Barium Sulfate

In this paper, we review the concept and principles of open partial laryngeal surgery, as well as the historical evolution and the indications for the main techniques. We also show our experience with horizontal supraglottic laryngectomy and supracricoid laryngectomy in a population of 123 patient with early and locally advance squamous cell carcinoma of the larynx. Oncologic (90.9% 5-year local control rate and 82.9% 5-year disease specific survival) and functional outcomes (91.9% cannula and feeding tube withdrawal after surgery, and 72.7% 5-year laryngo-esophageal dysfunction-free survival) support the idea that these techniques are useful tools for treating the cancer of the larynx while preserving laryngeal functions. Finally, we discuss the main advantages and drawbacks when comparing this surgery with other function-preserving treatment options, such as transoral laser surgery or non-surgical protocols.

In this study, surface modification of barium sulfate was investigated using several model molecules for chemical treatment: ethanesulfonic acid, butyric acid, trimethoxy(propyl) silane and phosphoric acid 2-hydroxyethyl methacrylate. Samples were characterized by FT-IR and TGA to check the capability of these model molecules to interact with BaSO 4 surface. The results pointed out the presence of an organic layer around the surface after the chemical treatment even after several washings to remove all species in excess. Model molecules were grafted onto BaSO 4 surface and grafted density was determined. It reveals that phosphoric acid and carboxylic acid are the best candidates for the modification of BaSO 4 surface. Both can be used as anchoring groups to modify the hydrophilic balance of barium sulfate surface in order to avoid the formation of aggregates and to improve the compatibility of this filler within hydrophobic polymer matrix.

After reading this article and taking the test, the reader will be able to: Ⅲ Identify the risk factors for primary gastrointestinal lymphoma. Ⅲ Discuss the role of imaging in patients with gastrointestinal lymphoma. Ⅲ Describe the spectrum of imaging features with correlative histopathologic findings in primary gastrointestinal lymphoma.

Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered during clinical practice in Pakistan and is associated with significant impairment of health-related quality of life. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Pakistani accepted directive by the standards of evidence-based medicine is still lacking. Our aim was to create an understanding of the natural history and presentations of reflux disease; evaluating possible treatment options available for the patients with complex and uncomplicated reflux ailments with the development of current and up to date evidence based endorsement, relevant to the needs of Pakistani health care providers in order to treat oesophageal manifestations of GERD. In order to make such guidelines, a comprehensive literature search was conducted with pertinent evidence reviewed, and quality of relevant data assessed. The result...

ImportanceThe Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy.ObjectiveTo (1) describe study participant characteristics and (2) examine who declined participation because of a preference for colonoscopy or stool testing (ie, fecal occult blood test [FOBT]/FIT) and assess that preference’s association with geographic and temporal factors.Design, Setting, and ParticipantsThis cross-sectional study within CONFIRM, which completed enrollment through 46 Department of Veterans Affairs medical centers between May 22, 2012, and December 1, 2017, with follow-up planned through 2028, comprised veterans aged 50 to 75 years with an average CRC risk and due for screening. Data were analyzed between March 7 and December 5, 2022.ExposureC...

This study was a retrospective single-center study conducted in a tertiary care teaching hospital in Puducherry, India, involving 257 introduction Plummer-Vinson syndrome (PVS) is a rare disease of the 21st century characterized by the triad of classical dysphagia, IDA, and esophageal webs. 1 This syndrome is named after two doctors who worked at the Mayo Clinic, Henry Stanley Plummer (1874-1936) and Porter Paisley Vinson (1890-1959). Although the exact cause of this syndrome is uncertain, iron deficiency is thought to be the most likely etiological factor. Other possible causative factors may include undernourishment, an inherent susceptibility, or immunological mechanisms, although their precise involvement in the etiopathogenesis of this syndrome remains unclear. In 1938, Waldenstrom and Hallen demonstrated that this disease could arise with iron deficiency itself, unaccompanied by anemia, thereby coining the term "sideropenic dysphagia." Symptoms of PVS include dysphagia, glossitis, bald tongue, atrophic oral mucosa, angular cheilitis, koilonychia, weakness, pallor, fatigue, and tachycardia. Splenomegaly and goiter may be associated occasionally. PVS can be successfully treated with iron supplementation, followed by mechanical dilation. PVS is a recognized risk factor for SCC of the pharynx and the esophagus, and hence, these patients should be followed up closely. As there are very few studies on this syndrome in the English literature, especially from India, we conducted a clinical retrospective study to understand the predisposing factors, the distribution of the disease, and its association with malignancy in patients from Puducherry, India.

1. Abstract
1.1. Introduction
Tuberculous lymphadenopathy, though typically presenting with
symptoms of tuberculosis, can exceptionally manifest as dysphagia
due to esophageal compression or involvement. This is a rare
occurrence, particularly in adults, and can be misdiagnosed as
esophageal cancer. Tuberculosis commonly affects the lungs, but
it can also involve lymph nodes, particularly in the mediastinum.
Dysphagia, can arise when enlarged mediastinal lymph nodes
compress or invade the oesophagus. While dysphagia is a common
symptom of esophageal cancer, it's a rare presentation of
tuberculous lymphadenopathy, making early diagnosis challenging.
1.2. Case Report
A fourty year old male, not a known case of any chronic illness,
chronic smoker and occasional alcoholic presented with weight
loss for last three months and dysphagia for last one month.
On evaluation he was found to be anaemic but rest of his labs
were essentially normal. On subjecting to endoscopy, an extrinsic
compression was found in mid-oesophagus, thus for determining
aetiology contrast enhanced computed tomography scan was done
which revealed mediastinal lymphadenopathy which was causing
extrinsic compression on oesophagus. The Endoscopic bronchial
ultrasonogram (EBUS) was done for taking FNAC which revealed
infective pathology only and ruled out malignancy. He was put on
four drug antitubercular therapy (ATT) for two months, followed
by two drug therapy for four months. He showed significant
improvement with three weeks and dysphagia completely subsided.
His six months ATT has completed without any adverse side
effects and is totally asymptomatic on follow up.
1.3. Conclusion
Tuberculosis can have varied and uncommon presentations. In
dysphagia, major concern is for malignancy which carries poor
prognosis in majority, in contrast to tuberculosis which can
completely resolved by oral ATT.

We present a 55 years old male with severe anemia with history of pain abdomen for 2 weeks and malena of 10 days duration. He was taking NSAID (Diclofenac sodium). Upper GI endoscopy done twice did not reveal any abnormality. Upper gastrointestinal (UGI) barium series with small bowel follow through revealed a diverticulum on medial wall of second part of duodenum and there was evidence of ulcer in diverticulum. He underwent diverticulectomy. On follow up after 6 months patient was asymptomatic.

Meconium periorchitis (MPO) is an uncommon disease secondary to meconium peritonitis. We report two infants with MPO one of whom presented with acute hydrocele while the other was asymptomatic (incidental diagnosis). Both of them did not have any other associated malformations. Abdomino-pelvic plain X-ray and ultrasound was useful in confirming the diagnosis. Both the patients were managed without surgery. There were no complications at 12-months and 2-months of followup respectively.

Spectral analysis of cardiovascular signals has been extensively used to investigate circulatory homeostatic mechanisms. However, the nature of very low-frequency (VLF) fluctuations remains unclear. Because we previously observed enhanced VLF fluctuations in blood pressure (BP) in the sympathectomized rat (a model characterized by markedly increased plasma epinephrine levels), the aims of our study were to assess whether the genesis of VLF fluctuations in BP depends on circulating catecholamines and to determine which adrenergic receptor(s) and which membrane ion channel(s) are involved. We used continuous intra-arterial BP recordings from unanesthetized unrestrained rats to compute the power of VLF fluctuations in BP in the intact condition, during acute ganglionic blockade with hexamethonium, and after restoration of BP levels by infusion (in addition to hexamethonium) of adrenergic agonists (epinephrine, norepinephrine, and clonidine) or nonadrenergic vasoconstrictors (vasopressi...

Background: Appendicogram is the barium appendix examination in the form of photo that can help to see blockages or dirt in the appendix. The purpose of this study was to find  the Appendicogram examination management with clinical appendicitis in the Radiology Installation of Arifin Achmad Hospital,  Riau Province, to find out why there were differences in appendicogram examination techniques between the theory and the Arifin Achmad Regional Hospital in Riau Province and to see the Appendicogram radiograph results with eight hours waiting time.   Method: This research is qualitative with a descriptive research design and a study case approach. The subjects used were 3 radiologists, 1 sending doctor, and 3 radiographers. The object of the study was 2 patients who had undergone an appendicogram examination with appendicitis clinical at Arifin Achmad Hospital, Riau Province.   Result: The results showed that the appendicogram examination did not need specific preparation. The patient ...

Barium studies of the upper gastrointestinal tract and small bowel were performed in 16 adult patients with biopsy-proven nontropical sprue. Commercially available contrast media containing micropulverized barium sulfate, suspending agents, and various other additives were used. Radiographs were analyzed for the incidence and pattern of duodenal vs. small-bowel changes associated with celiac disease. Thirteen of 16 patients (81%) demonstrated abnormalities of the duodenum which ranged from focal erosions to diffusely thickened and nodular folds. A nonspecific, mild dilatation pattern was present on the small-bowel series of 11 patients (69%). The classic radiographic signs of malabsorption, such as flocculation and segmentation, however, occurred in less than 20% of cases, apparently because of the stability of new barium suspensions. The pathogenesis of duodenal changes in sprue and its diagnostic implications are emphasized.

Resumo OBJETIVO: avaliar a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo do enema de bário com duplo contraste (EBDC) para o diagnóstico da endometriose do reto e sigmóide. MÉTODOS: estudo transversal prospectivo que incluiu 37 pacientes com quadro clínico suspeito de endometriose profunda. As pacientes foram submetidas ao EBDC de acordo com a técnica padrão descrita na literatura. Em seguida, foram submetidas à laparoscopia. Os exames foram realizados e seus resultados e imagens foram interpretados e comparados com base na avaliação histológica. A análise estatística foi realizada pela análise de associação (teste do χ 2 ) e análise de concordância (teste de Kappa). RESULTADOS: a média de idade das pacientes estudadas foi de 35,8±4,4 anos (faixa de 28 a 48 anos), sendo 85,6% brancas e 14,4% negras. A endometriose profunda foi confirmada por laparoscopia e pelo exame histológico em todas as pacientes estudadas. A endometriose intestinal foi confirmada histologicamente em 27 mulheres (72,9%). O EBDC demonstrou sinais radiológicos sugestivos de infiltração intestinal por endometriose em 24 mulheres (64,9%) e ausência de sinais em 13 mulheres (35,1%). A sensibilidade do método foi de 87,5%, especificidade de 53,8%, valor preditivo positivo de 77,8% e valor preditivo negativo de 70%. Dentre os 24 exames anormais, 16 (43,2%) apresentaram imagem radiológica do tipo espícula, 16 (43,2%) apresentavam imagem compatível com estenose e quatro (10,8%) o duplo contorno. CONCLUSÕES: o EBDC apresenta elevada sensibilidade e elevado valor preditivo positivo no diagnóstico da endometriose do reto e sigmóide. As imagens radiológicas do tipo espícula e estenose apresentam elevada sensibilidade e valor preditivo positivo para a infiltração intestinal por endometriose.

To evaluate the sensitivity, specificity, negative predictive value, positive predictive value, association, and agreement of double-contrast barium enema (DCBE) and transrectal endoscopic ultrasonography (Tr EUS) in the diagnosis of rectosigmoid colon endometriosis. Design: Prospective nonrandomized (Canadian Task Force classification II-2). Setting: University hospital. Patients: We evaluated 37 patients with clinically suspected deeply infiltrating endometriosis (DIE) from January 2004 through January 2005. Interventions: Clinical examination, DCBE, Tr EUS, and laparoscopy for histologic confirmation. Measurements and Main Results: Deeply infiltrating endometriosis was confirmed by laparoscopic visualization and by histopathologic examination in all patients. Intestinal endometriosis was observed in 27 patients (72.9%). DCBE showed abnormalities suggestive of bowel endometriosis in 24 patients (64.9%) and Tr EUS in 28 patients (75.7%). Considering the DCBE findings we observed among the 24 abnormal examination results, 16 (42.3%) had spiculation, 16 (42.3%) had circumferential narrowing of the bowel, and 4 (10.8%) had the mass effect sign. For DCBE the sensitivity was 88%, the specificity was 54%, the negative predictive value (NPV) was 70%, and the positive predictive value (PPV) was 78%. For Tr EUS the sensitivity, specificity, NPV, and PPV were 96%, 100%, 90%, and 100%. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE (p ϭ .017) and a moderate agreement of the methods ( ϭ 0.44) was also observed. Conclusion: Our data, although limited by sample size, confirmed that DCBE has a good sensitivity and a low specificity in the diagnosis of intestinal DIE. The Tr EUS proved to have a higher sensitivity and specificity with elevated NPV and PPV. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE and a moderate agreement of the methods was also observed.

Corrosive gastric injury is common in India due to easily available acids which are ingested mostly for suicide attempt. Resulting gastric outlet strictures need operation in majority of the patients. We review our experience of surgical management of these cases. Thirty-seven consecutive patients over the last 4 years with corrosive gastric strictures were reviewed. Extent of gastric cicatrisation was assessed by endoscopy and barium study. Nutrition was maintained, if necessary by feeding jejunostomy. Early definitive operation was preferred. Outcome of surgery was assessed. Patients presented with vomiting, weight loss, and dysphagia. Twenty patients (54 %) had predominant gastric corrosive injury. The oesophageal stricture in other 17 patients (46 %) could be managed easily by endoscopic dilatation. Prepyloric short gastric stricture was found in 19 patients (51 %). Surgical procedures included stricturoplasty for short strictures and gastrojejunostomy for more extensive distal gastric cicatrisation. Complications included wound infection in six (16 %) patients and pneumonitis in four (11 %) patients. All patients gained weight within 6 to 8 weeks. Management of corrosive gastric injury depends on the extent of gastric involvement, associated oesophageal stricture, and general condition of the patient. Early definitive operation and avoiding gastric resection can give satisfactory outcome.

Although it is well known now that age affects swallowing function, few data have been reported for larger bolus sizes, such as 20 mL or sequential cup swallows, and few have reported data on the "oldest old," or those older than 80 years. The purpose of this investigation was to provide data for future investigations on adults, ranging in age from 21 to older than 100 years, using thin liquid, puree, and solid boluses, ranging from 5 mL to 3 oz, and to add to the database regarding the effects of age, gender, bolus size, and bolus volume on swallowing function. Symptoms relating to swallowing dysfunction were also examined, including the presence of oropharyngeal residue and penetration-aspiration. Having incorporated data on larger swallows from older individuals than in the past and incorporating an 8-point penetrationaspiration scale, several findings emerged in this investigation that have not been clearly defined in prior research as being results of the aging process. Most prominently, it was observed that for older individuals laryngeal penetration is common, often with material remaining in the laryngeal vestibule after the swallow. Differences in oral transit duration and the duration of the onset of the pharyngeal swallow that may result from varying methodologies are also discussed. Implications are drawn for the appropriate evaluation and management of older adults with suspected dysphagia.

The stable isotope ratios of sulfur (δ 34 S relative to Vienna Cañon Diablo Troilite) in sulfates and sulfides determined by elemental analysis and isotope ratio mass spectrometry (EA/IRMS) have been proven to be a remarkable tool for studies of the (bio)geochemical sulfur cycles in modern and ancient environments. However, the use of EA/IRMS to measure δ 34 S in arsenides and sulfarsenides may not be straightforward. This difficulty can lead to potential health and environmental hazards in the workplace and analytical problems such as instrument contamination, memory effects, and a non-matrix-matched standardization of δ 34 S measurements with suitable reference materials. To overcome these practical and analytical challenges, we developed a procedure for sulfur isotope analysis of arsenides, which can also be safely used for EA/IRMS analysis of arsenic sulfides (i.e., realgar, orpiment, arsenopyrite, and arsenian pyrite), and mercury sulfides (cinnabar). The sulfur dioxide produced from off-line EA combustion was trapped in an aqueous barium chloride solution in a leak-free system and precipitated as barium sulfate after quantitative oxidation of hydrogen sulfite by hydrogen peroxide. The derived barium sulfate was analyzed by conventional EA/IRMS, which bracketed the δ 34 S values of the samples with three international sulfate reference materials. The protocol (BaSO 4-EA/IRMS) was validated by analyses of reference materials and laboratory standards of sulfate and sulfides and achieved accuracy and precision comparable with those of direct EA/IRMS. The δ 34 S values determined by BaSO 4-EA/IRMS in sulfides (arsenopyrite, arsenic, and mercury sulfides) samples from different origins were comparable to those obtained by EA/IRMS, and no sulfur isotope fractionations were introduced during sample preparation. We report the first sulfur isotope data of arsenides obtained by BaSO 4-EA/IRMS.

Microcolon is a radiographic feature of a low intestinal obstruction that result from intrauterine underutilization or what is term unused colon. The finding of microcolon on contrast enema study in newborn with distended abdomen usually suggests jejunoileal obstruction, jejunoileal atresia, meconium ileus, or occasionally totals colonic agangliosis. We are therefore presenting this case to highlight the wonders that imaging will perform in prompt diagnosis and management of this condition.

To establish a `one-stop' dysphagia service in which a consultation, barium swallow and endoscopy can all be performed in the same hospital visit. MATERIALS AND METHODS: In order to allow both barium swallow examination and endoscopy to be performed on the same day, a novel technique for clearing barium from the upper gastrointestinal tract was established. Following the barium swallow examination, patients were given diet cola and metoclopramide syrup. If appropriate, an upper gastrointestinal endoscopy was then performed shortly afterwards. The service was piloted for 6 months in which time 25 patients were investigated in this way. RESULTS: All patients were seen within 2 weeks of referral. The mean time between barium swallow and endoscopy was 3 h 38 min (range, 1 h 50 min to 5 h 20 min). In all 24 patients in whom an endoscopy was performed, barium had been satisfactorily cleared from the oesophagus and stomach. CONCLUSION: This technique allows both barium swallow and upper gastrointestinal endoscopy to be performed on the same day, providing a rapid, safe and accurate diagnosis with minimum patient inconvenience.

Glow peak at 608 K in Mn doped Barite. Minimum detectable dose of 1.45 70.12 mGy with 35% fading in 30 days storage time. Reproducible TL signal within 75%. Suitable for retrospective dosimetry and geochronology of young deposits extending to 20 ka.

The consecutive double contrast barium meal examinations of 100 elderly patients (aged over 65 years) and a group of 33 younger adult patients were analysed by two observers for technical quality and pathological abnormalities. Technical quality declined with patient age, especially in those over 75 years, but was sufficient to enable diagnosis of abnormalities in 60% of the elderly group. It is concluded that, in the majority of elderly patients, the technical quality of double contrast barium meal examinations is sufficiently high to offer considerable diagnostic utility.

Background: Appendicogram is the barium appendix examination in the form of photo that can help to see blockages or dirt in the appendix. The purpose of this study was to find  the Appendicogram examination management with clinical appendicitis in the Radiology Installation of Arifin Achmad Hospital,  Riau Province, to find out why there were differences in appendicogram examination techniques between the theory and the Arifin Achmad Regional Hospital in Riau Province and to see the Appendicogram radiograph results with eight hours waiting time.   Method: This research is qualitative with a descriptive research design and a study case approach. The subjects used were 3 radiologists, 1 sending doctor, and 3 radiographers. The object of the study was 2 patients who had undergone an appendicogram examination with appendicitis clinical at Arifin Achmad Hospital, Riau Province.   Result: The results showed that the appendicogram examination did not need specific preparation. The patient ...

Transverse Colon Jack M. A. Tishler1 Segmental tuberculosis of the transverse colon is very rare and when present is usually associated with active pulmonary tuberculosis. These patients may have initial symptoms suggestive of neoplasm or of Crohn's disease. Radiographically the lesion manifests itself as a fairly long area of narrowing with nodular and ulcerated mucosa. Sinuses and fistulae may arise from the area of involvement. These changes are not specific for tuberculosis. The lesion is unpredictable. It may respond to medical therapy, but complications such as bleeding and sinus tract formation may require surgical intervention.

394 Erciyes Med J 2019; 41(4): 394–7 • DOI: 10.14744/etd.2019.98470 ORIGINAL ARTICLE – OPEN ACCESS This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Emine İnce , Semire Serin Ezer , Abdülkerim Temiz , Hasan Özkan Gezer , Akgün Hiçsönmez Post-necrotizing Enterocolitis Stricture: Misdiagnosis of this Complication Results in Greater Infant Mortality Objective: Intestinal stricture following necrotizing enterocolitis (NEC) is often misdiagnosed as recurrent functional constipation, enteritis, and malnutrition, and it increases the rates of morbidity and mortality in infants. Although a number of studies have focused on the potential etiologic factors leading to NEC, the information regarding the occurrence and diagnosis of post-NEC strictures is limited. The aim of this study was to evaluate the clinical presentation and diagnostic and surgical methods to treat NEC. Materials and Methods: The medical records of infants who had undergone ...

Objective To describe the experience of a radiology unit in using open access computed tomography (CT) colonography instead of double-contrast barium enema in patients who refused or had an incomplete first-attempt colonoscopy. Methods All consecutive patients who underwent CT colonography from December 1998 to August 2001 were recalled and evaluated. Patients in whom CT colonography showed intraluminal growths were sent for colonoscopy, performed using deep sedation if the first attempt failed. Results A total of 463 consecutive CT colonography examinations were performed: 304 patients were retraceable and were evaluated. In 85 cases CT colonography reported the presence of intraluminal growth. Colonoscopy confirmed the presence of 74 of the 94 polyps, and of 43 of the 48 cancers found at CT colonography. Colonoscopy also diagnosed an additional two cancers in two patients with CT colonography findings of inflammatory changes, and an additional 26 polyps in 16 patients. On a per-lesion basis, the positive predictive value of CT colonography was 73%, 80% and 87% for polyps < 5 mm, 6-9 mm and > 10 mm, respectively, and was 90% for cancer. On a per-patient basis, the positive predictive value was 60%, 72% and 89% for lesions < 5 mm, 6-9 mm and > 10 mm, respectively, and was 93% for cancer. be confidently used as a routine test instead of doublecontrast barium enema when total colonoscopy cannot be performed.

1. The supernatant obtained by centrifugation of a rat liver homogenate at 10000Og for 1 h contained a heat-labile macromolecular inhibitor of the thrombin-fibrinogen reaction. 2. The inhibitor was purified to electrophoretic homogeneity by repeated pre- parative polyacrylamide disc electrophoresis. Inhibition was observed with purified inhibitor equivalent to about 1 jig of protein/ml. 3. The inhibitor had a pI of 3.50-3.75, a molecular weight (from sodium dodecyl sulphate-polyacrylamide-gel electrophoresis) of 72000±3000 and was inactivated by p-hydroxymercuribenzoate or 5,5'-dithiobis- (2-nitrobenzoic acid). 4. Kinetic studies revealed a non-competitive inhibition, with the inhibitor probably acting on the thrombin-fibrinogen complex. Studies on the subcellular localization of the coagu- lation factor VII (Gaarder & Prydz, 1967, 1969) revealed the presence of an inhibitor of blood coagu- lation in the 100000g supernatant from perfused rat liver. We report here the purification of this inhibitor and some studies of its mode of action.

1. The N-terminal fragment (PF-I) split off from prothrombin during coagulation was purified to homogeneity from human serum. 2. The apparent molecular weight is 27000±2000 in sodium dodecyl sulphate–polyacrylamide-gel electrophoresis, whereas a value of about 19600 is obtained by calculation based on amino acid and carbohydrate analyses. The N-terminal sequence is an Ala-Asx bond. The fragment contains about 16% carbohydrate, binds phospholipids in the presence of Ca2+and is adsorbed to BaSO4. The pKa of its BaSO4-binding group(s) is 3.1–3.5. 3. By CNBr cleavage of fragment PF-I two peptides (C-1 and C-2) were obtained with molecular weights of about 5900 (C-2) and 12400 (C-1) on the basis of amino acid and carbohydrate analyses. Only the smaller (N-terminal) peptide is adsorbed to BaSO4 and, since the ability of the whole protein to bind to BaSO4 is known to be absent in samples obtained from patients treated with vitamin K antagonists, this peptide probably contains the site of a...

BACKGROUND: Defecography is the gold standard for assessing functional anorectal disorders but is limited by the need for a specific radiologic environment, exposure of patients to radiation, and inability to show all anatomic structures involved in defecation. Echodefecography is a 3-dimensional dynamic ultrasound technique developed to overcome these limitations. OBJECTIVE: This study was designed to validate the effectiveness of echodefecography compared with defecography in the assessment of anorectal dysfunctions related to obstructed defecation.

This work reports the versatility of polydopamine (PD) when applied as a particle coating in a composite of polylactide (PLA). Polydopamine was observed to increase the particle–matrix interface strength and facilitate the adsorption of drugs to the material surface. Here, barium sulfate radiopaque particles were functionalized with polydopamine and integrated into a polylactide matrix, leading to the formulation of a biodegradable and X-ray opaque material with enhanced mechanical properties. Polydopamine functionalized barium sulfate particles also facilitated the adsorption and release of the antibiotic levofloxacin. Analysis of the antibacterial capacity of these composites and the metabolic activity and proliferation of human dermal fibroblasts in vitro demonstrated that these materials are non-cytotoxic and can be 3D printed to formulate complex biocompatible materials for bone fixation devices.

This work explores the behaviour of a standard biological treatment system when exposed to two of the most common residuals from novel bleaching processes: hydrogen peroxide and the chelant DTPA. The potential problems for an activated sludge biological treatment unit, from the introduction of a chelating agent and hydrogen peroxide, were anticipated to stem from the sequestering of vital trace elements by the chelant, and the oxidation of biomass by the hydrogen peroxide. Typical residual quantities from TCF bleaching processes are 0.875 g DTPA / L and 0.2 g FL,02 / L, although the peroxide residual concentration is variable, up to approximately 1 g/L. The effects of running a typical biological treatment system on effluent from novel bleaching processes were also determined, in addition to the effects of switching influent sources between novel and conventional bleaching effluent. Activated sludge secondary treatment systems could successfully treat elementally chlorine free (ECF)...

Colorectal cancer is a leading cause of death and the third most common cancer in Canada. Evidence suggests that screening can reduce mortality rates and the cost effectiveness of a program compares favourably with initiatives for breast and cervical cancer. The objectives of the Association des gastro-entérologues du Québec Task Force were to determine the need for a policy on screening for colorectal cancer in Quebec, to evaluate the testing methods available and to propose one or more of these alternatives as part of a formal screening program, if indicated. Fecal occult blood testing (FOBT), endoscopy (including sigmoidoscopy and colonoscopy), barium enema and virtual colonoscopy were considered. Although most clinical efficacy data are available for FOBT and sigmoidoscopy, there are limitations to programs based on these strategies. FOBT has a high false positive rate and a low detection yield, and even a combination of these strategies will miss 24% of cancers. Colonoscopy is the best strategy to both detect and remove polyps and to diagnose colorectal cancer, with double contrast barium enema also being a sensitive detection method. The Task Force recommended the establishment, in Quebec, of a screening program with five-to 10-yearly double contrast barium enema or 10-yearly colonoscopy for individuals aged 50 years or older at low risk. The program should include outcome monitoring, public and professional education to increase awareness and promote compliance, and central coordination with other provincial programs. The program should be evaluated; specific billing codes for screening for colorectal cancer would help facilitate this. Formal feasibility, effectiveness and cost-effectiveness studies in Quebec are now warranted.

X-ray tomography is a powerful tool giving access to the morphology of biofilms, in 3D porous media, at the mesoscale. Due to the high water content of biofilms, the attenuation coefficient of biofilms and water are very close, hindering the distinction between biofilms and water without the use of contrast agents. Until now, the use of contrast agents such as barium sulfate, silver-coated micro-particles or 1-chloronaphtalene added to the liquid phase allowed imaging the biofilm 3D morphology. However, these contrast agents are not passive and potentially interact with the biofilm when injected into the sample. Here, we use a natural inorganic compound, namely iron sulfate, as a contrast agent progressively bounded in dilute or colloidal form into the EPS matrix during biofilm growth. By combining a very long source-to-detector distance on a X-ray laboratory source with a Lorentzian filter implemented prior to tomographic reconstruction, we substantially increase the contrast betwe...

Background: Small bowel obstruction is a common clinical challenge because the proper management of small bowel obstruction requires a methodology which on one hand can promptly recognise the presence of strangulationobstruction and hence the need for urgent operative intervention; and on the other hand, can avoid a non-therapeutic laparotomy along with its associated morbidities and further adhesion formation with its potential sequelae. The study was done to identify relevant features in the patient's clinical and CT abdomen findings which when present would be highly predictive of the requirement of an operative intervention in a patient with small bowel obstruction. The study was a hospital based analytical observational study on patients admitted from March 2013 to May 2014 with a diagnosis of small bowel obstruction and who underwent a concurrent CT abdomen. Correlation of line of management was done with respect to the three chosen parameters, obstipation (history), mesenteric edema (CT imaging) and lack of small bowel feces Sign (CT imaging). Results: A total of 74 patients were included with Male:Female ratio being 3.1:1. Forty patients were managed conservatively and remaining underwent surgery with adhesions being the most frequent etiology. The most common operative procedure performed was adhesiolysis with or without band release. Twenty-three cases were performed by open method and remaining laparoscopically. Evaluation of the three parameters revealed that these variables, when present independently or in combination, are predictive for need for operative intervention (p-value <0.001). The sensitivity and specificity to predict the need for exploration when all 3 features were present concurrently was 38.24% and 100%, respectively. Conclusions: Small-bowel obstruction is a common surgical dilemma, the management of which is dealt on a daily basis by surgeons and non-surgeons. The management using variables based on history and radiology may help classify patients into those requiring conservative management and those in need of early exploration.

Background Sleeve gastrectomy is a restrictive procedure for treatment of obese patients with different body mass index (BMI) and presents good results in terms of a reduction of percentage of excess weight loss and BMI. There is no consensus which is the optimal technique regarding to the diameter of the gastric tube, but a capacity of 100-120 ml has been suggested. In this prospective study, we compare the gastric capacity evaluated with barium sulfate or computer-aided tomography (CAT) scan early and 24 months after operation compared to the changes in body weight and BMI reduction in a small group of 15 consecutive patients submitted to sleeve gastrectomy. Methods Fifteen successive obese patients submitted to laparoscopic sleeve gastrectomy were included. They were studied in order to measure the residual gastric capacity with barium sulfate and CAT scan early (3 days) and late (2 years) after surgery. Results The early postoperative gastric volume was 108± 25 ml (80-120 ml) and 116.2±78.24 assessed with barium sulfate and CAT scan, respectively. The gastric capacity at the late control increased to 250 ±85 and 254 ± 56.8 assessed with the same techniques. However, patients remained stable with a BMI close to 25 without regain of weight at least at the time of observation. Conclusions Gastric capacity can increase late after sleeve gastrectomy even after performing a narrow gastric tubulization. It is very important to measure objectively residual gastric volume after sleeve gastrectomy and its eventual increase in order to determine the late clinical results and to indicate eventual strategy for retreatment.

Background: Barium sulfate is utilized for imaging of the gastrointestinal tract and is usually not deposited within the wall of the intestine. It is thought that mucosal injury may allow barium sulfate to traverse the mucosa, and allow deposition to occur uncommonly. Most pathology textbooks describe the typical barium sulfate deposition pattern as small granular accumulation in macrophages, and do not describe the presence of larger rhomboid crystals. This review will summarize the clinical background, radiographic, gross, and microscopic features of barium sulfate deposition in the gastrointestinal tract. A review of the PubMed database was performed to identify all published cases of barium sulfate deposition in the gastrointestinal tract that have been confirmed by pathologic examination. A review of the literature shows that the most common barium sulfate deposition pattern in the gastrointestinal tract is finely granular deposition (30 previously described cases), and less commonly large rhomboid crystals are seen (19 cases) with or without finely granular deposition. The fine granules are typically located in macrophages, while rhomboid crystals are usually extracellular. There are various methods to support that the foreign material is indeed barium sulfate, however, only a minority of studies perform ancillary testing. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS) can be useful for definitive confirmation. This review emphasizes the importance of recognizing both patterns of barium sulfate deposition, and the histologic differential diagnosis.

Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. The diagnosis of wounds and diaphragmatic rupture remains difficult and often delayed. Methods: We conducted a descriptive observational study with retrospective data collection. It took place in two referral hospitals in Algeria. Results: Our study involved 19 cases of diaphragmatic injuries. The sex-ratio was 8.5. The mean age was 29 years. Traffic accident represented 78.95%. The diaphragmatic rupture was on the left side in 84.21 % (16 cases). The surgical procedure involved a reduction of herniated viscera and a suture of the diaphragm by "X" non absorbable points in 73.68 % (15 cases). The evolution was favorable in all patients, except one death. Conclusion: A diaphragmatic rupture is often integrated into a polytrauma, of which it is a criterion of Severity; however the diagnosis may be overlooked in the acute phase because it poses a real diagnostic and therapeutic challenge.

A BaCO 3 slurry, containing radioactive 14 C, is produced during the reprocessing of spent nuclear fuel. This slurry is encapsulated in a Portland-blastfurnace slag composite cement. The effect of BaCO 3 on the hydration of OPC and Portland-blastfurnace slag cements has been studied in this work. Samples containing a simulant BaCO 3 slurry were cured for up to 720 days at 20 and 60 °C and analysed by XRD, SEM(EDX) and ICC. BaCO 3 reacted with OPC to precipitate BaSO 4 from a reaction between soluble sulfate and BaCO 3 . Calcium monocarboaluminate subsequently formed from the carbonate released. The monocarboaluminate precipitated as crystals in voids formed during hydration. At 60 °C in OPC, it was not identified by XRD, suggesting the phase is unstable in this system around this temperature. In the Portland-blastfurnace slag cements containing BaCO 3 , less monocarboaluminate and BaSO 4 were formed, but the hydration of BFS was promoted and monocarboaluminate was stable up to 60 °C.

Background. The presence of swallowing dysfunction in children without obvious risk factors remains under appreciated. Early identification and prompt initiation of appropriate treatments are critical for reduction of morbidities associated with dysphagia. Objective. To describe the clinical presentations, radiologic characteristics, and long-term outcomes in children with oropharyngeal dysphagia presenting as unexplained respiratory problems. We completed a retrospective chart review of all children without known dysphagic risk factors upon presentation to Speech-Language Pathology (December 1991-April 1995) for feeding/swallowing evaluations because of refractory respiratory problems and dysphagic concerns, and who subsequently were diagnosed with dysphagia on Videofluoroscopic Swallow Study (VFSS). In August 2002, follow-up telephone interviews were conducted with caregivers of 14 children. Results. We identified 19 children (mean age 1.14 years; range 0.9-5.75) with dysphagia presenting as unexplained respiratory problems. On VFSS, delayed pharyngeal swallow onset was the most common abnormal radiologic finding and always preceded penetration or tracheal aspiration. Eleven (57.9%) children aspirated. Aspiration occurred only with liquids and 100% of aspiration events were silent (i.e., no cough). Dysphagia was not a concern in 11 children at a mean age 3.2 years (range 0.7-10) and persisted in three children who were 9 years or older. Conclusions. Oropharyngeal dysphagia should be considered in the differential diagnosis of young children without known risk factors associated with swallowing dysfunction when they present with unexplained respiratory problems. Although the prognosis for resolution of dysphagic concerns is very good, it may take several years.

Superior mesenteric artery syndrome is an uncommon cause of proximal small bowel obstruction in which the third part of the duodenum is compressed between the superior mesenteric artery (SMA) and the aorta. It is a rare entity and is usually considered as a diagnosis of exclusion. In this case report, a 21-year-old male patient is shown who has the typical SMA syndrome symptoms such as vomiting, upper abdominal pain, and h/o weight loss. Initially, conservative management was tried for a few days, but symptoms continued to persist. The patient underwent laparoscopic duodenojejunal bypass after imaging studies confirmed the diagnosis. The patient had a smooth post-operative course and was discharged in stable condition. The minimally invasive surgical intervention is safe and successful in treating SMA syndrome and preventing complications.

We evaluated the radiopacity and antibacterial properties of various concentrations of double antibiotic paste (DAP) containing barium sulfate (BaSO) or zirconium oxide (ZrO) radiopaque agents. The radiopacity of 1, 10, and 25 mg/mL DAP containing 30% (w/v) BaSO or ZrO, DAP-free radiopaque pastes, and commercially available radiopaque calcium hydroxide (Ca[OH]) were evaluated according to ISO 6876/2001 with slight modifications (n = 6 per group). Dentin samples (n = 70) infected anaerobically for 3 weeks with bacterial biofilms obtained from a root canal of an immature tooth with pulpal necrosis were treated with similar experimental pastes or received no treatment (n = 7). After 1 week, the pastes were rinsed off, and biofilm disruption assays were conducted. To show the residual antibacterial effects, sterile dentin samples (n = 70) were pretreated for 1 week with the same pastes (n = 7). The pastes were rinsed off, and the samples were immersed in phosphate-buffered saline for 24...

Background: Barium sulfate is utilized for imaging of the gastrointestinal tract and is usually not deposited within the wall of the intestine. It is thought that mucosal injury may allow barium sulfate to traverse the mucosa, and allow deposition to occur uncommonly. Most pathology textbooks describe the typical barium sulfate deposition pattern as small granular accumulation in macrophages, and do not describe the presence of larger rhomboid crystals. This review will summarize the clinical background, radiographic, gross, and microscopic features of barium sulfate deposition in the gastrointestinal tract. A review of the PubMed database was performed to identify all published cases of barium sulfate deposition in the gastrointestinal tract that have been confirmed by pathologic examination. A review of the literature shows that the most common barium sulfate deposition pattern in the gastrointestinal tract is finely granular deposition (30 previously described cases), and less commonly large rhomboid crystals are seen (19 cases) with or without finely granular deposition. The fine granules are typically located in macrophages, while rhomboid crystals are usually extracellular. There are various methods to support that the foreign material is indeed barium sulfate, however, only a minority of studies perform ancillary testing. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS) can be useful for definitive confirmation. This review emphasizes the importance of recognizing both patterns of barium sulfate deposition, and the histologic differential diagnosis.