Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone disease.Despite its success,approximately 10%of patients may experience persistent biliary symptoms,leading to t...Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone disease.Despite its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this syndrome.The objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant gallbladders.Methods:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo Hospitals in South India.All patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were included.The following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative outcomes.Results:In total,36 patients were included and analysed.The majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 years.The most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open surgery.Cholecystoenteric fistula to the colon was observed in one patient.Choledocholithiasis was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients preoperatively.Conclusion:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and infection.Patients who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain risks.This study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder with cystic duct or bile duct stones.展开更多
Gall bladder cancer(GBC)is becoming a very devastating form of hepatobiliary cancer in India.Every year new cases of GBC are quite high in India.Despite recent advanced multimodality treatment options,the survival of ...Gall bladder cancer(GBC)is becoming a very devastating form of hepatobiliary cancer in India.Every year new cases of GBC are quite high in India.Despite recent advanced multimodality treatment options,the survival of GBC patients is very low.If the disease is diagnosed at the advanced stage(with local nodal metastasis or distant metastasis)or surgical resection is inoperable,the prognosis of those patients is very poor.So,perspectives of targeted therapy are being taken.Targeted therapy includes hormone therapy,proteasome inhibitors,signal transduction and apoptosis inhibitors,angiogenesis inhibitors,and immunotherapeutic agents.One such signal transduction inhibitor is the specific short interfering RNA(siRNA)or short hairpin RNA(shRNA).For developing siRNAmediated therapy shRNA,although several preclinical studies to evaluate the efficacy of these key molecules have been performed using gall bladder cells,many more clinical trials are required.To date,many such genes have been identified.This review will discuss the recently identified genes associated with GBC and those that have implications in its treatment by siRNA or shRNA.展开更多
BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,whic...BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI.展开更多
Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency o...Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.展开更多
Gall bladder torsion(GBT) is a relatively uncommon entity and rarely diagnosed preoperatively. A constant factor in all occurrences of GBT is a freely mobile gall bladder due to congenital or acquired anomalies. GBT i...Gall bladder torsion(GBT) is a relatively uncommon entity and rarely diagnosed preoperatively. A constant factor in all occurrences of GBT is a freely mobile gall bladder due to congenital or acquired anomalies. GBT is commonly observed in elderly white females. We report a 77-year-old, Caucasian lady who was originally diagnosed as gall bladder perforation but was eventually found with a two staged torsion of the gall bladder with twisting of the Riedel's lobe(part of tongue like projection of liver segment 4A). This together, has not been reported in literature, to the best of our knowledge. We performed laparoscopic cholecystectomy and she had an uneventful postoperative period. GBT may create a diagnostic dilemma in the context of acute cholecystitis. Timely diagnosis and intervention is necessary, with extra care while operating as the anatomy is generally distorted. The fundus first approach can be useful due to altered anatomy in the region of Calot's triangle. Laparoscopic cholecystectomy has the benefit of early recovery.展开更多
The study has explored 11 correlative variables which might affect the gallblad-der pressure GBP of patients with gall stone after auricular electrical stimulation by means of multiplestepwise regression. It was found...The study has explored 11 correlative variables which might affect the gallblad-der pressure GBP of patients with gall stone after auricular electrical stimulation by means of multiplestepwise regression. It was found that the size of gallbladder stone (X9), cholecystolithiasis (X4),sex (X1), and the baseline of GBP (X10) could affect the GBP change range (Y1) depressingly orreinforcingly. Also the baseline of GBP (Y1) could be affected by the variables X1 (sex), X2 (age),and X6 (long diameter of the gallbladder, LDGB), etc.. The result shows that the change in GBPafter auricular electrical stimulation is comprehensively influenced by multiple factors. And it providessome useful information for predicting the curative effect of auricular therapy on gallbladder stone inclinic.展开更多
Only a few species of aphids induce galls. Among these, Paracletus cimiciformis, Forda marginata, Forda formicaria, Geoica utricularia and Baizongia pistaciae induce galls on Pistacia terebinthus leaflets. Prior to pr...Only a few species of aphids induce galls. Among these, Paracletus cimiciformis, Forda marginata, Forda formicaria, Geoica utricularia and Baizongia pistaciae induce galls on Pistacia terebinthus leaflets. Prior to present study the author examined microscopically P. terebinthus leaflets. He also studied the microscopic morphology of galls induced by the five species mentioned above. A clear microscopic difference between these galls is that in the wall of galls induced by the genera Paracletus and Forda a single vascular bundle is seen. The interpretation is that these galls are laminae of the modified leaflets. However, in the walls of the galls induced by the genera Geoica and Baizongia, two vascular bundles are observed. In the present paper a study of the early stages of development of galls produced by G. utricularia is described. The study was designed to explain the origin of the two vascular bundles present in the walls of these galls. The findings indicate that the aphid induces a massive development of the two vascular bundles present in the midvein of the leaflets of P. terebinthus: the main vascular bundle and the small supernumerary vascular bundle. Both these extremely developed vascular bundles occupy the walls of the galls induced by G. utricularia.展开更多
Objective:To study the detailed pharmacognostic profile of galls of Quercus infectoria Olivier(Q.infectoria olivier)(Fagaceae),an important medicinal plant used in the Indian system of medicine.Methods:Samples of gall...Objective:To study the detailed pharmacognostic profile of galls of Quercus infectoria Olivier(Q.infectoria olivier)(Fagaceae),an important medicinal plant used in the Indian system of medicine.Methods:Samples of galls of Q.infectoria were studied by macroscopical,microscopical,physiochemical,phytochemical.fluorescence analysis and othjer methods for standardization as recommended by WHO.Results:Macroscopically,the crude drug is globose with horny appearances on external surface(1.4-2.3 cm in length and 1-1.5 cm in diameter),with greyish-brown to brownish-black in colour externally and dark brown buff colored.Surface is smooth with numerous horny protuberances giving rough touch,and witfi unpleasant odour.Microscopically,a wide zone of radially elongated parenchyma cells between upper and lower epidermis were found.The vascular strands were present at all places and radially elongated sclerides touched the lower epidermis.In physico-chemical studies,the moisture,total ash,acid insoluble ash,alcohol soluble,water soluble,petroleum ether,chloroform extractive value and tannin content were found to be 2.790,5.020,0.110,38.780,41.210,0.402,1.590 and 49.200 percentage respectively.Prcliminary phytochemical screening showed the presence of phenols,flavonoids,steroids,triterpenes,tannins,saponins and alkaloids.Cooclusions:The results of the present study serve as a valuable source of information and provide suitable standards for identification of this medicinally important plant drug material for future investigations and applications.展开更多
Faba bean(Vicia faba L.) has an important place in the Ethiopian national diet. It is consumed in various forms and contributes to the improvement of soil fertility. However,its production and productivity are affecte...Faba bean(Vicia faba L.) has an important place in the Ethiopian national diet. It is consumed in various forms and contributes to the improvement of soil fertility. However,its production and productivity are affected by biotic and abiotic constraints. Among the biotic constraints, the emerging faba bean gall disease, caused by Olpidium uiciae, is the major and most destructive disease wherever faba bean is grown. Field experiments were conducted at two locations(Farta and Tach Gayint districts) to evaluate the reaction of faba bean varieties to faba bean gall disease and to assess them for yield and yield components during the 2014 and 2015 main cropping seasons. Thirteen faba bean varieties and one local check were plantecd in three replications Lusing a randomized complete block design. The disease incidence and severity of faba bean gall were recorded(on a 1-9 scale) five tinmes at10-day intervals. A combined analysis of variance showed za significant difference(P < 0.05)among faba bean varieties with respect to the incidence and severity of gall disease at both locations. Disease incidence, severity, and AUDPC were lowest for variety Turmsa at both locatiOons, but this variety showed lhigh yield only at tlhe Farta location. 'The lhighest yields were obtained from varieties Degaga(1157.74 kg ha ') and Nc58(828.97 kg ha ') at Farta and Tach Gayint, respectively and these varieties slhowed low faba bean gall severity and AUDPC. Thus, higher-yielding faba bean varieties such as Degaga and Nc58 are recommended for faba bean production areas in northwestern Ethiopia.展开更多
Candida endocarditis is extremely rare in term neonates,and gall bladder involvement due to candidemia has never been reported amongst neonates and infants.A term,appropriate for gestational age neonate developed Cand...Candida endocarditis is extremely rare in term neonates,and gall bladder involvement due to candidemia has never been reported amongst neonates and infants.A term,appropriate for gestational age neonate developed Candida tropicalis blood stream infection in second week of life.He was started on conventional amphotericin B.However,he failed to show any clinical improvement,and candidemia keep on persisting.Repeat sanctuary sites screening revealed multiple echogenic masses in heart(vegetations) and gall bladder.On changing the treatment to liposomal amphotericin B and fluconazole,he recovered clinically,echogenic masses in gall bladder disappeared,and intracardiac vegetations decreased in size.展开更多
BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance...BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance so that it is difficult to differentiate between primary ICA and liver metastasis of GBC,which sometimes becomes a point of discussion in clinical practice.Although these cancers demonstrate significant differences in their mutational landscape,several reports demonstrated shared genomic alteration in paired primary and metastatic site aids in distinguishing metastatic recurrence from second primary cancers.CASE SUMMARY We present a 73-year-old female patient who underwent curative resection for GBC harboring epidermal growth factor receptor 2(ERBB2)activating mutation on next-generation sequencing(NGS)-based genomic testing.One year later,a hepatic lesion was observed on follow-up imaging and she underwent surgical resection for a pathological diagnosis.The histological findings of the hepatic lesion were similar to those of the primary lesion.Additionally,using NGS panel testing,the hepatic lesion was found to have ERBB2 activating mutation,which is the identical mutation detected in the sequencing result of the primary site.ERBB2 activating mutation occurs more frequently in GBC than ICA and ECA.Therefore,in the present case,we think this molecular finding potentiated the diagnosis of the liver mass toward a metastatic recurrence.Additionally,this patient underwent HER2-targeted treatment with lapatinib in combination with capecitabin and obtained clinical benefit.CONCLUSION This case illustrated NGS panel usefulness in distinguishing GBC recurrence from second primary cancer and HER2-targeted agent efficacy on ERBB2 mutated GBC.展开更多
Crown gall of Prunus subhirtella Miq., flowering cherry, is a soil-borne bacterial disease caused by Agrobacterium tumefaciens Smith & Townsend and has caused serious damage to the species in recent years in China...Crown gall of Prunus subhirtella Miq., flowering cherry, is a soil-borne bacterial disease caused by Agrobacterium tumefaciens Smith & Townsend and has caused serious damage to the species in recent years in China. In this study, the colonization of sapling roots, the biocontrol efficacy, the expression of defense-related genes and the enzyme activity in roots of P. subhirtella inoculated with the Bacillus velezensis JK-XZ8 against A. tumefaciens were determined under greenhouse conditions. The results showed that the JK-XZ8 strain colonized in the rhizosphere and root surfaces of the saplings. Sole application of the strain increased activities of polyphenol oxidase (PPO) and phenylalanine ammonia lyase (PAL) without affecting superoxide dismutase (SOD). SOD and PPO activities increased in the prevention group, and the activity of PAL increased in both the prevention and cure groups. The expression of the defense-related genes PAL and PR-1 of salicylic acid pathway in roots increased in both the prevention and cure groups. Simultaneously on day 3, the expression of both COI and MYC2 genes of the jasmonic acid pathway significantly increased in the two groups. The incidence of crown gall in the prevention and the cure groups were 48.1% and 66.7%, respectively, significantly lower compared to the pathogens alone (87.5%). This study showed that the application of the JK-XZ8 strain reduced the incidence of crown gall in P. subhirtella saplings in the two groups, and the prevention group had better control efficacy. In addition, the JK-XZ8 strain protects against crown gall by developing induced systemic resistance and systemic acquired resistance in the roots of the cherry saplings.展开更多
Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to...Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to evaluate this effect of extract of Oak Gall for vaginal tightening and rejuvenation in women with vaginal relaxation. Methods: This double blind clinical trial was performed on women with vaginal relaxation at Asali Hospital in Khorramabad from May to October 2012 and was candidate for colporrhaphy due to different types of pelvic organ prolapse. Sampling method was done on nonprobability basis according to the number of patients referred to clinic. Using blocked random allocation method, the participants were divided into 4 groups of 30 patients (three intervention group and one control group) who were age-matched. Then, an extract of Oak Gall in specified concentrations (10 - 15 and 20 grams in 1.5%, 2% and 2.5% jells) were administered to each intervention group. Finally, the obtained data were analyzed with Chi-square, Pearson, Fisher’s exact test and ANOVA using SPSS software version 19. Results: A total of 120 patients entered into the study with mean age of 36 ± 5.4 years. The evaluation of mean scores showed that sense of sexual satisfaction and orgasm, sense of vaginal tightness during intercourse, sense of vaginal lubrication and loss of vaginal dryness was significantly improved in patients in intervention group. Also other parameters including urinary incontinence, sense of vaginal mass exit, lack of orgasm, sense of air outflow during intercourse, sense of calmness after sex and loss of libido were significantly reduced in the group of patients who received jell 2.5% compared to other groups (P Conclusion: Our findings show that using topical jell of Oak Gall not only is associated with contracting effects, but also improves vaginal lubrication and reduces its dryness. Regarding the lack of previous studies in this field and considering some limitations of this study, we suggest that Oak Gall to be used for management of women with vaginal relaxation.展开更多
The African Rice Gall Midge, Orseolia oryzivora H. & G., is an important insect pest recorded in 20 countries in Sub-Sahara Africa. In Burkina Faso, the insect pest particularly prevails in Western and South-Weste...The African Rice Gall Midge, Orseolia oryzivora H. & G., is an important insect pest recorded in 20 countries in Sub-Sahara Africa. In Burkina Faso, the insect pest particularly prevails in Western and South-Western of the country where both biotic and abiotic conditions favor its development. The insect pest can damage up to 60% of rice tillers in Western Burkina Faso. A study was conducted during the 2011 wet season in the Kou Valley, located 25 km North-West of Bobo-Dioulas- so, Western Burkina Faso. Its objective was to evaluate the damage of this insect pest in farmers’ fields in relation with rice transplanting periods. The Kou Valley rice scheme, 1200 ha, was divided into two zones within which 48 farmers’ fields were randomly selected in relation with rice transplanting periods: P1: 1st period;P2: 2nd period and P3: 3rd period;that is 16 fields per period. Both agronomic and entomological evaluations were performed each week starting from the 21th day after transplanting (DAT) up to 84 DAT. Results showed that the highest average damage level (16% of galls) was recorded in the 3rd transplanting period. The highest larval and pupal parasitism was recorded in P3 at 84 DAT. Pupal parasitism due to Aprostocetus procerae Risbec was higher than larval parasitism due to Platygaster diplosisae Risbec. Lastly, the lowest yield (4.78 t/ha) was recorded in P3. These results can be used in the implementation of an integrated pest management strategy for this insect pest in the Kou Valley.展开更多
The xingkai Lake pine(Pinus lakahasii Nakai) gall rust caused by Cronartiumquereuum(Berk.)Miyabe:Shirai is a serious stem rust in the northeast region of China.The alternatehost is oak (Quercus mongolica Fisch).Germin...The xingkai Lake pine(Pinus lakahasii Nakai) gall rust caused by Cronartiumquereuum(Berk.)Miyabe:Shirai is a serious stem rust in the northeast region of China.The alternatehost is oak (Quercus mongolica Fisch).Germination of both acciospores and urediospores wasoptimal at 12℃ and occurred over a range of temperatures,from 4℃ to 32℃.Teliosperes germinatedoptimally at 16--18℃ and over a range of 8--28℃.All spores germinated best under natural light anddark conditions.Direct light inhibited germination eren when followed by darkness.The incubauonperiods of urediospores and teliospores in inoculation experiments were 6--16 days and 3--33daysrespectively. Anatomical studies of Cribartium quercuum galls showed that rust hyphae freely ramify throughthe intereellular spaces within parenchymatous lissues of the cortex,phloem,cambium,and xylemHyphac are perennial;largc haustoria are cylindrical with rounded or blunt ends. Among the 12 fungieides tested for control the rust,pine-tar,pine-tar;diesel oil(1:1。展开更多
Gall bladder cancer(GBC) has one of the poorest outcomes of all cancers. Early GBC is difficult to diagnose on even computed tomography. GB has no submucosa and the cancer infiltrates directly into the muscularis prop...Gall bladder cancer(GBC) has one of the poorest outcomes of all cancers. Early GBC is difficult to diagnose on even computed tomography. GB has no submucosa and the cancer infiltrates directly into the muscularis propria. GB wall is thin and important adjacent organs viz. liver, duodenum and pancreas get easily infiltrated. Tumor in the GB neck often needs extended right hepatectomy. Infiltration of duodenum/pancreas may necessitate pancreato-duodenectomy or evenhepato-pancreato-duodenectomy. Mortality of surgical procedures, when performed for GBC, is higher than when performed for other cancers. Survival in GBC, even after R0 resection, is poor. There is no proven role of neo-adjuvant or adjuvant therapy for loco-regionally advanced GBC. There is no role of palliative surgery in metastatic GBC. Early GBC is diagnosed incidentally after cholecystectomy for stones and requires reoperation for completion extended cholecystectomy but unfortunately, most surgeons are not aware of this. GBC has a peculiar epidemiology and is uncommon in the West and has, therefore, not received much attention. Preventive cholecystectomy for asymptomatic stones is not recommended and there is no serum marker for screening. With all factors pitched against it, it does appear that GBC is a bad cancer per se!展开更多
基金The study was approved by the institutional review board and the approval number is AMH-C-S-042/07-23.
文摘Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone disease.Despite its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this syndrome.The objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant gallbladders.Methods:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo Hospitals in South India.All patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were included.The following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative outcomes.Results:In total,36 patients were included and analysed.The majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 years.The most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open surgery.Cholecystoenteric fistula to the colon was observed in one patient.Choledocholithiasis was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients preoperatively.Conclusion:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and infection.Patients who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain risks.This study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder with cystic duct or bile duct stones.
文摘Gall bladder cancer(GBC)is becoming a very devastating form of hepatobiliary cancer in India.Every year new cases of GBC are quite high in India.Despite recent advanced multimodality treatment options,the survival of GBC patients is very low.If the disease is diagnosed at the advanced stage(with local nodal metastasis or distant metastasis)or surgical resection is inoperable,the prognosis of those patients is very poor.So,perspectives of targeted therapy are being taken.Targeted therapy includes hormone therapy,proteasome inhibitors,signal transduction and apoptosis inhibitors,angiogenesis inhibitors,and immunotherapeutic agents.One such signal transduction inhibitor is the specific short interfering RNA(siRNA)or short hairpin RNA(shRNA).For developing siRNAmediated therapy shRNA,although several preclinical studies to evaluate the efficacy of these key molecules have been performed using gall bladder cells,many more clinical trials are required.To date,many such genes have been identified.This review will discuss the recently identified genes associated with GBC and those that have implications in its treatment by siRNA or shRNA.
文摘BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI.
文摘Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.
基金Supported by Lilavati Hospital and Research Centre
文摘Gall bladder torsion(GBT) is a relatively uncommon entity and rarely diagnosed preoperatively. A constant factor in all occurrences of GBT is a freely mobile gall bladder due to congenital or acquired anomalies. GBT is commonly observed in elderly white females. We report a 77-year-old, Caucasian lady who was originally diagnosed as gall bladder perforation but was eventually found with a two staged torsion of the gall bladder with twisting of the Riedel's lobe(part of tongue like projection of liver segment 4A). This together, has not been reported in literature, to the best of our knowledge. We performed laparoscopic cholecystectomy and she had an uneventful postoperative period. GBT may create a diagnostic dilemma in the context of acute cholecystitis. Timely diagnosis and intervention is necessary, with extra care while operating as the anatomy is generally distorted. The fundus first approach can be useful due to altered anatomy in the region of Calot's triangle. Laparoscopic cholecystectomy has the benefit of early recovery.
文摘The study has explored 11 correlative variables which might affect the gallblad-der pressure GBP of patients with gall stone after auricular electrical stimulation by means of multiplestepwise regression. It was found that the size of gallbladder stone (X9), cholecystolithiasis (X4),sex (X1), and the baseline of GBP (X10) could affect the GBP change range (Y1) depressingly orreinforcingly. Also the baseline of GBP (Y1) could be affected by the variables X1 (sex), X2 (age),and X6 (long diameter of the gallbladder, LDGB), etc.. The result shows that the change in GBPafter auricular electrical stimulation is comprehensively influenced by multiple factors. And it providessome useful information for predicting the curative effect of auricular therapy on gallbladder stone inclinic.
文摘Only a few species of aphids induce galls. Among these, Paracletus cimiciformis, Forda marginata, Forda formicaria, Geoica utricularia and Baizongia pistaciae induce galls on Pistacia terebinthus leaflets. Prior to present study the author examined microscopically P. terebinthus leaflets. He also studied the microscopic morphology of galls induced by the five species mentioned above. A clear microscopic difference between these galls is that in the wall of galls induced by the genera Paracletus and Forda a single vascular bundle is seen. The interpretation is that these galls are laminae of the modified leaflets. However, in the walls of the galls induced by the genera Geoica and Baizongia, two vascular bundles are observed. In the present paper a study of the early stages of development of galls produced by G. utricularia is described. The study was designed to explain the origin of the two vascular bundles present in the walls of these galls. The findings indicate that the aphid induces a massive development of the two vascular bundles present in the midvein of the leaflets of P. terebinthus: the main vascular bundle and the small supernumerary vascular bundle. Both these extremely developed vascular bundles occupy the walls of the galls induced by G. utricularia.
基金Supported by Tamil Nadu Science and Technology of Tamilnadu State Council for Science and Technology(Grant No.TNSCST/S&T Projects/VR/MS/201213/203)
文摘Objective:To study the detailed pharmacognostic profile of galls of Quercus infectoria Olivier(Q.infectoria olivier)(Fagaceae),an important medicinal plant used in the Indian system of medicine.Methods:Samples of galls of Q.infectoria were studied by macroscopical,microscopical,physiochemical,phytochemical.fluorescence analysis and othjer methods for standardization as recommended by WHO.Results:Macroscopically,the crude drug is globose with horny appearances on external surface(1.4-2.3 cm in length and 1-1.5 cm in diameter),with greyish-brown to brownish-black in colour externally and dark brown buff colored.Surface is smooth with numerous horny protuberances giving rough touch,and witfi unpleasant odour.Microscopically,a wide zone of radially elongated parenchyma cells between upper and lower epidermis were found.The vascular strands were present at all places and radially elongated sclerides touched the lower epidermis.In physico-chemical studies,the moisture,total ash,acid insoluble ash,alcohol soluble,water soluble,petroleum ether,chloroform extractive value and tannin content were found to be 2.790,5.020,0.110,38.780,41.210,0.402,1.590 and 49.200 percentage respectively.Prcliminary phytochemical screening showed the presence of phenols,flavonoids,steroids,triterpenes,tannins,saponins and alkaloids.Cooclusions:The results of the present study serve as a valuable source of information and provide suitable standards for identification of this medicinally important plant drug material for future investigations and applications.
基金Holeta Agricultural Research CenterAdet Agricultural Research Center for generously providing seeds of improved faba bean varieties and Debre Tabor University for financial support of the research project
文摘Faba bean(Vicia faba L.) has an important place in the Ethiopian national diet. It is consumed in various forms and contributes to the improvement of soil fertility. However,its production and productivity are affected by biotic and abiotic constraints. Among the biotic constraints, the emerging faba bean gall disease, caused by Olpidium uiciae, is the major and most destructive disease wherever faba bean is grown. Field experiments were conducted at two locations(Farta and Tach Gayint districts) to evaluate the reaction of faba bean varieties to faba bean gall disease and to assess them for yield and yield components during the 2014 and 2015 main cropping seasons. Thirteen faba bean varieties and one local check were plantecd in three replications Lusing a randomized complete block design. The disease incidence and severity of faba bean gall were recorded(on a 1-9 scale) five tinmes at10-day intervals. A combined analysis of variance showed za significant difference(P < 0.05)among faba bean varieties with respect to the incidence and severity of gall disease at both locations. Disease incidence, severity, and AUDPC were lowest for variety Turmsa at both locatiOons, but this variety showed lhigh yield only at tlhe Farta location. 'The lhighest yields were obtained from varieties Degaga(1157.74 kg ha ') and Nc58(828.97 kg ha ') at Farta and Tach Gayint, respectively and these varieties slhowed low faba bean gall severity and AUDPC. Thus, higher-yielding faba bean varieties such as Degaga and Nc58 are recommended for faba bean production areas in northwestern Ethiopia.
文摘Candida endocarditis is extremely rare in term neonates,and gall bladder involvement due to candidemia has never been reported amongst neonates and infants.A term,appropriate for gestational age neonate developed Candida tropicalis blood stream infection in second week of life.He was started on conventional amphotericin B.However,he failed to show any clinical improvement,and candidemia keep on persisting.Repeat sanctuary sites screening revealed multiple echogenic masses in heart(vegetations) and gall bladder.On changing the treatment to liposomal amphotericin B and fluconazole,he recovered clinically,echogenic masses in gall bladder disappeared,and intracardiac vegetations decreased in size.
文摘BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance so that it is difficult to differentiate between primary ICA and liver metastasis of GBC,which sometimes becomes a point of discussion in clinical practice.Although these cancers demonstrate significant differences in their mutational landscape,several reports demonstrated shared genomic alteration in paired primary and metastatic site aids in distinguishing metastatic recurrence from second primary cancers.CASE SUMMARY We present a 73-year-old female patient who underwent curative resection for GBC harboring epidermal growth factor receptor 2(ERBB2)activating mutation on next-generation sequencing(NGS)-based genomic testing.One year later,a hepatic lesion was observed on follow-up imaging and she underwent surgical resection for a pathological diagnosis.The histological findings of the hepatic lesion were similar to those of the primary lesion.Additionally,using NGS panel testing,the hepatic lesion was found to have ERBB2 activating mutation,which is the identical mutation detected in the sequencing result of the primary site.ERBB2 activating mutation occurs more frequently in GBC than ICA and ECA.Therefore,in the present case,we think this molecular finding potentiated the diagnosis of the liver mass toward a metastatic recurrence.Additionally,this patient underwent HER2-targeted treatment with lapatinib in combination with capecitabin and obtained clinical benefit.CONCLUSION This case illustrated NGS panel usefulness in distinguishing GBC recurrence from second primary cancer and HER2-targeted agent efficacy on ERBB2 mutated GBC.
基金This work was supported by the National Key Research and Development Program of China(2017YFD0600104)the Priority Academic Program Development of the Jiangsu Higher Education Institutions(PAPD)。
文摘Crown gall of Prunus subhirtella Miq., flowering cherry, is a soil-borne bacterial disease caused by Agrobacterium tumefaciens Smith & Townsend and has caused serious damage to the species in recent years in China. In this study, the colonization of sapling roots, the biocontrol efficacy, the expression of defense-related genes and the enzyme activity in roots of P. subhirtella inoculated with the Bacillus velezensis JK-XZ8 against A. tumefaciens were determined under greenhouse conditions. The results showed that the JK-XZ8 strain colonized in the rhizosphere and root surfaces of the saplings. Sole application of the strain increased activities of polyphenol oxidase (PPO) and phenylalanine ammonia lyase (PAL) without affecting superoxide dismutase (SOD). SOD and PPO activities increased in the prevention group, and the activity of PAL increased in both the prevention and cure groups. The expression of the defense-related genes PAL and PR-1 of salicylic acid pathway in roots increased in both the prevention and cure groups. Simultaneously on day 3, the expression of both COI and MYC2 genes of the jasmonic acid pathway significantly increased in the two groups. The incidence of crown gall in the prevention and the cure groups were 48.1% and 66.7%, respectively, significantly lower compared to the pathogens alone (87.5%). This study showed that the application of the JK-XZ8 strain reduced the incidence of crown gall in P. subhirtella saplings in the two groups, and the prevention group had better control efficacy. In addition, the JK-XZ8 strain protects against crown gall by developing induced systemic resistance and systemic acquired resistance in the roots of the cherry saplings.
文摘Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to evaluate this effect of extract of Oak Gall for vaginal tightening and rejuvenation in women with vaginal relaxation. Methods: This double blind clinical trial was performed on women with vaginal relaxation at Asali Hospital in Khorramabad from May to October 2012 and was candidate for colporrhaphy due to different types of pelvic organ prolapse. Sampling method was done on nonprobability basis according to the number of patients referred to clinic. Using blocked random allocation method, the participants were divided into 4 groups of 30 patients (three intervention group and one control group) who were age-matched. Then, an extract of Oak Gall in specified concentrations (10 - 15 and 20 grams in 1.5%, 2% and 2.5% jells) were administered to each intervention group. Finally, the obtained data were analyzed with Chi-square, Pearson, Fisher’s exact test and ANOVA using SPSS software version 19. Results: A total of 120 patients entered into the study with mean age of 36 ± 5.4 years. The evaluation of mean scores showed that sense of sexual satisfaction and orgasm, sense of vaginal tightness during intercourse, sense of vaginal lubrication and loss of vaginal dryness was significantly improved in patients in intervention group. Also other parameters including urinary incontinence, sense of vaginal mass exit, lack of orgasm, sense of air outflow during intercourse, sense of calmness after sex and loss of libido were significantly reduced in the group of patients who received jell 2.5% compared to other groups (P Conclusion: Our findings show that using topical jell of Oak Gall not only is associated with contracting effects, but also improves vaginal lubrication and reduces its dryness. Regarding the lack of previous studies in this field and considering some limitations of this study, we suggest that Oak Gall to be used for management of women with vaginal relaxation.
文摘The African Rice Gall Midge, Orseolia oryzivora H. & G., is an important insect pest recorded in 20 countries in Sub-Sahara Africa. In Burkina Faso, the insect pest particularly prevails in Western and South-Western of the country where both biotic and abiotic conditions favor its development. The insect pest can damage up to 60% of rice tillers in Western Burkina Faso. A study was conducted during the 2011 wet season in the Kou Valley, located 25 km North-West of Bobo-Dioulas- so, Western Burkina Faso. Its objective was to evaluate the damage of this insect pest in farmers’ fields in relation with rice transplanting periods. The Kou Valley rice scheme, 1200 ha, was divided into two zones within which 48 farmers’ fields were randomly selected in relation with rice transplanting periods: P1: 1st period;P2: 2nd period and P3: 3rd period;that is 16 fields per period. Both agronomic and entomological evaluations were performed each week starting from the 21th day after transplanting (DAT) up to 84 DAT. Results showed that the highest average damage level (16% of galls) was recorded in the 3rd transplanting period. The highest larval and pupal parasitism was recorded in P3 at 84 DAT. Pupal parasitism due to Aprostocetus procerae Risbec was higher than larval parasitism due to Platygaster diplosisae Risbec. Lastly, the lowest yield (4.78 t/ha) was recorded in P3. These results can be used in the implementation of an integrated pest management strategy for this insect pest in the Kou Valley.
文摘The xingkai Lake pine(Pinus lakahasii Nakai) gall rust caused by Cronartiumquereuum(Berk.)Miyabe:Shirai is a serious stem rust in the northeast region of China.The alternatehost is oak (Quercus mongolica Fisch).Germination of both acciospores and urediospores wasoptimal at 12℃ and occurred over a range of temperatures,from 4℃ to 32℃.Teliosperes germinatedoptimally at 16--18℃ and over a range of 8--28℃.All spores germinated best under natural light anddark conditions.Direct light inhibited germination eren when followed by darkness.The incubauonperiods of urediospores and teliospores in inoculation experiments were 6--16 days and 3--33daysrespectively. Anatomical studies of Cribartium quercuum galls showed that rust hyphae freely ramify throughthe intereellular spaces within parenchymatous lissues of the cortex,phloem,cambium,and xylemHyphac are perennial;largc haustoria are cylindrical with rounded or blunt ends. Among the 12 fungieides tested for control the rust,pine-tar,pine-tar;diesel oil(1:1。
文摘Gall bladder cancer(GBC) has one of the poorest outcomes of all cancers. Early GBC is difficult to diagnose on even computed tomography. GB has no submucosa and the cancer infiltrates directly into the muscularis propria. GB wall is thin and important adjacent organs viz. liver, duodenum and pancreas get easily infiltrated. Tumor in the GB neck often needs extended right hepatectomy. Infiltration of duodenum/pancreas may necessitate pancreato-duodenectomy or evenhepato-pancreato-duodenectomy. Mortality of surgical procedures, when performed for GBC, is higher than when performed for other cancers. Survival in GBC, even after R0 resection, is poor. There is no proven role of neo-adjuvant or adjuvant therapy for loco-regionally advanced GBC. There is no role of palliative surgery in metastatic GBC. Early GBC is diagnosed incidentally after cholecystectomy for stones and requires reoperation for completion extended cholecystectomy but unfortunately, most surgeons are not aware of this. GBC has a peculiar epidemiology and is uncommon in the West and has, therefore, not received much attention. Preventive cholecystectomy for asymptomatic stones is not recommended and there is no serum marker for screening. With all factors pitched against it, it does appear that GBC is a bad cancer per se!
