Outcomes of laparoscopic-assisted ERCP in gastric bypass patients at a community hospital center.

Background: Obesity is a prevalent issue in today's society, increasing the number of gastric weight loss surgeries (Bowman et al. in Surg Endosc. https://doi.

Primary Squamous Cell Carcinoma of the Stomach: A Case Report and Review of the Literature.

Primary gastric squamous cell carcinoma (PGSCC) is an exceedingly rare disease, accounting for 0.04% - 0.07% of all gastric cancers.

The role of endoscopic ultrasound and cyst fluid analysis in the initial evaluation and follow-up of incidental pancreatic cystic lesions.

Purpose: To assess the role of endoscopic ultrasound (EUS) in the initial evaluation and follow-up of incidental pancreatic cystic lesions (PCL).

Methods: Retrospective analysis of patients with incidental PCL on imaging who were evaluated by EUS and had a minimal follow-up of 1 year.

Results: There were 62 patients (40 females and 22 males).

Intraductal US is a useful adjunct to ERCP for distinguishing malignant from benign biliary strictures.

Background: Distinguishing malignant from benign biliary strictures remains a challenge. This prospective study assessed intraductal US as an adjunct to endoscopic retrograde cholangiography and tissue sampling for diagnosis of malignant and benign biliary strictures.

Methods: Sixty-two patients were enrolled who had biliary strictures suspected to be malignant but with negative tissue sampling by endoscopic retrograde cholangiography, or suspected biliary strictures based on clinical manifestations and/or cross-sectional imaging.

A novel endoscopic full-thickness plicator for treatment of GERD: an animal model study.

Background: This study was designed to demonstrate the efficacy and safety of a novel endoscopic full-thickness plication device for the treatment of GERD.

Methods: Gastric pressures and reflux from the gastroesophageal junction were measured in 20 excised pig stomachs before and after full-thickness plication within 1 cm of the gastroesophageal junction. Endoscopic full-thickness plication was performed on 11 live mini-swine that were subsequently observed for up to 12 weeks.

The combination of stricture dilation, endoscopic needle aspiration, and biliary brushings significantly improves diagnostic yield from malignant bile duct strictures.

Background: Brush cytology, routinely performed at ERCP to assess malignant-appearing biliary strictures, is limited by relatively low sensitivity and negative predictive value. This study assessed whether the combination of stricture dilation, endoscopic needle aspiration, and biliary brushing improves diagnostic yield.

Methods: In a prospective nonrandomized study, 46 consecutive patients were evaluated with malignant-appearing biliary strictures at ERCP.

Detection and tumor staging of malignancy in cystic, intraductal, and solid tumors of the pancreas by EUS.

Background: EUS can provide detailed imaging of pancreatic malignancies and direct fine needle aspiration (FNA) of pancreatic masses. The ability of EUS to detect and stage malignancy in cystic and intraductal lesions has not been investigated. Our aim was to determine the sensitivity and specificity of EUS imaging and FNA in detecting and staging of malignancy in solid, cystic, and intraductal lesions of the pancreas.

Lipopolysaccharide activates distinct signaling pathways in intestinal epithelial cell lines expressing Toll-like receptors.

LPS elicits several immediate proinflammatoy responses in peripheral blood leukocytes via a recently described pathway including CD14, Toll-like receptors (TLR), serine-threonine kinases, and NF-kappaB transcription factor. However, the functional responses of intestinal epithelial cells (IEC) to stimulation with LPS are unknown. Expression of mRNA and protein for CD14 and TLRs were assessed by RT-PCR, immunoblotting, and immunohistochemistry in mouse and human IEC lines.

Experimental models to study molecular mechanisms underlying intestinal inflammation.

Experimental animal models, particularly the newer mouse models, have convincingly demonstrated that CD+ T cells play a central role in chronic intestinal inflammation. Such CD4+ effector T cells are induced by the bacterial flora. In at least one model, it is conventional protein antigens that are stimulating these pathogenic T cells.

Inhibition of type II collagen-induced arthritis in rats by triptolide.

The effects of purified triptolide, a diterpenoid triepoxide compound derived from the Chinese traditional anti-rheumatic medicinal plant extract, Tripterygium wilfordii Hook f (TWHf), were determined in type II collagen-induced arthritis (CIA) in rats. Lewis rats were immunized with bovine type II collagen and treated with purified triptolide 0.1 mg/kg/day or control (vehicle for triptolide) by daily gavage feedings for 28 days.

pANCA represents a cross-reactivity to enteric bacterial antigens.

pANCA (perinuclear antineutrophil cytoplasmic antibodies) occur at a high frequency in patients with ulcerative colitis. The purpose of this study was to investigate the frequency of pANCA in different mouse models of colitis and to determine whether there is any cross-reactivity of pANCA with bacterial antigens. Sera from 146 colitic mice and controls and from 30 patients with ulcerative colitis were tested for the presence of pANCA by indirect immunofluorescence with or without prior absorption with homogenized murine cecal bacteria.

Alteration of gene expression by intestinal epithelial cells precedes colitis in interleukin-2-deficient mice.

Intestinal epithelial cells may be actively involved in the immunoregulatory pathways leading to intestinal inflammation. The aim of this study was to assess expression by intestinal epithelial cells of cytokines with potential involvement in the development of intestinal inflammation in interleukin (IL)-2-deficient [(-/-)] mice. Wild-type mice, mice heterozygous for the disrupted IL-2 gene, and IL-2(-/-) mice were studied at 6, 16, and 24 wk of age.

CD4+ T cells reactive to enteric bacterial antigens in spontaneously colitic C3H/HeJBir mice: increased T helper cell type 1 response and ability to transfer disease.

C3H/HeJBir mice are a new substrain that spontaneously develop colitis early in life. This study was done to determine the T cell reactivity of C3H/HeJBir mice to candidate antigens that might be involved in their disease. C3H/HeJBir CD4+ T cells were strongly reactive to antigens of the enteric bacterial flora, but not to epithelial or food antigens.

Spontaneously colitic C3H/HeJBir mice demonstrate selective antibody reactivity to antigens of the enteric bacterial flora.

The idiopathic inflammatory bowel diseases, ulcerative colitis and Crohn's disease, are chronic disorders that appear to arise from an aberrant interaction of environmental, genetic, and immunologic factors. The aim of this study was to examine the immune reactivity of a spontaneously colitic mouse strain, C3H/HeJBir, to epithelial, food, and enteric bacterial Ags. Serum Ab responses of colitic C3H/HeJBir and noncolitic parental C3H/HeJ mice were measured by enhanced chemiluminescence Western blotting.

Isolation, purification, and characterization of immunosuppressive compounds from tripterygium: triptolide and tripdiolide.

Crude extracts derived from the root of Tripterygium wilfordii Hook f (TWHf) have previously been demonstrated to have immunosuppressive properties and have been used as anti-rheumatic therapy in Chinese traditional medicine. Although these extracts contain a large number of chemical components, the precise nature of the compound(s) responsible for this therapeutic effect has not been established with certainty. An aqueous extract of TWHf was resolved into chemical components by medium-pressure and high-performance liquid chromatography.

A pilot study of zileuton, a novel selective 5-lipoxygenase inhibitor, in patients with systemic lupus erythematosus.

Objective: This is a pilot study of zileuton, a selective 5-lipoxygenase inhibitor in systemic lupus erythematosus (SLE).

Methods: Forty patients with SLE received zileuton 600 mg qid or placebo in an 8 week, randomized prospective, double blind trial. Disease activity was manifested largely by constitutional, articular, and skin manifestations with no evidence of active renal, cardiac, or neurologic involvement.

Population pharmacokinetics of zileution, a selective 5-lipoxygenase inhibitor, in patients with rheumatoid arthritis.

The pharmacokinetics of zileuton, a novel selective 5-lipoxygenase inhibitor, were studied in 37 patients with rheumatoid arthritis after administration of 200 mg, 400 mg, and 600 mg, zileuton for 4 weeks. Patients had 6-h pharmacokinetic evaluation of zileuton on day 14. Plasma zileuton concentrations were quantitated using HPLC.

Combined treatment with terbutaline and aminophylline inhibits experimental amyloidosis in mice.

Objective: To investigate the effects of drugs known to elevate adenosine 3':5'-cyclic monophosphate (cAMP) on experimental amyloidosis.

Methods: A beta 2-agonist, terbutaline, and a phosphodiesterase inhibitor, aminophylline, were administered in combination in a mouse model of amyloidosis induced by inflammatory stimulation with silver nitrate. Amyloidosis was quantitated by radioimmunoassay for splenic amyloid A (AA) protein.

Case report: milk-alkali syndrome and pancreatitis.

The relation between hypercalcemia and pancreatitis, first described in patients with hyperparathyroidism, is controversial. Other causes of hypercalcemia also have been associated with pancreatitis. In this report, the authors describe a patient with pancreatitis and the milk-alkali syndrome who had the classic triad of hypercalcemia, alkalosis, and renal insufficiency.

Aberrant cellular localization of rubella viral genome in patients with adult Still's disease--a pilot study.

The rubella virus (RV) genome was detected using polymerase chain amplification techniques in several peripheral blood cell populations in patients with adult Still's disease (ASD) and normal controls (NC), including mononuclear cells (PBMC), B-cells, T-cells, monocyte/macrophages, and polymorphonuclear leukocytes (PMN). Five of 6 ASD patients and 3 of 6 NC subjects had detectable RV genome. Viral genomic load was significantly higher in ASD than in NC subjects (4.

Suppression of renal disease and arthritis, and prolongation of survival in MRL-lpr mice treated with an extract of Tripterygium wilfordii Hook f.

Objective: Treatment of MRL-lpr/lpr mice with Tripterygium wilfordii Hook f (TWHf) to evaluate its effects on mortality, renal disease, and arthritis.

Methods: Mice were fed water (group A, control), TWHf (group B), or first water and then TWHf (group C) from age 7 weeks until age 21 weeks.

Results: Arthritis and glomerulonephritis were decreased in groups B and C mice, and survival was increased in group B mice.

Defective lipopolysaccharide-induced production of both interleukin 1 alpha and interleukin 1 beta by A/J mouse macrophages is posttranscriptionally regulated.

Interleukin 1 (IL-1) production by A/J (A) and C57BL/6J (B6) mouse peritoneal macrophages stimulated with lipopolysaccharide (LPS) was determined. Strain A macrophages produced low levels of soluble IL-1 bioactivity compared with B6 macrophages. This defect was not reversed by indomethacin, interferon-gamma, phorbol myristate acetate, or calcium ionophore A23187.

Inhibition of type II collagen induced arthritis in mice by an immunosuppressive extract of Tripterygium wilfordii Hook f.

The effects of Tripterygium wilfordii Hook f (TWHf), a Chinese herbal remedy, on type II collagen induced arthritis (CIA) in DBA/1LacJ mice were determined. Mice were divided into 4 groups receiving oral treatment for 63 days: Group A, sham feedings; Group B, TWHf (78 mg/day); Group C, TWHf (140 mg/day); Group D, TWHf (140 mg/day) starting 21 days after collagen immunization. Arthritis incidence was reduced and day of onset delayed in Groups B and C compared with A.

Differential regulation of soluble interleukin 1 release and membrane expression by pharmacologic agents.

Membrane IL-1 (mIL-1) expression was compared with release of soluble IL-1 (sIL-1) by C3H/HeNCrl mouse peritoneal macrophages. Selective antagonists of protein kinase C (PKC) (H-7) and calmodulin (W-7) in combination inhibited LPS-induced mIL-1 and sIL-1 production, suggesting a role for these activation pathways in IL-1 induction. Low levels of A23187, when combined with OAG (a direct activator of PKC), stimulated mIL-1 expression in the absence of sIL-1 release.