[Objective] The aim was to establish a molecular biological method for identifying coccidium species.[Method]First,the pure species of Eimeria intestinalis was isolated by using single-oocyst isolation technique.Then,...[Objective] The aim was to establish a molecular biological method for identifying coccidium species.[Method]First,the pure species of Eimeria intestinalis was isolated by using single-oocyst isolation technique.Then,according to the 18s rDNA and 5.8s rDNA sequences of Eimeria coccidia published in GenBank,a pair of specific primers was designed and synthesized to amplify the internal transcribed spacer 1（ITS-1）.Finally,the PCR products were sent for sequencing.[Result]The pure species of E.intestinalis was isolated and the result of agarose gel electrophoresis showed that the PCR product was 434 bp,and at least 27-sporulated oocysts could be detected.[Conclusion]The research will provide a basis for accurate identification of coccidium species and strains.展开更多
AIM:To increase the understanding,diagnosis and treatment of pneumatosis cystoides intestinalis(PCI)and to find the characteristics and potential cause of the disease in China.METHODS:We report here one case of PCI in...AIM:To increase the understanding,diagnosis and treatment of pneumatosis cystoides intestinalis(PCI)and to find the characteristics and potential cause of the disease in China.METHODS:We report here one case of PCI in a 70-year-old male patient who received a variety of treatment methods.Then,we systematically searched the PCI eligible literature published from an available Chinese database from May 2002 to May 2012,including CBM,CBMDisc,CMCC,VIP,Wanfang,and CNKI.The key words were pneumatosis cystoides intestinalis,pneumatosis,pneumatosis intestinalis,pneumatosis coli and mucosal gas.The patients' information,histories,therapies,courses,and outcomes were reviewed.RESULTS:The study group consisted of 239 PCI cases(male:female = 2.4:1)from 77 reported incidents.The mean age was 45.3 ± 15.6 years,and the median illness course was 6 mo.One hundred and sixty patients(66.9%)were in high altitude areas.In addition,43.5%(104/239)of the patients had potential PCI-related disease,and 16.3% had complications with intestinal obstruction and perforation.The most common symptom was abdominal pain(53.9%),followed by diarrhea(53.0%),distention(42.4%),nausea and vomiting(14.3%),bloody stool(12.9%),mucous stool(12.0%)and constipation(7.8%).Most multiple pneumocysts developed in the submucosa of the colon(69.9%).The efficacy of the treatments by combined modalities,surgery,endoscopic treatment,conservative approach,oxygen,and antibiotics were 100%,100%,100%,93.3%,68.3% and 26.3%,respectively.CONCLUSION:PCI can be safely managed by conservative treatments,presents more frequently in males,in the large bowel and submucosa,than in females,in the small intestine and subserosa.High altitude residence maybe associated with the PCI etiology.展开更多
A 69-year-old man was diagnosed as having myasthenia gravis (MG) in September 2004,and treated with thymectomy and prednisolone. He was then diagnosed as having steroid-induced diabetes mellitus,and received sulfonylu...A 69-year-old man was diagnosed as having myasthenia gravis (MG) in September 2004,and treated with thymectomy and prednisolone. He was then diagnosed as having steroid-induced diabetes mellitus,and received sulfonylurea (SU) therapy in May 2005. An alpha-glucosidase inhibitor (αGI) was added in March 2006,resulting in good glycemic control. He experienced symptoms of abdominal distention,increased flatus,and constipation in October 2007,and was admitted into our hospital in late November with hematochezia. Plain abdominal radiography revealed small linear radiolucent clusters in the wall of the colon. Computed tomography (CT) showed intramural air in the sigmoid colon. Colonoscopy revealed multiple smooth surfaced hemispherical protrusions in the sigmoid colon. The diagnosis of pneumatosis cystoides intestinalis (PCI) was made on the basis of these findings. As the αGI voglibose was suspected as the cause of this patient's PCI,treatment was conservative,ceasing voglibose,with fasting and fluid supplementation. The patient progressed well,and was discharged 2 wk later. Recently,several reports of PCI associated with αGI therapy have been published,predominantly in Japan where αGIs are commonly used. If the use of αGIs becomes more widespread,we can expect more reports of this condition on a global scale. The possibility of PCI should be considered in diabetic patients complaining of gastrointestinal symptoms,and the gastrointestinal tract should be thoroughly investigated in these patients.展开更多
AIM： To share our experience of the management and outcomes of patients with pneumatosis cystoides in- testinalis （PCI）. METHODS： The charts of seven patients who under- went surgery for PCI between 2001 and 2009 ...AIM： To share our experience of the management and outcomes of patients with pneumatosis cystoides in- testinalis （PCI）. METHODS： The charts of seven patients who under- went surgery for PCI between 2001 and 2009 were re- viewed retrospectively. Clinical features, diagnoses and surgical interventions of patients with PCI are discussed. RESULTS： Seven patients with PCI （3 males, 4 fe- males; mean age, 50 ~ 16.1 years; range, 29-74 years） were analyzed. In three of the patients, abdominal pain was the only complaint, whereas additional vomiting and/or constipation occurred in four. Leukocytosis was detected in four patients, whereas it was within normal limits in three. Subdiaphragmatic free air was observed radiologically in four patients but not in three. Six of the patients underwent an applied lapa- rotomy, whereas one underwent an applied explorative laparoscopy. PCI localized to the small intestine only was detected in four patients, whereas it was localized to the small intestine and the colon in three. Three patients underwent a partial small intestine resection and four did not after PCI was diagnosed. Five patients were diagnosed with secondary PCI and two with pri- mary PCI when the surgical findings and medical his- tory were assessed together. Gastric atony developed in one case only, as a complication during a postopera- tive follow-up of 5-14 d. CONCLUSION： Although rare, PCl should be consid- ered in the differential diagnosis of acute abdomen. Diagnostic laparoscopy and preoperative radiological tests, including computed tomography, play an impor- tant role in confirming the diagnosis.展开更多
While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal f...While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.展开更多
A 39-year-old male reported fevers,weight loss,watery loose stools,and decreased visual acuity in his right eye over the prior five years.He was pancytopenic,had an elevated American council on exercise level,total bi...A 39-year-old male reported fevers,weight loss,watery loose stools,and decreased visual acuity in his right eye over the prior five years.He was pancytopenic,had an elevated American council on exercise level,total bilirubin,and alkaline phosphatase.Computed tomography revealed massive hepatosplenomegaly and emphysematous lung changes.Liver biopsy showed non caseating granulomas.The patient was diagnosed with extrapulmonary sarcoidosis and was treated with prednisone.The patient symptomatically improved but 5 mo later presented with abdominal pain caused by perforation of the cecum.He underwent a cecectomy and pathology revealed pneumatosis cystoides intestinalis.This represents the first reported association between pneumatosis cystoides intestinalis and sarcoidosis.The etiology of pneumatosis cystoides intestinalis in this case was likely multifactorial and involved both effects of the corticosteroids as well as the advanced nature of the gastrointestinal sarcoidosis.Furthermore this case has the unique features of emphysematous lung changes and pancytopenia which are uncommon with sarcoidosis.展开更多
Pneumatosis intestinalis(PI) often represents a benign condition that should not be considered as an argument for surgery. We report a patient with PI and obstructing intussusception who underwent urgent colectomy and...Pneumatosis intestinalis(PI) often represents a benign condition that should not be considered as an argument for surgery. We report a patient with PI and obstructing intussusception who underwent urgent colectomy and review the literatures regarding PI with intussusception. A 20-year-old man presented at our hospital with a 3-d intermittent lower abdominal pain history. He underwent steroid therapy for membranoproliferative glomerulonephritis for 4 years. Computed tomography revealed ascending colon intussusception with air within the wall. Intraoperative colonoscopy revealed numerous soft polypoid masses with normal overlying mucosa and right hemicolectomy was performed. Histological examination of colonic wall sections revealed large cysts in the submucosal layer. The pathological diagnosis was PI. Nine cases of intussusception associated with primary PI have been reported. Although primary PI often represents a benign condition that should not be considered as an argument for surgery,if the case involves intussusception and obstruction,emergent laparotomy should be considered.展开更多
Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, al...Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, although fluorouracil-related PCI is extremely rare. We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV). After 1 cycle of the treatment, he presented with diarrhea and abdominal pain. Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine. Laparotomy was performed, showing a suspected diagnosis of perforation in the gastrointestinal tract. Intraoperative findings revealed penumatosis of the intestine without evidence of perforation. He was treated supportively and his symptoms improved. In conclusion, we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.展开更多
Pneumatosis cystoides intestinalis(PCI) is a rare condition that may be associated with a variety of diseases.The presenting clinical picture may be very heterogeneous and represent a challenge for the clinician.In th...Pneumatosis cystoides intestinalis(PCI) is a rare condition that may be associated with a variety of diseases.The presenting clinical picture may be very heterogeneous and represent a challenge for the clinician.In the present paper we describe both a common and an uncommon clinical presentation of PCI and review the pertaining literature.Our cases confirm that,apart from asymptomatic cases,the clinical presentation of PCI may be widely different and suggest that a new onset of stipsis might be the presenting symptom.Diagnosis might be suggested by a simple X-ray of the digestive tract showing a change in the characteristics of the intestinal wall in two-thirds of these patients.However,one third of the patients do not have a suggestive X-ray and require a computed tomography(CT) scan/nuclear magnetic resonance that may reveal a thickened bowel wall containing gas to confirm the diagnosis and distinguish PCI from intraluminal air or submucosal fat.CT also allows the detection of additional findings that may suggest an underlying,potentially worrisome cause of PCI such as bowel wall thickening,altered contrast mucosal enhancement,dilated bowel,soft tissue stranding,ascites and the presence of portal air.Our results also point out that clinicians and endoscopists should be aware of the possible presentations of PCI in order to correctly manage the patients affected with this disease and avoid unnecessary surgeries.The increasing number of colonoscopies performed for colon cancer screening makes PCI more frequently casually encountered and/or provoked,therefore the possible endoscopic appearances of this disease should be well known by endoscopists.展开更多
Objective:To extract the bioactive compound from Enteromorpha intestinalis(E. intestinalis) and determine its in vitro antimicrobial activity. Methods: E. intestinalis was extracted by methanol and subjected to antimi...Objective:To extract the bioactive compound from Enteromorpha intestinalis(E. intestinalis) and determine its in vitro antimicrobial activity. Methods: E. intestinalis was extracted by methanol and subjected to antimicrobial screening. The antimicrobial activity was studied by using disc diffusion and broth dilution method. The effect of the extract on the growth profile of the bacterial was also examined via time-kill assay. Microscopy observations using SEM was done to determine the major alterations in the microstructure of methicillin-resistant Staphylococcus aureus(MRSA). Results: The results showed methanolic extract of E. intestinalis exhibited a favourable antimicrobial activity against tested bacteria with produced inhibition zone ranging from 8.0-19.0 mm. However, all the tested fungi and yeast were resistant to the extract treatment. Time kill assay suggested that methanolic extract of E. intestinalis had completely inhibited MRSA growth and also exhibited prolonged antibacterial activity. The main abnormalities noted from the microscopic observations were the structural deterioration in the normal morphology and complete collapsed of the bacteria cells after 36 h of treatment. Conclusions: The significant antibacterial activity shown by crude extract suggested its potential against MRSA infection. The extract may have potential to develop as antibacterial agent in pharmaceutical use.展开更多
Objective:To evaluate the anti-microsporidial effects of the active component of Nigella sativa seeds,thymoquinone,against Encephalitozoon intestinalis using an in vitro model.Methods:Anti-microsporidial effect of thy...Objective:To evaluate the anti-microsporidial effects of the active component of Nigella sativa seeds,thymoquinone,against Encephalitozoon intestinalis using an in vitro model.Methods:Anti-microsporidial effect of thymoquinone against Encephalitozoon intestinalis was evaluated by using various concentrations of thymoquinone(0,1,5,10,15,20,30,35,and 40μM)and sterile dimethyl sulfoxide.Real time PCR was used to evaluate the inhibitory effects of thymoquinone on the life cycle of Encephalitozoon intestinalis.Results:The cytotoxic effect of thymoquinone on HEK293 cell line was observed with 30,35,and 40μM concentrations of thymoquinone after 24,48,and 72 hours of incubation.It was observed that 10,15,20,and 30μM concentrations of thymoquinone decreased the spore density compared with the control;however,it was significant only at 30μM.Conclusions:Thymoquinone shows potent anti-microsporidial effects against Encephalitozoon intestinalis in the in vitro model;however,the toxic concentrations of thymoquinone are also toxic to the host cells.展开更多
The development of intramural intestinal gas may indi-cate a serious postoperative complication and thereforeany radiological indication of such "pneumatosis intes-tinalis"(PI) in an unwell patient after sur...The development of intramural intestinal gas may indi-cate a serious postoperative complication and thereforeany radiological indication of such "pneumatosis intes-tinalis"(PI) in an unwell patient after surgery shouldput the clinical team on high-alert. However immedi-ate recourse to relook laparotomy may not be alwaysnecessary and, further, in some cases may possiblyaccelerate the deterioration especially if it proves to benon-therapeutic. Careful and close clinical monitoring,as is described in this clinical report, may allow discrimi-native identification of those in whom this finding is infact transient and therefore benign and who thereforecan be successfully treated without operative re-inter-vention. We describe the presenting features and back-ground scenario of PI early after laparoscopic total col-ectomy for medically refractory, severe ulcerative colitisand detail the critical postoperative decision pivots.展开更多
Pneumatosis intestinalis and portomesenteric vein gas are rare and potentially severe radiological findings that occur both in pediatric and adult populations.They actually are radiographic signs of underlying intra-a...Pneumatosis intestinalis and portomesenteric vein gas are rare and potentially severe radiological findings that occur both in pediatric and adult populations.They actually are radiographic signs of underlying intra-abdominal pathology,abnormality or diagnostic medical interference.If combined with other radiological or clinical signs of intestinal ischemia or sepsis,the prognosis is dismal and urgent laparotomy is mandatory.We report two cases of surgical treatment with ominous outcome in an effort to characterize this finding correctly as an absolute surgical indication or as an additional diagnostic criterion that simply marks a further breakdown of the systems in patients with a long list of severe medical conditions.展开更多
Pneumatosis intestinalis(PI)is an uncommon disease defined as gas-filled cysts that are found in the wall of the gastrointestinal(GI)tract.The exact causes of PI are still unclear,but it may associated with coexisting...Pneumatosis intestinalis(PI)is an uncommon disease defined as gas-filled cysts that are found in the wall of the gastrointestinal(GI)tract.The exact causes of PI are still unclear,but it may associated with coexisting diseases,such as some GI disorders,connective tissue disease,some medication and drugs,and rarely malignancy.The most common localization is the small intestine.Gastric PI secondary to malignancy has been rarely documented.We report on a 94-year- old man with gastric PI associated with inoperable adenocarcinoma localized in the duodenum.Following the gastrojejunostomy and choledochojejunostomy bypass,his general condition improved and PI disappeared,but he died due to poor performance status and malignancy 6 mo later.We suggest that in patients presenting with PI,malignancy should be considered in the differential diagnosis.展开更多
Previous study demonstrated that Ganoderma meroterpene derivative(GMD)increased the abundance of butyrate-producing bacteria in gut and subsequently delivered anti-metabolic disorder effect of host.To specify the key ...Previous study demonstrated that Ganoderma meroterpene derivative(GMD)increased the abundance of butyrate-producing bacteria in gut and subsequently delivered anti-metabolic disorder effect of host.To specify the key commensal bacteria associating with the beneficial effects,we tried to isolate and compare the microbiota from the cecal samples of GMD-and vehicle-treated ob/ob mice,and further identified butyrate-producing bacterial strains.It was found that Faeciroseburia intestinalis was enriched and 11 strains affiliated to F.intestinalis were cultivated from the gut of GMD-treated mice.In vitro assay attested butyrate production by representative strain of F.intestinalis.Oral administration with F.intestinalis further demonstrated its benefits on regulating hyperglycemia and hyperlipidemia,on decreasing plasma lipopolysaccharide(LPS)and inflammation,and on improving hepatic injuries.Treatment with F.intestinalis effectively enhanced the level of gut butyrate,which subsequently ameliorated the intestinal barrier function and activated epithelial PPAR-γ signaling pathway to regulate microbiome homeostasis in gut.Our study demonstrated that the causal relationship between the butyrate-producing bacteria and the GMD's therapeutic effects and confirmed the important function of the butyrate-producing F.intestinalis in maintaining host metabolism homeostasis.展开更多
Pneumatosis intestinalis(PI) is a striking radiological diagnosis. Formerly a rare diagnostic finding, it is becoming more frequently diagnosed due to the wider availability and improvement of computed tomography scan...Pneumatosis intestinalis(PI) is a striking radiological diagnosis. Formerly a rare diagnostic finding, it is becoming more frequently diagnosed due to the wider availability and improvement of computed tomography scan imaging. Once associated only with poor outcome, its clinical and prognostic significance nowadays has to be cross-referenced to the nature of the underlying condition.Multiple mechanisms of pathogenesis have been debated and multiple causes have been detected during the years. All this contributes to creating a broad range of clinical and radiological presentations. The management of patients presenting PI is related to the determining cause if it is identified. Otherwise, in particular if an association with portal venous gas and/or pneumoperitoneum is present, the eventual decision between surgery and non-operative management is challenging,even for stable patients, since this clinical condition is traditionally associated to intestinal ischemia and consequently to pending clinical collapse if not treated.Considering the wide variety of origin and outcomes, PI still remains for surgeons a demanding clinical entity. The manuscript is an updated narrative review and gives some suggestions that may help make the decisional process easier,identifying patients who can benefit from surgical intervention and those who can benefit from non-operative management avoiding unnecessary procedures.展开更多
Twenty species of seaweed were collected from the coast of Zhejiang, China, extracted with ethanol, and screened for algicidal activity against red tide microalgae H eterosigma akashiwo and Prorocentrum micans. Inhibi...Twenty species of seaweed were collected from the coast of Zhejiang, China, extracted with ethanol, and screened for algicidal activity against red tide microalgae H eterosigma akashiwo and Prorocentrum micans. Inhibitory eff ects of fresh and dried tissues of green alga U lva intestinalis were assessed and the main algicidal compounds were isolated, purifi ed, and identifi ed. Five seaweed species, U. intestinalis, U. fasciata, Grateloupia romosissima, Chondria crassicaulis, and Gracilariopsis lemaneiformis, were investigated for their algicidal activities. Fresh tissues of 8.0 and 16.0 mg/m L of U. intestinalis dissolved in media signifi cantly inhibited growth of H. akashiwo and P. micans, respectively. Dried tissue and ethyl acetate(Et OAc) extracts of U. intestinalis at greater than 1.2 and 0.04 mg/m L, respectively, were fatal to H. akashiwo, while its water and Et OAc extracts in excess of 0.96 and 0.32 mg/m L, respectively, were lethal to P. micans. Three algicidal compounds in the Et OAc extracts were identifi ed as 15-ethoxy-(6z,9z,12z)-hexadecatrienoic acid(I),(6E,9E,12E)-(2-acetoxy- β- D-glucose)-octadecatrienoic acid ester(II) and hexadecanoic acid(III). Of these, compound II displayed the most potent algicidal activity with IC_(50) values of 4.9 and 14.1 μg/m L for H. akashiwo and P. micans, respectively. Compound I showed moderate algicidal activity with IC_(50) values of 13.4 and 24.7 μg/m L for H. akashiwo and P. micans, respectively. These fi ndings suggested that certain macroalgae or products therefrom could be used as ef fective biological control agents against red tide algae.展开更多
Toxic epidermal necrolysis(TEN) is a severe adverse drug reaction, which is characterized by erythema, blisters, and/or erosions of the mucous membranes and skin, but intestinal involvement is rare. In contrast, pneum...Toxic epidermal necrolysis(TEN) is a severe adverse drug reaction, which is characterized by erythema, blisters, and/or erosions of the mucous membranes and skin, but intestinal involvement is rare. In contrast, pneumatosis cystoides intestinalis(PCI) is a rare condition associated with a wide variety of underlying diseases, but to date no patient has presented with PCI associated with TEN. A 55-year-old man was admitted to intensive care unit for treatment of TEN caused by phenobarbital. On day 8 after admission, he presented with progressive abdominal distention and hypotension. Computed tomography(CT) showed gas in the superior mesenteric vein and air filled cysts in the walls of the small intestine. He was suspected of having septic shock due to PCI. As there were no indications of bowel ischemia or necrosis, the patient was managed conservatively with antibiotics and oxygen therapy. On day 10 after admission, he was weaned off catecholamines, with CT on day 11 showing complete resolution of gas in the superior mesenteric vein and air filled cysts. To our knowledge, this article describes the first patient presenting with PCI associated with TEN.展开更多
Pneumatosis intestinalis(PI) is defined as gas within the gastrointestinal wall and is associated with a variety of disorders.As a concurrent occurrence with pneumoperitoneum,it can easily to be mistaken for bowel isc...Pneumatosis intestinalis(PI) is defined as gas within the gastrointestinal wall and is associated with a variety of disorders.As a concurrent occurrence with pneumoperitoneum,it can easily to be mistaken for bowel ischemia with perforated peritonitis.In fact,air dissection or rupture from subserosal cysts may be the cause of intraperitoneal and intraluminal free air,with clinical symptoms such as abdominal pain and fullness occurring as a result.We hereby report a case of an 82-year-old male with a history of chronic obstructive pulmonary disease who was diagnosed with bowel ischemia and received emergency laparotomy because of the appearance of PI and pneumoperitoneum on abdominal computed tomography scan.However,no perforated hollow organ or necrotic bowel segment was found,only diffusely distributed massive intraperitoneal air and PI of gastrointestinal tract.The laparotomy seemed non-therapeutic for this patient.This is significant warning for clinicians to differentiate the associated conditions of PI,and to evaluate whether or not emergency surgery is necessary.展开更多
基金Supported by the Program of National Rabbit Industrial Production Technology System of Ministry of Agriculture~~
文摘[Objective] The aim was to establish a molecular biological method for identifying coccidium species.[Method]First,the pure species of Eimeria intestinalis was isolated by using single-oocyst isolation technique.Then,according to the 18s rDNA and 5.8s rDNA sequences of Eimeria coccidia published in GenBank,a pair of specific primers was designed and synthesized to amplify the internal transcribed spacer 1（ITS-1）.Finally,the PCR products were sent for sequencing.[Result]The pure species of E.intestinalis was isolated and the result of agarose gel electrophoresis showed that the PCR product was 434 bp,and at least 27-sporulated oocysts could be detected.[Conclusion]The research will provide a basis for accurate identification of coccidium species and strains.
文摘AIM:To increase the understanding,diagnosis and treatment of pneumatosis cystoides intestinalis(PCI)and to find the characteristics and potential cause of the disease in China.METHODS:We report here one case of PCI in a 70-year-old male patient who received a variety of treatment methods.Then,we systematically searched the PCI eligible literature published from an available Chinese database from May 2002 to May 2012,including CBM,CBMDisc,CMCC,VIP,Wanfang,and CNKI.The key words were pneumatosis cystoides intestinalis,pneumatosis,pneumatosis intestinalis,pneumatosis coli and mucosal gas.The patients' information,histories,therapies,courses,and outcomes were reviewed.RESULTS:The study group consisted of 239 PCI cases(male:female = 2.4:1)from 77 reported incidents.The mean age was 45.3 ± 15.6 years,and the median illness course was 6 mo.One hundred and sixty patients(66.9%)were in high altitude areas.In addition,43.5%(104/239)of the patients had potential PCI-related disease,and 16.3% had complications with intestinal obstruction and perforation.The most common symptom was abdominal pain(53.9%),followed by diarrhea(53.0%),distention(42.4%),nausea and vomiting(14.3%),bloody stool(12.9%),mucous stool(12.0%)and constipation(7.8%).Most multiple pneumocysts developed in the submucosa of the colon(69.9%).The efficacy of the treatments by combined modalities,surgery,endoscopic treatment,conservative approach,oxygen,and antibiotics were 100%,100%,100%,93.3%,68.3% and 26.3%,respectively.CONCLUSION:PCI can be safely managed by conservative treatments,presents more frequently in males,in the large bowel and submucosa,than in females,in the small intestine and subserosa.High altitude residence maybe associated with the PCI etiology.
文摘A 69-year-old man was diagnosed as having myasthenia gravis (MG) in September 2004,and treated with thymectomy and prednisolone. He was then diagnosed as having steroid-induced diabetes mellitus,and received sulfonylurea (SU) therapy in May 2005. An alpha-glucosidase inhibitor (αGI) was added in March 2006,resulting in good glycemic control. He experienced symptoms of abdominal distention,increased flatus,and constipation in October 2007,and was admitted into our hospital in late November with hematochezia. Plain abdominal radiography revealed small linear radiolucent clusters in the wall of the colon. Computed tomography (CT) showed intramural air in the sigmoid colon. Colonoscopy revealed multiple smooth surfaced hemispherical protrusions in the sigmoid colon. The diagnosis of pneumatosis cystoides intestinalis (PCI) was made on the basis of these findings. As the αGI voglibose was suspected as the cause of this patient's PCI,treatment was conservative,ceasing voglibose,with fasting and fluid supplementation. The patient progressed well,and was discharged 2 wk later. Recently,several reports of PCI associated with αGI therapy have been published,predominantly in Japan where αGIs are commonly used. If the use of αGIs becomes more widespread,we can expect more reports of this condition on a global scale. The possibility of PCI should be considered in diabetic patients complaining of gastrointestinal symptoms,and the gastrointestinal tract should be thoroughly investigated in these patients.
文摘AIM： To share our experience of the management and outcomes of patients with pneumatosis cystoides in- testinalis （PCI）. METHODS： The charts of seven patients who under- went surgery for PCI between 2001 and 2009 were re- viewed retrospectively. Clinical features, diagnoses and surgical interventions of patients with PCI are discussed. RESULTS： Seven patients with PCI （3 males, 4 fe- males; mean age, 50 ~ 16.1 years; range, 29-74 years） were analyzed. In three of the patients, abdominal pain was the only complaint, whereas additional vomiting and/or constipation occurred in four. Leukocytosis was detected in four patients, whereas it was within normal limits in three. Subdiaphragmatic free air was observed radiologically in four patients but not in three. Six of the patients underwent an applied lapa- rotomy, whereas one underwent an applied explorative laparoscopy. PCI localized to the small intestine only was detected in four patients, whereas it was localized to the small intestine and the colon in three. Three patients underwent a partial small intestine resection and four did not after PCI was diagnosed. Five patients were diagnosed with secondary PCI and two with pri- mary PCI when the surgical findings and medical his- tory were assessed together. Gastric atony developed in one case only, as a complication during a postopera- tive follow-up of 5-14 d. CONCLUSION： Although rare, PCl should be consid- ered in the differential diagnosis of acute abdomen. Diagnostic laparoscopy and preoperative radiological tests, including computed tomography, play an impor- tant role in confirming the diagnosis.
文摘While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.
文摘A 39-year-old male reported fevers,weight loss,watery loose stools,and decreased visual acuity in his right eye over the prior five years.He was pancytopenic,had an elevated American council on exercise level,total bilirubin,and alkaline phosphatase.Computed tomography revealed massive hepatosplenomegaly and emphysematous lung changes.Liver biopsy showed non caseating granulomas.The patient was diagnosed with extrapulmonary sarcoidosis and was treated with prednisone.The patient symptomatically improved but 5 mo later presented with abdominal pain caused by perforation of the cecum.He underwent a cecectomy and pathology revealed pneumatosis cystoides intestinalis.This represents the first reported association between pneumatosis cystoides intestinalis and sarcoidosis.The etiology of pneumatosis cystoides intestinalis in this case was likely multifactorial and involved both effects of the corticosteroids as well as the advanced nature of the gastrointestinal sarcoidosis.Furthermore this case has the unique features of emphysematous lung changes and pancytopenia which are uncommon with sarcoidosis.
文摘Pneumatosis intestinalis(PI) often represents a benign condition that should not be considered as an argument for surgery. We report a patient with PI and obstructing intussusception who underwent urgent colectomy and review the literatures regarding PI with intussusception. A 20-year-old man presented at our hospital with a 3-d intermittent lower abdominal pain history. He underwent steroid therapy for membranoproliferative glomerulonephritis for 4 years. Computed tomography revealed ascending colon intussusception with air within the wall. Intraoperative colonoscopy revealed numerous soft polypoid masses with normal overlying mucosa and right hemicolectomy was performed. Histological examination of colonic wall sections revealed large cysts in the submucosal layer. The pathological diagnosis was PI. Nine cases of intussusception associated with primary PI have been reported. Although primary PI often represents a benign condition that should not be considered as an argument for surgery,if the case involves intussusception and obstruction,emergent laparotomy should be considered.
文摘Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, although fluorouracil-related PCI is extremely rare. We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV). After 1 cycle of the treatment, he presented with diarrhea and abdominal pain. Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine. Laparotomy was performed, showing a suspected diagnosis of perforation in the gastrointestinal tract. Intraoperative findings revealed penumatosis of the intestine without evidence of perforation. He was treated supportively and his symptoms improved. In conclusion, we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.
文摘Pneumatosis cystoides intestinalis(PCI) is a rare condition that may be associated with a variety of diseases.The presenting clinical picture may be very heterogeneous and represent a challenge for the clinician.In the present paper we describe both a common and an uncommon clinical presentation of PCI and review the pertaining literature.Our cases confirm that,apart from asymptomatic cases,the clinical presentation of PCI may be widely different and suggest that a new onset of stipsis might be the presenting symptom.Diagnosis might be suggested by a simple X-ray of the digestive tract showing a change in the characteristics of the intestinal wall in two-thirds of these patients.However,one third of the patients do not have a suggestive X-ray and require a computed tomography(CT) scan/nuclear magnetic resonance that may reveal a thickened bowel wall containing gas to confirm the diagnosis and distinguish PCI from intraluminal air or submucosal fat.CT also allows the detection of additional findings that may suggest an underlying,potentially worrisome cause of PCI such as bowel wall thickening,altered contrast mucosal enhancement,dilated bowel,soft tissue stranding,ascites and the presence of portal air.Our results also point out that clinicians and endoscopists should be aware of the possible presentations of PCI in order to correctly manage the patients affected with this disease and avoid unnecessary surgeries.The increasing number of colonoscopies performed for colon cancer screening makes PCI more frequently casually encountered and/or provoked,therefore the possible endoscopic appearances of this disease should be well known by endoscopists.
基金The Ministry of Science, Technology and Innovation and Universiti Sains Malaysia for awarding the RUI research grant ( RUT1001 /pkimia/ 855006 ) to support this study
文摘Objective:To extract the bioactive compound from Enteromorpha intestinalis(E. intestinalis) and determine its in vitro antimicrobial activity. Methods: E. intestinalis was extracted by methanol and subjected to antimicrobial screening. The antimicrobial activity was studied by using disc diffusion and broth dilution method. The effect of the extract on the growth profile of the bacterial was also examined via time-kill assay. Microscopy observations using SEM was done to determine the major alterations in the microstructure of methicillin-resistant Staphylococcus aureus(MRSA). Results: The results showed methanolic extract of E. intestinalis exhibited a favourable antimicrobial activity against tested bacteria with produced inhibition zone ranging from 8.0-19.0 mm. However, all the tested fungi and yeast were resistant to the extract treatment. Time kill assay suggested that methanolic extract of E. intestinalis had completely inhibited MRSA growth and also exhibited prolonged antibacterial activity. The main abnormalities noted from the microscopic observations were the structural deterioration in the normal morphology and complete collapsed of the bacteria cells after 36 h of treatment. Conclusions: The significant antibacterial activity shown by crude extract suggested its potential against MRSA infection. The extract may have potential to develop as antibacterial agent in pharmaceutical use.
文摘Objective:To evaluate the anti-microsporidial effects of the active component of Nigella sativa seeds,thymoquinone,against Encephalitozoon intestinalis using an in vitro model.Methods:Anti-microsporidial effect of thymoquinone against Encephalitozoon intestinalis was evaluated by using various concentrations of thymoquinone(0,1,5,10,15,20,30,35,and 40μM)and sterile dimethyl sulfoxide.Real time PCR was used to evaluate the inhibitory effects of thymoquinone on the life cycle of Encephalitozoon intestinalis.Results:The cytotoxic effect of thymoquinone on HEK293 cell line was observed with 30,35,and 40μM concentrations of thymoquinone after 24,48,and 72 hours of incubation.It was observed that 10,15,20,and 30μM concentrations of thymoquinone decreased the spore density compared with the control;however,it was significant only at 30μM.Conclusions:Thymoquinone shows potent anti-microsporidial effects against Encephalitozoon intestinalis in the in vitro model;however,the toxic concentrations of thymoquinone are also toxic to the host cells.
文摘The development of intramural intestinal gas may indi-cate a serious postoperative complication and thereforeany radiological indication of such "pneumatosis intes-tinalis"(PI) in an unwell patient after surgery shouldput the clinical team on high-alert. However immedi-ate recourse to relook laparotomy may not be alwaysnecessary and, further, in some cases may possiblyaccelerate the deterioration especially if it proves to benon-therapeutic. Careful and close clinical monitoring,as is described in this clinical report, may allow discrimi-native identification of those in whom this finding is infact transient and therefore benign and who thereforecan be successfully treated without operative re-inter-vention. We describe the presenting features and back-ground scenario of PI early after laparoscopic total col-ectomy for medically refractory, severe ulcerative colitisand detail the critical postoperative decision pivots.
文摘Pneumatosis intestinalis and portomesenteric vein gas are rare and potentially severe radiological findings that occur both in pediatric and adult populations.They actually are radiographic signs of underlying intra-abdominal pathology,abnormality or diagnostic medical interference.If combined with other radiological or clinical signs of intestinal ischemia or sepsis,the prognosis is dismal and urgent laparotomy is mandatory.We report two cases of surgical treatment with ominous outcome in an effort to characterize this finding correctly as an absolute surgical indication or as an additional diagnostic criterion that simply marks a further breakdown of the systems in patients with a long list of severe medical conditions.
文摘Pneumatosis intestinalis(PI)is an uncommon disease defined as gas-filled cysts that are found in the wall of the gastrointestinal(GI)tract.The exact causes of PI are still unclear,but it may associated with coexisting diseases,such as some GI disorders,connective tissue disease,some medication and drugs,and rarely malignancy.The most common localization is the small intestine.Gastric PI secondary to malignancy has been rarely documented.We report on a 94-year- old man with gastric PI associated with inoperable adenocarcinoma localized in the duodenum.Following the gastrojejunostomy and choledochojejunostomy bypass,his general condition improved and PI disappeared,but he died due to poor performance status and malignancy 6 mo later.We suggest that in patients presenting with PI,malignancy should be considered in the differential diagnosis.
基金supported by the National Key R&D program of China(2019YFA0905602)the National Natural Science Foundation of China(81773614)the Strategic Priority Research Program of Chinese Academy of Sciences(grant No.XDB 38020300).
文摘Previous study demonstrated that Ganoderma meroterpene derivative(GMD)increased the abundance of butyrate-producing bacteria in gut and subsequently delivered anti-metabolic disorder effect of host.To specify the key commensal bacteria associating with the beneficial effects,we tried to isolate and compare the microbiota from the cecal samples of GMD-and vehicle-treated ob/ob mice,and further identified butyrate-producing bacterial strains.It was found that Faeciroseburia intestinalis was enriched and 11 strains affiliated to F.intestinalis were cultivated from the gut of GMD-treated mice.In vitro assay attested butyrate production by representative strain of F.intestinalis.Oral administration with F.intestinalis further demonstrated its benefits on regulating hyperglycemia and hyperlipidemia,on decreasing plasma lipopolysaccharide(LPS)and inflammation,and on improving hepatic injuries.Treatment with F.intestinalis effectively enhanced the level of gut butyrate,which subsequently ameliorated the intestinal barrier function and activated epithelial PPAR-γ signaling pathway to regulate microbiome homeostasis in gut.Our study demonstrated that the causal relationship between the butyrate-producing bacteria and the GMD's therapeutic effects and confirmed the important function of the butyrate-producing F.intestinalis in maintaining host metabolism homeostasis.
文摘Pneumatosis intestinalis(PI) is a striking radiological diagnosis. Formerly a rare diagnostic finding, it is becoming more frequently diagnosed due to the wider availability and improvement of computed tomography scan imaging. Once associated only with poor outcome, its clinical and prognostic significance nowadays has to be cross-referenced to the nature of the underlying condition.Multiple mechanisms of pathogenesis have been debated and multiple causes have been detected during the years. All this contributes to creating a broad range of clinical and radiological presentations. The management of patients presenting PI is related to the determining cause if it is identified. Otherwise, in particular if an association with portal venous gas and/or pneumoperitoneum is present, the eventual decision between surgery and non-operative management is challenging,even for stable patients, since this clinical condition is traditionally associated to intestinal ischemia and consequently to pending clinical collapse if not treated.Considering the wide variety of origin and outcomes, PI still remains for surgeons a demanding clinical entity. The manuscript is an updated narrative review and gives some suggestions that may help make the decisional process easier,identifying patients who can benefit from surgical intervention and those who can benefit from non-operative management avoiding unnecessary procedures.
基金Supported by the National Natural Science Foundation of China(Nos.40876073,41276122)the Doctoral Fund of the Ministry of Education(No.20123305110002)the K.C.Wong Magna Fund from Ningbo University
文摘Twenty species of seaweed were collected from the coast of Zhejiang, China, extracted with ethanol, and screened for algicidal activity against red tide microalgae H eterosigma akashiwo and Prorocentrum micans. Inhibitory eff ects of fresh and dried tissues of green alga U lva intestinalis were assessed and the main algicidal compounds were isolated, purifi ed, and identifi ed. Five seaweed species, U. intestinalis, U. fasciata, Grateloupia romosissima, Chondria crassicaulis, and Gracilariopsis lemaneiformis, were investigated for their algicidal activities. Fresh tissues of 8.0 and 16.0 mg/m L of U. intestinalis dissolved in media signifi cantly inhibited growth of H. akashiwo and P. micans, respectively. Dried tissue and ethyl acetate(Et OAc) extracts of U. intestinalis at greater than 1.2 and 0.04 mg/m L, respectively, were fatal to H. akashiwo, while its water and Et OAc extracts in excess of 0.96 and 0.32 mg/m L, respectively, were lethal to P. micans. Three algicidal compounds in the Et OAc extracts were identifi ed as 15-ethoxy-(6z,9z,12z)-hexadecatrienoic acid(I),(6E,9E,12E)-(2-acetoxy- β- D-glucose)-octadecatrienoic acid ester(II) and hexadecanoic acid(III). Of these, compound II displayed the most potent algicidal activity with IC_(50) values of 4.9 and 14.1 μg/m L for H. akashiwo and P. micans, respectively. Compound I showed moderate algicidal activity with IC_(50) values of 13.4 and 24.7 μg/m L for H. akashiwo and P. micans, respectively. These fi ndings suggested that certain macroalgae or products therefrom could be used as ef fective biological control agents against red tide algae.
文摘Toxic epidermal necrolysis(TEN) is a severe adverse drug reaction, which is characterized by erythema, blisters, and/or erosions of the mucous membranes and skin, but intestinal involvement is rare. In contrast, pneumatosis cystoides intestinalis(PCI) is a rare condition associated with a wide variety of underlying diseases, but to date no patient has presented with PCI associated with TEN. A 55-year-old man was admitted to intensive care unit for treatment of TEN caused by phenobarbital. On day 8 after admission, he presented with progressive abdominal distention and hypotension. Computed tomography(CT) showed gas in the superior mesenteric vein and air filled cysts in the walls of the small intestine. He was suspected of having septic shock due to PCI. As there were no indications of bowel ischemia or necrosis, the patient was managed conservatively with antibiotics and oxygen therapy. On day 10 after admission, he was weaned off catecholamines, with CT on day 11 showing complete resolution of gas in the superior mesenteric vein and air filled cysts. To our knowledge, this article describes the first patient presenting with PCI associated with TEN.
文摘Pneumatosis intestinalis(PI) is defined as gas within the gastrointestinal wall and is associated with a variety of disorders.As a concurrent occurrence with pneumoperitoneum,it can easily to be mistaken for bowel ischemia with perforated peritonitis.In fact,air dissection or rupture from subserosal cysts may be the cause of intraperitoneal and intraluminal free air,with clinical symptoms such as abdominal pain and fullness occurring as a result.We hereby report a case of an 82-year-old male with a history of chronic obstructive pulmonary disease who was diagnosed with bowel ischemia and received emergency laparotomy because of the appearance of PI and pneumoperitoneum on abdominal computed tomography scan.However,no perforated hollow organ or necrotic bowel segment was found,only diffusely distributed massive intraperitoneal air and PI of gastrointestinal tract.The laparotomy seemed non-therapeutic for this patient.This is significant warning for clinicians to differentiate the associated conditions of PI,and to evaluate whether or not emergency surgery is necessary.
