Metastatic tumors to the stomach: clinical and endoscopic features.

AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric metastases from solid malignant tumors were retrospectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient's clinical history are useful for correct diagnosis of gastric metastases

Role of tyrosine 238 in the active site of Rhodotorula gracilis D-amino acid oxidase - A site-directed mutagenesis study

Y238, one of the very few conserved residues in the active site of d-amino acid oxidases (DAAO), was mutated to phenylalanine and serine in the enzyme from the yeast Rhodotorula gracilis. The mutated proteins are catalytically competent thus eliminating Tyr238 as an active-site acid/base catalyst. Y238F and Y238S mutants exhibit a threefold slower turnover on d-alanine as substrate, which can be attributed to a slower rate of product release relative to the wild-type enzyme (a change of the rate constants for substrate binding was also evident). The Y238 DAAO mutants have spectral properties similar to those of the wild-type enzyme but the degree of stabilization of the flavin semiquinone and the redox properties in the free form of Y238S are different. The binding of the carboxylic acid competitive inhibitors and the substrate d-alanine are changed only slightly, suggesting that the overall substrate binding pocket remains intact. In agreement with data from the pH dependence of ligand binding and with the protein crystal structure, site-directed mutagenesis results emphasize the importance of residue Y238 in controlling access to the active site instead of a role in the substrate/ligand interaction

Fatigue crack propagation mechanisms in C70250 and CuCrZr copper alloys

A previous study concerning the characterization of CuNiSi (C70250) and CuCrZr alloys showed very interesting characteristics of toughness evaluated with tensile tests and preliminary tests on Charpy specimens. These alloys could have interesting applications such as devices used for energy production, particle physics and aerospace. These alloys are used in the ITER (International Thermonuclear Experimental Reactor) project, an international program of great interest. For this reason, it seems important to characterize the mechanical properties of these alloys. In particular, fatigue crack propagation rate (da/dn vs ΔK) measurements were performed

LigaSure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choice? A Randomized, Clinical Trial

Introduction. Milligan-Morgan haemorrhoidectomy performed with LigaSure system (LS) seems to be mainly effective where a large tissue demolition is required. This randomized study is designed to compare LigaSure haemorrohidectomy with conventional diathermy (CD) for treatment of IV-degree haemorrhoids. Methods. 52 patients with IV-degree haemorrhoids were randomized to two groups (conventional diathermy versus LigaSure haemorrhoidectomy). They were evaluated on the basis of the following main outcomes: mean operative time, postoperative pain, day of discharge, early and late complications. The time of recovery of work was also assessed. All patients had a minimum follow-up of twelve months (range 12-24). All data were statistically evaluated. Results. 27 patients were treated by conventional diathermy, 25 by LigaSure. The mean operative time was significantly shorter in LS, such as postoperative pain, mainly lower on the third and fourth postoperative day: moreover pain disappeared earlier in LS than CD. The time off-work was shorter in LS, while there was no difference in hospital stay and overall complications rate. Conclusions. LigaSure is an effective instrument when a large tissue demolition is required. This study supports its use as treatment of choice for IV degree haemorrhoids, even if the procedure is more expansive than conventional operation

Induction of Cytotoxic Oxidative Stress by d-Alanine in Brain Tumor Cells Expressing Rhodotorula gracilis d-Amino Acid Oxidase: A Cancer Gene Therapy Strategy

Overview summary Gene-directed enzyme prodrug therapy (GDEPT) is an antineoplastic treatment strategy designed to overcome the systemic toxicity of chemotherapy by specifically expressing a foreign enzyme in malignant cells that converts a nontoxic prodrug into a cytotoxic metabolite. The relative inefficiency of current in situ gene transfer methodology suggests that enzyme/prodrug combinations that produce membrane permeable metabolites will elicit a more favorable therapeutic response. Ideally, the agent produced by the transduced cell “factories” would be cytotoxic toward both proliferating and quiescent cells. We describe a novel GDEPT approach using d-amino acid oxidase from the red yeast Rhodotorula gracilis and d-alanine as a substrate that generates hydrogen peroxide, a reactive metabolite of oxygen that has both these characteristics. We also demonstrate the ability to sensitize tumor cells to this GDEPT protocol by manipulating cellular antioxidant pathways.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63220/1/hum.1998.9.2-185.pd

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) has proven to be a safe and effective surgical treatment for morbid obesity. It can be a simple, fast, reversible, anatomy-preserving procedure. Despite these advantages, its long-term efficacy came into question by the occurrence of complications such as intragastric band migration. Consistent information regarding this complication is still lacking. Treatment for migration is still being debated as well. Most of the inconsistencies of these data stem from the very low number of patients reported in single-center experiences or case reports. Lack of multicenter experience is evident. The aim of this study was to perform a retrospective analysis of data on intragastric migration in a large multicenter cohort of patients who underwent LAGB. METHODS: A retrospective multicenter study on LAGB patients was performed. Data had been entered into a prospective database of the Italian Group for LapBand(®) (GILB) since January 1997. Pars flaccida and perigastric positioning were considered along with different kinds of gastric bands by the same manufacturer. Time of diagnosis, mean body mass index (BMI), presentation symptoms, and conservative and surgical therapy of intragastric migration were considered. RESULTS: From January 1997 to December 2009, a total of 6,839 patients underwent LAGB and their data were recorded [5,660 females, 1,179 males; mean age 38.5 ± 18.2 years (range 21-62 years); mean BMI = 46.7 ± 7.7 kg/m(2) (range 37.3-68.3); excess weight (EW) 61.8 ± 25.4 kg (range 36-130); %EW 91.1 ± 32.4 % (range 21-112 %)]. A total of 177 of 6,839 (2.5 %) intragastric erosions were observed. According to the postoperative time of follow-up, the diagnosis of intragastric migration was made in 74 (41.8 %), 14 (7.9 %), 38 (21.4 %), 40 (22.6 %), 6 (3.4 %), and 4 (2.2 %) banded patients at 6-12, 24, 36, 48, 60, and 72 months after banding, respectively. Most of intragastric band migration during the first 2 years occurred in bands with no or a few milliliters of filling. In patients with late erosion, the bands were adjusted several times; no band was overfilled but one was filled to the maximum or submaximum with a maximum of two adjustments. Erosions diagnosed during the first 24 months were related to the experience of the surgical staff, while late erosions were not. CONCLUSIONS: Intragastric band migration or band erosion is a rare, disturbing, and usually not life-threatening complication of gastric banding. Its pathogenesis is probably linked to different mechanisms in early (technical failure in retrogastric passage) or late (band management) presentation. It is usually asymptomatic and there is no pathognomonic presentation. A wide range of therapeutic options are available, from simple endoscopic or laparoscopic removal to early or late band replacement or other bariatric procedure. More experience and more studies are needed to lower its presentation rate and definitively clarify its pathogenesis to address the right therapeutic option

Improvement in health-related quality of life in first year after laparoscopic adjustable gastric banding

BACKGROUND: We analyzed the health-related quality of life (HRQOL) and its determinants in the first year after laparoscopic adjustable gastric banding (LAGB). The setting was 10 Italian public and private bariatric surgery centers. METHODS: Data collected in an ongoing, prospective, 3-year multicenter Italian study on the changes in HRQOL after LAGB were used. HRQOL was investigated using the Medical Outcomes Study Short-Form 36 questionnaire. Hunger, satiety, and the self-perceived effects of LAGB were recorded. RESULTS: A total of 334 patients were enrolled. The follow-up rate was 92.2%. The percentage of excess weight loss was 39.6% \ub1 25.8%, with very few side effects or complications. Hunger in the morning (0-10 scale) was 4.5 \ub1 2.7 before surgery and 3.8 \ub1 2.4 after 1 year (P <.001). Satiety after a meal (0-10 scale) was 7.1 \ub1 2.7 before surgery and 8.2 \ub1 1.9 at 1 year (P <.001). The self-perceived effect of LAGB on caloric intake (0-10 scale) was 8.4 \ub1 1.9 after 1 year. The scores for the 8 Medical Outcomes Study Short-Form 36 subscales were significantly improved after surgery. The physical component summary score was 52.6 \ub1 11.9 at baseline and 79.1 \ub1 15.6 after 1 year (P <.001). The corresponding mental component summary scores were 52.2 \ub1 12.3 and 76.5 \ub1 17.2 (P <.001). Greater physical component summary improvement was independently associated with a low initial physical component summary (P <.001), high satiety (P = .002), a high percentage of excess weight loss (P = .013), and a high self-perceived effect of the LAGB (P = .026). Greater mental component summary improvement was associated with a low initial mental component summary (P <.001), high satiety (P <.001), a low frequency of heartburn (P = .004), and a high percentage of excess weight loss (P = .012). CONCLUSIONS: Significant improvements in HRQOL were observed in the first year after LAGB. A poor baseline HRQOL, a high efficacy of the banding in eating control, and better weight loss might influence HRQOL change

Ecology and technological capability of lactic acid bacteria isolated during Grillo grape vinification in the Marsala production area.

Grapes of “Grillo” variety, used to produce Marsala wine, were harvested from five vineyards different for climatic and agronomic parameters, in order to obtain a first mapping of lactic acid bacteria (LAB) inhabiting the production area. Marsala base wine production was followed at large-scale and two experimental vinifications, different for lysozyme and SO2 concentration and combination, were carried out at pilot-plant scale. LAB communities and conventional chemical parameters were periodically analysed. LAB were found on grapes at an average concentration of about 102 CFU g-1 which decreased during the transformation process. A total of 146 colonies were collected, but only 35 were recognized as presumptive LAB. On the basis of phenotypic differences and isolation source, 16 isolates were then subjected to genotypic identification and gathered into the following species: Lactococcus lactis subsp. lactis, Lactococcus lactis subsp. cremoris, Enterococcus faecium, Leuconostoc fallax and Sporalactobacillus nakayamae subsp. nakayamae. Lactococcus lactis subsp. lactis strains was the species most frequently isolated during winemaking showing the highest resistance to SO2 and lysozyme

Lesiones adquiridas de los tejidos duros dentarios : Su prevalencia

Se denomina lesiones de tejidos duros dentarios a cambios patológicos sufridos por esmalte, dentina o cemento, luego de completada la odontogénesisnormal. Se incluye desgastes, modificaciones del color y modificaciones cuantitativas de los tejidos dentarios originadas en cambios biológicos o patológicos locales. La nómina de lesiones más importantes incluye: fracturas, atrición, abrasión, erosión, reabsorciones, pigmentaciones y caries dental. Se estudiara durante un periodo de 2 años, a una población de pacientes adultos, concurrentes al SEPOI (Servicio de Práctica Odontológica Integral de la FOLP), siendo el objetivo de este trabajo determinar la prevalencia de lesiones adquiridas de los tejidos duros dentarios en adultos, considerando a estas lesiones como cambios patológicos sufridos por esmalte, dentina o cemento luego de completada la odontogénesis normal.Facultad de Odontologí

Lesiones adquiridas de los tejidos duros dentarios : Su prevalencia

Se denomina lesiones de tejidos duros dentarios a cambios patológicos sufridos por esmalte, dentina o cemento, luego de completada la odontogénesisnormal. Se incluye desgastes, modificaciones del color y modificaciones cuantitativas de los tejidos dentarios originadas en cambios biológicos o patológicos locales. La nómina de lesiones más importantes incluye: fracturas, atrición, abrasión, erosión, reabsorciones, pigmentaciones y caries dental. Se estudiara durante un periodo de 2 años, a una población de pacientes adultos, concurrentes al SEPOI (Servicio de Práctica Odontológica Integral de la FOLP), siendo el objetivo de este trabajo determinar la prevalencia de lesiones adquiridas de los tejidos duros dentarios en adultos, considerando a estas lesiones como cambios patológicos sufridos por esmalte, dentina o cemento luego de completada la odontogénesis normal.Facultad de Odontologí