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Pouch
Kinds of Pouch Terms modified by Pouch Selected AbstractsEXTRAGENITAL MULLERIAN ADENOSARCOMA WITH SARCOMATOUS OVERGROWTH ARISING IN AN ENDOMETRIOTIC CYST IN THE POUCH OF DOUGLASPATHOLOGY INTERNATIONAL, Issue 12 2001Murugasu A No abstract is available for this article. [source] Anti-Fenton reaction activity of three taxa of water yam (Dioscorea alata L.)INTERNATIONAL JOURNAL OF FOOD SCIENCE & TECHNOLOGY, Issue 9 2007Tsu-Shing Wang Summary In the present study, we compared the anti-Fenton reaction activity of three taxa of water yam (Dioscorea alata L.): DS2, TN2 and PSY [D. alata L. var. purpurea (Roxb.) M. Pouch]. Anti-Fenton reaction activity was evaluated by measuring the damage inflicted on calf thymus DNA by copper ions combined with hydrogen peroxide with the use of an ethidium bromide binding assay and agarose gel electrophoresis. We found that extracts of tuber pulp from all three taxa of yam had significant anti-Fenton reaction activity. The protection pattern of the three tuber pulp extracts was similar to that of EDTA, a typical divalent metal ion chelator, which displayed a significant protection lag-phase. With the use of thin-layer chromatography, we found that a common, major ansialdehyde-sulphuric acid stained spot (possibly a polysaccharide mucilage) with an Rf of 0.09 may be the most likely contributor to the anti-Fenton reaction activities of the yam tuber extracts investigated. The present study identifies the mechanism of the health benefit of the Dioscorea family. The copper-chelating and absorbing capability of yam tuber pulp extracts may be useful in functional screening. [source] Long-Term Survival of Nonhuman Primate Islets Implanted in an Omental Pouch on a Biodegradable ScaffoldAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2009D. M. Berman The aim of this study was to test whether an omental pouch can be used as an alternative site for islet implantation in diabetic monkeys. Here we report the successful engraftment of islets in diabetic cynomolgus monkeys when loaded on a synthetic biodegradable scaffold and placed in an omental pouch. One autologous and five allogeneic diabetic monkey transplants under the cover of steroid-free immune suppression (SFIS) were undertaken. Fasting blood glucose (FBG) and C-peptide (CP), exogenous insulin requirements (EIR), intravenous glucose tolerance test (IVGTT), A1C and histopathology were used to assess islet engraftment and survival. All animals achieved CP levels > 1.0 ng/mL following transplant, a 66,92% posttransplant decrease in EIR and reduced A1C. Following graft removal, CP became negative and histopathological analysis of the explanted grafts demonstrated well-granulated and well-vascularized, insulin-positive islets, surrounded by T-cell subsets and macrophages. Compared to intrahepatic allogeneic islet transplants (n = 20), there was a delayed engraftment for omental pouch recipients but similar levels of CP production were ultimately achieved, with a broad range of IEQ/kg transplanted in both sites. Our results suggest this extrahepatic transplantation site has potential as an alternative site for clinical islet cell transplantation. [source] Receiving: The Use of Web 2.0 to Create a Dynamic Learning Forum to Enrich Resident EducationACADEMIC EMERGENCY MEDICINE, Issue 2009Adam Rosh Receiving (http://www.drhem.com) is a powerful web-based tool that encompasses web 2.0 technologies. "Web 2.0" is a term used to describe a group of loosely related network technologies that share a user-focused approach to design and functionality. It has a strong bias towards user content creation, syndication, and collaboration (McGee 2008). The use of Web 2.0 technology is rapidly being integrated into undergraduate and graduate education, which dramatically influences the ways learners approach and use information (Sandars 2007). Knowledge transfer has become a two-way process. Users no longer simply consume and download information from the web; they create and interact with it. We created this blog to facilitate resident education, communication, and productivity. Using simple, freely available blog software (Wordpress.com), this inter-disciplinary web-based forum integrates faculty-created, case-based learning modules with critical essays and articles related to the practice of emergency medicine (EM). Didactic topics are based on the EM model and include multi-media case presentations. The educational modules include a visual diagnosis section (VizD), United States Medical Licensing Examination (USMLE) board-style cases (quizzER), radiographic interpretation (radER), electrocardiogram interpretation (Tracings), and ultrasound image and video clip interpretation (Morrison's Pouch). After viewing each case, residents can submit their answers to the questions asked in each scenario. At the end of each week, a faculty member posts the answer and facilitates an online discussion of the case. A "Top 10 Leader Board" is updated weekly to reflect resident participation and display a running tally of correct answers submitted by the residents. Feedback by the residents has been very positive. In addition to the weekly interactive cases, Receiving also includes critical essays and articles on an array of topics related to EM. For example, "Law and Medicine" is a monthly essay written by an emergency physician who is also a lawyer. This module explores legal issues related to EM. "The Meeting Room" presents interviews with leading scholars in the field. "Got Public Health?", written by a resident, addresses relevant social, cultural, and political issues commonly encountered in the emergency department. "Mini Me" is dedicated to pediatric pearls and is overseen by a pediatric emergency physician. "Sherwin's Critical Care" focuses on critical care principles relevant to EM and is overseen by a faculty member. As in the didactic portion of the website, residents and faculty members are encouraged to comment on these essays and articles, offering their own expertise and interpretation on the various topics. Receiving is updated weekly. Every post has its own URL and tags allowing for quick and easy searchability and archiving. Users can search for various topics by using a built-in search feature. Receiving is linked to an RSS (Really Simple Syndication) feed, allowing users to get the latest information without having to continually check the website for updates. Residents have access to the website anytime and anywhere that the internet is available (e.g., home computer, hospital computer, IphoneÔ, BlackBerryÔ), bringing the classroom to them. This unique blend of topics and the ability to create a virtual interactive community creates a dynamic learning environment and directly enhances resident education. Receiving serves as a core educational tool for our residency, presenting interesting and relevant EM information in a collaborative and instructional environment. [source] Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic PregnancyACADEMIC EMERGENCY MEDICINE, Issue 8 2007Chris Moore MD BackgroundEctopic pregnancies are frequently present in women who present to the emergency department with pregnancy and abdominal pain or bleeding, a subset of whom may require operative intervention. ObjectivesTo prospectively determine if emergency physician (EP)-performed transabdominal pelvic ultrasonography (US) with determination of free abdominal fluid in the hepatorenal space predicted the need for operative intervention. MethodsPatients who were suspected to have an ectopic pregnancy were prospectively enrolled over a ten-month period. An EP-performed bedside transabdominal pelvic US that included a view of the hepatorenal space (Morison's pouch) for free fluid. The EP US was classified as intrauterine pregnancy (IUP) or no definitive IUP, with Morison's pouch classified as positive or negative. The majority of patients had a subsequent transvaginal pelvic US performed by the Department of Radiology. Patients were followed up for radiology results, need for operative intervention, and ultimate outcome of the pregnancy. ResultsThere were 242 patients enrolled, with an average time to complete the EP US of 4 minutes and 27 seconds. There were 28 ectopic pregnancies diagnosed (11.6%), of which 18 patients underwent operative intervention. Free fluid in Morison's pouch was identified in ten patients, nine of whom underwent operative intervention, yielding a positive likelihood ratio of 112 (95% confidence interval = 15 to 831) for patients with suspected ectopic pregnancy who required operative intervention. ConclusionsFree intraperitoneal fluid found in Morison's pouch in patients with suspected ectopic pregnancy may be rapidly identified at the bedside by EP-performed US and predicts the need for operative intervention. [source] Robotic assisted radical cystectomy: short to medium-term oncologic and functional outcomesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2008P. Dasgupta Summary Purpose:, To report short- and medium-term oncological and functional outcomes of the first robotic-assisted laparoscopic radical cystectomy (RARC) series from the UK. Materials and methods:, Thirty patients underwent RARC between 2004 and 2007 at our unit. We report oncological and functional outcomes of this procedure in 20 patients (17 ileal conduit and three Studer Pouches), who have completed at least 6 months of follow up. Results:, There were 17 men and three women, median age 66 years (range 38,77 years). Median operating time was 330 min (range 295,510 min), and median blood loss 150 ml (range 100,1150 ml). There were two major complications (10%); a port site bleed and a rectal injury. The median follow up of this cohort is 23 months (range 7,44 months). One patient died of distant metastases at 8 months, and another developed a right ureteric tumour at 7 months. None of the patients had local pelvic or port site recurrence. The overall and disease-free survival are 95% and 90% respectively. Functional complications included a neovesico-urethral stricture at 3 months, a left upper ureteric stricture at 6 months and an incisional hernia at 12 months. Conclusion:, Robotic-assisted laparoscopic radical cystectomy is an emerging minimally invasive procedure which at short- to medium-term follow up, in our experience, is oncologically and functionally equivalent to open radical cystectomy. [source] Sterilization of Food in Retort PouchesINTERNATIONAL JOURNAL OF FOOD SCIENCE & TECHNOLOGY, Issue 6 2008Ioannis S. Arvanitoyannis PhD Dr No abstract is available for this article. [source] Effect of Oxygen-Absorbing Packaging on the Shelf Life of a Liquid-Based Component of Military Operational RationsJOURNAL OF FOOD SCIENCE, Issue 4 2009Carmen Gomes ABSTRACT:, Oxygen within the sealed package can reduce the quality of liquid-based food products with high oil content such as hot-filled meal-ready-to-eat (MRE) cheese spread, a component of military operational rations. The aim of this study was to test a novel oxygen absorber-containing laminate material and its ability to maintain and/or extend shelf life of a cheese-spread MRE item. An iron-based oxygen absorber (ABSO2RB®) activated by moisture was incorporated into the laminate and used to pack hot-filled cheese spread MREs. The kinetics of oxygen absorption due to humidity and temperature were characterized and peel tests performed to ensure pouch seal integrity. Accelerated shelf-life tests of ABSO2RB and regular MRE pouches without the O2 -absorber were conducted for 3 mo at 51.7 °C (125 °F), and 6 mo at 37.8 °C (100 °F) by measuring oxygen concentration (Mocon O2 -analyzer), microbiological, and physicochemical quality characteristics, including color, texture, moisture, free fatty acid (FFA), pH, water activity, and vitamins and A. Pouches stored at 26.7 °C (80 °F) for 12 mo served as calibrated controls. Consumer tests were conducted in-house and a confirmatory sensory test was conducted at Natick by a trained panel using a 9-point hedonic scale. ABSO2RB-laminates maintain the same seal integrity and strength as those of the control samples. The headspace oxygen concentrations in these pouches reached (P < 0.05) < 0.5% in 11 d of storage at 26.7 °C (80 °F) and remained below this level throughout the storage period (1 y). No microbial growth (aerobic, coliforms, yeast, and molds) was detected (P < 0.05) for both packages. Overall, the ABSO2RB-pouches indicate an improved reduction in oxygen and vitamin C retention compared with MRE controls and maintained product quality (physicochemical and organoleptic). ABSO2RB-laminates met the accelerated shelf-life requirement of 1 mo at 51.7 °C (125 °F), and 6 mo at 37.8 °C (100 °F). This study clearly shows the benefits of using active packaging technology on retaining nutrition and prolonging shelf life of high-fat, liquid content MRE items. [source] Effect of high-pressure food processing on the mass transfer properties of selected packaging materialsPACKAGING TECHNOLOGY AND SCIENCE, Issue 5 2010Maria Jose Galotto Abstract The effect of high-pressure processing (HPP) on the total migration into distilled water and olive oil and on the barrier properties of four complex packaging materials were evaluated. The films were polyethylene/ethylene-vinyl-alcohol/polyethylene (PE/EVOH/PE), metallized polyester/polyethylene, polyester/polyethylene (PET/PE), and polypropylene-SiOx (PPSiOx). Pouches made from these films were filled with food simulants, sealed and then processed at a pressure of 400,MPa for 30,min, at 20 or 60°C. Pouches kept at atmospheric pressure were used as controls. Prior to and after treatment, all films were evaluated for their barrier properties (oxygen transmission rate and water vapour transmission rate) and ,Total' migration into the two food simulants. In the case of water as the food stimulant, a low ,Total' migration was observed and even a lower one after the HPP treatment. In the case of oil as the food simulant, a higher ,Total' migration was found compared to the control as a result of damage to the structures during the HPP treatment. The gas permeability of the films increased after the HPP, compared to the control, due to damages in the structure caused during the treatment. The PET/PE film presented minimum changes in properties after HPP. Copyright © 2010 John Wiley & Sons, Ltd. [source] Heat penetration characteristics and shelf-life studies of mushrooms in brine processed in retort pouchesPACKAGING TECHNOLOGY AND SCIENCE, Issue 4 2004V. Chandrasekar Abstract White button mushrooms were washed, blanched and cut longitudinally into two halves. 100,g mushroom halves was placed into each retort pouch and 90,ml hot brine (2% salt, 0.1% citric acid) was added. Retort pouches (105,µm thick) had an outer polyester layer (12.5,µm), a middle aluminium layer (12.5,µm) and an inner cast polypropylene layer (80,µm); pouch size was 20 × 16,cm, seal size 10,mm and lip size 4,mm. Pouches were fixed with thermocouples for recording the core temperature of the mushroom pieces, using a data recorder and a computer. After sealing and over-pressure retorting at F0 = 9.6, the pouches were stored at the ambient conditions. The heat penetration parameters were calculated. The heating curve obtained was logarithmic in nature. Sensory evaluation of mushroom curry prepared from the stored mushrooms showed that the product had high acceptability (7.9 on a scale of 10) which reduced very slightly (to 7.5) during storage for 12 months. No deformity, leakage or spoilage was noticed and the product remained sterile and acceptable even after 12 months of storage at the ambient conditions (20,30°C). Copyright © 2004 John Wiley & Sons, Ltd. [source] Influence of high-pressure processing on selected polymeric materials and on the migration of a pressure-transmitting fluidPACKAGING TECHNOLOGY AND SCIENCE, Issue 5 2002A. Schauwecker Abstract This study investigated the migration of 1,2-propanediol (PG) through selected food packaging films exposed to high-pressure processing (HPP). Pouches made from these materials were filled with 95% ethanol as a food-simulating liquid. These packages were then processed using a pilot-scale high-pressure food processor at 400, 600 and 827,MPa and 30, 50 and 75°C for 10,min. Controls were processed at similar temperatures and times, but at atmospheric pressure. To investigate any structural changes to these films during HPP, water was used as the food simulant at temperatures of 30, 75, 85, 90 and 95°C and at pressures of 200, 400, 690 and 827,MPa. No detectable PG migration into the polyester/nylon/aluminium (Al) polypropylene (PP) meal-ready-to eat (MRE)-type pouches was observed. PG migration into the nylon/ethylene vinyl alcohol (EVOH)/PE (EVOH) pouches was similar at 30, 50 and 75°C after 10,min under atmospheric pressure. However, PG migration into the EVOH pouches significantly decreased when treated with high pressure at 30, 50 and 75°C. At 75 and 50°C, the PG migration was significantly higher than the amounts detected at 30°C. Visible signs of delamination between the polypropylene (PP) and aluminum (Al) layers were observed in the MRE pouches processed at ,200,MPa and 90°C for 10,min. This delamination appeared to occur between the PP and Al layers. The differential scanning calorimetric analyses and Fourier transform infrared (FTIR) spectra were similar for the high-pressure treated pouches when compared to their respective controls. This indicated that there were no HPP-induced molecular changes to the treated pouches. Results from this study should be useful to HPP users for predicting PG migration trends and in deciding the selection of appropriate packaging materials for use under similar processing conditions. Copyright © 2002 John Wiley & Sons, Ltd. [source] Predators with Pouches: the Biology of Carnivorous MarsupialsAUSTRAL ECOLOGY, Issue 2 2005EUAN G. RITCHIE No abstract is available for this article. [source] Prdm1a is necessary for posterior pharyngeal arch development in zebrafishDEVELOPMENTAL DYNAMICS, Issue 10 2009Denise A. Birkholz Abstract Multiple tissue interactions and signaling within the pharyngeal arches are required for development of the craniofacial skeleton. Here, we focus on the role of the transcription factor prdm1a in the differentiation of the posterior skeleton. prdm1a is expressed in the presumptive pharyngeal arch region and later in an endodermal pouch, the otic vesicle, and pharyngeal teeth. prdm1a mutants display a reduction in pharyngeal arch markers, a loss of posterior ceratobranchial cartilages, and a reduction in most neural crest,derived dermal bones. This is likely caused by a decrease in the number of proliferating cells but not an increase in cell death. Finally, a reduction in two key developmental signaling pathways, Fgf and retinoic acid, alters prdm1a expression, suggesting that prdm1a expression is mediated by these signaling pathways to pattern the posterior craniofacial skeleton. Together, these results indicate an essential role for prdm1a in the development of the zebrafish craniofacial skeleton. Developmental Dynamics 238:2575,2587, 2009. © 2009 Wiley-Liss, Inc. [source] WNT signaling affects gene expression in the ventral diencephalon and pituitary gland growthDEVELOPMENTAL DYNAMICS, Issue 4 2008Mary Anne Potok Abstract We examined the role of WNT signaling in pituitary development by characterizing the pituitary phenotype of three WNT knockout mice and assessing the expression of WNT pathway components. Wnt5a mutants have expanded domains of Fgf10 and bone morphogenetic protein expression in the ventral diencephalon and a reduced domain of LHX3 expression in Rathke's pouch. Wnt4 mutants have mildly reduced cell differentiation, reduced POU1F1 expression, and mild anterior lobe hypoplasia. Wnt4, Wnt5a double mutants exhibit an additive pituitary phenotype of dysmorphology and mild hypoplasia. Wnt6 mutants have no obvious pituitary phenotype. We surveyed WNT expression and identified transcripts for numerous Wnts, Frizzleds, and downstream pathway members in the pituitary and ventral diencephalon. These findings support the emerging model that WNT signaling affects the pituitary gland via effects on ventral diencephalon signaling, and suggest additional Wnt genes that are worthy of functional studies. Developmental Dynamics 237:1006,1020, 2008. © 2008 Wiley-Liss, Inc. [source] Outcome of craniopharyngioma in children: long-term complications and quality of lifeDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2004Andrea Poretti MB BS Childhood craniopharyngiomas are histologically benign tumours arising from remnants of Rathke's pouch in the hypothalamic,pituitary region. The two common treatment approaches are primary total resection or limited resection followed by radiotherapy. To study the outcome after a primary surgical approach, we followed 25 consecutive patients (10 females, 15 males) under 16 years of age who were treated in a single institution with a management policy of radical tumour excision (mean age at diagnosis 9 years 2 months, SD 4 years 3 months; range 2 years 9 months to 15 years 11 months). Mean follow-up after primary surgery was 11 years 3 months (SD 7 years 7 months). Tumour control, and neurological, endocrine, and hypothalamic complications and their impact on health-related quality of life were assessed (medical follow-up, semi-structured interview, and questionnaires). Results of tumour control were generally good, however, local failure was observed in 6 of 25 patients, and severe late-treatment complications decreased quality of life for many long-time survivors. Endocrine deficiency occurred in 24/25, visual complications in 16/24, neurological complications in 8/24, obesity in 14/23, increased daytime sleepiness in 6/21, and significant school problems in 10/20. Patients with craniopharyngioma rated their health-related quality of life as considerably lower than healthy controls; the domains of social and emotional functioning were particularly affected. Parents'ratings were considerably lower than those of the patients. Poor functional outcome was associated with large tumours infiltrating or displacing the hypothalamus, the occurrence of hydrocephalus, and young age at diagnosis, but also with multiple operations due to tumour recurrence. Alternative treatment strategies should be considered, especially in very young patients with large tumours. [source] Light and electron microscopic study of the anterior oesophagus of Bulla striata (Mollusca, Opisthobranchia)ACTA ZOOLOGICA, Issue 2 2010Alexandre Lobo-da-Cunha Abstract Lobo-da-Cunha, A., Oliveira, E., Alves, Â., Coelho, R. and Calado, G. 2010. Light and electron microscopic study of the anterior oesophagus of Bulla striata (Mollusca, Opisthobranchia). ,Acta Zoologica (Stockholm) 91: 125,138. The anterior oesophagus of Bulla striata was investigated with light and electron microscopy. In the most anterior region, the ridges of the oesophageal wall are covered by a ciliated columnar epithelium forming large apical blebs which are released into the lumen, an activity that is particularly intense in the oesophageal pouch. In the last two-thirds of the anterior oesophagus, the epithelium is covered with microvilli embedded in a cuticle, but apocrine secretion and cilia are absent. Subepithelial secretory cells are very abundant in the oesophageal wall, except in the roof of the pouch. They have a long neck that crosses the epithelium, whereas the cell body containing the nucleus is embedded in the connective tissue. Large electron-lucent secretory vesicles and many Golgi stacks fill most of their cytoplasm. The histochemical and cytochemical assays show that these cells secrete acid mucopolysaccharides. With the current and future studies we aim to obtain data for the establishment of relationships between morphofunctional features of the digestive system and food types in cephalaspideans. Additionally, the new data about the oesophageal pouch of B. striata may be useful for the establishment of eventual homologies with the oesophageal diverticula of other opisthobranchs. [source] Genital system anatomy and development of Ovatella myosotis by three-dimensional computer visualizationACTA ZOOLOGICA, Issue 2 2009Bernhard Ruthensteiner Abstract Adult anatomy as well as organogenesis of the genital system of the ellobiid pulmonate Ovatella myosotis is investigated in detail by means of serial sectioning and three-dimensional computer reconstruction and visualization. From the middle portion of the adult, which has four nidamental glands, a spermoviduct leads to a common genital aperture. From here two separate structures, the vas deferens and a groove on the body surface, lead anteriorly. The latter is termed the egg groove because it carries the egg ribbon anteriorly, a function that is recognized here for the first time in the Ellobiidae. The evolution of this structure is discussed. In development, the organ system arises from four separate anlagen: (1) the ovotestis anlage, (2) the pallial anlage giving rise to the hermaphrodite duct, fertilization pouch,spermatheca complex, nidamental glandular complex and spermoviduct, (3) the bursa copulatrix anlage and (4) the anlage of the copulatory organ, vas deferens and egg groove. This development mode strongly resembles that of the siphonariid Williamia radiata, supporting its interpretation as a plesiomorphy in Pulmonata. Similarities in development of primitive pulmonates and evolution in gastropods lead to the assumption that ontogenesis of this organ system reflects evolution to some degree. [source] The antimicrobial triclocarban stimulates embryo production in the freshwater mudsnail Potamopyrgus antipodarum,ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 4 2010Ben D. Giudice Abstract Recent research has indicated that the antimicrobial chemical triclocarban (TCC) represents a new type of endocrine disruptor, amplifying the transcriptional activity of steroid hormones and their receptors while itself exhibiting little affinity for these receptors. The effects of TCC were studied in the freshwater mudsnail Potamopyrgus antipodarum. Specimens were exposed to concentrations ranging from 0.05 to 10.5 µg/L dissolved TCC and were removed and dissected, and embryos contained within the brood pouch were counted and classified as shelled or unshelled after two and four weeks of exposure. After four weeks, environmentally relevant TCC concentrations of 1.6 to 10.5 µg/L resulted in statistically significant increases in the number of unshelled embryos, whereas 0.2, 1.6, and 10.5 µg/L exposures significantly increased numbers of shelled embryos. The lowest observed effect concentration (LOEC) was 0.2 µg/L, the no observed effect concentration (NOEC) was 0.05 µg/L; the 10% effective concentration (EC10) and the median effective concentration (EC50) for unshelled effects were 0.5 µg/L and 2.5 µg/L, respectively. Given the widespread occurrence of TCC in the environment and the effects shown at environmentally relevant concentrations, these results indicate that TCC may be causing reproductive effects in the environment. Furthermore, the present study indicates that environmental risk from a new class of endocrine-disrupting chemicals (EDCs) is both qualitatively and quantitatively similar to risk from existing classes of EDCs. Environ. Toxicol. Chem. 2010;29:966,970. © 2009 SETAC [source] A cranial intercondylar arthroscopic approach to the caudal medial femorotibial joint of the horseEQUINE VETERINARY JOURNAL, Issue 1 2009T. Muurlink Summary Reason for performing study: Current noninvasive techniques for imaging the soft tissue structures of the stifle have limitations. Arthroscopy is commonly used for the investigation and treatment of stifle pain. Cranial and caudal arthroscopic approaches to the femorotibial joints are used. However, complete examination of the axial aspect of the medial femorotibial joint (MFTJ) is not possible currently. Objective: To develop a cranial approach to the caudal pouch of the MFTJ and to assess whether it would allow a more complete examination of the compartment and facilitate the caudomedial approach. Method: The regional anatomy was reviewed and the technique developed on cadavers. A series of nonrecovery surgeries were performed to evaluate the procedure, which was then used in 7 clinical cases. Advantages compared to existing techniques and complications encountered were recorded. Results: Successful entry into the caudal pouch of the MFTJ was achieved in 20 of 22 cadaver legs, 8 of 8 joints of nonrecovery surgery horses and 6 of 7 clinical cases operated. The caudal ligament of the medial meniscus could be visualised, along with other axial structures of the caudal joint pouch. The technique was used to facilitate a caudomedial approach and allowed better triangulation within the joint space. Complications were minor and included puncture of the caudal joint capsule and scoring of the axial medial femoral condyle. Conclusions and potential relevance: It is possible to access the caudal pouch of the MFTJ arthroscopically using a cranial intercondylar approach. The technique has advantages when compared to existing techniques and is associated with few significant complications. A cranial approach to the caudal pouch of the MFTJ could complement existing techniques and be useful clinically. [source] M cells and associated lymphoid tissue of the equine nasopharyngeal tonsilEQUINE VETERINARY JOURNAL, Issue 3 2001P. KUMAR Summary The aim of this study was to characterise the morphological and histochemical features of equine nasopharyngeal tonsillar tissue. Nasal and oropharyngeal tonsillar tissue has been described as the gatekeeper to mucosal immunity because of its strategic location at the entrance to the respiratory and alimentary tracts. A combination of light, scanning and transmission electron microscopy has revealed the presence of follicle-associated epithelium (FAE) overlying lymphoid tissue of the equine nasopharyngeal tonsil caudal to the pharyngeal opening of the guttural pouch. Membranous microvillus (M) cells were identified in the FAE on the basis of short microvilli, an intimate association with lymphocytes, cytoplasmic vimentin filaments and epitopes on the apical surface reactive with lectin GS I-B4 specific for ,-linked galactose. CD4-positive lymphocytes were scattered throughout the lamina propria mucosae as well as forming dense aggregates in the subepithelial part. The central follicular area was heavily populated with B lymphocytes and the dome and parafollicular areas contained both CD4- and CD8-positive lymphocytes. CD8-positive lymphocytes were also present in the epithelium and, together with B lymphocytes, in small numbers in the lamina propria mucosae. These observations indicate that the nasopharyngeal tonsil is potentially an important mucosal immune induction site in the horse and an appropriate target forintranasally administered vaccines. [source] Role of nitric oxide in the reflex diuresis in rabbits during pulmonary lymphatic obstructionEXPERIMENTAL PHYSIOLOGY, Issue 4 2004K. M. McCormick The role of nitric oxide in the reflex diuresis in response to pulmonary lymphatic drainage was examined in anaesthetized, artificially ventilated New Zealand White rabbits. Pulmonary lymphatic drainage was obstructed by raising the pressure in a pouch created from the right external jugular vein. Pulmonary lymphatic obstruction resulted in a significant increase in urine flow from an initial control value of 8.9 ± 0.5 ml (10 min),1 to 12.1 ± 0.6 ml (10 min),1 during lymphatic obstruction (mean ±s.e.m.; n= 17, P < 0.001). This increase in urine flow was accompanied by a significant increase in the excretion of sodium. Additionally, renal blood flow remained unchanged during the increase in urine flow caused by lymphatic obstruction. Intravenous infusion of l -NAME, a non-selective inhibitor of nitric oxide synthase (NOS), abolished the reflex diuresis. Furthermore, intraperitoneal administration of the relatively selective neuronal NOS blocker, 7-nitroindazole also abolished the response. It was observed that infusion of a more soluble neuronal NOS blocker, 7-nitroindazole sodium salt (7-NINA), into the renal medulla also abolished the reflex diuresis. These findings suggest that the increase in urine flow in rabbits caused by pulmonary lymphatic obstruction is dependent upon the integrity of neuronal NOS activity within the renal medulla. [source] Microlaryngoscopic repair of iatrogenic pharyngeal pouch perforations: Treatment of choice?HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2007FRCS (ORL-HNS), Vinidh Paleri MS Background. Endoscopic stapled diverticulostomy (ESD) has become the preferred technique for managing pharyngeal pouches. Iatrogenic perforation, created during stapling, is a rare but serious complication with significant morbidity and mortality. The conventional management in these instances is to convert it to an external procedure and excise the pouch. Methods. Iatrogenic perforations were noticed after stapling in 3 cases in our series of 73 patients who underwent ESD. They were repaired using microlaryngoscopic techniques. Results. All patients had an unremarkable postoperative course. Conclusions. Selected cases with iatrogenic perforations can be repaired primarily and observed with excellent outcome, obviating the need for an external pouch excision. © 2006 Wiley Periodicals, Inc. Head Neck, 2007 [source] Evaluation of endoscopic and imaging modalities in the diagnosis of structural disorders of the ileal pouchINFLAMMATORY BOWEL DISEASES, Issue 9 2010Linda Tang MD Abstract Background: Computerized tomography enterography (CTE), gastrograffin enema (GGE), magnetic resonance imaging (MRI), and pouch endoscopy (PES) have commonly been used to assess ileal pouch disorders. However, their diagnostic utility has not been systematically evaluated. The aims of this study were to compare these imaging techniques to each other and to optimize diagnosis of pouch disorders by using a combination of these diagnostic modalities. Methods: Clinical data of patients from the Pouchitis Clinic from 2003 to 2008 who had a PES and at least 1 additional imaging modalities (CTE, GGE, or MRI) used for evaluation of ileal pouch disorders were retrospectively evaluated. We analyzed the accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) with which these tests were able diagnose pouch inlet and distal small bowel and pouch outlet strictures, pouch fistulas, sinuses, and leaks. Subsequently, accuracy was recalculated by combining 2 imaging modalities to see if this could enhance accuracy. Results: A total of 66 patients underwent evaluation with PES and 1 other imaging modality as follows: PES + CTE (n = 23), PES + GGE (n = 34), and PES + MRI (n = 26). The mean age was 41.5 ± 14.5 years, with 28 being female (42.4%). Sixty patients (90.9%) had J pouches and 59 (89.4%) had a preoperative diagnosis of ulcerative colitis. Overall, CTE, GGE, MRI, and PES all had reasonable accuracy for the diagnosis of small bowel and inlet strictures (73.9%,95.4%), outlet strictures (87.9%,92.3%), fistula (76.9%,84.8%), sinus (68.0%,93.9%), and pouch leak (83,93.9%). CTE had the lowest accuracy for small bowel and inlet strictures (73.9%) and MRI had the lowest accuracy for pouch sinus (68.0%). Combining 2 imaging tests can increase the accuracy of diagnosis to 100% for strictures, fistulas, sinus, and pouch leaks. Conclusions: CTE, GGE, MRI, and PES offer complementary information on disorders of the pouch and the combination of these tests increases diagnostic accuracy for complex cases. (Inflamm Bowel Dis 2010) [source] Efficacy of infliximab in refractory pouchitis and Crohn's disease-related complications of the pouch: A Belgian case seriesINFLAMMATORY BOWEL DISEASES, Issue 2 2010Marc Ferrante MD Abstract Background: Up to 25% of inflammatory bowel disease (IBD) patients undergoing surgery with an ileal pouch,anal anastomosis (IPAA) will develop chronic pouchitis not responding to antibiotics. In case reports, thiopurine analogs and infliximab (IFX) have been proposed as effective therapy in this setting. We analyzed the long-term efficacy of IFX in Belgian patients with refractory pouch complications. Methods: We identified 28 IPAA patients who received IFX for refractory luminal inflammation (pouchitis and/or pre-pouch ileitis, n = 25) and/or pouch fistula (n = 7). Patients with elements of Crohn's disease after review of the colectomy specimen were excluded. Clinical response was defined as complete in case of cessation of diarrhea, blood loss, and abdominal pain, and as partial in case of marked clinical improvement. Fistula response was defined as complete in case of cessation and as partial in case of reduction of fistula drainage. Results: Eighty-two percent of patients were concomitantly treated with immunomodulatory agents. At week 10 following start of IFX, 88% of patients with refractory luminal inflammation showed clinical response (14 partial, 8 complete), while 6 patients (86%) showed fistula response (3 partial, 3 complete). The mPDAI dropped significantly from 9.0 (interquartile range [IQR] 8.0,10.0) to 4.5 (3.0,7.0) points (P < 0.001). After a median follow-up of 20 (7,36) months, 56% showed sustained clinical response while 3 out of 7 fistula patients showed sustained fistula response. Five patients needed permanent ileostomy. Conclusions: In this series, IFX was effective long-term in IPAA patients with refractory luminal inflammation and pouch fistula. These results warrant a prospective multicenter randomized controlled trial. Inflamm Bowel Dis 2009 [source] Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouchINFLAMMATORY BOWEL DISEASES, Issue 2 2009Bo Shen MD Abstract Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch,anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56,6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48,11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19,3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74,11.4). Conclusions The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure. (Inflamm Bowel Dis 2008) [source] Probiotic administration in patients with ileal pouch,anal anastomosis for ulcerative colitis is associated with expansion of mucosal regulatory cellsINFLAMMATORY BOWEL DISEASES, Issue 5 2008Annamaria Pronio MD Abstract Background: Probiotics have anti-inflammatory effects in patients with inflammatory bowel disease and appear to regulate mucosal immune response through reductions in proinflammatory cytokines. The probiotic VSL#3 prevents pouchitis if started within a week of ileostomy closure and maintains remission following antibacterial treatment in patients with refractory or recurrent pouchitis. However, the efficacy of probiotics and their effects on regulatory cells if started at a greater time after surgery in patients undergoing ileal pouch anal anastomosis (IPAA) for ulcerative colitis are unknown. Methods: We conducted an open-label study in which 31 patients at different periods from surgery without signs and symptoms of pouchitis were randomized to 2 sachets of VSL#3 once daily or no treatment for 12 months. Pouchitis disease activity index (PDAI) was evaluated at baseline and after 3, 6, and 12 months. The percentage of CD4+ T lymphocytes expressing CD25 and the inactive form of transforming growth factor-, [latency-associated peptide (LAP)] were evaluated at baseline and after 3 and 6 months in peripheral-blood mononuclear cells and mucosal biopsies. Variation in tissue interleukin-1, and Foxp3 mRNA expression was also evaluated. Results: During the study period, VSL#3-treated patients showed a significant reduction in PDAI score and a significant increase in the percentage of mucosal CD4+CD25high and CD4+ LAP-positive cells compared with baseline values. Tissue samples at different points showed a significant reduction in IL-1, mRNA expression, and a significant increase in Foxp3 mRNA expression. Conclusions: We conclude that VSL#3 administration in patients with IPAA modulates the PDAI and expands the number of mucosal regulatory T cells. (Inflamm Bowel Dis 2008) [source] Pilot study on the effect of reducing dietary FODMAP intake on bowel function in patients without a colonINFLAMMATORY BOWEL DISEASES, Issue 12 2007Catherine Croagh MB Abstract Background: Poorly absorbed short-chain carbohydrates (FODMAPs) in the diet should, by virtue of their osmotic effects, increase fecal output following colectomy and ileal pouch formation or ileorectal anastomosis (IRA). The aim was to perform a proof-of-concept evaluation of this hypothesis. Methods: Fifteen patients (13 pouch, 2 IRA) had dietary and symptomatic evaluation before and during a low FODMAP diet. Carbohydrate malabsorption was evaluated by breath tests. Pouchitis was assessed clinically/endoscopically or by fecal lactoferrin. Results: Of 8 patients with a breath hydrogen response to lactulose, 7 had fructose malabsorption, 3 with lactose malabsorption, and 1 had lactose malabsorption alone. Five of 7 studied retrospectively improved stool frequency (from median 8 to 4 per day; P = 0.02), this being sustained over 0.5,3 years of follow-up. Five of 8 patients completed a prospective arm of the study. One patient had sustained improvement in stool frequency and 1 had reduced wind production. Overall, none of 8 patients who had pouchitis improved. In contrast, median daily stool frequency fell from 8 to 4 (P = 0.001) in the 7 without pouchitis. The degree of change in FODMAP intake also predicted response. There was a tendency for pouchitis to be associated with low baseline FODMAP intake. Conclusions: There is a high prevalence of carbohydrate malabsorption in these patients. Reduction of the intake of FODMAPs may be efficacious in reducing stool frequency in patients without pouchitis, depending on dietary adherence and baseline diet. (Inflamm Bowel Dis 2007) [source] Increased bacterial permeation in long-lasting ileoanal pouchesINFLAMMATORY BOWEL DISEASES, Issue 8 2006Anton J. Kroesen MD Abstract Background and Aims: Bacterial overgrowth appears to play an important role in the pathogenesis of ileoanal pouches. Therefore, the capability of bacterial permeation and its determinants is of great interest. The aim of this study was to examine bacterial permeation in the ileoanal pouch and to correlate the results with the degree of inflammation, the epithelial resistance, the mucosal transport function, and the age of the ileoanal pouches. Materials and Methods: Biopsies were taken from 54 patients before colectomy (n = 13; preileal pouch-anal anastomosis [IPAA]), and closure of ileostomy (n = 7; deviation), <1 year after closure of ileostomy (n = 8; intact pouch I), >1 year after closure of ileostomy (n = 16; intact pouch II), in the case of pouchitis (n = 11), and in 11 controls. Tissues were mounted in a miniaturized Ussing chamber. Escherichia coli was added to the mucosal side of the Ussing chamber, and the permeation was proven by serosal presence of E. coli. Epithelial and subepithelial resistance was determined by transmural impedance analysis. Active Na+ -glucose cotransport and active Cl, secretion were measured. Specimens were analyzed by fluorescent in situ hybridization with oligonucleotide probes targeting the bacterial 16s ribosomal RNA. The bacteria in and on the tissue were enumerated. Results: Bacterial permeation occurred in 2 of 13 pre-IPAA, 2 of 7 deviations, 0 of 8 intact pouch I, 9 of 16 intact pouch II, 5 of 11 pouchitis specimens, and 0 of 11 ileum controls. The frequency of bacterial permeation in the intact pouch II group is higher than in the intact pouch I group (P < 0.001). Epithelial resistance, mannitol fluxes, electrogenic chloride secretion, sodium-glucose cotransport of the bacterially permeated specimens versus nonpermeated of the intact pouch II group, and the pouchitis group and subepithelial resistance remained unchanged. Intramural bacteria could be detected by fluorescence in situ hybridization mainly in long-lasting pouches, but there was no correlation with bacterial permeation. Conclusions: The long-lasting ileoanal pouch is associated with increased bacterial permeability. This is not correlated with a disturbed function of the pouch mucosa but could be a precursor of pouchitis. [source] Azathioprine or 6-mercaptopurine before colectomy for ulcerative colitis is not associated with increased postoperative complicationsINFLAMMATORY BOWEL DISEASES, Issue 5 2002Uma Mahadevan Abstract Aim To determine whether the use of azathioprine/6-mercaptopurine before colectomy is associated with an increased rate of postoperative complications. Methods All patients who underwent colectomy with ileal pouch,anal anastomosis for ulcerative colitis between 1997 and 1999 were identified. Medical records were abstracted for demographics, extent and duration of disease, dose and duration of corticosteroids and azathioprine/6-mercaptopurine, albumin, and Truelove/Witts score. Early (30-day) and late (6-month) complications were identified. Noncorticosteroid immunosuppressive use was coded as none, azathioprine/6-mercaptopurine within 1 week of surgery, or therapy with other immunosuppressive agents within 1 month of surgery. A logistic regression analysis assessed the association between these variables and complications. Results Early complications occurred in 49 of 151 (32%) patients not treated with immunosuppressive agents, 12 of 46 (26%) azathioprine/6-mercaptopurine-treated patients, and 4 of 12 (33%) patients treated with other immunosuppressive agents (p = 0.71). Late complications occurred in 72 of 148 (49%), 20 of 46 (43%), and 8 of 12 (67%) patients in these same groups, respectively. Intravenous or oral steroids at doses of 40 mg/d or greater (p < 0.01) and severe or fulminant disease (p = 0.0094) were associated with greater early complication rates. Conclusion Early complications after restorative proctocolectomy for ulcerative colitis are associated with high dose steroids and severe disease but not use of azathioprine/6-mercaptopurine. [source] CELLULAR LOCALIZATION AND EXPRESSION OF pygo DURING DROSOPHILA DEVELOPMENTINSECT SCIENCE, Issue 2 2003LIN Xin-da Abstract Wg/Wnt signaling is a key signaling pathway in Drosophila. Many genes involved in Wingless(wg) signal transduction pathway downstream of Wg, or it s vertebrate Wg homologue Wnt, have been identified. Transduction of the Wg signal downstream of Wg is mediated by nuclear TCF/LEF-1, through association with Armadillo (Arm),-catenin. Pygopus (pygo) is a new identified component in this pathway. Cellular localization experiment showed that pygo was expressed specifically in the nucleus. The expression profile of pygo in embryos was examined using in situ hybridization. Although pygo expressed ubiquitously in the embryos, it expressed at relatively high level in pre-blastoderm embryos which indicate a high degree of maternally provided message, followed by a low level of ubiquitous zygotic expression. This continues into larval tissues (including wing disc, eye disc and leg disc), where pygo appears to be expressed at low level. Comparison of pygo expression levels, in the wing disc, eye disc and leg disc, showed pygo expression level in the wing disc pouch and leg disc were relative higher. [source] | |||||||||||||||||||||||||||||||||||||