Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

<p>Abstract</p> <p>Background</p> <p>Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass.</p> <p>Case presentation</p> <p>A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction.</p> <p>Conclusions</p> <p>In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.</p

Application of a functional model for the modernization of devices designed to eliminate emergency oil spills

The article describes the stages of creation and composition of the functional model, which can be used for the design of oil spill response devices. The principle of operation of the functional model given in the article and it's graphical scheme are show

Decreased expression of HLA-DQ and HLA-DR on cells of the monocytic lineage in cystic fibrosis.

We studied HLA class II molecules on blood monocyte subsets, blood dendritic cells, sputum macrophages, and monocyte-derived macrophages at the protein (flow cytometry) and mRNA level (RT-PCR) in adult patients with cystic fibrosis (CF) and healthy control subjects as putative contributors to the CF phenotype. In healthy donors, we found a high average HLA-DQ expression of 4.35 mean specific fluorescence intensity units (&Delta;MnI) on classical blood monocytes. In F508del homozygous CF patients, the average &Delta;MnI was low (1.80). Patients were divided into two groups, in which 14 of these patients had HLA-DQ expression above 2 &Delta;MnI (average 3.25 &Delta;MnI, CF-DQgroup1) and 36 below (average 1.24 &Delta;MnI, CF-DQgroup2). Also, the CD16-positive monocyte subset and blood dendritic cells showed much lower levels of HLA-DQ for the CF-DQgroup2 patients compared with healthy controls. In macrophages from sputum and derived from monocytes, in vitro HLA-DQ expression was dramatically decreased to background levels in CF-DQgroup2. MHC class II transcripts were reduced in CF with a sevenfold decrease in HLA-DQ&beta;1 for CF-DQgroup2 patients. Higher levels of the inflammation marker CRP were associated with low HLA-DQ protein expression, and in vitro treatment with the inflammatory molecule lipopolysaccharide reduced HLA-DQ expression. Interferon &gamma; (IFN&gamma;) could overcome this effect in healthy donor cells while, in CF, the IFN&gamma;-induced activation was impaired. Our data demonstrate a pronounced reduction of HLA-DQ expression in CF, which is associated with inflammation and a reduced response to IFN&gamma;. Key message &bull; CF patients show a reduced expression of MHCII molecules in monocytes and macrophages.&bull; HLA-DQ and HLA-DR transcript levels are also reduced in CF patients.&bull; CF patient C-reactive protein levels correlate with low HLA-DQ expression.&bull; Reduced expression of MHC class II molecules appears to be linked to inflammation.&bull; CF patients exhibit an impaired response to IFNgamma