A case of gallstone ileus with an unusual impaction site and spontaneous evacuation

Gallstone ileus is an unusual cause of colonic obstruction. The formation of a fistula between the gall bladder and the bowel wall may allow a gallstone to enter the intestinal tract. Plain abdominal films, abdominal ultrasound and abdominal computed tomography aid in the diagnosis. Although surgery is the treatment of choice in cases of colonic gallstone ileus, colonoscopic removal of the impacted stone should be attempted. We describe the case of an 85-year-old man who presented with symptoms and signs of large bowel obstruction. Diagnostic evaluation revealed a large gallstone impacted in the sigmoid colon, which is a rather unusual impaction site. Despite our efforts we could not extract the stone endoscopically, mainly due to its large size. Yet, despite its large size, the stone was spontaneously evacuated a few hours later

Treatment of Catecholaminergic Polymorphic Ventricular Tachycardia: Lessons from One Case

We report a case of a 27-year-old female with catecholaminergic polymorphic ventricular tachycardia, presenting with syncope during emotional stress. β-Blockade alone was ineffective, whereas the addition of amiodarone prevented arrhythmia-relapses for 28 months. In view of planned pregnancy, the latter was substituted with flecainide, coupled with defibrillator-implantation. Fourteen months later, the patient had 3 appropriate, followed by 3 inappropriate shocks. This case highlights the short-comings of pharmacological treatment and the limitations of device-therapy; the high rate of inefficacious shocks, along with the proarrhythmic potential, point towards the judicious use of defibrillators, aiming at shock-delivery only for ventricular fibrillation

A common polymorphism of the human cardiac sodium channel alpha subunit (SCN5A) gene is associated with sudden cardiac death in chronic ischemic heart disease

Cardiac death remains one of the leading causes of mortality worldwide. Recent research has shed light on pathophysiological mechanisms underlying cardiac death, and several genetic variants in novel candidate genes have been identified as risk factors. However, the vast majority of studies performed so far investigated genetic associations with specific forms of cardiac death only (sudden, arrhythmogenic, ischemic etc.). The aim of the present investigation was to find a genetic marker that can be used as a general, powerful predictor of cardiac death risk. To this end, a case-control association study was performed on a heterogeneous cohort of cardiac death victims (n=360) and age-matched controls (n=300). Five single nucleotide polymorphisms (SNPs) from five candidate genes (beta2 adrenergic receptor, nitric oxide synthase 1 adaptor protein, ryanodine receptor 2, sodium channel type V alpha subunit and transforming growth factor-beta receptor 2) that had previously been shown to associate with certain forms of cardiac death were genotyped using sequence-specific real-time PCR probes. Logistic regression analysis revealed that the CC genotype of the rs11720524 polymorphism in the SCN5A gene encoding a subunit of the cardiac voltage-gated sodium channel occurred more frequently in the highly heterogeneous cardiac death cohort compared to the control population (p=0.019, odds ratio: 1.351). A detailed subgroup analysis uncovered that this effect was due to an association of this variant with cardiac death in chronic ischemic heart disease (p=0.012, odds ratio =1.455). None of the other investigated polymorphisms showed association with cardiac death in this context. In conclusion, our results shed light on the role of this non-coding polymorphism in cardiac death in ischemic cardiomyopathy. Functional studies are needed to explore the pathophysiological background of this association. © 2015 Marcsa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Strategic noise mapping of the Greek medium size urban agglomerations of corfu (KERKYRA) and agrinio according to the European directive 2002/49/EU, with emphasis to the int. Airport of corfu

Environmental noise mapping as defined in the Directive 2002/49/EC has been incorporated in the Greek legislative framework by the Joint Ministerial Decision (JMD) 13586/724/E/Gaz.no/384/28.3.2006 (Harmonization of the Greek Legislation with the European Directive 2002/49/EC «for the assessment and management of the environmental noise»). The subject and the scope of the present paper is the implementation of the Directive 2002/49/EU for the urban agglomerations of Corfu (Kerkyra) and Agrinio, and is related to environmental noise caused by road traffic and air traffic noise as well as industrial noise (noise from port activities in the urban agglomeration of Corfu (Kerkyra). The methodology that was followed was first to prepare a complete Digital Terrain Model of the two cities and the relevant road axes as well as a detailed survey of all the existing sources of environmental noise: roads, industries, airport and port. In order to calibrate the noise prediction software with the available traffic data 61 24hour acoustical measurements were conducted, 31 in Agrinio and 30 in Corfu with the use of mobile stations. The correlation for both cities proved exceptional. The maps that were prepared concerned the Lden and Lnight indices as they are described in the relevant Directive. Afterwards the population exposure to different noise zones per noise source was calculated as well as the exposure to the combination of all noise sources per city. Especially for the airport noise in Corfu there is a presentation of the population exposure to noise zones due to aircraft noise by using two different prediction models-methodologies. The models used were INM and Cad-naA/IMMI and the noise maps for the indices Lden and Lnight were produced for each model. The exposure of population in noise zones of aircraft noise was calculated for each model and finally there was a comparison between the relevant results

Tissue engineering for post-myocardial infarction ventricular remodeling

Myocardial tissue engineering involves the design of biomaterial scaffolds, aiming at regenerating necrotic myocardium after myocardial infarction. Biomaterials provide mechanical support to the infarct area and they can be used as vehicles for sustained and controlled local administration of cells and growth factors. Although promising results have been reported in experimental studies, many issues need to be addressed before human use.© 2011 Bentham Science Publishers Ltd

A case of gallstone ileus with an unusual impaction site and spontaneous evacuation

Gallstone ileus is an unusual cause of colonic obstruction. The formation of a fistula between the gall bladder and the bowel wall may allow a gallstone to enter the intestinal tract. Plain abdominal films, abdominal ultrasound and abdominal computed tomography aid in the diagnosis. Although surgery is the treatment of choice in cases of colonic gallstone ileus, colonoscopic removal of the impacted stone should be attempted. We describe the case of an 85-year-old man who presented with symptoms and signs of large bowel obstruction. Diagnostic evaluation revealed a large gallstone impacted in the sigmoid colon, which is a rather unusual impaction site. Despite our efforts we could not extract the stone endoscopically, mainly due to its large size. Yet, despite its large size, the stone was spontaneously evacuated a few hours later