Bile stone ileus with cholecystoduodenal fistula--Bouveret's syndrome

This is a case report of a 71-year-old man, who presented to emergency department with elevated temperature, vomiting and epigastric pain. Computed tomography of the abdomen revealed a large fistulous tract extending from the gallbladder to the duodenal bulb, as well as a large calculus obstructing the second part of the duodenum. The patient subsequently underwent successful surgical therapy.     

Comparative study of the uniformity of coating thickness of pellets coated with a conventional Wurster chamber and a swirl generator-equipped Wurster chamber

This study evaluated the performance of two bottom-spray coaters and the effect of pellet-size variability on coating uniformity. A conventional Wurster chamber was used for the first group of trials, and a Wurster chamber with a novel swirl-flow generator design was used for the second. The results confirmed that when using a conventional Wurster coating chamber, pellets with a smaller diameter receive significantly less coating material compared to those with larger diameters. The swirl generator-equipped Wurster chamber achieved close to uniform coating thickness regardless of pellet size. The ratio (M(S)) of the mass of dye deposited in the coating layer to pellet surface area indicates that coating was much more evenly distributed using the swirl-flow coater. Coating thickness was also analyzed using SEM micrographs and the results were in close agreement with the M(S) factor values. Inter-particle coating mass variation was also lower in case of swirl-flow coater. The results of this study show that a swirl-flow coater is suitable for coating particles of variable size. They also showed an improvement in coating process yield when using the swirl-flow coater.     

Spherical crystallization of drugs

Spherical crystallization of drugs is the process of obtaining larger particles by agglomeration during crystallization. The most common techniques used to obtain such particles are spherical agglomeration and quasi-emulsion solvent diffusion. Ammonia diffusion systems and crystallo-co-agglomeration are extensions of these techniques. By controlling process parameters during crystallization, such as temperature, stirring rate, type and amount of solvents, or excipient selection, it is possible to control the formation of agglomerates and obtain spherical particles of the desired size, porosity, or hardness. Researchers have reported that the particles produced have improved micromeritic, physical, and mechanical properties, which make them suitable for direct compression. In some cases, when additional excipients are incorporated during spherical crystallization, biopharmaceutical parameters including the bioavailability of drugs can also be tailored.     

Association of sVAP-1, sRAGE, and CML with lactation-induced insulin sensitivity in young non-diabetic healthy women

BackgroundIn comparison with non-lactating women breast-feeding mothers display higher insulin sensitivity. Recent data suggest that advanced glycation end products, soluble receptor for advanced glycation end products (sRAGE) and soluble vascular adhesion protein-1 (sVAP-1) may play a role in insulin resistance even in healthy subjects.AimWe studied whether breast-feeding induced insulin sensitivity associates with changes in concentrations of circulating sVAP-1, sRAGE and N^ε-(carboxymethyl)lysine (CML) — chemically defined advanced glycation end product and RAGE ligand.MethodsIn 74 lactating non-diabetic mothers, 45 weaned non-diabetic mothers and 50 age-matched non-parous women insulin sensitivity was assessed using Quantitative insulin-sensitivity check index (QUICKI). sVAP-1, sRAGE and CML levels were determined.ResultsLactating mothers were more insulin sensitive than their weaned and non-parous counterparts. Lactating mothers displayed the highest concentrations of sRAGE, and higher sVAP-1 levels if compared to weaned mothers. Both groups of mothers presented with lower CML levels than the non-parous women.ConclusionLactation-induced insulin sensitivity is associated with higher sVAP-1 and a tendency towards higher sRAGE levels. Lactation-associated rise in sVAP-1 may promote effective glucose utilization in the mother. Lactation-induced insulin sensitivity vanishes shortly after weaning. In young healthy women CML levels are of no clinical relevance to insulin sensitivity.     

Antibacterial nanofiber materials activated by light

Electrospun polymeric nanofiber materials doped with 5,10,15,20-tetraphenylporphyrin (TPP) photosensitizer were prepared from four different polymers and were characterized with microscopic methods, steady-state, and time-resolved fluorescence and absorption spectroscopy. The polymers used included polyurethane Larithane? (PUR), polystyrene (PS), polycaprolactone (PCL), and polyamide 6 (PA6). The antibacterial activity of all nanofiber materials against E. coli was activated by visible light and it was dependent on oxygen permeability/diffusion coefficients and the diameter of the polymeric nanofibers. This activity is based on oxidation ability of singlet oxygen O?(1Δ(g)) that is generated upon irradiation. All tested nanofiber materials exhibited prolonged antibacterial properties, even in the dark after long-duration irradiation. The post-irradiation effect was explained by the photogeneration of H?O?, which provided the material with long-lasting antibacterial properties.     

Pentapeptide-modified poly(N,N-diethylacrylamide) hydrogel scaffolds for tissue engineering

Poly(N,N-diethylacrylamide) (PDEAAm) hydrogel scaffolds were prepared by radical copolymerization of N,N-diethylacrylamide (DEAAm), N,N'-methylenebisacrylamide and methacrylic acid in the presence of (NH?)?SO? or NaCl. The hydrogels were characterized by low-vacuum scanning electron microscopy in the water-swollen state, water and cyclohexane regain, and by mercury porosimetry. The pentapeptide, YIGSR-NH?, was immobilized on the hydrogel. Human embryonic stem cells (hESCs) were cultured with the hydrogels to test their biocompatibility. The results suggest that the PDEAAm hydrogel scaffolds are nontoxic and support hESC attachment and proliferation, and that interconnected pores of the scaffolds are important for hESC cultivation. Immobilization of YIGSR-NH? pentapeptide on the PDEAAm surface improved both adhesion and growth of hESCs compared with the unmodified hydrogel. The YIGSR-NH?-modified PDEAAm hydrogels may be a useful tool for tissue-engineering purposes.     

Anxiety and depression during hospital treatment of exacerbation of chronic obstructive pulmonary disease

This study investigated the prevalence, risk factors and rate of recognition of anxiety and depression in 50 patients hospitalized for exacerbation of chronic obstructive pulmonary disease (COPD). Using the Primary Care Evaluation of Mental Disorders questionnaire, 13 patients were identified as having depression, four had anxiety and eight had a combination of the two. Patients with anxiety and/or depression had a significantly higher partial pressure of oxygen and pH, and a lower partial pressure of carbon dioxide, in arterial blood on admission, more severe dyspnoea after a 6-min walk test and less improvement of dyspnoea from admission to discharge than COPD patients without anxiety and/or depression. Two patients were referred to a mental health specialist during their hospitalization, indicating a low rate of recognition. The results suggest that patients with mental disorders are referred and admitted to hospital earlier in the course of a COPD exacerbation due to earlier and more intense perception of dyspnoea.