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Sample records for duodenal bulb biopsies

  1. An approach to duodenal biopsies

    PubMed Central

    Serra, S; Jani, P A

    2006-01-01

    The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis. PMID:16679353

  2. Endoscopic mucosal resection of duodenal bulb adenocarcinoma with neuroendocrine features: An extremely rare case report

    PubMed Central

    Wen, Ming-Yao; Wang, Yu; Meng, Xiao-Yan; Xie, Hua-Ping

    2015-01-01

    Duodenal adenocarcinoma, especially duodenal bulb with neuroendocrine features (NEF), is extremely rare. Here, we report one such case of duodenal bulb adenocarcinoma with neuroendocrine features. A 63-year-old Han Chinese woman was admitted to our department with the diagnosis of a duodenal bulb polyp and underwent an endoscopic mucosal resection. The pathological findings confirmed it as duodenal bulb adenocarcinoma with NEF. The patient remains curative after one and half a years of follow-up. Duodenal adenocarcinoma with NEF might be a low malignant neuroendocrine tumor rather than a conventional adenocarcinoma. Endoscopic treatment, including endoscopic mucosal resection, might be an ideal option for the adenocarcinomas with NEF. PMID:26140012

  3. Paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb: a case report

    PubMed Central

    2013-01-01

    Background In cases of esophageal hernia, incarceration of peritoneal organs other than the stomach is rare. Case presentation An 84-year-old female was admitted to our institution with a complaint of nausea and vomiting. Abdominal computed tomography revealed an esophageal hiatal hernia with incarceration of the gastric antrum and duodenal bulb. Gastrofluorography under gastroendoscopy confirmed prolapse of the antrum and duodenal bulb into the esophageal hernial sac. Although gastroendoscopy guided repositioning of the prolapsed organs was successful, reprolapse occurred immediately. Therefore, surgical treatment was indicated. The gastric antrum and duodenal bulb were associated with a paraesophageal hernia. Therefore, they were repositioned, and passage from the duodenal bulb to the descending portion of the duodenum was improved. Conclusion We report a rare case of paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb. PMID:24207166

  4. Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

    PubMed Central

    Kakushima, Naomi; Kanemoto, Hideyuki; Sasaki, Keiko; Kawata, Noboru; Tanaka, Masaki; Takizawa, Kohei; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki; Ono, Hiroyuki

    2015-01-01

    AIM: To investigate the accuracy of endoscopic or biopsy diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs). METHODS: Clinicopathological data were reviewed for 84 superficial NADETs from 74 patients who underwent surgery or endoscopic resection between September 2002 and August 2014 at a single prefectural cancer center. Superficial NADETs were defined as lesions confined to the mucosa or submucosa. Demographic and clinicopathological data were retrieved from charts, endoscopic and pathologic reports. Endoscopic reports included endoscopic diagnosis, location, gross type, diameter, color, and presence or absence of biopsy. Endoscopic diagnoses were made by an endoscopist in charge of the examination before biopsy specimens were obtained. Endoscopic images were obtained using routine, front-view, high-resolution video endoscopy, and chromoendoscopy with indigocarmine was performed for all lesions. Endoscopic images were reviewed by at least two endoscopists to assess endoscopic findings indicative of carcinoma. Preoperative diagnoses based on endoscopy and biopsy findings were compared with histological diagnoses of resected specimens. Sensitivity, specificity, and accuracy were assessed for endoscopic diagnosis and biopsy diagnosis. RESULTS: The majority (81%) of the lesions were located in the second portion of the duodenum. The median lesion diameter was 14.5 mm according to final histology. Surgery was performed for 49 lesions from 39 patients, and 35 lesions from 35 patients were endoscopically resected. Final histology confirmed 65 carcinomas, 15 adenomas, and 3 hyperplasias. A final diagnosis of duodenal carcinoma was made for 91% (52/57) of the lesions diagnosed as carcinoma by endoscopy and 93% (42/45) of the lesions diagnosed as carcinoma by biopsy. The sensitivity, specificity, and accuracy of endoscopic diagnoses were 80%, 72%, and 78%, respectively, whereas those of biopsy diagnoses were 72%, 80%, and 74%, respectively

  5. [The prognostic value of gastric metaplasia in the duodenal mucosa in patients with Helicobacter pylori positive duodenal bulb ulcer].

    PubMed

    Marshalko, O V; Konorev, M R

    2008-01-01

    The predictive value of gastric metaplasia in the duodenal mucosa in patients Helicobacter pylori-positive patients with duodenal bulb ulcer (DBU) was investigated. One hundred and twenty four randomly selected patients with DBU were included in this prospective study. The detection of Helicobacter pylori (HP) in the stomach and duodenum was carried out with Giemsa (using standard visual analogue scale), rapid urease test (standard Jatrox-HP test, Rohm Pharma, Germany), and polymerase chain reaction (PCR) to detect the specific fragment of ureC HP gene (Helicopol II, Lytech, Russia). Regions of gastric metaplasia of the duodenum were confirmed by periodic acid-Schiff and alcian blue (Serva) staining (pH 1.0; 2.5) Duodenal ulcer (DU) complications were registered within 8 to 10 years. Estimation of the predictive factor (gastric metaplasia in the duodenum) was carried out in patients with non-complicated DU (Group 1; n = 73), and with such complications as bleeding, perforation, penetration, pyloroduodenal stenosis (Group 2; n = 51) which were revealed within the 8 to 10 years of observation. Gastric metaplasia in the duodenum was found in 64 or 87.7% of the 73 patients with non-complicated DU and in 5 or 9.8% of the 51 patients with complicated DU within 8 to 10 years of observation. The following facts about the predictive factor for the prognosis of DU complication were found: the sensitivity of 83.6%, the specificity of 92.8%, the predictive accuracy of 88.7%, the relative risk of the predicted outcome of 7.5, the relative risk of a different outcome of 0.11, the odds ration of 65.4. The study revealed a high and significant (p < 0.001) predictive value of gastric metaplasia in the duodenum as a marker of non-complicated clinical course of DU in HP-positive patients within an 8 to 10-year period.

  6. Early, Isolated Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma Presenting without Symptoms or Grossly Apparent Endoscopic Lesions and Diagnosed by Random Duodenal Biopsies.

    PubMed

    Gjeorgjievski, Mihajlo; Makki, Issa; Khanal, Pradeep; Amin, Mitual B; Blenc, Ann Marie; Desai, Tusar; Cappell, Mitchell S

    2016-01-01

    Clinical data regarding mucosa-associated lymphoid tissue lymphoma (MALToma) solely involving the duodenum are sparse because of the relative rarity of the disease. A comprehensive literature review revealed only 17 cases reported until 2004, and only a moderate number of cases have been reported since. MALToma can be asymptomatic in its very early stages but frequently produces localized or nonspecific symptoms, including early satiety, abdominal pain, vomiting, and involuntary weight loss in later stages. While gastric MALToma is strongly associated with gastric Helicobactor pylori infection, duodenal MALToma is often unassociated with H. pylori infection. A 74-year-old female presented with only dysphagia (without symptoms referable to a duodenal lesion), without systemic 'B' symptoms, and with no evident duodenal lesions at esophagogastroduodenoscopy; however, she was diagnosed with duodenal MALToma by pathologic examination of random duodenal biopsies performed to exclude celiac disease. An important clinical feature of this case is that duodenal MALToma was diagnosed by pathologic analysis of duodenal biopsies despite (1) no endoscopically apparent duodenal lesions; (2) duodenal involvement without gastric involvement; (3) lack of symptoms attributable to duodenal MALToma, and (4) absence of evident H. pylori infection. This work shows that early duodenal MALToma can be difficult to diagnose because of absent symptoms, absence of gastric involvement, absence of endoscopic abnormalities, and absence of H. pylori infection; it may require random duodenal biopsies for diagnosis. PMID:27482191

  7. Early, Isolated Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma Presenting without Symptoms or Grossly Apparent Endoscopic Lesions and Diagnosed by Random Duodenal Biopsies

    PubMed Central

    Gjeorgjievski, Mihajlo; Makki, Issa; Khanal, Pradeep; Amin, Mitual B.; Blenc, Ann Marie; Desai, Tusar; Cappell, Mitchell S.

    2016-01-01

    Clinical data regarding mucosa-associated lymphoid tissue lymphoma (MALToma) solely involving the duodenum are sparse because of the relative rarity of the disease. A comprehensive literature review revealed only 17 cases reported until 2004, and only a moderate number of cases have been reported since. MALToma can be asymptomatic in its very early stages but frequently produces localized or nonspecific symptoms, including early satiety, abdominal pain, vomiting, and involuntary weight loss in later stages. While gastric MALToma is strongly associated with gastric Helicobactor pylori infection, duodenal MALToma is often unassociated with H. pylori infection. A 74-year-old female presented with only dysphagia (without symptoms referable to a duodenal lesion), without systemic ‘B’ symptoms, and with no evident duodenal lesions at esophagogastroduodenoscopy; however, she was diagnosed with duodenal MALToma by pathologic examination of random duodenal biopsies performed to exclude celiac disease. An important clinical feature of this case is that duodenal MALToma was diagnosed by pathologic analysis of duodenal biopsies despite (1) no endoscopically apparent duodenal lesions; (2) duodenal involvement without gastric involvement; (3) lack of symptoms attributable to duodenal MALToma, and (4) absence of evident H. pylori infection. This work shows that early duodenal MALToma can be difficult to diagnose because of absent symptoms, absence of gastric involvement, absence of endoscopic abnormalities, and absence of H. pylori infection; it may require random duodenal biopsies for diagnosis. PMID:27482191

  8. Gender and Racial Disparities in Duodenal Biopsy to Evaluate For Celiac Disease

    PubMed Central

    Lebwohl, Benjamin; Tennyson, Christina A.; Holub, Jennifer L.; Lieberman, David A.; Neugut, Alfred I.; Green, Peter H.R.

    2012-01-01

    Background Celiac disease (CD) is common but under-diagnosed in the United States. Serological screening studies indicate that, although CD occurs at the same frequency in both genders, women are diagnosed more frequently than men (2:1). CD is less frequently diagnosed among black patients, though the seroprevalence in this group is not known. Objective to measure the rates of duodenal biopsy during esophagogastroeduodenoscopy (EGD) for symptoms consistent with CD. Design Retrospective cohort study. Setting Clinical Outcomes Research Initiative National Endoscopy Database, spanning the years 2004–2009. Patients Adults undergoing EGD for the indication of diarrhea, anemia, iron deficiency, or weight loss, in which the endoscopic appearance of the upper gastrointestinal tract was normal. Main outcome measurement performance of duodenal biopsy. Results Of 13,091 individuals (58% females, 9% blacks) who met the inclusion criteria, duodenal biopsy was performed in 43%, 45% of females and 39% of males (p<0.0001). Blacks underwent duodenal biopsy in 28% of EGD’s, compared to 44% for whites (p<0.0001). On multivariate analysis, male gender (OR 0.81 95%CI 0.75–0.88), older age (OR for ≥70 compared to 20–49 0.51 95%CI 0.46–0.57), and black race (OR 0.55 95%CI 0.48–0.64) were associated with decreased odds of duodenal biopsy. Limitations Lack of histopathologic correlation with CD prevalence. Conclusions In this multi-region endoscopy database spanning 2004–2009, rates of duodenal biopsy increased modestly over time, but overall remain low in patients with possible clinical indications for biopsy. Non-performance of duodenal biopsy during endoscopy may be contributing to the under-diagnosis of CD in the United States. PMID:22732871

  9. Successful mucosal incision-assisted biopsy for the histological diagnosis of duodenal lymphoma: A case report

    PubMed Central

    MORISHITA, ASAHIRO; MORI, HIROHITO; KOBARA, HIDEKI; NISHIYAMA, NORIKO; FUJIHARA, SHINTARO; YACHIDA, TATSUO; AYAKI, MAKI; MATSUNAGA, TAE; SAKAMOTO, TEPPEI; MAEDA, EMIKO; NOMURA, TAKAKO; TANI, JOJI; MIYOSHI, HISAAKI; YONEYAMA, HIROHITO; HIMOTO, TAKASHI; KAGAWA, SEIKO; HABA, REIJI; MASAKI, TSUTOMU

    2016-01-01

    Tissue sampling of primary duodenal lymphoma is essential for its histological diagnosis. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), which is frequently used for submucosal tumor (SMT)-like duodenal tumors, is adequate for cytological diagnosis, but not for histological diagnosis. Therefore, in the present study, a mucosal incision-assisted biopsy (MIAB) was performed in an 81-year-old woman for the diagnosis of an SMT-like duodenal mass, as tissue sampling for histological analysis using a regular endoscopic biopsy had failed to establish a definite diagnosis of malignant lymphoma. EUS-FNA had also led to poor tissue sampling due to the difficult location of the duodenal tumor. The pathological examination of biopsy samples using MIAB revealed the presence of a diffuse proliferation of atypical lymphocytes, and the expression of cluster of differentiation (CD)20 and CD79a, but no expression of CD3 in the tumor specimens. The patient was diagnosed with diffuse large B-cell lymphoma. To the best of knowledge, this is first report of a case using MIAB as a sampling method for the histological diagnosis of SMT-like primary duodenal lymphoma. This case suggests that MIAB may be an essential method for obtaining tissue samples from SMT-like duodenal tumors. PMID:26870243

  10. Value of routine duodenal biopsy in diagnosing coeliac disease in patients with iron deficiency anaemia

    PubMed Central

    Mandal, A; Mehdi, I; Munshi, S; Lo, T

    2004-01-01

    Background: Iron deficiency anaemia (IDA) is a recognised feature of coeliac disease in adults and can be its only presentation. Objective: To determine the yield of routine distal duodenal biopsies in diagnosing coeliac disease in adult and elderly patients with IDA whose endoscopy revealed no upper gastrointestinal cause of iron deficiency. Study design: Prospective study in a teaching hospital endoscopy unit. Method: Altogether 504 consecutive patients with IDA, aged 16–80 years, attending for endoscopy were included in this study. At least two distal duodenal biopsies were taken if endoscopy revealed no cause of iron deficiency. Result: In nine (1.8%) patients duodenal biopsies revealed typical histological features of coeliac disease. Of these, five patients were above 65 years old. Conclusion: In adult and elderly patients undergoing endoscopy for IDA, the endoscopist should take distal duodenal biopsies to exclude coeliac disease if no upper gastrointestinal cause of anaemia is found. Coeliac disease is not an uncommon cause of IDA in patients >65 years of age and a history of chronic diarrhoea increases diagnostic yield in this age group. PMID:15299158

  11. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    PubMed Central

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status. PMID:27678365

  12. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    PubMed Central

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status.

  13. Celiac disease: is it really possible to overcome duodenal biopsy?

    PubMed

    Grande, Elisabetta; Ferranti, Silvia; Gaggiano, Carla; Di Virgilio, Nicola; Vascotto, Marina

    2016-05-06

    We report the case of a two-year-five-month-old child who underwent screening for celiac disease due to strong familiarity. During the first observation body weight and height were at 25th and 50th centile for gender and age. Physical examination did not reveal any sign of disease. Blood tests showed increased transaminases levels and antibodies research showed: tTG IgA: 100 UI/ml, tTG IgG: 36,6 UI/ml, EMA IgA: positive. HLA study revealed homozygous allelic combination DRB1*07;DQA102:01; DQB1* 02:02 with presence of a double copy of beta chain in the composition of the  DQ2 heterodymer. Biopsy with histological examination did find neither mucosal alteration  nor lymphocytic infiltrates (Marsh 0). During follow up with free diet the patient remained asymptomatic and all antibody titers decreased up to normalization. According to ESPGHAN guidelines the finding of hypertransaminasemia as sign of celiac hepatic inflammation, a more than 10-fold increase of tTG IgA and a high-risk HLA would permit diagnosis of celiac disease but histological examination done due to mismatch between paucity of clinical sings and a "multiple risk combination" excluded it, allowing diagnosis of potential celiac disease.  We believe that this case is interesting because of its being in contrast with current literature data that suggest a linear relationship between antibodies levels and histological damage with tTG IgA at the upper reference range in case of potential celiac disease. According to guidelines we could have avoided intestinal biopsy but we would have considered as celiac a patient who is maybe just potentially affected.

  14. Isolation and culture of fibroblasts from endoscopic duodenal biopsies of celiac patients

    PubMed Central

    Roncoroni, Leda; Elli, Luca; Doneda, Luisa; Piodi, Luca; Ciulla, Michele M; Paliotti, Roberta; Bardella, Maria Teresa

    2009-01-01

    Background Fibroblasts are actually considered pivotal in inflammation and tissue remodelling process and for these reasons they are involved in the pathogenesis of autoimmune disorders such as celiac disease. Investigations to define the role of fibroblasts in celiac diseases are obstructed by the absence of specific models. Our objective is to isolate and culture primary fibroblasts from endoscopic duodenal biopsies of celiac and non-celiac subjects, to analyze their growth patterns and the morphometric characteristics. Methods 60 duodenal bioptic specimens from 20 celiac patients and 114 from 38 non-celiac subjects were mechanically chopped and enzymatically digested in order to obtain primary cell cultures. Growth patterns, karyotype (Q-banding analysis), expression of typing proteins (fibroblast surface protein and cytokeratin 20) and morphometric parameters (diameters and their ratio, perimeter, area and perimeter/area ratio at computerised image analysis) were investigated on cultured cells. Results Primary cells were successfully cultured in 78% of the collected duodenal biopsies. Cultured cells, expressing the fibroblast surface protein, were negative for cytokeratine 20 and maintained a normal kariotype. Cells grew slowly without differences between the celiac and the non celiac group. Morphometric analysis of celiac fibroblasts revealed significantly increased dimensions, with a preserved diameters ratio, and a reduced perimeter/area ratio. Conclusion For the first time this study demonstrates the feasibility of culturing primary fibroblast cell from endoscopic duodenal biopsies in celiac and non-celiac subjects, opening a new window of opportunity in studies intended to establish the role of fibroblasts as a possible partaker in the pathogenesis of the celiac mucosal damage. PMID:19497109

  15. Evaluation of endoscopically obtained duodenal biopsy samples from cats and dogs in an adapter-modified Ussing chamber

    PubMed Central

    DeBiasio, John V.; Suchodolski, Jan S.; Newman, Shelley; Musch, Mark W.; Steiner, Jörg M.

    2014-01-01

    This study was conducted to evaluate an adapter-modified Ussing chamber for assessment of transport physiology in endoscopically obtained duodenal biopsies from healthy cats and dogs, as well as dogs with chronic enteropathies. 17 duodenal biopsies from five cats and 51 duodenal biopsies from 13 dogs were obtained. Samples were transferred into an adapter-modified Ussing chamber and sequentially exposed to various absorbagogues and secretagogues. Overall, 78.6% of duodenal samples obtained from cats responded to at least one compound. In duodenal biopsies obtained from dogs, the rate of overall response ranged from 87.5% (healthy individuals; n = 8), to 63.6% (animals exhibiting clinical signs of gastrointestinal disease and histopathological unremarkable duodenum; n = 15), and 32.1% (animals exhibiting clinical signs of gastrointestinal diseases and moderate to severe histopathological lesions; n = 28). Detailed information regarding the magnitude and duration of the response are provided. The adapter-modified Ussing chamber enables investigation of the absorptive and secretory capacity of endoscopically obtained duodenal biopsies from cats and dogs and has the potential to become a valuable research tool. The response of samples was correlated with histopathological findings. PMID:24378587

  16. Duodenal biopsy may be avoided when high transglutaminase antibody titers are present

    PubMed Central

    Vivas, Santiago; Ruiz de Morales, Jose G; Riestra, Sabino; Arias, Laura; Fuentes, Dolores; Alvarez, Noemi; Calleja, Sara; Hernando, Mercedes; Herrero, Blanca; Casqueiro, Javier; Rodrigo, Luis

    2009-01-01

    AIM: To evaluate the predictive value of tissue transglutaminase (tTG) antibodies for villous atrophy in adult and pediatric populations to determine if duodenal biopsy can be avoided. METHODS: A total of 324 patients with celiac disease (CD; 97 children and 227 adults) were recruited prospectively at two tertiary centers. Human IgA class anti-tTG antibody measurement and upper gastrointestinal endoscopy were performed at diagnosis. A second biopsy was performed in 40 asymptomatic adults on a gluten-free diet (GFD) and with normal tTG levels. RESULTS: Adults showed less severe histopathology (26% vs 63%, P < 0.0001) and lower tTG antibody titers than children. Levels of tTG antibody correlated with Marsh type in both populations (r = 0.661, P < 0.0001). Multiple logistic regression revealed that only tTG antibody was an independent predictor for Marsh type 3 lesions, but clinical presentation type and age were not. A cut-off point of 30 U tTG antibody yielded the highest area under the receiver operating characteristic curve (0.854). Based on the predictive value of this cut-off point, up to 95% of children and 53% of adults would be correctly diagnosed without biopsy. Despite GFDs and decreased tTG antibody levels, 25% of the adults did not recover from villous atrophy during the second year after diagnosis. CONCLUSION: Strongly positive tTG antibody titers might be sufficient for CD diagnosis in children. However, duodenal biopsy cannot be avoided in adults because disease presentation and monitoring are different. PMID:19824110

  17. Prevalence of celiac disease in adult patients with refractory functional dyspepsia: Value of routine duodenal biopsy

    PubMed Central

    Giangreco, Emiliano; D’agate, Cinzia; Barbera, Carmelo; Puzzo, Lidia; Aprile, Giuseppe; Naso, Pietro; Bonanno, Giacomo; Russo, Francesco Paolo; Nicoletti, Alessandra; Incarbone, Salvatore; Trama, Giuseppe; Russo, Antonio

    2008-01-01

    AIM: To investigate the prevalence of celiac disease (CD) in adult patients referred to an open access gastroenterology clinic in the south of Italy and submitted to esophago-gastro-duodenoscopy (EGD) for evaluation of refractory functional dyspepsia. METHODS: Seven hundred and twenty six consecutive dyspeptic patients (282 male, 444 female; mean age 39.6 years, range 18-75 years) with unexplained prolonged dyspepsia were prospectively enrolled. Duodenal biopsies were taken and processed by standard staining. Histological evaluation was carried out according to the Marsh-Oberhuber criteria. RESULTS: The endoscopic findings were: normal in 61.2%, peptic lesions in 20.5%, malignancies in 0.5%, miscellaneous in 16.7%. CD was endoscopically diagnosed in 8 patients (1.1%), histologically in 15 patients (2%). The endoscopic features alone showed a sensitivity of 34.8% and specificity of 100%, with a positive predictive value (PPV) of 100% and a negative predictive value (NPP) of 97.9%. CONCLUSION: This prospective study showed that CD has a high prevalence (1:48) in adult dyspeptic patients and suggests the routine use of duodenal biopsy in this type of patient undergoing EGD. PMID:19058330

  18. Increased immunoglobulin G production by short term cultured duodenal biopsy samples from HIV infected patients

    PubMed Central

    Schneider, T; Zippel, T; Schmidt, W; Pauli, G; Wahnschaffe, U; Chakravarti, S; Heise, W; Riecken, E; Zeitz, M; Ullrich, R

    1998-01-01

    Background—Secretory immunity is a major defence mechanism against infections at mucosal surfaces which are common in HIV infected patients. 
Aims—To analyse intestinal immunoglobulin production in HIV infection in comparison with that in saliva and serum. 
Patients and methods—Immunoglobulin G (IgG), A (IgA), and M (IgM) concentrations were determined in supernatants of short term cultured duodenal biopsy samples, serum, and saliva from HIV infected patients (n = 28) and controls (n = 14) by radial immunodiffusion. 
Results—IgG was increased in the supernatants of short term cultured biopsy samples and saliva from HIV infected patients compared with controls (p<0.01), but IgA and IgM levels were normal. In contrast, both IgG and IgA concentrations in serum were higher in HIV infected patients than in controls (p<0.002). No correlation was found between IgA produced by duodenal biopsy specimens and serum IgA. 
Conclusion—Abnormalities in mucosal immunoglobulin production in HIV infection were suprisingly small, indicating that specific secretory immunity rather than quantitative immunoglobulin production may be impaired. However, increased production of IgG could contribute to mucosal inflammation by complement activation. Our findings of normal mucosal IgA production and the lack of correlation between serum and mucosal IgA argues against an intestinal origin for the increased serum IgA levels in HIV infected patients. 

 Keywords: mucosal immunity; HIV infection; intestinal antibodies PMID:9577341

  19. Quantitative histological study of mucosal inflammatory cell densities in endoscopic duodenal biopsy specimens from dyspeptic patients using computer linked image analysis.

    PubMed Central

    Collins, J S; Hamilton, P W; Watt, P C; Sloan, J M; Love, A H

    1990-01-01

    Inflammatory cell counting in endoscopic biopsy sections was carried out on duodenal mucosal samples from defined sites in patients with duodenal ulcer, duodenitis but no ulcer, non-ulcer dyspepsia, and asymptomatic controls using computer linked image analysis. The variables measured included polymorphonuclear and mononuclear cells per mm of superficial epithelium and per mm2 lamina propria. Duodenal ulcer crater margin and mucosal biopsy specimens from endoscopically inflamed mucosa in the group with duodenitis but no ulcer showed significantly higher inflammatory cell counts than endoscopically normal non-ulcer dyspepsia and control mucosa. Biopsy specimens from non-ulcer dyspepsia patients showed significantly higher lamina propria polymorphs than control group mucosa. Endoscopically normal duodenal ulcer and duodenitis but no ulcer mucosa also showed significantly higher acute and chronic inflammatory cell counts than controls. The prevalence of Helicobacter pylori in duodenal biopsy specimens was low (0-22%) and unrelated to local inflammatory response. Despite histological appearances, duodenal biopsy specimens from non-ulcer dyspepsia patients showed significantly higher inflammatory cell infiltration than control specimens, suggesting that at least some represent part of a spectrum of subclinical peptic disease. PMID:2387505

  20. Prudence is necessary in the application of the new ESPGHAN criteria for celiac disease omitting duodenal biopsy: a case report.

    PubMed

    Schirru, Enrico; Jores, Rita-Désirée; Congia, Mauro

    2014-06-01

    New guidelines for celiac disease (CD) diagnosis from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) propose the option to omit the duodenal biopsy in the diagnosis of CD. For this option, all four of the following criteria have to apply in children and adolescents: signs and symptoms suggestive of CD, anti-transglutaminase type 2 antibody (anti-TG2) levels more than 10 times the upper limit of normal, positive confirmation tests of anti-endomysium-IgA antibodies (EMA), and at-risk HLA-DQ2 or HLA-DQ8. Here, we report the case of a female patient, 2 years old, with chronic diarrhea that started after an acute viral gastroenteritis. The patient had anti-TG2 levels of more than 10 times the upper limit of normal, positivity for EMA, antigliadin IgA, and IgG (AGA-IgA, AGA-IgG, respectively), and the at-risk HLA-DRB1*0301, DQB1*0201/DRB1*10, DQB1*0501 genotype, thus fulfilling all criteria for the diagnosis of CD. Although the diarrhea disappeared after about 5 weeks, anti-TG2, EMA, and AGA-IgG remained positive. Therefore, a duodenal biopsy was performed and evidenced a normal mucosa (Marsh 0). After about 18 months, the antibody titer for AGA-IgG, anti-TG2, and EMA became negative. The patient was all the time on a normal, gluten-containing diet. This clinical case represents an exception to the new ESPGHAN guidelines for CD diagnosis. During 5 weeks, the new ESPGHAN criteria were all fulfilled, allowing to propose for this patient the diagnosis of CD without performing a duodenal biopsy. Therefore, a prudent approach is suggested when the pediatric gastroenterologist makes a diagnosis of CD without duodenal biopsy. PMID:24694761

  1. [Intramural duodenal hematoma and acute pancreatitis as a complication of diagnostic biopsy of a duodenal 6-year-old boy].

    PubMed

    Krzesiek, Elżbieta; Iwańczak, Barbara; Zaleska-Dorobisz, Urszula; Patkowski, Dariusz

    2016-01-01

    Hematoma duodenum is a very rare complication of diagnostic endoscopy of the upper gastrointestinal tract when biopsy of the duodenum is performed (average frequency is estimated as 1:1,250 biopsies). Most often, it affects children and young adults without any risk factors. Symptoms result from obstruction of the duodenum and compression of the adjacent structures. Conservative treatment, which consists of parenteral nutrition and aspiration of gastric contents until the absorption of hematoma and patency of the gastrointestinal tract returns, is preferred. This paper describes a 6-year-old boy diagnosed due to short stature and low weight in whom the diagnostic biopsy of the duodenum caused formation of a hematoma in the descending duodenum and led to total ileus and acute pancreatitis. The boy was treated conservatively with good result and complete resolution of symptoms was achived.

  2. Immunohistochemical stains for CD3 and CD8 do not improve detection of gluten-sensitive enteropathy in duodenal biopsies.

    PubMed

    Hudacko, Rachel; Kathy Zhou, Xi; Yantiss, Rhonda K

    2013-09-01

    Patients with gluten-sensitive enteropathy usually have increased numbers of duodenal intraepithelial lymphocytes even if the villous architecture is normal. Some authors advocate the use of CD8 and CD3 immunohistochemical stains to improve detection of intraepithelial lymphocytosis, yet the added value of immunohistochemistry when biopsies appear normal remains unproven. The purpose of this study was to evaluate the utility of CD3 and CD8 immunostains in detecting intraepithelial lymphocytosis among duodenal biopsies originally interpreted to be normal based on routine evaluation. We identified 200 duodenal biopsies from 172 patients, all of which were accompanied by a clinical question of gluten-sensitive enteropathy. Five well-oriented villi from each biopsy were assessed. Intraepithelial lymphocytes present in hematoxylin and eosin (H&E)-stained slides were counted and compared with the number of CD3 and CD8 immunopositive cells present in the villous epithelium. Results were expressed as the mean number of intraepithelial lymphocytes or immunopositive cells present per 20 villous tip enterocytes. Review of H&E-stained slides revealed a mean of 2.1 ± 0.1 intraepithelial lymphocytes, compared with 3.2 ± 0.1 CD3-positive and 2.1 ± 0.1 CD8-positive intraepithelial cells (P=<0.001 and 1, respectively), although none of the cases displayed sufficient numbers of intraepithelial lymphocytes to be considered abnormal (ie, ≥ 12/20 enterocytes) by any method. The number of intraepithelial lymphocytes detected by H&E evaluation or immunohistochemistry did not correlate with results of serologic studies for markers of gluten sensitivity. We conclude that immunostains for T cell markers do not improve detection of gluten-sensitive enteropathy when H&E-stained sections are normal.

  3. Surface morphology of the gastroduodenal mucosa in duodenal ulceration.

    PubMed Central

    Steer, H W

    1984-01-01

    Endoscopic biopsies from the duodenal cap and prepyloric areas of 25 patients have been examined with the scanning electron microscope. Eleven patients had duodenal ulceration. Bacteria are related only to the surface of gastric type epithelial cells whether these cells are located at areas of gastric metaplasia in the duodenal bulb or in the pre-pyloric region of the stomach. The bacteria are not associated with the surface of intestinal type epithelial cells. The bacteria are absent from the biopsies of those patients with a normal stomach and duodenum. Of those patients with duodenal ulceration, 73% have bacteria related to the epithelial surface. The bacteria are of two morphological types - a kidney shaped bacillus and an S-shaped bacillus. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:6500361

  4. Distinguishing Intestinal Lymphoma From Inflammatory Bowel Disease in Canine Duodenal Endoscopic Biopsy Samples.

    PubMed

    Carrasco, V; Rodríguez-Bertos, A; Rodríguez-Franco, F; Wise, A G; Maes, R; Mullaney, T; Kiupel, M

    2015-07-01

    Inflammatory bowel disease (IBD) and intestinal lymphoma are intestinal disorders in dogs, both causing similar chronic digestive signs, although with a different prognosis and different treatment requirements. Differentiation between these 2 conditions is based on histopathologic evaluation of intestinal biopsies. However, an accurate diagnosis is often difficult based on histology alone, especially when only endoscopic biopsies are available to differentiate IBD from enteropathy-associated T-cell lymphoma (EATL) type 2, a small cell lymphoma. The purpose of this study was to evaluate the utility of histopathology; immunohistochemistry (IHC) for CD3, CD20, and Ki-67; and polymerase chain reaction (PCR) for antigen receptor rearrangement (T-cell clonality) in the differential diagnosis of severe IBD vs intestinal lymphoma. Endoscopic biopsies from 32 dogs with severe IBD or intestinal lymphoma were evaluated. The original diagnosis was based on microscopic examination of hematoxylin and eosin (HE)-stained sections alone followed by a second evaluation using morphology in association with IHC for CD3 and CD20 and a third evaluation using PCR for clonality. Our results show that, in contrast to feline intestinal lymphomas, 6 of 8 canine small intestinal lymphomas were EATL type 1 (large cell) lymphomas. EATL type 2 was uncommon. Regardless, in dogs, intraepithelial lymphocytes were not an important diagnostic feature to differentiate IBD from EATL as confirmed by PCR. EATL type 1 had a significantly higher Ki-67 index than did EATL type 2 or IBD cases. Based on the results of this study, a stepwise diagnostic approach using histology as the first step, followed by immunophenotyping and determining the Ki67 index and finally PCR for clonality, improves the accuracy of distinguishing intestinal lymphoma from IBD in dogs.

  5. Stimulation of duodenal biopsies and whole blood from dogs with food-responsive chronic enteropathy and healthy dogs with Toll-like receptor ligands and probiotic Enterococcus faecium.

    PubMed

    Schmitz, S; Henrich, M; Neiger, R; Werling, D; Allenspach, K

    2014-08-01

    The composition of the microbiome plays a significant role in the pathogenesis of inflammatory bowel disease (IBD) in humans and chronic enteropathies (CE) in dogs. The administration of probiotic micro-organisms is one way of modulating the microbiome, but experiments elucidating mechanisms of action of probiotics in the intestine of healthy and CE dogs are lacking. The aim of our study was to investigate the effects of different Toll-like receptor (TLR) ligands and Enterococcus faecium (EF) on ex vivo cultured duodenal samples and whole blood (WB) from dogs with food-responsive chronic enteropathy (FRE) when compared to healthy dogs. Biopsy stimulation was performed in 17 FRE and 11 healthy dogs; WB stimulation was performed in 16 FRE and 16 healthy dogs. Expression of TLR2, 4, 5 and 9, IL-17A, IL-22, IFNy, TNFα, IL-4, IL-10, TGFβ and PPARy was determined in biopsies by quantitative polymerase chain reaction (PCR). In addition, production of TNFα, IL-10, IFNy and IL-17A protein in WB and biopsy supernatants was assessed by ELISA. Treatment with individual TLR ligands or EF induced a variety of changes in the expression of different TLRs and cytokines, but not necessarily a consistent change with a single stimulating agent. Even though cytokine protein could not be detected in supernatants from ex vivo stimulated biopsies, we found TNFα protein responses in blood to be opposite of the transcriptional responses seen in the biopsies. Stimulation of canine duodenal biopsies with TLR ligands can potentially induce anti-inflammatory gene expression, especially in healthy tissue, whereas the effects of EF were limited.

  6. Megaduodenum with Duodenal Diospyrobezoars

    PubMed Central

    Park, Hyun Woo

    2015-01-01

    Bezoars are retained masses of ingested materials accumulating within the gastrointestinal track. While gastric bezoars are often observed, duodenal bezoars are rarely reported. A 77-year-old man who had frequently consumed persimmons and had never undergone gastric surgery had symptoms of epigastric pain and early satiety for 10 days. Esophagogastroduodenoscopy showed many diospyrobezoars in a severely distended duodenal bulb, otherwise known as megaduodenum. The patient's treatment consisted of repeated endoscopic removal of the bezoars by using a retrieval net. PMID:26473129

  7. Biopsy

    MedlinePlus

    Tissue sampling ... biopsy is called a percutaneous biopsy. It removes tissue using a needle attached to a hollow tube ... The needle is passed several times through the tissue being examined. The doctor uses the needle to ...

  8. Infantile demyelinating neuropathy associated with a de novo point mutation on Ser72 in PMP22 and basal lamina onion bulbs in skin biopsy.

    PubMed

    Ceuterick-de Groote, C; De Jonghe, P; Timmerman, V; Van Goethem, G; Löfgren, A; Ceulemans, B; Van Broeckhoven, C; Martin, J J

    2001-01-01

    Codon 72 has been designated as a hot spot for distinct missense mutations in the peripheral myelin protein 22 (PMP22) gene. Ser72Leu substitution was associated with Dejerine-Sottas syndrome (DSS) in four patients and with congenital hypomyelination neuropathy (CHN) in one patient. Our objective was to report one other DSS patient with Ser72Leu substitution in PMP22 and to concurrently illustrate how less invasive procedures such as skin biopsy could provide a rapid and reliable alternative to conventional sural nerve biopsy for the characterization of histophenotypic features. A skin biopsy was carried out in a 2 4/12-year-old girl with muscle atrophy, hypotonia and weakness, as well as generalized areflexia and absent sensory and motor nerve responses. Standard electron microscope techniques were used. PMP22 was screened by automated direct nucleotide sequencing analysis. Morphological examination revealed basal lamina onion bulbs surrounding a de- or hypomyelinated axon in all nerve bundles. Mutation analysis demonstrated a missense point mutation in codon 72 of the PMP22 gene leading to a Ser72Leu substitution. Further genotype-phenotype correlations will have to determine whether morphologically distinct phenotypes can be correlated with specific mutations. For this purpose, cutaneous nerve bundles could serve as an alternative tool to help identify and classify subtypes in this heterogeneous syndrome. PMID:11314784

  9. Evaluation of the Correlation Between tTG-IgA Titer and Duodenal Biopsy Findings in Children With Suspected Celiac Disease

    PubMed Central

    Aldaghi, Mitra-Azra; Dehghani, Seyed-Mohsen; Haghighat, Mahmood

    2016-01-01

    Background: Celiac disease is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten in genetically sensitive individuals. Objectives: In this study, we aimed to evaluate the predictive value of tissue transglutaminase (tTG) antibodies for the diagnosis of celiac disease in a pediatric population in order to determine if duodenal biopsy can be avoided. Patients and Methods: The subjects were selected among individuals with probable celiac disease, referring to a gastrointestinal clinic. After physical examinations and performing tissue transglutaminase-immunoglobulin A (tTG-IgA) tests, upper endoscopy was performed if serological titer was higher than 18 IU/mL. Therapy started according to pathologic results. Results: The sample size was calculated to be 121 subjects (69 female and 52 male subjects); the average age of subjects was 8.4 years. A significant association was found between serological titer and pathologic results; in other words, subjects with high serological titer had more positive pathologic results for celiac disease, compared to others (P < 0.001). Maximum sensitivity (65%) and specificity (65.4%) were achieved at a serological titer of 81.95 IU/ml; the calculated accuracy was lower in comparison with other studies. As the results indicated, lower antibody titer was observed in patients with failure to gain weight and higher antibody titer was reported in diabetic patients. Conclusions: As the results indicated, a single serological test (tTg-IgA test) was not sufficient for avoiding intestinal biopsy. PMID:26848375

  10. Acute duodenal Crohn's disease successfully managed with low-speed elemental diet infusion via nasogastric tube: a case report.

    PubMed

    Yamamoto, Takayuki; Nakahigashi, Maki; Umegae, Satoru; Kitagawa, Tatsushi; Matsumoto, Koichi

    2006-01-28

    Duodenal Crohn's disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn's disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn's disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens, mucosal cytokine levels were measured; interleukin (IL)-1beta, IL-6, IL-8, and tumor necrosis factor-alpha levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available Elental(TM), which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus. The infusion speed was 10 mL/h (usual speed, 100 mL/h). After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, low-speed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn's disease.

  11. Laparoscopic and endoscopic cooperative surgery for duodenal neuroendocrine tumor (NET) G1: Report of a case

    PubMed Central

    Tsushimi, Takaaki; Mori, Hirohito; Harada, Takasuke; Nagase, Takashi; Iked, Yoshitaka; Ohnishi, Hiromo

    2014-01-01

    INTRODUCTION We report a case of duodenal neuroendocrine tumor (NET) G1 resected by laparoscopic and endoscopic cooperative surgery (LECS) technique. PRESENTATION OF CASE A 58-year-old woman underwent esophagastroduodenoscopy, revealing an 8-mm, gently rising tumor distal to the pylorus, on the anterior wall of the duodenal bulb. Endoscopic ultrasonography suggested the tumor might invade the submucosal layer. The tumor was pathologically diagnosed as a G1 duodenal NET, by biopsy. Endoscopic submucosal dissection was attempted, but was unsuccessful because of the difficulty of endoscopically performing an inversion operation in the narrow working space. The case was further complicated by the patient's duodenal ulcer scar. We performed a full-thickness local excision using laparoscopic and endoscopic cooperative surgery. The tumor was confirmed and endoscopically marked along the resection line. After full-thickness excision, using endoscopy and laparoscopy, interrupted full-thickness closure was performed laparoscopically. DISCUSSION Endoscopic treatment is generally recommended for G1 NETs <10 mm in diameter and extending only to the submucosal layer. However, some cases are difficult to resect endoscopically because the wall of duodenum is thinner than that of stomach, and endoscope maneuverability is limited within the narrow working space. LECS is appropriate for early duodenal G1 NETs because they are less invasive and resection of the lesion area is possible. CONCLUSION We demonstrated that LECS is a safe and feasible procedure for duodenal G1 NETs in the anterior wall of the first portion of the duodenum. PMID:25460463

  12. Duodenal atresia

    MedlinePlus

    ... would. Many infants with duodenal atresia also have Down syndrome. Duodenal atresia is often associated with other birth ... abnormality. Other problems (such as those related to Down syndrome) must be treated as appropriate. Outlook (Prognosis) Recovery ...

  13. Bulb Miser

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The Bulb-Miser was developed during NASA's Apollo program to protect the Saturn launch vehicle from electrical current surge. It is now being produced for the commercial market by Bulb-Miser, Inc., Houston, Texas. Technically known as a "temperature compensating thermistor," the Bulb-Miser is a simple, inexpensive device which looks like a washer about the size of a quarter. It is slipped between bulb and socket and can be used with any incandescent bulb that screws into a standard socket. In addition to delaying burnout, the Bulb-Miser also offers some reduction of electrical energy. But the economy of the device goes beyond energy use or bulb cost; to big users of bulbs, it makes possible substantially lower maintenance labor costs. One field test involving an apartment complex showed that it took two men 30 man hours monthly to replace light bulbs; after Bulb-Miser installation only nine man hours a month were needed. Bulb-Misers are used not only in private homes but also by hospitals, schools, hotels and motels, restaurants, banks and firms providing contract maintenance for large outdoor electric signs. The broadest use is in industrial facilities; the list of big companies which have purchased the Bulb-Miser reads like a Who's Who of American industry.

  14. Duodenal polyposis secondary to portal hypertensive duodenopathy

    PubMed Central

    Gurung, Ananta; Jaffe, Philip E; Zhang, Xuchen

    2015-01-01

    Portal hypertensive duodenopathy (PHD) is a recognized, but uncommon finding of portal hypertension in cirrhotic patients. Lesions associated with PHD include erythema, erosions, ulcers, telangiectasia, exaggerated villous pattern and duodenal varices. However, duodenal polyposis as a manifestation of PHD is rare. We report a case of a 52-year-old man who underwent esophagogastroduodenoscopy and was found with multiple small duodenal polyps ranging in size from 1-8 mm. Biopsy of the representative polyps revealed polypoid fragments of duodenal mucosa with villiform hyperplasia lined by reactive duodenal/gastric foveolar epithelium and underlying lamina propria showed proliferating ectatic and congested capillaries. The features were diagnostic of polyps arising in the setting of PHD. PMID:26634042

  15. Duodenal Villous Atrophy in a TTG-Negative Patient Taking Olmesartan: A Case Report and Review of the Literature.

    PubMed

    Kulai, Tasha; Arnason, Thomas; MacIntosh, Donald; Igoe, John

    2016-01-01

    Olmesartan, an angiotensin II receptor antagonist used to treat hypertension, is associated with few adverse effects. Here, a case of severe sprue-like enteropathy and acute kidney injury is described in a 68-year-old male taking olmesartan for 3-4 years. He presented to hospital with a five-week history of diarrhea, vomiting, and a 20 lb weight loss. Anti-TTG was negative with a normal IgA. Biopsies of the distal duodenum and duodenal cap revealed marked blunting of the villi with near complete villous atrophy of the biopsies from the bulb. There was an increase in intraepithelial lymphocytes as well as neutrophils in the surface epithelium. The patient's diarrhea improved upon discontinuation of olmesartan and he returned to his previous weight. Repeat endoscopy four months later demonstrated complete resolution of inflammatory change with normal villous architecture. Long-term olmesartan use is associated with severe sprue-like enteropathy. The mechanism of intestinal injury is unknown. Duodenal biopsy results may mimic other enteropathies such as celiac disease. Physicians should consider medications as potential etiologies of enteropathy. PMID:27446852

  16. Duodenal Villous Atrophy in a TTG-Negative Patient Taking Olmesartan: A Case Report and Review of the Literature

    PubMed Central

    Kulai, Tasha; Arnason, Thomas; MacIntosh, Donald; Igoe, John

    2016-01-01

    Olmesartan, an angiotensin II receptor antagonist used to treat hypertension, is associated with few adverse effects. Here, a case of severe sprue-like enteropathy and acute kidney injury is described in a 68-year-old male taking olmesartan for 3-4 years. He presented to hospital with a five-week history of diarrhea, vomiting, and a 20 lb weight loss. Anti-TTG was negative with a normal IgA. Biopsies of the distal duodenum and duodenal cap revealed marked blunting of the villi with near complete villous atrophy of the biopsies from the bulb. There was an increase in intraepithelial lymphocytes as well as neutrophils in the surface epithelium. The patient's diarrhea improved upon discontinuation of olmesartan and he returned to his previous weight. Repeat endoscopy four months later demonstrated complete resolution of inflammatory change with normal villous architecture. Long-term olmesartan use is associated with severe sprue-like enteropathy. The mechanism of intestinal injury is unknown. Duodenal biopsy results may mimic other enteropathies such as celiac disease. Physicians should consider medications as potential etiologies of enteropathy. PMID:27446852

  17. Prostate biopsy

    MedlinePlus

    ... prostate biopsy; Fine needle biopsy of the prostate; Core biopsy of the prostate; Targeted prostate biopsy; Prostate biopsy - transrectal ultrasound (TRUS); Stereotactic transperineal prostate biopsy (STPB)

  18. Duodenal Amyloidosis Masquerading as Iron Deficiency Anemia

    PubMed Central

    Hurairah, Abu

    2016-01-01

    The present study is a unique illustration of duodenal amyloidosis initially manifesting with iron deficiency anemia. It underscores the importance of clinical suspicion of amyloidosis while performing upper gastrointestinal endoscopy with a biopsy to establish the definite diagnosis in patients with unexplained iron deficiency anemia. PMID:27625911

  19. From cysteamine to MPTP: structure-activity studies with duodenal ulcerogens

    SciTech Connect

    Szabo, S.; Cho, C.H.

    1988-01-01

    Cysteamine is the first chemical identified that induces acute and chronic duodenal ulcers in rodents. Structure-activity studies with cysteamine, propionitrile and their derivatives, as well as with analogues of toluene, revealed numerous alkyl and aryl duodenal ulcerogens. Among these, one of the most interesting from an etiologic and pathogenetic point of view is the dopaminergic neurotoxin MPTP, which shows structural similarities with toluene. The chemically-induced duodenal ulcers are similar and localized on the anterior and posterior wall of the duodenal bulb. Both cysteamine and MPTP affect endogenous dopamine; MPTP is especially potent in depleting central dopamine and inducing lesions in the substantia nigra. MPTP given in high doses induces Parkinson's disease-like syndrome and gastric ulcers. Cysteamine and propionitrile also cause dyskinesia in large and multiple doses. The motility disorders and duodenal ulcers are abolished by dopamine agonists. Cysteamine and MPTP have been known to increase and decrease gastric acid secretion, respectively. However, both compounds induced duodenal dysmotility, decreased bicarbonate production, and reduced its delivery from distal to proximal duodenum. These factors decrease acid neutralization in the duodenal bulb and contribute to duodenal ulceration. Thus, studies with animal models may reveal endogenous mediators and specific receptors which might be involved in the pathogenesis of duodenal ulceration. Specific structure-activity studies in toxicology may lead to new insights in the pathogenesis and pharmacology of a poorly understood human disorder such as duodenal ulceration. 39 references.

  20. Duodenal stents for malignant duodenal strictures.

    PubMed Central

    Johnston, S. D.; McKelvey, S. T. D.; Moorehead, R. J.; Spence, R. A. J.; Tham, T. C. K.

    2002-01-01

    Duodenal obstruction may be caused by inoperable malignant disease. Symptoms of nausea and vomiting have been traditionally palliated by surgery. The aim of the study was to determine the efficacy of the endoscopic placement of metal self expanding duodenal stents for the palliation of malignant duodenal obstruction. Four patients with malignant gastric outlet obstruction are described. One patient had a history of oesophagectomy for oesophageal adenocarcinoma and presented with further dysphagia. At endoscopy the recurrent oesophageal tumour and an adenocarcinoma involving the pylorus were both stented. In the other three patients there was a previous history of colonic carcinoma, cholangiocarcinoma and oesophageal adenocarcinoma respectively. All four patients were successfully stented with good palliation of their symptoms. Duodenal Wallstents are a useful alternative to surgery in patients with inoperable malignant duodenal obstruction or those who are unfit for surgery. Images Fig 1 Fig 2 PMID:12137161

  1. [Chronic Duodenitis and Celiac Disease: a path between the nonspecific and the early stages of Marsh].

    PubMed

    Passera, Andrea Helena; Passera, Mario Luis; Higa, Antonio Luis; Nuñez, Maria; Armando, Lucas; Barzón, Silvia

    2015-01-01

    Given the advances in diagnosis for CD, some patients are detected with symptoms and signs of food intolerance, which have positive antibodies and autoantibodies for coeliac disease, whom present proximal bowel biopsies with chronic nonspecific duodenitis and are not associated with stages 0 and 1 Marsh. On the other hand, patients with bloating, abdominal pain, pondostatural delay, negative antibodies for CD, and chronic nonspecific duodenitis in whom removing cow's milk or gluten, the symptoms remit. There are also celiac patients with biopsies before diagnosis, with chronic nonspecific duodenitis. In this paper, we summarize three brothers with different degrees of chronic duodenitis, one with chronic nonspecific duodenitis, and two with histopathological sings of coeliac disease. It is an invitation to think that chronic nonspecific duodenitis in some patients may be an earlier manifestation of celiac disease.

  2. Jacketed lamp bulb envelope

    DOEpatents

    MacLennan, Donald A.; Turner, Brian P.; Gitsevich, Aleksandr; Bass, Gary K.; Dolan, James T.; Kipling, Kent; Kirkpatrick, Douglas A.; Leng, Yongzhang; Levin, Izrail; Roy, Robert J.; Shanks, Bruce; Smith, Malcolm; Trimble, William C.; Tsai, Peter

    2001-01-01

    A jacketed lamp bulb envelope includes a ceramic cup having an open end and a partially closed end, the partially closed end defining an aperture, a lamp bulb positioned inside the ceramic cup abutting the aperture, and a reflective ceramic material at least partially covering a portion of the bulb not abutting the aperture. The reflective ceramic material may substantially fill an interior volume of the ceramic cup not occupied by the bulb. The ceramic cup may include a structural feature for aiding in alignment of the jacketed lamp bulb envelope in a lamp. The ceramic cup may include an external flange about a periphery thereof. One example of a jacketed lamp bulb envelope includes a ceramic cup having an open end and a closed end, a ceramic washer covering the open end of the ceramic cup, the washer defining an aperture therethrough, a lamp bulb positioned inside the ceramic cup abutting the aperture, and a reflective ceramic material filling an interior volume of the ceramic cup not occupied by the bulb. A method of packing a jacketed lamp bulb envelope of the type comprising a ceramic cup with a lamp bulb disposed therein includes the steps of filling the ceramic cup with a flowable slurry of reflective material, and applying centrifugal force to the cup to pack the reflective material therein.

  3. [THE COMBINATION OF RECURRENT INTUSSUSCEPTION DUODENAL, ZENKER DIVERTICULUM, HIATAL HERNIA AND HASTROPTOSIS AS A MANIFESTATION OF NON-DIFFERENT DYSPLASIA OF CONNECTIVE TISSUE].

    PubMed

    Pavlov, M V; Orlova, N V

    2015-01-01

    Presented rare clinical case: a combination of recurrent intussusception duodenal, diverticulum Zenker, hiatal hernia and hastroptosis as a manifestation of non-different dysplasia of connective tissue. Special interest is recurrent intussusception upper horizontal portion duodenal in the bulb, is not detected when esophagogastroduodenoscopy.

  4. Intramural duodenal hematoma after submucosal injection of epinephrine for a bleeding ulcer: case report and review

    PubMed Central

    DIBRA, A.; KËLLIÇI, S.; ÇELIKU, E.; DRAÇINI, Xh.; MATURO, A.; ÇELIKU, E.

    2015-01-01

    We present a case of intramural duodenal hematoma as a complication of endoscopic therapy for a bleeding duodenal ulcer in an adult patient with no evidence of other pathologies. A 18-year-old man was admitted in emergency room with gastrointestinal bleeding manifested by melena. Previous medical history revealed that he had endoscopic sclerotherapy for bleeding duodenal ulcer 5 months before. Endoscopy revealed a Forrest 2a ulcer in the duodenal bulb and sclerotherapy was performed by injecting 10 ml of 0.2% epinephrine and 20 ml of NaCl 0.9% solution. Upper occlusion’s signs appeared 36 hours after the procedure. The hematoma, that was identified by endoscopy and confirmed by MRI and CT scan of the abdomen, caused transient duodenal obstruction. Combined conservative management with nasogastric tube and total parenteral nutrition resulted in reduction of obstructive symptoms within 4 weeks. PMID:25827667

  5. Helicobacter pylori infection after gastrectomy and vagotomy in duodenal ulcer patients.

    PubMed

    Sito, E; Konturek, P C; Konturek, S J; Bielański, W; Stachura, J

    1996-03-01

    The eradication of Helicobacter pylori (Hp) is known to reduce the recurrence rate of duodenal ulcer (DU) to similar extent as gastrectomy but it is not clear what is the prevalence of Hp in DU patients after surgical interventions such as gastrectomy or vagotomy. The purpose of this study was to evaluate the influence of gastrectomy or truncal vagotomy with pyloroplasty on the prevalence of Hp in 51 DU patients just before and 6-8 months after these procedures. Using C14-urea breath test (UTB), rapid CLO-test and histology of the biopsy samples of gastric mucosa obtained during gastroscopy, the Hp was detected in all DU subjects submitted to operation. Following distal gastric resection (antrectomy) with Billroth II anastomosis (N = 32) due to an ulcer resistance to conservative therapy, peptic ulceration was not observed during 6-8 months in any of the examined subjects and the Hp was only rarely observed (only in 3 out of 32 operated patients). Histologically, in antral biopsies taken prior to surgery, all DU patients presented chronic active gastritis. After the surgery, the absence of Hp was confirmed also by histology. Histological evaluation of gastrectomy stump biopsies revealed typical chronic gastritis with concomitant foveolar hyperplasia and focal gland dilation. Following selective vagotomy and pyloroplasty (N = 19), the scarring of duodenal bulb (without active ulcer) was seen in 4 out of 19 operated patients but the Hp was detected in all (100%) cases. Gastric biopsies prior and after vagotomy revealed chronic active gastritis associated with Hp infection. Basal plasma gastrin was reduced after gastrectomy by about 30% and basal and maximal pentagastrin-induced acid secretion was decreased by about 60% and 70%, respectively. Vagotomy did not reduce activity of the mucosal inflammation and the incidence of Hp. Basal plasma gastrin level was increased by about 60%, while basal and pentagastrin induced acid secretion was decreased by 25% and 40

  6. Kidney biopsy

    MedlinePlus

    Renal biopsy; Biopsy - kidney ... Barisoni L, Arend LJ, Thomas DB. Introduction to renal biopsy. In: Zhou M, Mari-Galluzzi C, eds. ... Saunders; 2015:chap 7. Topham PS, Chen Y. Renal biopsy. In: Johnson RJ, Feehally J, Floege J, ...

  7. Gum biopsy

    MedlinePlus

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  8. Motors and Bulbs in Series

    ERIC Educational Resources Information Center

    Whitaker, Robert J.

    2009-01-01

    One of Paul Hewitt's "Figuring Physics" that appeared in this journal dealt with the heating of a motor. This phenomenon can be demonstrated with a miniature motor and a bulb as part of a series of activities with "batteries and bulbs." Students examine the effect on the brightness of a single bulb when a second, identical bulb is placed in series…

  9. Experimenting with Bulbs

    NASA Astrophysics Data System (ADS)

    Cavicchi, Elizabeth M.

    1998-04-01

    What questions come about as learners explore physical materials? How does their learning deepen through inventing experiments and making and testing their own interpretations? I present episodes from the investigatory work of three adult learners who met regularly with me to explore batteries, bulbs and wires. I taught by engaging the learners' interest in these materials and by interactively researching their developing understandings. As both teacher and researcher, I used what I learned about their understandings to support their efforts to extend the body of experimental knowledge they were developing. Development is evident in experimental details. Initially, by hand-holding, they light a bulb with a wire and battery. Later, in soldering connections, they wonder about the bulb's internal structure. They research thoughts about this through dissecting a bulb -- and lighting its exposed filament. Such experimenting changed thinking: from imagining sequential loops, to questioning electrical contacts, to inferring circuital paths.

  10. Primary duodenal carcinoma.

    PubMed Central

    Adedeji, O. A.; Trescoli-Serrano, C.; Garcia-Zarco, M.

    1995-01-01

    Eight cases of primary duodenal carcinoma in a district general hospital are presented. The cases highlight the advanced state of the disease at presentation, the difficulty in diagnosis, and its poor prognosis. Duodenal carcinoma occurs in both sexes worldwide with no predisposing factors in the majority of cases. There is an increased risk in patients with familial adenomatous polyposis and adenomas of the duodenum. Duodenal carcinoma occurs about 22 years from the diagnosis of familial adenomatous polyposis in about 2% of patients, forming over 50% of upper gastrointestinal cancers occurring in these patients. Carcinomatous changes occur in 30 to 60% of duodenal villous adenomas and much less in tubulo-villous and tubular adenomas. These categories of patients should be screened and adequately followed up. Aggressive and radical surgery, even in the presence of locally advanced disease and lymph node involvement, gives a better outcome. When curative surgery is not possible, chemotherapy must accompany palliation with or without radiotherapy. Pre-operative chemotherapy may facilitate a curative radical resection. The general five-year survival is 17-33% but some centres have achieved a five-year survival of 40-60% with aggressive management of these patients. PMID:7644397

  11. Solar light bulb

    SciTech Connect

    Smith, D.A.

    1983-07-26

    A system for generating light directly using solar energy is provided herein. It includes a concentrator and accumulator for the sun's rays to generate a concentrated beam of visible solar radiation. A distributor shaft is provided for distributing the beam of visible solar radiation. A fork is provided in the distributor shaft to define a plurality of branch lines, each provided with a mirror at the intersection to direct the beam down the respective branch line to permit parallel fractions of the beam to be reflected off the respective mirrors and to pass down the respective branch line. A solar bulb is provided including a double walled upper bulbous portion including the inlet from the branch line and a pair of heat outlet tubes, and a double walled lower bulbous portion, the upper portion thereof being divergently reflective, with the lower portion having walls which are either transparent or translucent to provide greater light diffusion, and the space between the two walls being maintained under vacuum to provide heat insulation values. A structure is provided within the solar bulb for the absorption and radiation of the concentrated beam of visible solar radiation. Preferably structure is provided connected to the solar bulb to draw in outside air in the summer to direct it past the solar bulb and to air vent hot air produced at the solar bulb to the outside, thereby providing light with minimal heat in the summer. The same structure is operated in the winter to draw in household air to direct it past the solar bulb and to recirculate such heated air produced at the solar bulb to the house, thereby providing light and heat in the winter.

  12. Liver biopsy

    MedlinePlus

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  13. Biopsy - polyps

    MedlinePlus

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  14. Duodenal bleeding from metastatic renal cell carcinoma.

    PubMed

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-04-20

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

  15. Duodenal Bleeding from Metastatic Renal Cell Carcinoma

    PubMed Central

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-01-01

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested. PMID:21577373

  16. Illuminating Physics with Light Bulbs.

    ERIC Educational Resources Information Center

    Leff, Harvey S.

    1990-01-01

    Presents ideas on how common household light bulbs can be used to develop interest in learning physics. Focuses on supermarket data taking and analyses, filament temperatures, detective work with three-way bulbs, and lifetime statistics. (YP)

  17. Duodenal luminal nutrient sensing

    PubMed Central

    Rønnestad, Ivar; Akiba, Yasutada; Kaji, Izumi; Kaunitz, Jonathan D

    2016-01-01

    The gastrointestinal mucosa is exposed to numerous chemical substances and microorganisms, including macronutrients, micronutrients, bacteria, endogenous ions, and proteins. The regulation of mucosal protection, digestion, absorption and motility is signaled in part by luminal solutes. Therefore, luminal chemosensing is an important mechanism enabling the mucosa to monitor luminal conditions, such as pH, ion concentrations, nutrient quantity, and microflora. The duodenal mucosa shares luminal nutrient receptors with lingual taste receptors in order to detect the five basic tastes, in addition to essential nutrients, and unwanted chemicals. The recent ‘de-orphanization’ of nutrient sensing G protein-coupled receptors provides an essential component of the mechanism by which the mucosa senses luminal nutrients. In this review, we will update the mechanisms of and underlying physiological and pathological roles in luminal nutrient sensing, with a main focus on the duodenal mucosa. PMID:25113991

  18. Hairy Cell Leukemia Presenting with Duodenal Involvement Duodenum: A Case Report

    PubMed Central

    Sen, Parijat; Shaaban, Hamid; Modi, Tejas; Kumar, Abhishek; Guron, Gunwant

    2015-01-01

    Context: A rare case of adult hairy cell leukemia (HCL) with duodenal involvement is presented. Case Report: The patient was a 48-year-old man, who had a history of hairy cell leukemia. Three days after completion of 2-chlorodeoxyadenosine (CDA) chemotherapy, the patient started experiencing abdominal pain. An extensive gastroenterological workup culminated in the patient getting an esophagogastroduodenoscopy (EGD) that revealed duodenal inflammation and biopsies were taken. The duodenal biopsy was positive for chronic inflammatory infiltrate, primarily consisting of atypical lymphocytes and plasma cells with tartrate-resistant acid phosphatase (TRAP) positivity, and hence a diagnosis of duodenal involvement with HCL was made. Repeat bone marrow biopsy done 2 weeks after finishing chemotherapy revealed residual disease. At the 3-month follow-up, the patient was asymptomatic with a normocellular marrow and no residual disease. Repeat abdomen computerized tomography (CT) scan at completion of therapy showed resolution of duodenal thickening and spleen size of 12 cm. Currently, patient is in clinical remission for 6 years with 4-6 monthly follow-up visits and continues to do well. Conclusion: This case is presented to highlight the first case report of HCL with duodenal involvement that was successfully treated with CDA. PMID:26199927

  19. Kidney Biopsy

    MedlinePlus

    ... right diagnosis. [ Top ] What should a person do days before a kidney biopsy? Days before the procedure, ... Top ] What can a person expect on the day of the kidney biopsy? A person should arrive ...

  20. Tongue biopsy

    MedlinePlus

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  1. Nuclear light bulb

    NASA Technical Reports Server (NTRS)

    Latham, Tom

    1991-01-01

    The nuclear light bulb engine is a closed cycle concept. The nuclear light bulb concept provides containment by keeping the nuclear fuel fluid mechanically suspended in a cylindrical geometry. Thermal heat passes through an internally cooled, fused-silica, transparent wall and heats hydrogen propellant. The seeded hydrogen propellant absorbs radiant energy and is expanded through a nozzle. Internal moderation was used in the configuration which resulted in a reduced critical density requirement. This result was supported by criticality experiments. A reference engine was designed that had seven cells and was sized to fit in what was then predicted to be the shuttle bay mass and volume limitations. There were studies done of nozzle throat cooling schemes to remove the radiant heat. Elements of the nuclear light bulb program included closed loop critical assembly tests done at Los Alamos with UF6 confined by argon buffer gas. It was shown that the fuel region could be seeded with constituents that would block UV radiation from the uranium plasma. A combination of calculations and experiments showed that internal moderation produced a critical mass reduction. Other aspects of the research are presented.

  2. Liver Biopsy

    MedlinePlus

    ... PDF, 341 KB)​​​​. Alternate Language URL Español Liver Biopsy Page Content On this page: What is a ... to Remember Clinical Trials What is a liver biopsy? A liver biopsy is a procedure that involves ...

  3. [Rupture of a gastroduodenal artery aneurysm caused by duodenal ulcer: a case report].

    PubMed

    Isono, Yoshiaki; Baba, Youichirou; Saito, Tomonori; Kumazawa, Hiroaki; Tanaka, Hiroki; Matsusaki, Shimpei; Sase, Tomohiro; Okano, Hiroshi; Mukai, Katsumi

    2015-10-01

    A 73-year-old man with a history of tarry stools was admitted to our hospital. Gastroduodenoscopy on admission revealed an ulcer with an exposed vessel at the duodenal bulb. During endoscopic clipping for prevention of re-bleeding, a large amount of bleeding from the vessel was observed. Hemostasis was achieved after the procedure. However, 7 days later, the patient passed a large amount of tarry stools and experienced hypovolemic shock. Endoscopic re-examination revealed a pulsatile aneurysmal vessel at the base of the duodenal ulcer. Abdominal contrast-enhanced computed tomography and abdominal angiography demonstrated an aneurysm of the gastroduodenal artery, which was successfully treated with transcatheter arterial embolization. Thus, here we report a rare case of an aneurysm of the gastroduodenal artery caused by a duodenal ulcer.

  4. Shedding Some Light on Fluorescent Bulbs.

    ERIC Educational Resources Information Center

    Guilbert, Nicholas R.

    1996-01-01

    Explores some of the principles behind the working of fluorescent bulbs using a specially prepared fluorescent bulb with the white inner fluorescent coating applied along only half its length. Discusses the spectrum, the bulb plasma, and light production. (JRH)

  5. Adenocarcinoma of the minor duodenal papilla: report of a case.

    PubMed

    Hoshino, Arichika; Nakamura, Yoshiharu; Suzuki, Hideyuki; Mizutani, Satoshi; Ishii, Hideaki; Watanabe, Masanori; Bou, Hideki; Yoshino, Masanori; Komine, Osamu; Uchida, Eiji

    2013-01-01

    We report a rare case of adenocarcinoma of the minor papilla of the duodenum treated with transduodenal minor papillectomy. A 64-year-old woman was treated for an asymptomatic duodenal tumor detected on gastroduodenoscopy. Endoscopy showed a 15-mm sessile mass in the descending duodenum proximal to the major papilla. The major papilla was a villous 24-mm-diameter polypoid tumor. Histopathologic examination of the biopsy specimen showed tubular adenoma with moderate epithelial atypia. Transduodenal major and minor papillectomies were performed. The orifice of the duct of Santorini and the pancreatic duct were re-approximated to the duodenal wall to prevent acute pancreatitis caused by scarring and stenosis of the duct orifice. Histological findings were consistent with well-differentiated adenocarcinoma limited to the minor duodenal papilla, without infiltration of the duodenal wall submucosa, and confirmed complete resection. The patient had an uneventful postoperative course and has remained asymptomatic, without evidence of tumor recurrence or stenosis of the pancreatic duct orifice, for 4 years.

  6. Traumatic duodenal lesions in children due to two-point seat-belt: the seat-belt syndrome.

    PubMed

    Guanà, R; Sangiorgio, L; Tessiatore, P; Seymandi, P

    2012-02-01

    Two consecutive children, motor vehicle accident victims, were treated between December 2006 and January 2007. They reported duodenal perforations due to lap-belt action. In the first case (a 9-year-old boy), symptoms became immediately evident after the trauma. Early computerized tomography (CT) scan demonstrated biliaryhemoperitonitis and free sub-diaphragmatic air. At the laparotomy a complete duodenal transection, at the level of duodenal bulb, was found. In the second patient, early X-ray and CT scan revealed no free abdominal air; only the second CT scan, repeated after 48 hours, when general conditions of the girl become critical, demonstrated biliary peritonitis and aerial extraluminal gas image in the right peri-kidney space. At the surgical exploration a duodenal laceration was noted, at the passage between the second and the third duodenal portion, in the postero-lateral wall, with an extension of 6 cm. In both children direct suture of duodenal injury without stoma construction was performed. Not early or late postoperative complications were registered (follow-up: 18 months). In the traumatic duodenal lesions an early diagnosis is not always possible because of the paucity of the clinical signs. Tightened clinical and radiological monitoring of the patient is fundamental in the successive hours to the trauma. Early diagnosis and high level of suspicious rest crucial for better prognosis in this group of patients.

  7. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    PubMed

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation.

  8. Cat scratch disease, a rare cause of hypodense liver lesions, lymphadenopathy and a protruding duodenal lesion, caused by Bartonella henselae.

    PubMed

    van Ierland-van Leeuwen, Marloes; Peringa, Jan; Blaauwgeers, Hans; van Dam, Alje

    2014-10-29

    A 46-year-old woman presented with right upper abdominal pain and fever. At imaging, enlarged peripancreatic and hilar lymph nodes, as well as hypodense liver lesions, were detected, suggestive of malignant disease. At endoscopy, the mass adjacent to the duodenum was seen as a protruding lesion through the duodenal wall. A biopsy of this lesion, taken through the duodenal wall, showed a histiocytic granulomatous inflammation with necrosis. Serology for Bartonella henselae IgM was highly elevated a few weeks after presentation, consistent with the diagnosis of cat scratch disease. Clinical symptoms subsided spontaneously and, after treatment with azithromycin, the lymphatic masses, liver lesions and duodenal ulceration disappeared completely.

  9. Lamp bulb with integral reflector

    DOEpatents

    Levin, Izrail; Shanks, Bruce; Sumner, Thomas L.

    2001-01-01

    An improved electrodeless discharge lamp bulb includes an integral ceramic reflector as a portion of the bulb envelope. The bulb envelope further includes two pieces, a reflector portion or segment is cast quartz ceramic and a light transmissive portion is a clear fused silica. In one embodiment, the cast quartz ceramic segment includes heat sink fins or stubs providing an increased outside surface area to dissipate internal heat. In another embodiment, the quartz ceramic segment includes an outside surface fused to eliminate gas permeation by polishing.

  10. What Is the Real Efficiency of Bulbs?

    ERIC Educational Resources Information Center

    Polacek, Lubos

    2012-01-01

    Bulbs are considered to be very inefficient sources of light. Bulbs give light and heat. As we use them for a long time, especially in winter, a large part of the heat produced by bulbs lowers the power consumption of the heating system. In this paper the problem of the real efficiency of a bulb is solved when both the lighting and heating effects…

  11. Synovial biopsy

    MedlinePlus

    ... small incision. After anesthesia, an instrument called a trocar is inserted into the joint space. This tool ... area. A biopsy grasper is inserted through the trocar and turned to cut out a tissue segment. ...

  12. CT of gastro-duodenal obstruction.

    PubMed

    Millet, I; Doyon, F Curros; Pages, E; Faget, C; Zins, M; Taourel, P

    2015-10-01

    Gastro-duodenal obstruction encompasses a spectrum of benign and malignant disease. Historically, chronic peptic ulcer disease was the main cause of gastro-duodenal obstruction, whereas now malignant cause with gastric carcinomas for gastric obstruction and pancreatic tumors for duodenal obstruction predominate. This paper reviews the role of CT in diagnosing gastro-duodenal obstruction, its level, its cause by identifying intraluminal, parietal, or extrinsic process, and the presence of complication.

  13. Inflammatory duodenal necrosis complicating gastroschisis

    PubMed Central

    Fouad, Dina; Lee, Geraint J.; Upadhyaya, Manasvi; Drake, David

    2016-01-01

    Babies with gastroschisis have an increased risk of necrotizing enterocolitis (NEC) that can lead to short bowel syndrome, a long-term parenteral nutrition requirement, and its associated complications. To our knowledge, this is the first case report of recurrent duodenal ischemia and necrosis associated with gastroschisis in the absence of NEC totalis. PMID:27695214

  14. Inflammatory duodenal necrosis complicating gastroschisis

    PubMed Central

    Fouad, Dina; Lee, Geraint J.; Upadhyaya, Manasvi; Drake, David

    2016-01-01

    Babies with gastroschisis have an increased risk of necrotizing enterocolitis (NEC) that can lead to short bowel syndrome, a long-term parenteral nutrition requirement, and its associated complications. To our knowledge, this is the first case report of recurrent duodenal ischemia and necrosis associated with gastroschisis in the absence of NEC totalis.

  15. Epidemiology and etiology of "autonomous" nonspecific duodenitis.

    PubMed

    Cheli, R; Nicoló, G; Bovero, E; Salvi, S; Testino, G; De Iaco, F

    1994-04-01

    In this prospective study we looked for possible epidemiological and etiological factors in "autonomous" nonspecific duodenitis. Of 136 dyspeptic patients who entered the study, duodenitis was found in 25.6% (94.4% chronic duodenitis and 5.6% isolated active duodenitis). Men predominated with a significant prevalence of 74%; 49% of them had white-collar jobs, but age, psychological factors, and the season of the year played no role. We found that smoking and alcohol and coffee intake bore no relation to duodenitis. Helicobacter pylori (HP) was present in only 17.1% of patients with duodenitis, little different from the 10% prevalence in dyspeptic patients without duodenitis. HP was always associated with gastric metaplasia and inflammatory activity.

  16. Childhood chronic gastritis and duodenitis: Role of altered sensory neuromediators

    PubMed Central

    Islek, Ali; Yilmaz, Aygen; Elpek, Gulsum Ozlem; Erin, Nuray

    2016-01-01

    AIM To investigate the roles of the neuropeptides vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) in chronic gastritis and duodenitis in children. METHODS Biopsy samples from the gastric and duodenal mucosa of 52 patients and 30 control subjects were obtained. Samples were taken for pathological examination, immunohistochemical staining, enzyme activity measurements and quantitative measurements of tissue peptide levels. RESULTS We observed differential effects of the disease on peptide levels, which were somewhat different from previously reported changes in chronic gastritis in adults. Specifically, SP was increased and CGRP and VIP were decreased in patients with gastritis. The changes were more prominent at sites where gastritis was severe, but significant changes were also observed in neighboring areas where gastritis was less severe. Furthermore, the degree of changes was correlated with the pathological grade of the disease. The expression of CD10, the enzyme primarily involved in SP hydrolysis, was also decreased in patients with duodenitis. CONCLUSION Based on these findings, we propose that decreased levels of VIP and CGRP and increased levels of SP contribute to pathological changes in gastric mucosa. Hence, new treatments targeting these molecules may have therapeutic and preventive effects. PMID:27729741

  17. Lymph node biopsy

    MedlinePlus

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... then sent to the laboratory for examination. A needle biopsy involves inserting a needle into a lymph ...

  18. Testicular biopsy

    MedlinePlus

    ... egg in the lab. This process is called in vitro fertilization. Testicular biopsy may also be done if you have found a lump during testicular self-examination . If tests ... the lump may be in the testicle, surgery may be needed to look ...

  19. Risk factors for healing of duodenal ulcer under antacid treatment: do ulcer patients need individual treatment?

    PubMed

    Massarrat, S; Müller, H G; Schmitz-Moormann, P

    1988-03-01

    In order to identify the risk factors affecting the healing of duodenal ulcer, a clinical trial with effective dose of antacid was carried out in 53 patients. Duration of ulcer history, number of relapses, duration of the last and present relapse, number, duration and severity of pain attacks in the present ulcer relapse, pain radiation to back, vomiting, appetite, smoking habit, intake of analgesics and previous haemorrhage were registered. Number of ulcers, ulcer depth, bublar narrowing, erosions, duodenitis at initial endoscopy and healing of ulcer were assessed by one endoscopist. Basic and peak acid output were measured. The extent of duodenitis on the site opposite the ulcer was determined by histological examination. Sixty per cent of the duodenal ulcers were healed after three weeks. By univariate analysis, the following factors affect the healing; pain radiation to back and pain duration during treatment (p less than 0.001), multiple or deep ulcers, narrowing of duodenal bulb (p less than 0.01), number of pain attacks and poor appetite (p less than 0.05). By the stepwise logistic regression model, the following factors were selected as predictors for healing of duodenal ulcer with 76% correct classification: pain radiation to back (p = 0.002), deep ulcer (p = 0.013), multiple ulcers (p = 0.028). Number of cigarettes/day (p less than 0.007) and male sex (p = 0.036). By this model, the prediction of healing could be accurately assessed in 78% in a new sample. Individual treatment should be carried out on the basis of these factors. PMID:3356359

  20. Distribution of Prostaglandin E2 in Gastric and Duodenal Mucosa: Possible Role in the Pathogenesis of Peptic Ulcer

    PubMed Central

    Park, Sill Moo; Yoo, Byung Chul; Lee, Hyo Rang; Chung, Hyuk; Lee, Young Soon

    1992-01-01

    Background Prostaglandin E which is present abundantly in the gastric mucosa is a powerful inhibitor of gastric acid secretion and a stimulus to gastric mucus production. In addition, prostaglandin E2 inhibits ulcer formation in animals, and the synthetic analogues of prostaglandin E have successfully been used in the treatment of patients with gastric and duodenal ulcer disease. To evaluate the role of endogenous prostaglandin E2 in the pathogenesis of the peptic ulcer disease, we measured mucosal prostaglandin E2 levels in patients with gastric and duodenal ulcer disease and compared with that of non-ulcer control persons. Methods The study population was made up of 44 non-ulcer persons, 36 patients with a benign gastric ulcer, and 48 with a duodenal ulcer. Every mucosai specimen, taken from the antrum and from the duodenal bulb, were homogenized, mixed with 1 M HCI, and centrifuged. After removal of the supernatant, precipitate was eluted with ethyl acetate in the Amprep C18 minicolumn. Then the extracted prostaglandin E2 in the ethyl acetate fractions was converted into its methyl oximate derivatives, and the prostaglandin E2 level was measured by radioimmunoassay. During the procedure any homogenized specimen which was looking grossly bloody was removed from the assay in order to avoid any possible contamination or prostaglandin E2 in blood. Results In non-ulcer persons, the mean values was 258.17±127.03 pg/mg. tissue in antrum and 121.07±67.46 pg/mg. tissue in duodenal bulb. The corresponding values were 186.42±70.51 pg/mg. tissue, 79.44±39.04 pg/mg. tissue in gastric ulcer patients and 204. 94 92.03 pg/mg. tissue, 99.66±56.10 pg/mgl. tissue in duodenal ulcer patients respectively. Gastric ulcer patients have the significantly lower level of the antral and duodenal prostaglandin E2 (p<0.005). Those levels of duodenal ulcer patients were also significantly lower than those of non-ulcer persons (p<0.025 & 0.05). Antral prostaglandin E2 level increased to

  1. No-Light Light Bulbs

    ERIC Educational Resources Information Center

    Modern Schools, 1976

    1976-01-01

    A thumbnail sketch of some of the light bulbs manufactured for a purpose other than seeing. These "dark" lamps perform varied tasks including keeping food fresh, detecting and preventing disease, spurring plant growth, heating, and copying printed material. (Author/MLF)

  2. Dengue hemorrhagic fever presenting with hemorrhagic pancreatitis and an intramural hematoma of the duodenal wall: a case report and review of the literature.

    PubMed

    Lee, Chun-Yuan; Tsai, Hung-Chin; Lee, Susan Shin-jung; Lin, Chun-Ku; Huang, Jer-Shyung; Chen, Yao-Shen

    2013-05-01

    Dengue fever may present with atypical manifestations. Here we report a 47 year-old male presenting with fever and sore throat for 2 days, followed by epigastric pain and tarry stool for 4 days. The esophagogastroduodenoscopy revealed multiple ulcers with a nodular margin in the duodenal bulb and second portion of the duodenum. A MRI of the abdomen revealed hemorrhagic pancreatitis, with a large intramural hematoma in the second portion of duodenum. The final diagnosis was dengue hemorrhagic fever, grade II, complicated with hemorrhagic pancreatitis and an intramural hematoma of the duodenal wall. Physicians should be aware of the atypical abdominal presentations of dengue fever.

  3. Nasal mucosal biopsy

    MedlinePlus

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  4. Biopsy - biliary tract

    MedlinePlus

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  5. Expression of macrophage migration-inhibitory factor in duodenal ulcer and its relation to Helicobacter pylori infection.

    PubMed

    Yu, X H; Zhang, Q; Yang, X P; Yang, W; Dai, F; Qian, Z; Wang, Z L; Wu, C F; Zhao, H Z; Wang, G H

    2015-10-30

    The aim of this study was to examine the expression of macrophage migration-inhibitory factor (MIF) in duodenal ulcer epithelial cells and its relation to Helicobacter pylori (Hp) infection, and to discuss the pathogenic roles of MIF expression and Hp infection in duodenal ulcer. MIF protein and mRNA expression was examined in samples from patients with duodenal ulcer with and without Hp infection (N = 40 each, experimental group), and in normal duodenal bulb mucosal tissue (N = 40, control group) using immunohistochemistry and in situ hybridization. Patients without Hp infection received routine treatment, and treatment was provided to the patients positive for Hp to eradicate Hp infection. Hp and MIF expression levels before treatment and after the ulcer had been cured were compared. The positive rates of MIF protein and mRNA in patients with Hp infection before treatment were 67.5 and 65%, respectively, and were 18.9 and 21.6% in the 37 patients from whom Hp was eliminated. These were statistically different both before and after treatment compared with controls (P < 0.05). In the patients without Hp infection, the positive rates of MIF protein and mRNA expression before (45 and 47.5%, respectively) and after (32.5 and 30%) treatment were not significantly different (P > 0.05). The results of this study suggested that MIF is related to the development of duodenal ulcer, and that the presence of Hp is closely related with the expression of MIF in the duodenal mucosa and the development of duodenal ulcer.

  6. Increased Duodenal Eosinophil Degranulation in Patients with Functional Dyspepsia: A Prospective Study

    PubMed Central

    Du, Lijun; Shen, Jinhua; Kim, John J.; Yu, Yunxian; Ma, Liqin; Dai, Ning

    2016-01-01

    Functional dyspepsia (FD) is a functional gastrointestinal disorder diagnosed by symptom-based criteria. It has been said that duodenal immune activation plays a role in the pathogenesis of FD. The primary aims of the study were to compare the total number of duodenal eosinophil and evaluate the eosinophil degranulation rate, number of duodenal degranulated eosinophil and mast cell between patients with FD and healthy subjects. We enrolled 96 patients with FD and 24 healthy controls at Sir Run Run Shaw Hospital. The total number of eosinophil was comparable in the second portion of duodenum (D2) and duodenal bulb (D1) between patients with FD and healthy controls (all P > 0.05). Significant higher eosinophil degranulation positive rate in D2 (P = 0.003) and a trend towards higher in D1 (P = 0.084) were observed in patients with FD compared with healthy controls. Moreover, the number of duodenal degranulated eosinophil in patients with FD were significantly increased than healthy controls in D1(9.8 ± 6.3 vs 2.9 ± 2.1 per HPF, P = 0.0002) and a trend towards increase in D2 (10.7 ± 7.7 vs 5.3 ± 0.9 per HPF, P = 0.077), respectively. However, degranulated mast cells in patients with FD were almost same with healthy controls. Increased eosinophils degranulation in duodenum play an important role in pathogenesis of FD. PMID:27708358

  7. Duodenal Adenocarcinoma Metastatic to the Breast

    PubMed Central

    Yu, Haibo; Song, Hongliang; Jiang, Yi

    2016-01-01

    Abstract Duodenal adenocarcinoma, a very rare malignant gastrointestinal tumor, mainly metastasizes via the lymphatic system. Metastases from duodenal adenocarcinomas to the breast are very uncommon. A 31-year-old woman presented at our department with a left breast tumor. She had a past medical history of duodenal adenocarcinoma. Physical examination on admission confirmed a 2.5-cm-diameter tumor in the outer lower quadrant of the left breast. Computed tomography (CT) examination showed a soft lesion with tissue-like density and enlarged axillary lymph nodes. Local excision was performed to remove the breast lesion. The findings of cytologic, histologic, and immunohistochemistry examination indicated a breast metastasis from the previous duodenal adenocarcinoma. The patient was treated with palliative chemotherapy. Metastases from duodenal adenocarcinoma to the breast are rare. The diagnosis depends on medical history, imaging, and pathologic examination including immunohistochemistry. An accurate diagnosis is important to avoid unnecessary surgery. PMID:26986146

  8. Normal jugular bulb oxygen saturation

    PubMed Central

    Chieregato, A; Calzolari, F; Trasforini, G; Targa, L; Latronico, N

    2003-01-01

    Background: Normal values of the jugular bulb oxygen saturation were obtained in 1942 and in 1963. Correct catheter positioning was not confirmed radiologically. Objectives: To replicate the measurements during angiographic catheterisation of the jugular bulb. Methods: Oxygen saturation in the jugular bulb (SjO2), inferior petrosal sinus (SipsO2), and internal jugular vein was bilaterally measured in 12 patients with Cushing's syndrome undergoing selective bilateral catheterisation of the inferior petrosal sinus. In addition, data from the two old series were reanalysed for comparison. Results: SjO2 values (44.7%) were significantly lower than in the two old series, particularly concerning the normal lower limit (54.6% and 55.0% respectively). Comparative analysis suggests that contamination with the extracerebral blood of the facial veins and inferior petrosal sinuses was responsible for falsely high SjO2 values in the two old series. Conclusions: The normal lower SjO2 limit is lower than previously recognised. This may have practical implications for treating severe head trauma patients. PMID:12754351

  9. Duodenal Chemosensing and Mucosal Defenses

    PubMed Central

    Akiba, Yasutada; Kaunitz, Jonathan D.

    2011-01-01

    The duodenal mucosa is exposed to endogenous and exogenous chemicals, including acid, CO2, bile acids and nutrients. Mucosal chemical sensors are necessary to exert physiological responses such as secretion, digestion, absorption, and motility. We propose a mucosal chemosensing system by which luminal chemicals are sensed via mucosal acid sensors and G-protein-coupled receptors. Luminal acid/CO2 sensing consists of ecto- and cytosolic carbonic anhydrases, epithelial ion transporters, and acid sensors expressed on the afferent nerves in the duodenum. Furthermore, a luminal L-glutamate signal is mediated via mucosal L-glutamate receptors, including metabotropic glutamate receptors and taste receptor 1 family heterodimers, with activation of afferent nerves and cyclooxygenase, whereas luminal Ca2+ is differently sensed via the calcium-sensing receptor in the duodenum. Recent studies also show the involvement of enteroendocrine G-protein-coupled receptors in bile acid and fatty acid sensing in the duodenum. These luminal chemosensors help activate mucosal defense mechanisms in or- der to maintain the mucosal integrity and physiological responses. Stimulation of luminal chemosensing in the duodenal mucosa may prevent mucosal injury, affect nutrient metabolism, and modulate sensory nerve activity. PMID:21389725

  10. Reflux esophagitis and hiatal hernia as concomitant abnormality in patients presenting with active duodenal or gastric ulcer: cross-sectional endoscopic study in consecutive patients.

    PubMed

    Loffeld, R J.L.F.; van der Putten, A B.M.M.

    2002-05-01

    BACKGROUND: Follow-up studies have shown that patients with ulcer disease are at risk of developing reflux esophagitis (RE) after successful eradication of Heliobacter pylori. It is still not clear whether this is induced by eradication of H. pylori or whether RE is already present at the time the ulcer is diagnosed. A cross-sectional study was done in consecutive patients suffering from active ulcer disease in order to assess coincidental RE. METHODS: Patients with an active duodenal or gastric ulcer were included in the study. Concomitant RE and the presence of hiatal hernia (HH) were scored. Biopsy specimens were taken for detection of H. pylori. RESULTS: In 375 patients (77%), an active duodenal ulcer was the only abnormality. In 43 patients (8.8%), duodenal ulcer and concomitant RE were present and 69 patients (14.2%) had a duodenal ulcer with concomitant HH. Patients with a duodenal ulcer were significantly younger than patients with concomitant RE or HH. From 374 patients (76.8%) with a duodenal ulcer, biopsy specimens were available for the detection of H. pylori. The majority of duodenal ulcer patients were H. pylori-positive. H. pylori was significantly more often present in patients with an active duodenal ulcer than it was in duodenal ulcer patients suffering from concomitant RE (P=0.04). In 218 patients (76%), a gastric ulcer was the only abnormality. Fifteen patients (5.2%) also had RE and 54 patients (18.8%) had a concomitant HH. There was no difference in H. pylori status in these three groups of patients. CONCLUSIONS: Given the low prevalence of concomitant RE, it is concluded that this condition is likely to occur in a large percentage of patients suffering from H. pylori-positive ulcer disease after successful eradication therapy.

  11. Duodenal ulcer penetration into the liver at the previous left hemihepatectomy site☆

    PubMed Central

    Hayashi, Hironori; Kitagawa, Hirohisa; Shoji, Masatoshi; Nakanuma, Shin-ichi; Makino, Isamu; Oyama, Katsunobu; Inokuchi, Masafumi; Nakagawara, Hisatoshi; Miyashita, Tomoharu; Tajima, Hidehiro; Takamura, Hiroyuki; Ninomiya, Itasu; Fushida, Sachio; Fujimura, Takashi; Tani, Takashi; Ohta, Tetsuo

    2013-01-01

    INTRODUCTION Duodenal ulcer penetration into the liver is a rare, but serious complication. Its frequency was thought to have decreased owing to advances in therapies for peptic ulcers. However, we encountered a case in which the duodenal ulcer had penetrated into a previous hemihepatectomy site. PRESENTATION OF CASE A 69-year-old man with a history of left hemihepatectomy 20 months previously presented to the emergency room with sudden-onset abdominal pain and nausea. An upper gastrointestinal examination with a fiberscope revealed a giant ulcer in the duodenal bulb. In addition, a foreign body was detected at the ulcer floor and was strongly suspected of being a ligature from previous hemihepatectomy. DISCUSSION The presence of a gas-filled liver mass and bowel wall thickening with inflammatory changes are important imaging findings for prompt diagnosis of such a condition, but in this case, none of these were reported. Further, no definite abscess was found. Thus, the patient was treated conservatively with a proton pump inhibitor. CONCLUSION This case demonstrates the importance of using absorbable suture materials, adequate lavage in the postoperative peritoneal space and gastroduodenal mucosal protection postoperatively. PMID:24240081

  12. Duodenal pH in health and duodenal ulcer disease: effect of a meal, Coca-Cola, smoking, and cimetidine.

    PubMed Central

    McCloy, R F; Greenberg, G R; Baron, J H

    1984-01-01

    Intraluminal duodenal pH was recorded using a combined miniature electrode and logged digitally every 10 or 20 seconds for five hours (basal/meal/drink) in eight control subjects and 11 patients with duodenal ulcer (five on and off treatment with cimetidine). Over the whole test there were no significant differences in duodenal mean pH or log mean hydrogen ion activity (LMHa) between control subjects and patients with duodenal ulcer, but there were significantly longer periods of duodenal acidification (pH less than 4) and paradoxically more periods of duodenal alkalinisation (pH greater than 6) in the duodenal ulcer group compared with controls. After a meal duodenal mean pH and LMHa fell significantly in both controls and patients with duodenal ulcer, with more periods of duodenal acidification and alkalinisation in the duodenal ulcer group. An exogenous acid load (Coca-Cola) significantly increased the periods of duodenal acidification, and reduced alkalinisation, in both groups. Cimetidine significantly increased mean pH and LMHa and abolished the brief spikes of acidification in four of five patients with duodenal ulcer. Peak acid output (but not basal acid output) was significantly correlated with duodenal mean pH and LMHa but not with the periods of duodenal acidification. Smoking did not affect duodenal pH in either group. PMID:6706217

  13. Duodenal pH in health and duodenal ulcer disease: effect of a meal, Coca-Cola, smoking, and cimetidine.

    PubMed

    McCloy, R F; Greenberg, G R; Baron, J H

    1984-04-01

    Intraluminal duodenal pH was recorded using a combined miniature electrode and logged digitally every 10 or 20 seconds for five hours (basal/meal/drink) in eight control subjects and 11 patients with duodenal ulcer (five on and off treatment with cimetidine). Over the whole test there were no significant differences in duodenal mean pH or log mean hydrogen ion activity (LMHa) between control subjects and patients with duodenal ulcer, but there were significantly longer periods of duodenal acidification (pH less than 4) and paradoxically more periods of duodenal alkalinisation (pH greater than 6) in the duodenal ulcer group compared with controls. After a meal duodenal mean pH and LMHa fell significantly in both controls and patients with duodenal ulcer, with more periods of duodenal acidification and alkalinisation in the duodenal ulcer group. An exogenous acid load (Coca-Cola) significantly increased the periods of duodenal acidification, and reduced alkalinisation, in both groups. Cimetidine significantly increased mean pH and LMHa and abolished the brief spikes of acidification in four of five patients with duodenal ulcer. Peak acid output (but not basal acid output) was significantly correlated with duodenal mean pH and LMHa but not with the periods of duodenal acidification. Smoking did not affect duodenal pH in either group.

  14. Duodenal gland cysts and pseudodiverticula in sheep.

    PubMed

    Penadés, Mariola; Guerrero, Irene; Benito-Peña, Alberto; Corpa, Juan M

    2010-07-01

    Six cases of acquired duodenal diverticulitis (pseudodiverticula) were found in a flock of sheep over a short period of time. All the animals had duodenal lesions characterized by the presence of multiple saccular dilations filled with feed material. The mucosal surface was elevated by multiple small nodules that histologically corresponded to cystic dilatations of the duodenal glands, which likely caused the displacement, atrophy, and disappearance of the muscular layer, leading to pseudodiverticula. The gross appearance, microscopic findings, and epidemiological characteristics suggest that this is a different pathological process to that described for diverticula in animals to date.

  15. Open lung biopsy

    MedlinePlus

    Biopsy - open lung ... An open lung biopsy is done in the hospital using general anesthesia , which means you are asleep and pain- ... The open lung biopsy is done to evaluate lung problems seen on x-ray or CT scan .

  16. Bone biopsy (image)

    MedlinePlus

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  17. Muscle biopsy (image)

    MedlinePlus

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  18. Robotic Surgery for Benign Duodenal Tumors

    PubMed Central

    Downs-Canner, Stephanie; Van der Vliet, Wald J.; Thoolen, Stijn J. J.; Boone, Brian A.; Zureikat, Amer H.; Hogg, Melissa E.; Bartlett, David L.; Callery, Mark P.; Kent, Tara S.; Zeh, Herbert J.

    2015-01-01

    Introduction Benign duodenal and periampullary tumors are uncommon lesions requiring careful attention to their complex anatomic relationships with the major and minor papillae as well as the gastric outlet during surgical intervention. While endoscopy is less morbid than open resection, many lesions are not amenable to endoscopic removal. Robotic surgery offers technical advantages above traditional laparoscopy, and we demonstrate the safety and feasibility of this approach for a variety of duodenal lesions. Methods We performed a retrospective review of all robotic duodenal resections between April 2010 and December 2013 from two institutions. Demographic, clinicopathologic, and operative details were recorded with special attention to the post-operative course. Results Twenty-six patients underwent robotic duodenal resection for a variety of diagnoses. The majority (88 %) were symptomatic at presentation. Nine patients underwent transduodenal ampullectomy, seven patients underwent duodenal resection, six patients underwent transduodenal resection of a mass, and four patients underwent segmental duodenal resection. Median operative time was 4 h with a median estimated blood loss of 50 cm3 and no conversions to an open operation. The rate of major Clavien-Dindo grades 3–4 complications was 15 % at post-operative days 30 and 90 without mortality. Final pathology demonstrated a median tumor size of 2.9 cm with a final histologic diagnoses of adenoma (n=13), neuroendocrine tumor (n=6), gastrointestinal stromal tumor (GIST) (n=2), lipoma (n=2), Brunner’s gland hamartoma (n=1), leiomyoma (n=1), and gangliocytic paraganglioma (n=1). Conclusion Robotic duodenal resection is safe and feasible for benign and premalignant duodenal tumors not amenable to endoscopic resection. PMID:25348238

  19. Future directions of duodenal endoscopic submucosal dissection

    PubMed Central

    Matsumoto, Satohiro; Miyatani, Hiroyuki; Yoshida, Yukio

    2015-01-01

    Endoscopic therapies for lesions of the duodenum are technically more difficult than those for lesions of the other parts of the gastrointestinal tract due to the anatomical features of the duodenum, and the incidence rate of complications such as perforation and bleeding is also higher. These aforementioned trends were especially noticeable for the case of duodenal endoscopic submucosal dissection (ESD). The indication for ESD of duodenal tumors should be determined by assessment of the histopathology, macroscopic morphology, and diameter of the tumors. The three types of candidate lesions for endoscopic therapy are adenoma, carcinoma, and neuroendocrine tumors. For applying endoscopic therapies to duodenal lesions, accurate preoperative histopathological diagnosis is necessary. The most important technical issue in duodenal ESD is the submucosal dissection process. In duodenal ESD, a short needle-type knife is suitable for the mucosal incision and submucosal dissection processes, and the Small-caliber-tip Transparent hood is an important tool. After endoscopic therapies, the wound should be closed by clipping in order to prevent complications such as secondary hemorrhage and delayed perforation. At present, the criteria for selection between ESD and EMR vary among institutions. The indications for ESD should be carefully considered. Duodenal ESD should have limitations, such as the need for its being performed by experts with abundant experience in performing the procedure. PMID:25901218

  20. Gastric emptying abnormal in duodenal ulcer

    SciTech Connect

    Holt, S.; Heading, R.C.; Taylor, T.V.; Forrest, J.A.; Tothill, P.

    1986-07-01

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease.

  1. Is a raised intraepithelial lymphocyte count with normal duodenal villous architecture clinically relevant?

    PubMed Central

    Mahadeva, S; Wyatt, J I; Howdle, P D

    2002-01-01

    Background: A raised intraepithelial lymphocyte (IEL) count with normal villous architecture is a recognised finding in latent coeliac disease. Little information is available in cases without gluten sensitive enteropathy in adults. Aims: To assess the frequency of such a finding in routine practice and to determine whether it is clinically relevant. Methods: Patients with subjectively increased IELs as the only abnormality were identified prospectively from a routine duodenal biopsy series over a 12 month period. The biopsy specimens in these index cases were re-examined together with two controls with normal histology for each case, and three counts of IEL/100 epithelial cells were made in all samples. The index cases were then contacted and interviewed to obtain clinical information, approximately 12 months from the initial biopsy. Further data were obtained from their clinical records. Results: Fourteen of 626 (2.2%) patients who had duodenal biopsies over the 12 month period had a subjective increase in IELs with normal villous architecture. Fifteen patients with newly diagnosed gluten sensitive enteropathy were also identified during the study period. Formal counting of the index cases and controls revealed a significant difference in IELs/100 epithelial cell counts between the two (mean, 38 (SD, 6.2) v 12.4 (4.6); p < 0.0001). Three of the 14 index cases tested had a positive coeliac antibody test compared with 12 of 15 newly diagnosed patients with coeliac disease and 10 of 93 patients with normal histology. The major clinical diagnostic categories in raised IEL cases were those with positive coeliac serology (n = 3), unexplained anaemia (n = 3), and chronic liver disease (n = 3). Six of 10 patients who were interviewed had ongoing gastrointestinal symptoms one year later. Three patients had had follow up duodenal biopsies, at the discretion of their responsible clinicians, with no change in IEL counts despite the commencement of a gluten free diet in two

  2. The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

    PubMed Central

    McLean, Carolyn; Gregor, James; Yan, Brian

    2016-01-01

    Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI) complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD), H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations. PMID:27478819

  3. The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy.

    PubMed

    Teriaky, Anouar; AlNasser, Abdullah; McLean, Carolyn; Gregor, James; Yan, Brian

    2016-01-01

    Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI) complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD), H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations. PMID:27478819

  4. Skin biopsy: Biopsy issues in specific diseases.

    PubMed

    Elston, Dirk M; Stratman, Erik J; Miller, Stanley J

    2016-01-01

    Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

  5. Seasonal behaviour of healed duodenal ulcer.

    PubMed

    Gupta, A K; Pal, L S

    1998-04-01

    Incidence of peptic ulcer is more in people living at higher altitude and similarly relapse of healed duodenal ulcer is more in winter season. Seasonal behaviour of healed duodenal ulcer with or without maintenance therapy with H2 blockers was studied among subjects residing around Shimla (approximate altitude 7000 feet above mean sea level). Sixty-four subjects of endoscopically healed duodenal ulcer were alternatively advised placebo (32 subjects) and ranitidine 150 mg (32 subjects) at bed time as maintenance therapy for period of one year. Subjects were reviewed endoscopically and evaluated for H pylori by rapid urease test, every months or earlier if symptomatic. Relapse rate was analysed among 60 subjects at the end of one year. Cumulative relapse rate was found 60% in ranitidine group and 100% in placebo group. In ranitidine group percentage of relapse to number of endoscopic examinations was 21.4% throughout the year, but in placebo group during winter and spring season relapse was 87.5% of endoscopic examination whereas 57.2% during summer and fall season. Incidence of duodenal ulcer relapse without maintenance therapy was more in winter and spring season (October to March) as compared to summer and fall (April to September), whereas intermittent seasonal treatment is efficacious in prevention of duodenal ulcer relapse and also improves cost benefit ratio of ulcer treatment.

  6. Complete duodenogastric reflux: A scintigraphic sign of significant duodenal pathology

    SciTech Connect

    Drane, W.E.; Hanner, J.S. )

    1989-09-01

    Complete reflux of duodenal contents into the stomach with persistent retention on hepatobiliary scintigraphy or radionuclide gastrointestinal bleeding studies is a relatively rare occurrence. Two cases of complete duodenogastric reflux are reported: one case in a patient with a perforated duodenal diverticulum and the other in a patient with an inflamed, bleeding duodenal ulcer. The finding of complete duodenogastric reflux and persistent retention in the stomach should instigate a thorough evaluation for significant duodenal pathology.

  7. From Batteries and Bulbs to High Tech.

    ERIC Educational Resources Information Center

    Schwartz, Maurice L.; Schwartz, Ivan C.

    1986-01-01

    Presents a new, high-technology approach to making bulbs light in series and parallel circuits. Contains diagrams that illustrate the circuit patterns. Provides suggestions for applying the electronic principles that were addressed in the activities. (ML)

  8. Light On the Behavior of Light Bulbs.

    ERIC Educational Resources Information Center

    Armstrong, H. L.

    1985-01-01

    Discusses a problem (on page 523 of "College Physics," by Sears, Zemansky, and Young, published by Addison-Wesley, 1980) concerning light bulbs and resistance. Shows why the assumption of constant resistance is unrealistic and provides guidelines for revision. (DH)

  9. The Amaryllis--From Bulb to Blossom.

    ERIC Educational Resources Information Center

    Radue, Anna K.

    1991-01-01

    Describes the life cycle of the Amaryllis plant from bulb to blossom. Suggests 12 activities in which students monitor plant growth, examine plant parts, make drawings of the plant, and eat flowers of other plants. (MDH)

  10. Optimization of prostate biopsy

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Weir, James; Zhang, Wei; Sesterhenn, Isabell A.; Connelly, Roger R.; Moul, Judd W.; Mun, Seong K.

    1999-05-01

    Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this technique has a significant sampling error. We have developed a novel 3D computer assisted prostate biopsy simulator based upon 201 whole- mounted step-sectioned radical prostatectomy specimens to compare the diagnostic accuracy of various prostate needle biopsy protocols. Computerized prostate models have been developed to accurately depict the anatomy of the prostate and all individual tumor foci. We obtained 18-biopsies of each prostate model to determine the detection rates of various biopsy protocols. As a result, the 10- and 12- pattern biopsy protocols had a 99.0 percent detection rate, while the traditional sextant biopsy protocol rate was only 72.6 percent. The 5-region biopsy protocol had a 90.5 percent detection rate. the lateral sextant pattern revealed a detection rate of 95.5 percent, whereas the 4-pattern lateral biopsy protocol had a 93.5 percent detection rate. Our results suggest that all the biopsy protocols that use laterally placed biopsies based upon the five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Lateral biopsies in the mid and apical zones of the gland are the most important.

  11. Duodenal-mucosal bacteria associated with celiac disease in children.

    PubMed

    Sánchez, Ester; Donat, Ester; Ribes-Koninckx, Carmen; Fernández-Murga, Maria Leonor; Sanz, Yolanda

    2013-09-01

    Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of cereal gluten proteins. This disorder is associated with imbalances in the gut microbiota composition that could be involved in the pathogenesis of CD. The aim of this study was to characterize the composition and diversity of the cultivable duodenal mucosa-associated bacteria of CD patients and control children. Duodenal biopsy specimens from patients with active disease on a gluten-containing diet (n = 32), patients with nonactive disease after adherence to a gluten-free diet (n = 17), and controls (n = 8) were homogenized and plated on plate count agar, Wilkins-Chalgren agar, brain heart agar, or yeast, Casitone, and fatty acid agar. The isolates were identified by partial 16S rRNA gene sequencing. Renyi diversity profiles showed the highest diversity values for active CD patients, followed by nonactive CD patients and control individuals. Members of the phylum Proteobacteria were more abundant in patients with active CD than in the other child groups, while those of the phylum Firmicutes were less abundant. Members of the families Enterobacteriaceae and Staphylococcaceae, particularly the species Klebsiella oxytoca, Staphylococcus epidermidis, and Staphylococcus pasteuri, were more abundant in patients with active disease than in controls. In contrast, members of the family Streptococcaceae were less abundant in patients with active CD than in controls. Furthermore, isolates of the Streptococcus anginosus and Streptococcus mutans groups were more abundant in controls than in both CD patient groups, regardless of inflammatory status. The findings indicated that the disease is associated with the overgrowth of possible pathobionts that exclude symbionts or commensals that are characteristic of the healthy small intestinal microbiota. PMID:23835180

  12. Fluorescent light bulbs - energy saver or environmental hazard?

    SciTech Connect

    Christenson, S.M.

    1995-03-01

    Businesses and homeowners have installed millions of fluorescent light bulbs in buildings around the country in the last few decades. Because fluorescent light bulbs are energy efficient and save electricity, environmentalists and governmental officials - including U.S. EPA - have promoted their use. Yet, fluorescent bulbs raise environmental concerns of their own. When these bulbs burn out, environmental and facility managers face complex issues about whether the old bulbs are regulated as hazardous waste.

  13. [Study of genetic markers of duodenal ulcer].

    PubMed

    Tsimmerman, Ia S; Onosova, E A; Tsimmerman, I Ia

    1989-05-01

    The results of determination of various hereditary predisposition markers in peptic ulcer are given: in the population, in patients with duodenal ulcer and in their siblings (risk group). Of importance for revealing subjects with hereditary predisposition to duodenal ulcer are the clinico-genealogical analysis, determination of the blood group, especially in simultaneous determination of a "secretory status" ("status of non-secretion" of the ABH blood system agglutinogen in the saliva), increase in the mass of parietal cells and, to some extent, of the distinguishing features of dermatoglyphics (in combination with the above markers). Determination of taste sensitivity to phenylthiocarbamide is non-informative. PMID:2770215

  14. Duodenal angiolipoma -- endoscopic diagnosis and therapy.

    PubMed

    Mohl, W; Fischinger, J; Moser, C; Remberger, K; Zeuzem, S; Stallmach, A

    2004-12-01

    We report on two patients with upper gastrointestinal bleeding owing to duodenal angiolipomas, and their endoscopic diagnosis and therapy. In both cases the bleeding source was a pedunculated tumour. Diagnosis and definitive therapy was made by endoscopic snare polypectomy. After stopping the bleeding from the mucosal defect by injection therapy in one patient, the further course was uneventful in both. A colonic angiolipoma in one of the patients was also treated by polypectomy. Gastrointestinal angiolipomas are exceedingly rare, however, these case reports show that duodenal angiolipomas do exist and that they, as lipomas, may lead to substantial gastrointestinal bleeding and may be treated successfully by standard polypectomy techniques.

  15. Cold knife cone biopsy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003910.htm Cold knife cone biopsy To use the sharing features on this page, please enable JavaScript. A cold knife cone biopsy (conization) is surgery to remove ...

  16. Nerve biopsy (image)

    MedlinePlus

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  17. Percutaneous liver biopsy.

    PubMed

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  18. Co-existence of Sarcina Organisms and Helicobacter pylori Gastritis/Duodenitis in Pediatric Siblings

    PubMed Central

    Sauter, Jennifer L.; Nayar, Suresh K.; Anders, Paige D.; D’Amico, Michael; Butnor, Kelly J.; Wilcox, Rebecca L.

    2015-01-01

    Sarcina are gram-positive anaerobic bacteria found to be associated with delayed gastric emptying and gastric outlet obstruction. We describe two cases of Sarcina co-existing with Helicobacter pylori organisms in pediatric siblings presenting within four months of each other with pyloric obstruction secondary to severe gastritis/duodenitis. The co-existence of Sarcina and Helicobacter pylori has not, to our knowledge, been previously reported. Its characteristic tetrad packeted morphology permits Sarcina to be readily identified on routine sections. Detection of these organisms in gastric biopsies should prompt consideration of gastric outlet obstruction and/or delayed gastric emptying as a possible etiologic factor. PMID:25664331

  19. Duodenal neuroendocrine tumor and the onset of severe diabetes mellitus in a US veteran

    PubMed Central

    Murray, Lauren; Haley, Chelsey; Berry-Cabán, Cristóbal S; Toledo, Almond

    2016-01-01

    Objective: Neuroendocrine tumors are neoplasms derived from endocrine cells, most commonly occurring in the gastrointestinal tract. Duodenal neuroendocrine tumors are rare tumors averaging 1.2–1.5 cm, and most are asymptomatic. Common presentation is abdominal pain, upper gastrointestinal bleed, constipation, anemia, and jaundice. Methods: An adult, Black, male patient with newly diagnosed diabetes mellitus presented to the emergency department with elevated liver function test and fatigue. Results: Magnetic resonance cholangiopancreatography demonstrated a large obstructing mass (3.6 cm × 4.4 cm × 3 cm) within the second and third portions of the duodenum at the ampulla. Esophagogastroduodenoscopy demonstrated an ulcerated duodenal mass that was biopsied. Immunohistochemical stains were positive for synaptophysin, chromogranin B, and CK7. Chromogranin A was in normal range. Post-Whipple procedure demonstrated a 5.5 cm × 4.1 cm × 2.9 cm duodenal mass with invasion of the subserosal tissue of the small intestine, a mitotic rate of 2 per high-power field, and antigen Ki-67 of 2%–5%. Conclusion: This case raises the question as to if the patient developed diabetes mellitus due to the tumor size and location or if the new onset of diabetes was coincidental. This case also demonstrates the importance of a proficient history and physical. PMID:27489708

  20. [Clinical and morphological peculiarities of the clinical course of duodenal ulcer in patients with bronchial asthma].

    PubMed

    Cherniaevskaia, G M; Maksimenko, G V; Beloborodova, É I; Ustiuzhanina, E A; Denisova, O A

    2014-01-01

    This work was aimed to study clinical features of H. pylori-associated duodenal ulcer (DU) and elucidate morphological features of gastric mucosa (GM) in patients with bronchial asthma (BA). Simultaneous prospective examination of 118 patients aged 18-64 yr included clinical and endoscopic study of the gastroduodenal region with the assessment of gastroenterological symptoms and morphological analysis of GM and duodenal biopsies by histological, histochemical, and morphometric methods. It was shown that GM inflammation in patients with DU and BA is associated not only with H. pylori infection but also with the phase of BA. Structural changes of GM in the patients with DU and BA, unlike those with DU without BA, were apparent not only in the antrum but also in the fundus. Growing density of eosinophil, neutrophil and mast cell infiltration of fundal and antral GM as well as increased total number of cells in the antrum reflects active immune-mediated inflammation in GM lamina propria. It is concluded that negative effect of uncontrolled BA on the clinical course of DU is not restricted to the association of DU exacerbation with the absence of BA control; it is also responsible for enhanced activity of gastritis. One of the possible factors determining combination of H. pylori-associated duodenal ulcer with BA is chronic hyperergic inflammation and marked structural changes in GM. PMID:25269182

  1. Duodenal Webs: An Experience With 18 Patients

    PubMed Central

    Sharma, Akshay; Sinha, Shalini; Deshpande, Vidyanand Pramod

    2012-01-01

    Aim: To describe the management and outcome of patients with duodenal webs, managed over a period of 12 ½ years in our unit. Methods: It is a retrospective case series of 18 patients with congenital duodenal webs, managed in our unit, between 1999 and 2011. The medical record of these patients was retrieved and analyzed for demographic details, clinical presentation, associated anomalies, and outcome. Results: The median age of presentation was 8 days (range 1 day to 1.5 years). Antenatal diagnosis was made in only 2 (11.1%) patients. The commonest presentation was bilious vomiting. Associated anomalies were present in 8/18 patients, common being malrotation of gut. Down’s syndrome was seen in 2 patients and congenital heart disease in 1 patient. One patient had double duodenal webs. There was a delay in presentation of more than 5 days of life in 11/18 (61%) patients. Three patients who presented beyond neonatal age group had fenestrated duodenal membranes causing partial obstruction. In addition, the diagnosis was missed in patients operated for malrotation elsewhere (n=2), imperforate anus (n=2) and esophageal atresia with tracheo-esophageal fistula (n=1). A lateral duodenotomy with excision of the obstructive membrane was done in all patients. A trans-anastomotic tube (TAT) for enteral feeding was used in 8 patients The mortality rate was 4/18 (22%); the main causes being sepsis, prematurity, very low birth weight and associated congenital anomalies. The mean hospital stay for the 14 survivors was 18 days. Total parental nutrition (TPN) was not given to any patient. Conclusions: Congenital duodenal webs are different as the diagnosis is often missed especially in case of perforated webs. Outcome depends upon the time of presentation and associated anomalies. The use of TAT feeding for nutritional support is an easy alternative to TPN. PMID:26023379

  2. Centrifugal innervation of the mammalian olfactory bulb.

    PubMed

    Matsutani, Shinji; Yamamoto, Noboru

    2008-12-01

    Although it has been known for decades that the mammalian olfactory bulb receives a substantial number of centrifugal inputs from other regions of the brain, relatively few data have been available on the function of the centrifugal olfactory system. Knowing the role of the centrifugal projection and how it works is of critical importance to fully understanding olfaction. The centrifugal fibers can be classified into two groups, a group that release neuromodulators, such as noradrenaline, serotonin, or acetylcholine, and a group originating in the olfactory cortex. Accumulating evidence suggests that centrifugal neuromodulatory inputs are associated with acquisition of odor memory. Because the distribution of the terminals on these fibers is diffuse and widespread, the neuromodulatory inputs must affect diverse subsets of bulbar neurons at the same time. In contrast, knowledge of the role of centrifugal fibers from the olfactory cortical areas is limited. Judging from recent morphological evidence, these fibers may modify the activity of neurons located in sparse and discrete loci in the olfactory bulb. Given the modular organization of the olfactory bulb, centrifugal fibers from the olfactory cortex may help coordinate the activities of restricted subsets of neurons belonging to distinct functional modules in an odor-specific manner. Because the olfactory cortex receives inputs from limbic and neocortical areas in addition to inputs from the bulb, the centrifugal inputs from the cortex can modulate odor processing in the bulb in response to non-olfactory as well as olfactory cues.

  3. Surgical and Medical Treatment of Pyloric and Duodenal Pythiosis in a Dog.

    PubMed

    Dycus, David Lee; Fisher, Cory; Butler, Ryan

    2015-01-01

    A 5 yr old, male, neutered mixed-breed dog was referred for persistent vomiting 2 wk following a pyloric biopsy for a pyloric outflow obstruction. Histopathology at the time of initial surgery was suggestive of pythiosis. Following referral, the dog underwent radical surgical treatment with a Billroth II procedure, partial pancreatectomy, and cholecystoduodenostomy. Histopathology and serology confirmed the diagnosis of pythiosis and medical treatment consisting of itraconazole and terbinafine was started postoperatively. Serology titers were checked again at 8, 12, and 24 wk postoperatively revealing a positive response to treatment and no reoccurrence of pythiosis. Since surgery, the patient experienced waxing and waning elevations of liver values and laparoscopic liver biopsies 10 mo postoperatively revealed hepatic cirrhosis with fibrosis, bile duct hyperplasia, and chronic inflammation. This report documents successful treatment of pyloric/duodenal pythiosis and the long-term (17 mo) consequences associated with the Billroth II, partial pancreatectomy, and biliary rerouting in the dog. PMID:26535457

  4. REGULATOR OF BULB BIOGENESIS1 (RBB1) Is Involved in Vacuole Bulb Formation in Arabidopsis.

    PubMed

    Han, Sang Won; Alonso, Jose M; Rojas-Pierce, Marcela

    2015-01-01

    Vacuoles are dynamic compartments with constant fluctuations and transient structures such as trans-vacuolar strands and bulbs. Bulbs are highly dynamic spherical structures inside vacuoles that are formed by multiple layers of membranes and are continuous with the main tonoplast. We recently carried out a screen for mutants with abnormal trafficking to the vacuole or aberrant vacuole morphology. We characterized regulator of bulb biogenesis1-1 (rbb1-1), a mutant in Arabidopsis that contains increased numbers of bulbs when compared to the parental control. rbb1-1 mutants also contain fewer transvacuolar strands than the parental control, and we propose the hypothesis that the formation of transvacuolar strands and bulbs is functionally related. We propose that the bulbs may function transiently to accommodate membranes and proteins when transvacuolar strands fail to elongate. We show that RBB1 corresponds to a very large protein of unknown function that is specific to plants, is present in the cytosol, and may associate with cellular membranes. RBB1 is involved in the regulation of vacuole morphology and may be involved in the establishment or stability of trans-vacuolar strands and bulbs.

  5. Endoscopic evaluation of celiac disease severity and its correlation with histopathological aspects of the duodenal mucosa

    PubMed Central

    Bonatto, Mauro W.; Kotze, Luiz; Orlandoski, Marcia; Tsuchyia, Ricardo; de Carvalho, Carlos A.; Lima, Doryane; Kurachi, Gustavo; Orso, Ivan R.B.; Kotze, Lorete

    2016-01-01

    Background and study aims: Celiac disease (CD) is a chronic systemic autoimmune disorder affecting genetically predisposed individuals, triggered and maintained by the ingestion of gluten. Triggered and maintained by the ingestion of gluten, celiac disease is a chronic systemic autoimmune disorder affecting genetically predisposed individuals. Persistent related inflammation of the duodenal mucosa causes atrophy architecture detectable on esophagogastroduodenoscopy (EGD) and histopathology. We investigated the association between endoscopic features and histopathological findings (Marsh) for duodenal mucosa in celiac disease patients and propose an endoscopic classification of severity. Patients and methods: Between January 2000 and March 2010, an electronic database containing 34,540 EDGs of patients aged > 14 years was searched for cases of CD. Out of 109 cases, 85 met the inclusion criteria: conventional EGD combined with chromoendoscopy, zoom and biopsy. EGD types 0, I and II corresponds to Marsh grades 0, 1 and 2, respectively, while EGD type III corresponds to Marsh grade 3 and 4. Results: Five patients (5.8 %) were EGD I but not Marsh grade 1; 25 patients (29.4 %) were EGD II, 4 of whom (16 %) were classified as Marsh grade 2; and 55 patients (64.7 %) were EGD III, 51 (92.7 %) of whom were classified as Marsh grades 3 and 4. The Spearman correlation coefficient (r = 0.33) revealed a significant association between the methods (P = 0.002). Conclusions: Changes in the duodenal mucosa detected on EGD were significantly and positively associated with histopathologic findings. The use of chromoendoscopy in addition to conventional EGD enhances changes in the duodenal mucosa and permits diagnosis of CD, even in routine examinations. The proposed endoscopic classification is practical and easily reproducible and provides valuable information regarding disease extension. PMID:27556094

  6. In vitro adhesion of enterotoxigenic Escherichia coli to human intestinal epithelial cells from mucosal biopsies.

    PubMed

    Knutton, S; Lloyd, D R; Candy, D C; McNeish, A S

    1984-05-01

    An adhesion assay with isolated human enterocytes prepared from duodenal biopsies has been developed and tested by using human enterotoxigenic Escherichia coli expressing colonization factor antigens I and II (CFA/I and CFA/II) and type 1 fimbriae. Enterotoxigenic E. coli strains H10407 (CFA/I) and B2C (CFA/II) bound to duodenal enterocytes to a much greater extent (mean of 4.6 and 4.0 bacteria per brush border) than did strain H10407P, a CFA/I- mutant of H10407 (mean of 0.1 bacteria per brush border). Type 1 fimbriae also promoted adhesion of strain H10407P to duodenal enterocytes but attachment was to basolateral rather than brush border surfaces. CFA/I and CFA/II, on the other hand, promoted adhesion only to human enterocyte brush borders.

  7. Intestinal phase of gastric secretion in patients with duodenal ulcer.

    PubMed

    Konturek, S J; Kwiecien, N; Obtułowicz, W; Sito, E; Oleksy, J

    1978-04-01

    In 10 healthy subjects and 10 duodenal ulcer patients the intestinal phase of gastric acid secretion was studied by intraduodenal infusion of a 10% liver extract meal (pH 7) at 400 ml/h for three hours. A gastroduodenal double lumen tube with two balloons was used to block the pylorus and to prevent duodenogastric reflux. Gastric acid response to a duodenal meal of liver extract reached a peak at the end of the first hour of infusion of the extract and was then followed by a relatively well-sustained plateau. When the figure was normalised as a percentage of peak response to pentagastrin it was about 45% in healthy subjects and 63% in duodenal ulcer patients. Serum gastrin concentration increased significantly during a duodenal meal of liver extract only in duodenal ulcer patients and not in healthy subjects. The combination of the duodenal meal of liver extract with pentagastrin infusion resulted in a significantly greater increase in acid output in duodenal ulcer patients than in healthy controls. Duodenal perfusion with a liver extract meal in which the pH was gradually decreased caused a pH-dependent reduction in acid output, but not in serum gastrin, both in the duodenal ulcer patients and in healthy subjects. This study shows that the intestinal phase in man results in a potent gastric acid stimulation which is pH-dependent, greatly augmented by pentagastrin, and more vigorous in duodenal ulcer patients than in healthy controls.

  8. Surgical management of complicated intra-mural duodenal hematoma: A case-report and review of literature

    PubMed Central

    Elmoghazy, Walid; Noaman, Islam; Mahfouz, Ahmed-Emad; Elaffandi, Ahmed; Khalaf, Hatem

    2015-01-01

    Introduction Intramural duodenal hematoma (IDH) is a rare pathological entity that occurs as a complication of trauma, pancreatitis, peptic ulcer disease or endoscopic biopsy procedures. In this report, we present a case of IDH related to a duodenal diverticulum that was complicated by intra-abdominal bleeding and peritonitis. Presentation of case We report a 31-year old male who presented with pancreatitis that was complicated with IDH, as diagnosed using endoscopy and CT scan of the abdomen. The condition was related to a duodenal diverticulum as appears on imaging. The patient was treated conservatively over a course of 1 week when he started to have intra-abdominal bleeding and developed peritonitis. The patient was successfully treated with laparotomy, drainage of intra-abdominal abscess, evacuation of IDH and repair of duodenal perforation. We discuss this case in the context of the current indications of surgery in cases of IDH. Conclusion Despite shift towards conservative management of IDH cases over last few decades, these cases should be handled carefully as they might develop life-threatening complications. PMID:26595897

  9. Neonatal Duodenal Obstruction: A 15-Year Experience

    PubMed Central

    Rattan, Kamal Nain; Singh, Jasbir; Dalal, Poonam

    2016-01-01

    Background: Congenital duodenal obstruction is one of the commonest causes of neonatal intestinal obstruction. We are presenting our 15-year experience by analyzing clinical spectrum and outcome in neonates with duodenal obstruction admitted at our center. Material and Methods: The hospital records of all neonates admitted with duodenal obstruction from June 2000 to June 2015 were reviewed. The patient records were analyzed for antenatal diagnosis, age, sex, clinical presentation, diagnosis, associated anomalies, surgical procedures performed; postoperative morbidity and mortality. We excluded from our study malrotation of gut associated with congenital diaphragmatic hernia and abdominal wall defects. Results: A total of 81 patients were admitted, out of which 56 were males and 25 were females. Polyhydramnios was detected in 24 (30%) pregnancies. Average birth weight was 2.1±1.0Kg and average gestational age was 38 (SD±1) weeks with 17 (21%) preterm neonates. Presenting features were vomiting in 81(100%) which was bilious in 81% and non-bilious in 19%, epigastric fullness in 56 (69%) and dehydration in 18 (22%) and failure to thrive in 16 (19%). Most common cause of obstruction was duodenal atresia in 38 (46.9%), followed by malrotation of gut in 33 (40.7%), and annular pancreas in 4 cases. Depending upon site of location, infra-ampullary obstruction was the most common in 64 (79%), supra-ampullary in 9 (7.4%) and ampullary 8 neonates. Both duodenal atresia and malrotation of gut was present in 4 cases. X-ray abdomen was most commonly used investigation to confirm the diagnosis. All cases were managed surgically by open laparotomy. Eleven (13.5%) patients died due to sepsis and associated congenital anomalies. Conclusion: Congenital duodenal obstruction most commonly presents in early neonatal period with features of upper GIT obstruction like vomiting and epigastrium fullness as in our series. Early antenatal diagnosis and surgical interventions hold the key in

  10. Demonstrating Absorption Spectra Using Commercially Available Incandescent Light Bulbs

    NASA Astrophysics Data System (ADS)

    Birriel, Jennifer J.

    In introductory astronomy courses, I typically introduce the three types of spectra: continuous, absorption line, and emission line. It is standard practice to use an ordinary incandescent light bulb to demonstrate the production of a continuous spectrum, and gas discharge tubes to demonstrate the production of an emission line spectrum. The concept of an absorption spectrum is more difficult for students to grasp. A variety of commercially available light bulbs can be used to demonstrate absorption spectra. Here I discuss the use of specialty incandescent light bulbs to demonstrate the phenomenon of absorption of the continuous spectrum produced by a hot tungsten filament. The bulbs examined include the GE Reveal bulb, yellow anti-insect lights, colored party bulbs, and an incandescent "black light" bulb. The bulbs can be used in a lecture or laboratory setting.

  11. Clinical food hypersensitivity: the relevance of duodenal immunoglobulin E-positive cells.

    PubMed

    Caffarelli, C; Romanini, E; Caruana, P; Street, M E; de' Angelis, G

    1998-10-01

    Owing to poor reliability of laboratory tests, diagnosis of food allergy is based on clinical response to double-blind placebo-controlled food challenge. The aim of the present study was to assess the value of duodenal IgE-positive cells in the diagnosis of food allergy. Thirty-one children with a history of possible food allergy underwent duodenal biopsies, skin prick tests, and measurement of serum IgE antibodies, and were put on an elimination diet followed by food challenge. Open food challenges were performed in patients under 12 mo of age, and double-blind placebo-controlled challenges were for suspected foods. On the basis of clinical food hypersensitivity, patients were divided into two groups. Group 1 consisted of 13 children with food allergy. Thirteen of 20 positive provocations elicited reactions within 12 h from the end of the challenge, seven later. Group 2 was the control group and included 18 patients with negative food challenges. The number of IgE-positive cells in biopsy specimens was significantly more elevated in group 1 with respect to group 2 (153.24 +/- 83.13 versus 18.4 +/- 18.9; p < 0.01). Total serum IgE levels were elevated compared with that of the control group (p < 0.01) and correlated with the number of IgE-positive cells (p < 0.001, r = 0.62). Enhanced IgE-containing cells were found in all delayed reactors, but about one-third had negative skin prick tests or specific serum IgE antibodies to the offending foods. Our results showed that systemic reactions to foods are associated with an IgE-mediated response in the duodenal mucosa. Larger studies would be required to assess the predictive value of an increased number of IgE-positive cells in the diagnosis of allergy to food, especially in children with delayed reactions.

  12. Neoseiulus paspalivorus, a predator from coconut, as a candidate for controlling dry bulb mites infesting stored tulip bulbs.

    PubMed

    Lesna, Izabela; da Silva, Fernando R; Sato, Yukie; Sabelis, Maurice W; Lommen, Suzanne T E

    2014-06-01

    The dry bulb mite, Aceria tulipae, is the most important pest of stored tulip bulbs in The Netherlands. This tiny, eriophyoid mite hides in the narrow space between scales in the interior of the bulb. To achieve biological control of this hidden pest, candidate predators small enough to move in between the bulb scales are required. Earlier experiments have shown this potential for the phytoseiid mite, Neoseiulus cucumeris, but only after the bulbs were exposed to ethylene, a plant hormone that causes a slight increase in the distance between tulip bulb scales, just sufficient to allow this predator to reach the interior part of the bulb. Applying ethylene, however, is not an option in practice because it causes malformation of tulip flowers. In fact, to prevent this cosmetic damage, bulb growers ventilate rooms where tulip bulbs are stored, thereby removing ethylene produced by the bulbs (e.g. in response to mite or fungus infestation). Recently, studies on the role of predatory mites in controlling another eriophyoid mite on coconuts led to the discovery of an exceptionally small phytoseiid mite, Neoseiulus paspalivorus. This predator is able to move under the perianth of coconuts where coconut mites feed on meristematic tissue of the fruit. This discovery prompted us to test N. paspalivorus for its ability to control A. tulipae on tulip bulbs under storage conditions (ventilated rooms with bulbs in open boxes; 23 °C; storage period June-October). Using destructive sampling we monitored predator and prey populations in two series of replicated experiments, one at a high initial level of dry bulb mite infestation, late in the storage period, and another at a low initial dry bulb mite infestation, halfway the storage period. The first and the second series involved treatment with N. paspalivorus and a control experiment, but the second series had an additional treatment in which the predator N. cucumeris was released. Taking the two series of experiments together

  13. Neoseiulus paspalivorus, a predator from coconut, as a candidate for controlling dry bulb mites infesting stored tulip bulbs.

    PubMed

    Lesna, Izabela; da Silva, Fernando R; Sato, Yukie; Sabelis, Maurice W; Lommen, Suzanne T E

    2014-06-01

    The dry bulb mite, Aceria tulipae, is the most important pest of stored tulip bulbs in The Netherlands. This tiny, eriophyoid mite hides in the narrow space between scales in the interior of the bulb. To achieve biological control of this hidden pest, candidate predators small enough to move in between the bulb scales are required. Earlier experiments have shown this potential for the phytoseiid mite, Neoseiulus cucumeris, but only after the bulbs were exposed to ethylene, a plant hormone that causes a slight increase in the distance between tulip bulb scales, just sufficient to allow this predator to reach the interior part of the bulb. Applying ethylene, however, is not an option in practice because it causes malformation of tulip flowers. In fact, to prevent this cosmetic damage, bulb growers ventilate rooms where tulip bulbs are stored, thereby removing ethylene produced by the bulbs (e.g. in response to mite or fungus infestation). Recently, studies on the role of predatory mites in controlling another eriophyoid mite on coconuts led to the discovery of an exceptionally small phytoseiid mite, Neoseiulus paspalivorus. This predator is able to move under the perianth of coconuts where coconut mites feed on meristematic tissue of the fruit. This discovery prompted us to test N. paspalivorus for its ability to control A. tulipae on tulip bulbs under storage conditions (ventilated rooms with bulbs in open boxes; 23 °C; storage period June-October). Using destructive sampling we monitored predator and prey populations in two series of replicated experiments, one at a high initial level of dry bulb mite infestation, late in the storage period, and another at a low initial dry bulb mite infestation, halfway the storage period. The first and the second series involved treatment with N. paspalivorus and a control experiment, but the second series had an additional treatment in which the predator N. cucumeris was released. Taking the two series of experiments together

  14. Management of simultaneous biliary and duodenal obstruction: the endoscopic perspective.

    PubMed

    Baron, Todd H

    2010-09-01

    Obstructive jaundice often develops in patients with unresectable malignancy in and around the head of the pancreas. Duodenal obstruction can also occur in these patients, and usually develops late in the disease course. Palliation of both malignant biliary and duodenal obstruction is traditionally performed with surgical diversion of the bile duct and stomach, respectively. With the advent of nonsurgical palliation of biliary obstruction using endoscopic transpapillary expandable metal stent placement, a similar approach can be used to palliate duodenal obstruction by placement of expandable metal gastroduodenal stents. Endoscopic palliation can be achieved in patients who require relief of both biliary obstruction and duodenal obstruction, although this can be technically difficult to achieve depending on the level of duodenal obstruction in relation to the major papilla. This article reviews the endoscopic approaches for combined palliative relief of malignant biliary and duodenal obstruction.

  15. Flexible bulb large storage box hydrogen maser

    NASA Technical Reports Server (NTRS)

    Reinhardt, V.

    1973-01-01

    The principal limitation on the accuracy of the hydrogen maser as a primary frequency standard has been the irreproducibility of the frequency shift caused by collisions of the radiating atoms with the walls of the vessel containing them. The flexible bulb-large storage box hydrogen maser allows correction for this wall shift within a single device, sidestepping the reproducibility problem, and reducing the frequency error from the wall shift to the level imposed by the device's stability. The principles of the device are discussed including the flexible bulb technique and the complications caused by a multiple region storage bulb. The stability of the device is discussed including a comparison with an ordinary hydrogen maser. Data is presented from a working flexible bulb-large storage box hydrogen maser demonstrating the feasibility of the device and showing some of its operating characteristics. The flexibility of the device is demonstrated by showing how the device's added degrees of freedom allow measurement of parameters unmeasurable in an ordinary hydrogen maser.

  16. If the Sun Were a Light Bulb.

    ERIC Educational Resources Information Center

    Adney, Kenneth J.

    1991-01-01

    An activity in which students compare the sun's brightness with that of a light bulb of known luminosity (in watts) to determine the luminosity of the sun is presented. As an extension, the luminosity value that the student obtains for the sun can also be used to estimate the sun's surface temperature. (KR)

  17. Bone marrow biopsy

    MedlinePlus

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may ... This captures a tiny sample, or core, of bone marrow within the needle. The sample and needle are ...

  18. [Piracetam in combined pathogenetic therapy of recurrent duodenal ulcer].

    PubMed

    Tsimmerman, Ia S; Shchetkin, D I

    2002-01-01

    Duodenal ulcer cure, as a systemic gastroenterologic disease, can be achieved in some patients by the addition of the nootropic drug piracetam to current antisecretory and antihelicobacter therapy. Piracetam corrects vegetative and psychoemotional disorders in duodenal ulcer, normalizes gastric motility, has an antioxidant effect and improves cerebral circulation. An optimal effect on clinico-endoscopic manifestations of recurrent duodenal ulcer was achieved in combination of piracetam with current antisecretory (omeprazole) and antihelicobacter (de-nol, amoxicillin, metronidazole) medicines. Such combination improves both short- and long-term outcomes of duodenal ulcer treatment.

  19. Embryologic and anatomic basis of duodenal surgery.

    PubMed

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

    2000-02-01

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

  20. Spectroscopic Analysis of Today's Compact Fluorescent Light Bulbs

    NASA Astrophysics Data System (ADS)

    Pluhar, Edward

    2012-03-01

    In today's consumer market, there are many different light bulbs that claim to produce `natural' light. In my research, I both quantitatively and qualitatively analyzed this claim. First, utilizing a spectroscope, I compared the spectra emitted by different brands and types of compact fluorescent light (CFL) bulbs to the spectra emitted by the Sun. Once the bulbs were quantitatively analyzed, I proceeded to qualitatively analyze them by exposing subjects to the different bulbs. The subjects were asked to rate the quality of color in different pictures illuminated by each type of CFL. From these tests, I was able to determine the ``best'' CFL bulbs, and conclude whether the health risks associated with CFL bulbs outweigh the cost savings, longevity of the bulbs, and/or quality of light benefits.

  1. Gastrointestinal bleeding as the initial manifestation of a polyarteritis nodosa-associated hepatic artery aneurysm-duodenal fistula--a case report.

    PubMed

    Shuster, Thomas A; Almeida, Jose; Coats, Richard; Kalra, Ajay; Silver, Donald

    2004-01-01

    The authors report an unusual case of upper gastrointestinal bleeding from a hepatic artery aneurysm-duodenal fistula in a 21-year-old male. Arteriography revealed multiple visceral artery aneurysms. Biopsy of the hepatic artery aneurysm (HAA) revealed focal areas of necrosis, medial degeneration, fibrosis, and giant cells. The necrotizing vasculitis plus the multiple visceral aneurysms were highly suggestive of polyarteritis nodosa (PAN). This report reviews the pathophysiology and management of PAN and the diagnosis and management of HAA.

  2. Salivary gland biopsy

    MedlinePlus

    Biopsy - salivary gland ... You have several pairs of salivary glands that drain into your mouth: A major pair in front of the ears (parotid glands) Another major pair beneath your jaw (submandibular ...

  3. Colposcopy - directed biopsy

    MedlinePlus

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy ... also called cervical dysplasia) Cervical warts (infection with human papilloma virus , or HPV) If the biopsy does not determine ...

  4. Mediastinoscopy with biopsy

    MedlinePlus

    ... procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders . Normal Results Biopsies of lymph ... findings may indicate: Hodgkin disease Lung cancer Lymphoma Sarcoidosis The spread of disease from one body part ...

  5. Biopsy catheter (image)

    MedlinePlus

    ... examination, a heart biopsy can be performed. A catheter is carefully threaded into an artery or vein to gain access into the heart. A bioptome (catheter with jaws in its tip) is then introduced. ...

  6. Hearing light from an incandescent bulb

    NASA Astrophysics Data System (ADS)

    Zhu, Zheyuan; Du, Li; Zhang, Youtian; Wang, Sihui; Zhou, Huijun; Gao, Wenli

    2015-01-01

    In this paper, we present an interesting experiment to turn the vibratory light from an incandescent light bulb into audible sound. Inspired by research on the photoacoustic effect (PAE) using lasers, we construct a similar device in an undergraduate physics laboratory with everyday articles including light bulbs, glass beakers and soot. Using our device, a distinct sound is detected and analysed experimentally. Particular attention is paid to the attenuation effect of the acoustic signal, which can be explained by modifying the existing theory and using the adiabatic boundary condition according to the incident light source we use. This demonstration is a comprehensive experiment with the combination of sound, light and heat. The modification on the model can help undergraduate students gain an intuitive understanding of different boundary conditions.

  7. Cure of duodenal ulcer after eradication of Helicobacter pylori.

    PubMed

    George, L L; Borody, T J; Andrews, P; Devine, M; Moore-Jones, D; Walton, M; Brandl, S

    1990-08-01

    Eighty-two patients, whose duodenal ulcers were recurrent or resistant to H2-receptor antagonist therapy, were entered in a treatment protocol of ranitidine followed by a four-week "triple therapy" course to eradicate Helicobacter pylori (HP) infection. The triple therapy consisted of colloidal bismuth subcitrate, tetracycline and metronidazole. Duodenal ulcer healed in all 78 patients available for endoscopy and H. pylori infection was shown to be eliminated in 75 patients (96%) at rebiopsy four weeks after cessation of therapy. In these 75 remaining patients the relapse rates for H. pylori infection and duodenal ulcer were studied endoscopically, yearly and at any recurrence of symptoms. At Year 1, 71 of 73 patients remained free of H. pylori infection (HP-negative) and duodenal ulcer. The corresponding figures subsequently were: Year 2, 57/57; Year 3, 34/34; Year 4, 15/15. No duodenal ulcers recurred in HP-negative patients who were followed for up to four years. Two patients of the original cohort of 75 HP-negative patients were HP-positive with endoscopic duodenitis at 12 months, and one at 36 months, but all were without reulceration. Distorted duodenal caps gradually returned to near-normal appearance in 80% of patients by two years. From this four-year follow-up study we conclude that duodenal ulcer disease will not recur provided the patient remains free of H. pylori.

  8. Duodenal adenocarcinoma in a 10-year-old boy.

    PubMed

    Mohamed, Zouari; Habib, Bouthour; Rabia, Ben Abdallah; Youssef, Hlel; Riath, Ben Malek; Youssef, Gharbi; Nejib, Kaabar

    2014-01-01

    Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed. PMID:24647303

  9. Olfactory bulb encoding during learning under anesthesia

    PubMed Central

    Nicol, Alister U.; Sanchez-Andrade, Gabriela; Collado, Paloma; Segonds-Pichon, Anne; Kendrick, Keith M.

    2014-01-01

    Neural plasticity changes within the olfactory bulb are important for olfactory learning, although how neural encoding changes support new associations with specific odors and whether they can be investigated under anesthesia, remain unclear. Using the social transmission of food preference olfactory learning paradigm in mice in conjunction with in vivo microdialysis sampling we have shown firstly that a learned preference for a scented food odor smelled on the breath of a demonstrator animal occurs under isofluorane anesthesia. Furthermore, subsequent exposure to this cued odor under anesthesia promotes the same pattern of increased release of glutamate and gamma-aminobutyric acid (GABA) in the olfactory bulb as previously found in conscious animals following olfactory learning, and evoked GABA release was positively correlated with the amount of scented food eaten. In a second experiment, multiarray (24 electrodes) electrophysiological recordings were made from olfactory bulb mitral cells under isofluorane anesthesia before, during and after a novel scented food odor was paired with carbon disulfide. Results showed significant increases in overall firing frequency to the cued-odor during and after learning and decreases in response to an uncued odor. Analysis of patterns of changes in individual neurons revealed that a substantial proportion (>50%) of them significantly changed their response profiles during and after learning with most of those previously inhibited becoming excited. A large number of cells exhibiting no response to the odors prior to learning were either excited or inhibited afterwards. With the uncued odor many previously responsive cells became unresponsive or inhibited. Learning associated changes only occurred in the posterior part of the olfactory bulb. Thus olfactory learning under anesthesia promotes extensive, but spatially distinct, changes in mitral cell networks to both cued and uncued odors as well as in evoked glutamate and GABA

  10. B-glucuronidase in duodenal secretions.

    PubMed

    Ayulo, J A; Forrest, G L

    1975-09-01

    Determination of B-glucuronidase activity was carried out in 203 subjects including 60 controls. A modified technic for assaying B-glucuronidase activity was used that employs glass column chromatography and Sephadex. Although the lowest mean value was in the group of patients with cancer of the pancreas, there was wide range of activity of B-glucuronidase in all groups and subgroups and considerable overlap in values between them. It was concluded, therefore, that B-glucuronidase activity assay of the duodenal contents was of no value as a diagnostic test for cancer of the pancreas or for distinguishing between the several diseases affecting the pancreas. PMID:1181924

  11. Duodenal perforation: an unusual complication of sickle cell anemia.

    PubMed

    Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

    2014-01-01

    Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia. PMID:25422692

  12. Molecular pathogenesis of sporadic duodenal cancer.

    PubMed Central

    Achille, A.; Baron, A.; Zamboni, G.; Orlandini, S.; Bogina, G.; Bassi, C.; Iacono, C.; Scarpa, A.

    1998-01-01

    Whether duodenal adenocarcinoma should be considered as a gastrointestinal or as a peripancreatic cancer is a matter of debate, as is the opportunity and type of treatment. We investigated 12 such cancers for the genetic anomalies involved in the pathogenesis of gastrointestinal malignancies, including (a) those occurring in common-type cancers - allelic losses at chromosomes 3p, 5q, 17p and 18q, and Ki-ras and p53 alterations; and (b) those characteristic of mutator-phenotype cancers - microsatellite instability and TGF-betaRII gene mutations. We found Ki-ras and p53 mutations in five (42%) and eight cancers (67%), respectively; chromosome 3p, 5q, 17p and 18q allelic losses in two of nine (22%), six of ten (60%), six of nine (67%) and three of ten (30%) informative cancers, respectively. Finally, three cancers (25%) showed widespread microsatellite instability and two of them had a TGF-betaRII gene mutation. Our data suggest that duodenal cancers may arise from either of the two known pathogenetic molecular pathways of gastric and colorectal cancers. The majority of our cases were highly aggressive cancers with frequent chromosomal changes and p53 mutations as observed in the common-type gastrointestinal malignancies, while widespread subtle alterations characteristic of mutator-phenotype cancers occurred in a minority, which also showed a favourable long-term outcome. Images Figure 1 Figure 2 Figure 3 PMID:9514055

  13. [Results of the morphometric study of endocrine cells of the antral part of the stomach in duodenal ulcer].

    PubMed

    Movchan, K N

    1989-01-01

    The endocrine system of the antrum of the resected stomachs in 19 patients with chronic duodenal ulcer was studied. It is established that a clear view of the hormonal system of the stomach can be formed on the basis of studying the histotopograms, or a large number of biopsy specimens of the gastric mucosa. The hormonal cells can be found in the deep portions of the mucosa, as a rule, in the region of the fundus and body of the glands. The ulcer recurrence after vagotomy not always can be related to hyperplasia of the endocrine cells of the gastric antrum. PMID:2478753

  14. CD1-restricted recognition of exogenous and self-lipid antigens by duodenal gammadelta+ T lymphocytes.

    PubMed

    Russano, Anna M; Bassotti, Gabrio; Agea, Elisabetta; Bistoni, Onelia; Mazzocchi, Alessandro; Morelli, Antonio; Porcelli, Steven A; Spinozzi, Fabrizio

    2007-03-15

    Gammadelta T cells are present in the mucosal intestinal epithelia and secrete factors necessary to maintain tissue integrity. Ags recognized by these cells are poorly defined, although in mice non-classical MHC class I molecules have been implicated. Since MHC class I-like CD1 receptors are widely expressed at the surface of epithelial and dendritic intestinal cells and have the capacity to present lipid Ags to T cells, we hypothesized that these molecules might present autologous and/or exogenous phospholipids to intestinal gammadelta T lymphocytes. Intraepithelial T lymphocytes from normal human duodenal mucosal biopsies were cloned and exposed to natural and synthetic phospholipids using CD1a-, CD1b-, CD1c- or CD1d-transfected C1R lymphoblastoid or HeLa cell lines as APCs. Their cytolytic properties and regulatory cytokine secretion were also examined. Most clones obtained from duodenal mucosa (up to 70%) were TCRalphabeta+, and either CD4+ or CD8+, whereas 20% were CD4-CD8- (6 clones) or TCRgammadelta+ (12 clones). A relevant percentage (up to 66%) of TCRgammadelta+ but few (<5%) TCRalphabeta+ T cell clones responded to synthetic and/or natural phospholipids presented by CD1 molecules, as measured by both [(3)H]thymidine incorporation and IL-4 release assays. A Th1-like cytolytic and functional activity along with the ability to secrete regulatory cytokines was observed in most phospholipid-specific gammadelta T cell clones. Thus, a substantial percentage of TCRgammadelta+ but few TCRalphabeta+ from human duodenal mucosa recognize exogenous phospholipids in a CD1-restricted fashion. This adaptive response could contribute to mucosal homeostasis, but could also favor the emergence of inflammatory or allergic intestinal diseases. PMID:17339459

  15. Temporary duodenal stenting as a bridge to ERCP for inaccessible papilla due to duodenal obstruction: a retrospective study

    PubMed Central

    Donatelli, Gianfranco; Cereatti, Fabrizio; Dumont, Jean-Loup; Dhumane, Parag; Tuszynski, Thierry; Derhy, Serge; Meduri, Alexandre; Vergeau, Bertrand Marie; Meduri, Bruno

    2016-01-01

    Background and study aims: Duodenal obstruction may prevent performance of endoscopic retrograde cholangiopancreatography (ERCP). Percutaneous transhepatic biliary drainage (PTBD) or Endoscopic ultrasonograhy-guided biliary access (EUS-BD) are alternative treatments but are associated with a higher morbidity and mortality rate. The aim of the study is to report overall technical success rate and clinical outcome with deployment of temporary fully or partially covered self-expanding duodenal stent (pc/fcSEMS) as a bridge to ERCP in case of inaccessible papilla due to duodenal strictures. Patients and methods: This retrospective study included 66 consecutive patients presenting with a duodenal stricture impeding the ability to perform an ERCP. Provisional duodenal stenting was performed as a bridge to ERCP. A second endoscopic session was performed to remove the provisional stent and to perform an ERCP. Afterward, a permanent duodenal stent was delivered if necessary. Results: Sixty-six duodenal stents (17 pcSEMS and 49 fcSEMS) were delivered with a median indwelling time of 3.15 (1 – 7) days. Two migrations occurred in the pcSEMS group, 1 of which required lower endoscopy for retrieval. No other procedure-related complications were observed. At second endoscopy a successful ERCP was performed in 56 patients (85 %); 10 patients (15 %) with endoscopic failure underwent PTBD or EUS-BD. Forty patients needed permanent duodenal stenting. Conclusions: Provisional removable covered duodenal stenting as a bridge to ERCP for duodenal obstruction is safe procedure and in most cases allows successful performance of therapeutic ERCP. This technique could be a sound option as a step up approach before referring such cases for more complex techniques such as EUS-BD or PTBD. PMID:27652301

  16. Temporary duodenal stenting as a bridge to ERCP for inaccessible papilla due to duodenal obstruction: a retrospective study

    PubMed Central

    Donatelli, Gianfranco; Cereatti, Fabrizio; Dumont, Jean-Loup; Dhumane, Parag; Tuszynski, Thierry; Derhy, Serge; Meduri, Alexandre; Vergeau, Bertrand Marie; Meduri, Bruno

    2016-01-01

    Background and study aims: Duodenal obstruction may prevent performance of endoscopic retrograde cholangiopancreatography (ERCP). Percutaneous transhepatic biliary drainage (PTBD) or Endoscopic ultrasonograhy-guided biliary access (EUS-BD) are alternative treatments but are associated with a higher morbidity and mortality rate. The aim of the study is to report overall technical success rate and clinical outcome with deployment of temporary fully or partially covered self-expanding duodenal stent (pc/fcSEMS) as a bridge to ERCP in case of inaccessible papilla due to duodenal strictures. Patients and methods: This retrospective study included 66 consecutive patients presenting with a duodenal stricture impeding the ability to perform an ERCP. Provisional duodenal stenting was performed as a bridge to ERCP. A second endoscopic session was performed to remove the provisional stent and to perform an ERCP. Afterward, a permanent duodenal stent was delivered if necessary. Results: Sixty-six duodenal stents (17 pcSEMS and 49 fcSEMS) were delivered with a median indwelling time of 3.15 (1 – 7) days. Two migrations occurred in the pcSEMS group, 1 of which required lower endoscopy for retrieval. No other procedure-related complications were observed. At second endoscopy a successful ERCP was performed in 56 patients (85 %); 10 patients (15 %) with endoscopic failure underwent PTBD or EUS-BD. Forty patients needed permanent duodenal stenting. Conclusions: Provisional removable covered duodenal stenting as a bridge to ERCP for duodenal obstruction is safe procedure and in most cases allows successful performance of therapeutic ERCP. This technique could be a sound option as a step up approach before referring such cases for more complex techniques such as EUS-BD or PTBD.

  17. Characterizations of substrate and enzyme specificity of glucoamylase assays of mucosal starch digestion with determinations of group and single biopsy reference values

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Carbohydrate digesting enzyme activities are measured in duodenal biopsies to detect deficiencies of lactase and sucrase activities, however glucoamylase (GA) assays for starch digestion are not included. Because food starch represents half of energy intake in the human diet, assays for starch diges...

  18. Breast Biopsy System

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Charge Coupled Devices (CCDs) are high technology silicon chips that connect light directly into electronic or digital images, which can be manipulated or enhanced by computers. When Goddard Space Flight Center (GSFC) scientists realized that existing CCD technology could not meet scientific requirements for the Hubble Space Telescope Imagining Spectrograph, GSFC contracted with Scientific Imaging Technologies, Inc. (SITe) to develop an advanced CCD. SITe then applied many of the NASA-driven enhancements to the manufacture of CCDs for digital mammography. The resulting device images breast tissue more clearly and efficiently. The LORAD Stereo Guide Breast Biopsy system incorporates SITe's CCD as part of a digital camera system that is replacing surgical biopsy in many cases. Known as stereotactic needle biopsy, it is performed under local anesthesia with a needle and saves women time, pain, scarring, radiation exposure and money.

  19. Approach to the endoscopic resection of duodenal lesions

    PubMed Central

    Gaspar, Jonathan P; Stelow, Edward B; Wang, Andrew Y

    2016-01-01

    Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection. Brunner’s gland tumors, solitary Peutz-Jeghers polyps, and non-ampullary and ampullary adenomas are mucosally-based duodenal lesions, which can require removal and are typically amenable to endoscopic resection. Several anatomic characteristics of the duodenum make endoscopic resection of duodenal lesions challenging. However, advanced endoscopic techniques exist that enable the resection of large mucosally-based duodenal lesions. Endoscopic papillectomy is not without risk, but this procedure can effectively resect ampullary adenomas and allows patients to avoid surgery, which typically involves pancreaticoduodenectomy. Endoscopic mucosal resection and its variations (such as cap-assisted, cap-band-assisted, and underwater techniques) enable the safe and effective resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum. PMID:26811610

  20. Case of a tumor comprising gastric cancer and duodenal neuroendocrine tumor

    PubMed Central

    Kaneko, Hiroaki; Miyake, Akio; Ishii, Yasuaki; Sue, Soichiro; Miwa, Haruo; Sasaki, Tomohiko; Tamura, Toshihide; Kondo, Masaaki; Maeda, Shin

    2016-01-01

    The present report describes a rare case of a tumor composed of early gastric cancer and a duodenal neuroendocrine tumor (NET). A 78-year-old woman underwent esophagogastroduodenoscopy at a local institution for screening of the upper gastrointestinal tract which revealed a protruded tumor through the pyloric ring from the pyloric antrum. The tumor was too large to treat at the facility; consequently, she was referred to our hospital for further management. Esophagogastroduodenoscopy with tumor biopsy of the lesion revealed the diagnosis of early gastric cancer. Endoscopic submucosal dissection was performed with sufficient free margins in both vertical and horizontal directions. Histopathological findings showed NET confined to the submucosal layer and covered by well-differentiated adenocarcinoma. Immunohistochemical stainings showed that the two lesions existed continuously. While the possibility of a collision cancer was considered, it was suggested that the two lesions existed continuously. Finally, the tumor was diagnosed as gastric cancer composed of duodenal NET G1, with a lymphatic invasion of NET component.

  1. Case of a tumor comprising gastric cancer and duodenal neuroendocrine tumor.

    PubMed

    Kaneko, Hiroaki; Miyake, Akio; Ishii, Yasuaki; Sue, Soichiro; Miwa, Haruo; Sasaki, Tomohiko; Tamura, Toshihide; Kondo, Masaaki; Maeda, Shin

    2016-09-28

    The present report describes a rare case of a tumor composed of early gastric cancer and a duodenal neuroendocrine tumor (NET). A 78-year-old woman underwent esophagogastroduodenoscopy at a local institution for screening of the upper gastrointestinal tract which revealed a protruded tumor through the pyloric ring from the pyloric antrum. The tumor was too large to treat at the facility; consequently, she was referred to our hospital for further management. Esophagogastroduodenoscopy with tumor biopsy of the lesion revealed the diagnosis of early gastric cancer. Endoscopic submucosal dissection was performed with sufficient free margins in both vertical and horizontal directions. Histopathological findings showed NET confined to the submucosal layer and covered by well-differentiated adenocarcinoma. Immunohistochemical stainings showed that the two lesions existed continuously. While the possibility of a collision cancer was considered, it was suggested that the two lesions existed continuously. Finally, the tumor was diagnosed as gastric cancer composed of duodenal NET G1, with a lymphatic invasion of NET component. PMID:27688667

  2. Case of a tumor comprising gastric cancer and duodenal neuroendocrine tumor

    PubMed Central

    Kaneko, Hiroaki; Miyake, Akio; Ishii, Yasuaki; Sue, Soichiro; Miwa, Haruo; Sasaki, Tomohiko; Tamura, Toshihide; Kondo, Masaaki; Maeda, Shin

    2016-01-01

    The present report describes a rare case of a tumor composed of early gastric cancer and a duodenal neuroendocrine tumor (NET). A 78-year-old woman underwent esophagogastroduodenoscopy at a local institution for screening of the upper gastrointestinal tract which revealed a protruded tumor through the pyloric ring from the pyloric antrum. The tumor was too large to treat at the facility; consequently, she was referred to our hospital for further management. Esophagogastroduodenoscopy with tumor biopsy of the lesion revealed the diagnosis of early gastric cancer. Endoscopic submucosal dissection was performed with sufficient free margins in both vertical and horizontal directions. Histopathological findings showed NET confined to the submucosal layer and covered by well-differentiated adenocarcinoma. Immunohistochemical stainings showed that the two lesions existed continuously. While the possibility of a collision cancer was considered, it was suggested that the two lesions existed continuously. Finally, the tumor was diagnosed as gastric cancer composed of duodenal NET G1, with a lymphatic invasion of NET component. PMID:27688667

  3. [Peculiarities of diet therapy in children with duodenal ulcers associated with the genus Candida].

    PubMed

    Malanichevskaia, T G; Narykov, R Kh; Denisova, S N

    2012-01-01

    In children with relapsing DU in 50.8% cases there is a complicated disease course with Candida infection, as evidenced by the positive results of mycological examination of biopsy specimens of duodenal mucosa and detection of circulating Candida antigen in serum. The use in the complex therapy in children with DU associated with Candida species of instant New Zealand goat milk "Amalteya" leads to an overall therapeutic effect in 81.3% cases, which is manifested in the reduction of the duration of relapse 1.4 times prolongation of remission in 3 times and milder disease. Carried out in the dynamics fibrogastroduodenoscopy after treatment showed that 100% of the observed total endoscopic remission which is manifested in the disappearance of opalescent gray overlay on the bottom of the ulcer and ulcer epithelization. PMID:23402178

  4. Improving management of duodenal ulcer disease.

    PubMed Central

    Bateson, M. C.; Diffey, B. L.

    1997-01-01

    Audit of treatment of duodenal ulcer disease has allowed management to improve and keep abreast of rapid advances in care. Eradication of Helicobacter pylori was assessed by 14C urea breath test one to two months after anti-Helicobacter therapy. The old triple therapy regime of bismuth, tetracycline and metronidazole for two weeks was found to be toxic and of low effectiveness (82%). Regimes with lansoprazole for one month and antibiotics for one week gave 90-98% success rates. The best success has been with regimes containing both clarithromycin and a nitro-imidazole. There was complete success in 98% of 109 patients given quadruple therapy with lansoprazole 30 mg daily for one month plus tetracycline 500 mg twice daily, clarithromycin 250 mg twice daily and metronidazole 400 mg twice daily for one week. PMID:9519185

  5. Thyroid storm precipitated by duodenal ulcer perforation.

    PubMed

    Natsuda, Shoko; Nakashima, Yomi; Horie, Ichiro; Ando, Takao; Kawakami, Atsushi

    2015-01-01

    Thyroid storm is a rare and life-threatening complication of thyrotoxicosis that requires prompt treatment. Thyroid storm is also known to be associated with precipitating events. The simultaneous treatment of thyroid storm and its precipitant, when they are recognized, in a patient is recommended; otherwise such disorders, including thyroid storm, can exacerbate each other. Here we report the case of a thyroid storm patient (a 55-year-old Japanese male) complicated with a perforated duodenal ulcer. The patient was successfully treated with intensive treatment for thyroid storm and a prompt operation. Although it is believed that peptic ulcer rarely coexists with hyperthyroidism, among patients with thyroid storm, perforation of a peptic ulcer has been reported as one of the causes of fatal outcome. We determined that surgical intervention was required in this patient, reported despite ongoing severe thyrotoxicosis, and reported herein a successful outcome.

  6. Thyroid gland biopsy (image)

    MedlinePlus

    The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating ... sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During ...

  7. Acute pancreatitis secondary to duodeno-duodenal intussusception caused by a duodenal membrane, in a patient with intestinal malrotation

    PubMed Central

    Larsen, Pernille Oehlenschläger; Ellebæk, Mark Bremholm; Pless, Torsten; Qvist, Niels

    2015-01-01

    Duodeno-duodenal intussusception is often caused by an intraluminal tumour. The condition is rare owing to the retroperitoneal fixation of the duodenum, which is sometime absent in cases of intestinal malrotation. We describe the case of a 19-year old man admitted to hospital with abdominal pain and vomiting. A CT scan revealed a duodeno-duodenal intussusception including the head of the pancreas, which was confirmed by laparotomy. The cause was found to be a duodenal membrane with a pinhole passage combined with non-rotation of the duodenum. PMID:26117447

  8. Duodenal adenoma surveillance in patients with familial adenomatous polyposis

    PubMed Central

    Campos, Fábio Guilherme; Sulbaran, Marianny; Safatle-Ribeiro, Adriana Vaz; Martinez, Carlos Augusto Real

    2015-01-01

    Familial adenomatous polyposis (FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient’s age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion (1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP. PMID:26265988

  9. Relapsed duodenal ulcer after cure of Helicobacter pylori infection.

    PubMed

    Miwa, H; Matsushima, H; Terai, T; Tanaka, H; Kawabe, M; Namihisa, A; Watanabe, S; Sato, N

    1998-08-01

    We report a patient--a 42-year-old man--who had suffered from recurrent duodenal ulcer for about 20 years. Successful curative therapy for Helicobacter pylori infection was performed for 2 weeks with new triple omeprazole, anoxicillin, clarithromycin (OAC) treatment in October 1995, and cure of the infection was repeatedly confirmed by histology, culture, and the 13C urea breath test. One month after the curative therapy, recurrence of a small duodenal ulcer was observed and in February another duodenal ulcer and reflux esophagitis occurred, with severe symptoms, despite the continuous administration of ranitidine. None of the examinations to reconfirm cure of the infection revealed the presence of H. pylori. As the patient experienced continual psychological stress and smoked more frequently during the recurrent episode and had not used nonsteroidal anti-inflammatory drugs, stress and smoking appeared to play important roles in the relapse of duodenal ulcer in this patient after cure of H. pylori infection.

  10. [PRINCIPLES OF POSTOPERATIVE DRUG THERAPY OF COMPLICATED DUODENAL ULCERS].

    PubMed

    Denisova, E V; Nazarov, V E

    2015-01-01

    The article highlights the principles of individualized drug therapy of complicated duodenal ulcers in the postoperative period, based on the removal of the pathophysiological changes that occurred after different types of medical or surgical benefits. PMID:26415272

  11. Pancreatic Anastomosis Leak 15 Years after Simultaneous Pancreas-Kidney Transplantation from Late-Onset Allograft Cytomegalovirus Duodenal Ulcers Presenting with Gross Hematuria

    PubMed Central

    Tantisattamo, Ekamol; Chung, Heath; Okado, Manami

    2013-01-01

    Cytomegalovirus (CMV) infection is one of the most important causes of morbidity and mortality in solid organ transplantation. It can present with hematuria, the most common urological complication in the early post-simultaneous pancreas-kidney (SPK) transplant period. In SPK transplantation, CMV infection usually occurs 1 month after transplantation. We report an instance of bladder-drained SPK transplant presenting with recurrent gross hematuria from CMV infected duodenal graft ulcers 15 years after preserved well-functioning grafts. Serum quantitative Polymerase Chain Reaction (qPCR) for CMV was negative. Postmortem duodenal graft staining for CMV was positive, and revealed the cause of the inciting ulcer. To our knowledge, our patient is the first reported case of very late onset invasive CMV disease causing duodenal graft ulcers 15 years after transplantation, as previously reported cases of posttransplant CMV disease occurred only as late as 18 months. In addition, the absence of correlation between CMV viremia and CMV-infected duodenal allograft in SPK transplant has not been reported. Our case demonstrates that CMV viral load is -unreliable to diagnose invasive CMV disease, and tissue biopsy should be obtained to avoid missed diagnosis causing high morbidity and mortality. PMID:24349888

  12. The "Brightness Rules" Alternative Conception for Light Bulb Circuits

    ERIC Educational Resources Information Center

    Bryan, Joel A.; Stuessy, Carol

    2006-01-01

    An alternative conception for the observed differences in light bulb brightness was revealed during an unguided inquiry investigation in which prospective elementary teachers placed identical bulbs in series, parallel, and combination direct current circuits. Classroom observations, document analyses, and video and audio transcriptions led to the…

  13. Evolution of nonspecific duodenal lymphocytosis over 2 years of follow-up

    PubMed Central

    Losurdo, Giuseppe; Piscitelli, Domenico; Giangaspero, Antonio; Principi, Mariabeatrice; Buffelli, Francesca; Giorgio, Floriana; Montenegro, Lucia; Sorrentino, Claudia; Amoruso, Annacinzia; Ierardi, Enzo; Di Leo, Alfredo

    2015-01-01

    AIM: To assess the evolution of duodenal lymphocytosis (DL), a condition characterized by increased intraepithelial lymphocytes (IELs), over 2 years of follow-up. METHODS: Consecutive patients undergoing upper endoscopy/histology for abdominal pain, diarrhea, weight loss, weakness or other extraintestinal features compatible with celiac disease (CD) were included. Evaluation of IELs infiltrate in duodenal biopsy samples was carried out by CD3-immunohistochemistry and expressed as number of positive cells/100 enterocytes. Diagnostic agreement on the IELs count was tested by calculating the weighted k coefficient. All patients underwent serological detection of autoantibodies associated with CD: IgG and IgA anti-tissue transglutaminase and endomysium. Each patient underwent further investigations to clarify the origin of DL at baseline and/or in the course of 2 years of follow-up every six months. Autoimmune thyroiditis, intestinal infections, parasitic diseases, bacterial intestinal overgrowth, hypolactasia and wheat allergy were detected. Colonoscopy and enteric magnetic resonance imaging were performed when necessary. Risk factors affecting the final diagnosis were detected by multinomial logistic regression and expressed as OR. RESULTS: Eighty-five patients (16 males, 69 females, aged 34.1 ± 12.5 years) were followed up for a mean period of 21.7 ± 11.7 mo. At baseline, endoscopy/duodenal biopsy, CD3 immunohistochemistry revealed: > 25 IELs/100 enterocytes in 22 subjects, 15-25 IELs in 37 and < 15 IELs in 26. They all had negative serum anti-transglutaminase and anti-endomysium, whilst 5 showed IgG anti-gliadin positivity. In the course of follow-up, 23 developed CD seropositivity and gluten sensitivity (GS) was identified in 19. Other diagnoses were: 5 Helicobacter pylori infections, 4 jejunal Crohn’s disease, 1 lymphocytic colitis and 1 systemic sclerosis. The disease in the remaining 32 patients was classified as irritable bowel syndrome because of the lack

  14. Immune cell populations in the duodenal mucosa of cats with inflammatory bowel disease.

    PubMed

    Waly, Nashwa E; Stokes, Christopher R; Gruffydd-Jones, Timothy J; Day, Michael J

    2004-01-01

    The aim of this study was to characterize the phenotype of leukocytes infiltrating the duodenal mucosa of cats with inflammatory bowel disease (IBD) by using immunohistochemistry and computer-aided morphometry to assess whether immunologic markers would aid in characterization of IBD. Frozen and formalin-fixed duodenal biopsies were collected from cats referred for investigation of chronic vomiting, diarrhea, or both (n = 34). Reference ranges were previously established by using duodenal samples from healthy cats (n = 16). No significant difference was found in the number of immunoglobulin G+ (IgG+) or IgA+ in either the villous lamina propria or the crypt lamina propria between cats with IBD and control cats. T cells (CD3+) increased in number from crypt to the tip of the villi in biopsies from both diseased (mean +/- SD for each group was 18.8 +/- 6.6 and 17.7 +/- 4.2 cells/ 10,000 m2 in cryptal areas to 25.2 +/- 9.5 and 29.1 +/- 13.3 cells/10,000m2 in villous areas) and healthy animals (17.9 +/- 3.9 cells/10,000 microm2 in cryptal areas to 24.1 +/- 9.3 cells/10,000 microm2 in villous areas) and no significant difference was found between diseased and control cats. By contrast, major histocompatibility complex (MHC) class II expression by leukocytes with dendritic cell or macrophage morphology in the lamina propria was significantly greater in cats with IBD (13.3 +/- 4.2 cells/10,000 microm2 in cryptal area; P = .016) than in healthy cats (11.9 +/- 3.0 cells/10,000 microm2) and MHC class II expression by enterocytes also was more pronounced in these cats showing an overall intensity of expression of 7.1 +/- 4.0 cells/10,000 microm2 in cats with IBD as opposed to 0.0 +/- 0.0 cells/10,000 microm2 to 0.3 +/- 0.7 cells/10,000 microm2 in healthy cats. These findings suggest that a subtle immunologic dysregulation occurs in spontaneously arising feline IBD.

  15. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  16. [The differentiated phytotherapy of patients with duodenal peptic ulcer].

    PubMed

    Chernomorets, N N; Seleznev, A V; Revutskiĭ, B I; Alifanova, R E; Kravchenko, Z V; Cherkasskaia, E P

    1992-02-01

    Resulted are analysed of complex treatment of 103 patients with duodenal ulcer. Infusions and concoctions of medicinal plants were used. The regimen of administration and composition of the cocktail from herbs depended on the character of gastric secretion and dyskinesia of the gastroduodenal zone as well as on the presence of concomitant diseases; cholecystitis, gastritis, hepatitis, pancreatitis, enterocolitis. Intragastric drip administration of the concoctions and infusions of medicinal plants favour scarring of duodenal ulcers and reduction of the number and duration of recurrences.

  17. Biliopancreatic Diversion with Duodenal Switch: Surgical Technique and Perioperative Care.

    PubMed

    Biertho, Laurent; Lebel, Stéfane; Marceau, Simon; Hould, Frédéric-Simon; Julien, François; Biron, Simon

    2016-08-01

    The goal of this article is to present an overview of selection criteria, surgical technique, and perioperative outcomes of biliopancreatic diversion with duodenal switch. The standard follow-up requirements, including vitamin supplementation, and long-term risks associated with metabolic surgery are also discussed. Most of the data reported here are based on the authors' experience with 4000 biliopancreatic diversions with duodenal switch performed in their institution since 1990.

  18. Preduodenal Portal Vein with Situs Inversus Totalis causing Duodenal Obstruction.

    PubMed

    D'souza, Flavia; Nage, Amol; Bendre, Pradnya

    2016-01-01

    Congenital duodenal obstruction sometimes may be secondary to unusual entities like preduodenal portal vein (PDPV) the identification of which is very important to avoid inadvertent injury or incorrect surgery. A 6-day old neonate presented with congenital duodenal obstruction. Investigations revealed situs inversus totalis with many congenital cardiovascular anomalies. At operation preduodenal portal vein and malrotation were found. Correction of malrotation and bypass duodeno-duodenostomy were done.

  19. Preduodenal Portal Vein with Situs Inversus Totalis causing Duodenal Obstruction

    PubMed Central

    D’souza, Flavia; Bendre, Pradnya

    2016-01-01

    Congenital duodenal obstruction sometimes may be secondary to unusual entities like preduodenal portal vein (PDPV) the identification of which is very important to avoid inadvertent injury or incorrect surgery. A 6-day old neonate presented with congenital duodenal obstruction. Investigations revealed situs inversus totalis with many congenital cardiovascular anomalies. At operation preduodenal portal vein and malrotation were found. Correction of malrotation and bypass duodeno-duodenostomy were done. PMID:27398325

  20. [Non-functional duodenal neuroendocrine neoplasia in the proximal duodenum--case reports and proposal for a "high-risk-/low-risk-concept" in the decision for local endoscopic therapy].

    PubMed

    Scheerer, F; Schmitt, W

    2013-11-01

    Early duodenal neuroendocrine neoplasms (dNENs) are being increasingly diagnosed. Non-functional dNENs in the bulb expressing gastrin are by far the most frequent entity. In the period from 2004 to 2012, 17 cases of 16 patients with NET in the duodenal bulb were evaluated. dNENs of the ampulla of Vater and functional dNEN/gastrinoma were not included due to possibly different malignant potentials. The average age of the patients was 65.7 years, the mean tumour size was 10.2  mm, the maximum proliferation index Ki 67 was 5 % (NET G2). In most cases the maximum depth of invasion was down to the submucosa. In cases of dNEN without risk factors (size up to 10 mm, G1 situation, no invasion of the muscularis propria, no angioinvasion) in 10 out of 11 cases (90.9 %), endoscopic therapy was sufficient. In cases of existing risk factors, sole endoscopic treatment was only possible in 1 out of 5 cases (20 %). In the absence of risk factors in the current follow-up period (mean: 36.7 months) no lymph node metastases were detected. In the presence of risk factors or indications for surgery we found an increase in the rate of lymph node metastases. Our own data indicate that in case of a G2 situation, a tumour size >10  mm or infiltration of the muscularis propria the need for surgical treatment increases significantly for early non-functional dNENs in the duodenal bulb. A high-risk-/low-risk-concept for the endoscopic therapy for early non-functional dNEN has been established.

  1. Broadcasting of cortical activity to the olfactory bulb.

    PubMed

    Boyd, Alison M; Kato, Hiroyuki K; Komiyama, Takaki; Isaacson, Jeffry S

    2015-02-24

    Odor representations are initially formed in the olfactory bulb, which contains a topographic glomerular map of odor molecular features. The bulb transmits sensory information directly to piriform cortex, where it is encoded by distributed ensembles of pyramidal cells without spatial order. Intriguingly, piriform cortex pyramidal cells project back to the bulb, but the information contained in this feedback projection is unknown. Here, we use imaging in awake mice to directly monitor activity in the presynaptic boutons of cortical feedback fibers. We show that the cortex provides the bulb with a rich array of information for any individual odor and that cortical feedback is dependent on brain state. In contrast to the stereotyped, spatial arrangement of olfactory bulb glomeruli, cortical inputs tuned to different odors commingle and indiscriminately target individual glomerular channels. Thus, the cortex modulates early odor representations by broadcasting sensory information diffusely onto spatially ordered bulbar circuits.

  2. Broadcasting of cortical activity to the olfactory bulb.

    PubMed

    Boyd, Alison M; Kato, Hiroyuki K; Komiyama, Takaki; Isaacson, Jeffry S

    2015-02-24

    Odor representations are initially formed in the olfactory bulb, which contains a topographic glomerular map of odor molecular features. The bulb transmits sensory information directly to piriform cortex, where it is encoded by distributed ensembles of pyramidal cells without spatial order. Intriguingly, piriform cortex pyramidal cells project back to the bulb, but the information contained in this feedback projection is unknown. Here, we use imaging in awake mice to directly monitor activity in the presynaptic boutons of cortical feedback fibers. We show that the cortex provides the bulb with a rich array of information for any individual odor and that cortical feedback is dependent on brain state. In contrast to the stereotyped, spatial arrangement of olfactory bulb glomeruli, cortical inputs tuned to different odors commingle and indiscriminately target individual glomerular channels. Thus, the cortex modulates early odor representations by broadcasting sensory information diffusely onto spatially ordered bulbar circuits. PMID:25704808

  3. Antimicrobial and antioxidant effect of methanolic Crinum jagus bulb extract in wound healing

    PubMed Central

    Udegbunam, Sunday Ositadimma; Udegbunam, Rita Ijeoma; Nnaji, Theophilus Okafor; Anyanwu, Madubuike Umunna; Kene, Raphel Okoli Chukwujekwu; Anika, Silavanus Maduka

    2015-01-01

    Aim: The aim of this study was to evaluate the antimicrobial and antioxidant effects of Crinum jagus (J. Thomps.) Dandy methanolic bulb extract in wound healing. Materials and Methods: Phytochemical screening revealed the presence of alkaloids, glycosides, tannins, and saponins in the extract. In vitro antimicrobial activity of the extract was determined by agar well diffusion method. In vivo antimicrobial activity of the extract was determined by microbial assay of excision wound in rats contaminated with Staphylococcus aureus, Bacillus subtilis, Pseudomonas areuginosa, and Candida albicans and treated with 300 mg/kg body weight (bw) of 10 and 5% methanolic C. jagus bulb extract ointment (MCJBEO), respectively. Enzymatic antioxidant effect of the extract was determined in vivo by assaying superoxide dismutase (SOD) and catalase (CAT) activity, and malondialdehyde (MDA) level in excision wound biopsies of rats treated with 10 and 5% MCJBEO, respectively, following standard methods. Non-enzymatic antioxidant effect of the extract was determined in vitro using diphenylpicrylhydrazyl (DPPH) method following standard procedure. Results: The extract exhibited in vitro antimicrobial effect in a concentration-dependent manner with one hundred (100) mg/ml concentration of the extract having the highest inhibitory zone diameter for B. subtilis (25 mm), S. aureus (21 mm), and C. albicans (14 mm) followed by the 50, 25 and 12.5 mg/ml concentrations, respectively. B. subtilis, S. aureus, and C. albicans were not isolated from wounds of animals treated with both extract concentrations 10% and 5% MCJBEO, and reference drug (framycetin sulfate/clotrimazole). Activities of the enzymatic antioxidants SOD and CAT in wound biopsies treated with 10% MCJBEO were significantly (P < 0.05) higher when compared with those treated with 5% MCJBEO. Significantly (P < 0.05) decreased MDA level of wound biopsies from extract-treated rats was observed. The extract exhibited non

  4. Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: a case report

    PubMed Central

    2013-01-01

    Introduction Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of comorbidities and/or concurrent therapies. Case presentation We report the case of a 53-year-old Caucasian man with a history of chronic myeloid leukemia on maintenance therapy (100mg/day) with imatinib who was found to have a subphrenic abscess resulting from a perforated duodenal ulcer that had been clinically overlooked. Our patient was febrile (38.5°C) with abdominal tenderness and hypoactive bowel sounds. On the abdominal plain X-ray films, a right subphrenic abscess could be seen. On contrast-enhanced multi-detector computed tomography, a huge air-fluid collection extending from the subphrenic to the subhepatic anterior space was observed. After oral administration of 500cm3 of 3 percent diluted diatrizoate meglumine, an extraluminal leakage of the water-soluble iodinated contrast media could then be appreciated as a result of a perforated duodenal ulcer. During surgery, the abscess was drained and extensive adhesiolysis had to be performed to expose the duodenal bulb where the ulcer was first identified by methylene blue administration and then sutured. Conclusions While subphrenic abscesses are well known complications of perforated gastric or duodenal ulcers, they have nowadays become rare thanks to advances in both diagnostic and therapeutic strategies for peptic ulcer disease. However, when peptic ulcer disease is not clinically suspected, the contribution of imaging may be substantial. PMID:24215711

  5. Stereotactic (Mammographically Guided) Breast Biopsy

    MedlinePlus

    ... Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type of breast imaging that uses ... the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not ...

  6. Celiac Disease Diagnosis: Endoscopic Biopsy

    MedlinePlus

    ... This is done in a procedure called a biopsy: the physician eases a long, thin tube called ... the tissue using instruments passed through the endoscope. Biopsy of the small intestine is the only way ...

  7. Effect of the hexapeptide dalargin on ornithine decarboxylase activity in the duodenal mucosa of rats with experimental duodenal ulcer

    SciTech Connect

    Yarygin, K.N.; Shitin, A.G.; Polonskii, V.M.; Vinogradov, V.A.

    1987-08-01

    The authors study the effect of dalargin on ornithine decarboxylase in homogenates of the duodenal ulcer from rats with experimental duodenal ulcer induced by cysteamine. Activity of the enzyme was expressed in pmoles /sup 14/CO/sub 2//mg protein/h. Protein was determined by Lowry's method. The findings indicate that stimulation of ornithine decarboxylase and the antiulcerative effect of dalargin may be due to direct interaction of the peptide with cells of the intestinal mucosa and with enterocytes.

  8. Helicobacter pylori and gastric or duodenal ulcer.

    PubMed

    2016-01-01

    In patients with gastric or duodenal ulcer associated with Helicobacter pylori, treatment of the infection improves healing and prevents complications and recurrences. The drug regimen generally consists of a high-dose proton-pump inhibitor (PPI) such as omeprazole plus antibiotics. Using the standard Prescrire methodology, we conducted a review of the literature in order to determine the standard empirical antibiotic regimen for H. pylori infection in adults with gastric or duodenal ulcer in France. In 2015, due to an increase in H. pylori resistance to clarithromycin, a 7-day course of the PPI + clarithromycin + amoxicillin combination is effective in only about 70% of cases. A Cochrane systematic review and meta-analysis of trials involving thousands of patients suggests that prolonging treatment with a PPI + amoxicillin + clarithromycin or a PPI + amoxicillin + metronidazole to 10 or 14 days improves the rate of H. pylori eradication by 5% to 10%. A metanalysis of seven trials including a total of about 1000 patients showed that combination therapy with a PPI + amoxicillin + clarithromycin + metronidazole for 5 days eradicates H. pylori in about 90% of cases, compared to about 80% of cases with a PPI + amoxicillin + clarithromycin given for 7 days. Sequential treatment with amoxicillin for 5 days, followed by clarithromycin + metronidazole for 5 days, has also been tested in thousands of patients. Efficacy and adverse effects were similar to those observed when the same antibiotics were taken simultaneously for 5 days. In randomised trials, replacing clarithromycin or amoxicillin with a fluoroquinolone yielded conflicting results. In 2009, nearly 20% of H. pylori isolates were resistant to levofloxacin in France. Tetracycline has only been evaluated in combination with bismuth. The few available data on doxycycline suggest that its efficacy is similar to that of tetracycline. A fixed-dose combination of bismuth subcitrate potassium + metronidazole

  9. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Help a Friend Who Cuts? Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow Print A A A Text Size What's in ... Risks If You Have Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone ...

  10. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material.

    PubMed

    Shrestha, Bidhan; Hughes, E Richard; Kumar Singh, Raj; Suwal, Pramita; Parajuli, Prakash Kumar; Shrestha, Pragya; Sharma, Arati; Adhikari, Galav

    2015-01-01

    Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration.

  11. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material

    PubMed Central

    Shrestha, Bidhan; Hughes, E. Richard; Kumar Singh, Raj; Suwal, Pramita; Parajuli, Prakash Kumar; Shrestha, Pragya; Sharma, Arati; Adhikari, Galav

    2015-01-01

    Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration. PMID:26491575

  12. Vitamin D-enhanced duodenal calcium transport.

    PubMed

    Wongdee, Kannikar; Charoenphandhu, Narattaphol

    2015-01-01

    For humans and rodents, duodenum is a very important site of calcium absorption since it is exposed to ionized calcium released from dietary complexes by gastric acid. Calcium traverses the duodenal epithelium via both transcellular and paracellular pathways in a vitamin D-dependent manner. After binding to the nuclear vitamin D receptor, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] upregulates the expression of several calcium transporter genes, e.g., TRPV5/6, calbindin-D9k, plasma membrane Ca(2+)-ATPase1b, and NCX1, thereby enhancing the transcellular calcium transport. This action has been reported to be under the regulation of parathyroid-kidney-intestinal and bone-kidney-intestinal axes, in which the plasma calcium and fibroblast growth factor-23 act as negative feedback regulators, respectively. 1,25(OH)2D3 also modulates the expression of tight junction-related genes and convective water flow, presumably to increase the paracellular calcium permeability and solvent drag-induced calcium transport. However, vitamin D-independent calcium absorption does exist and plays an important role in calcium homeostasis under certain conditions, particularly in neonatal period, pregnancy, and lactation as well as in naturally vitamin D-impoverished subterranean mammals.

  13. Detection of Active Epstein-Barr Virus Infection in Duodenal Mucosa of Patients With Refractory Celiac Disease.

    PubMed

    Perfetti, Vittorio; Baldanti, Fausto; Lenti, Marco Vincenzo; Vanoli, Alessandro; Biagi, Federico; Gatti, Marta; Riboni, Roberta; Dallera, Elena; Paulli, Marco; Pedrazzoli, Paolo; Corazza, Gino Roberto

    2016-08-01

    Refractory celiac disease is characterized by mucosal damage in patients with celiac disease despite a gluten-free diet. Little is known about the mechanisms that cause persistent intestinal inflammation in these patients. We performed a case-control study of 17 consecutive patients diagnosed with refractory celiac disease from 2001 through 2014 (median age, 51 y; 10 women) and 24 patients with uncomplicated celiac disease (controls) to determine whether refractory disease is associated with infection by lymphotropic oncogenic viruses. We performed real-time PCR analyses of duodenal biopsy samples from all patients to detect Epstein-Barr virus (EBV), human herpesvirus-8, and human T-cell lymphotropic virus-I, -II, or -III. We used in situ hybridization and immunohistochemical analyses to identify infected cells and viral proteins. We did not detect human herpesvirus-8 or human T-cell lymphotropic viruses in any of the biopsy specimens. However, 12 of 17 (70.5%) biopsy specimens from patients with refractory celiac disease were positive for EBV, compared with 4 of 24 (16.6%) biopsy specimens from controls (P < .001). EBV was detected in inflammatory cells and enterocytes. An analysis of latency- and replication-associated proteins confirmed active infection. Further studies are needed to determine whether EBV infection contributes to the pathogenesis of refractory celiac disease and enteropathy-associated T-cell lymphoma.

  14. Autoradiographic localization of a gluten peptide during organ culture of human duodenal mucosa

    SciTech Connect

    Fluge, G.; Aksnes, L.

    1983-01-01

    An 125I-labeled subfraction of Frazer's fraction III (molecular weight, 8,000) was added to the culture medium during organ culture of duodenal biopsies from two patients with celiac disease in exacerbation. The isotope-labeled gluten peptide was localized by autoradiography after 6, 12, and 24 h of culture. At 6 h, labeling was located mainly in the basal layers of the biopsies. The tissue was well preserved. After 12 h in culture, the labeling had spread to the lamina propria and the crypts. A few grains were located over enterocytes and desquamated cells. Moderate histological signs of toxicity were observed. After 24 h, there was marked toxic deterioration, comparable to that seen after culture with alpha-gliadin. Labeling had spread throughout the entire section. There seemed to be no specificity of the binding, for the entire section was affected. Culture with the identical gluten fraction, in the radionegative state, produced histological deterioration comparable to that seen after exposure to the isotope-labeled peptide. Gluten peptides are presented to the target cells in a unique way during organ culture, different from in vivo conditions. This may influence the results when the organ culture method is used to investigate the pathogenesis of celiac disease.

  15. Effect of Atmospheric Press on Wet Bulb Depression

    NASA Technical Reports Server (NTRS)

    Wheeler, Raymond M.; Stasiak, Michael A.; Lawson, Jamie; Wehkamp, Cara Ann P.; Dixon, Michael A.

    2008-01-01

    Our measurements of wet bulb depression at different pressures matched the modeled adiabatic saturation temps reasonably well. At a dry bulb temp of 25 C, the normal wet bulb temp for 30% RH and 100 kPa is approx.15 C, but this dropped to approx.8 C at 10 kPa. The results suggest that psychrometers need direct calibration at the target pressures or that pressure corrected charts are required. For a given vapour pressure deficit, any moist surfaces, including transpiring plant leaves, will be cooler at lower pressures due to the increased evaporation rates.

  16. The endomyocardial biopsy.

    PubMed

    Schneiderman, H; Hager, W D; Gondos, B

    1986-01-01

    Endomyocardial biopsy (EMB) provides a safe, simple method of gathering unique information. Although the role of EMB continues to evolve rapidly, present consensus includes the following indications, based on the ability of EMB to provide diagnoses unobtainable by other means: assessment of early rejection following cardiac transplantation; determination of myocarditis as etiology of clinically obscure cardiac dysfunction; quantification of chemotherapeutic (especially anthracycline) cardiotoxicity; and distinction between constrictive and restrictive heart disease. Each of these indications carries major therapeutic as well as prognostic implications. Methods of processing EMB are presented, complications listed, artifacts described, findings and uses illustrated, and suggestions for future development addressed briefly.

  17. Telepathology and Optical Biopsy

    PubMed Central

    Ferrer-Roca, Olga

    2009-01-01

    The ability to obtain information about the structure of tissue without taking a sample for pathology has opened the way for new diagnostic techniques. The present paper reviews all currently available techniques capable of producing an optical biopsy, with or without morphological images. Most of these techniques are carried out by physicians who are not specialized in pathology and therefore not trained to interpret the results as a pathologist would. In these cases, the use of telepathology or distant consultation techniques is essential. PMID:20339507

  18. Methodology of stereotactic biopsy.

    PubMed

    Carapella, C M; Mastrostefano, R; Raus, L; Riccio, A

    1989-01-01

    The great technological improvement in the neurosurgical tools and in the neuroradiological imaging has brought about the diffusion of the stereotactic techniques. They are crucial for the diagnosis and treatment of intracranial expanding lesions of small dimensions or located in sites inaccessible to conventional techniques. The Authors describe the most common systems and methodologies for the stereotactic biopsy. They stress the importance of performing serial explorations which can provide evidence of the heterogeneity of the neoplastic lesion and of the infiltration of the brain adjacent to the tumor.

  19. Increased duodenal expression of miR-146a and -155 in pediatric Crohn’s disease

    PubMed Central

    Szűcs, Dániel; Béres, Nóra Judit; Rokonay, Réka; Boros, Kriszta; Borka, Katalin; Kiss, Zoltán; Arató, András; Szabó, Attila J; Vannay, Ádám; Sziksz, Erna; Bereczki, Csaba; Veres, Gábor

    2016-01-01

    AIM: To evaluate the role of microRNA (miR)-146a, -155 and -122 in the duodenal mucosa of pediatric patients with Crohn’s disease (CD) and the effect of transforming growth factor-β (TGF-β) on these miRs in duodenal epithelial and fibroblast cells. METHODS: Formalin-fixed, paraffin-embedded biopsies derived from the macroscopically inflamed (CD inflamed: n = 10) and intact (CD intact: n = 10) duodenal mucosa of pediatric CD patients and control children (C: n = 10) were examined. Expression of miR-146a, -155 and -122 was determined by real-time polymerase-chain reaction (PCR). The expression of the above miRs was investigated in recombinant human TGF-β (1 nmol/L, 24 h) or vehicle treated small intestinal epithelial cells (CCL-241) and primary duodenal fibroblast cells derived from healthy children as well. RESULTS: Expression of miR-146a was significantly higher in the inflamed duodenal mucosa compared to the intact duodenal mucosa of children with CD (CD inflamed: 3.21 ± 0.50 vs CD intact: 0.62 ± 0.26, P ≤ 0.01) and to the control group (CD inflamed: 3.21 ± 0.50 vs C: 1.00 ± 0.33, P ≤ 0.05). The expression of miR-155 was significantly increased in the inflamed region of the duodenum compared to the control group (CD inflamed: 4.87 ± 1.02 vs Control: 1.00 ± 0.40, P ≤ 0.001). The expression of miR-122 was unchanged in the inflamed or intact mucosa of CD patients compared to controls. TGF-β treatment significantly decreased the expression of miR-155 in small intestinal epithelial cells (TGF-β: 0.7 ± 0.083 vs Control: 1 ± 0.09, P ≤ 0.05) and also the expression of miR-146a (TGF-β: 0.67 ± 0.04 vs Control: 1 ± 0.15, P ≤ 0.01) and miR-155 (TGF-β: 0.72 ± 0.09 vs Control: 1 ± 0.06, P ≤ 0.05) in primary duodenal fibroblasts compared to corresponding vehicle treated controls. TGF-β treatment did not influence the expression of miR-122. CONCLUSION: The elevated expression of miR-146a and -155 in the inflamed duodenal mucosa of CD patients

  20. Residue dynamics of tebuconazole and quinalphos in immature onion bulb with leaves, mature onion bulb and soil.

    PubMed

    Mohapatra, Soudamini; Deepa, M; Jagdish, G K

    2011-12-01

    Residue persistence of tebuconazole and quinalphos in immature onion bulb with leaves (spring onion), mature onion bulb and soil was studied following their spray applications 3 times. The applications were untreated control; tebuconazole @ 187.5 and 375 g a.i. ha(-1); quinalphos @ 300 and 600 g a.i. ha(-1). Initial residue deposits of tebuconazole in immature onion bulb with leaves from the two treatments were 0.628 and 1.228 mg kg(-1). The residues of tebuconazole dissipated with the half-life of 5 and 7.7 days. The safe pre-harvest intervals (PHI) for consumption of immature onion bulb with leaves were 16 and 35 days, respectively. Initial residue deposits of quinalphos in immature onion bulb with leaves from the two treatments were 0.864 and 2.283 mg kg(-1). Loss of quinalphos residues from immature onion bulb with leaves was very fast. The residues dissipated with the half-life of 1.7 and 2.6 days and the required PHI was 5 and 11 days, respectively. At harvest mature onion bulbs were free from residues of both tebuconazole and quinalphos.

  1. Social aspects of chronic duodenal ulcer. A case control study.

    PubMed

    Nasiry, R; Piper, D W

    1983-01-01

    A case-control study of 80 patients with duodenal ulcer and 80 community controls was undertaken to compare these two groups regarding social and environmental factors including socio-economic status, marital status, country of birth, childhood and family factors. An increased risk of duodenal ulcer was associated with status incongruity in males; the male patients, when matched on suburb of residence, having lower status occupations than controls, and when matched on occupational status, tending to have lower educational levels than controls. Being unmarried was associated with an increased risk of duodenal ulcer in females. The number of siblings was also a risk factor in the male patients, those with more than 5 siblings being at an increased risk. Factors not associated with duodenal ulcer included country of birth, childhood happiness, sibling sequence and family stability. In conclusion, the factors associated with chronic duodenal ulcer were found predominantly in adult life and could produce their adverse effects by causing chronic stress which may be more relevant than acute stress as produced by major life events.

  2. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    SciTech Connect

    Oh, Jung Suk Lee, Hae Giu Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-10-15

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

  3. Differential Muscarinic Modulation in the Olfactory Bulb

    PubMed Central

    Smith, Richard S.; Hu, Ruilong; DeSouza, Andre; Eberly, Christian L.; Krahe, Krista; Chan, Wilson

    2015-01-01

    Neuromodulation of olfactory circuits by acetylcholine (ACh) plays an important role in odor discrimination and learning. Early processing of chemosensory signals occurs in two functionally and anatomically distinct regions, the main and accessory olfactory bulbs (MOB and AOB), which receive extensive cholinergic input from the basal forebrain. Here, we explore the regulation of AOB and MOB circuits by ACh, and how cholinergic modulation influences olfactory-mediated behaviors in mice. Surprisingly, despite the presence of a conserved circuit, activation of muscarinic ACh receptors revealed marked differences in cholinergic modulation of output neurons: excitation in the AOB and inhibition in the MOB. Granule cells (GCs), the most abundant intrinsic neuron in the OB, also exhibited a complex muscarinic response. While GCs in the AOB were excited, MOB GCs exhibited a dual muscarinic action in the form of a hyperpolarization and an increase in excitability uncovered by cell depolarization. Furthermore, ACh influenced the input–output relationship of mitral cells in the AOB and MOB differently showing a net effect on gain in mitral cells of the MOB, but not in the AOB. Interestingly, despite the striking differences in neuromodulatory actions on output neurons, chemogenetic inhibition of cholinergic neurons produced similar perturbations in olfactory behaviors mediated by these two regions. Decreasing ACh in the OB disrupted the natural discrimination of molecularly related odors and the natural investigation of odors associated with social behaviors. Thus, the distinct neuromodulation by ACh in these circuits could underlie different solutions to the processing of general odors and semiochemicals, and the diverse olfactory behaviors they trigger. SIGNIFICANCE STATEMENT State-dependent cholinergic modulation of brain circuits is critical for several high-level cognitive functions, including attention and memory. Here, we provide new evidence that cholinergic

  4. Management of gastric and duodenal neuroendocrine tumors.

    PubMed

    Sato, Yuichi; Hashimoto, Satoru; Mizuno, Ken-Ichi; Takeuchi, Manabu; Terai, Shuji

    2016-08-14

    Gastrointestinal neuroendocrine tumors (GI-NETs) are rare neoplasms, like all NETs. However, the incidence of GI-NETS has been increasing in recent years. Gastric NETs (G-NETs) and duodenal NETs (D-NETs) are the common types of upper GI-NETs based on tumor location. G-NETs are classified into three distinct subgroups: type I, II, and III. Type I G-NETs, which are the most common subtype (70%-80% of all G-NETs), are associated with chronic atrophic gastritis, including autoimmune gastritis and Helicobacter pylori associated atrophic gastritis. Type II G-NETs (5%-6%) are associated with multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome (MEN1-ZES). Both type I and II G-NETs are related to hypergastrinemia, are small in size, occur in multiple numbers, and are generally benign. In contrast, type III G-NETs (10%-15%) are not associated with hypergastrinemia, are large-sized single tumors, and are usually malignant. Therefore, surgical resection and chemotherapy are generally necessary for type III G-NETs, while endoscopic resection and follow-up, which are acceptable for the treatment of most type I and II G-NETs, are only acceptable for small and well differentiated type III G-NETs. D-NETs include gastrinomas (50%-60%), somatostatin-producing tumors (15%), nonfunctional serotonin-containing tumors (20%), poorly differentiated neuroendocrine carcinomas (< 3%), and gangliocytic paragangliomas (< 2%). Most D-NETs are located in the first or second part of the duodenum, with 20% occurring in the periampullary region. Therapy for D-NETs is based on tumor size, location, histological grade, stage, and tumor type. While endoscopic resection may be considered for small nonfunctional D-NETs (G1) located in the higher papilla region, surgical resection is necessary for most other D-NETs. However, there is no consensus regarding the ideal treatment of D-NETs. PMID:27570419

  5. Management of gastric and duodenal neuroendocrine tumors

    PubMed Central

    Sato, Yuichi; Hashimoto, Satoru; Mizuno, Ken-ichi; Takeuchi, Manabu; Terai, Shuji

    2016-01-01

    Gastrointestinal neuroendocrine tumors (GI-NETs) are rare neoplasms, like all NETs. However, the incidence of GI-NETS has been increasing in recent years. Gastric NETs (G-NETs) and duodenal NETs (D-NETs) are the common types of upper GI-NETs based on tumor location. G-NETs are classified into three distinct subgroups: type I, II, and III. Type I G-NETs, which are the most common subtype (70%-80% of all G-NETs), are associated with chronic atrophic gastritis, including autoimmune gastritis and Helicobacter pylori associated atrophic gastritis. Type II G-NETs (5%-6%) are associated with multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome (MEN1-ZES). Both type I and II G-NETs are related to hypergastrinemia, are small in size, occur in multiple numbers, and are generally benign. In contrast, type III G-NETs (10%-15%) are not associated with hypergastrinemia, are large-sized single tumors, and are usually malignant. Therefore, surgical resection and chemotherapy are generally necessary for type III G-NETs, while endoscopic resection and follow-up, which are acceptable for the treatment of most type I and II G-NETs, are only acceptable for small and well differentiated type III G-NETs. D-NETs include gastrinomas (50%-60%), somatostatin-producing tumors (15%), nonfunctional serotonin-containing tumors (20%), poorly differentiated neuroendocrine carcinomas (< 3%), and gangliocytic paragangliomas (< 2%). Most D-NETs are located in the first or second part of the duodenum, with 20% occurring in the periampullary region. Therapy for D-NETs is based on tumor size, location, histological grade, stage, and tumor type. While endoscopic resection may be considered for small nonfunctional D-NETs (G1) located in the higher papilla region, surgical resection is necessary for most other D-NETs. However, there is no consensus regarding the ideal treatment of D-NETs. PMID:27570419

  6. Topographical representation of odor hedonics in the olfactory bulb.

    PubMed

    Kermen, Florence; Midroit, Maëllie; Kuczewski, Nicola; Forest, Jérémy; Thévenet, Marc; Sacquet, Joëlle; Benetollo, Claire; Richard, Marion; Didier, Anne; Mandairon, Nathalie

    2016-07-01

    Hedonic value is a dominant aspect of olfactory perception. Using optogenetic manipulation in freely behaving mice paired with immediate early gene mapping, we demonstrate that hedonic information is represented along the antero-posterior axis of the ventral olfactory bulb. Using this representation, we show that the degree of attractiveness of odors can be bidirectionally modulated by local manipulation of the olfactory bulb's neural networks in freely behaving mice. PMID:27273767

  7. Acrodynia: exposure to mercury from fluorescent light bulbs

    SciTech Connect

    Tunnessen, W.W. Jr.; McMahon, K.J.; Baser, M.

    1987-05-01

    Medical attention was sought for a 23-month-old toddler because of anorexia, weight loss, irritability, profuse sweating, peeling and redness of his fingers and toes, and a miliarial rash. The diagnosis was mercury poisoning, and an investigation of his environment disclosed that he had been exposed to mercury from broken fluorescent light bulbs. Acrodynia resulting from fluorescent bulbs has not been previously reported.

  8. Duodenal adenocarcinoma: Advances in diagnosis and surgical management

    PubMed Central

    Cloyd, Jordan M; George, Elizabeth; Visser, Brendan C

    2016-01-01

    Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma (DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multi-institutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles. PMID:27022448

  9. Duodenal mucosal protection by bicarbonate secretion and its mechanisms.

    PubMed

    Konturek, S J; Konturek, P C; Pawlik, T; Sliwowski, Z; Ochmański, W; Hahn, E G

    2004-07-01

    Proximal portion of duodenum is exposed to intermittent pulses of gastric H(+) discharged by the stomach. This review summarizes the mechanisms of duodenal mucosal integrity, mainly the role of mucus-alkaline secretion and the mucous barrier protecting surface epithelium against gastric H(+). The mucous barrier protects the leaky duodenal epithelium against each pulse of gastric H(+), which penetrates this barrier and diffuses into duodenocytes, but fails to damage them due to; a) an enhanced expression of cyclooxygenase-1 (COX-1), with release of protective prostaglandins (PG) and of nitric oxide (NO) synthase (NOS) with, however, production of NO, stimulating duodenal HCO(3)(-) secretion and b) the release of several neurotransmitters also stimulating HCO(3)(-) secretion such as vasoactive intestinal peptide (VIP), pituitary adenylate-cyclase activating polypeptide (PACAP), acetylcholine, melatonin, leptin and ghrelin released by enteric nerves and mucosal cells. At the apical duodenocyte membrane at least two HCO(3)(-)/Cl(-) anion exchangers operate in response to luminal H(+) to provide adequate extrusion of HCO(3)(-) into duodenal lumen. In the basolateral portion of duodenocyte membrane, both non-electrogenic (NBC) and electrogenic (NBC(n)) Na(+) HCO(3)(-) cotransporters are activated by the exposure to duodenal acidification, causing inward movement of HCO(3)(-) from extracellular fluid to duodenocytes. There are also at least three Na(+)/H(+) (NHE1-3) amiloride-sensitive exchangers, eliminating H(+)which diffused into these cells. The Helicobacter pylori (Hp) infection and gastric metaplasia in the duodenum with bacterium inoculating metaplastic mucosa and inhibiting HCO(3)(-) secretion by its endogenous inhibitor, asymmetric dimethyl arginine (ADMA), may result in duodenal ulcerogenesis. PMID:15608357

  10. A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

    PubMed Central

    Calhan, Turan; Kahraman, Resul; Soydaş, Barış; Tosun, Ali; Cebeci, Egemen

    2015-01-01

    Duodenal intramural hematoma (DIH) usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders. PMID:26697240

  11. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations

    PubMed Central

    Erden, Ayse; Ustuner, Evren; Uzun, Caglar; Bektas, Mehmet

    2015-01-01

    This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery. PMID:26576112

  12. Duodenal adenocarcinoma presenting as a mass with aneurismal dilatation.

    PubMed

    Mama, Nadia; Ben Slama, Aïda; Arifa, Nadia; Kadri, Khaled; Sriha, Badreddine; Ksiaa, Mehdi; Jemni, Hela; Tlili-Graiess, Kalthoum

    2014-01-01

    Duodenal adenocarcinoma is frequent. Aneurysmal dilatation of the small bowel is reported to be a lymphoma characteristic imaging finding. A 57-year-old male was found to have a duodenal adenocarcinoma with aneurismal dilatation on imaging which is an exceptional feature. On laparotomy, the wall thickening of the dilated duodenum extended to the first jejunal loop, with multiple mesenteric lymph nodes and ascites. Segmental palliative resection with gastro-entero-anastomosis was done. Histopathology revealed a moderately differentiated adenocarcinoma with neuro-endocrine differentiation foci. Wide areas of necrosis and vascular emboli were responsible for the radiological feature of the dilated duodenum with wall thickening.

  13. Renal biopsy: methods and interpretation.

    PubMed

    Vaden, Shelly L

    2004-07-01

    Renal biopsy most often is indicated in the management of dogs and cats with glomerular disease or acute renal failure. Renal biopsy can readily be performed in dogs and cats via either percutaneous or surgical methods. Care should be taken to ensure that proper technique is used. When proper technique is employed and patient factors are properly addressed, renal biopsy is a relatively safe procedure that minimally affects renal function. Patients should be monitored during the post biopsy period for severe hemorrhage, the most common complication. Accurate diagnosis of glomerular disease, and therefore, accurate treatment planning,requires that the biopsy specimens not only be evaluated by light microscopy using special stains but by electron and immunofluorescent microscopy. PMID:15223207

  14. DUODENAL CYTOCHROME B: A NOVEL FERRIREDUCTASE IN AIRWAY EPITHELIAL CELLS

    EPA Science Inventory

    Catalytically active iron in the lung causes oxidative stress and promotes microbial growth that can be limited by intracellular sequestration of iron within ferritin. Because cellular iron uptake requires membrane ferrireductase activity that in the gut can be provided by duoden...

  15. Tubercular duodenal, jejunal and ileocecal stricture in a patient

    PubMed Central

    Sisodiya, Rajesh; Ramachandra, Lingadakai

    2013-01-01

    Gastrointestinal tuberculosis is a major health problem in the developing countries. Duodenal involvement is uncommon and can mimic superior mesenteric artery syndrome. Our case presented as proximal intestinal obstruction had tubercular stricture in the third part of the duodenum, proximal jejunum and ileocecal region, an uncommon and difficult intraoperative situation. PMID:24334467

  16. Combined biliary and duodenal stenting for palliation of pancreatic cancer.

    PubMed

    Profili, S; Feo, C F; Meloni, G B; Strusi, G; Cossu, M L; Canalis, G C

    2003-10-01

    The aim of this case report was to evaluate the usefulness of combined biliary and duodenal stenting in the palliation of pancreatic cancer. We report a series of 4 consecutive patients (2 men and 2 women, mean age 58.5 years, range 38-77 years) who underwent combined biliary and duodenal stenting in our department between March 2000 and April 2001. All patients had cancer of the head of the pancreas causing stricture of the common bile duct and second portion of the duodenum. Biliary and duodenal stents were successfully positioned, with relief of symptoms in all cases. No early complications were observed, except for a transient increase in serum lipase and amylase in one case. Mean follow-up was 7.5 months (range 5-14 months). One patient presenting recurrence of vomiting after 4 months because of tumour overgrowth at the distal edge of the prosthesis was successfully treated by insertion of a partially overlapping second coaxial stent. Combined biliary and duodenal stenting for the palliation of pancreatic cancer was performed safely and successfully. Stents allowed effective re-canalization of the biliary tract and duodenum, relieving both jaundice and vomiting. This procedure should be considered as an alternative to palliative surgery, especially in critically ill patients.

  17. [Duodenal ulcers caused by chloroquine-proguanil association].

    PubMed

    Roux, X; Imbert, P; Rivière, F; Méchaï, F; Rapp, C

    2010-12-01

    Chloroquine-proguanil association is recommended for prophylaxis against falciparum malaria in countries with a low prevalence of chloroquine resistance. It is usually well tolerated with mild side effects consisting mainly of transient digestive discomfort and buccal manifestations (mouth sores or ulcers). The purpose of this report is to describe a case of duodenal ulcers presenting as epigastric pain with 10-kg weight-loss in a 32-year-old man taking chloroquine-proguanil for malaria prophylaxis during a stay in Haiti. No other causes of duodenal ulcers or weight-loss were found. Chloroquine-proguanil prophylaxis was discontinued and replaced by omeprazole for four weeks. Symptoms improved quickly and full recovery was observed within one month. To our knowledge, the occurrence of duodenal ulcers under chloroquine-proguanil association is quite rare, but possibly severe. Upper digestive endoscopy should be performed if a patient under chloroquine-proguanil develops abdominal pain especially in association with weight-loss. If endoscopy reveals duodenal ulcers, chloroquine-proguanil should be discontinued and replaced by another prophylactic regimen.

  18. Management of a large mucosal defect after duodenal endoscopic resection

    PubMed Central

    Fujihara, Shintaro; Mori, Hirohito; Kobara, Hideki; Nishiyama, Noriko; Matsunaga, Tae; Ayaki, Maki; Yachida, Tatsuo; Masaki, Tsutomu

    2016-01-01

    Duodenal endoscopic resection is the most difficult type of endoscopic treatment in the gastrointestinal tract (GI) and is technically challenging because of anatomical specificities. In addition to these technical difficulties, this procedure is associated with a significantly higher rate of complication than endoscopic treatment in other parts of the GI tract. Postoperative delayed perforation and bleeding are hazardous complications, and emergency surgical intervention is sometimes required. Therefore, it is urgently necessary to establish a management protocol for preventing serious complications. For instance, the prophylactic closure of large mucosal defects after endoscopic resection may reduce the risk of hazardous complications. However, the size of mucosal defects after endoscopic submucosal dissection (ESD) is relatively large compared with the size after endoscopic mucosal resection, making it impossible to achieve complete closure using only conventional clips. The over-the-scope clip and polyglycolic acid sheets with fibrin gel make it possible to close large mucosal defects after duodenal ESD. In addition to the combination of laparoscopic surgery and endoscopic resection, endoscopic full-thickness resection holds therapeutic potential for difficult duodenal lesions and may overcome the disadvantages of endoscopic resection in the near future. This review aims to summarize the complications and closure techniques of large mucosal defects and to highlight some directions for management after duodenal endoscopic treatment. PMID:27547003

  19. Congenital duodenal web: successful management with endoscopic dilatation

    PubMed Central

    Poddar, Ujjal; Jain, Vikas; Yachha, Surender Kumar; Srivastava, Anshu

    2016-01-01

    Background and study aims: Congenital duodenal web (CDW) is an uncommon cause of duodenal obstruction and endoscopic balloon dilatation has been reported in just eight pediatric cases to date. Here we are reporting three cases of CDW managed successfully with balloon dilatation. Cases and methods: In 2014 we diagnosed three cases of CDW on the basis of typical radiological and endoscopic findings. Endoscopic balloon dilatation was done under conscious sedation with a through-the-scope controlled radial expansion (CRE) balloon. Results: All three children presented late (median age 8 [range 2 – 9] years) with bilious vomiting, upper abdominal distension, and failure to thrive. One of them had associated Down syndrome and another had horseshoe kidney. In all cases, CDW was observed in the second part of the duodenum beyond the ampulla, causing partial duodenal obstruction. After repeated endoscopic dilatation (2 – 4 sessions), all three patients became asymptomatic. None of the patients experienced complications after balloon dilatation. Conclusions: Duodenal diaphragm should be suspected in patients with abdominal distension with bilious vomiting, even in relatively older children. Endoscopic balloon dilatation is a simple and effective method of treating this condition. PMID:27004237

  20. Treating bilio-duodenal obstruction: combining new endoscopic technique with 6 Fr stent introducer.

    PubMed

    Maetani, Iruru; Nambu, Tomoko; Omuta, Shigefumi; Ukita, Takeo; Shigoka, Hiroaki

    2010-06-14

    Periampullary cancer may cause not only biliary but also duodenal obstructions. In patients with concomitant duodenal obstructions, endoscopic biliary stenting remains technically difficult and may often require percutaneous transhepatic biliary drainage. We describe a method of metal stent placement via a thin forward-viewing endoscope in patients with simultaneous biliary and duodenal obstruction. In two consecutive patients with biliary and duodenal obstruction due to pancreatic cancer, a new biliary metal stent mounted in a slim delivery catheter was placed via a thin forward viewing endoscope after passage across the duodenal stenosis without balloon dilation. In both patients, with our new placement technique, metallic stents were successfully placed in a short time without adverse events. After biliary stenting, one patient received curative resection and the other received duodenal stenting for palliation. Metallic stent placement with a forward-viewing thin endoscope is a beneficial technique, which can avoid percutaneous drainage in patients with bilio-duodenal obstructions due to periampullary cancer.

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

    PubMed Central

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

    2016-01-01

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

  2. Duodenal Toxicity After Fractionated Chemoradiation for Unresectable Pancreatic Cancer

    SciTech Connect

    Kelly, Patrick; Das, Prajnan; Pinnix, Chelsea C.; Beddar, Sam; Briere, Tina; Pham, Mary; Krishnan, Sunil; Delclos, Marc E.; Crane, Christopher H.

    2013-03-01

    Purpose: Improving local control is critical to improving survival and quality of life for patients with locally advanced unresectable pancreatic cancer (LAPC). However, previous attempts at radiation dose escalation have been limited by duodenal toxicity. In order to guide future studies, we analyzed the clinical and dosimetric factors associated with duodenal toxicity in patients undergoing fractionated chemoradiation for LAPC. Methods and Materials: Medical records and treatment plans of 106 patients with LAPC who were treated with chemoradiation between July 2005 and June 2010 at our institution were reviewed. All patients received neoadjuvant and concurrent chemotherapy. Seventy-eight patients were treated with conventional radiation to 50.4 Gy in 28 fractions; 28 patients received dose-escalated radiation therapy (range, 57.5-75.4 Gy in 28-39 fractions). Treatment-related toxicity was graded according to Common Terminology Criteria for Adverse Events, version 4.0. Univariate and multivariate analyses were performed to assess prognostic influence of clinical, pathologic, and treatment-related factors by using Kaplan-Meier and Cox regression methods. Results: Twenty patients had treatment-related duodenal toxicity events, such as duodenal inflammation, ulceration, and bleeding. Four patients had grade 1 events, 8 had grade 2, 6 had grade 3, 1 had grade 4, and 1 had grade 5. On univariate analysis, a toxicity grade ≥2 was associated with tumor location, low platelet count, an absolute volume (cm{sup 3}) receiving a dose of at least 55 Gy (V{sub 55} {sub Gy} > 1 cm{sup 3}), and a maximum point dose >60 Gy. Of these factors, only V{sub 55} {sub Gy} ≥1 cm{sup 3} was associated with duodenal toxicity on multivariate analysis (hazard ratio, 6.7; range, 2.0-18.8; P=.002). Conclusions: This study demonstrates that a duodenal V{sub 55} {sub Gy} >1 cm{sup 3} is an important dosimetric predictor of grade 2 or greater duodenal toxicity and establishes it as a

  3. Loss of intestinal O-glycans promotes spontaneous duodenal tumors.

    PubMed

    Gao, Nan; Bergstrom, Kirk; Fu, Jianxin; Xie, Biao; Chen, Weichang; Xia, Lijun

    2016-07-01

    Mucin-type O-glycans, primarily core 1- and core 3-derived O-glycans, are the major mucus barrier components throughout the gastrointestinal tract. Previous reports identified the biological role of O-glycans in the stomach and colon. However, the biological function of O-glycans in the small intestine remains unknown. Using mice lacking intestinal core 1- and core 3-derived O-glycans [intestinal epithelial cell C1galt1(-/-);C3GnT(-/-) or double knockout (DKO)], we found that loss of O-glycans predisposes DKO mice to spontaneous duodenal tumorigenesis by ∼1 yr of age. Tumor incidence did not increase with age; however, tumors advanced in aggressiveness by 20 mo. O-glycan deficiency was associated with reduced luminal mucus in DKO mice before tumor development. Altered intestinal epithelial homeostasis with enhanced baseline crypt proliferation characterizes these phenotypes as assayed by Ki67 staining. In addition, fluorescence in situ hybridization analysis reveals a significantly lower bacterial burden in the duodenum compared with the large intestine. This phenotype is not reduced with antibiotic treatment, implying O-glycosylation defects, rather than bacterial-induced inflammation, which causes spontaneous duodenal tumorigenesis. Moreover, inflammatory responses in DKO duodenal mucosa are mild as assayed with histology, quantitative PCR for inflammation-associated cytokines, and immunostaining for immune cells. Importantly, inducible deletion of intestinal O-glycans in adult mice leads to analogous spontaneous duodenal tumors, although with higher incidence and heightened severity compared with mice with O-glycans constitutive deletion. In conclusion, these studies reveal O-glycans within the small intestine are critical determinants of duodenal cancer risk. Future studies will provide insights into the pathogenesis in the general population and those at risk for this rare but deadly cancer.

  4. Radioinhibition process in Argentinian garlic and onion bulbs

    NASA Astrophysics Data System (ADS)

    Curzio, O. A.; Croci, C. A.

    Technological aspects of garlic and onion bulbs subjected to the radioinhibition process and extended storage under warehouse conditions were studied. Garlic and onion of the "Colorado" and "Valenciana sintética 14" varieties respectively, were irradiated in dormancy period with an average dose of 50.0 Gy of 60Co gamma rays and kept in storage up to ten months post-harvest. Throughout the control period (180-300 days post-harvest) obvious benefits were attained as to reducing the weight loss and increasing the percentage of marketable bulbs. In general, the irradiated bulbs were superior to the non-irradiated ones with regard to the external aspect, firmness and internal aspect, while the odor of the bulbs was not affected by the process. The radioinhibition process does not seem to affect adversely the levels of dry matter, carbohydrates and ascorbic acid as well as the acidity in onion bulbs. In two marketing trials a very favourable reception was perceived in the consumer public regarding the quality of the products. These studies have promoted the construction of a multipurpose irradiation facility in the Universidad Nacional del Sur for the development of the radiation processing technology.

  5. The GLOBE Soil Moisture Campaign's Light Bulb Oven

    NASA Astrophysics Data System (ADS)

    Whitaker, M. P.; Tietema, D.; Ferre, T. P.; Nijssen, B.; Washburne, J.

    2003-12-01

    The GLOBE Soil Moisture Campaign (SMC) (www.hwr.arizona.edu/globe/sci/SM/SMC) has developed a light bulb oven to provide a low budget, low-technology method for drying soil samples. Three different soils were used to compare the ability of the light bulb oven to dry soils against a standard laboratory convection oven. The soils were: 1) a very fine sandy loam (the "Gila" soil); 2) a silty clay (the "Pima" soil); and 3) a sandy soil (the "Sonoran" soil). A large batch of each soil was wetted uniformly in the laboratory. Twelve samples of each soil were placed in the light bulb oven and twelve samples were placed in the standard oven. The average gravimetric soil moisture of the Gila soil was 0.214 g/cm3 for both ovens; the average Pima soil moisture was 0.332 g/cm3 and 0.331 g/cm3 for the traditional and light bulb ovens, respectively; and the Sonoran soil moisture was 0.077 g/cm3 for both ovens. These results demonstrate that the low technology light-bulb oven was able to dry the soil samples as well as a standard laboratory oven, offering the ability to make gravimetric water content measurements when a relatively expensive drying oven is not available.

  6. Distribution of prostaglandins in gastric and duodenal mucosa of healthy subjects and duodenal ulcer patients: effects of aspirin and paracetamol.

    PubMed

    Konturek, S J; Obtulowicz, W; Sito, E; Oleksy, J; Wilkon, S; Kiec-Dembinska, A

    1981-04-01

    The distribution of mucosal PGE2-like activity was determined by bioassay technique in the body and antrum of the stomach and in the duodenum of healthy subjects and duodenal ulcer patients before and after administration of aspirin, paracetamol, or histamine. In healthy subjects, the oxyntic, antral and duodenal mucosa was found to be capable of generating large amounts of PGE2, which were not significantly different from those found in duodenal ulcer patients. No correlation was found between the generation of PGE2 and gastric acid secretory status or serum gastrin level. Aspirin-and to a much lesser extent, paracetamol-caused a dramatic reduction in the ability of the gastric mucosa to biosynthesis PGE2 and this was accompanied by marked side-effects and injury to the gastric mucosa. Administration of histamine caused small but significant reduction in the biosynthesis of PGE2 but it was accompanied by marked mucosal damage. This study indicates that the gastric and duodenal mucosa is capable of generating PGE2-like activity which may be involved in the mechanism that protects the mucosa against the damage caused by aspirin.

  7. Management of maxillectomy defect with a hybrid hollow bulb obturator.

    PubMed

    Singh, Kamleshwar; Singh, Saumyendra V; Mishra, Niraj; Agrawal, Kaushal Kishor

    2013-01-01

    A woman having already undergone maxillectomy came to the department complaining of difficulty in eating and speech. During the construction of an obturator, the bulb area should be hollowed to reduce weight so that the teeth and supporting tissues are not stressed unnecessarily. The conventional open design drains fluid from the adjacent mucosa, possibly increasing the weight of the prosthesis, and is difficult to clean. The closed bulb design does not drain secretions and may cause obstruction and susceptibility to infection in the paranasal and pharyngeal regions, though it is easier to maintain. An alternative to the two designs, combining their advantages, is presented in this report. As the open hollow part of the obturator was shallow, it was easy to clean. Making the inferior part of the bulb hollow and closed led to a reduction in the overall weight of the prosthesis while increasing its resonance. PMID:23436886

  8. Radiation Dose-Volume Effects and the Penile Bulb

    SciTech Connect

    Roach, Mack; Nam, Jiho; Gagliardi, Giovanna; El Naqa, Issam; Deasy, Joseph O.; Marks, Lawrence B.

    2010-03-01

    The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulb may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.

  9. Parvalbumin-expressing interneurons linearly control olfactory bulb output

    PubMed Central

    Kato, Hiroyuki K.; Gillet, Shea N.; Peters, Andrew J.; Isaacson, Jeffry S.; Komiyama, Takaki

    2013-01-01

    SUMMARY In the olfactory bulb, odor representations by principal mitral cells are modulated by local inhibitory circuits. While dendrodendritic synapses between mitral and granule cells are typically thought to be a major source of this modulation, the contributions of other inhibitory neurons remain unclear. Here we demonstrate the functional properties of olfactory bulb parvalbumin-expressing interneurons (PV cells) and identify their important role in odor coding. Using paired recordings, we find that PV cells form reciprocal connections with the majority of nearby mitral cells, in contrast to the sparse connectivity between mitral and granule cells. In vivo calcium imaging in awake mice reveals that PV cells are broadly tuned to odors. Furthermore, selective PV cell inactivation enhances mitral cell responses in a linear fashion while maintaining mitral cell odor preferences. Thus, dense connections between mitral and PV cells underlie an inhibitory circuit poised to modulate the gain of olfactory bulb output. PMID:24239124

  10. Atomic hydrogen maser active oscillator cavity and bulb design optimization

    NASA Technical Reports Server (NTRS)

    Peters, H. E.; Washburn, P. J.

    1984-01-01

    The performance characteristics and reliability of the active oscillator atomic hydrogen maser depend upon oscillation parameters which characterize the interaction region of the maser, the resonant cavity and atom storage bulb assembly. With particular attention to use of the cavity frequency switching servo (1) to reduce cavity pulling, it is important to maintain high oscillation level, high atomic beam flux utilization efficiency, small spin exchange parameter and high cavity quality factor. It is also desirable to have a small and rigid cavity and bulb structure and to minimize the cavity temperature sensitivity. Curves for a novel hydrogen maser cavity configuration which is partially loaded with a quartz dielectric cylinder and show the relationships between cavity length, cavity diameter, bulb size, dielectric thickness, cavity quality factor, filling factor and cavity frequency temperature coefficient are presented. The results are discussed in terms of improvement in maser performance resulting from particular design choices.

  11. Parvalbumin-expressing interneurons linearly control olfactory bulb output.

    PubMed

    Kato, Hiroyuki K; Gillet, Shea N; Peters, Andrew J; Isaacson, Jeffry S; Komiyama, Takaki

    2013-12-01

    In the olfactory bulb, odor representations by principal mitral cells are modulated by local inhibitory circuits. While dendrodendritic synapses between mitral and granule cells are typically thought to be a major source of this modulation, the contributions of other inhibitory neurons remain unclear. Here we demonstrate the functional properties of olfactory bulb parvalbumin-expressing interneurons (PV cells) and identify their important role in odor coding. Using paired recordings, we find that PV cells form reciprocal connections with the majority of nearby mitral cells, in contrast to the sparse connectivity between mitral and granule cells. In vivo calcium imaging in awake mice reveals that PV cells are broadly tuned to odors. Furthermore, selective PV cell inactivation enhances mitral cell responses in a linear fashion while maintaining mitral cell odor preferences. Thus, dense connections between mitral and PV cells underlie an inhibitory circuit poised to modulate the gain of olfactory bulb output. PMID:24239124

  12. Bone biopsy in haematological disorders.

    PubMed Central

    Burkhardt, R; Frisch, B; Bartl, R

    1982-01-01

    Bone marrow biopsies are now widely used in the investigation and follow-up of many diseases. Semi-thin sections of 8216 undecalcified biopsies of patients with haematological disorders were studied. Observations were made on the cytopenias and the myelodysplastic syndromes, the acute leukaemias the myeloproliferative disorders, Hodgkin's disease and the malignant lymphomas including multiple myeloma, hairy cell leukaemia and angioimmunoblastic lymphadenopathy. Bone marrow biopsies are essential for the differential diagnosis of most cytopenias and for the early recognition of fibrosis which most frequently occurred as a consequence of megakaryocytic proliferation in the myeloproliferative disorders. Different patterns of bone marrow involvement were found in the lymphoproliferative disorders and both their type and extent constituted factors of prognostic significance. A survey of the literature is given and the conclusion is drawn that bone marrow biopsies provide indispensible information for the diagnostic evaluation and the follow-up of patients with haematological disorders. Images PMID:7040489

  13. Gram stain of tissue biopsy

    MedlinePlus

    ... stain of tissue biopsy test involves using crystal violet stain to test a sample of tissue taken ... microscope slide. The specimen is stained with crystal violet stain and goes through more processing before it ...

  14. Experience with transjugular liver biopsy.

    PubMed Central

    Bull, H J; Gilmore, I T; Bradley, R D; Marigold, J H; Thompson, R P

    1983-01-01

    The results of 193 transjugular liver biopsies performed with a modified needle are described. An adequate specimen was obtained in 97%, and complications were rare, although puncture of the liver capsule does occur and caused bleeding in two patients. Fever after the procedure was reduced by ultrasonic cleaning of the needle. Although not easy, this technique is safe and preferable in the management of selected patients, but in most patients percutaneous biopsy is to be preferred. PMID:6629116

  15. Foot Pad Skin Biopsy in Mouse Models of Hereditary Neuropathy

    PubMed Central

    Dacci, Patrizia; Dina, Giorgia; Cerri, Federica; Previtali, Stefano Carlo; Lopez, Ignazio Diego; Lauria, Giuseppe; Feltri, Maria Laura; Bolino, Alessandra; Comi, Giancarlo; Wrabetz, Lawrence; Quattrini, Angelo

    2010-01-01

    Numerous transgenic and knockout mouse models of human hereditary neuropathies have become available over the past decade. We describe a simple, reproducible, and safe biopsy of mouse skin for histopathological evaluation of the peripheral nervous system (PNS) in models of hereditary neuropathies. We compared the diagnostic outcome between sciatic nerve and dermal nerves found in skin biopsy (SB) from the hind foot. A total of five animal models of different Charcot-Marie-Tooth neuropathies, and one model of congenital muscular dystrophy associated neuropathy were examined. In wild type mice, dermal nerve fibers were readily identified by immunohistochemistry, light, and electron microscopy and they appeared similar to myelinated fibers in sciatic nerve. In mutant mice, SB manifested myelin abnormalities similar to those observed in sciatic nerves, including hypomyelination, onion bulbs, myelin outfolding, redundant loops, and tomacula. In many strains, however, SB showed additional abnormalities—fiber loss, dense neurofilament packing with lower phosphorylation status, and axonal degeneration—undetected in sciatic nerve, possibly because SB samples distal nerves. SB, a reliable technique to investigate peripheral neuropathies in human beings, is also useful to investigate animal models of hereditary neuropathies. Our data indicate that SB may reveal distal axonal pathology in mouse models and permits sequential follow-up of the neuropathy in an individual mouse, thereby reducing the number of mice necessary to document pathology of the PNS. © 2010 Wiley-Liss, Inc. PMID:20878767

  16. Early rupture of an ultralow duodenal stump after extended surgery for gastric cancer with duodenal invasion managed by tube duodenostomy and cholangiostomy.

    PubMed

    Blouhos, Konstantinos; Boulas, Konstantinos A; Konstantinidou, Anna; Salpigktidis, Ilias I; Katsaouni, Stavroula P; Ioannidis, Konstantinos; Hatzigeorgiadis, Anestis

    2013-01-01

    When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula. PMID:24159410

  17. The relationship of mucosal bacteria to duodenal histopathology, cytokine mRNA, and clinical disease activity in cats with inflammatory bowel disease.

    PubMed

    Janeczko, S; Atwater, D; Bogel, E; Greiter-Wilke, A; Gerold, A; Baumgart, M; Bender, H; McDonough, P L; McDonough, S P; Goldstein, R E; Simpson, K W

    2008-04-01

    Feline inflammatory bowel disease (IBD) is the term applied to a group of poorly understood enteropathies that are considered a consequence of uncontrolled intestinal inflammation in response to a combination of elusive environmental, enteric microbial, and immunoregulatory factors in genetically susceptible cats. The present study sought to examine the relationship of mucosal bacteria to intestinal inflammation and clinical disease activity in cats with inflammatory bowel disease. Duodenal biopsies were collected from 27 cats: 17 undergoing diagnostic investigation of signs of gastrointestinal disease, and 10 healthy controls. Subjective duodenal histopathology ranged from normal (10), through mild (6), moderate (8), and severe (3) IBD. The number and spatial distribution of mucosal bacteria was determined by fluorescence in situ hybridization with probes to 16S rDNA. Mucosal inflammation was evaluated by objective histopathology and cytokine profiles of duodenal biopsies. The number of mucosa-associated Enterobacteriaceae was higher in cats with signs of gastrointestinal disease than healthy cats (P<0.001). Total numbers of mucosal bacteria were strongly associated with changes in mucosal architecture (P<0.001) and the density of cellular infiltrates, particularly macrophages (P<0.002) and CD3(+)lymphocytes (P<0.05). The number of Enterobacteriaceae, E. coli, and Clostridium spp. correlated with abnormalities in mucosal architecture (principally atrophy and fusion), upregulation of cytokine mRNA (particularly IL-1, -8 and -12), and the number of clinical signs exhibited by the affected cats. These data establish that the density and composition of the mucosal flora is related to the presence and severity of intestinal inflammation in cats and suggest that mucosal bacteria are involved in the etiopathogenesis of feline IBD.

  18. Duodenal injury post laparoscopic cholecystectomy: Incidence, mechanism, management and outcome

    PubMed Central

    Machado, Norman Oneil

    2016-01-01

    AIM: To study the etiopathogenesis, management and outcome of duodenal injury post laparoscopic cholecystectomy (LC). METHODS: A Medline search was carried out for all articles in English, on duodenal injury post LC, using the search word duodenal injury and LC. The cross references in these articles were further searched, for potential articles on duodenal injury, which when found was studied. Inclusion criteria included, case reports, case series, and reviews. Articles even with lack of details with some of the parameters studied, were also analyzed. The study period included all the cases published till January 2015. The data extracted were demographic details, the nature and day of presentation, potential cause for duodenal injury, site of duodenal injury, investigations, management and outcome. The model (fixed or random effect) for meta analyses was selected, based on Q and I2 statistics. STATA software was used to draw the forest plot and to compute the overall estimate and the 95%CI for the time of detection of injury and its outcome on mortality. The association between time of detection of injury and mortality was estimated using χ2 test with Yate’s correction. Based on Kaplan Meier survival curve concept, the cumulative survival probabilities at various days of injury was estimated. RESULTS: Literature review detected 74 cases of duodenal injury, post LC. The mean age of the patients was 58 years (23-80 years) with 46% of them being males. The cause of injury was due to cautery (46%), dissection (39%) and due to retraction (14%). The injury was noted on table in 46% of the cases. The common site of injury was to the 2nd part of the duodenum with 46% above the papilla and 15% below papilla and in 31% to the 1st part of duodenum. Duodenorapphy (primary closure) was the predominant surgical intervention in 63% with 21% of these being carried out laparoscopically. Other procedures included, percutaneous drainage, tube duodenostomy, gastric resection

  19. [Prevention and complex treatment of duodenal stump incompetence].

    PubMed

    Salikhov, I A; Fedorov, V V; Krasil'nikov, D M; Knubovets, S Ia; Minnegaliev, M M; Mosikhin, B B

    1989-10-01

    The results of surgical treatment of 1,069 patients for gastric and duodenal ulcer were studied. Duodenal stump incompetence (DSI) developed in 25 patients (6.3%) after the Billroth II operation; the incompetence was manifested by three clinical forms: infiltrative, primary-fistular, and perforative-peritoneal. Each form of DSI calls for specific tactics of treatment. The perforative-peritoneal form is most dangerous; during its operative management active aspiration-perfusion drainage of the zone of the stump must be installed and the duodenum relieved of a load as much as possible. Drugs reducing pancreatic function, postural drainage, and a diet is included in the complex of therapeutic measures in DSI. The wide introduction of organ-preserving operations into surgical practice will make it possible to avoid this threatening complication.

  20. Lipase assay in duodenal juice using a conductimetric method.

    PubMed

    Ballot, C; Favre-Bonvin, G; Wallach, J M

    1984-11-15

    Lipase activity in duodenal juice is known to undergo important variations in pathologic states, especially in cases of chronic pancreatitis. Almost all of the current assay methods are based on the measurement of hydrolysis of olive oil or triolein, mainly by potentiometry. As we have developed a conductimetric method for enzyme activity measurements, we have applied it to lipase assay. A higher experimental conductimetric sensitivity is obtained when liberated acids have a short chain (higher limiting equivalent conductivity). We have therefore used triacetin as a substrate and compared out method with potentiometry (pH-stat) and spectrophotometry. The correlation coefficients of both methods with conductimetry were 0.94 and 0.97, respectively, indicating that the conductimetric method may be used for lipase assay in duodenal juice, using triacetin as a substrate.

  1. Congenital duodenal obstruction with delayed presentation: seven years of experience

    PubMed Central

    Karami, Hasan; Saneian, Hossein

    2016-01-01

    Introduction The duodenum is the most common site for congenital intestinal obstruction. The duodenal web with a central hole can present without any overt signs of obstruction at a later age. Material and methods Over a 7-year period, children with congenital intestinal obstruction were identified in this study. The complications and operative findings of patients with duodenal web with conditions such as wind sock deformity and delayed diagnosis were evaluated in this study. Results This study included 81 infants with congenital intestinal obstruction. At operation, 48 patients demonstrated duodenal obstruction with atresia in 27, annular pancreas in 15 and malrotation in 6. Also, we observed incomplete obstruction of the duodenum due to a fenestrated web in 8 patients. The age of these patients at operation time ranged from 5 days to 72 months. Fifty percent of affected patients were associated with trisomy 21, all of whom exhibited failure to thrive due to food intolerance. The patients older than 2 years presented with major complications of gastroesophageal reflux such as esophageal ulcer, stricture and dysphagia. Additionally we had a unique case of a patient who had been referred with an epigastric mass. During the operation, we found 440 seeds of various fruits in the stomach and the first portion of the duodenum. Conclusions Our study emphasizes that duodenal web with a central hole can present without signs of obstruction at a later age with only failure to thrive and food intolerance. Therefore a high index of suspicion is necessary for diagnosis when it presents beyond the usual age. PMID:27695493

  2. [Perforated duodenal diverticula. Case report and treatment options].

    PubMed

    Guardado-Bermúdez, Fernando; Ardisson-Zamora, Fernando Josafat; Rojas-González, Juan Daniel; Medina-Benítez, Alberto; Corona-Suárez, Fernando

    2013-01-01

    Antecedentes: los divertículos duodenales los describió por primera vez Chromel en 1710. El divertículo duodenal es el segundo sitio más frecuente de divertículos en el tubo digestivo, el diagnóstico se limita a los casos con complicaciones y síntomas. Los divertículos duodenales se localizan en 10- 67% en la segunda porción del duodeno. Su hallazgo en la mayoría de los casos es incidental. Cerca de 90% de los pacientes cursan asintomáticos y sólo se manifiestan cuando sobrevienen las complicaciones, como la hemorragia digestiva y la perforación. Caso clínico: paciente femenina de 78 años de edad, que acudió al hospital debido a disnea de medianos esfuerzos y epigastralgia moderada, distensión abdominal, constipación y dificultad para canalizar gases. La laparotomía identificó un divertículo duodenal con perforación en su cúpula de 5 mm que dio pie a la realización de la diverticulectomía. Conclusiones: el diagnóstico de divertículo duodenal, como etiología de abdomen agudo, debe contemplarse en cualquier diagnóstico diferencial con cuadro de abdomen agudo, apoyados siempre en la imagenología y endoscopia. El tratamiento quirúrgico del divertículo duodenal, en especial su resección, sigue siendo la recomendación dirigida a la menor morbilidad y mejor recuperación.

  3. Perforated duodenal diverticulae: importance for the surgeon and gastroenterologist

    PubMed Central

    Haboubi, Danya; Thapar, Ankur; Bhan, Chetan; Oshowo, Ayo

    2014-01-01

    We present the case of a 78-year-old woman who was admitted for an elective left hemicolectomy for diverticular disease. Two days following the elective procedure, bilious fluid was noted in her pelvic drain. The patient returned to theatre, where a perforated duodenal diverticulum was excised and the defect primarily repaired. The patient then developed a low output enterocutaneous fistula which was treated conservatively with nasojejunal feeding and resolved spontaneously. PMID:25270157

  4. Duodenal ulcer and working-class mobility in an African population in South Africa.

    PubMed Central

    Segal, I; Dubb, A A; Tim, L O; Solomon, A; Sottomayor, M C; Zwane, E M

    1978-01-01

    The number of Africans in Johannesburg presenting with duodenal ulcers has steadily increased over the past 50 years. The characteristics of 105 patients with duodenal ulcer who presented a Baragwanath Hospital were compared with those of matched and unmatched samples of patients without gastrointestinal conditions in the same hospital. Men with duodenal ulcers were found to be significantly better educated than their controls, most had been born in the town, and more of them were employed at higher, though not the highest, educational levels. These data were used to test Susser's proposition that duodenal ulcers are associated with "early urbanisation." Johannesburg blacks with duodenal ulcer did seem to fit the pattern, but the relation between stress and duodenal ulcer remains unclear. PMID:626837

  5. On the Intensity Profile of Electric Lamps and Light Bulbs

    ERIC Educational Resources Information Center

    Bacalla, Xavier; Salumbides, Edcel John

    2013-01-01

    We demonstrate that the time profile of the light intensity from domestic lighting sources exhibits simple yet interesting properties that foster lively student discussions. We monitor the light intensity of an industrial fluorescent lamp (also known as TL) and an incandescent bulb using a photodetector connected to an oscilloscope. The light…

  6. Genetic Analyses of Soluble Carbohydrate Concentrations in Onion Bulbs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fructans are the primary soluble carbohydrate in onion (Allium cepa L.) bulbs and show significant correlations with dry weights and pungency. In this research, we estimated the genetic effects and interactions between two chromosome regions associated with higher amounts of soluble carbohydrates i...

  7. Factors contributing to bacterial bulb rots of onion

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The incidence of bacterial rots of onion bulbs is increasing and has become a serious problem for growers. This increase is likely due to a combination of factors, such as high bacterial populations in soils and irrigation water, heavy rains flooding production fields, higher temperatures, etc. It m...

  8. Voltage-Dependent Intrinsic Bursting in Olfactory Bulb Golgi Cells

    ERIC Educational Resources Information Center

    Pressler, R. Todd; Rozman, Peter A.; Strowbridge, Ben W.

    2013-01-01

    In the mammalian olfactory bulb (OB), local synaptic circuits modulate the evolving pattern of activity in mitral and tufted cells following olfactory sensory stimulation. GABAergic granule cells, the most numerous interneuron subtype in this brain region, have been extensively studied. However, classic studies using Golgi staining methods…

  9. The ``Green Lab'': Power Consumption by Commercial Light Bulbs

    NASA Astrophysics Data System (ADS)

    Einsporn, James A.; Zhou, Andrew F.

    2011-09-01

    Going "green" is a slogan that is very contemporary, both with industry and in the political arena. Choosing more energy-efficient devices is one way homeowners can "go green." A simple method is to change home lighting from hot incandescent bulbs to compact fluorescent lights (CFLs). But do they really save energy? How do their illuminations compare? Even if the CFLs are more energy efficient, they still add to our pollution problem because of the mercury inside them. Light-emitting diodes (LEDs) could be the answer, but they are not available at our local stores. Can LEDs be made to screw right into a standard socket? How expensive are they? What are the power consumptions of so-called "60-W" and "100-W" CFL and LED light bulbs? These are the questions that are answered during this lab activity. Students measure the voltage and current for each of the three types of bulbs, and then calculate the electrical power required by each. An optional experiment is to set the light outputs of each bulb so they are equal in intensity, and then determine the power consumed. While not practical in the home, this experiment gives students an understanding of value for their buck.

  10. Integrating temperature with odor processing in the olfactory bulb.

    PubMed

    Kludt, Eugen; Okom, Camille; Brinkmann, Alexander; Schild, Detlev

    2015-05-20

    Temperature perception has long been classified as a somesthetic function solely. However, in recent years several studies brought evidence that temperature perception also takes place in the olfactory system of rodents. Temperature has been described as an effective stimulus for sensory neurons of the Grueneberg ganglion located at the entrance of the nose. Here, we investigate whether a neuronal trace of temperature stimulation can be observed in the glomeruli and mitral cells of the olfactory bulb, using calcium imaging and fast line-scanning microscopy. We show in the Xenopus tadpole system that the γ-glomerulus, which receives input from olfactory neurons, is highly sensitive to temperature drops at the olfactory epithelium. We observed that thermo-induced activity in the γ-glomerulus is conveyed to the mitral cells innervating this specific neuropil. Surprisingly, a substantial number of thermosensitive mitral cells were also chemosensitive. Moreover, we report another unique feature of the γ-glomerulus: it receives ipsilateral and contralateral afferents. The latter fibers pass through the contralateral bulb, cross the anterior commissure, and then run to the ipsilateral olfactory bulb, where they target the γ-glomerulus. Temperature drops at the contralateral olfactory epithelium also induced responses in the γ-glomerulus and in mitral cells. Temperature thus appears to be a relevant physiological input to the Xenopus olfactory system. Each olfactory bulb integrates and codes temperature signals originating from receptor neurons of the ipsilateral and contralateral nasal cavities. Finally, temperature and chemical information is processed in shared cellular networks.

  11. The "Green Lab": Power Consumption by Commercial Light Bulbs

    ERIC Educational Resources Information Center

    Einsporn, James A.; Zhou, Andrew F.

    2011-01-01

    Going "green" is a slogan that is very contemporary, both with industry and in the political arena. Choosing more energy-efficient devices is one way homeowners can "go green." A simple method is to change home lighting from hot incandescent bulbs to compact fluorescent lights (CFLs). But do they really save energy? How do their illuminations…

  12. Electrophysiological differentiation of new neurons in the olfactory bulb.

    PubMed

    Belluzzi, Ottorino; Benedusi, Mascia; Ackman, James; LoTurco, Joseph J

    2003-11-12

    The subventricular zone produces neuroblasts that migrate to the olfactory bulb (OB) and differentiate into interneurons throughout postnatal life (Altman and Das, 1966; Hinds, 1968; Altman, 1969; Kishi et al., 1990; Luskin, 1993; Lois and Alvarez-Buylla, 1994). Although such postnatally generated interneurons have been characterized morphologically, their physiological differentiation has not been thoroughly described. Combining retroviral-mediated labeling of newly generated neurons with patch-clamp electrophysiology, we demonstrated that soon after new cells enter the layers of the olfactory bulb, they display voltage-dependent currents typical of more mature neurons. We also show that these "newcomers" express functional GABA and glutamate receptor channels, respond synaptically to stimulation of the olfactory nerve, and may establish both axodendritic and dendrodendritic synaptic contacts within the olfactory bulb. These data provide a basic description of the physiology of newly generated cells in the OB and show that such new cells are functional neurons that synaptically integrate into olfactory bulb circuitry soon after their arrival.

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

    PubMed Central

    Zuccarello, Biagio; Spada, Antonella; Centorrino, Antonio; Turiaco, Nunzio; Chirico, Maria Rosaria; Parisi, Saveria

    2009-01-01

    Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD) is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results. Our “inverted-diamond-shaped-duodenoduodenostomy” (i-DSD) allowed postoperative oral feeding to start on days 2 to 3, peripheral intravenous fluids discontinuity on days 3 to 8 (median values 3.6); time to achieve full oral feeds on days 8 to 12 (median values 9.4); the length of hospitalisation ranged from 10 and 14 days (median value 11.2). No complications related to the anastomosis, by Viz leakage, dehiscence, biliary stasis, or stenosis were observed. Conclusions. The i-DSD provides a safe procedure to protect the ampulla of Vater from injury and avoids any formation of a blind loop. The results show that patients who have i-DSD achieve full oral feeds in a very short time period and, consequently, the length of hospitalisation is also significantly reduced. PMID:19946416

  14. Mechanism of action of Trolox on duodenal contractility.

    PubMed

    Fagundes, D S; Grasa, L; Gonzalo, S; Martinez de Salinas, F; Arruebo, M P; Plaza, M A; Murillo, M D

    2013-12-01

    Trolox is a hydrophilic analogue of vitamin E. The aim of this work was to study the mechanism of action of Trolox on rabbit duodenal spontaneous motility and contractility. The duodenal contractility studies in vitro were carried out in an organ bath. Trolox (12 mM) reduced the amplitude and frequency of spontaneous contractions and the acetylcholine-induced contractions in the longitudinal and circular smooth muscle of rabbit duodenum. Quinine reverted the Trolox-induced (12 mM) reduction on the amplitude and frequency of spontaneous contractions in the longitudinal and circular muscle. Charibdotoxin and glibenclamide reverted only the amplitude of spontaneous contractions in circular muscle of the duodenum. The decrease of ACh-induced contractions evoked by Trolox 12 mM in the longitudinal and circular smooth muscle of the duodenum was antagonized by quinine in longitudinal and circular muscle and by Bay K8644, 1H-[1,2,4]oxadiazolo [4, 3-α]quinoxalin-1-one (ODQ) and nimesulide in circular muscle. We conclude that in the decrease of duodenal contractility induced by Trolox participate K(+) and Ca(2+) channels, adenylyl cyclase, guanylyl cyclase and cyclooxygenase-2.

  15. Effects of captopril on the cysteamine-induced duodenal ulcer in the rat.

    PubMed

    Saghaei, Firoozeh; Karimi, Iraj; Jouyban, Abolghasem; Samini, Morteza

    2012-05-01

    Oxidative stress is important factor underlying in a variety of diseases. Antioxidative enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) are part of the physiological defenses against oxidative stress. Malondialdehyde (MDA) is a lipid peroxidation biomarker and its elevated level in various diseases is related to free radical damage. Cysteamine is a cytotoxic agent, acting through generation of reactive oxygen species (ROS) and may decrease defense activity of antioxidative enzymes against ROS and induce duodenal ulcer. Captopril, acts as free radical scavengers and protect against injuries from oxidative damage to tissues.The aim of this study was the evaluation of the effect of captopril against cysteamine-induced duodenal ulcer by determining duodenal damage, duodenal tissue SOD and GSH-PX activities and plasma MAD level. This study was performed on 3 groups of 7 rats each: saline, cysteamine and cysteamine plus captopril treated groups. The effect of captopril against cysteamine-induced duodenal ulcer is determined by evaluating the duodenal damage, duodenal tissue SOD and GSH-PX activities and plasma MDA level. All animals were euthanized 24h after the last treatment and 2 ml blood and duodena samples were collected for calculation of ulcer index, histopathological assessment and measurement of tissue SOD, GSH-PX activities and plasma MDA level. Cysteamine produced severe duodenal damage, decreased the activity of duodenal tissue SOD and GSH-PX and increased the plasma MDA level compared with saline pretreated rats. Pretreatment with captopril decreased the cysteamine-induced duodenal damage and plasma level of MDA and increased the activities of SOD and GSH-PX in duodenal tissue compared with cysteamine pretreated animal. Our results suggest that captopril protects against cysteamine-induced duodenal ulcer and inhibits the decrease in SOD and GSH-PX activities and lipid peroxidation by increasing antioxidant defenses.

  16. Effect of Atmospheric Pressure on Wet Bulb Depression

    NASA Astrophysics Data System (ADS)

    Wheeler, Raymond; Stasiak, Michael; Lawson, Jamie; Wehkamp, Cara Ann; Dixon, Mike

    Future space exploration missions will likely operate at pressures less than 1 atm ( 100 kPa) to reduce gas leakage and structural mass, and facilitate rapid EVAs. Understanding environmental monitoring, control, and physiological responses to reduced pressures will be required to assure mission success. Wet / dry bulb psychrometers are useful devices for monitoring humidity and provide insights into cooling phenomena for wet, evaporating surfaces. To study the effects of pressure on psychrometers we conducted a series of tests in a hypobaric chamber. Chamber RH monitoring and control were based on capacitance type devices, which previous testing and manufacturer's specifications have shown to be unaffected by pressure. Test data were gathered using an Enercorp model HT-WD-A psychrometer with matched platinum RTD temperature probes positioned side-by-side with a dew point (chilled mirror) device and two capacitance RH sensors. The chamber was kept dark and measurements were taken at three RHs (30, 50, and 70) and four pressures (10, 25, 50, and 97 kPa). Results showed an increase in wet bulb depression (i.e., a drop in wet bulb temperature) for a given RH as the pressure decreased, with the largest changes occurring as pressure dropped from 25 and 10 kPa. At a dry bulb temperature of 25 C, the normal wet bulb temperature for 30 RH and 97 kPa is 15 C, but this dropped to 8 C at 10 kPa. These observations are consistent with previous reports of increased evaporation rates at reduced pressure and match recently published psychrometric models for different pressures. The results suggest that psychrometers need direct calibration at the target pressures or that pressure corrected charts are required. Moreover, for a given vapor pressure deficit, any moist surfaces, including transpiring plant leaves, will be cooler at lower pressures due to the increased evaporation rates.

  17. [Flexible bronchoscopy techniques: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy].

    PubMed

    Escribano Montaner, A; Moreno Galdó, A

    2005-04-01

    This article completes previous recommendations of the Techniques Group of the Spanish Society of Pediatric Pulmonologists on the practice of flexible bronchoscopy in children. We review the most frequently performed diagnostic and therapeutic procedures applied through the flexible bronchoscope: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy. Recommendations are also provided on the practice of nonbronchoscopic bronchoalveolar lavage. We review the indications and contraindications of these techniques, the equipment required, and the preparation and monitoring of the patient before, during and after the procedure. The complications of these techniques are also discussed. These recommendations may be adopted, modified or rejected according to clinical needs and constraints.

  18. The therapeutic strategy for autoimmune pancreatitis is subject to the endoscopic features of the duodenal papilla

    PubMed Central

    Kubota, Kensuke; Nakajima, Atushi

    2010-01-01

    Autoimmune pancreatitis (AIP) often presents with a swollen duodenal papilla, however, the clinical significance of the duodenal papilla in AIP has not been fully elucidated. Data have shown swollen duodenal papillae shaped like a pear and/or with a submucosal tumor having IgG4-bearing plasma cells. Immunohistopathology has potentially verified duodenal papillitis associated with AIP. FOXP3-positive lymphocytes are also recognized in AIP. AIP has shown spontaneous remission and relapse irrelevance to corticosteroid therapy. The results of a multivariate analysis revealed the absence of a swollen duodenal papilla as the only significant independent factor predictive of spontaneous remission in AIP cases. In addition, the results of another multivariate analysis revealed the presence of a swollen duodenal papilla and the presence of extrapancreatic lesions as the significant independent factors predictive of relapse in these cases. Results suggest that the lack of a swollen duodenal papilla is a predictive factor for spontaneous remission, and thus negates the need to administer corticosteroids in those AIP patients. In contrast, a swollen duodenal papilla and the presence of extrapancreatic lesions are risk factors for relapse, and those AIP patients are candidates for maintenance corticosteroid therapy to reduce relapse. Therefore, the therapeutic strategy such as the indication for corticosteroid administration is subject to the endoscopic features of the duodenal papilla. PMID:21180617

  19. Oral biopsy: oral pathologist's perspective.

    PubMed

    Kumaraswamy, K L; Vidhya, M; Rao, Prasanna Kumar; Mukunda, Archana

    2012-01-01

    Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  20. Vacuum enhanced cutaneous biopsy instrument

    DOEpatents

    Collins, Joseph

    2000-01-01

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  1. Biopsy techniques for intraocular tumors

    PubMed Central

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-01-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88–95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  2. Vacuum Enhanced Cutaneous Biopsy Instrument

    SciTech Connect

    Collins, Joseph

    1999-06-25

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  3. Neuronal circuits and computations: pattern decorrelation in the olfactory bulb.

    PubMed

    Friedrich, Rainer W; Wiechert, Martin T

    2014-08-01

    Neuronal circuits in the olfactory bulb transform odor-evoked activity patterns across the input channels, the olfactory glomeruli, into distributed activity patterns across the output neurons, the mitral cells. One computation associated with this transformation is a decorrelation of activity patterns representing similar odors. Such a decorrelation has various benefits for the classification and storage of information by associative networks in higher brain areas. Experimental results from adult zebrafish show that pattern decorrelation involves a redistribution of activity across the population of mitral cells. These observations imply that pattern decorrelation cannot be explained by a global scaling mechanism but that it depends on interactions between distinct subsets of neurons in the network. This article reviews insights into the network mechanism underlying pattern decorrelation and discusses recent results that link pattern decorrelation in the olfactory bulb to odor discrimination behavior.

  4. Gas mediators involved in modulating duodenal HCO3(-) secretion.

    PubMed

    Takeuchi, K; Aihara, E; Kimura, M; Dogishi, K; Hara, T; Hayashi, S

    2012-01-01

    The secretion of HCO3(-) in the duodenum is increased by mucosal acidification, and this process is modulated by gas mediators such as nitric oxide (NO), hydrogen sulfide (H2S), and carbon monoxide (CO), in addition to prostaglandins (PGs). The secretion is increased by NOR3 (NO donor), NaHS (H2S donor), and CORM-2 (CO donor). The HCO3(-) responses to NOR3 and CORM-2 are attenuated by indomethacin, while that to NaHS is mitigated by indomethacin and L-NAME as well as sensory deafferentation. NOR3 and CORM-2 increase mucosal PGE2 production, while H2S increases mucosal PGE2 content and luminal NO release. The HCO3(-) response to mucosal acidification is attenuated by indomethacin, propargylglycine, and SnPP, each inhibiting PG, H2S and CO production, respectively. The acid-induced duodenal damage is worsened when either PG, H2S or CO is lacking. These findings suggest that 1) NO, H2S, and CO, generated endogenously or exogenously, stimulate HCO3(-) secretion in the duodenum; 2) the stimulatory action of NO and CO is mediated, at least partly, by endogenous PGs, while that of H2S is mediated by PGs and NO as well as sensory neurons; 3) these gas mediators are involved in the local regulation of acid-induced HCO3(-) secretion, in addition to endogenous PGs; 4) the acid-induced duodenal damage is worsened by agents inhibiting the endogenous production of NO, H2S or CO. It is assumed that these gas mediators play a role in maintaining the integrity of the duodenal mucosa by modulating the secretion of HCO3(-).

  5. LEDs Illuminate Bulbs for Better Sleep, Wake Cycles

    NASA Technical Reports Server (NTRS)

    2015-01-01

    Life on the International Space Station (ISS) wreaks havoc on an astronaut’s biological rhythms, and one way NASA mitigates the problem is through the use of LED lighting to alternately stimulate energy and focus and induce relaxation. Satellite Beach, Florida-based Lighting Science partnered with Kennedy Space Center to commercialize an LED system designed for the ISS, resulting in its DefinityDigital product line of light bulbs now used in numerous homes, hotel chains, and resorts.

  6. Supraduodenal Branch of the Left Hepatic Artery: A Rare Cause of Bleeding Duodenal Ulcer

    SciTech Connect

    Kapoor, Baljendra S.; Berscheid, Bruce; Saddekni, Souheil

    2009-07-15

    This is a case report describing a rare cause of massive duodenal ulcer hemorrhage resulting from the erosion of the supraduodenal branch of the left hepatic artery. This arterial branch is not a well known variation and is rarely recognized as a source of duodenal bleeding.

  7. Is there a role for pyloric exclusion after severe duodenal trauma?

    PubMed

    Cruvinel Neto, José; Pereira, Bruno Monteiro Tavares; Ribeiro, Marcelo Augusto Fontenelle; Rizoli, Sandro; Fraga, Gustavo Pereira; Rezende-Neto, João Baptista

    2014-01-01

    Duodenal trauma is an infrequent injury, but linked to high morbidity and mortality. Surgical management of duodenal injuries is dictated by: patient's hemodynamic status, injury severity, time of diagnosis, and presence of concomitant injuries. Even though most cases can be treated with primary repair, some experts advocate adjuvant procedures. Pyloric exclusion (PE) has emerged as an ancillary method to protect suture repair in more complex injuries. However, the effectiveness of this procedure is debatable. The "Evidence Based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club performed a critical appraisal of the literature and selected three relevant publications on the indications for PE in duodenal trauma. The first study retrospectively compared 14 cases of duodenal injuries greater than grade II treated by PE, with 15 cases repaired primarily, all of which penetrating. Results showed that PE did not improve outcome. The second study, also retrospective, compared primary repair (34 cases) with PE (16 cases) in blunt and penetrating grade > II duodenal injuries. The authors concluded that PE was not necessary in all cases. The third was a literature review on the management of challenging duodenal traumas. The author of that study concluded that PE is indicated for anastomotic leak management after gastrojejunostomies. In conclusion, the choice of the surgical procedure to treat duodenal injuries should be individualized. Moreover, there is insufficient high quality scientific evidence to support the abandonment of PE in severe duodenal injuries with extensive tissue loss. PMID:25140657

  8. A computerized questionnaire analysis of duodenal ulcer symptoms.

    PubMed

    Earlam, R

    1976-08-01

    The characteristics, daily routine of life, and symptom patterns of 100 patients with a radiologically proven duodenal ulcer were compared with 100 controls. This confirmed that ulcer pain occurred periodically with attacks and remissions, could be relieved by antacids, vomiting, and avoiding fatty food, but was made worse by worry. The anatomical site was usually epigastric but other sites were common. Pain was unaffected by diet or a change in the seasons and had no constant relationship to meals. It occurred during the day in all of the patients and at night in 88%.

  9. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency

    PubMed Central

    Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-01-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance. PMID:27790589

  10. Optical and thermal design of light emitting diodes omnidirectional bulb.

    PubMed

    Ye, Zhi Ting; Kuo, Hao-Chung; Chen, Cheng-Huan

    2015-10-01

    The penetration of LED light bulbs into the lighting market is growing quickly in recent years due to significant increase of LED efficiency and reduction of cost. One major issue to be improved is the overall light bulb efficiency, which can fulfill "Energy Star for Lamps" while keeping sufficiently high efficiency. The efficiency issue results mainly from the high directionality of the LED sources and the corresponding solutions to make the emission more diverse. In this paper, a diffusion white reflection sheet (DWRS) with an array of holes is proposed as a high efficiency solution for modulating a light emission profile with SMD type LED source. The hole size is adjusted with fixed hole pitch to both maximize the efficiency and meet the omnidirectional specification. In addition, the concept of thermal plastic insertion molding metal is proposed for thermal management without fins for cooling. The prototype demonstrates the efficiency (Ef.) of 87.6% and LED pad temperature of 85°C, which shows the feasibility as a total solution for high efficiency LED omnidirectional bulbs. PMID:26479672

  11. Increased plasma noradrenaline and serum gastrin in patients with duodenal ulcer.

    PubMed

    Brandsborg, O; Brandsborg, M; Løvgreen, N A; Christensen, N J

    1978-02-01

    Serum gastrin, serum insulin, plasma noradrenaline, plasma adrenaline, pulse rate and blood pressure were measured repeatedly during 24h in six patients with duodenal ulcer and in six control subjects. Mean serum gastrin concentration was 3-4 times higher in duodenal ulcer patients than in controls during both the day and at night. Serum insulin was the same in both groups of subjects. Overnight fasting and mean supine plasma noradrenaline as well as mean supine pulse rate were significantly higher in duodenal ulcer patients than in controls. Plasma adrenaline and arterial blood pressure were the same in patients and controls. These results suggest that sympathetic nervous activity is increased in patients with duodenal ulcer. The increased sympathetic nervous activity may mean that duodenal ulcer patients are subject to more stress than normal subjects or may be compensatory to increased vagal nervous activity presumed by some authors to be present in such patients.

  12. Palliation of Malignant Biliary and Duodenal Obstruction with Combined Metallic Stenting

    SciTech Connect

    Akinci, Devrim Akhan, Okan; Ozkan, Fuat; Ciftci, Turkmen; Ozkan, Orhan S.; Karcaaltincaba, Musturay; Ozmen, Mustafa N.

    2007-11-15

    Purpose. The purpose of this study is to evaluate the efficacy of palliation of malignant biliary and duodenal obstruction with combined metallic stenting under fluoroscopy guidance. Materials and Methods. A retrospective analysis of 9 patients (6 men and 3 women) who underwent biliary and duodenal stenting was performed. The mean age of patients was 61 years (range: 42-80 years). The causes of obstruction were pancreatic carcinoma in 7 patients, cholangiocellular carcinoma in one, and duodenal carcinoma in the other. Biliary and duodenal stents were placed simultaneously in 4 patients. In other 5 patients dudodenal stents were placed after biliary stenting when the duodenal obstruction symptoms have developed. In two patients duodenal stents were advanced via transgastric approach. Results. Technical success rate was 100 %. After percutaneous biliary drainage and stenting bilirubin levels decreased to normal levels in 6 patients and in remaining 3 patients mean reduction of 71% in bilirubin levels was achieved. Tumoral ingrowth occurred in one patient and percutaneous biliary restenting was performed 90 days after the initial procedure. Of the 9 patients, 6 patients were able to tolerate solid diet, whereas 2 patients could tolerate liquid diet and one patient did not show any improvement. Mean survival periods were 111 and 73 days after biliary and duodenal stenting, respectively. Conclusion. Combined biliary and duodenal stent placement which can be performed under fluoroscopic guidance without assistance of endoscopy is feasible and an effective method of palliation of malignant biliary and duodenal obstructions. If transoral and endoscopic approaches fail, percutaneous gastrostomy route allows duodenal stenting.

  13. Biopsies

    MedlinePlus

    ... computed tomography (CT) , fluoroscopy , ultrasound , or MRI . A mammography unit is a rectangular box that houses the ... seen. Some lesions, such as clustered calcifications on mammography are not as clearly shown with ultrasound as ...

  14. Biopsy

    MedlinePlus

    ... Sections of the JAOCD JAOCD Archive Published Members Online Dermatology Journals Edit This Favorite Name: Category: Share: Yes ... 2/2017 2017 AOCD Spring Current Concepts in Dermatology Meeting more Latest News ... Surveys About AOCD The AOCD was recognized in ...

  15. Liquid biopsy in liver cancer.

    PubMed

    Labgaa, Ismail; Villanueva, Augusto

    2015-04-01

    Liver cancer has become the second cause of cancer-related death worldwide. Most patients are still diagnosed at intermediate or advanced stage, where potentially curative treatment options are not recommended. Unlike other solid tumors, there are no validated oncogenic addiction loops and the only systemic agent to improve survival in advanced disease is sorafenib. All phase 3 clinical trials testing molecular therapies after sorafenib have been negative, none of which selected patients based on predictive biomarkers of response. Theoretically, analysis of circulating cancer byproducts (e.g., circulating tumor cells, cell-free nucleic acids), namely "liquid biopsy," could provide easy access to molecular tumor information, improve patients' stratification and allow to assess tumor dynamics over time. Recent technical developments and preliminary data from other malignancies indicate that liquid biopsy might have a role in the future management of cancer patients. PMID:25977189

  16. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DUE TO PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a... does not have pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence of the presence of pneumoconiosis....

  17. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DUE TO PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a... does not have pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence of the presence of pneumoconiosis....

  18. Testing Biopsy and Cytology Specimens for Cancer

    MedlinePlus

    ... articles window. My Saved Articles » My ACS » Testing Biopsy and Cytology Specimens for Cancer Download Printable Version [ ... on the topics below to get started. Testing Biopsy and Cytology Specimens for Cancer How is cancer ...

  19. Gastric and Duodenal Stents: Follow-Up and Complications

    SciTech Connect

    Pinto Pabon, Isabel Teresa; Paul Diaz, Laura; Ruiz de Adana, Juan Carlos; Lopez Herrero, Julio

    2001-05-15

    Purpose: To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.Methods: A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.Results: All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE {+-} 4.6).Conclusions: The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.

  20. Calcium transport by rat duodenal villus and crypt basolateral membranes

    SciTech Connect

    Walters, J.R.F.; Weiser, M.M.

    1987-02-01

    Rat duodenal cells were isolated sequentially to give fractions enriched for villus and crypt cells. From each of these fractions, basolateral-enriched membrane vesicles were prepared and ATP-dependent calcium uptake was studied. Calcium uptake was sensitive to temperature, was inhibited by vanadate and by A23187, and was lower in vitamin D-deficient animals. In normal animals, (UVCa)-transport was approximately twofold greater in villus-tip than in crypt cell-fraction basolateral membranes though the affinity of the uptake for calcium was similar (K/sub m/ = 0.3 M). In vitamin D-deficient animals, the crypt-to-villus gradient was reduced, and in all fractions, calcium transport was similar to or lower than that in the crypts of normal animals. Six hours after vitamin D-deficient animals were repleted with 1,25-dihydroxycholecalciferol, a significant increase in calcium transport by everted gut sacs was present; however, basolateral calcium transport was significantly increased in only the mid-villus fractions, and no change was seen in the villus-tip fractions. Thus vitamin D appears necessary for the development of increased basolateral membrane calcium pump activity in duodenal villus cells, but not all cells in vitamin D-deficient rats are able to respond to 1,25-dihydroxycholecalciferol.

  1. Cure of duodenal ulcer associated with eradication of Helicobacter pylori.

    PubMed

    Rauws, E A; Tytgat, G N

    1990-05-26

    50 patients with intractable duodenal ulcer were randomly assigned to 4 weeks of treatment with colloidal bismuth subcitrate (CBS) alone (26 patients) or with amoxicillin and metronidazole (24 patients). 5 patients (all on triple therapy) withdrew because of side-effects. In 17 of the 45 patients who completed the treatment, Helicobacter pylori was eradicated, and there was no ulcer relapse during the first 12 months of follow-up. The ulcer relapse rate was significantly higher (17 of 21 [89%]) among patients who remained positive for H pylori. 9 patients who remained positive for H pylori and had ulcer relapses within 6 months of treatment with CBS alone, were subsequently given triple therapy. 7 of the 9 showed H pylori eradication and no relapses within the next 12 months. The 2 patients still H pylori-positive after triple therapy had further ulcer relapses. H pylori eradication, without altering acid output, will become the mainstay of duodenal ulcer treatment because it cures the disease.

  2. Perforated duodenal ulcer associated with ovarian hyperstimulation syndrome: Case Report.

    PubMed

    Uhler, M L; Budinger, G R; Gabram, S G; Zinaman, M J

    2001-01-01

    Ovarian hyperstimulation syndrome (OHSS) remains the most serious medical complication of controlled ovarian stimulation. An unusual case of perforated duodenal ulcer following critical OHSS is presented. A 29 year old nulligravid woman with polycystic ovarian syndrome underwent her first attempt at in-vitro fertilization. She was admitted to the hospital with critical OHSS and subsequently found to have a perforated posterior duodenal ulcer. She underwent exploratory laparotomy, antrectomy and gastrojejunostomy. Pathological analysis of her gastric antrum confirmed chronic gastritis and Helicobacter pylori. She required prolonged assisted ventilation, vasopressor support, multiple i.v. antibiotics, blood product replacement and nutritional support. The patient was hospitalized for a total of 47 days and then transferred to a rehabilitation facility for an additional 30 days before being discharged to home. In this critically ill patient with OHSS, severe stress associated with invasive monitoring and multiple medical therapies in the intensive care unit as well as H. pylori infection appear to be the most probable causative factors of her perforated viscus. Prompt recognition of potential complications and proper medical intervention are essential in the management of patients with OHSS. Avoidance strategies are still needed.

  3. Method of producing a storage bulb for an atomic hydrogen maser

    NASA Technical Reports Server (NTRS)

    Erpenbach, H. (Inventor)

    1975-01-01

    A storage bulb for an atomic hydrogen maser is produced by coating its internal surface with an emulsion containing both TFE and FEP particles. The emulsion is produced by mixing a first quantity of TFE in an aqueous dispersion with a second quantity of FEP in an aqueous dispersion, with a third quantity of distilled water. The emulsion is poured into the bulb to coat it uniformly so as to form a thin film of emulsion on the bulb's internal surface. After excess emulsion is drained out of the bulb the emulsion in the bulb is dried to remove the water and most of the aqueous matter therefrom. The remaining emulsion is then cured by heating the bulb to a temperature of at least 380 C.

  4. Surgical treatment of the high jugular bulb by compressing sinus sigmoideus: two cases.

    PubMed

    Oztürkcan, Sedat; Katilmiş, Hüseyin; Ozkul, Yilmaz; Erdoğan, Nezahat; Başoğlu, Sinan; Tayfun, Mehmet Ali

    2008-08-01

    If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no flow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and different treatment perspectives accompanied by literature. PMID:18046566

  5. Flowering pathway is regulated by bulb size in Lilium longiflorum (Easter lily).

    PubMed

    Lazare, S; Zaccai, M

    2016-07-01

    Lilium longiflorum (Easter lily) vegetative propagation occurs through production of underground bulbs containing apical and axillary meristems. In addition, sexual reproduction is achieved by flowering of elongated shoots above the bulb. It is generally accepted that L. longiflorum has an obligatory requirement for vernalisation and that long day (LD) regime hastens flowering. However, the effect of bulb size and origin, with respect to axillary or apical meristems on flowering, as well as the interactions between these meristems are largely unknown. The aim of this study was to explore the effect of bulb size, vernalisation and photoperiod on L. longiflorum flowering. To this end, we applied vernalisation and photoperiod treatments to the different bulb sizes and used a system of constant ambient temperature of 25 °C, above vernalisation spectrum, to avoid cold-dependent floral induction during plant growth. Vernalisation and LD hasten flowering in all bulbs. Large, non-vernalised bulbs invariably remained at a vegetative stage. However, small non-vernalised bulbs flowered under LD conditions. These results demonstrate for the first time that cold exposure is not an obligatory prerequisite for L. longiflorum flowering, and that an alternative flowering pathway can bypass vernalisation in small bulbs. We suggest that apical dominance interactions determine the distinct flowering pathways of the apical and axillary meristems. Similar floral induction is achieved in propagated bulblets from scaling. These innovative findings in the field of geophyte floral induction represent valuable applicative knowledge for lily production. PMID:26833779

  6. Flowering pathway is regulated by bulb size in Lilium longiflorum (Easter lily).

    PubMed

    Lazare, S; Zaccai, M

    2016-07-01

    Lilium longiflorum (Easter lily) vegetative propagation occurs through production of underground bulbs containing apical and axillary meristems. In addition, sexual reproduction is achieved by flowering of elongated shoots above the bulb. It is generally accepted that L. longiflorum has an obligatory requirement for vernalisation and that long day (LD) regime hastens flowering. However, the effect of bulb size and origin, with respect to axillary or apical meristems on flowering, as well as the interactions between these meristems are largely unknown. The aim of this study was to explore the effect of bulb size, vernalisation and photoperiod on L. longiflorum flowering. To this end, we applied vernalisation and photoperiod treatments to the different bulb sizes and used a system of constant ambient temperature of 25 °C, above vernalisation spectrum, to avoid cold-dependent floral induction during plant growth. Vernalisation and LD hasten flowering in all bulbs. Large, non-vernalised bulbs invariably remained at a vegetative stage. However, small non-vernalised bulbs flowered under LD conditions. These results demonstrate for the first time that cold exposure is not an obligatory prerequisite for L. longiflorum flowering, and that an alternative flowering pathway can bypass vernalisation in small bulbs. We suggest that apical dominance interactions determine the distinct flowering pathways of the apical and axillary meristems. Similar floral induction is achieved in propagated bulblets from scaling. These innovative findings in the field of geophyte floral induction represent valuable applicative knowledge for lily production.

  7. Effect of environmental factors and bulb mass on the invasive geophyte Oxalis pes-caprae development

    NASA Astrophysics Data System (ADS)

    Verdaguer, Dolors; Sala, Anna; Vilà, Montserrat

    2010-01-01

    Oxalis pes-caprae is an invasive pseudoannual plant that reproduces exclusively via offspring bulbs in the introduced range. It is most abundant in disturbed, fertile sites such as agricultural fields, but it is also found in undisturbed shrublands and shadier forest habitats. Oxalis infestation depends on long distance bulb dispersal (mainly anthropogenic) and on the ability of bulbs to grow and reproduce successfully. We conducted a greenhouse experiment to test the effects of parent bulb size on Oxalis growth and offspring production as a function of light availability (ambient and shade), planting depth (surface vs. 9 cm deep), and soil volume (full pots and pots with reduced soil volume). Oxalis grew and reproduced prolifically in all treatments. However, plant development and final offspring bulb production were sensitive to environmental conditions. Shading and reduced soil volume reduced maximum plant biomass relative to control and planting depth treatments, which produced either higher number of offspring bulbs (control) or larger offspring bulbs and higher total offspring bulb biomass (planting depth). Parent bulb size and vegetative reproductive organs had little effect on plant growth and offspring production. Our results are consistent with the lower abundance of Oxalis in undisturbed soils and shadier habitats in the field but indicate that even in these marginal habitats Oxalis can reproduce prolifically and contribute to further spread.

  8. [The surgical treatment of chronic duodenal obstruction in combination with chronic pancreatitis and tumors of the pancreaticoduodenal area].

    PubMed

    Kasum'ian, S A; Alibegov, R A; Snytko, N P

    1997-01-01

    Results of 102 surgical interventions were analyzed. In 39 patients chronic duodenal obstruction was associated with benign diseases, 63 patients had malignant tumours. The chronic duodenal obstruction resulted from diseases in the pancreatoduodenal area in 80 patients, in 22 patients it proved to be the cause of chronic pancreatitis. The adequate surgical correction of the duodenal obstruction is believed to be sufficient for normalizing the pancreas functions in patients with primary chronic duodenal obstruction. Direct surgical interventions are preferable for secondary chronic duodenal obstruction. Prophylactic formation of gastroenterostomy during the biliodigestive surgery can relieve the symptoms of the developing duodenal obstruction and allows to avoid another operation at the advanced stage of chronic duodenal obstruction.

  9. A prospective study of intraoperative methods to diagnose and resect duodenal gastrinomas.

    PubMed Central

    Sugg, S L; Norton, J A; Fraker, D L; Metz, D C; Pisegna, J R; Fishbeyn, V; Benya, R V; Shawker, T H; Doppman, J L; Jensen, R T

    1993-01-01

    OBJECTIVE: This study determined, prospectively, whether duodenotomy (DX) should be routinely performed in explorations for patients with Zollinger-Ellison syndrome (ZES). SUMMARY BACKGROUND DATA: Duodenal gastrinomas are now being found with increasing frequency in patients with Zollinger-Ellison syndrome. The surgical approach used to detect these tumors is controversial. Some recommend intraoperative endoscopy with transillumination (IOE) at surgery, while others recommend routine DX. METHODS: Beginning in 1989, the authors prospectively compared the ability of palpation, intraoperative ultrasound (IOUS), IOE, and DX (in that sequence) to detect gastrinomas in 35 consecutive patients with ZES. Each patient also underwent preoperative localization studies. RESULTS: Thirty-three of 35 patients (94%) had tumor detected and excised; duodenal gastrinomas were excised in 27 patients (77%). The average size of the duodenal tumors was 0.8 cm, significantly smaller (p < 0.005) than the pancreatic and lymph node tumors in this series. Standard palpation after a Kocher maneuver identified 19 of the 31 duodenal tumors (61%) in the 27 patients. IOUS revealed only eight duodenal tumors (26%) and no new lesions. IOE identified 20 duodenal gastrinomas (64%) and 6 new lesions. DX identified 31 duodenal tumors (100%) and 5 additional tumors. The morbidity rate was 17%. One patient had a duodenal fistula after operation (2.8%) and subsequently recovered. No patient died. CONCLUSIONS: These results demonstrate that the duodenum is the most common location for gastrinoma in patients with ZES (77%) and that DX to detect and remove duodenal gastrinomas should be routinely performed in all explorations for patients with ZES. Images Figure 3. Figure 6. PMID:8342993

  10. Bulb turbine operating at medium head: XIA JIANG case study

    NASA Astrophysics Data System (ADS)

    Loiseau, F.; Desrats, C.; Petit, P.; Liu, J.

    2012-11-01

    With lots of references for 4-blade bulb turbines, such as these of Wu Jin Xia (4 units - 36.1 MW per unit - 9.2 m rated head), Chang Zhou (15 units - 46.7 MW per unit - 9.5 m rated head) and Tong Wan (4 units - 46.2 MW per unit - 11 m rated head), ALSTOM Power Hydro is one of the major suppliers of bulb turbines operating under medium head for the Chinese market. ALSTOM Power Hydro has been awarded in November 2010 a contract by Jiang Xi Province Xia Jiang Water Control Project Headquarters to equip Xia Jiang's new hydropower plant. The power dam is located on the Gan Jiang river, at about 160 km away from Nan Chang town in South Eastern China. The supply will consist in 5 bulb units including the furniture of both the turbine and its generator, for a total capacity of 200 MW, under a rated net head of 8.6 m. The prototype turbine is a 7.8 m diameter runner, rotating at 71.4 rpm speed. For this project, ALSTOM has proposed a fully new design of 4-blade bulb runner. This paper outlines the main steps of the hydraulic development. First of all, a fine tuning of the blade geometry was performed to enhance the runner behaviour at high loads and low heads, so that to fulfill the demanding requirements of efficiencies and maximum output. The challenge was also to keep an excellent cavitation behaviour, especially at the outer blade diameter in order to avoid cavitation erosion on the prototype. The shape of the blade was optimized by using the latest tools in computational fluid dynamics. Steady state simulations of the distributor and the runner were performed, in order to simulate more accurately the pressure fields on the blade and the velocity distribution at the outlet of the runner. Moreover, draft tube computations have been performed close to the design point and at higher loads. Then, a model fully homologous with the prototype was manufactured and tested at ALSTOM's laboratory in Grenoble (France). The model test results confirmed the predicted ones: the

  11. On the Intensity Profile of Electric Lamps and Light Bulbs

    NASA Astrophysics Data System (ADS)

    Bacalla, Xavier; Salumbides, Edcel John

    2013-11-01

    We demonstrate that the time profile of the light intensity from domestic lighting sources exhibits simple yet interesting properties that foster lively student discussions. We monitor the light intensity of an industrial fluorescent lamp (also known as TL) and an incandescent bulb using a photodetector connected to an oscilloscope. The light intensity of these sources displays modulation at twice the ac power supply frequency. The familiarity of ac line power supply, commonplace light sources, and simplicity of the setup encourage student confidence, allowing them to think deeper and continually reassess their notions, and if managed can lead to a satisfactory explanation of the observations.

  12. Hydraulic model studies on bulb turbine intakes. Technical report

    SciTech Connect

    Pugh, C.A.

    1983-03-01

    Intakes for bulb and rim generator turbines are very large in relation to their runner diameters. Because the water velocity is low in the intake area, the losses are small. This report describes research on the effect that simplifying the intake design has on energy losses and flow distribution. Using straight surfaces in place of curved bellmouth entrances and shortening the length of the intake could significantly reduce construction costs. In addition, reducing the intake size would reduce the size of trashracks, gates, and associated operating equipment.

  13. To forget is human: the case of the retained bulb.

    PubMed

    Sakhel, Khaled; Hines, James

    2009-03-01

    The scenario of a forgotten instrument or foreign body has plagued surgical procedures from the early days. It has been estimated that the incidence of retained foreign bodies is around one in every 1,000-1,500 intra-abdominal operations and can be expected to occur at least once per year in hospitals where 8,000-18,000 major surgeries are performed annually. We report a case of a forgotten asepto bulb in the vagina following a robot-assisted total laparoscopic hysterectomy. PMID:27628453

  14. Status of nuclear light bulb engine design and performance analyses.

    NASA Technical Reports Server (NTRS)

    Bauer, H. E.

    1971-01-01

    The dynamic response is discussed of a nuclear light bulb engine to perturbations at full-power operating conditions, both with and without control systems. Start-up and shutdown procedures are described, along with the provisions for residual afterheat removal. Problems associated with uprated engine designs are examined. The results of some analytical studies indicate that satisfactory control can be obtained by varying the fuel injection rate by means of a control valve which responds to the rate of change of neutron flux, or to the difference between the instantaneous and steady-state neutron fluxes.

  15. Perforated Duodenal Ulcer –A Rare Cause of Acute Abdomen in Pregnancy

    PubMed Central

    Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

    2014-01-01

    Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind while dealing with cases of acute abdomen in pregnancy and to proceed with multidisciplinary approach for better feto-maternal outcome. PMID:25386494

  16. Laparoscopic drainage of a post-traumatic intramural duodenal hematoma in a child.

    PubMed

    Banieghbal, Behrouz; Vermaak, Cobus; Beale, Peter

    2008-06-01

    Duodenal intramural hematoma owing to blunt abdominal trauma is a relatively rare condition and is normally managed non-operatively. In this paper, we present the case of an 11-year-old boy with a post-traumatic duodenal hematoma, who after failing conservative management, underwent laparoscopic drainage. A four-port approach in a similar position to the laparoscopic cholecystectomy was used. After disentangling the inflammatory mass, the duodenal serosa was opened by simple hook diathermy and the hematoma evacuated. The child recovered uneventfully and was discharged home 48 hours later. To our knowledge, this is the first time that this condition has been successfully treated laparoscopically.

  17. Isolated Duodenal Crohn's Disease: A Case Report and a Review of the Surgical Management

    PubMed Central

    Karateke, Faruk; Menekşe, Ebru; Das, Koray; Ozyazici, Sefa; Demirtürk, Pelin

    2013-01-01

    Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn's diseases, and reviewed the surgical options in the literature. PMID:23781376

  18. The vagus, the duodenal brake, and gastric emptying.

    PubMed Central

    Shahidullah, M; Kennedy, T L; Parks, T G

    1975-01-01

    It has been suggested that an intact vagal supply is essential for the normal function of the recptors in the duodenum and proximal small bowel, which influence the rate of gastric emptying. This paper reports the effect of vagal denervation on gastric emptying and also examines the site and mode of action of receptors in the proximal small bowel.It has been demonstrated in the dog that most, if not all, the receptors controlling gastric emptying lie in the proximal 50 cm of the small bowel. Following truncal vagotomy the emptying time of each instillation increased significantly and the differential rate of emptying of different instillations remained unchanged. The proximal 50 cm of small bowel was capable to differentiating between different instillates even after selective extragastric vagotomy, in which the duodenum was vagally denervated and, therefore, duodenal braking receptors function independently of vagal innervation. PMID:1140630

  19. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-01-01

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended. PMID:26698210

  20. A Technique for Localizing Perforated Duodenal Ulcer During Laparoscopic Repair.

    PubMed

    Philip, Sujith; Varma, Deepak

    2015-12-01

    Laparoscopic repair of duodenal ulcer perforation has certain advantages over open repair. However, the conversion rate to open surgery is still high. The most common reason for conversion is inadequate localization of the ulcer perforation site during laparoscopy. Here, a technique is described which will aid in localizing the perforation, make suturing and repair easier, and helps in checking the integrity of the repair at the end of the procedure. This is done by compressing the gall bladder with an instrument like a laparoscopic fan retractor and simultaneously depressing the first part of the duodenum with another instrument. This results in bile flowing out through the perforation and simultaneously depressing the duodenum downward, making it more easily visible and making identification easier. Suturing is easier due to the liver also getting retracted simultaneously and more space being available consequently. Integrity of the anastomoses is also easily ascertained by this maneuver. PMID:27011591

  1. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  2. Cytokine mRNA quantification in duodenal mucosa from dogs with chronic enteropathies by real-time reverse transcriptase polymerase chain reaction.

    PubMed

    Peters, Iain R; Helps, Chris R; Calvert, Emma L; Hall, Edward J; Day, Michael J

    2005-01-01

    The pathogenesis of inflammatory bowel disease (IBD) and antibiotic-responsive diarrhea (ARD) in dogs likely involves an interaction between the intestinal immune system and luminal bacterial or food antigens. German Shepherd Dogs (GSD) are particularly predisposed to both IBD and ARD. CD4+ T cells are important for the regulation of immune responses in the mucosa, and they exert their effects through the secretion of cytokines. The present study examined the role of cytokines in the pathogenesis of canine chronic enteropathies by quantification of mRNA encoding interleukin-2 (IL-2), IL-4, IL-5, IL-6, IL-10, IL-12, IL-18, interferon gamma, tumor necrosis factor-alpha, transforming growth factor-beta, and glyceraldehyde-3-phosphate dehydrogenase by real-time reverse transcriptase polymerase chain reaction in duodenal mucosal biopsies obtained from 39 dogs with chronic diarrhea and 18 control dogs. Contemporaneously collected biopsies were assessed for histologic changes with a 4-point grading system. No significant difference in the expression of cytokine mRNA (P > .01) was detected between dogs with and those without chronic diarrhea. Similarly, no significant differences in cytokine mRNA expression were observed between GSD and other breeds with chronic diarrhea, or between histologically normal duodenal mucosa and that with evidence of inflammatory change. Failure to detect a difference in mRNA expression does not rule out the possibility of a defect downstream at the level of translation or protein function. No conclusion can be drawn from these data as to the predominant CD4+ cell type in the pathogenesis of these canine chronic enteropathies.

  3. Diagnostic values of dual focus narrow band imaging and probe-based confocal laser endomicroscopy in FAP-related duodenal adenoma

    PubMed Central

    Pittayanon, Rapat; Rerknimitr, Rungsun; Imraporn, Boonlert; Wisedopas, Naruemon; Kullavanijaya, Pinit

    2015-01-01

    Background and study aims: Familial adenomatous polyposis (FAP) is associated with an increased risk of development of periampullary and nonampullary adenoma. Either routine biopsy or endoscopic removal of the lesion is generally required to identify the presence of adenoma. Because the risk of tissue sampling from the ampulla is high and nonampullary polyps are sometimes numerous, resection of all the lesions is time-consuming. This study aimed to evaluate the diagnostic values of duodenal adenoma by dual focus NBI (dNBI) and probe-based confocal endomicroscopy (pCLE) in FAP patients. Patients and methods: The authors conducted a diagnostic study in a single tertiary-care referral center. Surveillance esophagogastroduodenoscopy with dNBI and pCLE was performed on 26 patients with FAP for real-time adenoma diagnosis by two different endoscopists; one used dNBI and the other pCLE. Histology from the matched lesion was used as the gold standard. Results: A total of 55 matched biopsies (25 ampullas, 30 nonampullas) were performed. The sensitivity, specificity, post predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI vs. pCLE from all duodenal lesions were 96.9 % vs. 93.8 %, 78.3 % vs. 81 %, 86.1 % vs. 88.2 %, 94.7 vs. 89.5 %, and 92.4 % vs. 88.6 %, respectively. Conclusions: For surveillance of periampullary and nonampullary adenoma in patients with FAP, the real-time readings provided a high degree of diagnostic value when histology was used as the gold standard. (Clinical trial registration number: NCT02162173). PMID:26528500

  4. Fluorescence guidance during stereotactic biopsy

    NASA Astrophysics Data System (ADS)

    Stepp, Herbert; Beyer, Wolfgang; Brucker, David; Ehrhardt, Andre; Fischer, Stefan; Goebel, Werner; Goetz, Marcus; Guenther, Bettina; Hennig, Georg; Herms, Jochen; Irion, Klaus-Martin; Johansson, Ann; Kienast, Yvonne; Kniebuehler, Gesa; Li, Pan; Ruehm, Adrian; Sandner, Sabine

    2012-02-01

    Objective: When a stereotactic biopsy is taken to enable histopathological diagnosis of a suspected brain tumor, it is essential to i) do this safely, that is not injure a major blood vessel and ii) to obtain relevant vital material from the tumor. We are investigating the suitability of Indocyanine Green (ICG) fluorescence for blood vessel recognition and 5- Aminolevulinic acid (5-ALA) induced Protoporphyrin IX (PpIX) fluorescence for identification of proliferative brain tumor tissue. Methods: A fiber-optic endoscopic approach was studied to generate and detect both fluorescence signals. PpIX concentrations in brain tumors have been measured by chemical extraction. Preliminary equipment was studied in a mouse model. Results: PpIX-concentrations in glioblastoma tissue showed high inner- and inter-patient variability, but each patient out of 15 with interpretable data showed at least one sample with a PpIX-concentration exceeding 2.4 μmol/l, which is easily detectable by state-of-the-art fiberoptic fluorescence spectroscopy and imaging. The imaging fluoroscope with 30,000 pixels resolution could be introduced through a position controlled stereotactic needle. ICG-fluorescence from vessels with diameters >= 0.1 mm can be detected with a contrast of 2-2.5 against surrounding tissue. Conclusion: Fluorescence detection during stereotactic biopsy might increase safety and precision of the procedure significantly.

  5. DNA adducts in bronchial biopsies.

    PubMed

    Dunn, B P; Vedal, S; San, R H; Kwan, W F; Nelems, B; Enarson, D A; Stich, H F

    1991-06-19

    To investigate the feasibility of measuring DNA-carcinogen adducts in the lungs of non-surgical patients, endobronchial biopsies were obtained from 78 patients undergoing routine diagnostic bronchoscopy. Lung cancer was present in 37 (47%) of the patients. DNA was isolated from the tissues and analyzed by HPLC- or nuclease-PI-enriched 32P-postlabelling, using procedures selective for aromatic adducts. Chromatograms from all 28 current smokers showed a distinctive diagonal adduct zone which was present in only 24 of 40 ex-smokers and 4 of 10 lifetime non-smokers. Adduct levels and chromatographic patterns were similar in bronchial tissue from different lobes of the lung, in bronchial and alveolar tissue, and in tumor and non-tumor bronchial tissue taken from the same subject. Bronchial DNA adduct levels were strongly associated with cigarette smoking status and dropped rapidly after smoking ceased. Higher levels of DNA adducts seen in the lung-cancer patients were mainly due to cigarette smoking. Frequent alcohol intake was the only dietary factor associated with higher levels of bronchial DNA adducts. We conclude that the level of bronchial DNA adducts is strongly associated with cigarette-smoking history and with alcohol intake, but is not associated with lung cancer independently from its relation to smoking. The results indicate the feasibility of using 32P-postlabelling to detect and quantitate genetic damage in bronchial biopsy specimens.

  6. Basics of kidney biopsy: A nephrologist's perspective

    PubMed Central

    Agarwal, S. K.; Sethi, S.; Dinda, A. K.

    2013-01-01

    The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from Vim–Silverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM) is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations. PMID:23960337

  7. Quality evaluation of onion bulbs during low temperature drying

    NASA Astrophysics Data System (ADS)

    Djaeni, M.; Asiah, N.; Wibowo, Y. P.; Yusron, D. A. A.

    2016-06-01

    A drying technology must be designed carefully by evaluating the foods' final quality properties as a dried material. Thermal processing should be operated with the minimum chance of substantial flavour, taste, color and nutrient loss. The main objective of this research was to evaluate the quality parameters of quercetin content, color, non-enzymatic browning and antioxidant activity. The experiments showed that heating at different temperatures for several drying times resulted in a percentage of quercetin being generally constant. The quercetin content maintained at the value of ±1.2 % (dry basis). The color of onion bulbs was measured by CIE standard illuminant C. The red color (a*) of the outer layer of onion bulbs changed significantly when the drying temperature was increased. However the value of L* and b* changed in a fluctuating way based on the temperature. The change of onion colors was influenced by temperature and moisture content during the drying process. The higher the temperature, the higher it affects the rate of non-enzymatic browning reaction. The correlation between temperature and reaction rate constant was described as Arrhenius equation. The rate of non-enzymatic browning increases along with the increase of drying temperature. The results showed that higher drying temperatures were followed by a lower IC10. This condition indicated the increase of antioxidant activity after the drying process.

  8. Anticancer Active Homoisoflavone from the Underground Bulbs of Ledebouria hyderabadensis

    PubMed Central

    Chinthala, Yakaiah; Chinde, Srinivas; kumar, Arigari Niranjana; Srinivas, K.V.N. Satya; Kumar, Jonnala Kotesh; Sastry, Kakaraparthy Pandu; Grover, Paramjit; Ramana, M. Venkat

    2014-01-01

    Background: Ledebouria is a genus of deciduous or weakly evergreen bulbs in the Hyacinthaceae family. This is recognized as the first collection made of the new taxon Ledebouria hyderabadensis, exist in the Hyderabad city of Andhra Pradesh, India. Objective: The goal of this work was to investigate the phytochemical constituents present in the new specifies and also to evaluate the cytotoxic properties of the extracts and pure compounds against human cancer cell lines. Materials and Methods: The anticancer activity was evaluated in in vitro mode by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test. Results: Phytochemical investigation of underground bulbs of indigenous, rare, and recently identified herb L. hyderabadensis yielded a bioactive homoisoflavanone, Scillascillin 1. The structure of the compound was established on the basis of various nuclear magnetic resonance and mass spectral data. The compound Scillascillin was isolated for the first time from L. hyderabadensis. In vitro anticancer activity, performed using MTT assay, showed compound 1 as significantly active against human cancer cell lines MCF-7 (breast cancer) and DU-145 (prostate cancer) with inhibitory concentration (IC)50 values 9.59 and 11.32 μg/ml respectively when compared with herb methanol extract (IC50 values 36.21 and 44.86 μg/ml respectively). PMID:25276067

  9. Vibration analysis of obturator prostheses with different bulb height designs.

    PubMed

    Kobayashi, Makio; Oki, Meiko; Ozawa, Shogo; Inoue, Takaaki; Mukohyama, Hitoshi; Takato, Tsuyoshi; Ohyama, Takashi; Taniguchi, Hisashi

    2002-12-01

    The purpose of this study was to investigate the effect on the vibratory characteristics of a cast hollow obturator prosthesis retainer when varying its bulb height. Bulb parts with high (H), middle (M), and low (L) lateral walls were prepared. A Vibration Generator was used to excite the three obturators, while a Laser-Doppler Vibrometer was employed to detect the vibrations at specified measurement points. The frequency response functions of each obturator were recorded on an FFT analyzer to enable their modal shapes to be identified. In addition, transient response simulations were carried out and the decay rate (DR) and the maximum amplitude (MA) of the rest and clasp parts of each obturator were obtained. These were statistically analyzed by ANOVA and Fisher's PLSD test (p < 0.01). The modal shapes were almost the same in all obturators. Significant differences were found in DR in all pairs among the three obturator prostheses, with the DR of the L type being the highest. On the other hand, there were no significant differences in MA. We conclude that the L type is preferable from the standpoint of its vibratory characteristics.

  10. Construction of odor representations by olfactory bulb microcircuits.

    PubMed

    Cleland, Thomas A

    2014-01-01

    Like other sensory systems, the olfactory system transduces specific features of the external environment and must construct an organized sensory representation from these highly fragmented inputs. As with these other systems, this representation is not accurate per se, but is constructed for utility, and emphasizes certain, presumably useful, features over others. I here describe the cellular and circuit mechanisms of the peripheral olfactory system that underlie this process of sensory construction, emphasizing the distinct architectures and properties of the two prominent computational layers in the olfactory bulb. Notably, while the olfactory system solves essentially similar conceptual problems to other sensory systems, such as contrast enhancement, activity normalization, and extending dynamic range, its peculiarities often require qualitatively different computational algorithms than are deployed in other sensory modalities. In particular, the olfactory modality is intrinsically high dimensional, and lacks a simple, externally defined basis analogous to wavelength or pitch on which elemental odor stimuli can be quantitatively compared. Accordingly, the quantitative similarities of the receptive fields of different odorant receptors (ORs) vary according to the statistics of the odor environment. To resolve these unusual challenges, the olfactory bulb appears to utilize unique nontopographical computations and intrinsic learning mechanisms to perform the necessary high-dimensional, similarity-dependent computations. In sum, the early olfactory system implements a coordinated set of early sensory transformations directly analogous to those in other sensory systems, but accomplishes these with unique circuit architectures adapted to the properties of the olfactory modality.

  11. Numerical investigation of cavitation performance on bulb tubular turbine

    NASA Astrophysics Data System (ADS)

    Sun, L. G.; Guo, P. C.; Zheng, X. B.; Luo, X. Q.

    2016-05-01

    The cavitation flow phenomena may occur in the bulb tubular turbine at some certain operation conditions, which even decrease the performance of units and causes insatiably noise and vibration when it goes worse. A steady cavitating flow numerical simulations study is carried out on the bulb tubular unit with the same blade pitch angle and different guide vane openings by using the commercial code ANSYS CFX in this paper. The phenomena of cavitation induction areas and development process are obtained and draws cavitation performance curves. The numerical results show that the travelling bubble cavity is the main types of cavitation development over a wide operating range of discharge and this type of cavitation begins to sensitive to the value of cavitation number when the discharge exceeding a certain valve, in this condition, it can lead to a severe free bubble formation with the gradually decrement of cavitation number. The reported cavitation performance curves results indicate that the flow blockage incident would happen because of a mount of free bubble formation in the flow passage when the cavity developed to certain extend, which caused head drop behavior and power broken dramatically and influenced the output power.

  12. Loss of CD4 T lymphocytes in patients infected with human immunodeficiency virus type 1 is more pronounced in the duodenal mucosa than in the peripheral blood. Berlin Diarrhea/Wasting Syndrome Study Group.

    PubMed Central

    Schneider, T; Jahn, H U; Schmidt, W; Riecken, E O; Zeitz, M; Ullrich, R

    1995-01-01

    Although changes in T lymphocyte subset distribution in the peripheral blood of patients infected with human immunodeficiency virus (HIV) are well defined it is not known whether these changes reflect changes in lymphoid compartments clearly involved in HIV related disease like the intestinal mucosa. This study analysed lymphocytes isolated simultaneously from the peripheral blood and duodenal biopsy specimens by three colour flow cytometry in eight asymptomatic HIV infected patients, 26 AIDS patients, and 23 controls. The proportion of CD4, CD8, CD4-CD8-, or gamma delta T cells did not correlate between circulating and duodenal T cells. CD4 T cells were reduced in the peripheral blood (7.5% (25th-75th percentile, 2-16%) v 52% (41-63%), p < 0.0005) and even more reduced in the duodenum (1% (1-2%) v 36% (23-57%), p < 0.0005) of AIDS patients compared with controls. Patients with asymptomatic HIV infection had intermediate CD4 T cells in the peripheral blood (24% (22-35%); p < 0.002 v controls; p < 0.01 v AIDS) but like AIDS patients very low CD4 T cells in the duodenum (3% (1-6%); p < 0.002 v controls). The ratio of duodenal to circulating CD4+ T cells was significantly reduced to 0.2 (0-1) in AIDS patients (p < 0.001) and even to 0.1 (0.04-0.5) in asymptomatic HIV infected patients (p < 0.002) compared with 0.72 (0.44-0.95) in controls. These findings show an early and preferential loss of duodenal CD4 T cells in HIV infection. Immunological abnormalities in HIV infection are distinct between lymphoid compartments, and profound immunodeficiency may occur in the intestinal immune system although circulating T cells are largely preserved. PMID:7489940

  13. Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review

    PubMed Central

    Steevens, Christopher; Abdalla, Maisa; Kothari, Truptesh H; Kaul, Vivek; Kothari, Shivangi

    2015-01-01

    Bleeding from duodenal varices is reported to be a catastrophic and often fatal event. Most of the cases in the literature involve patients with underlying cirrhosis. However, approximately one quarter of duodenal variceal bleeds is caused by extrahepatic portal hypertension and they represent a unique population given their lack of liver dysfunction. The authors present a case where a 61-year-old male with history of remote crush injury presented with bright red blood per rectum and was found to have bleeding from massive duodenal varices. Injection sclerotherapy with ethanolamine was performed and the patient experienced a favorable outcome with near resolution of his varices on endoscopic follow-up. The authors conclude that sclerotherapy is a reasonable first line therapy and review the literature surrounding the treatment of duodenal varices secondary to extrahepatic portal hypertension. PMID:26558159

  14. [The outlook for the ambulatory treatment of adolescents with duodenal peptic ulcer].

    PubMed

    Filimonbov, R M; Denisova, N A

    1990-01-01

    An analysis was made of the potentialities and efficacy of the treatment of adolescents suffering from duodenal ulcer under outpatient conditions. 65 patients aged 14 to 18 years with duodenal ulcer in the stage of clinical exacerbation and with the presence of ulcer in the acute phase were placed under observation. Outpatient treatment appeared effective in 83.3% of patients. The time of ulcer healing under out- and inpatient conditions was 21.5 +/- 2.5 and 23.5 +/- 3.1 days, respectively. Therefore, selection of adolescent patients with duodenal ulcer for outpatient treatment requires a strictly differentiated approach depending on the disease stage and the character of macroscopic changes in the gastric and duodenal mucosae. At the same time it is necessary to take into consideration the rate and accuracy of removing the painful and dyspeptic syndromes, the lack of complications, consent and interest on the part of adolescents and their parents. PMID:2336611

  15. Modeling data for pancreatitis in presence of a duodenal diverticula using logistic regression

    NASA Astrophysics Data System (ADS)

    Dineva, S.; Prodanova, K.; Mlachkova, D.

    2013-12-01

    The presence of a periampullary duodenal diverticulum (PDD) is often observed during upper digestive tract barium meal studies and endoscopic retrograde cholangiopancreatography (ERCP). A few papers reported that the diverticulum had something to do with the incidence of pancreatitis. The aim of this study is to investigate if the presence of duodenal diverticula predisposes to the development of a pancreatic disease. A total 3966 patients who had undergone ERCP were studied retrospectively. They were divided into 2 groups-with and without PDD. Patients with a duodenal diverticula had a higher rate of acute pancreatitis. The duodenal diverticula is a risk factor for acute idiopathic pancreatitis. A multiple logistic regression to obtain adjusted estimate of odds and to identify if a PDD is a predictor of acute or chronic pancreatitis was performed. The software package STATISTICA 10.0 was used for analyzing the real data.

  16. [Functional state of the gastro-duodenal area in gastro-esophageal reflux disease].

    PubMed

    Vakhrushev, Ia M; Potapova, L O

    2007-01-01

    The complex study of stomach and duodenal function was performed in 150 patients with GERD. It was revealed that 84,3% of patients had increased stomach acid-production. In GERD exacerbation we found the disturbance of gastric mucosa decreasing protective properties of esophageal, stomach and duodenal mucosa. The patients had increased intragastral and intraduodenal pressure leading to decreasing of closing function of pylorus. Due to dynamic gastroscintigraphy the slowing of stomach evacuation was revealed in 69,2% patients, the acceleration - in 7,7% patients. The prevalence of bradyperistalsis was found in elecrogastromyography. The role of hormones (gastrin, insulin, cortisol, thyrotrophin, thyroxin) in disorders of gastro-duodenal complex function was shown. The complex investigation of gastro-duodenal complex function opens the pathophysiologic base of GERD and these data may be used in the choice of adequate therapy.

  17. Role of Centrifugal Projections to the Olfactory Bulb in Olfactory Processing

    ERIC Educational Resources Information Center

    Kiselycznyk, Carly L.; Zhang, Steven; Linster, Christine

    2006-01-01

    While there is evidence that feedback projections from cortical and neuromodulatory structures to the olfactory bulb are crucial for maintaining the oscillatory dynamics of olfactory bulb processing, it is not clear how changes in dynamics are related to odor perception. Using electrical lesions of the olfactory peduncle, sparing output from the…

  18. Light Bulb Presentations in a Mathematics for the Liberal Arts Course

    ERIC Educational Resources Information Center

    Fox, Joseph A.

    2008-01-01

    Encouraging students to make independent discoveries is an effective way to get them excited about mathematics, and sharing their triumphant moments (their light bulb moments) helps to spread this excitement to their peers. A Mathematics for the Liberal Arts course is a perfect venue for the sharing of light bulb moments, as it helps to correct…

  19. Polyneuropathy in neurofibromatosis 2: clinical findings, molecular genetics and neuropathological alterations in sural nerve biopsy specimens.

    PubMed

    Hagel, Christian; Lindenau, Matthias; Lamszus, Katrin; Kluwe, Lan; Stavrou, Dimitrios; Mautner, Victor-Felix

    2002-08-01

    Neurofibromatosis 2 (NF2) is an autosomal dominant disease characterised by development of tumours in the central and peripheral nervous system. Some NF2 patients develop acro-distal sensory motor polyneuropathy that can hardly be explained by the tumour burden alone. In the present study eight sural nerve biopsy specimens from seven NF2 patients suffering from polyneuropathy were investigated, data including clinical course of the disease, electrophysiological findings, teased fibre preparations, histopathological, morphometric, immunohistochemical, electron microscopic and molecular genetic findings. All patients suffered from distal symmetric reflex loss, symmetrical stocking-like hypalgesia and hypesthesia and loss of vibration sense later followed by a slowly progressive distal muscle atrophy and paresis. Sural nerve biopsy specimens revealed a pathological reduction of nerve fibre density correlating with age. In addition, diffuse proliferation of Schwann cells was observed in five of eight biopsies, and small endoneurial tumourlets of schwannomas and perineuriomas were found in two of eight and one of eight samples, respectively. Ki-67 labelling revealed a slight endoneurial proliferative activity in three cases. Schwann cell onion bulbs with or without central myelinated axon were seen in two cases. The findings suggest an axonopathy of multifactorial origin resulting not only from gross tumour growth but, in addition, from small endoneurial tumourlets, diffuse proliferation of Schwann cells and proliferation of perineurial cells. PMID:12111361

  20. Brain astrocytomas: biopsy, then irradiation.

    PubMed

    Lunsford, L D; Somaza, S; Kondziolka, D; Flickinger, J C

    1995-01-01

    We believe that every patient who has clinical symptoms and neurodiagnostic imaging signs suggesting a low-grade glial neoplasm should undergo early diagnosis and treatment. Observation is not warranted for a tumor that has a median survival of 5 years. The value of cytoreductive surgery for many patients has yet to be proven. It is incumbent on neurosurgeons who advocate this approach to show that this more aggressive treatment strategy is preferable to minimally invasive techniques, such as stereotactic biopsy followed by radiation therapy. Clearly, some patients who have a glial tumor require early cytoreductive surgery: those with mass effect and significant neurologic deficits. Otherwise, they will not be able to tolerate fractionated radiation therapy. Because the long-term survival rate is very poor, observation is not warranted in patients with suspected glial neoplasm. Early stereotactic biopsy immediately identifies those patients who, in fact, have more anaplastic tumors and a much worse prognosis. Such patients may benefit from early, aggressive treatments such as cytoreductive surgery, chemotherapy, and radiation. Applying this philosophy, we have achieved a median survival of more than 10 years in patients with astrocytoma. Most patients maintain a high KPS rating, and most do not require delayed cytoreductive surgery. Although we believe that the outcomes of future patients with astrocytomas will improve, we must establish whether such improvement is related to better therapeutic options, earlier recognition enabled by advanced neuroimaging, or the availability of corticosteroids (28, 30). We also believe that neurosurgeons and neuro-oncologists should stop arguing over whether cytoreductive surgery is warranted. For some patients it is, and for others it is not. This prolonged controversy indicates the basic impotence with which neurosurgeons approach glial tumors. Our energy and efforts should be devoted toward more concrete and positive goals in

  1. Effect of dimethylsulphoxide on cysteamine-induced duodenal ulceration in rats.

    PubMed

    Ali, B H

    1990-06-01

    1. Rats were pretreated with dimethylsulphoxide (DMSO) at concentrations of 2, 4 and 6% v/v in the drinking water for 7 days, then injected with a single subcutaneous dose of cysteamine (28 mg/100 g bodyweight) to induce duodenal ulceration. 2. DMSO reduced, in a dose-dependent manner, the incidence and extent of the ulceration. 3. Mucus duodenal content was not significantly affected by either DMSO or cysteamine treatments.

  2. Septic Complication After Balloon-Occluded Retrograde Transvenous Obliteration of Duodenal Variceal Bleeding

    SciTech Connect

    Akasaka, Thai; Shibata, Toshiya Isoda, Hiroyoshi; Taura, Kojiro; Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori

    2010-12-15

    We report a 64-year-old woman with duodenal varices who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) complicated by intraprocedural variceal rupture. The patient developed shivering and a fever higher than 40{sup o}C 3 days after the B-RTO procedure. A blood culture grew Entereobacter cloacoe. This case represents a rare septic complication of B-RTO for duodenal varices.

  3. Gastric Duplication Cyst in Association with Duodenal Atresia in a Neonate

    PubMed Central

    Mirshemirani, Alireza; Roshanzamir, Fatollah; Razavi, Sajad; Sarafi, Mehdi

    2016-01-01

    Concurrence of duodenal atresia and gastric duplication cyst is extremely rare entity. We report a 6-day-old female neonate who presented with neonatal intestinal obstruction. X-ray abdomen showed double bubble sign. At laparotomy, a huge cystic structure attached to greater curvature of the stomach along with duodenal atresia of second part of duodenum was found. The cystic structure was excised and duodeno-duodenostomy performed. Histopathology report confirmed it gastric duplication cyst. PMID:26816679

  4. Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts

    PubMed Central

    Gjeorgjievski, Mihajlo; Manickam, Palaniappan; Ghaith, Gehad; Cappell, Mitchell S.

    2016-01-01

    Abstract Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports. Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords “cyst” and “duodenal” and “duplication”; or “cyst”, and “endoscopy” or “endoscopic”, and “therapy” or “decompression”; with reconciliation of generated references by two experts. Case report followed CARE guidelines. Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984–1999: 3 cases, 2000–2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77–44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1–6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically. A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid

  5. Image-Guided Adrenal and Renal Biopsy

    PubMed Central

    Sharma, Karun V.; Venkatesan, Aradhana M.; Swerdlow, Daniel; DaSilva, Daniel; Beck, Avi; Jain, Nidhi; Wood, Bradford J.

    2010-01-01

    Image-guided biopsy is a safe and well-established technique that is familiar to most interventional radiologists (IRs). Improvements in image-guidance, biopsy tools and biopsy techniques now routinely allow for safe biopsy of renal and adrenal lesions which traditionally were considered difficult to reach or technically challenging. Image-guided biopsy is used to establish the definitive tissue diagnosis in adrenal mass lesions that can not be fully characterized with imaging or laboratory tests alone. It is also used to establish definitive diagnosis in some cases of renal parenchymal disease and has an expanding role in diagnosis and characterization of renal masses prior to treatment. Although basic principles and techniques for image-guided needle biopsy are similar regardless of organ, this paper will highlight some technical considerations, indications and complications which are unique to the adrenal gland and kidney because of their anatomic location and physiologic features. PMID:20540919

  6. Postnatal neurogenesis in the olfactory bulbs of a lizard. A tritiated thymidine autoradiographic study.

    PubMed

    Garcia-Verdugo, J M; Llahi, S; Ferrer, I; Lopez-Garcia, C

    1989-04-10

    Autoradiographically labelled cells were observed in the olfactory bulbs of perinatal, young and adult specimens of the lizard Podarcis hispanica following intraperitoneal injection of tritiated thymidine (5 muCi/g b.wt). After survival times of 7, 18 and 28 days labelled cells were found in the granular layer of both main and accessory bulbs. A few labelled cells were observed in the ependyma, mitral and glomerular layer. In the main olfactory bulb, one week of survival time resulted in labelling of cells in the innermost part of the granular layer. Longer survival times (up to 4 weeks), resulted in labelling of cells mainly in the outermost part of the granular layer. This spatio-temporal gradient was not observed in the accessory bulb. Nevertheless, longer survival times resulted in greater number of labelled cells located in the dorsal and ventral parts of the granular layer of the accessory bulb.

  7. Massive normalization of olfactory bulb output in mice with a 'monoclonal nose'.

    PubMed

    Roland, Benjamin; Jordan, Rebecca; Sosulski, Dara L; Diodato, Assunta; Fukunaga, Izumi; Wickersham, Ian; Franks, Kevin M; Schaefer, Andreas T; Fleischmann, Alexander

    2016-01-01

    Perturbations in neural circuits can provide mechanistic understanding of the neural correlates of behavior. In M71 transgenic mice with a "monoclonal nose", glomerular input patterns in the olfactory bulb are massively perturbed and olfactory behaviors are altered. To gain insights into how olfactory circuits can process such degraded inputs we characterized odor-evoked responses of olfactory bulb mitral cells and interneurons. Surprisingly, calcium imaging experiments reveal that mitral cell responses in M71 transgenic mice are largely normal, highlighting a remarkable capacity of olfactory circuits to normalize sensory input. In vivo whole cell recordings suggest that feedforward inhibition from olfactory bulb periglomerular cells can mediate this signal normalization. Together, our results identify inhibitory circuits in the olfactory bulb as a mechanistic basis for many of the behavioral phenotypes of mice with a "monoclonal nose" and highlight how substantially degraded odor input can be transformed to yield meaningful olfactory bulb output. PMID:27177421

  8. Parotid gland biopsy for investigation of xerostomia.

    PubMed

    Ferguson, J W; Edwards, J L; Christmas, P I; Ferguson, M M

    1990-08-01

    A technique is described for biopsy of the parotid salivary gland under local anaesthesia, which has been undertaken for a series of 59 patients who presented with suspected inflammatory exocrinopathy. The procedure is reliable and is associated with negligible postoperative discomfort. The advantages of the technique suggest that parotid gland biopsy is an acceptable alternative to conventional lower lip biopsy of minor salivary glands in the investigation of xerostomia.

  9. Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome

    PubMed Central

    Yang, Wei-Liang; Zhang, Xin-Chen

    2008-01-01

    AIM: To assess the clinical value of duodenal circular drainage for superior mesenteric artery syndrome (SMAS). METHODS: Forty-seven cases of SMAS were treated with duodenal circular drainage from 1959 to 2001. Clinical data were analyzed retrospectively. RESULTS: In this group, good effects were achieved in 39 cases treated with duodenal circular drainage after 2-15 years of follow-up. The other eight cases were first treated with anterior repositioning of the duodenum (two cases), duodenojejunostomy (five cases), subtotal gastrectomy and billroth II gastrojejunostomy (one case), but vomiting was not relieved until duodenal circular drainage was performed again. A follow-up study of 8-10 years revealed satisfactory results in these eight patients. CONCLUSION: In SMAS, if the reversed peristalsis is strong and continuous, and vomiting occurs frequently, the symptom can not be relieved even if the obstruction of duodenum is removed surgically. The key treatment is the relief of reversed peristalsis. The duodenal circular drainage can resolve the drainage direction of duodenal content, thus relieving the symptom of vomiting. PMID:18186572

  10. Evaluation of repair in duodenal perforation with human amniotic membrane: An animal model (dog)

    PubMed Central

    Ghahramani, Leila; Jahromi, Ali Bagherpour; Dehghani, Mohammad Reza; Ashraf, Mohammad Javad; Rahimikazerooni, Salar; Rezaianzadeh, Abbas; Safarpour, Ali Reza; Hosseini, Seyed Vahid

    2014-01-01

    Background: There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog). Materials and Methods: A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded. Results: Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (Pv = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A. Conclusion: It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings. PMID:24804187

  11. Effect of tyrosine administration on duodenal ulcer induced by cysteamine in the rat

    SciTech Connect

    Oishi, T.; Szabo, S.

    1987-03-01

    Duodenal ulcers were produced by administering cysteamine to rats. Pretreatment with the catecholamine precursor, L-tyrosine (40 mg/100 g i.p. for 5 days), decreased the intensity of duodenal ulcers induced by cysteamine. Equimolar doses of tyrosine methyl ester (51.2 mg/100 g i.p. or s.c.) were equally effective in reducing ulcer intensity. Other amino acids (i.e., alanine, aspartic acid, glutamic acid, glycine, leucine, lysine, tryptophan and valine) did not prevent experimental duodenal ulcers. Coadministration of other large neutral amino acids (e.g., leucine and valine) that compete with tyrosine for uptake into the brain did not inhibit the effect of tyrosine on duodenal ulcers induced by cysteamine. Gastric, duodenal and brain dopamine concentrations were increased 1 hr after the injection of tyrosine methyl ester (25.6 mg/100 g s.c.). These results suggest that the effect of tyrosine on duodenal ulcer induced by cysteamine may be mediated by changes in gastrointestinal dopamine metabolism.

  12. Photoacoustic biopsy: a feasibility study

    NASA Astrophysics Data System (ADS)

    Xu, Guan; Tomlins, Scott A.; Siddiqui, Javed; Davis, Mandy A.; Kunju, Lakshmi P.; Wei, John T.; Wang, Xueding

    2015-03-01

    Photoacoustic (PA) measurements encode the information associated with both physical microstructures and chemical contents in biological tissues. A two-dimensional physio-chemical spectrogram (PCS) can be formulated by combining the power spectra of PA signals acquired at a series of optical wavelengths. The analysis of PCS, or namely PA physio-chemical analysis (PAPCA), enables the quantification of the concentrations and the spatial distributions of a variety of chemical components in the tissue. The chemical components and their distribution are the two major features observed in the biopsy procedures which have been regarded as the gold standard of the diagnosis of many diseases. Taking non-alcoholic fatty liver disease and prostate cancer for example, this study investigates the feasibility of PAPCA in characterizing the histopathological changes in the diseased conditions in biological tissue. A catheter based setup facilitating measurement in deep tissues was also proposed and tested.

  13. Evaluation of Hot Water Treatments for Management of Ditylenchus dipsaci and Fungi in Daffodil Bulbs

    PubMed Central

    Qiu, J.; Westerdahl, B. B.; Giraud, D.; Anderson, C. A.

    1993-01-01

    Treatment of daffodil (Narcissus pseudonarcissus) bulbs in a 0.37% formaldehyde water solution at 44 C for 240 minutes is a standard practice in California for management of the stem and bulb nematode, Ditylenchus dipsaci. Recent concern over the safety of formaldehyde and growers' requests for a shorter treatment time prompted a reevaluation of the procedure. The time (Y, in minutes) required to raise the temperature at the bulb center from 25 to 44 C was related to bulb circumference (X, in cm) and is described by the linear regression Y = -15 + 3.4X. The time required for 100% mortality of D. dipsaci in vitro without formaldehyde was 150, 60, and 15 minutes at 44, 46, and 48 C, respectively. Hot water treatment (HWT) with 0.37% formaldehyde at 44 C for 150 minutes controlled D. dipsaci and did not have a detrimental effect on plant growth and flower production. Shorter formaldehyde-HWT of 90, 45, and 30 minutes at 46, 48, and 50 C, respectively, controlled D. dipsaci but suppressed plant growth and flower production. Fungal genera commonly isolated from the bulbs in association with D. dipsaci were Penicillium sp., Fusarium oxysporum f. sp. narcissi, and Mucor plumbeus, representing 60, 25, and 5%, respectively, of the total fungi isolated. These fungi caused severe necrosis in daffodil bulbs. HWT at 44 C for 240 minutes reduced the number of colonies recovered from bulbs. The effects of formaldehyde, glutaraldehyde, and sodium hypochlorite in reducing the population of fungi within bulbs were variable. Satisfactory control of D. dipsaci within bulbs can be achieved with HWT of bulbs at 44 C for 150 minutes with 0.37% formaldehyde or at 44 C for 240 minutes without chemicals. PMID:19279827

  14. Immunohistochemical and morphometric analysis of intestinal full-thickness biopsy samples from cats with lymphoplasmacytic inflammatory bowel disease.

    PubMed

    Marsilio, S; Kleinschmidt, S; Nolte, I; Hewicker-Trautwein, M

    2014-05-01

    The distribution and numbers of CD3(+) T lymphocytes, immunoglobulin(+) plasma cells and calprotectin (L1)(+) macrophages was analyzed in full-thickness, formalin-fixed biopsy samples from the small intestine (duodenum, jejunum and ileum) and from the colon from nine cats with clinical signs of inflammatory bowel disease (IBD). All animals had lymphoplasmacytic enteritis or lymphoplasmacytic enterocolitis. Equivalent samples from the same intestinal regions from 12 healthy pet cats served as controls. Labelled cells in the lamina propria were counted by computer-aided morphometry. The different cell types were similarly distributed in both groups, but there were differences in their numbers. There were more CD3(+) T cells in the duodenum and jejunum of cats with IBD; however, the difference was only significant for the duodenum. There were significantly more IgA(+) cells in the duodenal crypt region. There were significantly more IgG(+) cells in the lower jejunal crypt region. Plasma cells expressing IgM were decreased in cats with IBD, but the difference was not significant. L1(+) macrophages were significantly decreased in the lower crypt area of the colon in cats with IBD and there was a trend to decreased L1(+) cells in the upper crypt area of the duodenum and jejunum. Comparison of the results of this study with previous findings on endoscopically-obtained duodenal biopsy samples from cats with IBD revealed some differences. These discrepancies might relate to differences between control cat populations, types of biopsy samples, methodological factors such as different counting techniques and the activity of the disease at the time of sampling.

  15. Structure and diversity in mammalian accessory olfactory bulb.

    PubMed

    Meisami, E; Bhatnagar, K P

    1998-12-15

    The accessory olfactory bulb (AOB) is the first neural integrative center for the olfactory-like vomeronasal sensory system. In this article, we first briefly present an overview of vomeronasal system organization and review the history of the discovery of mammalian AOB. Next, we briefly review the evolution of the vomeronasal system in vertebrates, in particular the reptiles. Following these introductory aspects, the structure of the rodent AOB, as typical of the well-developed mammalian AOB, is presented, detailing laminar organization and cell types as well as aspects of the homology with the main olfactory bulb. Then, the evolutionary origin and diversity of the AOB in mammalian orders and species is discussed, describing structural, phylogenetic, and species-specific variation in the AOB location, shape, and size and morphologic differentiation and development. The AOB is believed to be absent in fishes but present in terrestrial tetrapods including amphibians; among the reptiles AOB is absent in crocodiles, present in turtles, snakes, and some lizards where it may be as large or larger than the main bulb. The AOB is absent in bird and in the aquatic mammals (whales, porpoises, manatees). Among other mammals, AOB is present in the monotremes and marsupials, edentates, and in the majority of the placental mammals like carnivores, herbivores, as well as rodents and lagomorphs. Most bat species do not have an AOB and among those where one is found, it shows marked variation in size and morphologic development. Among insectivores and primates, AOB shows marked variation in occurrence, size, and morphologic development. It is small in shrews and moles, large in hedgehogs and prosimians; AOB continues to persist in New World monkeys but is not found in the adults of the higher primates such as the Old World monkeys, apes, and humans. In many species where AOB is absent in the adult, it often develops in the embryo and fetus but regresses in later stages of

  16. Hepatoprotective Activity of Easter Lily (Lilium longiflorum Thunb.) Bulb Extracts.

    PubMed

    Tang, Wenping; Munafo, John P; Palatini, Kimberly; Esposito, Debora; Huang, Mou-Tuan; Komarnytsky, Slavko; Ho, Chi-Tang; Gianfagna, Thomas J

    2015-11-11

    The hepatoprotective activities of two different extracts, a hydroethanolic crude bulb extract (CB) and a steroidal glycoside-rich 1-butanol extract (BuOH), prepared from the bulbs of Easter lily (Lilium longiflorum Thunb.), were evaluated in a 24 week study in the female KK.Cg-A(y)/J Type 2 diabetic mouse model. Animals were divided into six groups (n = 16): control mice received Easter lily bulb extract-free drinking water together with a low- or high-fat diet (diabetic control); drinking water for the remaining groups was supplemented with CB extract (1%), BuOH extract (0.1 or 0.2%), and reference drug Metformin (0.001%), together with a high-fat diet. Both CB and BuOH extract treatment groups exhibited significantly improved liver function based on comparisons of triglycerides [diabetic 219 ± 34 mg/dL, CB 131 ± 27 mg/dL, BuOH(0.2%) 114 ± 35 mg/dL], CB total cholesterol (TC) (diabetic 196 ± 12 mg/dL, CB 159 ± 5 mg/dL), average liver mass [diabetic 2.96 ± 0.13 g, CB 2.58 ± 0.08 g, BuOH(0.1%) 2.48 ± 0.13 g], alanine transferase [diabetic 74 ± 5 units/L, CB 25 ± 1 units/L, BuOH(0.1%) 45 ± 1 units/L], and histological examinations. Glucose metabolism was improved only in CB, which was confirmed by oral glucose tolerance tests (OGTT) in diet-induced obese C57BL/6J mice exposed to CB extract. These data suggest that steroidal glycosides 1-5 might play a role in the hepatoprotective activity of the BuOH extracts, while the results of the TC measurements and OGTT study indicate that other constituents present in the CB extract are responsible for its hypocholesterolemic and hypoglycemic activity.

  17. 75 FR 44946 - Spirotetramat; Receipt of Application for Emergency Exemption for Use on Dry Bulb Onions in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ... AGENCY Spirotetramat; Receipt of Application for Emergency Exemption for Use on Dry Bulb Onions in... the pesticide spirotetramat (CAS No. 203313-25-1) to treat up to 275 acres of dry bulb onions to... on dry bulb onions to control thrips. Information in accordance with 40 CFR part 166 was submitted...

  18. Adequate histologic sectioning of prostate needle biopsies.

    PubMed

    Bostwick, David G; Kahane, Hillel

    2013-08-01

    No standard method exists for sampling prostate needle biopsies, although most reports claim to embed 3 cores per block and obtain 3 slices from each block. This study was undertaken to determine the extent of histologic sectioning necessary for optimal examination of prostate biopsies. We prospectively compared the impact on cancer yield of submitting 1 biopsy core per cassette (biopsies from January 2010) with 3 cores per cassette (biopsies from August 2010) from a large national reference laboratory. Between 6 and 12 slices were obtained with the former 1-core method, resulting in 3 to 6 slices being placed on each of 2 slides; for the latter 3-core method, a limit of 6 slices was obtained, resulting in 3 slices being place on each of 2 slides. A total of 6708 sets of 12 to 18 core biopsies were studied, including 3509 biopsy sets from the 1-biopsy-core-per-cassette group (January 2010) and 3199 biopsy sets from the 3-biopsy-cores-percassette group (August 2010). The yield of diagnoses was classified as benign, atypical small acinar proliferation, high-grade prostatic intraepithelial neoplasia, and cancer and was similar with the 2 methods: 46.2%, 8.2%, 4.5%, and 41.1% and 46.7%, 6.3%, 4.4%, and 42.6%, respectively (P = .02). Submission of 1 core or 3 cores per cassette had no effect on the yield of atypical small acinar proliferation, prostatic intraepithelial neoplasia, or cancer in prostate needle biopsies. Consequently, we recommend submission of 3 cores per cassette to minimize labor and cost of processing. PMID:23764163

  19. Neuronal fate determinants of adult olfactory bulb neurogenesis.

    PubMed

    Hack, Michael A; Saghatelyan, Armen; de Chevigny, Antoine; Pfeifer, Alexander; Ashery-Padan, Ruth; Lledo, Pierre-Marie; Götz, Magdalena

    2005-07-01

    Adult neurogenesis in mammals is restricted to two small regions, including the olfactory bulb, where GABAergic and dopaminergic interneurons are newly generated throughout the entire lifespan. However, the mechanisms directing them towards a specific neuronal phenotype are not yet understood. Here, we demonstrate the dual role of the transcription factor Pax6 in generating neuronal progenitors and also in directing them towards a dopaminergic periglomerular phenotype in adult mice. We present further evidence that dopaminergic periglomerular neurons originate in a distinct niche, the rostral migratory stream, and are fewer derived from precursors in the zone lining the ventricle. This regionalization of the adult precursor cells is further supported by the restricted expression of the transcription factor Olig2, which specifies transit-amplifying precursor fate and opposes the neurogenic role of Pax6. Together, these data explain both extrinsic and intrinsic mechanisms controlling neuronal identity in adult neurogenesis.

  20. Sulfur-containing components of gamma-irradiated garlic bulbs

    NASA Astrophysics Data System (ADS)

    Kwon, Joong-Ho; Choi, Jong-Uck; Yoon, Hyung-Sik

    Sulfur-containing components associated with garlic flavors were investigated to determine the effect of γ-irradiation at 0.1 kGy on the quality of garlic bulbs ( Allium sativum L.) during storage at 3±1°C and 80±5% RH for 10 months. Irradiation treatment had no influence on the amount of total sulfur and thiosulfinate of stored garlic for 10 months, while the storage period brought about a significant reduction ( P<0.05) in the content of both components after the 6-8th month of storage compared with that at the beginning of storage period. The identity of irradiated alliin ( S-allyl- L-cysteine sulfoxide) at sprout-inhibition dose was confirmed according to thin-layer chromatography, i.r. and NMR spectroscopy data.

  1. Light bulb heat exchanger for magnetohydrodynamic generator applications - Preliminary evaluation

    NASA Technical Reports Server (NTRS)

    Smith, J. M.; Hwang, C. C.; Seikel, G. R.

    1974-01-01

    The light-bulb heat-exchanger concept is investigated as a possible means of using a combustion heat source to supply energy to an inert gas MHD power generator system. In this concept, combustion gases flow through a central passage which consists of a duct with transparent walls through which heat is transferred by radiation to a radiation receiver which in turn heats the inert gas by convection. The effects of combustion-gas emissivity, transparent-wall-transmissivity, radiation-receiver emissivity, and the use of fins in the inert gas coolant passage are studied. The results indicate that inert gas outlet temperatures of 2500 K are possible for combustion temperatures of 3200 K and that sufficient energy can be transferred from the combustion gas to reduce its temperature to approximately 2000 K. At this temperature more conventional heat exchangers can be used.

  2. Investigation of the corona current in a vacuum bulb

    NASA Astrophysics Data System (ADS)

    Chyhin, Vasyl

    2014-05-01

    The dependence of the negative corona current on the gas pressure was studied experimentally and theoretically in view of designing a gas-pressure sensor to be applied in the production of light bulbs. The gas pressure was varied in the range 1×10-2 Torr - 7.4×102 Torr. The dependence of the current on the gas pressure is characterized by a strong heterogeneity. This allowed the implementation of a prototype of a high-speed sensor for a wide range of gas pressures. A mathematical model was developed of the negative corona current behavior by taking into account the ionization of the gas molecules, the attachment and detachment of electrons, the charge drift and the surface ion-electron emission. The results of the numerical simulations describe satisfactorily the experimental dependences.

  3. Rauwolfia vomitoria inhibits olfaction and modifies olfactory bulb cells.

    PubMed

    Ekong, Moses B; Peter, Aniekan I; Edagha, Innocent A; Ekpene, Ubong U; Friday, Daniel A

    2016-06-01

    The rising cost of orthodox medication has endeared so many to the use of herbs for the management of neurological conditions. Rauwolfia vomitoria (RV) one of such herbs is a rainforest shrub whose parts are used locally in the management of psychiatry and other medical issues. Its usefulness though not in doubt is wrapped with adverse reports as its active constituents depletes brain monoamine and dopamine stores. This motivated this research on the effects of the root bark extract on olfaction and the olfactory bulb of adult Wistar rats. Eighteen adult Wistar rats (220g average) were divided into three groups (n=6); control (placebo), 200mg/kg and 400mg/kg RV root bark extract, respectively. The oral administration lasted for seven days and on day 8, test of olfaction was carried out and the animals immediately anaesthetized with ketamine hydrochloride (i.p.) and perfuse-fixed with 10% neutral buffered formalin. All the brains were processed for histology and immunoreactivity. Results showed loss of body weights and olfaction in the 200mg/kg and 400mg/kg RV groups. There was hypertrophy and atrophy of mitral cells respectively, in the 200mg/kg and 400mg/kg RV groups, while there was hyperplasia of cells in the internal granular and plexiform layers of both groups. There was decreased neuron specific enolase (NSE) and neurofilament (NF) expression in the 200mg/kg RV group, while NF and glial fibrillary acidic protein (GFAP) expression was decreased in the 400mg/kg RV group. However, NSE expression was enhanced in the 400mg/kg group, while GFAP expression was enhanced in the 200mg/kg RV group. These results suggest that these doses of RV affect olfaction and appetite, and stimulate adverse cellular changes in the olfactory bulb.

  4. Rauwolfia vomitoria inhibits olfaction and modifies olfactory bulb cells.

    PubMed

    Ekong, Moses B; Peter, Aniekan I; Edagha, Innocent A; Ekpene, Ubong U; Friday, Daniel A

    2016-06-01

    The rising cost of orthodox medication has endeared so many to the use of herbs for the management of neurological conditions. Rauwolfia vomitoria (RV) one of such herbs is a rainforest shrub whose parts are used locally in the management of psychiatry and other medical issues. Its usefulness though not in doubt is wrapped with adverse reports as its active constituents depletes brain monoamine and dopamine stores. This motivated this research on the effects of the root bark extract on olfaction and the olfactory bulb of adult Wistar rats. Eighteen adult Wistar rats (220g average) were divided into three groups (n=6); control (placebo), 200mg/kg and 400mg/kg RV root bark extract, respectively. The oral administration lasted for seven days and on day 8, test of olfaction was carried out and the animals immediately anaesthetized with ketamine hydrochloride (i.p.) and perfuse-fixed with 10% neutral buffered formalin. All the brains were processed for histology and immunoreactivity. Results showed loss of body weights and olfaction in the 200mg/kg and 400mg/kg RV groups. There was hypertrophy and atrophy of mitral cells respectively, in the 200mg/kg and 400mg/kg RV groups, while there was hyperplasia of cells in the internal granular and plexiform layers of both groups. There was decreased neuron specific enolase (NSE) and neurofilament (NF) expression in the 200mg/kg RV group, while NF and glial fibrillary acidic protein (GFAP) expression was decreased in the 400mg/kg RV group. However, NSE expression was enhanced in the 400mg/kg group, while GFAP expression was enhanced in the 200mg/kg RV group. These results suggest that these doses of RV affect olfaction and appetite, and stimulate adverse cellular changes in the olfactory bulb. PMID:27208729

  5. Draft tube flow phenomena across the bulb turbine hill chart

    NASA Astrophysics Data System (ADS)

    Duquesne, P.; Fraser, R.; Maciel, Y.; Aeschlimann, V.; Deschênes, C.

    2014-03-01

    In the framework of the BulbT project launched by the Consortium on Hydraulic Machines and the LAMH (Hydraulic Machine Laboratory of Laval University) in 2011, an intensive campaign to identify flow phenomena in the draft tube of a model bulb turbine has been done. A special focus was put on the draft tube component since it has a particular importance for recuperation in low head turbines. Particular operating points were chosen to analyse flow phenomena in this component. For each of these operating points, power, efficiency and pressure were measured following the IEC 60193 standard. Visualizations, unsteady wall pressure and efficiency measurements were performed in this component. The unsteady wall pressure was monitored at seven locations in the draft tube. The frequency content of each pressure signal was analyzed in order to characterize the flow phenomena across the efficiency hill chart. Visualizations were recorded with a high speed camera using tufts and cavitation bubbles as markers. The predominant detected phenomena were mapped and categorized in relation to the efficiency hill charts obtained for three runner blade openings. At partial load, the vortex rope was detected and characterized. An inflection in the partial load efficiency curves was found to be related to complex vortex rope instabilities. For overload conditions, the efficiency curves present a sharp drop after the best efficiency point, corresponding to an inflection on the power curves. This break off is more severe towards the highest blade openings. It is correlated to a flow separation at the wall of the draft tube. Also, due to the separation occurring in these conditions, a hysteresis effect was observed on the efficiency curves.

  6. Olfactory dysfunction, olfactory bulb pathology and urban air pollution

    PubMed Central

    Calderón-Garcidueñas, Lilian; Franco-Lira, Maricela; Henríquez-Roldán, Carlos; Osnaya, Norma; González-Maciel, Angelica; Reynoso-Robles, Rafael; Villarreal-Calderon, Rafael; Herritt, Lou; Brooks, Diane; Keefe, Sheyla; Palacios-Moreno, Juan; Villarreal-Calderon, Rodolfo; Torres-Jardón, Ricardo; Medina-Cortina, Humberto; Delgado-Chávez, Ricardo; Aiello-Mora, Mario; Maronpot, Robert R.; Doty, Richard L

    2010-01-01

    Mexico City (MC) residents are exposed to severe air pollution and exhibit olfactory bulb inflammation. We compared the olfactory function of individuals living under conditions of extreme air pollution to that of controls from a relatively clean environment and explore associations between olfaction scores, apolipoprotein E (APOE) status, and pollution exposure. The olfactory bulbs (OBs) of 35 MC and 9 controls 20.8 ± 8.5 y were assessed by light and electron microscopy. The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 62 MC / 25 controls 21.2 ±2.7 y. MC subjects had significantly lower UPSIT scores: 34.24 ± 0.42 versus controls 35.76 ± 0.40, p=0.03. Olfaction deficits were present in 35.5% MC and 12% of controls. MC APOE ε 4 carriers failed 2.4 ± 0.54 items in the 10-item smell identification scale from the UPSIT related to Alzheimer's disease, while APOE 2/3 and 3/3 subjects failed 1.36 ± 0.16 items, p = 0.01. MC residents exhibited OB endothelial hyperplasia, neuronal accumulation of particles (2/35), and immunoreactivity to beta amyloid βA42 (29/35) and/or α-synuclein (4/35) in neurons, glial cells and/or blood vessels. Ultrafine particles were present in OBs endothelial cytoplasm and basement membranes. Control OBs were unremarkable. Air pollution exposure is associated with olfactory dysfunction and OB pathology, APOE 4 may confer greater susceptibility to such abnormalities, and ultrafine particles could play a key role in the OB pathology. This study contributes to our understanding of the influences of air pollution on olfaction and its potential contribution to neurodegeneration. PMID:19297138

  7. Warming during cardiopulmonary bypass is associated with jugular bulb desaturation.

    PubMed

    Croughwell, N D; Frasco, P; Blumenthal, J A; Leone, B J; White, W D; Reves, J G

    1992-05-01

    The objective of this study was to characterize cerebral venous effluent during normothermic nonpulsatile cardiopulmonary bypass. Thirty-one (23%) of 133 patients met desaturation criteria (defined as jugular bulb venous oxygen saturation less than or equal to 50% or jugular bulb venous oxygen tension less than or equal to 25 mm Hg) during normothermic cardiopulmonary bypass (after hypothermic cardiopulmonary bypass at 27 degrees to 28 degrees C). Cerebral blood flow, calculated using xenon 133 clearance methodology, was significantly (p less than 0.005) higher in the saturated group (33.7 +/- 10.3 mL.100 g-1.min-1) than in the desaturated group (26.2 +/- 6.9 mL.100 g-1.min-1), whereas the cerebral metabolic rate for oxygen was significantly lower (p less than 0.005) in the saturated group (1.28 +/- 0.39 mL.100 g-.min-1) than in the desaturated group (1.52 +/- 0.36 mL.100 g-1.min-1) at normothermia. The arteriovenous oxygen difference at normothermia was lower in the saturated group (3.92 +/- 1.12 mL/dL) than in the desaturated group (5.97 +/- 1.05 mL/dL). Neuropsychological testing was performed in 74 of the 133 patients preoperatively and on day 7 postoperatively. There was a general decline in mean scores of all tests postoperatively in both groups with no significant difference between the groups. We conclude that cerebral venous desaturation represents a global imbalance in cerebral oxygen supply-demand that occurs during normothermic cardiopulmonary bypass and may represent transient cerebral ischemia. These episodes, however, are not associated with impared neuropsychological test performance as compared with the performance of patients with no evidence of desaturation.

  8. Functional properties of dopaminergic neurones in the mouse olfactory bulb

    PubMed Central

    Pignatelli, Angela; Kobayashi, Kazuto; Okano, Hideyuki; Belluzzi, Ottorino

    2005-01-01

    The olfactory bulb of mammals contains a large population of dopaminergic interneurones within the glomerular layer. Dopamine has been shown both in vivo and in vitro to modulate several aspects of olfactory information processing, but the functional properties of dopaminergic neurones have never been described due to the inability to recognize these cells in living preparations. To overcome this difficulty, we used a transgenic mouse strain harbouring an eGFP (enhanced green fluorescent protein) reporter construct under the promoter of tyrosine hydroxylase, the rate-limiting enzyme for cathecolamine synthesis. As a result, we were able to identify dopaminergic neurones (TH-GFP cells) in living preparations and, for the first time, we could study the functional properties of such neurones in the olfactory bulb, in both slices and dissociated cells. The most prominent feature of these cells was the autorhythmicity. In these cells we identified five main voltage-dependent conductances: the two having largest amplitude were a fast transient Na+ current and a delayed rectifier K+ current. In addition, we observed three smaller inward currents, sustained by Na+ ions (persistent type) and by Ca2+ ions (LVA and HVA). Using pharmacological tools and ion substitution methods we showed that the pacemaking process is supported by the interplay of the persistent Na+ current and of a T-type Ca2+ current. We carried out a complete kinetical analysis of the five conductances present in these cells, and developed a Hodgkin-Huxley model of TH-GFP cells, capable of reproducing accurately the properties of living cells, including autorhytmicity, and allowing a precise understanding of the process. PMID:15731185

  9. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Autopsy; biopsy. 718.106 Section 718.106 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND... pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence...

  10. Transjugular liver biopsy: indications, technique and results.

    PubMed

    Dohan, A; Guerrache, Y; Boudiaf, M; Gavini, J-P; Kaci, R; Soyer, P

    2014-01-01

    Transjugular liver biopsy is a safe, effective and well-tolerated technique to obtain liver tissue specimens in patients with diffuse liver disease associated with severe coagulopathies or massive ascites. Transjugular liver biopsy is almost always feasible. The use of ultrasonographic guidance for percutaneous puncture of the right internal jugular vein is recommended to decrease the incidence of local cervical minor complications. Semiautomated biopsy devices are very effective in obtaining optimal tissue samples for a precise and definite histological diagnosis with a very low rate of complication. The relative limitations of transjugular liver biopsy are the cost, the radiation dose given to the patient, the increased procedure time by comparison with the more common percutaneous liver biopsy, and the need of a well-trained interventional radiologist. PMID:24007769

  11. Biopsy needle detection in transrectal ultrasound.

    PubMed

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  12. Open lung biopsy in immunocompromised patients.

    PubMed

    McKenna, R J; Mountain, C F; McMurtrey, M J

    1984-11-01

    Increased use of open lung biopsy in the search for a treatable etiology of acute interstitial pneumonitis (AIP) in immunocompromised patients is based on the assumption that examination and cultures from biopsy specimens will yield significant information leading to beneficial treatment of the condition. To assess the true impact of the results of open lung biopsy on the subsequent treatment and outcome in such patients, a retrospective study was done of 64 consecutive patients undergoing the procedure in a recent five-year period. When open lung biopsy was performed for the diagnosis of AIP in immunocompromised patients after empiric broad spectrum treatment failed, it rarely missed a specific, treatable etiology, if present. However, the results from open lung biopsy infrequently lead to a change in the treatment that improves the patient's clinical course.

  13. Delayed culture of Leishmania in skin biopsies.

    PubMed

    Dedet, J P; Pratlong, F; Pradinaud, R; Moreau, B

    1999-01-01

    Between January 1997 and October 1998, 16 skin biopsies collected from 13 patients with cutaneous leishmaniasis in French Guiana were inoculated in culture medium after travel for 3-17 days from the place of biopsy to the culture laboratory in France. Each biopsy fragment was introduced near the flame of a Bunsen burner into the transport medium (RPMI medium supplemented with 10% fetal calf serum) which was maintained at ambient temperature during postal delivery to France. In France the biopsies were ground in sterile saline before being inoculated into NNN culture tubes. The cultures were incubated at 25 degrees C and subcultured every week until the 5th week. The cultures were positive in 9 cases, remained negative in 4, and were contaminated in 3 cases. Positive results were obtained at all seasons and for 3 different Leishmania species. The study indicates that delayed culture can yield useful results from biopsies taken in field conditions.

  14. Needle catheter duodenostomy: a technique for duodenal alimentation of birds.

    PubMed

    Goring, R L; Goldman, A; Kaufman, K J; Roberts, C; Quesenberry, K E; Kollias, G V

    1986-11-01

    A technique for duodenal alimentation (needle catheter duodenostomy) of birds was developed, using the domestic pigeon (Columba livia) as the experimental model. A needle catheter was inserted into the descending duodenum of 5 pigeons and was secured to the body wall and dorsum of each bird. A liquid diet was administered daily (in equal amounts of 0, 4, 8, 12, and 16 hours) for 14 days without adverse effects. On day 15, the catheters were removed, and the birds immediately resumed normal consumption of a pigeon ration and water diet. Although 4 of the 5 birds had minor weight loss, dietary alterations probably could be used on an individual basis to alleviate this problem. After oral alimentation was resumed, the 5 birds exceeded their initial body weight within 7 days. Four weeks after catheter removal, positive-contrast radiographic evaluations indicated that the duodenum of each pigeon appeared normal. Needle catheter duodenostomy was a viable method of alimentation in the domestic pigeon. This technique should be applicable for other avian species requiring bypass of the upper gastrointestinal tract proximal to the region of catheter insertion in the duodenum.

  15. Effect of sucralfate on gastric emptying in duodenal ulcer patients

    SciTech Connect

    Petersen, J.M.; Caride, V.J.; Prokop, E.K.; Troncale, F.; McCallum, R.W.

    1985-05-01

    Duodenal ulcer (DU) patients may have accelerated gastric emptying (GE) suggesting that there is an increase in unbuffered gastric acid reaching the duodenum contributing to DU disease. Aluminum-containing antacids were shown to delay GE. The authors' aim was to investigate whether another aluminum-containing compound, Sucralfate, affects GE in normal and DU patients. Nine normal volunteers and 10 patients with documented DU disease were studied. For each test the subject ingested a meal composed of chicken liver Tc-99m-S-C mixed with beef stew and eaten with 4 oz. of water labelled with 100..mu..Ci of III-in-DTPA. On two separate days, subjects received 1 gram of Sucralfate (190 mg of aluminum per gram) or placebo in a randomized double-blind fashion one hour prior to the test meal. GE of liquids and solids in normal subjects was not significantly changed by Sucralfate. Sucralfate in the DU patients significantly slowed liquid emptying in the initial 40 min and solid food throughout the study compared to placebo (p<0.05). This paper summarizes that; GE of solids but not liquids is accelerated in DU patients compared to normal subjects; and sucralfate delays GE of both liquid and solid components of a meal in DU patients but has no effect on GE in normals. The authors conclude that a slowing of gastric emptying possibly mediated by aluminum ions, may be one mechanism by which Sucralfate enhances healing and decreases recurrence of DU.

  16. PDX-1 (pancreatic/duodenal homeobox-1 protein 1).

    PubMed

    Pedica, F; Beccari, S; Pedron, S; Montagna, L; Piccoli, P; Doglioni, C; Chilosi, M

    2014-12-01

    The homeodomain-containing transcription factor pancreatic duodenal homeobox 1 (PDX-1) plays a key role in pancreatic development and β-cell function. It is a major regulator of transcription in pancreatic cells, and transactivates the insulin gene by binding to a specific DNA motif in its promoter region. Glucose also regulates insulin gene transcription through PDX-1. It has been shown that PDX-1 is required for maintaining pancreatic islet functions by activating gene expression and has a dual role in pancreatic development. It initially contributes to pancreatic formation during embryogenesis and subsequently regulates the pancreatic islet cell physiology in mature islet cells. Because of this key role in the embryologic development of the pancreas, PDX-1 expression has been investigated in pancreatic cancer cell lines and human tumors. Moreover, a few reports have described expression of PDX-1 in other human neoplasms and have investigated its potential role in differential diagnosis, but data on normal human tissues are lacking. Understanding the molecular mechanisms of pancreas formation, and especially the function of PDX-1, may contribute to the improved treatment and prevention of debilitating diseases such as diabetes, insulinomas and pancreatic carcinomas. Nevertheless, further studies are needed concerning its possible application in routine practice.

  17. Long-term risk of gastrointestinal cancers in persons with gastric or duodenal ulcers.

    PubMed

    Søgaard, Kirstine K; Farkas, Dóra K; Pedersen, Lars; Lund, Jennifer L; Thomsen, Reimar W; Sørensen, Henrik T

    2016-06-01

    Peptic ulcer predicts gastric cancer. It is controversial if peptic ulcers predict other gastrointestinal cancers, potentially related to Helicobacter pylori or shared lifestyle factors. We hypothesized that gastric and duodenal ulcers may have different impact on the risk of gastrointestinal cancers. In a nationwide cohort study using Danish medical databases 1994-2013, we quantified the risk of gastric and other gastrointestinal cancers among patients with duodenal ulcers (dominantly H. pylori-related) and gastric ulcers (dominantly lifestyle-related) compared with the general population. We started follow-up 1-year after ulcer diagnosis to avoid detection bias and calculated absolute risks of cancer and standardized incidence ratios (SIRs). We identified 54,565 patients with gastric ulcers and 38,576 patients with duodenal ulcers. Patient characteristics were similar in the two cohorts. The 1-5-year risk of any gastrointestinal cancer was slightly higher for gastric ulcers patients (2.1%) than for duodenal ulcers patients (2.0%), and SIRs were 1.38 (95% CI: 1.31-1.44) and 1.30 (95% CI: 1.23-1.37), respectively. The SIR of gastric cancer was higher among patients with gastric ulcer than duodenal ulcer (1.92 vs. 1.38), while the SIRs for other gastrointestinal cancers were similar (1.33 vs. 1.29). Compared with gastric ulcer patients, duodenal ulcer patients were at lower risk of smoking- and alcohol-related gastrointestinal cancers. The risk of nongastric gastrointestinal cancers is increased both for patients with gastric ulcers and with duodenal ulcers, but absolute risks are low. H. pylori may be less important for the development of nongastric gastrointestinal cancer than hypothesized.

  18. Increasing olfactory bulb volume due to treatment of chronic rhinosinusitis--a longitudinal study.

    PubMed

    Gudziol, V; Buschhüter, D; Abolmaali, N; Gerber, J; Rombaux, P; Hummel, T

    2009-11-01

    Differentiation of progenitor cells into neurons in the olfactory bulb depends on olfactory stimulation that can lead to an increase in olfactory bulb volume. In this study, we investigated whether the human olfactory bulb volume increases with increasing olfactory function due to treatment of chronic rhinosinusitis. Nineteen patients with chronic rhinosinusitis were investigated before and after treatment. For comparison, additional measurements were performed in 18 healthy volunteers. Volumetric measurements of the olfactory bulb were based on planimetric manual contouring of magnetic resonance scans. Olfactory function was evaluated separately for each nostril using tests for odour threshold, odour discrimination and odour identification. Measurements were performed on two occasions, 3 months apart. In healthy controls, the olfactory bulb volume did not change significantly between the two measurements. In contrast, the olfactory bulb volume in patients increased significantly from the initial 64.5 +/- 3.2 to 70.0 +/- 3.5 mm(3) on the left side (P = 0.02) and from 60.9 +/- 3.5 to 72.4 +/- 2.8 mm(3) on the right side (P < 0.001). The increase in olfactory bulb volume correlated significantly with an increase in odour thresholds (r = 0.60, P = 0.006, left side; r = 0.49, P = 0.03, right side), but not with changes in odour discrimination or odour identification. Results of this study support the idea that stimulation of olfactory receptor neurons impacts on the cell death in the olfactory bulb, not only in rodents but also in humans. To our knowledge, this is the first longitudinal study that describes an enlargement of the human olfactory bulb due to improvement of peripheral olfactory function. PMID:19773353

  19. Olfactory bulb recovery following reversible deafferentation with repeated detergent application in the adult zebrafish.

    PubMed

    Paskin, T R; Iqbal, T R; Byrd-Jacobs, C A

    2011-11-24

    The neuroplasticity and regenerative properties of the olfactory system make it a useful model for studying the ability of the nervous system to recover from damage. We have developed a novel method for examining the effects of long-term deafferentation and regeneration of the olfactory organ and resulting influence on the olfactory bulb in adult zebrafish. To test the hypothesis that repeated damage to the olfactory epithelium causes reduced olfactory bulb afferent input and cessation of treatment allows recovery, we chronically ablated the olfactory organ every 2-3 days for 3 weeks with the detergent Triton X-100 while another group was allowed 3 weeks of recovery following treatment. Animals receiving chronic treatment showed severe morphological disruption of the olfactory organ, although small pockets of epithelium remained. These pockets were labeled by anti-calretinin, indicating the presence of mature olfactory sensory neurons (OSNs). Following a recovery period, the epithelium was more extensive and neuronal labeling increased, with three different morphologies of sensory neurons observed. Repeated peripheral exposure to Triton X-100 also affected the olfactory bulb. Bulb volumes and anti-tyrosine hydroxylase-like immunoreactivity, which is an indicator of afferent activity, were diminished in the olfactory bulb of the chronically treated group compared to the control side. In the recovery group, there was little difference in bulb volume or antibody staining. These results suggest that repeated, long-term nasal irrigation with Triton X-100 eliminates a substantial number of mature OSNs and reduces afferent input to the olfactory bulb. It also appears that these effects are reversible and regeneration will occur in both the peripheral olfactory organ and the olfactory bulb when given time to recover following cessation of treatment. We report here a new method that allows observation not only of the effects of deafferentation on the olfactory bulb but also

  20. Analysis of the Dryden Wet Bulb GLobe Temperature Algorithm for White Sands Missile Range

    NASA Technical Reports Server (NTRS)

    LaQuay, Ryan Matthew

    2011-01-01

    In locations where workforce is exposed to high relative humidity and light winds, heat stress is a significant concern. Such is the case at the White Sands Missile Range in New Mexico. Heat stress is depicted by the wet bulb globe temperature, which is the official measurement used by the American Conference of Governmental Industrial Hygienists. The wet bulb globe temperature is measured by an instrument which was designed to be portable and needing routine maintenance. As an alternative form for measuring the wet bulb globe temperature, algorithms have been created to calculate the wet bulb globe temperature from basic meteorological observations. The algorithms are location dependent; therefore a specific algorithm is usually not suitable for multiple locations. Due to climatology similarities, the algorithm developed for use at the Dryden Flight Research Center was applied to data from the White Sands Missile Range. A study was performed that compared a wet bulb globe instrument to data from two Surface Atmospheric Measurement Systems that was applied to the Dryden wet bulb globe temperature algorithm. The period of study was from June to September of2009, with focus being applied from 0900 to 1800, local time. Analysis showed that the algorithm worked well, with a few exceptions. The algorithm becomes less accurate to the measurement when the dew point temperature is over 10 Celsius. Cloud cover also has a significant effect on the measured wet bulb globe temperature. The algorithm does not show red and black heat stress flags well due to shorter time scales of such events. The results of this study show that it is plausible that the Dryden Flight Research wet bulb globe temperature algorithm is compatible with the White Sands Missile Range, except for when there are increased dew point temperatures and cloud cover or precipitation. During such occasions, the wet bulb globe temperature instrument would be the preferred method of measurement. Out of the 30

  1. Downregulation of duodenal SLC transporters and activation of proinflammatory signaling constitute the early response to high altitude in humans.

    PubMed

    Wojtal, Kacper A; Cee, Alexandra; Lang, Silvia; Götze, Oliver; Frühauf, Heiko; Geier, Andreas; Pastor-Anglada, Marçal; Torres-Torronteras, Javier; Martí, Ramon; Fried, Michael; Lutz, Thomas A; Maggiorini, Marco; Gassmann, Max; Rogler, Gerhard; Vavricka, Stephan R

    2014-10-01

    Solute carrier (SLC) transporters mediate the uptake of biologically active compounds in the intestine. Reduced oxygenation (hypoxia) is an important factor influencing intestinal homeostasis. The aim of this study was to investigate the pathophysiological consequences of hypoxia on the expression and function of SLCs in human intestine. Hypoxia was induced in human intestinal epithelial cells (IECs) in vitro (0.2; 1% O2 or CoCl2). For human in vivo studies, duodenal biopsies and serum samples were obtained from individuals (n = 16) acutely exposed to 4,554 meters above sea levels. Expression of relevant targets was analyzed by quantitative PCR, Western blotting, or immunofluorescence. Serum levels of inflammatory mediators and nucleosides were determined by ELISA and LC/MS-MS, respectively. In the duodenum of volunteers exposed to high altitude we observed decreased mRNA levels of apical sodium-dependent bile acid transporter (ASBT), concentrative nucleoside transporters 1/2 (CNT1/2), organic anion transporting polypeptide 2B1 (OATP2B1), organic cation transporter 2 (OCTN2), peptide transporter 1 (PEPT1), serotonin transporter (SERT), and higher levels of IFN-γ, IL-6, and IL-17A. Serum levels of IL-10, IFN-γ, matrix metalloproteinase-2 (MMP-2), and serotonin were elevated, whereas the levels of uridine decreased upon exposure to hypoxia. Hypoxic IECs showed reduced levels of equilibrative nucleoside transporter 2 (ENT2), OCTN2, and SERT mRNAs in vitro, which was confirmed on the protein level and was accompanied by activation of ERK1/2, increase of hypoxia-inducible factor (HIF) proteins, and production of IL-8 mRNA. Costimulation with IFN-γ and IL-6 during hypoxia further decreased the expression of SERT, ENT2, and CNT2 in vitro. Reduced oxygen supply affects the expression pattern of duodenal SLCs that is accompanied by changes in serum levels of proinflammatory cytokines and biologically active compounds demonstrating that intestinal transport is affected

  2. Transplant biopsy beyond light microscopy.

    PubMed

    Adam, Benjamin; Mengel, Michael

    2015-01-01

    Despite its long-standing status as the diagnostic "gold standard", the renal transplant biopsy is limited by a fundamental dependence on descriptive, empirically-derived consensus classification. The recent shift towards personalized medicine has resulted in an increased demand for precise, mechanism-based diagnoses, which is not fully met by the contemporary transplantation pathology standard of care. The expectation is that molecular techniques will provide novel pathogenetic insights that will allow for the identification of more accurate diagnostic, prognostic, and therapeutic targets. Here we review the current state of molecular renal transplantation pathology. Despite significant research activity and progress within the field, routine adoption of clinical molecular testing has not yet been achieved. The recent development of novel molecular platforms suitable for use with formalin-fixed paraffin-embedded tissue will offer potential solution for the major barriers to implementation. The recent incorporation of molecular diagnostic criteria into the 2013 Banff classification is a reflection of progress made and future directions in the area of molecular transplantation pathology. Transcripts related to endothelial injury and NK cell activation have consistently been shown to be associated with antibody-mediated rejection. Prospective multicenter validation and implementation of molecular diagnostics for major entities remains an unmet clinical need in transplantation. It is expected that an integrated system of transplantation pathology diagnosis comprising molecular, morphological, serological, and clinical variables will ultimately provide the greatest diagnostic precision. PMID:26249165

  3. Linear halogen bulb as a powerful light source for physics experiments

    NASA Astrophysics Data System (ADS)

    Bochníček, Zdeněk

    2015-11-01

    The paper describes the usage of a conventional lamp equipped with a linear halogen bulb for physics experiments. The irradiance gain and limitation of spectral resolution are treated in detail theoretically and verified experimentally. The analysis shows that, in comparison with a standard bulb and slit arrangement, the linear bulb can increase irradiance of the spectrum image by an order of magnitude without a significant loss of spectral resolution in comparable experimental arrangements. Some concrete examples of experiments with a white light spectrum and diffraction are presented.

  4. Effect of Sulindac and Erlotinib vs Placebo on Duodenal Neoplasia in Familial Adenomatous Polyposis

    PubMed Central

    Samadder, N. Jewel; Neklason, Deborah W.; Boucher, Kenneth M.; Byrne, Kathryn R.; Kanth, Priyanka; Samowitz, Wade; Jones, David; Tavtigian, Sean V.; Done, Michelle W.; Berry, Therese; Jasperson, Kory; Pappas, Lisa; Smith, Laurel; Sample, Danielle; Davis, Rian; Topham, Matthew K.; Lynch, Patrick; Strait, Elena; McKinnon, Wendy; Burt, Randall W.; Kuwada, Scott K.

    2016-01-01

    IMPORTANCE Patients with familial adenomatous polyposis (FAP) are at markedly increased risk for duodenal polyps and cancer. Surgical and endoscopic management of duodenal neoplasia is difficult and chemoprevention has not been successful. OBJECTIVE To evaluate the effect of a combination of sulindac and erlotinib on duodenal adenoma regression in patients with FAP. DESIGN, SETTING, AND PARTICIPANTS Double-blind, randomized, placebo-controlled trial, enrolling 92 participants with FAP, conducted from July 2010 through June 2014 at Huntsman Cancer Institute in Salt Lake City, Utah. INTERVENTIONS Participants with FAP were randomized to sulindac (150 mg) twice daily and erlotinib (75 mg) daily (n = 46) vs placebo (n = 46) for 6 months. MAIN OUTCOMES AND MEASURES The total number and diameter of polyps in the proximal duodenum were mapped at baseline and 6 months. The primary outcome was change in total polyp burden at 6 months. Polyp burden was calculated as the sum of the diameters of polyps. The secondary outcomes were change in total duodenal polyp count, change in duodenal polyp burden or count stratified by genotype and initial polyp burden, and percentage of change from baseline in duodenal polyp burden. RESULTS Ninety-two participants (mean age, 41 years [range, 24–55]; women, 56 [61%]) were randomized when the trial was stopped by the external data and safety monitoring board because the second preplanned interim analysis met the prespecified stopping rule for superiority. Grade 1 and 2 adverse events were more common in the sulindac-erlotinib group, with an acne-like rash observed in 87% of participants receiving treatment and 20% of participants receiving placebo (P < .001). Only 2 participants experienced grade 3 adverse events. OutcomeBaseline6-moFollow-upMedianChangeBetween-GroupDifference (95% CI)PValueMedian Duodenal Polyp Burden, mmSulindac-erlotinib29.019.5−8.5−19.0 (−32.0 to −10.9)<.001Placebo23.031.08.0Median Duodenal Polyp Count, No

  5. Utilization trends and positive biopsy rates for prostate biopsies in the United States: 2005 to 2011.

    PubMed

    Kapoor, Deepak A; Bostwick, David G; Mendrinos, Savvas E; Anderson, Ann E; Olsson, Carl A

    2013-01-01

    This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in > 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%-this was identical at both the NRL and UPL (P = .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P = .03). For the most recent 3-year period (2009-2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P = 0.08). Positive biopsy rate correlated strongly (P < .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009 to

  6. Utilization Trends and Positive Biopsy Rates for Prostate Biopsies in the United States: 2005 to 2011

    PubMed Central

    Kapoor, Deepak A; Bostwick, David G; Mendrinos, Savvas E; Anderson, Ann E; Olsson, Carl A

    2013-01-01

    This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in > 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%-this was identical at both the NRL and UPL (P = .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P = .03). For the most recent 3-year period (2009–2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P = 0.08). Positive biopsy rate correlated strongly (P < .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009

  7. Prevention of sepsis prior to prostate biopsy

    PubMed Central

    Toner, Liam; Bolton, Damien M

    2016-01-01

    Purpose Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. Results Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice. PMID:26981590

  8. Duodenal ileus caused by a calf feeding nipple in a cow

    PubMed Central

    2011-01-01

    Background The aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow. Case Presentation The clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation. Conclusions To our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar. PMID:21211012

  9. A Newly Designed Stent for Management of Malignant Distal Duodenal Stenosis

    SciTech Connect

    Zhou, Wei-Zhong Yang, Zheng-Qiang Liu, Sheng Zhou, Chun-Gao Xia, Jin-Guo Zhao, Lin-Bo Shi, Hai-Bin

    2015-02-15

    PurposeTo evaluate the clinical effectiveness of a newly designed stent for the treatment of malignant distal duodenal stenosis.MethodsFrom March 2011 to May 2013, six patients with malignant duodenal stenosis underwent fluoroscopically guided placement of the new duodenal stent consisting of braided, nested stent wires, and a delivery system with a metallic mesh inner layer. Primary diseases were pancreatic cancer in three patients, gastric cancer in two patients, and endometrial stromal sarcoma in one patient. Duodenal obstructions were located in the horizontal part in two patients, the ascending part in two patients, and the duodenojejunal flexure in two patients. Technical success, defined as the successful stent deployment, clinical symptoms before and after the procedure, and complications were evaluated.ResultsTechnical success was achieved in all patients. No major complications were observed. Before treatment, two patients could not take any food and the gastric outlet obstruction scoring system (GOOSS) score was 0; the other four patients could take only liquids orally (GOOSS score = 1). After treatment, five patients could take soft food (GOOSS score = 2) and one patient could take a full diet (GOOSS score = 3). The mean duration of primary stent patency was 115.7 days.ConclusionsThe newly designed stent is associated with a high degree of technical success and good clinical outcome and may be clinically effective in the management of malignant distal duodenal obstruction.

  10. The protective effect of zinc sulphate pretreatment against duodenal ulcers in the rat.

    PubMed

    Troskot, B; Simicevic, V N; Dodig, M; Rotkvic, I; Ivankovic, D; Duvnjak, M

    1997-10-01

    Exogenously administered zinc compounds have been shown to possess antiulcer activity in the development of gastric lesions. The aim of this study was to investigate the effects of zinc sulphate pretreatment of rats on cysteamine-induced duodenal ulcers and to correlate them with changes in zinc serum and tissue levels. Atomic absorption spectrophotometry was used to determine zinc serum and tissue concentrations in all animal groups. Cysteamine produced marked duodenal ulceration in control animals 24 h after application, with an increase in endogenous zinc tissue concentrations and a marked decrease in serum concentrations. Zinc sulphate (20, 40 or 80 mg kg-1) applied per os one hour prior to cysteamine application inhibited the development of duodenal lesions in a dose-related manner. The application of zinc sulphate in a single intraperitoneal (i.p.) application (80 mg kg-1) did not, however, prevent the formation of duodenal lesions. In order to assess zinc absorption from the gastrointestinal tract, one group of rats received a single oral dose of zinc sulphate (80 mg kg-1) without cysteamine application. The observations of this study seem to indicate that zinc plays an important cytoprotective role in duodenal ulcer disease.

  11. ERCP-induced duodenal perforation successfully treated with endoscopic purse-string suture: a case report.

    PubMed

    Li, Quanpeng; Ji, Jie; Wang, Fei; Ge, Xianxiu; Nie, Junjie; Xu, Boming; Zhang, Xiuhua; Jiang, Guobing; Miao, Lin

    2015-07-10

    Duodenal perforation is one of the most serious complications of endoscopic retrograde cholangiopancreatography (ERCP) and is difficult to manage. Recently, endoscopic purse-string suture, using endoloops with endoclips, is a relatively new technology and has provided good clinical results. However, the study and use of endoscopic purse-string suture on duodenal perforation is less and its feasibility and safety are unknown. Here, we report a case of ERCP-induced duodenal perforation successfully treated with endoscopic purse-string suture. During ERCP, fluoroscopy revealed abnormal perinephric gas shadowing after breaking and extracting the stones with a stone-removal basket. Then duodenal endoscopy showed an approximately 2.0 cm × 1.5 cm perforation on the lateral duodenal wall, with visible retroperitoneal loose connective tissue. Titanium clips were used to attempt closure of the perforation but failed because of the long diameter of the injury. Therefore, an endoscopic purse-string suture, using endoloops with endoclips, was employed with an Olympus double-lumen endoscope. The perforation was successfully closed. At the 2-month follow-up visit, the patient had no complaints or symptoms. Our case once again proved its feasibility and safety and provided a new perspective for surgeons.

  12. Correlation of salivary and gastric acid secretions in duodenal ulcer patients in tropics

    PubMed Central

    Nagwani, P. L.; Naik, S. R.; Sachdev, S.; Srivastava, P. N.; Chuttani, H. K.

    1979-01-01

    Salivary flow rates on mechanical stimulation by forced spitting method and by chemical stimulation with 10% citric acid and gastric acidity using an augmented histamine test were determined in 20 adult patients suffering from duodenal ulcer and in 20 adult control subjects matched with respect to age, sex, and body weight. Salivary flow rates were found to be much higher in response to chemical than to mechanical stimulus in both the groups. Duodenal ulcer patients exhibited an unexplained exaggerated response to chemical stimulation. Salivary pH, amylase, sodium, and potassium levels showed no significant differences between the two groups. The flow rates by either method generally showed a positive correlation with body weight in both the groups. Histamine stimulated gastric acid secretion was higher in duodenal ulcer patients than in controls. Acid secretion did not appear to be related to weight and also showed no consistent correlation with the salivary flow rates. It was concluded that (1) the salivary flow was dependent on body weight in duodenal ulcer patients as well as in controls, and (2) although salivary gland hyperplasia could be postulated in duodenal ulcer patients on the basis of increased salivary flow, the latter was poorly related to maximal acid secretion and therefore, if a combination of parietal cell and salivary gland hyperplasia did exist, it should be considered as incidental. PMID:488755

  13. Endoscopic Closure for EUS and ERCP Related Duodenal Perforation by Endoclips

    PubMed Central

    Liu, Yaping

    2016-01-01

    Objective. To investigate the therapeutic safety, feasibility, and efficacy of endoclips for closing the endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) related duodenal perforation in a retrospective study from a single center. Methods. Patients who developed EUS and ERCP related duodenal perforation between January 2012 and January 2015 were included in the study. All the cases underwent endoscopic closure by endoclips, and the efficacy, feasibility, and safety of this technique were evaluated. Results. During the study period, a total of 17,406 patients were treated by EUS and/or ERCP. EUS and ERCP related duodenal perforation occurred in 9 cases (0.05%): 2 males and 7 females. The mean age was 69 years (range: 59–79 years). The success rate of endoscopic closure by endoclips was 100%. The mean procedure time was 45 ± 12.5 min. The mean number of endoclips placed for the closure of the duodenal perforation was 7 ± 3.2. All the patients recovered completely without any severe complications. Conclusion. The endoscopic closure by using endoclips is recommended as the first-line treatment for duodenal perforation associated with EUS and ERCP.

  14. PET-Based Percutaneous Needle Biopsy.

    PubMed

    El-Haddad, Ghassan

    2016-07-01

    PET can be used to guide percutaneous needle biopsy to the most metabolic lesion, improving diagnostic yield. PET biopsy guidance can be performed using visual or software coregistration, electromagnetic needle tracking, cone-beam computed tomography (CT), and intraprocedural PET/CT guidance. PET/CT-guided biopsies allow the sampling of lesions that may not be clearly visible on anatomic imaging, or of lesions that are morphologically normal. PET can identify suspicious locations within complex tumors that are most likely to contain important diagnostic and prognostic information. PMID:27321036

  15. Radiation therapy for localized duodenal low-grade follicular lymphoma

    PubMed Central

    Harada, Arisa; Oguchi, Masahiko; Terui, Yasuhito; Takeuchi, Kengo; Igarashi, Masahiro; Kozuka, Takuyo; Harada, Ken; Uno, Takashi; Hatake, Kiyohiko

    2016-01-01

    The aim of this study was to evaluate the initial treatment results and toxicities of radiation therapy for patients with early stage low-grade follicular lymphoma (FL) arising from the duodenum. We reviewed 21 consecutive patients with early stage duodenal FL treated with radiation therapy between January 2005 and December 2013 at the Cancer Institute Hospital, Tokyo. The characteristics of patients were: median age 62 years (range, 46–79 years), gender (male, 6; female, 15), clinical stage (I, 20; II1, 1), histological grade (I, 17; II, 4). All patients were treated with radiation therapy alone. The median radiation dose was 30.6 Gy (range, 30.6–39.6) in 17 fractions. The involved-site radiation therapy was delivered to the whole duodenum. The median follow-up time was 43.2 months (range 21.4–109.3). The 3-year overall survival (OS), relapse-free survival (RFS) and local control (LC) rates were 94.7%, 79.3% and 100%, respectively. There were four relapses documented outside the treated volumes: two in the gastrointestinal tract (jejunum, terminal ileum), one in an abdominal lymph node (mesenteric lymph node) and one in the bone marrow. None died of the disease; one death was due to acute myeloid leukemia. No toxicities greater than Grade 1 were observed during treatment and over the follow-up time. The 30.6 Gy of involved-site radiation therapy provided excellent local control with very low toxicities. Radiation therapy could be an effective and safe treatment option for patients with localized low grade FL arising from the duodenum. PMID:27009323

  16. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    MedlinePlus

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  17. Formaldehyde exposure alters miRNA expression profiles in the olfactory bulb.

    PubMed

    Li, Guifa; Yang, Jing; Ling, Shucai

    2015-01-01

    It has been reported that inhaling formaldehyde (FA) causes damage to the central nervous system. However, it is unclear whether FA can disturb the function of the olfactory bulb. Using a microarray, we found that FA inhalation altered the miRNA expression profile. Functional enrichment analysis of the predicted targets of the changed miRNA showed that the enrichment canonical pathways and networks associated with cancer and transcriptional regulation. FA exposure disrupts miRNA expression profiles within the olfactory bulb.

  18. Centrifugal telencephalic afferent connections to the main and accessory olfactory bulbs.

    PubMed

    Mohedano-Moriano, Alicia; de la Rosa-Prieto, Carlos; Saiz-Sanchez, Daniel; Ubeda-Bañon, Isabel; Pro-Sistiaga, Palma; de Moya-Pinilla, Miguel; Martinez-Marcos, Alino

    2012-01-01

    Parallel to the olfactory system, most mammals possess an accessory olfactory or vomeronasal system. The olfactory and vomeronasal epithelia project to the main and accessory olfactory bulbs, which in turn project to adjacent areas of the telencephalon, respectively. New data indicate that projections arising from the main and accessory olfactory bulbs partially converge in the rostral telencephalon and are non-overlapping at caudal telencephalic levels. Therefore, the basal telencephalon should be reclassified in olfactory, vomeronasal, and mixed areas. On the other hand, it has been demonstrated that virtually all olfactory- and vomeronasal-recipient structures send reciprocal projections to the main and accessory olfactory bulbs, respectively. Further, non-chemosensory recipient structures also projects centrifugally to the olfactory bulbs. These feed-back projections appear to be essential modulating processing of chemosensory information. The present work aims at characterizing centrifugal projections to the main and accessory olfactory bulbs arising from olfactory, vomeronasal, mixed, and non-chemosensory recipient telencephalic areas. This issue has been addressed by using tracer injections in the rat and mouse brain. Tracer injections were delivered into the main and accessory olfactory bulbs as well as in olfactory, vomeronasal, mixed, and non-chemosensory recipient telencephalic structures. The results confirm that olfactory- and vomeronasal-recipient structures project to the main and accessory olfactory bulbs, respectively. Interestingly, olfactory (e.g., piriform cortex), vomeronasal (e.g., posteromedial cortical amygdala), mixed (e.g., the anterior medial amygdaloid nucleus), and non-chemosensory-recipient (e.g., the nucleus of the diagonal band) structures project to the main and to the accessory olfactory bulbs thus providing the possibility of simultaneous modulation and interaction of both systems at different stages of chemosensory processing.

  19. Centrifugal telencephalic afferent connections to the main and accessory olfactory bulbs

    PubMed Central

    Mohedano-Moriano, Alicia; de la Rosa-Prieto, Carlos; Saiz-Sanchez, Daniel; Ubeda-Bañon, Isabel; Pro-Sistiaga, Palma; de Moya-Pinilla, Miguel; Martinez-Marcos, Alino

    2012-01-01

    Parallel to the olfactory system, most mammals possess an accessory olfactory or vomeronasal system. The olfactory and vomeronasal epithelia project to the main and accessory olfactory bulbs, which in turn project to adjacent areas of the telencephalon, respectively. New data indicate that projections arising from the main and accessory olfactory bulbs partially converge in the rostral telencephalon and are non-overlapping at caudal telencephalic levels. Therefore, the basal telencephalon should be reclassified in olfactory, vomeronasal, and mixed areas. On the other hand, it has been demonstrated that virtually all olfactory- and vomeronasal-recipient structures send reciprocal projections to the main and accessory olfactory bulbs, respectively. Further, non-chemosensory recipient structures also projects centrifugally to the olfactory bulbs. These feed-back projections appear to be essential modulating processing of chemosensory information. The present work aims at characterizing centrifugal projections to the main and accessory olfactory bulbs arising from olfactory, vomeronasal, mixed, and non-chemosensory recipient telencephalic areas. This issue has been addressed by using tracer injections in the rat and mouse brain. Tracer injections were delivered into the main and accessory olfactory bulbs as well as in olfactory, vomeronasal, mixed, and non-chemosensory recipient telencephalic structures. The results confirm that olfactory- and vomeronasal-recipient structures project to the main and accessory olfactory bulbs, respectively. Interestingly, olfactory (e.g., piriform cortex), vomeronasal (e.g., posteromedial cortical amygdala), mixed (e.g., the anterior medial amygdaloid nucleus), and non-chemosensory-recipient (e.g., the nucleus of the diagonal band) structures project to the main and to the accessory olfactory bulbs thus providing the possibility of simultaneous modulation and interaction of both systems at different stages of chemosensory processing

  20. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    PubMed

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing.

  1. Double-blind randomised clinical trial of a pepsin-inhibitory pentapeptide (pepstatin) in the treatment of duodenal ulcer.

    PubMed Central

    Bonnevie, O; Svendsen, L B; Holst-Christensen, J; Johansen, T S; Søltoft, J; Christiansen, P M

    1979-01-01

    In a double-blind randomised clinical trial a specific inhibition of peptic activity with a pentapeptide, pepstatin, had no significant advantage over placebo in the ulcer healing and symptomatology of duodenal ulcer. Thus, the inhibition of pepsin in human gastric juice does not appear to have a major influence on the healing of duodenal ulcer. PMID:385457

  2. Duodenal nutrient infusion: effects on feeding in intact and vagotomized rabbits.

    PubMed

    Rezek, M; Novin, D

    1976-06-01

    A comparative study on the satiating effect of duodenal infusions of glycerol, casein and glucose was performed in intact and vagotomized rabbits during both diuranal and nocturnal periods. All duodenally infused substances had satiating effects. Glycerol infusions produced the largest reduction of food intake during the day while casein hydrolysate infusion was most effective in this respect during the night. The most apparent and consistent effect of vagotomy was the elimination of hypophagic effect of diurnal and nocturnal infusions of glucose. Pretreatment with atropine methyl nitrate, which prevented the evoked gastric contractions in response to electrical stimulation of the efferent cervical vagus nerve in acute preparations but did not influence spontaneous intake in free-feeding animals, had no effect on duodenal glucose induced satiety. This result indicates that afferent vagal mediation of information from peripheral metabolic organs is vital to the short-term glucostatic regulation of food intake.

  3. Perforated Duodenal Ulcer in High Risk Patients: Is Percutaneous Drainage Justified?

    PubMed Central

    Saber, Aly; Gad, Mohammad A; Ellabban, Gouda M

    2012-01-01

    Background: Conservative treatment was recommended as the treatment of choice in perforated acute peptic ulcer. Here, we adjunct percutaneous peritoneal drainage with nonoperative conservative treatment in high risk elderly patients with perforated duodenal ulcer. Aim: The work was to study the efficacy of percutaneous peritoneal drainage under local anesthesia supported by conservative measures in high risk elderly patients, according to the American Society of Anesthesiologists grading, with perforated duodenal ulcer. Patients and Methods: Twenty four high risk patients with age >65 years having associated medical illness with evidence of perforated duodenal ulcer. Results: The overall morbidity and mortality were comparable with those treated by conservative measures alone. Conclusion: In high risk patients with perforated peptic ulcer and established peritonitis, percutaneous peritoneal drainage under local anesthesia seems to be effective with least operative trauma and mortality rate. PMID:22393546

  4. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed Central

    Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-01-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient.

  5. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed Central

    Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-01-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient. PMID:27630887

  6. Safety and Efficacy of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Neoplasms: A Case Series

    PubMed Central

    Akiyama, Hitoshi; Suzuki, Koyu; Fujita, Yoshiyuki

    2015-01-01

    Sixteen non-ampullary duodenal neoplasms in 16 patients were treated with endoscopic submucosal dissection (ESD) performed by an endoscopist and an instrument assistant between February 2011 and November 2014. En bloc resection was performed in 15 cases (94%); lateral and vertical margins were pathologically free in 13 cases. Perforation occurred during submucosal dissection using a flex knife, but no perforations occurred in 15 cases using the hook knife only. No postoperative bleeding nor recurrence has been reported in any patient during the median 17-month follow-up period. Use of the hook knife as the main instrument and targeted training of the endoscopist and instrument assistant contributed to safe and effective duodenal ESD for non-ampullary duodenal neoplasms. PMID:26157945

  7. An Unusual Case of Duodenal Perforation Caused by a Lollipop Stick: A Case Report

    PubMed Central

    Cho, Eun Ae; Lee, Du Hyeon; Hong, Hyoung Ju; Park, Seon Young; Kim, Hyun Soo; Choi, Sung Kyu; Rew, Jong Sun

    2014-01-01

    Most ingested foreign bodies often pass through the gastrointestinal tract uneventfully; however, complications such as perforation do occur. Most cases of perforation are caused by thin, pointed objects such as needles, toothpicks, or fish and chicken bones. Herein, we report an unusual case of duodenal perforation caused by a lollipop stick with blunt ends. A 23-year-old woman was admitted to the emergency department complaining of epigastric and right upper quadrant pain for the last 2 days. Abdominal computed tomography scans confirmed the presence of a foreign body in the duodenum, with signs of duodenal perforation and inflammation. The patient was not aware of ingesting the foreign body. Endoscopy revealed the presence of a lollipop stick in the duodenum, which was removed with forceps. The duodenal perforation was successfully managed by using hemoclips and a detachable snare. PMID:24765603

  8. [Endoscopic nasobiliary and nasopancreatic drainage contributing to healing of duodenal ulcer perforation: a case report].

    PubMed

    Enokida, Kohei; Kikuyama, Masataka; Kurokami, Takafumi; Shirane, Naofumi; Aoyama, Haruna; Aoyama, Hiroyuki; Sato, Tatsunori; Taki, Yusuke

    2015-10-01

    A 75-year-old man with vomiting and right abdominal pain was admitted to the Department of Surgery in our hospital. With a diagnosis of perforated duodenal ulcer, he was treated conservatively. On the day 8 of hospitalization, his general condition worsened and he underwent surgery. During operation, the perforated duodenal ulcer and paraduodenal fluid collection was observed, and percutaneous drainage was accordingly established. After this procedure, renal dysfunction was exacerbated and he was transferred to our department for endoscopic treatment. On day 28 of hospitalization, nasobiliary and nasopancreatic drainage was administered. Renal dysfunction gradually improved, and healing of the perforated duodenal ulcer was recognized on day 93. On day 112, the patient was discharged. PMID:26440686

  9. Alternative types of duodenal ulcer induced in mice by partial x irradiation of the thorax

    SciTech Connect

    Michalowski, A.; Uehara, S.; Yin, W.B.; Burgin, J.; Silvester, J.A.

    1983-07-01

    The present study extends our earlier observations on gastrointestinal pathology in thorax-irradiated female CFLP mice. It shows that exposure of the lower mediastinum to single doses of 14 to 30 Gy x rays results in the formation of the proximal duodenal ulcer accompanied frequently by erosion of the antral gastric mucosa. X irradiation of the lateral thoracic fields is responsible for single ulcers in the proximity of duodenal papilla, often associated with a circumscribed area of degeneration of the fundic mucosa of the stomach. In view of the small amount of radiation received by the subdiaphragmatic parts of the alimentary tract, these gastro-duodenal lesions represent abscopal effects of thoracic irradiation.

  10. Alternative types of duodenal ulcer induced in mice by partial X irradiation of the thorax

    SciTech Connect

    Michalowski, A.; Uehara, S.; Yin, W.B.; Burgin, J.; Silvester, J.A.

    1983-07-01

    The present study extends our earlier observations on gastrointestinal pathology in thorax-irradiated female CFLP mice. It shows that exposure of the lower mediastinum to single doses of 14-30 Gy X rays results in the formation of the proximal duodenal ulcer accompanied frequently by erosion of the antral gastric mucosa. X irradiation of the lateral thoracic fields is responsible for single ulcers in the proximity of duodenal papilla, often associated with a circumscribed area of degeneration of the fundic mucosa of the stomach. In view of the small amount of radiation received by the subdiaphragmatic parts of the alimentary tract, these gastro-duodenal lesions represent abscopal effects of thoracic irradiation.

  11. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed

    Rathi, Chetan Devendra; Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-07-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient. PMID:27630887

  12. Organization of the main olfactory bulb of lesser hedgehog tenrecs.

    PubMed

    Kosaka, Katsuko; Künzle, Heinz; Kosaka, Toshio

    2005-12-01

    Using a confocal laser scanning microscope (CLSM) and an electron microscope, we investigated the organization of the main olfactory bulb (MOB) of tenrecs, which were previously included into insectivores but now considered to be in a new order "Afrosoricida" in the superclade 'Afrotheria'. We confirmed that the overall structural organization of the tenrec MOB was similar to that of rodents: (1) the compartmental organization of glomeruli and two types of periglomerular cells we proposed as the common organizational principles were present; (2) there were characteristic dendrodendritic and axo-dendritic synapses in the glomerulus and external plexiform layer (EPL) and gap junctions in glomeruli; and (3) no nidi, particular synaptic regions reported only in laboratory musk shrew and mole MOBs, were encountered. However, instead of nidi, we often observed a few tangled olfactory nerves (ONs) with large irregular boutons in the glomerular-external plexiform layer border zone, with which dendrites of various displaced periglomerular cells were usually found to be intermingled. Electron microscopic (EM) examinations confirmed characteristic large mossy terminal-like ON terminals making asymmetrical synapses to presumed mitral/tufted cell and displaced periglomerular cell dendrites. In addition, gap junctions were also encountered between dendritic processes in these tiny particular regions, further showing their resemblance to glomeruli.

  13. Rapid odor perception in rat olfactory bulb by microelectrode array.

    PubMed

    Zhou, Jun; Dong, Qi; Zhuang, Liu-jing; Li, Rong; Wang, Ping

    2012-12-01

    Responses of 302 mitral/tufted (M/T) cells in the olfactory bulb were recorded from 42 anesthetized freely breathing rats using a 16-channel microwire electrode array. Saturated vapors of four pure chemicals, anisole, carvone, citral and isoamyl acetate were applied. After aligning spike trains to the initial phase of the inhalation after odor onset, the responses of M/T cells showed transient temporal features including excitatory and inhibitory patterns. Both odor-evoked patterns indicated that mammals recognize odors within a short respiration cycle after odor stimulus. Due to the small amount of information received from a single cell, we pooled results from all responsive M/T cells to study the ensemble activity. The firing rates of the cell ensembles were computed over 100 ms bins and population vectors were constructed. The high dimension vectors were condensed into three dimensions for visualization using principal component analysis. The trajectories of both excitatory and inhibitory cell ensembles displayed strong dynamics during odor stimulation. The distances among cluster centers were enlarged compared to those of the resting state. Thus, we presumed that pictures of odor information sent to higher brain regions were depicted and odor discrimination was completed within the first breathing cycle. PMID:23225857

  14. Functional transformations of odor inputs in the mouse olfactory bulb.

    PubMed

    Adam, Yoav; Livneh, Yoav; Miyamichi, Kazunari; Groysman, Maya; Luo, Liqun; Mizrahi, Adi

    2014-01-01

    Sensory inputs from the nasal epithelium to the olfactory bulb (OB) are organized as a discrete map in the glomerular layer (GL). This map is then modulated by distinct types of local neurons and transmitted to higher brain areas via mitral and tufted cells. Little is known about the functional organization of the circuits downstream of glomeruli. We used in vivo two-photon calcium imaging for large scale functional mapping of distinct neuronal populations in the mouse OB, at single cell resolution. Specifically, we imaged odor responses of mitral cells (MCs), tufted cells (TCs) and glomerular interneurons (GL-INs). Mitral cells population activity was heterogeneous and only mildly correlated with the olfactory receptor neuron (ORN) inputs, supporting the view that discrete input maps undergo significant transformations at the output level of the OB. In contrast, population activity profiles of TCs were dense, and highly correlated with the odor inputs in both space and time. Glomerular interneurons were also highly correlated with the ORN inputs, but showed higher activation thresholds suggesting that these neurons are driven by strongly activated glomeruli. Temporally, upon persistent odor exposure, TCs quickly adapted. In contrast, both MCs and GL-INs showed diverse temporal response patterns, suggesting that GL-INs could contribute to the transformations MCs undergo at slow time scales. Our data suggest that sensory odor maps are transformed by TCs and MCs in different ways forming two distinct and parallel information streams.

  15. Electrical properties of periglomerular cells in the frog olfactory bulb.

    PubMed

    Magherini, P C; Bardoni, R; Belluzzi, O

    1997-03-01

    Whole-cell patch clamp recording techniques were applied to periglomerular (PG) cells in slices of the frog olfactory bulb (OB) preparation to study the basic electrical properties of these inhibitory interneurons. The cells were intracellularly stained with Lucifer Yellow for precise identification. Under current-clamp conditions PG cells showed rich spontaneous excitatory synaptic activity at rest, usually leading to overshooting, TTX-sensitive action potentials. The passive cable properties of the cell membrane have been carefully characterised. Depolarisation of this neurone under voltage-clamp conditions activated a complex pattern of current flow, that has been dissected into its main components. The currents have been isolated resorting to their different kinetic and pharmacological properties. Four main voltage dependent ionic currents have been isolated, two inward currents, I(Na) and I(Ca), and two outward currents carried by potassium ions, one fast transient, I(A)-type and another similar to the delayed rectifier type. These currents have been characterised kinetically and pharmacologically. The functional implications of their properties are discussed.

  16. Learning Mechanism for Column Formation in the Olfactory Bulb

    PubMed Central

    Migliore, M.; Inzirillo, Carlo; Shepherd, Gordon M.

    2007-01-01

    Sensory discrimination requires distributed arrays of processing units. In the olfactory bulb, the processing units for odor discrimination are believed to involve dendrodendritic synaptic interactions between mitral and granule cells. There is increasing anatomical evidence that these cells are organized in columns, and that the columns processing a given odor are arranged in widely distributed arrays. Experimental evidence is lacking on the underlying learning mechanisms for how these columns and arrays are formed. To gain insight into these mechanisms, we have used a simplified realistic circuit model to test the hypothesis that distributed connectivity can self-organize through an activity-dependent dendrodendritic synaptic mechanism. The results point to action potentials propagating in the mitral cell lateral dendrites as playing a critical role in this mechanism. The model predicts that columns emerge from the interaction between the local temporal dynamics of the action potentials and the synapses that they activate during dendritic propagation. The results suggest a novel and robust learning mechanism for the development of distributed processing units in a cortical structure. PMID:18958240

  17. Thaw bulb dimensions determined using electrical imaging across thermokarst lakes, Seward Peninsula, Alaska

    NASA Astrophysics Data System (ADS)

    Nolan, J. T.; Slater, L. D.; Parsekian, A.; Plug, L. J.; Grosse, G.; Walter Anthony, K. M.

    2009-12-01

    Geophysical imaging of thaw bulb dimensions underlying thermokarst lakes may provide data required to validate models for thaw bulb evolution and to quantify availability of previously frozen soil carbon to atmospheric emission. Direct measurements by drilling are costly in remote arctic regions and are limited by poor spatial resolution. We report the results of an experiment to test the use of electrical resistivity imaging for determining thaw bulb dimensions of thermokarst lakes on the Seward Peninsula, Alaska. Continuous resistivity measurements were collected using a floating array of electrodes pulled by a motorized inflatable boat. The inversion of the resistivity data was conducted using a one dimensional laterally constrained inversion routine that solves for thickness and resistivity based on three layer model. Since the water layer is partly constrained in terms of thickness (from depth sounder measurements) and resistivity (from measurements made with a conductance probe), and the thaw bulb and permafrost resistivity are known from coring, the only totally unconstrained parameter is the thickness of the thaw bulb sediments. This overdetermined inverse problem yields a high degree of confidence in the resulting model, as evident from low model residuals and parameter covariance analysis. Results from this experiment show that electrical resistivity imaging is a relatively low cost method for determining the thaw bulb dimensions along a laterally continuous survey line.

  18. Permanent transparent color-warming glazes for dimmable and non-dimmable LED bulbs

    NASA Astrophysics Data System (ADS)

    Spanard, Jan-Marie A.

    2014-02-01

    Illuminant metameric failure is frequently experienced when viewing material samples under LED generated light vs. traditional incandescent light. LED light temperatures can be improved with phosphor coatings, but long-wave red light is still generally absent in LED "warm-white" light, resulting in metameric failure of orange-to-red objects. Drawing on techniques developed for the architectural restoration of stained glass, we find that transparent, heat-resistant, permanent, pigmented coatings can be applied to any glass, aluminum or plastic surface of an LED bulb, including the phosphor plate, dome or envelope, to produce warmer visible light than in current warm-light LED bulbs. These glazes can be applied in combination with existing technologies to better tune the LED emitted light or they may be used alone. These pigmented coatings include, but are not limited to, those made by suspending inorganic materials in potassium silicates or durable transparent pigmented resins. The pigmented resin glazes may be produced in either a clear gloss vehicle or an iridescent, light diffusing transparent base. Further, a graduated density of the tinted glazes on dimmable bulbs allow the light to change color as wattage is diminished. The glazes may be applied in the manufacturing of the bulb or marketed to current bulb owners as an after-market product to better tune the thousands of LED light bulbs currently in use.

  19. Magnetic Resonance (MR)-Guided Breast Biopsy

    MedlinePlus

    ... the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not ... considered if the lesion can be seen on mammography or on ultrasound , where the biopsy can be ...

  20. Increased duodenal DMT-1 expression and unchanged HFE mRNA levels in HFE-associated hereditary hemochromatosis and iron deficiency.

    PubMed

    Byrnes, V; Barrett, S; Ryan, E; Kelleher, T; O'Keane, C; Coughlan, B; Crowe, J

    2002-01-01

    HFE-associated hereditary hemochromatosis is characterized by imbalances of iron homeostasis and alterations in intestinal iron absorption. The identification of the HFE gene and the apical iron transporter divalent metal transporter-1, DMT-1, provide a direct method to address the mechanisms of iron overload in this disease. The aim of this study was to evaluate the regulation of duodenal HFE and DMT-1 gene expression in HFE-associated hereditary hemochromatosis. Small bowel biopsies and serum iron indices were obtained from a total of 33 patients. The study population comprised 13 patients with hereditary hemochromatosis (C282Y homozygous), 10 patients with iron deficiency anemia, and 10 apparently healthy controls, all of whom were genotyped for the two common mutations in the HFE gene (C282Y and H63D). Total RNA was isolated from tissue and amplified via RT-PCR for HFE, DMT-1, and the internal control GAPDH. DMT-1 protein expression was additionally assessed by immunohistochemistry. Levels of HFE mRNA did not differ significantly between patient groups (P = 0.09), specifically between C282Y homozygotes and iron deficiency anemic patients, when compared to controls (P = 0.09, P = 0.9, respectively). In contrast, DMT-1 mRNA levels were at least twofold greater in patients with hereditary hemochromatosis and iron deficiency anemia when compared to controls (P = 0.02, P = 0.01, respectively). Heightened DMT-1 protein expression correlated with mRNA levels in all patients. Loss of HFE function in hereditary hemochromatosis is not derived from inhibition of its gene expression. DMT-1 expression in C282Y homozygote subjects is consistent with the hypothesis of a "paradoxical" duodenal iron deficiency in hereditary hemochromatosis. The observed twofold upregulation of the DMT-1 is consistent with the slow but steady increase in body iron stores observed in those presenting with clinical features of hereditary hemochromatosis.

  1. A role for guanylate cyclase C in acid-stimulated duodenal mucosal bicarbonate secretion.

    PubMed

    Rao, S P; Sellers, Z; Crombie, D L; Hogan, D L; Mann, E A; Childs, D; Keely, S; Sheil-Puopolo, M; Giannella, R A; Barrett, K E; Isenberg, J I; Pratha, V S

    2004-01-01

    Luminal acidification provides the strongest physiological stimulus for duodenal HCO3- secretion. Various neurohumoral mechanisms are believed to play a role in acid-stimulated HCO3- secretion. Previous studies in the rat and human duodenum have shown that guanylin and Escherichia coli heat-stable toxin, both ligands of the transmembrane guanylyl cyclase receptor [guanylate cyclase C (GC-C)], are potent stimulators for duodenal HCO3- secretion. We postulated that the GC-C receptor plays an important role in acid-stimulated HCO3- secretion. In vivo perfusion studies performed in wild-type (WT) and GC-C knockout (KO) mice indicated that acid-stimulated duodenal HCO3- secretion was significantly decreased in the GC-C KO animals compared with the WT counterparts. Pretreatment with PD-98059, an MEK inhibitor, resulted in attenuation of duodenal HCO3- secretion in response to acid stimulation in the WT mice with no further effect in the KO mice. In vitro cGMP generation studies demonstrated a significant and comparable increase in cGMP levels on acid exposure in the duodenum of both WT and KO mice. In addition, a rapid, time-dependent phosphorylation of ERK was observed with acid exposure in the duodenum of WT mice, whereas a marked attenuation in ERK phosphorylation was observed in the KO animals despite equivalent levels of ERK in both groups of animals. On the basis of these studies, we conclude that transmembrane GC-C is a key mediator of acid-stimulated duodenal HCO3- secretion. Furthermore, ERK phosphorylation may be an important intracellular mediator of duodenal HCO3- secretion. PMID:12881226

  2. Cysteamine-induced inhibition of acid neutralization and the increase in hydrogen ion back-diffusion in duodenal mucosa

    SciTech Connect

    Ohe, K.; Okada, Y.; Fujiwara, T.; Inoue, M.; Miyoshi, A.

    1982-03-01

    To investigate the possible impairment of defensive mechanisms in cysteamine-induced duodenal ulceration, the effect of cysteamine on the neutralization of acid by the duodenum and the back-diffusion of hydrogen ions into the duodenal mucosa has been studied. The results obtained were as follows. (1) The intraduodenal pH started to decrease between 3 and 4 hr after cysteamine injection. (2) By perfusion of the duodenal loop excluding the opening of bile and pancreatic ducts, the amount of hydrogen ions (H+) neutralized was found to be significantly lower in cysteamine-treated animals than in the controls. (3) the back-diffusion of luminal H+ into the duodenal mucosa, estimated by measuring the H+ disappearance from the test solution including 100 mM HCl, was significantly increased by cysteamine. From these findings, it has been concluded that cysteamine reduces the resistance of duodenal mucosa to acid coming from the stomach.

  3. Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts: Case Report and Comprehensive Review of 28 Cases Reported in the Literature.

    PubMed

    Gjeorgjievski, Mihajlo; Manickam, Palaniappan; Ghaith, Gehad; Cappell, Mitchell S

    2016-05-01

    Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords "cyst" and "duodenal" and "duplication"; or "cyst", and "endoscopy" or "endoscopic", and "therapy" or "decompression"; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984-1999: 3 cases, 2000-2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77-44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1-6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically.A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid from cyst with rapid relief of symptoms. At

  4. [The treatment of chronic duodenal ulcer with accompanying Helicobacter pylori infection].

    PubMed

    Petsch, B; Kabala, A; Pawłowski, W

    1998-08-01

    Three hundred seventy four patients with duodenal ulcers and Helicobacter pylori infections were given a four-week treatment of bismuth or ranitidin. In all patients two-week antibiotic therapy were given. Endoscopies with urease tests and histologic examinations were performed before initiation and four weeks after cessation of therapy. Four-week therapy with ranitidini and two-week therapy with amoxicillin and metronidasole is highly effective (89.6%) in duodenal ulcer healing and symptom improvement comparison to bismuth and antibiotic therapy.

  5. Self-expanding metal stents for palliative treatment of malignant biliary and duodenal stenoses.

    PubMed

    Maetani, I; Ogawa, S; Hoshi, H; Sato, M; Yoshioka, H; Igarashi, Y; Sakai, Y

    1994-10-01

    Patients with malignant biliary stenosis due to pancreatic head cancer often have the associated problem of duodenal obstruction. We report here the case of a 78-year-old woman with this clinical situation, who was treated with self-expanding Gianturco metal stents placed in the distal common bile duct and, nine months later, placed in the descending duodenum. The patient's frequent vomiting resolved, and she was able to tolerate peroral solid food; jaundice also decreased (bilirubin pre-stenting: 7.8; post-stenting: 1.2). Self-expanding metal stents therefore appear to be effective for the palliative treatment of malignant duodenal stenosis as well as biliary stenosis.

  6. Adult neurogenesis restores dopaminergic neuronal loss in the olfactory bulb.

    PubMed

    Lazarini, Françoise; Gabellec, Marie-Madeleine; Moigneu, Carine; de Chaumont, Fabrice; Olivo-Marin, Jean-Christophe; Lledo, Pierre-Marie

    2014-10-22

    Subventricular zone (SVZ) neurogenesis continuously provides new GABA- and dopamine (DA)-containing interneurons for the olfactory bulb (OB) in most adult mammals. DAergic interneurons are located in the glomerular layer (GL) where they participate in the processing of sensory inputs. To examine whether adult neurogenesis might contribute to regeneration after circuit injury in mice, we induce DAergic neuronal loss by injecting 6-hydroxydopamine (6-OHDA) in the dorsal GL or in the right substantia nigra pars compacta. We found that a 6-OHDA treatment of the OB produces olfactory deficits and local inflammation and partially decreases the number of neurons expressing the enzyme tyrosine hydroxylase (TH) near the injected site. Blockade of inflammation by minocycline treatment immediately after the 6-OHDA administration rescued neither TH(+) interneuron number nor the olfactory deficits, suggesting that the olfactory impairments are most likely linked to TH(+) cell death and not to microglial activation. TH(+) interneuron number was restored 1 month later. This rescue resulted at least in part from enhanced recruitment of immature neurons targeting the lesioned GL area. Seven days after 6-OHDA lesion in the OB, we found that the integration of lentivirus-labeled adult-born neurons was biased: newly formed neurons were preferentially incorporated into glomerular circuits of the lesioned area. Behavioral rehabilitation occurs 2 months after lesion. This study establishes a new model into which loss of DAergic cells could be compensated by recruiting newly formed neurons. We propose that adult neurogenesis not only replenishes the population of DAergic bulbar neurons but that it also restores olfactory sensory processing. PMID:25339754

  7. Diagnosis of malignant change in duodenal villous adenoma.

    PubMed

    Stella, M; Zerbi, A; Braga, M; Faravelli, A; Di Carlo, V

    1990-10-31

    Villous adenomas of the duodenum are rare, and malignancy is discovered in about 30% of the lesions. The authors describe two cases of villous adenoma of the second portion of the duodenum (13 and 8 cm in diameter). The diagnosis was obtained through endoscopy, which did not demonstrate any malignant change. In both patients, malignant change was shown by intraoperative frozen sections, and a pancreatico-duodenectomy was performed. Review of the literature and the authors' experience indicate endoscopic biopsies do not rule out the presence of malignancy in adenomatous pathology of the duodenum. Therefore, laparotomy should be performed whenever endoscopic excision of the neoplasm is not feasible. The authors emphasize the importance of an intraoperative diagnosis based on accurate frozen sections and propose a correct procedure to obtain the best results. PMID:2256198

  8. Cyclic tests of P-bulb end-seal designs for a shuttle-type wing-elevon cove membrane seal

    NASA Technical Reports Server (NTRS)

    Hunt, L. R.

    1979-01-01

    Four P-bulb end seal designs were tested at room temperature in a cyclic seal test apparatus. Test results show that all the P-bulb end seals have the durability required for a 100 mission life (neglecting possible elevated-temperature effects) and three of the four P-bulbs provide an adequate seal against a 7.0-kPa air pressure differential. Antifriction material attached to the P-bulb rub surface reduced friction slightly but could degrade the sealing effectiveness. A flat rub surface molded into the P-bulb discouraged wrinkling and rolling and thereby reduced leakage. However, the P-bulbs lacked resilience, as indicated by increased leakage when P-bulb compression was reduced. The best P-bulb design tested included an antifriction interface bonded to a flat surface molded into the P-bulb.

  9. [Prostate biopsy: Procedure in the clinical routine].

    PubMed

    Enzmann, T; Tokas, T; Korte, K; Ritter, M; Hammerer, P; Franzaring, L; Heynemann, H; Gottfried, H-W; Bertermann, H; Meyer-Schwickerath, M; Wirth, B; Pelzer, A; Loch, T

    2015-12-01

    Over the last decade there has been a 25% decrease in the mortality rates for prostate cancer. The reasons for this significant decrease are most likely associated with the application of urological screening tests. The main tools for early detection are currently increased public awareness of the disease, prostate-specific antigen (PSA) tests and transrectal ultrasound (TRUS) guided topographically assignable biopsy sampling. Together with the histopathological results these features provide essential information for risk stratification, diagnostics and therapy decisions. The evolution of prostate biopsy techniques as well as the use of PSA testing has led to an increased identification of asymptomatic men, where further clarification is necessary. Significant efforts and increased clinical research focus on determining the appropriate indications for a prostate biopsy and the optimal technique to achieve better detection rates. The most widely used imaging modality for the prostate is TRUS; however, there are no clearly defined standards for the clinical approach for each individual biopsy procedure, dealing with continuous technical optimization and in particular the developments in imaging. In this review the current principles, techniques, new approaches and instrumentation of prostate biopsy imaging control are presented within the framework of the structured educational approach. PMID:26704284

  10. Common Data Elements for Muscle Biopsy Reporting

    PubMed Central

    Dastgir, Jahannaz; Rutkowski, Anne; Alvarez, Rachel; Cossette, Stacy A.; Yan, Ke; Hoffmann, Raymond G.; Sewry, Caroline; Hayashi, Yukiko K.; Goebel, Hans-Hilmar; Bonnemann, Carsten; Lawlor, Michael W.

    2016-01-01

    Context There is no current standard among myopathologists for reporting muscle biopsy findings. The National Institute of Neurological Disorders and Stroke has recently launched a common data element (CDE) project to standardize neuromuscular data collected in clinical reports and to facilitate their use in research. Objective To develop a more-uniform, prospective reporting tool for muscle biopsies, incorporating the elements identified by the CDE project, in an effort to improve reporting and educational resources. Design The variation in current biopsy reporting practice was evaluated through a study of 51 muscle biopsy reports from self-reported diagnoses of genetically confirmed or undiagnosed muscle disease from the Congenital Muscle Disease International Registry. Two reviewers independently extracted data from deidentified reports and entered them into the revised CDE format to identify what was missing and whether or not information provided on the revised CDE report (complete/incomplete) could be successfully interpreted by a neuropathologist. Results Analysis of the data highlighted showed (1) inconsistent reporting of key clinical features from referring physicians, and (2) considerable variability in the reporting of pertinent positive and negative histologic findings by pathologists. Conclusions We propose a format for muscle-biopsy reporting that includes the elements in the CDE checklist and a brief narrative comment that interprets the data in support of a final interpretation. Such a format standardizes cataloging of pathologic findings across the spectrum of muscle diseases and serves emerging clinical care and research needs with the expansion of genetic-testing therapeutic trials. PMID:26132600

  11. Effect of dopamine-related drugs on duodenal ulcer induced by cysteamine or propionitrile: prevention and aggravation may not be mediated by gastrointestinal secretory changes in the rat

    SciTech Connect

    Gallagher, G.; Brown, A.; Szabo, S.

    1987-03-01

    Dose- and time-response studies have been performed with dopamine agonists and antagonists using the cysteamine and propionitrile duodenal ulcer models in the rat. The experiments demonstrate that the chemically induced duodenal ulcer is prevented by bromocriptine, lergotrile and reduced by apomorphine or L-dopa. Aggravation of cysteamine-induced duodenal ulcer was seen especially after (-)-butaclamol, (-)-sulpiride, haloperidol and, less effectively, after other dopaminergic antagonists. The duodenal antiulcerogenic action of dopamine agonists was more prominent after chronic administration than after a single dose, whereas the opposite was found concerning the proulcerogenic effect of dopamine antagonists. In the chronic gastric fistula rat, both the antiulcerogens bromocriptine or lergotrile and the proulcerogens haloperidol, pimozide or (-)-N-(2-chlorethyl)-norapomorphine decreased the cysteamine- or propionitrile-induced gastric secretion. No correlation was apparent between the influence of these drugs on duodenal ulcer development and gastric and duodenal (pancreatic/biliary) secretions. In the chronic duodenal fistula rat, decreased acid content was measured in the proximal duodenum after haloperidol, and diminished duodenal pepsin exposure was recorded after bromocriptine. Furthermore, the aggravation by dopamine antagonists of experimental duodenal ulcer probably involves a peripheral component. The site of dopamine receptors and physiologic effects which modulate experimental duodenal ulcer remain to be identified, but their elucidation may prove to be an important element in the pathogenesis and treatment of duodenal ulcer.

  12. Effect of intermittent administration of omeprazole on serum pepsinogens in duodenal ulcer patients and healthy volunteers.

    PubMed

    Biemond, I; Crobach, L F; Jansen, J B; Lamers, C B

    1990-04-01

    1. Omeprazole, a substituted benzimidazole inhibitor of the gastric H+/K(+)-APT-ase, was administered orally at a dose of 20 mg in the morning of 3 consecutive days, followed by a period of 4 days without medication, and this intermittent dosage regimen was continued for 4 weeks. 2. During intermittent administration of omeprazole to 10 patients with duodenal ulcer disease and 10 healthy volunteers concentrations of serum pepsinogen A and serum pepsinogen C were monitored by sensitive and specific radioimmunoassays to study whether the effect of this treatment on serum pepsinogens is different between patients and normal subjects and to evaluate whether serum pepsinogen levels can be used to assess compliance with therapy. 3. Administration of omeprazole for 3 days induced significant increases in pepsinogen A and pepsinogen C serum concentrations, which rapidly fell after stopping the omeprazole intake. The pattern of serum pepsinogens after stopping the drug was different for duodenal ulcer patients and normal subjects. Both pepsinogens were intra-individually related in both patients and healthy subjects when compared during the first and last 3-day course with omeprazole, but in duodenal ulcer patients both pepsinogens tended to be higher in the last treatment course, while the opposite was found in the normal subjects. 4. The present study confirms that serum pepsinogen concentrations are higher in duodenal ulcer patients than in normal subjects, but also shows for the first time that serum pepsinogens in the patients respond differently upon stimulation with omeprazole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2328194

  13. A Case of Gastro-Duodenal Artery Aneurism: Treatment and Complications.

    PubMed

    Gassend, Jean-Loup; Dimitrief, Maria; Chan, Hon Lai; Roulet, Daniel; Trachsel, Lysiane; Doenz, Francesco; Cherbanyk, Floryn

    2016-01-01

    We present the case of a 75-year-old patient with asymptomatic gastro-duodenal artery aneurism (GAA) that was coiled through the left femoral artery. The gastro-duodenal artery (GDA) was then embolized. Following the intervention, the patient'™s left foot became cold. A sub-acute ischemia caused by a stenotic effect in the left external iliac artery and by lower limb embolic phenomena caused by the introductor, was diagnosed. A thromboembolectomy of the popliteal, anterior and posterior tibial and peroneal arteries was performed with a Fogarty catheter with good results. Aneurisms of the GDA are rare. Rupture is a severe and unpredictable complication that complicates management and darkens prognosis. Though endovascular treatment for splanchnic aneurisms are used more and more often and offers numerous advantages compared to surgery, it is not without risk. A multidisciplinary approach with careful collaboration between the surgeon and the radiologist is recommended. Abbreviattions: GAA: gastro-duodenal artery aneurism, GDA: gastro-duodenal artery. PMID:27604672

  14. A Metagenomic Investigation of the Duodenal Microbiota Reveals Links with Obesity

    PubMed Central

    Carrière, Frédéric; Bachar, Dipankar; Laugier, René; Lagier, Jean-Christophe; Robert, Catherine; Michelle, Caroline; Henrissat, Bernard; Raoult, Didier

    2015-01-01

    Background Few studies have tested the small intestine microbiota in humans, where most nutrient digestion and absorption occur. Here, our objective was to examine the duodenal microbiota between obese and normal volunteers using metagenomic techniques. Methodology/Principal Findings We tested duodenal samples from five obese and five normal volunteers using 16S rDNA V6 pyrosequencing and Illumina MiSeq deep sequencing. The predominant phyla of the duodenal microbiota were Firmicutes and Actinobacteria, whereas Bacteroidetes were absent. Obese individuals had a significant increase in anaerobic genera (p < 0.001) and a higher abundance of genes encoding Acyl-CoA dehydrogenase (p = 0.0018) compared to the control group. Obese individuals also had a reduced abundance of genes encoding sucrose phosphorylase (p = 0.015) and 1,4-alpha-glucan branching enzyme (p = 0.05). Normal weight people had significantly increased FabK (p = 0.027), and the glycerophospholipid metabolism pathway revealed the presence of phospholipase A1 only in the control group (p = 0.05). Conclusions/Significance The duodenal microbiota of obese individuals exhibit alterations in the fatty acid and sucrose breakdown pathways, probably induced by diet imbalance. PMID:26356733

  15. Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease

    PubMed Central

    Eichele, Derrick D; Ross, Meredith; Tang, Patrick; Hutchins, Grant F; Mailliard, Mark

    2013-01-01

    Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP) and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy. PMID:24222967

  16. Duodenal diversion of percutaneous biliary drain through a percutaneous endoscopic gastrostomy: report of a case.

    PubMed

    Mohandas, K M; Swaroop, V S; Desai, D C; Nagral, A; Jagannath, P; Desouza, L J; Kamble, M

    1991-10-01

    Occasionally, percutaneous biliary drainage is the only possible form of treatment in a patient with a malignant obstruction at the porta hepatis. We report on a case of gallbladder carcinoma with a complete block at the porta hepatis, which was palliated with a percutaneous biliary drain. Enteral reinfusion of bile was accomplished through a duodenal tube placed through a percutaneous endoscopic gastrostomy.

  17. Transhepatic contemporary palliation of biliary and duodenal stenoses by means of metallic stents.

    PubMed

    Cozzi, G; Chiaraviglio, F; Bonfanti, G; Civelli, E M

    2004-01-01

    We describe the treatment of a stenosing lesion of the horizontal duodenum by means of a large-bore metallic stent inserted percutaneously in a patient with transhepatic biliary drainage. In the same session, we used an expandable metallic stent in the biliary tree to relieve jaundice. We recommend the transhepatic approach for duodenal metallic stent insertion in patients with percutaneous biliary drainage.

  18. [Prognostic factors of efficacy of eradication therapy in patients with duodenal ulcer].

    PubMed

    Kozlova, I V; Eliseev, Iu Iu; Pakhomova, A L; Khan, Sadzhad Akhmad

    2005-01-01

    The aim of the study was to determine microorganism-associated predictors of efficacy of eradication therapy in patients with Helicobacter pylori-associated duodenal ulcer. The subjects were 129 such patients. Clinical, endoscopic, microbiological, and immunological examination revealed differences in the initial immune status, the structure of gastroduodenal zone mucosa, and large bowel biocenosis, which predict efficacy of eradication therapy. PMID:16117427

  19. Duodenal myotomy blocks reduction of meal size and prolongation of intermeal interval by cholecystokinin.

    PubMed

    Lateef, Dalya M; Washington, Martha C; Raboin, Shannon J; Roberson, Allison E; Mansour, Mahmoud M; Williams, Carol S; Sayegh, Ayman I

    2012-02-01

    We have shown that vagotomy (VGX) attenuates the reduction of meal size (MS) produced by cholecystokinin (CCK) -8 and -33 and that celiaco-mesenteric ganglionectomy (CMGX) attenuates the prolongation of the intermeal interval (IMI) produced by CCK-33. Here, we report the following novel data. First, by determining the distribution of CCK(1) receptor messenger RNA, which mediates reduction of MS and prolongation of IMI by CCK, in seven regions of the gastrointestinal tract in the adult rat we found that the duodenum contains the highest concentration of this receptor in the gut. Second, based on the previous finding we performed a unique surgical technique known as duodenal myotomy (MYO), which severs all the nerves of the gut wall in the duodenum including vagus, splanchnic and enteric nerves. Third, we determined MS and IMI in duodenal MYO rats in responses to endogenous CCK-58 released by the non-nutrient, trypsin inhibitor, camostat and CCK-8 to test the possibility that the duodenum is the site of action for reduction of MS and prolongation of IMI. We found that, similar to the previous work reported by using CCK-8 and MS, duodenal MYO also blocked reduction of MS by camostat. Forth, duodenal MYO blocked prolongation of IMI by camostat. As such, our current results suggest that the duodenum is the gut site that communicates both feeding signals of endogenous CCK, MS and IMI, with the brain through vagal and splanchnic afferents. PMID:22047890

  20. Coexisting urogenital anomaly and duodenal atresia in two atypical Holt–Oram syndrome

    PubMed Central

    Ali, Tuncer Ahmet; Afra, Karavelioğlu; Didem, Baskin Embleton; Muhsin, Elmas

    2016-01-01

    Holt–Oram syndrome (HOS) is a rare autosomal dominant disorder, characterized by upper limb dysplasia and congenital cardiac defect. We report two cases with HOS, first associated with renal agenesis, coronal hypospadias, urethral duplication and second associated with duodenal atresia and horseshoe kidney that have not been reported in English literature.

  1. Coexisting urogenital anomaly and duodenal atresia in two atypical Holt–Oram syndrome

    PubMed Central

    Ali, Tuncer Ahmet; Afra, Karavelioğlu; Didem, Baskin Embleton; Muhsin, Elmas

    2016-01-01

    Holt–Oram syndrome (HOS) is a rare autosomal dominant disorder, characterized by upper limb dysplasia and congenital cardiac defect. We report two cases with HOS, first associated with renal agenesis, coronal hypospadias, urethral duplication and second associated with duodenal atresia and horseshoe kidney that have not been reported in English literature. PMID:27695215

  2. Evaluation of the polymerase chain reaction for detecting the urease C gene of Helicobacter pylori in gastric biopsy samples and dental plaque.

    PubMed

    Bickley, J; Owen, R J; Fraser, A G; Pounder, R E

    1993-11-01

    A polymerase chain reaction (PCR) assay with oligonucleotide primers homologous to a portion of the urease C gene of Helicobacter pylori was evaluated for specificity with pure DNA and biopsy material. The assay was used to test for the presence of the organism in dental plaque. The species specificity of detection was confirmed by ensuring that the primers did not amplify DNA extracts from H. cinaedi, H. felis, H. fennelliae, H. mustelae and H. nemestrinae. Sixty-two gastric biopsy samples collected from 14 patients (antrum, body and duodenal sites) were cultured and PCR was performed on the samples after culture. Primer sites were conserved in genomically diverse strains. Samples prepared by single-step heat lysis of bacterial cells and biopsy material did not inhibit PCR. The overall specificity was 96% irrespective of genotype. H. pylori was not cultured from dental plaque (15 patients), neither was H. pylori DNA detected by PCR in either urea breath test-positive or -negative individuals. The results showed that primer pair sequences within the urease C gene are conserved in most strains and provide an accurate basis for detecting H. pylori. As the PCR assay was not inhibited and did not yield false positive results with crude extracts from organisms or in the presence of biopsy material, its value as a diagnostic test was confirmed. PMID:8246250

  3. Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

    SciTech Connect

    Laredo, Jean-Denis Hamze, Bassam; Jeribi, Riadh

    2009-09-15

    Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. The Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.

  4. The role of endoscopy and biopsy in the management of severe gastrointestinal disease in cystic fibrosis patients.

    PubMed

    Shah, Neil; Tan, Hui-leng; Sebire, Neil; Suri, Ranjan; Leuven, Ku

    2013-12-01

    There is increasing evidence to suggest the presence of chronic inflammation in the gastrointestinal (GI) tract of cystic fibrosis (CF) patients. Some CF patients continue to have very severe gastrointestinal symptoms despite conventional CF treatment. In our center, these patients are managed in a CF gastroenterology clinic, jointly with a pediatric gastroenterologist. A number have required GI endoscopy and biopsy. The aim of our study was to characterize these patients and determine whether endoscopy and biopsy changed their management. We reviewed all the patients seen in the CF gastroenterology clinic from 2004 to 2009, who had GI endoscopies performed. The GI symptoms these patients were experiencing included abdominal pain, nausea and vomiting, rectal bleeding, failure to thrive, loose stools, and constipation. Twelve patients had GI endoscopies with mucosal biopsies performed. The median [interquartile range (IQR)] age at referral to the CF gastroenterology clinic was 4 years [0.9-8]. Their body mass index (BMI) was 15.2 [13.7-15.5]. Twenty-five percent were homozygous delta F508. Two patients had previously had meconium ileus as neonates requiring surgical intervention. One other patient had needed abdominal surgery for intussusception. Ninty-two percent were pancreatic insufficient, 25% were chronically infected with Pseudomonas aeruginosa and 17% were on regularly 3 monthly intravenous antibiotics. Of the 10 patients who were able to perform spirometry, FEV1 was 101% [67-125] predicted. Nine of the 12 patients had evidence of mucosal inflammation in their biopsies, including duodenitis with eosinophilic infiltrate, chronic non-specific inactive gastritis, enteropathy with partial villous atrophy, and non-specific colitis. Immunosuppressive and anti-inflammatory therapies were commenced in these nine patients, including prednisolone, azathioprine, methotrexate, ketotifen, mesalazine, and sulfasalazine as well as the use of parenteral nutrition and

  5. Response of garlic (Allium sativum L.) bolting and bulbing to temperature and photoperiod treatments.

    PubMed

    Wu, Cuinan; Wang, Mengyi; Cheng, Zhihui; Meng, Huanwen

    2016-01-01

    This research was conducted to evaluate the effect of temperature and photoperiod treatments on the bolting and bulb formation of three local garlic cultivars (cvs) in two consecutive years. Naturally vernalized plants of cvs G107, G025 and G064 were transplanted into growth chambers and subjected to various combinations of temperature [T15/10, 15°C/10°C; T20/15, 20°C/15°C and T25/18, 25°C/18°C (day/night)] and photoperiod (L8, 8 h and L14,14 h) treatments. Plant growth, endogenous phytohormone and methyl jasmonate (MeJA) levels, along with the bolting and yield of garlic were evaluated. The experimental results from two consecutive years indicated that higher temperature (20°C or 25°C) and longer photoperiod (14 h) treatments significantly enhanced the garlic bolting, bulbing and cloving with a shorter growth period and a higher bulb weight. Moreover, the endogenous phytohormone and MeJA levels in the test plants were significantly increased by the higher temperature (25°C for the phytohormone level; 20°C for the MeJA level) and longer photoperiod [14 h, except for abscisic acid (ABA), which had the highest level at 8 h] conditions and were decreased by the lowest test temperature (15°C) and shorter photoperiod (8 h, except for ABA) conditions. This response coincided with that of the bulbing index, bolting rate, growth period and bulb weight. In addition, plants treated under the conditions of 20°C/15°C-14 h and 25°C/18°C-14 h produced the highest phytohormone levels (except for ABA) for cvs G025 and G064, respectively, and showed the best bolting and bulbing behavior. It is reasonable to assume that endogenous phytohormone (especially gibberellic acid) and MeJA levels are highly related to garlic bolting and bulbing, which might lead to the different responses of the three studied cultivars to the combination of temperature and photoperiod treatments. Furthermore, cvs G107 and G025 bolt well and have better bulb formation under 20

  6. Response of garlic (Allium sativum L.) bolting and bulbing to temperature and photoperiod treatments

    PubMed Central

    Wu, Cuinan; Wang, Mengyi; Cheng, Zhihui; Meng, Huanwen

    2016-01-01

    ABSTRACT This research was conducted to evaluate the effect of temperature and photoperiod treatments on the bolting and bulb formation of three local garlic cultivars (cvs) in two consecutive years. Naturally vernalized plants of cvs G107, G025 and G064 were transplanted into growth chambers and subjected to various combinations of temperature [T15/10, 15°C/10°C; T20/15, 20°C/15°C and T25/18, 25°C/18°C (day/night)] and photoperiod (L8, 8 h and L14,14 h) treatments. Plant growth, endogenous phytohormone and methyl jasmonate (MeJA) levels, along with the bolting and yield of garlic were evaluated. The experimental results from two consecutive years indicated that higher temperature (20°C or 25°C) and longer photoperiod (14 h) treatments significantly enhanced the garlic bolting, bulbing and cloving with a shorter growth period and a higher bulb weight. Moreover, the endogenous phytohormone and MeJA levels in the test plants were significantly increased by the higher temperature (25°C for the phytohormone level; 20°C for the MeJA level) and longer photoperiod [14 h, except for abscisic acid (ABA), which had the highest level at 8 h] conditions and were decreased by the lowest test temperature (15°C) and shorter photoperiod (8 h, except for ABA) conditions. This response coincided with that of the bulbing index, bolting rate, growth period and bulb weight. In addition, plants treated under the conditions of 20°C/15°C–14 h and 25°C/18°C–14 h produced the highest phytohormone levels (except for ABA) for cvs G025 and G064, respectively, and showed the best bolting and bulbing behavior. It is reasonable to assume that endogenous phytohormone (especially gibberellic acid) and MeJA levels are highly related to garlic bolting and bulbing, which might lead to the different responses of the three studied cultivars to the combination of temperature and photoperiod treatments. Furthermore, cvs G107 and G025 bolt well and have better bulb

  7. Renal Biopsy in Type 2 Diabetic Patients

    PubMed Central

    Espinel, Eugenia; Agraz, Irene; Ibernon, Meritxell; Ramos, Natalia; Fort, Joan; Serón, Daniel

    2015-01-01

    The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients. PMID:26239461

  8. Simulation of punch biopsies: a case study.

    PubMed

    Sessanna, Dennis; Stredney, Don; Hittle, Brad; Lambert, David

    2008-01-01

    As the incidence of skin cancer continues to rise, there is an increasing need for skilled practitioners that are proficient in identifying suspicious lesions and competent in acquiring biopsies that provide for optimal determination of malignancy and staging. We report on the development of a prototype simulation that emulates the basic procedures necessary to acquire a punch biopsy. The objective of this effort is to produce a low-cost, effective method to teach non-specialists, i.e., nurse practitioners, internists, etc., the optimal placement of the punch to obtain a biopsy for pathological analysis. The simulation can be utilized for synchronous sessions with remote experts, as well as asynchronous sessions for deliberate practice. The simulation is designed to allow for easy import of digital images of various lesions to promote use and present the wide pathological variance experienced in the clinic.

  9. Muscle biopsy findings in inflammatory myopathies.

    PubMed

    Dalakas, Marinos C

    2002-11-01

    The inflammatory myopathies encompass a heterogeneous group of acquired muscle diseases characterized clinically, by muscle weakness, and histologically, by inflammatory infiltrates within the skeletal muscles. The group of these myopathies comprise three major and discrete subsets: polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM). Each subset retains its characteristic clinical, immunopathologic, and morphologic features regardless of whether it occurs separately or in connection with other systemic diseases. Although the diagnosis of these disorders is based on the combination of clinical examination, electromyographic data, serum muscle enzyme levels, various autoantibodies, and the muscle biopsy findings, the muscle biopsy offers the most definitive diagnostic information in the majority of the cases. This article summarizes the main histologic features that characterize PM, DM, or IBM and emphasizes the main pitfalls associated with interpretation of the biopsies.

  10. The olfactory bulb structure of African giant rat (Cricetomys gambianus, Waterhouse 1840) I: cytoarchitecture.

    PubMed

    Olude, M A; Ogunbunmi, T K; Olopade, J O; Ihunwo, A O

    2014-09-01

    The olfactory system typically consists of two parallel systems: the main olfactory system and the accessory olfactory system. The main olfactory bulb (MOB) acts as the initial processing site for volatile chemical stimuli and receives input from the olfactory receptor cells located in the olfactory epithelium. The African giant rat is reputed to have abilities to detect landmines and tuberculosis samples by sniffing. This study therefore is a preliminary study on the histological and immunohistochemical anatomy of the olfactory bulb of the African giant rat (Cricetomys gambianus, Waterhouse). Nissl and Klüver-Barrera histological staining of the olfactory bulb revealed a cytoarchitecture typical of most mammals with 6 cell layers, and 1-2-layered glomeruli measuring approximately 150 μm each in diameter. Immunohistochemical staining with glial fibrillary acidic protein (GFAP) and 2',3'-cyclic nucleotide 3-phosphodiesterase (CNPase) revealed cellular conformations relative to most mammals. GFAP immunohistochemistry also revealed cell bodies and processes within the periglomerular area which may potentiate signaling from the olfactory receptor cells, while CNPase largely showed soma and evidence of myelin sheath deposition, confirming myelination at different layers of the bulb. Neurogenesis was examined using the neurogenic markers doublecortin (DCX) and Ki-67. Migration of newly generated cells was observed in all layers of the MOB with DCX and in most layers with Ki-67. The anatomy of the olfactory bulb is described as relatively large in the African giant rat, having a neuroarchitecture similar to most rodents.

  11. Massive normalization of olfactory bulb output in mice with a 'monoclonal nose'

    PubMed Central

    Roland, Benjamin; Jordan, Rebecca; Sosulski, Dara L; Diodato, Assunta; Fukunaga, Izumi; Wickersham, Ian; Franks, Kevin M; Schaefer, Andreas T; Fleischmann, Alexander

    2016-01-01

    Perturbations in neural circuits can provide mechanistic understanding of the neural correlates of behavior. In M71 transgenic mice with a “monoclonal nose”, glomerular input patterns in the olfactory bulb are massively perturbed and olfactory behaviors are altered. To gain insights into how olfactory circuits can process such degraded inputs we characterized odor-evoked responses of olfactory bulb mitral cells and interneurons. Surprisingly, calcium imaging experiments reveal that mitral cell responses in M71 transgenic mice are largely normal, highlighting a remarkable capacity of olfactory circuits to normalize sensory input. In vivo whole cell recordings suggest that feedforward inhibition from olfactory bulb periglomerular cells can mediate this signal normalization. Together, our results identify inhibitory circuits in the olfactory bulb as a mechanistic basis for many of the behavioral phenotypes of mice with a “monoclonal nose” and highlight how substantially degraded odor input can be transformed to yield meaningful olfactory bulb output. DOI: http://dx.doi.org/10.7554/eLife.16335.001 PMID:27177421

  12. An arterially perfused nose-olfactory bulb preparation of the rat

    PubMed Central

    Stanić, Davor; Farmer, David; Dutschmann, Mathias; Egger, Veronica

    2015-01-01

    A main feature of the mammalian olfactory bulb network is the presence of various rhythmic activities, in particular, gamma, beta, and theta oscillations, with the latter coupled to the respiratory rhythm. Interactions between those oscillations as well as the spatial distribution of network activation are likely to determine olfactory coding. Here, we describe a novel semi-intact perfused nose-olfactory bulb-brain stem preparation in rats with both a preserved olfactory epithelium and brain stem, which could be particularly suitable for the study of oscillatory activity and spatial odor mapping within the olfactory bulb, in particular, in hitherto inaccessible locations. In the perfused olfactory bulb, we observed robust spontaneous oscillations, mostly in the theta range. Odor application resulted in an increase in oscillatory power in higher frequency ranges, stimulus-locked local field potentials, and excitation or inhibition of individual bulbar neurons, similar to odor responses reported from in vivo recordings. Thus our method constitutes the first viable in situ preparation of a mammalian system that uses airborne odor stimuli and preserves these characteristic features of odor processing. This preparation will allow the use of highly invasive experimental procedures and the application of techniques such as patch-clamp recording, high-resolution imaging, and optogenetics within the entire olfactory bulb. PMID:26108959

  13. An arterially perfused nose-olfactory bulb preparation of the rat.

    PubMed

    Pérez de los Cobos Pallarés, Fernando; Stanić, Davor; Farmer, David; Dutschmann, Mathias; Egger, Veronica

    2015-09-01

    A main feature of the mammalian olfactory bulb network is the presence of various rhythmic activities, in particular, gamma, beta, and theta oscillations, with the latter coupled to the respiratory rhythm. Interactions between those oscillations as well as the spatial distribution of network activation are likely to determine olfactory coding. Here, we describe a novel semi-intact perfused nose-olfactory bulb-brain stem preparation in rats with both a preserved olfactory epithelium and brain stem, which could be particularly suitable for the study of oscillatory activity and spatial odor mapping within the olfactory bulb, in particular, in hitherto inaccessible locations. In the perfused olfactory bulb, we observed robust spontaneous oscillations, mostly in the theta range. Odor application resulted in an increase in oscillatory power in higher frequency ranges, stimulus-locked local field potentials, and excitation or inhibition of individual bulbar neurons, similar to odor responses reported from in vivo recordings. Thus our method constitutes the first viable in situ preparation of a mammalian system that uses airborne odor stimuli and preserves these characteristic features of odor processing. This preparation will allow the use of highly invasive experimental procedures and the application of techniques such as patch-clamp recording, high-resolution imaging, and optogenetics within the entire olfactory bulb.

  14. Subicular and CA1 hippocampal projections to the accessory olfactory bulb.

    PubMed

    de la Rosa-Prieto, C; Ubeda-Banon, I; Mohedano-Moriano, A; Pro-Sistiaga, P; Saiz-Sanchez, D; Insausti, R; Martinez-Marcos, A

    2009-02-01

    The hippocampal formation is anatomically and functionally related to the olfactory structures especially in rodents. The entorhinal cortex (EC) receives afferent projections from the main olfactory bulb; this constitutes an olfactory pathway to the hippocampus. In addition to the olfactory system, most mammals possess an accessory olfactory (or vomeronasal) system. The relationships between the hippocampal formation and the vomeronasal system are virtually unexplored. Recently, a centrifugal projection from CA1 to the accessory olfactory bulb has been identified using anterograde tracers. In the study reported herein, experiments using anterograde tracers confirm this projection, and injections of retrograde tracers show the distribution and morphology of a population of CA1 and ventral subicular neurons projecting to the accessory olfactory bulb of rats. These results extend previous descriptions of hippocampal projections to the accessory olfactory bulb by including the ventral subiculum and characterizing the morphology, neurochemistry (double labeling with somatostatin), and distribution of such neurons. These data suggest feedback hippocampal control of chemosensory stimuli in the accessory olfactory bulb. Whether this projection processes spatial information on conspecifics or is involved in learning and memory processes associated with chemical stimuli remains to be elucidated.

  15. Spatial assessment of net mercury emissions from the use of fluorescent bulbs

    SciTech Connect

    Matthew J. Eckelman; Paul T. Anastas; Julie B. Zimmerman

    2008-11-15

    While fluorescent lighting is an important technology for reducing electrical energy demand, mercury used in the bulbs is an ongoing concern. Using state and country level data, net emissions of mercury from the marginal use of fluorescent lightbulbs are examined for a base year of 2004 for each of the 50 United States and 130 countries. Combustion of coal for electric power generation is generally the largest source of atmospheric mercury pollution; reduction in electricity demand from the substitution of incandescent bulbs with fluorescents leads to reduced mercury emissions during the use of the bulb. This analysis considers the local mix of power sources, coal quality, thermal conversion efficiencies, distribution losses, and any mercury control technologies that might be in place. Emissions of mercury from production and end-of-life treatment of the bulbs are also considered, providing a life-cycle perspective. Net reductions in mercury over the entire life cycle range from -1.2 to 97 mg per bulb depending on the country. The consequences for atmospheric mercury emissions of several policy scenarios are also discussed. 46 refs., 4 figs., 3 tabs.

  16. Evidence of a novel allergenic protein Narcin in the bulbs of Narcissus tazetta

    PubMed Central

    Sinha, Mau; Singh, Amar; Shokeen, Akshita; Sharma, Pradeep; Kaushik, Sanket; Mitra, Dipendra K; Kaur, Punit; Sharma, Sujata; Singh, Tej P

    2013-01-01

    Several plant-derived allergens have been identified which result in the formation of immunoglobulin E antibodies. Primarily, these allergens belong to the protein families including seed storage proteins, structural proteins and pathogenesis-related proteins. Several allergens are also reported from flower bulbs which cause contact dermatitis. Such symptoms are highly common with the bulb growers handling different species of Narcissus. Narcissus toxicity is also reported if the bulbs are consumed accidentally. The present study aimed to characterize the protein from the bulbs of Narcissus tazetta responsible for its allergenic response. A 13 kDa novel allergenic protein, Narcin was isolated from the bulbs of Narcissus tazetta. The protein was extracted using ammonium sulfate fractionation. The protein was further purified by anion exchange chromatography followed by gel filtration chromatography. The N-terminal sequence of the first 15 amino-acid residues was determined using Edman degradation. The allergenicity of the protein was measured by cytokine production using flow cytometry in peripheral blood mononuclear cells. Further estimation of total IgE was performed by ELISA method. This novel protein was found to induce pro-inflammatory cytokines and thus induce allergy by elevating total IgE level. The novel protein, Narcin isolated from Narcissus tazetta was found to exhibit allergenic properties. PMID:23936740

  17. Spatial assessment of net mercury emissions from the use of fluorescent bulbs.

    PubMed

    Eckelman, Matthew J; Anastas, Paul T; Zimmerman, Julie B

    2008-11-15

    While fluorescent lighting is an important technology for reducing electrical energy demand, mercury used in the bulbs is an ongoing concern. Using state and country level data, net emissions of mercury from the marginal use of fluorescent lightbulbs are examined for a base year of 2004 for each of the 50 United States and 130 countries. Combustion of coal for electric power generation is generally the largest source of atmospheric mercury pollution; reduction in electricity demand from the substitution of incandescent bulbs with fluorescents leads to reduced mercury emissions during the use of the bulb. This analysis considers the local mix of power sources, coal quality, thermal conversion efficiencies, distribution losses, and any mercury control technologies that might be in place. Emissions of mercury from production and end-of-life treatment of the bulbs are also considered, providing a life-cycle perspective. Net reductions in mercury over the entire life cycle range from -1.2 to 97 mg per bulb depending on the country. The consequences for atmospheric mercury emissions of several policy scenarios are also discussed.

  18. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer

    PubMed Central

    Graham, David Y

    2014-01-01

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease” or for “Sippy” diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori

  19. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer.

    PubMed

    Graham, David Y

    2014-05-14

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician's believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for "surgical disease" or for "Sippy" diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases.

  20. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  1. Best way to perform a punch biopsy.

    PubMed

    Domínguez-Cherit, Judith; Gutiérrez Mendoza, Daniela

    2015-04-01

    Nail punch biopsy is used to obtain a tissue sample for the diagnosis and treatment of nail diseases. The best results will be possible if the surgeon is familiar with the anatomy and physiology of the nail apparatus. A punch biopsy can be used in all regions of the nail apparatus in the presence or absence of nail plate. When the procedure is performed with a careful handling of the anatomic site and specimen, in most cases a successful diagnosis can be achieved. PMID:25828717

  2. Retroperitoneoscopic renal biopsy: still a good indication!

    PubMed

    Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

    2014-01-01

    The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique. PMID:25198939

  3. Aspiration biopsy cytology of the salivary gland.

    PubMed

    Kline, T S; Merriam, J M; Shapshay, S M

    1981-09-01

    Aspiration biopsy by fine needle from the major salivary glands has been an under-utilized technic in the United States. To evaluate this form of biopsy, 69 patients with salivary gland enlargement were examined by this technic; 47 had confirmative histology. Characteristic ABC patterns were seen in the benign mixed tumor, the papillary cystadenoma lymphomatosum, the mucoepidermoid carcinoma, and malignancy metastatic to the salivary gland. These findings are described. The method proved complication-free and accurate and is recommended for all tumors of the salivary gland.

  4. Case Report: Ischaemic appendicitis post mesenteric biopsy

    PubMed Central

    Zukiwskyj, Marianna; Tun, June; Desai, Shashank

    2016-01-01

    A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach.  There are no reports to date of ischaemia to the appendix as a complication of this procedure.   We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis. PMID:26937277

  5. Antibodies in the Diagnosis of Coeliac Disease: A Biopsy-Controlled, International, Multicentre Study of 376 Children with Coeliac Disease and 695 Controls

    PubMed Central

    Petroff, David; Richter, Thomas; Uhlig, Holm H.; Laaβ, Martin W.; Hauer, Almuthe; Stern, Martin; Bossuyt, Xavier; de Laffolie, Jan; Flemming, Gunter; Villalta, Danilo; Schlumberger, Wolfgang; Mothes, Thomas

    2014-01-01

    Diagnosis of coeliac disease (CD) relies on a combination of clinical, genetic, serological and duodenal morphological findings. The ESPGHAN suggested that biopsy may not be necessary in all cases. New guidelines include omission of biopsy if the concentration of CD-specific antibodies exceeds 10 times the upper limit of normal (10 ULN) and other criteria are met. We analysed the 10 ULN criterion and investigated multiple antibody-assays. Serum was collected from 1071 children with duodenal biopsy (376 CD patients, 695 disease-controls). IgA-antibodies to tissue transglutaminase (IgA-aTTG), IgG-antibodies to deamidated gliadin peptides (IgG-aDGL) and IgA-endomysium antibodies (IgA-EMA) were measured centrally. We considered 3 outcomes for antibody test procedures utilizing IgA-aTTG and/or IgG-aDGL: positive (≥10 ULN, recommend gluten-free diet), negative (<1 ULN, no gluten-free diet) or unclear (perform biopsy). Positive (PPV) and negative (NPV) predictive values were based on clear test results. We required that they and their lower confidence bounds (LCB) be simultaneously very high (LCB >90% and PPV/NPV >95%). These stringent conditions were met for appropriate antibody-procedures over a prevalence range of 9–57%. By combining IgG-aDGL with IgA-aTTG, one could do without assaying total IgA. The PPV of IgG-aDGL was estimated to be extremely high, although more studies are necessary to narrow down the LCB. The proportion of patients requiring a biopsy was <11%. The procedures were either equivalent or even better in children <2 years compared to older children. All 310 of the IgA-aTTG positive children were also IgA-EMA positive. Antibody-assays could render biopsies unnecessary in most children, if experienced paediatric gastroenterologists evaluate the case. This suggestion only applies to the kits used here and should be verified for other available assays. Confirming IgA-aTTG positivity (≥10 ULN) by EMA-testing is unnecessary if performed on the same

  6. Simulated prostate biopsy: prostate cancer distribution and clinical correlation

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Zhang, Wei; Sesterhenn, Isabell A.; Dean, Robert; Moul, Judd W.; Mun, Seong K.

    2000-04-01

    Our group has recently obtained data based upon whole- mounted step-sectioned radical prostatectomy specimens using a 3D computer assisted prostate biopsy simulator that suggests an increased detection rate is possible using laterally placed biopsies. A new 10-core biopsy pattern was demonstrated to be superior to the traditional sextant biopsy. This patter includes the traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland. The objective of this study is to confirm the higher prostate cancer defection rate obtained using our simulated 10-core biopsy pattern in a small clinical trial. We retrospectively reviewed 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Of the 35 patients diagnosed with prostate cancer, 54.3 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent of patients were diagnosed solely with the laterally placed biopsies. Our results suggest that biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern.

  7. A rare cause of conductive hearing loss: High lateralized jugular bulb with bony dehiscence.

    PubMed

    Barr, James G; Singh, Pranay K

    2016-06-01

    We present a rare case of pediatric conductive hearing loss due to a high lateralized jugular bulb. An 8-year-old boy with a right-sided conductive hearing loss of 40 dB was found to have a pink bulge toward the inferior part of the right eardrum. Computed tomography showed a high, lateralized right jugular bulb that had a superolaterally pointing diverticulum that bulged into the lower mesotympanum and posterior external auditory meatus. It was explained to the child's parents that it is important never to put any sharp objects into the ears because of the risk of injury to the jugular vein. A high, lateralized jugular bulb with a diverticulum is a rare anatomic abnormality. Correct diagnosis of this abnormality is important so that inappropriate intervention does not occur.

  8. Light bulbs and complete circuits: what ones says about the other

    NASA Astrophysics Data System (ADS)

    Engelhardt, Paula V.; Gray, Kara; Rebello, N. Sanjay

    2004-05-01

    Students' conceptual difficulties of dc circuits have been well documented. Research [1] suggests that students who have difficulty lighting a flashlight bulb with a 1.5 V battery and a single wire are having difficulty understanding the concept of a complete circuit. Although this may be part of the story, our research indicates that many students do not understand how a light bulb is wired internally. This talk will present evidence of how students believe a light bulb is internally wired and a key experiment that helps them alter their incorrect image. An additional experiment will be presented that helps students develop a more comprehensive definition of complete circuits. [1] Lillian C. McDermott and Peter S. Shaffer, Research as a guide for curriculum development: An example from introductory electricity. Part 1: Investigation of student understanding, Am. J. Phys. 60, 996 (Nov. 1992).

  9. Antioxidant activity of bulbs and aerial parts of Crocus caspius, impact of extraction methods.

    PubMed

    Khalili, Masomeh; Fathi, Hamed; Ebrahimzadeh, Mohammad Ali

    2016-05-01

    Crocus genus (Iridaceae) is comprises approximately 80 species. In this study in vitro antioxidant activities of extracts from C. caspius bulbs and aerial parts were investigated. Ultrasonically assisted extraction (US), percolation method (PE) and polyphenolic fraction (PP) were used. Antioxidant activities were evaluated with five different tests. Aerial parts US extract with high levels of phenol and flavonoids were the most potent extract in DPPH radical scavenging than others. Aerial parts PE extract had shown very potent reducing power, which was so better than other extracts (p<0.01). Aerial parts PP fraction showed very good Fe(2+) chelating ability. Aerial parts US extract were the most potent extract in scavenging of H(2)O(2). Bulb PP fraction with IC(50)=22.8±0.7 µg ml(-1) was the most potent fraction in nitric oxide scavenging. The results improved high levels of antioxidant activities of C. caspius bulbs and aerial parts in all tested models.

  10. A rare cause of conductive hearing loss: High lateralized jugular bulb with bony dehiscence.

    PubMed

    Barr, James G; Singh, Pranay K

    2016-06-01

    We present a rare case of pediatric conductive hearing loss due to a high lateralized jugular bulb. An 8-year-old boy with a right-sided conductive hearing loss of 40 dB was found to have a pink bulge toward the inferior part of the right eardrum. Computed tomography showed a high, lateralized right jugular bulb that had a superolaterally pointing diverticulum that bulged into the lower mesotympanum and posterior external auditory meatus. It was explained to the child's parents that it is important never to put any sharp objects into the ears because of the risk of injury to the jugular vein. A high, lateralized jugular bulb with a diverticulum is a rare anatomic abnormality. Correct diagnosis of this abnormality is important so that inappropriate intervention does not occur. PMID:27304441

  11. Antioxidant activity of bulbs and aerial parts of Crocus caspius, impact of extraction methods.

    PubMed

    Khalili, Masomeh; Fathi, Hamed; Ebrahimzadeh, Mohammad Ali

    2016-05-01

    Crocus genus (Iridaceae) is comprises approximately 80 species. In this study in vitro antioxidant activities of extracts from C. caspius bulbs and aerial parts were investigated. Ultrasonically assisted extraction (US), percolation method (PE) and polyphenolic fraction (PP) were used. Antioxidant activities were evaluated with five different tests. Aerial parts US extract with high levels of phenol and flavonoids were the most potent extract in DPPH radical scavenging than others. Aerial parts PE extract had shown very potent reducing power, which was so better than other extracts (p<0.01). Aerial parts PP fraction showed very good Fe(2+) chelating ability. Aerial parts US extract were the most potent extract in scavenging of H(2)O(2). Bulb PP fraction with IC(50)=22.8±0.7 µg ml(-1) was the most potent fraction in nitric oxide scavenging. The results improved high levels of antioxidant activities of C. caspius bulbs and aerial parts in all tested models. PMID:27166547

  12. Olfactory bulb and retrobulbar regions in the hedgehog tenrec: organization and interconnections.

    PubMed

    Radtke-Schuller, S; Künzle, H

    2000-08-01

    The Madagascan lesser hedgehog tenrec (Echinops telfairi) is a terrestrial, nocturnal insectivore with a low encephalization index and a huge olfactory bulb. To gain insight into the organization and evolution of olfactory regions in placental mammals, the cytoarchitecture (Nissl), neurochemical attributes [zinc and acetylcholinesterase stain, nicotinamide adenine dinucleotide phosphate (NADPh)-diaphorase, and calcium-binding proteins], and interconnections (injections of wheat germ agglutinin-horseradish peroxidase and biotinylated dextran amine) of tenrec bulbar and retrobulbar regions were examined. The tenrec has a well-laminated main olfactory bulb, and modified (atypical) glomeruli are found that, to date, have been demonstrated only in murine rodents. Compared with the main olfactory bulb, the accessory bulb is relatively small, with clearly different staining characteristics, particularly with respect to NADPh-diaphorase, anticalbindin, and anticalretinin. External and central anterior olfactory nuclei also show characteristic cytoarchitectural and chemoarchitectural features. The medial olfactory peduncle seems to differ considerably from that in rodents. A small taenial structure can be separated from the hippocampal continuation. This taenia tecti presumably corresponds to the superior part of the tenia tecti in rodents, but no homologue of the rodent's prominent inferior taenia tecti could be found. The connections of bulbar and retrobulbar regions are similar to those seen in other mammals. Interbulbar projection systems connect the two olfactory bulbs through an external (topographic) and central (nontopographic) anterior nucleus; however, the topographic arrangement of the intrabulbar association system seems to differ from that seen in rodents. A reciprocity of direct olfactory bulb connections with the frontal (sulcal/orbital) cortex was found in the tenrec that has not been reported so far in other species.

  13. Seasonal dynamics of non-structural carbohydrates in bulbs and shoots of the geophyte Galanthus nivalis.

    PubMed

    Orthen, Birgit; Wehrmeyer, Andreas

    2004-04-01

    Seasonal dynamics of non-structural carbohydrates were studied in Galanthus nivalis L. over a 2-year period. The plants were collected in the field and separated into above- and below-ground biomass. The polysaccharide fraction of the bulbs consisted of fructans and starch. Seasonal variations suggest that the polysaccharides were utilized for carbon and energy supply for re-growth and flower development. With the re-sprouting of the bulbs in autumn the fructans within the bulbs were depolymerized and an increase of low degree of polymerization fructans as well as sucrose was observable. Within shoots the major polysaccharides were fructans, the starch content was much lower. Gas liquid chromatography and high-performance, anion-exchange chromatographyanalysis of the fructan fraction revealed that the fructans within the shoots were predominantly those with a low degree of polymerization. In addition to the two polysaccharides the other dominant sugar in shoots was sucrose. During the period of slow re-growth and flowering, fructan and starch pools were depleted to different degrees. Calculation of the difference between the carbohydrate content at the start of visible growth and at the time of lowest content revealed that the starch pool showed a higher depletion than the fructan pool. During the re-growth periods in 1996/97 and 1997/98 fructans were catabolized by 39 and 32% only, whereas the starch pool was depleted by 92% (1996/97) and 79% (1997/98), respectively. During rapid shoot growth and fruiting, the bulbs and above-ground organs appeared to be competing sinks for the photosynthetically fixed carbon. Refilling of the bulbs carbohydrate reserve started in February/March In shoots, the period of refilling the bulbs was characterized by a low content of oligosaccarides and a high content of hexoses.

  14. Patterns of olfactory bulb neurogenesis in the adult zebrafish are altered following reversible deafferentation.

    PubMed

    Trimpe, Darcy M; Byrd-Jacobs, Christine A

    2016-09-01

    Adult brain plasticity can be investigated using reversible methods that remove afferent innervation but allow return of sensory input. Repeated intranasal irrigation with Triton X-100 in adult zebrafish diminishes innervation to the olfactory bulb, resulting in a number of alterations in bulb structure and function, and cessation of the treatment allows for reinnervation and recovery. Using bromodeoxyuridine, Hu, and caspase-3 immunoreactivity we examined cell proliferation, differentiation, migration, and survival under conditions of acute and chronic deafferentation and reafferentation. Cell proliferation within the olfactory bulb was not influenced by acute or chronic deafferentation or reafferentation, but cell fate (including differentiation, migration, and/or survival of newly formed cells) was affected. We found that chronic deafferentation caused a bilateral increase in the number of newly formed cells that migrated into the bulb, although the amount of cell death of these new cells was significantly increased compared to untreated fish. Reafferentation also increased the number of newly formed cells migrating into both bulbs, suggesting that the deafferentation effect on cell fate was maintained. Reafferentation resulted in a decrease in newly formed cells that became neurons and, although death of newly formed cells was not altered from control levels, survival was reduced in relation to that seen in chronically deafferented fish. The potential effect of age on cell genesis was also examined. While the amount of cell migration into the olfactory bulbs was not affected by fish age, more of the newly formed cells became neurons in older fish. Younger fish displayed more cell death under conditions of chronic deafferentation. In sum, our results show that reversible deafferentation affects several aspects of cell fate, including cell differentiation, migration, and survival, and age of the fish influences the response to deafferentation. PMID:27343831

  15. Photokeratitis Linked to Metal Halide Bulbs in Two Gymnasiums - Philadelphia, Pennsylvania, 2011 and 2013.

    PubMed

    Finn, Lauren E; Gutowski, Jennifer; Alles, Steve; Mirowitz, Naomi; Johnson, Caroline; Osterhoudt, Kevin C; Patel, Ami

    2016-01-01

    In December 2011 and December 2013, the Philadelphia Department of Public Health (PDPH) received separate reports of clusters of photokeratitis linked to gymnasium events. Photokeratitis, a painful eye condition resulting from unprotected exposure to ultraviolet radiation, has previously been linked to metal halide lamps with broken outer envelopes (1,2). To investigate the cause of these clusters and further characterize patients with photokeratitis, PDPH administered questionnaires to potentially exposed persons, established a case definition, and conducted environmental assessments of both gymnasiums. Because event attendee registration information was available, a cohort study was conducted to evaluate the 2011 cluster of 242 persons who met the photokeratitis case definition. A case-series investigation was conducted to evaluate the 2013 cluster of 20 persons who met the photokeratitis case definition for that event. These investigations indicated that Type R metal halide bulbs with broken outer envelopes found in both gymnasiums were the probable cause of the photokeratitis. The Food and Drug Administration has made a number of recommendations regarding the use of metal halide bulbs in facilities where bulbs are at elevated risk for breaking, such as schools and indoor sports facilities (3). Because Type R metal halide lamps do not self-extinguish once the outer envelope is broken, these bulbs should be removed from settings with a high risk for outer envelope rupture, such as gymnasiums, or should be placed within enclosed fixtures. In instances where these bulbs cannot be exchanged for self-extinguishing lamps, Type R lamps with a broken outer envelope should be replaced immediately to limit exposure to ultraviolet radiation. A broken outer envelope can be detected by the presence of glass on the floor, or visual examination of the bulb when the power is turned off. A broken outer envelope is difficult to detect when the lamp is emitting light. PMID

  16. The renal biopsy in the genomic era.

    PubMed

    Liapis, Helen; Gaut, Joseph P

    2013-08-01

    Renal biopsy was introduced in the 1950s. By 1980 the pathologic diagnostic criteria for the majority of medical kidney diseases known today, including pediatric diseases, were established using light, electron microscopy and immunohistochemistry. However, it has become clear that there are limitations in the morphologic evaluation, mainly because a given pattern of injury can be caused by different aetiologies and, conversely, a single aetiology may present with more than one histological pattern. An explosion in kidney disease research in the last 20-30 years has brought new knowledge from bench to bedside rapidly and resulted in new molecular and genetic tools that enhance the diagnostic and prognostic power of the renal biopsy. Genomic technologies such as polymerase chain reaction (PCR), in situ hybridization and oligonucleotide microarrays, collectively known as genomics, detect single or multiple genes underscoring the pathologic changes and revealing specific causes of injury that may require different treatment. The aims of this review are to (1) summarize current recommendations for diagnostic renal biopsies encompassing light microscopy, immunofluorescence or immunohistochemistry and electron microscopy; (2) address the limitations of morphology; (3) show current contributions of genomic technologies adjunct to the renal biopsy, and provide examples of how these may transform pathologic interpretation into molecular disease phenotypes.

  17. Clinical role of the renal transplant biopsy

    PubMed Central

    Williams, Winfred W.; Taheri, Diana; Tolkoff-Rubin, Nina; Colvin, Robert B.

    2013-01-01

    Percutaneous needle core biopsy is the definitive procedure by which essential diagnostic and prognostic information on acute and chronic renal allograft dysfunction is obtained. The diagnostic value of the information so obtained has endured for over three decades and has proven crucially important in shaping strategies for therapeutic intervention. This Review provides a broad outline of the utility of performing kidney graft biopsies after transplantation, highlighting the relevance of biopsy findings in the immediate and early post-transplant period (from days to weeks after implantation), the first post-transplant year, and the late period (beyond the first year). We focus on how biopsy findings change over time, and the wide variety of pathological features that characterize the major clinical diagnoses facing the clinician. This article also includes a discussion of acute cellular and humoral rejection, the toxic effects of calcineurin inhibitors, and the widely varying etiologies and characteristics of chronic lesions. Emerging technologies based on gene expression analyses and proteomics, the in situ detection of functionally relevant molecules, and new bioinformatic approaches that hold the promise of improving diagnostic precision and developing new, refined molecular pathways for therapeutic intervention are also presented. PMID:22231130

  18. Frictional insertion kinetics of bone biopsy needles.

    PubMed

    Heiner, A D; Brown, T D; Rossin, V; Buckwalter, J A

    2001-12-01

    Patients undergoing a percutaneous bone biopsy often complain of pain during needle insertion, despite local anesthesia. Bone biopsy needles are typically inserted with combined axial and twisting motions. These motions could cause pain through frictional heating or direct mechanical irritation. The hypothesis of this study is that the insertion energy of bone biopsy needles can be reduced by modifying the insertion kinetics or by adding a friction-lowering coating to the needles. Jamshidi bone biopsy needles were driven into a bone analog model by an MTS materials testing machine operating under axial and rotational displacement control. The load/torque recordings showed that, to significantly decrease insertion energy and peak resistance to needle insertion, axial velocity and angular frequency had to be decreased to one quarter of the baseline, typical-usage parameters. However the increased insertion time may not be acceptable clinically. The majority of the insertion energy was associated with the needle axial thrust rather than with needle twisting. Overcoming friction against the side of the needle consumed much more of the insertion energy than did the process of cutting per se. None of five needle coatings tested succeeded in appreciably lowering the insertion energy, and none achieved a substantial decrease in peak resisting force.

  19. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    PubMed

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing. PMID:23551843

  20. Radiation preservation of foods of plant origin. Part 2. Onions and other bulb crops

    SciTech Connect

    Thomas, P.

    1984-01-01

    The various factors contributing to post harvest losses in onions and other bulb crops are briefly outlined in terms of the current storage methods. The present status of research on sprout inhibition by irradiation is reviewed in detail with respect to dose requirements, effect of time interval between harvest and irradiation, and the influence of environment on sprouting during storage. Biochemical mechanisms of sprout inhibition, metabolic and compositional changes (particularly sugars, anthocyanins, flavor and lachrymatory principles), and the culinary and processing qualities of irradiated onions are discussed. The future prospects for the commercial irradiation for sprout inhibition of bulb crops are considered.

  1. Functional neurology of a brain system: a 3D olfactory bulb model to process natural odorants.

    PubMed

    Migliore, Michele; Cavarretta, Francesco; Hines, Michael L; Shepherd, Gordon M

    2013-01-01

    The network of interactions between mitral and granule cells in the olfactory bulb is a critical step in the processing of odor information underlying the neural basis of smell perception. We are building the first computational model in 3 dimensions of this network in order to analyze the rules for connectivity and function within it. The initial results indicate that this network can be modeled to simulate experimental results on the activation of the olfactory bulb by natural odorants, providing a much more powerful approach for 3D simulation of brain neurons and microcircuits.

  2. Numerical analysis of a measured efficiency hysteresis on a bulb turbine model

    NASA Astrophysics Data System (ADS)

    Houde, S.; Carrier, A.; Buron, J. D.; Deschênes, C.

    2014-03-01

    Within the framework of the BulbT project, simulations were performed to understand the origin of a measured hysteresis on the efficiency hill chart of a bulb turbine model. This hysteresis is associated with a sharp drop of efficiency located at slightly higher discharge than the best efficiency operating condition. It appears as a variation in the turbine performance whether an operating condition located in the efficiency drop is reached from a lower or a higher discharge. This hysteresis was reproduced numerically using Reynolds Averaged Navier Stokes (RANS) simulations. The paper presents the experimental results, the numerical methodology and a comprehensive analysis of the simulations to shed light on this interesting phenomenon.

  3. Elemental mercury emission in the indoor environment due to broken compact fluorescent light (CFL) bulbs--paper

    EPA Science Inventory

    Compact fluorescent light (CFL) bulbs contain a few milligrams (mg) of elemental mercury. When a CFL breaks, some of the mercury is immediately released as elemental mercury vapor and the remainder is deposited on indoor surfaces with the bulb debris. In a controlled study design...

  4. In vitro bulb development in shallot (Allium cepa L. Aggregatum Group): effects of anti-gibberellins, sucrose and light.

    PubMed

    Le Guen-Le Saos, F; Hourmant, A; Esnault, F; Chauvin, J E

    2002-04-01

    Bulbing was studied in shallot plants cultured in vitro. Bulbing occurred under a 16 h photoperiod with fluorescent + incandescent light and 30-50 g 1(-1) sucrose in the culture medium. Exogenous gibberellin (10 microM GA3) inhibited leaf and root growth and bulbing. When added to the medium at a concentration of 10 microM, three inhibitors of gibberellin biosynthesis (ancymidol, flurprimidol and paclobutrazol) promoted bulb formation and the percentage of bulbing. When ancymidol was used in combination with GA3, it did not reverse the effect of GA3 applied alone. Under treatments with 30-70 g l(-1) sucrose, bulbing ratios greater than those found in control plants were achieved by addition of ancymidol, and bulb fresh weight was increased in the same way. Ancymidol caused a 66% decrease in sucrose content in leaf bases but greatly increased the glucose, fructose and fructan contents. The increase in fructan content by ancymidol could result from the three-fold rise in total [14C]sucrose uptake per plant from the culture medium associated with a marked increase in leaf base labelling at the expense of root labelling. The possible role of ancymidol is discussed and evidence supports a major regulatory role for gibberellins in bulbing.

  5. Effects of postharvest onion curing parameters on bulb rot caused by Pantoea agglomerans, Pantoea ananatis, and Pantoea allii in storage

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Crop loss of onion bulbs during storage carries an exceptionally high economic impact since a large portion of the production expenses have been expended before storage occurs. Because of this, it is important to define practices that can reduce onion bulb losses caused by storage rots. This study...

  6. Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack.

    PubMed

    Kamalakar, G; Prasad, V Devi; Devaratnam, J; Ganeshan, A

    2015-01-01

    A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy. PMID:26623378

  7. [Utility of the WallFlexTM duodenal stent for unresectable advanced gastric cancer related to gastric outlet obstruction].

    PubMed

    Aoki, Taro; Hyuga, Satoshi; Kato, Aya; Chono, Teruhiro; Watanabe, Risa; Komori, Takamichi; Matsumoto, Takashi; Takachi, Kou; Nishioka, Kiyonori; Uemura, Yoshio; Kobayashi, Kenji

    2012-11-01

    Duodenal stenting for malignant disease related to gastric outlet obstruction(GOO) has been covered by health insurance in Japan since April 2010. We inserted WallFlexTM duodenal stents(WDS) in 4 patients with GOO caused by unresectable gastric cancer. WDS insertion was successful in all 4 cases. Duodenal perforation occurred in 1 case. One case each of stent obstruction and stent migration occurred. All patients could eat a soft-food diet for 3-6 months (median, 5.3 months). Survival time ranged between 5 and 14 months (median, 6 months). Three patients underwent S-1 combination chemotherapy. Duodenal stenting is expected to be effective for advanced gastric cancer related to GOO.

  8. Effect of selenium treatment on mineral nutrition, bulb size, and antioxidant properties of garlic (Allium sativum L.).

    PubMed

    Põldma, Priit; Tõnutare, Tõnu; Viitak, Anu; Luik, Anne; Moor, Ulvi

    2011-05-25

    Foliar selenium (Se) treatment of garlic at concentrations of 10, 50, and 100 μg of Se/mL was carried out in open field conditions in 2008 and 2009 in Estonia. Bulb weight and yield structure, content of total Se, S, N, P, K, Ca, and Mg, ascorbic acid content (AAC), pungency, total phenolics, and total antioxidant capacity (TAC) were determined. The highest level of Se decreased total S, K, and Ca in both years; no negative impact on bulb weight was observed. In 2009 Se10 treatment had significantly more bulbs with the largest diameter compared to the other treatments. In 2008, the AAC was decreased by Se50 and the content of total phenolics by all Se treatments; however, TAC was increased. Foliar Se fertilization of garlic at rates of 10-50 μg of Se/mL can be recommended to increase the number of large bulbs and increase bulb antioxidant capacity.

  9. Molecular Mechanisms Regulating the Dendritic Development of Newborn Olfactory Bulb Interneurons in a Sensory Experience-Dependent Manner

    PubMed Central

    Yoshihara, Sei-ichi; Takahashi, Hiroo; Tsuboi, Akio

    2016-01-01

    Inhibitory interneurons in the olfactory bulb are generated continuously throughout life in the subventricular zone and differentiate into periglomerular and granule cells. Neural circuits that undergo reorganization by newborn olfactory bulb interneurons are necessary for odor detection, odor discrimination, olfactory memory, and innate olfactory responses. Although sensory experience has been shown to regulate development in a variety of species and in various structures, including the retina, cortex, and hippocampus, little is known about how sensory experience regulates the dendritic development of newborn olfactory bulb interneurons. Recent studies revealed that the 5T4 oncofetal trophoblast glycoprotein and the neuronal Per/Arnt/Sim domain protein 4 (Npas4) transcription factor regulate dendritic branching and dendritic spine formation, respectively, in olfactory bulb interneurons. Here, we summarize the molecular mechanisms that underlie the sensory input-dependent development of newborn interneurons and the formation of functional neural circuitry in the olfactory bulb. PMID:26793053

  10. Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors

    NASA Astrophysics Data System (ADS)

    Harmon, Stephanie A.; Tuite, Michael J.; Jeraj, Robert

    2016-10-01

    Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: (1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and (2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.

  11. Is Helicobacter pylori Infection the Primary Cause of Duodenal Ulceration or a Secondary Factor? A Review of the Evidence.

    PubMed

    Kate, Vikram; Ananthakrishnan, N; Tovey, Frank I

    2013-01-01

    Helicobacter pylori (H. pylori) has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. Against this concept there are issues that need explanation such as the reason why only a minority of infected persons develop duodenal ulceration when infection with H. pylori is widespread. There is evidence that H. pylori infection has been prevalent for several centuries, yet duodenal ulceration became common at the beginning of the twentieth century. The prevalence of duodenal ulceration is not higher in countries with a high prevalence of H. pylori infection. This paper debate puts forth the point of view of two groups of workers in this field whether H. pylori infection is the primary cause of duodenal ulcer disease or a secondary factor. PMID:23606834

  12. Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps

    PubMed Central

    Lim, Chul-Hyun; Kim, Won Chul; Kim, Jin Soo; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong; Chung, In-Sik

    2012-01-01

    Background/Aims It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy. Methods Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue. Results Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps. Conclusions Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered. PMID:22741133

  13. Multiple Biopsies and Detection of Cervical Cancer Precursors at Colposcopy

    PubMed Central

    Wentzensen, Nicolas; Walker, Joan L.; Gold, Michael A.; Smith, Katie M.; Zuna, Rosemary E.; Mathews, Cara; Dunn, S. Terence; Zhang, Roy; Moxley, Katherine; Bishop, Erin; Tenney, Meaghan; Nugent, Elizabeth; Graubard, Barry I.; Wacholder, Sholom; Schiffman, Mark

    2015-01-01

    Purpose Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies. Methods The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies. Results In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone. Conclusion Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy. PMID:25422481

  14. Gastric and Duodenal Pseudomelanosis: An Extended Unusual Finding in a Patient with End Stage Kidney Disease

    PubMed Central

    Qureshi, Noor Ul Ain; Younus, Muhammad Faraz; Alavi, Kourosh

    2016-01-01

    Gastric and duodenal pseudomelanosis is a rare endoscopic mucosal finding, characterized by the accumulation of iron in macrophages of the lamina propria of the stomach and duodenum. The clinical significance and long term sequelae have not been clarified yet. However, this benign condition is associated with a variety of clinical conditions, such as essential hypertension, chronic renal failure, diabetes mellitus, long term intake of iron supplements, and furosemide. Duodenal pseudomelanosis appears to be more common than gastric pseudomelanosis given the fact that a few cases of gastric pseudomelanosis have been reported in the literature so far. We report a case of 88-year-old lady with ESRD who is maintained on hemodialysis and presented with abdominal pain. An upper GI endoscopy showed discoloration of the antrum of the stomach and most portion of her duodenum. Histopathology report confirmed the presence of iron laden macrophages in the lamina propria of both stomach and duodenum. PMID:27042366

  15. Palliation of biliary and duodenal obstruction in patients with unresectable pancreatic cancer: endoscopy or surgery?

    PubMed

    Maire, F; Sauvanet, A

    2013-06-01

    Patients with unresectable pancreatic adenocarcinoma often develop biliary and/or duodenal obstruction during the course of their disease. Jaundice, pruritis, nausea and vomiting impact negatively on the quality of life and chemotherapy must often be withheld until these symptoms are resolved. In the past, an open surgical palliative bypass was proposed, but the development of endoprosthetic stents has changed the management of these patients. The success rate for placement of duodenal and biliary stents is greater than 90% with low morbidity. Classical surgical bypass surgery includes biliary-digestive and gastro-jejunal anastomoses. Many studies have compared endoscopic and surgical treatment, and there is a clear advantage to endoscopic treatment in terms of quality of life and cost.

  16. Surgical management of duodenal obstruction in older children in Kaduna, Nigeria.

    PubMed

    Udezue, N O

    1993-08-01

    Twenty children, aged between six years and fourteen years were seen and treated for duodenal obstruction at the Department of Surgery, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, between 1st January 1990 and 31st December, 1990. Both extrinsic and intrinsic factors caused the duodenal obstruction. All the patients were surgically treated and all survived. The main presenting clinical features, diagnosis and treatment are discussed. Follow up on some of the patients has been erratic because of patients defaulting on clinic appointments. In spite of successful surgical treatment and relief of symptoms, growth retardation, as shown by height and weight measurements, persisted relatively in patients in whom it was present at the time of diagnosis and treatment.

  17. [Remote results of conservative and operative treatment of patients with duodenal ulcer complicated by bleeding].

    PubMed

    Iefremov, V V

    2013-08-01

    Analyzed long-term outcomes of 690 patients with duodenal ulcer, complicated by bleeding in Kyiv City Centre gastrointestinal bleeding for the periods 1994-1996 (control group) and 2004-2008 (main group). In the late period of patients who were found giperhlorgidry (moderate and severe), increased by 1.4 tImes, indicating a higher voltage continuous acid production In the main group. With the introduction of modern circuits Helicobacter therapy incidence of H. pylori reduced by half. Improving modern tactical approaches to conservative treatment helped to reduce the frequency of relapses in duodenal ulcer remote period by 2.2 times, acute bleeding--in 1.9 times, increase the frequency of excellent results--in 2.8 times.

  18. Down syndrome: Molecular mapping of the congenital heart disease and duodenal stenosis

    SciTech Connect

    Korenburg, J.R. ); Bradley, C.; Disteche, C.M. )

    1992-02-01

    Down syndrome (DS) is a major cause of congenital heart and gut disease and mental retardation. DS individuals also have characteristic facies, hands, and dermatoglyphics, in addition to abnormalities of the immune system, and increased risk of leukemia, and an Alzheimer-like dementia. Although their molecular basis is unknown, recent work on patients with DS and partial duplications of chromosome 21 has suggested small chromosomal regions located in band q22 that are likely to contain the genes for some of these features. The authors now extend these analyses to define molecular markers for the congenital heart disease, the duodenal stenosis, and an 'overlap' region for the facial and some of the skeletal features. They report the clinical, cytogenetic, and molecular analysis of two patients. These studies provide the molecular basis for the construction of a DS phenotypic map and focus the search for genes responsible for the physical features, congenital heart disease, and duodenal stenosis of DS.

  19. [Surgical management of duodenal ulcer with hemorrhage from the gastroduodenal artery: antrectomy versus conservative surgery?].

    PubMed

    Brehant, O; Fuks, D; Sabbagh, C; Wouters, A; Mention, C; Dumont, F; Regimbeau, J M

    2008-01-01

    When surgery is indicated for bleeding duodenal ulcer, the traditional standard of care has been "radical surgical treatment is preferable to conservative therapy since the risk of rebleeding is reduced without an augmentation in morbidity and mortality". This principle is based on two prospective studies published before 1995. Radical surgery at that time consisted of antrectomy, while conservative therapy included oversewing of the bleeding vessel in the ulcer bed and ligation of the gastroduodenal artery (Weinberg procedure). This strategy must be re-evaluated in 2008 in view of our better understanding of the role of Helicopacter pylori in the causation of duodenal ulceration and the decreased risk of post-operative re-bleeding with the use of proton pump inhibitors. The role of surgery has changed. Its aim is no longer to cure the ulcer diathesis but rather to urgently control bleeding in anticipation of ulcer cure with medical therapy.

  20. Abdominal pain and hematuria: duodenal perforation from ingested foreign body causing ureteral obstruction and hydronephrosis.

    PubMed

    Kolbe, Nina; Sisson, Kathleen; Albaran, Renato

    2016-01-01

    Foreign body (FB) ingestion is a relatively common reason for visits to the emergency room. If the FB is symptomatic or damaging to the patient, either endoscopic or surgical intervention should ensue. We present a case of abdominal pain and hematuria beginning ∼24 h after an incidental FB ingestion. Initial CT imaging defined a linear opacity perforating through the posterior duodenal wall abutting the ureter causing inflammation and hydronephrosis. After two unsuccessful endoscopic attempts at retrieval, we were able to identify the object with the aid of intraoperative fluoroscopy and surgically remove the FB. The patient recovered uneventfully and was discharged home. Posterior duodenal perforation by an FB may not manifest with obvious localized or systemic symptoms unless the perforation involves surrounding structures such as the aorta, vena cava or ureter. In such cases, surgical intervention is required for FB removal. PMID:26903557

  1. Abdominal pain and hematuria: duodenal perforation from ingested foreign body causing ureteral obstruction and hydronephrosis

    PubMed Central

    Kolbe, Nina; Sisson, Kathleen; Albaran, Renato

    2016-01-01

    Foreign body (FB) ingestion is a relatively common reason for visits to the emergency room. If the FB is symptomatic or damaging to the patient, either endoscopic or surgical intervention should ensue. We present a case of abdominal pain and hematuria beginning ∼24 h after an incidental FB ingestion. Initial CT imaging defined a linear opacity perforating through the posterior duodenal wall abutting the ureter causing inflammation and hydronephrosis. After two unsuccessful endoscopic attempts at retrieval, we were able to identify the object with the aid of intraoperative fluoroscopy and surgically remove the FB. The patient recovered uneventfully and was discharged home. Posterior duodenal perforation by an FB may not manifest with obvious localized or systemic symptoms unless the perforation involves surrounding structures such as the aorta, vena cava or ureter. In such cases, surgical intervention is required for FB removal. PMID:26903557

  2. Gastric emptying of combined liquid-solid meals in healed duodenal ulcer

    SciTech Connect

    Moore, J.G.; McIntyre, B.; Alazraki, N.

    1985-12-01

    The gastric emptying rates of combined liquid and solid radioisotopically labeled meals in 47 healed duodenal ulcer subjects and 17 healthy control subjects are compared. No significant differences were found between the groups in emptying slopes and the emptying half-times or in the percent retention values at any of the counting intervals for either the liquid or solid meals. These results are compatible with the observation that the rapid gastric emptying in many patients with duodenal ulcer is associated with the disease and that healing results in a return to normal gastric emptying rates. However, since gastric emptying rates during active ulceration were not determined in our patients, a more definitive interpretation awaits a study comparing emptying rates obtained during and after healing of active ulceration in the same patient.

  3. Duodenal Lipomatosis as a Curious Cause of Upper Gastrointestinal Bleed: A Report with Review of Literature

    PubMed Central

    Wani, Majid; Tiwari, Priyanka; Ramaswamy, Palaniswamy Kalipatti; Kumar, Reddy Prasanna

    2016-01-01

    Lipomas of the gastrointestinal tract are rare. Duodenal lipomas are incidental and mostly asymptomatic. Tumours may produce symptoms of abdominal pain and discomfort or cause bleeding due to ulceration or intestinal obstruction due to intussusception. We describe a 45-year-old man presenting in emergency with 3 days history of melena with normal gastroduodenoscopy and contrast enhanced computed tomography revealing multiple polypoid lesion in duodenum and proximal jejunum suggestive of lipoma. Due to ongoing bleed, he underwent laparotomy with duodenectomy and uneventful postoperative recovery. Our review of cases published in last 67 years indicate that duodenal lipomas are rare to occur but commonly found in second part, they may be seen in third and fourth part of duodenum which may be missed on endoscopy. They can be multiple and may present as severe UGI bleeding which could be managed surgically. Though CT is diagnostic, histopathology confirms the diagnosis which shows lipomatous lesion composed of mature adipose arranged in lobules. PMID:27437304

  4. Successful treatment of active haemorrhage from a duodenal diverticulum using surgicel (absorbable haemostat): a case report.

    PubMed

    Muguti, Gi; Gandhi, H; Ridgeway, D

    2007-01-01

    Haemorrhage is one of the rare but serious complications of duodenal diverticula. Current methods of treatment include: endoscopy with injection therapy or hemoclip application and diverticulectomy. In this paper we present the case of a 61 year old man with life threatening haemorrhage who was managed successfully with gentle packing of a bleeding duodenal diverticulum using SURGICEL (Absorbable Haemostat). This appears to be a simple and effective way of dealing with the problem especially in situations where other methods are ineffective or inapplicable. Early surgical intervention before the development of any coagulopathy increases the chances of a successful outcome. It has not been possible to find a similar report from a thorough literature search. PMID:20353131

  5. How diet and lifestyle affect duodenal ulcers. Review of the evidence.

    PubMed Central

    Ryan-Harshman, Milly; Aldoori, Walid

    2004-01-01

    OBJECTIVE: To demonstrate the role of diet in reducing or aggravating risk of duodenal ulcer (DU). QUALITY OF EVIDENCE: MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between diet and lifestyle and DU using the key words duodenal ulcer and diet, fibre, or lifestyle. Evidence that these factors are associated with DU arose mainly from three case-control and three prospective studies (level II evidence) and from expert opinion (level III evidence). MAIN MESSAGE: A high-fibre diet appears to reduce risk of DU; soluble fibre might be associated with reduced risk also. Vitamin A intake is associated with lower risk of DU. Little evidence indicates that fat, type of fat, protein intake, or consumption of alcohol or caffeine affect the etiology of DU. CONCLUSION: A high-fibre diet, particularly if the fibre comes from fruit and vegetables, could reduce risk of DU; vitamin A might also be beneficial. PMID:15171675

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

    PubMed

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

    2015-01-01

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

  7. Tonic and stimulus-evoked nitric oxide production in the mouse olfactory bulb

    PubMed Central

    Lowe, Graeme; Buerk, Donald G.; Ma, Jie; Gelperin, Alan

    2008-01-01

    Nitric oxide (NO) has been long assumed to play a key role in mammalian olfaction. This was based largely on circumstantial evidence, i.e. prominent staining for nitric oxide synthase (NOS) and cyclic GMP or soluble guanylyl cyclase, an effector enzyme activated by NO, in local interneurons of the olfactory bulb. Here we employ innovative custom-fabricated NO micro-sensors to obtain the first direct, time-resolved measurements of NO signaling in the olfactory bulb. In 400 μm thick mouse olfactory bulb slices, we detected a steady average basal level of 87 nM NO in the extracellular space of mitral or granule cell layers. This NO ‘tone’ was sensitive to NOS substrate manipulation (200 μM L-arginine, 2 mM L-NAME) and Mg2+ modulation of NMDA receptor conductance. Electrical stimulation of olfactory nerve fibers evoked transient (peak at 10 s) increments in NO levels 90 – 100 nM above baseline. In the anesthetized mouse, NO micro-sensors inserted into the granule cell layer detected NO transients averaging 55 nM in amplitude and peaking at 3.4 sec after onset of a 5 sec odorant stimulation. These findings suggest dual roles for NO signaling in the olfactory bulb – tonic inhibitory control of principal neurons, and regulation of circuit dynamics during odor information processing. PMID:18407420

  8. Identification and developmental expression profiling of putative alkaloid biosynthetic genes in Corydalis yanhusuo bulbs

    PubMed Central

    Liao, Dengqun; Wang, Pengfei; Jia, Chan; Sun, Peng; Qi, Jianjun; Zhou, Lili; Li, Xian’en

    2016-01-01

    Alkaloids in bulbs of Corydalis (C.) yanhusuo are the major pharmacologically active compounds in treatment of blood vessel diseases, tumors and various pains. However, due to the absence of gene sequences in C. yanhusuo, the genes involved in alkaloid biosynthesis and their expression during bulb development remain unknown. We therefore established the first transcriptome database of C. yanhusuo via Illumina mRNA-Sequencing of a RNA composite sample collected at Bulb initiation (Day 0), early enlargement (Day 10) and maturation (Day 30). 25,013,630 clean 90 bp paired-end reads were de novo assembled into 47,081 unigenes with an average length of 489 bp, among which 30,868 unigenes (65.56%) were annotated in four protein databases. Of 526 putative unigenes involved in biosynthesis o f various alkaloids, 187 were identified as the candidate genes involved in the biosynthesis of benzylisoquinoline alkaloids (BIAs), the only alkaloid type reported in C. yanhusuo untill now. BIAs biosynthetic genes were highly upregulated in the overall pathway during bulb development. Identification of alkaloid biosynthetic genes in C. yanhusuo provide insights on pathways and molecular regulation of alkaloid biosynthesis, to initiate metabolic engineering in order to improve the yield of interesting alkaloids and to identify potentially new alkaloids predicted from the transcriptomic information. PMID:26777987

  9. Generalization of the Wet-Bulb Temperature Notion to the Case of Electromagnetic Drying

    NASA Astrophysics Data System (ADS)

    Afanas'ev, A. M.; Siplivyi, B. N.

    2016-05-01

    A method of estimating the stationary temperature of the surface a body blown over by air and subjected to the action of electromagnetic radiation, representing a generalization of the wet-bulb temperature notion to the case of electromagnetic drying, has been developed.

  10. Analytical equation for calculating the adiabatic temperature of the wet-bulb thermometer

    NASA Astrophysics Data System (ADS)

    Baskakov, A. P.; Rakov, O. A.

    2013-03-01

    A formula for calculating the adiabatic temperature of the wet-bulb thermometer has been obtained analytically without using the analogy between the heat and mass transfer processes. A comparison of the results of calculations with the use of this formula and formulas of other authors used in the technical literature has been made.

  11. Endovascular treatment of symptomatic vestibular aqueduct dehiscence as a result of jugular bulb abnormalities.

    PubMed

    Thénint, Marie-Aude; Barbier, Charlotte; Hitier, Martin; Patron, Vincent; Saleme, Suzana; Courthéoux, Patrick

    2014-11-01

    A new endovascular treatment consisting of stent-assisted coil implantation is described for jugular bulb abnormalities causing symptomatic vestibular aqueduct dehiscence. Three patients presenting with vertigo associated with pulsatile tinnitus or hearing loss were treated. This technique cured the vertigo and pulsatile tinnitus in all patients and preserved normal cerebral venous drainage with no side effects.

  12. Turn It on with Light Bulb Reading! Sound-Switching Strategies for Struggling Readers.

    ERIC Educational Resources Information Center

    Vogt, Maryellen; Nagano, Patty

    2003-01-01

    Notes that "Light Bulb Reading" is done in short, one-on-one, daily lessons that include oral reading with note-taking and discussions about miscues, skills, and strategies. Suggests that this is an effective approach for assisting struggling readers that focuses on specific, individual, assessed needs. Outlines an 11-step plan. (SG)

  13. Olfactory Perceptual Learning Requires Action of Noradrenaline in the Olfactory Bulb: Comparison with Olfactory Associative Learning

    ERIC Educational Resources Information Center

    Vinera, Jennifer; Kermen, Florence; Sacquet, Joëlle; Didier, Anne; Mandairon, Nathalie; Richard, Marion

    2015-01-01

    Noradrenaline contributes to olfactory-guided behaviors but its role in olfactory learning during adulthood is poorly documented. We investigated its implication in olfactory associative and perceptual learning using local infusion of mixed a1-ß adrenergic receptor antagonist (labetalol) in the adult mouse olfactory bulb. We reported that…

  14. Improved spatial accuracy of functional maps in the rat olfactory bulb using supervised machine learning approach.

    PubMed

    Murphy, Matthew C; Poplawsky, Alexander J; Vazquez, Alberto L; Chan, Kevin C; Kim, Seong-Gi; Fukuda, Mitsuhiro

    2016-08-15

    Functional MRI (fMRI) is a popular and important tool for noninvasive mapping of neural activity. As fMRI measures the hemodynamic response, the resulting activation maps do not perfectly reflect the underlying neural activity. The purpose of this work was to design a data-driven model to improve the spatial accuracy of fMRI maps in the rat olfactory bulb. This system is an ideal choice for this investigation since the bulb circuit is well characterized, allowing for an accurate definition of activity patterns in order to train the model. We generated models for both cerebral blood volume weighted (CBVw) and blood oxygen level dependent (BOLD) fMRI data. The results indicate that the spatial accuracy of the activation maps is either significantly improved or at worst not significantly different when using the learned models compared to a conventional general linear model approach, particularly for BOLD images and activity patterns involving deep layers of the bulb. Furthermore, the activation maps computed by CBVw and BOLD data show increased agreement when using the learned models, lending more confidence to their accuracy. The models presented here could have an immediate impact on studies of the olfactory bulb, but perhaps more importantly, demonstrate the potential for similar flexible, data-driven models to improve the quality of activation maps calculated using fMRI data. PMID:27236085

  15. Comment on "Human neuroblasts migrate to the olfactory bulb via a lateral ventricular extension".

    PubMed

    Sanai, Nader; Berger, Mitchel S; Garcia-Verdugo, Jose Manuel; Alvarez-Buylla, Arturo

    2007-10-19

    Curtis et al. (Research Articles, 2 March 2007, p. 1243) claimed discovery of a human neuronal migratory stream to the olfactory bulb along a putative lateral ventricular extension. However, high levels of proliferation reported with proliferating cell nuclear antigen were not confirmed using different markers, neuronal chain migration was not demonstrated, and no serial reconstruction shows a true ventricular extension.

  16. Use of metabolic activation systems of tulip bulbs in the Ames test for environmental mutagens

    SciTech Connect

    Higashi, K.; Ikeuchi, K.; Karasaki, Y.

    1982-01-01

    The effects of trace amounts of PAH on the carcinogenesis in animals and human beings and on the ecology of plants are examined. An in vitro method has been developed which traces the metabolic fate of environmental mutagens in tulip bulbs. The method has been successful in confirming the presence of metabolic activation systems only for potent carcinogens. (JMT)

  17. Wheat curl mite and dry bulb mite: untangling a taxonomic conundrum through a multidisciplinary approach

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The taxonomy of two economically important eriophyoid species, Aceria tosichella (wheat curl mite, WCM) and A. tulipae (dry bulb mite, DBM), was confounded in the world literature until the late 20th century due to their morphological similarity and ambiguous data from plant-transfer and virus-trans...

  18. Adult Olfactory Bulb Interneuron Phenotypes Identified by Targeting Embryonic and Postnatal Neural Progenitors

    PubMed Central

    Figueres-Oñate, Maria; López-Mascaraque, Laura

    2016-01-01

    Neurons are generated during embryonic development and in adulthood, although adult neurogenesis is restricted to two main brain regions, the hippocampus and olfactory bulb. The subventricular zone (SVZ) of the lateral ventricles generates neural stem/progenitor cells that continually provide the olfactory bulb (OB) with new granule or periglomerular neurons, cells that arrive from the SVZ via the rostral migratory stream. The continued neurogenesis and the adequate integration of these newly generated interneurons is essential to maintain homeostasis in the olfactory bulb, where the differentiation of these cells into specific neural cell types is strongly influenced by temporal cues. Therefore, identifying the critical features that control the generation of adult OB interneurons at either pre- or post-natal stages is important to understand the dynamic contribution of neural stem cells. Here, we used in utero and neonatal SVZ electroporation along with a transposase-mediated stable integration plasmid, in order to track interneurons and glial lineages in the OB. These plasmids are valuable tools to study the development of OB interneurons from embryonic and post-natal SVZ progenitors. Accordingly, we examined the location and identity of the adult progeny of embryonic and post-natally transfected progenitors by examining neurochemical markers in the adult OB. These data reveal the different cell types in the olfactory bulb that are generated in function of age and different electroporation conditions. PMID:27242400

  19. Hypothesis That Urethral Bulb (Corpus Spongiosum) Plays an Active Role in Male Urinary Continence

    PubMed Central

    Rehder, Peter; Staudacher, Nina M.; Schachtner, Joerg; Berger, Maria E.; Schillfahrt, Florian; Hauser, Verena; Mueller, Raphael; Skradski, Viktor; Horninger, Wolfgang; Glodny, Bernhard

    2016-01-01

    The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the “cushion” of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous) urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA). PMID:27022393

  20. Tool for installing or extracting small bulbs in limited-access spaces

    NASA Technical Reports Server (NTRS)

    Snyder, E. B.; Parker, J. H.

    1973-01-01

    Installing and extracting component of tool is plastic tubing with inside diameter which provides snug fit over bulb. Other components, which provide sturdiness and ease of operation, consist of metal tube, with collar near one end, and plunger, with knob on one end and Teflon tip on the other.