Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area

Brunner's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunner's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunner's gland hyperplasia. The final diagnosis was the coexistence of Brunner's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunner's gland hyperplasia is reviewed

How good are rodent models of carcinogenesis in predicting efficacy in humans? A systematic review and meta-analysis of colon chemoprevention in rats, mice and men

Tumours in rodent and human colon share many histological and genetic features. To know if rodent models of colon carcinogenesis are good predictors of chemopreventive efficacy in humans, we made a meta-analysis of aspirin, beta-carotene, calcium, and wheat bran studies. Controlled intervention studies of adenoma recurrence in human volunteers were compared with chemoprevention studies of carcinogen-induced tumours in rats, and of polyps in Min (Apc(+/-)) mice: 6714 volunteers, 3911 rats and 458 mice were included in the meta-analyses. Difference between models was small since most global relative risks were between 0.76 and 1.00. A closer look showed that carcinogen-induced rat studies matched human trials for aspirin, calcium, carotene, and were compatible for wheat bran. Min mice results were compatible with human results for aspirin, but discordant for calcium and wheat bran (no carotene study). These few results suggest that rodent models roughly predict effect in humans, but the prediction is not accurate for all agents. Based on three cases only, the carcinogen-induced rat model seems better than the Min mouse model. However, rodent studies are useful to screen potential chemopreventive agents, and to study mechanisms of carcinogenesis and chemoprevention

Hughes Abdominal Repair Trial (HART) – Abdominal wall closure techniques to reduce the incidence of incisional hernias: study protocol for a randomised controlled trial

Background Incisional hernias are common complications of midline closure following abdominal surgery and cause significant morbidity, impaired quality of life and increased health care costs. The ‘Hughes Repair’ combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. This theoretically distributes the load along the incision length as well as across it. There is evidence to suggest that this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared the Hughes Repair with standard mass closure for the prevention of incisional hernia formation following a midline incision. Methods/design This is a 1:1 randomised controlled trial comparing two suture techniques for the closure of the midline abdominal wound following surgery for colorectal cancer. Full ethical approval has been gained (Wales REC 3, MREC 12/WA/0374). Eight hundred patients will be randomised from approximately 20 general surgical units within the United Kingdom. Patients undergoing open or laparoscopic (more than a 5-cm midline incision) surgery for colorectal cancer, elective or emergency, are eligible. Patients under the age of 18 years, those having mesh inserted or undergoing musculofascial flap closure of the perineal defect in abdominoperineal wound closure, and those unable to give informed consent will be excluded. Patients will be randomised intraoperatively to either the Hughes Repair or standard mass closure. The primary outcome measure is the incidence of incisional hernias at 1 year as assessed by standardised clinical examination. The secondary outcomes include quality of life patient-reported outcome measures, cost-utility analysis, incidence of complete abdominal wound dehiscence and C-POSSUM scores. The incidence of incisional hernia at 1 year, assessed by computerised tomography, will form a tertiary outcome. Discussion A feasibility phase has been completed. The results of the study will be used to inform current and future practice and potentially reduce the risk of incisional hernia formation following midline incisions

Main principles of design of low energy houses. Comparison between Spanish and Czech energetic standards

With the tittle of our project, “Main principles of design of low-energy houses”, we want to study and prove that building a house that spent less energy and better materials is possible and necessary. Living in an ecological house is the best way to contribute to be more respectful with our environment and improve the quality of the people life inside it. In our society, if we analyse the normal buildings we can see that is one of the biggest source of contamination, in fact it consumes more than a half of the total of energy that we spend in the first world. Nowadays, in the ecological buildings we use land derivate materials, it means we can give back it again without so much damage, only following the biological cycle. Here we study all the different options and chooses with their corresponding results. Focusing the walls, floors and roofs design. But materials are not the only important, the correct use of energy, right orientation and design, accurate distribution of the inside stays, create protective environments, optimize solar imputes... are some of the things we are going to study during this project. The distribution of the stays, considering as a main factor the sunlight, is so important and necessary in countries in the North East of Europe. We design it and at same time we give importance to the form (surface and volume), that confirm us that the saving of energy increases so much.Outgoin

Free tours: present and future of a new model of business

Treball Final de Grau en Estudis Anglesos. Codi: EA0938. Curs acadèmic: 2016/2017The sector of tourism is one of the best examples of collaborative business nowadays and free tours are one of the relatively newest models of business in this sector. Traditional guided tours have monopolised the focus of attention until now and, since free tours are an innovative activity, there has been limited investigation in this area and questions arise in terms of the awareness of the concept, its usefulness in the leisure environment, the knowledge of the background and the uncertainty of its future. The following paper aims to clarify these enigmas throughout a survey provided to subjects from different ages and provenance in which questions are carefully chosen with the finality of giving the best answer to them. Once the survey is completed, the results intend to provide both theoretical and practical insights. They demonstrate that, although there is a general idea of the concept of free tour and the majority of subjects have used it in the past, the knowledge of the hidden details in the background, that is the financing and the companies managing free tours, is insufficient. Nonetheless, the future for this model of business is promising and it is believed that it can become entrenched as a consolidated activity in the tourism sector

Main principles of design of low energy houses. Comparison between Spanish and Czech energetic standards

With the tittle of our project, “Main principles of design of low-energy houses”, we want to study and prove that building a house that spent less energy and better materials is possible and necessary. Living in an ecological house is the best way to contribute to be more respectful with our environment and improve the quality of the people life inside it. In our society, if we analyse the normal buildings we can see that is one of the biggest source of contamination, in fact it consumes more than a half of the total of energy that we spend in the first world. Nowadays, in the ecological buildings we use land derivate materials, it means we can give back it again without so much damage, only following the biological cycle. Here we study all the different options and chooses with their corresponding results. Focusing the walls, floors and roofs design. But materials are not the only important, the correct use of energy, right orientation and design, accurate distribution of the inside stays, create protective environments, optimize solar imputes... are some of the things we are going to study during this project. The distribution of the stays, considering as a main factor the sunlight, is so important and necessary in countries in the North East of Europe. We design it and at same time we give importance to the form (surface and volume), that confirm us that the saving of energy increases so much.Outgoin

Expressive writing for adolescents in the efl classroom: a didactic proposal

Treball Final de Màster Universitari en Professor/a d'Educació Secundària Obligatòria i Batxillerat, Formació Professional i Ensenyaments d'Idiomes. Codi SAP419. Curs: 2018/2019.Although Communicative Language Teaching emerged in the 1960s, this approach has not fully materialised in the English as a Foreign Language classroom where, unfortunately, both teaching and textbooks are still too grammar-centred and testdriven. The prevalence of this teach-to-test approach does affect the way writing is taught in our country. Many EFL teachers see themselves between a rock and a hard place when trying to follow the established curriculum in the coursebook and, at the same time, attempting to cater for their students’ real communicative needs in a globalized world. Real-life tasks demand an integration of the main skills but, more often than not, writing is taught in isolation from the other language abilities and, remarkably, follows linear and fixed steps more inspired by the grammar translation method than by communicative language principles. The study of current writing pedagogies appears mandatory if we want to reverse this situation. The present master thesis dissertation takes as a point of departure a review of product, process and genre-based approaches in order to adopt expressive writing as a framework suitable to develop the writing skill. In that vein, a didactic proposal is designed with the twofold aim of teaching new writing competences and developing new writing identities in Higher Secondary Education students. Guidelines provided by scholars such as Small Roseboro (2019), Burns & Siegel (2018) or Rosa Manchón (2011, 2014), to name but a few, were adopted and adapted to the needs and interests of a group of Baccalaureate learners. Every writing lesson presented here adopts a strategic approach to writing through meaningful and motivating activities, enhanced by the inclusion of new technologies in the teaching-learning process. These activities intend to make writing the major goal of the writing lessons instead of using it as a mere excuse to practise more grammar or to memorise more vocabulary

Main principles of design of low energy houses. Comparison between Spanish and Czech energetic standards

With the tittle of our project, “Main principles of design of low-energy houses”, we want to study and prove that building a house that spent less energy and better materials is possible and necessary. Living in an ecological house is the best way to contribute to be more respectful with our environment and improve the quality of the people life inside it. In our society, if we analyse the normal buildings we can see that is one of the biggest source of contamination, in fact it consumes more than a half of the total of energy that we spend in the first world. Nowadays, in the ecological buildings we use land derivate materials, it means we can give back it again without so much damage, only following the biological cycle. Here we study all the different options and chooses with their corresponding results. Focusing the walls, floors and roofs design. But materials are not the only important, the correct use of energy, right orientation and design, accurate distribution of the inside stays, create protective environments, optimize solar imputes... are some of the things we are going to study during this project. The distribution of the stays, considering as a main factor the sunlight, is so important and necessary in countries in the North East of Europe. We design it and at same time we give importance to the form (surface and volume), that confirm us that the saving of energy increases so much.Outgoin

In vivo brain dialysis study of the somatodendritic release of serotonin in the raphe nuclei of the rat. Effects of 8-OH-DPAT

The characteristics of the serotonin (5-HT) output in the dorsal and median raphe nuclei of the rat were studies using in vivo microdialysis. The basal output of 5-HT increased after KCl was added to the perfusion fluid. In contrast, neither the omission of calcium ions nor the addition of 0.5 microM tetrodotoxin affected dialysate 5-HT or 5-hydroxyindoleacetic acid (5-HIAA). Reserpine did not decrease the output of 5-HT and 5-HIAA 24 h later and p-chloroamphetamine increased 5-HT in both vehicle- and reserpine-treated rats severalfold. 8-Hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), at 1 or 10 microM, perfused into the raphe did not change the outputs of 5-HT or 5-HIAA. Higher doses (0.1, 1, and 10 mM) increased extracellular 5-HT in the raphe, probably via an inhibition of uptake. In animals bearing two probes (raphe nuclei and ventral hippocampus), only the 10 mM dose of 8-OH-DPAT perfused into the raphe decreased the hippocampal output of 5-HT and 5-HIAA. The systemic injection of 0.1 mg/kg 8-OH-DPAT decreased dialysate 5-HT and 5-HIAA in the raphe and hippocampus. These results suggest that extracellular 5-HT in raphe nuclei originates from a cytoplasmic pool and is not dependent on either nerve impulse of 5-HT neurons or local activation of 5-HT1A receptors.Peer reviewe

Regional distribution of extracellular 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in the brain of freely moving rats.

The extracellular concentrations of 5-hydroxytryptamine (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) have been determined in six brain areas of awake rats (frontal cortex, striaturn, hypothalamus, hippocampus, inferior colliculus, and raphe nuclei) using intracerebral microdialysis. The extracellular levels of 5-HT showed no significant differences among the brain regions studied. The tissue levels of 5-HT and 5-HIAA as well as the extracellular concentration of 5-HIAA were significantly higher in raphe nuclei. The regional distribution of tissue and extracellular 5-HIAA were very similar, suggesting that extracellular 5-HIAA depends mainly on the output from the intracellular compartment. On the other hand, extracellular 5-HT and tissue 5-HT showed a different distribution pattern. The tissue/extracellular ratio for 5-HT ranged from 739 in frontal cortex to 2,882 in raphe, whereas it only amounted to 1.8–3.6 for 5-HIAA. The relationship between the present results and the density of 5-HT uptake sites in these areas is discussed.Peer reviewe