Exposure to plant toxins or microbiota that are able to digest common food ingredients to toxic structures might be responsible for biliary atresia (BA). An isoflavonoid, biliatresone is known to ...effectively alter the extrahepatic bile duct (EHBD) development in BALB/c mice. Biliatresone causes a reduction of Glutathione (GSH) levels, SOX17 downregulation and is effectively countered with N-Acetyl-L-cysteine treatment in vitro. Therefore, reversing GSH-loss appears to be a promising treatment target for a translational approach. Since BALB/c mice have been described as sensitive in various models, we evaluated the toxic effect of biliatresone in robust C57BL/6J mice and confirmed its toxicity. Comparison between BALB/c and C57BL/6J mice revealed similarity in the toxic model. Affected neonates exhibited clinical symptoms of BA, such as jaundice, ascites, clay-colored stools, yellow urine and impaired weight gain. The gallbladders of jaundiced neonates were hydropic and EHBD were twisted and enlarged. Serum and histological analysis proved cholestasis. No anomalies were seen in the liver and EHBD of control animals. With our study we join a chain of evidence confirming that biliatresone is an effective agent for cross-lineage targeted alteration of the EHBD system.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This volume collects the materials underlying the International Colloquium "Conciliation in the Globalized World of Today", held on 11 and 12 June 2015 in Vienna under the auspices of the Court of ...Conciliation and Arbitration within the OSCE. The aim of the Colloquium was to examine the merits and possible shortcomings of this method of conflict resolution, and it concluded that the pros heavily outweigh the cons.
The pathophysiology of Hirschsprung's disease (HSCR) is not fully understood. A significant proportion of patients have persisting bowel symptoms such as constipation, soiling, and enterocolitis ...despite correctly performed operations. Animal data suggest that stretch-activated 2-pore domain K
channels play a critical role in the maintenance of intestinal barrier integrity.
We investigated TREK-1 protein expression in ganglionic and aganglionic regions of HSCR patients (n = 10) vs. normal control colon (n = 10). Protein distribution was assessed by using immunofluorescence and confocal microscopy. Gene and protein expression were quantified using quantitative real-time polymerase chain reaction, western blot analysis, and densitometry.
Confocal microscopy of the normal colon revealed strong TREK-1 channel expression in the epithelium. TREK-1-positive cells were decreased in aganglionic and ganglionic bowel compared to controls. TREK-1 gene expression levels were significantly decreased in aganglionic and ganglionic bowel compared to controls (P < 0.05). Western blotting revealed decreased TREK-1 protein expression in aganglionic and ganglionic bowel compared to controls.
We demonstrate, for the first time, the expression and distribution of TREK-1 channels in the human colon. The decreased TREK-1 expression in the aganglionic and ganglionic bowel observed in HSCR may alter intestinal epithelial barrier function leading to the development of enterocolitis.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The aim of this paper is to assess the effectiveness and perioperative complications of splenic surgeries in children. In 41 splenectomies, an anterior abdominal laparoscopic approach was used, with ...35 including a partial laparoscopic splenectomy. Of these, three needed a conversion to open. Six patients had a total splenectomy, three of which were open. Patients ranged in age from 5 to 18 years. Splenectomy was performed for a variety of causes, including hereditary spherocytosis (
= 20), splenic cysts (
= 13), sickle cell disease (
= 3), primary malignancy (
= 1), sepsis (
= 1), embolism (
= 1), anemia (
= 1), and hypersplenism (
= 1). The average length of stay was 7.6 days, and the average operation time was 169.3 min. Pleural effusion in the left hemithorax was found in 31.6% of the patients, with 5.3% requiring a thorax drain. The majority of patients had the highest platelet count two weeks after surgery. There was no evidence of wound infection, pancreatic leak, colon perforation, or postoperative sepsis. The most encountered perioperative complication was bleeding with the need of transfusion (
= 6), and one patient needed a diaphragm repair. A partial splenectomy (PS) can be a difficult procedure with a steep learning curve. For most children who require a splenic operation, this should be the primary procedure of choice.
Conciliation has recently seen a successful revival. It provides States with a flexible remedy to peacefully settle their disputes with neighbouring States. The most prominent mechanism for that ...purpose is the OSCE Court of Conciliation and Arbitration, unused until today.
The transition zone (TZ) is defined by specific histological findings in patients with Hirschsprung Disease (HSCR). HSCR treatment includes surgical removal of the aganglionic zone (AZ). During the ...pull-through procedure, it is critical to resect the TZ. Given the TZ's wide histological heterogeneity, we wanted to know how extensive the histological transition zone is.
A retrospective study of patients who had pull-through surgery for rectosigmoid HSCR between January 2010 and December 2020 was carried out. Demographics, length of TZ and AZ, age and symptoms upon presentation, and complications after surgery were also obtained.
The inclusion criteria were met by 50 patients. The mean age of all patients was 10 months (0.1-107.5 months), with a mean age at pull-through of 16.3 months (3-112 months). Thirty-one out of fifty patients (62%) received primary laparoscopic endorectal pull-through surgery (LEPT). The average TZ length of all patients was 2.6 cm (0-10 cm), and the AZ length was 9.6 cm (1-30 cm). The length of the AZ and TZ were shown to have no correlation (r² = 0.237).
The current study found that the mean length of the TZ in individuals with rectosigmoid HSCR is less than 5 cm in most cases and has no correlation with the length of the AZ.
A Type IA choledochal cyst is a cystic or fusiform dilatation of the common bile duct affecting the extrahepatic biliary tree. Here, we present a case report of a 3-year-old girl with a prenatal ...asymptomatic choledochal cyst that in size, leading to intermittent clay-colored stools and aggravated jaundice. Magnetic resonance cholangiopancreatography revealed a large choledochal cyst of 184 cm3 obstructing the extrahepatic biliary tree and pancreatic duct. Clinical chemistry screening revealed asymptomatic hyponatremia of 124 mmol/l, analysed by an indirect ion selective electron (ISE)-based method. Furthermore, the patient had extreme hypercholesterolemia (1975 mg/dl), and an elevated lipoprotein X level (11.9 g/dl). Serum sodium was confirmed by using two additional independent methods: (i) centrifugal ultrafilter with indirect ISE and (ii) blood gas analyze, In contrast to indirect ISE, both methods indicated normal sodium levels, consistent with pseudohyponatremia. Following Roux-en-Y-Hepatojejunostomy, sequential serum sodium levels measured by indirect ISE gradually normalized, but remained within the normal range by direct ISE method. This case shows that biliary obstruction can lead to falsely elevated cholesterol and lipoprotein X analyses and that alternative methods are needed to avoid unnecessary treatments .
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Patients suffering from complete colonic aganglionosis (TCA) require the best surgical care possible. Only a few studies reported J-Pouch repair as the primary reconstructive surgery in TCA patients. ...This study adds to the current literature a thorough clinical and functional outcomes group.
Between 2011 and 2021, medical records of Hirschsprung disease (HD) patients who underwent J-Pouch reconstruction during infancy (n = 12) were reviewed. In close follow-up, bowel function and satisfaction with operation results were evaluated. The median age at the time of J-Pouch reconstruction was 16 months, and covering ileostomies were closed four months later. There were no postoperative problems. After the final repair, Pouch-related problems (PRP) occurred in 27% of the children and were treated conservatively. There was no histological evidence of pouchitis in any of the individuals. The median 24-h stooling frequency was 4-5 at the latest follow-up 51 months following enterostomy closure.
The current study's findings support the existing literature and advocate for J-pouch repair in TCA patients. However, more research will be needed to determine the best time to undergo pouch surgery and ileostomy closure in TCA patients.
From a conceptual viewpoint, the legal universe has found its almost perfect configuration in our time. Almost all of the peoples of the world are members of the United Nations and as such are ...entitled to co-operate in shaping the direction and content of policies at the global level. Before World War II, and even a considerable time after the horrendous events unleashed by that war, many nations had no say in international matters. They were placed under colonial rule, which meant that their voices were not heard—or heard only through the mediation of the powers that acted as their wards and guardians. That situation of structural discrimination has changed dramatically. All the peoples of the world have reached sovereign statehood and have been admitted to the world forum.
PDF
