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Acta Medica Indonesiana Jan 2024Corrosive injuries (CI) become medical problems related complications include esophageal, pyloric stricture and squamous cell carcinoma, physical and quality of life....
Corrosive injuries (CI) become medical problems related complications include esophageal, pyloric stricture and squamous cell carcinoma, physical and quality of life. Endoscopic (ED) dilatation is primary therapy. The ultrathin endoscope-assisted method is potentially safe and useful in avoiding technical failure. Describe clinical outcomes of ED ED-related CI including successful, refractory, recurrent, and complications-related procedures. Case series study of esophageal and/or pyloric stricture patients after CI who underwent dilatation at Soetomo General Hospital (July 2018 - July 2022). One - biweekly ED using Through The Scope (TTS) balloon or Savary Bougie dilator. The target diameter is 14mm. Fifteen patients with stricture-related CI. Eleven patients underwent ED with a total of 73 procedures. Mean age 31,45 years, predominantly male patients (6), suicide attempt (7), acid agent (9), located at esophagus (3), pylorus (3), or both (5). Number of esophageal dilatation to achieve the target of 14 mm was 1-2 and 2-15 procedures for simple and complex stricture. Five esophageal strictures were successfully dilated but 2 patients were recurrent and 3 cases were refractory to ED. Pyloric dilatation resulted in a lower success rate. Recurrent and refractory cases were 5 and 3 patients respectively. ED with ultrathin endoscope method is useful for traversing guidewire during ED. Ongoing inflammation and fibrosis were linked to recurrent and refractory stricture.
Topics: Humans; Male; Female; Caustics; Constriction, Pathologic; Esophagoscopy; Dilatation; Quality of Life; Treatment Outcome; Esophageal Stenosis; Endoscopes; Burns, Chemical
PubMed: 38561887
DOI: No ID Found -
IScience Apr 2024The tobacco hornworm is a laboratory model that is particularly suitable for analyzing gut inflammation, but a physiological reference standard is currently unavailable....
The tobacco hornworm is a laboratory model that is particularly suitable for analyzing gut inflammation, but a physiological reference standard is currently unavailable. Here, we present a surface atlas of the healthy hornworm gut generated by scanning electron microscopy and nano-computed tomography. This comprehensive overview of the gut surface reveals morphological differences between the anterior, middle, and posterior midgut, allowing the screening of aberrant gut phenotypes while accommodating normal physiological variations. We estimated a total resorptive midgut surface of 0.42 m for L5d6 larvae, revealing its remarkable size. Our data will support allometric scaling and dose conversion from to mammals in preclinical research, embracing the 3R principles. We also observed non-uniform gut colonization by enterococci, characterized by dense biofilms in the pyloric cone and downstream of the pylorus associated with pore and spine structures in the hindgut intima, indicating a putative immunosurveillance function in the lepidopteran hindgut.
PubMed: 38558941
DOI: 10.1016/j.isci.2024.109410 -
Insect Biochemistry and Molecular... May 2024The Drosophila hindgut is a classical model to study organogenesis. The adult hindgut originates from the precursor cells in the larval hindgut. However, the territory...
The Drosophila hindgut is a classical model to study organogenesis. The adult hindgut originates from the precursor cells in the larval hindgut. However, the territory of these cells has still not been well determined. A ring of wingless (wg)-expressing cells lies at the anterior zone of both the larval and adult hindgut. The larval Wg ring was thought as a portion of precursor of the adult hindgut. By applying a cell lineage tracing tool (G-TRACE), we demonstrate that larval wg-expressing cells have no cell lineage contribution to the adult hindgut. Additionally, adult Wg ring cells do not divide and move posteriorly to replenish the hindgut tissue. Instead, we determine that the precursors of the adult pylorus and ileum are situated in the cubitus interruptus (ci)-expressing cells in the anterior zone, and deduce that the precursor stem cells of the adult rectum locate in the trunk region of the larval pylorus including hedgehog (hh)-expressing cells. Together, this research advances our understanding of cell lineage origins and the development of the Drosophila hindgut.
Topics: Animals; Drosophila; Drosophila Proteins; Larva; Proto-Oncogene Proteins; Wnt1 Protein; Hedgehog Proteins; Gene Expression Regulation, Developmental
PubMed: 38552809
DOI: 10.1016/j.ibmb.2024.104114 -
Medicine Mar 2024Gastritis cystica profunda (GCP), commonly observed in remnant gastric anastomosis, is associated with developing gastric cancer. (Review)
Review
BACKGROUND
Gastritis cystica profunda (GCP), commonly observed in remnant gastric anastomosis, is associated with developing gastric cancer.
CASE
This case report describes a patient with GCP in a previously unoperated stomach that mimicked a pyloric submucosal tumor and caused anorexia, which is rare in clinical practice.
PATIENT CONCERNS
A 72-year-old woman presented with loss of appetite and weight.
DIAGNOSES
Gastroscopy detected a 20 mm diameter submucosal tumor near the pylorus. Computed tomography and magnetic resonance imaging identified a cystic lesion, unlike a usual submucosal tumor in the stomach. The diagnosis was difficult, even with endoscopic ultrasound-guided fine-needle aspiration.
INTERVENTIONS
Surgery was performed for diagnosis and treatment. The lesion was resected using a submucosal dissection technique after an incision of the gastric wall during open laparotomy. Histopathological examination confirmed the diagnosis of GCP and revealed no dysplasia or cancer.
OUTCOMES
Anorexia resolved after the surgery. Residual or recurrent lesions were not detected during follow-up examinations performed 1 year after surgery.
LESSONS
GCP occurring in a previously unoperated stomach as a macroscopic lesion like a submucosal tumor causing some symptoms is rare. GCP is associated with a risk of developing cancer. Therefore, careful evaluation and management during treatment are required.
Topics: Female; Humans; Aged; Pylorus; Anorexia; Stomach Neoplasms; Gastrointestinal Neoplasms; Cysts; Gastritis
PubMed: 38552036
DOI: 10.1097/MD.0000000000037652 -
Veterinary Research Communications Jun 2024The health of the gastrointestinal tract in cattle is one of the factors influencing adequate nutrient absorption and body weight gain. This study aimed to evaluate the...
The health of the gastrointestinal tract in cattle is one of the factors influencing adequate nutrient absorption and body weight gain. This study aimed to evaluate the prevalence of lesions found in the abomasum of Polish fattening Holstein-Friesian bulls. A total of 149 abomasa from adult bulls from two voivodeships of central Poland were inspected for pathologicalanatomic position (displacement, volvulus), impaction, mucosal membrane lesions (inflammation, hyperplasia), and signs of parasite infestation(Moroccan leather, worm nodules) in one of the Polish abattoirs just after slaughter. Among all the examined males no lesions were observed in only 8 individuals. The most common findings were erosions (75.8%) and type 1 ulcerations (48.3%) of the body, pylorus, or both locations. Signs of parasite infestations were observed in 78.5% of the inspected animals. Significant differences correlated with age were found in the prevalence of healed ulcers, and between voivodeships in the prevalence of type 2 ulcers. The findings of this study indicate that most fattening bulls in Poland suffer from subclinical forms of abomasa inflammation (both diffuse and focal) and middle-large abomasum parasites invasions, which can influence the economics and profitability, as well as welfare, of livestock production.
Topics: Animals; Cattle; Male; Poland; Abomasum; Cattle Diseases; Stomach Diseases; Prevalence
PubMed: 38539030
DOI: 10.1007/s11259-024-10366-4 -
Journal of Gastrointestinal Surgery :... Jun 2024Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy. There remains an active debate over the effect of gastrointestinal (GI)... (Comparative Study)
Comparative Study
BACKGROUND
Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy. There remains an active debate over the effect of gastrointestinal (GI) reconstruction techniques, such as antecolic (AC) or transmesocolic (TMC) reconstruction, on DGE rates. This study compared the rates of DGE between AC reconstruction and TMC reconstruction after pylorus-preserving pancreaticoduodenectomy (PPPD) and classic pancreaticoduodenectomy (PD).
METHODS
This was a retrospective analysis of a prospectively maintained pancreatic surgery database in a single, high-volume center. Demographic, perioperative, and surgical outcome data were recorded from patients who underwent a PD or PPPD between 2013 and 2021. DGE grades were classified using the International Study Group of Pancreatic Surgeons (ISGPS) criteria. Postoperatively, all patients were managed using an accelerated Whipple recovery protocol.
RESULTS
A total of 824 patients were assessed, with 303 patients undergoing AC reconstruction and 521 patients undergoing TMC reconstruction. The risk of DGE was significantly greater in patients who received an AC reconstruction than in patients who received a TMC reconstruction (odds ratio [OR], 1.51; 95% CI, 1.07-2.15; P < .05). In addition, AC reconstruction was shown to have a greater incidence of severe DGE (ISGPS grades B or C) than TMC reconstruction, with approximately a 2-fold increase in severe DGE (OR, 1.94; 95% CI, 1.10-3.45; P < .05). Logistic regression and propensity score matching have found increased DGE incidence with AC reconstruction (OR: 1.69 and 1.73, respectively; P < .05).
CONCLUSIONS
Although the correlation between GI reconstruction methods and DGE remains a subject of ongoing debate, our study indicated that TMC reconstruction may be superior to AC reconstruction in minimizing the development and severity of DGE for patients after PD.
Topics: Humans; Pancreaticoduodenectomy; Male; Female; Retrospective Studies; Middle Aged; Aged; Postoperative Complications; Gastroparesis; Plastic Surgery Procedures; Gastric Emptying; Pylorus; Colon
PubMed: 38538477
DOI: 10.1016/j.gassur.2024.03.007 -
Journal of Vascular and Interventional... Jul 2024To evaluate the safety and long-term clinical outcomes of stent-graft placement to treat hepatic arterial hemorrhage after pancreaticobiliary surgery.
PURPOSE
To evaluate the safety and long-term clinical outcomes of stent-graft placement to treat hepatic arterial hemorrhage after pancreaticobiliary surgery.
MATERIALS AND METHODS
Outcomes were retrospectively evaluated in 61 patients (50 men and 11 women; mean age, 63 years) who underwent stent-graft placement for delayed arterial hemorrhage (after 24 hours) after pancreaticobiliary surgery from 2006 to 2023. Bleeding sites included the gastroduodenal artery stump (n = 54), common or proper hepatic artery (n = 5), and right hepatic artery (n = 2). The stent-grafts used were Viabahn (n = 27), Comvi (n = 11), Jostent (n = 3), Covera (n = 11), and Lifestream (n = 7). Technical and clinical success and adverse events (AE) were evaluated. After stent-graft placement, overall survival (OS), hemorrhage-free survival (HFS), and stent patency were evaluated.
RESULTS
The technical and clinical success rates of stent-graft placement were 97% and 93%, respectively. The severe AE rate was 12% and was significantly higher in patients who underwent pylorus-sacrificing rather than pylorus-preserving surgery (P = .001). None of the severe AEs were associated with patient mortality. Median OS after stent-graft placement was 854 days, and median HFS was 822 days. The 1-, 3-, 5-, and 10-year stent patency rates were 87%, 84%, 79%, and 72%, respectively.
CONCLUSIONS
Stent-graft placement was safe and provided long-term control of hepatic arterial hemorrhage after pancreaticobiliary surgery.
Topics: Humans; Male; Female; Middle Aged; Retrospective Studies; Hepatic Artery; Stents; Aged; Time Factors; Postoperative Hemorrhage; Blood Vessel Prosthesis Implantation; Blood Vessel Prosthesis; Endovascular Procedures; Risk Factors; Treatment Outcome; Adult; Vascular Patency; Aged, 80 and over; Prosthesis Design; Biliary Tract Surgical Procedures
PubMed: 38519001
DOI: 10.1016/j.jvir.2024.03.020 -
ACG Case Reports Journal Mar 2024
PubMed: 38501035
DOI: 10.14309/crj.0000000000001278 -
Cirugia Espanola May 2024Controversy exists in the literature as to the best technique for pancreaticoduodenectomy (PD), whether pyloric preservation (PP-CPD) or Whipple's technique (with... (Comparative Study)
Comparative Study
INTRODUCTION
Controversy exists in the literature as to the best technique for pancreaticoduodenectomy (PD), whether pyloric preservation (PP-CPD) or Whipple's technique (with antrectomy [W-CPD]), the former being associated with a higher frequency of delayed gastric emptying (DGE).
METHODS
Retrospective and comparative study between PP-CPD technique (n = 124 patients) and W-CPD technique (n = 126 patients), in patients who were operated for tumors of the pancreatic head and periampullary region between the period 2012 and 2023.
RESULTS
Surgical time was longer, although not significant, with the W-CPD technique. Pancreatic and peripancreatic tumor invasion (p = 0.031) and number of lymph nodes resected (p < 0.0001) reached statistical significance in W-CPD, although there was no significant difference between the groups in terms of lymph node tumor invasion. Regarding postoperative morbimortality (medical complications, postoperative pancreatic fistula [POPF], hemorrhage, RVG, re-interventions, in-hospital mortality, Clavien-Dindo complications), ICU and hospital stay, no statistically significant differences were observed between the groups. During follow-up, no significant differences were observed between the groups for morbidity and mortality at 90 days and survival at 1, 3 and 5 years. Binary logistic regression analysis for DGE showed that binary relevant POPF grade B/C was a significant risk factor for DGE.
CONCLUSIONS
Postoperative morbidity and mortality and long-term survival were not significantly different with PP-CPD and W-CPD, but POPF grade B/C was a risk factor for DGE grade C.
Topics: Humans; Pancreaticoduodenectomy; Retrospective Studies; Male; Female; Pancreatic Neoplasms; Middle Aged; Pylorus; Aged; Postoperative Complications; Organ Sparing Treatments; Adult
PubMed: 38493929
DOI: 10.1016/j.cireng.2024.02.007 -
Endoscopy May 2024
Topics: Gastroparesis; Humans; Pyloromyotomy; Pylorus
PubMed: 38490249
DOI: 10.1055/a-2279-9899