Rupture of liver abscess following hepatogastric fistula caused by perforation of remnant gastric carcinoma: a case report.

OBJECTIVE: We report the case of a 73-year-old man, with a history of proximal subtotal gastrectomy, who suffered acute abdominal symptoms and signs. Laparotomy showed rupture of liver abscess and hepatogastric fistula formation caused by perforation of remnant stomach. CASE REPORT: Residual stomach resection, incision and drainage of liver abscess were performed, and the patient was smoothly discharged from hospital nineteen days after the emergency operation. RESULTS: The final pathology confirmed the remnant gastric adenocarcinoma. This case is so far the first reported liver abscess caused by perforation of residual stomach malignant tumor. CONCLUSIONS: Liver abscess and hepatogastric fistula are rare. This is the first report on a remnant gastric adenocarcinoma (RGC) invading the adjacent liver, with ruptured liver abscess resulting from gastric perforation. We speculated that there were inevitable factors for this case. Direct invasion to the liver capsule of gastric carcinoma was the bridging basic of the formation of a hepatogastric fistula. Pyloric obstruction caused by gastric carcinoma was the driver of liver abscess rupture since the increased proximal gastrointestinal pressure led to the inner pressure of liver abscess rising through the conduction of hepatogastric fistula. The recommended treatment protocol for this clinical entity comprises removal of the primary lesions and drainage of the liver abscess. This successful case provided us with a great deal of clinical information and treatment experience.

Impact of bilateral subcostal rooftop incision combined double lifting retractor on recent surgical outcomes of obese patients with advanced gastric cancer.

OBJECTIVE: To investigate the impact of bilateral subcostal rooftop incision under bilateral costal margins combined double lifting retractors on the recent surgical outcome of obese patients with advanced gastric cancer. PATIENTS AND METHODS: We retrospectively analyzed the clinical data of 138 obese patients with gastric cancer under radical gastrectomy. The patients were divided into two groups, the MI group (n=68) and RI group (n=70). Patients in MI group were treated by midline incision via upper abdomen combined single double lifting retractor technology while the patients in RI group were treated by roof incision under bilateral costal margins under combined double lifting technology. The abdomen entering and closing time, the operation time, bleeding volume, blood transfusion rate, postoperative drainage volume, postoperative hospitalization time, postoperative detected number of perigastric lymph node, postoperative pain score, postoperative complications and short-term survival between the two groups were compared and analyzed. RESULTS: The average abdominal entering and closing time of RI group were slightly longer than MI group, but the average total operation time of RI group was shorter than MI group. The average bleeding volume was 98.4 ± 46.8 ml, the postoperative intraperitoneal drainage was 24 h (123.8 ± 69.0 ml), 48 h (101.9±36.7 ml), 72 h (45.1±24.6 ml), and the postoperative hospitalization time was 12.9 ± 2.5 d, and the incidence of postoperative complications was 17.1%, all of which were less than MI group. The difference on the average total detected number of perigastric lymph node between the two groups was not statistically significant. 129 cases (93.5%) were followed up for 12 to 36 months, and the difference on survival curve between the two groups was not statistically significant (p>0.05). CONCLUSIONS: Bilateral subcostal rooftop incision was favorable for exposing the stomach, adjacent organs and large vessels, convenient for operation and would not affect the postoperative recovery, so it was a good choice for obese patients with gastric cancer.

Identification of the microRNA expression profile in the regenerative neonatal mouse heart by deep sequencing.

MicroRNAs (miRNAs) are small noncoding RNAs that are involved in key biological processes, including development, differentiation, and regeneration. The global miRNA expression profile that regulates the regenerative potential of the neonatal mouse heart has not been reported. We performed deep sequencing to determine the genome-wide miRNA expression profile of the neonatal mouse heart at three key ages (1, 6, and 7 days). The miRNAs at least 1.4-fold differentially expressed between the three time points were selected for further analysis. Two miRNAs (mmu-miR-22-5p and mmu-miR-338-3p) were significantly upregulated, and nine miRNAs (mmu-miR-324-5p, mmu-miR-337-5p, mmu-miR-339-5p, mmu-miR-365-1-5p, mmu-miR-500-3p, mmu-miR-505-5p, mmu-miR-542-5p, mmu-miR-668-3p, and mmu-miR-92a-1-5p) were significantly downregulated in cardiac tissue of 7-day-old mice compared to 1- and 6-day-old mice. The expression patterns of five significantly different miRNAs were verified by quantitative real-time PCR. Furthermore, the potential targets of these putative miRNAs were suggested using miRNA target prediction tools. The candidate target genes are involved in the myocardial regenerative process, with a prominent role for the Notch signaling pathway. Our study provides a valuable resource for future investigation of the biological function of miRNAs in heart regeneration.

Fabp3 inhibits proliferation and promotes apoptosis of embryonic myocardial cells.

Fatty acid binding protein 3 (FABP3) is a member of a family of binding proteins. The protein is mainly expressed in cardiac and skeletal muscle cells, and it has been linked to fatty acid metabolism, trafficking, and signaling. Using suppression subtractive hybridization, we previously found that FABP3 is highly regulated in ventricular septal defect (VSD) patients and may play a significant role in the development of human VSD. We therefore aimed to identify the biological characteristics of the FABP3 gene in embryonic myocardial cells. On the basis of RT-PCR and western blotting analyses, we demonstrated that the expression levels of FABP3 mRNA and protein were up-regulated initially and then gradually decreased with P19 cell differentiation. MTT assays and cell cycle analysis showed that FABP3 inhibits P19 cell proliferation, and data from annexin V-FITC assays revealed that FABP3 can promote apoptosis of P19 cells. Further data from quantitative real-time RT-PCR revealed lower expression levels of cardiac muscle-specific molecular markers (cTnT, alpha-MHC, GATA4, and MEF2c) in FABP3-overexpressing cell lines than in the control cells during differentiation. Our results demonstrate that FABP3 may be involved in the differentiation of cardiac myocytes.

Effect of gallic acid on the wear behavior of early carious enamel.

The purpose of this research was to investigate the wear behavior of early carious enamel remineralized with gallic acid. Forty natural human premolar specimens with early caries lesions were prepared. A remineralization pH-cycling treatment agent of 4000 ppm gallic acid was used for 12 days to treat the early lesions. The changes in microhardness were monitored. Nanoscratch tests were used to evaluate wear resistance. The experimental data were analyzed by using a t-test. The widths of traces were measured by an AMBIOS XP-2 stylus profilometer. After remineralization, all samples re-hardened significantly. The coefficients of friction became higher, and the widths of scratches were larger than they were before remineralization. Gallic acid significantly improved the early carious enamel's hardness. The wear damage of the samples treated with gallic acid was more severe than that of the control group. There were more obvious cracks and delaminations on the traces of the treated group. Compared with the control group, the enamel remineralized with gallic acid had inferior wear resistance. After remineralization, the dominant damage mechanisms of early carious enamel had changed from plastic deformation and adhesive wear to a combination of brittle cracks and delamination of enamel.

Tetrahedral onsager crosses for solubility improvement and crystallization bypass.

Pure organic molecules exhibiting a suitable concave rigid shape are expected to give porous glasses in the solid state. Such a feature opens new opportunities to avoid crystallization and to improve molecular solubility in relation to the high internal energy of these solid phases. To quantitatively explore the latter strategy, a series of rigid tetrahedral conjugated molecules nC and the corresponding models nR have been synthesized. Related to the present purpose, several properties have been investigated using UV absorption, steady-state fluorescence emission, differential scanning calorimetry, (1)H NMR translational self-diffusion, magic angle spinning (13)C NMR, and multiple-beam interferometry experiments. The present tetrahedral crosses are up to 8 orders of magnitude more soluble than the corresponding model compounds after normalization to the same molecular length. In addition, they give concentrated monomeric solutions that can be used to cover surfaces with homogeneous films whose thickness goes down to the nanometer range. Such attractive features make cross-like molecular architectures promising for many applications.