Showing papers in "Gastroenterology Research in 2010"
TL;DR: The results of this present study suggested that aqueous extract of Psidium guajava leaves may be hepatoprotective, and not hepatotoxic, with hematopoietic potentials in both male and female rats.
Abstract: Background Serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), albumin and total protein levels, as well as the tissue histological assay are known to be useful in assessing the functional integrity of the liver. Also, assessment of red and white blood cells count, hematocrit and hemoglobin concentrations is useful in determining the effect of some chemical substances on hemotopoietic system. In recent times, reports from medicinal plants research indicate that extracts from some plants are both hepatotoxic and hematotoxic, while others on the other hand are reported to be hepatoprotective and hematopoietic in action. This study considers the effects of aqueous extract of Psidium guajava (P. guajava) leaves on the histology and biochemical indices of liver function as well as hematological indices in rats. Methods In this study, phytochemical screening of the aqueous extract of P. guajava leaves was carried out. Also, male and female rats were administered with 200 mg/kg body weight oral daily doses of aqueous extract of P. guajava leaves for a period of 30 days. At the end of the administration period, the rats were anaesthesized with chloroform vapors and dissected for the collection of blood and liver tissues which were used for the hematopoietic and liver functions investigations. Results Preliminary phytochemical analysis of the plant leaves showed the presence of alkaloids, flavonoids, glycosides, polyphenols, reducing compounds, saponins and tannins. Liver function tests revealed that the serum ALT, AST and ALP, as well as the concentrations of total protein and albumin in male and female rats were not significantly (P > 0.05) affected by the oral administration of the extract. Histopathological study also did not show any adverse alteration in the morphological architecture of the liver tissues in both sexes of the animal model. However, red blood cell counts, hemotocrit and hemoglobin concentrations increased significantly (P 0.05) from that obtained for the female rats. Conclusions The results of this present study suggested that aqueous extract of Psidium guajava leaves may be hepatoprotective, and not hepatotoxic, with hematopoietic potentials in both male and female rats. These findings are therefore of clinical importance given the various reported medicinal potentials of the plant.
66 citations
TL;DR: The addition of a traditional Japanese medicine, TJ-100, reduced bloating and abdominal pain in patients with chronic constipation receiving stimulant laxatives, possibly by decreasing the bowel gas volume.
Abstract: Background: This study was to compare the effect of a stimulant laxative alone and in combination with traditional Japanese medicine Daikenchuto (TJ-100) in improving stool frequency and in alleviating bloating and abdominal pain in patients with chronic constipation. Methods: Twenty-two patients with chronic constipation who required sennoside (24 - 60 mg daily) were allocated to two groups for treatment with 7.5 g /day (N = 14) or with 15 g/day (N = 8) of TJ-100. The study period was 12 weeks and consisted of 4 weeks (pretreatment phase) before the administration of TJ-100, 6 weeks (treatment phase) for the administration of TJ-100, and 2 weeks (washout period) after cessation of TJ-100. The bowel movement frequency and the dose of sennoside required were recorded during the study period. Bloating and abdominal pain and gastrointestinal symptoms rating scale were evaluated at 0, 4, 6, and 8 weeks. The gas volume score was measured at 0 week and 6 weeks. Results: The addition of TJ-100 to sennoside resulted in significant improvement in bloating (P < 0.01) and abdominal pain (P < 0.05). Its effects for abdominal pain were dose-dependent. There was no significant change in frequency of bowel movements or the dose of sennoside used. The gas volume score was significantly decreased after the addition of TJ-100 (P < 0.05). Conclusions: The addition of a traditional Japanese medicine, TJ100, reduced bloating and abdominal pain in patients with chronic constipation receiving stimulant laxatives, possibly by decreasing the bowel gas volume.
27 citations
TL;DR: Hemoglobinopathies can affect any part of the body and one of the main organs to be affected is the hepatobiliary system, which manifests in several clinical conditions which poses diagnostic and therapeutic dilemmas to the treating physicians.
Abstract: Sickle cell anemia is one of the common hemoglobinopathies around the world. It results from a single change of one amino acid valine instead of glutamic acid in the hemoglobin beta change. This change leads to polymerization of the hemoglobin when the oxygen saturation is lowered, resulting in deformity of the red blood cells and microvascular occlusion. Sickle cell anemia can affect any part of the body and one of the main organs to be affected is the hepatobiliary system either directly from the sicklening process or indirectly as a result of chronic hemolysis and multiple blood transfusions. This manifests in several clinical conditions which poses diagnostic and therapeutic dilemmas to the treating physicians. These hepatobiliary manifestations will be outlined in this review.
26 citations
TL;DR: Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centers with experienced surgeons.
Abstract: Background The liver is one of the most frequently damaged organs when abdominal trauma occurs. Currently, a conservative management constitutes the treatment of choice in patients with hemodynamic stability. The aim of this study is to evaluate the results of an operative and conservative management of 143 patients with liver injury treated in a single institution. Methods A retrospective study of the patients admitted with the diagnosis of liver trauma was performed from 1992-2008. The patients were classified according to the intention to treatment: Group I, operative management; Group II, conservative management. Variables analyzed included demographic data, injury classification, associated lesions, surgical treatment, transfusions, morbi-mortality, and hospital stay. We established two periods (1992-1999; 2000-2008) in order to compare diagnosis and management. Results A total of 143 patients were analyzed. Thirty-one percent correspond to severe injuries. Conservative treatment was followed in 60.8 % with surgery undertaken in 14.9 % of patients from this group due to failure of conservative treatment. Immediate surgery was carried out in 38.2 %. Total mortality was 14 %. Morbidity (35.7-38.5 %) in the group of immediate surgery and failure of conservative management is similar, but not in mortality (28.6-15.4 %). In the second group (2000-2008) there are more patients with conservative treatment, with a low percentage of failure of this treatment and morbi-mortality. Conclusions Conservative treatment is an adequate treatment in a great number of patients. Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centers with experienced surgeons.
16 citations
TL;DR: Levels of fibrinogen, D-dimer, protein C, factor VIII, total homocystein and the number of platelets were found to be significantly higher in Crohn’s disease patients who were in active period of the disease.
Abstract: Background: Inflammatory bowel disease (IBD) patients have an increased risk for thromboembolism. The aim of this study was to assess the presence of thrombophilic risk factors in IBD patients and to assess the associations of these factors with disease activity. Methods: Forty-eight patients with IBD (24 ulcerative colitis, 24 Crohn’s disease) and 40 matched healthy control individuals were enrolled. In addition to routine biochemical analysis, fasting blood samples were studied for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, protein-C, protein-S, antithrombin III, factor VII, factor VIII, D-dimer, vitamin B 12 , folic acid and homocysteine. Results: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, D-dimer and the number of platelets were significantly higher in patients with IBD. When compared to control group, in patients with Crohn’s disease serum homocystein levels were significantly higher (p = 0.025) while serum folic acid levels were significantly lower (p < 0.019). Levels of fibrinogen, D-dimer, protein C, factor VIII, total homocystein and the number of platelets were found to be significantly higher in Crohn’s disease patients who were in active period of the disease. Conclusions: Thrombophilic defects are multifactorial and might be frequently seen in IBD patients. They might contribute to thrombotic complications of this disease.
15 citations
TL;DR: It is concluded that actinomycosis of the pancreas is a rare entity with only 5 cases reported in English literature to the best of the knowledge and if diagnosed preoperatively, early institution of antibiotics can improve the surgical outcome.
Abstract: Actinomyces is a normal commensal of the upper aerodigestive tract, colon and female reproductive tract. It can give rise to invasive disease in case of any breach in mucosal integrity, as well as, in patients with immunosuppression. Rarely, actinomycosis can involve the pancreas especially after episodes of pancreatitis or in post operative patients. We observed a case of actinomycosis affecting recurrent intraductal papillary mucinous neoplasm (IPMN) of pancreatic remnant, 5 years after a Whipple's procedure. Our patient, a 66 years old male with a history of Whipple's procedure for IPMN of pancreatic uncinate process, presented with repeated episodes of acute pancreatitis. Repeated radiological investigations (CT, MRI and EUS) revealed resolving pancreatitis with recurrent IPMN of the pancreatic tail. The patient underwent laparobotic assisted resection of the remnant pancreas and spleen 3 months later. Intraoperatively, in addition to the recurrent IPMN of pancreatic tail, we found a dense peripancreatic desmoplastic reaction with areas of thick yellow pus pockets in the remnant pancreatic body. Bacteriology and histopathology revealed it as a recurrent IPMN associated with actinomycosis of pancreas with chronic xanthogranulomatous changes. We conclude that actinomycosis of the pancreas is a rare entity with only 5 cases reported in English literature to the best of our knowledge. If diagnosed preoperatively, early institution of antibiotics can improve the surgical outcome. Fortunately, after diagnosis, we were able to start antibiotics in early postoperative period with successful outcome.
14 citations
TL;DR: A higher proportion of low BMI sufferers was found in the STC patients, and the reason may be related to the lower release of the plasma motilin.
Abstract: Background : Constipation is a common clinical symptom but its etiology remains unknown. The aims of the study are to discuss the relation between body mass index (BMI), motilin and the slow transit constipation (STC). Methods: A total of 178 patients with STC and 123 healthy volunteers as controls were divided into three groups according to the BMI, group A (BMI 25). Fasting and one hour postprandial plasma motilin were measured and the results were analyzed. Results: There was significant difference in the constituent ratio between STC patients and healthy controls (p , respectively; and group A had a higher percentage. Plasma motilin of fasting and one hour postprandial in STC patients of group A was significantly lower than that of group B and C (p 0.05). There was no significant difference in the results of plasma motilin of fasting and one hour postprandial among the three groups of healthy controls (p > 0.05). Plasma motilin of fasting and one hour postprandial in STC patients of group A was significantly lower than those healthy controls of group A (p s of plasma motilin of fasting and one hour postprandial could be seen in group B and C, respectively (p Conclusions: A higher proportion of low BMI sufferers was found in the STC patients. The reason may be related to the lower release of the plasma motilin. doi:10.4021/gr2010.02.168w
14 citations
TL;DR: A 32-year-old woman with subcapsular liver hematoma secondary to HELLP syndrome managed conservatively is presented.
Abstract: Subcapsular liver hematoma, as a rare complication of HELLP syndrome, must be managed in a tertiary center for prompt recognition and treatment with close monitoring of hemodynamic and coagulation parameters, treatment of underlying disorders, and assessment by the imaging techniques. These patients underwent different therapeutic options varying from conservative therapy to operative management, including liver transplantation. As a choice of treatment, patients with HELLP syndrome can be followed up conservatively in stable hemodynamic conditions. In this report, we presented a 32-year-old woman with subcapsular liver hematoma secondary to HELLP syndrome managed conservatively.
12 citations
TL;DR: Intussusception is a relatively common cause of intestinal obstruction in children but a rare, and uncommon clinical entity in adults accounting for 1%.
Abstract: Intussusception is a relatively common cause of intestinal obstruction in children but a rare, and uncommon clinical entity in adults accounting for 1%. Lipoma accounts for 4% of all benign tumors of the gut. Most of these are seen in the large intestine, usually submucosal and around ileocecal valve. These are often asymptomatic. Though these lesions are benign, it continues to present difficulties in the preoperative differentiation between malignant and benign colonic neoplasm.
11 citations
TL;DR: The clinical course and treatment of primary small cell carcinoma of the liver in a female patient, who had 13 cm x 7 cm tumor in the right lobe of liver, is discussed.
Abstract: Primary small cell carcinoma of the liver is very rare tumor. Till date only 12 cases have been reported in the English literature. We are reporting a case of primary small cell carcinoma of the liver in a female patient. She had 13 cm x 7 cm tumor in the right lobe of liver and fine needle aspiration cytology revealed features of small cell carcinoma. After ruling primary from elsewhere, patient underwent central bisectionectomy of the liver and histopathology confirmed the diagnosis of primary small cell carcinoma of the liver. On immunohistochemistry examination, the tumor was positive for Neuron-specific enolase and synaptophysin but negative for Thyroid transcription factor 1 and Hep-Par 1. Here we discuss the clinical course and treatment of primary small cell carcinoma of the liver in our case and review the literature.
9 citations
TL;DR: A 50-year-old female patient who presented with acute cholangitis was confirmed as a case of intrabilary rupture on ultrasonography, endoscopic retrograde cholangsiopancreatography and magnetic resonance cholANGiopancreatingography andRupture of hydatid cyst of liver in right hepatic and the gallbladder was confirmed on surgery.
Abstract: Hydatid cyst liver rupture into the biliary tree may involve the common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts or rarely the gallbladder. Rupture can be occult or frank. A frank intrabiliary rupture of hepatic hydatid cyst is a rare but serious event. The authors are reporting a case of concomitant rupture of hydatid cyst of liver into right hepatic duct and the gallbladder. A 50-year-old female patient who presented with acute cholangitis was confirmed as a case of intrabilary rupture on ultrasonography, endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography. Rupture of hydatid cyst of liver in right hepatic and the gallbladder was confirmed on surgery. Suture repair of cystobiliary fistula, choledochoduodenostomy with cholecystectomy was done.
TL;DR: The case of a patient with post-ERCP subcutaneous emphysema, pneumomediastinum and pneumothorax treated conservatively is reported, and other cases previously reported are reviewed.
Abstract: Retroperitoneal perforation during therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is uncommon and is usually manifested by abdominal pain, fever and leukocytosis. We report the case of a patient with post-ERCP subcutaneous emphysema, pneumomediastinum and pneumothorax treated conservatively. A 79-year-old woman with a diagnosis of choledocholitiasis was referred to our institution for an elective outpatient therapeutic ERCP. At the end of the procedure, subcutaneous emphysema was observed, and a thoracic computed tomography revealed a right pneumothorax and pneumomediastinum. Supportive care was instituted and she was discharged asymptomatic after 10 days of hospitalization. Subcutaneous emphysema, pneumothorax and pneumomediastinum are potencial complications of ERCP and sphincterotomy. We review the other cases previously reported and discuss the management.
TL;DR: Neem extract administered 12 hours after the ethanol administration showed regenerative potential against ethanol-induced mucosal damage and may be adopted in the management of gastrointestinal disorders such as ulcer.
Abstract: Background : The aim of this study was to examine whether neem Azadirachta indica possesses regenerative potential on the stomach and ileum at 500 mg/kg dose given every 12 hours after mucosa lesion was brought by the administration of 1 ml of 50% ethanol for 21 consecutive days in adult W istar rats. Methods : Adult male Wistar rats used in the study were divided into 3 groups: group A received oral normal saline and served as control; group B received 1.0 ml of 50% ethanol orally every 12 hours; and group C received neem extract (500 mg/kg) orally 12 hours after ethanol (50%, 1.0 ml) administration to verify its regenerative potential. The experiment lasted for 21 days after which the animals were sacrificed following chloroform inhalation and the stomach and ileum excised and processed for histological and morphometric examinations . Results : Ethanol treated rats showed marked gross mucosal lesions in the stomach and ileum. Ulcerated mucosa with marked apoptotic bodies and destruction of glandular elements were evident in the animals (group B). Neem extract administered 12 hours after the ethanol administration showed regenerative potential against ethanol-induced mucosal damage. This was characterized by mild restoration of the ulcerated mucosa epithelium and reorganization of the cyto-architechtural outline in group C. Conclusions : Our investigation suggests that neem extract has a regenerative potential and may be adopted in the management of gastrointestinal disorders such as ulcer. doi:10.4021/gr2010.04.173w
TL;DR: BMI, blood glucose ≥ 190 mg/dL, hematocrit level ≥ 43 % and pleural effusion detected by plain chest radiograph are simple tests which provide significant predictive power for clinical decision-making.
Abstract: Background: To propose simple tests for the prediction of severe acute pancreatitis (SAP), which are accurate and could be performed at emergency departments and outpatient clinics. Methods: A prospective study was performed on 149 patients admitted with acute pancreatitis. Body mass index (BMI), plain chest radiograph, blood biochemical data were obtained at the time of admission; white cell, lymphocyte and platelet counts, hematocrit level, prothrombin time, Pa O 2 , creatinine, calcium, blood sugar, total protein, aspartate aminotransferase, total bilirubin, amylase, lipase and C-reaction protein were determined. Patients were graded into severe and mild acute pancreatitis based on CT Balthazar grading system. Results: Twenty-seven patients were diagnosed to have SAP and 122 patients considered mild acute pancreatitis. Comparing parameters between both groups; significant factors (P Conclusion: BMI, blood glucose ? 190 mg/dL, hematocrit level ? 43 % and pleural effusion detected by plain chest radiograph are simple tests and provide significant predictive power for clinical decision-making. doi:10.4021/gr2010.02.172w
TL;DR: A link between nodular gastritis and gastric malignancy should be considered, especially in young women who have diffuse-type nodular Gastritis involving both the antrum and corpus of the stomach.
Abstract: Nodular gastritis is a Helicobacter pylori-related gastritis with endoscopically proven gooseflesh skin-like nodularity in the gastric antrum. Although an association between nodular gastritis and gastric malignancies has been suggested, there is neither a treatment strategy nor a treatment guideline for this condition because of its relative rarity. We have recently experienced two cases of diffuse-type nodular gastritis invading both the antrum and corpus of the stomach with atypical findings that required specific treatments in two young females. The first patient was diagnosed with a suspicious low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma lesion on a diffuse-type nodular gastritis, and was cured by H. pylori eradication. The second patient was diagnosed with a signet cell type gastric cancer on a diffuse-type nodular gastritis, and was cured by surgical resection. When considering the nature and significance of these gastric lesions, a link between nodular gastritis and gastric malignancy should be considered, especially in young women who have diffuse-type nodular gastritis involving both the antrum and corpus of the stomach.
TL;DR: Pancreas preserving strategy – suture of head side of pancreas and an internal drainage of left remnant with a Roux-en-Y jejunal loop is feasible and safe and should be considered in selected cases.
Abstract: Background: To assess the feasibility and safety of a pancreas preserving operative technique in the management of isolated complete pancreatic neck transection following blunt abdominal trauma. Methods: Two patients with isolated blunt fracture of the pancreatic neck underwent pancreas preserving procedure comprising of oversewing of the proximal pancreas and Roux-en-Y pancreatico jejunostomy to the distal remnant. A feeding jejunostomy tube was placed for postoperative nutritional support in these patients. Both patients received subcutaneous octreotide 300 μg/day. Results: Their ages ranged from 15 years to 20 years, mode of injury was bicycle handle-bar injury (n = 2). Both had pancreatic transection at neck in the line of superior mesenteric vessels. One had ascites. These patients had pancreas parenchyma preserving surgery – internal drainage of the left remnant in a Roux-en-Y jejunal loop. The postoperative course was uneventful in these and both are well on follow-up. Conclusions: Pancreas preserving strategy – suture of head side of pancreas and an internal drainage of left remnant with a Roux-en-Y jejunal loop is feasible and safe and should be considered in selected cases. Substantial amount of normal pancreatic parenchyma is preserved.
TL;DR: A 75-year-old man was admitted to the authors' hospital because of nausea, vomiting, and weakness, and an endoscopic examination revealed a duodenal tumor which was pure squamous cell carcinoma without differentiation into adenocarcinoma or endocrine carcinoma.
Abstract: Only two cases of squamous cell carcinoma of the duodenum have been reported in the literature. The author herein reports a case of squamous cell carcinoma of the duodenum. A 75-year-old man was admitted to our hospital because of nausea, vomiting, and weakness. An endoscopic examination revealed a duodenal tumor. The tumor was circumferential elevated one with duodenal obstruction, and located in the descending part near and distal to the ampulla of Vater. Imaging modalities also detected the duodenal tumor, but did not show tumors of other locations including the pancreas. The duodenal tumor was different from ampullary tumor and pancreatic tumor. Six biopsies were obtained from the duodenal tumor. All the six biopsies showed malignant cells arranged in a medullary pattern. The malignant cells showed hyperchromatic nuclei, and mitotic figures were scattered. Keratinization and intercellular bridges were recognized. The pathologic features were interpreted as a squamous cell carcinoma of the duodenum. The carcinoma was pure squamous cell carcinoma without differentiation into adenocarcinoma or endocrine carcinoma. Operation was not possible because of the patient’s age and weakness. The patient was treated by chemotherapy and radiation, but he showed a downhill course. Metastases emerged, and he died of systemic metastasis 17 months after the first presentation. Autopsy was not performed.
TL;DR: This article summarizes the current knowledge about the epidemiology, origin and pathogenesis of the disease, and discuses several practical questions, especially those related to how the affected patients should be treated.
Abstract: Eosinophilic esophagitis (EoE) is a chronic clinicopathological entity characterized by large numbers of intraepithelial eosinophils infiltrating the esophageal mucosa. The inflammation leads to alterations in the caliber and the motility of the organ, which determines esophageal symptoms, especially dysphagia and frequent food impaction. Firstly described in 1978, EoE represents today an increasingly recognized disease, with cases coming from all developed countries and rising epidemiology. The origin of EoE has been related to allergy to food components or inhalants, and a number of studies support a Th2-type reaction in the origin of the disease. Thus, several treatment strategies based on controlling the exposition to triggering allergens or therapies using anti-allergic drugs have demonstrated efficacy in EoE. Since EoE frequently presents with esophageal stenosis, endoscopic dilation has been also used in treating these patients, but a high risk of complications has been documented. However, single treatment strategies have not been compared to a placebo group in most of studies, and we do not know the long-term consequences of eosinophilic inflammation, esophageal fibrous remodeling or its possible modifications using different therapies. Furthermore, we lack of a common accepted therapeutic end-point to assess the efficacy of the treatment: from mere resolution of symptoms to full control of esophageal inflammation. This article summarizes the current knowledge about the epidemiology, origin and pathogenesis of the disease, and discuses several practical questions, especially those related to how the affected patients should be treated.
TL;DR: Transanal drainage tube placement following urgent colonoscopy was effective in the management of acute left-sided colorectal obstruction in the majority of patients and the materials and methods used were simple and easy.
Abstract: Background: If it is possible, endoscopic decompression for acute left-sided colorectal obstruction will be effective in critically ill patients. This study was to evaluate the techniques and outcomes of transanal drainage tube placement following urgent colonoscopy in management of acute left-sided colorectal obstruction. Methods: From January 2000 to December 2009, 69 consecutive patients (36 males, age 38 to 94, mean = 71) were hospitalized because of acute left-sided colorectal obstruction. Urgent colonoscopy was performed within 12 hours of entry for diagnosis and treatment (mean time, 6.5 hours). Endoscopic decompression using a transanal drainage tube was attempted. Clinical success, methods used, and complications were retrospectively evaluated. Results: The cause of obstruction was colorectal carcinoma in 66 patients (96%). The site of obstruction was sigmoid colon in 37 (54%), rectum in 20 (29%), and descending colon in 12 (17%). Out of 69 patients, endoscopic decompression using the transanal drainage tube was successful in 66 (96%). The use of combination of transanal drainage tube and the equipped guidewire enabled endoscopic decompression was successful in 45 patients (65%), though a small-diameter upper endoscope was used in 2 patients to introduce the guidewire beyond the obstruction. Perforation during the placement developed in 2 patients and one patient was unsuccessful. Conclusions: Transanal drainage tube placement following urgent colonoscopy was effective in the management of acute left-sided colorectal obstruction. In the majority of patients, the materials and methods used for the transanal drainage tube placement were simple and easy. doi:10.4021/gr233w
TL;DR: Oral rhEGF can promote healing of the rats with gastric ulcer by stimulating Cox-2 and TGF-beta expression and the beneficial effects ofrhEGF in the management of ulcer healing can be understood.
Abstract: Background: To study the effect (s) of recombinant human Epidermal Growth Factor (rhEGF) on naproxen induced gastric ulcer in Wistar NIN rats. Methods: Male Wistar NIN rats were randomly divided into six experimental groups: Group I - Control, Group II - Naproxen treated, Group III - Naproxen with rhEGF/7 days, Group IV - Naproxen without rhEGF/7 days, Group V - Naproxen with rhEGF/14 days, and Group VI - Naproxen without rhEGF/14 days. Gastric ulcer was induced with naproxen at a concentration of 80 mg/kg by oral administration. After 24 hours of induction of ulcer, rhEGF treatment was started at a concentration of 100 µg/kg. Ulcer presence and healing were confirmed by histopathology and molecular markers. Results: Naproxen per se induced gastric antral ulcers in Wistar NIN rats. Compared with control rats, naproxen induced rats had increased lipid peroxide content in serum. Subsequent decrease in lipid peroxide was observed in rhEGF treated groups. Treatment with rhEGF significantly resulted in healing of the ulcers, which was evident by 7 days of rhEGF treatment with total healing seen by 14 days. Significant increase in immunoreactivity for Cox-2 was observed when compared to control groups, whereas less immunoreactivity of Cox-2 was observed in rhEGF treated group. Compared with control group, naproxen induced group exhibited more gene expression of both Cox-2 and TGF beta while gene expression of Cox-2 and TGF beta in rhEGF group was comparable to control group. Conclusions: The beneficial effects of rhEGF in the management of ulcer healing can be understood. Oral rhEGF can promote healing of the rats with gastric ulcer by stimulating Cox-2 and TGF-beta expression.
TL;DR: Over-expression of M MP-1 and MMP-3 play a critical role in the pathogenesis of SDUC.
Abstract: Background: This study was to investigate the pathological significance of protein expression of matrix metalloproteinase-1 (MMP1) and matrix metalloproteinase-3 (MMP3) in colon tissues of remission patients of steroid-dependent uncreative colitis (SDUC). Methods: To test the possible involvement of MMP-1 and MMP-3 in SDUC, Western- blot and immunohistochemistry were applied to examine the protein expression of MMP-1 and MMP-3 in the colonic healing region from 10 remission patients with SDUC as well as from 10 remission patients with non-SDUC. Ten specimens from normal colon tissues were used as controls. Results: Compared with the control group, the protein expression of MMP-1 and MMP-3 from non-SDUC remission patients slightly increased (p > 0.05), in contrast, those from SDUC patients significantly increased (p < 0.01). Conclusions: Over-expression of MMP-1 and MMP-3 play a critical role in the pathogenesis of SDUC.
TL;DR: This mesenchymal tumors case illustrates the difficulty of diagnosis and sometimes shows how non-invasive test can be few helpful.
Abstract: Gastrointestinal stromal tumors (GISTs) are rare tumors and can be a cause of gastrointestibnal bleeding, when other causes have already been excluded. This mesenchymal tumors can be diagnosed hardly, and they should be included in any differential diagnosis. Our case illustrates the difficulty of diagnosis and sometimes shows how non-invasive test can be few helpful. Surgery is very often indicated, and becomes therapeutic and diagnostic. GIST tumors are rare and surgical resection with curative intent is the treatment of choice.
TL;DR: The factorial structure of the RFIPC was able to be replicated with a slight modification in the Swedish version, and the separate factors identified in this structure provide more detailed information about the worries and concerns of IBD patients as these components of worries are different related to HRQOL and general health.
Abstract: Background: Worries and concerns of patients with IBD comprise an important negative factor in their HRQOL. The Rating Form of Inflammatory Bowel Disease Patient Concerns (RFIPC) was developed to d ...
TL;DR: Clinical response of the autoimmune hepatitis to a combination therapy with corticosteroids and azothiopurine was achieved and although partially regressed for the first 12 months of theraphy, the skin lesions did not disappear completely and after 18 months of continious treatment there was no skin lesion.
Abstract: Erythema annulare centrifugum is characterized by dermal perivascular lymphocytic infiltrates. It is often associated with infections, autoimmune or neoplastic diseases but in most cases the cause is unexplained. A case of erythema annulare centrifugum related to autoimmune hepatitis in a 24-year-old woman is described in this case report. Clinical response of the autoimmune hepatitis to a combination therapy with corticosteroids and azothiopurine was achieved. Although partially regressed for the first 12 months of theraphy, the skin lesions did not disappear completely. However, after 18 months of continious treatment there was no skin lesion.
TL;DR: A case of non-occulusive jejunal ischemia leading to infarction that occurred in a patient with cirrhosis and no previous history of cardiovascular disease is described.
Abstract: Acute mesenteric ischemia has a variety of etiologies. Non-occulusive mesenteric ischemia accounts for 20-30% of patients with acute mesenteric ischemia. We describe a case of non-occulusive jejunal ischemia leading to infarction that occurred in a patient with cirrhosis and no previous history of cardiovascular disease.
TL;DR: Follicular dendritic cells (FDC) are a subset of the immune system and present in the germinal centers of lymphoid follicles in the spleen and lymph nodes and are associated with Epstein-Barr virus expression.
Abstract: Follicular dendritic cells (FDC) are a subset of the immune system and present in the germinal centers of lymphoid follicles in the spleen and lymph nodes. They are functionally as antigen-presenting cells and thus improving the quality of the humoral immune response. Follicular dendritic cell tumor is rare but considered low-grade sarcoma. Including our case, there were totally 17 cases with FDC tumor involved the liver from Medline. In these cases, the mean age was 47 years old, ranged from 19 to 82. It was much more common in females than in males (13:4). The clinical manifestations of these patients included abdominal discomfort, palpable mass, weight loss and malaise. The average size of the tumor was 11 cm. Most of the FDC tumors were associated with Epstein-Barr virus expression, 13/17 (76.5%). Surgical resection remains the mainstay of the treatment.
TL;DR: The case described here is that of a 35 years old hypothyroid male who presented with perforations peritonitis due to spontaneous perforation of the rectosigmoid.
Abstract: Spontaneous perforation of the colon is a well documented but rare clinical entity commonly found to occur in the elderly and associated with chronic constipation. Hypothyroidism is known to be associated with intestinal motility disorders ranging from chronic constipation to more serious conditions like mega colon and pseudo obstruction. The case described here is that of a 35 years old hypothyroid male who presented with perforation peritonitis due to spontaneous perforation of the rectosigmoid. A thorough search of literature shows only one report of spontaneous perforation of the colon associated with hypothyroidism, to date. This case gives an opportunity to review the literature and discuss such unusual and dangerous presentations of hypothyroidism associated colonic motility disorders.
TL;DR: What is believed to be the first case of life threatening rectal bleeding following transrectal ultrasound-guided prostate biopsy is reported, which was successfully treated with angiographic embolization.
Abstract: Rectal bleeding is often seen in patients who undergo transrectal ultrasound-guided prostate biopsy. It is usually mild and stops spontaneously. We report what we believe is the first case of life threatening rectal bleeding following this procedure which was successfully treated with angiographic embolization. An endoscopic injection of epinephrine done on admission achieved only temporary hemostasis and the patient developed a second episode of massive rectal bleeding that warranted angiographic treatment. We present this case in detail and review other alternatives for treating fulminant rectal bleed which is a consequence of this procedure.
TL;DR: A 21-year-old female who presented with jaundice and elevated liver enzymes after 4 weeks completion of 10 day course of cephalexin, prescribed prophylactically after mammoplasty is described.
Abstract: Cephalexin is a well tolerated antimicrobial and hepatic injury is an infrequent occurrence with its use. We here describe a 21-year-old female who presented with jaundice and elevated liver enzymes after 4 weeks completion of 10 day course of cephalexin, prescribed prophylactically after mammoplasty. Extensive work up including all causes of hepatitis was within normal limits and she improved with conservative management. This case highlights the need to suspect drug induced liver injury in cases of jaundice and cephalexin use.
TL;DR: Initial endoscopic diagnosis, progression and then spontaneous resolution of D. congolensis infection, once the patient's occupational exposure had ceased, are demonstrated.
Abstract: We report the first case of Dermatophilus congolensis infection of the human esophagus. We demonstrate initial endoscopic diagnosis, progression and then spontaneous resolution of D. congolensis infection, once the patient's occupational exposure had ceased.