Colocolic intussusception in an older child: a rare case report and a literature review.

Intussusception is a common cause of intestinal obstruction and colicky abdominal pain in the children, particularly infants, the commonest being the ileocolic variety with colocolic variety being a very rare entity. We present a case of colocolic intussusception in a 13-year-old boy which is otherwise seen in adults, precipitated by colonic malignancies. The patient presented with acute abdominal pain and bleeding perrectum with obstipation for 7 days. Preoperative USG abdomen was normal, and abdominal X-rays showed multiple air fluid levels. Intraoperative findings included a polypoidal growth in the descending colon as the leading point with the formation of a colo-colic intussusception. Following reduction and segmental resection, histopathology reported mucinous adenocarcinoma of colon which is also a rarity in pediatric age group. This case has been compared with previous cases reported in the literature.

A rare presentation of midgut malrotation as an acute intestinal obstruction in an adult: Two case reports and literature review.

INTRODUCTION: Midgut malrotation is a congenital anomaly presenting mainly in the childhood. Its presentation as an acute intestinal obstruction is extremely rare in adults usually recognized intra-operatively, therefore a high index of suspicion is always required when dealing with any case of acute intestinal obstruction. PRESENTATION OF CASE: We report two cases of young adults who presented with symptoms of acute intestinal obstruction and were diagnosed intra-operatively as cecal volvulus and paraduodenal hernia, respectively, caused by midgut malrotation. Post-operative CT scan confirmed these findings. DISCUSSION: Malrotation of the intestinal tract is a product of an aberrant embryology. The presentation of intestinal malrotation in adults is rare (0.2-0.5%). Contrast enhanced CT can show the abnormal anatomic location of a right sided small bowel, a left-sided colon and an abnormal relationship of the superior mesenteric vein (SMV) situated to the left of the superior mesenteric artery (SMA) instead of to the right. CONCLUSION: Anomalies like midgut malrotation can present as an operative surprise and awareness regarding these anomalies can help surgeons deal with these conditions.

Effect of reuse on surface characteristics of balloon angioplasty catheters.

Surfaces of reused angioplasty catheter balloons were characterized by scanning electron microscopy (SEM), image analysis, Fourier transform infrared (FT-IR) spectroscopy and X-ray photoelectron spectroscopy (XPS). The surfaces were found to have longitudinal ridges, cracks, wrinkled regions and particulates. Most of the particles were carbon-based, and contained traces of Cl and Si. The average number of particles ranged between 11 and 38 per mm2, while the average particle size ranged from 14 micron to 28 micron. About 70%-90% of the particles were larger then 10 micron which is approximately the diameter of the fine blood capillaries. The particles appeared to be firmly attached to the outer surface of the balloon. FT-IR and XPS analysis revealed the presence of Si, the absence of proteins, and suggested that the surface of the reused balloon catheters was oxidized. The study highlights the large number of particles created and released during angioplasty.

Ascitic fluid cholesterol in differential diagnosis of ascites.

Cholesterol was estimated in ascitic fluid of 89 patients (29 malignant and 60 non-malignant ascites). Mean ascitic cholesterol level was significantly higher in malignant ascites (89.52 mg/dl) as compared to non-malignant ascites (29.93 mg/dl). At a cut off value of 48 mg/dl, the sensitivity, specificity, positive and negative predictive value and overall diagnostic accuracy for diagnosing malignant ascites is 96.5%, 96.6%, 93.3%, 98.3% and 96.6% respectively. Ascitic fluid cholesterol estimation is an easy and reliable test for differentiating malignant ascites from non-malignant ascites.

Release of chemicals from polyurethane foam in the Même breast implant.

Samples of polyurethane (PU) foam from the Même breast implant were incubated at 37 degrees C in either 0.3-3.0 N sodium hydroxide (NaOH) solutions, normal saline, or methanol. The chemicals released were analyzed by gas chromatography (GC), gas chromatography/mass spectrometry (GC/MS), and Fourier-transform infra-red (FT-IR) spectroscopy. The surfaces of the treated and untreated foam samples were studied by scanning electron microscopy (SEM). The NaOH solutions hydrolysed the foam, releasing toluene diamine (TDA). Incubating the foam in methanol washed out trace quantities of anti-oxidant, 2,4-dimethyl-6-t-butylphenol (DBP). When the foam was incubated in normal saline at 37 degrees C no TDA was detectable but another compound with a mass ion of 173 was detected. Further GC/MS studies confirmed that this compound was polyol, one of the reagents used to manufacture the PU foam. Repeatedly incubating or washing the foam in normal saline or methanol eliminated the release of polyol. SEM studies of the foam samples before and after incubation experiments, showed no evidence of polymer degradation. These findings indicated that polyol was present in the PU foam only as an impurity or residue and did not originate from the breakdown of the foam itself.

Chemical investigation and anti-inflammatory activity of Vitex negundo seeds.

The CHCl3 extract of the defatted seeds of Vitex negundo exhibited anti-inflammatory activity and yielded four triterpenoids: 3 beta-acetoxyolean-12-en-27-oic acid [1], 2 alpha, 3 alpha-dihydroxyoleana-5,12-dien-28-oic acid [2], 2 beta,3 alpha-diacetoxyoleana-5,12-dien-28-oic acid [3], and 2 alpha,3 beta-diacetoxy-18-hydroxyoleana-5,12-dien-28-oic acid [5]. This is the first report of the isolation of compounds 2, 3, and 5 from a natural source.

In vitro degradation of a poly(ether urethane) by trypsin.

In vitro enzymatic degradation of non-porous films of segmented poly(ether urethane) (Pellethane 2363-80AE) was investigated by incubating the biomaterial in concentrated trypsin solutions for 5 months at room temperature. Chemical degradation of films was monitored by surface analysis techniques such as Fourier transform infrared spectroscopy-attenuated total reflectance and electron spectroscopy for chemical analysis. This latter technique proved to be much superior in detecting chemical changes. Extraction of films with methanol and characterization of the extracts by gel permeation chromatography revealed the presence of low-molecular-weight polymers. Results have shown that trypsin has the ability to induce degradation in PEU, the soft segment being most affected, particularly the CH2-O bond of the ether linkages.

Leaching of plasticizers from and surface characterization of PVC blood platelet bags.

The leaching of phthalate plasticizers from four types of blood platelet bags was investigated. The anticoagulant solutions used in the blood collection bags had pH values of 5.64 +/- .04 and contained no detectable amounts of phthalates. Platelet bag materials from each bag were soaked in normal salines for up to 5 days. The salines were tested for the leached phthalates from the bags but none could be found. However, di-(2-ethylhexyl) phthalate (DEHP) leached out of the PL-146 and Terumo bags into bovine calf serum used for soaking the bag materials. There was an increase in the amount of DEHP leached from about 1.1 mg at the end of one day to about 3.3 mg per gm of bag material at the end of a five day extraction with the serum. In PL-732 sets, a platelet bag made of a specialty polyolefin, the amount of DEHP leached out was less than 0.02 mg per g of bag material. CLX bags, which contained tri-(2-ethylhexyl) trimelliate (TETM) as a plasticizer, showed a negligible amount of it leaching into the calf serum. Infra-red spectra showed that PL-146 bags had been coated with a layer of a fatty acid amide while the Terumo bags contained a layer of a silicone fluid on their inner surfaces. CLX bags showed a coating of stearates, which were probably soaps of calcium or zinc. Scanning electron microscopy (SEM) showed that the inner surfaces of each brand of the bag were distinctly different morphologically. The two PVC bags were very similar whereas the surfaces morphology of PL-732 was rougher. Terumo bag had a different surface morphology than those of the other bags whereas the CLX bags had a very regular surface pattern. The exact significance of the surface morphology is not certain but excessively rough surfaces may not be desirable for the bags.

Immobilization of enzymes on polypropylene bead surfaces by anhydrous ammonia gaseous plasma technique.

Anhydrous ammonia gaseous plasma technique was used for the surface modification of polypropylene beads. Amino groups were added onto the surfaces of beads by exposing them to ammonia plasma. Through these amino groups covalent immobilization of glucose oxidase and peroxidase were carried out. The total amounts of immobilized glucose oxidase and immobilized peroxidase were found to be 52 and 43 micrograms/cm2, respectively. To assess the stability of enzyme-polypropylene linkage, beads with covalently immobilized glucose oxidase and peroxidase were washed with phosphate buffer. It was found that after the removal of the adsorbed enzymes, the concentration of covalently immobilized enzymes tended to reach a steady state. After additional washing with buffer for 5 to 6 h, 40-55% of the immobilized enzymes were found to be in the active form.

Degradation of explanted polyurethane cardiac pacing leads and of polyurethane.

Polyurethane cardiac pacing leads explanted at autopsy and from reoperated patients were examined for degradation in the insulation. Scanning electron microscopy (SEM) analysis showed cracks on the polyurethane surface which were both parallel and perpendicular to the longitudinal axis of the lead. Surface analyses of leads were performed using Fourier-Transform Infra-red (FT-IR) spectrophotometry in the attenuated total reflectance mode. The FT-IR spectra of visibly deteriorated polyurethane from explanted lead sheaths were compared with that of unused polyurethane tubing used for such sheaths. Changes were most evident in the regions of 3000-2800, 1730 and 1368 cm-1. The observed alterations in the FT-IR spectra were consistent with a degradation mechanism involving oxidative chain cleavage in the polyurethane amorphous regions. New polyurethane tubing (Pellethane-Type 80A) was exposed to sodium hypochlorite to simulate a possible in-vivo process and generate reference material. Degradation with associated decreases in tensile strength and molecular weight was recorded. This study showed that polyurethane insulation used in pacing leads is susceptible to oxidative degradation.

Enhanced albumin binding to polypropylene beads via anhydrous ammonia gaseous plasma.

Plasma surface modification technique was used to add amino groups onto the surfaces of polypropylene beads by exposing them to anhydrous ammonia plasma. Through these amino groups, albumin was attached to the polypropylene beads. Attached albumin was further stabilized by crosslinking with glutaraldehyde. The effect of washing albuminated polypropylene beads with saline and human plasma was investigated. It was found that after initial rapid removal of albumin, the concentration of attached albumin tended to reach a steady-state. After 52 h of washing, the amount of albumin retained on the beads varied between 125 and 171 micrograms/cm2.