Prolonged Irritation Research Articles

An Insilco approach on Trachyspermum Ammi to Discover a Drug that Reduces the Burden of Gallstone and Gallbladder Tumor

Nowadays, after pandemic circumstances peoples from developing countries and in particular Indians have faith towards herbal medicine to treat chronic disorders. Based on the previous literature it is stated that Indians has genetic impact for the formation of gallstones in liver. The mutation on a single gene in the liver may leads to liver malfunctions and stone formation. In Tamil Nadu most commonly peoples were affected with two types of stone with the major compositions of bilirubin, cholesterol, and calcium with 26%, 7%, and 8 % respectively. Initially gallstone is asymptomatic under medical diagnosis; the burden of disease increases day-by-day prolonged irritation of gall stone in gall bladder may leads to cancer. The mortality rate increases as the disease progresses. Hence, peoples are in need of alternate medicine to treat gall stone initially. In this regard, peoples of south part of India believe herbal medicine to treat and reduce the burden without any side effect. Based on the above, we made an attempt to find the bioactive compounds from Trachyspermum ammi (Ajwain seeds) using ethanol, petroleum ether and water for extraction. Gas chromatography-mass spectroscopy was used to analyze the plant's ethanol extract (GC-MS). Out of the thirty compounds that were chosen based on retention time, five aromatic functionally active compounds underwent docking studies using the bicyclo [3.1.0] of the tumor suppressor protein's SMAD4 receptor. hexan-2-ol, oleyl alcohol, trifluoroacetate, 3-cyclohexen-1-ol, 4-methyl-1-(1-methylethyl)-, thymol, phosphinoline, 1,2,3,4-tetrahydro-. The Insilco studies with protein-drug interaction significantly interact with 10 different proteins as a cascade process for biological changes. The result of the present study concluded that the extract has anti-inflammatory, antimicrobial, antioxidant, anticancer activity, specifically for gallbladder.

A New Insight Into Ectopic Sebaceous Glands in the Vagina: A Result of Surgery?

Abstract Introduction/Objective Ectopic sebaceous glands with or without hair follicles are well documented in a variety of sites including the vulva, cervix, esophagus, and male genitalia. Ectopic sebaceous glands in the vagina, however, are extremely rare, with only 2 case reports and a third case described in a journal correspondence letter in the English literature. Methods/Case Report We present a 39-year-old patient with Laurence-Moon-Biedl syndrome with pseudotumor cerebri, retinitis pigmentosa/macular degeneration, chronic kidney disease status post renal transplant, obesity, diabetes insipidus, and a urethrovaginal fistula and hypoplastic vagina status post repair and vaginoplasty at age 3 months. High grade squamous intraepithelial lesion on a cervicovaginal Pap test prompted colposcopy, during which a confluent plaque non-staining with Lugol’s solution was noted on the right vaginal sidewall extending from the introitus to 4 cm distal to the cervix. Biopsy of this area revealed hyper- and parakeratosis along with sebaceous glands and hair follicles in the subepithelial stroma. Two theories are proposed in the literature regarding the origin of vaginal ectopic sebaceous glands/cutaneous adnexal structures. The first is a developmental anomaly with aberrant differentiation in-utero, as the lower two thirds of the vagina is normally endodermal in origin and the upper one third is derived from mesoderm, while cutaneous adnexal structures are ectodermal in origin. The second postulates sebaceous glands in the vagina arise from a metaplastic process after prolonged irritation or inflammation. We add a third possibility in this patient, that vaginal plastic surgery performed at 3 months of age involved tissue re- arrangement or grafting which introduced ectodermal structures to the vagina. The patient’s vaginal surgical records were not available for review. Results (if a Case Study enter NA) NA. Conclusion We add a fourth case of ectopic cutaneous adnexal structures in the vagina in a patient with Laurence-Moon-Biedl syndrome to the literature. The origin of these structures may have resulted from vaginal surgery as an infant rather than from a developmental anomaly or metaplasia.

The reaction of the body during the implementation of the spokes of transosseous fixation devices in biologically active zones

Connection between complications (local and general) and lesions as well as prolonged irritation of biologically active zones by pins during external intraosseous osteosynthesis was detected and proved. Preventive measures of those complications were elaborated. Those preventive measures included insertion of pins beyond active zones after preliminary marking of active points (or canal). Observance of those rules provided decrease of the complication rate by 1.6 times when hinge-distraction devices were used and decrease by 1.8 times in application of reposition- fixation devices. When complications occurred the most radical treatment was either removal of pin that injured the biologically active point or reinsertion of that pin beyond the zone. Analysis of 770 cases (320 patients with hinge-distraction devices and 450 patients with reposition- fixation devices) was taken as a principle of that work.

The biliary continuum: an up-to-date look at biliary tract diseases

In the structure of gastrointestinal diseases, the pathology of the hepatobiliary system currently ranks second in frequency of occurrence. The stages of diseases of the biliary system can be combined into the so-called “biliary continuum”, when one patient has a consistent development of pathogenetically related diseases of the biliary tract. The progressive course of functional motility disorders of the biliary tract gradually leads to the development of organic pathology, including chronic cholecystitis, the subsequent development of gallstone disease and possible postcholecystectomy complications. Among the diseases of the biliary system, one of the most frequently used diagnoses is chronic cholecystitis. The development of chronic cholecystitis is associated with repeated attacks of acute inflammation or prolonged irritation of large gallstones. The clinical aspects of chronic cholecystitis and other pathologies included in the the «biliary continuum» largely depends on concomitant dyskinesia. There are several directions for the treatment of pathologies of the biliary system: diet therapy, medication, endoscopic and surgical treatment. According to the latest guidelines, the most important direction in modern therapy of diseases of the biliary system is the restoration of the motility of the biliary tract and the normalization of the physicochemical properties of bile. The central place in the treatment of diseases of the “biliary continuum” is given to antispasmodic drugs. The administration of antispasmodics is recommended in order to relieve biliary pain and dyspeptic symptoms caused by spasm of smooth muscles, as well as to control the inflammatory process due to a decrease in the release of pro-inflammatory substances. This article describes in detail the importance of the recovery of the biliary tract motor activity and the improvement of the physico-chemical properties of bile acids.

Neurotoxic alkaloid in pollen and nectar excludes generalist bees from foraging at death-camas,Toxicoscordion paniculatum(Melanthiaceae)

AbstractMany plants produce broadly active toxins to which specialist herbivores—typically insects—have evolved counter-adaptations, sometimes spawning co-evolutionary arms races. Many non-social bee species are likewise taxonomic host specialists, but the specialists’ pollen hosts frequently attract diverse floral generalists as well, even to flowers of plants that are otherwise chemically defended. In this study of foothills death-camas, Toxicoscordion paniculatum (Nutt.) Rydberg (formerly Zigadenus), we show that its pollen and nectar both contain zygacine, the steroidal alkaloid responsible for this plant’s notorious mammalian toxicity. Hungry naïve adults of a generalist solitary bee, Osmia lignaria Say (Megachilidae), would briefly drink death-camas nectar or biologically relevant doses of zygacine in syrup, followed by prolonged bouts of irritable tongue grooming; many became paralyzed and some even died. Larvae fed dosed provision masses likewise often ceased feeding and sometimes died. Prolonged irritation and subsequent deterrence of foraging O. lignaria likely illustrates why it and 50+ other vernal bee species were absent from death-camas flowers in a five-state survey. The sole visiting bee, Andrena astragali, foraged exclusively at death-camas flowers for pollen and nectar. Thus, a toxic alkaloid found in death-camas pollen and nectar deters generalist bees from flowers of this pollinator-dependent monocot, restricting visitation to a single specialist bee that tolerates death-camas toxins and is its likely pollinator.

ОZONETHERAPY INFLUENCE ON MORPHOLOGIC CHANGES OF LIVER IN PURULENT INFLAMMATION OF THE LUNGS IN THE EXPERIMENT

Relevance. Ozone increases the oxygen transport function of the blood. The use of ozone therapy for pulmonary pathology is promising. The effect of ozone therapy is associated with the ability of ozone to eliminate hypoxemia and tissue hypoxia, which is always present in patients with pathology of the bronchopulmonary apparatus. Objective: to study morphofunctional changes in liver tissue, in the dynamics of the use of ozonized water in rats in an experimental model of chronic purulent pneumonia.Materials and methods. Three groups were formed from 30 male white rats (180-200 g). In group 1 (n = 10) healthy rats were injected intraperitoneally with 5 ml of ozonated (0.02 mg / L) 0.9% NaCl once a day for 10 minutes. Course 10 days. Animals of the 2 (n = 10) and 3 (n = 10) groups were first modeled for chronic pneumonia. For this, under local novocaine anesthesia, a 1.5-2.0 cm long incision was made on the animal's neck. A nylon thread with a diameter of 0.4 mm and a length of 10-12 cm was inserted into the lumen of the trachea, between its rings, on a thin piercing needle. The distal end of the thread was located in the lumen of the trachea, and its proximal end was fixed on the skin. The wound was sutured tightly in layers. After 45 days, the thread was removed without opening the trachea. Subsequently, animals of group 2 did not receive treatment. And rats of group 3 were injected once a day with 5 ml of ozonized (0.02 mg / l) 0.9% NaCl for 10 minutes. Course 10 days. The animals were removed from the experiment by instant decapitation. The taken pieces of the liver were fixed in formalin. Histological sections were stained with hematoxylin and eosin. Microscopy was performed using an XS-213 light microscope and a Leica microscope. Results. With prolonged irritation of the respiratory tract, structural changes in the liver, characteristic of toxic hepatitis, were revealed. After treatment with ozonated saline, the morphological picture of the liver improved. In healthy rats, ozone therapy did not have a negative effect on the general condition and behavior of the animals. Conclusions. Treatment with ozonated saline improves the morphological picture of the liver of rats with chronic pneumonia.

Hypochlorous acid antiseptic washout improves patient comfort after intravitreal injection: A patient reported outcomes study.

Purpose:Current ocular antiseptic practice for intravitreal injection (IVI) employs 5% povidone–iodine (Betadine®) drops which frequently cause ocular discomfort and prolonged irritation. In an effort to improve comfort while maintaining efficacy, we studied a hypochlorous acid (HOCL 0.01%) spray washout prior to injection.Methods:Patients had received a minimum of 3 IVIs prepared with Betadine® antisepsis prior to entry in this study. Their subsequent IVIs were prepared with Betadine® followed by HOCL 0.01% washout. Facets of comfort were measured by a Likert-scaled questionnaire to compare their experiences after IVI.Results:Thirty-seven participants were enrolled. Addition of HOCL 0.01% spray after Betadine® reduced the duration of discomfort (P = 0.001) and need for artificial tears postinjection (P = 0.003). It improved their reported quality of life (P = 0.04) and sleep (P = 0.01). There were neither HOCL-related side effects nor endophthalmitis during this study.Conclusion:Topical HOCL 0.01% spray after topical Betadine® antisepsis significantly improved patient comfort following IVIs.

Sumbawanga eye camp follow-up study 2019

In 2019 the German Commission for the Prevention of Blindness (DKVB) held an eye camp in the Tanzanian town of Sumbawanga. For patients with mature cataracts and the ability to see light cateracts were treated by manual small incision cataract surgery (MSICS). For the first time in this camp the quality of the results of the cataract operations was measured. The quality of the cataract operations is presented and the results were assessed in the context of the guidelines of the World Health Organization (WHO). Those patients who had acataract operation in the first week were examined during the second week with respect to the parameters vision, refraction, split lamp microscopic findings, results and complications after surgery. The results were retrospectively evaluated and compared with the guidelines of the WHO. A total of 42postoperative patients from the eye camp could be examined within 5-9days after cataract sugery. The following parameters were found: median postoperative visual acuity 0.26, spherical equivalent -2.82 dpt, astigmatism -2.2 dpt, axis 113°. Visual acuity >0.3 in 14.2% (WHO 80%), vision 0.1-0.3 in 62% (WHO 15%), vision <0.1 in 23.8% (WHO 5%). Prolonged healing time and intraocular irritation in 29% of the cases. Although the vision improved, the results are sobering when taken in the context of the WHO guidelines. The postoperative refraction showed amyopic shift and an high level of astigmatism. The reasons are manifold: ocular comorbidities, limited diagnostic and therapeutic possibilities in anonclinical setting. Other factors are the kind of training of the staff in the camp, the difficult circumstances and advanced findings. Consideration of the results of this study is imperative to be able to measure the quality of the work and to create the potential to make future improvements.

THE INFLUENCE OF OZONE THERAPY ON THE MORPHOLOGIC CHANGES IN THE PATIENTS PRESENTING WITH PURULENT INFLAMMATION OF THE LUNGS IN THE EXPERIMENT

We have created the experimental model of chronic inflammation of lungs by means of prolonged mechanical irritation of the bronchi in 30 outbred rats and studied the morphological changes in the lung tissue of these animals rats in three series of experiments. Each rat was given an intraperitoneal injection of an ozonised saline solution produced by a «Binafsha» ozonator. The objective of the study was to compare a control group of healthy animals and the group of experimental animals with chronic purulent pneumonia. The prolonged irritation of the respiratory tract in experimental animals was found to induce the structural changes in the tissues of the lungs characteristic of chronic purulent inflammation. The course of treatment with the ozonised saline solution in healthy animals with experimentally modelled chronic purulent inflammation of the lungs did not have a negative impact on the general condition and the behaviour of the animals. The treatment of experimental chronic inflammation of lungs caused by prolonged mechanical irritation of the respiratory tract resulted in the improvement of the morphological status of the laboratory animals, but the purulent inflammation process failed to be completely resolved after the treatment which needs to be taken into consideration in the clinical practice.

QUALITATIVE AND QUANTITATIVE CHANGES IN THE CELLULAR COMPOSITION OF GUMS IN PATIETS WITH PERIODONTAL DISEASES

Background. The results of a comprehensive study of cytological features of epithelial differentiation processes in gums in patients with generalized periodontitis are presented in the article.Objective. The objects of clinical observations were patients with generalized periodontitis. The disease duration was 3-5 years.Methods. Material for the study was gums epithelium taken from a marginal area of gums in young adults, with generalized periodontitis. The epithelium was removed with a spatula, with subsequent transfer to a glass plate and drying in the open air for 3-5 minutes. The colouring of the material was done according to Romanovskyy-Himza, with a next microscopic and morphological analysis, taking into account the percentage of different forms of epithelial cells in normal and due to an age aspect.Results. One of cytological signs of periodontal pathology in young people is epithelial cells with signs of irritation. It should be noted that these cellular elements belong to the intermediate layer of cells that meet histological sections and ribbed surface layers are characterized by homogenization and vacuolization of cytoplasm as a manifestation of prolonged irritation by bacterial cell aggression.Conclusions. Analysis of cytograms proved general periodontitis in the examined patients, in absence of adequate therapy as automotive continuous process. Its components may regress under the influence of effective treatment and re-activate during exacerbation of the inflammatory process under the influence of pathogenic factors such as microbial, hygienic and immune.

The Laparoscopic Management of the Ureteropelvic Junction Obstruction: Our Initial Experience

Objective: Higher morbidity rates, extensive scar tissue formation and longer hospitalization periods of the standard open surgical methods for ureteropelvic obstruction has led to acceleration of minimal invasive techniques. Success rate and clinical outcomes of laparoscopic pyeloplasty has become comparable with open surgery. Purpose: The aim was to evaluate the clinical results and complications of transperitoneal laparoscopic pyeloplasty in ureteropelvic obstruction. Material and Methods: Thirty-three patients with ureteropelvic obstruction were enrolled into this study. Eighteen patients underwent Anderson-Hynes dismembered Pyeloplasty and 15 underwent Y-V plasty. Patients were followed-up at postoperative 3., 6. months and then yearly. Partial or total relief of symptoms and improvement in diuretic renogram were accepted as success. Results: Median age was 34.5±15.5(13-74) years, number of males were 13 (39.4%) and females were 20 (60.6%). Median Body Mass Index (BMI) was 25.3±15.4(18.5-33.4). Eight were asymptomatic, and 23 had intermittent pain, preoperatively. Fourteen cases had left ureteropelvic obstruction (42.4%) and 19 had in the right kidney . Intraoperatively 19 cases had aberrant vessel. Mean surgery time was 127.9±38.9 (68-245) minutes, median anastomosis time was 20.8±7.3 (8-39) minutes. Median blood loss was 57.1±28.3 (20-150) mL, median postoperative drainage time was 2.6±1.1 (2-7) days. Only one had prolonged ileus and peritoneal irritation findings. Median narcotic and nonnarcotic requirements were 21.5±4.8 (15-30) and 132.6±37.2 (75-200) mg/day, respectively. Median follow-up period was 35.1±13.6 (11-59) months. Conclusions: Laparoscopic pyeloplasty, is minimally invasive and reliable technique replaces open pyeloplasty in many institutions. Shorter hospitalization, lower postoperative morbidity rates, better cosmetic results and higher success rates can be easily achieved..

Changes in plasma steroids and cytokines levels in betel chewing patients in Taiwan

Betel nut is the second largest economic food product in Taiwan. In Southeast Asia, the habit of chewing betel nut seems to be highly correlated with oral submucous fibrosis and oral squamous cell carcinoma. Oral submucous fibrosis is characterized by abnormal accumulation of oral submucous collagen fibers and limitation of mouth opening. Although the mechanism responsible for tissue damage is still unknown, prolonged irritation caused by betel nut and tobacco is considered to be a major factor contributing to the pathogenesis of oral submucous fibrosis. The effect of betel nut chewing on immune system remains unknown. Present study aims to investigate the change of plasma hormones including cortisol, testosterone, and inflammatory cytokine concentrations in male chewing betel nut compared with normal subjects. Heparinized blood was obtained from control group (normal young+mid-aged individuals), betel nut-chewing, and oral cancer male subjects. The study was approved by the Ethics Committee of the Chang-Gung Memorial Hospital. Written informed consent was granted by the patients. Plasma cortisol and testosterone concentrations were detected by commercial enzyme-linked immunosorbent assay (ELISA). The inflammatory cytokines, including interleukin-1β (IL-1β), IL-15, tumor necrosis factor-α (TNF-α), were analyzed by ELISA with commercial monoclonal capture antibodies and polyclonal detection antibodies. The median concentrations of plasma IL-1β, IL-15, and TNF-α were 3.14pg/ml, 3.14pg/ml, and 6.85pg/ml, respectively, in patients with oral cancer, compared with median plasma IL-1β, IL-15, and TNF-α concentration of 2.64pg/ml, 5.86pg/ml, and 5.38pg/ml, respectively, in patients with betel nut-chewing habit. In contrast, the median concentrations of plasma IL-1β, IL-15, and TNF-α in mid-aged males (aged 30–50) were 7.00pg/ml, 10.64pg/ml, and 31.73pg/ml, respectively, compared with median plasma concentration of IL-1β, IL-15, and TNF-α of 4.48pg/ml, 33.36pg/ml, and 97.77pg/ml in young males (aged 20–22), respectively. Also, significantly elevated plasma cortisol concentration was noted in betel nut-chewing (median 727.2ng/ml) and oral cancer patients (561.9ng/ml) compared to the mid-aged (176.8ng/ml) and young males (173.4ng/ml), respectively. In addition, lower plasma testosterone concentrations were found in betel nut-chewing subjects compared with young males (2.6±3.3ng/ml vs 6.2±2.9ng/ml). To summarize, the inflammatory cytokines and steroid hormones may reflect the degree of inflammation in betel nut-chewing males and the oral cancer subjects. The above findings suggest that betel nut-chewing or oral cancer inhibits plasma cytokines and regulates steroid hormones concentrations compared to mid-aged or young normal subjects. It is also indicated that betel nut-chewing causes decreased inflammatory cytokines as the same levels as in oral cancer subjects.

Ectodermal Structures Within the Uterine Cervix and Vagina

Ectodermal structures, in the form of sebaceous glands and hair follicles, are extremely rare within the cervix and vagina. We describe the clinicopathologic findings in 11 cases (10 cervix, 1 vagina) with a view to exploring the histogenesis of this unusual phenomenon. The cases occurred in patients aged 33 to 71. In 10 of the cases, sebaceous glands were present that were associated with hair follicle-like structures in 3 cases forming pilosebaceous units. In the other case, hair follicle- and sweat gland-like structures were present; the latter have not been previously described in the cervix. The ectodermal structures were usually either attached to the basal layer of the surface squamous epithelium or lay "free" within the superficial stroma, although in 1 case sebaceous glands were located within the squamous epithelium. The squamous epithelium overlying the ectodermal structures typically exhibited hyperkeratosis. Although we were unable to definitively resolve the debate as to whether ectodermal structures within the cervix and vagina represent misplaced embryonal tissue and a true heterotopia or a "metaplastic" process, we favor the latter as a response to prolonged irritation or chronic injury.

Primary mucinous adenocarcinoma of the renal pelvis

Mucinous adenocarcinoma of the renal pelvis is a rare disease and preoperative diagnosis is difficult. It often presents with a mucinous-like discharge and is associated with prolonged irritation of inflammation or infection. We present a case in which the patient suffered from right flank dull pain with staghorn stone, and share our clinical experience of renal pelvis mucinous adenocarcinoma. The patient underwent right nephroureterectomy and pathological stage was pT1. He did not receive adjuvant chemotherapy. No recurrent tumor or metastasis was noted for about 1 year.

Ovarian Artery Embolization in Patients With Collateral Supply to Symptomatic Uterine Leiomyomata

To evaluate the safety and outcome of ovarian artery embolization (OAE) in patients with collateral supply to symptomatic uterine leiomyomata. Thirteen patients with relevant leiomyoma perfusion by way of enlarged ovarian arteries underwent additional OAE during the same (N = 10) or a second procedure (N = 3). Uterine artery embolization (UAE) was performed bilaterally in 10 and unilaterally in 2 patients with a single artery. One patient had no typical uterine arteries but bilaterally enlarged ovarian arteries, prompting bilateral OAE. OAE was accomplished with coil embolization in one and particle embolization in 12 patients. Symptoms before therapy and clinical outcome were assessed using a standardized questionnaire. Contrast-enhanced magnetic resonance (MR) imaging after embolization was available in 11 of 13 patients and was used to determine the percentage of fibroid infarction. UAE and OAE were technically successful in all patients. One patient experienced prolonged irritation at the puncture site. Median clinical follow-up time was 16 months (range 4-37). Ten of 13 patients showed improvement or complete resolution of clinical symptoms. One patient reported only slight improvement of her symptoms. These women presented with regular menses. Two patients (15%), 47 and 48 years, both with unilateral OAE, reported permanent amenorrhea directly after embolization. Their symptoms completely resolved. Seven patients showed complete and 4 showed >90% fibroid infarction after embolization therapy. OAE is technically safe and effective in patients with ovarian artery collateral supply to symptomatic uterine leiomyomata. The risk of permanent amenorrhea observed in this study is similar to the reported incidence after UAE.

Captan: Transition from ‘B2’ to ‘not likely’. How pesticide registrants affected the EPA Cancer Classification Update

On 24 November 2004 EPA changed the cancer classification of captan from a 'probable human carcinogen' (Category B2) to 'not likely' when used according to label directions. The new cancer classification considers captan to be a potential carcinogen at prolonged high doses that cause cytotoxicity and regenerative cell hyperplasia. These high doses of captan are many orders of magnitude above those likely to be consumed in the diet, or encountered by individuals in occupational or residential settings. This revised cancer classification reflects EPA's implementation of their new cancer guidelines. The procedures involved in the reclassification effort were agreed upon with EPA and involved an Independent Transparent Review as it related to four components that formed the basis of the original 1986 B2 classification: mouse tumors; rat tumors; mutagenicity; and structural similarity to other carcinogens. A Peer Review Panel organized and administered by Toxicology Excellence for Risk Assessment (TERA) met on 2-3 September 2003. The Panel concluded that captan acted through a non-mutagenic threshold mode of action that required prolonged irritation of the duodenal villi as the initial key event. EPA's Cancer Assessment Review Committee (CARC) met on 9 June 2004 and endorsed the Peer Review findings. EPA intended to have the FIFRA Scientific Advisory Panel (SAP) consider the basis for this reclassification but found the science was robust and judged that a SAP review was not warranted. Using the revised classification, the margin of exposure is approximately 1,200,000, supporting the 'not likely' characterization.

Incidence of marginal ulcers and the use of absorbable anastomotic sutures in laparoscopic Roux-en- Y gastric bypass

Objectives A precipitating factor for marginal ulcer formation after Roux-en- Y gastric bypass may be the prolonged irritation by foreign material, such as nonabsorbable suture at the gastrojejunostomy. This study examines the incidence of marginal ulcers before and after a change was made from using nonabsorbable suture to using absorbable suture for the inner layer of the anastomosis. Methods A total of 3285 laparoscopic Roux-en- Y gastric bypass operations were performed during a 5-year period. The gastrojejunostomy technique was modified in August 2002. Those patients who developed a marginal ulcer postoperatively were identified, and their charts were retrospectively analyzed for the operative technique, patient age, history of previous gastric surgery, presence of preoperative diabetes, coronary artery disease, or peptic ulcer disease, and use of nonsteroidal anti-inflammatory medications or tobacco. Results The incidence of marginal ulceration after Roux-en- Y gastric bypass decreased significantly from 2.6% (28/1095) with the use of nonabsorbable suture to 1.3% (29/2190) after the change to absorbable suture for the inner layer of the gastrojejunal anastomosis ( P < .001). The incidence of visible suture adjacent to the ulcer on endoscopy was also significantly reduced (64.3% vs 3.4%; P < .001). When the results were corrected for length of follow-up, the difference in the incidence of ulcers occurring within 1 year of surgery remained significant between the two groups ( P = .002). There were no other significant differences in the factors analyzed. Conclusions The use of nonabsorbable sutures for the inner layer of the gastrojejunal anastomosis is associated with an increased incidence of marginal ulcers, and the adoption of absorbable suture material has reduced this incidence.

REVIEW OF STUDIES CONCERNING THE TUMORIGENICITY OF 2-BUTOXYETHANOL IN B6C3F1 MICE AND ITS RELEVANCE FOR HUMAN RISK ASSESSMENT

The U.S. National Toxicology Program (NTP) has completed 2-yr inhalation exposures in rats and mice with 2-butoxyethanol (BE). This review concerns the most significant findings from those studies and describes recent research into the mechanistic aspects of BE-mediated tumorigenesis in the mouse and the relevance of such effects to humans. Two tumor types were increased in B6C3F1 mice leading to the classification of “some evidence” of carcinogenicity: liver hemangiosarcomas in male mice and forestomach tumors in female mice (primarily benign papillomas). The results of research collected to date indicate that the tumorigenesis noted for BE was produced by indirect mechanisms. In particular, the occurrence of liver hemangiosarcomas in male mice has been linked to oxidative damage subsequent to red blood cell hemolysis and iron deposition in this organ. Oral administration of BE in mice up to 600 mg/kg/d for up to 90 d produces a dose-related increase in iron (Perl’s staining) in Kupffer cells and hepatocytes, increased DNA synthesis in endothelial cells, and enhanced oxidative damage. Further, iron alone, and not BE or BAA, is responsible for producing oxidative damage in cultured hepatocytes from rats or mice. Forestomach neoplasms in female mice were most likely a result of prolonged exposure-induced irritation with compensatory hyperplasia and subsequent tumor promotion. This mechanism is supported by studies indicating elevated levels of BE and BAA in the mouse forestomach tissues and stomach contents following multiple routes of exposure, forestomach epithelial cell cytotoxicity and cell proliferation following administration of BE and BAA, and the increased capacity of forestomach tissues from female mice to metabolize BE to the more irritating metabolite, BAA. The current article summarizes the results of a number of in vivo and in vitro studies designed to elucidate the underlying mechanisms of tumorigenesis by BE in the mouse and discusses the relevance of these for human risk.

A Comprehensive Evaluation of the Carcinogenic Potential of Middle Distillate Fuels

ABSTRACTMiddle distillate fuels (MDFs), which include jet fuel, kerosene, and diesel fuel, are a class of hydrocarbons distilled from crude oil at approximately 350-700°F (176-37 P C). Although MDFs generally do not contain appreciable levels of potentially carcinogenic polycyclic aromatic compounds (PACs), they have produced weak tumorigenic responses in mouse skin characterized by low tumor yield and long latency. Recent studies demonstrated that the tumorigenic effects of these MDFs were dependent upon chronic dermal irritation. In the absence of skin irritation, tumors did not develop.Mechanistic studies suggest that straight-run MDFs containing low levels of PACs cause skin tumors through a nongenotoxic mechanism. MDFs cause chronic skin irritation and injury with repeated application to the skin. They have been found to have little or no activity in the modified Ames mutagenicity assay, lack tumor initiating activity, and are active skin tumor promoters. It has been hypothesized that the tumorigenic response to MDFs results from the promotion of preexisting, spontaneously initiated cells.Two recent studies, a one-year tumor promotion study and a two-year skin painting study, evaluated the role of skin irritation on the tumorigenic activity of MDFs in mice. MDFs were applied in pure and diluted forms to assess the effect of equal weekly doses of irritating and nonirritating test materials. The tumorigenicity of straight-run MDFs correlated to the level of skin irritation. No significant increase in tumor incidence occurred under conditions that resulted in minimal skin irritation and injury. These studies indicate that the tumorigenic activity of MDFs containing low levels of PACs is secondary to chronic skin irritation. These materials should not present a carcinogenic hazard in the absence of prolonged skin irritation.

Nickel and gold in skin lesions of pierced earlobes with contact dermatitis. A study using scanning electron microscopy and x-ray microanalysis.

Cases of contact dermatitis due to nickel and gold especially in pierced earlobes, are increasing in number the world over. However, the presence of these metal fragments has not been demonstrated in the skin lesions. The aim of this study was to demonstrate nickel and gold in contact dermatitis lesions in pierced earlobes. Skin specimens taken from such earlobe lesions were examined using scanning electron microscopy and x-ray microanalysis. The pierced earrings worn when the lesions appeared were examined by the same techniques, and their analysis confirmed. In nickel dermatitis, small, electron-dense fragments were seen in the specimens examined by scanning electron microscopy, and nickel was detected in locations corresponding to these fragments by x-ray microanalysis. In contact dermatitis due to gold, small dense fragments containing gold were observed. It is suggested that small fragments of nickel and gold remain in the skin lesions of pierced earlobes for a long time, even after the studs have been removed, and cause prolonged irritation and various cutaneous reactions.