Hemobilia due to cystic artery pseudoaneurysm: A rare late complication of laparoscopic cholecystectomy

We discuss a patient with late presentation of hemobilia following cholecystectomy, which is unusual because pseudoaneurysm caused by vascular injury during surgery typically presents soon after surgery. Endoscopic retrograde cholangiopancreatography revealed a large blood clot arising from the biliary orifice with subsequent computed tomography angiography diagnosing a large pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips. Embolization was performed via direct percutaneous puncture of the pseudoaneurysm

An on-line solid phase extraction procedure for the routine quantification of urinary methylmalonic acid by liquid chromatography-tandem mass spectrometry

Background: The goal of this study was to develop and to validate an improved isotope-dilution-liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of methylmalonic acid (MMA) in urine. Methods: A previously described sample preparation protocol requires two solvent extraction steps, including evaporation. The first extraction is to extract the analyte from the sample, and second occurs following derivatization of the extract. In the method described here, the second evaporation step was substituted by on-line solid phase extraction employing column-switching and a permanent co-polymer based extraction cartridge. A standard validation protocol was applied to investigate the performance of the method. Results: The method was found to be linear in the clinically relevant range of concentrations (6-100 mu mol/L). Total coefficients of variation were below 10% and inaccuracy was <10% for quality control samples at three concentrations. Conclusions: By omitting one evaporation step, the semi-automated method described in this article enables for more convenient work-flow in the quantification of urinary MMA compared to the previous protocol. This is of relevance for MMA measurement in the routine clinical laboratory setting. Validation demonstrated acceptable analytical performance. Clin Chem Lab Med 2010;48:1647-50

Nonlinear Dynamics of Composite Plates and Shells

The equations of refined geometrically nonlinear theory of dynamic deformation of flexible with respect to transversal shear and compression ofplates and shells are proposed. The solutions for problems of transversal nonlinear vibrations of hinge fixedplate-strip are obtained. Numerical results are compared with the known in literature

ДОСЛІДЖЕННЯ ТОКСИЧНОСТІ C-ФІКОЦІАНІНУ У РИБ ГУППІ ТА ІНФУЗОРІЇ PARAMECIUM CAUDATUM

One of the important and urgent tasks, whose successful solution depends on the supply of food to the population, is to increase the production of livestock products. Ensuring a high level of production of livestock products largely depends on the quality of feed, which is determined, first of all, by toxicological control. C-phycocyanin is a protein complex that belongs to phycobiliproteins and can be used as one of the potential natural components to improve the feeding of commercial fish. In order to establish the safety of the use of active feed components for feeding and ready-made feed into which these components are introduced, first of all, it is necessary to study their effect on the organisms of protozoa and fish, which are used for laboratory research. The high sensitivity of ciliates to the appearance of toxic substances in their environment and changes in their concentration led to the use of these organisms for testing the most diverse chemical elements and compounds. The article presents the results of studying the effect (harmlessness) of C-phycocyanin on the bodies of protozoa (Paramecium caudatum) and guppy fish. When studying the effect of C-phycocyanin on the body of protozoa (Paramecium caudatum), it was established that its use for 48 hours in doses of 5, 10, 25, 50, and 100 mg/l did not cause the death of ciliates. When studying the effect of C-phycocyanin on the body of guppy fish, it was established that its use in doses of 5, 10, 25, 50, and 100 mg/l did not cause the death of fish. So, on the basis of the conducted research, it was established that C-phycocyanin belongs to class 4, and is a non-toxic substance for Paramecium caudatum ciliates. In addition, it was established that its use in the above doses did not cause the death of fish, and its LC50 is higher than 100 mg/l.Одним з важливих і невідкладних завдань, від успішного вирішення яких залежить постачання населенню продуктів харчування, є збільшення виробництва продуктів тваринництва. Забезпечення високого рівня виробництва продукції тваринництва значною мірою залежить від якості кормів, яка визначається, перш за все, токсикологічним контролем. С-фікоціанін є протеїновим комплексом, який належить до фікобіліпротеїнів і може застосовуватись як один із потенційних природних компонентів для покращення годівлі промислових риб. З метою встановлення безпечності використання для годівлі діючих компонентів корму і готового корму, до складу якого вводяться ці компоненти, в першу чергу, необхідно вивчити їх вплив на організм найпростіших і риб, які використовуються для лабораторних досліджень. Висока чутливість інфузорій до появи в оточуючому її середовищі токсичних речовин та зміна їхньої концентрації зумовила використання цих організмів для тестування найрізноманітніших, за хімічною природою, елементів та сполук. У статті наведені результати вивчення впливу (нешкідливість) С-фікоціаніну на організм найпростіших (Paramecium caudatum) і риб гупі. При вивченні впливу С-фікоціаніну на організм найпростіших (Paramecium caudatum) було встановлено, що його застосування упродовж 48 год у дозах 5, 10, 25, 50 та 100 мг/л не викликало загибелі інфузорій. При вивченні впливу С-фікоціаніну на організм риб гупі було встановлено, що його застосування у дозах 5, 10, 25, 50 та 100 мг/л не викликало їх загибелі. Отже, на основі проведених досліджень було встановлено, що С-фікоціанін належить до 4 класу, тобто є не токсичною речовиною для інфузорій Paramecium caudatum. Крім того, було встановлено, що його застосування у вище вказаних дозах не викликало загибелі риб, а його ЛК50 є вищою, ніж 100 мг/л

Endoscopic retrieval of a proximally migrated biliary stent using extracorporeal shockwave lithotripsy, electrohydraulic lithotripsy, and cholangioscopy with minisnare

Video 1ERCP was notable for a proximally migrated biliary stent. Cholangiogram demonstrated multiple filling defects consistent with choledocholithiasis surrounding the proximally migrated biliary stent. Retrieval of the stent was successful using cholangioscopy-directed electrohydraulic lithotripsy, extracorporeal shockwave lithotripsy, mechanical lithotripsy, and minisnare over the course of 2 ERCPs. Complete duct clearance of stones was accomplished with balloon sweeps

EU integration in the (post)-migrant-crisis context: learning new integration modes?

This article explores the integration of the European Union (EU) as an institution after the 2015-2016 migrant crisis. Qualitative data from elite interviews in Brussels and policy analysis, in the framework of a bigger project about the impact of the migrant crisis on European integration, highlight the EU learning about new integration modes as a key theme following the crisis. The article focuses on this theme and argues that EU integration has been happening through intensive learning after the-migrant crisis, whereby the EU has been exploring a combination of certain integration modes: shaping the relationships with candidate countries by restraining from enlargement; shaping the relationships with (prospectively) exiting Member States by considering fuzziness at the borders; exploring differentiation among the existing Member States, possibly through promoting a two-tier EU, instead of universal deepening. A key contribution lies in applying the notion ‘learning’ to understanding EU integration modes specifically after the migrant crisis

Development and performance evaluation of a tandem mass spectrometry assay for 4 adrenal steroids

Journal ArticleCongenital adrenal hyperplasia is a group of autosomal recessive disorders caused by a deficiency of 1 of 4 enzymes required for the synthesis of glucocorticoids, mineralocorticoids, and sex hormones. Analysis of 11-deoxycortisol (11DC), 17-hydroxyprogesterone (17OHP), 17-hydroxypregnenolone (17OHPr), and pregnenolone (Pr) in blood allows detection of these enzyme defects