Adult Abdomen Research Articles

A Rare Cause of Acute Abdomen in Adults: Intestinal Malrotation

A Rare Cause of Acute Abdomen in Adults: Intestinal Malrotation

Evaluation of efficacy of metal artefact reduction technique using contrast media in Computed Tomography

The aim of this study was to evaluate the efficacy of metal artefact reduction using contrasts media in Computed Tomography (CT) imaging. A water-based abdomen phantom of diameter 32 cm (adult body size) was fabricated using polymethyl methacrylate (PMMA) material. Three different contrast agents (iodine, barium and gadolinium) were filled in small PMMA tubes and placed inside a water-based PMMA adult abdomen phantom. The orthopedic metal screw was placed in each small PMMA tube separately. These two types of orthopedic metal screw (stainless steel and titanium alloy) were scanned separately. The orthopedic metal crews were scanned with single-energy CT at 120 kV and dual-energy CT at fast kV-switching between 80 kV and 140 kV. The scan modes were set automatically using the current modulation care4Dose setting and the scans were set at different pitch and slice thickness. The use of the contrast media technique on orthopedic metal screws were optimised by using pitch = 0.60 mm, and slice thickness = 5.0 mm. The use contrast media can reduce the metal streaking artefacts on CT image, enhance the CT images surrounding the implants, and it has potential use in improving diagnostic performance in patients with severe metallic artefacts. These results are valuable for imaging protocol optimisation in clinical applications.

128 slice computed tomography dose profile measurement using thermoluminescent dosimeter

The increasing use of computed tomography (CT) in clinical practice marks the needs to understand the dose descriptor and dose profile. The purposes of the current study were to determine the CT dose index free-in-air (CTDIair) in 128 slice CT scanner and to evaluate the single scan dose profile (SSDP). Thermoluminescent dosimeters (TLD-100) were used to measure the dose profile of the scanner. There were three sets of CT protocols where the tube potential (kV) setting was manipulated for each protocol while the rest of parameters were kept constant. These protocols were based from routine CT abdominal examinations for male adult abdomen. It was found that the increase of kV settings made the values of CTDIair increased as well. When the kV setting was changed from 80 kV to 120 kV and from 120 kV to 140 kV, the CTDIair values were increased as much as 147.9% and 53.9% respectively. The highest kV setting (140 kV) led to the highest CTDIair value (13.585 mGy). The p-value of less than 0.05 indicated that the results were statistically different. The SSDP showed that when the kV settings were varied, the peak sharpness and height of Gaussian function profiles were affected. The full width at half maximum (FWHM) of dose profiles for all protocols were coincided with the nominal beam width set for the measurements. The findings of the study revealed much information on the characterization and performance of 128 slice CT scanner.

Mating Disruption of Grapholita molesta by RNA Interference of a Fatty Acid Desaturase Expressed in Adult Abdomen

Mating Disruption of Grapholita molesta by RNA Interference of a Fatty Acid Desaturase Expressed in Adult Abdomen

Morphology of the adult male and pupal exuviae of Glyptotendipes (Glyptotendipes) glaucus (Meigen 1818) (Diptera, Chironomidae) using scanning electron microscope (SEM).

In this paper, a study of the morphology of the pupa and male imago of Glyptotendipes (G.) glaucus (Meigen 1818) was carried out, with the aid of a scanning electron microscope (SEM). The SEM provided additional valuable information on the morphology of the species. Adult male head, antenna, wing, leg, abdomen, hypopygium, pupal cephalothorax and abdomen were examined. It is emphasized that SEM was not often used in Chironomidae studies. The present results confirm SEM as a suitable approach in carrying out morphological and taxonomical descriptions of Chironomidae species.

Retrospective analysis of cases of intestinal invagination treated and followed-up at our clinic.

OBJECTIVE:The purpose of this study was to present data on the diagnosis, treatment, clinical course, and outcome of cases of intestinal invagination.METHODS:Data of 11 patients treated for intestinal invagination at one center between June 2009 and July 2015 were analyzed retrospectively in terms of demographic data, etiological factors, anatomical localization of invagination, admission complaints, physical examination findings, diagnostic imaging modalities used, postoperative complications, and hospital stay.RESULTS:Of the total, 9 (81.8%) patients were female and 2 (18.2%) were male. Nine (81.8%) cases occurred due to benign causes and 2 to malignant causes. One (9%) patient had jejunojejunal invagination, 5 (45.5%) had ileoileal invagination, and 5 (45.5%) had ileocecal invagination. Right hemicolectomy-ileotransversostomy was performed in 5 (45.5%) patients and segmental small bowel resection with end-to-end anastomosis in 6 (54.5%).CONCLUSION:Intestinal invagination is a rare cause of acute abdomen in adults that may have a variety of etiologies and therefore may present with different clinical pictures. Abdominal pain, nausea, and vomiting are the most common symptoms. The rate of accurate diagnosis is 30% to 35% using ultrasonography and 50% to 80% using computerized tomography. In adults, the preferred treatment is surgery. As malignant pathologies are responsible for some cases of invagination, oncological principles should be strictly observed in surgical treatment. Though a rare cause of acute abdomen and/or ileus in adults, invagination is a clinical condition that must be kept in mind in the differential diagnosis.

Identification of functions of DWnt4 gene in ventral epidermis of embryos and abdomen of adult Drosophila during development

Wnt protein forms a multigenic family secreting signaling molecules important for various key developmental events in animals. Wingless (wg) is the prototype member of Wnt gene family, while DWnt4 has been identified recently from a clonal library of proteins associated in vivo with Ubx protein. DWnt4 has been reported to function in embryo epidermis patterning, female gonade development, motor neuron axon guidance. In this study, validation was done for some reported functions of DWnt4 with ectopic expression and identified some novel functions using RNA interference. Knockdown of DWnt4 caused in ventral ectoderm reduced denticles with loss of one or two rows or entire denticle belt. Loss of DWnt4 also loss of polarity of wing hairs, loss of wing veins and notched wing phenotype. All the bristles from adult abdomen were lost when DWnt4 was driven with ubiquitous driver actineGal4. Tissue specific drivers enGal4 caused loss of polarity of dorsal tergite bristles and patches of tergites from adult abdomen. Thus, the DWnt4 seems to function in the cuticular differentiation of adult abdomen polarity of tergites bristles in Drosophila.

Hyperbilirubinemia as a Significant Indicator in Diagnosis of Complicated Acute Appendicitis: A Prospective Study

Background: Acute appendicitis is the most common cause of acute abdomen in young adults. In recent years, studies emerged showing that elevated serum total bilirubin levels could indicate a complicated case of acute appendicitis. An elevated serum total bilirubin that is not explained by liver disease or biliary obstruction can be present in many patients of acute appendicitis. Patients and methods: This is a prospective interventional non-randomized non-controlled study conducted on 175 consecutive cases of acute appendicitis admitted to the emergency unit in the Department of General Surgery at Ain Shams University hospitals, Cairo, Egypt in the period from July 2014 to August 2016. Liver function tests were done as a part of the preoperative investigations. Clinical diagnosis was confirmed postoperatively by histopathological examination. Their clinical and investigative data were analyzed, The level of significance was set at P< 0.05. Results: Serum total bilirubin was found to be significantly elevated in cases of complicated acute appendicitis. Conclusion: Serum total bilirubin is a new important adjunct in the diagnosis of complicated acute appendicitis.

Differential butterfly performance on host plant variants from populations under intense vs. low mammalian herbivory

AbstractEvolutionary interactions between a pair of species can be modified by the presence of another species that interacts with either or both species. However, only a few studies have demonstrated such complex interactions. Here, we report a case where a population of the red admiral butterfly (Vanessa indica) is assumed to change fitness traits in response to an evolutionary change in its major host plant, the Japanese stinging nettle (Urtica thunbergiana), caused by intense browsing pressure from sika deer (Cervus nippon). Nara Park (NP) in Japan has been home to several hundred protected sika deer for approximately 1200 yr, and their intense browsing pressure is assumed to have selected for heavily haired nettles that are more resistant to deer browsing compared to normal lightly haired nettles occurring in areas with low densities of sika deer. We found that the water and nitrogen contents of leaves are lower and the specific leaf mass is higher in heavily haired nettles at NP compared to the lightly haired nettles at the Takatori Castle Site (TCS) 30 km south of NP. Feeding experiments showed that V. indica larvae from NP reared on heavily haired nettles reach a greater adult body mass and relative abdomen mass than those from TCS, suggesting the possibility that the NP V. indica population has adapted to the heavily haired, nutritionally poorer variant. Analysis of the nucleotide sequence of the mitochondrial cytochrome c oxidase subunit I gene of V. indica from NP and nearby locations including TCS found one haplotype exclusive to NP, suggesting that movement of this butterfly is somewhat restricted. However, analysis using amplified fragment length polymorphism markers showed no genetic differentiation between the seven V. indica populations including the NP and TCS populations. These results suggest that adaptation of the NP population to the heavily haired nettle occurred in a relatively short period. Our study demonstrates a rare example of an indirect evolutionary impact of one herbivore (sika deer) on another herbivore (red admiral butterfly) through an evolutionary change in their shared food plant (Japanese nettle).

Intestinal Intussusception: Etiology, Diagnosis, and Treatment.

Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. Idiopathic ileocolic intussusception is the most common form in children and is typically managed with nonoperative reduction via pneumatic and/or hydrostatic enemas. In the adult population, intussusception is uncommon and occurs more often in the small intestine than in the colon. It is associated with lead point pathology in most symptomatic cases presenting as bowel obstruction. When lead point pathology is present in adult small bowel intussusception, it is usually benign, though when malignant it is most frequently due to diffuse metastatic disease, for example, melanoma. In contrast, adult ileocolic and colonic intussusception lead point pathology is most frequently primary adenocarcinoma when malignant. The diagnosis is typically made intraoperatively or by cross-sectional imaging. With increasingly frequent CT/MRI of the adult abdomen in the current era, transient and/or asymptomatic intussusceptions are increasingly found and may often be appropriately observed without intervention. When intervention in the adult population is warranted, usually oncologic bowel resection is performed due to the association with lead point pathology.

Avoidance, escape and microstructural adaptations of the tea green leafhopper to water droplets.

Rain and dew droplets can dislodge or drown small insects and may be important factors that drive adaptations for avoidance and escape. Studying the microstructure of small insects and insect behaviour can help understand these adaptations. We quantified avoidance behaviour and entrapment of nymphs and adults of the tea green leafhopper (Empoasca onukii) using simulated rainfall onto host plant foliage and made observations of pretarsi and abdomen microstructures. Adults responded rapidly to simulated rainfall and escaped by jumping whilst most young nymphs were washed from water-sprayed leaves though older nymphs tended to remain on leaves and subsequently escaped from water droplets. Adults had denser covering of water-repelling brochosomes on pretarsi and abdomen surface than nymphs, and were able to stand on water film whilst most nymphs had multiple penetrating tarsi. Removal of brochosomes from the abdomen of adults reduced hydrophobicity, demonstrating the hydrophobic significance of brochosomes in the capacity of leafhopper to escape from water droplets. Nymphs exhibited a higher pull-off force than adults. This research is one of the few studies to focus on the wettability and water avoidance of small insect pests and has implications for pest management.

Bioassay and Scanning Electron Microscopic Observations Reveal High Virulence of Entomopathogenic Fungus, Beauveria bassiana, on the Onion Maggot (Diptera: Anthomyiidae) Adults.

When flies were dipped in 1 × 108 conidia/ml conidia suspensions and then kept in the incubator (22 ± 1 °C, 70 ± 5% RH), scanning electron microscope observations revealed that, at 2 h, the majority of adhering Beauveria bassiana conidia were attached to either the wing surface or the interstitial area between the macrochaetae on the thorax and abdomen of the onion maggot adults. Germ tubes were being produced and had oriented toward the cuticle by 18 h. Penetration of the insect cuticle had occurred by 36 h, and by 48 h, germ tubes had completely penetrated the cuticle. Fungal mycelia had emerged from the insect body and were proliferating after 72 h. The superficial area and structure of the wings and macrochaetae may facilitate the attachment of conidia and enable effective penetration. The susceptibility of adults to 12 isolates, at a concentration of 1 × 107 conidia/ml, was tested in laboratory experiments. Eight of the more potent strains caused in excess of 85% adult mortality 8 d post inoculation, while the median lethal time (LT50) of these strains was <6 d. The virulence of the more effective strains was further tested, and the median lethal concentrations (LC50) were calculated by exposing adults to doses ranging from 103-107 conidia/ml. The lowest LC50 value, found in the isolate XJWLMQ-32, for the adults was 3.87 × 103 conidia/ml. These results demonstrate that some B. bassiana strains are highly virulent to onion maggot adults and should be considered as potential biocontrol agents against the adult flies.

“Chronic Recurrent Abdominal Pain And Evaluation of Disease By Various Diagnostic Modalities”

OBJECTIVES: This study is done to make a definitive diagnosis by using various diagnostic modalities available at Coimbatore Medical College Hospital and to identify the Common etiologies for Chronic Recurrent Pain. METHODS: This study was conducted at Coimbatore Medical College Hospital. A sample size of 50 patients with complaints of Chronic Recurrent pain abdomen were taken into this study. The patients with Acute Abdomen, patients undergoing previous surgeries and urological and Gynaecological causes were excluded from this Study. RESULTS: Of the total 50 patients studied, it was found that the incidence was more commoner in males, and patients between 31-40 years were commonly affected.16 of the 50 patients were Alcoholics for more than 10 years and Chronic smokers and vegetarians were less commonly affected than people taking mixed diet. The patients with low Socio Economic status were commonly affected in this study. This study also showed that OGD scopy revealed the diagnosis in patients with peptic ulcer disease, GORD and Gastritis, CT was confirmatory in case of Chronic pancreatitis and colonoscopy proved its importance in identification of intra luminal pathologies such as Neoplastic Growth. Of the total 50 patients 43 patients were treated conservatively of which 17 got relieved of their symptoms and 7 patients were subjected to surgical treatment of which 4 patients got relieved of their symptoms. CONCLUSION: The common etiology for chronic recurrent pain abdomen in adults at Coimbatore Medical College Hospital was peptic ulcer, chronic pancreatitis, Gastritis, GORD, TB abdomen followed by malignancy. For patients with upper abdominal pathology, endoscopy proves to be a confirmatory diagnosis and for patients with lower abdominal pathology CT abdomen and diagnostic Laparoscopy gives better information in arriving at a diagnosis. For 5 out of total 50 patients, definitive diagnosis could not be established inspite of all investigations. These patients were classified as chronic intractable abdominal pain, which is found to be more common in females. They were given placebo and referred to psychiatrists for further management.

A pictorial key to the sections, groups, and species of the Aedes (Diceromyia)in the Afrotropical Region (Diptera: Culicidae).

Nine species of the subgenus Diceromyia Theobald of genus Aedes Meigen in the Afrotropical Region are treated in a pictorial key based on diagnostic morphological features. Images of the diagnostic morphological structures of the adult head, thorax, abdomen, leg and wing are included. The medical importance of the Furcifer Group species in Africa was briefly reviewed.

Adult idiopathic ileocolic intussusception: A case report

Introduction: Intussusception is a rare cause of acute abdomen in adults. Traditionally, management of adult intussusception has mandated surgical interventions due to a high incidence of malignant lesion resulting in intussusception. However, recent literature challenges the traditional view of mandatory surgical interventions for all adult intussusceptions due to an increasing number of benign and idiopathic cases. These benign and idiopathic cases of adult intussusceptions are more readily identified partly due to recent widespread use of computed tomography imaging technique. With the growing number of idiopathic cases, recent literature recommends against the traditional mandatory operative exploration of all adult intussusceptions, only advocating surgical interventions for selected cases. Case Report: A 38-year-old female presented with an acute onset of severe right-sided abdominal pain with associated nausea, vomiting and rectal bleeding to our emergency department. Her computed tomography scan of abdomen and pelvis showed an ileocolic intussusception which had advanced to the level of the hepatic flexure without any mass

Determination of reference dose levels among selected X-ray centers in Lagos State, South-West Nigeria

Background: With increasing use of diagnostic X-ray machines across Lagos, South-West Nigeria, relevant international bodies have proposed the use of reference dose levels (RDLs) to help manage radiation dose to patients without compromising image quality. Objectives: The purpose of this study was to determine the entrance surface dose (ESD) at third quartile (75 th percentile) in Lagos metropolis for normal adult radiographic examinations and to compare them with national and international established reference dose guidelines. Materials and Methods: One dedicated X-ray unit in each diagnostic center was used for this study denoted as H1-H10. A noninvasive Unfors ThinX RAD kilovoltage (kVp) meter which served as the phantom (mimicked patient) was used for measurements. The ESDs were determined by placing the Unfors ThinX RAD kVp meter on the patient's table bucky at a source to image distance (SID) of 100 cm and at the erect bucky at a SID of 180 cm. The peak tube kVp was varied at different milliampere seconds (mAs). Results : The mean ESD for adult postero-anterior (PA) chest, antero-posterior (AP) Abdomen and (AP) lumbar spine X-ray examination were 0.603, 2.57, and 2.57 mGy, respectively. While the ESD for the third quartile for adult (PA) chest, (AP) abdomen, and (AP) lumbar spine X-ray examination among the ten X-ray centers were 0.93, 2.74, and 2.47 mGy, respectively. Conclusion: Third quartile ESD which translate to RDL for adult (PA) chest examination for this study was higher compared to other national and international RDLs but adult (AP) abdomen and lumbar spine examinations were within accepted national and international range.

Imaginal Disc Transplantation in Drosophila.

Since Ephrussi and Beadle introduced imaginal disc transplantation to Drosophila research in 1936, the method played an important part towards a better understanding of disc patterning, tissue regeneration, and reprogramming phenomena like transdetermination. Despite increasing usage of high-throughput approaches towards solving biological problems this classical manual method is still in use for studying disc development in a semi-physiological context. Here we describe in detail a protocol and provide recommendations on the procedure in particular for analyzing the regenerative potential of imaginal disks. The steps consist of disc dissection and fragmentation, transplantation into the larval or adult abdomen, and the recovery of implants from the host abdomen. Additionally, we also describe how to make the special transplantation needle from a glass capillary.

Evaluation of the effects of subject thickness on the exposure index in digital radiography

The exposure index (EI) was proposed as a new X-ray dose index by the International Electrotechnical Commission (IEC) and has since been implemented as an international standard. The EI is calculated by use of an approximation equation under IEC-specified calibration conditions. However, several factors encountered in clinical practice, including the patient's body thickness and the tube voltage, differ with regard to these calibration conditions. We, therefore, require a solid water phantom-based function that can incorporate the IEC-specified conditions and different subject thicknesses to evaluate the effects of subject thickness on the EI. Here, we assumed average thicknesses of 10cm for a child, 15cm for slender patients, and 21cm for an average adult abdomen and we evaluated errors, that are included in the EI, which were calculated by use of the function. Our results suggested that the EI depends on the subject thickness. At the 21-cm thickness (average adult abdomen), the display EI exhibited a small error level. In contrast, EI values calculated from the calibration conditions exhibited maximum errors that were as high as 34% at the lower subject thicknesses (10 and 15cm), suggesting a significant influence of the subject thickness on the EI. In conclusion, the EI should be used cautiously during the examination of children and thin patients, with a complete understanding of the discrepancy revealed by our study results.

Knockdown of NADPH-cytochrome P450 reductase results in reduced resistance to buprofezin in the small brown planthopper, Laodelphax striatellus (fallén)

NADPH-cytochrome P450 reductase (CPR) plays an important role in cytochrome P450 function, and CPR knockdown in several insects leads to increased susceptibility to insecticides. However, a putative CPR gene has not yet been fully characterized in the small brown planthopper Laodelphax striatellus, a notorious agricultural pest in rice that causes serious damage by transmitting rice stripe and rice black-streaked dwarf viruses. The objective of this study was to clone the cDNA and to knock down the expression of the gene that encodes L. striatellus CPR (LsCPR) to further determine whether P450s are involved in the resistance of L. striatellus to buprofezin. First, the full-length cDNA of LsCPR was cloned and found to contain an open reading frame (ORF) encoding a polypeptide of 679 amino acids with a calculated molecular mass and isoelectric point of 76.92kDa and 5.37, respectively. The deduced amino acid sequence shares high identity with the CPRs of other insects (98%, 97%, 75% and 68% for Sogatella furcifera, Nilaparvata lugens, Cimex lectularius and Anopheles gambiae, respectively) and possesses the characteristic features of classical CPRs, such as an N-terminal membrane anchor and conserved domains for flavin mononucleotide (FMN), flavin adenine dinucleotide (FAD) and nicotinamide adenine dinucleotide phosphate (NADPH) binding. Phylogenetic analysis revealed that LsCPR is located in a branch along with the CPRs of other hemipteran insects. LsCPR mRNA was detectable in all examined body parts and developmental stages of L. striatellus, as determined by real-time quantitative PCR (qPCR), and transcripts were most abundant in the adult abdomen and in first-instar nymphs and adults. Ingestion of 200μg/mL of LsCPR double-stranded RNA (dsLsCPR) by the planthopper for 5days significantly reduced the transcription level of LsCPR. Moreover, silencing of LsCPR caused increased susceptibility to buprofezin in a buprofezin-resistant (YN-BPF) strain but not in a susceptible (YN) strain. These data further suggested that the P450-mediated metabolic detoxification of xenobiotics might be an important mechanism for buprofezin resistance in L. striatellus.

Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study.

To evaluate the potential of low tube voltage dual source (DS) single energy (SE) and dual energy (DE) computed tomography (CT) to reduce contrast media (CM) dose in adult abdominal examinations of various sizes while maintaining soft tissue and iodine contrast-to-noise ratio (CNR). Four abdominal phantoms simulating a body mass index of 16 to 35 kg/m(2) with four inserted syringes of 0, 2, 4, and 8 mgI/ml CM were scanned using a 64-slice DS-CT scanner. Six imaging protocols were used; one single source (SS) reference protocol (120 kV, 180 reference mAs), four low kV SE protocols (70 and 80 kV using both SS and DS), and one DE protocol at 80/140 kV. Potential CM reduction with unchanged CNRs relative to the 120 kV protocol was calculated along with the corresponding increase in radiation dose. The potential contrast media reductions were determined to be approximately 53% for DS 70 kV, 51% for SS 70 kV, 44% for DS 80 kV, 40% for SS 80 kV, and 20% for DE (all differences were significant, P < 0.05). Constant CNR could be achieved by using DS 70 kV for small to medium phantom sizes (16-26 kg/m(2)) and for all sizes (16-35 kg/m(2)) when using DS 80 kV and DE. Corresponding radiation doses increased by 60%-107%, 23%-83%, and 6%-12%, respectively. DS single energy CT can be used to reduce CM dose by 44%-53% with maintained CNR in adult abdominal examinations at the cost of an increased radiation dose. DS dual-energy CT allows reduction of CM dose by 20% at similar radiation dose as compared to a standard 120 kV single source.