Foreign body ingestion is an uncommon cause of gastric outlet obstruction in adults. Not all ingested objects pass the gastrointestinal tract spontaneously. In most cases, endoscopic removal is required. A surgical ap...Foreign body ingestion is an uncommon cause of gastric outlet obstruction in adults. Not all ingested objects pass the gastrointestinal tract spontaneously. In most cases, endoscopic removal is required. A surgical approach is required if endoscopic removal is unsuccessful or in the event of a complication. We present a case of a 45-year-old woman, previously diagnosed endoscopically with chronic duodenal ulcer with pyloric stenosis, who presented with copious effortless offensive non-bilious vomiting, and epigastric pain of three weeks’ duration. She was dehydrated with positive gastric succussion splash. Esophago-gastro-duodenoscopy showed an impacted neck-pendant occluding a stenosed pylorus which dislodged on attempts to extract it and was later excreted in the stool, with resolution of her symptoms.展开更多
The specific transformative steps that occur from the multipotent through the mature cardiomyocyte state are determined in large part by changes in gene expression. The exact differentiation and developmental programs...The specific transformative steps that occur from the multipotent through the mature cardiomyocyte state are determined in large part by changes in gene expression. The exact differentiation and developmental programs are tightly regulated in a step-wise systematic fashion based on the influence of specific instigating and signaling factors. Crucial to the observed cell behavior and tissue specific phenotypic differences are alterations in the organization, translocation and expression of nuclear proteins during differentiation. The cardiomyogenic differentiation of Mesenchymal Stem Cells (MSCs) remains a precarious process. Transplanted MSCs must respond to endogenous signaling molecules involved in early embryonic cardiomyogenesis by activating the specific gene regulatory network required for successful cardiomyogenesis and transdifferentiation. To do that, transplanted MSCs would have to be genuinely reprogrammed genetically to become functional cardiac myocytes. A consideration of recent experimental findings suggests that Bone morphogenic protein (BMP-2/4), insulin-like growth factor (IGF-1) and fibroblast growth factor (FGF-2) in combination is a potent inducer of MSC cardiomyogenesis. The development of an optimum and reliable in vitro culture milieu for directing their cardiomyogenesis will provide an indispensable model system for molecular studies and genetic manipulation.展开更多
文摘Foreign body ingestion is an uncommon cause of gastric outlet obstruction in adults. Not all ingested objects pass the gastrointestinal tract spontaneously. In most cases, endoscopic removal is required. A surgical approach is required if endoscopic removal is unsuccessful or in the event of a complication. We present a case of a 45-year-old woman, previously diagnosed endoscopically with chronic duodenal ulcer with pyloric stenosis, who presented with copious effortless offensive non-bilious vomiting, and epigastric pain of three weeks’ duration. She was dehydrated with positive gastric succussion splash. Esophago-gastro-duodenoscopy showed an impacted neck-pendant occluding a stenosed pylorus which dislodged on attempts to extract it and was later excreted in the stool, with resolution of her symptoms.
文摘The specific transformative steps that occur from the multipotent through the mature cardiomyocyte state are determined in large part by changes in gene expression. The exact differentiation and developmental programs are tightly regulated in a step-wise systematic fashion based on the influence of specific instigating and signaling factors. Crucial to the observed cell behavior and tissue specific phenotypic differences are alterations in the organization, translocation and expression of nuclear proteins during differentiation. The cardiomyogenic differentiation of Mesenchymal Stem Cells (MSCs) remains a precarious process. Transplanted MSCs must respond to endogenous signaling molecules involved in early embryonic cardiomyogenesis by activating the specific gene regulatory network required for successful cardiomyogenesis and transdifferentiation. To do that, transplanted MSCs would have to be genuinely reprogrammed genetically to become functional cardiac myocytes. A consideration of recent experimental findings suggests that Bone morphogenic protein (BMP-2/4), insulin-like growth factor (IGF-1) and fibroblast growth factor (FGF-2) in combination is a potent inducer of MSC cardiomyogenesis. The development of an optimum and reliable in vitro culture milieu for directing their cardiomyogenesis will provide an indispensable model system for molecular studies and genetic manipulation.
