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Ureteral stents have been widely used as biomedical devices to treat some urological diseases for several decades. However, the encrustation complications hamper the long-time clinical use of the ureteral stents. In this work, a new type of biodegradable material for the ureteral stents, methoxypoly(ethylene glycol)-block-poly(L-lactide-ran-Ɛ-caprolactone) (mPEG-PLACL), is evaluated to overcome this problem. The results show that the hydrophilicity and degradation rate in artificial urine of mPEG-PLACL are both significantly increased. It is worth noting that the mPEG-PLACL shows a lower amount of encrustation after immersing the stents in the dynamic urinary extracorporeal circulation (DUEC) model for 7 days. In addition, 71% Ca and 92% Mg are inhibited in vivo by quantitative analysis. Pathological analysis exhibit that the mPEG-PLACL cause less diffuse mucosal hyperplasia after 7 weeks of implantation. All the results indicate that this new type of biodegradable material had an excellent potential for the ureteral stents in the future.

Background: Management of refractory esophageal strictures in children is challenging and mostly involves frequent and prolonged dilatations that are associated with significant physical and psychological complications. Biodegradable stents (BDS) have recently been used and it is particularly attractive in children as stent removal is avoided due to their dissolution. Report of Cases: We report our experience with BDS use in 3 children with severe refractory esophageal strictures. Two of the patients had strictures as a result of caustic ingestion and 1 after long-gap esophageal atresia repair. Median number of dilatations prestent is 5 per year. Custom-made uncovered BDS were inserted under general anesthesia. Median follow-up period was 23 months. Results: Minor postprocedure complications occurred in 1 patient. Stent insertion led to temporary improvement in swallowing in all cases. However, all of the patients developed recurrent symptoms as severe as before stenting and need for dilatations remained unchanged. They also experienced mucosal hyperplasia that contributed to their recurrent symptoms. Conclusion: All of the cases in our series did not have a favorable outcome with BDS use. BDS is yet to be proven as an effective management option for refractory esophageal strictures in children from our experience as well as most other published reports.

DETERMINATION OF THE STRUCTURE OF THE WALLS OF THE FRONTAL SINUS ACCORDING TO SPIRAL COMPUTED TOMOGRAPHY Alekseeva V., Gargin V. The anatomical structure of the frontal sinus is of key importance for the development of its inflammation and the development of complications with spread to neighboring organs and tissues (orbital phlegmon, brain abscesses, meningitis). The aim of our study was to compare the density and thickness of the bone tissue of the unchanged frontal sinus and in various forms of chronic inflammation. Materials and methods. We observed 121 patients with various forms of chronic frontal sinusitis: 56 with chronic hyperplastic (mucosal hyperplasia (up to 6 mm) and 33 patients with chronic purulent-polypous frontal sinusitis, manifested by a total and subtotal decrease in sinus pneumatization according to spiral computed tomography (SCT). 32 SCT samples were selected to form a comparison group without any abnormalities of the paranasal sinuses. Results. The maximum density typical for the lower wall of the frontal sinus under physiological conditions and was found to be 107.96 ± 201.64Hu, the minimum for the posterior wall in purulent-polypous frontal sinusitis was -103.74 ± 195.37Hu. The bone thickness both in the posterior region and in the region practically does not depend on the degree of the severity of pathological changes in it and is 1.0006 ± 0.538 mm, 0.91 ± 0.26 mm, 0.82 ± 0.169 mm under physiological conditions , with mucosal hyperplasia and with purulent-polypous frontal sinusitis in the posterior wall, respectively. In the region of the lower wall, 4.05 ± 2.04 mm, 2.32 ± 1.16 mm, and 4.002 ± 1.16 mm, respectively, according to the above order. Conclusion. It can be assumed that the larger the change in PNSs, the lower the bone density. This in turn affects the prediction of possible complications during surgical treatment of chronic frontal sinusitis. Key words: frontal sinus, computed tomography, bone thickness, bone density Резюме. ВИЗНАЧЕННЯ МОРФОЛОГІЧНОЇ СТРУКТУРИ СТІНОК ЛОБНОЇ ПАЗУХИ ЗА ДОПОМОГОЮ СПІРАЛЬНОЇ КОМП'ЮТЕРНОЇ ТОМОГРАФІЇ Алєксєєва B.B., Гаргін B.B. Анатомічна будова лобної пазухи має ключове значення для виникнення запальних процесів та розвитку ускладнень із поширенням на сусідні органи та тканини (формування флегмони орбіти, абсцесів мозку, менінгіту). Метою нашого дослідження було порівняння щільності та товщини кісткової тканини лобної пазухи в фізіологічних умовах та при різних формах хронічного запального процесу. Матеріали та методи. Під спостереженням було 89 пацієнтів з різними формами хронічного фронтального синуситу: 56 - з хронічним гіперпластичним фронтальним синуситом (гіперплазією слизової оболонки до 6 мм) та 33 пацієнти з хронічним гнійно-поліпозним фронтальним синуситом, що при проведенні спіральної комп’ютерної томографії (СКТ) проявлявся тотальним і субтотальним зниженням пневматизації. Контрольна група - 32 СКТ людей з фізіологічним станом навколоносових пазух. Результати. Максимальна щільність кісткової тканини була визначена в області нижньої стінки лобної пазухи та становила - 107.96 ± 201.64 Hu, мінімальна - в області задньої стінки при гнійно-поліпозному лобному синуситі - -103.74 ± 195.37 Hu. Товщина кісток практично не залежала від ступеня виразності патологічних змін у ній і становить в області задньої стінки - 1.0006 ± 0.538 мм, 0.91 ± 0.26 мм, 0.82 ± 0.169 мм у фізіологічних умовах, при гіперплазії слизової оболонки і при гнійно-поліпозному фронтальному синуситі. В області нижньої стінки 4.05 ± 2.04 мм, 2.32 ± 1,16 мм та 4.002 ± 1.16 мм відповідно. Висновки. Можна припустити, що щільність кісткової тканини залежить від ступеня виразності патологічних змін в лобній пазусі. Це в свою чергу впливає на прогнозування розвитку ускладнень. Ключові слова: лобна пазуха, спіральна комп'ютерна томографія, товщина кісток, щільність кісток. Резюме. ОПРЕДЕЛЕНИЕ МОРФОЛОГИЧЕСКОЙ СТРУКТУРЫ СТЕНОК ЛОБНОЙ ПАЗУХИ С ПОМОЩЬЮ СПИРАЛЬНОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ Алексеева B.B., Гаргин B.B. Анатомическое строение лобной пазухи имеет ключевое значение для возникновения воспалительных процессов и развития осложнений с распространением на соседние органы и ткани (формирование флегмоны орбиты, абсцессов мозга, менингита). Целью нашего исследования было сравнение плотности и толщины костной ткани лобной пазухи в физиологических условиях и при различных формах хронического воспалительного процесса.Материалы и методы. Под наблюдением находилось 89 пациентов с различными формами хронического фронтального синусита: 56 - с хроническим гиперпластическим фронтальным синуситом (гиперплазией слизистой оболочки до 6 мм) и 33 пациента с хроническим гнойно-полипозным фронтальным синуситом, что при проведении спиральной компьютерной томографии (СКТ) проявлялся тотальным и субтотальным снижением пневматизации. Контрольная группа - 32 СКТ людей с физиологическим состоянием околоносовых пазух.Результаты. Максимальная плотность костной ткани была определена в области нижней стенки лобной пазухи в физиологических условиях и составила - 107.96 ± 201.64 Hu, минимальная - в области задней стенки при гнойно-полипозном лобном синусите - -103.74 ± 195.37 Hu. Толщина костей практически не зависила от степени выраженности патологических изменений в ней и составляла в области задней стенки - 1.0006 ± 0.538 мм, 0.91 ± 0.26 мм, 0.82 ± 0.169 мм в физиологических условиях, при гиперплазии слизистой оболочки и при гнойно-полипозном фронтальном синусите. В области нижней стенки 4.05 ± 2.04 мм, 2.32 ± 1.16 мм и 4.002 ± 1.16 мм, соответственно. Выводы. Можно предположить, что плотность костной ткани зависит от степени выраженности патологических изменений в лобной пазухе. Это в свою очередь влияет на прогнозирование возможности развития осложнений. Ключевые слова: лобная пазуха, спиральная компьютерная томография, толщина костей, плотность костей.

ZusammenfassungEine Verumontanum-Mukosahyperplasie (VMGH) ist eine benigne mikroazinäre proliferative Läsion, die ausschließlich im Verumontanum und in der posterioren Urethra auftritt und die zu den pseudoneoplastischen Imitatoren eines „low risk“ azinären Adenokarzinoms der Prostata zählt. Wir präsentieren den Fall eines 72-jährigen Patienten, bei dem 5 Jahre nach radikaler Prostatektomie wegen Adenokarzinom der Prostata pT2c pN0 cM0 R0, Gleason-Score: 3 + 3 = 6 der bildmorphologische Verdacht eines PSA-negativen Lokalrezidivs 3 × 2 cm im ehemaligen Prostatabett erhoben wurde. Das klinische Bild in Zusammenhang mit der histologischen Diagnostik führten zur Diagnose einer VMGH. Die VMGH ist eine kaum bekannte Differenzialdiagnose zum Lokalrezidiv eines Prostatakarzinoms bei einem PSA im Nullbereich, deren klinisches Bild dargestellt werden soll.

Adenomyomatosis of the gallbladder (AMG) is characterized by mucosal hyperplasia leading to invagination through the thickened muscle layer, which is relatively common in adults, but is rare in childhood. We report a 12-year-old boy with adenomyomatosis of the gallbladder combined segmental and fundal type. This combined type is rare in adults and is first reported here in childhood. Although initial imaging with computed tomography (CT) suggested the presence of a circular solid mass-like lesion because of its rare morphology, repeated ultrasonography (US) was useful for leading to a correct diagnosis.

The incidence of oral candidiasis has increased in the elderly in recent years. Although the increase of the elderly population plays a big role in this rise of oral candidiasis, the broader recognition that elderly people have higher infection rates for oral candidiasis is considered to be also an important factor. Oral candidiasis can be categorized into three types. Pseudomembranous oral candidiasis is characterized by the appearance of white moss, erythematous oral candidiasis by the eruption of erythema, and hyperplastic oral candidiasis by mucosal hyperplasia. Miconazole has been commonly used when treating oral candidiasis. Elderly patients, however, have a tendency to develop oral candidiasis repeatedly. It is therefore critical to take measures to prevent recurrence. We recommend the use an oral moisturizer containing hinokitiol, an antifungal substance, on a regular basis, to help prevent recurrence of oral candidiasis.

We report an infant who developed complete gastric outlet obstruction secondary to gastric antral mucosal hyperplasia and muscular hypertrophy after CDH repair. This condition has been reported only once before when it also occurred in association with congenital diaphragmatic hernia. Other causes of gastric outlet obstruction in the newborn were excluded. The infant recovered well after undergoing a gastric antrectomy. The cause of this obscure condition is unknown. This rare condition needs to be considered in an infant who develops gastric outlet obstruction after CDH repair. Keywords: Gastric outlet obstruction, Gastric antrum hypertrophy, Prepyloric stenosis

Despite innovative surgical techniques and use of current frontal sinus stents from different materials, the problem of treatment failure with consecutive reoperation remains present. The aim of our study is to investigate biocompatibility, degradation kinetics, and functionality of a newly developed fluoride-coated magnesium-based nasal stent. A minipig anatomy of frontal sinus adapted design and an external surgical approach were developed and established. The functionality of the stents was evaluated endoscopically. The stent-tissue blocks were analysed after 90 and 180 days using microcomputed tomography (µ-CT), histology, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). Functional evaluation revealed an unobstructed stent lumen in all cases. Histological analysis showed moderate mucosal hyperplasia with a mild, nonspecific inflammatory response, and nonosteoconductive effect. Rejection reactions or necrosis did not occur. The volumetric analysis of the stents showed 51% volume loss after 180 days. The EDS analysis did not detect any neodymium (Nd) in the mucosa or bone. The Mg-2 wt % Nd stents are a promising option when treating the narrow passages following paranasal sinus surgery. In particular, its good biocompatibility and good functionality facilitate the re-epithelization of these constricted passages. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 350-365, 2017.

A major aspect of pathology in otitis media (OM), the most common childhood bacterial disease, is hyperplasia of the middle ear mucosa. Activation of innate immune receptors during OM leads to the activation of NF-κB, a pleiotropic transcription factor involved both in inflammation and tissue growth. To explore the role of NF-κB in mucosal hyperplasia during OM, we evaluated the expression of genes involved in two modes of NF-κB activation during a complete episode of acute, bacterial OM in mice. We also determined the effects of inhibitors of each pathway on infection-stimulated mucosal growth in vitro. A majority of the genes that mediate both the canonical and the non-canonical pathways of NF-κB activation were regulated during OM, many with kinetics related to the time course of mucosal hyperplasia. Inhibition of either pathway reduced the growth of cultured mucosal explants in a dose-dependent manner. However, inhibition of the canonical pathway produced a greater effect, suggesting that this mode of NF-κB activation dominates mucosal hyperplasia during OM.

This study is to describe the reaction of urothelial cells to a silk suture placed surgically in the urinary bladder. Experimental rats have a single silk suture transmurally inserted in the wall and lumen of the bladder. The controls received sham operations. At various time intervals up to the 54th week, the sequence of morphologic events which took place in the bladder wall has been studied by gross and by light and electron microscopic examinations. The mucosal hyperplasia was the major finding for those sacrificed at weeks 2, 4, and 8. A single growth or multiple polypoid growths composed of well differentiated urothelial cells were found at weeks 16, 24, and 54. None of these growths were invasive. They exhibited little evidence of progressive morphologic change with time. Ultrastructurally, the tumor cells essentially showed characteristics of urothelial cells. None of the controls developed a similar urothelial growth. In conclusion, presence of a silk suture in the urinary bladder resulted in mucosal hyperplasia followed by noninvasive tumorous growth of well differentiated transitional cells. Exact mechanisms of this growth promotion by a silk suture and the potential of the growths becoming invasive neoplasms remain to be determined.

The aims of the present study were: (1) to assess the prevalence of symptom-based irritable bowel syndrome (IBS) in Korean adults, (2) to assess several organic abnormalities which can be found in IBS patients, and (3) to analyze the risk or associated factors that influence the presence of IBS. Adult health examinees were requested to fill out a questionnaire. The prevalence of IBS was calculated using Rome II criteria. Using several tests, several organic abnormalities were identified in the IBS group. Risk factors were analyzed by comparing the IBS and normal groups. The prevalence value for IBS according to Rome II criteria was 16.8%. Mucosal hyperplasia, lymphocyte aggregation, and increased eosinophil counts were relatively common microscopic findings in IBS group. Female gender, self-consciousness of IBS, and irregular defecation were expressed as significantly independent risk or associated factors for IBS. Several colonic microscopic findings mentioned above may be helpful in accurate diagnosis of IBS. Therefore a more-precise and large population study about these findings is necessary to reach a definitive conclusion.

To evaluate the feasibility of use of a covered, retrievable prostatic urethral stent and to determine urethrographic and histologic changes in the prostate induced by the stent in a canine model.Polytetrafluoroethylene-covered retrievable nitinol stents were placed in the normal prostatic urethras of 13 dogs. The stents were removed 8 weeks after placement. The dogs were killed immediately after stent removal (group 1, n = 5) or 8 weeks after stent removal (group 2, n = 8). Retrograde urethrograms were obtained every 2 weeks after stent placement and after stent removal in dogs that had not been killed. The histologic changes in the prostate were compared between the two groups.Stent placement was technically successful in all dogs. In two dogs, a second stent was placed because of migration of the first stent into the urinary bladder. Stent removal was successful in 12 dogs. One stent was removed in its expanded state. On follow-up urethrograms, dilation of the prostatic urethra persisted until animals were killed (P = .14). The mucosal hyperplasia that occurred after stent placement at both ends of the stent gradually decreased after stent removal (P.001). Histologic examination revealed prostate glandular atrophy and periurethral fibrosis, which did not differ between the two groups (P = .72 and P = .83, respectively). Papillary hyperplasia of the uroepithelium and submucosal inflammatory cell infiltration was decreased significantly in group 2 compared with group 1 (P = .002, P = .011, respectively).Covered retrievable prostatic urethral stents seem to be feasible for use in the canine prostatic urethra. The stent-induced prostatic urethral dilation and prostate glandular atrophy persist until 8 weeks after stent removal.

We describe a case of the extremely rare entity of myxoglobulosis of the appendix in an 18-year-old man who underwent laparoscopic appendectomy with the clinical diagnosis of recurrent appendicitis. Transaction of the appendix after ligation resulted in extrusion of numerous whitish egg-like globules ranging in size from 0.2 to 0.7 cm in diameter. It was initially thought to be hydatid of appendix, resulting in emergent usage of povidine iodine as scolicidal after suction of all the cysts/eggs. On microscopic examination, the globules consisted of faintly eosinophilic laminations of mucin surrounding an amorphous granular core were found. The mucin was identified by positivity with histochemical mucin stains. After thorough microscopic examination of the appendix, our case was diagnosed as myxoglobulosis due to mucosal hyperplasia, associated with luminal obstruction with possibly a membrane.

A large number of vaginal calculi were observed in a juvenile harbor porpoise (Phocoena phocoena) stranded on Whidbey Island, Washington. Vaginal calculi have been reported in other species, but not in harbor porpoises. Histologic examination of the urinary tract revealed mucosal hyperplasia most likely attributable to the calculi. The calculi were numerous (.30), composed completely of struvite (magnesium ammonium phosphate), and on culture yielded Enterococcus spp., a bacterium not usually associated with struvite urolith formation in domestic animals. The only other lesion of note was severe hepatic lipidosis, and its relationship to the development of the vaginal calculi is unknown.

The treatment of infants and children with short bowel syndrome aims at restoring the intestinal continuity and at improving the physiological process of gut adaptation. Mucosal hyperplasia allows the remaining gut to ensure an adequate digestion and an absorption process leading to intestinal autonomy. During the period of adaptation, appropriate parenteral and/or enteral feeding must be directed at maintaining an optimal nutritional status. Delay of intestinal autonomy depends on the characteristics of the residual intestine: length, presence of the ileocecal valve and colon, and motor function. Bacterial overgrowth compromises intestinal adaptation and increases the risk of liver disorders. Few patients will remain long-term dependent on parenteral nutrition. All approaches aimed at achieving intestinal autonomy should be tried: use of trophic factors, intestinal tapering, and lengthening. In a few residual patients, permanent intestinal failure or extreme short bowel syndrome require intestinal transplantation.

Two double-toothed barbets (Lybius bidentatus) were swallowed and regurgitated by a snake within a free-flight aviary. Trematodes were observed histopatholgically within the renal pelvises and proximal ureters with associated mucosal hyperplasia and mild heterohistiocytic inflammation in both birds. Trematodes were identified as Tanaisia (Tamerlania) zarudnyi, which have a life cycle involving terrestrial snails. Trematodes have been reported within kidneys in several orders of birds, including the Columbiformes, Passeriformes, Stercorariidae, Anseriformes, Galliformes, and Piciformes. Snails were not uncommon within the barbets' aviary and may have been the source of exposure. Renal trematodiasis is probably an incidental finding in these birds because there were no clinical signs and the birds lacked pronounced histologic lesions in the kidney that would be associated with ureteral or pelvic obstruction.

Background. Otitis media (OM) is the most common childhood bacterial infection and also the leading cause of conductive hearing loss in children. Currently, there is an urgent need for developing novel therapeutic agents for treating OM based on full understanding of molecular pathogenesis in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. Objective. To provide a state-of-the-art review concerning recent advances in OM in the areas of molecular biology, biochemistry, genetics, and animal model studies and to discuss the future directions of OM studies in these areas. Data Sources and Review Methods. A structured search of the current literature (since June 2007). The authors searched PubMed for published literature in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. Results. Over the past 4 years, significant progress has been made in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. These studies brought new insights into our understanding of the molecular and biochemical mechanisms underlying the molecular pathogenesis of OM and helped identify novel therapeutic targets for OM. Conclusions and Implications for Practice. Our understanding of the molecular pathogenesis of OM has been significantly advanced, particularly in the areas of inflammation, innate immunity, mucus overproduction, mucosal hyperplasia, middle ear and inner ear interaction, genetics, genome sequencing, and animal model studies. Although these studies are still in their experimental stages, they help identify new potential therapeutic targets. Future preclinical and clinical studies will help to translate these exciting experimental research findings into clinical applications. (Less)

Insulin-like growth factor (IGF)-I enhances the mucosal hyperplasia that normally occurs after massive small-bowel resection. The present studies examined whether growth hormone (GH) infusion increases serum IGF-I levels and, thereby, enhances mucosal hyperplasia after small-bowel resection.Male Sprague-Dawley rats weighing approximately 140 g were subjected to 80% jejunoileal resection or sham operation (ileal transection). A mini-osmotic pump was then inserted under the skin immediately after surgery to deliver either vehicle or 3mg/kg/day GH. All animals were killed 7 days postoperatively, and the remaining intestine was removed and divided at the anastomotic site.Food intake did not differ between control and GH-infused groups. Resected rats infused with GH grew faster than resected rats infused with vehicle. However, GH did not stimulate the weight gain of sham-operated rats. In both duodenojejunum and ileum, GH infusion did not stimulate hyperplasia beyond that which normally occurs after small-bowel resection, nor did it increase mucosal mass in sham-operated rats. GH infusion did not alter serum IGF-I or IGF-binding protein (IGFBP) levels in either resected or sham-operated rats. GH infusion resulted in increased sucrase and maltase activities in the ileal mucosa of resected rats.The present results suggest that a pharmacologic dose of GH directly stimulates growth of resected animals and ileal sucrase and maltase activities without increasing serum IGF-I levels or increasing absorptive surface area in the small intestine.

Experimentally-induced perforating wounds in 4 Holstein Friesian lactating cows were sutured using Gambee, continuous 2-layer (Cushing for submucosal layer and continuous horizontal mattress for skin and intermediate layer), separated 2-layer (simple continuous for mucosal layer and vertical mattress for skin and intermediate layer) and 3-layer (simple continuous for mucosal and intermediate layers, simple interrupted for skin) suture patterns. Wound healing was evaluated by radiography, blood flowmetry, tensiometry, measurement of hydroxyproline content and histopathology. The present results suggest that 3-layer pattern provided the best healing of the entire teat. Mucosal hyperplasia was observed in Gambee and continuous 2-layer pattern while eversion of the skin, presence of suture tracts and greater amount of granulation tissue were observed in continuous and separated 2-layer patterns.

Self-expanding wire mesh stents have been developed for endoscopic placement across malignant biliary strictures, but tumor ingrowth may limit the usefulness of open mesh stents. We reasoned that coating the wire mesh might prevent tumor ingrowth. Tissue response to covered and uncovered stents was compared in dogs. Stents were surgically placed in the bile ducts of 22 mongrel dogs through the sphincter of Oddi. Either a silicone-covered stent or an uncovered stent was inserted. Liver function test values remained normal throughout a 1- or 3-month study. Necropsy revealed that all ducts were unobstructed. Bile duct histologic examination revealed mild-to-moderate cellular infiltration in all animals. Mucosal hyperplasia was more marked in the animals with uncovered stents and the bare wires became deeply embedded in bile duct epithelium, whereas the wires of covered stents did not. We conclude that covered stents are well tolerated by the canine bile duct. These results suggest that such stents may be removable, making self-expanding metal stents an appropriate treatment for both benign and malignant biliary strictures.

Subchronic toxicity of a horseradish extract (HRE), consisting mainly of a mixture of allyl isothiocyanate (AITC) and other isothiocyanates, was investigated with administration at concentrations of 0, 0.0125, 0.025 and 0.05% of HRE in drinking water for 13 weeks to male and female F344 rats. For comparison, treatment with 0.0425% of AITC was similarly performed. Body weight gain was reduced in the 0.05% HRE and AITC males as compared to the 0% controls, and the cause was considered at least partly related to decreased water consumption due to the acrid smell of the test substance and decreased food consumption. Serum biochemistry demonstrated increased urea nitrogen in 0.025 and 0.05% HRE and AITC males and 0.0125-0.05% HRE and AITC females, along with decreased total cholesterol in 0.0125-0.05% HRE females. On histopathological assessment, papillary/nodular hyperplasia of bladder mucosa was observed in 0.05% HRE and AITC males and females, in addition to simple mucosal hyperplasia found in all treated groups. Based on the above findings, no-observed-adverse-effect levels (NOAELs) were estimated to be below 0.0125% of HRE for both males and females, corresponding to 9.4 and 8.0 mg/kg body weight/day, respectively, and there appeared to be comparable toxicological properties of HRE to AITC, such as the inductive effect of significant proliferative lesions in the urinary bladder.

Aims: To highlight an uncommon situation during stenting for obesity surgery complications. Place and Duration of Study: 1st Propaideutic Surgical Unit, Hippokration Hospital, Athens between December 2008 and November 2010. Results: 2 cases of obese patients are presented where the placing of metal stents in esophagogastric region after leakage in the postoperative period of sleeve gastrectomy, resulted in formation of papilloma at the edge of these stents. Conclusion: May be these cases are two of the very few reports in the medical literature which describe mucosal hyperplasia in the esophagus at the edge of a covered metal stent placed for a benign condition.

Allergic contact stomatitis (ACS) can occur with variable clinical presentations such as erythematous, erosive, and lichenoid forms. Burning mouth symptoms may also be a result of allergic contact stomatitis. Additionally, gingival hyperplasia has been reported in exceptional cases of ACS caused by dental metals. Here, two rare cases are presented of nickel-induced oral mucosal hyperplasia with gingival and upper palatal involvement from metal-porcelain crowns and metal-acrylic upper denture, respectively. In both cases the diagnosis was made on the basis of the positive patch test results to nickel sulfate and the regression of the lesions after removing the nickel containing dental materials. Nickel-induced ACS should be borne in mind in every case of oral mucosal hyperplasia appearing after dental procedures, especially in the presence of previous allergies and sensitization risks such as ear piercing. It might be further suggested to include this variant within the clinical forms of ACS.

Covered self-expandable metal stents were developed to overcome tumor in-growth through the metal mesh. Stent migration is one of their malfunctions. Recently, the partially covered wallflex stent (PCWS) was developed with flared ends to prevent migration However, difficulty has been reported in its removal. We describe the removal of a PCWS embedded in mucosal hyperplasia at the uncovered proximal flared end, visualized by using SpyGlass cholangioscopy.

We describe a case of the extremely rare entity of myxoglobulosis of the appendix from a 45-year-old white man who was operated urgently with the clinical diagnosis of acute appendicitis. Sectioning of the appendix revealed the presence in the dilated appendiceal lumen of numerous whitish opaque globules ranging in size from 0.2 to 0.7 cm in diameter. A ruptured diverticulum and several smaller ones were also found. On microscopic examination, the globules consisted of faintly eosinophilic laminations of mucin surrounding an amorphous granular core. The mucin was identified by positivity with histochemical mucin stains. After thorough microscopic examination of the appendix, our case was diagnosed as myxoglobulosis due to mucosal hyperplasia, associated with ruptured diverticulum and acellular extra-appendiceal mucin deposits.

Only scarce knowledge exists of morphologic changes after antiperistaltic reversal of the small intestine. Previous animal models using a reversed segment of the small intestine after massive intestinal resection have been mostly concerned with assessing absorption. A rat model was therefore developed for the purpose of studying mucosal surface area in the small intestine after reversal of an intestinal segment. A reversal of 10 cm, representing a length of about 10%, was found suitable for the investigation. Marked dilatation of the reversed segment occurred. A pronounced increase in mucosal surface area caused by mucosal hyperplasia was observed. The mucosal surface area in an anastomosed, but not reversed, segment also increased markedly compared with a group undergoing no operation, although less than in the reversed segment. We conclude that a reversed intestinal segment will increase mucosal surface area in an optimal length used for this purpose. This increase is possibly caused by prolonged exposure to intestinal chyme.

Summary Diphtheroid necrotic inflammation of the larynx in calves in its advanced stage mostly requires surgical therapy. Diagnostic procedure, surgery and post-operative care were described for three calves (aged 3–8 weeks). The clinical diagnosis was confirmed by laryngoscopy. In all three cases, a laryngotomy with resection of necrotic tissue was performed. After surgery two calves showed complications (tracheal stricture, mucosal hyperplasia). Both were cured in further surgery. In cases of post-operative complications, further surgical intervention can be very promising.

Glucagon-like peptide-2 (GLP-2), a 33-amino-acid proglucagon-derived peptide (PGDP), was first identified as a peptide with intestinal growth factor-like activity following experiments demonstrating that subcutaneously implanted glucagon-producing tumors produced intestinal growth in nude mice. These observations were consistent with several case reports of intestinal mucosal hyperplasia in patients with glucagon-producing tumors and experimental evidence linking increased PGDP expression with adaptation to intestinal injury in rodents and human subjects. Following intestinal injury or resection, the circulating levels of the PGDPs including GLP-2 rapidly increase in parallel with the adaptive response and growth of the remnant bowel.

Among factors promoting mucosal hyperplasia after bowel resection, long-chain fatty acids may have a special role. The purpose of the present study was to evaluate the effects of high-fat diet (HFD) on early intestinal adaptation in rats with short bowel syndrome (SBS). Male Sprague-Dawley rats underwent either a bowel transection with re-anastomosis (Sham rats) or 75% small bowel resection (SBS rats). Animals were randomly assigned to one of three groups: Sham rats fed normal chow (Sham-NC); SBS rats fed NC (SBS-NC); and SBS rats fed HFD (SBS-HFD). Rats were killed on days 3 or 14. Body weight and parameters of intestinal adaptation (overall bowel and mucosal weight, mucosal DNA and protein, villus height, and crypt depth) were determined at time of killing. By day 3, SBS-HFD rats demonstrated higher duodenal and jejunal bowel and mucosal weights and ileal villus height and jejunal crypt depth vs SBS-NC rats. By day 14 SBS-HFD rats continued to demonstrate increased duodenal and jejunal bowel weight and duodenal mucosal weight vs SBS-NC animals. We conclude that early exposure to HFD both augmented and accelerated structural bowel adaptation in a rat model of SBS.

c yclosporin i.s a selective immunosuppressant that is used extensively in organ transplant surgery to prevent graft rejection.’ The drug has many unwanted effects,2 but of particular concern to the dental surgeon is the association between chronic use of this drug and gingival overgrowth.3V8 This unwanted effect has been reported in approximately a third of dentate transplant patients taking cyclosporin.8 The prevalence increases to nearly 50 % when both cyclosporin and nifedipine, a dihydropyridine derivative, are used eoncomitantly.8, g Young patients appear to be more susceptible to cyclosporin-induced gingival changes than adults.1° Although gingival overgrowth associated with cyclosporin and the calcium channel blocking agents is well documented, drug-associated overgrowth of masticatory mucosa in edentulous patients is rare. We report such a case in a renal transplant patient.

OBJECTIVE. The objective of our study was to evaluate the long-term effectiveness of metallic stent placement in the treatment of benign biliary strictures and to report our experience with interventional procedures for the management of stent occlusion to achieve secondary patency.CONCLUSION. The clinical course of these patients is compromised by repeated stent occlusions, caused by stone or mucosal hyperplasia. The results of primary stent patency are disappointing with the primary patency rate decreasing from 75% after 12 months to 25% after 36 months. The different interventional procedures used to restore bile flow make an important contribution to the secondary stent patency and provide a satisfactory clinical result in a patient subpopulation in whom stent placement is considered the last resort.

Background: Polyamines have been shown to be important regulators of the intestinal adaptation process after massive bowel resection. Saccharomyces boulardii is yeast that has the ability to synthesize polyamines. Therefore, S. boulardii may be useful in the treatment of short bowel syndrome. Methods: Twenty 150-g male Sprague-Dawley rats were subjected to 80% jejunoileal resection. Another 20 animals received transection and closure and served as pair fed controls. One half of the resected rats and one half of the controls were given S. boulardii 25 mg/day. Results: After 2 weeks, mucosal mass (mg/cm bowel) did not differ between treated and non-treated animals despite the presence of a marked resection effect. Mucosal DNA, protein, and sucrase activity likewise did not differ. Subsequently, the experiment was repeated four times the original dose (100 mg/day) and found comparable results. In the proximal bowel, mucosal mass was 92 ± 6 mg/cm in treated animals versus 107 ± 8 mg/cm in untreated rats. In the distal small bowel, comparable values were 85 ± 5 mg/cm and 88 ± 4 mg/cm. Again, mucosal DNA, protein, and sucrase activity levels paralleled these results. Conclusions: Although S. boulardii may stimulate polyamine synthesis, it does not seem to be helpful in augmenting gut adaptation in this animal model of short bowel syndrome.

Typical megaileum occurred in young male Wistar rats three months after ileum myenteric plexus denervation. An average of 58.4% denervation of the Auerbach plexus was obtained by serosal application of benzalkonium chloride (0.2% v/v). Denervation was assessed by ganglion cell counts in an 8 nm ring-shaped histological sectfrom the midportion of the treated segment. A morphometric study showed that the increased thickness of the megaileum wall was due to muscle hypertrophy and mucosal hyperplasia. The potential usefulness of this model of megaileum is emphasized.

Purpose Gianturco self-expanding metallic stents have been useful in cases of benign biliary stenoses; however, the stents have not worked well in the presence of intraluminal tumor because of tumor growth between the wire struts. Stents were covered with polymeric membranes, which may prevent tumor ingrowth, and the feasibility of using these covered stents in the common bile duct was studied in healthy adult dogs. Materials and Methods Initially, stents (10 × 6 mm) covered with polycaprolactone (PCL), segmented polyether polyurethane (SPP), and silicone were placed in the common bile duct of dogs and were followed up for 3–12 months. Subsequently, four types of modified silicone-covered stents were evaluated. Rough-surface, small-diameter (3-mm), half-covered, and tapered stents were placed and followed up for 3 months. Results In the initial study, the SPP and silicone membranes remained intact, but the PCL covering broke in all dogs. In all but two dogs, luminal narrowing caused by varying degrees of papillary mucosal hyperplasia at both ends of the stent was observed. In the subsequent study, mucosal hyperplasia was considerably reduced by using half-covered stents and was virtually eliminated with tapered stents. All small-diameter stents migrated into the bowel. Conclusion These studies suggest that tapered Gianturco self-expanding stents covered with silicone may be useful in the biliary tract in cases of intraluminal tumor.