Melanosis ilei is a condition that's characterized by gross greyish-black or brownish-black pigmentation of the mucosa of the terminal ileum. There were several substances that produce gastrointestinal tract pigmentation such as lipofuscin, iron sulphide (FeS), Hemosiderin and exogenous material such as silicates and titanium. We report here on a case of a 58-year-old female who ingested charcoal for a long time, and she was diagnosed with melanosis ilei by colonoscopy. Her condition improved after she stopped ingesting the charcoal.
Charcoal ; Colonoscopy ; Female ; Gastrointestinal Tract ; Hemosiderin ; Humans ; Ileum ; Iron ; Lipofuscin ; Melanosis* ; Middle Aged ; Mucous Membrane ; Pigmentation ; Silicates ; Titanium

The civilization has given us a great comfort and convenience but also it has been threatening our life at the same time. Recently among these causes of death the traffic accident is the most dangerous thing to threat our life. Most traffic accidents happen on the road but are increasing on the sea and river recently. Accordingly this paper presents an accident example for a boat collision accident which was anlalyzed from the evidences drawn by forensic medical and scientific methods for a passenger death accident by a collision between two boats. The forensic medical accident interpretation was made up by autopsy and drug toxicology inspection. A person who has met an unnatural death at the accident time was drunken condition. The cause of death was judged by the multiple viscera injury, and presumed to be killed by applying an high external force. In order to perform a forensic scientific analysis, we investigated the passenger's life jacket that a person killed in the accident was wearing and also investigated the external appearance of two boats which have 150h.p and 130h.p. Through comparing the position of two boats with the direction of impact on the surface of the water, we could assume that the 130h.p boat impacted the tail on the right side of 150h.p boat with constant acceleration or constant velocity.
Acceleration ; Accidents, Traffic ; Autopsy ; Cause of Death ; Civilization ; Humans ; Rivers ; Ships* ; Toxicology ; Viscera ; Water

PURPOSE: Bone morphogenetic protein (BMP) is a potent differentiating agent for cells of the osteoblastic lineage. It has been used in the oral cavity under a variety of indications and with different carriers. However, the optimal carrier for each indication is not known. This study evaluated the bone regenerative effect of rhBMP-2 delivered with different carrier systems. MATERIALS AND METHODS: 8 mm critical-sized rat calvarial defects were used in 60 male Sprague-Dawley rats. The animals were divided into 6 groups containing 10 animals each. Two groups were controls that had no treatment and absorbable collagen membrane only. 4 groups were experimentals that contained rhBMP-2 only and applied with absorbable collagen sponge(Collatape(R)), MBCP(R), Bio-Oss(R) each. The histological and histometric parameters were used to evaluate the defects after 2- or 8-week healing period. The shape and total augmented area were stable in all groups over the healing time. RESULTS: New bone formation was significantly greater in the rhBMP-2 with carrier group than control group. rhBMP-2/ACS was the highest in bone density but gained less new bone area than rhBMP-2/MBCP(R) and rhBMP-2/Bio-Oss(R). The bone density after 8 weeks was greater than that after 2 weeks in all groups. However, rhBMP-2 alone failed to show the statistically significant difference in new bone area and bone density compared to control group. Also MBCP(R) and Bio-Oss(R) particles remained after 8 weeks healing period. CONCLUSION: These results suggest that rhBMP-2 with carrier system is an excellent inductive agent for bone formation and we can use it as the predictable bone tissue engieering technique. Future study will likely focus on the kinetics of BMP release and development of carriers that is ideal for it.
Animals ; Bone and Bones ; Bone Density ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; Bone Regeneration ; Collagen ; Humans ; Kinetics ; Male ; Membranes ; Mouth ; Osteoblasts ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; Transforming Growth Factor beta

Mental health is influenced by the gut-brain axis; for example, gut dysbiosis has been observed in patients with major depressive disorder (MDD).Gut microbial changes by fecal microbiota transplantation or probiotics treatment reportedly modulates depressive symptoms. However, it remains unclear how gut dysbiosis contributes to mental dysfunction, and how correction of the gut microbiota alleviates neuropsychiatric disorders. Our previous study showed that chronic consumption of Lactobacillus reuteri ATG-F4 (F4) induced neurometabolic alterations in healthy mice. Here, we investigated whether F4 exerted therapeutic effects on depressive-like behavior by influencing the central nervous system. Using chronic unpredictable stress (CUS) to induce anhedonia, a key symptom of MDD, we found that chronic F4 consumption alleviated CUS-induced anhedonic behaviors, accompanied by biochemical changes in the gut, serum, and brain. Serum and brain metabolite concentrations involved in tryptophan metabolism were regulated by CUS and F4. F4 consumption reduced the elevated levels of serotonin (5-HT) in the brain observed in the CUS group. Additionally, the increased expression of Htr1a, a subtype of the 5-HT receptor, in the medial prefrontal cortex (mPFC) of stressed mice was restored to levels observed in stress-naïve mice following F4 supplementation. We further demonstrated the role of Htr1a using AAV-shRNA to downregulate Htr1a in the mPFC of CUS mice, effectively reversing CUS-induced anhedonic behavior. Together, our findings suggest F4 as a potential therapeutic approach for relieving some depressive symptoms and highlight the involvement of the tryptophan metabolism in mitigating CUS-induced depressive-like behaviors through the action of this bacterium.

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*

Most ingested foreign bodies spontaneously pass through the upper and lower intestinal tract. The impaction of an ingested foreign body in the colon is rare. Foreign bodies swallowed inadvertently often cause serious complications, such as perforation, obstruction, abscess formation, enterocolic fistula, or hemorrhage. Physicians should proceed with routine medical care while considering the possibility of the ingestion of a foreign body In cases where abdominal pain of an unknown origin is observed, particularly in elderly patients who wear dentures, alcoholics, mentally disturbed, or rapid eating, and presenting with altered bowel habits. We report a case of a colonoscopically-removed wooden toothpick that impacted the sigmoid colon and was complicated by the formation of a local abscess with a review of the literature.
Abdominal Pain ; Abscess ; Aged ; Alcoholics ; Colon ; Colon, Sigmoid* ; Colonoscopy ; Dentures ; Eating ; Fistula ; Foreign Bodies ; Hemorrhage ; Humans

Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20–24 hours) or short-term (2–4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastoceles, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared. Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the completion of re-expansion was faster in women who became pregnant than in those who did not for both culture durations (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3–4 hours after warming is an important marker for embryo selection.

A 77-year-old woman was admitted with 5 days history of melena. She had an open cholecystectomy 30 years ago. Abdominal computed tomography and duodenoscopy revealed massive hemobilia. Angiography showed right hepatic arterial fistula to common bile duct near the surgical clip. Embolization was done successfully and the patient recovered. We experienced a case of a massive hemobilia which was occurred after a long period of time since open cholecystectomy without pseudoaneurysmal change of the right hepatic artery. And we suggest the direct vessel injury and fistula between the bile duct and a blood vessel as a possible cause of hemobilia in this case.
Aged ; Aneurysm, False ; Angiography ; Bile Ducts ; Blood Vessels ; Cholecystectomy* ; Common Bile Duct ; Duodenoscopy ; Female ; Fistula ; Hemobilia* ; Hepatic Artery ; Humans ; Melena ; Surgical Instruments

Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.
Abdominal Pain ; Adult ; Emergencies ; Hamartoma ; Hepatitis ; Hepatitis A ; Humans ; Intussusception ; Laparotomy ; Physical Examination ; Rare Diseases ; Vomiting

PURPOSE: To evaluate the diagnostic utility and predictors for determinate results of an enzyme-linked immunospot assay using induced sputum cells (IS ELISPOT) for a rapid diagnosis of pulmonary tuberculosis (TB). MATERIALS AND METHODS: Subjects suspected of pulmonary TB who had either sputum acid fast bacilli smear-negative or not producing sputum spontaneously were prospectively enrolled. ELISPOT assay was performed using cells from induced sputum. RESULTS: A total of 43 subjects, including 25 with TB (TB group) and 18 with non-TB disease (non-TB group) were enrolled. Results of IS ELISPOT were determinate in only 17/43 (39%) subjects, but all of determinate results were consistent with the final diagnosis. Of the 43 sputum samples, 11 (26%) were inadequate to perform IS ELISPOT. Of 32 adequate sputum samples, the proportion of determinate results was significantly higher in the TB group (75%, 15/20) than in the non-TB group (17%, 2/12) (p=0.002). The status of active TB was a unique predictor but smear positivity was not a significant predictor for determinate results. In addition, sensitivity of IS ELISPOT (75%, 9/12) in smear negative TB was higher than that of TB-polymerase chain reaction (25%, 3/12). CONCLUSION: IS ELISPOT showed relatively high diagnostic value and accuracy in the TB group, independent of smear positivity. IS ELISPOT may provide additional diagnostic yield for microbiological tools in the rapid diagnosis of smear-negative TB.
Adult ; Aged ; *Enzyme-Linked Immunospot Assay ; Female ; Humans ; Immunologic Tests/*methods ; Male ; Middle Aged ; Mycobacterium tuberculosis/*isolation & purification ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Sputum/*microbiology ; Tuberculosis, Pulmonary/*diagnosis/microbiology