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Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report
Christophe Riquoir,Luis Antonio Díaz,David Chiliquinga,Roberto Candia,Fernando Pimentel,Alex Arenas 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinalbleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to accessthe biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, apediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinalbleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did notreveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using apediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolutionwas found to be satisfactory.
Han, Kap-Hoon,Chun, Yoon-Hee,de Castro Pimentel Figueiredo, Bá,rbara,Soriani, Frederico Marianetti,Savoldi, Marcela,Almeida, Agostinho,Rodrigues, Fernando,Cairns, Charlie Timothy,Bignell, Elaine Blackwell Publishing Ltd 2010 Molecular microbiology Vol.75 No.6
<P>Summary</P><P>Carbon dioxide (CO<SUB>2</SUB>) and its hydration product bicarbonate (HCO<SUB>3</SUB><SUP>-</SUP>) are essential molecules in various physiological processes of all living organisms. The reversible interconversion between CO<SUB>2</SUB> and HCO<SUB>3</SUB><SUP>-</SUP> is in equilibrium. This reaction is slow without catalyst, but can be rapidly facilitated by Zn<SUP>2+</SUP>-metalloenzymes named carbonic anhydrases (CAs). To gain an insight into the function of multiple clades of fungal CA, we chose to investigate the filamentous fungi <I>Aspergillus fumigatus</I> and <I>A. nidulans</I>. We identified four and two CAs in <I>A. fumigatus</I> and <I>A. nidulans</I>, respectively, named <I>cafA-D</I> and <I>canA-B</I>. The <I>cafA</I> and <I>cafB</I> genes are constitutively, strongly expressed whereas <I>cafC</I> and <I>cafD</I> genes are weakly expressed but CO<SUB>2</SUB>-inducible. Heterologous expression of the <I>A. fumigatus cafB</I>, and <I>A. nidulans canA</I> and <I>canB</I> genes completely rescued the high CO<SUB>2</SUB>-requiring phenotype of a <I>Saccharomyces cerevisiae</I>&Dgr;<I>nce103</I> mutant. Only the &Dgr;<I>cafA</I>&Dgr;<I>cafB</I> and &Dgr;<I>canB</I> deletion mutants were unable to grow at 0.033% CO<SUB>2</SUB>, of which growth defects can be restored by high CO<SUB>2</SUB>. Defects in the CAs can affect <I>Aspergilli</I> conidiation. Furthermore, <I>A. fumigatus</I>&Dgr;<I>cafA</I>, &Dgr;<I>cafB</I>, &Dgr;<I>cafC</I>, &Dgr;<I>cafD</I> and &Dgr;<I>cafA</I>&Dgr;<I>cafB</I> mutant strains are fully virulent in a low-dose murine infection.</P>
An Unusual Case of Extra-Enteric Blastocystosis in the Uterine Cervix
Yolanda Escutia-Guzman,Williams Arony Martinez-Flores,Joel Martinez-Ocana,Ramon Martinez-Pimentel,Marisol Benitez-Ramirez,Fernando Martinez-Hernandez,Sara Arroyo-Escalante,Mirza Romero-Valdovinos,Guad 대한기생충학열대의학회 2020 The Korean Journal of Parasitology Vol.58 No.5