Portal Vein Thrombosis after Restorative Proctocolectomy for Familial Adenomatous Polyposis and Sigmoid Cancer

Postoperative portal vein thrombosis (PVT) is rare, but has been described after various open as well as minimal access abdominal operations, especially splenectomy and colorectal surgical procedures. We report the case of a 39-year-old female who underwent restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis with sigmoid cancer. She presented 14 days later with vague upper abdominal pain, nausea, vomiting and high output stoma. Doppler ultrasonography confirmed PVT and therefore anticoagulant therapy was started. Her condition improved dramatically and she underwent closure of ileostomy after finishing adjuvant chemotherapy. She remained well at 3-year follow-up with good pouch function and no local or distant recurrence. A high index of suspicion is essential for early diagnosis and prompt treatment of postoperative PVT after restorative proctocolectomy. Early anticoagulation is essential to avoid subsequent complications

Portal vein thrombosis; risk factors, clinical presentation and treatment

<p>Abstract</p> <p>Background</p> <p>Portal vein thrombosis (PVT) is increasingly frequently being diagnosed, but systematic descriptions of the natural history and clinical handling of the condition are sparse. The aim of this retrospective study was to describe risk factors, clinical presentation, complications and treatment of portal vein thrombosis in a single-centre.</p> <p>Methods</p> <p>Sixty-seven patients were identified in the electronic records from 1992 to 2005. All data were obtained from the patient records.</p> <p>Results</p> <p>One or more risk factors (e.g. prothrombotic disorder or abdominal inflammation) were present in 87%. Symptoms were abdominalia, splenomegaly, fever, ascites, haematemesis, and weight loss. Abdominalia and fever occurred more frequently in patients with acute PVT. Frequent complications were splenomegaly, oesophageal- and gastric varices with or without bleeding, portal hypertensive gastropathy and ascites. Varices and bleeding were more frequent in patients with chronic PVT. Patients who received anticoagulant therapy more frequently achieved partial/complete recanalization. Patients with varices who were treated endoscopically in combination with β-blockade had regression of the varices. The overall mortality was 13% in one year, and was dependent on underlying causes.</p> <p>Conclusion</p> <p>Most patients had a combination of local and systemic risk factors for PVT. We observed that partial/complete recanalization was more frequent in patients treated with anticoagulation therapy, and that regression of varices was more pronounced in patients who where treated with active endoscopy combined with pharmacological treatment.</p

Never gonna GIF you up:Analyzing the cultural significance of the animated GIF

The animated Graphics Interchange Format (GIF) is a digital file format with a long history within internet cultures and digital content. Emblematic of the early Web, the GIF fell from favor in the late 1990s before experiencing a resurgence that has seen the format become ubiquitous within digital communication. While the GIF has certain technical affordances that make it highly versatile, this is not the sole reason for its ubiquity. Instead, GIFs have become a key communication tool in contemporary digital cultures thanks to a combination of their features, constraints, and affordances. GIFs are polysemic, largely because they are isolated snippets of larger texts. This, combined with their endless, looping repetition, allows them to relay multiple levels of meaning in a single GIF. This symbolic complexity makes them an ideal tool for enhancing two core aspects of digital communication: the performance of affect and the demonstration of cultural knowledge. The combined impact of these capabilities imbues the GIF with resistant potential, but it has also made it ripe for commodification. In this article, we outline and articulate the GIF’s features and affordances, investigate their implications, and discuss their broader significance for digital culture and communication

Coordinating the impact of structural genomics on the human α-helical transmembrane proteome

Given the recent successes in determining membrane-protein structures, we explore the tractability of determining representatives for the entire human membrane proteome. This proteome contains 2,925 unique integral α-helical transmembrane-domain sequences that cluster into 1,201 families sharing more than 25% sequence identity. Structures of 100 optimally selected targets would increase the fraction of modelable human α-helical transmembrane domains from 26% to 58%, providing structure and function information not otherwise available

Архетип свобода у контексті французької політичної теорії та історії

Розглянуто сучасні підходи щодо аналізу політичної ментальності. У межах політологічного аналізу окреслено коло проблем, які потребують вирішення з використанням підходів психології. Зроблено висновок про те, що архетип “свобода” становить важливий елемент політичної ментальності французів.Modern approaches of analysis of political mentality are considered. Within the limits of political science analysis outlined circle of problems which need decision with the use of approaches of psychology. A conclusion is done that archetype freedom makes the important element of political mentality of French’s

Isolation, Cloning and Structural Characterisation of Boophilin, a Multifunctional Kunitz-Type Proteinase Inhibitor from the Cattle Tick

Inhibitors of coagulation factors from blood-feeding animals display a wide variety of structural motifs and inhibition mechanisms. We have isolated a novel inhibitor from the cattle tick Boophilus microplus, one of the most widespread parasites of farm animals. The inhibitor, which we have termed boophilin, has been cloned and overexpressed in Escherichia coli. Mature boophilin is composed of two canonical Kunitz-type domains, and inhibits not only the major procoagulant enzyme, thrombin, but in addition, and by contrast to all other previously characterised natural thrombin inhibitors, significantly interferes with the proteolytic activity of other serine proteinases such as trypsin and plasmin. The crystal structure of the bovine α-thrombin·boophilin complex, refined at 2.35 Å resolution reveals a non-canonical binding mode to the proteinase. The N-terminal region of the mature inhibitor, Q16-R17-N18, binds in a parallel manner across the active site of the proteinase, with the guanidinium group of R17 anchored in the S1 pocket, while the C-terminal Kunitz domain is negatively charged and docks into the basic exosite I of thrombin. This binding mode resembles the previously characterised thrombin inhibitor, ornithodorin which, unlike boophilin, is composed of two distorted Kunitz modules. Unexpectedly, both boophilin domains adopt markedly different orientations when compared to those of ornithodorin, in its complex with thrombin. The N-terminal boophilin domain rotates 9° and is displaced by 6 Å, while the C-terminal domain rotates almost 6° accompanied by a 3 Å displacement. The reactive-site loop of the N-terminal Kunitz domain of boophilin with its P1 residue, K31, is fully solvent exposed and could thus bind a second trypsin-like proteinase without sterical restraints. This finding explains the formation of a ternary thrombin·boophilin·trypsin complex, and suggests a mechanism for prothrombinase inhibition in vivo

SpeB of Streptococcus pyogenes Differentially Modulates Antibacterial and Receptor Activating Properties of Human Chemokines

BACKGROUND: CXC chemokines are induced by inflammatory stimuli in epithelial cells and some, like MIG/CXCL9, IP-10/CXCL10 and I-TAC/CXCL11, are antibacterial for Streptococcus pyogenes. METHODOLOGY/PRINCIPAL FINDINGS: SpeB from S. pyogenes degrades a wide range of chemokines (i.e. IP10/CXCL10, I-TAC/CXCL11, PF4/CXCL4, GROalpha/CXCL1, GRObeta/CXCL2, GROgamma/CXCL3, ENA78/CXCL5, GCP-2/CXCL6, NAP-2/CXCL7, SDF-1/CXCL12, BCA-1/CXCL13, BRAK/CXCL14, SRPSOX/CXCL16, MIP-3alpha/CCL20, Lymphotactin/XCL1, and Fractalkine/CX3CL1), has no activity on IL-8/CXCL8 and RANTES/CCL5, partly degrades SRPSOX/CXCL16 and MIP-3alpha/CCL20, and releases a 6 kDa CXCL9 fragment. CXCL10 and CXCL11 loose receptor activating and antibacterial activities, while the CXCL9 fragment does not activate the receptor CXCR3 but retains its antibacterial activity. CONCLUSIONS/SIGNIFICANCE: SpeB destroys most of the signaling and antibacterial properties of chemokines expressed by an inflamed epithelium. The exception is CXCL9 that preserves its antibacterial activity after hydrolysis, emphasizing its role as a major antimicrobial on inflamed epithelium

Carboniferous and Permian Rugosochonetidae (Brachiopoda) from West Spitsbergen

The rugosochonetid brachiopod species Lissochonetes geinitzianus from the Kazimovian of the Nordenskioldbreen Formation, and Dyoros (Dyoros) mucronata sp. nov., Dyoros (Dyoros) spitzbergianus and Lissochonetes superba from the Artinskian to latest Permian Kapp Starostin Formation in West Spitsbergen are described and figured. Dyoros is generally restricted to the Boreal Realm, whereas Lissochonetes is mostly distributed in the Boreal Realm, but occasionally present in the Palaeoequatorial and Gondwanan Realms<br /