BACKGROUND Acute non-variceal bleeding accounts for approximately 20%of all-cause bleeding episodes in patients with liver cirrhosis.It is associated with high morbidity and mortality therefore prompt diagnosis and en...BACKGROUND Acute non-variceal bleeding accounts for approximately 20%of all-cause bleeding episodes in patients with liver cirrhosis.It is associated with high morbidity and mortality therefore prompt diagnosis and endoscopic management are crucial.AIM To evaluate available data on the efficacy of endoscopic treatment modalities used to control acute non-variceal gastrointestinal bleeding(GIB)in cirrhotic patients as well as to assess treatment outcomes.METHODS Employing PRISMA methodology,the MEDLINE was searched through PubMed using appropriate MeSH terms.Data are reported in a summative manner and separately for each major non-variceal cause of bleeding.RESULTS Overall,23 studies were identified with a total of 1288 cirrhotic patients of whom 958/1288 underwent endoscopic therapy for acute non-variceal GIB.Peptic ulcer bleeding was the most common cause of acute non-variceal bleeding,followed by portal hypertensive gastropathy,gastric antral vascular ectasia,Mallory-Weiss syndrome,Dieaulafoy lesions,portal hypertensive colopathy,and hemorrhoids.Failure to control bleeding from all-causes of non-variceal GIB accounted for less than 3.5%of cirrhotic patients.Rebleeding(range 2%-25%)and mortality(range 3%-40%)rates varied,presumably due to study heterogeneity.Rebleeding was usually managed endoscopically and salvage therapy using arterial embolisation or surgery was undertaken in very few cases.Mortality was usually associated with liver function deterioration and other organ failure or infections rather than uncontrolled bleeding.Endoscopic treatment-related complications were extremely rare.Lower acute non-variceal bleeding was examined in two studies(197/1288 patients)achieving initial hemostasis in all patients using argon plasma coagulation for portal hypertensive colopathy and endoscopic band ligation or sclerotherapy for bleeding hemorrhoids(rebleeding range 10%-13%).Data on the efficacy of endoscopic therapy of cirrhotic patients vs non-cirrhotic controls with acute GIB are very scarce.CONCLUSION Endother展开更多
In the early days of deciphering the injured neuronal tissues led to the realization that contrast is necessary to discern the parts of the recovering tissues from the damaged ones.Early attempts relied on available(a...In the early days of deciphering the injured neuronal tissues led to the realization that contrast is necessary to discern the parts of the recovering tissues from the damaged ones.Early attempts relied on available(and often naturally occurring)staining substances.Incidentally,the active ingredients of most of them were small molecules.With the advent of time,the knowledge of chemistry helped identify compounds and conditions for staining.The staining reagents were even found to enhance the visibility of the organelles.Silver impregnation identification of Golgi bodies was discovered in owl optic nerve.Staining reagents since the late 1800s were widely used across all disciplines and for nerve tissue and became a key contributor to advancement in nerve-related research.The use of these reagents provided insight into the organization of the neuronal tissues and helped distinguish nerve degeneration from regeneration.The neuronal staining reagents have played a fundamental role in the clinical research facilitating the identification of biological mechanisms underlying eye and neuropsychiatric diseases.We found a lack of systematic description of all staining reagents,whether they had been used historically or currently used.There is a lack of readily available information for optimal staining of different neuronal tissues for a given purpose.We present here a grouping of the reagents based on their target location:(I)the central nervous system(CNS),(II)the peripheral nervous system(PNS),or(III)both.The biochemical reactions of most of the staining reagents is based on acidic or basic pH and specific reaction partners such as organelle or biomolecules that exists within the given tissue type.We present here a summary of the chemical composition,optimal staining condition,use for given neuronal tissue and,where possible,historic usage.Several biomolecules such as lipids and metabolites lack specific antibodies.Despite being non-specific the reagents enhance contrast and provide corroboration about the microenvironm展开更多
Light emission and photochemistry can be related in different ways:photochemical reactions can lead to dual emission,[1]such as in excited state intramolecular proton transfer,but they often lead to emission quenching...Light emission and photochemistry can be related in different ways:photochemical reactions can lead to dual emission,[1]such as in excited state intramolecular proton transfer,but they often lead to emission quenching.One such quenching process is the Mallory reaction undergone by molecules that contain Z-1,2-diphenyl ethylene(DPE)units.[2]It is a photochemical oxidative coupling(stepwise cyclization and hydrogen elimination)that converts DPE derivatives into phenanthrenes.展开更多
The interesting contribution of Qin et al.[1]about radiation injury on the rectum deserves to be integrated with observations regarding the equivalent damage to the perineal striated muscles.In approaching this topic,...The interesting contribution of Qin et al.[1]about radiation injury on the rectum deserves to be integrated with observations regarding the equivalent damage to the perineal striated muscles.In approaching this topic,not yet extensively studied,we were interested at first in delineating its basic pathology by histological methods,as already proposed[2,3].For this,we selected from our anatomopathological archive 20 surgical specimens of abdominoperineal resections.In the first group,we enclosed 10 surgical specimens of lower rectal cancers operated on 5-6 weeks after a neoadjuvant radiochemotherapy,consisting of 50 Gy,fractioned in 5 weeks,and associated with a FOLFOX pharmacological treatment.In the second group,we included 5 cases of the same pathology,at a lower stage,and submitted for surgery 10 days after a‘short-term’neoadjuvant radiotherapy of 25 Gy in 5 fractions over 1 week.A third group encompassed 5 surgical specimens of abdominoperineal resection,performed for recurrent anal cancer 1 year after the same radiation treatment of 50 Gy as applied in the first group.From our study,we excluded cases with neoplastic infiltration of the perineal muscles,previous perineal surgery,radiation or trauma,systemic diseases such as diabetes,vasculitis,connective-tissue or musculoskeletal disorders,manifest atherosclerosis,morbid obesity,and poor nutrition.Clearly,the second and third groups were implemented for dose-and timerelated controls,in comparison to the first group.The perineal striated muscles found in the specimens were extensively studied with serial histological sections of 4mm and different staining techniques(Haematoxylin-Eosin,Trichrome Masson,and Mallory Azan).展开更多
文摘BACKGROUND Acute non-variceal bleeding accounts for approximately 20%of all-cause bleeding episodes in patients with liver cirrhosis.It is associated with high morbidity and mortality therefore prompt diagnosis and endoscopic management are crucial.AIM To evaluate available data on the efficacy of endoscopic treatment modalities used to control acute non-variceal gastrointestinal bleeding(GIB)in cirrhotic patients as well as to assess treatment outcomes.METHODS Employing PRISMA methodology,the MEDLINE was searched through PubMed using appropriate MeSH terms.Data are reported in a summative manner and separately for each major non-variceal cause of bleeding.RESULTS Overall,23 studies were identified with a total of 1288 cirrhotic patients of whom 958/1288 underwent endoscopic therapy for acute non-variceal GIB.Peptic ulcer bleeding was the most common cause of acute non-variceal bleeding,followed by portal hypertensive gastropathy,gastric antral vascular ectasia,Mallory-Weiss syndrome,Dieaulafoy lesions,portal hypertensive colopathy,and hemorrhoids.Failure to control bleeding from all-causes of non-variceal GIB accounted for less than 3.5%of cirrhotic patients.Rebleeding(range 2%-25%)and mortality(range 3%-40%)rates varied,presumably due to study heterogeneity.Rebleeding was usually managed endoscopically and salvage therapy using arterial embolisation or surgery was undertaken in very few cases.Mortality was usually associated with liver function deterioration and other organ failure or infections rather than uncontrolled bleeding.Endoscopic treatment-related complications were extremely rare.Lower acute non-variceal bleeding was examined in two studies(197/1288 patients)achieving initial hemostasis in all patients using argon plasma coagulation for portal hypertensive colopathy and endoscopic band ligation or sclerotherapy for bleeding hemorrhoids(rebleeding range 10%-13%).Data on the efficacy of endoscopic therapy of cirrhotic patients vs non-cirrhotic controls with acute GIB are very scarce.CONCLUSION Endother
基金supported by an unrestricted grant from Research to Prevent Blindness and NIH grants EY14801,EY031292.
文摘In the early days of deciphering the injured neuronal tissues led to the realization that contrast is necessary to discern the parts of the recovering tissues from the damaged ones.Early attempts relied on available(and often naturally occurring)staining substances.Incidentally,the active ingredients of most of them were small molecules.With the advent of time,the knowledge of chemistry helped identify compounds and conditions for staining.The staining reagents were even found to enhance the visibility of the organelles.Silver impregnation identification of Golgi bodies was discovered in owl optic nerve.Staining reagents since the late 1800s were widely used across all disciplines and for nerve tissue and became a key contributor to advancement in nerve-related research.The use of these reagents provided insight into the organization of the neuronal tissues and helped distinguish nerve degeneration from regeneration.The neuronal staining reagents have played a fundamental role in the clinical research facilitating the identification of biological mechanisms underlying eye and neuropsychiatric diseases.We found a lack of systematic description of all staining reagents,whether they had been used historically or currently used.There is a lack of readily available information for optimal staining of different neuronal tissues for a given purpose.We present here a grouping of the reagents based on their target location:(I)the central nervous system(CNS),(II)the peripheral nervous system(PNS),or(III)both.The biochemical reactions of most of the staining reagents is based on acidic or basic pH and specific reaction partners such as organelle or biomolecules that exists within the given tissue type.We present here a summary of the chemical composition,optimal staining condition,use for given neuronal tissue and,where possible,historic usage.Several biomolecules such as lipids and metabolites lack specific antibodies.Despite being non-specific the reagents enhance contrast and provide corroboration about the microenvironm
基金Ministerio de Ciencia,Innovación y Universidades,Grant/Award Number:PID-2019-104654GB-I00。
文摘Light emission and photochemistry can be related in different ways:photochemical reactions can lead to dual emission,[1]such as in excited state intramolecular proton transfer,but they often lead to emission quenching.One such quenching process is the Mallory reaction undergone by molecules that contain Z-1,2-diphenyl ethylene(DPE)units.[2]It is a photochemical oxidative coupling(stepwise cyclization and hydrogen elimination)that converts DPE derivatives into phenanthrenes.
文摘The interesting contribution of Qin et al.[1]about radiation injury on the rectum deserves to be integrated with observations regarding the equivalent damage to the perineal striated muscles.In approaching this topic,not yet extensively studied,we were interested at first in delineating its basic pathology by histological methods,as already proposed[2,3].For this,we selected from our anatomopathological archive 20 surgical specimens of abdominoperineal resections.In the first group,we enclosed 10 surgical specimens of lower rectal cancers operated on 5-6 weeks after a neoadjuvant radiochemotherapy,consisting of 50 Gy,fractioned in 5 weeks,and associated with a FOLFOX pharmacological treatment.In the second group,we included 5 cases of the same pathology,at a lower stage,and submitted for surgery 10 days after a‘short-term’neoadjuvant radiotherapy of 25 Gy in 5 fractions over 1 week.A third group encompassed 5 surgical specimens of abdominoperineal resection,performed for recurrent anal cancer 1 year after the same radiation treatment of 50 Gy as applied in the first group.From our study,we excluded cases with neoplastic infiltration of the perineal muscles,previous perineal surgery,radiation or trauma,systemic diseases such as diabetes,vasculitis,connective-tissue or musculoskeletal disorders,manifest atherosclerosis,morbid obesity,and poor nutrition.Clearly,the second and third groups were implemented for dose-and timerelated controls,in comparison to the first group.The perineal striated muscles found in the specimens were extensively studied with serial histological sections of 4mm and different staining techniques(Haematoxylin-Eosin,Trichrome Masson,and Mallory Azan).
