Abdominal cocoon syndrome-a rare culprit behind small bowel ischemia and obstruction:Three case reports

BACKGROUND Abdominal cocoon syndrome(ACS)represents a category within sclerosing encapsulating peritonitis,characterized by the encapsulation of internal organs with a fibrous,cocoon-like membrane of unknown origin,resulting in bowel obstruction and ischemia.Diagnosing this condition before surgery poses a cha-llenge,often requiring confirmation during laparotomy.In this context,we depict three instances of ACS:One linked to intestinal obstruction,the second exclu-sively manifesting as intestinal ischemia without any obstruction,and the final case involving a discrepancy between the radiologist and the surgeon.CASE SUMMARY Three male patients,aged 53,58,and 61 originating from Northern Thailand,arrived at our medical facility complaining of abdominal pain without any prior surgeries.Their vital signs remained stable during the assessment.The diagnosis of abdominal cocoon was confirmed through abdominal computed tomography(CT)before surgery.In the first case,the CT scan revealed capsules around the small bowel loops,showing no enhancement,along with mesenteric congestion affecting both small and large bowel loops,without a clear obstruction.The second case showed intestinal obstruction due to an encapsulated capsule on the CT scan.In the final case,a patient presented with recurring abdominal pain.Initially,the radiologist suspected enteritis as the cause after the CT scan.However,a detailed review led the surgeon to suspect encapsulating peritoneal sclerosis(ACS)and subsequently perform surgery.The surgical procedure involved complete removal of the encapsulating structure,resection of a portion of the small bowel,and end-to-end anastomosis.No complications occurred during surgery,and the patients had a smooth recovery after surgery,eventually discharged in good health.The histopathological examination of the fibrous membrane(cocoon)across all cases consistently revealed the presence of fibro-collagenous tissue,without any indications of malignancy.CONCLUSION Individuals diagnosed with abdominal cocoons commonly manifest vague symptoms of abdominal discomfort.An elevated degree of clinical suspicion,combined with the application of appropriate radiological evaluations,markedly improves the probability of identifying the abdominal cocoon before surgical intervention.In cases of complete bowel obstruction or ischemia,the established norm is the comprehensive removal of the peritoneal sac as part of standard care.Resection with intestinal anastomosis is advised solely when ischemia and gangrene have been confirmed.

配置Tomcat使Apache服务器支持Java动态网页编程

介绍了在Apache服务器上实现Servlet/JSP技术的一种主要解决方案Tomcat ,及其安装与配置。讨论了处理servlet/JSP的方法 。

一种基于XML的WEB应用框架的设计

WEB应用框架旨在为开发人员提供一套WEB应用程序的开发框架和一套表现业务逻辑的组件,简化WEB应用开发人员的开发过程,提高开发效率。经过对同类WEB应用框架的分析比较,文章提出了一个基于XML的WEB应用框架(SeaFrame),该框架符合“请求-应答”模式,并将“请求”“应答”全部封装为XML格式,故可以应用到符合这一模式的各种网络协议的客户终端;该框架还支持用户按功能模块等划分编写配置文件,从而提高各模块的并行开发效率,使整个应用的导航更加清晰;该框架充分运用XML和XSLT技术,更好地分离了控制、模型和视图,更多地减少了用户代码。

基于COCOON框架的网站开发技术

介绍了一个全新的基于XML的Web出版框架Cocoon技术。Cocoon技术将网页的静态内容、程序逻辑和表现样式相分离,大大提高了站点的开发速度以及站点的可管理性。

浙江省蚕品种的推广及对蚕茧质量的影响

蚕品种与茧丝质量关系密切。浙江蚕品种历经5次更新,每次更新都促进了蚕茧质量的提高。新蚕品种必须按照规定程序在茧丝质、生产性、强健性等方面达到审定标准方可推广应用。为促进蚕品种更新换代,必须加快新品种选育与推广;同时为适应蚕丝多用途的需要,应开展特殊用途蚕品种的研究与开发。生产优质蚕茧,应用优良品种是基础,而良好的气候、优质优价政策的执行也是必不可少的条件。

基于Cocoon+XSP框架的网站开发技术

XSP是一种基于Java和XML的能产生动态Web内容的服务器端语言。在Internet应用程序开发中,使用XSP可以实现静态内容、表现形式和程序逻辑的分离,而这种分离是通过ApacheCocoon实现的。Cocoon是一个用Java语言编写的、提供静态和动态Web内容的,基于XML的Web出版框架。XSP与Cocoon的结合大大提高了站点的开发速度以及站点的可管理性。

Investigation on the Pointed Cocoon of Wild Silkworm Descendant

[Objective] To study the cocoon traits of wild silkworm descendants. [Method] In the selective breeding of domesticated raising wild silkworm and wild silkworm descendants, investigation on the traits of the built cocoons was carried out. [Result] The pointed traits of cocoons displayed obviously in the wild silkworm descendants, its pointed parts were consistent with the rear part of silkworm chrysalis, and the female silkworm has slight difference, indicating the silkworm co- coon pointed trait was hereditary. [Conclusion] This study provided references for the study of silkworm cocoon traits of wild silkworm descendant and guides the selective breeding of silkworm variety.

新一代的网站开发技术XSP

本文介绍了一个全新的基于XML的W eb开发技术XSP。XSP是一种基于Java和XML的能产生动态W eb内容的服务器端语言。使用XSP可以实现W eb的静态内容、表现形式和程序逻辑的分离,而这种分离是通过Apache Cocoon实现的。XSP与Cocoon的结合大大提高了站点的开发速度以及站点的可管理性。

Development and Utilization of Naturally Colored Cocoon Resources of Bombyx mori

This paper summarized the diversity and prominent characteristics of naturally colored cocoon resources of Bombyx mori, and introduced the production methods of colored cocoons, the development and utilization of naturally colored cocoon resources at home and abroad as well as the variety breeding instances, based on which suggestions were proposed for the development of colored cocoon industry.

Breeding of a Natural Colored-Cocoon Bombyx mori Variety Shuhuang No.1

[Objective] This study aimed to develop a new Bombyx mori variety Shuhuang No.1 and investigate its characteristics.[Method] The new variety was developed through cross breeding and pedigree separation.Its characteristics were identified by laboratory tests and rural promotion practices in Sichuan Province.[Result]The cocoon produced by the new variety Shuhuang No.1 was golden-yellow and radiantly beautiful.Shuhuang No.1 was strong and easy to rear,uniform in development.The male and female ones could be distinguished by their larval color and markings.The cocoon yield per 10 000 the 4th instar larvae reached 20.30 kg; the length of a cocoon filament was about 1 115.0 m,and a non-broken filament was 882.95 mm long,accounting for 79.15％ of the total length.The raw silk ratio of fresh cocoon was 18.39％,and the neatness was 91.25 point.The main economic features of Shuhuang No.1 were better than those of the control.[Conclusion] The new variety had been approved by Sichuan Silkworm Evaluation Commission.It can be promoted in parent silkworm rearing areas Sichuan,Chongqing,Yangtze River basin.

基于MVC的框架开发技术研究

本文介绍了MVC模式和几种基于MVC模式的框架开发技术,这些框架开发技术在web开发特别是在J2EE的开发中,在解决企业应用开发软件复杂性方面,得到了较普遍的应用,并对这些技术进行了分析。

THE CAUSES OF DROPPING END AND THE SOLUTIONS

The exploration of the causes of dropping end is much necessary in raising reelabilityof poor raw cocoon. This paper, by an analysis of the curves of gumming force and dissoci-ating tension of cocoon filament, put forward a view that dissociation consists of a processof alternate tension and relaxation of the tensile force on the bave being dissociated. Also,based on the cocooning pattern of silkworms and the composition of the tensile force indissociation, a conclusion was reached that dropping end takes place when the energy con-sumed in dissociating a certain length of bave goes beyond the work of brittle rupture of thebave. Consequently tests were made in possible ways to improve reelability and the resultswere discussed.

WAP门户的设计及实现

为了满足3GWAP业务的需要,该文设计并实现了适用于3G手机的商用WAP门户.该门户的实现基于最新的WAP2.0规范,分层结构体系及管道处理机制等技术.

Encapsulating peritoneal sclerosis

Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease.

Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome

Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Ab-dominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.

Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon):A report of 5 cases

Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterized by a thick grayish-white fibrotic membrane encasing the small bowel. SEP can be classified as idiopathic,also known as abdominal cocoon,or secondary. It is difficult to make a definite pre-operative diagnosis. We experienced five cases of abdominal cocoon,and the case files were reviewed retrospectively for the clinical presentation,operative findings and outcome. All the patients presented with acute,subacute and chronic intestinal obstruction. Computed tomography (CT) showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle in four cases. Four cases had an uneventful post-operative period,one case received second adhesiolysis due to persistent ileus. The imaging techniques may facilitate pre-operative diagnosis. Surgery is important in the management of SEP.

Idiopathic abdominal cocoon syndrome with unilateral abdominal cryptorchidism and greater omentum hypoplasia in a young case of small bowel obstruction

Abdominal cocoon syndrome(ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and greater omentum hypoplasia is even rarer clinically. We successfully treated a 26-year-old male case of small bowel obstruction with acute peritonitis. He was finally diagnosed with idiopathic ACS with unilateral abdominal cryptorchidism and greater omentum hypoplasia during exploratory laparotomy. He then underwent enterolysis, cryptorchidectomy, and appendectomy. He recovered gradually from the operations and early postoperative inflammatory ileus. There has been no recurrence of intestinal obstruction since the operation, and he is still in follow-up. We analyzed his clinical data and retrospectively reviewed the literature, and our findings may be helpful for the clinical diagnosis and treatment on ACS.

简化Apache Cocoon对数据库的访问

ApacheCocoon是一个优秀的基于组件技术和XML和Web应用开发框架。在Cocoon中,提供了一套使用XSP对数据库进行数据访问的机制。本文讨论了一种通过对Cocoon核心部件进行扩充,来实现更简洁、更高效的数据库数据访问机制。ApacheCocoon有两个系列Cocoon1和Cocoon2,本文以Cocoon2为基础。

Coexistence of abdominal cocoon, intestinal perforation and incarcerated Meckel's diverticulum in an inguinal hernia: A troublesome condition

Sclerosing encapsulating peritonitis(SEP) is a rare dis-ease entity, in which the small intestine becomes en-cased and mechanically obstructed by a dense, fibrotic membrane. The disorder is characterized as either primary(idiopathic) or secondary to other causes. The idiopathic cases of SEP, which lack any identifiable eti-ology according to clinical, radiological and histopatho-logical findings, are also reported under the designation of abdominal cocoon syndrome. The most frequent presenting symptoms of all SEP cases are nausea, vom-iting, abdominal distention and inability to defecate, all of which are associated with the underlying intestinal obstruction. Persistent untreated SEP may advance to intestinal perforation, representing a life-threatening condition. However, preoperative diagnosis remains a particular clinical challenge, and most diagnoses are confirmed only when the typical fibrous membrane en-casing the small intestine is discovered by laparotomy. Here, we report the clinical presentation of an 87-year-old male with signs of intestinal obstruction and the ul-timate diagnosis of concurrent abdominal cocoon, rightincarcerated Meckel's diverticulum, and gastrointestinal perforation in laparotomy.

Expression Differences of Flavonoid Synthase Ⅰ(BmFNS Ⅰ)in the Tissues of Bombyx Mori with Sex-identified Fluorescent Cocoon Color

Expression differences of flavonoid synthase I（BmFNS I）gene in the midgut,silk gland and fat body of the male and female Bombyx Mori with sex-identified fluorescent cocoon color were detected by fluorescence quantitative PCR.The result showed that the relative expression level of BmFNS I gene in midgut of Bombyx Mori was the highest,followed by that in fat body,and the expression level in silk gland was the lowest,indicating that BmFNS I gene played an important role in flavonoids anabolism in mulberry leaves,which was the food of silkworm.However,there was no significant difference in BmFNS I gene expression level between midguts of male and female Bombyx Mori species with sex-identified fluorescent cocoon color,suggesting that there was no difference in flavonoids anabolism of mulberry leaves between the male and female Bombyx Mori with sex-identified fluorescent cocoon color,at least no difference in flavonoids anabolism regulated by FSN I gene.