Idiopathic Superior Mesenteric Vein Thrombosis Resulting in Small Bowel Ischemia in a Pregnant Woman

Background. Small bowel ischemia due to superior mesenteric vein thrombosis (MVT) is rare during pregnancy. However, additional precipitating factors should usually be identified. Case. A 31-year-old woman, pregnant at 34 weeks, was sent to the emergency department because of acute peritonitis. An emergency exploration revealed a segmental gangrene of the small intestine without any mechanical obstruction. Together with the termination of pregnancy, resection of the damaged small bowel was performed, and an end-to-end enterostomy was followed. Based on the operative and pathological findings, small bowel ischemia might be attributed to superior mesenteric vein thrombosis. Conclusion. Hypercoagulation state normally found in pregnant women is believed to lead to this catastrophic condition without other precipitating factors

Antioxidation activity and total phenolic contents of various Toona sinensis extracts

Products Processing Division, LRI, COA, Tainan, Taiwan. Accepted 1 August, 2012 The purpose of this study was to analyze the antioxidation activities and total phenolic contents of Toona sinensis. An extractive method of the antioxidant activities of local T. sinensis leaf extracts and various antioxidation models were analyzed. The effects of various solvent concentrations to extract the T. sinensis leaf on the antioxidation activity were compared. The results showed that the T. sinensis leaf extracts of various solvent concentrations had good antioxidant activities. The chelating abilities of ferrous ion in the T. sinensis leaf extracts obtained from various solvent concentrations were above 80%. It is concluded that T. sinensis leaf extracts could be used as biopreservatives of food products. The total antioxidant activities, chelating abilities of ferrous ions and reducing capacities of the T. sinensis leaf extracts might provide a substitute for a natural antioxidant.Keywords: Antioxidative activity, bio-preservatives, extracts, Toona sinensi

Palpation of preoperatively inserted indwelling angiocatheter facilitates intraoperative localization of obscure gastrointestinal bleeding of small intestinal origin

SummaryBackgroundPalpation of the indwelling angiographic catheter inserted before operation to localize obscure gastrointestinal bleeding of small intestinal origin during laparotomy has rarely been reported in the literature.PurposeThe purpose of the study is to investigate the role of palpable indwelling angiocatheter inserted before operation in localizing obscure gastrointestinal bleeding of small intestinal origin during laparotomy.MethodsBetween January 2003 and December 2010, seven patients who had a clinical impression of obscure gastrointestinal bleeding of small intestinal origin and angiographic extravasation from the mesenteric artery had an angiocatheter inserted into the distal mesenteric branch. During laparotomy the catheter was palpated to guide subsequent resection of the intestine. The clinical outcomes of these patients were retrospectively reviewed.ResultsDuring laparotomy the retained catheter failed to be palpated in one patient. Six patients underwent segmental resection of intestine under guidance of the palpated catheter. All six patients had positive identification of small bowel bleeding. The yield rate of intraoperative localization was 86% (6 out of 7). Two of the six patients ceased bleeding after operation, but died of underlying disease progression. Four of the six patients had an uneventful postoperative clinical course without recurrent bleeding after a median follow-up period of 25 months.ConclusionPalpation of the indwelling angiographic catheter selectively left before operation is effective for precisely locating obscure gastrointestinal bleeding of small intestinal origin during laparotomy

Will Your Project Get the Green Light? Predicting the Success of Crowdfunding Campaigns

Capital is always essential for a business project over times. After emerging in 2000, crowdfunding gradually becomes one of the most popular fundraising resources. However, the mechanism of crowdfunding significantly differs from traditional capital-collecting approaches. As long as the amount of pledged money reaches the goal in time, the project succeeds, its initiator receives the funds, the platform gains the revenue, and its backers acquire rewards. Reaching the goal by deadline becomes an important issue. The goal of our study is to develop an effective technique for predicting whether a crowdfunding campaign will succeed or fail. On the basis of a dataset collected from Kickstarter, our empirical evaluation results suggest that our proposed technique significantly outperforms the benchmark method. In addition, with the use of time-dependent factors, the prediction accuracy improves from 72.89% at day 0 to 87.13% at the first day and eventually to 89.62% at day 7

Retrospective study of necrotizing fasciitis and characterization of its associated Methicillin-resistant Staphylococcus aureus in Taiwan

<p>Abstract</p> <p>Background</p> <p>Methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) has emerged as a prevalent pathogen of necrotizing fasciitis (NF) in Taiwan. A four-year NF cases and clinical and genetic differences between hospital acquired (HA)- and community-acquired (CA)-MRSA infection and isolates were investigated.</p> <p>Methods</p> <p>A retrospective study of 247 NF cases in 2004-2008 and antimicrobial susceptibilities, staphylococcal chromosomal cassette <it>mec </it>(SCC<it>mec</it>) types, pulsed field gel electrophoresis (PFGE) patterns, virulence factors, and multilocus sequence typing (MLST) of 16 NF-associated MRSA in 2008 were also evaluated.</p> <p>Results</p> <p>In 247 cases, 42 microbial species were identified. <it>S. aureus </it>was the major prevalent pathogen and MRSA accounted for 19.8% of NF cases. Most patients had many coexisting medical conditions, including diabetes mellitus, followed by hypertension, chronic azotemia and chronic hepatic disease in order of decreasing prevalence. Patients with MRSA infection tended to have more severe clinical outcomes in terms of amputation rate (p < 0.05) and reconstruction rate (p = 0.001) than those with methicillin-sensitive <it>S. aureus </it>or non-<it>S. aureus </it>infection. NF patients infected by HA-MRSA had a significantly higher amputation rate, comorbidity, C-reactive protein level, and involvement of lower extremity than those infected by CA-MRSA. In addition to over 90% of MRSA resistant to erythromycin and clindamycin, HA-MRSA was more resistant than CA-MRSA to trimethoprim-sulfamethoxazole (45.8% <it>vs</it>. 4%). ST59/pulsotype C/SCC<it>mec </it>IV and ST239/pulsotype A/SCC<it>mec </it>III isolates were the most prevalent CA- and HA-MRSA, respectively in 16 isolates obtained in 2008. In contrast to the gene for γ-hemolysin found in all MRSA, the gene for Panton-Valentine leukocidin was only identified in ST59 MRSA isolates. Other three virulence factors TSST-1, ETA, and ETB were occasionally identified in MRSA isolates tested.</p> <p>Conclusion</p> <p>NF patients with MRSA infection, especially HA-MRSA infection, had more severe clinical outcomes than those infected by other microbial. The prevalent NF-associated MRSA clones in Taiwan differed distinctly from the most predominant NF-associated USA300 CA-MRSA clone in the USA. Initial empiric antimicrobials with a broad coverage for MRSA should be considered in the treatment of NF patients in an endemic area.</p

Hypertension is an important predictor of recurrent colorectal adenoma after screening colonoscopy with adenoma polypectomy

AbstractBackgroundThe predictors of recurrent colorectal adenoma have not been fully examined. This study aimed to evaluate the predictors of recurrent colorectal adenoma after initial screening colonoscopy with adenoma polypectomy.MethodsA retrospective cohort study was conducted at the Taipei Veterans General Hospital from 2003 to 2011. After screening, 356 patients who had undergone two consecutive colonoscopies with colorectal adenoma polypectomy at the initial colonoscopy were enrolled. The recurrence group was patients with recurrent colorectal adenoma at the second colonoscopy, whereas the nonrecurrence group was patients without recurrence. Anthropometric data, biochemical tests, metabolic comorbidities, and adenoma characteristics at initial colonoscopy were compared between the two groups. Cox proportional hazard regression analysis was conducted to identify the predictors of recurrent colorectal adenoma.ResultsDuring a mean follow-up interval of 3.07 ± 1.42 years, 94 patients (26.4%) were in the recurrence group, 262 patients (73.6%) were in the nonrecurrence group. The recurrence group was older, had a wider waist circumference, higher levels of serum alanine aminotransferase (ALT) and triglyceride, a higher prevalence of smoking, nonalcoholic fatty liver disease, metabolic syndrome, and hypertension, and a higher occurrence of initial multiply-located adenomas when compared with the nonrecurrence group (p < 0.05). Cox regression analysis showed that hypertension, smoking, higher ALT level (>40 IU/mL), and multiply-located adenomas were independent predictors for recurrent colorectal adenoma. The risk of recurrent adenoma increased when hypertension was combined with smoking, high ALT level, or multiply-located adenomas.ConclusionHypertension is an important predictor for recurrent colorectal adenoma after screening colonoscopy with polypectomy

Reduced expression of alpha-1,2-mannosidase I extends lifespan in Drosophila melanogaster and Caenorhabditis elegans

Exposure to sub-lethal levels of stress, or hormesis, was a means to induce longevity. By screening for mutations that enhance resistance to multiple stresses, we identified multiple alleles of alpha-1,2-mannosidase I (mas1) which, in addition to promoting stress resistance, also extended longevity. Longevity enhancement is also observed when mas1 expression is reduced via RNA interference in both Drosophila melanogaster and Caenorhabditis elegans. The screen also identified Edem1 (Edm1), a gene downstream of mas1, as a modulator of lifespan. As double mutants for both mas1 and Edm1 showed no additional longevity enhancement, it appeared that both mutations function within a common pathway to extend lifespan. Molecular analysis of these mutants revealed that the expression of BiP, a putative biomarker of dietary restriction (DR), is down-regulated in response to reductions in mas1 expression. These findings suggested that mutations in mas1 may extend longevity by modulating DR

Effect of Antrodia

Antrodia camphorata is a rare Taiwanese medicinal mushroom. Antrodia camphorata extract has been reported to exhibit antioxidant, anti-inflammation, antimetastasis, and anticancer activities and plays a role in liver fibrosis, vasorelaxation, and immunomodulation. Critical vascular inflammation leads to vascular dysfunction and cardiovascular diseases, including abdominal aortic aneurysms, hypertension, and atherosclerosis. Platelet activation plays a crucial role in intravascular thrombosis, which is involved in a wide variety of cardiovascular diseases. However, the effect of Antrodia camphorata on platelet activation remains unclear. We examined the effects of Antrodia camphorata on platelet activation. In the present study, Antrodia camphorata treatment (56–224 μg/mL) inhibited platelet aggregation induced by collagen, but not U46619, an analogue of thromboxane A2, thrombin, and arachidonic acid. Antrodia camphorata inhibited collagen-induced calcium (Ca2+) mobilization and phosphorylation of protein kinase C (PKC) and Akt. In addition, Antrodia camphorata significantly reduced the aggregation and phosphorylation of PKC in phorbol-12, 13-dibutyrate (PDBu) activated platelets. In conclusion, Antrodia camphorata may inhibit platelet activation by inhibiting of Ca2+ and PKC cascade and the Akt pathway. Our study suggests that Antrodia camphorata may be a potential therapeutic agent for preventing or treating thromboembolic disorders

The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P < 0.001) and GOLD staging (P < 0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS = 0.670) and GOLD staging (rS = 0.531), followed by symptoms (rS = 0.482; rS = 0.346, respectively), and mental status (rS = 0.340; rS = 0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD