Pleurobiliary fistula, a rare complication of hepatocellular carcinoma after locoregional chemotherapy: a case report

A rare complication of the compilation of high intrahepatic biliary pressure and the formation of a subdiaphragmatic abscess is that of pleurobiliary fistula. We present a case of 67-year-old male who presented with pleurobiliary fistula following transarterial chemoembolization in a patient with a large hepatocellular carcinoma, as well as the course of the diagnostic procedures and the therapeutics interventions which took place

Molecular dissection of the prototype foamy virus (PFV) RNA 5′-UTR identifies essential elements of a ribosomal shunt

The prototype foamy virus (PFV) is a nonpathogenic retrovirus that shows promise as a vector for gene transfer. The PFV (pre)genomic RNA starts with a long complex leader that can be folded into an elongated hairpin, suggesting an alternative strategy to cap-dependent linear scanning for translation initiation of the downstream GAG open reading frame (ORF). We found that the PFV leader carries several short ORFs (sORFs), with the three 5′-proximal sORFs located upstream of a structural element. Scanning-inhibitory hairpin insertion analysis suggested a ribosomal shunt mechanism, whereby ribosomes start scanning at the leader 5′-end and initiate at the downstream ORF via bypass of the central leader regions, which are inhibitory for scanning. We show that the efficiency of shunting depends strongly on the stability of the structural element located downstream of either sORFs A/A′ or sORF B, and on the translation event at the corresponding 5′-proximal sORF. The PFV shunting strategy mirrors that of Cauliflower mosaic virus in plants; however, in mammals shunting can operate in the presence of a less stable structural element, although it is greatly improved by increasing the number of base pairings. At least one shunt configuration was found in primate FV (pre)genomic RNAs

Push enteroscopy in the investigation of small intestinal disease

Background: Endoscopic investigation of the small intestine remains the last frontier in endoscopy. Push type enteroscopy, a recent method for investigating the small intestine, is currently undergoing assessment. Aim: To assess the diagnostic yield of push - type enteroscopy in small bowel diseases. Patients and methods: From January 1994 to November 2000, 235 consecutive patients underwent push- type enteroscopy, using the Pentax, VSB 2900 video enteroscope. The indications were: unexplained iron deficiency anemia (n= 59); macroscopic gastrointestinal bleeding (n= 49); abnormal small bowel radiology (n= 12); chronic diarrhea and/or malabsorption (n=81); abdominal pain (n= 22); suspected neoplasia (n=7); polyposis syndromes (n=5). Results: The median depth of small intestine intubated was 80 cm past the ligament of Treitz, (range 20-160 cm). Procedure time varied from 15-45 minutes. Tolerance of the examination was good for all patients, and there were no complications. In patients with gastrointestinal bleeding/anemia, abnormalities were detected in 64/108 patients (59%), while 19/108 patients (17,5%) had findings located in the upper gastrointestinal tract. In those with abnormal small bowel radiology, abnormalities were diagnosed or excluded as artifacts in 11/12 patients (91%). In those with diarrhea /or malabsorption a diagnosis was made in 28/81 patients (34,5%). In patients with abdominal pain abnormalities were detected in 3/22 patients (13,5%). Finally in patients with Peutz-Jengers syndrome enteroscopy was found very accurate in detecting the jejunal polyps. Conclusion: Push type enteroscopy is safe and efficacious in the diagnosis of small bowel diseases.Σκοπός: Να μελετηθεί η συμβολή της προωθητικού τύπου εντεροσκόπησης στη διάγνωση των νοσημάτων του λεπτού εντέρου. Ασθενείς και μέθοδοι: Από τον Ιανουάριο του 1994 μέχρι το Νοέμβριο του 2001 υποβλήθηκαν σε προωθητικού τύπου εντεροσκόπηση συνολικά 235 ασθενείς. Όλες οι εντεροσκοπήσεις διενεργήθηκαν με το βίντεο εντεροσκόπιο VSB 2900 της εταιρείας Pentax. Οι ενδείξεις για την εξέταση ήταν: σιδηροπενική αναιμία μη διευκρινισθείσης αιτιολογίας (n=59), μακροσκοπική αιμορραγία μη εμφανούς αιτιολογίας (n=49), παθολογικός απεικονιστικός έλεγχος του λεπτού εντέρου (n=12), χρόνια διάρροια με ή χωρίς δυσαπορρόφηση (n=81 ), κοιλιακό άλγος (n=22), αναζήτηση πρωτοπαθούς ή δευτεροπαθούς νεοπλασματικής εστίας (n=7), σύνδρομα πολυποδίασης (n=5). Αποτελέσματα: Το διάμεσο βάθος της διείσδυσης ήταν 80 εκατοστά, (εύρος 20 έως 160 εκατοστά), μετά το σύνδεσμο του Treitz. Η διάρκεια της εξέτασης κυμαίνονταν από 15 έως 45 λεπτά. Η εξέταση ήταν καλώς ανεκτή από όλους τους ασθενείς, και κανείς δεν παρουσίασε επιπλοκές. Στους ασθενείς με απώλεια αίματος από το πεπτικό, αλλοιώσεις ανευρέθησαν σε 64/108 (59%) ασθενείς, ενώ σε 19/108 (17,5%) τα ευρήματα εντοπίζονταν εντός του διαγνωστικού πεδίου του γαστροσκοπίου. Στους ασθενείς με παθολογικό απεικονιστικό έλεγχο του λεπτού εντέρου, οι αλλοιώσεις επιβεβαιώθηκαν ή αποκλείστηκαν στους 11/12 ασθενείς (91%). Στους ασθενείς με διάρροια με ή χωρίς δυσαπορρόφηση, η διάγνωση ετέθη στους 28/81 ασθενείς (34,5%). Τέλος σε αυτούς με σύνδρομο Peutz-Jengers η εντεροσκόπηση επέτρεψε με απόλυτη ακρίβεια την προεγχειρητική διάγνωση όλων των πολυπόδων στη νήστιδα. Συμπέρασμα: Η προωθητικού τύπου εντεροσκόπηση αποτελεί ασφαλή και αξιόπιστη μέθοδο για τη διάγνωση των παθήσεων του λεπτού εντέρου

Catalytic enantioselective Gilman-Speeter synthesis of β-lactams by nucleophilic activation of carboxylic acids

A novel Gilman-Speeter synthesis of β-lactams has been developed that was rendered highly enantioselective by virtue of isothiourea catalyst’s nucleophilicity. This process depends upon the HATU conversion of carboxylic acids to activated esters which then undergo attack by the homochiral catalyst and subsequently deprotonated by inorganic base to furnish catalytic quantities of the corresponding enolate ions that react with imines to provide the requisite β-lactams in good yields and enantiomeric excesses

Increased Functional Foods’ Consumption and Mediterranean Diet Adherence May Have a Protective Effect in the Appearance of Gastrointestinal Diseases: A Case–Control Study

Background: Epidemiological studies have suggested a possible correlation between nutritional factors and gastrointestinal diseases. Methods: A case–control study was designed in order to investigate if functional foods consumption and Mediterranean diet adherence have a positive effect in ulcerative colitis, Crohn’s disease, irritable bowel syndrome, and gastroesophageal reflux disease. In total, 142 patients (cases) and 147 gender-matched healthy people (controls) participated in the study. Functional food consumption was screened by using a Food Frequency Questionnaire based on the NHANES study, while Mediterranean diet adoption was evaluated by a 14-item Med Diet Assessment tool based on the PREDIMED study. The statistical analysis was performed with SPSS-22. Results: In the previous 2–3 years, the controls had more frequently consumed some categories (probiotics, prebiotics-enriched, and low-fat foods) and some kinds of functional foods (mountain tea, berries, pomegranate, oats, mastics, turmeric, soybeans, and raisins) compared to the cases (p < 0.05). Healthy people were more adherent to the Mediterranean diet than patients (p < 0.05). A multifactor analysis showed that the augmented score of the Mediterranean diet and the augmented consumption of categories and kinds of functional foods were protective factors in the appearance of gastrointestinal diseases. Conclusions: More studies should be conducted in order to further investigate the possible association between specific food components and gastrointestinal diseases’ pathophysiology

Secondary extramedullary plasmacytoma of sigmoid colon in a patient with multiple myeloma: a case report

Abstract Background Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases. Case presentation A 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon. Conclusions Plasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity

Recovery of Water from Secondary Effluent through Pilot Scale Ultrafiltration Membranes: Implementation at Patras’ Wastewater Treatment Plant

Fresh water shortages affect larger areas each year due to the increased human population combined with climate change. Reuse of treated sewage water (mostly for nonpotable uses) can have a significant impact on reducing water scarcity. Ultrafiltration membranes are widely considered as a very good candidate for the remediation of this type of water. The case of Patras’ sewage treatment plant was examined for the treatment of its secondary settling tank effluent using a pilot ultrafiltration unit to produce permeate water suitable for reuse according to Greek legislation. The physicochemical characteristics of the membrane permeate stream showed significant improvements in the quality of the produced water. Turbidity was reduced by 99%, total suspended solids were decreased by more than 94%, while COD was reduced by 37%. E. coli and Enterococcus were detected at high concentrations in the feed stream but were eliminated in the membrane permeate. The results presented herein indicate that the installed equipment is capable of producing improved quality water suitable for reuse even with the strictest limits imposed by Greek legislation