[Idiopathic esophageal submucosal hematoma during antithrombotic therapy for essential thrombocythemia].

A 73-year-old woman was hospitalized with sudden chest pain and hematemesis. Chest computed tomography and upper gastrointestinal endoscopy revealed an idiopathic submucosal hematoma from the cervical esophagus to the esophagogastric mucosal junction. Idiopathic esophageal submucosal hematoma is often prone to a bleeding tendency of an underlying disorder. The patient had a history of essential thrombocythemia (ET) and was taking aspirin. She successfully recovered after aspirin discontinuation and conservative treatment; however, died of cardiopulmonary arrest in the ward on day 9 of hospitalization. The autopsy revealed that the cause of death was pulmonary thromboembolism. This is the first report of ET with submucosal hematoma of the esophagus. The possibility of an esophageal submucosal hematoma should be considered when patients with ET complain of chest pain since ET and treatment with aspirin are considered risk factors for bleeding. Additionally, close attention should be focused on the risk of developing thrombosis if a patient with myeloproliferative neoplasm is required to discontinue antithrombotic therapy due to a bleeding event.

Effects of feeding polyphenol-rich winery wastes on digestibility, nitrogen utilization, ruminal fermentation, antioxidant status and oxidative stress in wethers.

Four wethers were used in a 4 × 4 Latin square design experiment to evaluate the availability of two types of winery wastes, winery sediment and grape pomace, as ruminant feeds possessing antioxidant activities. Each wether was assigned to one of the following four treatments: (i) 75 g/kg winery sediment (WS) on a dry matter (DM) basis; (ii) 166 g/kg DM winery grape pomace (WP); (iii) control diet (CD; 17 g/kg DM soybean meal);and (iv) only tall fescue hay (TFH; no additive). Winery sediment and grape pomace had high levels of polyphenols and of radical scavenging activities. Feeding with winery sediment and grape pomace did not negatively affect the intake, but it depressed crude protein (CP) digestibility compared with CD (P = 0.052 and P < 0.01 for WS and WP, respectively). Polyphenols in winery wastes decreased ruminal ammonia production (P = 0.089 and P < 0.05), likely due to their inhibitive effect on microbial activities in the rumen. The addition of winery sediment and grape pomace decreased urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG; an index of oxidative damages) excretion per day (P < 0.05 and P = 0.059). The results indicated that winery sediment and grape pomace could alter nitrogen metabolism and/or act as new antioxidants for ruminants.