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AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars. METHODS:A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola. RESULTS:After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent complete dissolution (P = 0.006). Gender, symptom duration, size of bezoar and method of cola administration were not significantly different between the two groups. Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation. CONCLUSION:The rate of complete dissolution with three liters of cola was 23.5%, but no case of diospyrobezoar was completely dissolved using this method. However, pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.

Multiwalled carbon nanotube (MWNT)/poly (vinyl alcohol) (PVA) blend membranes were prepared by the solution-casting method to determine the effect of MWNTs with nanoscale empty inner space along the tube length on the pervaporation performance of a PVA membrane in the separation of alcohol/water mixtures. The blend membranes were then characterized with several analytical methods such as transmission electron microscopy, differential scanning calorimetry, and X-ray diffractometry: Transmission electron microscopy showed that the MWNTs were homogeneously distributed through the PVA matrix. The glass-transition temperature of the PVA membrane was increased from 69.21 to 78.53 C via blending with MWNTs. The crystallinity of the PVA matrix decreased with increasing MWNTs up to 5 wt % from 41 to 36%. The pervaporation properties of the blend membranes were completely different from those of the pure PVA membrane in the separation of water/ethanol mixtures. The flux of the membrane was increased with the amount of MWNTs, whereas the separation factor was maintained up to 1.0 wt % MWNTs. However, beyond that, it was reduced. These results suggested that two factors, the crystallinity of the membrane and the diameters of the MWNTs, affected the performance of the membranes.

Chimeric antigen receptor‐T (CAR‐T) cell immunotherapy has shown impressive clinical outcomes for hematologic malignancies. However, its broader applications are challenged due to its complex ex vivo cell‐manufacturing procedures and low therapeutic efficacy against solid tumors. The limited therapeutic effects are partially due to limited CAR‐T cell infiltration to solid tumors and inactivation of CAR‐T cells by the immunosuppressive tumor microenvironment. Here, a facile approach is presented to in vivo program macrophages, which can intrinsically penetrate solid tumors, into CAR‐M1 macrophages displaying enhanced cancer‐directed phagocytosis and anti‐tumor activity. In vivo injected nanocomplexes of macrophage‐targeting nanocarriers and CAR‐interferon‐γ‐encoding plasmid DNA induce CAR‐M1 macrophages that are capable of CAR‐mediated cancer phagocytosis, anti‐tumor immunomodulation, and inhibition of solid tumor growth. Together, this study describes an off‐the‐shelf CAR‐macrophage therapy that is effective for solid tumors and avoids the complex and costly processes of ex vivo CAR‐cell manufacturing.

An enhanced formation of nitric oxide (NO), due to the induction of inducible nitric oxide synthase (iNOS), has been implicated in the pathogenesis of shock and inflammation, but its role in acute pancreatitis still remains controversial. To clarify the role of NO in acute pancreatitis, the present experiment investigated the expression of iNOS and the effect of NOS inhibition on cerulein-induced pancreatitis in rats. Group I received intraperitoneal (ip) injection of normal saline. Group II received two ip injections of cerulein (20 g/kg). Group III received injections of N G -nitro-L-arginine methyl ester (L-NAME) (30 mg/kg) with cerulein. Group IV received Larginine (250 mg/kg) with cerulein and L-NAME. The expression of iNOS in the pancreas was examined by western blot analysis. The plasma concentration of NO metabolites was measured. The severity of pancreatitis was assessed by measuring serum amylase, pancreas water content and histopathological examination. Compared with controls, the cerulein group displayed significantly increased expression of iNOS and raised plasma NO metabolites. Treatment with L-NAME significantly decreased hyperamylasemia, plasma NO level, and the extent of pancreatic injury. Treatment with L-arginine reversed the effects of L-NAME. These findings suggest that an enhanced formation of NO by iNOS plays an important role in the development of acute pancreatitis, and inhibition of NO production has the beneficial effects in reducing pancreas injury.

Colonoscopy is regarded as a relatively safe procedure and is widely performed. However, complications such as bleeding, perforation, and coagulation syndromes can occur during colonoscopy. Although bowel perforation is as rare as 0.4-1.9% of cases, it is the most serious and awful adverse event which can lead to a death. Colon perforation may occur as either intraperitoneal or extraperitoneal, or in combination. Right subdiaphragmatic free air suggests intraperitoneal perforation while pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema suggest extraperitoneal perforation. Combined intraperitoneal and extraperitoneal perforation is very rare. Herein, we present a case of combined intraperitoneal and extraperitoneal colon perforation which manifested as pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema. The lesion was closed with endoscopic clipping. (Gut and Liver 2007;1:79-81)

Summary: The effect of multi-walled carbon nanotubes (MWNTs) incorporated for the modification of membrane performances was studied. Two different types of membranes were prepared by using MWNTs: one was polysulfone (PSf) ultrafiltration (UF) membrane and the other was polyvinyl alcohol (PVA) pervaporation membrane. The PSf UF membranes with different contents of MWNTs were prepared by the conventional phase inversion process, and used for water-treatment. On the other hand, the PVA membranes with different amount of MWNTs were prepared by the casting and drying method, and used for the pervaporation separation of water out of ethanol solution containing 10% of water. The two different types of membranes were then characterized with several analytical methods to figure out how the MWNTs were distributed through the membranes and affect on the properties of them: For the PSf membranes, the MWNTs mainly located on the surface of the membranes made them more hydrophilic and improved the selective permeation performances of the membranes. In the case of the PVA membranes, the MWNTs were distributed rather homogeneously through out the membranes, and affected on the micro-morphology of the membranes, causing them to have different pervaporation performances.

In this study, we evaluated the clinical significance of detecting carcinoembryonic antigen (CEA) mRNA in the peripheral blood samples of patients with gastric cancer. We analyzed the peripheral blood of 46 patients with gastric cancer who had undergone curative resection. The presence of CEA mRNA was serially monitored using a CEA-specific reverse transcription-polymerase chain reaction (RT-PCR) every 2 months. The clinical recurrence rates according to category were as follows: 100% (3 of 3) in the positive conversion, 0% (0 of 18) in the negative conversion, 50% (3 of 6) in the always-positive, and 10.5% (2 of 19) in the always-negative category. The recurrence rate was 66.7% (6 of 9) in the positive group and 5.4% (2 of 37) in the negative group (P < or =0.00022). Multiple logistic regression analysis demonstrated that only group variable had a significant effect on clinical recurrence (P = 0.015). We conclude that RT-PCR analysis of CEA mRNA in the peripheral blood seems to be a promising tool for the early detection of micrometastatic circulating tumor cells in gastric carcinoma patients and that it can be useful used to identify patients at risk for recurring.