Parkpoe1693

The next day, reoperation was performed. Intraoperative cholangiography with contrast dye revealed the perforation site in the left triangular ligament and a partial resection was performed. Bile excretion from the C-tube was subsequently observed, but the patient's jaundice did not improve. Although endoscopic retrograde cholangiopancreatography revealed that the EST site was normal, ERBD was placed again, and the jaundice gradually improved. Although EST was performed in this case, biliary peritonitis resulting from spontaneous bile duct rupture occurred. This case was very informative because biliary perforation may occur even after EST.A 35-year-old Japanese man with no significant medical history presented to the emergency department complaining of abdominal pain, nausea, and vomiting 35 h after ingesting raw horse mackerel, sardines, and tuna. Computed tomography of the abdomen with intravenous contrast revealed significant thickening of the terminal ileum with mild proximal dilatation and moderate ascites. On colonoscopy, an actively moving anisakis larva was discovered in the terminal ileum. The larva was removed with endoscopic forceps. The patient's symptoms resolved quickly following the procedure.Metastasis to the colon from another primary internal malignancy is an untypical and a seldom reported entity. Direct visualization during colonoscopy is considered the gold standard of diagnosis. Pathologic diagnosis with immunohistochemical staining is essential to differentiate primary colorectal malignancy from secondary metastasis to the colon. We, hereby, present a case of a 53-year-old female status-post resection of left-sided papillary serous ovarian neoplasm who presented 2 years later with a single rectosigmoid intraluminal ulcerative mass imitating a primary colon cancer. Biopsies of the mass were consistent with metastasis from her primary ovarian carcinoma. We believe this case is unique because of the rarity of ovarian cancer metastasizing to the colon intraluminally rather than through direct locoregional invasion. Furthermore, it highlights the importance of considering secondary metastasis in patients with previous history of another primary internal malignancy.An 81-year-old man was brought to our hospital due to a suspicion of left incarcerated femoral hernia. He was previously diagnosed with incarcerated left groin hernia and was treated using the mesh plug method 1 month back at another hospital. Abdominal computed tomography scan revealed small bowel obstruction, incarcerated bowel, and compression of the left femoral vein. Thus, the patient was diagnosed with incarcerated femoral hernia. An emergency laparoscopic surgery was then performed, and we found that the small bowel was incarcerated into the let femoral ring and was necrotic. However, there was no recurrence of left inguinal hernia. The small necrotic bowel was resected and the femoral ring was repaired. The patient was discharged 8 days after the surgery, and there was no recurrence of femoral hernia after 1 year.Gastric varices (GV) carry a high risk of massive hemorrhage because of potential rupture. To reduce the risk associated with GV, patients need to undergo hemostatic and preventive treatment. The objective of this retrospective study was to evaluate the usefulness of a new method, direct forward-viewing endoscopic ultrasonography (DFV-EUS) for the treatment of GV. We performed endoscopic injection sclerotherapy with histoacryl (EIS-HA) using DFV-EUS for GV in four patients. The paracentesis success rate was 75% (3/4). DFV-EUS has a significant advantage for the treatment of GV in that it can show physicians endoscopic and ultrasound views in real time during the delivery of the sclerosant into the GV. However, the proper use of the ultrasound view must be elucidated through further research for safer and more effective therapy. In the presence of distance between the mucosal surface and vascular lumen or when the blood flow site requires puncture as an additional treatment, DFV-EUS might be a good candidate for the treatment of GV. Altogether, EIS-HA with DFV-EUS might be a new therapeutic option for patients with GV.Crowned dens syndrome (CDS) is a rare form of pseudogout which causes acute neck pain due to calcium pyrophosphate dehydrate deposition surrounding the odontoid process, commonly causing neck pain with rigidity. While invasive procedures such as surgery are known to present a risk of acute pseudogout, reports of occurrence after endoscopic procedures are scarce. We report the case of a 75-year-old man who presented with sudden neck pain after endoscopic submucosal dissection (ESD) for gastric cancer. He could nod but could not rotate his head. Computed tomography showed calcifications surrounding the odontoid process consistent with CDS. read more Prolonged dietary restrictions and proton pump inhibitor use following the ESD procedure may have caused hypomagnesemia, a precipitating factor for CDS. We prescribed colchicine 1 mg/day and symptoms resolved completely in 3 days. This is the first report of CDS after ESD. CDS should be included in the differential diagnosis of neck pain after endoscopic procedures.Drug-induced liver injury is an uncommon but life-threatening entity. Sunitinib is a tyrosine kinase inhibitor used for advanced and imatinib-refractory gastrointestinal stromal tumors. It causes transient elevation in liver enzymes. The incidence of fatal acute liver failure is rare. Five cases of sunitinib-induced acute liver injury have been reported in the literature thus far. We present a case of fatal acute liver failure and cardiomyopathy within 2 weeks of sunitinib therapy initiation for advanced pancreatic neuroendocrine carcinoma. We believe our case is unique due to the rarity of its presentation. It highlights hepatotoxicity as a potentially fatal side effect of sunitinib therapy.Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent flares of nausea and vomiting, often with significant abdominal pain, of several days duration. Although traditional prophylactic and abortive treatments for CVS are often successful, a subset of CVS patients with chronic abdominal pain may not respond as well to standard therapies. This report is the first, to our knowledge, to describe the use of outpatient ketamine infusions as therapy for refractory CVS. We describe a 63-year-old woman with history of CVS who presented with abdominal pain and recurrent episodes of nausea and vomiting. She first received ketamine during an inpatient admission for a CVS flare, with the aim of treating the abdominal pain. Given her improvement, she was offered a series of outpatient ketamine infusions, which led to a significant reduction in her symptoms. Thus, ketamine may be useful as both an abortive and prophylactic therapy in CVS. Prior reports have noted the anti-emetic effects of ketamine in the perioperative setting, and there is emerging evidence for the use of ketamine infusions for the treatment of chronic pain. However, this report is the first to describe ketamine as a potential prophylactic treatment for CVS.Hepatic angiomyolipomas (AML) are rare mesenchymal tumours of which the epithelioid type is a rare type with malignant potential. We report a case of primary hepatic epithelioid angiomyolipoma masquerading as liver abscess. A 46-year-old man presented with a 5-day history of fever with epigastric pain and nausea. On the night of admission, his temperature spiked to 39°C, his blood pressure was 135/79, his heart rate 98, his liver function test revealed albumin 37 g/L, bilirubin 25 μmol/L, ALP 298 U/L, ALT 247 U/L, and AST 344 U/L. The clinical suspicion was hepatobiliary sepsis and intravenous ceftriaxone was commenced. CT of the abdomen showed an ill-defined hypodense focus in segment 4A/8 (4.5 × 3.5 cm) with a minimal fluid component implying a developing abscess or phlegmon. The images were reviewed by a radiologist and showed minimal fluid for percutaneous drainage. MRI of the liver was performed to further characterize the lesion and revealed a solid mass with nodular areas of arterial enhancement and washout, suspicious of neoplasm. Ultrasound-guided liver biopsy of the lesion was performed. Histology showed a histiocyte-rich epithelioid neoplasm consistent with the epithelioid variant of AML. Immunohistochemical staining was positive for human melanoma black 45, melan-A and cluster of differentiation 68. He successfully underwent liver resection of segment 4A/8 after 6 weeks of antibiotics. To our knowledge, this is the first reported case in the literature of primary hepatic epithelioid angiomyolipoma masquerading as liver abscess.

Saturated fatty acids (SFAs) generally have been thought to worsen insulin-resistance and increase the risk of developing type 2 diabetes mellitus (T2DM). Recently, accumulating evidence has revealed that SFAs are not a single homogeneous group, instead different SFAs are associated with T2DM in opposing directions. Pentadecanoic acid (C150, PA) is directly correlated with dairy products, and a negative association between circulating PA and metabolic disease risk was observed in epidemiological studies. Therefore, the role of PA in human health needs to be reinforced. Whether PA has a direct benefit on glucose metabolism and insulin sensitivity needs further investigation.

The present study aimed to investigate the effect and potential mechanism of action of PA on basal and insulin stimulated glucose uptake in C2C12 myotubes.

Glucose uptake was determined using a 2-(N-[7-nitrobenz-2-oxa-1,3-diazol-4-yl] amino)-2-deoxyglucose (2-NBDG) uptake assay. Cell membrane proteins were isolated and glucose transpake via the AMPK-AS160 pathway and exhibits an insulin-sensitizing effect in myotubes.

PA, an odd-chain SFA, significantly stimulates glucose uptake via the AMPK-AS160 pathway and exhibits an insulin-sensitizing effect in myotubes.

Tartary buckwheat has beneficial effects on glucose and lipid metabolism of patients with type 2 diabetes mellitus. However, the physiological effects of a soluble dietary fiber (SDF) from tartary buckwheat have rarely been studied, especially

.

This study aimed to examine the hypoglycemic and hypolipidemic effects of SDF from tartary buckwheat bran on high-fat diet/streptozotocin-induced diabetic mice.

The SDF of tartary buckwheat bran was collected according to the Association of Official Analytical Chemists method 991.43. Diabetic mice were treated with high-fat diets supplemented with 0.5, 1, and 2% SDF for 8 weeks. Parameters related to glucose and lipid metabolism and relevant mechanisms, including the excretion of short-chain fatty acids and the glycemic signaling pathway in the liver, were investigated. In addition, the structural characterization of a purified polysaccharide from SDF of tartary buckwheat bran was illustrated.

Supplementation with SDF in the diet resulted in reduced levels of fasting blood glucose, improved oral glucose tolerance, increased levels of liver glycogen and insulin, as well as improved lipid profiles in both the serum and liver, in diabetic mice. The amelioration of glucose and lipid metabolism by SDF was accompanied by an increase in the short-chain fatty acid levels in the cecum and co-regulated by hepatic adenosine-5'-monophosphate-activated protein kinase (AMPK) phosphorylation. A neutral tartary buckwheat polysaccharide with an average molecular weight of 19.6 kDa was purified from the SDF, which consisted mainly of glucose with α-glycosidic bonds.

The SDF of tartary buckwheat bran exhibits hypoglycemic and hypolipidemic effects in diabetic mice, contributing to the anti-diabetic mechanisms of tartary buckwheat.

The SDF of tartary buckwheat bran exhibits hypoglycemic and hypolipidemic effects in diabetic mice, contributing to the anti-diabetic mechanisms of tartary buckwheat.