Benign stenosis of common bile duct after Roux Y gastrectomy.

We present the case of a 60-year-old patient with the history of subtotal gastric resection and reconstruction of passage using the Roux-Y loop, five years later diagnosed with benign stenosis of the common bile duct. The possibilities of using endoscopy and interventional radiology for the bile duct treatment in the postoperatively altered terrain of the proximal digestive tract were limited. After failure of these methods the patient was indicated for surgery - biliodigestive anastomosis. The postoperative course was significantly complicated by bleeding and formation of bile and colic fistulas. Over time, a migrated stent was found in the small intestine, which was the cause of inflammatory changes and incomplete small bowel obstruction. Increased intraluminal pressure in the intestinal loops inhibited healing of the anastomosis and was a major cause of the complications.

Synchronous tumor duplicity of a neuroendocrine tumor of Meckels diverticulum with liver metastases and colorectal carcinoma.

INTRODUCTION: Meckels diverticulum (MD) is a developmental abnormality and a true diverticulum of the small intestine which can give rise to a malignant tumor. Neuroendocrine tumors (NETs) are the most common tumors arising in MD, but due to the prevalence of MD and its malignancy rate, there is no uniform guideline regarding these tumors. Recent knowledge shows that their biological behavior is aggressive and unrelated to size. Their behavior resembles that of an ileal NET. CASE REPORT: A 62-year-old male was examined for enterorrhagia, and an adenocarcinoma of the ascending colon was diagnosed along with multiple liver lesions that resembled metastases. Needle biopsy of a liver lesion was performed and showed the lesions to be NET metastases of unknown origin. Treatment with somatostatin analogs was commenced, and because of the patients anemization a right hemicolectomy was indicated, during which a normal Meckels diverticulum was found and resected. Histological evaluation of MD confirmed a moderately differentiated NET. CONCLUSION: Surgery is the primary modality for treating MD, including cases in which MD is asymptomatic and found incidentally during surgery for other causes. In the case of NET of MD, a radical surgical treatment is needed because of the risk of early metastatic dissemination. When liver metastases are present, an aggressive approach combining surgical and systemic treatment is recommended to improve the prognosis of the disease.

Interchangeable Biomass Fuels for Paper-Based Microfluidic Fuel Cells: Finding Their Power Density Limits.

Paper batteries are self-pumping emerging tools for powering portable analytical systems. These disposable energy converters must be low-cost and must achieve enough energy to power electronic devices. The challenge is reaching high energy while keeping the low cost. Here, for the first time, we report a paper-based microfluidic fuel cell (PµFC) equipped with Pt/C on a carbon paper (CP) anode and a metal-free CP cathode fed by biomass-derived fuels to deliver high power. The cells were engineered in a mixed-media configuration, where methanol, ethanol, ethylene glycol, or glycerol is electro-oxidized in an alkaline medium, while Na2S2O8 is reduced in an acidic medium. This strategy allows for optimizing each half-cell reaction independently. The colaminar channel of the cellulose paper was chemically investigated by mapping the composition, which reveals a majority of elements from the catholyte and anolyte on each respective side and a mixture of both at the interface, assuring the existing colaminar system. Moreover, the colaminar flow was studied by investigating the flow rate by considering recorded videos for the first time. All PµFCs show 150-200 s to build a stable colaminar flow, which matches the time to reach a stable open circuit voltage. The flow rate is similar for different concentrations of methanol and ethanol, but it decreases with the increase in ethylene glycol and glycerol concentrations, suggesting a longer residence time for the reactants. The cells perform differently for the different concentrations, and their limiting power densities are composed of a balance among anode poisoning, residence time, and viscosity of the liquids. The sustainable PµFCs can be interchangeably fed by the four biomass-derived fuels to deliver ∼2.2-3.9 mW cm-2. This allows choosing the proper fuel due to their availability. The unprecedented PµFC fed by ethylene glycol delivered 6.76 mW cm-2, which is the benchmark output power for a paper battery fed by alcohol.

Evaluation of the micronucleus assay in bone marrow and peripheral blood of rats for the determination of cigarette mainstream-smoke activity.

The mammalian in vivo micronucleus assay is widely used as part of the genotoxicity testing battery required during the development of new drugs. As such, the in vivo micronucleus assay has been used in a battery of assays for the assessment of cigarette ingredients or design modifications to help ensure that there is no increase in risk or any new risk introduced by these additions or modifications. The present series of studies was conducted to optimize and evaluate this assay for the assessment of the effects of mainstream smoke on the micronucleus frequency in the bone marrow and peripheral blood of rats. In a first experiment, the optimal conditions for performing the micronucleus assay in these tissues were determined. This was done by use of two compounds known for their micronucleus-inducing activity, i.e., the clastogen cyclophosphamide and the aneugen colchicine. In a second experiment, the effects of tube restraint on untreated control rats were investigated. In a third experiment, the optimal conditions were used to assess the clastogenic/aneugenic activity of cigarette smoke in Sprague-Dawley rats. The rat micronucleus assay in both bone marrow and peripheral blood is able to detect clastogenic and aneugenic activity. The flow cytometric determination of micronucleated cells in rat blood is at least as sensitive as determinations in bone marrow. No statistically significant differences were observed in micronucleus frequencies between rats with and without the additional stress of tube restraint; however, the cautious approach would be to use a fresh-air-exposed group (with tube restraint) as the negative control in inhalation experiments. Using the conditions identified as optimal in the above-mentioned experiments, the micronucleus assay was not able to detect effects induced by smoke from conventional cigarettes. Nevertheless, the micronucleus assay will remain a valuable tool as part of a testing battery used to investigate possible adverse effects related to product modifications.

Toxicological comparisons of cigarettes containing different amounts of vanillin.

Vanillin is a flavoring agent used in cigarettes. Previous toxicological examinations of the effects on the addition of vanillin to tobacco used mixtures with several other flavoring agents. In the present work, toxicological comparisons were made of experimental cigarettes containing no added vanillin against otherwise similar cigarettes with three different amounts of vanillin added to the tobacco. The main toxicological comparison was a subchronic inhalation study with mainstream smoke in Sprague-Dawley rats (exposures of 150 mg/m3 of total particulate matter, 6 h exposure per day, for 90 consecutive days). Vanillin concentrations in the tobacco of the 4 cigarette types at the end of the study were 0, 67, 1233, and 3109 ppm. Additional studies with mainstream smoke were Salmonella mutagenicity (5 bacterial strains, both with and without metabolic activation, particulate phase only), cytotoxicity of both particulate and gas/vapor phases (using the neutral red uptake assay), and analytical chemistry (49 analytes, including 5 metals). Similar responses were seen across the four cigarette types, and the responses were similar to those previously described in the scientific literature. At the same smoke concentration, the inhalation exposures produced effectively the same responses, in each of the four groups. Most of the changes produced in the 90 days of exposure were resolved in a 42-day postinhalation period. The addition of vanillin to tobacco at inclusion rates up to 3109 ppm did not influence a broad range of toxicological endpoints.