BURIED BUMPER SYNDROME AS A COMPLICATION OF PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN CANCER PATIENTS: THE BRAZILIAN EXPERIENCE

Background: Buried bumper syndrome (BBS) is a major complication of percutaneous endoscopic gastrostomy (PEG) in which the internal bumper migrates from the gastric lumen into the gastrostomy tract. The aim of the present study was to describe the frequency and characteristics of BBS in cancer patients. Methods: Retrospective chart review of cancer patients submitted to PEG placement. Results: Thirteen cases of BBS were diagnosed among 213 PEG procedures, with an incidence of 6.1%. The interval between PEG and BBS varied from 7 to 630 days (mean 217.5 days). All patients were treated on an outpatient basis. There were six partial, four subtotal and three total BBS. Three partial and four subtotal BBS were treated by external traction and replacement with a balloon‐tipped tube. In three cases of partial BBS the PEG tube was not removed, just repositioned. In three cases of total BBS it was necessary to redo the PEG procedure. Conclusion: BBS is an uncommon and usually late complication of PEG. Most of our cases were detected early, due to instructions provided to patients and caregivers and regular follow up. Early diagnosis permits simple treatment consisting of replacement of the original PEG tube by a balloon‐tube or repositioning the original system.     

Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity,Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis

Objective

To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).

Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients

Objectives

To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P.

Production of monolayer plaque assay slides

A jig for the simple and rapid production of monolayer plaque assay slides is described.     

Two large immunogenic and antigenic myoglobin peptides and the effects of cyclisation

Peptides corresponding to sequences (72-88) and (26-54) of beef myoglobin have been synthesised in their open-chain and cyclised forms (using a disulphide bridge) and tested for their antigenicity and immunogenicity. Antibodies raised to beef myoglobin bound to both peptides but more strongly to the 29-residue than to the 17-residue peptide. Cyclisation increased the antigenicity of the larger peptide. In this form the peptide competed much more strongly than in the uncyclised form for specific antibodies to beef myoglobin. The peptides are immunogenic in mice without being coupled to a protein carrier and produce antibodies which bind to beef myoglobin. Peptide (26-54) is the more immunogenic in producing a larger antibody titre to the parent myoglobin and cyclisation again enhances this property. The findings lend weight to the view that longer peptide sequences might be expected to favour the folded state, therefore binding more strongly to antibodies raised to the native protein and eliciting a population of antibodies which contain a larger proportion specific for that conformation. Cyclisation enhances antigenicity and immunogenicity presumably by decreasing the number of degrees of conformational freedom of a peptide without excluding native-like conformations.     

以“基础医学论坛”培养模式促进本科生科研素质的提高

培养医学本科生的科研素质和实践能力是发展其综合素质的重要组成部分。作者针对低年级部分医学类五年制本科生开展了各种形式的"基础医学论坛"活动,并对本科生科研素质现状的调查进行分析,探讨了基础医学论坛是否能促进医学本科生科研素质与创新能力的提高。     

Glial fibrillary changes induced by kainic acid in organotypic culture of the rat cerebellum

Organotypic cultures of cerebellum were exposed to 10^?3 and 10^?4 M kainic acid (KA) for 3 to 28 days. Ultrastructural studies revealed intensive production of intracytoplasmic glial fibrils in astrocytes at a given stage of maturation in vitro. Gliofibril production was preceded by dilatation of rough endoplasmic reticulum (RER) channels and mitochondrial damage. Glial fibrillary changes are considered as a primary response of glial cells to kainic acid due to disturbances of protein metabolism.     

Spin-label studies of hapten combining sites in anti-p-azobenzoate antibodies

The structural nature of the hapten combining site for anti-p-azobenzoate from four rabbits has been studied using spin-labeled benzoate haptens in which, (a) the spin-label (nitroxide free-radical) was attached directly to the p-aminobenzoate or with a spacer residue, viz., glycyl, β-alanyl or γ-aminobutyryl and (b), the spin-label was attached directly to m-aminobenzoate, o-aminobenzoate or to o-(methylamino) benzoate. Studies using the haptens under (a) showed that the rotational-freedom of the bound spin-label for the four preparations was increased with increased spacing and that although, for two of the preparations, the binding constant was decreased slightly by the introduction of the glycyl spacer, it increased with increasing spacer length. Of the haptens under (b), the o-(methylamino) benzoate derivative was not bound, presumably because the carboxylate group was displaced out of the plane of the benzene ring. On the other hand, the o-aminobenzoate derivative was measurably bound, presumably because the carboxylate group forms an intramolecular hydrogen bond to the amino group and is coplanar with the benzene ring. The meta-derivative was more strongly bound than the ortho-derivative but both the ortho- and meta-derivatives were bound less than the unspaced-p-aminobenzoate derivative. In the cases of both ortho-and meta-derivatives the spin-label was strongly immobilized indicating a tight fit for p-azobenzoate around these positions as was also indicated by the low binding of these compounds.     

Retinal morphology in patients with BBS1 and BBS10 related Bardet-Biedl Syndrome evaluated by Fourier-domain optical coherence tomography

Retinal dystrophy in Bardet-Biedl Syndrome (BBS) is caused by defective genes that are expressed within ciliated cells such as photoreceptors. The purpose of this study was to characterize and compare the retinal structure and lamination of two groups of patients, carrying mutations in BBS1 or BBS10. Eight patients with BBS (ages 11.9-28.5 years) and mutations in BBS1 (4/8) or BBS10 (4/8) were tested. A high-resolution hand-held probe Fourier-domain optical coherence tomography system (Fd-OCT) was used for retinal image acquisition. Macular scans were evaluated with respect to structure, retinal layering and photoreceptor integrity. Micro-structural in-vivo analysis showed abnormalities within retinal layers but preserved retinal lamination. Photoreceptor integrity was disrupted in all patients. Macular scans from patients with BBS10 mutations most often showed 'deposits' adjacent and anterior to Bruch's membrane. Age, genotype and presence of macular changes did not correlate with the structural changes observed. Retinal dystrophy in BBS is reflected by major changes in the outer retinal layers. This is the first report of in-vivo micro-structural analysis of retinal layers in patients with BBS. Mutations in different BBS genes seem to be associated with similar micro-structural changes in retinal layers.