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Sample records for duodenal bulb biopsies

  1. A Prospective Study on the Usefulness of Duodenal Bulb Biopsies in Celiac Disease Diagnosis in Children: Urging Caution.

    PubMed

    Taavela, Juha; Popp, Alina; Korponay-Szabo, Ilma Rita; Ene, Adina; Vornanen, Martine; Saavalainen, Päivi; Lähdeaho, Marja-Leena; Ruuska, Tarja; Laurila, Kaija; Parvan, Alexandru; Anca, Ioana; Kurppa, Kalle; Mäki, Markku

    2016-01-01

    Several recent celiac disease guidelines recommend the acquisition of duodenal bulb biopsies for diagnostics. This is in conflict with previously reported evidence and routine practice from the 1960s onward. We reopened the issue in a prospective multicenter study and used morphometric variables in evaluating the usefulness of bulb biopsies in children. We further sought to establish whether deposits of IgA targeting bulb transglutaminase 2 (TG2) could be of diagnostic help. Diagnoses of celiac disease were based on clinic and distal duodenal histopathology statements. Centralized reading of villous height (VH) to crypt depth (CrD) ratios and IgA deposits was performed on anatomical duodenal bulb specimens. All children participating also underwent routine investigations for other diseases. Twenty-two children had celiac disease, and another 22 served as non-celiac disease controls. The quality of the anatomical bulb specimens was unsatisfactory for reliable morphometric measurements in 20 out of 44 (45%) patients even after recuttings. All celiac disease patients had VH:CrD<2.0 (mean 0.2) but also 10 out of 13 (77%) non-celiac control patients had an injured bulb mucosal lining (mean 1.3) even up to false-positive "flat lesion". Bulb IgA deposits were able to separate celiac disease from disease controls. Morphological injury is common in the anatomical bulb even without celiac disease, increasing the risk of false-positive diagnoses. Premature conclusions might have been drawn on current care guidelines as to celiac disease diagnosis based solely on anatomical bulb specimens. Bulb mucosal IgA targeting TG2 in poor quality biopsy specimens is a powerful clinical tool in finding celiac disease patients.

  2. Duodenal Bulb Adenocarcinoma Benefitted from Neoadjuvant Chemotherapy: A Case Report.

    PubMed

    Zhang, Geng-Yuan; Mao, Jie; Zhao, Bin; Long, Bo; Zhan, Hao; Zhang, Jun-Qiang; Zhou, Hui-Nian; Guo, Ling-Yun; Jiao, Zuo-Yi

    2017-01-01

    Duodenal bulb adenocarcinoma is an extremely rare malignancy in the alimentary tract which has a low incidence rate and nonspecific symptoms. It is difficult to diagnose early, and the misdiagnosis rate is high. CT, MRI, upper gastrointestinal endoscopy, and other advanced imaging modalities should be combined to make a comprehensive evaluation. The diagnostic confirmation of this tumor type mainly depends on the pathological examination. The combination of surgery with other treatment modalities is effective. A review of reports on duodenal bulb adenocarcinoma with chemotherapy revealed 6 cases since 1990. However, there are few reports on neoadjuvant chemotherapy for the disease. In this report, preoperative S-1 in combination with oxaliplatin neoadjuvant chemotherapy achieved a complete pathological response in the treatment of duodenal bulb adenocarcinoma. Neoadjuvant chemotherapy shows a better clinical efficacy in the treatment of duodenal bulb adenocarcinoma, but its value needs to be further verified. © 2017 S. Karger AG, Basel.

  3. Role of the "immersion technique" in diagnosing celiac disease with villous atrophy limited to the duodenal bulb.

    PubMed

    Cammarota, Giovanni; Cesaro, Paola; La Mura, Rossella; Martino, Antonio; Cazzato, Alessia; Miele, Luca; Lupascu, Andrea; Vecchio, Fabio M; Larocca, Luigi M; Grieco, Antonio; Gasbarrini, Giovanni

    2007-07-01

    To investigate if the so-called immersion technique during upper endoscopy may be helpful to predict patterns of villous atrophy restricted to the duodenal bulb. Patients with celiac disease may have a patchy distribution of duodenal villous atrophy. In some cases, mucosa of duodenal bulb may be the only intestinal area involved. The immersion technique is a novel procedure that allows visualizing duodenal villi directly during endoscopy. With this prospective study, the immersion duodenoscopy was performed in 67 celiac subjects to investigate their duodenal villous pattern. Villi were evaluated both in the first and in the second duodenal segment and judged as present or absent (flat mucosa). Results were compared with histology as reference. Among celiac subjects, 49 were newly diagnosed and 18 previously diagnosed celiac patients. Four (8%) newly diagnosed and 7 (39%) previously diagnosed celiac subjects had an extension of the villous atrophy (flat mucosa) limited to the duodenal bulb. The sensitivity, specificity, and positive and negative predictive values of the immersion-based duodenal investigation in predicting areas of duodenal villous atrophy was always 100%. Immersion technique may be useful for directing duodenal biopsies in celiac subjects with a patchy distribution of villous atrophy. This procedure can avoid blinded sampling of the duodenal mucosa and enhance the diagnostic yield.

  4. 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

  5. Is duodenal biopsy appropriate in areas endemic for Helicobacter pylori?

    PubMed

    Sahin, Abdurrahman; Cihangiroglu, Gulcin; Bilgic, Yilmaz; Calhan, Turan; Cengiz, Mustafa

    2017-01-01

    The primary reason for obtaining duodenal biopsy sample is to diagnose celiac disease. Helicobacter pylori (H. pylori) and drug injury are common causes of duodenitis. The aim of this retrospective study was to explore effects of H. pylori and drugs on duodenal mucosa. Duodenal biopsy samples of patients who underwent upper gastrointestinal endoscopy (UGIE) between February 2014 and December 2014 were retrospectively examined. Clinical symptoms, referral indications, endoscopic findings, H. pylori status, and drug history were recorded. Duodenal biopsy findings were compared based on presence of H. pylori and drug history. Of 2389 patients who underwent UGIE, 206 had duodenal biopsy. Eight patients (3.9%) were diagnosed with celiac disease. After excluding cases with celiac disease, 76 patients of remaining 198 patients (36.9%) had duodenal histopathological abnormality. H. pylori was found in 95 (47.9%) patients. Drug usage was less common (42%). Of patients who had histopathological duodenitis, 59% were H. pylori-infected. Rate of duodenitis was higher in H. pylori (+) group than in H. pylori (-) group (45% vs 27.1%; odds ratio, 2.4; 95% confidence interval, 1.3-4.4; p=0.005). There was no difference between groups regarding drug use in terms of histopathological duodenitis. H. pylori is the major contributor to duodenitis in high prevalence regions. Serological testing may be more appropriate before performing duodenal biopsy in patients with suspected celiac disease.

  6. Patchy villous atrophy in adult patients with suspected gluten-sensitive enteropathy: is a multiple duodenal biopsy strategy appropriate?

    PubMed

    Hopper, A D; Cross, S S; Sanders, D S

    2008-03-01

    The current internationally accepted gold standard for diagnosing celiac disease is a small-bowel biopsy demonstrating villous atrophy. However, it has been suggested that the diagnosis might not be considered as confirmed if the villous atrophy is patchy. Our aim was to assess whether there is an optimal duodenal biopsy strategy for detecting villous atrophy in adult patients with suspected gluten-sensitive enteropathy. Patients who had positive endomysial or tissue transglutaminase antibodies were prospectively recruited. Nine biopsies were taken from the duodenum: one from the duodenal bulb, four from the proximal duodenum, and four from the distal duodenum. Each biopsy was graded according to the Marsh criteria. All possible biopsy regimes were evaluated for their ability to detect the presence and severity of villous atrophy. A total of 56 patients were recruited (23 men [41 %], 33 women [59 %]; mean age 47, range 16 - 85): 53/56 patients had villous atrophy present in at least one biopsy; 10/53 patients had biopsy specimens that showed "patchy" villous atrophy. In all 53 patients with villous atrophy this was detected by taking a minimum of three biopsies (sensitivity 100 %, 95 % confidence interval [CI] 93.2 % - 100 %). However, this strategy always incorporated a duodenal bulb biopsy. The most severe degree of villous atrophy in all 56 patients was only detected by using a five-biopsy regime (sensitivity 100 %, 95 % CI 93.6 % - 100 %). In this study we observed that villous atrophy in adult patients with suspected gluten-sensitive enteropathy (antibody-positive) is patchy. For this reason we would suggest a minimum of three biopsies, incorporating a duodenal bulb biopsy, to ensure that villous atrophy is detected. However, a five-biopsy regime is required for recognition of the most severe lesion.

  7. Duodenal bulb control of the flow rate of digesta in the fasted and fed dog.

    PubMed Central

    Malbert, C H; Ruckebusch, Y

    1989-01-01

    1. Continuous measurement of the flow of digesta near the pylorus, and 5 cm aborally, was assessed in the conscious dog using a chronically implanted flowmeter. The patterns of flow were related to motor activity of the gastroduodenal junction. 2. Electromagnetic measurement of the flow was calibrated in vitro by means of a pulsatile pump. Validation was obtained in vivo by direct evaluation of the amount of chyme collected from an open duodenal cannula and indirectly by a dye-dilution technique. 3. After a 12 h fast, only small amounts of gastric contents were delivered into the duodenum. This transfer occurred during periods of irregular motor activity recorded along the gastroduodenal junction, which occupied less than 25% of the recording time. The patterns of flow near the pylorus and beyond the duodenal bulb were correlated to antral and duodenal contractions respectively. 4. After a meal, gastric emptying occurred intermittently and was related to enhanced antral motor activity beyond the duodenal bulb; digesta flowed in clusters of gushes which were related to the duodenal contractions. 5. It is concluded that the mechanical role of the duodenal bulb is to change the intermittent juxtapyloric flow of digesta into a uniform flow at the duodenal level. PMID:2585295

  8. 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

  9. Low yield of routine duodenal biopsies for evaluation of abdominal pain

    PubMed Central

    Dubin, Sterling M; Kwong, Wilson T; Kalmaz, Denise; Savides, Thomas J

    2015-01-01

    AIM: To determine the yield of biopsying normal duodenal mucosa for investigation of abdominal pain. METHODS: This is a retrospective chart review of consecutive patients who underwent esophagogastroduodenoscopy (EGD) with duodenal biopsies of normal appearing duodenal mucosa for an indication that included abdominal pain. All the patients in this study were identified from an electronic endoscopy database at a single academic medical center and had an EGD with duodenal biopsies performed over a 4-year period. New diagnoses that were made as a direct result of duodenal biopsies were identified. All duodenal pathology reports and endoscopy records were reviewed for indications to perform the examination as well as the findings; all the medical records were reviewed. Exclusion criteria included age less than 18 years, duodenal mass, nodule, or polyp, endoscopic duodenitis, duodenal scalloping, known celiac disease, positive celiac serology, Crohns disease, or history of bone marrow transplant. Information was collected in a de-identified database with pertinent demographic information including human immunodeficiency virus (HIV) status, and descriptive statistics were performed. RESULTS: About 300 patients underwent EGD with biopsies of benign appearing or normal appearing duodenal mucosa. The mean age of patients was 44.1 ± 16.8 years; 189 of 300 (63%) were female. A mean of 4.3 duodenal biopsies were performed in each patient. In the subgroup of patients with abdominal pain without anemia, diarrhea, or weight loss the mean age was 43.4 ± 16.3 years. Duodenal biopsies performed for an indication that included abdominal pain resulting in 4 new diagnoses (3 celiac disease and 1 giardiasis) for an overall yield of 1.3%. 183 patients with abdominal pain without anemia, diarrhea, or weight loss (out of the total 300 patients) underwent duodenal biopsy of duodenal mucosa resulting in three new diagnoses (two cases of celiac disease and one giardiasis) for a yield of 1

  10. Low yield of routine duodenal biopsies for evaluation of abdominal pain.

    PubMed

    Dubin, Sterling M; Kwong, Wilson T; Kalmaz, Denise; Savides, Thomas J

    2015-06-28

    To determine the yield of biopsying normal duodenal mucosa for investigation of abdominal pain. This is a retrospective chart review of consecutive patients who underwent esophagogastroduodenoscopy (EGD) with duodenal biopsies of normal appearing duodenal mucosa for an indication that included abdominal pain. All the patients in this study were identified from an electronic endoscopy database at a single academic medical center and had an EGD with duodenal biopsies performed over a 4-year period. New diagnoses that were made as a direct result of duodenal biopsies were identified. All duodenal pathology reports and endoscopy records were reviewed for indications to perform the examination as well as the findings; all the medical records were reviewed. Exclusion criteria included age less than 18 years, duodenal mass, nodule, or polyp, endoscopic duodenitis, duodenal scalloping, known celiac disease, positive celiac serology, Crohns disease, or history of bone marrow transplant. Information was collected in a de-identified database with pertinent demographic information including human immunodeficiency virus (HIV) status, and descriptive statistics were performed. About 300 patients underwent EGD with biopsies of benign appearing or normal appearing duodenal mucosa. The mean age of patients was 44.1 ± 16.8 years; 189 of 300 (63%) were female. A mean of 4.3 duodenal biopsies were performed in each patient. In the subgroup of patients with abdominal pain without anemia, diarrhea, or weight loss the mean age was 43.4 ± 16.3 years. Duodenal biopsies performed for an indication that included abdominal pain resulting in 4 new diagnoses (3 celiac disease and 1 giardiasis) for an overall yield of 1.3%. 183 patients with abdominal pain without anemia, diarrhea, or weight loss (out of the total 300 patients) underwent duodenal biopsy of duodenal mucosa resulting in three new diagnoses (two cases of celiac disease and one giardiasis) for a yield of 1.6%. Duodenal biopsies of

  11. 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

  12. Impact of endoscopic duodenal biopsy on the detection of small intestinal villous atrophy.

    PubMed Central

    Saverymuttu, S. H.; Sabbat, J.; Burke, M.; Maxwell, J. D.

    1991-01-01

    Coeliac disease is underdiagnosed partly because of insufficient recognition of more subtle presentations and partly because of the relative difficulty of jejunal biopsy. We have compared new case detection of small intestinal villous atrophy in the 5 years following changing to endoscopic multiple biopsy with our preceding 9 year experience utilizing jejunal capsule suction biopsy. The detection rate for small intestinal disease doubled while the number of patients investigated by small bowel biopsy increased threefold. We recommend that endoscopic duodenal biopsy replace jejunal biopsy for routine diagnostic purposes. PMID:2057427

  13. Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease?

    PubMed

    Hopper, A D; Sidhu, R; Hurlstone, D P; McAlindon, M E; Sanders, D S

    2007-02-01

    Villous atrophy present on a duodenal biopsy remains the 'gold standard' diagnostic test for coeliac disease. However, endoscopic biopsy may cause morbidity and discomfort. Our aim was to evaluate wireless capsule endoscopy as an alternative test for the recognition of villous atrophy. Twenty-one patients with a positive endomysial antibody referred for endoscopy and duodenal biopsy were also offered a wireless capsule endoscopy to evaluate their small bowel. Concurrently, other patients (n=23) referred for a wireless capsule endoscopy acted as controls. Wireless capsule endoscopy reports were assessed for the presence of villous atrophy by one blinded investigator. Twenty endomysial antibody positive patients subsequently had villous atrophy on duodenal biopsy. The controls all had normal duodenal biopsies (with a negative endomysial antibody) and no evidence of villous atrophy noted on their wireless capsule endoscopy. Of the 20 endomysial antibody positive patients with confirmed villous atrophy on biopsy, 17 had villous atrophy also detected by wireless capsule endoscopy. The sensitivity, specificity, positive and negative predictive values for wireless capsule endoscopy recognising villous atrophy were 85%, 100%, 100%, 88.9%, respectively. Wireless capsule endoscopy may be an option to recognise villous atrophy in patients with a positive endomysial antibody who are unwilling, or unable to have a gastroscopy. However, a negative test should be followed by a biopsy if coeliac disease is to be excluded.

  14. Early elective surgery for bleeding ulcer in the posterior duodenal bulb. Own results and review of the literature.

    PubMed

    Mönig, Stefan P; Lübke, Thomas; Baldus, Stefan E; Schäfer, Hartmuth; Hölscher, Arnulf H

    2002-01-01

    Acute upper gastrointestinal bleeding represents the major, potentially life-threatening complication of gastroduodenal ulcer disease with an average mortality of 10%. To decrease mortality a risk-dependent combined endoscopic and operative approach for the treatment of bleeding ulcer in the posterior duodenal wall was developed. Between 1998 and 2000 in our hospital a total of 22 patients with bleeding posterior duodenal bulb ulcer were treated following a differentiated endoscopic-surgical concept. High-risk patients with high bleeding activity (n = 8) underwent early elective surgery after primary endoscopic treatment of the bleeding and stabilization of the patient in an intensive care unit. The management of patients presenting a low-risk profile (n = 14) included careful surveillance and a consecutive second endoscopy 24 hours after the initial endoscopy. Patients that underwent surgery showed more severe secondary diseases than patients of the endoscopic group. Hemoglobin concentration in patients requiring surgery was significantly lower, they showed a higher incidence of hypovolemic shock and received more blood transfusions within the first 24 hours. Mortality was 0% in both groups, a relevant rebleeding occurred in one patient after endoscopic therapy, which was successfully treated by reendoscopy with fibrin injection. Due to these results as well as results of other groups we recommend early elective surgery in high-risk patients with bleeding duodenal bulb ulcer after primary endoscopic treatment of the bleeding.

  15. Cytology Preparations of Formalin Fixative Aid Detection of Giardia in Duodenal Biopsy Samples.

    PubMed

    Panarelli, Nicole C; Gobara, Nariman; Hoda, Rana S; Chaump, Michael; Jessurun, Jose; Yantiss, Rhonda K

    2017-04-01

    Giardiasis is the most common intestinal parasitic infection in the United States. The organism elicits no, or minimal, inflammatory changes in duodenal biopsy samples, so it can be easily overlooked. We performed this study to determine whether Giardia could be isolated from the formalin fixative of biopsy samples, and to evaluate the value of fluid analysis in the assessment for potential infection. We prospectively evaluated duodenal biopsy samples from 92 patients with a clinical suspicion of giardiasis or symptoms compatible with that diagnosis (ie, diarrhea, bloating, or abdominal pain) Biopsy samples were routinely processed and stained with hematoxylin and eosin. Histologic diagnoses included giardiasis (5 cases, 4%), normal findings (64 cases, 70%), peptic injury/active duodenitis (12 cases, 13%), and intraepithelial lymphocytosis with villous blunting (10 cases, 12%). Fifteen cases (13%) showed detached degenerated epithelial cells or mucus droplets in the intervillous space that resembled Giardia. Cytology slides were prepared from formalin in the biopsy container using the standard Cytospin protocol and reviewed by a cytopathologist blinded to the biopsy findings. Cytologic evaluation revealed Giardia spp. in all 5 biopsy-proven cases, and identified an additional case that was not detected by biopsy analysis. Organisms were significantly more numerous (mean: 400 trophozoites; range, 120 to 810) and showed better morphologic features in cytology preparations compared with tissue sections (mean: 129 trophozoites; range, 37 to 253 organisms; P=0.05). Our findings suggest that cytology preparations from formalin fixative can resolve diagnostically challenging cases and even enhance Giardia detection in some cases.

  16. Duodenal biopsies for the diagnosis of coeliac disease: are we adhering to current guidance?

    PubMed

    Husnoo, Nilofer; Ahmed, Wafaa; Shiwani, Muhammad Hanif

    2017-01-01

    The British Society of Gastroenterology guidelines recommend taking at least four duodenal biopsy specimens at the time of upper gastrointestinal (UGI) endoscopy if coeliac disease (CD) is suspected and it has been shown to increase the diagnostic yield of CD. We assessed the compliance to these guidelines within our institution. We then applied measures to improve our compliance rate and assessed the resulting impact on our diagnostic rate of CD. We performed a retrospective audit of electronic records for all patients, with no prior diagnosis of CD, who underwent UGI endoscopy with duodenal biopsies between August 2014 and May 2015. We implemented measures to raise awareness among endoscopy users at our institution and carried out a reaudit between February and May 2016. 924 patients were found to be eligible in the first part of the study and 278 in the second part. The proportion of patients who had ≥4 biopsy specimens submitted increased from 21.9% to 60.8% (p<0.001). The diagnostic rate of CD increased from 3.5% in the audit group to 7.6% in the reaudit group (p=0.004). A positive serology result and suspected CD as an indication for biopsy were found to be independent predictors of the likelihood of complying with guidelines. Our study suggests that taking <4 duodenal biopsy specimens to assess for the presence of CD may lead to the diagnosis of CD being missed. Simple measures can improve the local compliance rate to current guidelines.

  17. Gastro-oesophageal reflux symptoms and coeliac disease: no role for routine duodenal biopsy.

    PubMed

    Mooney, Peter D; Evans, Kate E; Kurien, Matthew; Hopper, Andrew D; Sanders, David S

    2015-06-01

    Coeliac disease (CD) has been linked to gastro-oesophageal reflux disease (GORD). Previous studies have demonstrated an increased prevalence of reflux in patients with CD. However data on the risk for CD in patients presenting with reflux are conflicting. The aim of this study was to establish the prevalence of CD in patients with GORD and to elucidate the mechanisms for reflux symptoms in newly diagnosed CD patients. Group A: patients who had undergone routine duodenal biopsy were prospectively recruited between 2004 and 2014. Diagnostic yield was compared with that of a screening cohort. Group B: 32 patients with newly diagnosed CD who had undergone oesophageal manometry and 24-h pH studies were prospectively recruited. Group A: 3368 patients (58.7% female, mean age 53.4 years) underwent routine duodenal biopsy. Of these patients, 850 (25.2%) presented with GORD. The prevalence of CD among GORD patients was 1.3% (0.7-2.4%), which was not significantly higher than that in the general population (P=0.53). Within the context of routine duodenal biopsy at endoscopy (when corrected for concurrent symptoms, age and sex), reflux was found to be negatively associated with CD [adjusted odds ratio 0.12 (0.07-0.23), P<0.0001]. In group B, 34% of patients complained of reflux. On manometry, 9% had a hypotensive lower oesophageal sphincter and 40.6% had oesophageal motor abnormalities, with 25% significantly hypocontractile. On pH studies, 33% demonstrated reflux episodes. The prevalence of undiagnosed CD among GORD patients is similar to that in the general population, and routine duodenal biopsy cannot be recommended. A significant number of patients with newly diagnosed CD were found to have reflux and/or oesophageal dysmotility on pH/manometry studies; this may explain the high prevalence of reflux symptoms in CD.

  18. 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

  19. Duodenal biopsies for the diagnosis of coeliac disease: are we adhering to current guidance?

    PubMed Central

    Husnoo, Nilofer; Ahmed, Wafaa; Shiwani, Muhammad Hanif

    2017-01-01

    Background The British Society of Gastroenterology guidelines recommend taking at least four duodenal biopsy specimens at the time of upper gastrointestinal (UGI) endoscopy if coeliac disease (CD) is suspected and it has been shown to increase the diagnostic yield of CD. We assessed the compliance to these guidelines within our institution. We then applied measures to improve our compliance rate and assessed the resulting impact on our diagnostic rate of CD. Methods We performed a retrospective audit of electronic records for all patients, with no prior diagnosis of CD, who underwent UGI endoscopy with duodenal biopsies between August 2014 and May 2015. We implemented measures to raise awareness among endoscopy users at our institution and carried out a reaudit between February and May 2016. Results 924 patients were found to be eligible in the first part of the study and 278 in the second part. The proportion of patients who had ≥4 biopsy specimens submitted increased from 21.9% to 60.8% (p<0.001). The diagnostic rate of CD increased from 3.5% in the audit group to 7.6% in the reaudit group (p=0.004). A positive serology result and suspected CD as an indication for biopsy were found to be independent predictors of the likelihood of complying with guidelines. Conclusions Our study suggests that taking <4 duodenal biopsy specimens to assess for the presence of CD may lead to the diagnosis of CD being missed. Simple measures can improve the local compliance rate to current guidelines. PMID:28761690

  20. Diversity of Duodenal and Rectal Microbiota in Biopsy Tissues and Luminal Contents in Healthy Volunteers.

    PubMed

    Li, Gangping; Yang, Min; Zhou, Kan; Zhang, Lei; Tian, Lugao; Lv, Shangze; Jin, Yu; Qian, Wei; Xiong, Hanhua; Lin, Rong; Fu, Yu; Hou, Xiaohua

    2015-07-01

    The diverse microbial communities that colonize distinct segments of the gastrointestinal tract are intimately related to aspects of physiology and the pathology of human health. However, most recent studies have focused on the rectal or fecal microbiota, and the microbial signature of the duodenum is poorly studied. In this study, we compared the microbiota in duodenal and rectal samples to illustrate the characteristic microbial signatures of the duodenum in healthy adults. Nine healthy volunteers donated biopsies and luminal contents from the duodenum and rectum. To determine the composition and diversity of the microbiota, 454- pyrosequencing of bacterial 16S rRNA was performed and multiple bioinformatics analyses were applied. The α-diversity and phylogenetic diversity of the microbiota in the duodenal samples were higher than those of the rectal samples. There was higher biodiversity among the microbiota isolated from rectal biopsies than feces. Proteobacteria were more highly represented in the duodenum than in the rectum, both in the biopsies and in the luminal contents from the healthy volunteers (38.7% versus 12.5%, 33.2% versus 5.0%, respectively). Acinetobacter and Prevotella were dominant in the duodenum, whereas Bacteroides and Prevotella were dominant in the rectum. Additionally, the percentage of OTUs shared in biopsy groups was far higher than in the luminal group (43.0% versus 26.8%) and a greater number of genera was shared among the biopsies than the luminal contents. Duodenal samples demonstrated greater biological diversity and possessed a unique microbial signature compared with the rectum. The mucosa-associated microbiota was more relatively conserved than luminal samples.

  1. 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

  2. [Prospective study of 420 biopsies realised in patients with duodenal ulcer with positive Helicobacter pylori].

    PubMed

    Khayat, Olfa; Kilani, Afef; Chedly-Debbiche, Achraf; Zeddini, Abdelfattah; Gargouri, Dalila; Kharrat, Jamel; Souissi, Adnene; Ghorbel, Abdel Jabbar; Ben Ayed, Mohamed; Ben Khelifa, Habib

    2006-06-01

    It's a prospective study leaded between September 1997 and july 1999 (23 months ) in 75 patients with duodenal ulcer and positif for Helicobacter pylori. All patients had a first endoscopy with antral, fundic and duodenal biopsies, followed one month later by a second control fibroscopy with biopsies of the same sites. A total of 420 biopsies was realised. Chronic gastritis was evaluated according to sydney system. Patients was divided by randomisation in 4 groups. Every group was received a different therapeutic association. The results was conform to liberation concering activity 80%, intestinal metaplasia 12%. inflammation 100%. Atrophy was observed in 56% of cases, this percentage is variable in literature; chronic gastritis was predominant in antre relatively to fundus (p<0.005). After treatment, a significative fall of Helicobacter pylori and activity and atrophy was established, contrarity to intestinal metaplasia and chronic inflammation witch are persisted. The prevalence of follicular gastritis was 57%. The better rate of ulcer cicatrisation and Helicobacter pylori eradication was respectively of 79% and 66% in group 1 treated by omeprazol, amoxcillin, metronidazol by comparison with the others 3 groups (p<0.005).

  3. The composition of T cell subtypes in duodenal biopsies are altered in coeliac disease patients

    PubMed Central

    Steenholt, Janni V.; Nielsen, Christian; Baudewijn, Leen; Staal, Anne; Rasmussen, Karina S.; Sabir, Hardee J.; Barington, Torben; Husby, Steffen; Toft-Hansen, Henrik

    2017-01-01

    One of the hallmarks of Celiac disease (CD) is intraepithelial lymphocytosis in the small intestine. Until now, investigations to characterize the T cell subpopulations within the epithelial layer have not discriminated between the heterodimeric co-receptor molecule, CD8αβ, and the possibly immunoregulatory CD8αα homodimer molecule. Besides TCRαβ+ CD4+ cells, no other phenotypes have been shown to be gluten-reactive. Using flow cytometry on lymphocytes from duodenal biopsies, we determined that the number of B cells (CD3- CD19+) and the number of CD3+ CD4- CD8- double-negative (DN) T cells were elevated 6–7 fold in children with CD. We next isolated and quantified intraepithelial lymphocytes (IELs) from biopsies obtained from patients (both children and adults) with CD, potential CD and non-CD controls. Flow cytometric analysis of the duodenal T cell subpopulations was performed including the markers TCRαβ, TCRγδ, CD4, CD8α and CD8β. Proportions of γδ T cells and CD8αβ+ cells among IELs were increased in CD patients, whereas proportions of CD4+ CD8αα+ and CD4+ single-positive T cells were decreased. Additionally, two gluten-reactive T cell lines (TCLs) derived from CD biopsies were analyzed for changes in proportions of T cell subsets before and after gluten stimulation. In a proliferation assay, dividing cells were tracked with carboxyfluorescein succinimidyl ester (CFSE), and both αβ and γδ T cells proliferated in response to gluten. Changes in duodenal T cell subpopulations in potential CD patients followed the same pattern as for CD patients, but with less pronounced effect. PMID:28166225

  4. The composition of T cell subtypes in duodenal biopsies are altered in coeliac disease patients.

    PubMed

    Steenholt, Janni V; Nielsen, Christian; Baudewijn, Leen; Staal, Anne; Rasmussen, Karina S; Sabir, Hardee J; Barington, Torben; Husby, Steffen; Toft-Hansen, Henrik

    2017-01-01

    One of the hallmarks of Celiac disease (CD) is intraepithelial lymphocytosis in the small intestine. Until now, investigations to characterize the T cell subpopulations within the epithelial layer have not discriminated between the heterodimeric co-receptor molecule, CD8αβ, and the possibly immunoregulatory CD8αα homodimer molecule. Besides TCRαβ+ CD4+ cells, no other phenotypes have been shown to be gluten-reactive. Using flow cytometry on lymphocytes from duodenal biopsies, we determined that the number of B cells (CD3- CD19+) and the number of CD3+ CD4- CD8- double-negative (DN) T cells were elevated 6-7 fold in children with CD. We next isolated and quantified intraepithelial lymphocytes (IELs) from biopsies obtained from patients (both children and adults) with CD, potential CD and non-CD controls. Flow cytometric analysis of the duodenal T cell subpopulations was performed including the markers TCRαβ, TCRγδ, CD4, CD8α and CD8β. Proportions of γδ T cells and CD8αβ+ cells among IELs were increased in CD patients, whereas proportions of CD4+ CD8αα+ and CD4+ single-positive T cells were decreased. Additionally, two gluten-reactive T cell lines (TCLs) derived from CD biopsies were analyzed for changes in proportions of T cell subsets before and after gluten stimulation. In a proliferation assay, dividing cells were tracked with carboxyfluorescein succinimidyl ester (CFSE), and both αβ and γδ T cells proliferated in response to gluten. Changes in duodenal T cell subpopulations in potential CD patients followed the same pattern as for CD patients, but with less pronounced effect.

  5. Value of breath hydrogen analysis in management of diarrheal illness in childhood: comparison with duodenal biopsy.

    PubMed

    Davidson, G P; Robb, T A

    1985-06-01

    Breath hydrogen tests were carried out on 157 children either because they had chronic diarrhea or because they were on disaccharide-free diets. Lactose malabsorption was common in patients with postgastroenteritis syndrome (43%), and sucrose malabsorption was readily detected in patients with congenital sucrase-isomaltase deficiency. Secondary sucrose malabsorption and small bowel bacterial overgrowth were also detected. In predicting clinical response to dietary change, the breath hydrogen test, as we perform it, was clearly the most specific and sensitive and had a predictive accuracy of 96%. Duodenal biopsy results obtained from 48 of the children gave a 23% incidence of misleading disaccharidase results (16.7% falsely normal, 6.3% falsely abnormal), but biopsy remains vital in the diagnosis of congenital sucrase-isomaltase deficiency. False negative breath hydrogen results were obtained on occasions (4%) but in most instances were related to recent antimicrobial therapy or failure of the breath test mechanics (e.g., vomiting, length of sampling).

  6. 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

  7. Multiple giant duodenal ulcers associated with duodenal gastrinoma.

    PubMed

    Fujihara, Shintaro; Mori, Hirohito; Nishiyama, Noriko; Kobayashi, Mitsuyoshi; Kobara, Hideki; Masaki, Tsutomu

    2012-02-01

    A 59-year-old Japanese man with a history of chronic hepatitis C and cirrhosis was admitted to hospital because of severe abdominal pain and diarrhea. His discomfort had begun 2 months earlier and was localized to the upper abdomen. Upper gastrointestinal endoscopy showed multiple ulcerative lesions from the duodenal bulb to the descending part of the duodenum, one of which was a giant ulcer that filled half of the intestinal lumen. Despite continuous intravenous lansoprazole therapy, his abdominal symptoms did not improve. Upper gastrointestinal endoscopy was again performed to detect the tumor, but it was difficult to observe the tumor with a conventional endoscope. We then inverted a transnasal endoscope into the duodenum, and this enabled us to detect a 15-mm submucosal tumor in the upper wall of the duodenal bulb. Examination of specimens from endoscopic ultrasonography fine-needle aspiration biopsy of the tumor revealed gastrinoma in the duodenal bulb. We decided to perform an operative resection. The patient's symptoms resolved after surgery, and he remained asymptomatic at follow-up 18 months later. Therefore, when it is difficult to detect the tumor directly by conventional endoscopy, we recommend that attempts be made to detect the tumor by inverting a transnasal endoscope into the duodenal bulb.

  8. Ectopic Opening of the Common Bile Duct into the Duodenal Bulb Accompanied with Cholangitis and Gallbladder Cancer: A Report of Two Cases.

    PubMed

    Lee, Jae Min; Kim, Hong Jun; Ha, Chang Yoon; Min, Hyun Ju; Kim, Hyunjin; Kim, Tae Hyo; Jung, Woon Tae; Lee, Ok Jae

    2015-05-01

    An ectopic opening of the common bile duct (CBD) into the duodenal bulb is a very rare congenital anomaly of the biliary system, which may cause recurrent duodenal ulcer or biliary diseases such as choledocholithiasis and cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) plays a major role in the diagnosis of this anomaly. We report two such cases: one in a 61-year-old man and the other in a 57-year-old man. In the first case, this anomaly caused acute cholangitis with multiple CBD stones, which were successfully treated by ERCP. In the second case, abdominal computed tomography showed pneumobilia, which was further evaluated using ERCP. Besides, this patient was diagnosed with an ectopic opening of the CBD associated with gallbladder cancer. We report these unusual cases and review the relevant medical literature.

  9. Differentiating feline inflammatory bowel disease from alimentary lymphoma in duodenal endoscopic biopsies.

    PubMed

    Sabattini, S; Bottero, E; Turba, M E; Vicchi, F; Bo, S; Bettini, G

    2016-08-01

    This study aimed to evaluate the agreement between microscopic and molecular testing for differentiating feline intestinal bowel disease and small cell alimentary lymphoma in duodenal endoscopic biopsies. Four different diagnostic methods (cytology, histology, immunohistochemistry and clonality) were sequentially applied to 77 cases of feline chronic enteropathies. The agreement between the different diagnostic methods was calculated and survival data were obtained to assess the most reliable method for predicting outcome. Seventy-seven cases were included in the study. On multivariate survival analysis, only the clonality-based diagnosis of lymphoma was significantly associated with poor survival, with a risk of enteropathy-related death 2·8 times higher. By comparing the other tests with clonality, specificity was high (87 to 97%), whereas sensitivity was 36·8% for cytology, 39·5% for histology, 63·2% for immunohistochemistry, resulting in an overall accuracy of 62·3, 68·8 and 80·5%, respectively. Clonality analysis can consistently increase the possibility of correctly and early diagnosing small cell lymphoma on endoscopic biopsies. Histological suspicion of alimentary lymphoma, even if not confirmed by clonality, should never be ignored, as it may represent a debutant form of lymphoma or it may later progress to lymphoma. © 2016 British Small Animal Veterinary Association.

  10. P-glycoprotein expression in lamina propria lymphocytes of duodenal biopsy samples in dogs with chronic idiopathic enteropathies.

    PubMed

    Allenspach, K; Bergman, P J; Sauter, S; Gröne, A; Doherr, M G; Gaschen, F

    2006-01-01

    P-glycoprotein (p-gp) is a transmembrane protein functioning as a drug-efflux pump in the intestinal epithelium. Human patients with inflammatory bowel disease (IBD) who fail to respond to treatment with steroids express high levels of p-gp in lamina propria lymphocytes. The purpose of this study was to investigate p-gp expression in duodenal biopsy samples of dogs with chronic enteropathies and to evaluate the expression of p-gp after treatment with a known inducer of p-gp (prednisolone). Duodenal biopsy samples from 48 dogs were evaluated immunohistochemically with the mouse monoclonal antibody C219 for expression of p-gp in lamina propria lymphocytes. Biopsy samples were available from 15 dogs after treatment with prednisolone and 16 dogs after dietary therapy alone ("elimination diet"). Treatment with prednisolone resulted in an increase in p-gp expression (P=0.005). In contrast, dietary treatment alone produced no significant change in p-gp expression (P=0.59). A low p-gp score before initiation of steroid treatment was significantly associated with a positive response to treatment (P=0.01). These results indicate that lamina propria lymphocyte expression of p-gp is upregulated after prednisolone treatment in dogs with IBD, and that mucosal expression of p-gp may be of value in predicting the response to therapy.

  11. Utility of Tissue Transglutaminase Immunohistochemistry in Pediatric Duodenal Biopsies: Patterns of Expression and Role in Celiac Disease—A Clinicopathologic Review

    PubMed Central

    Almarzooqi, Saeeda; Houston, Ronald H.; Prasad, Vinay

    2013-01-01

    Tissue transglutaminase (tTG) is a ubiquitous multifunctional protein. It has roles in various cellular processes. tTG is a major target of autoantibodies in celiac disease, and its expression by immunohistochemistry in pediatric celiac disease has not been fully examined. We studied tTG expression in 78 pediatric duodenal biopsies by utilizing an antibody to transglutaminase 2. Serum tTG was positive in all celiac cases evaluated. Serum antiserum endomysial antibody (EMA) and tTG were negative in all control subjects and in inflammatory bowel disease and eosinophilic gastroenteritis. There was a statistically significant difference between cases of celiac disease and normal controls in terms of tTG immunohistochemical staining in duodenal biopsies surface epithelium (P value = 0.0012). There was no significant statistical difference in terms of staining of the villous surface or crypt between the cases of celiac disease and cases with IBD (P value = 0.5970 and 0.5227, resp.). There was no detected correlation between serum tTG values and immunohistochemical positivity on duodenal biopsy in cases of celiac disease (P value = 1). There was no relationship between Marsh classification and positivity of villous surface for tTG (P value = 0.4955). We conclude that tTG has limited utility in diagnosis of celiac disease in pediatric duodenal biopsies. PMID:24195009

  12. 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.

  13. Predictive value of hepatic ultrasound, liver biopsy, and duodenal tube test in the diagnosis of extrahepatic biliary atresia in Serbian infants.

    PubMed

    Boskovic, Aleksandra; Kitic, Ivana; Prokic, Dragan; Stankovic, Ivica; Grujic, Blagoje

    2014-04-01

    Extrahepatic biliary atresia (EHBA) is the most important cause of neonatal cholestasis. The validity of different diagnostic methods in the diagnosis of EHBA in developed countries has been presented elsewhere, but data from developing countries with low national incomes are scarce. The aim of this study was to investigate the relative accuracy and roles of abdominal ultrasonography, duodenal tube test (DTT), and liver biopsy in the diagnosis of EHBA in Serbia. The study included 156 infants with cholestasis admitted at the Mother and Child Health Care Institute. Data were collected according to the medical records observation technique. Extrahepatic biliary atresia was diagnosed in 72 of 156 infants with cholestasis. The frequency was insignificantly higher in females than in males (1.25:1). Most patients were diagnosed prior to 60 days of life (median 58, range 30-67). In a group of 156 infants with cholestasis, 109 had ultrasound, liver biopsy, duodenal tube test, and intraoperative cholangiography done. Liver biopsy confirmed surgical disease in 71/109 patients and denied it in 38/109 patients (sensitivity- Sn 98%, specificity- Sp 100%, diagnostic efficiency of test- DgEf 99.08%). Duodenal tube test had Sn 97%, Sp 72%, and DgEf 88.99%, and the ultrasound findings showed Sn 78%, Sp 81%, and DgEf 77.92%. Five-year survival rate after Kasai operation was 76%. A well-coordinated multidisciplinary approach is required in the assessment of suspected cases of biliary atresia. Histology examination of biopsy specimens is an integral part of the diagnostic algorithm and, therefore, plays a pivotal role in the diagnostic evaluation of this disease.

  14. Intraepithelial lymphocyte distribution differs between the bulb and the second part of duodenum

    PubMed Central

    2013-01-01

    Background Evaluation of intraepithelial duodenal lymphocytosis (IDL) is important in celiac disease (CD). There is no established cut-off value for increased number of IELs in the bulb. We therefore investigated the relation between IEL counts in the bulb and duodenal specimens in non-celiac subjects. Methods The number of CD3+ IELs was determined in specimens from the second part of the duodenum and from the bulb in 34 non-celiac subjects. The numbers of IELs in the villus tip and sides were counted and the quotient tip/side was calculated. HLA DQ2/DQ8 and serum antibodies against transglutaminase were analysed. Results The mean number of IELs per 100 enterocytes (95% CI) in specimens was 14.7 (11.8-17.6) in the bulb, and 21.2 (17.0-25.5) in the second part of the duodenum (p<0.01). There was no difference in IEL count or distribution comparing patients carrying or lacking HLA DQ2/DQ8. Conclusions IEL count in non-celiac, HLA DQ2/DQ8 positive or negative patients is significantly lower in the bulb than in the second part of the duodenum. These findings implicate that the site of biopsy should be taken into account when considering duodenal lymphocytosis. PMID:23841671

  15. Biopsies

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Biopsies - Overview A biopsy is the removal of tissue ... What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in ...

  16. Abnormalities in the duodenal transit and motility in duodenal ulcer patients: studies with a new isotopic technique.

    PubMed Central

    Quon, M G; Mena, I; Valenzuela, J E

    1989-01-01

    Abnormalities of duodenal motility have been described in patients with duodenal ulcer and in experimental ulcers in rats and it has been postulated that they could be pathogenic in peptic ulcer disease. We have investigated with an isotopic technique whether duodenal bulb clearance or duodenal transit are abnormal in duodenal ulcer. Six patients with inactive and six with active duodenal ulcers, all men, and six healthy male controls were studied. Motility of the duodenum was simultaneously monitored. A bolus of 99mTcDTPA was injected into the duodenum while water or acid were perfused on different occasions. Duodenal bulb clearance and transit to the ligament of Treitz were calculated. Duodenal transit in duodenal ulcer patients 108.8 (23) sec was faster than in controls, 194.9 (5.1) sec (p less than 0.05) during the quiescent period of the motility cycle. The frequency of duodenal bulb contractions during acid perfusion was higher in duodenal ulcer patients 1.7 (0.4) cont/min, than in controls 0.8 (0.1) cont/min (p less than 0.05). No other significant differences were observed between ulcer patients and controls. These data suggest that patients with duodenal ulcers do not have major abnormalities of duodenal bulb clearance, nor of duodenal transit and that duodenal motility does not play a primary role in the pathogenesis of the ulcer. Images Fig. 2 Fig. 3 Fig. 4 PMID:2659441

  17. Validation of celiac disease diagnoses recorded in the Danish National Patient Register using duodenal biopsies, celiac disease-specific antibodies, and human leukocyte-antigen genotypes

    PubMed Central

    Dydensborg Sander, Stine; Størdal, Ketil; Plato Hansen, Tine; Nybo Andersen, Anne-Marie; Murray, Joseph A; Lillevang, Søren Thue; Husby, Steffen

    2016-01-01

    Purpose The purpose of this study was to validate the celiac disease diagnoses recorded in the Danish National Patient Register. To validate the diagnoses, we used information on duodenal biopsies from a national register of pathology reports (the Patobank) and information on celiac disease-specific antibodies and human leukocyte antigen (HLA) genotypes obtained from patient medical records. Patients and methods We included all the children who were born from 1995 to 2012 and who were registered as having celiac disease in the Danish National Patient Register. We reviewed all the pathology reports on duodenal biopsies in the Patobank and the information in the medical records on celiac disease-specific antibodies (ie, anti-tissue transglutaminase 2 IgA and IgG, endomysial antibodies IgA, and anti-deamidated gliadin peptide IgG) and HLA genotypes. Results We identified 2,247 children who were registered in the Danish National Patient Register with celiac disease. Duodenal biopsies for 1,555 of the children (69%) were registered in the Patobank; 1,127 (50%) had a biopsy that was compatible with celiac disease (ie, Marsh 2–3). We accessed the medical records of 95% of the children who were registered in the Danish National Patient Register with celiac disease. We found that 1,510 (67%) had one or more positive antibody-test results; 1,120 (50%) had anti-tissue transglutaminase 2, IgA at tenfold or greater the upper limit of the normal range and/or positive endomysial antibody results. The positive predictive value depended on the criteria used for validation and the types and numbers of registrations that were included in the analysis and ranged from 62% (95% confidence interval: 60%–64%) to 86% (95% confidence interval: 84%–87%). Conclusion Our findings indicate that the Danish National Patient Register is a valuable source to identify patients who have been diagnosed with celiac disease. However, validation of the diagnoses is warranted before data on the

  18. Validation of celiac disease diagnoses recorded in the Danish National Patient Register using duodenal biopsies, celiac disease-specific antibodies, and human leukocyte-antigen genotypes.

    PubMed

    Dydensborg Sander, Stine; Størdal, Ketil; Plato Hansen, Tine; Nybo Andersen, Anne-Marie; Murray, Joseph A; Lillevang, Søren Thue; Husby, Steffen

    2016-01-01

    The purpose of this study was to validate the celiac disease diagnoses recorded in the Danish National Patient Register. To validate the diagnoses, we used information on duodenal biopsies from a national register of pathology reports (the Patobank) and information on celiac disease-specific antibodies and human leukocyte antigen (HLA) genotypes obtained from patient medical records. We included all the children who were born from 1995 to 2012 and who were registered as having celiac disease in the Danish National Patient Register. We reviewed all the pathology reports on duodenal biopsies in the Patobank and the information in the medical records on celiac disease-specific antibodies (ie, anti-tissue transglutaminase 2 IgA and IgG, endomysial antibodies IgA, and anti-deamidated gliadin peptide IgG) and HLA genotypes. We identified 2,247 children who were registered in the Danish National Patient Register with celiac disease. Duodenal biopsies for 1,555 of the children (69%) were registered in the Patobank; 1,127 (50%) had a biopsy that was compatible with celiac disease (ie, Marsh 2-3). We accessed the medical records of 95% of the children who were registered in the Danish National Patient Register with celiac disease. We found that 1,510 (67%) had one or more positive antibody-test results; 1,120 (50%) had anti-tissue transglutaminase 2, IgA at tenfold or greater the upper limit of the normal range and/or positive endomysial antibody results. The positive predictive value depended on the criteria used for validation and the types and numbers of registrations that were included in the analysis and ranged from 62% (95% confidence interval: 60%-64%) to 86% (95% confidence interval: 84%-87%). Our findings indicate that the Danish National Patient Register is a valuable source to identify patients who have been diagnosed with celiac disease. However, validation of the diagnoses is warranted before data on the patients are used for research purposes.

  19. The presence of anti-endomysial antibodies and the level of anti-tissue transglutaminases can be used to diagnose adult coeliac disease without duodenal biopsy.

    PubMed

    Tortora, R; Imperatore, N; Capone, P; De Palma, G D; De Stefano, G; Gerbino, N; Caporaso, N; Rispo, A

    2014-11-01

    The new ESPGHAN guidelines for diagnosis of paediatric coeliac disease suggest to avoid biopsy in genetically pre-disposed and symptomatic individuals with positive anti-endomysial antibodies (EMA) and anti-tissue transglutaminases (a-tTG). However, duodenal biopsy remains the gold standard in adult coeliac disease. To establish the cut-off values of a-tTG, which would: predict the presence of duodenal histology (Marsh ≥2) diagnostic for coeliac disease; and predict the presence of villous atrophy (Marsh 3) in adults. We performed an observational prospective study including all consecutive adult patients with suspected coeliac disease. All subjects were tested for EMA and a-tTG. Coeliac disease diagnosis was made in presence of Marsh ≥2, a-tTG >7 U/mL and positive EMA. A ROC curve was constructed to establish the best specificity cut-off of a-tTG levels, which would predict the presence of Marsh ≥2 and Marsh 3 at histology. The study included 310 patients with positive antibodies. Histology showed Marsh 1 in 8.7%, Marsh 2 in 3.5%, Marsh 3 in 87.7%. The best cut-off value of a-tTG for predicting Marsh ≥2 was 45 U/mL (sensitivity 70%; specificity 100%; PPV 100%; NPV 24.1%); the best cut-off for predicting villous atrophy was 62.4 U/mL (sensitivity 69%, specificity 100%; PPV 100%; NPV 31%). The diagnosis of coeliac disease can be reached without histology in adult patients with positive EMA and a-tTG levels >45 U/mL. An a-tTG level >62.4 was diagnostic for villous atrophy. These results could contribute to improving the diagnosis of coeliac disease by allowing for a significant reduction in diagnosis-related costs. © 2014 John Wiley & Sons Ltd.

  20. A comparison between lactose breath test and quick test on duodenal biopsies for diagnosing lactase deficiency in patients with self-reported lactose intolerance.

    PubMed

    Furnari, Manuele; Bonfanti, Daria; Parodi, Andrea; Franzè, Jolanda; Savarino, Edoardo; Bruzzone, Luca; Moscatelli, Alessandro; Di Mario, Francesco; Dulbecco, Pietro; Savarino, Vincenzo

    2013-02-01

    A lactose breath test (LBT) is usually used to diagnose lactase deficiency, and a lactose quick test (LQT) has been proposed as a new test on duodenal biopsies to detect this disorder. We aimed to assess the diagnostic accuracy of LBT and LQT and their ability to predict the clinical response to a lactose-free diet in patients with self-reported lactose intolerance. Fifty-five patients (age 47 ± 14 y; M/F 15/36) underwent upper gastrointestinal endoscopy and 25g-LBT. Two duodenal biopsies were taken to determine lactase deficiency (normal, mild, or severe) by LQT and to rule out other causes of secondary lactose malabsorption. Patients with a positive LBT and normal LQT also underwent a glucose breath test to exclude small intestinal bacterial overgrowth as a cause of the former result. The severity of gastrointestinal symptoms was measured with a GSS questionnaire, under basal condition and 1 month after a lactose-free diet. Lactose malabsorption was detected in 31/51 patients with LBT and in 37/51 patients with LQT (P = NS). Celiac disease was found in 2 patients. Two LBT+ patients showed a positive glucose breath test for small intestinal bacterial overgrowth. Eight patients had a mild hypolactasia by LQT and a negative LBT, but they had a significant improvement of symptoms after diet. LQT and LBT were concordant in 83% of cases and predicted the response to a lactose-free diet in 98% and 81% of the cases, respectively (P = 0.03). LQT is as sensitive as LBT in detecting lactase deficiency; however, it seems to be more accurate than LBT in predicting the clinical response to a lactose-free diet.

  1. 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 ...

  2. Acute duodenal Crohn’s disease successfully managed with low-speed elemental diet infusion via nasogastric tube: A case report

    PubMed Central

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

    2006-01-01

    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)-1β, IL-6, IL-8, and tumor necrosis factor-α 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 ElentalTM, 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. PMID:16489685

  3. Intestinal permeability to chromium-51 ethylenediamine tetraacetic acid in children with chronic obstructive respiratory disease: relationship with clinical and duodenal biopsy findings

    SciTech Connect

    Hoyoux, C.; Forget, P.P.; Borlee-Hermans, G.; Geubelle, F.

    1988-01-01

    Intestinal permeability (IP) to /sup 51/Cr ethylenediamine tetraacetic acid was investigated in 47 children with chronic obstructive respiratory disease (CORD). Endoscopic duodenal biopsies were performed in 22 of these patients. IP was significantly increased in CORD patients when compared to either control children or adults (P less than 0.001). Mean +/- 1 SD were 4.3 +/- 1.71%, 2.5 +/- 0.78%, and 2.3 +/- 0.77% in the three groups, respectively. IP was not related to the presence of atopy. Significant differences in IP results were found between CORD children with abdominal pain (4.5 +/- 1.4%) and both control children and CORD patients without abdominal pain (2.5 +/- 0.78% and 3.2 +/- 1.49%, respectively). A significant correlation was found between small bowel injury on the one hand and IP on the other hand (P less than 0.02). Furthermore, small bowel injury was significantly related to the presence of abdominal pain (P less than 0.05). We speculate that in CORD patients with abdominal pain, a factor exists that causes small bowel injury responsible for both abdominal pain and increased small bowel permeability. Food intolerance could, presumably, play a role in the mucosal damage-linked IP increase found in the subset of CORD patients who complain of abdominal pain.

  4. 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.

  5. Biopsy

    MedlinePlus

    ... Nemcek AA. Percutaneous biopsy. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. Image- ... by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is ...

  6. Effects of omeprazole and eradication of Helicobacter pylori on gastric and duodenal mucosal enzyme activities and DNA in duodenal ulcer patients.

    PubMed

    Vetvik, K; Schrumpf, E; Mowinckel, P; Aase, S; Andersen, K J

    1994-11-01

    Duodenal and gastric content of mucosal enzymes in duodenal ulcer (DU) patients differs from that of controls. The purpose of this study has been to examine the effect of omeprazole and eradication of Helicobacter pylori on mucosal enzymes in DU patients. The enzyme activities of seven gastric and duodenal mucosal marker enzymes from the brush border, lysosomes, and mitochondria have been studied. In study I the measurements were made in 29 patients with an active DU before and after 14 days of omeprazole treatment. In study II 22 duodenal ulcer patients were given bismuth subnitrate, oxytetracycline, and metronidazole (triple therapy) for 2 weeks to eradicate H. pylori. Biopsy specimens were taken from the duodenum and the stomach for enzyme measurements and histologic assessment. In study II additional specimens were obtained from the prepyloric region for urease tests and culture of H. pylori. The ulcer healing rates were more than 90% after both omeprazole and triple therapy. H. pylori was eradicated in 86% after triple therapy. The activities of the brush-border enzymes lactase, neutral-alpha-glucosidase, alkaline phosphatase, leucyl-beta-naphthylamidase, and gamma-glutamyltransferase (gamma-GT) increased significantly in the duodenal bulb and the descending duodenum during treatment with omeprazole. No changes in duodenal enzyme activity were detected after triple therapy, whereas a significant fall in gamma-GT and acid phosphatase activities was seen in the stomach. The mucosal DNA in the gastric antrum decreased both after treatment with omeprazole and after triple therapy. A similar decrease in mucosal DNA of the gastric antrum was demonstrated after both omeprazole and triple therapy with bismuth subnitrate, oxytetracycline, and metronidazole. Omeprazole also affects the content of duodenal mucosal enzymes, whereas triple therapy particularly affects the gastric mucosal enzyme activity.

  7. Celiac Disease and Other Causes of Duodenitis.

    PubMed

    Owen, Daniel R; Owen, David A

    2017-07-31

    - Patients who receive an upper gastrointestinal endoscopic examination frequently have biopsies taken from the duodenum. Accurate interpretation of duodenal biopsies is essential for patient care. Celiac disease is a common clinical concern, but pathologists need to be aware of other conditions of the duodenum that mimic celiac disease. - To review the normal histologic features of duodenal mucosa and describe the clinical and histologic findings in celiac disease and its mimics, listing the differentiating features of biopsies with villous atrophy and epithelial lymphocytosis. - The study comprises a literature review of pertinent publications as of November 30, 2016. - Celiac disease is a common cause of abnormal duodenal histology. However, many of the histologic features found in the duodenal biopsy of patients with celiac disease are also present in other conditions that affect the small bowel. Diagnostic precision may be enhanced by obtaining a careful patient history and by ancillary laboratory testing, particularly for the presence of antitissue transglutaminase antibodies.

  8. Duodenal carcinoid tumor - a case report.

    PubMed

    Debnath, C R; Debnath, M R; Haque, M A; Das, S N; Moshwan, M M; Karim, R; Uddoula, M S

    2014-01-01

    Carcinoid tumors are well differentiated neuroendochrine tumors which most frequently involve the gastrointestinal tract; however duodenal carcinoid tumors are rare. They can present with various clinical symptoms and are difficult to diagnose. A 52 years old lady presented with the symptoms of recurrent upper abdominal pain, burning sensation of whole body and passage of loose stool. On endoscopy of upper GIT, there was a duodenal polyp. Polyp was removed by endoscopic resection and tissue was taken for biopsy. Histological findings of biopsy specimen shows carcinoid tumor. As duodenal carcinoid tumor is a rare presentation so we are going to present this case in this article.

  9. Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia

    PubMed Central

    WALKER, M. M.; TALLEY, N. J.; PRABHAKAR, M.; PENNANEAC’H, C. J.; ARO, P.; RONKAINEN, J.; STORSKRUBB, T.; HARMSEN, W. S.; ZINSMEISTER, A. R.; AGREUS, L.

    2014-01-01

    SUMMARY Background Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional disorders without defined pathology. Mast cells and eosinophils interact with T lymphocytes and may alter enteric nerve and smooth muscle function. Aim To examine mast cell, eosinophil and intraepithelial lymphocyte populations in duodenal biopsies of subjects with IBS and FD. Methods A random sample of an adult Swedish population (n = 1001; mean age 54 years; 51% female) underwent upper endoscopy and biopsy; 51 cases with FD and 41 cases with IBS were compared with 48 randomly selected controls. Eosinophils were identified by light microscopy; mast cells by immunocytochemistry (CD117). Intraepithelial lymphocytes were counted per 100 enterocytes. Cell counts were quantified by counting the number per high power field (HPF) in 5HPFs in the bulb (D1) and second part of duodenum (D2), summed over 5HPFs at each site. Results Cases and controls showed similar demographics. Compared to controls, IELs in IBS-constipation were significantly increased (P = 0.005). Mast cells were significantly increased in IBS in D2 (P < 0.001), while eosinophils were significantly increased in FD in D1 and D2 (P < 0.001). Conclusion Duodenal mast cell hyperplasia is linked to IBS and eosinophilia to FD, and duodenal biopsy may identify subsets of these disorders. PMID:19183150

  10. [Frequency, diagnosis and dependance of duodenitis upon the morphological status of the gastric mucosa (author's transl)].

    PubMed

    Konstantinidis, T; Wagner, P K

    1978-08-01

    In a attempt to prove the dependence of duodenitis upon the morphological status of the gastric mucosa, a biopsy of the corpus, antrum, and duodenal canal had been made of 354 patients. In 56 cases, a superficial duodenitis was histologically verified; however, this infection had not contaminated the Brunner' glands. A duodenitis was found to be more often associated with surface gastritis of the corpus and antrum than it was with atropic gastritis. A duodenitis was discovered by a biopsy in 16 patients possessing a normal antrum mucosa and in 25 patients having a normal corpus mucosa, thus proving the possibility of isolated duodenitis.

  11. Prevalence, clinical, endoscopic and pathological features of duodenitis in children

    PubMed Central

    Alper, Arik; Hardee, Steven; Rojas-velasquez, Danilo; Escalera, Sandra; Morotti, Raffaella A; Pashankar, Dinesh S.

    2015-01-01

    Objectives While gastritis and esophagitis are well studied in children, there is very limited literature on duodenitis in children. We aimed to assess the prevalence, etiology, clinical, endoscopic, and pathological features in a large cohort of unselected children with duodenitis. Methods We reviewed the pathology reports of all upper endoscopies performed at our institution over 5 years to identify children with duodenitis. Biopsy sections were reviewed to confirm the diagnosis of duodenitis. Demographic, clinical, endoscopic data and presence of associated gastritis and esophagitis were noted in all children with duodenitis. Etiology of duodenitis was correlated with the patient's clinical diagnosis. Results Out of 2772 children who had endoscopy, 352 had duodenitis with the prevalence rate of 12.7%. Gastritis was seen in 64% of children with duodenitis compared with 46% of children without duodenitis (P < 0.001). Common indications for endoscopy in children with duodenitis were abdominal pain, positive celiac serology and diarrhea. The most common etiology was celiac disease (32%), followed by Crohn's disease (13%), ulcerative colitis (3%), and Helicobacter pylori infection (6%). In 63% of cases, endoscopic appearance of duodenum was normal. Cryptitis, villous changes and cellular infiltration were noted on histology. Conclusions Prevalence of duodenitis is 12.7% in children undergoing endoscopy. Celiac disease and inflammatory bowel disease are common causes of duodenitis. Associated gastritis is common in children with duodenitis and correlation of endoscopic appearance with histology is poor. PMID:26252915

  12. 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.

  13. 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.

  14. 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

  15. Duodenal Somatostatinoma: A Case Report and Review

    PubMed Central

    Kim, Jung A; Choi, Won-Ho; Kim, Chul Nam; Moon, Young Soo; Chang, Sun Hee

    2011-01-01

    Somatostatinomas are rare functioning carcinoid tumors that usually arise in the pancreas and duodenum. They are seldom associated with typical clinical symptoms; their diagnosis is confirmed only by histological and immunohistochemical studies and the presence of specific hormones. Two distinct clinicopathological forms of somatostatinoma exist: duodenal and pancreatic somatostatinomas. Clinically, compared to pancreatic somatostatinomas, duodenal somatostatinomas are more often associated with nonspecific symptoms and neurofibromatosis, but less often with somatostatinoma syndrome or metastasis. Histologically, duodenal somatostatinomas frequently have psammoma bodies in the tumor cells. We report a case of duodenal somatostatinoma in 58-year-old man with vague epigastric pain and nausea. He did not have diabetes, steatorrhea, or cholelithiasis. Abdominal computed tomography showed a 25-mm mass in the duodenum and 25-mm nodule in the liver. Endoscopic retrograde cholangiopancreatography showed a duodenal submucosal tumor. Although the endoscopic biopsies were free of malignancy, the patient subsequently underwent Whipple's operation for the duodenal mass. Examination revealed as a somatostatinoma using a special stain for somatostatin. PMID:21437171

  16. 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.

  17. Normal villous architecture with increased intraepithelial lymphocytes: a duodenal manifestation of Crohn disease.

    PubMed

    Patterson, Emily R; Shmidt, Eugenia; Oxentenko, Amy S; Enders, Felicity T; Smyrk, Thomas C

    2015-03-01

    To assess a possible association between inflammatory bowel disease (IBD) and the histologic finding in duodenal biopsy specimens of increased intraepithelial lymphocytes (IELs) with normal villous architecture. We identified all patients with duodenal biopsy specimens obtained between 2000 and 2010 showing increased IELs and normal architecture. Among the 74 such patients who also had IBD, we characterized the clinical features of IBD and reviewed all available upper gastrointestinal biopsy specimens. Fifty-eight patients had Crohn disease, 13 had ulcerative colitis, and three had IBD, type unclassified. No duodenal sample with increased IELs had other histologic features of IBD. Among gastric biopsy specimens from 34 patients with Crohn disease, nearly half (16) had focal gastritis. We propose that Crohn disease be included in the differential diagnosis for increased IELs with normal villous architecture in duodenal biopsy specimens, particularly when gastric biopsy specimens show focal gastritis. Copyright© by the American Society for Clinical Pathology.

  18. Prevalence and Clinical, Endoscopic, and Pathological Features of Duodenitis in Children.

    PubMed

    Alper, Arik; Hardee, Steven; Rojas-Velasquez, Danilo; Escalera, Sandra; Morotti, Raffaella A; Pashankar, Dinesh S

    2016-02-01

    Although gastritis and esophagitis are well studied in children, there is very limited literature on duodenitis in children. We aimed to assess the prevalence, etiology, clinical, endoscopic, and pathological features in a large cohort of unselected children with duodenitis. We reviewed the pathology reports of all the upper endoscopies performed at our institution during 5 years to identify children with duodenitis. Biopsy sections were reviewed to confirm the diagnosis of duodenitis. Demographic, clinical, endoscopic data, and the presence of associated gastritis and esophagitis were noted in all of the children with duodenitis. The etiology of duodenitis was correlated with the patients' clinical diagnosis. Out of 2772 children who had endoscopy, 352 had duodenitis with the prevalence rate of 12.7%. Gastritis was seen in 64% of children with duodenitis compared with 46% of children without duodenitis (P < 0.001). Common indications for endoscopy in children with duodenitis were abdominal pain, positive celiac serology, and diarrhea. The most common etiology was celiac disease (32%), followed by Crohn disease (13%), ulcerative colitis (3%), and Helicobacter pylori infection (6%). In 63% of cases, the endoscopic appearance of duodenum was normal. Cryptitis, villous changes, and cellular infiltration were noted on histology. Prevalence of duodenitis is 12.7% in children undergoing endoscopy. Celiac disease and inflammatory bowel disease are common causes of duodenitis. Associated gastritis is common in children with duodenitis, and the correlation of endoscopic appearance with histology is poor.

  19. Long-term effect of Helicobacter pylori eradication on gastric metaplasia in patients with duodenal ulcer.

    PubMed

    Kim, N; Lim, S H; Lee, K H; Choi, S E

    1998-10-01

    There have been conflicting reports on the effect of Helicobacter pylori eradication on gastric metaplasia in the duodenal bulb (DGM). In the present study, we have investigated the relationships between DGM and H. pylori by examining whether or not H. pylori-positive patients had more DGM than H. pylori-negative patients with nonulcer dyspepsia (NUD) or duodenal ulcer (DU), and by examining the effect of eradication of H. pylori on the prevalence and the extent of DGM during the long-term up to 4 years. Fifty H. pylori-positive and seven H. pylori-negative patients with DU and 23 H. pylori-positive and 23 H. pylori-negative NUD subjects were studied. Two duodenal bulb biopsy specimens were taken for histologic evaluation and the presence and the extent of DGM were evaluated. The extent of DGM was classified as none (grade 0), focal (grade 1), multifocal (grade 2), and diffuse type (grade 4). In H. pylori-positive patients with DU, follow-up gastroscopy was conducted 4 weeks, 1 year, and 4 years after H. pylori eradication. DGM was significantly (p < 0.001) more common (DU: 93%, NUD: 22%) and significantly (p < 0.001) greater in extent for patients with DU than for NUD subjects (DU: 1.89, NUD: 0.28). Neither the prevalence nor the extent of DGM was affected by H. pylori status in patients with DU or NUD; the prevalence (extent) of DGM of H. pylori-positive and -negative patients with DU were 96% (1.94) and 71% (1.57), respectively. In the 43 "H. pylori-eradicated" group, initial prevalence of DGM was 95% and those of 4 weeks, 1 year, and 4 years after eradication were 91%, 96%, and 79%, respectively. The initial extent of DGM was 1.93, and those of 4 weeks, 1 year, and 4 years after eradication were 1.90, 1.88, and 1.57, respectively. In conclusion, the prevalence and the extent of DGM were not related to H. pylori in patients with DU or NUD. In addition, the prevalence and the extent of DGM did not change until 1 year after H. pylori eradication in patients with

  20. Idiopathic duodenal obstruction: an unappreciated complication of pancreatitis.

    PubMed Central

    Bradley, E L; Clements, J L

    1981-01-01

    Intestinal obstruction as a complication of pancreatitis is infrequently recognized. Only four cases of idiopathic duodenal obstruction associated with pancreatitis have been previously reported. In a three-year study of 878 patients with pancreatitis, nine cases of idiopathic duodenal obstruction associated with pancreatitis have been found. Each of the nine cases was characterized by frank obstruction in the second or third portions of the duodenum and an intact mucosa in the area of stricture. Four patients gave an abrupt history of moderately severe pancreatitis. Resolution of the duodenal obstruction occurred by three weeks in each of these four cases. Surgical exploration in one of these patients revealed marked duodenal edema with intramural hematoma. The remaining five patients reported a chronic history of obstruction. Inadequate resolution of the obstruction after four weeks of hyperalimentation led to surgical bypass. Duodenal biopsy specimens revealed inflammation, muscle destruction, and extensive fibrosis. Duodenal involvement in the inflammatory process of moderately severe pancreatitis was discovered in 25% of the upper gastrointestinal studies, but was usually self-limiting and of a mild degree. Since contiguous duodenal edema is common and fibrosing pancreatoduodenitis only occurs in an occasional patient, surgical intervention for duodenal obstruction associated with pancreatitis should only be considered after demonstrated failure of conservative management. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. PMID:7235767

  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. 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…

  3. 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…

  4. 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.

  5. 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.

  6. Bulb mounting of solar cell

    SciTech Connect

    Thompson, M.E.

    1983-04-05

    An energy converting assembly is provided for parasiting of light from a fluorescent light bulb utilizing a solar cell. The solar cell is mounted on a base member elongated in the dimension of elongation of the fluorescent bulb, and electrical interconnections to the cell are provided. A flexible sheet of opaque material having a flat white interior reflective surface surrounds the fluorescent bulb and reflects light emitted from the bulb back toward the bulb and the solar cell. The reflective sheet is tightly held in contact with the bottom of the bulb by adhesive, a tie strap, an external clip, or the like.

  7. Spontaneous choledochoduodenal fistula with tuberculous duodenal ulceration

    PubMed Central

    Karthikeyan, VS; Ram, D; Ali, SM; Rajkumar, N; Balasubramaniam, G; Sanker, MS

    2014-01-01

    Spontaneous choledochoduodenal fistulas (CDFs) are rare. The most common aetiology is penetrating duodenal ulcers, observed in 80% of cases. Even in areas where acid peptic disease is common, tuberculosis should be considered as a cause, especially in developing countries like India, where tuberculosis is common. The management of CDF due to acid peptic disease is predominantly surgical while healing of tuberculous CDF has been reported with antitubercular treatment. A preoperative diagnosis of tuberculous CDF by endoscopic biopsy from the duodenal ulcer or image guided fine needle aspiration if abdominal lymph nodes are present can eliminate the need for surgery and achieve a cure with antitubercular treatment. The CDF in this case was due to caseation of periduodenal lymph nodes rupturing into the duodenum and the bile duct. PMID:24417856

  8. 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)

  9. 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)

  10. Changing of the Bulbs.

    ERIC Educational Resources Information Center

    Baba, Keith

    1995-01-01

    Explains how a school's use of compact fluorescents can reduce operating costs and maintain performance. Indicates that energy cost savings can repay the initial costs of buying incandescent bulbs in as short as 12 months with continuing savings thereafter. Tips for avoiding costly mistakes in lighting retrofits are highlighted. (GR)

  11. Management of duodenal fistulas.

    PubMed

    Sandler, J T; Deitel, M

    1981-03-01

    A review of records of 27 patients with duodenal fistulas admitted to St. Joseph's Health Centre in Toronto since 1969, when total parenteral nutrition (TPN) was instituted, showed that in 19 patients the fistula formed after gastric resection, pyloroplasty or transduodenal sphincteroplasty. The remaining fistulas resulted from delayed presentation of perforated duodenal ulcers, trauma suffered in motor vehicle accidents and disease in neighbouring organs. Management included early nasogastric suctioning, withholding oral intake, draining the fistula contents, protecting the skin effectively, replacing fluid and electrolytes and administering TPN to suppress secretions and to promote anabolism. In seven patients who had associated duodenal obstruction in this intensely inflamed area, a gastrojejunostomy was performed. In no instance was a direct attack made on the fistula. In 25 patients (92.6%) the fistula healed spontaneously in an average of 21 days. Two patients (7.4%) died with patent fistulas. It appears that a direct surgical attack on duodenal fistulas is rarely necessary. With appropriate management, the majority will heal spontaneously. Total parenteral nutrition is the cornerstone of therapy and gastrojejunostomy is invaluable in certain cases.

  12. 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.

  13. 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

  14. Prevalence and Characteristics of Duodenal Villous Atrophy in Renal Transplant Patients Presenting With Persistent Diarrhea in a Developing Country.

    PubMed

    Hanif, Farina M; Luck, Nasir Hassan; Abbas, Zaigham; Aziz, Tahir; Hassan, Syed Mujahid; Mubarak, Muhammed

    2016-04-01

    Persistent diarrhea is a common complication after solid-organ transplant, including kidney transplant. Data on duodenal villous atrophy as a cause of persistent diarrhea in renal transplant recipients are scarce. We conducted a prospective analysis of 207 patients who received renal transplants from 2009 to 2012 with persistent diarrhea and who underwent upper gastrointestinal endoscopy and duodenal biopsies. Duodenal biopsies were examined for duodenal villous atrophy. Age, sex, transplant duration, and drugs were compared between patients with and without duodenal villous atrophy. After exclusion of known causes of duodenal villous atrophy, a 3-month course of antibiotics was given and outcomes were analyzed. Of 207 renal transplant recipients, 104 patients (49.8%) displayed duodenal villous atrophy. Of these, 92 (88.5%) were male patients. The mean age of patients with duodenal villous atrophy was 34.9 ± 10.3 years. The mean onset of persistent diarrhea in DVA-positive patients posttransplant was 2.16 ± 0.8 years. Celiac disease serology was positive in 18 (17.3) patients. Giardiasis was demonstrated in 11 patients (10.7%), whereas immunoproliferative small intestinal disease was shown in 7 patients (6.8%). The remaining 68 patients (65.38%) received antibiotics, with 50 recipients (74.6%) showing complete response, although 13 of these patients (26%) relapsed. Among the remaining 18 patients (26.47%), 9 (50%) had other causes and 9 (50%) had no cause found. Isoniazid prophylaxis showed statistically significant negative association with duodenal villous atrophy. Duodenal villous atrophy is highly prevalent in renal transplant recipients irrespective of age, sex, and posttransplant duration. We found tropical sprue, giardiasis, immunoproliferative small intestinal disease, and celiac disease to be important causes of duodenal villous atrophy. Therefore, duodenal biopsy is recommended in renal transplant recipients with persistent diarrhea.

  15. External bulb variable volume maser

    NASA Technical Reports Server (NTRS)

    Reinhardt, V. S.; Cervenka, P. O. (Inventor)

    1978-01-01

    A maser functioning as a frequency standard stable to one part in 10 to the 14th power includes a variable volume, constant surface area storage bulb having a fixed volume portion located in a resonant cavity from which the frequency standard is derived. A variable volume portion of the bulb, exterior to the resonant cavity, has a maximum volume on the same order of magnitude as the fixed volume bulb portion. The cavity has a length to radius ratio of at least 3:1 so that the operation is attained without the need for a feedback loop. A baffle plate, between the fixed and variable volume bulb portions, includes apertures for enabling hydrogen atoms to pass between the two bulb portions and is an electromagnetic shield that prevents coupling of the electromagnetic field of the cavity into the variable volume bulb portion.

  16. Prostate biopsy

    MedlinePlus

    ... prostate biopsy; Fine needle biopsy of the prostate; Core biopsy of the prostate; Targeted prostate biopsy; Prostate ... to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein ...

  17. Improving incandescent bulb efficiency

    SciTech Connect

    Hauer, C.R.

    1980-04-01

    Incandescent light bulb efficiency is improved by: (1) modifying the surface micro-structure of a lamp filament in such a way as to increase the emissivity in the visible region of the spectrum without significantly increasing this quantity outside this spectral region, or suppressing the emission of energy outside the visible portion of the spectrum by modifying the surface structure; (2) application of refractory coatings on the lamp filament that are highly emissive in the visible region of the spectrum; and (3) coating the filament with an ''optically thin'' refractory material to suppress filament evaporation, permitting higher operating temperature.

  18. Enteropathy of coeliac disease in adults: increased number of enterochromaffin cells the duodenal mucosa.

    PubMed Central

    Sjölund, K; Alumets, J; Berg, N O; Håkanson, R; Sundler, F

    1982-01-01

    Twenty-nine adult patients with coeliac disease and 39 patients with a normal duodenal morphology were studied with respect to the 5-ht containing enterochromaffin cells. Their number in duodenal biopsies was assessed by fluorescence histochemistry and they were examined by immunohistochemistry for peptides known or believed to occur in enterochromaffin cells. Antisera used were raised against substance P, motilin, and leu-enkephalin. In addition, the concentration of 5-HT was determined chemically. In adult coeliac disease there was a significant increase in the number of duodenal enterochromaffin cells compared with the control group. The concentration of 5-HT in the duodenal mucosa was also greatly increased. Substance P was found in a minority population of enterochromaffin cells. These cells were very few and did not increase in number in coeliac disease. Motilin cells were distinct from enterochromaffin cells. No enkephalin immunoreactive cells were found in the biopsies. Images Fig. 1 Fig. 4 Fig. 5 PMID:7056495

  19. 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)

  20. 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)

  1. Hybrid resection of duodenal tumors.

    PubMed

    Poultsides, George A; Pappou, Emmanouil P; Bloom, George Peter; Orlando, Rocco

    2011-09-01

    The aim of this study was to review our experience with the hand-assisted laparoscopic management of duodenal tumors with no or low malignant potential and to compare this approach with published case reports of purely laparoscopic local duodenal resection. Eight cases of hand-assisted laparoscopic local duodenal resection performed from 2000 to 2008 were retrospectively reviewed. Hand-assistance was utilized for complete duodenal mobilization, and local duodenal resection was accomplished extracorporeally through the hand-access incision. Patient and tumor characteristics, operative time, length of stay, and complications were compared with 18 cases of totally laparoscopic local excision of duodenal tumors published since 1997. Patients with ampullary tumors were excluded. Compared with the purely laparoscopic approach, the hand-assisted technique was associated with shorter operative time (179 versus 131 minutes, P=.03) and was more commonly used for lesions located in the third portion of the duodenum (0% versus 37.5%, P=.02). Tumor size (2.9 cm versus 3.2 cm, P=.61) and length of hospital stay (5.9 versus 5.9 days, P=.96) were similar between the two groups. The rate of complications was also comparable (0% versus 12.5%, P=.31); 1 of 8 patients in the hand-assisted group developed an incisional hernia at the hand-access site. Hand-assisted laparoscopic local duodenal resection is a feasible, safe, and effective alternative to the totally laparoscopic approach. In addition to being associated with comparable length of hospital stay, hand-assistance can shorten operative time by facilitating duodenal mobilization as well as extracorporeal duodenal resection and closure.

  2. 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 ...

  3. Bladder biopsy

    MedlinePlus

    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  4. 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 ...

  5. Kidney biopsy

    MedlinePlus

    ... may require a blood transfusion) Bleeding into the muscle, which might cause soreness Infection (small risk) Alternative Names Renal biopsy; Biopsy - kidney Images Kidney anatomy Kidney - blood and urine flow Renal biopsy References ...

  6. Refractory duodenal ulcer.

    PubMed Central

    Bardhan, K D

    1984-01-01

    A refractory duodenal ulcer was arbitrarily defined as one that had failed to heal completely after treatment with cimetidine 1 g daily for three months. Of 66 patients with refractory duodenal ulcer, healing eventually occurred in 37 patients, after treatment for an average of 7.4 months. But 28 patients did not heal despite treatment for an average of 9.4 months; and one patient defaulted. In 41 patients the daily dose of cimetidine was increased to 2 g: the ulcers in 31 patients healed. In eight patients the daily dose was increased to 3 g and healing occurred in four patients. Eighteen patients required admission on 22 occasions because of severe symptoms despite treatment. Nine patients underwent surgery but in five the results were poor. Differences in clinical and endoscopic features between refractory and non-refractory ulcer patients were small. Acid and pepsin secretion were similar and gastrin concentrations normal. Blood levels of the drug and suppression of acid secretion were both satisfactory. Identification of refractory ulcer patients at the start of treatment was therefore not possible. Refractoriness could occur at any time during the course of the disease, previous treatment with cimetidine often having resulted in rapid healing, but subsequent relapses were also usually refractory. The cause of refractoriness remains unknown and the rather poor results of surgery in this series suggests that optimal management of these patients remains to be determined. Refractoriness probably indicates a changed natural history of the disease and in some patients a more poor prognosis. PMID:6428982

  7. Giardia lamblia trophozoites in gastric biopsies.

    PubMed

    Misra, Vatsala; Misra, S P; Dwivedi, Manisha; Singh, P A

    2006-10-01

    To assess the prevalence of gastric giardiasis in gastric biopsies of patients with carcinoma stomach and in patients taking treatment for duodenal ulcer. Gastric biopsy specimens from 54 patients of carcinoma stomach and 100 antral biopsies from patients taking treatment for duodenal ulcer were included in the study. Sections were stained with haematoxylin and eosin, methylene blue and May Grunwald-Giemsa stains and examined for presence of Giardia lamblia trophozoites. Eight out of 54 (14.9%) biopsies of gastric carcinoma patients harboured trophozoites of Giardia lamblia. Associated H. pylori infection was present in all biopsies (8/8; 100%). Atrophy and intestinal metaplasia was present in 62.5% (5/8) and 25% (2/8) cases respectively. Sections from seven out of 35 patients (20%) taking treatment for duodenal ulcer showed presence of G. lamblia. H. pylori infection, gastritis and atrophy were found in 85.7% (6/7), 71.4% (5/7) and 28.6% (2/7) cases respectively. First gastric biopsy in these patients was negative for G. lamblia but 2nd and 3rd biopsies were positive. A careful search for G. lamblia trophozoites should be made while examining the gastric biopsies, especially in patients with carcinoma stomach, intestinal metaplasia, atrophic gastritis and those taking treatment for duodenal ulcer. This may help in indirect diagnosis of clinically unsuspected cases of intestinal giardiasis and may explain persistence of vague upper gastrointestinal tract (UGIT) symptoms despite clearance of H. pylori in patients on anti-ulcer therapy.

  8. 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.

  9. Duodenal stump leak following a duodenal switch: A case report

    PubMed Central

    Nelson, Lars; Moon, Rena C.; Teixeira, Andre F.; Jawad, Muhammad A.

    2015-01-01

    Introduction Duodenal switch (DS) is a superior choice for surgical weight loss in the super obese patient population. However, there is an associated risk of adverse events following a DS procedure including vitamin deficiencies, bleeding, obstruction, stricture, and leakage. Presentation of Case A 37-year-old female with body mass index of 67 kg/m2 and multiple comorbidities underwent a Da Vinci-assisted, laparoscopic, one-stage, single-anastomosis DS procedure. On postoperative day 11, the patient developed persistent nausea, fatigue, and severe abdominal pain. She underwent diagnostic laparoscopy and was found to have hemoperitoneum, which was evacuated, but active bleeding source was not identifiable. Three days later, the patient underwent exploratory laparotomy, for bleeding with duodenal stump blowout. Discussion Duodenal stump blowout is the result from increased pressure caused by distal obstruction with the back up of duodenal contents. Anastomotic leakage/blow-out following surgery when suspected, should be individualized and management strategy should be implemented according to the size of the leak, extent of the abscess, and status of the patient. Conclusion Duodenal stump leaks must be diagnosed as early as possible, and treated appropriately with operative intervention. Regardless of the operative technique the key to appropriate treatment is stabilize the patient, repair the duodenal stump, and adequate drainage. PMID:26210718

  10. [Duodenal villous atrophy associated with Mycophenolate mofetil: report of one case].

    PubMed

    Tapia, Oscar; Villaseca, Miguel; Sierralta, Armando; Roa, Juan Carlos

    2010-05-01

    Mycophenolate mofetil (MMF) is an immunosupressor agent frequently used in patients after bone marrow or solid organ transplants. The most common adverse reactions of the drug are gastrointestinal, specially diarrhea and vomiting. We report a 53-year-old male, that received a heart transplant receiving immunosuppression with cyclosporine, mycophenolate mofetil and prednisone. Six months after the transplant, the patient started with diarrhea, anorexia and weight loss. A duodenal biopsy showed villous atrophy. Celiac disease and the presence of parasites were discarded. Mycophenolate mofetil was discontinued and one week later, diarrhea subsided. Two months later the patient was asymptomatic and recovered weight. A new duodenal biopsy showed absence of villous atrophy.

  11. 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…

  12. 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…

  13. Compact Fluorescent Light Bulbs (CFLs)

    EPA Pesticide Factsheets

    CFLs can help you save money, use less energy, reduce light bulb changes, and lower greenhouse gas emissions, which lead to climate change. Learn about proper cleanup, recycling and disposal, labels, mercury, and UV radiation.

  14. Diagnostic and therapeutic implications of a novel immunohistochemical panel detecting duodenal mucosal invasion by pancreatic ductal adenocarcinoma

    PubMed Central

    Sopha, Sabrina C; Gopal, Purva; Merchant, Nipun B; Revetta, Frank L; Gold, David V; Washington, Kay; Shi, Chanjuan

    2013-01-01

    Background: We investigated a series of pancreaticoduodenectomy and duodenal biopsies with a panel of immunohistochemical markers to identify duodenal mucosal invasion by pancreatic ductal adenocarcinoma (PDAC), including markers of poor prognosis and targets of promising novel immunotherapies. Materials and Methods: Eighteen consecutive pancreaticoduodenectomy specimens with duodenal mucosal invasion by PDAC were examined for expression of MUC1, MUC4, MUC5AC, MUC6, mesothelin, MUC2, CDX2, and DPC4 on formalin-fixed, paraffin-embedded sections of duodenal-ampullary-pancreatic junctions. Expression of all but MUC6 was also assessed in duodenal biopsies from 12 patients with duodenal mucosal invasion by PDAC. Results: The duodenal mucosa expressed MUC1 (crypts), MUC2 (goblet cells), MUC6 (Brunner glands), CDX2, and DPC4. PDACs in the duodenal mucosa from the resection (n=16-18) and biopsy (n=12) specimens were marked as follows: MUC1 100% (30/30), MUC4 83% (24/29), MUC5AC 83% (25/30), mesothelin 82% (23/28), MUC2 7% (2/30), and CDX2 36% (10/28). Loss of DPC4 expression was seen in 16 of 29 (55%) cases. Reactive mucosa adjacent to PDAC expressed MUC4, MUC5AC and mesothelin in 65% (17/26), 19% (5/27), and 19% (5/26) of cases, respectively. While MUC5AC and mesothelin had high diagnostic accuracy for detection of PDAC, MUC2, CDX2 and DPC4 expression demonstrated negative correlation with PDAC, with absent expression being highly specific for PDAC. Conclusion: Immunohistochemical labeling for PDAC biomarkers may aid the diagnosis of PDAC in duodenal biopsy, especially in situations where diagnosis of a pancreatic mass is challenging. PMID:24228110

  15. 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.

  16. Pancreaticoduodenectomy for nonampullary duodenal lesions: indications and results.

    PubMed

    Shamali, Awad; McCrudden, Raymond; Bhandari, Pradeep; Shek, Fanny; Barnett, Emily; Bateman, Adrian; Abu Hilal, Mohammed

    2016-12-01

    Pancreaticoduodenectomy (PD) is a complex procedure, associated with a definite risk of mortality and 30-50% risk of complications. For nonampullary duodenal lesions, PD can carry a higher morbidity as they are more commonly associated with a soft pancreas and narrow-calibre main pancreatic ducts. It is therefore paramount that the risks and benefits of surgery are considered carefully in this group of patients. A preoperative histological diagnosis for duodenal lesions is normally achieved by endoscopic biopsy. In this study, we aim to assess the outcome of PD in patients with nonampullary duodenal lesions and correlate the preoperative endoscopic histology work-up with the definitive postoperative pathology. We reviewed a prospectively collected PD database from January 2007 to December 2013. Demographic and clinical data were included. Preoperative endoscopic histology was compared with final specimen histology to assess concordance. Forty patients (55% women, mean age 69.4 years, range 45-83 years) underwent PD for duodenal lesions over a 7-year time period. The most common presenting symptom was epigastric pain (32.5%), followed by anaemia (20%). Overall, the complication rate was 55%, with the most frequent adverse event being pancreatic fistula in 13/40 (32.5%). The perioperative mortality was 2/40 (5%). Duodenal adenocarcinoma (65%) was the most common postoperative histological diagnosis. The mean tumour size was 36 mm (range 5-103 mm) and a median of 13 nodes were harvested. The median length of stay was 15 days (range 7-66 days). Overall, 12/40 patients (30%) had a preoperative diagnosis of high-grade dysplasia. The postoperative specimen in this subgroup of patients was reviewed carefully and only 3/12 (25%) patients had high-grade dysplasia in the resection specimen. In the remaining patients, 3/12 (25%) had adenocarcinoma in the resection specimen and 6/12 patients (50%) had low-grade dysplasia. PD carries a high mortality and morbidity

  17. 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.

  18. Antral function in duodenal ulcer

    PubMed Central

    Tovey, F. I.; Parker, K.; Swaminathan, M.; Daniell, A.

    1969-01-01

    A dye-dilution technique is used to compare the concentration and output of acid, chloride and pepsin in duodenal ulcer patients and controls following stimulation of the antrum with alcohol, sodium bicarbonate and peptone with the response to insulin hypoglycaemia and maximal histamine stimulation. The mean secretory rate was higher in response to all the stimuli in duodenal ulcer patients except to sodium bicarbonate. Following antral stimulation by peptone and sodium bicarbonate the acid and chloride concentrations rose to very high levels. The mean outputs were the same as those following maximal histamine stimulation although there were wide individual variations. There was no difference between duodenal ulcer patients and controls. The ‘neutral chloride’ concentration was much less than in the other phases. The basal secretion and the secretions in response to insulin and histamine stimulation showed higher concentrations, as well as higher outputs of acid and chloride in duodenal ulcer patients. Pepsin concentration in response to the various stimuli showed no difference between duodenal ulcer patients and controls and the pepsin output reflected the changes in secretory volume. PMID:4892935

  19. Gum biopsy

    MedlinePlus

    ... be sealed off with an electric current or laser. This is called electrocauterization . After the numbness wears ... Images Gum biopsy Tooth anatomy References Ellis E. Principles of differential diagnosis and biopsy. In: Hupp JR, ...

  20. Kidney Biopsy

    MedlinePlus

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

  1. 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.

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

    PubMed Central

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

    2014-01-01

    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. PMID:25355744

  3. Acupuncture treatment for duodenal ulcer.

    PubMed

    Debreceni, L; Denes, L

    1988-01-01

    The effect of acupuncture therapy for duodenal ulcer was investigated in 21 male and female patients. The diagnosis and healing were verified by gastroscopy. It was found that the needle therapy for 3 weeks led to complete recovery in 76 percent of the patients. Diet, alcohol and cigarette abstinency were necessary for healing. Cuti-visceral reflex activation eliciting the improvement of the secretory and motor function of the gastrointestinal tract and effects in the CNS leading to analgesia and tranquilization may play a role in the mechanism of action. Our conclusion is that acupuncture can be satisfactory method to cure duodenal ulcer.

  4. Burden and profile of somatic mutation in duodenal adenomas from patients with familial adenomatous- and MUTYH-associated polyposis.

    PubMed

    Thomas, Laura Elizabeth; Hurley, Joanna J; Meuser, Elena; Jose, Sian; Ashelford, Kevin E; Mort, Matthew; Idziaszczyk, Shelley; Maynard, Julie; Leon Brito, Helena; Harry, Manon; Walters, Angharad; Raja, Meera; Walton, Sarah Jane; Dolwani, Sunil; Williams, Geraint T; Morgan, Meleri; Moorghen, Morgan; Clark, Susan K; Sampson, Julian R

    2017-08-08

    Duodenal polyposis and cancer are important causes of morbidity and mortality in familial adenomatous polyposis (FAP) and MUTYH-associated polyposis (MAP). This study aimed to comprehensively characterize somatic genetic changes in FAP and MAP duodenal adenomas to better understand duodenal tumorigenesis in these disorders.

    Experimental Design: Sixty-nine adenomas were biopsied during endoscopy in 16 FAP and 10 MAP patients with duodenal polyposis. Ten FAP and 10 MAP adenomas and matched blood DNA samples were exome sequenced, 42 further adenomas underwent targeted sequencing and 47 were studied by array comparative genomic hybridization. Findings in FAP and MAP duodenal adenomas were compared to each other and to the reported mutational landscape in FAP and MAP colorectal adenomas.

    Results: MAP duodenal adenomas had significantly more protein-changing somatic mutations (P = 0.018), truncating mutations (P = 0.006) and copy number variants (P = 0.005) than FAP duodenal adenomas, even though MAP patients had lower Spigelman stage duodenal polyposis. Fifteen genes were significantly recurrently mutated. Targeted sequencing of APC, KRAS, PTCHD2 and PLCL1 identified further mutations in each of these genes in additional duodenal adenomas. In contrast to MAP and FAP colorectal adenomas, neither exome nor targeted sequencing identified WTX mutations (P=0.0017).

    Conclusions: The mutational landscapes in FAP and MAP duodenal adenomas overlapped with, but had significant differences to those reported in colorectal adenomas. The significantly higher burden of somatic mutations in MAP than FAP duodenal adenomas despite lower Spigelman stage disease could increase cancer risk in the context of apparently less severe benign disease. Copyright ©2017, American Association for Cancer Research.

  5. Stochastic modeling of hourly dry-bulb and wet-bulb temperatures

    SciTech Connect

    Kline, D.E.; Woeste, F.E.

    1984-01-01

    A stochastic model of hourly dry-bulb and wet-bulb temperatures was developed. The periodic variations over the course of a year were estimated by least-square approximation. A multisite Markov model was used to simulate the stochastic nature of the data. These two models were combined to simulate years of hourly dry-bulb and wet-bulb temperatures.

  6. 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)

  7. 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)

  8. 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

  9. Cold knife cone biopsy

    MedlinePlus

    ... biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - cone biopsy; Colposcopy - cone biopsy Images Female reproductive anatomy Cold cone biopsy Cold cone removal References American ...

  10. What is the real efficiency of bulbs?

    NASA Astrophysics Data System (ADS)

    Poláček, Luboš

    2012-09-01

    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 of illumination of the interior of buildings are taken into account. It is analysed from the viewpoints of the energy consumed and the price of that energy. The real efficiency of bulbs and the savings obtained by replacing them with fluorescent lamps are calculated for various locations.

  11. 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

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

    PubMed

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

    2016-10-07

    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. 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. 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. 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.

  13. Acute Reversible Duodenitis Following Non-Therapeutic Upper Gastrointestinal Endoscopy. Is Duodenal Diverticulum a Predisposing Factor?

    PubMed Central

    Unal, Emre; Ayan, Elif Nurbegum; Yazgan, Sibel

    2016-01-01

    Summary Background Diagnostic upper gastrointestinal (UGI) endoscopy has been regarded as a safe procedure. Case report We report of a 67-year-old woman who developed epigastric pain and dyspeptic complaints following an uneventful upper gastrointestinal endoscopy. The diagnosis of an acute reversible duodenitis was made on the basis of imaging studies. A duodenal diverticulum was also found on CT images, which raised the suspicion that duodenal diverticulum could be a predisposing factor for duodenitis. Conclusions Despite significant inflammation the patient demonstrated rapid clinical improvement with conservative treatment. Presence of a duodenal diverticulum may predispose to acute duodenitis following diagnostic UGI endoscopy. PMID:27994697

  14. Resolution of a metaplastic duodenal polyp after cure of Helicobacter pylori infection.

    PubMed

    Yousfi, M M; el-Zimaity, H M; Cole, R A; Genta, R M; Graham, D Y

    1996-07-01

    Although there have been several reports of hyperplastic gastric polyps associated with persistent Helicobacter pylori gastritis, the association of H. pylori infection with metaplastic polyps in the duodenum has not hitherto been described. After a 52-year-old man had a single episode of hematemesis, endoscopy showed a smooth polyp 1 cm in greatest dimension formed by a proliferation of gastric epithelial cells of fundic and antral type found in the duodenal bulb. The outer surface was entirely covered with a single layer of hyperplastic columnar epithelium with many H. pylori organisms. After administration of metronidazole 500 mg, omeprazole 20 mg for 4 weeks, and clarithromycin 250 mg twice a day for 2 weeks, endoscopy showed a decrease in size of the duodenal polyp. At 12 weeks there was complete regression of the polyp. This report documents a new and unusual finding: resolution of a gastric metaplastic polyp in the duodenum associated with cure of H. pylori.

  15. Duodenal Mucosa-Associated Lymphoid Tissue Lymphomas: Two Cases and the Evaluation of Endoscopic Ultrasonography

    PubMed Central

    Kim, Su Jin; Choi, Choel Woong; Ha, Jong Kun; Hong, Young Mi; Park, Jin Hyun; Park, Soo Bum; Kang, Dae Hwan

    2013-01-01

    Mucosa-associated lymphoid tissue lymphoma mainly arises in the stomach, with fewer than 30% arising in the small intestine. We describe here two cases of primary duodenal mucosa-associated lymphoid tissue lymphoma which were evaluated by endoscopic ultrasonography. A 52-year-old man underwent endoscopy due to abdominal pain, which demonstrated a depressed lesion on duodenal bulb. Endoscopic ultrasonographic finding was hypoechoic lesion invading the submucosa. The other case was a previously healthy 51-year-old man. Endoscopy showed a whitish granular lesion on duodenum third portion. Endoscopic ultrasonography image was similar to the first case, whereas abdominal computed tomography revealed enlargement of multiple lymph nodes. The first case was treated with eradication of Helicobacter pylori, after which the mucosal change and endoscopic ultrasound finding were normalized in 7 months. The second case was treated with cyclophosphamide, vincristine, prednisolone, and rituximab every 3 weeks. After 6 courses of chemotherapy, the patient achieved complete remission. PMID:24143321

  16. HISTOPATHOLOGY OF THE DUODENAL-JEJUNAL MUCOSA OBTAINED BY CROSBY BIOPSY IN A CASE OF NUTRITIONAL MEGALOBLASTIC ANEMIA FOLIC ACID-RESPONSIVE (ISTOPATOLOGIA DELLA MUCOSA DUODENODIGIUNALE OTTENUTA CON BIOPSIA ALLA CROSBY IN UN CASO DI ANEMIA MEGALOBLASTICA NUTRIZIONALE FOLICO-RESPONSIVA),

    DTIC Science & Technology

    In a nutritional megaloblastic anemia case, responsive to folic acid, partial or subtotal atrophy of the villi was observed in the duodenal-jejunal... villous tunica and of the pericryptic area, the presence of pseudocrypts, alterations of the glandular acini, and hyperplasia of the interstitial

  17. Sun Releases Solar Light Bulb

    NASA Image and Video Library

    2017-09-27

    The first of a series of coronal mass ejections (CMEs) over three days (Aug. 20-22), this bulbous CME certainly resembles a light bulb. It has the thin outer edge and a bright, glowing core at its center. CMEs are often bulbous, but it has been years since we have seen one with the elements (pun intended) of a light bulb. The frames were taken by SOHO's LASCO C3 instrument. Credit: NASA/GSFC/SOHO NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  18. Liver Biopsy

    MedlinePlus

    ... for a liver biopsy by talking with a health care provider having blood tests arranging for a ride home fasting before the ... for a liver biopsy by talking with a health care provider having blood tests arranging for a ride home fasting before the ...

  19. [Surgical treatment of duodenal ulcer].

    PubMed

    Lese, M; Naghi, I; Pop, C

    2001-01-01

    The medical and endoscopic treatment of duodenal ulcer are decreasing the frequency of surgical treatment in this disease. The authors study the operations performed for duodenal ulcer within the period 1989-1999 in the County Hospital Baia Mare. The decrease of the rate of surgical interventions is the pure effect of the medical treatment, as long as the endoscopic treatment is not yet available in our service. The rate of ulcer--induced perforations remained, however, unmodified (48% of total operatory indications), as well as the postoperative morbidity and--mortality (18% respectively 9%). The last category seems not to be influenced by the type of chosen surgical procedure, but by the patient's age, duration of the disease, and associated pathology.

  20. Calmodulin independence of human duodenal adenylate cyclase.

    PubMed Central

    Smith, J A; Griffin, M; Mireylees, S E; Long, R G

    1991-01-01

    The calmodulin and calcium dependence of human adenylate cyclase from the second part of the duodenum was assessed in washed particulate preparations of biopsy specimens by investigating (a) the concentration dependent effects of free [Ca2+] on enzyme activity, (b) the effects of exogenous calmodulin on enzyme activity in ethylene glycol bis (b-aminoethyl ether)N,N'-tetra-acetic acid (EGTA) washed particulate preparations, and (c) the effects of calmodulin antagonists on enzyme activity. Both basal (IC50 = 193.75 (57.5) nmol/l (mean (SEM)) and NaF stimulated (IC50 = 188.0 (44.0) nmol/l) adenylate cyclase activity was strongly inhibited by free [Ca2+] greater than 90 nmol/l. Free [Ca2+] less than 90 nmol/l had no effect on adenylate cyclase activity. NaF stimulated adenylate cyclase activity was inhibited by 50% at 2.5 mmol/l EGTA. This inhibition could not be reversed by free Ca2+. The addition of exogenous calmodulin to EGTA (5 mmol/l) washed particulate preparations failed to stimulate adenylate cyclase activity. Trifluoperazine and N-(8-aminohexyl)-5-IODO-1-naphthalene-sulphonamide (IODO 8) did not significantly inhibit basal and NaF stimulated adenylate cyclase activity when measured at concentrations of up to 100 mumol/l. These results suggest that human duodenal adenylate cyclase activity is calmodulin independent but is affected by changes in free [Ca2+]. PMID:1752461

  1. Duodenal perforation in a cheetah (Acinonyx jubilatus).

    PubMed

    Johnson, J H; Wolf, A M; Jensen, J M; Fossum, T; Rohn, D; Green, R W; Willard, M

    1997-12-01

    An 11-yr-old female cheetah (Acinonyx jubilatus) from a privately owned breeding center for endangered species was referred for evaluation with a history of vomiting and depression of 10 days' duration. After anesthetic induction with tiletamine and zolazepam and anesthetic maintenance with isoflurane, a complete diagnostic workup was performed, including hematology, serum chemistry, and radiography. The clinical diagnosis was septic suppurative inflammation and hemorrhage in the abdomen, consistent with perforation or rupture of the gastrointestinal tract. An exploratory laparotomy showed a perforated duodenal ulcer, which was resected. Subsequent endoscopy revealed no further evidence of ulceration in the upper gastrointestinal tract. Biopsy of the ulcerated tissue collected from the duodenum revealed Gastrospirillum-like organisms. Histologic examination revealed widespread infiltration of lymphocytes and plasma cells into the lamina propria and submucosa. Intraepithelial leukocytes were present along with attenuation, erosion, and ulceration of the superficial epithelium. Fourteen days after surgery, this cheetah was returned to its breeding compound, and no subsequent vomiting has been observed for 4 yr.

  2. A 12-mm carcinoid tumor of the minor duodenal papilla with lymph node metastases.

    PubMed

    Fukami, Yasuyuki; Kurumiya, Yasuhiro; Mizuno, Keisuke; Sekoguchi, Ei; Kobayashi, Satoshi; Ito, Akira; Tomida, Akihiro; Onishi, Sakura; Shirotsuki, Ryo; Okubo, Kenji; Narita, Michihiko

    2013-01-01

    Carcinoid tumors located in the minor duodenal papilla are extremely rare, with only a few cases reported in the literature. Herein, we report the case of a 71-year-old man with a 12-mm carcinoid tumor at the minor duodenal papilla with lymph node metastases. Multidetector-row computed tomography with contrast enhancement revealed a 12-mm well-enhanced tumor in the duodenum. Upper gastrointestinal endoscopy showed a 12-mm submucosal tumor at the minor papilla of the duodenum. Biopsy specimens revealed a carcinoid tumor, and a subtotal stomach-preserving pancreatoduodenectomy was performed. Carcinoid tumors at the minor duodenal papilla have a high prevalence of nodal disease, even for tumors <2 cm in diameter. Therefore, we believe that radical resection with tumor-free margins (i.e. pancreatoduodenectomy) is the treatment of choice.

  3. [Morphometric characteristics of fundal glands of the stomach in duodenal ulcer and pre-ulcer condition].

    PubMed

    Uspenskiĭ, V M

    1978-01-01

    Biopsy material was used for morphometric study of the fundal glands in 114 patients with duodenal ulcers, 177 patients with various forms of gastroduodenal pathology but with typical signs of duodenal ulcer, and in 21 normal subjects. Three variants of the increase in the amount of secretory elements of the fundal glands were found: owing to an increase in the number of main cells (first variant), main and parietal cells (second variant), and parietal cells (third variant). These changes in the fundal glands are not specific for ulcer and pre-ulcer conditions, they are observed in normal subjects with constitutional hypersecretion of hydrochloric acid and pepsin. The patients with duodenal ulcer and pre-ulcer conditions are characterized by "hyper-pepsinogenic shift" in the epithelial formula of the fundal gland (45% and 31-38%, respectively) owing to an increase in the number of main cells.

  4. A Case of Congenital Duodenal Web Causing Duodenal Stenosis in a Down Syndrome Child: Endoscopic Resection with an Insulated-Tip Knife

    PubMed Central

    Lee, Sang Seon; Hwang, Seon Tae; Jang, Nam Gil; Tchah, Hann; Choi, Duk Young; Kim, Hyun Young

    2011-01-01

    A 35-month-old girl visited our hospital with repetitive vomiting and abdominal distention; this was especially aggravated after the introduction of solid and semisolid foods. At 5 months of age, the patient, who had Down's syndrome, had undergone surgery for ventricular septal defect, atrial septal defect, and patent ductus arteriosus, and had subsequently been frequently hospitalized for respiratory infections and other viral infectious diseases. After her admission, the abdominal distension improved with fasting and intravenous fl uid therapy. Radiograph from a small-bowel series revealed a thin fi lling defect with a dilated duodenal bulb in the distal region of the second portion of the duodenum, suggesting a duodenal web, and endoscopy revealed duodenal stenosis. We therefore performed endoscopic resection with an insulated-tip knife because of the history of prior operations, fasting problems after operations, and respiratory infections. Seven days later, scar formation was noted on the second portion of the duodenum, the scope passed well at the excision site, and no retained food material was noted on the follow-up endoscopy. After the procedure, the patient's abdominal distention and repetitive vomiting subsided, and she was discharged with the ability to eat eat an age-appropriate normal diet. There were no specifi c symptoms or other complications for 1 year after the procedure. PMID:21461083

  5. Synovial biopsy

    MedlinePlus

    ... abnormal buildup of iron deposits) Systemic lupus erythematosus (autoimmune disease that affects the skin, joints, and other organs) ... and the A.D.A.M. Editorial team. Autoimmune Diseases Read more Biopsy Read more Fungal Infections Read ...

  6. Bone Biopsy

    MedlinePlus

    ... than surgical biopsy and may not require general anesthesia. Tell your doctor about any recent illnesses or ... and whether you have any allergies, especially to anesthesia. Discuss any medications you’re taking, including herbal ...

  7. Tongue biopsy

    MedlinePlus

    ... Results Mean Abnormal results may mean: Amyloidosis Tongue (oral) cancer Viral ulcer Benign tumors Risks Risks for this ... D.A.M. Editorial team. Biopsy Read more Oral Cancer Read more Tongue Disorders Read more A.D. ...

  8. 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

  9. Optical markers in duodenal mucosa predict the presence of pancreatic cancer.

    PubMed

    Liu, Yang; Brand, Randall E; Turzhitsky, Vladimir; Kim, Young L; Roy, Hemant K; Hasabou, Nahla; Sturgis, Charles; Shah, Dhiren; Hall, Curtis; Backman, Vadim

    2007-08-01

    Pancreatic cancer remains one of the most deadly cancers and carries a dismal 5-year survival rate of <5%. Therefore, there is urgent need to develop a highly accurate and minimally invasive (e.g., without instrumentation of the pancreatic duct given high rate of complications) method of detection. Our group has developed a collection of novel light-scattering technologies that provide unprecedented quantitative assessment of the nanoscale architecture of the epithelium. We propose a novel approach to predict pancreatic cancer through the assessment of the adjacent periampullary duodenal mucosa without any interrogation of the pancreatic duct or imaging of the pancreas. Endoscopically and histologically normal-appearing periampullary duodenal biopsies obtained from 19 pancreatic cancer patients were compared with those obtained at endoscopy from 32 controls. Biopsies were analyzed using our newly developed optical technologies, four-dimensional elastic light-scattering fingerprinting (4D-ELF) and low-coherence enhanced backscattering (LEBS) spectroscopy. 4D-ELF- and LEBS-derived optical markers from normal-appearing periampullary duodenal mucosa can discriminate between pancreatic cancer patients and normal controls with 95% sensitivity and 91% specificity. Moreover, the diagnostic performance of these optical markers was not compromised by confounding factors such as tumor location and stage. Here, we showed, for the first time, that optical analysis of histologically normal duodenal mucosa can predict the presence of pancreatic cancer without direct visualization of the pancreas.

  10. Duodenal ulcerogens cysteamine and propionitrile decrease duodenal neutralization of acid in the rat

    SciTech Connect

    Adler, R.S.; Gallagher, G.T.; Szabo, S.

    1983-08-01

    Neutralization of acid was evaluated in rat proximal duodenal segments isolated from biliary and pancreatic secretions. Duodenal ulcerogenic doses of cysteamine produced a significant decrease in acid disposal 0.5-2 hr after treatment. Oral or subcutaneous administration of the duodenal ulcerogen was effective. The potent ulcerogen cysteamine produced a more pronounced decrease than propionitrile (a weak duodenal ulcerogen). The failure of ethanolamine, a nonulcerogenic structural analog of cysteamine to significantly alter acid disposal suggests that the effect is not due to the toxic properties of the duodenal ulcerogen. The results reinforce the concept that the duodenum is able to dispose of significant quantities of acid. The decrease in acid-handling may contribute to duodenal susceptibility to acid after treatment with ulcerogens and possibly reflects pathophysiologic changes early in duodenal ulceration.

  11. Traumatic duodenal hematoma in the pediatric patient.

    PubMed

    Winthrop, A L; Wesson, D E; Filler, R M

    1986-09-01

    Twenty children with duodenal hematomas secondary to blunt trauma were treated between 1953 and 1983. The duodenal injury was isolated in ten cases and associated with intra-abdominal injuries in the others. In ten, the duodenal injury was suspected on admission and the diagnosis was confirmed within 24 hours by radiographic contrast studies. All ten were managed successfully with nasogastric suction and intravenous fluids. Ten patients underwent laparotomy for increasing abdominal tenderness and guarding. An isolated duodenal hematoma was found in four and treated by evacuation and/or gastroenterostomy. In five of the remaining six surgical patients, all of whom had multiple intra-abdominal injuries, the duodenum was left untouched. Three of these patients had postoperative contrast studies that showed early resolution of the duodenal hematoma. No duodenal stricture or leak developed in any patient. The children with isolated duodenal hematomas who were treated conservatively had a mean hospital stay of six days, whereas those treated surgically had a mean stay of 17 days. The ten patients with multiple intra-abdominal injuries had a mean hospital stay of 32 days. In this group, eight required total parenteral nutrition or nasojejunal feeds for nutritional support. In these patients, an isolated duodenal hematoma resulted in minimal morbidity and nonoperative management was usually successful. The presence of associated intra-abdominal injuries was responsible for the prolonged hospitalization and delayed return of normal intestinal function in some patients.

  12. A Patient with Duodenal Mucinous Adenocarcinoma Presenting as a Laterally Spreading Tumor

    PubMed Central

    Chae, Myung Joon; Oh, Yu Mi; Lim, Jun Uk; Jeon, Jung Won; Shin, Hyun Phil; Joo, Kwang Ro; Lee, Joung Il

    2015-01-01

    Primary duodenal carcinoma is rare. Duodenal mucinous adenocarcinoma (DMA) is even rarer, and its associated manifestations and typical endoscopic or imaging findings are not well characterized. Herein, we report a case of primary DMA in an asymptomatic 58-year-old man who visited our hospital for a regular health screening. Upper endoscopy revealed an approximately 4-cm lesion in the second portion of the duodenum, but the mass was not visualized on computed tomography. Biopsies revealed a tubular adenoma that was subsequently resected. Frozen biopsies demonstrated DMA with a background of low-grade tubular adenoma for which we performed Roux-en-Y duodenojejunostomy and jejunojejunostomy. To our knowledge, this is the first report of a patient with DMA in Korea. PMID:26240810

  13. Skin Biopsy

    MedlinePlus

    ... a biopsy because of a tumor, lump, or mass, don't hit the panic button. Often, a lump or bump is benign, which means it's not cancerous. If you're worried, talk with your doctor, your ... For Teens For Kids ...

  14. Duodenal intraepithelial T lymphocytes in patients with functional dyspepsia

    PubMed Central

    Gargala, Gilles; Lecleire, Stéphane; François, Arnaud; Jacquot, Serge; Déchelotte, Pierre; Ballet, Jean Jacques; Favennec, Loic; Ducrotté, Philippe

    2007-01-01

    AIM: To quantify the intraepithelial lymphocytes (IELs) and to document the membrane expression of CD4, CD8, TCRγδ and adhesion and/or activation-associated molecules (CD103, CD28, CD44, CD69, HLA-DR, CD95/Fas) in the duodenal mucosa of patients with functional dyspepsia (FD) in order to provide arguments for an immunological process in FD. METHODS: Twenty-six FD patients according to Rome II criteria (20 were H pylori negative) were studied and compared to 12 healthy adults. IELs were isolated from five duodenal biopsy samples, then quantified by microscopy and flow cytometry while the membrane phenotypes were determined by cytofluorometry. RESULTS: Duodenal histological examination was normal. In H pylori negative patients, the number of IELs was not different from that in healthy controls. Median percentage expression of CD4, CD8, or TCRγδ and CD103, CD44, CD28, CD69 on CD3+ IELs, among the adhesion/activation associated molecules tested, was not different from that in healthy controls. In contrast, the median percentage expression of CD95/Fas [22 (9-65) vs 45 (19-88), P = 0.03] and HLA-DR expressing CD3+ IELs [4 (0-30) vs 13 (4-42), P = 0.04] was significantly lower in the H pylori negative FD group than in healthy controls, respectively. The number of IELs was significantly greater in H pylori positive FD patients than in healthy controls [median ratiofor 100 enterocytes 27.5 (6.7-62.5) vs 10.8 (3-33.3), P = 0.02] due to a higher number of CD8+ CD3+ IELs. CONCLUSION: In H pylori negative FD patients, the phenotypic characterization of IELs suggests that we cannot exclude a role of IELs in FD. PMID:17511033

  15. Duodenal Perforation Precipitated by Scrub Typhus.

    PubMed

    Rajat, Raghunath; Deepu, David; Jonathan, Arul Jeevan; Prabhakar, Abhilash Kundavaram Paul

    2015-01-01

    Scrub typhus is an acute febrile illness usually presenting with fever, myalgia, headache, and a pathognomonic eschar. Severe infection may lead to multiple organ failure and death. Gastrointestinal tract involvement in the form of gastric mucosal erosions and ulcerations owing to vasculitis resulting in gastrointestinal bleeding is common. This process may worsen a pre-existent asymptomatic peptic ulcer, causing duodenal perforation, and present as an acute abdomen requiring surgical exploration. We report the case of a patient with no previous symptoms or risk factors for a duodenal ulcer, who presented with an acute duodenal perforation, probably precipitated by scrub typhus infection.

  16. Acute Necrotizing Esophagitis Followed by Duodenal Necrosis.

    PubMed

    Del Hierro, Piedad Magdalena

    2011-12-01

    Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved.

  17. Annular pancreas associated with duodenal carcinoma

    PubMed Central

    Brönnimann, Enrico; Potthast, Silke; Vlajnic, Tatjana; Oertli, Daniel; Heizmann, Oleg

    2010-01-01

    Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics. PMID:20593508

  18. [Psychological factors in duodenal ulcers].

    PubMed

    Bauer, B; Bergmann, M

    1981-01-01

    With the aid of a clinical questionnaire and the I-N-R-personality test of Eysenck (as modified by Böttcher), we examined 127 male patients with clinically and radiologically proven ulcer compared to 145 age-matched persons without gastric affections. The features extraversion, neuroticism (emotional lability) and rigidity were determined and the question of an association with symptoms, age at onset of disease as well as occupational and familial factors statistically analyzed. With high significance, duodenal ulcer patients are more often emotionally labile and psychically more rigid. In the event the disease manifests under the age of 30, in ulcer patients introversion too is pronounced with highly significant frequency. Those patients complaining of conflicts with collaborators, lack of sleep, occupational overexertion, noise, draught at work place, present, compared to others without these complaints, a frequently emotional lability with high significance.

  19. Cytotoxic T cells are preferentially activated in the duodenal epithelium from patients with florid coeliac disease.

    PubMed

    Buri, Caroline; Burri, Philipp; Bähler, Peter; Straumann, Alex; Müller-Schenker, Beatrice; Birrer, Stefan; Mueller, Christoph

    2005-06-01

    Villous atrophy and increased numbers of intraepithelial T cells in duodenal biopsies represent a hallmark of coeliac disease. In the present study, an attempt has been made to define whether cytotoxic cell subsets are activated in situ in the affected mucosa of susceptible individuals early after ingestion of a gluten-containing diet. Duodenal biopsies from 11 patients with coeliac disease who repeatedly underwent endoscopic biopsy after ingestion of individually dosed amounts of gluten were used for immunohistochemistry and in situ hybridization. To identify the cell subsets expressing perforin mRNA and protein, in situ hybridization and FACS analyses were performed on cells isolated from fresh biopsies. Compared with normal mucosa, the number of intraepithelial lymphocytes containing perforin mRNA and protein increased significantly in tissue samples showing moderate or florid coeliac disease and closely paralleled the severity of morphological alteration, whereas the frequency of perforin-expressing lamina propria lymphocytes increased only moderately. Cells isolated from florid biopsies that expressed perforin mRNA and protein were preferentially T-cell receptor (TCR) alphabeta T cells. The increase in both the absolute number and the percentage of lymphocytes expressing perforin mRNA indicates in situ activation of lymphocytes within the epithelial compartment in florid coeliac disease upon ingestion of a gluten-containing diet in patients predisposed to coeliac disease. Copyright 2005 Pathological Society of Great Britain and Ireland

  20. 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.

  1. Small duodenal carcinoids: a case series comparing endoscopic resection and autoamputation with band ligation.

    PubMed

    Scherer, John R; Holinga, Julie; Sanders, Michael; Chennat, Jennifer; Khalid, Asif; Fasanella, Kenneth; Singhi, Aatur D; McGrath, Kevin

    2015-04-01

    We sought to compare the efficacy and safety of endoscopic ultrasound-guided endoscopic resection (ER) and endoscopic band ligation (EBL) for autoamputation of small duodenal carcinoids. The ideal management of small duodenal carcinoid tumors remains unclear. A retrospective review of duodenal carcinoids over a 10-year period (2002 to 2012) was performed at our tertiary-care teaching hospital. All patients with duodenal carcinoids ≤10 mm in size treated with either ER or EBL were included. The main outcome measurements were the efficacy and safety of endotherapy. A total of 37 patients with 39 subcentimeter duodenal carcinoids were identified. In the EBL group, the mean (SD) tumor size was 6.7±2.1 mm compared with 6.7±1.7 mm in the ER group (P=0.943). The mean Ki-67 index was ≤2% in specimens available for histologic analysis in both groups (16/23 EBL and 15/16 ER). The positive deep margin rate in the ER group was 68.8%. Residual carcinoid tumor cells were detected on follow-up biopsies in 1 patient after EBL, and 2 patients after ER. All underwent subsequent successful endotherapy. No adverse events occurred in the EBL group compared with an 18.8% adverse event rate in the ER group (P=0.066). Endoscopic ultrasound-guided EBL is a safe, effective method for removal of small superficial duodenal carcinoids and seems to be a lower risk alternative to conventional ER with cautery.

  2. Don't Zap that Light Bulb!

    NASA Astrophysics Data System (ADS)

    Ray, Biswajit

    2006-09-01

    Children are often told by their parents not to play with the light switch because every time a light bulb is switched on and off, it costs an extra penny. However, the life of a light bulb under repeated switching is more of a concern than the negligible (estimated to be less than one-thousandth of a penny) additional electricity cost. This brief note explores the connection between the life of a light bulb and the electrical transient associated with switching it on.

  3. The effect of tri-potassium di-citrato bismuthate on the duodenal mucosa during ulceration. An ultrastructural study.

    PubMed

    Gregory, M A; Moshal, M G; Spitaels, J M

    1982-07-10

    The manner in which tri-potassium di-citrato bismuthate (TDB) promotes duodenal ulcer healing is not known. Endoscopic biopsy specimens were taken from the edges of duodenal ulcers from 5 patients before and after treatment with TDB. Using the bismuth contained within this drug as an electron-dense marker, the mode of action of TDB was determined by transmission electron microscopy. TDB was found to promote ulcer healing by adhering to the ulcerative mucosa, thereby providing an effective barrier to the substances which cause and maintain ulceration.

  4. Duodenal carcinoma in MUTYH‐associated polyposis

    PubMed Central

    Nielsen, M; Poley, J W; Verhoef, S; van Puijenbroek, M; Weiss, M M; Burger, G T; Dommering, C J; Vasen, H F A; Kuipers, E J; Wagner, A; Morreau, H; Hes, F J

    2006-01-01

    Bi‐allelic germline mutations in the MUTYH gene give rise to multiple adenomas and an increased incidence of colorectal cancer. In addition, duodenal adenomas and other extra‐colonic manifestations have been described in MUTYH‐associated polyposis (MAP) patients. We describe two patients with bi‐allelic MUTYH gene mutations with duodenal carcinoma. The tumour in Patient A was detected during evaluation of non‐specific abdominal complaints. Patient B was already diagnosed with tens of adenomas and a colon carcinoma, when a duodenal neoplasm was detected. The identification of somatic G>T mutations in codon 12 of the K‐RAS2 gene provides evidence that the duodenal lesions were induced by MUTYH deficiency. Studies in larger series of MAP patients are needed to investigate the risk of upper‐gastro‐intestinal malignancies and to determine further guidelines for endoscopical surveillance. PMID:16943222

  5. Intraoperative methods to stage and localize pancreatic and duodenal tumors.

    PubMed

    Norton, J A

    1999-01-01

    Intraoperative methods to stage and localize tumors have dramatically improved. Advances include less invasive methods to obtain comparable results and precise localization of previously occult tumors. The use of new technology including laparoscopy and ultrasound has provided some of these advances, while improved operative techniques have provided others. Laparoscopy with ultrasound has allowed for improved staging of patients with pancreatic cancer and exclusion of patients who are not resectable for cure. We performed laparoscopy with ultrasound on 50 consecutive patients with adenocarcinoma of the pancreas or liver who appeared to have resectable tumors based on preoperative computed tomography. 22 patients (44%) were found to be unresectable because of tumor nodules on the liver and/or peritoneal surfaces or unsuspected distant nodal or liver metastases. The site of disease making the patient unresectable was confirmed by biopsy in each case. Of the 28 remaining patients in whom laparoscopic ultrasound predicted to be resectable for cure, 26 (93%) had all tumor removed. Thus laparoscopy with ultrasound was the best method to select patients for curative surgery. Intraoperative ultrasound (IOUS) has been a critical method to identify insulinomas that are not palpable. Nonpalpable tumors are most commonly in the pancreatic head. Because the pancreatic head is thick and insulinomas are small, of 9 pancreatic head insulinomas only 3 (33%) were palpable. However, IOUS precisely identified each (100%). Others have recommended blind distal pancreatectomy for individuals with insulinoma in whom no tumor can be identified. However, our data suggest that this procedure is contraindicated as these occult tumors are usually within the pancreatic head. Recent series suggest that previously missed gastrinomas are commonly in the duodenum. IOUS is not able to identify these tumors, but other methods can. Of 27 patients with 31 duodenal gastrinomas, palpation identified 19

  6. Ulcerative colitis with gastric and duodenal involvement.

    PubMed

    García Gavilán, María Del Carmen; López Vega, María Carmen; Sánchez, Isabel María

    2017-07-01

    Ulcerative colitis is one of the forms of presentation of the inflammatory bowel disease. UC yypically affects the large bowel but in the last few years more cases with proximal involvement have been described (diffuse gastritis, focally enhanced gastritis and duodenitis). We present the case of gastric and duodenitis involvement in the context of a moderate-severe ulcerative pancolitis which showed a good evolution and resolution of symptoms with corticoid treatment.

  7. [A clamp for suturing of duodenal stump].

    PubMed

    Komarov, I A

    1991-03-01

    An original clamp was used in suturing a duodenal stump after gastric resection in 77 patients. The complex relief of the blades of the clamp holds the duodenum reliably during application of the sutures and ensures their air-tightness. The trauma inflicted to the duodenum in this case is minimal. During resection of the stomach in 37 patients the author used the clamp in closure of the lesser curvature. Incompetence of the duodenal stump was not encountered.

  8. 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)

  9. 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)

  10. 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)

  11. 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)

  12. Fuzzy linear programming for bulb production

    NASA Astrophysics Data System (ADS)

    Siregar, I.; Suantio, H.; Hanifiah, Y.; Muchtar, M. A.; Nasution, T. H.

    2017-01-01

    The research was conducted at a bulb company. This company has a high market demand. The increasing of the market demand has caused the company’s production could not fulfill the demand due to production planning is not optimal. Bulb production planning is researched with the aim to enable the company to fulfill the market demand in accordance with the limited resources available. From the data, it is known that the company cannot reach the market demand in the production of the Type A and Type B bulb. In other hands, the Type C bulb is produced exceeds market demand. By using fuzzy linear programming, then obtained the optimal production plans and to reach market demand. Completion of the simple method is done by using software LINGO 13. Application of fuzzy linear programming is being able to increase profits amounted to 7.39% of the ordinary concept of linear programming.

  13. 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)

  14. 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)

  15. 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

  16. Pulse calorimetry with a light bulb

    NASA Astrophysics Data System (ADS)

    Kraftmakher, Yaakov

    2004-11-01

    A normal light bulb provides excellent opportunities for learning modern calorimetric techniques. The tungsten filament in a light bulb allows calorimetric measurements to be made over a wide range of high temperatures. The filament serves simultaneously as a sample, a heater and a thermometer. A student experiment employing a pulse calorimetric technique is described. A brief review of existing calorimetric techniques is given, and the temperature dependence of specific heat of solids is considered.

  17. Caffeine and the olfactory bulb.

    PubMed

    Hadfield, M G

    1997-08-01

    Caffeine, a popular CNS stimulant, is the most widely used neuroactive drug. Present in coffee, tea, chocolate, and soft drinks as well as over-the-counter and prescription medications, it influences millions of users. This agent has achieved recent notoriety because its dependency consequences and addictive potential have been re-examined and emphasized. Caffeine's central actions are thought to be mediated through adenosine (A) receptors and monoamine neurotransmitters. The present article suggests that the olfactory bulb (OB) may be an important site in the brain that is responsible for caffeine's central actions in several species. This conclusion is based on the extraordinarily robust and selective effects of caffeine on norepinephrine (NE), dopamine (DA), and particularly serotonin (5HT) utilization in the OB of mice. We believe that these phenomena should be given appropriate consideration as a basis for caffeine's central actions, even in primates. Concurrently, we review a rich rodent literature concerned with A, 5HT, NE, and DA receptors in the OB and related structures along with other monoamine parameters. We also review a more limited literature concerned with the primate OB. Finally, we cite the literature that treats the dependency and addictive effects of caffeine in humans, and relate the findings to possible olfactory mechanisms.

  18. 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.

  19. Duodenal obstruction - an unusual presentation of Strongyloides stercoralis enteritis: a case report

    PubMed Central

    2010-01-01

    Background Intestinal obstruction is a poorly recognized and probably underreported complication of strongyloidiasis. We present herein an unusual case, of complete duodenal obstruction caused by S. stercoralis. Methods A systematic review of the literature examining the clinical course, diagnostic methods, and outcome of this rare complication of strongyloidiasis was performed. Results A 42-year-old woman presented with a 5-month history of abdominal pain, vomit, and weight loss. An abdominal CT scan showed an obstruction of the third part of the duodenum. Segmental intestinal resection was carried out and histopathology examination revealed heavy Strongyloides stercoralis infestation. Duodenal obstruction is a rare complication of S. stercoralis infection, with only 8 cases described in the literature since 1970. Most of the patients are males, middle-aged, and the diagnosis was made by duodenal aspirate/biopsy, or analysis of surgical specimen. Conclusions Duodenal obstruction is an unusual, but potential fatal, complication of S. stercoralis infection. The large spectrum of clinical manifestation and lack of classic clinical syndrome make the final diagnosis of strongyloidiasis extremely difficult. A high index of suspicion, mainly in patients from endemic areas, is needed for correct and early diagnosis of this uncommon presentation of Strogyloides stercoralis enteritis. PMID:20698992

  20. 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. 2014 BMJ Publishing Group Ltd.

  1. Duodenal adenomatosis in familial adenomatous polyposis

    PubMed Central

    Bülow, S; Björk, J; Christensen, I J; Fausa, O; Järvinen, H; Moesgaard, F; Vasen, H F A

    2004-01-01

    Background: The prevalence of duodenal carcinoma is much higher in familial adenomatous polyposis (FAP) than in the background population, and duodenal adenomatosis is found in most polyposis patients. Aims: To describe the long term natural history of duodenal adenomatosis in FAP and evaluate if cancer prophylactic surveillance of the duodenum is indicated. Methods: A prospective five nation study was carried out in the Nordic countries and the Netherlands. Patients: A total of 368 patients were examined by gastroduodenoscopy at two year intervals during the period 1990–2001. Results: At the first endoscopy, 238 (65%) patients had duodenal adenomas at a median age of 38 years. Median follow up was 7.6 years. The cumulative incidence of adenomatosis at age 70 years was 90% (95% confidence interval (CI) 79–100%), and of Spigelman stage IV 52% (95% CI 28–76%). The probability of an advanced Spigelman score increased during the study period (p<0.0001) due to an increasing number and size of adenomas. Two patients had asymptomatic duodenal carcinoma at their first endoscopy while four developed carcinoma during the study at a median age of 52 years (range 26–58). The cumulative incidence rate of cancer was 4.5% at age 57 years (95% CI 0.1–8.9%) and the risk was higher in patients with Spigelman stage IV at their first endoscopy than in those with stages 0–III (p<0.01). Conclusions: The natural course of duodenal adenomatosis has now been described in detail. The high incidence and increasing severity of duodenal adenomatosis with age justifies prophylactic examination, and a programme is presented for upper gastrointestinal endoscopic surveillance. PMID:14960520

  2. Variant on Manifestation of Duodenal Metastasis 26 Years after Initial Diagnosis of Primary Cutaneous Melanoma

    PubMed Central

    Kitajima, Kumiko; Bardier-Dupas, Armelle; Breton, Sylvie; Rousseau, Géraldine; Siksik, Jean-Michel; Vaillant, Jean-Christophe; Hannoun, Laurent

    2010-01-01

    Malignant duodenal neoplasms are relatively rare, and the diagnosis is often delayed because of their vague and nonspecific symptoms. We report the case of a 79-year-old female who had a medical history of malignant melanoma of the cheek that had initially been diagnosed at 53 years of age. Work-up revealed severe stenosis of the duodenum caused by a large mass with ulceration at the tip of its mucosal surface. Tumor biopsy led to a histological diagnosis of extremely poorly differentiated carcinoma, but it was impossible to determine whether the lesion was a primary neoplasm or represented secondary involvement. Pancreatoduodenectomy was performed, and the surgical specimen showed a protuberant tumor in the nonampullary region of the second portion of the duodenum. Final diagnosis of metastatic duodenal melanoma was made by immunohistological examination. She is currently alive without recurrence 28 months after the surgical treatment. PMID:21103234

  3. Reduced Duodenal Cytochrome P450 3A Protein Expression and Catalytic Activity in Patients with Cirrhosis

    PubMed Central

    McConn, Donavon J.; Lin, Yvonne S.; Mathisen, Terri L.; Blough, David K.; Xu, Yang; Hashizume, Takanori; Taylor, Shari L.; Thummel, Kenneth E.; Shuhart, Margaret C.

    2009-01-01

    The small intestine and liver express high levels of cytochrome P450 3A (CYP3A), an enzyme subfamily contributing significantly to drug metabolism. In patients with cirrhosis, reduced metabolism of drugs is typically attributed to decreased liver function, but it is unclear whether intestinal drug metabolism is also compromised. In this study, we compared CYP3A protein expression and in vitro midazolam hydroxylation in duodenal mucosal biopsies from subjects with normal liver function (controls; n=20) and subjects with varying severity of cirrhosis (n=23). Compared to samples from controls, duodenal CYP3A expression and total midazolam hydroxylation was reduced by 47% and 34%, respectively in samples from subjects with cirrhosis. Greater decreases in CYP3A expression were seen in subjects with increasing severity of cirrhosis. Thus, patients with advanced cirrhosis may have increased drug exposure following oral dosing as a result of both impaired liver function and decreased intestinal CYP3A expression and activity. PMID:19212316

  4. Cortical Feedback Control of Olfactory Bulb Circuits

    PubMed Central

    Boyd, Alison M.; Sturgill, James F.; Poo, Cindy; Isaacson, Jeffry S.

    2013-01-01

    SUMMARY Olfactory cortex pyramidal cells integrate sensory input from olfactory bulb mitral and tufted (M/T) cells and project axons back to the bulb. However, the impact of cortical feedback projections on olfactory bulb circuits is unclear. Here, we selectively express channelrhodopsin-2 in olfactory cortex pyramidal cells and show that cortical feedback projections excite diverse populations of bulb interneurons. Activation of cortical fibers directly excites GABAergic granule cells, which in turn inhibit M/T cells. However, we show that cortical inputs preferentially target short axon cells that drive feedforward inhibition of granule cells. In vivo, activation of olfactory cortex that only weakly affects spontaneous M/T cell firing strongly gates odor-evoked M/T cell responses: cortical activity suppresses odor-evoked excitation and enhances odor-evoked inhibition. Together, these results indicate that although cortical projections have diverse actions on olfactory bulb microcircuits, the net effect of cortical feedback on M/T cells is an amplification of odor-evoked inhibition. PMID:23259951

  5. Use of narrow band imaging in assessing duodenal villous atrophy.

    PubMed

    Goswami, Amitava; Dadhich, Sunil; Bhargava, Narendra

    2014-09-01

    Narrow band imaging endoscopy with magnification (NBI-ME) has already been established in Barrett's esophagus, stomach, and colonic mucosa, but limited work has been done in the mucosal evaluation of duodenum. A study was done to determine the correlation between NBI and histology in grading villous architecture in varied etiology. A prospective observational study comprising 105 subjects with suspected malabsorption. The presence of a diagnosed celiac disease, severe life threatening comorbidity, or pregnancy was considered as exclusion criteria. Standard endoscopy (SE), NBI-ME, multiple duodenal biopsies with histopathological examination were done in all. Fifty-one patients had celiac disease while 54 patients comprised mainly functional dyspepsia, iron deficiency anemia, tropical malabsorption syndrome, and irritable bowel syndrome. Four NBI-ME image subtypes of villous morphology have been proposed (NBI type I/II/III/IV). NBI-ME had 95 % sensitivity, 90.2 % specificity, 91.2 % positive predictive value, and 94.2 % negative predictive value for diagnosing altered villous morphology. Intraobserver kappa agreement coefficient (κ) for NBI-ME was 0.83 while interobserver agreement was 0.89 (95 % CI 0.8-0.97). NBI-ME has good performance characteristics and very good kappa intra/interobserver agreement coefficient for varied subtypes of villous morphology. NBI-ME is most useful for obtaining a targeted biopsy which can be missed by conventional white light endoscopy.

  6. Metabolic Alkalosis resulting from a Congenital Duodenal Diaphragm.

    PubMed

    A, Passariello; Y, Maddalena; M, Malamisura; S, Rojo; N, Aragione; E, Iaccarino; G, Franco; P, Giliberti

    2014-01-01

    Duodenal diaphragm is an unusual cause of upper intestinal obstruction. We present here a neonate with duodenal diaphragm who presented with features of metabolic alkalosis. Further, an algorithm of management of metabolic alkalosis in a newborn is suggested.

  7. Metabolic Alkalosis resulting from a Congenital Duodenal Diaphragm

    PubMed Central

    A, Passariello; Y, Maddalena; M, Malamisura; S, Rojo; N, Aragione; E, Iaccarino; G, Franco; P, Giliberti

    2014-01-01

    Duodenal diaphragm is an unusual cause of upper intestinal obstruction. We present here a neonate with duodenal diaphragm who presented with features of metabolic alkalosis. Further, an algorithm of management of metabolic alkalosis in a newborn is suggested. PMID:26023519

  8. Duodenal eosinophilia and early satiety in functional dyspepsia: confirmation of a positive association in an Australian cohort.

    PubMed

    Walker, Marjorie M; Aggarwal, Kavita R; Shim, Lisa Se; Bassan, Milan; Kalantar, Jamshid S; Weltman, Martin D; Jones, Michael; Powell, Nicholas; Talley, Nicholas J

    2014-03-01

    Functional dyspepsia (FD), defined by unexplained pain or discomfort centered in the upper abdomen, is common. Diagnosis and treatment of FD based on the symptom-based Rome criteria remains challenging. Recently, eosinophilia in the duodenum has been implicated in the pathophysiology of FD in adults, specifically increased eosinophils in early satiety and postprandial distress, but the association remains controversial. The aim of this study was to characterize upper gastrointestinal (GI) tract pathology, specifically duodenal eosinophilia, in an Australian cohort of patients with FD. Patients prospectively referred for an upper GI endoscopy (n = 55; mean age, 49.6 years; 61.8% female) were stratified to FD cases (n = 33) and controls (n = 22) using Rome II criteria. All subjects completed a validated bowel symptom questionnaire. The eosinophil count per square millimeter in the duodenal bulb (D1) and second part (D2) was assessed and Helicobacter pylori status determined by gastric histology. Associations with clinical symptoms were assessed. Cases and controls were demographically similar. Duodenal eosinophilia was significantly increased in subjects experiencing early satiety (P = 0.01) and postprandial fullness (P = 0.001). This association was seen in D2 but not D1. Abdominal pain was associated with eosinophilia in both D1 (P = 0.02) and D2 (P = 0.005). Smoking was also associated with higher eosinophil counts in D2 (P = 0.007) and symptoms of early satiety (P = 0.02). Duodenal eosinophilia occurs in a subset of FD. The potential role of duodenal eosinophils in FD has implications for diagnosis and therapeutic trials. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  9. Laparoscopic resection of duodenal gastrointestinal stromal tumour

    PubMed Central

    Zioni, Tammy; Dizengof, Vitaliy; Kirshtein, Boris

    2017-01-01

    Only a few studies have revealed using laparoscopic technique with limited resection of gastrointestinal stromal tumour (GIST) of the duodenum. A 68-year-old man was admitted to the hospital due to upper gastrointestinal (GI) bleeding. Evaluation revealed an ulcerated, bleeding GI tumour in the second part of the duodenum. After control of bleeding during gastroduodenoscopy, he underwent a laparoscopic wedge resection of the area. During 1.5 years of follow-up, the patient is disease free, eats drinks well, and has regained weight. Surgical resection of duodenal GIST with free margins is the main treatment of this tumour. Various surgical treatment options have been reported. Laparoscopic resection of duodenal GIST is an advanced and challenging procedure requiring experience and good surgical technique. The laparoscopic limited resection of duodenal GIST is feasible and safe, reducing postoperative morbidity without compromising oncologic results. PMID:28281485

  10. 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.

  11. Ruptured hepatic abscess caused by fish bone penetration of the duodenal wall: report of a case.

    PubMed

    Kadowaki, Yoshihiko; Tamura, Ryuji; Okamoto, Takahiro; Mori, Takeki; Mori, Takashi

    2007-01-01

    The accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon; however, the development of a hepatic abscess secondary to foreign body perforation is extremely rare. We report the case of a ruptured hepatic abscess caused by fish bone penetration of the duodenal bulb, resulting in generalized peritonitis. A 73-year-old man was admitted to our hospital with generalized abdominal pain and high fever. Computed tomography of the abdomen showed ascites and a heterogeneously enhanced mass with a less-dense center and a linear dense object. We diagnosed a ruptured hepatic abscess caused by a calcified foreign body, which was managed by peritoneal lavage, drainage of the hepatic abscess, and removal of the fish bone, followed by simple closure of the hepatoduodenal fistula. The patient's postoperative course was complicated by systemic inflammatory response syndrome, but he recovered eventually.

  12. Postural Syncope and Constipation: An Unusual Presentation of a Duodenal Dieulafoy's Lesion

    PubMed Central

    Chikezie, Alvarez; Khan, Muhammad Yasir; Zia, Sana; Tahir, Muhammad

    2017-01-01

    Dieulafoy lesions are a rare etiology of gastrointestinal bleeding from a large caliber-persistent tortuous submucosal artery. They account for 1-2% of all causes of acute gastrointestinal hemorrhage with 80%–95% of these lesions located in the stomach along the lesser curvature. One-third of these lesions present at an extragastric location, with the proximal duodenum accounting for 15% of them. We present a 21-year-old male with no significant past medical history or risk factors, who presented with repeated syncopal episodes followed by hematemesis, found to have a Dieulafoy lesion located at the duodenal bulb. This lesion was diagnosed and successfully treated via upper endoscopy with epinephrine injection and the application of 2 endoscopic clips. PMID:28367340

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

    PubMed Central

    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. PMID:25915922

  14. Chemoarchitecture of the monotreme olfactory bulb.

    PubMed

    Ashwell, Ken W S

    2006-01-01

    The cyto- and chemoarchitecture of the olfactory bulb of two monotremes (shortbeaked echidna and platypus) was studied to determine if there are any chemoarchitectural differences from therian mammals. Nissl staining in conjunction with enzyme reactivity for NADPH diaphorase, and immunoreactivity for calcium binding proteins (parvalbumin, calbindin and calretinin), neuropeptide Y, tyrosine hydroxylase and non-phosphorylated neurofilament protein (SMI-32 antibody) were applied to the echidna. Material from platypus bulb was Nissl stained, immunoreacted for calretinin, or stained for NADPH diaphorase. In contrast to eutherians, no immunoreactivity for either the SMI-32 antibody or calretinin was found in the mitral or dispersed tufted cells of the monotremes and very few parvalbumin or calbindin immunoreactive neurons were found in the bulb of the echidna. On the other hand, immunoreactivity for tyrosine hydroxylase in the echidna was similar in distribution to that seen in therians, and periglomerular and granule cells showed similar patterns of calretinin immunoreactivity to eutherians. Multipolar neuropeptide Y immunoreactive neurons were confined to the deep granule cell layer and underlying white matter of the echidna bulb and NADPH diaphorase reactivity was found in occasional granule cells, fusiform and multipolar cells of the inner plexiform and granule cell layers, as well as underlying white matter. Unlike eutherians, no NPY immunoreactive or NADPH diaphorase reactive neurons were seen in the glomerular layer. The bulb of the echidna was comparable in volume to prosimians of similar body weight, and its constituent layers were highly folded. In conclusion, the monotreme olfactory bulb does not show any significant chemoarchitectural dissimilarities from eutheria, despite differences in mitral/tufted cell distribution.

  15. [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.

  16. Carbon nanotube filaments in household light bulbs

    NASA Astrophysics Data System (ADS)

    Wei, Jinquan; Zhu, Hongwei; Wu, Dehai; Wei, Bingqing

    2004-06-01

    Household light bulbs made from macroscopic single-walled and double-walled carbon nanotube filaments were fabricated and tested. The nanotube bulbs are found to possess several interesting features when compared to a conventional tungsten filament in safelight (36 V, 40 W), such as lower threshold voltage for light emission and higher brightness at high voltages. Electrically induced excited peaks at 407, 417, 655 nm were identified to be an intrinsic property of nanotubes and these peaks are observed to become stronger in the light emission spectra at high temperatures which cannot be explained easily with the concept of blackbody emission.

  17. Duodenal microbiota composition and mucosal homeostasis in pediatric celiac disease

    PubMed Central

    2013-01-01

    Background Celiac disease (CD) is an autoimmune disorder of the small intestine which is triggered by dietary gluten in genetically predisposed (HLA-DQ2/DQ8 positive) individuals. Only a fraction of HLA-DQ2/DQ8 positive individuals develop CD indicating that other factors have a role in the disorder. Several studies have addressed intestinal microbiota aberrancies in pediatric CD, but the results are inconsistent. Previously, we demonstrated that pediatric CD patients have lower duodenal expression of TLR2 and higher expression of TLR9 as compared to healthy controls (HC) indicating that microbiota may have a role in CD. Methods We used bacterial phylogenetic microarray to comprehensively profile the microbiota in duodenal biopsies of CD (n = 10) and HC (n = 9) children. The expression of selected mucosa-associated genes was assessed by qRT-PCR in CD and HC children and in treated CD adults (T-CD, n = 6) on gluten free diet. Results The overall composition, diversity and the estimated microbe associated molecular pattern (MAMP) content of microbiota were comparable between CD and HC, but a sub-population profile comprising eight genus-like bacterial groups was found to differ significantly between HC and CD. In HC, increased TLR2 expression was positively correlated with the expression of tight junction protein ZO-1. In CD and T-CD, the expression of IL-10, IFN-g and CXCR6 were higher as co5mpared to HC. Conclusions The results suggest that microbiota and altered expression of mucosal receptors have a role in CD. In CD subjects, the increased expression of IL-10 and IFN-g may have partly resulted from the increased TLR9 expression and signaling. PMID:23844808

  18. 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.

  19. 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

  20. 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 ...

  1. 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 ...

  2. Pleural needle biopsy

    MedlinePlus

    ... of the pleural membrane. Pleural biopsy can diagnose tuberculosis , cancer, and other diseases. If this type of pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the ...

  3. The complicated duodenal diverticulum: retrospective analysis of 11 cases.

    PubMed

    de Perrot, Thomas; Poletti, Pierre-Alexandre; Becker, Christoph D; Platon, Alexandra

    2012-01-01

    A series of rare complicated duodenal diverticula were reported with emphasis on causes for misdiagnosis. Patients with a discharge diagnosis of complicated duodenal diverticulum were retrospectively obtained. Computed tomographic (CT) reports and findings were reviewed. Complications consisted of diverticulitis (n=2), perforation (n=7), or obstructive cholangitis (n=2). CT imaging demonstrated a duodenal diverticular structure with findings due to the kind of complications. At the time of CT interpretation, a complicated duodenal diverticulum was suspected in 5 out of 11 patients. Awareness of the duodenal diverticulum and complications may improve the diagnostic value of CT in this setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Trichophytobezoar duodenal obstruction in New World camelids.

    PubMed

    Sullivan, Eileen K; Callan, Robert J; Holt, Timothy N; Van Metre, David C

    2005-01-01

    To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. Retrospective study. Alpacas (7) and 1 llama. Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.

  5. Duodenal web with preduodenal portal vein.

    PubMed

    Golombek, S; Bilgi, J; Ukabiala, O

    1995-06-01

    This article described an unusual case of an infant with duodenal atresia and preduodenal portal vein without Down's syndrome or other anatomical anomalies associated with this condition. Duodenoduodenostomy was effective. Enteral feeding was re-established 72 hours post-operatively and the patient was discharged home one day later.

  6. Duodenal organ injury severity (OIS) and outcome.

    PubMed

    Kline, G; Lucas, C E; Ledgerwood, A M; Saxe, J M

    1994-07-01

    The effect of organ injury severity on outcome was assessed in 101 patients treated for duodenal trauma. Most patients were men (89%) and victims of penetrating wounds (93%). Grade I is minor hematoma or incomplete perforation; Grade II is major hematoma or small complete perforation; Grade III is large perforation excluding ampulla; Grade IV is large perforation at ampulla; Grade V is duodenopancreatic crunch. The injuries were as follows: Grade I (5 patients), Grade II (31), Grade III (40), Grade IV (12), and Grade V (13). Fourteen patients exsanguinated from associated vessel injury; each had Grade IV or Grade V injury. All 36 patients with Grade I and Grade II injury had primary repair; the single death was due to liver necrosis. Most (31 patients) Grade III injuries and three Grade IV injuries were treated by primary repair alone; the three deaths were unrelated to the duodenal injury. Other major injuries were treated by duodenal exclusion (4 patients), duodenal diverticulization (6), or resection (4); the single death was unrelated to the duodenum. Primary closure is favored for minor injuries and most Grade III injuries. Severe injuries may require exclusion, diverticulization, or resection.

  7. Duodenal leiomyosarcoma mimicking a pancreatic pseudocyst.

    PubMed

    Sperti, C; Pasquali, C; Di Prima, F; Baffa, R; Pedrazzoli, S

    1994-01-01

    A case of duodenal leiomyosarcoma presenting as a cystic mass is reported. Amylase, tumour markers levels in the cyst fluid and radiological findings suggested an inflammatory pancreatic pseudocyst. Exploratory laparotomy and frozen section examination showed a smooth muscle tumour of the duodenum. Pancreatoduodenectomy with pylorus-preser vation was performed and the patient remained symptom-free at 8 months follow-up.

  8. Hydrogen maser - Measurement of wall shift with a flexible bulb

    NASA Technical Reports Server (NTRS)

    Brenner, D.

    1970-01-01

    Flexible bulb is squeezed to change mean free path of hydrogen atoms, and to change bulb's volume without changing its surface area. Volumes in the different configurations are measured to learn the change in mean free path and calculate wall shift. Various bulb coating materials are described.

  9. 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)

  10. 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.

  11. 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)

  12. 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

  13. Adenocarcinoma of the third duodenal portion: Case report and review of literature

    PubMed Central

    Sista, Federico; Santis, Giuseppe De; Giuliani, Antonio; Cecilia, Emanuela Marina; Piccione, Federica; Lancione, Laura; Leardi, Sergio; Amicucci, Gianfranco

    2012-01-01

    We focus on the diagnostic and therapeutic problems of duodenal adenocarcinoma, reporting a case and reviewing the literature. A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum, avoiding a duodeno-cephalo-pancreatectomy. This tumor is very rare and frequently affects the III and IV duodenal portion. A precocious diagnosis and the exact localization of this neoplasia are crucial factors in order to decide the surgical strategy. Given a non-specificity of symptoms, endoscopy with biopsy is the diagnostic gold standard. Duodeno-cephalo-pancreatectomy (DCP) and segmental resection of the duodenum (SRD) are the two surgical options, with overlapping morbidity (27% vs 18%) and post operative mortality (3% vs 1%). The average incidence of postoperative long-term survival is 100%, 73.3% and 31.6% of cases after 1, 3 and 5 years from surgery, respectively. Long-term survival is made worse by two factors: the presence of metastatic lymph nodes and tumor localization in the proximal duodenum. The two surgical options are radical: DCP should be used only for proximal localizations while SRD should be chosen for distal localizations. PMID:22347539

  14. Role of duodenal iron transporters and hepcidin in patients with alcoholic liver disease.

    PubMed

    Dostalikova-Cimburova, Marketa; Balusikova, Kamila; Kratka, Karolina; Chmelikova, Jitka; Hejda, Vaclav; Hnanicek, Jan; Neubauerova, Jitka; Vranova, Jana; Kovar, Jan; Horak, Jiri

    2014-09-01

    Patients with alcoholic liver disease (ALD) often display disturbed iron indices. Hepcidin, a key regulator of iron metabolism, has been shown to be down-regulated by alcohol in cell lines and animal models. This down-regulation led to increased duodenal iron transport and absorption in animals. In this study, we investigated gene expression of duodenal iron transport molecules and hepcidin in three groups of patients with ALD (with anaemia, with iron overload and without iron overload) and controls. Expression of DMT1, FPN1, DCYTB, HEPH, HFE and TFR1 was measured in duodenal biopsies by using real-time PCR and Western blot. Serum hepcidin levels were measured by using ELISA. Serum hepcidin was decreased in patients with ALD. At the mRNA level, expressions of DMT1, FPN1 and TFR1 genes were significantly increased in ALD. This pattern was even more pronounced in the subgroups of patients without iron overload and with anaemia. Protein expression of FPN1 paralleled the increase at the mRNA level in the group of patients with ALD. Serum ferritin was negatively correlated with DMT1 mRNA. The down-regulation of hepcidin expression leading to up-regulation of iron transporters expression in the duodenum seems to explain iron metabolism disturbances in ALD. Alcohol consumption very probably causes suppression of hepcidin expression in patients with ALD.

  15. 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

  16. Acute enteral glutamine infusion enhances heme oxygenase-1 expression in human duodenal mucosa.

    PubMed

    Coëffier, Moïse; Le Pessot, Florence; Leplingard, Antony; Marion, Rachel; Lerebours, Eric; Ducrotté, Philippe; Déchelotte, Pierre

    2002-09-01

    The heat shock protein, heme oxygenase-1 (HO-1), contributes to the protection of the intestine. Some experimental models suggest that induction of HO-1 by glutamine may contribute to the preservation of intestinal mucosa. The effect of an enteral infusion of glutamine for 6 h on HO-1 expression in duodenal mucosa was studied in healthy men and women and compared with an isonitrogenous mixture of amino acids. After enteral infusion, endoscopic duodenal biopsies were performed and either fixed in formalin for immunohistochemistry or frozen for HO-1 mRNA analysis by reverse transcriptase-polymerase chain reaction. Histologic examination revealed that HO-1 was constitutively expressed in intestinal epithelial cells (IEC), and that glutamine increased the grade of HO-1 immunostaining (P duodenal mucosa. These data support further evaluation of the effects of glutamine on intestinal HO-1 during states of intestinal inflammation.

  17. Comparison of relapse rates and of mucosal abnormalities after healing of duodenal ulceration and after one year's maintenance with cimetidine or sucralfate: a light and electron microscopy study.

    PubMed Central

    Tovey, F I; Husband, E M; Yiu, Y C; Baker, L; McPhail, G; Lewin, M R; Jayaraj, A P; Clark, C G

    1989-01-01

    Forty six patients with endoscopically diagnosed duodenal ulceration were randomly allocated to treatment with either sucralfate 1 g qds (n = 24) or cimetidine 200 mg tds and 400 mg nocte (n = 22). When the ulcers healed, a maintenance dose of sucralfate 1 g bd or cimetidine 400 mg nocte was given for one year (or until relapse if earlier). Biopsies of duodenal mucosa adjacent to ulcer sites for light and electron microscopy were obtained before and after healing and again after one year's maintenance if the ulcer remained healed. Duodenal biopsies were also taken from 20 age and sex matched controls. Rates of healing and relapse during maintenance did not differ between the two treatments, although relapses occurred earlier with cimetidine. In the three year post-maintenance follow up period 10/13 cimetidine patients relapsed compared with four of 11 sucralfate patients (p less than 0.05), the relapses occurring significantly earlier in the cimetidine treated patients (p less than 0.05). Mucosal biopsies from both treatment groups still showed considerable abnormalities after healing. During maintenance, however, the sucralfate scores fell significantly (p less than 0.02) to near control levels unlike the cimetidine scores which remained raised at pretreatment values. The histological and ultrastructural changes were not predictive of later relapse. These findings favour the use of sucralfate in preference to cimetidine for maintenance treatment in the prevention of relapse of healed duodenal ulcers. Images Fig. 1 Fig. 2 PMID:2731750

  18. 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.

  19. Novel optical properties of a submerged light bulb

    NASA Astrophysics Data System (ADS)

    James, Mark C.

    2008-09-01

    When an unlit frosted light bulb is immersed in water, the inside frosting appears to shrink, and the outside surface of the bulb appears to become reflective. We explore these interesting effects using geometric optics at the level of introductory physics. It is found that rays emitted from the particles of powder that coat the inside surface of a frosted bulb emerge in conical beams when the bulb is submerged, which results in a reduction of the apparent size of the bulb's internal surface. The observed reflectivity is explained by the total internal reflection that occurs at the internal glass-gas interface. Light rays that refract through a clear bulb are analyzed to understand why a small spherical internal surface appears to exist in this case. The effects of bulb thickness, viewing height, and frustrated total internal reflection are also considered.

  20. Feasibility and safety of endoscopic cryoablation at the duodenal papilla: Porcine model

    PubMed Central

    Yang, Dennis; Reinhard, Mary K; Wagh, Mihir S

    2015-01-01

    AIM: To assess the feasibility and safety of liquid nitrogen spray cryoablation at the duodenal papilla in a porcine model. METHODS: This prospective study protocol was approved by the University of Florida Institutional Animal Care and Use Committee. Six pigs underwent liquid nitrogen spray cryotherapy at the duodenal papilla. Freeze time of 20-s was applied per cycle (4 cycles/session). Survival animals (n = 4) were monitored for adverse events. Hemoglobin, white blood count, liver tests, and lipase were obtained at baseline and post-treatment. EGD was performed on day#7 to evaluate the papilla and for histology. All animals were euthanized and necropsy was performed at the end of the one-week survival period. Feasibility was defined as successful placement of the decompression tube in the duodenum, followed by delivery of spray cryotherapy to the duodenal papilla. Safety was determined by monitoring post-treatment blood tests and clinical course. Treatment effect was defined as endoscopic and histologic changes after cryotherapy. This was established by comparing endoscopic and histologic findings from mucosal biopsies prior to cryotherapy and on post-operative day (POD)#7. Full-thickness specimen was obtained post-mortem to assess depth of injury. RESULTS: Spray cryotherapy was feasible and successfully performed in all 6/6 (100%) animals. Cryospray with liquid nitrogen (four 20-s freeze-thaw cycles) at the duodenal papilla resulted in white frost formation at and around the target region. The mean procedural time was 54.5 min (range 50-58 min). All six animals studied had stable blood pressure, heart rate, and pulse oximetry measurements during the procedure. There were no significant intra-procedural adverse events. There were no significant differences in hemoglobin, white cell count, liver tests or lipase from baseline to post-cryotherapy. Survival animals were monitored daily post-operatively without any clinical ill effects from the cryotherapy. There was

  1. Duodenal villous morphology assessed using magnification narrow band imaging correlates well with histology in patients with suspected malabsorption syndrome.

    PubMed

    Dutta, Amit Kumar; Sajith, Kattiparambil Gangadharan; Shah, Gautam; Pulimood, Anna Benjamin; Simon, Ebby George; Joseph, Anjilivelil Joseph; Chacko, Ashok

    2014-11-01

    Narrow band imaging with magnification enables detailed assessment of duodenal villi and may be useful in predicting the presence of villous atrophy or normal villi. We aimed to assess the morphology of duodenal villi using magnification narrow band imaging and correlate it with histology findings in patients with clinically suspected malabsorption syndrome. Patients with clinical suspicion of malabsorption presenting at a tertiary care center were prospectively recruited in this diagnostic intervention study. Patients underwent upper gastrointestinal endoscopy using magnification narrow band imaging. The villous morphology in the second part of the duodenum was assessed independently by two endoscopists and the presence of normal or atrophic villi was recorded. Biopsy specimen was obtained from the same area and was examined by two pathologists together. The sensitivity and specificity of magnification narrow band imaging in detecting the presence of duodenal villous atrophy was calculated and compared to the histology. One hundred patients with clinically suspected malabsorption were included in this study. Sixteen patients had histologically confirmed villous atrophy. The sensitivity and specificity of narrow band imaging in predicting villous atrophy was 87.5% and 95.2%, respectively, for one endoscopist. The corresponding figures for the second endoscopist were 81.3% and 92.9%, respectively. The interobserver agreement was very good with a kappa value of 0.87. Magnification narrow band imaging performed very well in predicting duodenal villous morphology. This may help in carrying out targeted biopsies and avoiding unnecessary biopsies in patients with suspected malabsorption. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  2. 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.

  3. [An unusual case of duodenal sarcoidosis].

    PubMed

    Leroy, C; Girard, C; Girard-Madoux, M-H; Coppéré, B; Desmurs-Clavel, H; Pérard, L; Hot, A; Ninet, J

    2015-11-01

    Sarcoidosis is a systemic granulomatous disorder of unknown aetiology. It may rarely affect the gastrointestinal tract. We reported a 54-year-old woman with a delayed diagnosis of duodenal sarcoidosis. She presented with gastric and right upper abdominal pain associated with vomiting and marked weight loss. Abdominal computed tomographic scan showed non-compressive retroperitoneal lymph nodes and histological examination revealed non-caseating epithelioid granulomas typical of sarcoidosis. Diagnosis of duodenal sarcoidosis was obtained at the third gastroscopy. The patient's condition improved quickly with corticosteroid therapy. Gastrointestinal sarcoidosis should be looked for in patients with digestive symptoms and another sarcoid localisation. Furthermore, it is important to repeat gastroscopy to confirm diagnosis because treatment improved most patients. Copyright © 2015. Published by Elsevier SAS.

  4. 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

  5. Malignant colo-duodenal fistula; case report and review of the literature

    PubMed Central

    Soulsby, Ruth; Leung, Edmund; Williams, Nigel

    2006-01-01

    Background Colo-duodenal fistula is a rare complication of malignant and inflammatory bowel disease. Cases with malignant colo-duodenal fistulae can present with symptoms from the primary, from the fistula or from metastatic disease. The fistula often results in diarrhoea and vomiting with dramatic weight loss. Upper abdominal pain is usually present as is general malaise both from the presence of the disease and from the metabolic sequelae it causes. The diarrhoea relates to colonic bacterial contamination of the upper intestines rather than to a pure mechanical effect. Vomiting may be faeculant or truly faecal and eructation foul smelling but in the case reports this 'classic' symptomatology was often absent despite a fistula being present and patent enough to allow barium through it. Occasionally patients will present with a gastro-intestinal bleed. Case presentation We present an unusual case of colorectal carcinoma, where a 65 year old male patient presented with diarrhoea and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Adenocarcinoma was confirmed on histology from a biopsy obtained during the patient's oesophageogastroduodenoscopy, and the fistula was demonstrated in his barium enema. Staging computed tomography showed a locally advanced carcinoma of the proximal transverse colon, with a fistula to the duodenum and regional lymphadenopathy. The patient was also found to have subcutaneous metastasis. Following discussions at the multidisciplinary meeting, this patient was referred for palliation, and died within 4 months after discharge from hospital. Conclusion We present the case, discuss the management and review the literature. Colo-duodenal fistulae from colonic primaries are rare but early diagnosis may allow curative surgery. This case emphasises the importance of accurate staging and repeated clinical examination. PMID:17147825

  6. A duodenal role in gastrin release

    PubMed Central

    Hayes, J. R.; Ardill, Joy; Kennedy, T. L.; Buchanan, K. D.

    1974-01-01

    Observations on the plasma gastrin response to feeding protein in patients with the dumping syndrome, patients with pyloric stenosis, and patients asymptomatic after gastric surgery suggested that the duodenum might be important in the mechanism of gastrin release. This duodenal role was confirmed by the finding that when the stimulus was placed directly in the duodenum peak gastrin levels occurred earlier than when the stimulus was placed directly in the stomach. PMID:4422726

  7. The jugular bulb diverticulum. A radioanatomic investigation.

    PubMed

    Wadin, K; Wilbrand, H

    1986-01-01

    Two hundred and forty-five temporal bone specimens were examined radiographically. Subsequently the topographic relationship between the jugular fossa and surrounding structures was evaluated in plastic casts of the specimens. Fifty-eight casts showed a high jugular fossa and in 17 a jugular bulb diverticulum was found. A diverticulum is regarded as an anomaly of the high jugular bulb and presumably has a potential for expansion. Most frequently a diverticulum was directed medially into the space between the internal acoustic meatus, the vestibular aqueduct and the posterior cranial fossa. Seven diverticula reached the level of the internal acoustic meatus. Encroachment upon the vestibular aqueduct was seen in 4 casts and both the internal acoustic meatus and the cochlear aqueduct were very close to the diverticulum. A few diverticula were directed postero-laterally close to the facial canal and the stapedius muscle. The investigation was supplemented with a selected clinical material of radiographs of temporal bones with high fossae. The results corresponded to those of the experimental investigation. The jugular bulb diverticulum is a relatively common feature and should be regarded as an anomaly with a potential to give rise to clinical symptoms consequent to its intrusion upon surrounding structures.

  8. Ethnic Variations in Duodenal Villous Atrophy Consistent with Celiac Disease in the United States

    PubMed Central

    Krigel, Anna; Turner, Kevin O.; Makharia, Govind K.; Green, Peter HR; Genta, Robert M.; Lebwohl, Benjamin

    2016-01-01

    Background & Aims Celiac disease is a common disorder with a worldwide distribution, though the prevalence among different ethnicities varies. We aimed to measure the prevalence of duodenal villous atrophy among patients of different ethnicities throughout the United States (US). Methods We performed a cross-sectional study of all patients who had duodenal biopsies submitted to a national pathology laboratory between January 2, 2008 and April 30, 2015. The prevalence of villous atrophy was calculated for the following ethnicities, using a previously published algorithm based on patient names: North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish, and other Americans. Results Among all patients (n=454,885), the median age was 53 years and 66% were female. The overall prevalence of celiac disease was 1.74%. Compared to other Americans (n=380,163; celiac disease prevalence 1.83%), celiac disease prevalence was lower in patients of South Indian (n=177, 0%; P=.08), East Asian (n=4700, 0.15%; P=<.0001), and Hispanic (n=31,491, 1.06%; P=<.0001) ethnicities. Celiac disease was more common in patients from the Punjab region (n=617, 3.08%) than in others from North India (n=1195, 1.51%; P=.02). The prevalence of celiac disease among patients of Jewish (n=17,806, 1.80%; P=.78) and Middle Eastern (n=1903, 1.52%; P=.33) ethnicities was similar to that of other Americans. Among Jewish individuals (n=17,806), the prevalence of celiac disease was 1.83% in Ashkenazi persons (n=16,440) and 1.39% in Sephardic persons (n=1366; P=.24). Conclusions Among patients undergoing duodenal biopsy, individuals from the Punjab region of India constitute the ethnic group in the US with the highest prevalence of villous atrophy consistent with celiac disease. Compared to other Americans, villous atrophy prevalence on duodenal biopsy is significantly lower among US residents of South Indian, East Asian, and Hispanic ancestry. PMID:27155557

  9. Ethnic Variations in Duodenal Villous Atrophy Consistent With Celiac Disease in the United States.

    PubMed

    Krigel, Anna; Turner, Kevin O; Makharia, Govind K; Green, Peter H R; Genta, Robert M; Lebwohl, Benjamin

    2016-08-01

    Celiac disease is a common disorder with a worldwide distribution, although the prevalence among different ethnicities varies. We aimed to measure the prevalence of duodenal villous atrophy among patients of different ethnicities throughout the United States. We performed a cross-sectional study of all patients who had duodenal biopsies submitted to a national pathology laboratory between January 2, 2008 and April 30, 2015. The prevalence of villous atrophy was calculated for the following ethnicities by using a previously published algorithm based on patient names: North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish, and other Americans. Among all patients (n = 454,885), the median age was 53 years, and 66% were female. The overall prevalence of celiac disease was 1.74%. Compared with other Americans (n = 380,163; celiac disease prevalence, 1.83%), celiac disease prevalence was lower in patients of South Indian (n = 177, 0%; P = .08), East Asian (n = 4700, 0.15%; P ≤ .0001), and Hispanic (n = 31,491, 1.06%; P ≤ .0001) ethnicities. Celiac disease was more common in patients from the Punjab region (n = 617, 3.08%) than in patients from North India (n = 1195, 1.51%; P = .02). The prevalence of celiac disease among patients of Jewish (n = 17,806, 1.80%; P = .78) and Middle Eastern (n = 1903, 1.52%; P = .33) ethnicities was similar to that of other Americans. Among Jewish individuals (n = 17,806), the prevalence of celiac disease was 1.83% in Ashkenazi persons (n = 16,440) and 1.39% in Sephardic persons (n = 1366; P = .24). Among patients undergoing duodenal biopsy, individuals from the Punjab region of India constitute the ethnic group in the United States with the highest prevalence of villous atrophy consistent with celiac disease. Compared with other Americans, villous atrophy prevalence on duodenal biopsy is significantly lower among U.S. residents of South Indian, East Asian, and Hispanic ancestry. Copyright © 2016 AGA

  10. The ultrastructural characteristics of the hair bulb of segmented heterochromia in the scalp hair.

    PubMed

    Sohn, Seonghyang; Lee, Joong Sun; Lee, Eun-So; Yoon, Kyeong Han; Kang, Hee Young

    2004-01-01

    Segmented heterochromia is a pigmentary disorder characterized by alternating dark and light segments on each hair shaft. Our aim was to observe the ultrastructure of hair shafts and bulbs to understand the pathogenesis of the disease. Biopsy specimens including normal or diseased hair follicles were prepared for transmission electron microscopy. In dark segments, dense and ellipsoidal melanosomes were noted while small, round ones were found in the light segments. Two groups of melanosomes lined up on the matrix, one of which was composed of compact ellipsoidal melanosomes, and the other was composed of melanosomes with irregular sizes and shapes. Melanocytes seemed to be under necrosis, apoptosis, or dark cell transformation. Langerhans cells were found in the bulb. Two kinds of melanosomes were produced in the same hair bulb simultaneously. Degenerating melanocytes might produce deformed melanosomes. Langerhans cells might be involved in the death of melanocytes. It is unknown how either group of melanosomes is adopted and transferred to the hair cortex producing the characteristic pattern of pigmentation.

  11. Inferior vena caval filter strut perforation causing intramural duodenal haematoma

    PubMed Central

    Williams, Zoheb Berry; Organ, Nicole M.; Deane, Stephen

    2016-01-01

    We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means. Causes of duodenal haematoma include blunt trauma, haematologic malignancy, coagulopathy, percutaneous or endoscopic procedures, pancreatic pathology, peptic ulcer disease and aortoenteric fistula. Duodenal haematoma is rare and is usually managed conservatively or by percutaneous drainage. While this patient had a typical presentation, IVC filter strut perforation has not been described in the literature as a cause for duodenal haematoma. PMID:27887016

  12. A refractory duodenal ulcer with a biliary-duodenal fistula following the administration of bevacizumab.

    PubMed

    Horibe, Yohei; Adachi, Seiji; Okuno, Mitsuru; Ohno, Tomohiko; Goto, Naoe; Iwama, Midori; Yamauchi, Osamu; Saito, Koshiro; Yasuda, Ichiro; Shimizu, Masahito

    2016-07-01

    A 65-year-old woman with recurrent breast cancer was repeatedly treated with bevacizumab, an anti-VEGF antibody. In addition, she was also frequently prescribed a nonsteroidal anti-inflammatory drug for abdominal pain. Melena was revealed 2 months after the final treatment with bevacizumab, and an endoscopic study revealed a duodenal ulcer (DU) that was resistant to anti-ulcer therapy. A cholangiography identified a biliary-duodenal fistula with bile juice leaking from the ulcer base. Therefore, a biliary stent was placed into the common bile duct for 3 months until the DU healed. This is the first case of a refractory DU with a biliary-duodenal fistula in a patient treated with bevacizumab.

  13. Partial regression of duodenal lesions of intestinal follicular lymphoma after antibiotic treatment.

    PubMed

    Yaguchi, Tomonori; Imaeda, Hiroyuki; Kizaki, Masahiro; Hosoe, Naoki; Suzuki, Hidekazu; Ogata, Haruhiko; Iwao, Yasushi; Kameyama, Kaori; Ikeda, Yasuo; Hibi, Toshifumi

    2010-10-01

    A 51-year-old man was referred to our hospital because of duodenal lesions of lymphoma. Endoscopy showed multiple tiny smooth whitish granules in the second portion of the duodenum including the papilla of Vater. Biopsy specimens showed medium-sized centrocyte-like cells forming lymphoid follicles, and immunohistology showed positive staining for bcl-2 and CD10. A small bowel series showed multiple granular lesions extending from the second portion of the duodenum to the proximal jejunum and the proximal ileum. On the basis of these findings, the tumor was diagnosed as stage I follicular lymphoma (FL). Although the patient was negative for Helicobacter pylori, he underwent antibiotic treatment. The lesions improved 3 months after antibiotic treatment, but biopsy specimens showed residual lymphoma cells. The patient therefore received combination chemotherapy with rituximab. Endoscopy 4 months later showed regression of FL, and there was no evidence of recurrence during 3 years of follow up. The partial regression of duodenal lesions of intestinal FL may be due to the effect of antibiotic treatment.

  14. Association of Tissue Transglutaminase Antibody Titer with Duodenal Histological Changes in Children with Celiac Disease

    PubMed Central

    Al-Zoubi, Basim

    2016-01-01

    Celiac disease is usually diagnosed by demonstrating gluten enteropathy in small bowel biopsy. Celiac specific antibodies are used as an initial screening test. The goal of this study is to test the relationship of the anti-tTG titer and severity of histological changes in Jordanian children with celiac disease. Method. The medical records of 81 children who had elevated anti-tTG titer and had duodenal biopsies available were retrospectively reviewed. Result. Assessing the association of anti-tTG titer with duodenal histopathological changes, 94% of those with high anti-tTG titer (≥180 U/mL) had histological evidence of celiac disease. There was statistically significant positive association between high anti-tTG titer and Marsh grading as 82% of patients with Marsh III had high anti-tTG titer (Chi2 18.5; P value 0.00; Odds Ratio 8.5). The fraction of patients with Marsh III who were correctly identified as positive by anti-tTG titer ≥ 180 U/mL was high (sensitivity = 81.6). Moreover, the fraction of patients with anti-tTG titer ≥ 180 U/mL who had Marsh III was also high (positive predictive value = 78.4). Conclusion. Anti-tTG titer ≥ 180 U/mL had significant positive association with Marsh III histopathological changes of celiac disease. PMID:27867394

  15. More Distally Located Duodenal Webs: A Case Series

    PubMed Central

    Gupta, Rahul; Mathur, Praveen; Gubbi, Sharanabasappa; Gupta, Pradeep Kumar; Shukla, Ramendra; Bhandari, Anu

    2016-01-01

    Duodenal atresia is a frequent cause of intestinal obstruction in the newborn. Obstruction due to duodenal web is infrequent, but its location other than second part of duodenum is rare with only a few cases reported in the literature. We are reporting three patients where we found duodenal webs at unusual locations. In one neonate the web was located at third part of duodenum and in other two patients the web was present at duodeno-jejunal junction (DJ). PMID:27896164

  16. Postoperative Gastric Perforation in a Newborn with Duodenal Atresia

    PubMed Central

    Antabak, Anko; Bogović, Marko; Vuković, Jurica; Grizelj, Ruža; Babić, Vinka Barbarić; Papeš, Dino; Luetić, Tomislav

    2016-01-01

    Gastric perforation (GP) in neonates is a rare entity with high mortality. Although the etiology is not completely understood, it mostly occurs in premature neonates on assisted ventilation. Combination of duodenal atresia and gastric perforation is very rare. We present a case duodenal atresia who developed gastric perforation after operetion for duodenal atresia. Analysis of the patient medical record and histology report did not reveal the etiology of the perforation. PMID:27896170

  17. Russell body duodenitis with immunoglobulin kappa light chain restriction.

    PubMed

    Munday, William R; Kapur, Lucy Harn; Xu, Mina; Zhang, Xuchen

    2015-01-16

    Russell bodies are eosinophilic intracytoplasmic globules which are likely the result of disturbed secretion of immunoglobulins that accumulate within the plasma cell. Russell body collections have been identified within the stomach, known as Russell body gastritis. Similar lesions within the duodenum are referred to as Russell body duodenitis, which is rare. Several Russell body gastritis case reports are associated with Helicobacter pylori. However, the etiology of Russell body duodenitis remains unclear. Here we report the first case of Russell body duodenitis with immunoglobulin light chain restriction in a background of peptic duodenitis.

  18. [Melatonin production in patients with duodenal ulcer at different stages of disease].

    PubMed

    Komarov, F I; Rapoport, S I; Malinovskaia, N K; Voznesenskaia, L A; Sharov, A A; Vetterberg, L

    1998-01-01

    Melatonin secretion was measured in patients with duodenal ulcer in exacerbation and remission. Melatonin production was found abnormal both in duodenal ulcer remission and exacerbation. It is suggested that melatonin may participate in pathogenesis of duodenal ulcer.

  19. Experimental Measurement to Determine Fine Dry-Bulb and Wet-Bulb Thermocouple Response Times

    DTIC Science & Technology

    2004-12-20

    constants were calculated by first using Statistica software to find the range of time during which the change in temperature takes place. After the...temperature before and after the change for both the dry-bulb and the wet-bulb were determined, the data were graphed and the initial and final temperatures...bias, B, and experimental standard error of the mean, Sz, was determined from: URSS = [B2 + (t95S•)2Y1 (20) where t95 = Student t statistic for a

  20. 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.

  1. [Mortality of cattle following feeding of moldy flower bulbs].

    PubMed

    Peperkamp, N H; Gruys, E; Joosten, A; Peeters, H; Sybesma, J; Notermans, S H; Haagsma, J

    1992-03-15

    Five of eight meat cattle died suddenly without showing prior symptoms of disease. The sudden death occurred in connection with the feeding of mouldy tulip bulbs. A short review is given of the use of flower bulbs as cattle feed, the use of herbicides/fungicides in bulb cultivation, and the relevant legislation. Several toxicological aspects that should be taken into consideration when flower bulbs are used as cattle feed are discussed. Both the Central Veterinary Institute and the State Institute for Public Health and Environmental Hygiene showed, in experiments with mice, the presence of a toxin in extracts of the mouldy tulip bulbs. This toxin is probably produced by moulds present in the tulip bulbs. The death of the animals was probably caused by an as yet unidentified mycotoxin.

  2. The photosensitizing potential of compact fluorescent vs incandescent light bulbs.

    PubMed

    Chignell, Colin F; Sik, Robert H; Bilski, Piotr J

    2008-01-01

    Recently an article about the new energy-saving compact fluorescent light (CFL) bulbs appeared in Parade magazine [Rosenfeld, I. (2008) Parade Feb 3, 22]. Under the heading "Bright Lights, Bad Headache?" the writer states that "new research suggests some dangers" involving these lights because they are fluorescent and "can aggravate skin rashes in people with lups, eczema, dermatitis or porphyria." We measured the emission spectrum of a 14 W compact fluorescent bulb (with the same luminous flux as a 60 W incandescent bulb) and compared it to 60 W soft white incandescent and cool white fluorescent (CWF) bulbs. Our results clearly show that the spectral irradiance of the compact fluorescent bulb is similar to that of the CWF bulb; both exhibit sharp Hg emission lines at 365 nm (very weak), 404 nm (weak), 435 nm (moderate) and 543 nm (strong). In contrast, the emission of the incandescent bulb begins at 375 nm and then increases monotonically to above 750 nm. From their respective absorption spectra we calculated the potential photosensitization indices of protoporphyrin IX (PPIX; a prototypic porphyria skin photosensitizer) and riboflavin (a putative lens photosensitizer) vs 14 W compact fluorescent, CWF and 60 W incandescent bulbs. A higher photosensitization index would indicate a greater chance that the light/photosensitizer combination would cause photosensitization of the skin or eyes. We found that for PPIX and riboflavin the photosensitization index of the compact fluorescent bulb is less than half that of the 60 W incandescent bulb. These results suggest that substitution of a compact fluorescent bulb for an incandescent bulb of the same luminous flux should not increase the phototoxicity of skin porphyrins or lens riboflavin.

  3. An improved storage bulb mount for DSN hydrogen masers

    NASA Technical Reports Server (NTRS)

    Dachel, P. R.; Russell, D. P.; Tucker, T. K.; Stratman, L. B.

    1979-01-01

    The presently used JPL hydrogen maser suspended atomic storage bulb and a rigid, single-plane mounted bulb are compared. The new bulb incorporates three major design changes: (1) mounting design; (2) alterations to the collimator; and (3) decrease in mass. These design changes are expected to increase the long-term stability of the frequency standard by reducing its sensitivity to vibration and thermal effects.

  4. Sentinel node biopsy (image)

    MedlinePlus

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  5. 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 ...

  6. Standards for prostate biopsy

    PubMed Central

    Bjurlin, Marc A.; Taneja, Samir S.

    2014-01-01

    Purpose of review A variety techniques have emerged for optimization of prostate biopsy. In this review, we summarize and critically discuss the most recent developments regarding the optimal systematic biopsy and sampling labeling along with multiparametric MRI and MR targeted biopsies. Recent findings The use of 10–12-core extended-sampling protocols increases cancer detection rates compared to traditional sextant sampling and reduces the likelihood that patients will require a repeat biopsy, ultimately allowing more accurate risk stratification without increasing the likelihood of detecting insignificant cancers. As the number of cores increases above 12 cores, the increase in diagnostic yield becomes marginal. However, limitations of this technique include undersampling, over-sampling, and the need for repetitive biopsy. MRI and MR-targeted biopsies have demonstrated superiority over systematic biopsies for the detection of clinically significant disease and representation of disease burden, while deploying fewer cores and may have applications in men undergoing initial or repeat biopsy and those with low risk cancer on or considering active surveillance. Summary A 12-core systematic biopsy that incorporates apical and far-lateral cores in the template distribution allows maximal cancer detection, avoidance of a repeat biopsy, while minimizing the detection of insignificant prostate cancers. MRI guided prostate biopsy has an evolving role in both initial and repeat prostate biopsy strategies, as well as active surveillance, potentially improving sampling efficiency, increasing detection of clinically significant cancers, and reducing detection of insignificant cancers. PMID:24451092

  7. Evaluation of a new method for routine in vitro cultivation of Giardia lamblia from human duodenal fluid.

    PubMed Central

    Gordts, B; Hemelhof, W; Van Tilborgh, K; Retoré, P; Cadranel, S; Butzler, J P

    1985-01-01

    Although a method for in vitro cultivation of Giardia lamblia was described as early as 1927, only a few clinical isolates were cultured in vitro due to the complexity of the techniques. We developed a method which allows for the routine isolation of Giardia trophozoites from human duodenal fluid and maintenance of the organisms in axenic culture. This study evaluates the method in 198 patients. Seventeen strains of Giardia were isolated and cultivated axenically. The method was more sensitive than the microscopic examination of aspirated fluid and examination of an impression of mucosal biopsy. Five patients, however, excreted cysts in the stool, although no trophozoites could be demonstrated in the duodenal fluid. G. lamblia were cultivated from one patient who did not excrete cysts. The method will enable the collection of G. lamblia strains from clinical material in large numbers and can offer an important advance in epidemiological, biochemical, immunological, and therapeutic investigations of giardiasis. PMID:4056001

  8. [Duodenal complications of rheumatoid purpura. Endoscopic aspects].

    PubMed

    Chapoy, P; Guidon, M J; Louchet, E

    1984-01-01

    The aim of this work was to describe the endoscopic features and clinical outcome of the duodenal complications in anaphylactoid purpura. Over a 3-year period, 20 patients were hospitalized in our unit because of purpura rheumatica. Duodenal complications occurred in 5 cases warranting endoscopic assessment. All patients had bilious vomiting and epigastric pain, constantly associated with low-grade purpuric rash. Plasma factor XIII concentrations were always decreased. The duodenal complication was suspected radiologically in 2 cases when "thumbprint" impressions were seen. Petechiae, oedema and intramural hematoma with superficial erosions were present endoscopically in 3 cases. The lesions were severe and extensive, involving the entire duodenum in 3 cases and the jejunum in one case. In one patient, there was a stricture of the upper part of the second duodenum. Treatment consisted of parenteral nutrition (using a central catheter: 3 cases, or a peripheral vein: 2 cases) and cimetidine (30 mg/kg.bw). The clinical outcome was favorable in 4 patients; the symptoms vanished and the endoscopic lesions were reversible (including the stricture) with restitutio ad integrum after 10 days. The last patient died the 8th day of treatment, 3 days after digestive improvement; the cause of death was probably iatrogenic and related to accidental migration of the central catheter. These results suggest that endoscopic examination should be performed in all patients with anaphylactoid purpura presenting with bilious vomiting. Endoscopy seems to be of great value in deciding if parenteral nutrition is indicated--or not--and perhaps in order to contraindicate the use of steroid therapy in the case of ulcerated hematomas.

  9. Emergency Pancreaticoduodenectomy in Duodenal Paraganglioma: Case Report

    PubMed Central

    Parray, Fazl Q.; Lone, Iqbal M.; Chowdri, Nisar A.; Wani, Imtiaz; Wani, Mehmood A.; Gulzar, G. M.; Thakur, Natasha

    2011-01-01

    Duodenal gangliocytic paraganglioma (DGP) is a rare tumor that characteristically occurs in the second part of duodenum. These appear as submucosal masses that protrude into the lumen of a duodenum. Gastrointestinal bleeding is the commonest manifestation of DGP. Metastatic spread to regional lymph nodes occurs rarely. Surgical resection is the treatment of choice for DGP. A case of a DGP is reported in young female who presented with a recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy (UGIE) documented a mass in the ampullary region with ulceration in its middle which was bleeding. Recurrent gastrointestinal bleeding necessitated an emergency pancreaticoduodenectomy. Histopathology of specimen documented gangliocytic paraganglioma. PMID:22084750

  10. Emergency pancreaticoduodenectomy in duodenal paraganglioma: case report.

    PubMed

    Parray, Fazl Q; Lone, Iqbal M; Chowdri, Nisar A; Wani, Imtiaz; Wani, Mehmood A; Gulzar, G M; Thakur, Natasha

    2011-01-01

    Duodenal gangliocytic paraganglioma (DGP) is a rare tumor that characteristically occurs in the second part of duodenum. These appear as submucosal masses that protrude into the lumen of a duodenum. Gastrointestinal bleeding is the commonest manifestation of DGP. Metastatic spread to regional lymph nodes occurs rarely. Surgical resection is the treatment of choice for DGP. A case of a DGP is reported in young female who presented with a recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy (UGIE) documented a mass in the ampullary region with ulceration in its middle which was bleeding. Recurrent gastrointestinal bleeding necessitated an emergency pancreaticoduodenectomy. Histopathology of specimen documented gangliocytic paraganglioma.

  11. Microscopic colitis in patients with mild duodenal damage: A new clinical and pathological entity (“lymphocytic enterocolitis”)?

    PubMed Central

    Bonagura, Gabriele Antonio; Ribaldone, Davide Giuseppe; Fagoonee, Sharmila; Sapone, Nicoletta; Caviglia, Gian Paolo; Saracco, Giorgio Maria; Astegiano, Marco; Pellicano, Rinaldo

    2016-01-01

    AIM To evaluate the potential association between mild duodenal damage and microscopic colitis (MC). METHODS We retrospectively included 105 consecutive patients with type I Marsh-Oberhuber duodenal damage and negativity for immunoglobulin A anti-endomysium and anti-tissue transglutaminase. The following parameters were analyzed: Sex, age at execution of esophagogastroduodenoscopy, duodenal damage, and number of intraepithelial lymphocytes at biopsies, prevalence of Helicobacter pylori infection, age at execution of colonoscopy, macroscopic and microscopic features of colonoscopy, family history of gastrointestinal and autoimmune diseases, smoking habits, biochemical parameters of inflammation and autoimmunity, use of proton pump inhibitors or nonsteroidal anti-inflammatory drugs, adverse reactions to drugs or foods, pathologies known to be associated with celiac disease or MC, living on a gluten-free diet or on a gluten-low diet for at least 1 mo. RESULTS Colonoscopy was performed in 59 patients, but only in 48 of them biopsies were taken in the entire colon. Considering the latter cohort, the diagnosis of MC was met in 25 (52.1%) patients while in 18 patients other pathologic findings were reported: 13 (27%) cases of nonspecific inflammatory bowel disease, 2 (4.2%) cases of Crohn’s disease, 2 (4.2%) cases of eosinophilic gastroenteritis, and 1 (2.1%) case of autoimmune enteritis. Five (10.4%) patients had a normal colonoscopic result. Matching the groups by age, and considering only patients who underwent colonoscopy (42.7 ± 15.5 years) vs those who did not undergo colonoscopy (36.9 ± 10.6 years), a statistical difference was found (P = 0.039). Focusing on symptoms, diarrhea was statistically more prevalent in MC group than in patients who did not undergo colonoscopy (P = 0.03). CONCLUSION Mild duodenal damage is associated with MC in more than half of the cases. This association supports the hypothesis of a link between these two entities. PMID:27895976

  12. Cold snare piecemeal resection of colonic and duodenal polyps ≥1 cm

    PubMed Central

    Choksi, Neel; Elmunzer, B. Joseph; Stidham, Ryan W.; Shuster, Dmitry; Piraka, Cyrus

    2015-01-01

    Background: Endoscopic removal of duodenal and colorectal adenomas is currently considered to be the standard of care for prevention of adenocarcinoma. The use of cautery carries a risk of delayed bleeding, post-polypectomy syndrome, and perforation. We examined the safety and feasibility of removing colonic and duodenal polyps ≥ 1 cm using a piecemeal cold snare polypectomy technique. Patients: The study included 15 patients with duodenal polyps ≥ 1 cm and 15 patients with colonic polyps ≥ 1 cm. Main outcome measurements: Bleeding, perforation, abdominal pain, or hospitalization occurring within 2 weeks of polypectomy. Results: Between 24 August 2011 and 29 April 2013, 15 patients had removal of duodenal polyps ≥ 1 cm. Mean patient age was 64 years and 9/15 patients were male. The mean polyp size was 24 mm (10 – 60 mm). All polyps were removed with a cold snare and some required cold biopsy forceps. One patient required hospitalization for gastrointestinal blood loss 7 days post-polypectomy; this patient was using Coumadin. Between 27 February 2012 and 30 May 2013, 15 patients underwent resection of a ≥ 1 cm colonic polyp. Mean patient age was 68 years and 9/15 were male. The mean polyp size was 20 mm (10 – 45 mm). All polyps were primarily removed with a cold snare. None of the patients required hemostatic clips for control of immediate bleeding. One patient presented to the emergency department with abdominal pain 1 day after initial endoscopy. CT scan showed no abnormalities and the patient was discharged. Conclusions: Cold snare polypectomy for large duodenal and colonic polyps is technically feasible and may have a favorable safety profile compared to standard electrocautery-based endoscopic resection. Comparative trials are required to determine the relative safety and efficacy of cold snare techniques for complete and durable resection of large polyps compared to standard hot snare methods. PMID:26528509

  13. Congenital duodenal obstruction due to a preduodenal portal vein.

    PubMed

    Pathak, D; Sarin, Yogesh Kumar

    2006-05-01

    Only about 80 cases of pre-duodenal portal vein (PDPV), a rare congenital anomaly of portal vein development that was first described by Knight in 1921, have been reported till date.[1] We report a neonate with duodenal obstruction caused by PDPV and briefly review the available literature.

  14. 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.

  15. Physical activity at work and duodenal ulcer risk.

    PubMed Central

    Katschinski, B D; Logan, R F; Edmond, M; Langman, M J

    1991-01-01

    To determine whether the social class differences in duodenal ulcer frequency may be explained by differences in physical activity at work, the energy expenditure during work, smoking habits, and social class were compared in 76 recently diagnosed duodenal ulcer patients and in age and sex matched community controls. As anticipated, the relative risk of duodenal ulcer showed significant associations with smoking and social class. Social class and physical activity at work were associated with one another. After adjusting for age, sex, smoking, and social class, physically active work was still associated with duodenal ulcer, with relative risks for moderate and high activity compared with sedentary work being 1.3 (0.6-3.0) and 3.6 (1.3-7.8) respectively. Within each social class stratum, the relative risk of having a duodenal ulcer was greater in those with a high level of occupational activity than in those undertaking sedentary work. PMID:1916502

  16. A case of a duodenal duplication cyst presenting as melena

    PubMed Central

    Ko, Seung Yeon; Ko, Sun Hye; Ha, Sungeun; Kim, Mi Sung; Shin, Hyang Mi; Baeg, Myong Ki

    2013-01-01

    Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population, but seldom in adults. Symptoms depend on the type and location and can present as abdominal pain, distension, dysphagia or dyspepsia. They have been reported to be responsible for duodenal obstruction, pancreatitis and, in rare cases, gastrointestinal bleeding. We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena. Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus. However, the patient began passing melena after 3 d, with an acute decrease in hemoglobin levels. Subsequent studies revealed a duplication cyst in the second portion of the duodenum which was surgically resected. Histology revealed a duodenal duplication cyst consisting of intestinal mucosa. There was no further bleeding and the patient recovered completely. In rare cases, duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis. PMID:24151370

  17. Non-classified type duodenal atresia: case report.

    PubMed

    Aydin, Emrah

    2015-01-01

    Our aim is to present a case with initial diagnosis of non-classified type duodenal atresia operated in our clinic. A patient with prenatally suspected to be duodenal atresia was explored. At laparotomy type 3 duodenal atresia was found between 2(nd) and 3(rd) parts of duodenum. In addition, a web was detected distal to the atresic part. Duodenoduodenostomy together with web excision was performed. He had not any additional pathology. Although duodenal atresia is a very well known pathology by pediatric surgeons, though rarely a non-classified type duodenal atresia can be encountered. Possible presence of a second atresia should be kept in mind, proximal and distal segments of the duodenum and intestinal passage must be explored carefully for the presence of second atresic segment before performing duodenoduodenostomy.

  18. How the Energy Independence and Security Act of 2007 Affects Light Bulbs

    EPA Pesticide Factsheets

    Inefficient light bulbs are being phased out under the New Light Bulb Law. It does not sweepingly ban incandescent bulbs, just those not energy efficient (with some exemptions). It also includes many provisions not pertaining to lighting.

  19. Abdominal wall fat pad biopsy

    MedlinePlus

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... method of taking an abdominal wall fat pad biopsy . The health care provider cleans the skin on ...

  20. Interdigestive gastroduodenal manometry in humans. Indication of duodenal phase III as a retroperistaltic pump.

    PubMed

    Björnsson, E S; Abrahamsson, H

    1995-03-01

    To elucidate the specific function of the three phases (I-III) of the migrating motor complex (MMC) by manometry, detailed analysis of individual pressure waves in the proximal duodenum was performed. Twenty healthy subjects (10 men and 10 women of whom 11 were tube-naive) underwent computerized manometry for 5 h during fasting followed by 45 min after a meal using an 8-channel water perfused catheter. Three recording points were in the antrum, three in the proximal duodenum (2 cm apart), one in the distal duodenum and one in the proximal jejunum. In all subjects at least one phase III (median 2) was observed during the 5-h fasting recording. In the proximal duodenum the mean proportion of retrograde pressure waves, out of all propagating waves, was significantly increased in the last part of phase III (85 +/- 9%, mean, SE), compared with early phase III (6 +/- 5%), late phase II (5 +/- 4%) and the feeding phase (10 +/- 5%), irrespective of gender or previous tube-experience. The median length of the MMCs was 108.5 min. There was no statistically significant difference between men and women or between tube-naive and tube-experienced subjects for the duodeno-jejunal motility indices of phase II and phase III, nor for duration or migration of phase III. The postprandial motility index of the small intestine was increased compared with the interdigestive late phase II, particularly in the jejunum (P < 0.02). The last part of the duodenal interdigestive phase III in healthy subjects shows the feature of a retrosperistaltic pump. This cyclic sequence of retropropagation coincides with the reported rapid alkalinization of the duodenal bulb and the gastric antrum occurring in early antral phase I.

  1. 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

  2. Duodenal fat intensifies the perception of heartburn

    PubMed Central

    Meyer, J; Lembo, A; Elashoff, J; Fass, R; Mayer, E

    2001-01-01

    BACKGROUND—Patients with gastro-oesophageal reflux disease (GORD) frequently report that meals high in fat worsen heartburn. Nevertheless, studies to determine whether high fat meals promote gastro-oesophageal reflux have produced conflicting and equivocal conclusions.
PATIENTS AND METHODS—To determine, alternatively, whether fat in the small intestinal lumen intensifies the perception of heartburn, we studied 11 patients with typical heartburn from GORD. After being placed on omeprazole to suppress endogenous acid, these fasting subjects underwent oesophageal perfusions with graded doses of HCl at pH values of 1.0, 1.5, 2.0, and 2.5. Oesophageal perfusions were conducted while the duodenum was perfused with saline (control) and again with fat at 8 g/h.
RESULTS—Time to onset, intensity, and severity of heartburn varied with dose of oesophageal acid (p<0.01). Time to onset was significantly (p<0.01) shorter, and intensity and severity of heartburn significantly (p<0.05) greater, during duodenal perfusion with fat.
CONCLUSION—We conclude that duodenal fat intensifies the perception of heartburn.


Keywords: gastro-oesophageal reflux disease; heartburn; perception; fat PMID:11600463

  3. New treatment of vertigo caused by jugular bulb abnormalities.

    PubMed

    Hitier, Martin; Barbier, Charlotte; Marie-Aude, Thenint; Moreau, Sylvain; Courtheoux, Patrick; Patron, Vincent

    2014-08-01

    Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo can be very disabling and may need surgical treatments with risk of hearing loss, major bleeding or facial palsy. Hence, we have developed a new treatment for vertigo caused by jugular bulb anomalies, using an endovascular technique. Three patients presented with severe vertigos mostly induced by high venous pressure. One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone computed tomography scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence and compression of the vestibular aqueduct in all cases. We plugged the upper part of the bulb with coils, and we used a stent to maintain the coils and preserving the venous permeability. After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing return to work. The 3-month arteriographs showed good permeability of the sigmoid sinus and jugular bulb through the stent, with complete obstruction of the upper part of the bulb in all cases. Disabling vertigo induced by jugular bulb abnormalities can be effectively treated by an endovascular technique. This technique is minimally invasive with a probable greater benefit/risk ratio compare with surgery. © The Author(s) 2013.

  4. 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…

  5. Exogenous ethylene inhibits sprout growth in onion bulbs

    PubMed Central

    Bufler, Gebhard

    2009-01-01

    Background and Aims Exogenous ethylene has recently gained commercial interest as a sprouting inhibitor of onion bulbs. The role of ethylene in dormancy and sprouting of onions, however, is not known. Methods A cultivar (Allium cepa ‘Copra’) with a true period of dormancy was used. Dormant and sprouting states of onion bulbs were treated with supposedly saturating doses of ethylene or with the ethylene-action inhibitor 1-methylcyclopropene (1-MCP). Initial sprouting was determined during storage at 18 °C by monitoring leaf blade elongation in a specific size class of leaf sheaths. Changes in ATP content and sucrose synthase activity in the sprout leaves, indicators of the sprouting state, were determined. CO2 and ethylene production of onion bulbs during storage were recorded. Key results Exogenous ethylene suppressed sprout growth of both dormant and already sprouting onion bulbs by inhibiting leaf blade elongation. In contrast to this growth-inhibiting effect, ethylene stimulated CO2 production by the bulbs about 2-fold. The duration of dormancy was not significantly affected by exogenous ethylene. However, treatment of dormant bulbs with 1-MCP caused premature sprouting. Conclusions Exogenous ethylene proved to be a powerful inhibitor of sprout growth in onion bulbs. The dormancy breaking effect of 1-MCP indicates a regulatory role of endogenous ethylene in onion bulb dormancy. PMID:18940850

  6. 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…

  7. Geometric systematic prostate biopsy.

    PubMed

    Chang, Doyoung; Chong, Xue; Kim, Chunwoo; Jun, Changhan; Petrisor, Doru; Han, Misop; Stoianovici, Dan

    2017-04-01

    The common sextant prostate biopsy schema lacks a three-dimensional (3D) geometric definition. The study objective was to determine the influence of the geometric distribution of the cores on the detection probability of prostate cancer (PCa). The detection probability of significant (>0.5 cm(3)) and insignificant (<0.2 cm(3)) tumors was quantified based on a novel 3D capsule model of the biopsy sample. The geometric distribution of the cores was optimized to maximize the probability of detecting significant cancer for various prostate sizes (20-100cm(3)), number of biopsy cores (6-40 cores) and biopsy core lengths (14-40 mm) for transrectal and transperineal biopsies. The detection of significant cancer can be improved by geometric optimization. With the current sextant biopsy, up to 20% of tumors may be missed at biopsy in a 20 cm(3) prostate due to the schema. Higher number and longer biopsy cores are required to sample with an equal detection probability in larger prostates. Higher number of cores increases both significant and insignificant tumor detection probability, but predominantly increases the detection of insignificant tumors. The study demonstrates mathematically that the geometric biopsy schema plays an important clinical role, and that increasing the number of biopsy cores is not necessarily helpful.

  8. Modeling the wet bulb globe temperature using standard meteorological measurements.

    PubMed

    Liljegren, James C; Carhart, Richard A; Lawday, Philip; Tschopp, Stephen; Sharp, Robert

    2008-10-01

    The U.S. Army has a need for continuous, accurate estimates of the wet bulb globe temperature to protect soldiers and civilian workers from heat-related injuries, including those involved in the storage and destruction of aging chemical munitions at depots across the United States. At these depots, workers must don protective clothing that increases their risk of heat-related injury. Because of the difficulty in making continuous, accurate measurements of wet bulb globe temperature outdoors, the authors have developed a model of the wet bulb globe temperature that relies only on standard meteorological data available at each storage depot for input. The model is composed of separate submodels of the natural wet bulb and globe temperatures that are based on fundamental principles of heat and mass transfer, has no site-dependent parameters, and achieves an accuracy of better than 1 degree C based on comparisons with wet bulb globe temperature measurements at all depots.

  9. 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.

  10. Modeling the wet bulb globe temperature using standard meteorological measurements.

    SciTech Connect

    Liljegren, J. C.; Carhart, R. A.; Lawday, P.; Tschopp, S.; Sharp, R.; Decision and Information Sciences

    2008-10-01

    The U.S. Army has a need for continuous, accurate estimates of the wet bulb globe temperature to protect soldiers and civilian workers from heat-related injuries, including those involved in the storage and destruction of aging chemical munitions at depots across the United States. At these depots, workers must don protective clothing that increases their risk of heat-related injury. Because of the difficulty in making continuous, accurate measurements of wet bulb globe temperature outdoors, the authors have developed a model of the wet bulb globe temperature that relies only on standard meteorological data available at each storage depot for input. The model is composed of separate submodels of the natural wet bulb and globe temperatures that are based on fundamental principles of heat and mass transfer, has no site-dependent parameters, and achieves an accuracy of better than 1 C based on comparisons with wet bulb globe temperature measurements at all depots.

  11. 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

  12. Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection

    PubMed Central

    2011-01-01

    Background Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection. Methods From March 2005 till February 2010, we prospectively followed all patients with diffuse duodenal nodular lymphoid hyperplasia (DDNLH). Patients underwent esophagogastroduodenoscopy with targeted biopsies, colonoscopy, and small bowel video capsule endoscopy. Duodenal nodular lesions were graded from 0 to 4 based on their size and density. Patients were screened for celiac sprue (IgA endomysial antibody), immunoglobulin abnormalities (immunoglobulin levels & serum protein electrophoresis), small intestine bacterial overgrowth (lactulose hydrogen breath test), and Helicobacter pylori infection (rapid urease test, and histological examination of gastric biopsies). Patients infected with Helicobacter pylori received sequential antibiotic therapy and eradication of infection was evaluated by 14C urea breath test. Follow up duodenoscopies with biopsies were performed to ascertain resolution of nodular lesions. Results Forty patients (Males 23, females 17; mean age ± 1SD 35.6 ± 14.6 years) with DDNLH were studied. Patients presented with epigastric pain, vomiting, and weight loss. Esophagogastroduodenoscopy showed diffuse nodular lesions (size varying from 2 to 5 mm or more) of varying grades (mean score ± 1SD 2.70 ± 0.84) involving postbulbar duodenum. Video capsule endoscopies revealed nodular disease exclusively limited to duodenum. None of the patients had immunoglobulin deficiency or small intestine bacterial overgrowth or positive IgA endomysial antibodies. All patients were infected with Helicobacter pylori infection. Sequential antibiotic therapy eradicated Helicobacter pylori infection in 26 patients. Follow up duodenoscopies in these patients showed significant reduction of duodenal nodular lesions score (2.69 ± 0.79 to 1.50 ± 1

  13. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization

    PubMed Central

    2011-01-01

    Background Epidemiology of celiac disease (CD) is increasing. CD mainly presents in early childhood with small intestinal villous atrophy and signs of malabsorption. Compared to healthy individuals, CD patients seemed to be characterized by higher numbers of Gram-negative bacteria and lower numbers Gram-positive bacteria. Results This study aimed at investigating the microbiota and metabolome of 19 celiac disease children under gluten-free diet (treated celiac disease, T-CD) and 15 non-celiac children (HC). PCR-denaturing gradient gel electrophoresis (DGGE) analyses by universal and group-specific primers were carried out in duodenal biopsies and faecal samples. Based on the number of PCR-DGGE bands, the diversity of Eubacteria was the higher in duodenal biopsies of T-CD than HC children. Bifidobacteria were only found in faecal samples. With a few exceptions, PCR-DGGE profiles of faecal samples for Lactobacillus and Bifidobacteria differed between T-CD and HC. As shown by culture-dependent methods, the levels of Lactobacillus, Enterococcus and Bifidobacteria were confirmed to be significantly higher (P = 0.028; P = 0.019; and P = 0.023, respectively) in fecal samples of HC than in T-CD children. On the contrary, cell counts (CFU/ml) of presumptive Bacteroides, Staphylococcus, Salmonella, Shighella and Klebsiella were significantly higher (P = 0.014) in T-CD compared to HC children. Enterococcus faecium and Lactobacillus plantarum were the species most diffusely identified. This latter species was also found in all duodenal biopsies of T-CD and HC children. Other bacterial species were identified only in T-CD or HC faecal samples. As shown by Randomly Amplified Polymorphic DNA-PCR analysis, the percentage of strains identified as lactobacilli significantly (P = 0.011) differed between T-CD (ca. 26.5%) and HC (ca. 34.6%) groups. The metabolome of T-CD and HC children was studied using faecal and urine samples which were analyzed by gas-chromatography mass

  14. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization.

    PubMed

    Di Cagno, Raffaella; De Angelis, Maria; De Pasquale, Ilaria; Ndagijimana, Maurice; Vernocchi, Pamela; Ricciuti, Patrizia; Gagliardi, Francesca; Laghi, Luca; Crecchio, Carmine; Guerzoni, Maria Elisabetta; Gobbetti, Marco; Francavilla, Ruggiero

    2011-10-04

    Epidemiology of celiac disease (CD) is increasing. CD mainly presents in early childhood with small intestinal villous atrophy and signs of malabsorption. Compared to healthy individuals, CD patients seemed to be characterized by higher numbers of Gram-negative bacteria and lower numbers Gram-positive bacteria. This study aimed at investigating the microbiota and metabolome of 19 celiac disease children under gluten-free diet (treated celiac disease, T-CD) and 15 non-celiac children (HC). PCR-denaturing gradient gel electrophoresis (DGGE) analyses by universal and group-specific primers were carried out in duodenal biopsies and faecal samples. Based on the number of PCR-DGGE bands, the diversity of Eubacteria was the higher in duodenal biopsies of T-CD than HC children. Bifidobacteria were only found in faecal samples. With a few exceptions, PCR-DGGE profiles of faecal samples for Lactobacillus and Bifidobacteria differed between T-CD and HC. As shown by culture-dependent methods, the levels of Lactobacillus, Enterococcus and Bifidobacteria were confirmed to be significantly higher (P = 0.028; P = 0.019; and P = 0.023, respectively) in fecal samples of HC than in T-CD children. On the contrary, cell counts (CFU/ml) of presumptive Bacteroides, Staphylococcus, Salmonella, Shighella and Klebsiella were significantly higher (P = 0.014) in T-CD compared to HC children. Enterococcus faecium and Lactobacillus plantarum were the species most diffusely identified. This latter species was also found in all duodenal biopsies of T-CD and HC children. Other bacterial species were identified only in T-CD or HC faecal samples. As shown by Randomly Amplified Polymorphic DNA-PCR analysis, the percentage of strains identified as lactobacilli significantly (P = 0.011) differed between T-CD (ca. 26.5%) and HC (ca. 34.6%) groups. The metabolome of T-CD and HC children was studied using faecal and urine samples which were analyzed by gas-chromatography mass spectrometry

  15. Complications of prostate biopsy.

    PubMed

    Anastasiadis, Anastasios; Zapała, Lukasz; Cordeiro, Ernesto; Antoniewicz, Artur; Dimitriadis, Georgios; De Reijke, Theo

    2013-07-01

    Biopsy of the prostate is a common procedure with minor complications that are usually self-limited. However, if one considers that millions of men undergo biopsy worldwide, one realizes that although complication rate is low, the number of patients suffering from biopsy complications should not be underestimated and can be a clinically relevant problem for healthcare professionals. In this review, the authors present diagnosis and management of postbiopsy of prostate complications. Bleeding is the most common complication observed after prostate biopsy, but the use of aspirin or nonsteroidal anti-inflammatory drugs is not an absolute contraindication to prostate biopsy. Emerging resistance to ciprofloxacin is the most probable cause of the increasing risk of infectious complications after prostate biopsy. Even though extremely rare, fatal complications are possible and were described in case reports.

  16. Analysis of bone biopsies.

    PubMed

    Goodrich, J A; Difiore, R J; Tippens, J K

    1983-11-01

    The orthopedic surgeon is frequently confronted with the decision of when to perform a bone biopsy and whether to do a needle biopsy or an open biopsy. Frequently consultations are received from other services requesting bone biopsies with questionable indications. The indications and contraindications for performing bone biopsies are discussed as well as advantages and disadvantages of either closed or open technique. Four selective cases are discussed with illustrations. The challenge of undiagnosed osseous lesions is best met by rational evaluation of each individual case and coordinated with the team effort of the primary care physician, surgeon, pathologist, and radiologist. The decision for either an open or closed biopsy technique must be based on the experience and skills of the surgeon and pathologist.

  17. Utility of synovial biopsy

    PubMed Central

    2009-01-01

    Synovial biopsies, gained either by blind needle biopsy or minimally invasive arthroscopy, offer additional information in certain clinical situations where routine assessment has not permitted a certain diagnosis. In research settings, synovial histology and modern applications of molecular biology increase our insight into pathogenesis and enable responses to treatment with new therapeutic agents to be assessed directly at the pathophysiological level. This review focuses on the diagnostic usefulness of synovial biopsies in the light of actual developments. PMID:19951395

  18. Biopsies in oncology.

    PubMed

    de Bazelaire, C; Coffin, A; Cohen, S; Scemama, A; de Kerviler, E

    2014-01-01

    Imaging-guided percutaneous biopsies in patients in oncology provide an accurate diagnosis of malignant tumors. Percutaneous biopsy results are improved by correct use of sampling procedures. The risks of percutaneous biopsy are low and its complications are generally moderate. These risks can be reduced using aids such as blund tip introducers, hydrodissection and correct patient positioning. The multidisciplinary team meetings dialogue between oncologist, surgeon and radiologist correctly defines the indications in order to improve the treatment strategies.

  19. Acute Duodenal Obstruction After Percutaneous Placement of Metallic Biliary Stents: Peroral Treatment with Enteral Stents

    SciTech Connect

    Lopera, Jorge E. Alvarez, Oscar A.; Perdigao, Joseph; Castaneda-Zuniga, Wilfrido

    2003-09-15

    Three patients with malignant biliary obstruction were treated with placement of metallic biliary stents. Two patients had known partial duodenal stenosis but had no symptoms of gastrointestinal obstruction. The patients developed symptomatic duodenal obstruction early after biliary metallic stent placement. The symptomatic duodenal obstructions were successfully treated with peroral placement of duodenal stents, which obviated the need for surgical intervention.

  20. Colposcopy - directed biopsy

    MedlinePlus

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy Images Female reproductive anatomy Colposcopy-directed biopsy Uterus References American College of ...

  1. Evaluation of intestinal biopsies for pediatric enteropathy: a proposed immunohistochemical panel approach.

    PubMed

    Martin, Brock A; Kerner, John A; Hazard, Florette K; Longacre, Teri A

    2014-10-01

    Congenital enteropathies are rare disorders with significant clinical consequences; however, definitive diagnosis based on morphologic assessment of duodenal biopsies with routine stains alone is often impossible. To determine the role of immunohistochemistry (IHC) in the evaluation for microvillous inclusion disease, congenital tufting enteropathy (intestinal epithelial dysplasia), and enteroendocrine cell dysgenesis, a series of duodenal biopsies from 26 pediatric patients with chronic/intractable diarrhea was retrospectively reviewed. IHC stains for CD10, EpCAM, chromogranin, and villin were performed on all biopsies, and the results were correlated with hematoxylin and eosin and ultrastructural findings using electron microscopy, when available. Biopsies from 2 patients diagnosed with microvillous inclusion disease at the time of original biopsy demonstrated diffuse CD10-positive cytoplasmic inclusions within enterocytes and normal expression of EpCAM and chromogranin. Biopsies from 3 patients, including 2 siblings with confirmed EPCAM mutations, demonstrated complete loss of EpCAM expression and normal expression of CD10 and chromogranin; electron microscopic evaluation revealed characteristic ultrastructural findings of tufting enteropathy. Biopsies from 1 patient with a confirmed NEUROG3 mutation demonstrated an absence of intestinal enteroendocrine cells by chromogranin staining, consistent with enteroendocrine cell dysgenesis. Four patients' biopsies displayed nonspecific staining patterns for CD10 and/or EpCAM with normal expression of chromogranin, and 16 patients' biopsies exhibited normal expression for all 3 markers. Villin stains demonstrated heterogenous brush border labeling with nonspecific cytoplasmic reactivity, a pattern variably present throughout the biopsy series. In conclusion, the routine use of an IHC panel of CD10, EpCAM, and chromogranin is warranted in patients meeting specific age and/or clinical criteria, as the morphologic findings

  2. Modeling Olfactory Bulb Evolution through Primate Phylogeny

    PubMed Central

    Heritage, Steven

    2014-01-01

    Adaptive characterizations of primates have usually included a reduction in olfactory sensitivity. However, this inference of derivation and directionality assumes an ancestral state of olfaction, usually by comparison to a group of extant non-primate mammals. Thus, the accuracy of the inference depends on the assumed ancestral state. Here I present a phylogenetic model of continuous trait evolution that reconstructs olfactory bulb volumes for ancestral nodes of primates and mammal outgroups. Parent-daughter comparisons suggest that, relative to the ancestral euarchontan, the crown-primate node is plesiomorphic and that derived reduction in olfactory sensitivity is an attribute of the haplorhine lineage. The model also suggests a derived increase in olfactory sensitivity at the strepsirrhine node. This oppositional diversification of the strepsirrhine and haplorhine lineages from an intermediate and non-derived ancestor is inconsistent with a characterization of graded reduction through primate evolution. PMID:25426851

  3. Duodenal obstruction due to a preduodenal portal vein.

    PubMed

    Vilakazi, Mnc; Ismail, F; Swanepoel, H M; Muller, E W; Lockhat, Z I

    2014-01-01

    An infant presented with clinical signs and symptoms suggestive of a pyloric stenosis. On abdominal ultrasound, pyloric stenosis was excluded, and other causes for proximal duodenal obstruction, such as a duodenal web or annular pancreas, were suspected. At surgery, the cause was found to be due to an anterior portal vein or preduodenal portal vein, compressing the duodenum. There were no associated findings such as midgut malrotation, duodenal web and congenital anomalies. The treatment was a diamond-shaped duodeno-duodenostomy anterior to the portal vein. The patient improved after surgery.

  4. 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.

  5. Comparison of routinely used intestinal biopsy forceps in dogs: an ex vivo histopathological approach.

    PubMed

    Dahan, J; Semin, M O; Monton, C; Amiriantz, S; Concordet, D; Raymond-Letron, I; Dossin, O

    2017-03-01

    To compare the quality of duodenal and ileal samples obtained with different biopsy forceps. Fifteen dogs were included in a prospective ex vivo study. After euthanasia, the duodenum and the ileum were sampled with four different forceps and evaluated according to a standardised scoring system. The biopsy forceps evaluated had alligator jaws or cups with smooth edge with or without a needle. The global quality of the biopsies was better in the ileum that in the duodenum regardless of the biopsy forceps. Biopsy forceps with smooth edge including a needle resulted in fewer artefacts than biopsy forceps with smooth edge but no needle in both sites and those with alligator jaws without a needle provided deeper biopsies than those with smooth edge without a needle only in the duodenum. There was no effect of the biopsy forceps type on the size of the biopsies. Our findings may aid in choosing the appropriate type of forceps for intestinal biopsy. © 2017 British Small Animal Veterinary Association.

  6. 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

  7. Duodenal villous atrophy: a cause of chronic diarrhea after solid-organ transplantation.

    PubMed

    Weclawiak, H; Ould-Mohamed, A; Bournet, B; Guilbeau-Frugier, C; Fortenfant, F; Muscari, F; Sallusto, F; Dambrin, C; Esposito, L; Guitard, J; Abbal, M; Rostaing, L; Kamar, N

    2011-03-01

    Persistent diarrhea is commonly observed after solid organ transplantation (SOT). A few cases of mycophenolate mofetil (MMF)-induced duodenal villous atrophy (DVA) have been previously reported in kidney-transplant patients with chronic diarrhea. Herein, we report on the incidence and characteristics of DVA in SOT patients with chronic diarrhea. One hundred thirty-two SOT patients with chronic diarrhea underwent an oesophago-gastroduodenoscopy (OGD) and a duodenal biopsy after classical causes of diarrhea have been ruled out. DVA was diagnosed in 21 patients (15.9%). It was attributed to mycophenolic acid (MPA) therapy in 18 patients (85.7%) (MMF [n = 14] and enteric-coated mycophenolate sodium [n = 4]). MPA withdrawal or dose reduction resulted in diarrhea cessation. The incidence of DVA was significantly higher in patients with chronic diarrhea receiving MPA compared to those who did not (24.6% vs. 5.1%, p = 0.003). DVA was attributed to a Giardia lamblia parasitic infection in two patients (9.5%) and the remaining case was attributed to azathioprine. In these three patients, diarrhea ceased after metronidazole therapy or azathioprine dose reduction. In conclusion, DVA is a frequent cause of chronic diarrhea in SOT recipients. MPA therapy is the most frequent cause of DVA. An OGD should be proposed to all transplant recipients who present with persistent diarrhea. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  8. Investigating population risk factors of pancreatic cancer by evaluation of optical markers in the duodenal mucosa.

    PubMed

    Turzhitsky, Vladimir; Liu, Yang; Hasabou, Nahla; Goldberg, Michael; Roy, Hemant K; Backman, Vadim; Brand, Randall

    2008-01-01

    Pancreatic cancer screening has been hampered by the high rate of complications associated with interrogating the pancreas. The closest non-invasively accessible mucosa available for pancreatic cancer screening is the periampullary duodenal tissue. Our earlier report has shown the potential of using optical markers to interrogate this tissue for the presence of pancreatic cancer. In this study, we report a larger data set of low-coherence enhanced backscattering (LEBS) and elastic light scattering fingerprinting (ELF) optical markers from the periampullary duodenal mucosa. Optical measurements from biopsy samples were acquired from a total of 203 patients with varying clinical classification including healthy controls, a family history of pancreatic cancer, pancreatitis, mucinous cystic precursor lesions, pancreatic cancer, and other pancreatic malignancies. Evaluation of the performance of an independent testing set for discriminating healthy control patients from pancreatic cancer patients showed a 95% sensitivity, 71% specificity, and 85% area under the receiver operator characteristic (AUROC) curve. Importantly, this performance was uncompromised for detecting potentially curable stages of the disease. Additionally, optical markers in higher risk populations such as family history and pancreatitis had values between those of healthy control and pancreatic cancer patients, thus allowing for future investigations of screening from these high risk groups.

  9. Short food deprivation inhibits orexin receptor 1 expression and orexin-A induced intracellular calcium signaling in acutely isolated duodenal enterocytes.

    PubMed

    Bengtsson, Magnus W; Mäkelä, Kari; Herzig, Karl-Heinz; Flemström, Gunnar

    2009-03-01

    Close intra-arterial infusion of the appetite regulating peptide orexin-A stimulates bicarbonate secretion from the duodenal mucosa. The aim of the present study was to elucidate the ability of orexin-A to induce intracellular calcium signaling in acutely isolated duodenal enterocytes. Freshly isolated clusters of enterocytes, obtained from rat duodenal mucosa or human duodenal biopsies, were loaded with fura 2-AM and mounted in a perfusion chamber. Cryptlike enterocytes were selected (caged), and changes in intracellular calcium concentration ([Ca2+]i) were evaluated by fluorescence imaging. Total RNA was extracted from pellets of enterocytes and reverse transcribed to cDNA, and expression of orexin receptors 1 and 2 (OX1R and OX2R) was measured by quantitative real-time PCR. Orexin-A at all concentrations tested (1-100 nM) increased [Ca2+]i in enterocytes isolated from continuously fed rats, and the OX1R-antagonist SB-334867 (10 nM) attenuated the response. The primary [Ca2+]i response was a slow increase to a sustained plateau persisting after orexin-A removal, and a similar response was observed in enterocytes from human biopsies. In contrast to orexin-A, the OX2R agonist (Ala11,D-Leu15)-orexin-B (1-10 nM) did not induce calcium signaling. There were no significant [Ca2+]i responses in enterocytes from animals food deprived overnight, and overnight fasting decreased (P<0.01) enterocyte OX1R as well as OX2R mRNA. Induction of intracellular calcium signaling in isolated duodenal enterocytes is thus mediated primarily by OX1R receptors. Short (overnight) food deprivation markedly depresses receptor expression and inhibits orexin-A induced increases in [Ca2+]i. Studies of enterocyte signaling and intestinal secretion requires particular evaluation regarding feeding status.

  10. 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

  11. FLOWERING LOCUS T genes control onion bulb formation and flowering.

    PubMed

    Lee, Robyn; Baldwin, Samantha; Kenel, Fernand; McCallum, John; Macknight, Richard

    2013-01-01

    Onion (Allium cepa L.) is a biennial crop that in temperate regions is planted in the spring and, after a juvenile stage, forms a bulb in response to the lengthening photoperiod of late spring/summer. The bulb then overwinters and in the next season it flowers and sets seed. FLOWERING LOCUS T (FT) encodes a mobile signaling protein involved in regulating flowering, as well as other aspects of plant development. Here we show that in onions, different FT genes regulate flowering and bulb formation. Flowering is promoted by vernalization and correlates with the upregulation of AcFT2, whereas bulb formation is regulated by two antagonistic FT-like genes. AcFT1 promotes bulb formation, while AcFT4 prevents AcFT1 upregulation and inhibits bulbing in transgenic onions. Long-day photoperiods lead to the downregulation of AcFT4 and the upregulation of AcFT1, and this promotes bulbing. The observation that FT proteins can repress and promote different developmental transitions highlights the evolutionary versatility of FT.

  12. 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.

  13. A cheap simple ammeter for batteries-and-bulbs activities

    NASA Astrophysics Data System (ADS)

    Kagan, David T.

    2000-04-01

    The use of batteries and bulbs to teach the fundamentals of circuit analysis has been with us for many years. Even recent innovations in pedagogy seem to rely on batteries and bulbs. In addition, the California Science Content Standards for fourth grade require that "students know how to design and build simple series and parallel circuits using components such as wires, batteries, and bulbs." These standards go on to indicate that students should be able to use a compass to detect magnetic fields and know that electric currents produce magnetic fields.

  14. A new maintenance friendly concept for bulb type generators

    SciTech Connect

    Scheidl, W.

    1998-07-01

    Bulb type generators in the rating range up to 15 MW are in a severe competition with geared up machines which operate at much higher speed and are therefore smaller and cheaper. Up to now the conventional bulb type generator in the standard design as it is used on several rivers in Austria and many other countries was not so economic in the lower rating range. A new and maintenance friendly concept for the bulb type generator design especially for these lower rating range ended in a more economic solution and is now able to compete with the geared up machines.

  15. 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.

  16. [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.

  17. Duodenal injuries due to trauma: Review of the literature.

    PubMed

    García Santos, Esther; Soto Sánchez, Ana; Verde, Juan M; Marini, Corrado P; Asensio, Juan A; Petrone, Patrizio

    2015-02-01

    Duodenal injuries constitute a challenge to the Trauma Surgeon, mainly due to their retroperitoneal location. When identified, they present associated with other abdominal injuries. Consequently, they have an increased morbidity and mortality. At best estimates, duodenal lesions occur in 4.3% of all patients with abdominal injuries, ranging from 3.7% to 5%, and because of their anatomical proximity to other organs, they are rarely an isolated injury. The aim of this paper is to present a concise description of the anatomy, diagnosis, surgical management and treatment of complications of duodenal trauma, and an analysis of complications and mortality rates of duodenal injuries based on a 46-year review of the literature. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Pellagra revealing a congenital duodenal diaphragm in an adult.

    PubMed

    Khouloud, Bouslama; Haykel, Bedioui; Ahmed, Saidani; Houcine, Maghrebi; Yacine, Ben Safta; Farah, Jokho; Zoubeir, Ben Safta

    2013-12-01

    Pellagra is a nutritional disease caused by the deficiency of niacin. It is a clinical syndrome characterized by four "D's": diarrhea, dermatitis, dementia and ultimately death. We describe a case of pellagra as the initial presentation of congenital duodenal diaphragm.

  19. Lemmel Syndrome Secondary to Duodenal Diverticulitis: A Case Report

    PubMed Central

    Wermers, Joshua D; Beteselassie, Nebiyu

    2017-01-01

    Lemmel syndrome occurs when a duodenal diverticulum causes obstructive jaundice due to a mechanical obstruction of the common bile duct. Additional pathophysiologic processes may also contribute to the development of Lemmel syndrome. These include duodenal diverticula causing dysfunction of the sphincter of Oddi as well as compression of the common bile duct by duodenal diverticula. It is uncommon for duodenal diverticulum to become inflamed. We report the case of a 25-year-old female presenting with unintentional weight loss and fatigue. Since her initial labs were concerning for possible infection with hepatobiliary abnormalities, a contrast-enhanced CT was obtained. This study revealed a large periampullary diverticulum with mucosal enhancement and fat stranding consistent with diverticulitis. PMID:28409067

  20. 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.

  1. 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

  2. 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

  3. Preduodenal portal vein: a cause of prenatally diagnosed duodenal obstruction.

    PubMed

    Choi, S O; Park, W H

    1995-10-01

    Preduodenal portal vein is a rare congenital anomaly that causes high intestinal obstruction. The authors report on a newborn who was diagnosed as having duodenal obstruction at 30 weeks' gestation. During surgery the patient was found to have duodenal obstruction caused by a preduodenal portal vein. Malrotation was an associated finding. Treatment consisted of Ladd's procedure and a diamond-shaped duodenoduodenostomy performed anterior to the portal vein.

  4. 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.

  5. 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

  6. Brain processing of duodenal and portal glucose sensing.

    PubMed

    Boubaker, J; Val-Laillet, D; Guérin, S; Malbert, C-H

    2012-08-01

    Peripheral and central glucose sensing play a major role in the regulation of food intake. Peripheral sensing occurs at duodenal and portal levels, although the importance of these sensing sites is still controversial. The present study aimed to compare the respective influence of these sensing pathways on the eating patterns; plasma concentrations of glucose, insulin and glucagon-like peptide-1 (GLP-1); and brain activity in juvenile pigs. In Experiment 1, we characterised the changes in the microstructure as a result of a 30-min meal in eight conscious animals after duodenal or portal glucose infusion in comparison with saline infusion. In Experiment 2, glucose, insulin and GLP-1 plasma concentrations were measured during 2 h after duodenal or portal glucose infusions in four anaesthetised animals. In Experiment 3, single photon emission computed tomography brain imaging was performed in five anaesthetised animals receiving duodenal or portal glucose or saline infusions. Both duodenal and portal glucose decreased the amount of food consumed, as well as the ingestion speed, although this effect appeared earlier with the portal infusion. Significant differences of glucose and GLP-1 plasma concentrations between treatments were found at the moment of brain imaging. Both duodenal and portal glucose infusions activated the dorsolateral prefrontal cortex and primary somatosensory cortex. Only duodenal glucose infusion was able to induce activation of the prepyriform area, orbitofrontal cortex, caudate and putamen, as well as deactivation of the anterior prefrontal cortex and anterior entorhinal cortex, whereas only portal glucose infusion induced a significant activation of the insular cortex. We demonstrated that duodenal and portal glucose infusions led to the modulation of brain areas that are known to regulate eating behaviour, which probably explains the decrease of food intake after both stimulations. These stimulation pathways induced specific systemic and

  7. 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

  8. Enhanced gastric nitric oxide synthase activity in duodenal ulcer patients.

    PubMed Central

    Rachmilewitz, D; Karmeli, F; Eliakim, R; Stalnikowicz, R; Ackerman, Z; Amir, G; Stamler, J S

    1994-01-01

    Nitric oxide, the product of nitric oxide synthase in inflammatory cells, may have a role in tissue injury through its oxidative metabolism. Nitric oxide may have a role in the pathogenesis of duodenal ulcer and may be one of the mechanisms responsible for the association between gastric infection with Helicobacter pylori and peptic disease. In this study, calcium independent nitric oxide synthase activity was detected in human gastric mucosa suggesting expression of the inducible isoform. In 17 duodenal ulcer patients gastric antral and fundic nitric oxide synthase activity was found to be two and 1.5-fold respectively higher than its activity in the antrum and fundus of 14 normal subjects (p < 0.05). H pylori was detected in the antrum of 15 of 17 duodenal ulcer patients and only in 7 of 14 of the control subjects. Antral nitric oxide synthase activity in H pylori positive duodenal ulcer patients was twofold higher than in H pylori positive normal subjects (p < 0.05). In duodenal ulcer patients antral and fundic nitric oxide synthase activity resumed normal values after induction of ulcer healing with ranitidine. Eradication of H pylori did not further affect gastric nitric oxide synthase activity. These findings suggest that in duodenal ulcer patients stimulated gastric mucosal nitric oxide synthase activity, though independent of the H pylori state, may contribute to the pathogenesis of the disease. PMID:7525417

  9. [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

    the presence of duodenal diverticula was first described in 1710 by Chromel. Duodenal diverticulum is the second most common site of diverticula in the digestive tract. Anatomically duodenal diverticula are located in 10 to 67% in the second portion of duodenum, and its finding in most cases incidental. About 90% of patients appear asymptomatic, manifesting symptoms mostly once established complications such as: gastrointestinal bleeding and perforation. 78-years-old woman who attended our Emergency department with dyspnea, moderate epigastralgia, abdominal bloating, constipation and difficulty to pass gas; Laparotomy was performed to identify duodenal diverticulum in the third portion of the duodenum with a perforation of 5 mm in its cupula. It proceeds with diverticulectomy. The diagnosis of duodenal diverticulum as a cause of acute abdomen must be considered in our differential diagnosis in acute abdomen supported by imaging and endoscopy. The surgical management of duodenal diverticulum, in particular the resection of the diverticulum, remains as the recommendation for treatment with less morbidity and a good recovery.

  10. 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

    Camera, Luigi; Calabrese, Milena; Romeo, Valeria; Scordino, Fabrizio; Mainenti, Pier Paolo; Clemente, Marco; Rapicano, Gaetano; Salvatore, Marco

    2013-11-11

    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. 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. 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.

  11. 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

  12. Enteral delivery of proteins enhances the expression of proteins involved in the cytoskeleton and protein biosynthesis in human duodenal mucosa.

    PubMed

    Goichon, Alexis; Bertrand, Julien; Chan, Philippe; Lecleire, Stéphane; Coquard, Aude; Cailleux, Anne-Françoise; Vaudry, David; Déchelotte, Pierre; Coëffier, Moïse

    2015-08-01

    Amino acids are well known to be key effectors of gut protein turnover. We recently reported that enteral delivery of proteins markedly stimulated global duodenal protein synthesis in carbohydrate-fed healthy humans, but specifically affected proteins remain unknown. We aimed to assess the influence of an enteral protein supply on the duodenal mucosal proteome in carbohydrate-fed humans. Six healthy volunteers received for 5 h, on 2 occasions and in random order, either an enteral infusion of maltodextrins alone (0.25 g · kg⁻¹ · h⁻¹) mimicking the fed state or maltodextrins with a protein powder (0.14 g proteins · kg⁻¹ · h⁻¹). Endoscopic duodenal biopsy specimens were then collected and frozen until analysis. A 2-dimensional polyacrylamide gel electrophoresis-based comparative proteomics analysis was then performed, and differentially expressed proteins (at least ±1.5-fold change; Student's t test, P < 0.05) were identified by mass spectrometry. Protein expression changes were confirmed by Western blot analysis. Thirty-two protein spots were differentially expressed after protein delivery compared with maltodextrins alone: 28 and 4 spots were up- or downregulated, respectively. Among the 22 identified proteins, 11 upregulated proteins were involved either in the cytoskeleton (ezrin, moesin, plastin 1, lamin B1, vimentin, and β-actin) or in protein biosynthesis (glutamyl-prolyl-transfer RNA synthetase, glutaminyl-transfer RNA synthetase, elongation factor 2, elongation factor 1δ, and eukaryotic translation and initiation factor 3 subunit f). Enteral delivery of proteins altered the duodenal mucosal proteome and mainly stimulated the expression of proteins involved in cytoskeleton and protein biosynthesis. These results suggest that protein supply may affect intestinal morphology by stimulating actin cytoskeleton remodeling. © 2015 American Society for Nutrition.

  13. [The duodenal microbiota composition in children with active coeliac disease is influenced by the degree of enteropathy].

    PubMed

    Girón Fernández-Crehuet, F; Tapia-Paniagua, S; Moriñigo Gutiérrez, M A; Navas-López, V M; Juliana Serrano, M; Blasco-Alonso, J; Sierra Salinas, C

    2016-04-01

    To establish whether the duodenal mucosa microbiota of children with active coeliac disease (CD) and healthy controls (HC) differ in composition and biodiversity. Samples of duodenal biopsies in 11 CD patients were obtained at diagnosis, and in 6 HC who were investigated for functional intestinal disorders of non-CD origin. Total duodenal microbiota and the belonging to the genus Lactobacillus using PCR-denaturing gradient gel electrophoresis (DGGE) were analysed. The banding patterns obtained in the resulting gels were analysed to determine the differences between the microbiota of CD patients and HC (FPQuest 4.5) while environmental indexes (richness, diversity and habitability) were calculated with the Past version 2.17 program. The intestinal microbiota of patients with Marsh 3c lesion showed similarity of 98% and differs from other CD patients with other type of histologic lesion as Marsh3a, Marsh3b and Marsh2. The main differences were obtained in ecological indexes belonging to the genus Lactobacillus, with significant richness, diversity and habitability reduction in CD patients. In CD bands were categorized primarily with Streptococcus, Bacteroides and E.coli species. In HC the predominant bands were Bifidobacterium, Lactobacillus and Acinetobacter, though the Streptococcus and Bacteroides were lower. The celiac patients with major histological affectation presented a similar microbiota duodenal. The ecological indexes applied to the genus Lactobacillus were significantly reduced in CD. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  14. 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.

  15. 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

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

    PubMed

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

    2015-06-28

    To assess the evolution of duodenal lymphocytosis (DL), a condition characterized by increased intraepithelial lymphocytes (IELs), over 2 years of follow-up. 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. 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 of diagnostic evidence

  17. Inferoposterior duodenal approach for laparoscopic pancreaticoduodenectomy

    PubMed Central

    Wang, Xiao-Ming; Sun, Wei-Dong; Hu, Ming-Hua; Wang, Gua-Nan; Jiang, Ya-Qi; Fang, Xiao-San; Han, Meng

    2016-01-01

    AIM: To investigate the advantages of inferoposterior duodenal approach (IPDA) for laparoscopic pancreaticoduodenectomy (LPD). METHODS: A total of 36 patients subjected to LPD were admitted to the Affiliated Yijishan Hospital of Wannan Medical College from December 2009 to February 2015. These patients were diagnosed with an ampullary tumour or a pancreatic head tumour through computed tomography, magnetic resonance imaging or endoscopic retrograde cholangiopancreatography preoperatively. The cases were selected on the basis of the following criteria: tumour diameter < 4 cm; no signs of peripheral vascular invasion; evident lymph node swelling; and distant metastasis. Of the 36 cases, 20 were subjected to anterior approach (AA; AA group) and 16 were subjected to IPDA (IPDA group). Specimen removal time, intraoperative blood loss and postoperative complications in the two groups were observed, and their differences were compared. RESULTS: During the operation, 2 cases in the AA group and 2 cases in the IPDA group were converted to laparotomy; these cases were excluded from statistical analysis. The remaining 32 cases successfully completed the surgery. The AA group and IPDA group exhibited the specimen removal time of 205 ± 52 and 160 ± 35 min, respectively, and the difference was significant (P < 0.01). The AA group and IPDA group revealed the intraoperative blood loss of 360 ± 210 mL and 310 ± 180 mL, respectively, but these values were not significantly different. Postoperative pathological results revealed 4 cases of inferior common bile duct cancer, 8 cases of duodenal papillary cancer, 6 cases of ampullary cancer, 13 cases of pancreatic cancer, 3 cases of chronic pancreatitis accompanied with cyst formation or duct expansion, and 2 cases of mucinous cystic tumour in the pancreatic head. The postoperative complications were pulmonary Staphylococcus aureus infection, incision faulty union, ascites induced poor drainage accompanied with infection, bile

  18. 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.

  19. Evaluation of autonomic innervation of the clitoris and bulb.

    PubMed

    Yilmaz, Ugur; Kromm, Brenda G; Yang, Claire C

    2004-11-01

    Female sexual dysfunction is a common disorder but there are few objective measures of female genital function. We present a novel technique to record electrical activity of the female genital erectile tissue. We placed concentric needle electrodes in the right clitoral crus and the bulb of 22 healthy women. Following spontaneous activity recording we stimulated the median nerve to activate the sympathetic nervous system. We simultaneously measured evoked activity in the clitoris and bulb, and hand sympathetic skin responses (SSRs). Spontaneous electrical activity of the clitoris and bulb was present in 13 subjects. A total of 21 subjects had evoked activity in the bulb, while 18 had evoked activity in the clitoris. All subjects had hand SSRs. Evoked genital response latencies were similar to hand SSR latency (p > 0.05). Evoked electrical activity was recordable in the clitoris and bulb but it was more easily performed in the bulb. Evoked electrical activity is more consistently obtained than spontaneous activity. These tests represent possible objective measures of female genital autonomic innervation, which may have relevance to female sexual function.

  20. A modification method on runner blades in a Bulb turbine

    NASA Astrophysics Data System (ADS)

    Yang, W.; Wu, Y.; Liu, S.

    2010-08-01

    In this paper a modification method of the runner blades in a Bulb turbine is proposed, in which the main scale of the runner is maintained. In the modification method the runner blade is expressed by a gather of coordinate points. In order to make the modification simple and efficient, one of the coordinate is fixed and only the angles of the points are changed according to different modification purposes. The Bezier curve is applied to keep the modified blades smooth. For the purpose of verification, the modification method is used in some a prototype Bulb turbine in China. In order to check the modification effectiveness, a three dimensional turbulent computation is carried out through the whole passage including the bulb body, guide vanes, runner and draft tube of a prototype Bulb turbine under its rated operation. An SST k-ω turbulence model is used during the flow simulation. The performance prediction of the bulb turbine is conducted by the steady flow simulation. Comparisons of the computational results between the original turbine and a modified one indicate that the modification method is practical and can improve the performance of the bulb turbine.

  1. Duodenal obstruction caused by duodenal sigmoid flexure volvulus in dairy cattle: 29 cases (2006-2010).

    PubMed

    Vogel, Susan R; Nichols, Sylvain; Buczinski, Sébastien; Desrochers, André; Babkine, Marie; Veillette, Manon; Francoz, David; Doré, Elizabeth; Fecteau, Gilles; Bélanger, Anne-Marie; Badillo, Mauricio

    2012-09-01

    To characterize duodenal sigmoid flexure volvulus (DSFV) and determine the prognosis for affected cattle undergoing surgery. Retrospective case series. 29 dairy cattle. The medical records were analyzed for history, signalment, clinical signs, medical management, surgical findings, and outcome. 29 cattle were determined to have DSFV between December 2006 and August 2010. Twenty cattle had had an omentopexy or pyloropexy performed 1 day to 2 years before initial evaluation. Cattle were afebrile, tachycardic, and moderately dehydrated, with a small zone of percussion with a ping at the 10th to 12th right intercostal spaces and associated succussion. Biochemical changes were a severe hypokalemic (mean ± SD, 2.9 ± 0.5 mmol/L; median, 3.1 mmol/L; range, 2.08 to 3.92 mmol/L), hypochloremic (mean, 69.7 ± 11.1 mmol/L; median, 71.7 mmol/L; range, 49.1 to 94.1 mmol/L) metabolic alkalosis (mean total CO(2), 44.5 ± 7.4 mmol/L; median, 45.3 mmol/L; range, 31.5 to 59.6 mmol/L) and hyperbilirubinemia (mean, 32.4 ± 29.0 μmol/L; median, 20.5 μmol/L; range, 7.8 to 107 μmol/L). Surgical findings for DSFV included an empty descending duodenum adjacent to a dorsally displaced and dilated cranial segment of the duodenum, distended abomasum and gallbladder, and a tight volvulus at the base of the duodenal sigmoid flexure. Manual reduction was considered successful if the descending duodenum filled after cranial duodenal massage. Twenty-two patients were successfully treated; the remaining 7 died or were euthanized within 4 days after surgery. A condition clinically resembling abomasal volvulus but affecting the duodenal sigmoid flexure has been recognized in dairy cattle. When a focal, dorsal right-sided ping and succussion are present combined with severe hypokalemic, hypochloremic metabolic alkalosis and high bilirubin concentration, DSFV should be suspected, especially when there is a history of prior abomasal fixation. After surgical correction, the prognosis is fair to good.

  2. What to Do if a Compact Fluorescent Light (CFL) Bulb or Fluorescent Tube Light Bulb Breaks: Printable Instructions

    EPA Pesticide Factsheets

    The broken bulb can continue to release mercury vapor until it is cleaned up and removed. This cleanup guidance represents minimum recommended actions to reduce mercury exposure, and will be updated as more efficient practices are identified.

  3. 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 ...

  4. Nasal mucosal biopsy

    MedlinePlus

    ... The tissue in the nose is normal. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different ... Avoid blowing your nose after the biopsy. Do ...

  5. Lung needle biopsy

    MedlinePlus

    ... if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does ... any type Bullae (enlarged alveoli that occur with emphysema) Cor pulmonale (condition that causes the right side ...

  6. Open pleural biopsy

    MedlinePlus

    ... due to a virus, fungus, or parasite Mesothelioma Tuberculosis Risks There is a slight chance of: Air ... More Metastatic pleural tumor Pleural needle biopsy Pulmonary tuberculosis Tumor Review Date 11/4/2014 Updated by: ...

  7. Lymph node biopsy

    MedlinePlus

    ... Performed The test is used to diagnose cancer, sarcoidosis, or an infection (such as tuberculosis): When you ... of lymph nodes and other organs and tissues ( sarcoidosis ) Risks Lymph node biopsy may result in any ...

  8. Mediastinoscopy with biopsy

    MedlinePlus

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

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

    USDA-ARS?s Scientific Manuscript database

    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...

  10. False-positive PCR detection of Tropheryma whipplei in cerebrospinal fluid and biopsy samples from a child with chronic lymphocytic meningitis.

    PubMed

    Goyo, Daniel; Camacho, Ana; Gómez, Carmen; de Las Heras, Rogelio Simón; Otero, Joaquín R; Chaves, Fernando

    2009-11-01

    We report the case of a teenager with chronic lymphocytic meningitis for whom Tropheryma whipplei 16S rRNA PCR results were positive in two cerebrospinal fluid samples and one duodenal biopsy specimen. PCR targeting another specific sequence of Tropheryma whipplei and sequencing of the initially amplified 16S rRNA fragment did not confirm the results.

  11. The terminal web of the duodenal enterocyte.

    PubMed

    Leeson, T S

    1982-06-01

    The terminal web-brush border complex of rodent duodenal enterocytes has been studied by electron microscopy to investigate its structure in relation to currently accepted models of motility in this region. The main adherens zone is composed chiefly of a fine feltwork of 5 to 7 nm filaments, some of which originate in zonulae adherentes. In some cells, this is not a complete layer or sheet. Passing into it from its deep aspect are 10 nm tonofilaments, which also form the basal zone. The filament density in the basal zone is less than that of the adherens zone, and many of the tonofilaments are associated with spot desmosomes. The apical zone contains a loose meshwork of 5 to 7 nm filaments with more filaments lying adjacent to plasmalemmae of the zonula occludens. The core of each microvillus contains a bundle of 17 to 48 microfilaments, 5-7 nm in diameter, apparently attached to the apical plasmalemma and with some slender cross filaments between core filaments and the plasmalemma. In the main, these core bundles of microfilaments pass deeply into and often through the adherens zone of the terminal web where they terminate abruptly. Filaments of the terminal web appear to interconnect microfilaments of adjacent core bundles but without positive evidence of 'splaying' of microfilaments of a core bundle within the adherens zone. These findings are discussed in relation to movement of microvilli.

  12. Duodenal perforation caused by a bird feather.

    PubMed

    Sahoo, Manash Ranjan; Kumar, Anil

    2013-02-15

    Ingestion of gastrointestinal (GI) foreign bodies represents a challenging clinical scenario. The greater risk is at extremes of age, in those wearing dentures, alcoholics and mentally handicapped. We present a case of duodenal perforation caused by a bird feather. A 64-year-old man was presented with abdominal pain for 4 days. Abdominal examination showed signs of peritonitis. The erect abdominal x-ray showed free gas under diaphragm. Exploratory laparotomy showed purulent fluid, but no definite site of perforation could be found. So the abdomen was closed with a drain in Morison's pouch. The postoperative recovery was uneventful. He came for a repeat check-up at 4 weeks with dull aching pain in the upper abdomen and was advised for a routine upper GI endoscopy which revealed a feather penetrating the first part of the duodenum, which was removed with a foreign body removing forceps. GI foreign bodies represent a significant problem and an increased level of suspicion is important for timely diagnosis and treatment.

  13. Biliary Stent Migration with Duodenal Perforation

    PubMed Central

    Yaprak, Muhittin; Mesci, Ayhan; Colak, Taner; Yildirim, Bulent

    2008-01-01

    Intestinal perforation from a migrated biliary stent is a known complication of endoscopic biliary stent placement. We present a case of stent migration and resultant duodenal perforation after stent placement for a malignant biliary stricture in a 52-year-old woman. We review the current literature on the diagnosis and management of stent migration and intestinal perforation after endoscopic stent placement for biliary strictures. A plain abdominal radiograph is necessary for early diagnosis of biliary stent migration. If a stent becomes lodged in the gastrointestinal tract, endoscopic or operative extraction of the stent is necessary to prevent subsequent intestinal perforation and peritonitis. Intestinal perforation secondary to biliary stent dislocation should be considered in all patients presenting with fever and abdominal pain after biliary stent insertion. Any abnormality that prevents stent migration through the intestinal tract such as gastroenterostomy, abdominal wall hernia, extensive adhesions or colonic divertucula may be a contraindication for insertion of a plastic biliary stent because of increased perforation risk. PMID:25610053

  14. The efferent connections of the olfactory bulb and accessory olfactory bulb in the snakes, Thamnophis sirtalis and Thamnophis radix.

    PubMed

    Halpern, M

    1976-10-01

    The efferent connections of the olfactory bulb and accessory olfactory bulb of two species of garter snakes, Thamnophis sirtalis and T. radix were studied with experimental anterograde degeneration techniques. Axons of cells located in the olfactory bulb terminate ipsilaterally in all parts of the anterior olfactory nucleus, olfactory tubercle and lateral pallium. In addition, some axons enter the ipsilateral stria medullaris thalami, cross the midline in the habenular commissure, enter the contralateral stria medullaris thalami and terminate in the contralateral lateral pallium. The axons of cells in the accessory olfactory bulb course through the telencephalon completely separated from the fibers of olfactory bulb origin and terminate predominantly in the nucleus sphericus. These results confirm previous reports of the separation between the central projections of the olfactory and vomeronasal systems in a variety of vertebrates. The totality of the separation between these two systems coupled with the extensive development of the vomeronasal-accessory bulb system in these snakes suggests that they may be ideal subjects for further research on the functional significance of the vomeronasal system.

  15. Transluminal endoscopic electrosurgical incision of fenestrated duodenal membranes.

    PubMed

    Blanco-Rodríguez, Gerardo; Penchyna-Grub, Jaime; Porras-Hernández, Juan D; Trujillo-Ponce, Adrián

    2008-06-01

    Duodenal fenestrated membranes are traditionally treated by side-to-side diamond-shaped duodenoduodenostomy, or duodenotomy and resection. We describe an alternative endoscopic approach for its resolution. A flexible panendoscopy reaching the duodenal membrane was performed. A balloon was inserted to dilate its orifice. Traction was applied to the balloon to differentiate the border of the membrane forming the duodenal wall. After visualizing the ampulla, the membrane was incised using a sphincterotome or needle knife on two sites opposite to the bile duct. From May 2001 to August 2007, ten patients with a fenestrated duodenal membrane underwent transluminal endoscopic electrosurgical incision (TEEI). Mean patient age was 3.4 years (range 1 month to 15 years). The endoscopic procedure lasted from 30 to 60 min. Oral intake began 24 h postsurgery in eight patients and at 48 h postsurgery in two patients. Hospital stay lasted for 2-5 days. After 1 year of follow-up, eight patients were asymptomatic and thriving at present, and one had a double membrane, required a second endoscopy with TEEI, and has experienced occasional vomiting. An additional asymptomatic patient was lost after 3 months of follow-up. TEEI of fenestrated duodenal membranes is a feasible and effective procedure in children.

  16. Percutaneous management of postoperative duodenal stump leakage with foley catheter.

    PubMed

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

    2013-10-01

    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. 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. 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. 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.

  17. Age of onset of symptoms in duodenal and gastric ulcer.

    PubMed

    Kang, J Y

    1990-08-01

    The influence of the age of onset of symptoms on various clinical features of peptic ulcer was studied in a personal series of 492 patients (duodenal ulcer 363, gastric ulcer 98, combined gastric and duodenal ulcer 31). Duodenal ulcer patients whose age of onset of symptoms was within the first three decades (n = 166) were more likely to be men (77%) and to have a positive family history of dyspepsia (45%) and a history of haemorrhage (46%) when compared with late onset patients (n = 197, men 57%, positive family history 23%, history of haemorrhage 36%). Early onset duodenal ulcer patients also secreted more gastric acid than late onset patients. In contrast, while early onset gastric ulcer patients were more likely to be men, when compared to late onset patients, the two groups were similar in their family history of dyspepsia, their history of haemorrhage, and their gastric acid output. The age of onset of Malay duodenal ulcer patients (mean (SD) 43.6 (16.0] was higher than those for Chinese patients (33.7 (16.1].

  18. 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

  19. Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient

    PubMed Central

    Spinner, Michael A.; Paulin, Heather N.; Wester, C. William

    2012-01-01

    Gastrointestinal histoplasmosis (GIH) is common in patients with disseminated disease but only rarely comes to clinical attention due to the lack of specific signs and symptoms. We report the unusual case of a 33-year-old Caucasian male with advanced AIDS who presented with upper GI bleeding from diffuse erosions throughout the duodenum. Biopsy of the lesions revealed small bowel mucosa with granulomatous inflammation and macrophages with small intracellular yeasts consistent with disseminated histoplasmosis. The patient demonstrated significant clinical improvement following a two-week course of liposomal amphotericin B. To our knowledge, this is the first case report of duodenal histoplasmosis leading to clinically significant bleeding, manifesting with worsening anemia and melanotic stools. Given our findings, we maintain that GIH should be considered on the differential diagnosis for GI bleeding in AIDS patients at risk, specifically those with advanced immunosuppression (i.e., CD4+ cell counts <100 cells/mm3) who reside in endemic areas (Ohio or Mississippi river valleys) and/or have a prior history of histoplasmosis. For diagnostic evaluation, we recommend checking a urine Histoplasma quantitative antigen EIA as well as upper and/or lower endoscopy with biopsy. We recommend treatment with a two-week course of liposomal amphotericin B followed by indefinite itraconazole. PMID:23091745

  20. 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.

  1. 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

  2. Diagnostic value of amplification of human cytomegalovirus DNA from gastrointestinal biopsies from human immunodeficiency virus-infected patients.

    PubMed Central

    Cotte, L; Drouet, E; Bissuel, F; Denoyel, G A; Trepo, C

    1993-01-01

    In order to assess the value of human cytomegalovirus (HCMV) DNA amplification of gastrointestinal biopsies, we studied 57 human immunodeficiency virus-infected patients with and without gastrointestinal HCMV diseases. After DNA extraction, a 406-bp fragment from the unique short region of the HCMV genome was amplified by 35 cycles of polymerase chain reaction (PCR) and semiquantified from 80 to 80,000 HCMV genomic copies. Among 12 non-AIDS patients, the PCR assay was negative for 11 of 12 duodenal and 8 of 8 colorectal samples. It was also negative for 28 of 31 duodenal and 12 of 15 colorectal samples from 31 AIDS patients without gastrointestinal HCMV diseases. Among 14 AIDS patients with gastrointestinal HCMV diseases, the PCR assay was positive for 12 of 12 patients with HCMV duodenitis and for 13 of 13 patients with HCMV colitis. Results were dichotomized between high and low HCMV-DNA copy numbers. For duodenitis, sensitivity was 92% and specificity was 100%. For colitis, sensitivity was 92% and specificity was 93%. Specificity and sensitivity were not influenced by shedding status for HCMV or by other gastrointestinal infections. HCMV DNA amplification of gastrointestinal biopsies is a sensitive and specific tool for the diagnosis of gastrointestinal HCMV diseases in AIDS patients. Images PMID:8396587

  3. 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.

  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. Duodenal Atresia Associated with Apple Peel Atresia and Situs Inversus Abdominus: A Case Report

    PubMed Central

    Ben Hamida, H.; Hadj Salem, R.; Ben Ameur, K.; Rassas, A.; Chioukh, FZ.; Sakka, R.; Kechiche, N.; Bizid, M.; Sahnoun, L.; Monastiri, K.

    2016-01-01

    Duodenal atresia is rarely associated with situs inversus abdominus. We report a case of duodenal atresia associated with small bowel atresia of apple peel type and situs inversus abdominus. PMID:27896168

  6. 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.

  7. Enteral delivery of proteins stimulates protein synthesis in human duodenal mucosa in the fed state through a mammalian target of rapamycin-independent pathway.

    PubMed

    Coëffier, Moïse; Claeyssens, Sophie; Bôle-Feysot, Christine; Guérin, Charlène; Maurer, Brigitte; Lecleire, Stéphane; Lavoinne, Alain; Donnadieu, Nathalie; Cailleux, Anne-Françoise; Déchelotte, Pierre

    2013-02-01

    Glutamine modulates duodenal protein metabolism in fasted healthy humans, but its effects in a fed state remain unknown. We aimed to assess the effects of either glutamine or an isonitrogenous protein mixture on duodenal protein metabolism in humans in the fed state. Twenty-four healthy volunteers were randomly included in 2 groups. Each volunteer was studied on 2 occasions in a random order and received, during 5 h, either an enteral infusion of maltodextrins alone (0.25 g · kg⁻¹ · h⁻¹; both groups) that mimicked a carbohydrate fed state or maltodextrins with glutamine (group 1) or an isonitrogenous (22.4 mg N · kg⁻¹ · h⁻¹) protein powder (group 2). Simultaneously, a continuous intravenous infusion of ¹³C-leucine and ²H₅-phenylalanine (both 9 μmol · kg⁻¹ · h⁻¹) was performed. Endoscopic duodenal biopsies were taken. Leucine and phenylalanine enrichments were assessed by using gas chromatography-mass spectrometry in duodenal proteins and the intracellular free amino acids pool to calculate the mucosal fractional synthesis rate (FSR). Proteasome proteolytic activities and phosphokinase expression were assessed by using specific fluorogenic substrates and macroarrays, respectively. The FSR and proteasome activity were not different after the glutamine supply compared with after maltodextrins alone. In contrast, the FSR increased (1.7-fold increase; P < 0.05) after protein-powder delivery without modification of total proteasome activity. The protein powder increased insulinemia, PI3 kinase, and erk phosphorylation but did not affect the mammalian target of rapamycin (mTOR) pathway and mitogen-activated protein kinase signal-integrating kinase 1 phosphorylation. A trend for an increase of eukaryotic translation initiation factor 4E phosphorylation was observed (P = 0.07). In the carbohydrate fed state, enteral proteins but not glutamine increased duodenal protein synthesis through an mTOR independent pathway in humans.

  8. 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. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Upper gastrointestinal barium evaluation of duodenal pathology: A pictorial review

    PubMed Central

    Gupta, Pankaj; Debi, Uma; Sinha, Saroj Kant; Prasad, Kaushal Kishor

    2014-01-01

    Like other parts of the gastrointestinal tract (GIT), duodenum is subject to a variety of lesions both congenital and acquired. However, unlike other parts of the GIT viz. esophagus, rest of the small intestine and large intestine, barium evaluation of duodenal lesions is technically more challenging and hence not frequently reported. With significant advances in computed tomography technology, a thorough evaluation including intraluminal, mural and extramural is feasible in a single non-invasive examination. Notwithstanding, barium evaluation still remains the initial and sometimes the only imaging study in several parts of the world. Hence, a thorough acquaintance with the morphology of various duodenal lesions on upper gastrointestinal barium examination is essential in guiding further evaluation. We reviewed our experience with various common and uncommon barium findings in duodenal abnormalities. PMID:25170399

  10. Preduodenal portal vein with situs inversus and duodenal atresia.

    PubMed

    Ziv, Y; Lombrozo, R; Dintsman, M

    1986-02-01

    In a 7-day-old infant referred because of bile-stained vomiting, jaundice and lack of meconium, radiological examination revealed the 'double-bubble' sign of duodenal atresia as well as dextrocardia. This infant also had a strawberry haemangioma on the right shoulder. Operation disclosed situs inversus and a preduodenal portal vein as well as duodenal atresia. A side-to-side duodeno-jejunostomy was performed successfully without damage to the anomalous vein. The history of polyhydramnion during gestation, the presence of other anomalies, the rapid onset of bile-stained vomiting and the classic 'double-bubble' sign, together appeared to indicate that the duodenal atresia was intrinsic and not due to the external pressure of the anomalous vein on the duodenum.

  11. Simple closure of a perforated duodenal diverticulum: "a case report".

    PubMed

    Yokomuro, Shigeki; Uchida, Eiji; Arima, Yasuo; Mizuguchi, Yoshiaki; Shimizu, Tetsuya; Kawahigashi, Yutaka; Kawamoto, Masao; Takahashi, Ken; Arai, Masao; Arima, Yasuo; Tajiri, Takashi

    2004-10-01

    Spontaneous perforation of a duodenal diverticulum is a rare but serious complication with significant mortality rates. Just over 100 cases have been reported in the world literature. One case of perforated duodenal diverticulum treated by simple closure is reported. An elderly female was admitted to our hospital with an acute abdomen. Computed tomography of the abdomen showed retroperitoneal air around the duodenum and right kidney. Laparotomy with a Kocher maneuver disclosed a perforated diverticulum in the second portion of the duodenum. Although diverticulectomy is the most common treatment, simple closure of the perforated duodenal diverticulum with drainage was performed to avoid injury to the distal common bile duct and ampulla of Vater, which were close to the diverticulum. The patient has fully recovered and has been asymptomatic with no signs of recurrence for 25 months.

  12. A newborn with duodenal atresia and a gastric perforation.

    PubMed

    Akcora, Bulent; Eris, Ozge

    2010-01-01

    Congenital duodenal atresia complicated by gastric perforation (GP) is a very rare and a very mortal condition. Only three newborns could be cured in the reported 13 cases. We report a successfully treated newborn with this complicated disease. A 2-day-old male was hospitalized with prediagnosis of duodenal obstruction. Twelve hours later, significant abdominal distention occurred promptly. At laparotomy, GP and preampullary duodenal atresia were detected. Gastrorrhaphy and duodenoduodenostomy were performed in the same operation. The patient was discharged on the 15th postoperative day. This complicated disease can be treated by early diagnosis and surgical intervention. We choose one-stage operation because of the clean peritoneal cavity. However, generalized peritonitis may require two-stage operation in delayed cases.

  13. [Treatment of chronic aphthous stomatitis combined with duodenal ulcer].

    PubMed

    Dudchenko, M A; Skrypnikova, T P; Dudchenko, M A

    2014-01-01

    It is currently proved ulcerous stomatitis and duodenal ulcer to have common pathogenetic infectious link (the most studied agent being Helicobacter pylori) by concominant decrease of local and general immunity with hyperoxidation events. Eighty patients (44 female and 36 male aged 15-60) with chronic aphthous stomatitis (AS) combined with duodenal ulcer were included in the study and divided in two equal groups according to treatment received (control group of 40 patients was treated according to conventional scheme, while in 40 patients a new formulation Vipromak was added to treatment protocol). The symptoms of AS tend to resolve faster in vipromak group thus proving its efficiency in treatment of AS and duodenal ulcer.

  14. 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

  15. Duodenal varices successfully treated with cyanoacrylate injection therapy

    PubMed Central

    Malik, Ahsan; Junglee, Naushad; Khan, Anwar; Sutton, Jonathon; Gasem, Jaber; Ahmed, Waqar

    2011-01-01

    Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies have been employed with variable results. The authors present a case of 52-year-old male who was admitted with melaena. Upper gastrointestinal endoscopy was performed which identified bleeding varices in the second part of duodenum. The varices were injected with cyanoacrylate and the outcome was favourable. Subsequent endoscopies showed complete resolution of the varices. The authors conclude that cyanoacrylate injection is an effective first-line treatment for bleeding duodenal varices. PMID:22694885

  16. One week's anti-Helicobacter pylori treatment for duodenal ulcer.

    PubMed Central

    Logan, R P; Gummett, P A; Misiewicz, J J; Karim, Q N; Walker, M M; Baron, J H

    1994-01-01

    This open study tested whether eradication of Helicobacter pylori (H pylori) heals duodenal ulcers as well as decreasing recurrence. H pylori was detected in patients with endoscopic duodenal ulcers by histology, CLO-test, culture, and 13C-urea breath test (13C-UBT). Tripotassium dicitrato bismuthate (120 mg) and amoxycillin (500 mg) each four times daily, were given for seven days, with 400 mg metronidazole five times a day on days 5-7. The 13C-UBT was repeated immediately after treatment and endoscopy repeated within 21 days. After treatment unhealed ulcers were reinspected one month later and healed ulcers followed up by 13C-UBT alone for 12 months. Of 45 patients, 44 were available for follow up. Mean pretreatment excess delta 13CO2 excretion was 25.6 per mil, which fell to 2.4 per mil immediately after finishing treatment, indicating clearance of H pylori in every patient. At the second endoscopy (median interval 20 days from start of treatment) 33 of 44 (75%) duodenal ulcers had healed. Ten of the remaining 11 duodenal ulcers were smaller and those 10 healed in the next two weeks with no further treatment. Two patients' ulcers that initially healed with clearance of H pylori recurred three weeks later (both had metronidazole resistant H pylori). H pylori was eradicated in 28 of 44 (64%) patients (13C-UBT negative for median follow up 10.2 months). Overall 41 of 43 (93%, 95% confidence intervals 81%-99%) duodenal ulcers were healed at one month. This study suggests that one week of anti-H pylori triple treatment is effective in healing duodenal ulcers. PMID:8307442

  17. Duodenal bacterial overgrowth during treatment in outpatients with omeprazole.

    PubMed Central

    Fried, M; Siegrist, H; Frei, R; Froehlich, F; Duroux, P; Thorens, J; Blum, A; Bille, J; Gonvers, J J; Gyr, K

    1994-01-01

    The extent of duodenal bacterial overgrowth during the pronounced inhibition of acid secretion that occurs with omeprazole treatment is unknown. The bacterial content of duodenal juice of patients treated with omeprazole was therefore examined in a controlled prospective study. Duodenal juice was obtained under sterile conditions during diagnostic upper endoscopy. Aspirates were plated quantitatively for anaerobic and aerobic organisms. Twenty five outpatients with peptic ulcer disease were investigated after a 5.7 (0.5) weeks (mean (SEM)) treatment course with 20 mg (nine patients) or 40 mg (16 patients). The control group consisted of 15 outpatients referred for diagnostic endoscopy without prior antisecretory treatment. No patient in the control group had duodenal bacterial overgrowth. In the omeprazole group bacterial overgrowth (> or = 10(5) cfu/ml) was found in 14 (56%) patients (p = 0.0003). The number of bacteria (log10) in duodenal juice in patients treated with omeprazole was distinctly higher (median 5.7; range < 2-8.7) when compared with the control group (median < 2; range < 2-5.0; p = 0.0004). As well as orally derived bacteria, faecal type bacteria were found in seven of 14 and anaerobic bacteria in three of 14 patients. Bacterial overgrowth was similar with the two doses of omeprazole. These results indicate that duodenal bacterial overgrowth of both oral and faecal type bacteria occurs often in ambulatory patients treated with omeprazole. Further studies are needed to determine the clinical significance of these findings, particularly in high risk groups during long term treatment with omeprazole. PMID:8307444

  18. Gallbladder carcinoma - a rare cause of pyloric-duodenal stenosis.

    PubMed

    Niculescu, Zizi; Ulmeanu, Victoria; Ghinea, Mihaela Maria; Mocanu, Liliana; Niculescu, Costin; Grigorian, Mircea

    2016-01-01

    Pyloric duodenal stenosis is usually caused by pyloric, juxtapyloric or duodenal ulcer, or by postbulbar ulcer. Gallbladder cancer (GBC), duodenal diverticula, annular pancreas and superior mesenteric artery syndrome (Wilkie's syndrome) are rare causes of pyloric duodenal stenosis. The case of a 66-year-old female patient is presented. The patient was admitted to hospital presenting anorexia, repeated alimentary vomiting, epigastric pain, and weight loss. Objective clinical examination upon admission: clapotage à jeun is present, triggered by tapping the epigastric region. Laboratory tests reveal moderate anemia, hypokalemic alkalosis, increased levels of cholestatic enzymes and of tumor markers. Gastroendoscopy: Stomach presenting stasis fluid in large quantity. Deformed antropyloric region caused by extrinsic compression. Abdominal native magnetic resonance imaging (MRI) and with contrast medium: cholecyst lumen entirely obstructed with calculi; thickened wall, with heterogeneous gadolinophilia; gadolinophilic mass erasing the bordering limit in relation to the cholecyst wall and the colon hepatic angle, and leaving a print on the pyloric region. During surgery, upon opening the peritoneal cavity, a tumoral pericholecystic block was observed, including the pyloric-duodenal region and the transverse mesocolon. Histopathology tests of tissue samples showed adipose conjunctive tissue with invasive adenocarcinoma. Immunohistochemical tests [cytokeratin (CK) 7, CK17, CK19, CK20, CDX2, mucin (MUC) 1, MUC2, MUC5AC, MUC6, epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA)] were consistent with infiltrating neoplastic carcinoma, originating in the gallbladder epithelium. Gastrointestinal obstruction cases caused by gallbladder carcinoma are rare. The pyloric-duodenal region is more frequently affected, as compared to the small intestine or the colon.

  19. Duodenal Expression of 25 Hydroxyvitamin D3-1α-hydroxylase Is Higher in Adolescents Than in Children and Adults.

    PubMed

    Gawlik, Aneta; Gepstein, Vardit; Rozen, Nimrod; Dahan, Aviva; Ben-Yosef, Dafna; Wildbaum, Gizi; Verbitsky, Oleg; Shaoul, Ron; Weisman, Yosef; Tiosano, Dov

    2015-10-01

    Puberty is associated with increased dietary calcium absorption. However, little is known about the metabolic adaptations that enhance calcium absorption during puberty. To investigate duodenal 25-hydroxy vitamin D-1α-hydroxylase (CYP 27B1) mRNA expression and duodenal 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) production in children, adolescents, and adults. CYP27B1a nd IGF1 mRNA expression and 1,25(OH)2D3 production were determined in duodenal biopsies. CYP27B1 expression was also determined after IGF1R inhibitor treatment of human and mice duodenal explants. mRNA expression was determined by RT-PCR, and CYP27B1 activity was determined by incubating duodenal explants with 25(OH)D3 and measuring 1,25(OH)2D3 production by radioimmunoassay. CYP27B1 mRNA expression was 13.7 and 10.4 times higher in biopsies from adolescents compared to adults and children, respectively. IGF1 mRNA expression was 30% and 45% higher in explants from adolescents and children, respectively, compared to adults. Inhibition of IGF1 receptor activity decreased CYP27B1 expression in explants from both mice (85%) and humans (24%). 1,25(OH)2D3 production reached a maximum velocity of 768 ± 268 pmol/l/mg protein at 748.8 nmol/l of 25(OH)D3 in children and adolescents, whereas the maximum velocity was 86.4 ± 43.2 pmol/l/mg protein in adults. The substrate concentration at which the enzyme shows half of its maximum activity was similar in all groups, ranging between 624 and 837 nmol/L of 25(OH)D3. Increased CYP27B1 expression and local duodenal 1,25(OH)2D3 production during puberty may be a metabolic adaptation that promotes dietary calcium absorption. IGF1, a major factor in skeletal growth, is also involved in the modulation of CYP27B1 expression in the gut and may increase calcium supply for the growing bone.

  20. 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.

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

    PubMed

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

    2013-12-04

    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.

  2. Localization of neurotrophin receptors in olfactory epithelium and bulb.

    PubMed

    Deckner, M L; Frisén, J; Verge, V M; Hökfelt, T; Risling, M

    1993-12-13

    We used in situ hybridization to localize trk, trkB and trkC mRNA, in rat and cat olfactory bulb. Expression of mRNA encoding truncated trkB receptors was seen in all layers, while only very modest full-length trkB expression could be detected. trkC hybridization was seen in all layers, most dense in the mitral cell layer. The localization of full-length tyrosine kinase trkB receptor in olfactory bulb and epithelium was examined with immunohistochemistry. trkB-like immunoreactivity was seen in the fila olfactoria, epithelium and in vitro, in olfactory sensory neurones. Since BDNF is expressed by olfactory sensory neurone target cells in the olfactory bulb, these data suggest that BDNF may act as a target derived neurotrophic factor in the primary olfactory system.

  3. Neural Sensitivity to Odorants in Deprived and Normal Olfactory Bulbs

    PubMed Central

    Rodríguez, Francisco B.; Huerta, Ramón; Aylwin, Maria de la Luz

    2013-01-01

    Early olfactory deprivation in rodents is accompanied by an homeostatic regulation of the synaptic connectivity in the olfactory bulb (OB). However, its consequences in the neural sensitivity and discrimination have not been elucidated. We compared the odorant sensitivity and discrimination in early sensory deprived and normal OBs in anesthetized rats. We show that the deprived OB exhibits an increased sensitivity to different odorants when compared to the normal OB. Our results indicate that early olfactory stimulation enhances discriminability of the olfactory stimuli. We found that deprived olfactory bulbs adjusts the overall excitatory and inhibitory mitral cells (MCs) responses to odorants but the receptive fields become wider than in the normal olfactory bulbs. Taken together, these results suggest that an early natural sensory stimulation sharpens the receptor fields resulting in a larger discrimination capability. These results are consistent with previous evidence that a varied experience with odorants modulates the OB's synaptic connections and increases MCs selectivity. PMID:23580211

  4. 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.

  5. Numerical simulation of turbulence flow in a Bulb turbine

    NASA Astrophysics Data System (ADS)

    ENOMOTO, Yasuyuki; NAKAMURA, Takanori; OHTAKE, Norio; KUBO, Koichi; ZHAI, Yabin

    2016-11-01

    In this paper, high accuracy performance prediction method based on entire flow passage for a Bulb turbine is presented. The performance is predicted by solving steady and unsteady Reynolds-Averaged Navier-Stokes equations, Large Eddy simulation and Detached Eddy Simulation. The prediction accuracy was evaluated to compare with the model test results for efficiency characteristic, pressure fluctuation characteristic and velocity distribution at runner inlet and outlet of NQE 0.8 Bulb model turbine. As for the efficiency near the on-cam condition, it is possible to determine with high accuracy in the steady RANS analysis. However, for the analysis accuracy regarding pressure fluctuation characteristic and turbine characteristics at off-cam operating condition, it found that there is a need to further study. Evaluated prediction method for the turbine flow and performance is introduced to facilitate the future design and research works on Bulb type turbine.

  6. Synaptic clusters function as odor operators in the olfactory bulb.

    PubMed

    Migliore, Michele; Cavarretta, Francesco; Marasco, Addolorata; Tulumello, Eleonora; Hines, Michael L; Shepherd, Gordon M

    2015-07-07

    How the olfactory bulb organizes and processes odor inputs through fundamental operations of its microcircuits is largely unknown. To gain new insight we focus on odor-activated synaptic clusters related to individual glomeruli, which we call glomerular units. Using a 3D model of mitral and granule cell interactions supported by experimental findings, combined with a matrix-based representation of glomerular operations, we identify the mechanisms for forming one or more glomerular units in response to a given odor, how and to what extent the glomerular units interfere or interact with each other during learning, their computational role within the olfactory bulb microcircuit, and how their actions can be formalized into a theoretical framework in which the olfactory bulb can be considered to contain "odor operators" unique to each individual. The results provide new and specific theoretical and experimentally testable predictions.

  7. Synaptic clusters function as odor operators in the olfactory bulb

    PubMed Central

    Migliore, Michele; Cavarretta, Francesco; Marasco, Addolorata; Tulumello, Eleonora; Hines, Michael L.; Shepherd, Gordon M.

    2015-01-01

    How the olfactory bulb organizes and processes odor inputs through fundamental operations of its microcircuits is largely unknown. To gain new insight we focus on odor-activated synaptic clusters related to individual glomeruli, which we call glomerular units. Using a 3D model of mitral and granule cell interactions supported by experimental findings, combined with a matrix-based representation of glomerular operations, we identify the mechanisms for forming one or more glomerular units in response to a given odor, how and to what extent the glomerular units interfere or interact with each other during learning, their computational role within the olfactory bulb microcircuit, and how their actions can be formalized into a theoretical framework in which the olfactory bulb can be considered to contain “odor operators” unique to each individual. The results provide new and specific theoretical and experimentally testable predictions. PMID:26100895

  8. 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.

  9. Perforated duodenal ulcer in a young child: an uncommon condition.

    PubMed

    Yadav, R P; Agrawal, C S; Gupta, R K; Rajbansi, S; Bajracharya, A; Adhikary, S

    2009-01-01

    Duodenal ulcer is an uncommonly diagnosed entity in children. H. pylori infection, blood group 'O' or secondary to medications like non steroidal anti-inflammatory drugs (NSAID) and corticosteroids or physiological stress in burns, head injury and mucosal ischemia are implicated as risk factors for their causation. The diagnosis is usually overlooked because of vague and variable symptoms and remote index of suspicion accounted for their low incidence in children. Undiagnosed or mistreated perforations may carry high morbidity and mortality. We report a successfully treated 41/2 year old male child who presented with features of perforation peritonitis and was incidentally found to have a perforated duodenal ulcer.

  10. Duodenal rupture secondary to blunt trauma from a football.

    PubMed

    Luther, Alison; Mann, Christopher; Hart, Colin; Khalil, Khalil

    2013-01-04

    Duodenal rupture secondary to blunt trauma is a relatively uncommon event and is usually a result of a road traffic accident. As the duodenum is a retroperitoneal organ, delays in diagnosis can occur, as the patient may present with vague abdominal symptoms and other non-specific signs. Computed tomographic scanning is therefore a useful tool in the diagnosis of this condition. We present a 19-year-old girl who was hit in the abdomen with a football and subsequently had a duodenal rupture.

  11. Duodenal Lipoma as a Rare Cause of Upper Gastrointestinal Bleeding.

    PubMed

    Ouwerkerk, Helga M; Raber; Freling, G; Klaase, J M

    2010-12-01

    A 52-year-old female was referred because of melaena. After initital work-up, including gastroduodenoscopy, endosonography and CT scan, a duodenotomy was performed. Definite diagnosis was a duodenal lipoma based on histological findings. Lipomas of the gastrointestinal tract are rare. Only 4% occur in the duodenum. The peak incidence is around the 5th and 7th decade of life, with a slight female preponderance. Gastrointestinal lipomas are usually asymptomatic, but can present with mild to severe gastrointestinal bleeding, intussusceptions, abdominal pain, constipation and diarrhea. Clinical, endoscopical, surgical, and radiological features are described in this case of duodenal lipoma.

  12. Duodenal Lipoma as a Rare Cause of Upper Gastrointestinal Bleeding

    PubMed Central

    Ouwerkerk, Helga M.; Raber; Freling, G.; Klaase, J.M.

    2010-01-01

    A 52-year-old female was referred because of melaena. After initital work-up, including gastroduodenoscopy, endosonography and CT scan, a duodenotomy was performed. Definite diagnosis was a duodenal lipoma based on histological findings. Lipomas of the gastrointestinal tract are rare. Only 4% occur in the duodenum. The peak incidence is around the 5th and 7th decade of life, with a slight female preponderance. Gastrointestinal lipomas are usually asymptomatic, but can present with mild to severe gastrointestinal bleeding, intussusceptions, abdominal pain, constipation and diarrhea. Clinical, endoscopical, surgical, and radiological features are described in this case of duodenal lipoma. PMID:27942311

  13. Successful Treatment of Bleeding Duodenal Varix by Percutaneous Transsplenic Embolization.

    PubMed

    Kang, Dong Hun; Park, Ji Won; Jeon, Eui Yong; Kim, Sung Eun; Kim, Jong Hyeok; Kwon, Young Seok; Park, Seung Ah; Park, Choong Kee

    2015-11-01

    Variceal bleeding occurs primarily in the esophagus or stomach in patients with liver cirrhosis, but can also occur rarely in the duodenum. Duodenal variceal bleeding has a high mortality and poor prognosis due to heavy blood flow originating from the portal vein (PV) and the technical difficulty of hemostatic procedures. Treatments including endoscopic sclerotherapy, endoscopic ligations, endoscopic clipping and transjugular intrahepatic portosystemic shunt have been tried, with only moderate and variable success. A percutaneous transsplenic approach offers another way of accessing the PV. Here we report a case of successfully treated duodenal variceal bleeding by percutaneous transsplenic embolization.

  14. Preduodenal Portal Vein Associated with Duodenal Obstruction of other Etiology: A Case Series.

    PubMed

    Srivastava, Punit; Shaikh, Mishraz; Mirza, Bilal; Jaiman, Richa; Arshad, Muhammad

    2016-01-01

    DuodenalPreduodenal portal vein is a rare and interesting entity which often causes duodenal obstruction. It is also associated with other congenital anomalies. We report here three cases of preduodenal portal vein associated with other anomalies causing duodenal obstruction not related to direct compression by portal vein itself.

  15. Preduodenal Portal Vein Associated with Duodenal Obstruction of other Etiology: A Case Series

    PubMed Central

    Srivastava, Punit; Shaikh, Mishraz; Mirza, Bilal; Jaiman, Richa; Arshad, Muhammad

    2016-01-01

    DuodenalPreduodenal portal vein is a rare and interesting entity which often causes duodenal obstruction. It is also associated with other congenital anomalies. We report here three cases of preduodenal portal vein associated with other anomalies causing duodenal obstruction not related to direct compression by portal vein itself. PMID:27896162

  16. 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 ...

  17. Biopsy (For Parents)

    MedlinePlus

    ... you understand the procedure and its risks and alternatives and give your permission for it to be performed. The person doing the biopsy will know your child's medical history, but might ask additional questions, such as what medicines your child is taking or whether your child ...

  18. Percutaneous renal tumour biopsy.

    PubMed

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo

    2014-09-01

    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed. © 2014 John Wiley & Sons Ltd.

  19. Duodenal expression of iron transport molecules in patients with hereditary hemochromatosis or iron deficiency

    PubMed Central

    Dostalikova-Cimburova, Marketa; Kratka, Karolina; Balusikova, Kamila; Chmelikova, Jitka; Hejda, Vaclav; Hnanicek, Jan; Neubauerova, Jitka; Vranova, Jana; Kovar, Jan; Horak, Jiri

    2012-01-01

    Abstract Disturbances of iron metabolism are observed in chronic liver diseases. In the present study, we examined gene expression of duodenal iron transport molecules and hepcidin in patients with hereditary hemochromatosis (HHC) (treated and untreated), involving various genotypes (genotypes which represent risk for HHC were examined), and in patients with iron deficiency anaemia (IDA). Gene expressions of DMT1, ferroportin, Dcytb, hephaestin, HFE and TFR1 were measured in duodenal biopsies using real-time PCR and Western blot. Serum hepcidin levels were measured using ELISA. DMT1, ferroportin and TFR1 mRNA levels were significantly increased in post-phlebotomized hemochromatics relative to controls. mRNAs of all tested molecules were significantly increased in patients with IDA compared to controls. The protein expression of ferroportin was increased in both groups of patients but not significantly. Spearman rank correlations showed that DMT1 versus ferroportin, Dcytb versus hephaestin and DMT1 versus TFR1 mRNAs were positively correlated regardless of the underlying cause, similarly to protein levels of ferroportin versus Dcytb and ferroportin versus hephaestin. Serum ferritin was negatively correlated with DMT1 mRNA in investigated groups of patients, except for HHC group. A decrease of serum hepcidin was observed in IDA patients, but this was not statistically significant. Our data showed that although untreated HHC patients do not have increased mRNA levels of iron transport molecules when compared to normal subjects, the expression is relatively increased in relation to body iron stores. On the other hand, post-phlebotomized HHC patients had increased DMT1 and ferroportin mRNA levels possibly due to stimulated erythropoiesis after phlebotomy. PMID:21973163

  20. Dense representation of natural odorants in the mouse olfactory bulb

    PubMed Central

    Vincis, Roberto; Gschwend, Olivier; Bhaukaurally, Khaleel; Béroud, Jonathan; Carleton, Alan

    2013-01-01

    In mammals, odorant molecules are thought to activate only a few glomeruli, leading to the hypothesis that odor representation in the olfactory bulb is sparse. However, the studies supporting this model used anesthetized animals or monomolecular odorants at limited concentration range. In this study, using optical imaging and 2-photon microscopy, we show that natural odorants at their native concentrations can elicit dense representations in the olfactory bulb. Both anesthesia and odorant concentration are shown to modulate the representation density of natural odorants. PMID:22406552

  1. The 'Brightness Rules' alternative conception for light bulb circuits

    NASA Astrophysics Data System (ADS)

    Bryan, Joel A.; Stuessy, Carol

    2006-11-01

    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 discovery of this alternative conception, appropriately christened 'Brightness Rules'. Assessments administered three weeks after the activity confirmed that several prospective teachers maintained the 'Brightness Rules' conception even after instructor-led intervention. Implications of the discovery of this alternative conception are discussed with respect to a previously administered assessment question that could not identify the presence of this alternative conception.

  2. Validation study of villous atrophy and small intestinal inflammation in Swedish biopsy registers

    PubMed Central

    2009-01-01

    Background Small intestinal biopsy with villous atrophy (VA) is the gold standard for the diagnosis of celiac disease (CD). We validated VA (Marsh 3) and small intestinal inflammation without VA (Marsh 1+2) in Swedish regional biopsy registers. Methods All pathology departments in Sweden (n = 28) were searched to identify individuals with VA or duodenal/jejunal inflammation. The validation consisted of blinded examination of biopsy samples, manual review of biopsy reports, web surveys, and patient chart reviews of 121 individuals with VA and 39 with inflammation. Results We identified 29,148 individuals with VA and 13,446 individuals with inflammation. In a blinded examination, Swedish pathologists correctly classified 90% of biopsies with VA. Manual screening of 1,534 biopsy reports (performed by co-author JFL and a research assistant) found that comorbidity other than CD was rare. IBD was the most common comorbidity and occurred in 0.3% of biopsies with VA (1.6% in inflammation). Among 114 patients with VA and available data, 108 (95%) had a clinical diagnosis of CD. 79% of the validated individuals with VA and 64% of those with inflammation had documented gastrointestinal symptoms prior to biopsy. 88% of the validated individuals with VA had positive CD serology before their first biopsy. 172/180 (96%) of Swedish gastroenterologists and 68/68 (100%) of pediatricians perform a small intestinal biopsy in at least 9 out of 10 individuals prior to diagnosis of CD. Conclusion Regional biopsy data are feasible to identify individuals with CD and small-intestinal inflammation. The specificity of CD is high in villous atrophy. PMID:19284576

  3. Validation study of villous atrophy and small intestinal inflammation in Swedish biopsy registers.

    PubMed

    Ludvigsson, Jonas F; Brandt, Lena; Montgomery, Scott M; Granath, Fredrik; Ekbom, Anders

    2009-03-11

    Small intestinal biopsy with villous atrophy (VA) is the gold standard for the diagnosis of celiac disease (CD). We validated VA (Marsh 3) and small intestinal inflammation without VA (Marsh 1+2) in Swedish regional biopsy registers. All pathology departments in Sweden (n = 28) were searched to identify individuals with VA or duodenal/jejunal inflammation. The validation consisted of blinded examination of biopsy samples, manual review of biopsy reports, web surveys, and patient chart reviews of 121 individuals with VA and 39 with inflammation. We identified 29,148 individuals with VA and 13,446 individuals with inflammation. In a blinded examination, Swedish pathologists correctly classified 90% of biopsies with VA. Manual screening of 1,534 biopsy reports (performed by co-author JFL and a research assistant) found that comorbidity other than CD was rare. IBD was the most common comorbidity and occurred in 0.3% of biopsies with VA (1.6% in inflammation). Among 114 patients with VA and available data, 108 (95%) had a clinical diagnosis of CD. 79% of the validated individuals with VA and 64% of those with inflammation had documented gastrointestinal symptoms prior to biopsy. 88% of the validated individuals with VA had positive CD serology before their first biopsy. 172/180 (96%) of Swedish gastroenterologists and 68/68 (100%) of pediatricians perform a small intestinal biopsy in at least 9 out of 10 individuals prior to diagnosis of CD. Regional biopsy data are feasible to identify individuals with CD and small-intestinal inflammation. The specificity of CD is high in villous atrophy.

  4. Massive Hemorrhage from Ectopic Duodenal Varices: Importance of a Multidisciplinary Approach

    PubMed Central

    House, Tyler; Webb, Patrick; Baarson, Chad

    2017-01-01

    Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices. We present a case of massive duodenal variceal hemorrhage that highlights the complexity of initial diagnosis and ultimately required a transesophageal intrahepatic portosystemic shunt with coil embolization for control of bleeding. PMID:28203136

  5. 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

  6. Duodenal perforation with an unusual presentation: a case report.

    PubMed

    Sarmast, Arif Hussain; Parray, Fazl Q; Showkat, Hakim Irfan; Lone, Yasir A; Bhat, Naseer A

    2011-01-01

    A young female presented with classical complaints suggestive of peptic ulcer disease leading to signs of peritonitis. The said patient after being subjected to baseline workup was subjected to laparotomy which proved to be a surgical surprise. A live ascaris lumbricoides worm was seen pouting out of a duodenal perforation.

  7. Duodenal Perforation with an Unusual Presentation: A Case Report

    PubMed Central

    Sarmast, Arif Hussain; Parray, Fazl Q.; Showkat, Hakim Irfan; Lone, Yasir A.; Bhat, Naseer A.

    2011-01-01

    A young female presented with classical complaints suggestive of peptic ulcer disease leading to signs of peritonitis. The said patient after being subjected to baseline workup was subjected to laparotomy which proved to be a surgical surprise. A live ascaris lumbricoides worm was seen pouting out of a duodenal perforation. PMID:22567473

  8. 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...

  9. 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

  10. Duodenal atresia in association with situs inversus abdominus

    PubMed Central

    Shankar, Raghu; Rao, Sadashiva P.; Shetty, Kishan B.

    2012-01-01

    We report a rare association of duodenal atresia with situs inversus abdominus in a newborn. The infantogram revealed “reverse double-bubble sign” without dextrocardia. The sonography and echocardiography confirmed the diagnosis of situs inversus abdominus with multiple cardiac anomalies. Laparotomy and a duodenoduodenostomy were carried out. PMID:22529552

  11. 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...

  12. [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.

  13. Duodenal hematoma caused by endoscopic hemostatic procedures (sclerotherapy).

    PubMed

    Irisarri Garde, Rebeca; Vila Costas, Juan José

    2017-09-01

    Endoscopic hemostatic procedures such as local injection of epinephrine are commonly used for the treatment of bleeding ulcers. Although the risks are usually considered to be minimal, there are reports describing that duodenal intramural hematomas may develop as a complication after endoscopy especially in patients susceptible to hemorrhage such as those with anticoagulants therapy or blood dyscrasia.

  14. Multiple duodenal polyps in uraemia: a little known clinical entity.

    PubMed Central

    Paimela, H; Tallgren, L G; Stenman, S; von Numers, H; Scheinin, T M

    1984-01-01

    Multiple duodenal polyps were found by endoscopy in five out of 33 patients with chronic renal failure and in one of 300 controls. In the uraemic cases the polyps were caused by circumscribed nodular hyperplasia of Brunner's glands. One of these five patients later underwent surgery for duodenal obstruction caused by the polyps; the other patients were asymptomatic. One of the controls had multiple duodenal polyps. The recorded incidence of multiple duodenal polyps was significantly higher among patients with chronic renal failure than in patients without renal disease. Patients with chronic renal failure and polyps did not differ significantly from the other renal patients in the comparison of variables such as gastric acid secretion, serum concentrations of gastrin and group I pepsinogens or mean length of dialysis treatment. The mean pH of gastric resting juice was significantly higher, however, in uraemic patients with polyps than in those without. Uraemic patients displayed a gastric acid secretion capacity within normal range, and significantly raised serum gastrin and group I pepsinogen concentrations. Images Fig. 1 Fig. 2 PMID:6698441

  15. 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

  16. 30 CFR 27.37 - Tests to determine adequacy of safety devices for bulbs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tests to determine adequacy of safety devices for bulbs. 27.37 Section 27.37 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... § 27.37 Tests to determine adequacy of safety devices for bulbs. The glass envelope of bulbs with the...

  17. 30 CFR 27.37 - Tests to determine adequacy of safety devices for bulbs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tests to determine adequacy of safety devices for bulbs. 27.37 Section 27.37 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... § 27.37 Tests to determine adequacy of safety devices for bulbs. The glass envelope of bulbs with the...

  18. 30 CFR 27.37 - Tests to determine adequacy of safety devices for bulbs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tests to determine adequacy of safety devices for bulbs. 27.37 Section 27.37 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... § 27.37 Tests to determine adequacy of safety devices for bulbs. The glass envelope of bulbs with the...

  19. A Fan-tastic Alternative to Bulbs: Learning Circuits with Fans

    ERIC Educational Resources Information Center

    Ekey, Robert; Edwards, Andrea; McCullough, Roy; Reitz, William; Mitchell, Brandon

    2017-01-01

    The incandescent bulb has been a useful tool for teaching basic electrical circuits, as brightness is related to the current or power flowing through a bulb. This has led to the development of qualitative pedagogical treatments for examining resistive combinations in simple circuits using bulbs and batteries, which were first introduced by James…

  20. A Fan-tastic Alternative to Bulbs: Learning Circuits with Fans

    ERIC Educational Resources Information Center

    Ekey, Robert; Edwards, Andrea; McCullough, Roy; Reitz, William; Mitchell, Brandon

    2017-01-01

    The incandescent bulb has been a useful tool for teaching basic electrical circuits, as brightness is related to the current or power flowing through a bulb. This has led to the development of qualitative pedagogical treatments for examining resistive combinations in simple circuits using bulbs and batteries, which were first introduced by James…

  1. 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…

  2. 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…

  3. Genetic Analyses of Soluble Carbohydrate Concentrations in Onion Bulbs

    USDA-ARS?s Scientific Manuscript database

    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...

  4. Two new amaryllidaceae alkaloids from the bulbs of Lycoris radiata.

    PubMed

    Wang, Lei; Zhang, Xiao-Qi; Yin, Zhi-Qi; Wang, Ying; Ye, Wen-Cai

    2009-06-01

    Two new Amaryllidaceae alkaloids, named lycoranines A (1) and B (2), were isolated from the bulbs of Lycoris radiata. Their structures were elucidated on the basis of extensive spectroscopic analysis. Compound 2 was a new-type alkaloid, which provided a new insight into the biosynthesis of alkaloids in Amaryllidaceae plants.

  5. Factors contributing to bacterial bulb rots of onion

    USDA-ARS?s Scientific Manuscript database

    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...

  6. 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.

  7. 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…

  8. 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…

  9. Integral storage-bulb and microwave cavity for masers

    NASA Technical Reports Server (NTRS)

    Reinhardt, V. S.

    1980-01-01

    Mechanically-stable integral storage-bulb/microwave cavity made out of single piece of fused quartz improves frequency stability. Single-piece construction eliminates joints, making cavity dimensionally and hence frequency-stable. Fused quartz is used because of its low thermal expansion coefficient.

  10. 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…

  11. 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…

  12. Comparative morphology of the accessory olfactory bulb in bats.

    PubMed Central

    Frahm, H D; Bhatnagar, K P

    1980-01-01

    Bouin-perfused brains of 148 bats (76 species, 48 genera, 8 families) were examined in serial sections for the presence of an accessory olfactory bulb. A moderate to well developed AOB was identified in 26 species. However, absence of an AOB in a particular species does not preclude its presence in some other species of that genus. Descriptions and measurements of the AOBs of each species are reported. The unmyelinated vomeronasal nerve enters the bulb medially and posteriorly. The glomeruli, variable in diameter, appear better circumscribed than previously described. Mitral cells often form thick layers, up to five cells deep, which sometimes reach the dorsolateral surface of the bulb formation. Both external and internal plexiform layers are thin. The latter, however is seen only in a few species. The internal granular layer, reaching the ventricular ependyma in some species, is a prominent component of the bulb. The pars dorsalis of the lateral olfactory tract usually courses between the mitral and internal granular layers. The chiropteran AOB does not differ in significant detail from that of insectivores, primates and other mammals. The occurrence of a functional vomeronasal system in the frugivorous, nectarivorous, and sanguivorous Phyllosotomatidae points to a primary functional role of this system in feeding strategy, at least in bats. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 PMID:7400042

  13. Math in Action. March Math: Measuring and Graphing Bulb Growth.

    ERIC Educational Resources Information Center

    Burns, Marilyn

    1998-01-01

    This mathematics activity for K-3 students has students plant and measure the growth of bulbs. The activity teaches them to measure, collect, and graph data. The article presents a list of materials needed, instructions for creating a chart, and sample discussion questions. (SM)

  14. Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management

    PubMed Central

    Lim, Chul-Hyun; Cho, Young-Seok

    2016-01-01

    Nonampullary duodenal adenomas are relatively common in familial adenomatous polyposis (FAP), but nonampullary sporadic duodenal adenomas (SDAs) are rare. Emerging evidence shows that duodenal adenomas, regardless of their anatomic location and whether they are sporadic or FAP-related, share morphologic and molecular features with colorectal adenomas. The available data suggest that duodenal adenomas develop to duodenal adenocarcinomas via similar mechanisms. The optimal approach for management of duodenal adenomas remains to be determined. The techniques for endoscopic resection of duodenal adenoma include snare polypectomy, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and argon plasma coagulation ablation. EMR may facilitate removal of large duodenal polyps. Although several studies have reported cases of successful ESD for duodenal adenomas, the procedure is technically difficult to perform safely because of the anatomical properties of the duodenum. Although current clinical practice recommends endoscopic resection of all large duodenal adenomas in patients with FAP, endoscopic treatment is usually insufficient to guarantee a polyp-free duodenum. Surgery is indicated for FAP patients with severe polyposis or nonampullary SDAs or FAP-related polyps not amenable to endoscopic resection. Further studies are needed to develop newer endoscopic techniques to guide diagnostic and therapeutic decisions for future management of nonampullary duodenal adenomas. PMID:26811631

  15. Gram stain of tissue biopsy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003453.htm Gram stain of tissue biopsy To use the sharing features on this page, please enable JavaScript. Gram stain of tissue biopsy test involves using crystal violet ...

  16. Ultrasound-Guided Breast Biopsy

    MedlinePlus

    ... Breast Biopsy An ultrasound-guided breast biopsy uses sound waves to help locate a lump or abnormality ... exam. The transducer sends out inaudible, high—frequency sound waves into the body and then listens for ...

  17. Omeprazole promotes proximal duodenal mucosal bicarbonate secretion in humans.

    PubMed

    Mertz-Nielsen, A; Hillingsø, J; Bukhave, K; Rask-Madsen, J

    1996-01-01

    The proton pump inhibitor, omeprazole, surprisingly resulted in higher rates of proximal duodenal mucosal bicarbonate secretion than previously reported using an H2 receptor antagonist for gastric acid inhibition. Gastroduodenal perfusions were performed in healthy volunteers to evaluate whether this incidental finding is explained by more potent gastric acid inhibition by omeprazole or might be caused by the different mode of drug action. Basal and stimulated gastric and duodenal bicarbonate secretion rates were measured in the same subjects in control experiments (n = 17) and after pretreatment with high dose omeprazole (n = 17) and ranitidine (n = 9), respectively, by use of a technique permitting simultaneous measurements. Concentrations of bicarbonate were measured in the respective effluents by the method of back titration. Both omeprazole and ranitidine completely inhibited gastric acid secretion (pH 6.9 v 6.8; p > 0.05). Omeprazole caused higher rates of basal (mean (SEM)) (597 (48) v 351 (39) mumol/h; p < 0.02) and vagally stimulated (834 (72) v 474 (66) mumol/h; p < 0.02), but not acid stimulated (3351 (678) v 2550 (456) mumol/h; p > 0.05) duodenal bicarbonate secretion compared with control experiments. Also the combination of omeprazole and ranitidine increased (p = 0.05) duodenal bicarbonate secretion, while ranitidine alone caused no change in either basal or stimulated secretion. In the stomach basal as well as vagally stimulated bicarbonate secretion was independent of the means of acid inhibition. These results show that the proton pump inhibitor, omeprazole, promotes proximal duodenal mucosal bicarbonate secretion apparently independent of its gastric acid inhibitory effect. The mechanism of action remains speculative.

  18. 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.

  19. Omeprazole promotes proximal duodenal mucosal bicarbonate secretion in humans.

    PubMed Central

    Mertz-Nielsen, A; Hillingsø, J; Bukhave, K; Rask-Madsen, J

    1996-01-01

    The proton pump inhibitor, omeprazole, surprisingly resulted in higher rates of proximal duodenal mucosal bicarbonate secretion than previously reported using an H2 receptor antagonist for gastric acid inhibition. Gastroduodenal perfusions were performed in healthy volunteers to evaluate whether this incidental finding is explained by more potent gastric acid inhibition by omeprazole or might be caused by the different mode of drug action. Basal and stimulated gastric and duodenal bicarbonate secretion rates were measured in the same subjects in control experiments (n = 17) and after pretreatment with high dose omeprazole (n = 17) and ranitidine (n = 9), respectively, by use of a technique permitting simultaneous measurements. Concentrations of bicarbonate were measured in the respective effluents by the method of back titration. Both omeprazole and ranitidine completely inhibited gastric acid secretion (pH 6.9 v 6.8; p > 0.05). Omeprazole caused higher rates of basal (mean (SEM)) (597 (48) v 351 (39) mumol/h; p < 0.02) and vagally stimulated (834 (72) v 474 (66) mumol/h; p < 0.02), but not acid stimulated (3351 (678) v 2550 (456) mumol/h; p > 0.05) duodenal bicarbonate secretion compared with control experiments. Also the combination of omeprazole and ranitidine increased (p = 0.05) duodenal bicarbonate secretion, while ranitidine alone caused no change in either basal or stimulated secretion. In the stomach basal as well as vagally stimulated bicarbonate secretion was independent of the means of acid inhibition. These results show that the proton pump inhibitor, omeprazole, promotes proximal duodenal mucosal bicarbonate secretion apparently independent of its gastric acid inhibitory effect. The mechanism of action remains speculative. PMID:8566861

  20. The light bulb, cystoscopy, and Thomas Alva Edison.

    PubMed

    Moran, Michael E

    2010-09-01

    Thomas Alva Edison was an icon of American achievement who literally invented the 20th century. Although best known as the inventor of the electric light bulb, the phonograph, and motion pictures, he also left a lasting legacy via peripheral developmental applications, such as endoscopes. A review of published urologic writings about incandescent cystoscopes was cross-referenced to writings about or from Edison. Important events that allowed transference of technology from the Edison laboratory to clinical practice were emphasized. Edison was born in 1847 while Lincoln was serving in Congress; he died in 1931 when Hoover struggled with the Great Depression. Edison's life spanned the formative period of America that Henry Adams called the "coming of age." Edison received a Sprengel vacuum device in late 1879, and as usual, he was able to tweak the machine to better performance. For 5 days in October, 16 to 21, he improved the vacuum from 1/100,000 to 1/1,000,000 atm, and his first incandescent bulb burned softly. On December 21, 1879, he leaked the story to N.Y. Herald journalist Marshall Fox, and the world was notified of the light bulb. Special Christmas light visits started in Menlo Park just 4 days later. Edison patented the screw cap for easy changes, and the first bulbs sold for 40 cents (cost $1.40). 100,000 bulbs sold in 1882, 4 million by 1892, and 45 million in 1903. Immediately, competitors and specialty manufacturers entered the market. Dr. Henry Koch and Charles Preston in Rochester, N.Y., developed a smaller, low amperage bulb that could be fitted to medical devices. No discussion of electricity and modern applications would be complete without some discussion of Thomas Alva Edison and his sentinel contributions. The first church, post office, and ship were illuminated in 1892. The first hotel, theater, and electric sign were in 1893. The rapidity of dispersal and secondary applications of Edison's inventions is typified by the rise of cystoscopes

  1. Liver biopsy in sheep.

    PubMed

    Hidiroglou, M; Ivan, M

    1993-01-01

    Liver biopsies were performed in the same group of 16 sheep on 8 consecutive wk using an apparatus with a fibre optic continuous light source and a telescope. The sheep were placed in a sternal position on a special table constructed of metal pipes (3.8 cm diameter) and 4.5 cm spacing. Approximately 300 mg of fresh liver sample was removed from each sheep to be analyzed for copper or vitamin E.

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

    PubMed Central

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

    1981-01-01

    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. PMID:7239320

  3. 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.

  4. Local neurons play key roles in the mammalian olfactory bulb.

    PubMed

    Saghatelyan, Armen; Carleton, Alan; Lagier, Samuel; de Chevigny, Antoine; Lledo, Pierre-Marie

    2003-01-01

    Over the past few decades, research exploring how the brain perceives, discriminates, and recognizes odorant molecules has received a growing interest. Today, olfaction is no longer considered a matter of poetry. Chemical senses entered the biological era when an increasing number of scientists started to elucidate the early stages of the olfactory pathway. A combination of genetic, biochemical, cellular, electrophysiological and behavioral methods has provided a picture of how odor information is processed in the olfactory system as it moves from the periphery to higher areas of the brain. Our group is exploring the physiology of the main olfactory bulb, the first processing relay in the mammalian brain. From different electrophysiological approaches, we are attempting to understand the cellular rules that contribute to the synaptic transmission and plasticity at this central relay. How olfactory sensory inputs, originating from the olfactory epithelium located in the nasal cavity, are encoded in the main olfactory bulb remains a crucial question for understanding odor processing. More importantly, the persistence of a high level of neurogenesis continuously supplying the adult olfactory bulb with newborn local neurons provides an attractive model to investigate how basic olfactory functions are maintained when a large proportion of local neurons are continuously renewed. For this purpose, we summarize the current ideas concerning the molecular mechanisms and organizational strategies used by the olfactory system to encode and process information in the main olfactory bulb. We discuss the degree of sensitivity of the bulbar neuronal network activity to the persistence of this high level of neurogenesis that is modulated by sensory experience. Finally, it is worth mentioning that analyzing the molecular mechanisms and organizational strategies used by the olfactory system to transduce, encode, and process odorant information in the olfactory bulb should aid in

  5. Physiological, biochemical and transcriptional analysis of onion bulbs during storage

    PubMed Central

    Chope, Gemma A.; Cools, Katherine; Hammond, John P.; Thompson, Andrew J.; Terry, Leon A.

    2012-01-01

    Background and Aims During the transition from endo-dormancy to eco-dormancy and subsequent growth, the onion bulb undergoes the transition from sink organ to source, to sustain cell division in the meristematic tissue. The mechanisms controlling these processes are not fully understood. Here, a detailed analysis of whole onion bulb physiological, biochemical and transcriptional changes in response to sprouting is reported, enabling a better knowledge of the mechanisms regulating post-harvest onion sprout development. Methods Biochemical and physiological analyses were conducted on different cultivars (‘Wellington’, ‘Sherpa’ and ‘Red Baron’) grown at different sites over 3 years, cured at different temperatures (20, 24 and 28 °C) and stored under different regimes (1, 3, 6 and 6 → 1 °C). In addition, the first onion oligonucleotide microarray was developed to determine differential gene expression in onion during curing and storage, so that transcriptional changes could support biochemical and physiological analyses. Key Results There were greater transcriptional differences between samples at harvest and before sprouting than between the samples taken before and after sprouting, with some significant changes occurring during the relatively short curing period. These changes are likely to represent the transition from endo-dormancy to sprout suppression, and suggest that endo-dormancy is a relatively short period ending just after curing. Principal component analysis of biochemical and physiological data identified the ratio of monosaccharides (fructose and glucose) to disaccharide (sucrose), along with the concentration of zeatin riboside, as important factors in discriminating between sprouting and pre-sprouting bulbs. Conclusions These detailed analyses provide novel insights into key regulatory triggers for sprout dormancy release in onion bulbs and provide the potential for the development of biochemical or transcriptional markers for sprout

  6. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... 1- to 2-Year-Old Aspiration and Biopsy: Bone Marrow KidsHealth > For Parents > Aspiration and Biopsy: Bone Marrow Print A A A What's in this article? ... Aspiraciones y biopsias: médula ósea What It Is Bone marrow aspirations and biopsies are performed to examine bone ...

  7. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Your 1- to 2-Year-Old Aspiration and Biopsy: Bone Marrow KidsHealth > For Parents > Aspiration and Biopsy: Bone Marrow A A A What's in this ... ósea What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  8. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow A A A What's in this ... Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  9. Cost-effectiveness of two breast biopsy procedures: surgical biopsy versus vacuum-assisted biopsy.

    PubMed

    Pistolese, C A; Ciarrapico, A; Perretta, T; Cossu, E; della Gatta, F; Giura, S; Caramanica, C; Simonetti, G

    2012-06-01

    The aim of this study was to compare the cost-effectiveness of two breast biopsy procedures: surgical biopsy and vacuum-assisted biopsy (VAB). Between November 2008 and September 2009, 200 patients with suspicious breast lesions underwent biopsy procedures at our radiology department: 100 underwent VAB and 100 underwent surgical biopsy. 66 lesions were sampled under sonographic guidance, 109 under mammographic guidance and 25 under magnetic resonance guidance. All procedures were successfully completed. No significant differences in diagnostic efficacy were found between the biopsy procedures. Surgical biopsy has a higher unit cost compared with VAB. Our analysis emphasises the benefits of VAB compared with surgical biopsy in terms of both cost-effectiveness, and less invasiveness from a psychological and aesthetic point of view.

  10. Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet

    PubMed Central

    Larussa, Tiziana; Suraci, Evelina; Imeneo, Maria; Marasco, Raffaella; Luzza, Francesco

    2017-01-01

    Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2–33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03–1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03–1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6–192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling. PMID:28146115

  11. 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

  12. Audit of endoscopic surveillance biopsy specimens in HIV positive patients with gastrointestinal symptoms.

    PubMed Central

    Lim, S G; Lipman, M C; Squire, S; Pillay, D; Gillespie, S; Sankey, E A; Dhillon, A P; Johnson, M A; Lee, C A; Pounder, R E

    1993-01-01

    An audit of upper gastrointestinal endoscopy in HIV infected patients with gastrointestinal symptoms assessed the frequency of disease detected by endoscopy and routine laboratory analysis of surveillance biopsy specimens. Sixty nine consecutive endoscopies were performed in 59 HIV infected patients. Endoscopic biopsy specimens were taken from the lower oesophagus, gastric antrum, and third part of the duodenum for virology, histopathology, parasitology, bacteriology, and mycobacterial culture. Endoscopic appearances detected disease in 25/59 (42.4%) patients (oesophageal candida, 14; oesophageal ulcer, 3; Kaposi's sarcoma, 4; others, 4), but only 4/43 (9.3%) specimens showed evidence of disease in the absence of endoscopic abnormality. Virology for cytomegalovirus (detection of early antigenic fluorescent foci and culture) was positive in 6/59 (10.2%) patients, but parasitology and mycobacterial culture were negative in all cases. Histopathology was abnormal in 11/52 (21%) oesophageal biopsy specimens, 13/47 (28%) gastric biopsy specimens, and 4/65 (6%) duodenal biopsy specimens. Abnormal findings were found predominantly in those with advanced HIV disease (CDC Stage IV) (21/33 patients (64%)) compared with those with early HIV disease (CDC Stage II) (5/26 (19%)). In conclusion, upper gastrointestinal endoscopy detects macroscopic disease in AIDS patients and those with low CD4 counts, but routine surveillance biopsy specimens of apparently normal bowel in early HIV disease (or where CD4 counts are greater than 0.2 x 10(9)/1) are of little value. PMID:8244115

  13. [Total duodenal section. A reliable indicator of severe physical abuse].

    PubMed

    Baeza-Herrera, Carlos; Arcos-Aponte, Arturo; Villalobos-Castillejos, Alín; López-Castellanos, Javier; Cortés-García, Ricardo

    2008-01-01

    Rupture of the hollow viscera due to battered child syndrome is an unusual clinical finding and it is even less likely when we encounter total duodenum section. The literature on child abuse does not include visceral lesions as part of the spectrum. The aim of this study was to analize if complete duodenal section is a reliable indicator of severe physical abuse. Data were statistically analyzed using chi-square tests, likelihood ratios and the Cochran-Mantel-Haentzel test. Four children were admitted with a battered child syndrome diagnosis. All participants were surgically treated and the finding was total section of the duodenum. The postoperative course was normal. Statistical tests were p<0.0001 and the likelihood ratio 18.7 Duodenal rupture is a statistically reliable indicator of a severe form of physical abuse in children.

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

    PubMed

    Machado, Norman Oneil

    2016-04-27

    To study the etiopathogenesis, management and outcome of duodenal injury post laparoscopic cholecystectomy (LC). 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 I (2) 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 χ (2) test with Yate's correction. Based on Kaplan Meier survival curve concept, the cumulative survival probabilities at various days of injury was estimated. 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 2(nd) part of the duodenum with 46% above the papilla and 15% below papilla and in 31% to the 1(st) 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, Whipple resection

  15. An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar.

    PubMed

    Fan, Shengxian; Wang, Jing; Li, Yousheng

    2016-12-01

    Duodenal phytobezoar, an unusual cause of acute duodenal obstruction, is rarely seen. The most common cause of this type of bezoar is persimmon. It frequently arises from underlying gastrointestinal tract pathologies (gastric surgery, etc.). Here, we report the case of a 66-year-old man who had undergone distal gastrectomy with Billroth I reconstruction for gastric cancer and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. The abdominal computed tomography scan showed a large-sized mass in the horizontal portion of the duodenum. On following endoscopic examination, a large phytobezoar was revealed in the duodenum. He was treated with endoscopic fragmentation combined with nasogastric Coca-Cola. The patient tolerated the procedure well and resumed a normal oral diet 3 days later.

  16. Total Robotic Biliopancreatic Diversion with Duodenal Switch Technique.

    PubMed

    Antanavicius, Gintaras; Mohammed, Ricardo; Van Houtte, Olivier

    2016-12-31

    The use of robotic bariatric surgery has increased significantly since its advent in 1999. Its utility and safety has been demonstrated in the literature for all bariatric procedures, including most recently the biliopancreatic diversion with duodenal switch (BPDDS). The robotic-assisted biliopancreatic diversion with duodenal switch (RBPDDS) was first described by Sudan et al. in 2007 with the use of the robot primarily for the duodeno-ileal anastomosis, then in 2015, the same authors described 59 cases of totally RBPDDS using the robot for the most of the operation, but still utilizing laparoscopic staplers. Robotic staplers were introduced recently and it became possible to utilize robot throughout the entire procedure without relying on stapling performed by an assistant. Described here is the technique of a total RBPDDS utilizing robotic staplers.

  17. Symptomatic duodenal perforation by inferior vena cava filter.

    PubMed

    Baptista Sincos, Anna Pw; Sincos, Igor R; Labropoulos, Nicos; Donegá, Bruno C; Klepacz, Andrea; Aun, Ricardo

    2017-01-01

    Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.

  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. Percutaneous transbiliary biopsy.

    PubMed

    Andrade, Gustavo Vieira; Santos, Miguel Arcanjo; Meira, Marconi Roberto; Meira, Mateus Duarte

    2017-01-01

    Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico. Descrevemos a técnica de biópsia da lesão obstrutiva através do acesso de drenagem biliar, utilizando um fórcipe de biópsia endoscópica 7F, amplamente disponível e alguns reutilizáveis. Esta técnica aplica-se a lesões dos ductos hepáticos, do hepático comum e de toda extensão do colédoco.

  20. Increase in neuroendocrine cells in the duodenal mucosa of patients with refractory celiac disease.

    PubMed

    Di Sabatino, Antonio; Giuffrida, Paolo; Vanoli, Alessandro; Luinetti, Ombretta; Manca, Rachele; Biancheri, Paolo; Bergamaschi, Gaetano; Alvisi, Costanza; Pasini, Alessandra; Salvatore, Chiara; Biagi, Federico; Solcia, Enrico; Corazza, Gino Roberto

    2014-02-01

    Several immune-mediated gastrointestinal disorders, including celiac disease (CD), are associated with neuroendocrine cell hyperplasia. However, neuroendocrine cells have never been explored in refractory CD (RCD). Serial duodenal sections from 17 patients with RCD (6 type 1 and 11 type 2), 16 uncomplicated CD patients before and after gluten-free diet, 14 patients with potential CD, 27 patients with non-CD villous atrophy, i.e., common variable immunodeficiency (n=12), Whipple's disease (n=10) and giardiasis (n=5), and 16 healthy subjects were processed for the immunohistochemical detection of chromogranin A (CgA), serotonin, and somatostatin. Mucosal tryptophan hydroxylase (TpH)-1 and serotonin-selective reuptake transporter (SERT) transcripts were measured by quantitative reverse transcription-PCR. Serum CgA and 24-h urine 5-hydroxyindoleacetic acid (5-HIAA) were assessed. Biopsies from treated CD patients were cultured with serotonin or peptic tryptic digest of gliadin (PT-gliadin), and interferon (IFN)-γ was detected by ELISA in culture supernatants. Epithelial cells positive for CgA and serotonin, but not somatostatin, were significantly increased in RCD. Raised mucosal transcripts of TpH-1, but not SERT, were found in RCD. On biopsies from treated CD patients, serotonin upregulated IFN-γ production at levels comparable to those induced by PT-gliadin. Serum CgA, but not urine 5-HIAA, was increased in RCD. No significant difference was found between RCD type 1 and type 2 in terms of neuroendocrine cells, mucosal TpH-1 transcripts, and serum CgA. Serotonin-producing neuroendocrine cells are increased in RCD mucosa. IFN-γ upregulation induced by serotonin suggests that this monoamine may have a role in sustaining the local inflammatory response in CD.

  1. Interpretation of automotive light bulb examination results: an intriguing case.

    PubMed

    Stauffer, Eric

    2007-01-01

    During the examination of light bulbs from a vehicle involved in a road accident, the headlights did not reveal any evidence regarding whether they were energized or not. Additionally, a police officer turned the lights on after the accident to verify their functioning, thus damaging some of the evidence. By examining the vehicle, it was determined that the park lights could provide answers regarding the conditions of the headlights. After observations, it was concluded that the park lights and headlights were off at the time of the impact. This case report demonstrates how important it is to integrate the circumstances surrounding the case into the interpretation of the results. Nevertheless, it also demonstrates the necessity for examining both the vehicle and all light bulbs in order to reach the most pertinent and proper conclusion.

  2. Optimizing Structure of LED Light Bulb for Heat Transfer

    NASA Astrophysics Data System (ADS)

    Kobayashi, T.; Itami, D.; Hashimoto, R.; Takashina, T.; Kanematsu, H.; Mizuta, K.; Utsumi, Y.

    2013-04-01

    In this paper, in order to optimize the heat transfer structure of LED light bulb, the effects of various parameters on the temperature of the LED device were systematically analyzed, and a design guideline was shown. Although LED device has become popular due to its high-efficiency and long life, the design issues on the heat transfer structure of LED light bulbs has still remained. Because the original efficiency and life of the LED device can not be obtained due to the local temperature rise of LED element and the surrounding polymer molding material. Therefore, heat transfer analysis by finite element method was conducted systematically by changing parameters such as the shape, number and thickness of the radiating fin of the LED. As a result, advantage of open type structure was shown, and the proper design guidance for the structure of the fin shape was obtained.

  3. Duodenal gossypiboma: a case report and literature review.

    PubMed

    Velasco-Mata, Stephany; Díaz-Gómez, Marialy; Cova-Bianco, Tamarys; Hopp-Mora, Evelyn; Rodriguez-Rojas, Roselin; Chirinos-Malave, Yeirama; Carreiro-Rodriguez, Manuel

    2015-09-01

    Gossypiboma is a retained surgical cotton matrix material in the body after a surgical procedure. Cases are rarely reported due to medico-legal concerns. Although infrequent, it causes serious morbidity and even mortality if left undiagnosed. We present the case of a trans-mural migration of gossypiboma and a review of the literature. Gossypiboma's trans-duodenal migration is a rare complication of retained gauzes. Cases reported in the literature were easy to diagnose based on clinical grounds and endoscopic studies.

  4. The Effect of Helicobacter pylori Eradication on the Gastrointestinal Microbiota in Patients with Duodenal Ulcer.

    PubMed

    Li, Lin; Zhou, Xiaoying; Xiao, Shuping; Ye, Feng; Zhang, Guoxin

    2016-06-01

    Recent reports have indicated that Helicobacter pylori (H. pylori) might have an effect on gastrointestinal flora; moreover, gastric commensual bacteria have been observed in the development of duodenal ulcer (DU). In our study, we aimed to evaluate the effect of H. pylori eradication on gastrointestinal flora in DU patients. A case-control study was performed at Jiangsu Shengze Hospital between December, 2013 and April, 2014. The patients received antibiotic eradication therapy if H. pylori testing was positive. At least four weeks after cessation of the eradication therapy, a repeat gastroscopy was performed to collect biopsies again in the same position. Gastric mucosa samples and feces specimens were collected to extract bacteria DNA and then to quantify by real-time polymerase chain reaction (PCR). After the eradication of H. pylori, an increase of Lactobacillus group, Clostridium leptum subgroup, Enterobacteria and a decrease of Clostridium coccoides subgroup were found in the antrum. In the corpus, the number of bacteria in the Lactobacillus group was increased and the expression of Clostridium coccoides subgroup was significantly down-regulated. In the feces samples, only the number in the Lactobacillus group was increased. Moreover, the distribution was significantly different between female and the male patients. The presence of H. pylori in the stomach suppressed the colonization with Lactobacillus group, Clostridium leptum subgroup and Enterobacteria. Gender might affect the distribution and/or recolonization of the bacteria in DU patients.

  5. Analysis of the cytokine profile in the duodenal mucosa of refractory coeliac disease patients.

    PubMed

    Caruso, Roberta; Marafini, Irene; Sedda, Silvia; Del Vecchio Blanco, Giovanna; Giuffrida, Paolo; MacDonald, Thomas T; Corazza, Gino Roberto; Pallone, Francesco; Di Sabatino, Antonio; Monteleone, Giovanni

    2014-03-01

    RCD [refractory CD (coeliac disease)] is characterized by severe symptoms/signs of malabsorption and mucosal damage unresponsive to a GFD (gluten-free diet). The pathogenesis of RCD is not fully understood. In the present paper, we have characterized the mucosal profile of effector cytokines in RCD. Duodenal biopsies were taken from patients with RCD, patients with active CD and normal controls and were analysed for inflammatory cytokines by real-time PCR and ELISA. IFN (interferon)-γ and IL (interleukin)-21 transcripts were increased in active CD patients but not in RCD patients as compared with normal controls, whereas IL-17A RNA was up-regulated in both active CD and RCD. No significant increase in IL-15 transcripts was observed in both active CD and RCD, whereas IL-15 protein was increased in active CD. IL-6 and TNF (tumour necrosis factor)-α were up-regulated only in RCD. As a proof, we present the case of a woman affected by RCD who responded to anti-TNF-α treatment with improvement of malabsorptive symptoms/signs but no healing of mucosal lesions. The findings indicate that the profile of mucosal effector cytokines differs between RCD and active CD and suggest that TNF-α, IL-6 and IL-17A, but not Th1-type cytokines, could drive the detrimental response in this condition.

  6. 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.

  7. Estimating Wet Bulb Globe Temperature Using Standard Meteorological Measurements

    SciTech Connect

    Hunter, C.H.

    1999-11-18

    The heat stress management program at the Department of Energy''s Savannah River Site (SRS) requires implementation of protective controls on outdoor work based on observed values of wet bulb globe temperature (WBGT). To ensure continued compliance with heat stress program requirements, a computer algorithm was developed which calculates an estimate of WBGT using standard meteorological measurements. In addition, scripts were developed to generate a calculation every 15 minutes and post the results to an Intranet web site.

  8. Perforated duodenal ulcer: a rare complication of deferasirox in children.

    PubMed

    Yadav, Sunil Kumar; Gupta, Vipul; El Kohly, Ashraf; Al Fadhli, Wasmi

    2013-01-01

    Duodenal ulcer perforation in pediatric age group is an uncommon entity; hence, it is not usually considered in the differential diagnosis of acute abdomen in these patients. It is important for the emergency physician to consider perforated peptic ulcer in the differential diagnosis of children presenting with acute abdominal pain, gastrointestinal bleeding, or shock. We report a 6½-year-old male child with thalassemia major who presented to emergency room with an acute abdomen and shock, who was subsequently found to have a perforated duodenal ulcer, probably related to use of oral chelating agent, deferasirox. Although, gastrointestinal symptoms like nausea, vomiting, and abdominal pain has been mentioned as infrequent adverse event in the scientific product information of deferasirox, in our current knowledge this is the first case report of perforated duodenal ulcer after oral deferasirox. The severity of this event justifies the reporting of this case. This patient had an atypical presentation in that there were no signs or symptoms of peptic ulcer disease before perforation and shock he was successfully managed with open surgery after initial resuscitation and stabilization of his general condition.

  9. Duodenal gangliocytic paraganglioma: A case report and literature review

    PubMed Central

    Loftus, Tyler J.; Kresak, Jesse L.; Gonzalo, David H.; Sarosi, George A.; Behrns, Kevin E.

    2015-01-01

    Introduction Gangliocytic paraganglioma is a rare tumor that is most commonly located in the duodenum. At presentation, it may be confused with a gastrointestinal stromal tumor (GIST), but distinguishing between these tumors is critical because the natural history and treatment of these two tumors differs markedly. Duodenal gangliocytic paraganglioma typically exhibits benign behavior with occasional regional lymph node metastasis and no reports of tumor associated deaths. Recurrence after resection is rare. Presentation of case A 50 year-old male presented with melena and hemoglobin concentration of 4.6 g/dl. Esophagogastroduodenoscopy demonstrated a submucosal mass in the third portion of the duodenum with no active bleeding. CT scan identified no regional lymphadenopathy or distant metastasis. The tumor was resected through a longitudinal duodenotomy with negative margins. Discussion Endoscopic resection of duodenal gangliocytic paraganglioma appears to be safe and effective when tumor may be removed in its entirety by this method. If the tumor is not suspended by a stalk or there is suspicion for regional lymph node disease then surgical management is preferred. Radiation oncologists at high volume centers have endorsed utilization of adjuvant radiotherapy to the postsurgical bed in cases involving lymph node metastasis. Utilization of chemotherapy for management of this disease has not been reported. Conclusion Localized duodenal gangliocytic paragangliomas are best managed by resection with negative margins. In cases in which the tumor is resected with negative margins, it appears to be safe to embark on a course of surveillance and forego adjuvant therapy. PMID:25600615

  10. Duodenal endoluminal barrier sleeve alters gut microbiota of ZDF rats.

    PubMed

    Kim, T; Holleman, C L; Ptacek, T; Morrow, C D; Habegger, K M

    2017-03-01

    The combination of energy dense diets and reduced energy expenditure in modern society has escalated the prevalence of obesity and obesity-related comorbidities. Among these disease states, type-2 diabetics (T2D) are disproportionately associated with obesity, suggesting a shared etiology. In conjunction with defects in hormonal and inflammatory states, obesity and T2D are also characterized by dysbiosis. We have recently described the beneficial effects of duodenal nutrient exclusion, as induced by the duodenal endoluminal sleeve (DES); including body weight loss, prevented fat mass accumulation, and improved glucose tolerance in the ZDF rat, a rodent model of obesity and type-2 diabetes (T2D). To assess the relative role of DES on hindgut microbiota in the context of these metabolic changes, we analyzed cecal samples from rats implanted with a duodenal endoluminal sleeve (DES), or a sham control of this procedure. A group of pair-fed (pf) sham controls was also included to account for changes induced by reduced body weight and food intake. Analysis of hindgut microbiota following DES in the ZDF rat elucidated discrete changes in several microbial populations including a reduction in Paraprevotella family members of the Clostridiales order along with an increase in Akkermansia muciniphila and species of the Allobaculum and Bifidobacterium genera. Altogether, these observations suggest that like Roux-en Y gastric bypass (RYGB) and Metformin, regulation of gut microbiota may be a contributing factor to the therapeutic effects of DES.

  11. Influence of dietary fat on duodenal resistance to acid.

    PubMed

    Lugea, A; Salas, A; Guarner, F; Malagelada, J R

    1993-10-01

    Three experimental diets were prepared from a standard formula plus pure oleic, linoleic, or eicosapentaenoic acid (2% by weight). Mucosal resistance to acid was tested in anaesthetised rats fed the experimental diets for at least four weeks (60 rats per diet) by duodenal infusion of HCl (200 to 700 mumol) 30 minutes after pretreatment with either saline or 100 mumol HCl (used as a mild irritant). Rats were killed one hour after the test and the duodenal damage was assessed 'blindly' using a combined macroscopic and histological score. Differences were tested by analysis of covariance of the dose-response curves. Mucosal resistance was similar in the three groups when the acid challenge was given after saline pretreatment. Resistance to acid in all three groups was significantly increased by previous exposure to 100 mumol HCl (p < 0.01). Interestingly, rats fed a linoleic or eicosapentaenoic supplemented diet after pretreatment with HCl developed significantly higher resistance to acid than those fed the diet with oleic acid (p < 0.05). Pretreatment with indomethacin suppressed the difference between diets. In conclusion, dietary polyunsaturated fatty acids enhance duodenal resistance to acid by potentiation of adaptive cytoprotection.

  12. Intracerebral adrenoceptor agonists influence rat duodenal mucosal bicarbonate secretion.

    PubMed

    Larson, G M; Jedstedt, G; Nylander, O; Flemström, G

    1996-11-01

    We have studied the effects of intracerebral administration of selective alpha-adrenergic agonists on duodenal bicarbonate secretion. Duodenum free of Brunner's glands was cannulated in situ in anesthetized rats, and bicarbonate secretion into the luminal reperfusate was continuously titrated by pH stat. Infusion of the alpha 1-selective adrenoceptor agonist, phenylephrine (1,000-2,500 micrograms.kg-1.h-1), into a lateral brain ventricle increased (P < 0.01) duodenal bicarbonate secretion. Pretreatment with prazosin, an alpha 1-antagonist, significantly (P < 0.01) reduced the stimulatory effect when infused into the lateral ventricle (30 micrograms.kg-1.h-1), but not when administered intravenously (1,000 micrograms.kg-1.h-1). Hexamethonium (10 mg.kg-1.h-1 iv) abolished stimulation, whereas cervical vagotomy, epidural blockade, and naloxone were each without effect. Vasopressin, vasopressin antagonists, ts, and oxytocin did not affect basal secretion. Intracerebro-ventricular administration of the alpha 2-adrenoceptor agonist, clonidine (1,000 micrograms.kg-1.h-1), in contrast to alpha 1-receptor activation, decreased (P < 0.01) the secretion. Thus central nervous adrenoceptors influence duodenal mucosal bicarbonate te secretion, and alpha 1-adrenoceptor stimulation may provide protection against luminal acid. This potent stimulation was not mediated by the vagal nerves, spinal cord pathways, or the release of beta-endorphin but involves nicotinic, possibly enteric nervous transmission.

  13. Treatment of duodenal ulcer with pirenzepine and cimetidine.

    PubMed Central

    Brunner, H; Dittrich, H; Kratochvil, P; Brandstätter, G; Hentschel, E; Schütze, K; Tragl, K H; Kern, H; Löffelmann, K; Zeiler, H

    1984-01-01

    The purpose of this single blind controlled multicentre trial was to compare the relative effectiveness of pirenzepine and cimetidine in healing endoscopically proven duodenal ulcers. One hundred and twenty six patients with duodenal ulcer were treated with a daily dose of 100 mg pirenzepine (50 mg each before breakfast and before the evening meal), and 128 patients were treated with 1000 mg cimetidine (200 mg with breakfast, lunch, and evening meal and 400 mg at bedtime). Endoscopy was repeated after four weeks by an endoscopist who had not been informed about the treatment. Pirenzepine showed a healing rate of 64.3%, cimetidine one of 73.4%. This difference is not statistically significant (one-sided test: chi 1(2) = 2.48). After four weeks a higher proportion of first ulcers than of recurrent lesions was healed. Pain relief was rapidly achieved with both drugs. A significant trend in favour of cimetidine may, however, not be clinically relevant considering the small difference in the absolute numbers of pain free days and nights. Adverse effects were rare and reversible. We conclude that the efficacy of pirenzepine is similar to that of cimetidine in healing duodenal ulcers. PMID:6363220

  14. Heel bulb lacerations in horses: 101 cases (1988-1994).

    PubMed

    Janicek, John C; Dabareiner, Robin M; Honnas, Clifford M; Crabill, Mark A

    2005-02-01

    To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses. Retrospective study. 101 horses. Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained. 75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean +/- SD time from injury to referral was 24 +/- 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures. Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis.

  15. 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.

  16. Signal processing inspired from the olfactory bulb for electronic noses

    NASA Astrophysics Data System (ADS)

    Jing, Ya-Qi; Meng, Qing-Hao; Qi, Pei-Feng; Zeng, Ming; Liu, Ying-Jie

    2017-01-01

    A bio-inspired signal processing method is proposed for electronic noses (e-noses). The proposed method contains an olfactory bulb model and a feature generation step. The structure of the olfactory bulb model is similar to the anatomical structure of mammals’ olfactory bulb. It consists of olfactory receptor neurons, mitral cells, granule cells, periglomerular cells, and short axon cells. This model uses gas sensors’ original response curves and transforms them to neuron spiking series no matter what kind the response curve is. This largely simplifies the follow-up feature generation step. Recurrence quantification analysis is employed to perform feature generation and the five most important features are selected. Finally, in order to verify the performance of the proposed method, seven kinds of Chinese liquors are tested and three classification methods are used to classify them. The experimental results demonstrate that the proposed method has a higher classification rate (99.05%) and also a steadier performance with the change of sensor number and types than the classic one.

  17. 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

  18. Morphology and Physicochemical Properties of 3 Lilium Bulb Starches.

    PubMed

    Yu, Xurun; Zhang, Jing; Li, Aimin; Wang, Zhong; Xiong, Fei

    2015-08-01

    Lilium (Liliaceae) is an important wild plant and is used as food and traditional medicine worldwide. One Lilium cultivar (Lilium lancifolium) and 2 wild types (Lilium leucanthum and Lilium rosthornii) that are commonly distributed in Western China were investigated to completely utilize Lilium resources. The morphology of the flowers, bulbs, and scales and soluble sugar, total starch and amylose contents was remarkably different among the 3 Lilium species. Starches from the 3 Lilium species presented different granule size and shape. The starch of L. lancifolium exhibited higher swelling power and solubility than that of L. leucanthum and L. rosthornii. The starches from the 3 Lilium bulbs presented similar X-ray diffraction patterns and Fourier transform infrared spectroscopy. Among the 3 Lilium species, L. lancifolium showed the lowest crystallinity and the largest proportion of ordered structures in granule external region. Gelatinization temperatures and retrogradation percentage were significantly lower, but gelatinization enthalpy was significantly higher in L. lancifolium than those in L. leucanthum and L. rosthornii. Pasting properties of starch were different among the 3 Lilium species. Starch from L. lancifolium showed the highest degree of amylopectin branching, followed by L. leucanthum and L. rosthornii. Starches from L. leucanthum and L. rosthornii showed higher resistance to porcine pancreatic α-amylase hydrolysis compared to that of L. lancifolium. These results indicated that 3 Lilium bulbs exhibited remarkable differences in morphological, crystal, thermal, pasting, and hydrolysis properties of starches. © 2015 Institute of Food Technologists®

  19. [Follicular and mantle cell lymphoma diagnosed in biopsies of gastroenterocolic region].

    PubMed

    Plank, Lukáš; Balhárek, Tomáš; Szépe, Peter

    2016-01-01

    The authors present a retrospective analysis of follicular lymphomas (FL) and mantle cell lymphomas (MCL) diagnosed according to the WHO classification (2008) in consecutive biopsies of GI organs in a period of 11 years. The series includes 18 patients with FL verified in 22 biopsies and 44 patients with MCL diagnosed in 54 biopsies. FL represented always a solitary tumor, most often - up to ¾ of all the cases - of a small intestine, more often in its jejunoileal than duodenal parts. The biopsies were obtained almost equally by endoscopical approach, they were usually mucosal and rarely polypectomic, as well as by surgical resections (54,5 % and 45,5 % of the cases respectively). FL of grade 3 was identified in approximately 11 % of the cases, while majority of the patients showed FL of grade 1 or 2. Only 2 patients with duodenal FL relapsed and bioptically verified recidives did not show signs of a high grade transformation. Although it was difficult to identify a nodular growth pattern in more common small biopsies, a typical histomorphology and phenotype mostly allowed the FL diagnosis in the majority of the cases. The FL diagnosis had to be supported by detection of BCL2 translocation only in one case. MCL appeared most often in the stomach and large intestine, the small intestinal cases represented less than 23 %. In ¼ of the patients the lymphoma was multifocal and manifested as lymphomatoid polyposis affecting most often both large and small intestine. In a majority of the MCL patients, the diagnosis was done in mucosal and polypectomic endoscopic biopsies, surgical intervention and resection was recorded in less than 10 % of the cases. Most of the patients showed conventional "centrocytic" MCL morphology and approximately ¼ of the cases showed blastoid MCL. The rebiopsies of 9 patients revealed a relaps of the disease which was locoidentical in 5 of them; in other 4 patients the biopsies documented a dissemination to other GI organs. The blastic

  20. The effect of obturator bulb height on speech in maxillectomy patients.

    PubMed

    Kwon, H B; Chang, S W; Lee, S H

    2011-03-01

    The purpose of this study was to compare the speech function of low height bulb obturators with that of high height bulb obturators. Thirteen maxillectomy patients, who underwent post-operative prosthodontic rehabilitations, were included. Two obturators of the same design except for different bulb heights were fabricated for each maxillectomy patient. One of the two obturators had high bulb design and the other had low bulb design. After one of the obturators was used for a period of 3 weeks, the patient's speaking functions were evaluated by measuring nasalance scores, formant frequencies, and vowel working space areas. The same procedures were repeated with the second obturator following another 3-week period of usage. In addition, the effect of delivery sequence and anatomic conditions related to maxillectomy were analysed. The results demonstrated that the nasalance scores with the low bulb obturators were significantly higher than those with the high bulb obturators. There were no significant differences in formant frequencies based on the bulb height of the obturators. The vowel working spaces for the two obturators were similar in shape and there were no significant differences between the vowel working space areas created by the two obturators. The delivery sequence affected the results. However, there were no significant differences related to the other anatomical variables. Although low bulb obturators might function similarly with high bulb obturators in terms of the articulation of speech, they would exhibit a difficulty in controlling hypernasality in maxillectomy patients.

  1. 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.

  2. Ligation-assisted endoscopic submucosal resection with circumferential mucosal incision for duodenal carcinoid tumor.

    PubMed

    Harada, Hideaki; Suehiro, Satoshi; Shimizu, Takanori; Katsuyama, Yasushi; Hayasaka, Kenji; Ito, Hideto

    2015-09-14

    Here we present the case of a 64-year-old female with a duodenal carcinoid tumor treated by ligation-assisted endoscopic submucosal resection (ESMR-L) with circumferential mucosal incision (CMI). Band ligation was effective in resecting the duodenal carcinoid tumor after CMI, with an uneventful post-procedural course. Histopathological examination showed clear tumor margins at deeper tissue levels. Thus, in the present case, ESMR-L with CMI was useful for the treatment of duodenal carcinoid tumor.

  3. Ligation-assisted endoscopic submucosal resection with circumferential mucosal incision for duodenal carcinoid tumor

    PubMed Central

    Harada, Hideaki; Suehiro, Satoshi; Shimizu, Takanori; Katsuyama, Yasushi; Hayasaka, Kenji; Ito, Hideto

    2015-01-01

    Here we present the case of a 64-year-old female with a duodenal carcinoid tumor treated by ligation-assisted endoscopic submucosal resection (ESMR-L) with circumferential mucosal incision (CMI). Band ligation was effective in resecting the duodenal carcinoid tumor after CMI, with an uneventful post-procedural course. Histopathological examination showed clear tumor margins at deeper tissue levels. Thus, in the present case, ESMR-L with CMI was useful for the treatment of duodenal carcinoid tumor. PMID:26379409

  4. Association of Duodenal Atresia, Malrotation, and Atrial Septal Defect in a Down-Syndrome Patient

    PubMed Central

    Molinaro, F; Sica, M; Mariscoli, F; Bindi, E; Mazzei, O; Ferrara, F; Messina, M

    2016-01-01

    Duodenal atresia is the frequent cause of neonatal intestinal obstruction. The association between duodenal atresia, intestinal malrotation, cardiac anomalies and Down syndrome is infrequently reported. We present a prenatally suspected case of duodenal atresia which was associated with malrotation and atrial septal defect in a patient of Down syndrome. Duodenotomy and resection of web was performed in addition to Ladd’s procedure. Postoperative course remained uneventful. PMID:27170921

  5. The duodenal switch operation for the treatment of morbid obesity.

    PubMed

    Anthone, Gary J; Lord, Reginald V N; DeMeester, Tom R; Crookes, Peter F

    2003-10-01

    To determine the safety and efficacy of the duodenal switch procedure as surgical treatment of morbid obesity. The longitudinal gastrectomy and duodenal switch procedure as performed for morbid obesity involves a 75% subtotal greater curvature gastrectomy and long limb suprapapillary Roux-en-Y duodenoenterostomy. This results in a restricted caloric intake and diversion of bile and pancreatic secretions to induce fat malabsorption. Broad acceptance of this procedure has been impeded because of concerns that the malabsorptive component may produce serious nutritional complications. Review of data collected prospectively from all patients who underwent duodenal switch as the primary surgical treatment of morbid obesity at a single institution during the 10-year period beginning September 1992. Operative morbidity and mortality, weight loss, volume of food intake, and bowel function were recorded. Sequential measurements of serum albumin, hemoglobin, and calcium levels were obtained to assess metabolic function and nutrient absorption. Duodenal switch was performed as the primary operation in 701 (81%) of a total 863 patients undergoing bariatric surgery during the period of study. The average body mass index (BMI) was 52.8 (range, 34-95). Perioperative mortality was 1.4%, and morbidity (including leaks, wound dehiscence, splenectomy, and postoperative hemorrhage) occurred in 21 patients (2.9%). Weight loss averaged 127 pounds at 1 year, 131 at 3 years, and 118 at 5 or more years (% EBWL of 69%, 73%, and 66%, respectively). The mean number of bowel movements was fewer than 3 per day. Patients reported and maintained a mean restriction of 63% of their preoperative intake (approximately 1600 calories), with no specific food intolerance, at 3 or more years follow-up. At 3 years, serum albumin remained at normal levels in 98% of patients, hemoglobin in 52%, and calcium in 71%. No patients reported dumping, and marginal ulcers were not seen. The longitudinal gastrectomy

  6. The Duodenal Switch Operation for the Treatment of Morbid Obesity

    PubMed Central

    Anthone, Gary J.; Lord, Reginald V. N.; DeMeester, Tom R.; Crookes, Peter F.

    2003-01-01

    Objective: To determine the safety and efficacy of the duodenal switch procedure as surgical treatment of morbid obesity. Summary Background Data: The longitudinal gastrectomy and duodenal switch procedure as performed for morbid obesity involves a 75% subtotal greater curvature gastrectomy and long limb suprapapillary Roux-en-Y duodenoenterostomy. This results in a restricted caloric intake and diversion of bile and pancreatic secretions to induce fat malabsorption. Broad acceptance of this procedure has been impeded because of concerns that the malabsorptive component may produce serious nutritional complications. Methods: Review of data collected prospectively from all patients who underwent duodenal switch as the primary surgical treatment of morbid obesity at a single institution during the 10-year period beginning September 1992. Operative morbidity and mortality, weight loss, volume of food intake, and bowel function were recorded. Sequential measurements of serum albumin, hemoglobin, and calcium levels were obtained to assess metabolic function and nutrient absorption. Results: Duodenal switch was performed as the primary operation in 701 (81%) of a total 863 patients undergoing bariatric surgery during the period of study. The average body mass index (BMI) was 52.8 (range, 34–95). Perioperative mortality was 1.4%, and morbidity (including leaks, wound dehiscence, splenectomy, and postoperative hemorrhage) occurred in 21 patients (2.9%). Weight loss averaged 127 pounds at 1 year, 131 at 3 years, and 118 at 5 or more years (% EBWL of 69%, 73%, and 66%, respectively). The mean number of bowel movements was fewer than 3 per day. Patients reported and maintained a mean restriction of 63% of their preoperative intake (approximately 1600 calories), with no specific food intolerance, at 3 or more years follow-up. At 3 years, serum albumin remained at normal levels in 98% of patients, hemoglobin in 52%, and calcium in 71%. No patients reported dumping, and

  7. Endoscopic treatment of sporadic small duodenal and ampullary neuroendocrine tumors.

    PubMed

    Gincul, Rodica; Ponchon, Thierry; Napoleon, Bertrand; Scoazec, Jean-Yves; Guillaud, Olivier; Saurin, Jean-Christophe; Ciocirlan, Mihai; Lepilliez, Vincent; Pioche, Mathieu; Lefort, Christine; Adham, Mustapha; Pialat, Jean; Chayvialle, Jean-Alain; Walter, Thomas

    2016-11-01

    Background and study aim: As duodenal neuroendocrine tumors (NETs) are rare, their optimal management has not been clearly established. The aim of this study was to evaluate the feasibility and outcome of endoscopic treatment of duodenal NETs. Patients and methods: We reviewed the files of all patients who underwent endoscopic resection of a sporadic duodenal or ampullary NET between 1996 and 2014 at two centers. Results: A total of 29 patients with 32 uT1N0M0 NETs < 20 mm were included. Treatment consisted of endoscopic mucosal resection in 19 cases, and cap aspiration in 13 cases. Prior submucosal saline injection was used in 15 cases. Mortality was 3 % (one severe bleeding). Morbidity was 38 % (11/29). At post-resection analysis, mean tumor size was 8.9 mm (range 3 - 17 mm), 29 lesions were stage pT1, one was pT2, and 2 were pTx because of piecemeal resection. All NETs were well differentiated. A total of 27 lesions were classified as grade 1 and 5 were grade 2. The resection was R0, R1, and Rx for 16, 14, and 2 lesions, respectively. Three R1 patients underwent additional surgical treatment, with no residual tumor on the surgical specimen but with positive metastatic lymph nodes in two cases. One patient was lost to follow-up. Finally, 24 patients were included in the follow-up analysis. The median follow-up period was 56 months (range 6 - 175 months). Two patients presented a tumor recurrence during the follow-up period. Conclusions: Endoscopic treatment of small duodenal NETs was associated with significant morbidity, a difficulty in obtaining an R0 specimen, and the risk of lymph node metastasis. Nevertheless, it represents an interesting alternative in small grade 1 duodenal lesions and in patients at high surgical risk. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Management of biliary and duodenal complications of chronic pancreatitis.

    PubMed

    Vijungco, Joseph D; Prinz, Richard A

    2003-11-01

    Biliary stricture and duodenal obstruction have been increasingly recognized as complications of chronic pancreatitis. The anatomical relationship of the distal common bile duct and the duodenum with the head of the pancreas is the main factor for their involvement in chronic pancreatitis. In hospitalized patients with pancreatitis, the incidence of biliary stricture and duodenal obstruction is reported to be about 6% and 1.2%, respectively. For patients requiring an operation for chronic pancreatitis the incidence increases to 35% for biliary stricture and 12% for duodenal obstruction. Fibrosis around the distal common bile duct can cause stenosis with obstruction of bile flow. Clinically, the presentation of these patients ranges from being asymptomatic with elevated alkaline phosphatase or bilirubin, or both, to being septic with cholangitis. Jaundice, cholangitis, hyperbilirubinemia, and persistent elevation of serum alkaline phosphatase occur more frequently in patients with pancreatitis with a biliary stricture. A twofold elevation of alkaline phosphatase is a marker of possible common duct stenosis in patients with chronic pancreatitis. The incidence of both biliary cirrhosis and cholangitis in these patients is about 10%. ERCP reveals a characteristic long, smoothly tapered stricture of the intrapancreatic common bile duct. In duodenal obstruction, the factors that convert self-limiting edema to chronic fibrosis and stricture formation are unknown, but ischemia superimposed on inflammation may be the major cause. These patients present with a prolonged history of nausea and vomiting. Barium studies typically show a long constricting lesion of the duodenum, and endoscopy reveals reactive inflammatory changes in a narrowed duodenum. Operation is indicated in patients with common bile duct strictures secondary to chronic pancreatitis when there is evidence of cholangitis, biliary cirrhosis, common duct stones, progression of stricture, elevation of alkaline

  9. LIVER BIOPSY IN HUMAN LEPTOSPIROSIS.

    DTIC Science & Technology

    LEPTOSPIRA, DISEASES), (*LIVER, BIOPSY), LEPTOSPIRA ICTEROHAEMORRHAGIAE, HUMANS, PATHOLOGY, CELL STRUCTURE, MITOCHONDRIA, NECROSIS, ENZYMES, TOXINS AND ANTITOXINS, KIDNEYS, PARASITES, ELECTRON MICROSCOPY, BRAZIL

  10. Preduodenal portal vein in association with midgut malrotation and duodenal web-triple anomaly?

    PubMed

    Singal, Arbinder Kumar; Ramu, Chithra; Paul, Sarah; Matthai, John

    2009-02-01

    Preduodenal portal vein (PDPV) is a rare anomaly in which the portal vein passes anterior to the duodenum rather than posteriorly. Generally asymptomatic, PDPV may rarely cause duodenal obstruction or may coexist with other anomalies. We report a neonate who presented with duodenal obstruction and was found out to have 3 coexisting anomalies, each of which can lead to duodenal obstruction independently-PDPV, midgut malrotation, and duodenal web. A duodenoduodenostomy and a Ladd procedure were done, and the child recovered uneventfully. The mechanism of obstruction, interesting metabolic aberrations observed, outcome, and relevant literature are presented.

  11. Anatomical and neuropeptidergic properties of the duodenal neurons projecting to the gallbladder in the golden hamster.

    PubMed

    Seo, Je Hoon; Cho, Sa Sun; Lee, In Se; Lee, Heungshik S

    2002-10-01

    This study investigated the anatomical and neuropeptidergic properties of the duodenal neurons projecting to the gallbladder in the golden hamster. Fast blue (FB) was injected into the subserosa of the gallbladder in order to identify by retrograde tracing the duodenal neurons that project to the gallbladder. Subsequently, immunofluorescence microscopy was employed to see whether these duodenal neurons contained putative peptidergic neurotransmitters such as calcitonin gene-related peptide (CGRP), galanin (GAL) and vasoactive intestinal polypeptide (VIP). The FB-labeled cells were only found in the duodenal region adjacent to the major duodenal papilla where the biliary duct opens. On the other hand, there was no difference within this duodenal region in the numbers of FB-labeled cells between the mesenteric and antimesenteric portions, suggesting that these two portions of the duodenum equally contribute neuronal projections to the gallbladder. Double-immunofluorescence microscopy clearly demonstrated that a small population of FB-positive duodenal neurons contained putative neurotransmitters CGRP, GAL and VIP. Our data suggest that duodenal neurons around the major duodenal papilla in the golden hamster project to the gallbladder and exert their influence on the gallbladder via neuropeptides such as CGRP, GAL and VIP.

  12. Electro-acupuncture stimulation effects on duodenal motility in anesthetized rats.

    PubMed

    Noguchi, Eitaro; Ohsawa, Hideo; Tanaka, Hideki; Ikeda, Hiroko; Aikawa, Yoshihiro

    2003-02-01

    The effect of electro-acupuncture stimulation (EAS) on duodenal motility was examined in anesthetized, artificially ventilated rats. EAS was applied to the abdominal area or to a hindpaw for 30 s at stimulus intensities of 0.1-10.0 mA with a stimulus frequency of 20 Hz. The duodenal motility was measured using the balloon method at a position about 1.5 cm caudal from the pylorus. Duodenal motility was inhibited by EAS at intensities of more than 5.0 mA (suprathreshold of group IV afferent excitation) when applied to the abdominal area. The duodenal inhibitory response existed after bilateral vagotomy or spinal transection, but was abolished by sectioning bilateral splanchnic nerves. Duodenal motility was facilitated by EAS at intensities of more than 2.0 mA (subthreshold of group IV, and suprathreshold for groups II+III afferent excitation) when applied to a hindpaw. The duodenal facilitatory response by EAS to a hindpaw existed after sectioning the splanchnic nerves, but disappeared after bilateral vagotomy or spinal transection. Furthermore, repetitive electrical stimulation of vagal efferent nerves enhanced duodenal motility, while repetitive electrical stimulation of the splanchnic efferent nerves inhibited the motility. It was concluded that the inhibitory response of duodenal motility elicited by EAS to the abdominal area is a spinal reflex response involving splanchnic inhibitory efferent nerves, and the enhanced response of duodenal motility by EAS to a hindpaw is a supraspinal reflex response involving vagal excitatory nerves.

  13. Negative Biopsy after Referral for Biopsy-Proven Gastric Cancer

    PubMed Central

    Tae, Chung Hyun; Lee, Jun Haeng; Min, Byung-Hoon; Kim, Kyoung-Mee; Rhee, Poong-Lyul; Kim, Jae J.

    2016-01-01

    Background/Aims Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. Methods A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. Results Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. Conclusions A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral. PMID:25963084

  14. 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.

  15. Ultrasound-guided synovial biopsy

    PubMed Central

    Sitt, Jacqueline C M; Wong, Priscilla

    2016-01-01

    Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high diagnostic yield. In this review, we discuss the normal synovium, as well as the indications, technique, tissue handling and clinical applications of ultrasound-guided synovial biopsy. PMID:26581578

  16. Ultrasound-guided chest biopsies.

    PubMed

    Middleton, William D; Teefey, Sharlene A; Dahiya, Nirvikar

    2006-12-01

    Pulmonary nodules that are surrounded by aerated lung cannot be visualized with sonography. Therefore, percutaneous biopsy must be guided with computed tomography or fluoroscopy. Although this restriction only applies to central lung nodules, it has permeated referral patterns for other thoracic lesions and has retarded the growth of ultrasound-guided interventions. Nevertheless, sonography is an extremely flexible modality that can expeditiously guide many biopsy procedures in the thorax. Peripheral pulmonary nodules can be successfully biopsied with success rates exceeding 90% and complications rates of less than 5%. Orienting the probe parallel to the intercostal space facilitates biopsies of peripheral pulmonary nodules. Anterior mediastinal masses that extend to the parasternal region are often easily approachable provided the internal mammary vessels, costal cartilage, and deep great vessels are identified and avoided. Superior mediastinal masses can be sampled from a suprasternal or supraclavicular approach. Phased array probes or tightly curved arrays may provide improved access for biopsies in this location. Posterior mediastinal masses are more difficult to biopsy with ultrasound guidance because of the overlying paraspinal muscles. However, when posterior mediastinal masses extend into the posterior medial pleural region, they can be biopsied with ultrasound guidance. Because many lung cancers metastasize to the supraclavicular nodes, it is important to evaluate the supraclavicular region when determining the best approach to obtain a tissue diagnosis. When abnormal supraclavicular nodes are present, they often are the easiest and safest lesions to biopsy.

  17. A DIRECT-READING MERCURY THERMOMETER FOR THE WET BULB GLOBE TEMPERATURE INDEX.

    DTIC Science & Technology

    instrument and the WBGT index calculated by the conventional method from the readings of individual wet bulb, dry bulb, and globe thermometers. The...An instrument for direct measurement of the wet bulb globe temperature index (WBGT index ) is described and tested. The instrument is a fluid...analogue computer based on the mercury-in-glass thermometer and has no electronics. A linear correspondence was obtained between the readings of the

  18. Oral biopsy in dental practice.

    PubMed

    Mota-Ramírez, Amparo; Silvestre, Francisco Javier; Simó, Juan Manuel

    2007-11-01

    The conclusions drawn from the study of an oral biopsy are considered essential for the definitive diagnosis of diseases of the oral mucosa, and for the subsequent planning of appropriate treatment. Although the obtainment of biopsies is widely used in all medical fields, the practice is not so widespread in dental practice--fundamentally because of a lack of awareness of the procedure among dental professionals. In this context, it must be taken into account that the early diagnosis of invasive oral malignancy may be critical for improving the patient prognosis. However, in some cases the results are adversely affected by incorrect manipulation of the biopsy material. The present study provides an update on the different biopsy sampling techniques and their application. Such familiarization in turn will contribute to knowledge of the material and instruments required for correct biopsy performance in dentistry, as well as of the material required for correct sample storage and transport.

  19. [Surgical pleural biopsy].

    PubMed

    Bracco, A N; Bouteiller, J M; Della Torre, H A; Golonbek, M

    1965-10-01

    The authors emphasize on the importance of histologic study of the sick pleura to obtain a diagnosis and to decide the treatment, operative or not, which must be specific. They choose the surgical biopsy and analyze the results obtained in 104 operations performed on 100 patients. Four groups of lesions are established: 1) malignant tumors (primary and secondary), 2) Non specific pleuritis consecutive to carcinoma of the lung or other organs, usually metastatic from the breast or the digestive tract, 3) Non specific pleuritis, and 4) Tuberculosis. Cancer or tuberculosis are found in pleurisies of different types. Cancer was found in a 43,7% of the serous pleurisies, in a 64% of the seroushemorrhagic, and in a 46% of the hemorrhagic pleurisies. Tuberculosis was found in a 15,6 % of the serous, in a 7,14 % of the seroushemorrhagic and in a 15,7 % of the purulent. In one case of hemorrhagic pleurisy in which the diagnosis of tuberculosis was not made, further studies confirmed it. The authors point to the existence of non specific pleuritis without neoplastic infiltration in some pleurisies consecutive to lung tumors or from other organs and to its therapeutic consequences. They also inform having found tuberculosis in patients over 50 years of age (8 in 11 cases). In this series the youngest pleural cancer case was a 27 years old man.

  20. 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.

  1. Correlated firing in tufted cells of mouse olfactory bulb

    PubMed Central

    Ma, Jie; Lowe, Graeme

    2010-01-01

    Temporally correlated spike discharges are proposed to be important for the coding of olfactory stimuli. In the olfactory bulb, correlated spiking is known in two classes of output neurons, the mitral cells and external tufted cells. We studied a third major class of bulb output neurons, the middle tufted cells, analyzing their bursting and spike timing correlations, and their relation to mitral cells. Using patch-clamp and fluorescent tracing, we recorded spontaneous spiking from tufted-tufted or mitral-tufted cell pairs with visualized dendritic projections in mouse olfactory bulb slices. We found peaks in spike cross-correlograms indicating correlated activity on both fast (peak width 1 ms – 50 ms) and slow (peak width > 50 ms) time scales, only in pairs with convergent glomerular projections. Coupling appeared tighter in tufted-tufted pairs, which showed correlated firing patterns and smaller mean width and lag of narrow peaks. Some narrow peaks resolved into 2–3 sub-peaks (width 1–12 ms), indicating multiple modes of fast correlation. Slow correlations were related to bursting activity, while fast correlations were independent of slow correlations, occurring in both bursting and non-bursting cells. The AMPA receptor antagonist NBQX (20 μM) failed to abolish broad or narrow peaks in either tufted-tufted or mitral-tufted pairs, and changes of peak height and width in NBQX were not significantly different from spontaneous drift. Thus, AMPA-receptors are not required for fast and slow spike correlations. Electrical coupling was observed in all convergent tufted-tufted and mitral-tufted pairs tested, suggesting a potential role for gap junctions in concerted firing. Glomerulus-specific correlation of spiking offers a useful mechanism for binding the output signals of diverse neurons processing and transmitting different sensory information encoded by common olfactory receptors. PMID:20600657

  2. Placebo effect in the treatment of duodenal ulcer

    PubMed Central

    de Craen, Anton J M; Moerman, Daniel E; Heisterkamp, Simon H; Tytgat, Guido N J; Tijssen, Jan G P; Kleijnen, Jos

    1999-01-01

    Aims To assess whether frequency of placebo administration is associated with duodenal ulcer healing. Methods A systematic literature review of randomized clinical trials was undertaken. 79 of 80 trials that met the inclusion criteria. The pooled 4 week placebo healing rate of all duodenal ulcer trials that employed a four times a day regimen was compared with the rate obtained from trials with a twice a day regimen. Results The pooled 4 week healing rate of the 51 trials with a four times a day regimen was 44.2% (805 of 1821 patients) compared with 36.2% (545 of 1504 patients) in the 28 trials with a twice a day regimen (difference, 8.0% [equal effects model]; 95% confidence interval, 4.6% to 11.3%). Depending on the statistical analysis, the rate difference ranged from 6.0% (multivariable random effects model) to 8.0% (equal effects model). A number of sensitivity analyses showed comparable differences between the two regimens. Most of these sensitivity analyses were not significant, probably because a number of trials were excluded resulting in a loss of power. Conclusions We found a relation between frequency of placebo administration and healing of duodenal ulcer. We realize that the comparison was based on nonrandomized data. However, we speculate that the difference between regimens was induced by the difference in frequency of placebo administration. A better knowledge of various placebo effects is required in order to make clinically relevant assessments of treatment effects derived from placebo-controlled trials. PMID:10594490

  3. Current status in the multidisciplinary management of duodenal fistula.

    PubMed

    Babu, Benoy I; Finch, Jonathan G

    2013-06-01

    Paradigms in the management of duodenal fistula have evolved over the last half a century. Despite advances, morbidity and mortality still remain high. This paper provides a comprehensive, up to date, systematic review in the management of duodenal fistula, classifying the various strategies in the management of duodenal fistula A review was performed on Medline, Embase and Cochrane library databases using the Cochrane systematic reviews methodology. A final population of 42 studies reported on 349 patients, with a median (range) number of patients per study of two (1-68). The manuscripts were broadly divided in to "non-interventional" and "interventional". The interventional group was subdivided in to "minimally invasive" and the "open surgical approach". A total of 147 patients were treated conservatively (non-interventional group), with a median duration of 28 days (range 13-42 days) with 13 (9%) deaths recorded in this group. No deaths were reported in the 8 reports on minimally invasive approach.166 patients had open surgical approach with a mortality rate of 30% (50 patients). In the absence of randomised controlled trials, no one interventional modality can be considered superior. Initial multidisciplinary conservative approach with sepsis control and nutritional augmentation should be for 6 weeks. It would seem reasonable, in those fistulae that fail to close spontaneously, to attempt a low risk "minimally invasive" intervention where necessary expertise is available. More risky open surgical approaches should clearly be reserved for those that fail and are best performed in specialist centres. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  4. Can a topical scalp treatment reduce hair bulb extraction?

    PubMed

    Gruber, James V; Bouldin, Lisa; Lou, Kevin

    2007-01-01

    Generally speaking, when people talk about "hair breakage" they are typically referring to the idea that as they comb or brush their hair, the fibers are elongating and snapping at some weak point in the fiber length. It is well established that as people chemically treat their hair, the keratin proteins are degraded further and the hair become more brittle and susceptible to breakage. For the consumer, hair breakage is registered as hair fibers noted in their comb or brush, and in the drain that they see after a cosmetic treatment. However, a fundamental question that needs to be asked is whether or not the hairs that are seen in the drain are really the result of hair breakage (i.e., a fiber snapping) or are they the result of hairs that are actually being extracted from the scalp by their root bulbs. If the bulk of the hair fibers are actually extracted by the bulb, than it seems somewhat superfluous to try and improve hair strength by improving the exterior of the fiber. The fiber is dead and topical treatments can only smooth, and possibly moisten already established fiber structure and integrity. This paper will attempt to address hair strength by looking at the scalp and follicle as the target for treatment, showing that topical application of a product containing a blend of well-known skin active ingredients can demonstrate potential reductions in hair extractions. An in vivo testing protocol in which 15 voluntary participants with at least 12" hair length were professionally shampooed, and then treated, half-head, with a commercial conditioner, or the same conditioner that contained 5% of a mixture of yeast peptides, fruit acids and green tea polyphenols every day for five days will be discussed. At the beginning and end of the treatment period, the number of hairs that either broke along the fiber, or extracted by the bulb were gathered, separated and counted for both the treated and untreated side of the head. The results of this one-week study

  5. Noradrenergic and cholinergic modulation of olfactory bulb sensory processing

    PubMed Central

    Devore, Sasha; Linster, Christiane

    2012-01-01

    Neuromodulation in sensory perception serves important functions such as regulation of signal to noise ratio, attention, and modulation of learning and memory. Neuromodulators in specific sensory areas often have highly similar cellular, but distinct behavioral effects. To address this issue, we here review the function and role of two neuromodulators, acetylcholine (Ach) and noradrenaline (NE) for olfactory sensory processing in the adult main olfactory bulb. We first describe specific bulbar sensory computations, review cellular effects of each modulator and then address their specific roles in bulbar sensory processing. We finally put these data in a behavioral and computational perspective. PMID:22905025

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. Long QT Syndrome and Duodenal Ampullary Adenoma: A New Association

    PubMed Central

    Hughes, Laura; Talha Khan, Muhammad; Khalid Hasan, Muhammad; Inayat, Irteza

    2016-01-01

    KCNQ1 gene mutation has a well-known association with long QT syndrome (LQTS). However, recent studies suggest that it may be implicated in intestinal neoplasia. We present a 27-year-old Hispanic man with a known history of LQTS secondary to KCNQ1 mutation, who presented with painless jaundice. Endoscopic retrograde pancreatic cholangiography revealed a prominent ampulla, with histology consistent with ampullary adenoma with high-grade dysplasia. Further endoscopic studies did not suggest familial adenomatous polyposis. To date, this is the index case of duodenal ampullary adenoma in the setting of KCNQ1 mutation. PMID:27921062

  11. Gastrointestinal Hemorrhage Secondary to Duodenal Cystic Dystrophy in Heterotopic Pancreas

    PubMed Central

    Brotons, Alicia; Pico, Maria Dolores; Sola-Vera, Javier; Sillero, Carlos; Cuesta, Amador; Oliver, Israel

    2011-01-01

    Cystic dystrophy of the duodenal wall (CDDW) is a complication of heterotopic pancreatic tissue located in the wall of the gastrointestinal tract, characterized by the presence of multiple small cysts, usually found in the wall of the second part of the duodenum. Gastrointestinal hemorrhage due to CDDW is a rare complication. We report the case of a 50-year-old man who was admitted to our hospital for persistent vomiting. The imaging tests confirmed the diagnosis of CDDW. During his stay in hospital, the patient had a gastrointestinal hemorrhage secondary to this disorder, which made it necessary to perform a Roux-en-Y gastrojejunostomy (Billroth III). PMID:27957010

  12. Ghrelin accelerates the healing of cysteamine-induced duodenal ulcers in rats.

    PubMed

    Warzecha, Zygmunt; Ceranowicz, Dagmara; Dembiński, Artur; Ceranowicz, Piotr; Cieszkowski, Jakub; Kuwahara, Atsukazu; Kato, Ikuo; Dembiński, Marcin; Konturek, Peter C

    2012-05-01

    Previous studies have shown that administration of ghrelin exhibits protective and therapeutic effects in the gut. The aim of the present investigation was to examine the influence of ghrelin administration on the course of cysteamine-induced duodenal ulcers, as well as effects on mucosal production of oxygen free radicals and duodenal antioxidant defense. Duodenal ulcers were induced in male Wistar rats by cysteamine administered intragastrically at the dose of 200 mg/kg in 1 ml of saline, 3 times at 4-h intervals. Starting 24 h after the first dose of cysteamine, rats were treated intraperitoneally twice a day with saline or ghrelin given at the dose of 4, 8 or 16 nmol/kg/dose. Seven days after administration of the first dose of cysteamine, the study was terminated. Induction of ulcers by cysteamine was accompanied by a reduction in duodenal blood flow, mucosal DNA synthesis and mucosal activity of superoxide dismutase (SOD); whereas mucosal concentration of interleukin-1β and malonyldialdehyde (MDA - an index of lipid peroxidation) were increased. Treatment with ghrelin increased healing rate of duodenal ulcers and enhanced duodenal blood flow, mucosal DNA synthesis and mucosal activity of SOD, and reduced mucosal concentration of interleukin-1β and MDA. Treatment with ghrelin increases the healing rate of duodenal ulcers and this effect is related, at least in part, to improvement of duodenal mucosal blood flow, mucosal cell proliferation and antioxidant defense, as well as being related to reduction in mucosal oxidative stress and inflammatory response.

  13. Spontaneous Intramural Duodenal Hematoma: Pancreatitis, Obstructive Jaundice, and Upper Intestinal Obstruction

    PubMed Central

    Somsap, Kulyada; Ruangwannasak, Somchai; Sripanaskul, Anan

    2016-01-01

    Nontraumatic intramural duodenal hematoma can cause upper gastrointestinal tract obstruction, upper gastrointestinal hemorrhage, jaundice, and pancreatitis and may be present in patients with normal coagulation. However the pathogenesis of the condition and its relationship with acute pancreatitis remain unknown. We present a case of spontaneous intramural duodenal hematoma and a case of successful nonoperative treatments. PMID:27891286

  14. 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.

  15. Laparoscopic Biopsies in Pancreas Transplantation.

    PubMed

    Uva, P D; Odorico, J S; Giunippero, A; Cabrera, I C; Gallo, A; Leon, L R; Minue, E; Toniolo, F; Gonzalez, I; Chuluyan, E; Casadei, D H

    2017-08-01

    As there is no precise laboratory test or imaging study for detection of pancreas allograft rejection, there is increasing interest in obtaining pancreas tissue for diagnosis. Pancreas allograft biopsies are most commonly performed percutaneously, transcystoscopically, or endoscopically, yet pancreas transplant surgeons often lack the skills to perform these types of biopsies. We have performed 160 laparoscopic pancreas biopsies in 95 patients. There were 146 simultaneous kidney-pancreas biopsies and 14 pancreas-only biopsies due to pancreas alone, kidney loss, or extraperitoneal kidney. Biopsies were performed for graft dysfunction (89) or per protocol (71). In 13 cases, an additional laparoscopic procedure was performed at the same operation. The pancreas diagnostic tissue yield was 91.2%; however, the pancreas could not be visualized in eight cases (5%) and in 6 cases the tissue sample was nondiagnostic (3.8%). The kidney tissue yield was 98.6%. There were four patients with intraoperative complications requiring laparotomy (2.5%) with two additional postoperative complications. Half of all these complications were kidney related. There were no episodes of pancreatic enzyme leak and there were no graft losses related to the procedure. We conclude that laparoscopic kidney and pancreas allograft biopsies can be safely performed with very high tissue yields. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. Biopsy: Types of Biopsy Procedures Used to Diagnose Cancer

    MedlinePlus

    ... A biopsy also helps your doctor determine how aggressive your cancer is — the cancer's grade. The grade ... grade (grade 1) cancers are generally the least aggressive and high-grade (grade 4) cancers are generally ...

  17. [Pulmonary needle biopsy in children].

    PubMed

    Gerbeaux, J

    1975-01-01

    Pulmonary biopsy done with a needle of circular bore, can be performed on very young children. A sample of tissue, big enough to establish a precise diagnosis in 2/3 of cases, can be obtained. The main complication is pneumothorax occuring about once in five. Hemoptysia or hemorrhage has never been observed. A proposed indication of premortem biopsy accelerated the death of a child with congenital pulmonary fibrosis. The search of a diagnosis in diffuse pulmonary diseases is the major indication for pulmonary biopsy in the child.

  18. Laparoscopic-endoscopic cooperative surgery is a safe and effective treatment for superficial nonampullary duodenal tumors.

    PubMed

    Kyuno, Daisuke; Ohno, Keisuke; Katsuki, Shinichi; Fujita, Tomoki; Konno, Ai; Murakami, Takeshi; Waga, Eriko; Takanashi, Kunihiro; Kitaoka, Keisuke; Komatsu, Yuya; Sasaki, Kazuaki; Hirata, Koichi

    2015-11-01

    The use of endoscopic submucosal dissection (ESD) for duodenal neoplasms has increased in recent years, but delayed perforation and bleeding are also known to frequently occur. We present two cases in which duodenal adenoma was successfully treated with laparoscopic-endoscopic cooperative surgery. ESD was combined with laparoscopic seromuscular sutures. The lesions in both cases were located in the second portion of the duodenum. The patients requested resection of the lesion, and we performed laparoscopic-endoscopic cooperative surgery. After the laparoscopic surgeon mobilized the duodenum, the endoscopic surgeon performed ESD for the duodenal tumor without perforation. The laparoscopic surgeon sutured the duodenal wall in the seromuscular layer to strengthen the ulcer bed after ESD. Histopathological studies confirmed that the surgical margins were tumor-free in both cases. The patients were discharged with no complications. This unique laparoscopic-endoscopic cooperative procedure is a safe and effective method for resecting superficial nonampullary duodenal tumors.

  19. 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.

  20. Virtual filaments that mimic conventional light bulb filaments

    NASA Astrophysics Data System (ADS)

    Chaves, Julio; Munoz, Fernando; Minano, Juan Carlos; Benitez, Pablo; Parkyn, Bill; Falicoff, Waqidi; Sun, Yupin

    2004-09-01

    Conventional incandescent light bulbs have a wire filament acting as an extended light source with nearly constant intensity throughout its quasi-spherical emission pattern. Here we present a novel family of optical devices that make use of commercially available Lambertian or near-Lambertian LED light sources, in conjunction with tailored optical element bonded to the top surface of the LED. These hybrid devices can emulate the output of traditional incandescent filaments, or can be designed to produce a wide range of light output beam patterns. We call these new devices Virtual Filaments, as they can be designed to appear the same as an incandescent filament, with a similar light output pattern, and having a similar focal position above the base. These new lamps can then be used in the same applications as those they replace, thus eliminating the need to redesign or replace the original luminaire. We present several possible optical designs that can be used with a number of standard LEDs to replace standard incandescent bulbs. In one example we show a design that provides an output with near-uniform intensity across a full beam angle of 300 degrees, from a focal position 20 mm above an LED. Other major advantages of these new devices include their ability to be given sharp cutoffs, to homogenize non-uniform LED light sources and to color-mix the output of RGB LEDs.

  1. 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.

  2. Adrenergic modulation of olfactory bulb circuitry affects odor discrimination.

    PubMed

    Doucette, Wilder; Milder, Julie; Restrepo, Diego

    2007-08-01

    A rodent's survival depends upon its ability to perceive odor cues necessary to guide mate selection, sexual behavior, foraging, territorial formation, and predator avoidance. Arguably, the need to discriminate odor cues in a complex olfactory environment requires a highly adaptable olfactory system. Indeed, it has been proposed that context-dependent modulation of the initial sensory relay could alter olfactory perception. Interestingly, 40% of the adrenergic innervation from the locus coeruleus, fibers that are activated by contextual cues, innervates the first relay station in the olfactory system (the main olfactory bulb). Here we utilize restricted pharmacological inhibition of olfactory bulb noradrenergic receptors in awake-behaving animals. We show that combined blockade of alpha and beta adrenergic receptors does not impair two-odor discrimination behavior per se but does impair the ability to discriminate perceptually similar odors. Thus, contextual cues conveyed by noradrenergic fibers alter processing before the second synapse in the olfactory cortex, resulting in tuning of the ability to discriminate between similar odors.

  3. Development of the jugular bulb: a radiologic study.

    PubMed

    Friedmann, David R; Eubig, Jan; McGill, Megan; Babb, James S; Pramanik, Bidyut K; Lalwani, Anil K

    2011-10-01

    Jugular bulb (JB) abnormalities such as JB diverticulum and high-riding JBs of the temporal bone can erode into the inner ear and present with hearing loss, vestibular disturbance, and pulsatile tinnitus. Their cause and potential to progress remain to be studied. This comprehensive radiologic study investigates the postnatal development of the venous system from transverse sinus to internal jugular vein (IJV). Academic medical center. PATIENTS, INTERVENTION, MAIN OUTCOME MEASURE: Measurements of the transverse and sigmoid sinus, the JB, IJV, and carotid artery were made from computed tomographic scans of the neck with intravenous contrast in infants (n = 5), children (n = 13), adults (n = 35), and the elderly (n = 15). Jugular bulbs were not detected in patients younger than 2 years, enlarged in adulthood, and remained stable in the elderly. The venous system was larger in men than in women. From transverse sinus to IJV, the greatest variation in size was just proximal and distal to the JB with greater symmetry observed as blood returned to the heart. Right-sided venous dominance was most common occurring in 70% to 80% of cases. The JB is a dynamic structure that forms after 2 years, and its size stabilizes in adulthood. The determinants in its exact position and size are multifactorial and may be related to blood flow. Improved understanding of this structure's development may help to better understand the cause of the high-riding JB and JB diverticulum, both of which may cause clinical symptoms.

  4. Ca2+-permeable AMPA receptors in mouse olfactory bulb astrocytes

    PubMed Central

    Droste, Damian; Seifert, Gerald; Seddar, Laura; Jädtke, Oliver; Steinhäuser, Christian; Lohr, Christian

    2017-01-01

    Ca2+ signaling in astrocytes is considered to be mainly mediated by metabotropic receptors linked to intracellular Ca2+ release. However, recent studies demonstrate a significant contribution of Ca2+ influx to spontaneous and evoked Ca2+ signaling in astrocytes, suggesting that Ca2+ influx might account for astrocytic Ca2+ signaling to a greater extent than previously thought. Here, we investigated AMPA-evoked Ca2+ influx into olfactory bulb astrocytes in mouse brain slices using Fluo-4 and GCaMP6s, respectively. Bath application of AMPA evoked Ca2+ transients in periglomerular astrocytes that persisted after neuronal transmitter release was inhibited by tetrodotoxin and bafilomycin A1. Withdrawal of external Ca2+ suppressed AMPA-evoked Ca2+ transients, whereas depletion of Ca2+ stores had no effect. Both Ca2+ transients and inward currents induced by AMPA receptor activation were partly reduced by Naspm, a blocker of Ca2+-permeable AMPA receptors lacking the GluA2 subunit. Antibody staining revealed a strong expression of GluA1 and GluA4 and a weak expression of GluA2 in periglomerular astrocytes. Our results indicate that Naspm-sensitive, Ca2+-permeable AMPA receptors contribute to Ca2+ signaling in periglomerular astrocytes in the olfactory bulb. PMID:28322255

  5. Identification of distinctive clinical significance in hospitalized patients with endoscopic duodenal mucosal lesions

    PubMed Central

    Han, Yeji; Jung, Hye-Kyung; Chang, Ji Young; Moon, Chang Mo; Kim, Seong-Eun; Shim, Ki-Nam; Jung, Sung-Ae; Kim, Joo-Young; Bae, Ji-Yun; Kim, Sae-In; Lee, Ji-Hyun; Park, Sanghui

    2017-01-01

    Background/Aims Duodenitis is not infrequent finding in patient undergoing endoscopy. However, hospitalized patients have a higher incidence of secondary duodenal mucosal lesions that might be related with inflammatory bowel disease (IBD), cytomegalovirus (CMV) infection, tuberculosis, immunologic disorders, or other rare infections. We aimed to identify clinicopathologic features of duodenal mucosal lesions in hospitalized patients. Methods All hospitalized patients having duodenal mucosal lesions were identified by endoscopic registration data and pathologic data query from 2011 to 2014. The diagnostic index was designed to be sensitive; however, a detailed review of medical record and endoscopic findings was undertaken to improve specificity. Secondary duodenal lesion was defined as having specific reason to explain the duodenal lesion. Results Among 6,334 hospitalized patients have undergone upper endoscopy, endoscopic duodenal mucosal lesions was detected in 475 patients. Secondary duodenal lesions was 21 patients (4.4%) and the most frequent secondary cause was IBD (n = 7). The mean age of secondary group was significantly lower than that in primary group (42.3 ± 18.9 years vs. 58.5 ± 16.8 years, p = 0.00), and nonsteroidal anti-inflammatory drugs were less frequently used in secondary group, but there was no differences of gender or presence of Helicobacter pylori. The involvement of distal part of duodenum including postbulbitis or panduodenitis was more frequently detected in secondary group than in primary group. By multivariate regression analysis, younger age of 29 years and the disease extent were significant predictors for the secondary mucosal lesions. Conclusions Secondary duodenal mucosal lesions with different pathophysiology, such as IBD or CMV infection, are rare. Disease extent and age seems the most distinctive feature of secondary duodenal mucosal lesions. PMID:28823115

  6. 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.

  7. 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.

  8. Pancreas preserving surgery for duodenal gastrointestinal stromal tumor removal.

    PubMed

    Crocetti, Daniele; Sapienza, Paolo; Cisano, Claudio; Tarallo, Mariarita; Polistena, Andrea; Venturini, Luigi; Pedullà, Giuseppe; De Toma, Giorgio

    2016-10-01

    We reported our experience with high-risk, non-metastatic second portion duodenal gastrointestinal stromal tumor (GIST)s in patients who underwent 1-month neoadjuvant cycles with imatinib therapy followed by pancreas-preserving surgery and 12-month of adjuvant chemotherapic regimen including imatinib. This study was conducted to evaluate the short and long-term results. The study was conducted between January 2010 and May 2015. Medical charts and operative logbooks of patients were retrospectively reviewed. Nine patients form the basis of the current analysis. All patients underwent curative resection with pancreas preservation, and all specimens had histologically negative margins. The median follow-up was 35 months. Eight patients were alive, 1 patient died for myocardial infarction at a mean follow-up of 10 months, 1 patient had a recurrence at a mean follow-up of 32 months and no patients developed distant metastases. We are confident to suggest the use of neoadjuvant and adjuvant Imatinib therapy to those patients affected with D2, high-risk, duodenal GISTs to allow a limited resection.

  9. Further experience with epigastric pain reproduction test in duodenal ulceration.

    PubMed

    Earlam, R J

    1972-06-17

    Further evidence is presented that the epigastric pain of duodenal ulceration, situated between the rib margins and just below the xiphisternum, arises from the lower oesophagus.One-hundred patients with duodenal ulceration were divided into those with epigastric pain (61) and those with pain in the upper abdomen but not in the epigastrium (39). Perfusion of 0.1 N HCl into the lower oesophagus reproduced epigastric pain in 53 of the 61 with epigastric pain (mean 37 ml) but in none of the 39 without (mean 125 ml). All those who had been woken by epigastric pain at night in the previous four weeks had a positive test.In five the test remained positive even though the acid was neutralized by a continuous perfusion of alkali just below the gastro-oesophageal junction. In another five 200 ml 0.1 N HCl instilled into the stomach for 21 minutes did not reproduce epigastric pain, even though 30 ml perfused for three minutes into the lower oesophagus did.

  10. Further Experience with Epigastric Pain Reproduction Test in Duodenal Ulceration

    PubMed Central

    Earlam, Richard J.

    1972-01-01

    Further evidence is presented that the epigastric pain of duodenal ulceration, situated between the rib margins and just below the xiphisternum, arises from the lower oesophagus. One-hundred patients with duodenal ulceration were divided into those with epigastric pain (61) and those with pain in the upper abdomen but not in the epigastrium (39). Perfusion of 0·1 N HCl into the lower oesophagus reproduced epigastric pain in 53 of the 61 with epigastric pain (mean 37 ml) but in none of the 39 without (mean 125 ml). All those who had been woken by epigastric pain at night in the previous four weeks had a positive test. In five the test remained positive even though the acid was neutralized by a continuous perfusion of alkali just below the gastro-oesophageal junction. In another five 200 ml 0·1 N HCl instilled into the stomach for 21 minutes did not reproduce epigastric pain, even though 30 ml perfused for three minutes into the lower oesophagus did. PMID:5031711

  11. Duodenal and Ampullary Carcinoid Tumors: Size Predicts Necessity for Lymphadenectomy.

    PubMed

    Dogeas, Epameinondas; Cameron, John L; Wolfgang, Cristopher L; Hirose, Kenzo; Hruban, Ralph H; Makary, Martin A; Pawlik, Timothy A; Choti, Michael A

    2017-08-01

    Unlike other neuroendocrine tumors of the gastrointestinal tract, management of duodenal and periampullary carcinoids remains controversial. We aimed to determine the metastatic potential and optimal choice of therapy for these neoplasms. A retrospective review of all patients treated at the Johns Hopkins Hospital between 1996 and 2012 was conducted. Clinicopathologic factors associated with lymph nodal involvement and clinical outcomes were evaluated. A total of 101 patients were identified. Eighty (79.2%) tumors arose from the duodenum and 21 (20.8%) from the periampullary area. Thirty-five (34.7%) patients underwent pancreaticoduodenectomy (PD), 12 (11.9%) local resection, 38 (37.6%) endoscopic excision, and 16 (15.8%) patients harbored incidental tumors identified in the specimen after PD for another indication. Lymph node (LN) pathologic evaluation was done in 56 patients, among which 27 (48%) had positive LN. Specifically, LN positivity (LN+) for tumors <1 cm in size was 4.5% (1/22), for tumors 1-2 cm 72% (13/18), and for tumors >2 cm 81% (13/16). Tumor size was the only factor associated with LN+ (p = 0.029). Lymph nodal involvement is common for duodenal and periampullary carcinoid tumors, particularly among those >1 cm in size; therefore, resection with lymphadenectomyfor these larger tumors is recommended.

  12. 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.

  13. Duodenal ulcer perforation: the effect of H2 antagonists?

    PubMed Central

    Gillen, P.; Ryan, W.; Peel, A. L.; Devlin, H. B.

    1986-01-01

    One hundred and two patients with perforated duodenal ulcers over a 13 year period (1970 to 1982) have been prospectively followed-up at a special gastric clinic. Of the 37 patients with perforation of their acute ulcer, 34 were treated by oversew and three had an initial definitive operation (vagotomy and drainage). The remaining 65 patients presented with perforation of a chronic ulcer and 54 were treated by oversew and 11 underwent definitive surgery--nine had vagotomy and drainage and two had partial gastrectomies. Seven of the 34 patients (20.5%) with acute ulcer perforation treated by simple oversew subsequently required definitive ulcer surgery at a mean 17.5 months after perforation and 31 of the 54 patients (57.4%) with chronic ulcer perforations required definitive surgery at a mean 27.4 months after perforation. The introduction of H2 antagonists in 1977 did not alter the re-operation rate in patients with chronic ulcer perforation managed by oversew. Results of this study provide further evidence in favour of treating patients with perforation of their chronic duodenal ulcer by definitive surgery whenever possible. PMID:3789618

  14. Needle Biopsy of the Lung

    MedlinePlus

    ... than surgical biopsy and may not require general anesthesia. Tell your doctor about any recent illnesses or ... and whether you have any allergies, especially to anesthesia. Discuss any medications you’re taking, including herbal ...

  15. [Optimized standards for prostate biopsy].

    PubMed

    Wullich, B; Füssel, S; Grobholz, R

    2007-06-01

    As individual risk assessment mainly depends on the correct prediction of the tumor's biological behavior, primary diagnosis plays a key role in the clinical management of prostate cancer patients. Prostate core needle biopsy, as a primary diagnostic tool, should not only confirm clinical suspicion but also supply the urologist with information which is necessary for risk-adapted therapy. The experience and competence of both the urologist and the pathologist are crucial for the quality of prostate core needle biopsy diagnosis. Optimized handling and submission of prostate core needle biopsy specimens by the urologist to the pathologist are of outstanding importance for improving the number of cancer cases detected. Increasing availability of molecular markers leads to the necessity of developing new tissue sampling procedures which allow prostate core needle biopsy specimens to be simultaneously studied histologically and by molecular approaches.

  16. Getting the Most Out of Liver Biopsy.

    PubMed

    Lidbury, Jonathan A

    2017-05-01

    Histopathologic evaluation of liver biopsy specimens yields information that is not otherwise obtainable and is frequently essential for diagnosing hepatic disease. Percutaneous needle biopsy, laparoscopic biopsy, and surgical biopsy each have their own set of advantages and disadvantages. Care should be taken to ensure an adequate amount of tissue is collected for meaningful histologic evaluation. Because sampling error is a limitation of hepatic biopsy, multiple liver lobes should be biopsied. This article discusses the indications for liver biopsy, associated risks, advantages and disadvantages of different biopsy techniques, and strategies to get the most useful information possible out of this process. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Enhanced assymetrical noradrenergic transmission in the olfactory bulb of deoxycorticosterone acetate-salt hypertensive rats.

    PubMed

    Abramoff, Tamara; Guil, María J; Morales, Vanina P; Hope, Sandra I; Soria, Celeste; Bianciotti, Liliana G; Vatta, Marcelo S

    2013-10-01

    The ablation of olfactory bulb induces critical changes in dopamine, and monoamine oxidase activity in the brain stem. Growing evidence supports the participation of this telencephalic region in the regulation blood pressure and cardiovascular activity but little is known about its contribution to hypertension. We have previously reported that in the olfactory bulb of normotensive rats endothelins enhance noradrenergic activity by increasing tyrosine hydroxylase activity and norepinephrine release. In the present study we sought to establish the status of noradrenergic activity in the olfactory bulb of deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Different steps in norepinephrine transmission including tyrosine hydroxylase activity, neuronal norepinephrine release and uptake were assessed in the left and right olfactory bulb of DOCA-salt hypertensive rats. Increased tyrosine hydroxylase activity, and decreased neuronal norepinephrine uptake were observed in the olfactory bulb of DOCA-salt hypertensive rats. Furthermore the expression of tyrosine hydroxylase and its phosphorylated forms were also augmented. Intriguingly, asymmetrical responses between the right and left olfactory bulb of normotensive and hypertensive rats were observed. Neuronal norepinephrine release was increased in the right but not in the left olfactory bulb of DOCA-salt hypertensive rats, whereas non asymmetrical differences were observed in normotensive animals. Present findings indicate that the olfactory bulb of hypertensive rats show an asymmetrical increase in norepinephrine activity. The observed changes in noradrenergic transmission may likely contribute to the onset and/or progression of hypertension in this animal model.

  18. 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…

  19. 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…

  20. 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…