rat ileum in vitro under short-circuited conditions. The iso-molar addition of either 100 mM sorbitol, L-xylose, or lactose in mucosal buffer fluid increased the absorptive flux of Ca from mucosa to serosa to a similar extent and thus reversed ileal net Ca transport from net secretion to a zero net movement. The three substances decreased tissue conductance and reversed tissue polarity. At 200 mM, sorbitol induced a stimulation of net Ca transport due to an enhancement of absorptive Ca flux but in addition due to a decrease of secretory Ca flux from serosa to mucosa. The presence of 1 mM N-ethylmaleimide abolished the effects of sorbitol on ileal Ca flux. In conclusion, the present result shows that sorbitol, L-xylose, and lactose increase net Ca absorption to a comparable extent, in the absence of electrochemical or osmotic gradients. Such an absence of specificity suggests a stimulation of transcellular Ca transport related to the decrease of Na concentration in mucosal solution.

  14. Pediatric Crohn disease patients exhibit specific ileal transcriptome and microbiome signature

    Science.gov (United States)

    Haberman, Yael; Tickle, Timothy L.; Dexheimer, Phillip J.; Kim, Mi-Ok; Tang, Dora; Karns, Rebekah; Baldassano, Robert N.; Noe, Joshua D.; Rosh, Joel; Markowitz, James; Heyman, Melvin B.; Griffiths, Anne M.; Crandall, Wallace V.; Mack, David R.; Baker, Susan S.; Huttenhower, Curtis; Keljo, David J.; Hyams, Jeffrey S.; Kugathasan, Subra; Walters, Thomas D.; Aronow, Bruce; Xavier, Ramnik J.; Gevers, Dirk; Denson, Lee A.

    2014-01-01

    Interactions between the host and gut microbial community likely contribute to Crohn disease (CD) pathogenesis; however, direct evidence for these interactions at the onset of disease is lacking. Here, we characterized the global pattern of ileal gene expression and the ileal microbial community in 359 treatment-naive pediatric patients with CD, patients with ulcerative colitis (UC), and control individuals. We identified core gene expression profiles and microbial communities in the affected CD ilea that are preserved in the unaffected ilea of patients with colon-only CD but not present in those with UC or control individuals; therefore, this signature is specific to CD and independent of clinical inflammation. An abnormal increase of antimicrobial dual oxidase (DUOX2) expression was detected in association with an expansion of Proteobacteria in both UC and CD, while expression of lipoprotein APOA1 gene was downregulated and associated with CD-specific alterations in Firmicutes. The increased DUOX2 and decreased APOA1 gene expression signature favored oxidative stress and Th1 polarization and was maximally altered in patients with more severe mucosal injury. A regression model that included APOA1 gene expression and microbial abundance more accurately predicted month 6 steroid-free remission than a model using clinical factors alone. These CD-specific host and microbe profiles identify the ileum as the primary inductive site for all forms of CD and may direct prognostic and therapeutic approaches. PMID:25003194

  15. Experimental Evaluation of Ileal Patch in Delayed Primary Repair of Penetrating Colon Injuries: An Animal Study

    Directory of Open Access Journals (Sweden)

    Hamid Reza Abbasi

    2006-10-01

    Full Text Available Primary repair of traumatic colonic perforation is progressively gaining acceptance as the best method of management. However, when delayed, the risk of infection-related complications may increase. Here, we present a new method of repairing colon perforation in the presence of peritonitis. Acute colon injury was simulated in 22 German shepherd dogs. The dogs were randomly divided into two groups of 11 and after 24 hours they were operated on. The perforations were repaired by subserosal suture technique. In the first group (group A, ileal patch was used. In the other group (group B, the colon was closed by debridement and anastomosis. After 6 weeks, the repairs were assessed on the basis of survival, gross and histological assessments. Nine (82% dogs in group A and six (56% in group B survived. Ileal patch utilization significantly decreased the mortality rate (p < 0.05. The cause of death in two group A dogs and five group B dogs was peritonitis and intra-abdominal abscess formation. None of the surviving dogs showed evidence of anastomotic leakage or breakdown. Small bowel patch used in primary repair of colon injury in the presence of peritonitis may decrease the risk of postoperative infection-related complications and the mortality rate.

  16. Clinical utility of retrograde terminal ileum intubation in the evaluation of chronic non-bloody diarrhea.

    Science.gov (United States)

    Makkar, Rohit; Lopez, Rocio; Shen, Bo

    2013-10-01

    The aims of this study were to investigate the frequency and factors involved in the terminal ileum intubation of patients with chronic, non-bloody diarrhea and to compare diagnostic yields of colonoscopy and ileocolonoscopy. The medical records of 945 patients undergoing colonoscopy for chronic, non-bloody diarrhea were reviewed. Findings of microscopic colitis, Clostridium difficile colitis, celiac disease, inflammatory bowel disease or tropical sprue were considered as definitive causes of diarrhea. A total of 689 patients met the diagnosis of chronic, non-bloody diarrhea, in which 370 (53.7%) underwent ileocolonoscopy. Specific histological diagnosis could explain the patient's symptoms in 107 (15.5%) patients. The diagnostic yield were 15.0% in the colonoscopy-only group, 16.9% in the ileocolonoscopy without biopsy group, and 15.5% in the ileocolonoscopy with biopsy group. Of the 19 patients with an abnormal terminal ileal biopsy, six (31.6%) had an otherwise normal colonic appearance which would have been diagnosed as normal if the ileum had not been reached and biopsied. In those with Crohn's disease (n = 7), five had ileocolitis and two had colitis only. A multivariate analysis showed that age of the patients and otherwise normal gross endoscopic results to be the only factors associated with a lower likelihood of ileal intubation by endoscopists. The ileal intubation rate was 53.7% in our patients with chronic, non-bloody diarrhea. Diagnostic yield of ileocolonoscopy with biopsy in US patients with chronic, non-bloody diarrhea appeared to be low, if the colon side was normal on endoscopy. But this may provide supportive evidence in patients diagnosed with ileocolonic Crohn's disease. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

  17. 29 CFR 4043.24 - Termination or partial termination.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Termination or partial termination. 4043.24 Section 4043.24....24 Termination or partial termination. (a) Reportable event. A reportable event occurs when the Secretary of the Treasury determines that there has been a termination or partial termination of a plan...

  18. Development of ileal cytokine and immunoglobulin expression levels in response to early feeding in broilers and layers

    NARCIS (Netherlands)

    Simon, K.; Vries Reilingh, de G.; Kemp, B.; Lammers, A.

    2014-01-01

    Provision of feed in the immediate posthatch period may influence interaction between intestinal microbiota and immune system, and consequently immunological development of the chick. This study addressed ileal immune development in response to early feeding in 2 chicken breeds selected for

  19. Difference in in vitro fermentability of four carbohydrates and two diets, using ileal and faecal inocula from unweaned piglets

    NARCIS (Netherlands)

    Awati, A.; Bosch, M.W.; Tagliapietra, F.; Williams, B.A.; Verstegen, M.W.A.

    2006-01-01

    An experiment was conducted to examine differences in the in vitro fermentability of four carbohydrate-rich feed ingredients and two weaning piglet diets with and without these ingredients, using both the ileal contents and the faeces of unweaned piglets as inocula. In the first part of the

  20. Ileal endogenous nitrogen recovery is increased and its amino acid pattern is altered in pigs fed quebracho extract

    NARCIS (Netherlands)

    Steendam, C.A.; Tamminga, S.; Boer, H.; Jong, de E.J.; Visser, G.H.; Verstegen, M.W.A.

    2004-01-01

    Ileal endogenous nitrogen recovery (ENR) in pigs (9 ± 0.6 kg body weight) was estimated simultaneously using the 15N-isotope dilution technique (15N-IDT) and the peptide alimentation ultrafiltration (UF) method. Diets were cornstarch, enzyme-hydrolyzed casein with no (control) or high (4%) content

  1. 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.

  2. Effect of graded levels of dietary betaine on ileal and total tract nutrient digestibilities and intestinal bacterial metabolites in piglets.

    Science.gov (United States)

    Ratriyanto, A; Mosenthin, R; Jezierny, D; Eklund, M

    2010-12-01

    The study was conducted to investigate the effects of graded dietary inclusion levels of betaine on ileal and total tract nutrient digestibilities and intestinal bacterial metabolites in piglets. A total of eight barrows with an average initial body weight of 7.9 kg were randomly allocated to one of the four assay diets with two pigs per treatment in four repeated measurement periods. The assay diets included a basal diet based on wheat, barley and soybean meal alone, or supplemented with a liquid betaine product at dietary levels of 1.5, 3.0, or 6.0 g betaine per kilogram diet (as-fed). Ileal digestibilities of dry matter and neutral detergent fibre increased both quadratically and linearly, and ileal digestibility of glycine increased linearly as dietary betaine level increased (p digestibility of crude protein increased quadratically (p digestibilities of most amino acids tended to increase quadratically (p = 0.06 to p = 0.11) with increasing dietary betaine level. Moreover, there were linear increases in the concentrations of most bacterial metabolites which were significant p < 0.05 for ileal d-lactic acid and for faecal diaminopimelic acid. The results demonstrate that dietary betaine supplementation stimulates bacterial fermentation of fibre in the small intestine and bacterial degradation of crude protein in the large intestine. © 2010 Blackwell Verlag GmbH.

  3. Ileal, colonic and total tract nutrient digestibility in dogs (Canis familiaris) compared with total tract digestibility in mink (Neovison vison).

    Science.gov (United States)

    Tjernsbekk, Maria Therese; Tauson, Anne-Helene; Ahlstrøm, Oystein

    2014-01-01

    Mink (Neovison vison) was studied as a model for the determination of ileal crude protein (CP) and amino acid (AA) digestibility in dogs (Canis familiaris). Apparent ileal digestibility (AID) and apparent colonic digestibility (ACD) in dogs and apparent total tract digestibility (ATTD) in dogs and mink were measured for dry matter (DM), main nutrients and AA. Standardised ileal digestibility (SID) of CP and AA in dogs was calculated. Twelve dogs and 12 mink divided into three groups were fed one out of three diets differing in CP digestibility. In dogs, AID of CP was lower (74.4%) than ATTD (83.5%) (p Digestibility of AA followed the same pattern, and, except for Thr and Ser, ATTD in mink was very close to SID in dogs. Also, AID was close to ATTD in mink for several AA. High correlations were found between methods for digestibility of CP and most AA (p digestibility level (p digestibility was approximately 96% at all sites, while DM, starch and total carbohydrate digestibility increased from ileal to faecal level (p < 0.01). Mink ATTD of DM and main nutrients was closest to ACD in dogs. It was concluded that mink is a suitable model for the determination of AID and SID of CP and AA in dogs.

  4. Nitrogen utilization in pigs fed diets with soybean and rapeseed products leading to different ileal endogenous nitrogen losses

    NARCIS (Netherlands)

    Grala, W.; Verstegen, M.W.A.; Jansman, A.J.M.; Huisman, J.; Wasilewko, J.

    1998-01-01

    Nitrogen (N) balance was determined in 36 pigs (BW 24 to 30 kg) fed diets inducing different ileal endogenous N losses (ENL). We tested the hypothesis that enhanced ENL may be indicative of a higher recycling of endogenous proteins that will induce a greater urinary N loss and a lower efficiency of

  5. Standardized ileal digestible tryptophan to lysine ratios in growing pigs fed corn-based and non-corn-based diets

    Science.gov (United States)

    Two 21-d experiments were conducted to determine the optimum standard ileal digestible (SID) Trp:Lys ratio in growing pigs fed corn-based diets compared to non-corn-based diets. The primary response variables in both experiments were ADG and plasma urea N (PUN) concentrations with the optimum SID Tr...

  6. Antibiotic inclusion in the diet did not alter the standardized ileal digestible tryptophan to lysine ratio for growing pigs

    Science.gov (United States)

    Two 21-d experiments were conducted to determine the optimum standard ileal digestible (SID) Trp:Lys ratio in growing pigs fed diets supplemented with or without an antibiotic. The primary response variables in both experiments were ADG, ADFI, G:F and plasma urea N (PUN) concentrations with the opti...

  7. Omega-3 fatty acids in ileal effluent after consuming different foods containing microencapsulated fish oil powder - an ileostomy study.

    Science.gov (United States)

    Sanguansri, Luz; Shen, Zhiping; Weerakkody, Rangika; Barnes, Mary; Lockett, Trevor; Augustin, Mary Ann

    2013-01-01

    The intestinal absorption of omega-3 long chain polyunsaturated fatty acids (ω3 LCPUFA), [eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)], after consuming fish oil gelatine capsules or different food products fortified with microencapsulated fish oil, was determined using human ileostomates. The total amount of ω3 LCPUFA consumed per dose of fish oil capsule was 266 mg while that for fortified orange juice, yoghurt and cereal bar was 284 mg per serving of food product. In a time course experiment ω3 LCPUFA was measured in ileal effluent over 24 h post ingestion. Only 0.58-0.73% of the total ω3 LCPUFA dose was recovered in the ileal effluent irrespective of whether the fish oil was delivered in a gelatine capsule or in the form of a microencapsulated powder incorporated into fortified foods. Excretion of ω3 LCPUFA was detected in the 2-18 h effluent collections with none detected at 0 h or 24 h. post ingestion. The transit time of the minimal amount of ω3 LCPUFA that remained in the ileal effluent was dependent on the method of delivery of the fish oil. The ω3 LCPUFA content in the ileal effluent peaked at 2-8 h and declined after 10 h after consumption of fish oil capsules and fortified orange juice. In contrast, two peaks in ω3 LCPUFA content were observed in the ileal effluent, first at 2-8 h and again at 14-16 h, after consumption of fortified yoghurt and cereal bar. The highest recovery of the small amount of ω3 LCPUFA in the ileal effluent at 14-16 h was obtained when fortified cereal bar was consumed. The results suggest that the delivery of fish oil through food products fortified with microencapsulated fish oil does not compromise the bioavailability of the ω3 LCPUFA as evidence by no statistical differences detected in the remaining portion of ω3 LCPUFA in the ileal effluent (p = 0.58). However, the food matrix in which the microencapsulated oil was delivered may alter the transit kinetics of the ω3 LCPUFA through the small intestine.

  8. CONTAINER TERMINALS IN EUROPE

    Directory of Open Access Journals (Sweden)

    Bart W. WIEGMANS

    2001-01-01

    Full Text Available This paper aims to address the linkage between logistics (in particular, the management of marketing channel flows and transport markets, while also the interaction between these two markets and intermodal container terminals is analysed. The marketing channel theory is used to describe all relevant actors and flows that run through marketing channels, starting with customer needs and ending with customer satisfaction. Porter's theory of competitive advantages is used to review competitive forces in both markets. Finally, a competitor analysis is performed for the logistics and transport market. These theories are applied so as to be able to determine the competitive position of intermodal container terminals with a view to the management of marketing channel flows and the physical transport of freight flows. Hence, the central question of this paper is: Which markets are served by intermodal container terminals and with whom are they competing? At present, neither the maritime container terminals nor the continental container terminals appear to have a significant influence in the logistics service market; they concentrate mainly on the physical movement of containers (transshipment. Furthermore, maritime container terminals and continental container terminals are not dominant players in the transport service market. Our conclusion is that continental terminals are predominantly competing with unimodal road transport, with neighbouring continental terminals and with barge transport companies.

  9. The level of protein in milk formula modifies ileal sensitivity to LPS later in life in a piglet model.

    Directory of Open Access Journals (Sweden)

    Livie Chatelais

    Full Text Available BACKGROUND: Milk formulas have higher protein contents than human milk. This high protein level could modify the development of intestinal microbiota, epithelial barrier and immune functions and have long-term consequences. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the effect of a high protein formula on ileal microbiota and physiology during the neonatal period and later in life. Piglets were fed from 2 to 28 days of age either a normoprotein (NP, equivalent to sow milk or a high protein formula (HP, +40% protein. Then, they received the same solid diet until 160 days. During the formula feeding period ileal microbiota implantation was accelerated in HP piglets with greater concentrations of ileal bacteria at d7 in HP than NP piglets. Epithelial barrier function was altered with a higher permeability to small and large probes in Ussing chambers in HP compared to NP piglets without difference in bacterial translocation. Infiltration of T cells was increased in HP piglets at d28. IL-1β and NF-κB sub-units mRNA levels were reduced in HP piglets at d7 and d28 respectively; plasma haptoglobin also tended to be reduced at d7. Later in life, pro-inflammatory cytokines secretion in response to high doses of LPS in explants culture was reduced in HP compared to NP piglets. Levels of mRNA coding the NF-κB pathway sub-units were increased by the challenge with LPS in NP piglets, but not HP ones. CONCLUSIONS/SIGNIFICANCE: A high protein level in formula affects the postnatal development of ileal microbiota, epithelial barrier and immune function in piglets and alters ileal response to inflammatory mediators later in life.

  10. The level of protein in milk formula modifies ileal sensitivity to LPS later in life in a piglet model.

    Science.gov (United States)

    Chatelais, Livie; Jamin, Agnès; Gras-Le Guen, Christèle; Lallès, Jean-Paul; Le Huërou-Luron, Isabelle; Boudry, Gaëlle

    2011-05-09

    Milk formulas have higher protein contents than human milk. This high protein level could modify the development of intestinal microbiota, epithelial barrier and immune functions and have long-term consequences. We investigated the effect of a high protein formula on ileal microbiota and physiology during the neonatal period and later in life. Piglets were fed from 2 to 28 days of age either a normoprotein (NP, equivalent to sow milk) or a high protein formula (HP, +40% protein). Then, they received the same solid diet until 160 days. During the formula feeding period ileal microbiota implantation was accelerated in HP piglets with greater concentrations of ileal bacteria at d7 in HP than NP piglets. Epithelial barrier function was altered with a higher permeability to small and large probes in Ussing chambers in HP compared to NP piglets without difference in bacterial translocation. Infiltration of T cells was increased in HP piglets at d28. IL-1β and NF-κB sub-units mRNA levels were reduced in HP piglets at d7 and d28 respectively; plasma haptoglobin also tended to be reduced at d7. Later in life, pro-inflammatory cytokines secretion in response to high doses of LPS in explants culture was reduced in HP compared to NP piglets. Levels of mRNA coding the NF-κB pathway sub-units were increased by the challenge with LPS in NP piglets, but not HP ones. A high protein level in formula affects the postnatal development of ileal microbiota, epithelial barrier and immune function in piglets and alters ileal response to inflammatory mediators later in life.

  11. 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.

  12. Ileal Amino Acid Digestibility of Broken Rice Fed to Postweaned Piglets with or without Multicarbohydrase and Phytase Supplementation

    Directory of Open Access Journals (Sweden)

    J. C. Dadalt

    2016-10-01

    Full Text Available Most of amino acid (AA digestibility values for feed ingredients are obtained using pigs cannulated in the distal ileum. The ileal-cannulated pig model uses pigs older than six weeks due to difficulties related to implanting the T-cannula in distal ileum of younger pigs and complications during the post-surgical recovery. However, to properly formulate the diet of weaned pigs, the nutritive value of feed ingredients should be determined with younger pigs. Thus, 25 weaned pigs were used to determine the apparent total tract digestibility (ATTD of nutrients, energy, and apparent ileal digestibility (AID and standardized ileal digestibility (SID ileal AA digestibility of broken rice (BR, with or without multicarbohydrase (MC and phytase (Phy supplementation. Piglets were weaned at 23 d of age and individually housed in digestibility cages until 45 d of age. The trial consisted of 7 d of adaptation to the experimental diets and 3 d of excreta (feces and urine collection. Ileal digesta was collected at slaughter (about 6 weeks of age. A completely randomized experimental design was used to determine the effects of MC and Phy. Reference diets (RD, 5% casein was replaced by 30% of BR with or without MC, Phy, or MC+Phy. The RD was used to quantify endogenous AA losses. BR with Phy supplied had increased the ATTD of dry matter (p<0.05 and SID of histidine (p = 0.05, arginine, leucine, lysine, valine, alanine, and proline (p<0.05. BR with MC had been increased digestible energy and protein and SID for histidine (p<0.05. There was no interaction between Phy and MC on the BR nutrient digestibilities. Standardized amino acid digestibilities of BR, without enzymes, were lower than those values reported in the literature. The MC and Phy improved the digestibility of some nutrients and energy of BR in post-weaned piglet diets.

  13. Metabolizable energy, nitrogen balance, and ileal digestibility of amino acids in quality protein maize for pigs

    Science.gov (United States)

    2014-01-01

    Background To compare the nutritional value and digestibility of five quality protein maize (QPM) hybrids to that of white and yellow maize, two experiments were carried out in growing pigs. In experiment 1, the energy metabolizability and the nitrogen balance of growing pigs fed one of five QPM hybrid diets were compared against those of pigs fed white or yellow maize. In experiment 2, the apparent and standardized ileal digestibility (AID and SID, respectively) of proteins and amino acids from the five QPM hybrids were compared against those obtained from pigs fed white and yellow maize. In both experiments, the comparisons were conducted using contrasts. Results The dry matter and nitrogen intakes were higher in the pigs fed the QPM hybrids (P digestibility (P digestible lysine than normal maize. PMID:25045520

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

    Science.gov (United States)

    Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

    2015-01-01

    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). PMID:26195886

  15. Organizational Relationship Termination Competence

    DEFF Research Database (Denmark)

    Ritter, Thomas; Geersbro, Jens

    2011-01-01

    that a firm's percentage of unwanted customers decreases significantly as acceptance of termination increases, if the firm's definition of unwanted customers is well understood, and if a firm has clear termination routines. In addition, general focus on profitability and external constraints on relationship...

  16. Fecal microbiota transplantation for Clostridium difficile infection in patients with ileal pouches.

    Science.gov (United States)

    Lan, Nan; Ashburn, Jean; Shen, Bo

    2017-08-01

    Background:Clostridium difficile infection (CDI) in patients with ileal pouch-anal anastomosis (IPAA) has been increasingly recognized. The aim of this study was to evaluate the outcome of fecal microbiota transplantation (FMT) in patients with pouch and CDI. Methods: All consecutive patients that underwent FMT for CDI from 2012 to 2016 were extracted from our IRB-approved, prospectively maintained Registry of Pouch Disorders. The primary outcome was negative stool tests for Clostridium difficile after FMT and the secondary outcomes were symptomatic and endoscopic responses. Results: A total of 13 patients were included in this study, with 10 being Caucasian males (76.9%). All patients had underlying ulcerative colitis for J pouch surgery. After a mean of 2.8±0.8 courses of antibiotic treatments was given and failed, 22 sessions of FMT were administered with an average of 1.7±1.1 sessions each. Within the 22 sessions, 16 were given via pouchoscopy, 4 via esophagogastroduodenoscopy and 2 via enemas. All patients tested negative on C. difficile polymerase chain reaction (PCR) after the initial FMT with a total of 7/12 (58.3%) documented patients showed symptomatic improvements and 3/11 (27.3%) patients showed endoscopic improvement according to the modified Pouchitis Disease Activity Index. During the follow-up of 1.2±1.1 years, there were a total of five patients (38.5%) that had recurrence after the successful initial treatment and four of them were successfully treated again with FMT. Conclusions: FMT appeared to be effective in eradication of CDI in patients with ileal pouches. However, FMT had a modest impact on endoscopic inflammation and recurrence after FMT and recurrence was common.

  17. Host Responses to Persistent Mycobacterium avium Subspecies paratuberculosis Infection in Surgically Isolated Bovine Ileal Segments

    Science.gov (United States)

    Charavaryamath, Chandrashekhar; Gonzalez-Cano, Patricia; Fries, Patrick; Gomis, Susantha; Doig, Kimberley; Scruten, Erin; Potter, Andrew; Napper, Scott

    2013-01-01

    A lack of appropriate disease models has limited our understanding of the pathogenesis of persistent enteric infections with Mycobacterium avium subsp. paratuberculosis. A model was developed for the controlled delivery of a defined dose of M. avium subsp. paratuberculosis to surgically isolated ileal segments in newborn calves. The stable intestinal segments enabled the characterization of host responses to persistent M. avium subsp. paratuberculosis infections after a 9-month period, including an analysis of local mucosal immune responses relative to an adjacent uninfected intestinal compartment. M. avium subsp. paratuberculosis remained localized at the initial site of intestinal infection and was not detected by PCR in the mesenteric lymph node. M. avium subsp. paratuberculosis-specific T cell proliferative responses included both CD4 and γδ T cell receptor (γδTcR) T cell responses in the draining mesenteric lymph node. The levels of CD8+ and γδTcR+ T cells increased significantly (P paratuberculosis-specific tumor necrosis factor alpha (TNF-α) and gamma interferon secretion by lamina propria leukocytes was also significantly (P paratuberculosis infection. In conclusion, surgically isolated ileal segments provided a model system for the establishment of a persistent and localized enteric M. avium subsp. paratuberculosis infection in cattle and facilitated the analysis of M. avium subsp. paratuberculosis-specific changes in mucosal leukocyte phenotype and function. The accumulation of DC subpopulations in the lamina propria suggests that further investigation of mucosal DCs may provide insight into host responses to M. avium subsp. paratuberculosis infection and improve vaccine strategies to prevent M. avium subsp. paratuberculosis infection. PMID:23221000

  18. Lentinan diminishes apoptotic bodies in the ileal crypts associated with S-1 administration.

    Science.gov (United States)

    Suga, Yasuyo; Takehana, Kenji

    2017-09-01

    S-1 is an oral agent containing tegafur (a prodrug of 5-fluorouracil) that is used to treat various cancers, but adverse effects are frequent. Two pilot clinical studies have suggested that lentinan (LNT; β-1,3-glucan) may reduce the incidence of adverse effects caused by S-1 therapy. In this study, we established a murine model for assessment of gastrointestinal toxicity associated with S-1 and studied the effect of LNT. S-1 was administered orally to BALB/c mice at the effective dose (8.3mg/kg, as tegafur equivalent) once daily (5days per week) for 3weeks. Stool consistency and intestinal specimens were examined. We investigated the effect of combined intravenous administration of LNT at 0.1mg, which is an effective dose in murine tumor models. We also investigated the effect of a single administration of S-1. During long-term administration of S-1, some mice had loose stools and an increase in apoptotic bodies was observed in the ileal crypts. An increase in apoptotic bodies was also noted after a single administration of S-1 (15mg/kg). Prior or concomitant administration of LNT inhibited the increase in apoptotic bodies in both settings. Administration of LNT also increased the accumulation of CD11b + TIM-4 + cells in the ileum, while depletion of these cells by liposomal clodronate diminished the inhibitory effect of LNT on S-1 toxicity. Combined administration of LNT with S-1 led to a decrease in apoptotic bodies in the ileal crypts, possibly because LNT promoted phagocytosis of damaged cells by CD11b + TIM-4 + cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Exome sequencing identifies a de novo frameshift mutation in the imprinted gene ZDBF2 in a sporadic patient with Nasopalpebral Lipoma-coloboma syndrome.

    Science.gov (United States)

    Chacón-Camacho, Oscar F; Sobreira, Nara; You, Jing; Piña-Aguilar, Raul E; Villegas-Ruiz, Vanessa; Zenteno, Juan C

    2016-07-01

    Nasopalpebral lipoma-coloboma syndrome (NPLCS, OMIM%167730) is an uncommon malformation entity with autosomal dominant inheritance characterized by the combination of nasopalpebral lipoma, colobomas in upper and lower eyelids, telecanthus, and maxillary hypoplasia. To date, no genetic defects have been associated with familial or sporadic NPLCS cases and the etiology of the disease remains unknown. In this work, the results of whole exome sequencing in a sporadic NPLCS patient are presented. Exome sequencing identified a de novo heterozygous frameshift dinucleotide insertion c.6245_6246 insTT (p.His2082fs*67) in ZDBF2 (zinc finger, DBF-type containing 2), a gene located at 2q33.3. This variant was absent in parental DNA, in a set of 300 ethnically matched controls, and in public exome variant databases. This is the first genetic variant identified in a NPLCS patient and evidence supporting the pathogenicity of the identified mutation is discussed. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Effects of isolated and complex dietary fibre matrices in breads on carbohydrate digestibility and physicochemical properties of ileal effluent from pigs

    DEFF Research Database (Denmark)

    Kasprzak, Miroslaw Marek; Lærke, Helle Nygaard; Knudsen, Knud Erik Bach

    2012-01-01

    To assess the effects of content and structure of dietary fiber (DF) on the carbohydrate digestibility and physicochemical properties of ileal digesta, five bread diets were studied in an experiment with ileum-cannulated pigs in a crossover design. The diets consisted of two experimental breads...... effect of either DF content, structure, viscosity, or water-binding capacity on the ileal digestibility of starch, which was almost completely digested in the small intestine. Arabinoxylan and β-glucan were 11 and 81% degraded in the ileum, respectively, which resulted in a significant increase...... and decrease of ileal extract viscosities, respectively. It is concluded that the viscosity-elevating properties of soluble DF in breads and ileal digesta are strongly dependent on the content and structure of DF and degree of resistance toward microbial enzymes....

  1. Xylanase Increased the Ileal Digestibility of Non-Starch Polysaccharides and Concentration of Low Molecular Weight Non-Digestible Carbohydrates in Pigs Fed High Levels of wheat DDGS

    DEFF Research Database (Denmark)

    Pedersen, Mads Brøgger; Yu, Shukun; Arent, Susan

    2015-01-01

    with solubles (wDDGS). The control and 3 enzyme diets contained 96% wDDGS supplemented with vitamins, minerals, l-lysine, and chromic oxide as a digestibility marker in addition to enzyme premix. Eight ileal cannulated pigs were fed 4 experimental diets containing 96% wDDGS—a control diet or 1 of 3 diets...... with the control diet. Enzyme addition did not affect AID of OM, CP, starch, and fat (P > 0.3). In conclusion, addition of xylanases to wDDGS diets increased the ileal digestibility of NSP and generated LMW NDC components in the small intestine of pigs but did not affect ileal digestibility of nutrients......The objective was to study the effect of a commercially available xylanase (CAX), an experimental xylanase (EX), and EX in combination with protease (EXP) on the degradation of nondigestible carbohydrates (NDC) and apparent ileal digestibility (AID) of nutrients in wheat distillers dried grains...

  2. Comsat's TDMA traffic terminal

    Science.gov (United States)

    Benjamin, M. C.; Bogaert, W. M.

    1985-06-01

    Comsat has installed two traffic terminals in the Etam earth-station and is currently installing a third in the new Roaring Creek earth-station to access the Intelsat TDMA network. This paper describes the Comsat TDMA traffic terminal equipment from the supergroup interface to the antenna. Comsat's 1: N redundancy approach for terrestrial interface equipment and DSI unit back-up is described as well as electrical path length, amplitude and group delay equalization techniques, special on-line RF monitoring and failure reporting facilities and the operation and maintenance center which can operate and perform diagnostic testing on up to four traffic terminals from a central location.

  3. Marked Differences in Mucosal Immune Responses Induced in Ileal versus Jejunal Peyer’s Patches to Mycobacterium avium subsp. paratuberculosis Secreted Proteins following Targeted Enteric Infection in Young Calves

    Science.gov (United States)

    Facciuolo, Antonio; Gonzalez-Cano, Patricia; Napper, Scott; Griebel, Philip J.

    2016-01-01

    In cattle, Mycobacterium avium subsp. paratuberculosis infection is primarily mediated through M cells overlying Peyer’s patches (PP) in the ileum. The capacity of M. avium subsp. paratuberculosis to invade ileal PP (IPP) versus discrete PP in the jejunum (JPP) and subsequent differences in mucosal immune responses were investigated. Intestinal segments were surgically prepared in both mid-jejunum, containing two JPPs, and in terminal small intestine containing continuous IPP. M. avium subsp. paratuberculosis (109 CFU) was injected into the lumen of half of each intestinal segment when calves were 10–14 days-old and infection confirmed 1–2 months later by PCR and immunohistochemistry. Thirteen recombinant M. avium subsp. paratuberculosis proteins, previously identified as immunogenic, were used to analyze pathogen-specific B- and T-cell responses in PP and mesenteric lymph nodes. IgA plasma cell responses to 9 of 13 recombinant proteins were detected in JPP but not in IPP. Secretory IgA reacting in ELISA with 9 of the 13 recombinant proteins was detected in luminal contents from both jejunal and ileal segments. These observations support the conclusion that pathogen-specific IgA B cells were induced in JPP but not IPP early after a primary infection. The presence of secretory IgA in intestinal contents is consistent with dissemination of IgA plasma cells from the identified mucosa-associated immune induction sites. This is the first direct evidence for M. avium subsp. paratuberculosis uptake by bovine JPP and for local induction of pathogen-specific IgA plasma cell responses after enteric infection. We also provide evidence that bacterial invasion of IPP, a primary B lymphoid tissue, provides a novel strategy to evade induction of mucosal immune responses. Over 60% of PPs in the newborn calf small intestine is primary lymphoid tissue, which has significant implications when designing oral vaccines or diagnostic tests to detect early M. avium subsp

  4. [The effects of ileal transposition, gastrojejunal bypass and vertical gastroplasty on the regulation of ingestion in an experimental obesity model associated with diabetes mellitus type 2].

    Science.gov (United States)

    Sabench Pereferrer, Fàtima; Hernàndez Gonzàlez, Mercè; Blanco Blasco, Santiago; Sánchez Marín, Antonio; Morandeira Rivas, Antonio; Del Castillo Déjardin, Daniel

    2009-04-01

    The continual advances in our knowledge of the pathogenesis and hormonal disorders of morbid obesity lead to new studies in experimental animals and the development of new technical options. The aim is to asses whether ileal transposition can be a good treatment of morbid obesity associated with diabetes mellitus due to the action of intestinal peptide Glp-1 (enteroglucagon) compared to gastric bypass and vertical gastroplasty (VGB). Trial environment: experimental animals ZDF rats (Zucker Diabetic Fatty rats). Subjects of the study: three groups of 10 animals each one divided as: a) ileal tranposition; b) gastro-jejunal bypass; c) vertical gastroplasty. Parameters to determine: weight loss, levels of glycaemia, enteroglucagon, insulin and ghrelin in blood, one week before the operation as a baseline control, and 15 days after the surgical procedure. Gastrojejunal bypass produces the most significant weight loss. There is a significant decrease in intake in all groups. Hyperinsulinaemia and hyperglycaemia tend to decrease after surgery in all groups, but in ileal transposition there is better control of ketosis. After gastrojejunal bypass and ileal transposition, we observed an increase in GLP-1 levels but were only significant in ileal transposition. Ileal transposition produces a decrease in plasma glucose and better control of diabetes mellitus, which could benefit patients affected by morbid obesity and poor metabolic control. More studies are needed on other models of obesity. A model of exogenous and reversible obesity could be a good option to study the real benefits of the interventions.

  5. Terminated Multifamily Mortgages Database

    Data.gov (United States)

    Department of Housing and Urban Development — This dataset includes all terminated HUD Multifamily mortgages except those from the Hospital Mortgage Insurance Program. It includes the Holder and Servicer at the...

  6. Antecedents of Customer Relationship Termination

    DEFF Research Database (Denmark)

    Geersbro, Jens; Ritter, Thomas

    relationships as a managerial task. This paper contributes by (1) developing a conceptualization of relationship termination competence and (2) analyzing its antecedents. The empirical results identify termination acceptance, definition non-customers, organizational relationship termination routines...

  7. Acute small bowel obstruction due to ileal endometriosis: A case report and review of the most recent literature

    Directory of Open Access Journals (Sweden)

    Unalp Recai Haluk

    2012-01-01

    Full Text Available Introduction. Endometriosis is defined as the presence of benign endometrial glands and stroma outside the normal anatomical location. Endometriosis of the small bowel, especially symptomatic small bowel involvement, is very unusual. Case report. We presented a 45-year-old woman with acute intestinal obstruction due to ileal endometriosis The patient complained of severe abdominal pain, nausea and vomitting. Immediate laparotomy was carried out. Above the ileocecal valve there was an ulcerated, edematous and fragile segmental lesion that caused intestinal obstruction. Histology of this ileal segment revealed endometriosis and an annular stricture that again showed foci of endometriosis. Conclusion. In reproductiveage women with the symptoms of intestinal obstruction, intestinal endometriosis should be kept in mind.

  8. Ileal Diverticulitis as a Cause of Right Lower Quadrant Pain: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    P. Kothadia

    2015-12-01

    Full Text Available Introduction Small bowel diverticulitis is a rare clinical disease of the small bowel. The incidence of small bowel diverticulitis varies from 0.3 to 2.3 % in the general population. Complications of this rare clinical entity are often confused with other causes of acute abdomen such as acute appendicitis, perforated peptic ulcer, inflammatory bowel disease or ischemic bowel disease. Case Presentation We describe a 65-year-old male with a history of ileal diverticulosis who presented with acute abdomen and was subsequently found to have perforated ileal diverticulitis with abscess formation. Conclusions The case, differential diagnosis, imaging studies, complications and management of this rare clinical disease are discussed.

  9. Technical note: assessment of recovery site of mobile nylon bags for measuring ileal digestibility of starch in dairy cows.

    Science.gov (United States)

    Norberg, E; Volden, H; Harstad, O M

    2007-01-01

    The objective of this study was to evaluate recovery site of mobile nylon bags for measuring ileal digestibility of ruminally undegraded starch in dairy cows. Eight feed samples of untreated and treated concentrates were examined. Three lactating cows equipped with rumen fistula and duodenal and ileal cannulas were used in the experiment. The mobile nylon bags containing intact feeds or residues after a 12-h ruminal incubation were pretreated using a 2-step procedure to simulate abomasal digestion before insertion through the duodenal cannula. To assess the effect of hindgut fermentation on starch digestibility, approximately half of the bags were collected from the ileum and half from the feces. The results indicate that feed samples should be preincubated in rumen before insertion into duodenum, and that samples with relatively high fractions of rumen-undigestible starch should be collected from the ileum instead of from feces.

  10. Radical cystectomy and pelvic lymphadenectomy with ileal conduit urinary diversion and abdominal wall reconstruction: an interesting case of multidisciplinary management

    Directory of Open Access Journals (Sweden)

    Sofos SS

    2015-01-01

    Full Text Available Stratos S Sofos,1 Ciaran Walsh,2 Nigel J Parr,2 Kevin Hancock11Whiston Hospital, Prescot, 2Arrowe Park Hospital, Wirral, Merseyside, UKAbstract: The ileal conduit for urinary diversion after radical cystectomy is a well-described procedure. Furthermore, parastomal hernias, prolapse, stenosis, and retraction of the stoma have been reported as some of the more common complications of this procedure. The subsequent repair of parastomal hernias with a biological mesh and the potential of the conduit to “tunnel” through it has also been described. In this case report, we present a combined repair of a large incisional hernia with a cystectomy and a pelvic lymphadenectomy for invasive bladder cancer, with the use of a biological mesh for posterior component abdominal wall primary repair as well as for support to the ileal conduit used for urinary diversion.Keywords: incisional hernia, posterior component separation, biological mesh 

  11. The effects of the avilamycin, Protexin® and basil essential oil supplements on ileal bacteria of broiler chickens

    OpenAIRE

    Seyyed Reza Riyazi; Yahya Ebrahimnezhad; Sayed Abdoullah Hosseini; Amir Meimandipour; Abolfazl Ghorbani

    2015-01-01

    The effects of probiotic (Protexin®, Protexin Veterinary, Somerset, UK), medicinal plant (basil essential oil) and an antibiotic growth promoter (avilamycin) as broiler feed additives on ileal bacteria of broilers were studied. A total of 600 Arian broilers were divided into 6 treatments, with 4 replicates of 25 birds. Treatments were a plant essential oil in 3 level (200, 400 and 600 ppm), the probiotic (150 ppm), an antibiotic (150 ppm) and a control group with no additives. Birds in differ...

  12. Composition, ileal amino acid digestibility and nutritive value of organically grown legume seeds and conventional rapeseed cakes for pigs

    Directory of Open Access Journals (Sweden)

    K. PARTANEN

    2008-12-01

    Full Text Available Eight white-flowered pea (Pisum sativum and two white-flowered field bean (Vicia faba cultivars grown organically were analysed for proximate composition and amino acid content. In vivo ileal amino acid digestibilities and faecal energy digestibility were predicted from the in vitro enzymatic digestibility of nitrogen and organic matter, respectively. The crude protein (CP content of the pea and field bean cultivars ranged from 244 to 279 and from 320 to 347 g/kg dry matter (DM, respectively. The concentrations of several essential amino acids in protein decreased as the CP content increased. In peas, predicted in vivo digestibilities did not correlate with chemical composition, and in field beans were lower than in peas. A digestibility trial was carried out on six cannulated barrows according to a 6 ´ 5 cyclic change-over design to determine the faecal and ileal nutrient digestibilities of organically grown leafed peas (cv. Sohvi, 199 g CP/kg DM, semileafless peas (cv. Karita, 240 g CP/kg DM, field beans (cv. Kontu, 320 g CP/kg DM, narrow-leafed lupins (Lupinus angustifolius cv. Pershatsvet, 220 g CP/kg DM, and conventional warm- and cold-pressed rapeseed cakes (360 and 313 g CP/kg DM, respectively. The net energy contents of the leafed and semileafed peas, field beans, lupins, and cold- and warm-pressed rape seed cakes were 10.8, 11.2, 9.8, 9.7, 9.4 and 12.3 MJ/kg DM, respectively. The apparent ileal digestibilities of lysine and threonine were similar, but the digestibility of methionine was poor in all legume seeds. Cystine digestibility was highest in lupins and lowest in field beans. With the exception of phenylalanine, there was no difference in apparent ileal amino acid digestibilities between rapeseed cakes.;

  13. Utility of contrast enema for detecting anastomotic strictures after total proctocolectomy and ileal pouch-anal anastomosis.

    Science.gov (United States)

    Dolinsky, David; Levine, Marc S; Rubesin, Stephen E; Laufer, Igor; Rombeau, John L

    2007-07-01

    The purpose of our study was to determine the utility of contrast enemas for detecting clinically relevant anastomotic strictures after total proctocolectomy and ileal pouch-anal anastomosis and to facilitate management by defining a critical anastomotic caliber at or below which obstruction is likely to develop after ileostomy closure. Our radiology database revealed 42 patients with contrast enemas after total proctocolectomy and ileal pouch-anal anastomosis who fulfilled our exclusion criteria. The initial postoperative contrast enemas were reviewed blindly to determine the diameter of the ileoanal anastomosis. The diagnosis of a stricture was made only if the patient had signs of intestinal obstruction after ileostomy closure with confirmation on follow-up contrast enema or sigmoidoscopy and clinical improvement after anastomotic dilatation. The data were then correlated to determine if there was a critical anastomotic caliber at or below which such strictures were likely to develop. Using this threshold value, the sensitivity and specificity of routine contrast enemas for detecting clinically relevant anastomotic strictures were then determined. Six (14%) of the 42 patients who underwent total proctocolectomy and ileal pouch-anal anastomosis had strictures at the ileoanal anastomosis on contrast enemas. The mean diameter of the anastomosis was 5.8 mm in the six patients with anastomotic strictures versus 15 mm in the 36 patients without strictures (p = 0.0002). If an anastomotic diameter of 8 mm is defined as the critical caliber at or below which clinically relevant strictures are present, the sensitivity of contrast enemas for detecting strictures at the ileoanal anastomosis was 100% (six of six patients) and the specificity was 92% (33 of 36 patients). Routine contrast enema after total proctocolectomy and ileal pouch-anal anastomosis is a sensitive test for detecting clinically relevant strictures at the ileoanal anastomosis when an anastomotic diameter of

  14. Inhibition of ileal apical but not basolateral bile acid transport reduces atherosclerosis in apoE⁻/⁻ mice.

    Science.gov (United States)

    Lan, Tian; Haywood, Jamie; Dawson, Paul A

    2013-08-01

    Interruption of the enterohepatic circulation of bile acids induces hepatic bile acid synthesis, increases hepatic cholesterol demand, and increases clearance of apoB-containing lipoproteins in plasma. Based on these effects, bile acid sequestrants have been used for many years to treat hypercholesterolemia and the associated atherosclerosis. The objective of this study was to determine the effect of blocking ileal apical versus basolateral membrane bile acid transport on the development of hypercholesterolemia and atherosclerosis in mouse models. ApoE(-/-) and Ldlr(-/-) mice deficient in the apical sodium-dependent bile acid transporter (Asbt) or apoE(-/-) mice deficient in the basolateral bile acid transporter (Ostα) were fed an atherogenic diet for 16 weeks. Bile acid metabolism, cholesterol metabolism, gene expression, and development of atherosclerosis were examined. Mice deficient in Asbt exhibited the classic response to interruption of the enterohepatic circulation of bile acids, including significant reductions in hepatic and plasma cholesterol levels, and reduced aortic cholesteryl ester content. Ileal Fibroblast Growth Factor-15 (FGF15) expression was significantly reduced in Asbt(-/-)apoE(-/-) mice and was inversely correlated with expression of hepatic cholesterol 7-hydroxylase (Cyp7a1). Ileal FGF15 expression was directly correlated with plasma cholesterol levels and aortic cholesterol content. In contrast, plasma and hepatic cholesterol levels and atherosclerosis development were not reduced in apoE(-/-) mice deficient in Ostα. Decreases in ileal FGF15, with subsequent increases in hepatic Cyp7a1 expression and bile acid synthesis appear to be necessary for the plasma cholesterol-lowering and atheroprotective effects associated with blocking intestinal bile acid absorption. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Measurement of true ileal digestibility and total tract retention of phosphorus in corn and canola meal for broiler chickens.

    Science.gov (United States)

    Mutucumarana, R K; Ravindran, V; Ravindran, G; Cowieson, A J

    2014-02-01

    The study reported herein was conducted to determine and compare the nonphytate P, digestible P, and retainable P contents of corn and canola meal for broiler chickens. Four semipurified diets were formulated from each of ingredient to contain graded concentrations of nonphytate P. The experiment was conducted as a randomized complete block design with 4 weight blocks of 8 cages each (6 birds per cage). A total of 192 broilers (Ross 308), 21 d old, were assigned to the 8 test diets. Ileal digestibility and total tract retention coefficients of P were determined by the indicator and total collection methods, respectively, and linear regression method was used to determine the true P digestibility and true P retention coefficients. The apparent ileal digestibility of P in corn was influenced (quadratic, P 0.05). The apparent ileal P digestibility in broilers fed diets based on canola meal was similar (P > 0.05) at different P concentrations. Phosphorus retention in broilers fed diets based on canola meal (linear, P 0.05). Total P, nonphytate P, true digestible P, and true retainable P contents of corn were determined to be 2.5, 0.8, 1.7, and 1.6 g/kg (as received), respectively. The corresponding values for canola meal were 9.7, 2.8, 4.6, and 4.7 g/kg (as received), respectively. The present data demonstrated that the regression method can be successfully used to measure true P digestibility of low and high P feed ingredients and that both true ileal digestibility and retention coefficients are suitable to assess P availability in broilers.

  16. Standardized ileal digestibility of amino acids in eight genotypes of soft winter wheat fed to growing pigs

    DEFF Research Database (Denmark)

    Rosenfelder, P; Mosenthin, R; Spindler, H K

    2015-01-01

    A study with growing pigs was conducted to determine the chemical composition and standardized ileal digestibility (SID) of CP and AA of 8 wheat genotypes that have recently been added to the German Descriptive Variety List. These genotypes included Tabasco, KWS Erasmus, Tobak, Skalmeje, Mulan, E...... to literature data, digestibility values in actual feed tables for wheat may overestimate their protein values and need to be updated.......A study with growing pigs was conducted to determine the chemical composition and standardized ileal digestibility (SID) of CP and AA of 8 wheat genotypes that have recently been added to the German Descriptive Variety List. These genotypes included Tabasco, KWS Erasmus, Tobak, Skalmeje, Mulan......, and Mulan (69%). Adler had greater SID of Met (88%; P = 0.01) when compared to Tabasco (86%); Tobak, Skalmeje, and Mulan (85%); and Tommi (84%). Among the 8 wheat genotypes, standardized ileal digestible content (cSID) of CP followed total CP content and ranged from 9.1 to 11.3% (as-fed basis). Standardized...

  17. Phytase modulates ileal microbiota and enhances growth performance of the broiler chickens.

    Directory of Open Access Journals (Sweden)

    Anna Ptak

    Full Text Available Phytase is well studied and explored, however, little is known about its effects on the microbial ecology of the gastrointestinal tract. In total, 400 one-day-old female Ross 308 chicks were randomly distributed to four experimental groups. The dietary treatments were arranged as a 2 × 2 complete factorial design, with the factors being adequate (PC or insufficient calcium (Ca and digestible phosphor (dP(NC and with or without 5000 phytase units (FTU/kg of Escherichia coli 6-phytase. The gastrointestinal tract pH values, ileal microbial communities and short-chain fatty acid concentrations in the digesta were determined. The reduction in Ca and dP concentration significantly affected pH in the crop and caeca, and addition of phytase to the NC resulted in a pH increase in the ileum. The reduction in Ca and dP concentration significantly lowered, while phytase supplementation increased ileal total bacterial counts. Additionally, the deficient diet reduced butyrate- but increased lactate-producing bacteria. The addition of phytase increased Lactobacillus sp./Enterococcus sp. whereas in case of Clostridium leptum subgroup, Clostridium coccoides-Eubacterium rectale cluster, Bifidobacterium sp. and Streptococcus/Lactococcus counts, a significant Ca and dP level x phytase interaction was found. However, the recorded interactions indicated that the effects of phytase and Ca and dP levels were not consistent. Furthermore, the reduction of Ca and dP level lowered Clostridium perfringens and Enterobacteriaceae counts. The analysis of fermentation products showed that reducing the Ca and dP content in the diet reduced total SCFA, DL-lactate, and acetic acid in the ileum whereas phytase increased concentrations of these acids in the NC group. This suggests that P is a factor which limits fermentation in the ileum. It may be concluded that phytase plays a role in modulating the gut microbiota of chicken, however, this is clearly linked with the levels of P

  18. Molecular ecological analysis of porcine ileal microbiota responses to antimicrobial growth promoters.

    Science.gov (United States)

    Collier, C T; Smiricky-Tjardes, M R; Albin, D M; Wubben, J E; Gabert, V M; Deplancke, B; Bane, D; Anderson, D B; Gaskins, H R

    2003-12-01

    Cultivation-independent microbial molecular ecology approaches were used to examine the effects of antibiotic growth promoters on the pig ileal microbiota. Five-week-old barrows were fitted with a simple T-cannula at the distal ileum. Three diets meeting or exceeding the minimum nutrient requirements were fed for 5 wk and supplemented as follows: 1) negative control (no antibiotic; n = 5), 2) continuous tylosin administration (n = 5), and 3) an antibiotic rotation sequence (wk 1, chlorotetracycline sulfathiazole penicillin; wk 2, bacitracin and roxarsone; wk 3, lincomycin; wk 4, carbadox; wk 5, virginiamycin; n = 5). Ileal luminal contents were collected for DNA isolation at the end of each of the 5 wk of the testing period. The V3 region of 16S rDNA was amplified by PCR and analyzed via denaturing gradient gel electrophoresis (DGGE) and quantitative polymerase chain reaction (qPCR). Resulting PCR-DGGE band numbers (bacterial species) were counted, and the banding patterns analyzed by calculating Sorenson's pairwise similarity coefficients (C(S)), an index measuring bacterial species in common among samples. Band numbers and total bacterial DNA concentrations decreased (P antibiotic-treated pigs compared with controls. Comparisons between treatments yielded low intertreatment C(S) indices, indicating treatment-dependent alterations in banding patterns, whereas intratreatment comparisons revealed increased homogeneity in antibiotic-treated vs. control pigs. Sequence analysis of treatment-specific bands identified three Lactobacillus, one Streptococcus, and one Bacillus species that were diminished with antibiotic rotation treatment, whereas tylosin selected for the presence of L. gasseri. Lactobacillus-specific qPCR was performed and analyzed as a percentage of total bacteria to further evaluate the effects of antibiotic administration on this genus. Total bacteria were decreased (P antibiotics may reduce host-related intestinal or immune responses, which would

  19. Clostridium difficile infection after restorative proctocolectomy and ileal pouch anal anastomosis for ulcerative colitis.

    Science.gov (United States)

    Martinez Ugarte, M L; Lightner, A L; Colibaseanu, D; Khanna, S; Pardi, D S; Dozois, E J; Mathis, K L

    2016-05-01

    Clostridium difficile infection (CDI) of the ileal pouch following restorative proctocolectomy (RPC) is becoming increasingly recognized. We aimed to understand better (i) the associated risk factors, (ii) treatment practices and (iii) the pouch diversion and failure rate in patients who developed CDI of the pouch after RPC for ulcerative colitis (UC). Patients who tested positive for C. difficile of the pouch between 2007 and 2010 were included in the analysis. Data collected included patient demographics, time from RPC to documented CDI, the treatment of CDI and rate of excision of the pouch. Of 2785 patients recorded in the hospital CDI database, 15 had had an RPC with ileal pouch anal anastomosis. The median age was 44 years and the median interval from RPC to first documented episode of CDI was 3 years. Thirteen (81%) patients had had multiple episodes of pouchitis before and after CDI infection, and all were symptomatic at the time of testing for CDI. Within 30 days of the diagnosis of CDI, six (40%) patients were taking immunosuppressive medication, seven (47%) were taking a proton pump inhibitor and 12 (80%) had received antibiotics. Five patients required hospitalization for CDI and four had severe infections characterized by a serum creatinine more than 1.5 times baseline (n = 3) and a white cell count above 15 000 (n = 1). Six patients who underwent endoscopy had severe inflammation of the pouch including the presence of a pseudomembrane in one case. Ten patients were treated with metronidazole alone and five with vancomycin. Two patients had recurrent CDI of the pouch during a median follow-up period of 2.9 years and one had CDI refractory to medical management. This patient required diversion of the pouch with an ileostomy for refractory CDI but no patient required excision of the pouch. All 15 patients developing CDI of the pouch were successfully treated with antibiotics and only one required surgery in the form of an ileostomy. Colorectal

  20. Isolated Acute Terminal Ileitis Without Preexisting Inflammatory Bowel Disease Rarely Progresses to Crohn's Disease.

    Science.gov (United States)

    Tse, Chung Sang; Deepak, Parakkal; Smyrk, Thomas C; Raffals, Laura E

    2017-10-24

    Isolated acute terminal ileitis without chronic features of inflammation poses a diagnostic challenge. Few studies have investigated the clinical significance of this entity in patients without history of inflammatory bowel disease. We sought to elucidate the long-term prognosis of patients with isolated acute terminal ileitis, its rate of progression to Crohn's disease, and the factors associated with terminal ileitis development to Crohn's disease. Retrospective review of clinical, endoscopic, and radiographic records was performed on 108 patients with histologic evidence of isolated acute terminal ileitis on terminal ileal biopsies obtained by diagnostic ileocolonoscopy performed between January 1, 2002, and December 31, 2014, at the Mayo Clinic. Statistical analysis was performed with Student's t test and Fisher's exact test to identify the factors associated with the progression of isolated acute terminal ileitis to Crohn's disease. The median follow-up time across 108 patients was 54.7 months (interquartile range 32.0-89.0 months). Five patients (4.6%) developed Crohn's disease after a median of 32.3 months (7.5-43.2 months). The presence of narrowing/stricturing (p = 0.03) on abdominal cross-sectional imaging at the time of terminal ileitis diagnosis was correlated with eventual Crohn's disease development. No significant correlation was found with clinical symptoms, endoscopic features, laboratory testing, NSAID use, smoking history, or family history of inflammatory bowel disease. Isolated acute terminal ileitis discovered on diagnostic ileocolonoscopy rarely develops to Crohn's disease. Presence of stricturing/narrowing on cross-sectional imaging may predict eventual Crohn's disease development.

  1. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.

    Science.gov (United States)

    Wakefield, A J; Murch, S H; Anthony, A; Linnell, J; Casson, D M; Malik, M; Berelowitz, M; Dhillon, A P; Thomson, M A; Harvey, P; Valentine, A; Davies, S E; Walker-Smith, J A

    1998-02-28

    We investigated a consecutive series of children with chronic enterocolitis and regressive developmental disorder. 12 children (mean age 6 years [range 3-10], 11 boys) were referred to a paediatric gastroenterology unit with a history of normal development followed by loss of acquired skills, including language, together with diarrhoea and abdominal pain. Children underwent gastroenterological, neurological, and developmental assessment and review of developmental records. Ileocolonoscopy and biopsy sampling, magnetic-resonance imaging (MRI), electroencephalography (EEG), and lumbar puncture were done under sedation. Barium follow-through radiography was done where possible. Biochemical, haematological, and immunological profiles were examined. Onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children, with measles infection in one child, and otitis media in another. All 12 children had intestinal abnormalities, ranging from lymphoid nodular hyperplasia to aphthoid ulceration. Histology showed patchy chronic inflammation in the colon in 11 children and reactive ileal lymphoid hyperplasia in seven, but no granulomas. Behavioural disorders included autism (nine), disintegrative psychosis (one), and possible postviral or vaccinal encephalitis (two). There were no focal neurological abnormalities and MRI and EEG tests were normal. Abnormal laboratory results were significantly raised urinary methylmalonic acid compared with age-matched controls (p=0.003), low haemoglobin in four children, and a low serum IgA in four children. We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.

  2. Unusual binding of ursodeoxycholic acid to ileal bile acid binding protein: role in activation of FXRα.

    Science.gov (United States)

    Fang, Changming; Filipp, Fabian V; Smith, Jeffrey W

    2012-04-01

    Ursodeoxycholic acid (UDCA, ursodiol) is used to prevent damage to the liver in patients with primary biliary cirrhosis. The drug also prevents the progression of colorectal cancer and the recurrence of high-grade colonic dysplasia. However, the molecular mechanism by which UDCA elicits its beneficial effects is not entirely understood. The aim of this study was to determine whether ileal bile acid binding protein (IBABP) has a role in mediating the effects of UDCA. We find that UDCA binds to a single site on IBABP and increases the affinity for major human bile acids at a second binding site. As UDCA occupies one of the bile acid binding sites on IBABP, it reduces the cooperative binding that is often observed for the major human bile acids. Furthermore, IBABP is necessary for the full activation of farnesoid X receptor α (FXRα) by bile acids, including UDCA. These observations suggest that IBABP may have a role in mediating some of the intestinal effects of UDCA.

  3. Different degree of ileal colonization by segmented, filamentous bacteria in two strains of mice.

    Science.gov (United States)

    Klaasen, H L; Peters, B; Koopman, J P; Poelma, F G; van den Brink, M E; Bakker, M H; Beynen, A C

    1992-12-01

    Segmented, filamentous bacteria (SFBs) are autochthonous, apathogenic inhabitants of the ileum of various animal species. Outbred Swiss (Cpb:SE) mice have significantly higher degrees of SFB colonization than do inbred BALB/c mice. The present studies were carried out to identify determinants of this strain difference. In a cross-fostering experiment it was shown that SFB colonization of the pups is determined by the strain of the pups themselves rather than by the strain of the nursing dam. Thus, maternal effects may not be involved in SFB colonization. In a cross-infecting experiment using germ-free and SFB-positive animals of the two mouse strains, it was found that ileal SFB colonization is determined by host characteristics rather than by origin of the SFBs. Thus, SFBs that are specific for a given mouse strain may not exist in the two strains of mice. It is concluded that the mouse strain difference in SFB colonization is determined by host characteristics, which probably have a genetic basis.

  4. Literature Review: Double-Barrelled Wet Colostomy (One Stoma) versus Ileal Conduit with Colostomy (Two Stomas).

    Science.gov (United States)

    Gan, Jason; Hamid, Rizwan

    2017-01-01

    The aim of this literature review was to analyse the advantages and disadvantages of a traditional ileal conduit (IC) with separate colostomy technique compared to the outcomes of a double-barrelled wet colostomy (DBWC) technique. The former technique results in the formation of two stomas, and the latter results in the formation of one stoma. PubMed was searched electronically for articles on DBWC. Fifteen articles were retrieved and of them 13 were included in the literature review (350 patients). Of the articles, 3 directly compared DBWC to IC with colostomy. Review of 13 DBWC articles demonstrated perioperative mortality ranging between 0 and 11.1% and postoperative complications ranging from 0 to 100%. Three of the studies directly compared DBWC to IC with colostomy; median operating times and length of stay were shorter in DBWC patients (p colostomy technique, as it requires only one stoma. This literature review supports the use of the technically less challenging DBWC technique as a viable alternative to the traditional IC with colostomy technique. © 2016 S. Karger AG, Basel.

  5. Temporal differential proteomes of Clostridium difficile in the pig ileal-ligated loop model.

    Directory of Open Access Journals (Sweden)

    Tavan Janvilisri

    Full Text Available The impact of Clostridium difficile infection (CDI on healthcare is becoming increasingly recognized as it represents a major cause of nosocomial diarrhea. A rising number of CDI cases and outbreaks have been reported worldwide. Here, we developed the pig ileal-ligated loop model for semi-quantitative analysis comparing temporal differential proteomes in C. difficile following in vivo incubation with in vitro growth using isobaric tags for relative and absolute quantification (iTRAQ. Proteins retrieved from the in vitro cultures and the loop contents after 4, 8, and 12 h in vivo incubation were subjected to in-solution digestion, iTRAQ labeling, two-dimensional liquid chromatography/tandem mass spectrometry and statistical analyses. From a total of 1152 distinct proteins identified in this study, 705 proteins were available for quantitative measures at all time points in both biological and technical replicates; 109 proteins were found to be differentially expressed. With analysis of clusters of orthologous group and protein-protein network interactions, we identified the proteins that might play roles in adaptive responses to the host environment, hence enhancing pathogenicity during CDI. This report represents the quantitative proteomic analysis of C. difficile that demonstrates time-dependent protein expression changes under conditions that mimic in vivo infection and identifies potential candidates for diagnostic or therapeutic measures.

  6. Comparative evaluation of standardized ileal amino acid digestibility in protein supplements for piglets.

    Science.gov (United States)

    Eklund, M; Sauer, N; Hörner, S; Rademacher, M; Mosenthin, R

    2012-12-01

    Standardized ileal digestibility (SID) of AA was determined in 6 protein ingredients for piglets. A basal diet based on corn (Zea mays) starch and casein was supplemented with fluid-bed-dried porcine intestinal mucosa hydrolysate, spray-dried porcine intestinal mucosa hydrolysate, soy (Glycine max) protein concentrate, 2 batches of soy protein, or full-fat soybeans. The SID of AA did not differ between the 4 soybean products (P > 0.05). Compared to most SID values in the 4 soybean products, SID of AA were lower in the 2 porcine intestinal mucosa hydrolysates (P ≤ 0.05). In conclusion, although the initial trypsin inhibitor contents in the raw soybeans have not been determined, high SID values in the 4 soybean products indicate that the different processing procedures used to manufacture these products were efficient to inactivate trypsin inhibitors. For most AA in the 2 porcine intestinal mucosa hydrolysates, drying procedure did not affect SID of AA, but SID values were generally lower compared to the 4 soybean products.

  7. Standardised ileal crude protein and amino acid digestibilities in protein supplements for piglets.

    Science.gov (United States)

    Urbaityte, Renata; Mosenthin, Rainer; Eklund, Meike; Piepho, Hans-Peter; Sauer, Nadja; Rademacher, Meike

    2009-01-01

    Standardised ileal digestibilities (SID) of crude protein and amino acids (AA) originating from 24 different feed ingredients, including 11 feed ingredients produced from soybeans, seven by-products of starch processing, four whey products and two fish meals, were determined in piglets by means of the difference method. For the indispensable AA, the highest SID values were obtained in three out of four whey proteins (SID ≥90% for most indispensable AA), one out of two fish meals (SID ≥86%), soy protein concentrate, hydrolysed soy protein isolate (SID ≥86% for most indispensable AA), and by-products of starch processing (SID ≥84% for most indispensable AA). The lowest SID values were obtained in extruded soybeans and microbially fermented soy protein (SID ≤78% for most indispensable AA), whereas the SID values for high-protein soybean meal were intermediate (SID 80-89% for indispensable AA except for Thr). The SID values in the three enzymatically fermented soy proteins (SID 80-94% for most indispensable AA) were similar to those in high-protein soybean meal and soy protein concentrate. The results of the present study indicate that SID values of AA in feed ingredients for piglets differ considerably from those reported for grower-finisher pigs, thus there may be a need for separate feed tables for piglets.

  8. Reproduction of porcine proliferative enteropathy with pure cultures of ileal symbiont intracellularis.

    Science.gov (United States)

    McOrist, S; Jasni, S; Mackie, R A; MacIntyre, N; Neef, N; Lawson, G H

    1993-01-01

    Porcine proliferative enteropathy is consistently associated with the presence of intracellular curved bacteria in epithelial cells in affected portions of intestine. Two strains of these intracellular bacteria were cultured in a cell culture system with rat enterocytes (IEC-18) and passaged several times and used as oral inocula for 14 gnotobiotic and 8 conventional pigs. DNA and immunological studies had identified these bacteria as belonging to a new taxon, Ileal symbiont (IS) intracellularis. Conventional pigs dosed with approximately 3.7 x 10(6) of these organisms passaged six times in cell culture developed severe lesions of proliferative enteropathy in the ileum. Other conventional pigs dosed with a lower titer or with organisms passaged 13 times developed moderate and minor lesions, respectively. All gnotobiotic pigs dosed with organisms failed to develop lesions. Control pigs, eight conventional and two gnotobiotic, dosed with diluent, uninfected cell material or left undosed failed to develop lesions also. Reisolation of IS intracellularis and demonstration of the organism in mucosal and fecal samples only occurred in conventional pigs dosed with organisms. Gnotobiotic pigs lacking a normal intestinal flora have not been shown to be colonized by the organism. Seroconversion to IS intracellularis or mucosal infiltration by inflammatory cells was not observed in experimentally affected pigs, confirming the weak immune response characteristic of the natural disease. These results support the identification of IS intracellularis as an etiological agent of proliferative enteropathy in pigs. Images PMID:8406817

  9. Coal terminal guide 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-08-01

    IBJ`s third edition of its annual guide to the world`s multi-user coal terminals includes comprehensive details of terminals in 44 countries. The guide sets out information for rapid and easy reference comprising contact, full address and communication details as well as berth dimensions and constraints, loading equipment and daily loading rate, annual loading capacity, daily discharge rate, annual discharge capacity, annual throughput capacity, storage facilities, stockyard capacity and equipment, processing facilities and so on. All information has been compiled from specific questionnaires and is presented alphabetically in country order.

  10. Windows Terminal Servers Orchestration

    Science.gov (United States)

    Bukowiec, Sebastian; Gaspar, Ricardo; Smith, Tim

    2017-10-01

    Windows Terminal Servers provide application gateways for various parts of the CERN accelerator complex, used by hundreds of CERN users every day. The combination of new tools such as Puppet, HAProxy and Microsoft System Center suite enable automation of provisioning workflows to provide a terminal server infrastructure that can scale up and down in an automated manner. The orchestration does not only reduce the time and effort necessary to deploy new instances, but also facilitates operations such as patching, analysis and recreation of compromised nodes as well as catering for workload peaks.

  11. EXTREME AND TERMINAL STATES

    Directory of Open Access Journals (Sweden)

    P.F. Litvitsky

    2010-01-01

    Full Text Available Author brings modern conception of extreme and terminal states, their types, likenesses and differences, etiology, key common chains of pathogenesis, principles and methods of their treatment. Pathophysiological data on one of extreme states — collapse — is described in details. Next publications will present the data on shock and coma.Key words: extreme and terminal states, vicious circle of pathogenesis, extreme regulation, principles of treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(3:74-80

  12. Electrical termination techniques

    Science.gov (United States)

    Oakey, W. E.; Schleicher, R. R.

    1976-01-01

    A technical review of high reliability electrical terminations for electronic equipment was made. Seven techniques were selected from this review for further investigation, experimental work, and preliminary testing. From the preliminary test results, four techniques were selected for final testing and evaluation. These four were: (1) induction soldering, (2) wire wrap, (3) percussive arc welding, and (4) resistance welding. Of these four, induction soldering was selected as the best technique in terms of minimizing operator errors, controlling temperature and time, minimizing joint contamination, and ultimately producing a reliable, uniform, and reusable electrical termination.

  13. Terminal oxidases of cyanobacteria.

    Science.gov (United States)

    Hart, S E; Schlarb-Ridley, B G; Bendall, D S; Howe, C J

    2005-08-01

    The respiratory chain of cyanobacteria appears to be branched rather than linear; furthermore, respiratory and photosynthetic electron-transfer chains co-exist in the thylakoid membrane and even share components. This review will focus on the three types of terminal respiratory oxidases identified so far on a genetic level in cyanobacteria: aa3-type cytochrome c oxidase, cytochrome bd-quinol oxidase and the alternative respiratory terminal oxidase. We summarize here their genetic, biochemical and biophysical characterization to date and discuss their interactions with electron donors as well as their physiological roles.

  14. Atividade inflamatória em mucosa de reservatório ileal na polipose adenomatosa familiar e retocolite ulcerativa inespecífica: avaliação da expressão de TNF-alfa e IL-1beta, e da ativação NF- kapaB Inflammatory activity in pelvic ileal pouches for familial adenomatous polyposis and ulcerative colitis: expression of TNF-alpha, IL-1beta and the activation of NF- kappaB

    Directory of Open Access Journals (Sweden)

    Raquel Franco Leal

    2006-12-01

    Full Text Available A ileíte do reservatório pós retocolectomia total constitui uma das complicações mais comuns nos doentes com RCUI, apresentando pequena freqüência nos doentes com PAF. OBJETIVO: Avaliar a atividade inflamatória em mucosa de reservatórios ileais endoscopicamente normais, através da expressão de TNF-alfa, NF-kapaB e IL-1beta. CASUÍSTICA E MÉTODOS: Selecionaram-se 20 doentes submetidos à retocolectomia total com reservatório ileal em "J" pelo Grupo de Coloproctologia da UNICAMP, sendo 10 doentes com RCUI e 10 com PAF. O grupo controle foi constituído por íleo terminal de intestino normal. Realizadas biópsias da mucosa do reservatório ileal e do íleo terminal normal, e congeladas em nitrogênio líquido. A expressão de TNF-alfa e IL-1beta foi analisada por extrato total e de NF-kB por meio de imunoprecipitado. A separação protéica foi feita por eletroforese em gel de poliacrilamida. RESULTADOS: Expressão de TNF-alfa e IL-1beta apresentaram níveis maiores nos doentes com RCUI, quando comparados àqueles com PAF (p0.1 e IL-1beta (p > 0.05 sem diferença estatística em relação aos demais grupos. CONCLUSÃO: Os doentes com RCUI apresentaram maiores níveis de expressão das citocinas estudadas, mesmo sem evidência clínica e endoscópica de ileíte do reservatório, podendo justificar maior suscetibilidade dos doentes com RCUI a esta complicação.Pouchitis after total retocolectomy is one of the most common complication of patients with ulcerative colitis (UC, while its frequency is quite rare in familial adenomatous polyposis (FAP. PURPOSE: To evaluate the inflammatory activity in endoscopicaly normal mucosa of the ileal pouch, by determining the expression of TNF-alpha and IL-1beta, and the activation of NF-kappaB. METHODS AND PATIENTS: Twenty patients with "J" pouch after total retocolectomy were studied, being 10 patients with UC and 10 with FAP. The control group was constituted by biopsies from terminal ileum take

  15. Settings for Terminal Care.

    Science.gov (United States)

    Corless, Inge B.

    1988-01-01

    Examines topics related to delivery of terminal care services: ability of various hospice programs to survive financially, contributions of various models of hospice care, impact of Medicare legislation on hospice movement, demonstration of unique hospice intervention, integration of spiritual care into hospice, and role of hospice in care of…

  16. Termination of protein synthesis.

    Science.gov (United States)

    Tuite, M F; Stansfield, I

    1994-05-01

    One of three mRNA codons--UAA, UAG and UGA--is used to signal to the elongating ribosome that translation should be terminated at this point. Upon the arrival of the stop codon at the ribosomal acceptor(A)-site, a protein release factor (RF) binds to the ribosome resulting in the peptidyl transferase centre of the ribosome switching to a hydrolytic function to remove the completed polypeptide chain from the peptidyl-tRNA bound at the adjacent ribosomal peptidyl(P)-site. In this review recent advances in our understanding of the mechanism of termination in the bacterium Escherichia coli will be summarised, paying particular attention to the roles of 16S ribosomal RNA and the release factors RF-1, RF-2 and RF-3 in stop codon recognition. Our understanding of the translation termination process in eukaryotes is much more rudimentary with the identity of the single eukaryotic release factor (eRF) still remaining elusive. Finally, several examples of how the termination mechanism can be subverted either to expand the genetic code (e.g. selenocysteine insertion at UGA codons) or to regulate the expression of mammalian retroviral or plant viral genomes will be discussed.

  17. Making Wireless Terminals Simpler

    DEFF Research Database (Denmark)

    Christensen, Søren Skovgaard; Popovski, Petar; De Carvalho, Elisabeth

    2005-01-01

    The exponential growth of user demands and the limitations of 3G systems have brought researchers and industry to propose solutions for the next generation. Among the requirements are higher bit rates and cheaper deployment. In this paper we focus on a terminal complexity problem related to channel...

  18. Digestibilidades ileal aparente e verdadeira dos aminoácidos de farinhas de vísceras para suínos Apparent and true ileal digestibilities of poultry by-products amino acids for swine

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Pozza

    2005-12-01

    Full Text Available O experimento foi conduzido com o objetivo de determinar as digestibilidades ileal aparente e verdadeira de cinco diferentes farinhas de vísceras. Foram utilizados 10 suínos mestiços, machos castrados, com peso inicial de 34,11 ± 3,88 kg, previamente submetidos à cirurgia para implantação de cânula "T" simples. Os animais foram distribuídos em delineamento experimental de blocos ao acaso, com cinco tratamentos, quatro repetições e um animal por unidade experimental. Ao final das duas primeiras repetições, os mesmos animais foram redistribuídos e utilizados novamente nas repetições subseqüentes. Os tratamentos consistiram de uma dieta isenta de proteína à base de açúcar, amido, óleo e casca de arroz, tendo como única fonte protéica uma das cinco farinhas de vísceras. Os coeficientes de digestibilidade ileal aparente da lisina, treonina e metionina das diferentes farinhas de vísceras apresentaram variação de 63,40 a 74,01; 63,17 a 79,13 e 72,60 a 81,11%, respectivamente, e os coeficientes de digestibilidade ileal verdadeiros apresentaram variação de 64,38 a 74,88; 64,31 a 80,60 e 73,07 a 81,64%, respectivamente.The experiment was carried out with the objective of determining the apparent and true ileal digestibilities of amino acids from five different poultry by-product. Ten crossbreed swines, castrated males, averaging 31.11 ± 3.88 kg were used in the experiment. The animals were previously submitted to the surgery for simple T canula implantation and, then, allotted to a randomized block design with five treatments, four replicates and one animal per experimental unit. At the end of the first and second replicates, these animals were allotted again to the treatments and used in the third and fourth replicates. The treatments consisted of a free protein diet based on sugar, starch, vegetable oil and rice peel and one of the five poultry by-product as protein source in the diet. The coefficients of apparent ileal

  19. Standardized Ileal Amino Acid Digestibility of Commonly Used Feed Ingredients in Growing Broilers

    Directory of Open Access Journals (Sweden)

    Zafar Ullah

    2016-09-01

    Full Text Available This experiment was conducted to determine standardized ileal amino acid digestibility (SIAAD of commonly used feed ingredients in poultry diets in Pakistan. These feed ingredients included corn, rice broken (RB, rice polishings (RP, wheat bran (WB, sunflower meal (SFM, cottonseed meal (CSM, guar meal (GM, soybean meal (SBM from India and Argentine and fish meal (FM. The SIAAD of each ingredient was determined in triplicate using 21-days-old broilers. Day-old male broiler chicks (Hubbard× Hubbard were reared on corn-SBM based diet from 1 to 13 days and thereafter birds were fed experimental diets from day 14 to 21. Each diet was fed to 36 birds kept in six replicate cages, each cage had six birds. In cereals, the SIAAD of corn’s amino acid (AA (90.1% was similar (p>0.05 to RB (89.0%. Isoleucine (97.8% and lysine (96.9% were highly digestible AA in corn and RB, respectively. Among cereal-by products, WB’s SIAAD (76.9% was same (p>0.05 as RP (71.9%. Arginine from WB (82.5% and RP (83.2% was highly digestible. However, threonine in WB (72.7% and leucine in RP (69.6% were the lowest digestible AAs. In plant protein meals, AAs from Argentine-SBM (85.1% and Indian-SBM (83.4% had higher (p0.05. The SBM from plant protein meals had higher (p<0.05 SIAAD than other studied feed ingredients. However, the GM had the lowest (p<0.05 SIAAD among protein meals.

  20. Outcome after restorative proctocolectomy and ileal pouch-anal anastomosis in children and adults.

    Science.gov (United States)

    Diederen, K; Sahami, S S; Tabbers, M M; Benninga, M A; Kindermann, A; Tanis, P J; Oomen, M W; de Jong, J R; Bemelman, W A

    2017-11-01

    Studies comparing the outcome of ileal pouch-anal anastomosis (IPAA) in children and adults are scarce. This complicates decision-making in young patients. The aim of this study was to compare adverse events and pouch function between children and adults who underwent IPAA. This cross-sectional cohort study included all consecutive children (aged less than 18 years) and adults with a diagnosis of inflammatory bowel disease or familial adenomatous polyposis who underwent IPAA in a tertiary referral centre between 2000 and 2015. Adverse events were assessed by chart review, and pouch function by interview using a pouch function score (PFS). In total, 445 patients underwent IPAA: 41 children (median age 15 years) and 404 adults (median age 39 years), with a median follow-up of 22 (i.q.r. 8-68) months. Being overweight (P = 0·001), previous abdominal surgery (P = 0·018), open procedures (P children than adult patients. The occurrence of anastomotic leakage, surgical fistulas, chronic pouchitis and Crohn's of the pouch was not associated with paediatric age at surgery, nor was pouch failure. The development of anastomotic strictures was associated with having IPAA surgery during childhood (odds ratio 4·22, 95 per cent c.i. 1·13 to 15·77; P = 0·032). Pouch function at last follow-up was similar in the children and adult groups (median PFS 5·0 versus 6·0 respectively; P = 0·194). Long-term pouch failure rates and pouch function were similar in children and adults. There is no need for a more cautious attitude to use of IPAA in children based on concerns about poor outcome. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.