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1

Small Bowel Adenocarcinoma Presenting with Refractory Iron Deficiency Anemia – Case Report and Review of Literature  

Microsoft Academic Search

Cancers of the small bowel are relatively rare and account for approximately 1–2% of all gastrointestinal neoplasms. The most common histologic subtype – adenocarcinoma – constitutes 40% of all cases. These cancers generally present with vague abdominal discomfort and are often diagnosed at a late stage and carry a poor prognosis. The treatment of choice of early-stage small bowel adenocarcinoma

Nishant Poddar; Shahzad Raza; Bhawna Sharma; Ming Liu; Arash Gohari; Madhumati Kalavar

2011-01-01

2

Characterization of a new small bowel adenocarcinoma cell line and screening of anti-cancer drug against small bowel adenocarcinoma.  

PubMed

Small bowel adenocarcinoma (SBA) is a rare, aggressive malignancy with a poor prognosis, and the mechanisms of carcinogenesis in SBA remain unclear. Our aims were to investigate the molecular mechanisms underlying SBA and to identify treatments by establishing and characterizing an SBA cell line and performing anti-cancer drug screening. SIAC1 cells, established from jejunal SBA, showed epithelial characteristics and formed organoids in 3D culture. SIAC1 cells had a heterozygous ?-catenin deletion mutation, resulting in a stable ?-catenin protein with enhanced Wnt/?-catenin activity. SIAC1 cells lacked MLH1 and MSH6 expression, and target genes such as TGFBR2 and ACVR2 showed frameshift mutations. Among 10 clinical SBA samples, 2 (20%) had interstitial deletions in ?-catenin, expression of mismatch repair protein was aberrant in 4 (40%), and heterozygous frameshift mutations of three target genes were found in all 10 samples. On screening assay using 140 compounds, eribulin significantly inhibited SIAC1 cell growth both in vitro and in vivo by inhibition of the Wnt/?-catenin pathway via enhanced degradation of ?-catenin. In conclusion, we established an SBA cell line with molecular characteristics similar to those of clinical SBA samples, including ?-catenin deletion and mismatch repair protein deficiency, that will be useful for SBA research. Eribulin might be a candidate for SBA treatment due to its inhibitory effect on Wnt/?-catenin signaling. PMID:25478808

Suzuki, Hirobumi; Hirata, Yoshihiro; Suzuki, Nobumi; Ihara, Sozaburo; Sakitani, Kosuke; Kobayashi, Yuka; Kinoshita, Hiroto; Hayakawa, Yoku; Yamada, Atsuo; Watabe, Hirotsugu; Tateishi, Keisuke; Ikenoue, Tsuneo; Yamaji, Yutaka; Koike, Kazuhiko

2015-02-01

3

Adnexal mass: an unusual presentation of small-bowel adenocarcinoma.  

PubMed Central

Malignancy of the small bowel presents unique diagnostic and therapeutic challenges resulting in a delayed diagnosis in many cases. Small-bowel tumors respond poorly to most forms of treatment. Metastatic lesions to the ovaries comprise a small percentage of all ovarian malignant neoplasms. Ovarian metastases from primary small-bowel tumors are often difficult to differentiate from primary ovarian tumors. Only few reports have described ovarian metastases from small-bowel sources. A high index of suspicion can lead to an earlier diagnosis and can have an impact on the therapeutic options as well as the survival of the patients. The current report also underscores the importance of careful review of symptoms, investigative studies and pathology. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:16749659

Husain, Syed; Thompson, Daniel; Thomas, Louys; Donaldson, Brian; Sabbagh, Raja

2006-01-01

4

Small bowel adenocarcinoma and Crohn's disease: Any further ahead than 50 years ago?  

PubMed Central

This review of the literature on small bowel carcinoma associated with Crohn’s disease specifically addresses the incidence, risk factors, and protective factors which have been identified. It also reviews the clinical presentation, the current modalities of diagnosis, the pathology, treatment, and surveillance. Finally, the prognosis and future direction are addressed. Our experience with small bowel adenocarcinoma in Crohn’s disease is reported. Readers will be provided with a better understanding of this rare and often poorly recognized complication of Crohn’s disease. PMID:25206256

Cahill, Caitlin; Gordon, Philip H; Petrucci, Andrea; Boutros, Marylise

2014-01-01

5

Gastroesophageal heterotopia and HER2/neu overexpression in an adenocarcinoma arising from a small bowel duplication.  

PubMed

Small bowel duplications are congenital structures commonly lined by heterotopic gastric or pancreatic mucosa. Though benign in children, small bowel duplications have the potential for malignant degeneration in adulthood. Here, we present the first reported case of metastatic adenocarcinoma arising from a small bowel duplication lined by gastroesophageal mucosa. The cancer demonstrated overexpression of the HER2/neu oncoprotein and amplification of the HER2/neu gene. This represents the only report of HER2 overexpression in this type of lesion. The patient is being treated with traditional chemotherapeutic agents in addition to monoclonal antibody therapy directed at the HER2 protein, and has demonstrated a clinical benefit from treatment. This case demonstrates that the anatomic location of a mass may be distinct from its biological origin, and this difference may have important practical implications for diagnostic testing and treatment. PMID:24576036

Nussbaum, Daniel P; Bhattacharya, Syamal D; Jiang, Xiaoyin; Cardona, Diana M; Strickler, John H; Blazer, Dan G

2014-03-01

6

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Small Bowel Adenocarcinoma  

PubMed Central

Peritoneal carcinomatosis arising from small bowel adenocarcinoma (PCSBA) carries a dismal prognosis. Presently, limited data have been published on the outcome of PCSBA treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). This series represents the largest series published to date examining our experience with 17 patients. From 1995 to 2011, 17 patients underwent HIPEC with mitomycin for PCSBA. Patients in this study were identified from a prospectively maintained database. Twenty HIPEC procedures were performed on 17 patients with a mean age of 52.2 years. Patients have achieved a mean overall postoperative survival of 18.4 months after progression on chemotherapy with an overall postoperative one- and three-year survival of 52 and 23 per cent, respectively. The mean total length of hospital stay was 10 days. There was no treatment-related mortality. Six patients were readmitted to the hospital within 30 days of discharge (35%). Eight patients (47%) experienced postoperative complications, in which two patients had major postoperative complications in the form of intra-abdominal abscess requiring interventions (12%). HIPEC has encouraging survival results for patients with PCSBA compared with similar patients treated with conventional treatments. However, even with such advancement in management, treatment for small bowel adenocarcinoma still remains a challenge. PMID:23711278

SUN, YANKAI; SHEN, PERRY; STEWART, JOHN H.; RUSSELL, GREGORY B.; LEVINE, EDWARD A.

2013-01-01

7

Adenocarcinoma with adenoma in the jejunum suggesting an adenoma-carcinoma sequence in the small bowel: A case report  

PubMed Central

Other than that in the duodenum, adenocarcinoma in the small bowel is rare. The present study describes a case of adenocarcinoma with adenoma in the jejunum. A 70-year-old male was admitted to hospital due to dehydration induced by abdominal discomfort and difficulty with oral intake. Computed tomography revealed a tumor in the upper side of the jejunum, which was subsequently resected. The tumor contained adenocarcinoma and adenoma. The protein expression of p53 and Ki-67 was analyzed in the normal mucosa, adenoma and adenocarcinoma. The number of epithelial cells expressing p53 and Ki-67 was found to increase in the adenoma tissue compared with that in the normal mucosa. In the adenocarcinoma tissue, the number of cells expressing p53 and Ki-67 further increased, suggesting that an adenoma-adenocarcinoma sequence may occur in the small bowel, similar to that observed in the large bowel. PMID:25009647

NAKANO, YORIKA; ADACHI, YASUSHI; OKAMOTO, HIDEKI; KIYAMA, YOSHIAKI; KOYAMA, TAKASHI; NAKAMURA, SHIN-ICHI; LI, QING; SAKAIDA, NORIKO; UEMURA, YOSHIKO; IKEHARA, SUSUMU

2014-01-01

8

Occupation and small bowel adenocarcinoma: a European case-control study  

PubMed Central

OBJECTIVES—Because of the rarity of small bowel adenocarcinoma (SBA), little is known about the aetiology of this disease. This study aimed to identify occupational clustering of cases SBA as a systematic approach to new hypotheses on the aetiology of this disease.?METHODS—A European multicentre case-control study was conducted in 1995-7, inclusive. Incident cases aged 35-69 years with SBA (n=168) were recruited before acceptance by a pathologist. Altogether 107 cases and 3915 controls were accepted, of which 79 cases, 579 colon cancer controls, and 2070 population controls were interviewed.?RESULTS—The strongest industrial risk factors for SBA taking account of 10 years' exposure lag were dry cleaning, manufacture of workwear, mixed farming (women), and manufacture of motor vehicles (men). A significantly increased risk of SBA (odds ratio (OR) and 95% confidence interval (95% CI)) was found among men employed as building caretakers, OR 6.7 (1.7 to 26.0) and women employed as housekeepers, OR 2.2 (1.1 to 4.9); general farm labourers, OR 4.7 (1.8 to 12.2); dockers, OR 2.9 (1.0 to 8.2); dry cleaners or launderers, OR 4.1 (1.2 to 13.6); and textile workers (sewers or embroiders), OR 2.6 (1.0 to 6.8). For the last four groups, together with welders OR 2.7 (1.1 to 6.6) (men) an exposure-response pattern was found when calculating the ORs for jobs held 1-5 years and >5 years, with never having held the job as reference. The ORs (95% CIs) for 1-5 years and >5 years were 4.3 (0.4 to 44.0) and 3.5 (0.9 to 13.7), 3.0 (0.3 to 26.2) and 4.3 (0.9 to 21.2), 4.6 (0.4 to 48.1) and 11.0 (2.0 to 60.4), 1.3 (0.2 to 11.0) and 5.8 (2.0 to 17.2), and 2.8 (0.3 to 23.8) and 4.6 (1.3 to 16.6), respectively, for each of these occupations. Among welders, people performing semiautomatic arc welding (MIG/MAG) were identified as a high risk group (OR 5.0 (1.3 to 19.6)). ?CONCLUSIONS—This explorative study suggests an increased occurrence of SBA in certain occupations, which needs further evaluation. ???Keywords: small intestine; adenocarcinoma; occupational risk factors PMID:11024200

Kaerlev, L.; Teglbjaerg, P. S.; Sabroe, S.; Kolstad, H.; Ahrens, W.; Eriksson, M.; Gonzalez, A. L.; Guenel, P.; Hardell, L.; Launoy, G.; Merler, E.; Merletti, F.; Suarez-Varela, M.; Stang, A.

2000-01-01

9

Small bowel adenocarcinoma (SBA) three years after colonic adenocarcinoma in an elderly patient: Case report in a National Institute of Health and Aging (INRCA) and review of the literature  

PubMed Central

INTRODUCTION Adenocarcinoma of the small intestine is a rare malignancy (the annual incidence in the USA is approximately 3.9 cases per million persons with median age between 60 and 70 years) with limited data available to guide therapeutic decisions. Nonspecific signs and symptoms associated with difficulty in performing small bowel examination is the cause of delayed diagnosis made between 6 and 9 months after appearance of symptoms with the majority of patients presenting with late stage disease and either lymph node involvement or distant metastatic disease. PRESENTATION OF CASE An 87-year-old man treated 3 years previously for colonic adenocarcinoma with left colectomy, was brought to our attention with a 4.5 cm × 3.5 cm mass in the proximal jejunum associated with another abdominal wall enhancing mass of 5 cm in diameter in the rectus muscle. Diagnosis on gross examination after surgical resection was adenocarcinoma stage III (T4N1M0) with involvement of lymph nodes. DISCUSSION According to an analysis of the Surveillance, Epidemiology and End Results (SEER) database, patients who develop either a small or large intestine adenocarcinoma are at increased risk for a second cancer at both intestinal sites. The role of adjuvant therapy in patients who undergo curative resection is unclear. Recent retrospective and prospective studies have helped to clarify the optimal chemotherapy approach for advanced small bowel adenocarcinoma. CONCLUSION With our work, we present our personal case of metachronous primary carcinoma of small bowel following resected colorectal carcinoma and review the literature. PMID:25460441

Coco, Danilo; Leanza, Silvana; Boccoli, Gianfranco

2014-01-01

10

Small Bowel Bleeding  

MedlinePLUS

... time of the test, the yield is >90%. Deep small bowel enteroscopy In cases where a lesion has been found deep in the small bowel, beyond the reach of standard endoscopy, evaluation of the deep small bowel may be needed. One option to ...

11

Neurofibromatosis of the small bowel  

Microsoft Academic Search

Neurogenic tumors of the small bowel are uncommon. In general, the roentgen manifestations of all submucosal tumors are similar. The present case presented with abdominal pain, pelvic mass, and intussusception. After several small-bowel studies multiple intraluminal and intramural filling defects due to neurofibromas were finally demonstrated.

Richard H. Marshak; Seelig Freund; Daniel Maklansky

1963-01-01

12

Small Bowel Obstruction- A Surprise  

PubMed Central

Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction. PMID:25738033

CP, Ganesh Babu; M, Balachandar; M, Ramanathan

2015-01-01

13

Small bowel obstruction- a surprise.  

PubMed

Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction. PMID:25738033

Mathew, Jeffrey Daniel; Cp, Ganesh Babu; M, Balachandar; M, Ramanathan

2015-01-01

14

Severe adhesive small bowel obstruction.  

PubMed

Adhesive small bowel obstruction is a frequent cause of hospital admission. Water soluble contrast studies may have diagnostic and therapeutic value and avoid challenging demanding surgical operations, but if bowel ischemia is suspected, prompt surgical intervention is mandatory. A 58-year-old patient was operated for extensive adhesive small bowel obstruction after having had two previous laparotomies for colorectal surgery, and had a complex clinical course with multiple operations and several complications. Different strategies of management have been adopted, including non-operative management with the use of hyperosmolar water soluble contrast medium, multiple surgical procedures, total parenteral nutrition (TPN) support, and finally use of antiadherences icodextrin solution. After 2 years follow-up the patient was doing well without presenting recurrent episodes of adhesive small bowel obstruction. For patients admitted several times for adhesive small bowel obstruction, the relative risk of recurring obstruction increases in relation to the number of prior episodes. Several strategies for non-operative conservative management of adhesive small bowel obstruction have already addressed diagnostic and therapeutic value of hyperosmolar water soluble contrast. According to the most recent evidence-based guidelines, open surgery is the preferred method for surgical treatment of strangulating adhesive small bowel obstruction as well as after failed conservative management. Research interest and clinical evidence are increasing in adhesions prevention. Hyaluronic acid-carboxycellulose membrane and icodextrin may reduce incidence of adhesions. PMID:23054502

Di Saverio, Salomone; Catena, Fausto; Kelly, Michael D; Tugnoli, Gregorio; Ansaloni, Luca

2012-12-01

15

Small bowel tumours: yield of enteroscopy  

Microsoft Academic Search

A total of 258 patients with obscure gastrointestinal bleeding were referred for small bowel enteroscopy, a procedure which allows endoscopic evaluation of most of the small intestine. A small bowel tumour was found in 5% of patients. In 50% of patients no diagnosis could be made, but when the cause of obscure bleeding was discovered small bowel tumours were the

B S Lewis; A Kornbluth; J D Waye

1991-01-01

16

X-ray induced photoacoustic tomography  

NASA Astrophysics Data System (ADS)

X-ray induced photoacoustic tomography, also called X-ray acoustic computer tomography (XACT) is investigated in this paper. Short pulsed (?s-range) X-ray beams from a medical linear accelerator were used to generate ultrasound. The ultrasound signals were collected with an ultrasound transducer (500 KHz central frequency) positioned around an object. The transducer, driven by a computer-controlled step motor to scan around the object, detected the resulting acoustic signals in the imaging plane at each scanning position. A pulse preamplifier, with a bandwidth of 20 KHz-2 MHz at -3 dB, and switchable gains of 40 and 60 dB, received the signals from the transducer and delivered the amplified signals to a secondary amplifier. The secondary amplifier had bandwidth of 20 KHz-30 MHz at -3 dB, and a gain range of 10-60 dB. Signals were recorded and averaged 128 times by an oscilloscope. A sampling rate of 100 MHz was used to record 2500 data points at each view angle. One set of data incorporated 200 positions as the receiver moved 360°. The x-ray generated acoustic image was then reconstructed with the filtered back projection algorithm. The twodimensional XACT images of the lead rod embedded in chicken breast tissue were found to be in good agreement with the shape of the object. This new modality may be useful for a number of applications, such as providing the location of a fiducial, or monitoring x-ray dose distribution during radiation therapy.

Xiang, Liangzhong; Han, Bin; Carpenter, Colin; Pratx, Guillem; Kuang, Yu; Xing, Lei

2013-03-01

17

Small Bowel Dissemination of Coccidioidomycosis  

PubMed Central

Gastrointestinal coccidioidomycosis is extremely rare, with less than 10 cases reported in the literature. We report a case of small bowel dissemination of coccidioidomycosis in a 21-year-old African American male with a history of living in San Joaquin Valley. The patient presented with one week of abdominal pain, nausea, shortness of breath, intermittent fever, and sweat, and one month of abdominal distention. A chest radiograph revealed complete effusion of left lung. A computed tomography scan of the abdomen showed diffuse small bowel thickening and enhancement, as well as omental and peritoneal nodules, and ascites. The coccidioidal complement fixation titer was 1?:?256. The duodenal biopsy revealed many spherules filled with round fungal endospores. Later, blood fungal culture showed positivity for Coccidioides immitis. The final diagnosis is disseminated coccidioidomycosis involving lungs, blood, and duodenum. Despite aggressive antifungal therapy, the patient's clinical situation deteriorated and he succumbed to multisystem organ failure one and half months later. A high index of suspicion for gastrointestinal coccidioidomycosis should be maintained in patients from an endemic area presenting as abdominal distention and pain. PMID:25685582

Zhou, Shengmei; Ma, Yanling; Chandrasoma, Parakrama

2015-01-01

18

Small bowel dissemination of coccidioidomycosis.  

PubMed

Gastrointestinal coccidioidomycosis is extremely rare, with less than 10 cases reported in the literature. We report a case of small bowel dissemination of coccidioidomycosis in a 21-year-old African American male with a history of living in San Joaquin Valley. The patient presented with one week of abdominal pain, nausea, shortness of breath, intermittent fever, and sweat, and one month of abdominal distention. A chest radiograph revealed complete effusion of left lung. A computed tomography scan of the abdomen showed diffuse small bowel thickening and enhancement, as well as omental and peritoneal nodules, and ascites. The coccidioidal complement fixation titer was 1?:?256. The duodenal biopsy revealed many spherules filled with round fungal endospores. Later, blood fungal culture showed positivity for Coccidioides immitis. The final diagnosis is disseminated coccidioidomycosis involving lungs, blood, and duodenum. Despite aggressive antifungal therapy, the patient's clinical situation deteriorated and he succumbed to multisystem organ failure one and half months later. A high index of suspicion for gastrointestinal coccidioidomycosis should be maintained in patients from an endemic area presenting as abdominal distention and pain. PMID:25685582

Zhou, Shengmei; Ma, Yanling; Chandrasoma, Parakrama

2015-01-01

19

Pneumobilia associated with small-bowel obstruction  

SciTech Connect

The authors present a patient who admitted complaining of nausea, vomiting, and abdominal distention. A roentgenogram of the abdomen revealed a dilated stomach and pneumobilia. At surgery, he was found to have proximal small-bowel obstruction. To their knowledge, this is the first case of pneumobilia associated with proximal small-bowel obstruction not associated with a gallstone.

Bautista, J.L.; Budhraja, M.D.; Barcia, T.D.; Shankel, S.W.

1988-10-07

20

[A case of small bowel cancer with positive peritoneal cytology and five-year recurrence-free survival].  

PubMed

Small bowel cancer is frequently detected at an advanced stage and its prognosis is poor. We report on a patient with small bowel cancer with positive peritoneal cytology who survived for 5 years without recurrence after surgery.The case involved a 73-year-old woman who had undergone partial resection of the small intestine and lymphadenectomy for a small bowel tumor with obstruction. Pathological examination confirmed papillary adenocarcinoma with partial serosal invasion. Ascites cytology indicated a class V tumor. Adjuvant chemotherapy with TS-1 was administered for 20 months, and the patient has survived without evidence of disease for over 5 years.In this case, it is possible that TS-1 chemotherapy was effective for prevention against small bowel cancer recurrence.Furthermore , peritoneal cytology in patients with small bowel cancer should be evaluated as a predictor of prognosis. PMID:25731552

Matsumura, Atsushi; Shimizu, Keiji; Nishibeppu, Keiji; Matsuyama, Takehisa; Ogino, Shiro; Takemura, Manabu; Mugitani, Tatsuro; Ishida, Hidekazu; Akami, Toshikazu; Okano, Shinji

2014-11-01

21

Small bowel stricture following abdominal trauma.  

PubMed Central

A case of small bowel stricture developing 2 months after blunt abdominal trauma from a lap seat belt is presented. The cause of the stricture was probably a small perforation sustained at the time of the injury but overlooked clinically. At operation an abscess around the terminal ileum was found. The patient made an uneventful recovery following resection of the strictured small bowel. Images Figure 1 PMID:4095056

Welch, G. H.; Anderson, J. R.

1985-01-01

22

Small bowel emergency surgery: literature's review  

PubMed Central

Emergency surgery of the small bowel represents a challenge for the surgeon, in the third millennium as well. There is a wide number of pathologies which involve the small bowel. The present review, by analyzing the recent and past literature, resumes the more commons. The aim of the present review is to provide the main indications to face the principal pathologies an emergency surgeon has to face with during his daily activity. PMID:21214933

2011-01-01

23

An unusual case of small bowel obstruction.  

PubMed

A patient with small bowel obstruction due to a fruit pith (peach) is presented. The diagnostic work up, the treatment and a review of the literature in the matter of obstructions due to swallowed goods are presented. Intestinal obstruction due to ingested organic material is a clinical entity on its own, and careful history taking can give a clue for diagnosis. PMID:8830874

Verstocken, A; Himpens, J; Leman, G

1996-01-01

24

Transabdominal Ultrasonography of the Small Bowel  

PubMed Central

In the era of double balloon enteroscopy, capsule endoscopy, CT, and MRI enterography is transabdominal ultrasonography (TUS) underestimated method for evaluation of small bowel pathology. As often initial imagine method in abdominal complaints, nowadays has TUS much better diagnostic potential than two decades ago. High-resolution ultrasound probes with harmonic imaging significantly improve resolution of bowel wall in real time, with possibility to asses bowel peristalsis. Color flow doppler enables evaluation of intramural bowel vascularisation, pulse wave doppler helps to quantificate flow in coeliac and superior mesenteric arteries. Small intestine contrast ultrasonography with oral contrast fluid, as well as contrast enhanced ultrasonography with intravenous microbubble contrast also improves small bowel imaging. We present a review of small intestine pathology that should be detected during ultrasound examinations, discuss technical requirements, advantages and limitations of TUS, typical ultrasound signs of Crohn's disease, ileus, celiac disease, intussusception, infectious enteritis, tumours, ischemic and haemorrhagic conditions of small bowel. In the hands of experienced investigator, despite some significant limitations(obesity, meteorism), is transabdominal ultrasonography reliable, noninvasive and inexpensive alternative method to computerised tomography (CT) and magnetic resonance imaging (MRI) in small bowel examination. PMID:24348544

Trnovsky, Peter; Kopá?ová, Marcela

2013-01-01

25

Imaging in pediatric small bowel transplantation  

PubMed Central

Small bowel transplantation, alone or with other organs as multivisceral transplantation, is performed for patients with chronic intestinal failure. With advancing surgical techniques and improved post-surgical management, survival of these patients has increased tremendously in the last two decades. The radiologist has an important role in the preoperative and postoperative management of these patients. Knowledge of surgical techniques and post-surgical complications seen in the transplant recipient is necessary for adequate management of these patients. PMID:25489131

Khan, Nadir; Phillips, Grace S.; Heller, Matthew T.; Linam, Leann E.; Parnell, Shawn E.; Moshiri, Mariam; Bhargava, Puneet

2014-01-01

26

A Population-Based Study of the Incidence of Malignant Small Bowel Tumours: SEER, 1973–1990  

Microsoft Academic Search

722-728. Background. Little is known about the incidence of cancers of the small bowel. Methods. Data from cancer registries participating in the Surveillance, Epidemiology, and End-Results (SEER) Program from 1973 to 1990 were analysed to determine the incidence of the four major histological types of cancer occurring in the small Intestine: adenocarcinomas, malignant carcinoid tumours, lymphomas and sarcomas. In addition,

JEANNE S CHOW; CLARK C CHEN; HABIBUL AHSAN; ALFRED I NEUGUT

1996-01-01

27

X-ray induced photoconductivity in Vanadium Dioxide samples  

NASA Astrophysics Data System (ADS)

Vanadium Dioxide (VO2) goes through a first-order phase transition at approximately 340K, exhibiting both an insulator to metal transition (IMT) and a structural phase transition (SPT), with a monoclinic (M1) insulating phase at low temperatures and a rutile (R) metallic phase at high temperatures. We show an anomalous behavior of x-ray induced persistent photoconductivity (PPC) well below the temperature induced phase transition in VO2 devices. We present conductivity and X-ray Diffraction (XRD) measurements, revealing a large enhancement of conductivity due to photo-induced carriers. Moreover, with the addition of nominal electric fields, we are able to fully transition into the rutile metallic phase at room temperature. This effect is completely reversible, allowing the monoclinic insulating phase to be recovered via annealing.

Dietze, Sebastian; Mohanty, Jyoti; Marsh, Moses; Kim, Jong Woo; West, Kevin; Schuller, Ivan K.; Shpyrko, Oleg G.

2011-03-01

28

DNA sequence analysis of X-ray induced Adh null mutations in Drosophila melanogaster  

Microsoft Academic Search

The mutational spectrum for 28 X-ray induced mutations and 2 spontaneous mutations, previously determined by genetic and cytogenetic methods, consisted of 20 multilocus deficiencies (19 induced and 1 spontaneous) and 10 intragenic mutations (9 induced and 1 spontaneous). One of the X-ray induced intragenic mutations was lost, and another was determined to be a recombinant with the allele used in

J. Mahmoud; N. G. Fossett; P. Arbour-Reily; M. McDaniel; A. Tucker; S. H. Chang; W. R. Lee

1991-01-01

29

Small bowel bleeding: a comprehensive review  

PubMed Central

The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds. Deep enteroscopy has also an added advantage of therapeutic potential. Computed tomography is helpful in identifying extra-intestinal lesions. In cases of difficult diagnosis, surgery and intra-operative enteroscopy can help with diagnosis and management. The treatment is dependent upon the aetiology of the bleed. An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy. Small bowel bleeding can be managed by conservative, radiological, pharmacological, endoscopic and surgical methods, depending upon indications, expertise and availability. Some patients, especially those with multiple vascular lesions, can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician. PMID:24874805

Gunjan, Deepak; Sharma, Vishal; Bhasin, Deepak K

2014-01-01

30

[Surgical interventions for small bowel tumors at our department in the last 3 years].  

PubMed

Adenocarcinoma of the small intestine is a rare type of cancer in Hungary as well as in the world. It is more commonly found in patients with coeliac disease (lymphoma) and in hereditary bowel cancer syndromes (hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, and Peutz-Jegher syndrome). Due to the relatively featureless presentation there is usually a few months delay in diagnosis of the disease In addition, small bowel cancer is frequently diagnosed on laparotomy only. We analyzed the small bowel malignancies treated in our department in the last 3 years from the point of view of incidence, preoperative evaluation, surgical intervention, and pathology. All patients were admitted as emergencies, so they underwent rapid investigations, and emergency or semi-emergency surgical interventions. Importantly, preoperative investigations helped to establish operative indication only rather than providing exact diagnosis. The operative procedure was small bowel resection in all cases. Pathological diagnosis included GIST, adenocarcinoma, and non-Hodgkin lymphoma as well. PMID:21330259

Varga, Zsombor; Bálint, András; Vitályos, Tibor

2011-02-01

31

Small bowel obstruction due to phytobezoar: CT diagnosis  

Microsoft Academic Search

.   Small bowel phytobezoars are rare and are almost always obstructive. The literature contains few reports on the radiological\\u000a findings for primary small bowel bezoars. There is also very little published on CT results with this lesion, but the features\\u000a of the scan are characteristic. We present the CT findings in a patient with an obstructive small bowel phytobezoar, and

Tulin Yildirim; Sedat Yildirim; Ozlem Barutcu; Levent Oguzkurt; Turgut Noyan

2002-01-01

32

ANALYSIS OF X-RAY INDUCED HPRT MUTATIONS IN CHO CELLS: INSERTION AND DELETIONS  

EPA Science Inventory

Molecular alterations were examined in the hypoxanthine guanine phosphoribosyltransferase (hprt) gene of 41 independent X-ray-induced thioguanine-resistant (TGR) Chinese hamster ovary (CHO) cell clones. Rapid screening of the clones by multiplex polymerase chain reaction (PCR) fo...

33

Diarrhoea due to small bowel diseases.  

PubMed

Small intestinal diseases are a common, though often overlooked cause of diarrhoeal illness. Fully 1% of the Caucasian population are affected by coeliac disease and a substantial portion of children living in poverty in the developing world are affected by environmental enteropathy. These are but two examples of the many diseases that cause mucosal injury to the primary digestive and absorptive organ in our body. While diarrhoea may be a common, though not universally seen symptom of small bowel mucosal disease, the consequent malabsorption can lead to substantial malnutrition and nutrient deficiencies. The small intestine, unlike the colon, has been relatively inaccessible, and systematic evaluation is often necessary to identify and treat small intestinal mucosal diseases that lead to diarrhoea. Immunodeficiency states, including HIV enteropathy, adult autoimmune enteropathy, drug-associated enteropathy, and tropical sprue continue to occur and require specific therapy. All patients with severe diarrhoea or diarrhoea associated with features suggestive of malabsorption may have a disease of the small intestinal mucosa that requires careful evaluation and targeted management. PMID:23384804

Murray, Joseph A; Rubio-Tapia, Alberto

2012-10-01

34

Small Bowel Obstruction Mimicking Acute ST-Elevation Myocardial Infarction  

PubMed Central

We present a case of a 42-year-old female who presented to our institution with a small bowel obstruction and had emergent surgical decompression. Thirteen days postoperatively, the patient became tachycardic and had worsening epigastric pain. Electrocardiogram showed significant ST-segment elevations in leads II, III, aVF, and V3–V6, suggesting the possibility of acute inferolateral myocardial infarction. Subsequent workup revealed the cause of the ST-elevations to be due to recurrent small bowel obstruction. Although intra-abdominal causes of ST-elevation have been reported, our case may be the first to be associated with small bowel obstruction.

Chang, Nai-Lun; Shulik, Oleg; DePasquale, Joseph; Shamoon, Fayez

2015-01-01

35

Small bowel obstruction due to phytobezoar: CT diagnosis.  

PubMed

We report two cases of small bowel obstruction (SBO) due to phytobezoar impaction. In both cases, computed tomography (CT) demonstrated a well-defined, ovoid intraluminal mass with mottled gas pattern within the dilated small bowel at the site of obstruction and an abruptly collapsed lumen beyond the lesion. Recognition of these CT findings allows specific preoperative diagnosis of SBO owing to this uncommon lesion. PMID:9233879

Ko, S; Lee, T; Ng, S

1997-01-01

36

Kinetic Modeling of the X-ray-induced Damage to a Metalloprotein  

PubMed Central

It is well known that biological samples undergo x-ray-induced degradation. One of the fastest occurring x-ray-induced processes involves redox modifications (reduction or oxidation) of redox-active cofactors in proteins. Here we analyze room temperature data on the photoreduction of Mn ions in the oxygen evolving complex (OEC) of photosystem II, one of the most radiation damage sensitive proteins and a key constituent of natural photosynthesis in plants, green algae and cyanobacteria. Time-resolved x-ray emission spectroscopy with wavelength-dispersive detection was used to collect data on the progression of x-ray-induced damage. A kinetic model was developed to fit experimental results, and the rate constant for the reduction of OEC MnIII/IV ions by solvated electrons was determined. From this model, the possible kinetics of x-ray-induced damage at variety of experimental conditions, such as different rates of dose deposition as well as different excitation wavelengths, can be inferred. We observed a trend of increasing dosage threshold prior to the onset of x-ray-induced damage with increasing rates of damage deposition. This trend suggests that experimentation with higher rates of dose deposition is beneficial for measurements of biological samples sensitive to radiation damage, particularly at pink beam and x-ray FEL sources. PMID:23815809

Davis, Katherine M.; Kosheleva, Irina; Henning, Robert W.; Seidler, Gerald T.; Pushkar, Yulia

2013-01-01

37

Small bowel capsule endoscopy in 2007: Indications, risks and limitations  

PubMed Central

Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn’s disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy). PMID:18069752

Rondonotti, Emanuele; Villa, Federica; Mulder, Chris JJ; Jacobs, Maarten AJM; de Franchis, Roberto

2007-01-01

38

Diagnosis and management of duodenal adenocarcinomas: a comprehensive review for the radiologist.  

PubMed

Duodenal adenocarcinomas are the most common duodenal tumors, and represent 15-25% of small bowel carcinomas. Their management differs from other small bowel tumors, with imaging playing a very important role. In this article, we provide a comprehensive review of the diagnosis and management of duodenal adenocarcinomas, emphasizing the role of the radiologist in the same. PMID:25427987

Suh, Chong Hyun; Tirumani, Sree Harsha; Shinagare, Atul B; Kim, Kyung Won; Rosenthal, Michael H; Ramaiya, Nikhil H; Baheti, Akshay D

2014-11-27

39

Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure  

PubMed Central

Double balloon enteroscopy (DBE) is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT) findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made. PMID:23393642

Chen, Natalie; Lamba, Ramit; Lee, John; Lall, Chandana

2012-01-01

40

Analysis of the K-ras and p53 pathways in x-ray-induced lung tumors in the rat  

SciTech Connect

The risk from exposure to low-dose radiation in conjunction with cigarette smoking has not been estimated due in part to lmited knowledge surrounding the molecular mechanisms underlying radiation-induced cancers. The purpose of this investigation was to determine the frequency for alterations in genes within the K-ras and p53 signal and cell cycle regulatory pathways, respectively, in X-ray-induced lung tumors in the F344/N rat. These tumors were examined for genetic alterations in the K-ras, c-raf-1, p53, mdm2 and cip1 genes. No K-ras mutations were detected by sequencing in 18 squamous cell carcinomas (SCCs) or 17 adenocarcinomas. However, using a K-ras codon 12 mutation selection assay, a codon 12 GGT {r_arrow} GAT mutation was detected in one SCC, suggesting that activation of the K-ras proto-oncogene is both a rare and late event. Single-strand conformation polymorphism (SSCP) analysis of the kinase-binding domain of the c-raf-1 gene did not detect any polymorphisms. Three of 18 SCCs but none of the adenocarcinomas showed p53 nuclear immunoreactivity. Single-strand conformation polymorphism analysis of exons 4-9 of the p53 gene detected only an exon 9 mutation in one SCC. Mutations were not detected in the three SCCs with immunoreactive p53 protein. No amplification of the mdm2 gene was detected; however, nuclear mdm2 immunoreactivity was present in one of the three SCCs that stained positive for the p53 protein. The complete cDNA of the rat cip1 gene comprising 810 bases was cloned and sequenced. The frequency of somatic mutations in exon 2 of the cip1 gene was determined by SSCP analysis. No alterations in electrophoretic mobility were detected. The results of this investigation indicate that alterations in the K-ras and p53 pathways do not play a major role in the genesis of X-ray-induced lung tumors in the rat. 49 refs., 5 figs.

Belinsky, S.A.; Middleton, S.K.; Hahn, F.F.; Nikula, K.J. [Inhalation Toxicology Research Inst., Albuquerque, NM (United States); Picksley, S.M. [Medical Sciences Inst., Dundee (United Kingdom)

1996-04-01

41

[Imaging in the diagnosis of small bowel diseases].  

PubMed

There are still many difficulties in the diagnosis of small bowel diseases. Until recently, diagnosis of small bowel diseases relies primarily on imaging techniques. The traditional gastrointestinal barium meal examination and endoscopy can observe the changing of mucous membrane, but can not demonstrate the intestinal wall and the extraluminal structure. With the development and modification of CT and MR software and hardware, CT enterography(CTE) and MR enterography(MRE) are being increasingly usded in clinical practice, facilitating discrimination of mucous membrane, wall, lumen and extraluminal structure. Dynamic contrast scanning can reflect the blood supply of intestinal lesions, and CTA and MRA can reveal the vascularity and abnormality. Comprehensive analysis of imaging can provide overall and objective information and improve diagnostic accuracy of small bowel diseases. Besides, imaging features can be used as criteria in assessing the activity of Crohn's disease, which provides effective method of treatment selection and efficacy evaluation. PMID:25809321

Yan, Fuhua

2015-03-25

42

Capsule Endoscopy in the Small Bowel Crohn's Disease  

PubMed Central

CD is a chronic inflammatory disorder associated to mucosal and transmural inflammation of the bowel wall. It is well known that CD can affect the entire gastrointestinal. Therefore, ileocolonoscopy and biopsies of the terminal ileum as well as of each colonic segment to look for microscopic evidence of CD are the first-line procedures to establish the diagnosis. However, it has been observed that up to 30% of the patients have only small bowel involvement. Evaluation of the small bowel has been made with radiological procedures, barium radiography, and abdominal computed tomography or by ileocolonoscopy or enteroscopy, but they have many recognized limitations. CE is undoubtedly a very useful diagnostic tool proposed to observe small-bowel lesions undetectable by conventional endoscopy or radiologic studies. We review different studies that have been published reporting the use of CE in suspected and evaluation of the extension or the recurrence in CD and also its use in pediatric population and its complications. PMID:24741374

Argüelles-Arias, Federico; Rodríguez-Oballe, Juan; Duarte-Chang, Calixto; Castro-Laria, Luisa; García-Montes, Josefa María; Caunedo-Álvarez, Ángel; Herrerías-Gutiérrez, Juan Manuel

2014-01-01

43

Small bowel injury in low-dose aspirin users.  

PubMed

The use of low-dose aspirin (LDA) is well known to be associated with an increased risk of serious upper gastrointestinal complications, such as peptic ulceration and bleeding. Until recently, attention was mainly focused on aspirin-induced damage of the stomach and duodenum. However, recently, there has been growing interest among gastroenterologists on the adverse effects of aspirin on the small bowel, especially as new endoscopic techniques, such as capsule endoscopy (CE) and balloon-assisted endoscopy, have become available for the evaluation of small bowel lesions. Preliminary CE studies conducted in healthy subjects have shown that short-term administration of LDA can induce mild mucosal inflammation of the small bowel. Furthermore, chronic use of LDA results in a variety of lesions in the small bowel, including multiple petechiae, loss of villi, erosions, and round, irregular, or punched-out ulcers. Some patients develop circumferential ulcers with stricture. In addition, to reduce the incidence of gastrointestinal lesions in LDA users, it is important for clinicians to confirm the differences in the gastrointestinal toxicity between different types of aspirin formulations in clinical use. Some studies suggest that enteric-coated aspirin may be more injurious to the small bowel mucosa than buffered aspirin. The ideal treatment for small bowel injury in patients taking LDA would be withdrawal of aspirin, however, LDA is used as an antiplatelet agent in the majority of patients, and its withdrawal could increase the risk of cardiovascular/cerebrovascular morbidity and mortality. Thus, novel means for the treatment of aspirin-induced enteropathy are urgently needed. PMID:25501289

Endo, Hiroki; Sakai, Eiji; Kato, Takayuki; Umezawa, Shotaro; Higurashi, Takuma; Ohkubo, Hidenori; Nakajima, Atsushi

2015-04-01

44

Splenic angiosarcoma metastasis to small bowel presented with gastrointestinal bleeding  

PubMed Central

Primary splenic angiosarcoma is a very rare, aggressive neoplasm with a high metastatic rate and dismal prognosis. This neoplasm usually presents with abdominal pain, splenomegaly, anemia, and thrombocytopenia. Splenic angiosarcoma with bleeding gastrointestinal metastases is extremely rare. The literature contains only two case reports. This study reported a 44-year-old male patient with splenic angiosarcoma with sustained repeated gastrointestinal bleeding due to small bowel metastases. Salvage surgery was performed by splenectomy and resection of the metastatic small bowel tumors. The post-operative course was uneventful; the patient survived with the disease and had no GI bleeding, 7 mo after surgery. PMID:16425436

Hsu, Jun-Te; Lin, Chin-Yew; Wu, Ting-Jun; Chen, Han-Ming; Hwang, Tsann-Long; Jan, Yi-Yin

2005-01-01

45

Enteroscopy in small bowel Crohn's disease: A review.  

PubMed

Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract resulting in inflammation, stricturing and fistulae secondary to transmural inflammation. Diagnosis relies on clinical history, abnormal laboratory parameters, characteristic radiologic and endoscopic changes within the gastrointestinal tract and most importantly a supportive histology. The article is intended mainly for the general gastroenterologist and for other interested physicians. Management of small bowel CD has been suboptimal and limited due to the inaccessibility of the small bowel. Enteroscopy has had a significant renaissance recently, thereby extending the reach of the endoscopist, aiding diagnosis and enabling therapeutic interventions in the small bowel. Radiologic imaging is used as the first line modality to visualise the small bowel. If the clinical suspicion is high, wireless capsule endoscopy (WCE) is used to rule out superficial and early disease, despite the above investigations being normal. This is followed by push enteroscopy or device assisted enteroscopy (DAE) as is appropriate. This approach has been found to be the most cost effective and least invasive. DAE includes balloon-assisted enteroscopy, [double balloon enteroscopy (DBE), single balloon enteroscopy (SBE) and more recently spiral enteroscopy (SE)]. This review is not going to cover the various other indications of enteroscopy, radiological small bowel investigations nor WCE and limited only to enteroscopy in small bowel Crohn's. These excluded topics already have comprehensive reviews. Evidence available from randomized controlled trials comparing the various modalities is limited and at best regarded as Grade C or D (based on expert opinion). The evidence suggests that all three DAE modalities have comparable insertion depths, diagnostic and therapeutic efficacies and complication rates, though most favour DBE due to higher rates of total enteroscopy. SE is quicker than DBE, but lower complete enteroscopy rates. SBE has quicker procedural times and is evolving but the least available DAE today. Larger prospective randomised controlled trial's in the future could help us understand some unanswered areas including the role of BAE in small bowel screening and comparative studies between the main types of enteroscopy in small bowel CD. PMID:24147191

Tharian, Benjamin; Caddy, Grant; Tham, Tony Ck

2013-10-16

46

DNA sequence analysis of X-ray induced Adh null mutations in Drosophila melanogaster  

SciTech Connect

The mutational spectrum for 28 X-ray induced mutations and 2 spontaneous mutations, previously determined by genetic and cytogenetic methods, consisted of 20 multilocus deficiencies (19 induced and 1 spontaneous) and 10 intragenic mutations (9 induced and 1 spontaneous). One of the X-ray induced intragenic mutations was lost, and another was determined to be a recombinant with the allele used in the recovery scheme. The DNA sequence of two X-ray induced intragenic mutations has been published. This paper reports the results of DNA sequence analysis of the remaining intragenic mutations and a summary of the X-ray induced mutational spectrum. The combination of DNA sequence analysis with genetic complementation analysis shows a continuous distribution in size of deletions rather than two different types of mutations consisting of deletions and point mutations'. Sequencing is shown to be essential for detecting intragenic deletions. Of particular importance for future studies is the observation that all of the intragenic deletions consist of a direct repeat adjacent to the breakpoint with one of the repeats deleted.

Mahmoud, J.; Fossett, N.G.; Arbour-Reily, P.; McDaniel, M.; Tucker, A.; Chang, S.H.; Lee, W.R. (Louisiana State Univ., Baton Rouge (United States))

1991-01-01

47

DOI: 10.1002/adma.200800052 X-Ray Induced Synthesis of 8H Diamond**  

E-print Network

DOI: 10.1002/adma.200800052 X-Ray Induced Synthesis of 8H Diamond** By Zhongwu Wang,* Yusheng Zhao. Consequently, there has been a long-standing interest in exploring the possible diamond polytypes. Since the hexagonal form (2H diamond or lonsdaleite) was found in meteorites,[1] evidence for other non

Downs, Robert T.

48

Detection of Postoperative Intestinal Ischemia in Small Bowel Transplants  

PubMed Central

Small bowel transplantation is acknowledged as auto- and allotransplantation. In both instances, there is up to a 4%–10% risk of postoperative ischemia, and as the small bowel is extremely susceptible to ischemia, the timely diagnosis of ischemia is important. The location of the transplant, whether it is buried in the abdominal cavity or in the neck region, increases the challenge, as monitoring becomes more difficult and the consequences of neglect more dangerous. All methods for the early detection of postoperative ischemia in small bowel transplants are described together with the requirements of the ideal monitoring method. A small bowel transplant can be inspected directly or indirectly; the blood flow can be monitored by Doppler or by photoplethysmography, and the consequences of the blood flow can be monitored. The ideal monitoring method should be reliable, fast, minimally invasive, safe, objective, easy, cheap, and comfortable. No monitoring methods today fulfill the criteria of the ideal monitoring method, and evidence-based guidelines regarding postoperative monitoring cannot be made. The choice of whether to implement monitoring of ischemia—and if so, which method to choose—has to be made by the individual surgeon or center. PMID:23209878

Birke-Sorensen, Hanne

2012-01-01

49

Three cases of an unusual foreign body in small bowel  

Microsoft Academic Search

The inadvertent ingestion of foreign bodies is an infrequent occurrence in adults. Three cases of an unusual form of foreign body ingestion are reported here. In each case the foreign body recovered was a plastic bag clip, found attached to the small bowel mucosa. The radiographic appearances of this foreign body are demonstrated, and the pathologic findings related to its

Maha M. Guindi; Michael M. Troster; Virginia M. Walley

1987-01-01

50

Small Bowel Pleomorphic Liposarcoma: A Rare Cause of Gastrointestinal Bleeding  

PubMed Central

In this case report we present a 60-year-old male patient with overt midgastrointestinal bleeding of a primary ileal pleomorphic liposarcoma diagnosed by video capsule endoscopy (VCE). Clinical work-up for final diagnosis and the pathological background of this uncommon tumorous entity of the small bowel will be discussed in this paper. PMID:25161780

Schlag, Christoph; Becker, Valentin; Neu, Bruno; Hüser, Norbert; Gertler, Ralf; Schmid, Roland M.; von Delius, Stefan

2014-01-01

51

Successful anaesthesia and small-bowel anastomosis in the guineapig  

Microsoft Academic Search

Summary Using methoxyflurane and paying critical attention to maintenance of body temperature, tracheal aspiration and fluid replacement, guineapigs were rendered suitable for intraperitoneal operations lasting up to 3 h. Anaesthetic mortality was less than 2%. A technique of small-bowel anastomosis was developed using interrupted soluble sutures meticulously placed I mm apart and taking bites 1 mm deep. Survival was 95%.

N. J. BETTi; J. W. HYNDI; C. J. Green

1980-01-01

52

Ultraintense X-Ray Induced Ionization, Dissociation, and Frustrated Absorption in Molecular Nitrogen  

NASA Astrophysics Data System (ADS)

Sequential multiple photoionization of the prototypical molecule N2 is studied with femtosecond time resolution using the Linac Coherent Light Source (LCLS). A detailed picture of intense x-ray induced ionization and dissociation dynamics is revealed, including a molecular mechanism of frustrated absorption that suppresses the formation of high charge states at short pulse durations. The inverse scaling of the average target charge state with x-ray peak brightness has possible implications for single-pulse imaging applications.

Hoener, M.; Fang, L.; Kornilov, O.; Gessner, O.; Pratt, S. T.; Gühr, M.; Kanter, E. P.; Blaga, C.; Bostedt, C.; Bozek, J. D.; Bucksbaum, P. H.; Buth, C.; Chen, M.; Coffee, R.; Cryan, J.; Dimauro, L.; Glownia, M.; Hosler, E.; Kukk, E.; Leone, S. R.; McFarland, B.; Messerschmidt, M.; Murphy, B.; Petrovic, V.; Rolles, D.; Berrah, N.

2010-06-01

53

Protective effect of ethanol on X-ray-induced mitotic recombination in drosophilia melanogaster  

Microsoft Academic Search

The effect of ethanol treatment on X-ray-induced mitotic recombination in D. melanogaster females was investigated by means of the white\\/white{sup +} w\\/w{sup +} spot test. White females inseminated by yellow males were allowed to oviposit for 8 hr on medium containing 5%, 7.5% and 10% (v\\/v) ethanol and submitted to 10 Gy of X-rays 52 hr after the beginning of

Ana M. Palermo; Mónica Rey; E. R. Munoz

1994-01-01

54

Ultraintense X-Ray Induced Ionization, Dissociation, and Frustrated Absorption in Molecular Nitrogen  

SciTech Connect

Sequential multiple photoionization of the prototypical molecule N{sub 2} is studied with femtosecond time resolution using the Linac Coherent Light Source (LCLS). A detailed picture of intense x-ray induced ionization and dissociation dynamics is revealed, including a molecular mechanism of frustrated absorption that suppresses the formation of high charge states at short pulse durations. The inverse scaling of the average target charge state with x-ray peak brightness has possible implications for single-pulse imaging applications.

Hoener, M. [Western Michigan University Physics Department, Kalamazoo, Michigan 49008 (United States); Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Fang, L.; Murphy, B.; Berrah, N. [Western Michigan University Physics Department, Kalamazoo, Michigan 49008 (United States); Kornilov, O.; Gessner, O. [Ultrafast X-ray Science Laboratory Chemical Sciences Division Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Pratt, S. T.; Kanter, E. P. [Argonne National Laboratory, Argonne, Illinois 60439 (United States); Guehr, M.; Bucksbaum, P. H.; Cryan, J.; Glownia, M.; McFarland, B.; Petrovic, V. [PULSE Institute for Ultrafast Energy Science, SLAC National Accelerator Laboratory, Menlo Park, California 94025 (United States); Blaga, C.; DiMauro, L. [Ohio State University, Department of Physics, Columbus, Ohio 43210 (United States); Bostedt, C.; Bozek, J. D.; Coffee, R.; Messerschmidt, M. [Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park, California 94025 (United States)

2010-06-25

55

An Interesting Case of Recurrent Small Bowel Obstruction  

PubMed Central

Sclerosing mesenteritis is associated with a spectrum of diseases which include mesenteric lipodystrophy and mesenteric panniculitis. This inflammatory and fibrosing disorder can affect the small and large bowel wall and mesenteric vessels by exerting a mass effect. The following case highlights the difficulties with diagnosing and managing this unusual disease. A 64-year-old man presented with acute central abdominal pain, radiating to his back, and profuse vomiting. He was diagnosed clinically with small bowel obstruction. He had had an episode of small bowel obstruction 6 years earlier. At this time, he underwent an exploratory laparotomy, and a mass was identified in the small bowel mesentery. The features were thought to be in keeping with sclerosing mesenteritis. He had a dramatically favourable response to the initiation of prednisolone. He continued to be well and asymptomatic for a further 5 years on long-term maintenance low-dose steroids and 6-mercaptopurine. He re-presented in 2009 (six years after initial presentation) with very severe acute abdominal pain and vomiting. He had no recent change in weight or appetite, and had not had time off work. He underwent a second laparotomy and the tissue diagnosis was of metastatic carcinoid tumour involving the small bowel mesentery. This is the first case to our knowledge where sclerosing mesenteritis has been confirmed histologically on biopsy and then subsequently diagnosed with histologically proven carcinoid tumour. For this particular reason it must be always remembered that sclerosing mesenteritis is a ‘pathological’ and not a radiological diagnosis and that a large proportion of cases are associated with neoplasia. PMID:21103263

Allen, P.B.; De Cruz, P.; Efthymiou, M.; Fox, A.; Taylor, A.C.F.; Desmond, P.V.

2009-01-01

56

An Interesting Case of Recurrent Small Bowel Obstruction.  

PubMed

Sclerosing mesenteritis is associated with a spectrum of diseases which include mesenteric lipodystrophy and mesenteric panniculitis. This inflammatory and fibrosing disorder can affect the small and large bowel wall and mesenteric vessels by exerting a mass effect. The following case highlights the difficulties with diagnosing and managing this unusual disease. A 64-year-old man presented with acute central abdominal pain, radiating to his back, and profuse vomiting. He was diagnosed clinically with small bowel obstruction. He had had an episode of small bowel obstruction 6 years earlier. At this time, he underwent an exploratory laparotomy, and a mass was identified in the small bowel mesentery. The features were thought to be in keeping with sclerosing mesenteritis. He had a dramatically favourable response to the initiation of prednisolone. He continued to be well and asymptomatic for a further 5 years on long-term maintenance low-dose steroids and 6-mercaptopurine. He re-presented in 2009 (six years after initial presentation) with very severe acute abdominal pain and vomiting. He had no recent change in weight or appetite, and had not had time off work. He underwent a second laparotomy and the tissue diagnosis was of metastatic carcinoid tumour involving the small bowel mesentery. This is the first case to our knowledge where sclerosing mesenteritis has been confirmed histologically on biopsy and then subsequently diagnosed with histologically proven carcinoid tumour. For this particular reason it must be always remembered that sclerosing mesenteritis is a 'pathological' and not a radiological diagnosis and that a large proportion of cases are associated with neoplasia. PMID:21103263

Allen, P B; De Cruz, P; Efthymiou, M; Fox, A; Taylor, A C F; Desmond, P V

2009-01-01

57

Integrated intestinal capacity and nutritional status following small bowel transplantation  

Microsoft Academic Search

Successful small bowel transplantation requires normal functional capacity of the graft and unaltered metabolism of the host.\\u000a Weight gain and wet weight of muscle groups and intra-abdominal fat pads were compared between transplanted, sham-operated,\\u000a short bowel-operated, and normal rats that were fed either standard chow or fat-enriched (15 %) pellets. Weight gain and wet\\u000a weight of muscle groups and fat

Göran Kurlberg; Kent Lundholm; E. Haglind

1997-01-01

58

Oral contrast agents for small bowel distension in MRI: influence of the osmolarity for small bowel distention  

Microsoft Academic Search

To assess the effect of the osmolarity for small bowel distension in MRI, ten volunteers ingested at two separate occasions negative oral contrast agents with different quantity and osmolarity: (1) a water solution combined with 2.0% sorbitol and 0.2% locus bean gum (LBG) with a quantity of 1500 ml and an osmolarity of 148 mOsmol\\/l, (2) a water solution combined with 2.0%

Waleed Ajaj; Mathias Goyen; Hubert Schneemann; Christiane Kuehle; Michael Nuefer; Stefan G. Ruehm; Susanne C. Goehde; Thomas C. Lauenstein

2005-01-01

59

Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child  

PubMed Central

Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future. PMID:25901264

Lim, Yun Jung; Nam, So Hyun; Kim, Seon Jeong

2015-01-01

60

Principles of femtosecond X-ray/optical cross-correlation with X-ray induced transient optical reflectivity in solids  

NASA Astrophysics Data System (ADS)

The discovery of ultrafast X-ray induced optical reflectivity changes enabled the development of X-ray/optical cross correlation techniques at X-ray free electron lasers worldwide. We have now linked through experiment and theory the fundamental excitation and relaxation steps with the transient optical properties in finite solid samples. Therefore, we gain a thorough interpretation and an optimized detection scheme of X-ray induced changes to the refractive index and the X-ray/optical cross correlation response.

Eckert, S.; Beye, M.; Pietzsch, A.; Quevedo, W.; Hantschmann, M.; Ochmann, M.; Ross, M.; Minitti, M. P.; Turner, J. J.; Moeller, S. P.; Schlotter, W. F.; Dakovski, G. L.; Khalil, M.; Huse, N.; Föhlisch, A.

2015-02-01

61

Influence of caffeine on X-ray-induced killing and mutation in V79 cells  

SciTech Connect

Effects produced by caffeine on X-irradiated Chinese hamster V79 cells depended on the growth conditions of the cells. For exponentially growing cells, nontoxic concentrations of caffeine decreased the shoulder width from the survival curve, but the slope remained unchanged. The yield of mutants under the same conditions also remained unaffected. In case of density-inhibited cells, delaying trypsinization for 24 h after X irradiation increased the survival and decreased the yield of mutants. The presence of caffeine during this incubation period inhibited such recovery and significantly increased the yield of X-ray-induced mutants.

Bhattacharjee, S.B.; Bhattacharyya, N.; Chatterjee, S.

1987-02-01

62

Note: A novel method for in situ loading of gases via x-ray induced chemistry  

SciTech Connect

We have developed and demonstrated a novel method to load oxygen in a sealed diamond anvil cell via the x-ray induced decomposition of potassium chlorate. By irradiating a pressurized sample of an oxidizer (KClO{sub 3}) with either monochromatic or white beam x-rays from the Advanced Photon Source at ambient temperature and variable pressure, we succeeded in creating a localized region of molecular oxygen surrounded by unreacted sample which was confirmed via Raman spectroscopy. We anticipate that this technique will be useful in loading even more challenging, difficult-to-load gases such as hydrogen and also to load multiple gases.

Pravica, Michael; Bai, Ligang; Park, Changyong; Liu, Yu; Galley, Martin; Robinson, John; Bhattacharya, Neelanjan (UNLV); (CIW)

2011-12-14

63

X-ray-induced chromosome aberrations in Down lymphocytes: an explanation of their increased sensitivity  

SciTech Connect

Unstimulated lymphocytes from individuals with Down Syndrome (trisomy 21) are more sensitive to the induction of dicentric and ring aberrations by X rays than normal lymphocytes. Several explanations involving the more rapid rejoining of X-ray-induced lesions in Down cells have been offered. It is shown here that the repair of the DNA damage converted into chromosome aberrations is more rapid in Down cells than normal cells. This more rapid repair results in a higher probability of producing chromosome aberrations, and hence higher aberration frequencies in Down than normal cells.

Preston, R.J.

1981-01-01

64

X-ray-induced chromosome aberrations in Down lymphocytes: an explanation of their increased sensitivity  

SciTech Connect

Unstimulated lymphocytes from individuals with Down Syndrome (trisomy 21) are more sensitive to the induction of dicentric and ring aberrations by X rays than normal lymphocytes. Several explanations involving the more rapid rejoining of X-ray--induced lesions in Down cells have been offered. It is shown here that the repair of the DNA damage converted into chromosome aberrations is more rapid in Down cells than normal cells. This more rapid repair results in a higher probability of producing chromosomes aberrations, and hence higher aberration frequencies in Down than normal cells.

Preston, R.J.

1981-01-01

65

Left paraduodenal hernia presenting as recurrent small bowel obstruction  

PubMed Central

Internal herniation of the small bowel is a relatively rare cause of intestinal obstruction. Left paraduodenal hernia resulting from abnormal rotation of the midgut during embryonic development is the most common form of congenital internal hernia. We report our experience in the diagnosis and management of a young male with left paraduodenal hernia presenting as recurrent intestinal obstruction. Correct preoperative diagnosis of left paraduodenal hernia had been difficult due to non-specific clinical presentations, but the advent of modern imaging technology makes early and correct diagnosis possible. Due to the risk of obstruction and strangulation, surgical treatment is indicated; however, timely intervention increases the likelihood of a favorable outcome. PMID:16425435

Huang, Yu-Min; Chou, Andy Shau-Bin; Wu, Yung-Kang; Wu, Chao-Chuan; Lee, Ming-Che; Chen, Haw-Tzong; Chang, Yao-Jen

2005-01-01

66

An unusual cause of small bowel perforation: apricot pit.  

PubMed

Ingestion of foreign bodies can be a common problem, especially among children, alcoholics, and psychiatric and senile patients. Foreign bodies with smooth edges usually do not pose significant problems, but a sharp foreign object that is not retrieved immediately may penetrate the wall and cause complications. Ingested foreign bodies usually pass the intestinal tract uneventfully, and perforation occurs in less than 1%. In this study, we report a case of small bowel obstruction with perforation in a 73-year-old female due to the accidental swallowing of an apricot pit. PMID:21935813

Atila, Koray; Güler, Sanem; Bora, Seymen; Gülay, Hüseyin

2011-05-01

67

Characterization of X-ray-induced immunostaining of proliferating cell nuclear antigen in human diploid fibroblasts  

SciTech Connect

The repair of X-ray-induced DNA damage related to the proliferating cell nuclear antigen (PCNA) was characterized in human diploid fibroblasts by an indirect immunofluorescence method. PCNA staining induced by X rays was lost after DNase I treatment but not after RNase treatment. The staining was not induced when ATP was depleted or the temperature was lowered to 0{degrees}C during the X irradiation. When cells were incubated at 37{degrees}C after X irradiation, PCNA staining diminished gradually and was almost entirely absent 12-15 h later. On the other hand, PCNA staining persisted during aphidicolin treatment even 20 h after X irradiation. Induction of PCNA staining was not affected by the aphidicolin treatment. Cycloheximide treatment did not affect induction of the staining either, but did inhibit the disappearance of the staining. There was no difference in the staining pattern and time course of PCNA staining after X irradiation between normal and xeroderma pigmentosum group A (XP-A) cells. These results imply that PCNA-dependent, aphidicolin-sensitive DNA polymerases may be involved in repair of X-ray-induced DNA damage in vivo, but the repair initiation step could be different from that of nucleotide excision repair initiated by XP proteins. 39 refs., 6 figs.

Miura, Masahiko; Sasaki, Takehito [Tokyo Medical and Dental Univ. (Japan); Takasaki, Yoshinari [Juntendo Univ., Tokyo (Japan)

1996-01-01

68

Endoscopic band ligation for bleeding lesions in the small bowel  

PubMed Central

AIM: To investigate the safety and efficacy of endoscopic band ligation (EBL) for bleeding lesions in the small bowel. METHODS: This is a retrospective study evaluating EBL in six consecutive patients (three males, three females, 46-86 years of age) treated between May 2009 and February 2014: duodenal vascular ectasia; 1, jejunal bleeding diverticulum; 1, ileal Dieulafoy’s lesion; 1 and ileal bleeding diverticula; 3. The success of the initial hemostasis was evaluated, and patients were observed for early rebleeding (within 30 d after EBL), and complications such as perforation and abscess formation. Follow-up endoscopies were performed in four patients. RESULTS: Initial hemostasis was successfully achieved with EBL in all six patients. Eversion was not sufficient in four diverticular lesions. Early rebleeding occurred three days after EBL in one ileal diverticulum, and a repeat endoscopy revealed dislodgement of the O-band and ulcer formation at the banded site. This rebleeding was managed conservatively. Late rebleeding occurred in this case (13 and 21 mo after initial EBL), and re-EBL was performed. Follow-up endoscopies revealed scar formation and the disappearance of vascular lesions at the banded site in the case with a duodenal bleeding lesion, and unresolved ileal diverticula in three cases. Surgery or transarterial embolization was not required without any complications during the median follow-up period of 45 (range, 2-83) mo. CONCLUSION: EBL is a safe and effective endoscopic treatment for hemostasis of bleeding lesions in the small bowel. PMID:25324920

Ikeya, Takashi; Ishii, Naoki; Shimamura, Yuto; Nakano, Kaoru; Ego, Mai; Nakamura, Kenji; Takagi, Koichi; Fukuda, Katsuyuki; Fujita, Yoshiyuki

2014-01-01

69

Intestinal anisakiasis as a rare cause of small bowel obstruction.  

PubMed

Anisakiasis, a parasitic infection by larvae of the nematode Anisakis found in raw or undercooked saltwater fish, mostly involves stomach but rarely small intestine. We report a rare case of a 61-year-old man who presented with abdominal pain and developed small bowel obstruction caused by intestinal anisakiasis. Abdominal computed tomography revealed segmental edema of the intestinal wall with proximal dilatation. The patient underwent urgent laparotomy because strangulated small bowel obstruction was suspected. A localized portion of the intestine around jejunoileal junction was found to be erythematous, edematous, and hardened, which was resected. The resected specimen showed a linear whitish worm, Anisakis simplex, penetrating into the intestinal mucosa. It is often clinically challenging to consider intestinal anisakiasis in the differential diagnosis because of its nonspecific abdominal symptoms and findings. Although gastrointestinal anisakiasis is still rare in the United States, the incidence is expected to rise given the growing popularity of Japanese cuisine such as sushi or sashimi. Anisakiasis should be considered as one of the differential diagnoses in patients with nonspecific abdominal symptoms after consumption of raw or undercooked fish. PMID:23786678

Kojima, Gotaro; Usuki, Shinichiro; Mizokami, Ken; Tanabe, Marianne; Machi, Junji

2013-09-01

70

Constitutive basal and stimulated human small bowel contractility is enhanced in obesity  

Microsoft Academic Search

Small bowel contractility may be more prominent in obese subjects, such that there is enhanced nutrient absorption and hunger stimulation. However, there is little evidence to support this. This study examined in vitro small bowel contractility in obese patients versus non-obese patients. Samples of histologically normal small bowel were obtained at laparoscopic Roux-en-Y gastric bypass from obese patients. Control specimens

Tom K Gallagher; Alan W Baird; Desmond C Winter

2009-01-01

71

Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension  

Microsoft Academic Search

The purpose of this study was to compare two osmotic carbohydrate sugar alcohols (mannitol 2.5% and sorbitol 2.5%, 2.0%, and 1.5% watery solutions) in combination with 0.2% locust bean gum (LBG) for small bowel distension for MR imaging. Small bowel distension was quantified on coronal 2D TrueFISP images by measuring the diameters of 16 small bowel loops in each of

Waleed Ajaj; Susanne C. Goehde; Hubert Schneemann; Stefan G. Ruehm; Jörg F. Debatin; Thomas C. Lauenstein

2004-01-01

72

MRI of the small-bowel: how to differentiate primary neoplasms and mimickers  

PubMed Central

MRI of the gastrointestinal tract is gaining clinical acceptance and is increasingly used to evaluate patients with suspected small-bowel diseases. MRI may be performed with enterography or enteroclysis, both of which combine the advantages of cross-sectional imaging with those of conventional enteroclysis. In this paper, MRI features of primary small-bowel neoplasms, the most important signs for differential diagnosis and the diseases that can be considered as mimickers of small-bowel neoplasms, are discussed. PMID:22422388

Masselli, G; Colaiacomo, M C; Marcelli, G; Bertini, L; Casciani, E; Laghi, F; D'Amico, P; Caprasecca, S; Polettini, E; Gualdi, G

2012-01-01

73

Plasma Citrulline Concentration: A Reliable Marker of Small Bowel Absorptive Capacity Independent of Intestinal Inflammation  

Microsoft Academic Search

OBJECTIVES:Postabsorptive plasma citrulline concentration has been proposed as a reliable marker of small bowel absorptive capacity in short bowel patients. The aim of this study was to address the potentially confounding impact of intestinal inflammation.METHODS:Fifty-five patients were selected according to diagnosis, small bowel length, and degree of bowel inflammation. (a) Crohn's disease (CD) with massive small bowel resection leaving ?50

Cinzia Papadia; Roy A. Sherwood; Chrysostomos Kalantzis; Katharina Wallis; Umberto Volta; Erica Fiorini; Alastair Forbes

2007-01-01

74

Small bowel schwannoma revealed during an inguinal hernia: a case report  

PubMed Central

Introduction The association of bowel tumor and inguinal hernia is rare. We report according to our research the first case of the migration of a small bowel schwannoma into an inguinal hernia. Case presentation We report the case of a 51-year-old Moroccan malen admitted for a non-reducible right inguinal hernia in which surgical exploration showed the presence of a small bowel tumor that had migrated into his hernia sac. A histopathological examination of the tumor was in favor of a small bowel schwannoma. Conclusion Small bowel schwannoma is an exceptional clinical entity for which the diagnosis is difficult; its confirmation needs histological and immunohistochemical studies. PMID:25159340

2014-01-01

75

Use of small bowel capsule endoscopy in patients with chronic kidney disease: experience from a University Referral Center  

PubMed Central

Background There are only few reports on the diagnostic yield (DY) of small bowel capsule endoscopy (SBCE) in patients with chronic kidney disease (CKD). We aim to report our SBCE experience in patients with CKD. Methods Retrospective study; case notes of patients with low estimated glomerular filtration rate (eGFR) who underwent SBCE (March 2005-August 2012) for anemia and/or obscure gastrointestinal bleeding (OGIB) were retrieved and abstracted. Severity of CKD was defined according to Renal Association recommendations as: stage 3 (eGFR: 30-59); stage 4 (eGFR: 15-29); and stage 5 (eGFR <15 or on dialysis). Results In the aforementioned period, 69 patients with CKD [stage 3: 65/69 (92.8%), stage 4 or 5:4/69 (7.2%)] had SBCE. 51/65 (78.5%) patients with stage 3 CKD had SBCE due to unexplained anemia and/or OGIB [43 (66.1%) and 8 (12.3%), respectively]. In 25/51 (49%), the SBCE was normal and in 17/51 (33.3%) showed small-bowel angiectasias. Other findings were active bleeding (n=2), fold edema (n=2), ileal erosions (n=1), adenocarcinoma (n=1), and inconclusive/videos not available (n=3). All patients (n=4) with CKD grade 4 or 5 were referred due to unexplained anemia; 3/4 (75%) had angiectasias and 1 normal SBCE. Fecal calprotectin (FC) was measured in 12 patients with CKD stage 3 and unexplained anemia prior to their SBCE; no significant small-bowel inflammation was found in this subgroup. Conclusion SBCE has limited DY in CKD patients referred for unexplained anemia. Sinister SB pathology is rare, while the most common finding is angiectasias. Furthermore, FC measurement prior to SBCE -in this cohort of patients- is not associated with increased DY. PMID:25608445

Docherty, Emily; Koulaouzidis, Anastasios; Douglas, Sarah; Plevris, John N.

2015-01-01

76

Effect of longer battery life on small bowel capsule endoscopy  

PubMed Central

AIM: To determine if longer battery life improves capsule endoscopy (CE) completion rates. METHODS: A retrospective study was performed at a tertiary, university-affiliated hospital in Vancouver, Canada. Patients who underwent CE with either PillCam™ SB2 or SB2U between 01/2010 and 12/2013 were considered for inclusion. SB2 and SB2U share identical physical dimensions but differ in their battery lives (8 h vs 12 h). Exclusion criteria included history of gastric or small bowel surgery, endoscopic placement of CE, interrupted view of major landmarks due to technical difficulty or significant amount of debris, and repeat CE using same system. Basic demographics, comorbidities, medications, baseline bowel habits, and previous surgeries were reviewed. Timing of major landmarks in CE were recorded, and used to calculate gastric transit time, small bowel transit time, and total recording time. A complete CE study was defined as visualization of cecum. Transit times and completion rates were compared. RESULTS: Four hundred and eight patients, including 208 (51.0%) males, were included for analysis. The mean age was 55.5 ± 19.3 years. The most common indication for CE was gastrointestinal bleeding (n = 254, 62.3%), followed by inflammatory bowel disease (n = 86, 21.1%). There was no difference in gastric transit times (group difference 0.90, 95%CI: 0.72-1.13, P = 0.352) and small bowel transit times (group difference 1.07, 95%CI: 0.95-1.19, P = 0.261) between SB2U and SB2, but total recording time was about 14% longer in the SB2U group (95%CI: 10%-18%, P < 0.001) and there was a corresponding trend toward higher completion rate (88.2% vs 93.2%, OR = 1.78, 95%CI 0.88-3.63, P = 0.111). There was no statistically significant difference in the rates of positive findings (OR = 0.98, 95%CI: 0.64-1.51, P = 0.918). CONCLUSION: Extending the operating time of CE may be a simple method to improve completion rate although it does not affect the rate of positive findings.

Ou, George; Shahidi, Neal; Galorport, Cherry; Takach, Oliver; Lee, Terry; Enns, Robert

2015-01-01

77

Effect of caffeine on the expression of a major X-ray induced protein in human tumor cells  

SciTech Connect

We have examined the effect of caffeine on the concomitant processes of the repair of potentially lethal damage (PLD) and the synthesis of X-ray-induced proteins in the human malignant melanoma cell line, Ul-Mel. Caffeine administered at a dose of 5mM after X radiation not only inhibited PLD repair but also markedly reduced the level of XIP269, a major X-ray-induced protein whose expression has been shown to correlate with the capacity to repair PLD. The expression of the vast majority of other cellular proteins, including seven other X-ray-induced proteins, remained unchanged following caffeine treatment. A possible role for XIP269 in cell cycle delay following DNA damage by X irradiation is discussed.

Hughes, E.N.; Boothman, D.A. (Univ. of Pennsylvania School of Medicine, Philadelphia (USA))

1991-03-01

78

Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding  

PubMed Central

AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration (cases) and 60 matched patients with a non-bleeding peptic ulcer (controls) underwent small bowel capsule endoscopy, after a negative colonoscopy (compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowel lesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy. RESULTS: Forty (67%) cases and 18 (30%) controls presented small bowel erosions (P = 0.0001), while 22 (37%) cases and 4 (8%) controls presented small bowel ulcers (P < 0.0001). Among non-steroidal anti-inflammatory drug (NSAID) consumers, 39 (95%) cases and 17 (33%) controls presented small bowel erosions (P < 0.0001), while 22 (55%) cases and 4 (10%) controls presented small bowel ulcers (P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3 (SD = 1.4) g/dL in cases with small bowel ulcerative lesions and 10.5 (SD = 1.3) g/dL in those without (P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6 (27%) cases with small bowel ulcers presented bleeding recurrence most possibly attributed to small bowel ulcers, nevertheless 30-d mortality was zero. Presence of chronic obstructive lung disease and diabetes was related with unexplained recurrence of hemorrhage in logistic regression analysis, while absence of small bowel ulcers was protective (relative risk 0.13, P = 0.05). CONCLUSION: Among NSAID consumers, more bleeders than non-bleeders with peptic ulcers present small bowel ulcers; lesions related to more severe bleeding and unexplained episodes of bleeding recurrence. PMID:25512771

Tsibouris, Panagiotis; Kalantzis, Chissostomos; Apostolopoulos, Periklis; Zalonis, Antonios; Isaacs, Peter Edward Thomas; Hendrickse, Mark; Alexandrakis, Georgios

2014-01-01

79

[Acute small bowel obstruction: conservative or surgical treatment?].  

PubMed

Small bowel obstruction (SBO) is a common clinical syndrome caused mainly by postoperative adhesions. In complement to clinical and biological evaluations, CT scan has emerged as a valuable imaging modality and may provide reliable information. The early recognition of signs suggesting bowel ischemia is essential for urgent operation. However appropriate management of SBO remains a common clinical challenge. Although a conservative approach can be successful in a substantial percentage of selected patients, regular and close re-assessement is mandatory. Any persistance or progression of the critical symptoms and signs should indeed lead to surgical exploration. Here we review the principles of adhesive SBO management and suggest a decision procedure for conservative versus surgical treatment. PMID:21815533

Schwenter, F; Dominguez, S; Meier, R; Oulhaci-de Saussure, W; Platon, A; Gervaz, P; Morel, P

2011-06-22

80

Percutaneous needle decompression in treatment of malignant small bowel obstruction  

PubMed Central

AIM: To investigate the efficacy and safety of percutaneous needle decompression in the treatment of malignant small bowel obstruction (MSBO). METHODS: A prospective analysis of the clinical data of 52 MSBO patients undergoing percutaneous needle decompression was performed. RESULTS: Percutaneous needle decompression was successful in all 52 patients. Statistically significant differences were observed in symptoms such as vomiting, abdominal distension and abdominal pain before and after treatment (81.6% vs 26.5%, 100% vs 8.2%, and 85.7% vs 46.9%, respectively; all P < 0.05). The overall significantly improved rate was 19.2% (11/52) and the response rate was 94.2% (49/52) using decompression combined with nasal tube placement, local arterial infusion of chemotherapy and nutritional support. During the one-month follow-up period, puncture-related complications were acceptable. CONCLUSION: Percutaneous needle intestinal decompression is a safe and effective palliative treatment for MSBO. PMID:25741156

Jiang, Ting-Hui; Sun, Xian-Jun; Chen, Yue; Cheng, Hui-Qin; Fang, Shi-Ming; Jiang, Hao-Sheng; Cao, Yan; Liu, Bing-Yan; Wu, Shao-Qiu; Mao, Ai-Wu

2015-01-01

81

Direct nano-scale patterning of Ag films using hard X-ray induced oxidation.  

PubMed

The morphological change of silver nano-particles (AgNPs) exposed to an intense synchrotron X-ray beam was investigated for the purpose of direct nano-scale patterning of metal thin films. AgNPs irradiated by hard X-rays in oxygen ambient were oxidized and migrated out of the illuminated region. The observed X-ray induced oxidation was utilized to fabricate nano-scale metal line patterns using sectioned WSi2/Si multilayers as masks. Lines with a width as small as 21 nm were successfully fabricated on Ag films on silicon nitride. Au/Ag nano-lines were also fabricated using the proposed method. PMID:25537602

Kim, Jae Myung; Lee, Su Yong; Kang, Hyon Chol; Noh, Do Young

2015-01-01

82

Note: Loading method of molecular fluorine using x-ray induced chemistry  

SciTech Connect

We have successfully loaded molecular fluorine into a diamond anvil cell at high pressure using the synchrotron x-ray induced decomposition of perfluorohexane (C{sub 6}F{sub 14}). “White” x-ray radiation from the Advanced Photon Source was used to initiate the chemical decomposition of C{sub 6}F{sub 14}, which resulted in the in situ production of F{sub 2} as verified via Raman spectroscopy. Due to the toxic nature of fluorine, this method will offer significant advantages in the ability to easily load a relatively nontoxic and inert substance into a chamber (such as a diamond anvil cell) that, when sealed with other reactants and irradiate with hard x-rays (>7 keV), releases highly reactive and toxic fluorine into the sample/reaction chamber to enable novel chemical synthesis under isolated and/or extreme conditions.

Pravica, Michael, E-mail: pravica@physics.unlv.edu; Sneed, Daniel; White, Melanie; Wang, Yonggang [High Pressure Science and Engineering Center (HiPSEC) and Department of Physics and Astronomy, University of Nevada, Las Vegas (UNLV), Las Vegas, Nevada 89154-4002 (United States)

2014-08-15

83

Exocrine pancreatic function following proximal small bowel resection in rats.  

PubMed Central

1. In order to assess if proximal enterectomy induces changes in the function of the exocrine pancreas, the exocrine pancreas was studied 1 week, 4 weeks, and 6 months after 50 or 75% proximal small bowel resection. 2. One week after 50 and 75% proximal small bowel resections, basal pancreatic bicarbonate outputs, studied by means of an external pancreatic fistula in conscious rats, were increased significantly over control values by 43 and 78% respectively. Four weeks after a 75% resection, the bicarbonate output was still significantly higher in resected animals than in sham operated animals. 3. The increase of volume and bicarbonate of the basal pancreatic secretion coincided with a 4-fold increase in plasma secretin concentration 1 week after resection. Both increased pancreatic secretion and plasma secretin concentration were transient. 4. The pancreatic hypersecretion was specifically reversed to control values with an I.P. injection of jejunoileal mucosa homogenate. 5. Serum gastrin and somatostatin values in intestinal mucosa and pancreas were not changed 1 and 4 weeks after enterectomy compared with sham operated animals. 6. The weight of the pancreas and its content of DNA were unaltered by resection. Amylase and chymotrypsinogen per gram pancreatic tissue and per microgram DNA were reduced 4 weeks following resections as compared with sham operated rats. After 6 months, chymotrypsinogen appeared further reduced in resected animals. 7. It is concluded that extensive proximal enterectomy in rats produced early, transient and marked increases in basal pancreatic water and bicarbonate secretion and in plasma secretin due to the loss of jejunoileal inhibitor(s), and a selective decrease in certain enzymes in pancreatic tissue. PMID:6121911

Gelinas, M D; Morin, C L; Morisset, J

1982-01-01

84

Multiple singing magnet ingestion leading to pressure necrosis of the small bowel  

PubMed Central

Multiple Magnet ingestion may cause a number of sinister complications. We report a case of multiple singing magnets ingestion by a 2-year-old girl resulting in intestinal obstruction and pressure necrosis of the small bowel. A bunch of seven magnets present in the small bowel was removed operatively.

Mirza, M. Bilal; Bux, Nabi; Talat, Nabila; Saleem, Muhammad

2015-01-01

85

Multiple singing magnet ingestion leading to pressure necrosis of the small bowel.  

PubMed

Multiple Magnet ingestion may cause a number of sinister complications. We report a case of multiple singing magnets ingestion by a 2-year-old girl resulting in intestinal obstruction and pressure necrosis of the small bowel. A bunch of seven magnets present in the small bowel was removed operatively. PMID:25829675

Mirza, M Bilal; Bux, Nabi; Talat, Nabila; Saleem, Muhammad

2015-01-01

86

Closed perforation of the small bowel secondary to a phytobezoar: imaging findings  

Microsoft Academic Search

Small bowel perforation secondary to phytobezoars is a rare clinical entity, which is not well-documented in the radiological literature. Sonographic and com- puted tomography (CT) findings of a case of closed small bowel perforation secondary to phytobezoars in a patient with previous gastric surgery are present- ed. Both abdominal ultrasound and CT examinations revealed a collection containing air at the

Suna Özhan Oktar; Cem Yücel; Esra Aslan; Hakan Özdemir

87

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.  

PubMed

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Guideline was also reviewed and endorsed by the British Society of Gastroenterology (BSG). It addresses the roles of small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders. Main recommendations 1 ESGE recommends small-bowel video capsule endoscopy as the first-line investigation in patients with obscure gastrointestinal bleeding (strong recommendation, moderate quality evidence). 2 In patients with overt obscure gastrointestinal bleeding, ESGE recommends performing small-bowel capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 days, in order to maximize the diagnostic yield (strong recommendation, moderate quality evidence). 3 ESGE does not recommend the routine performance of second-look endoscopy prior to small-bowel capsule endoscopy; however whether to perform second-look endoscopy before capsule endoscopy in patients with obscure gastrointestinal bleeding or iron-deficiency anaemia should be decided on a case-by-case basis (strong recommendation, low quality evidence). 4 In patients with positive findings at small-bowel capsule endoscopy, ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by capsule endoscopy (strong recommendation, high quality evidence). 5 ESGE recommends ileocolonoscopy as the first endoscopic examination for investigating patients with suspected Crohn's disease (strong recommendation, high quality evidence). In patients with suspected Crohn's disease and negative ileocolonoscopy findings, ESGE recommends small-bowel capsule endoscopy as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known stenosis (strong recommendation, moderate quality evidence).ESGE does not recommend routine small-bowel imaging or the use of the PillCam patency capsule prior to capsule endoscopy in these patients (strong recommendation, low quality evidence). In the presence of obstructive symptoms or known stenosis, ESGE recommends that dedicated small bowel cross-sectional imaging modalities such as magnetic resonance enterography/enteroclysis or computed tomography enterography/enteroclysis should be used first (strong recommendation, low quality evidence). 6 In patients with established Crohn's disease, based on ileocolonoscopy findings, ESGE recommends dedicated cross-sectional imaging for small-bowel evaluation since this has the potential to assess extent and location of any Crohn's disease lesions, to identify strictures, and to assess for extraluminal disease (strong recommendation, low quality evidence). In patients with unremarkable or nondiagnostic findings from such cross-sectional imaging of the small bowel, ESGE recommends small-bowel capsule endoscopy as a subsequent investigation, if deemed to influence patient management (strong recommendation, low quality evidence). When capsule endoscopy is indicated, ESGE recommends use of the PillCam patency capsule to confirm functional patency of the small bowel (strong recommendation, low quality evidence). 7 ESGE strongly recommends against the use of small-bowel capsule endoscopy for suspected coeliac disease but suggests that capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy (strong recommendation, low quality evidence). PMID:25826168

Pennazio, Marco; Spada, Cristiano; Eliakim, Rami; Keuchel, Martin; May, Andrea; Mulder, Chris J; Rondonotti, Emanuele; Adler, Samuel N; Albert, Joerg; Baltes, Peter; Barbaro, Federico; Cellier, Christophe; Charton, Jean Pierre; Delvaux, Michel; Despott, Edward J; Domagk, Dirk; Klein, Amir; McAlindon, Mark; Rosa, Bruno; Rowse, Georgina; Sanders, David S; Saurin, Jean Christophe; Sidhu, Reena; Dumonceau, Jean-Marc; Hassan, Cesare; Gralnek, Ian M

2015-04-01

88

[A Case of Small Bowel Diffuse Large B-cell Lymphoma Mimicking Crohn's Disease].  

PubMed

A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn's disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn's disease. PMID:25896159

Koo, Tae Hyoung; Choi, Won Jong; Han, Seung Hee; Kim, Su Young; Lee, Jong Hun

2015-04-25

89

Small bowel capsule endoscopy: Where are we after almost 15 years of use?  

PubMed Central

The development of capsule endoscopy (CE) in 2001 has given gastroenterologists the opportunity to investigate the small bowel in a non-invasive way. CE is most commonly performed for obscure gastrointestinal bleeding, but other indications include diagnosis or follow-up of Crohn’s disease, suspicion of a small bowel tumor, diagnosis and surveillance of hereditary polyposis syndromes, Nonsteroidal anti-inflammatory drug-induced small bowel lesions and celiac disease. Almost fifteen years have passed since the release of the small bowel capsule. The purpose of this review is to offer the reader a brief but complete overview on small bowel CE anno 2014, including the technical and procedural aspects, the possible complications and the most important indications. We will end with some future perspectives of CE. PMID:25610531

Van de Bruaene, Cedric; De Looze, Danny; Hindryckx, Pieter

2015-01-01

90

Thrombocytosis and small bowel perforation: unusual presentation of abdominopelvic actinomycosis.  

PubMed

Intrauterine devices (IUD) are frequently used as a family planning procedure in developing countries because they are easy to administer and governmental policies support their use in many countries. It is recommended that IUDs be removed or replaced after 10 years, but longer use is common, especially in developing countries. In some cases, rare infections such as pelvic inflammatory diseases, pelvic tuberculosis, or abdominopelvic actinomycosis related to IUD can develop. Pelvic actinomycosis is a rare disease and is often diagnosed incidentally during surgery. In recent years, there has been an increase in actinomycotic infections mostly due to long-term usage of IUD and forgotten intravaginal pessaries. It usually develops as an ascending infection. It is usually associated with non-specific symptoms such as lower abdominal pain, menstrual disturbances, fever, and vaginal discharge. The disease is sometimes asymptomatic. The rate of accurate preoperative diagnosis for pelvic actinomycosis is less than 10%, and symptoms and imaging studies sometimes mimic pelvic malignancy. This report details a case with abdominopelvic actinomycosis associated with an IUD presenting with highly elevated thromboctye count and small bowel perforation with abscess formation. PMID:24334952

Desteli, Güldeniz Aksan; Gürsu, Tvrkan; Bircan, Hüseyin Yüce; K?z?lk?l?ç, Ebru; Demiralay, Ebru; Timurkaynak, Funda

2013-12-01

91

Protective effect of ethanol on X-ray-induced mitotic recombination in drosophilia melanogaster  

SciTech Connect

The effect of ethanol treatment on X-ray-induced mitotic recombination in D. melanogaster females was investigated by means of the white/white{sup +} w/w{sup +} spot test. White females inseminated by yellow males were allowed to oviposit for 8 hr on medium containing 5%, 7.5% and 10% (v/v) ethanol and submitted to 10 Gy of X-rays 52 hr after the beginning of the egg laying period (chronic treatments). For acute treatments 56 {+-}4-hr-old larvae grown in regular medium were held in petri dishes containing filter paper soaked with 50% (v/v) ethanol for 30 min before being irradiated with 10 Gy. The emerging heterozygous w/w{sup +} females were inspected for the presence of white spots (LS) in their eyes. Acute ethanol pretreatments lead to a significant reduction in the frequency of LS. This is suggested to be due to the scavenging by ethanol of free radicals originating during irradiation. If so, the contribution of the indirect action of radiation to mitotic recombination induced by X-rays must be significant. Chronic ethanol pretreatments also resulted in a decrease of LS, though impairment of larval development by ethanol may have partly contributed to the effect observed. At the concentrations tested, ethanol by itself did not modify the frequency of LS observed in the control. 29 refs., 4 tabs.

Palermo, A.M.; Rey, M.; Munoz, E.R. [Comision Nacional de Energia Atomica, Buenos Aires (Argentina)

1994-12-31

92

High resistance of cultured Mongolian gerbil cells to X-ray-induced killing and chromosome aberrations.  

PubMed

The Mongolian gerbil (Meriones unguiculatus) is known to be one of the most radioresistant animals. We have examined the X-ray sensitivity of normal diploid fibroblasts from Mongolian gerbil embryos compared with those of cultured embryo cells obtained from various laboratory animals and a normal human. There was a wide difference in X-ray sensitivity for cell killing among different mammalian species. The D0 values for Mongolian gerbil cells ranged from 2.08 to 2.28 Gy, values which are twice as high as those for human cells. The mean D0 value for human cells was 1.06 Gy. Mouse, rat, Chinese hamster, and Syrian/golden hamster cells showed similar D0 values ranging from 1.30 to 1.56 Gy. When cells were irradiated with X rays, ten times more chromosome aberrations were detected in human cells than in Mongolian gerbil cells. The frequencies of chromosome aberrations in other rodent cells were between the values for cells from humans and those from gerbils. These data indicate that the Mongolian gerbil cells are resistant to X-ray-induced cell killing and chromosome aberrations, and that the radiation sensitivity of mammalian cells in primary culture may be reflected by their radioresistance in vivo. PMID:1438686

Suzuki, F; Nakao, N; Nikaido, O; Kondo, S

1992-09-01

93

Femtosecond X-ray induced electron kinetics in dielectrics: application for FEL-pulse-duration monitor  

NASA Astrophysics Data System (ADS)

Modern X-ray free-electron lasers (FELs) provide pulses with photon energies from a few tens of eV up to the tens of keV and durations as short as only a few femtoseconds. Experimental pump-probe scheme with a FEL pump and a visible light probe of a solid-state target can be used for the pulse-duration monitor on a shot-to-shot basis. To study the electron cascading in different materials used for pulse-duration monitor, XCASCADE, a Monte Carlo model of the X-ray-induced electron cascading within an irradiated target is developed. It is shown here that the electron cascade duration is sensitive to a choice of material. An appropriately selected target can significantly shorten the electron relaxation times. The grounds, upon which such a choice of the material can be made, are discussed. The results suggest that for photon energies of 24 keV, one could achieve direct monitoring of the pulse duration of 40 fs. Further deconvolution of the electron density into the contribution from the pulse itself and from the secondary cascading can increase the resolution up to a scale of a femtosecond.

Medvedev, Nikita

2015-03-01

94

Crucial role of thyroid hormone in x-ray-induced neoplastic transformation in cell culture  

SciTech Connect

Incubation of mouse embryo fibroblasts (C3H/10T1/2) in media depleted of thyroidhormone for 1 week rendered the cells completely resistant to the trnsforming action of an x-ray dose, 4 grays, that yields transformation frequencies (no. foci per surviving cells) of approx. = 10kc in media supplemented with triiodothyronine (T3) (1 nM). Studies on the timing of the additions or removal of the hormone indicate that T3 was maximally effective when added 12 hr before irradiation and that progression from the time of irradiation to the appearance of foci (6 weeks) was independent of the presence or absence of the hormone. The dependence of x-ray-induced transformation on the concentration of T3 in the medium was virtually the same as that for augmentation of Na/sup +/, K/sup +/-ATPase activity. The latter effect was used as a measure of T3 induction of protein synthesis in the process is the abolition of T3- and x-ray-dependent transformation by cycloheximide at a concentration (100 ng/ml) that inhibits 50% of protein synthesis. We propose that thyroid hormone induces the synthesis of a host protein that is an obligatory participant in x-ray-mediated transformation.

Guernsey, D.L.; Borek, C.; Edelman, I.S.

1981-09-01

95

Crucial role of thyroid hormone in x-ray-induced neoplastic transformation in cell culture.  

PubMed Central

Incubation of mouse embryo fibroblasts (C3H/10T1/2) in media depleted of thyroid hormone for 1 week rendered the cells completely resistant to the transforming action of an x-ray dose, 4 grays, that yields transformation frequencies (no. foci per surviving cells) of approximately 10(-3) in media supplemented with triiodothyronine (T3) (1 nM). Studies on the timing of the additions or removal of the hormone indicate that T3 was maximally effective when added 12 hr before irradiation and that progression from the time of irradiation to the appearance of foci (6 weeks) was independent of the presence or absence of the hormone. The dependence of x-ray-induced transformation on the concentration of T3 in the medium was virtually the same as that for augmentation of Na+,K+-ATPase activity. The latter effect was used as a measure of T3 induction of protein synthesis. A further indication of the involvement of protein synthesis in the process is the abolition of T3- and x-ray-dependent transformation by cycloheximide at a concentration (100 ng/ml) that inhibits 50% of protein synthesis. We propose that thyroid hormone induces the synthesis of a host protein that is an obligatory participant in x-ray-mediated transformation. PMID:6272314

Guernsey, D L; Borek, C; Edelman, I S

1981-01-01

96

Small bowel obstruction in the emergency department: MDCT features of common and uncommon causes.  

PubMed

Small bowel obstruction is a common condition encountered by the radiologist in the emergency department. Though intestinal adhesions and obstructed hernias are the most common causes of acute small bowel obstruction, a variety of uncommon and rare conditions can cause acute and subacute bowel obstruction. Imaging plays a key role in the workup of bowel obstruction by identifying the cause, level, and degree of bowel obstruction. In this article, we present a comprehensive review of the multi-detector computed tomography features of common and uncommon causes of acute and subacute small bowel obstruction. PMID:24861419

Tirumani, Harika; Vassa, Ravi; Fasih, Najla; Ojili, Vijayanadh

2014-01-01

97

Multislice computed tomography angiography findings of chronic small bowel volvulus with jejunal diverticulosis.  

PubMed

A volvulus, which is torsion of the bowel and its mesentery, is a medical emergency. Small bowel volvulus rarely occurs in adults, although it has been reported in the presence of small bowel diverticulum. Multislice computed tomography (CT) angiography, by demonstrating the mesenteric vessels, can be of help in the diagnosis of small bowel volvulus, especially when CT or gastrointestinal studies fail to show the diverticulum. We present the multislice CT angiography findings of a 64-year-old woman with chronic intermittent volvulus resulting from jejunal diverticulosis, surgically confirmed. To our knowledge, no similar case has been reported previously in the literature. PMID:20661698

Li, Xiao-Bing; Guan, Wen-Xian; Gao, Yuan

2010-07-01

98

Glucagon in the scintigraphic diagnosis of small-bowel hemorrhage by Tc-99m-labeled red blood cells  

SciTech Connect

Twelve patients undergoing scintigraphy with Tc-99m-labeled red blood cells (RBC) exhibited abnormal small-bowel activity and were given glucagon to assess its role in detecting bleeding from the small bowel. Six demonstrated focal accumulation of activity which was not identified prior to glucagon. Endoscopy, barium studies, angiography, and colonoscopy located the small-bowel bleeding site in 4 patients; in the other 2, studies of the colon failed to show the bleeding site and the origin was presumed to be the small bowel. The authors suggest that intravenous glucagon can be beneficial as an adjuvant to Tc-99m-RBC when diagnosing bleeding from the small bowel.

Froelich, J.W.; Juni, J.

1984-04-01

99

Sclerosing mesenteritis presenting with small bowel obstruction and subsequent retroperitoneal fibrosis.  

PubMed

Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery of unknown aetiology. It poses a diagnostic challenge for clinicians, as it can be mistaken for malignancy. We report a case of sclerosing mesenteritis initially presented with abdominal pain, tender abdominal mass and small bowel obstruction. Emergency laparotomy revealed fibrous thickening of the small bowel mesentery mimicking small bowel lymphoma. An ileo-ileal bypass procedure was performed. Six months later, the patient developed retroperitoneal fibrosis, manifesting as bilateral obstructive uropathy. Our case is unique, as it describes retroperitoneal fibrosis developing in a patient with small bowel retractile mesenteritis, with no evidence of colonic or other anatomical involvement. Furthermore, the patient had no risk factors for this condition. We conclude that the presence of sclerosing mesenteritis should cue clinicians to search for other coexisting inflammatory disorders that can have serious sequelae. PMID:17099377

Lim, Chung S; Singh Ranger, Gurpreet; Tibrewal, Saket; Jani, Bhautesh; Jeddy, Taleb A; Lafferty, Kevin

2006-12-01

100

X-ray-induced photo-chemistry and X-ray absorption spectroscopy of biological samples  

PubMed Central

As synchrotron light sources and optics deliver greater photon flux on samples, X-ray-induced photo-chemistry is increasingly encountered in X-ray absorption spectroscopy (XAS) experiments. The resulting problems are particularly pronounced for biological XAS experiments. This is because biological samples are very often quite dilute and therefore require signal averaging to achieve adequate signal-to-noise ratios, with correspondingly greater exposures to the X-ray beam. This paper reviews the origins of photo-reduction and photo-oxidation, the impact that they can have on active site structure, and the methods that can be used to provide relief from X-ray-induced photo-chemical artifacts. PMID:23093745

George, Graham N.; Pickering, Ingrid J.; Pushie, M. Jake; Nienaber, Kurt; Hackett, Mark J.; Ascone, Isabella; Hedman, Britt; Hodgson, Keith O.; Aitken, Jade B.; Levina, Aviva; Glover, Christopher; Lay, Peter A.

2012-01-01

101

Small bowel obstruction due to phytobezoar formation within meckel diverticulum: CT findings  

SciTech Connect

Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet. 14 refs., 2 figs.

Frazzini, V.I. Jr.; English, W.J.; Bashist, B.; Moore, E. [Columbia Univ. College of Physicians and Surgeons, New York, NY (United States)] [Columbia Univ. College of Physicians and Surgeons, New York, NY (United States)

1996-05-01

102

Foreign body ingestion of blister pill pack causing small bowel obstruction  

Microsoft Academic Search

We report a case of foreign body ingestion of a blister pill pack, causing small bowel obstruction. A 76-year-old woman on\\u000a multiple medications presented with 3 days of progressive abdominal distention, nausea, and vomiting. A computed tomography\\u000a (CT) scan demonstrated small bowel obstruction with a distinctive metallic foreign body in the distal ileum with associated\\u000a wall thickening and mesenteric inflammatory changes.

Angela W. Tai; Aaron Sodickson

2007-01-01

103

Malignant Peripheral Nerve Sheath Tumor of the Small Bowel: An Unusual Presentation with Fatal Outcome  

PubMed Central

Malignant peripheral nerve sheath tumor of the small bowel is an extremely rare disease. Histologic distinction from other types of soft tissue sarcoma especially fibrosarcoma and leiomyosarcoma requires electron microscopy. Complete surgery remains the only curative treatment. However, late diagnosis makes curative surgery more difficult. The contribution of chemotherapy to incomplete surgery has been proved without controlled studies. We report a case of this type of lesion discovered following a small bowel perforation. PMID:24066249

Mohtaram, Amina; Mesmoudi, Siham; M'rabti, Hind; Rami, Amal; Latib, Rachida; Bernoussi, Zakia; Aaribi, Imane; Ben Ameur El Youbi, Meryam; Errihani, Hassan

2013-01-01

104

Genetics of x-ray induced double strand break repair in saccharomyces cerevisiae  

SciTech Connect

The possible fates of x-ray-induced double-strand breaks in Saccharomyces cerevisiae were examined. One possible pathway which breaks can follow, the repair pathway, was studied by assaying strains with mutations in the RAD51, RAD54, and RAD57 loci for double-strand break repair. In order of increasing radiation sensitivity one finds: rad57-1(23/sup 0/)> rad51-1(30/sup 0/)> rad54-3(36/sup 0/). At 36/sup 0/, rad54-3 cells cannot repair double-strand breaks, while 23/sup 0/, they can. Strains with the rad57-1 mutation can rejoin broken chromosomes at both temperatures. However, the low survival at 36/sup 0/ shows that the assay is not distinguishing large DNA fragments which allow cell survival from those which cause cell death. A rad51-1 strain could also rejoin broken chromosomes, and was thus capable of incomplete repair. The data can be explained with the hypothesis that rad54-3 cells are blocked in an early step of repair, while rad51-1 and rad57-1 strains are blocked in a later step of repair. The fate of double-strand breaks when they are left unrepaired was investigated with the rad54-3 mutation. If breaks are prevented from entering the RAD54 repair pathway they become uncommitted lesions. These lesions are repaired slower than the original breaks. One possible fate for an uncommitted lesion is conversion into a fixed lesion, which is likely to be an unrepairable or misrepaired double-strand break. The presence of protein synthesis after irradiation increases the probability that a break will enter the repair pathway. Evidence shows that increased probability of repair results from enhanced synthesis of repair proteins shortly after radiation. (ERB)

Budd, M.E.

1982-07-01

105

Novel Single Nucleotide Polymorphism Markers for Low Dose Aspirin-Associated Small Bowel Bleeding  

PubMed Central

Background Aspirin-induced enteropathy is now increasingly being recognized although the pathogenesis of small intestinal damage induced by aspirin is not well understood and related risk factors have not been established. Aim To investigate pharmacogenomic profile of low dose aspirin (LDA)-induced small bowel bleeding. Methods Genome-wide analysis of single nucleotide polymorphisms (SNPs) was performed using the Affymetrix DMET™ Plus Premier Pack. Genotypes of candidate genes associated with small bowel bleeding were determined using TaqMan SNP Genotyping Assay kits and direct sequencing. Results In the validation study in overall 37 patients with small bowel bleeding and 400 controls, 4 of 27 identified SNPs: CYP4F11 (rs1060463) GG (p=0.003), CYP2D6 (rs28360521) GG (p=0.02), CYP24A1 (rs4809957) T allele (p=0.04), and GSTP1 (rs1695) G allele (p=0.04) were significantly more frequent in the small bowel bleeding group compared to the controls. After adjustment for significant factors, CYP2D6 (rs28360521) GG (OR 4.11, 95% CI. 1.62 -10.4) was associated with small bowel bleeding. Conclusions CYP4F11 and CYP2D6 SNPs may identify patients at increased risk for aspirin-induced small bowel bleeding. PMID:24367646

Shiotani, Akiko; Murao, Takahisa; Fujita, Yoshihiko; Fujimura, Yoshinori; Sakakibara, Takashi; Nishio, Kazuto; Haruma, Ken

2013-01-01

106

Factors associated with incomplete small bowel capsule endoscopy studies  

PubMed Central

AIM: To identify patient risk factors associated with incomplete small bowel capsule endoscopy (CE) studies. METHODS: Data from all CE procedures performed at St. Paul’s Hospital in Vancouver, British Columbia, Canada, between December 2001 and June 2008 were collected and analyzed on a retrospective basis. Data collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure, hospitalization, diabetes mellitus with or without end organ damage, limitations in mobility, renal insufficiency, past history of bowel obstruction, abdominal surgery, abdominal radiation therapy and opiate use. Risk factors were analyzed using a univariable and multivariable logistic regression model. RESULTS: From a total of 535 CE procedures performed, 158 were incomplete (29.5%). The univariable analysis showed that CE procedures performed for overt gastrointestinal bleeding (P = 0.002), and for patients with a prior history of abdominal surgery (P = 0.023) or bowel obstruction (P = 0.023) were significantly associated with incomplete CE studies. Patients on opiate medications (P = 0.094) as well as hospitalized patients (P = 0.054) were not statistically significant, but did show a trend towards incomplete CE. The multivariable analysis showed that independent risk factors for an incomplete CE procedure include prior history of bowel obstruction [odds ratios (OR) 2.77, P = 0.02, 95% confidence intervals (CI): 1.17-6.56] and procedures performed for gastrointestinal bleeding (Occult OR 2.04, P = 0.037, 95% CI: 1.04-4.02 and Overt OR 2.69, P = 0.002, 95% CI: 1.44-5.05). Patients with a prior history of abdominal surgery (OR 1.46, P = 0.068, 95% CI: 0.97-2.19), those taking opiate medications (OR 1.54, P = 0.15, 95% CI: 0.86-2.76) and hospitalized patients (OR 1.82, P = 0.124, 95% CI: 0.85-3.93) showed a trend towards statistical significance. CONCLUSION: We have identified a number of risk factors for incomplete CE procedures that can be used to risk-stratify patients and guide interventions to improve completion rates. PMID:21072896

Lee, Mitchell M; Jacques, Andrew; Lam, Eric; Kwok, Ricky; Lakzadeh, Pardis; Sandhar, Ajit; Segal, Brandon; Svarta, Sigrid; Law, Joanna; Enns, Robert

2010-01-01

107

NADPH oxidase-mediated generation of reactive oxygen species: A new mechanism for X-ray-induced HeLa cell death  

SciTech Connect

Oxidative damage is an important mechanism in X-ray-induced cell death. Radiolysis of water molecules is a source of reactive oxygen species (ROS) that contribute to X-ray-induced cell death. In this study, we showed by ROS detection and a cell survival assay that NADPH oxidase has a very important role in X-ray-induced cell death. Under X-ray irradiation, the upregulation of the expression of NADPH oxidase membrane subunit gp91{sup phox} was dose-dependent. Meanwhile, the cytoplasmic subunit p47{sup phox} was translocated to the cell membrane and localized with p22{sup phox} and gp91{sup phox} to form reactive NADPH oxidase. Our data suggest, for the first time, that NADPH oxidase-mediated generation of ROS is an important contributor to X-ray-induced cell death. This suggests a new target for combined gene transfer and radiotherapy.

Liu Qing [Department of Radiobiology, Institute of Modern Physics, Chinese Academy of Sciences, 509 Nanchang Rd., Lanzhou 730000 (China); Key Laboratory of Heavy Ion Radiation Medicine of Gansu Province, 509 Nanchang Rd., Lanzhou 730000 (China); He Xiaoqing [First Affiliated Hospital of Lanzhou University, 1 Donggang West Rd., Lanzhou 730000 (China); Liu Yongsheng [Key Laboratory of Animal Virology of Ministry of Agriculture, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural, 1 Xujiaping Rd., Lanzhou 730046 (China); Du Bingbing; Wang Xiaoyan [College of Medicine, Lanzhou University, 222, South Tianshui Rd., Lanzhou 730000 (China); Zhang Weisheng [Gansu Province People's Hospital, 160 Donggang West Rd., Lanzhou 730000 (China); Jia Pengfei [Institute of Cell Biology, School of Life Science, Lanzhou University, 222, South Tianshui Rd., Lanzhou 730000 (China); Dong Jingmei [Institute of Sports Medicine, Lanzhou City University, Jiefang Rd., Lanzhou 730070 (China); Ma Jianxiu [College of Medicine, Northwest University for Nationalities, 1 Northwest New Village, Lanzhou 730030 (China); Wang Xiaohu [Department of Radiology, Gansu Province Cancer Hospital, 2 Xiaoxihu East Rd., Lanzhou 730050 (China); Li Sha [Department of Radiology, Lanzhou General Hospital of PLA, 98 Xiaoxihu West Rd., 730050 (China); Zhang Hong [Department of Radiobiology, Institute of Modern Physics, Chinese Academy of Sciences, 509 Nanchang Rd., Lanzhou 730000 (China); Key Laboratory of Heavy Ion Radiation Medicine of Gansu Province, 509 Nanchang Rd., Lanzhou 730000 (China)], E-mail: zhangh@impcas.ac.cn

2008-12-19

108

Outcome of small-bowel motor impairment in systemic sclerosis--a prospective manometric 5-yr follow-up  

Microsoft Academic Search

Objective. To assess the 5-yr course of small-bowel motor disorders, using manometry in patients with systemic sclerosis (SSc), and to investigate for an association between small-bowel motor dysfunction outcome and other clinical manifestations of SSc. Methods. Fasting and post-prandial motor activity of the small-bowel was systematically assessed in eight consecutive patients with SSc, using 24 h manometry: initially and at

I. Marie; P. Ducrotte ´; P. Denis; M.-F. Hellot; H. Levesque

2007-01-01

109

Small bowel diverticulosis in patient with early gastric cancer  

PubMed Central

Jejunal and ileal diverticula are rare in adults. Duodenal diverticula are five times more prevalent than jejunoileal diverticula. Most patients are asymptomatic. However, chronic symptoms including intermittent abdominal pain, flatulence, diarrhea and constipation are seen in 10%-30% of patients. Gastric cancer is the second most common cancer in South Korea and here we report a case of early gastric cancer with multiple duodenal and jejunal diverticula. A 67-year-old woman was admitted to Konkuk University Medical Center with chronic diarrhea and weight loss of 19 kg over 2 months. Following gastroduodenoscopy, we identified adenocarcinoma of the lower body of the stomach. On abdominopelvic computed tomography, diverticula of duodenum and jejunum were found. Patient underwent distal gastrectomy and gastroduodenostomy with lymphadenectomy. She was discharged on the tenth postoperative day without complications. PMID:25317417

Kim, Pyeong Su; Jung, Eun-Joo

2014-01-01

110

X-ray-induced cell death in the developing hippocampal complex involved neurons and requires protein synthesis  

SciTech Connect

Sprague-Dawley rats aged 1 or 15 days were irradiated with a single dose of 200 cGy X-rays and killed at different intervals from 3 to 48 hours (h). Dying cells were recognized by their shrunken and often fragmented nuclei and less damaged cytoplasm in the early stages. On the basis of immunocytochemical markers, dying cells probably represented a heterogeneous population which included neurons and immature cells. In rats aged 1 day the number of dying cells rapidly increased in the hippocampal complex with peak values 6 h after irradiation. This was following by a gentle decrease to reach normal values 48 h after irradiation. The most severely affected regions were the subplate and the cellular layer of the subiculum, gyrus dentatus and hilus, and the stratum oriens and pyramidale of the hippocampus (CA1 more affected than CA2, and this more affected than CA3). X-ray-induced cell death was abolished with an injection of cycloheximide (2 [mu]g/g i.p.) given at the time of irradiation. X-ray-induced cell death was not changed after the intraventicular administration of nerve growth factor (NGF; 10 [mu]g in saline) at the time of irradiation. Cell death was not induced by X-irradiation in rats aged 15 days. These results indicate that X-ray-induced cell death in the hippocampal complex of the developing rat is subjected to determinate temporal and regional patterns of vulnerability; it is an active process mediated by protein synthesis but probably not dependent on NGF. 60 refs., 5 figs.

Ferrer, I.; Serrano, T.; Alcantara, S.; Tortosa, A.; Graus, F.

1993-07-01

111

Capsule endoscopy retention as a helpful tool in the management of a young patient with suspected small-bowel disease  

PubMed Central

Capsule endoscopy is an easy and painless procedure permitting visualization of the entire small-bowel during its normal peristalsis. However, important problems exist concerning capsule retention in patients at risk of small bowel obstruction. The present report describes a young patient who had recurrent episodes of overt gastrointestinal bleeding of obscure origin, 18 years after small bowel resection in infancy for ileal atresia. Capsule endoscopy was performed, resulting in capsule retention in the distal small bowel. However, this event contributed to patient management by clearly identifying the site of obstruction and can be used to guide surgical intervention, where an anastomotic ulcer is identified. PMID:17451218

Kalantzis, Chryssostomos; Apostolopoulos, Periklis; Mavrogiannis, Panagiota; Theodorou, Dimitrios; Papacharalampous, Xenofon; Bramis, Ioannis; Kalantzis, Nikolaos

2007-01-01

112

Excess anticoagulation as a cause of small-bowel obstruction: a report of two cases  

PubMed Central

Spontaneous intramural haemorrhage is a rare cause of small-bowel obstruction, occurring most commonly in those who are anticoagulated. We describe two cases that presented with a history and imaging suggestive of small-bowel obstruction; both had International Normalized Ratios of above 10 on admission. The first case, a 62-year-old lady on warfarin for atrial fibrillation, was managed conservatively with good effect. In contrast, the second case, a 57-year-old gentleman on warfarin for his metallic aortic valve, underwent diagnostic laparotomy that revealed a 30-cm segment of proximal jejunum with spontaneous intramural haemorrhage. In this study, we emphasize the merit of conservative management for this rare cause of small-bowel obstruction. PMID:25858268

Creasy, Henrietta; Meleagros, Luke

2015-01-01

113

Ileo-colonic intussusception secondary to small-bowel lipomatosis: a case report.  

PubMed

Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%. Because the lipomas are diffusely distributed in the intestine, most patients are symptom-free, and invasive intervention is not advised by most doctors. Here, we describe a case with intussusception due to small-bowel lipomatosis. Partial small bowel resection and anastomosis were performed because the intestinal wall was on the verge of perforation. This case indicates that regular follow-up is necessary and endoscopic treatment should be considered to avoid surgical procedures if the lipoma is large enough to cause intestinal obstruction. PMID:24587685

Gao, Peng-Ji; Chen, Lei; Wang, Fu-Shun; Zhu, Ji-Ye

2014-02-28

114

Ileo-colonic intussusception secondary to small-bowel lipomatosis: A case report  

PubMed Central

Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%. Because the lipomas are diffusely distributed in the intestine, most patients are symptom-free, and invasive intervention is not advised by most doctors. Here, we describe a case with intussusception due to small-bowel lipomatosis. Partial small bowel resection and anastomosis were performed because the intestinal wall was on the verge of perforation. This case indicates that regular follow-up is necessary and endoscopic treatment should be considered to avoid surgical procedures if the lipoma is large enough to cause intestinal obstruction. PMID:24587685

Gao, Peng-Ji; Chen, Lei; Wang, Fu-Shun; Zhu, Ji-Ye

2014-01-01

115

Familial idiopathic small-bowel and colonic varices in three siblings.  

PubMed

Idiopathic small-bowel and colonic varices are a rare source of bleeding from the gastrointestinal tract. To date there are only eight published case series of familial idiopathic small-bowel and colonic varices. We present a case series detailing three affected siblings who presented with significant lower gastrointestinal bleeding and had multiple varices on endoscopy and imaging. Though not confirmed, consanguinity in the parents suggests an autosomal recessive mode of inheritance. We summarize the literature to date and describe our institution's experience of endoscopy, diagnostic imaging, and treatment in these patients. PMID:25036657

Boland, Paul; Leonard, Jennifer; Saunders, Michael; Bursey, Ford

2014-10-01

116

A rare case of small bowel obstruction secondary to ovarian torsion in an IVF pregnancy  

PubMed Central

A 39-?year-old woman, who conceived following in vitro fertilisation (IVF) treatment, presented at 12?weeks gestation with symptoms of ovarian hyperstimulation syndrome (OHSS), abdominal pain, vomiting and diarrhoea. Subsequent investigations found small bowel obstruction  secondary to ovarian torsion. Surgical management to remove a necrotic ovary and fallopian tube led to a good recovery from the acute illness. A postoperative ultrasound scan confirmed a viable pregnancy and the patient was discharged. Her case demonstrates a rare complication of OHSS and ovarian torsion leading to small bowel obstruction. PMID:23417952

Lazaridis, Alexandros; Maclaran, Kate; Behar, Nebil; Narayanan, Priya

2013-01-01

117

X-ray induced lock-in transition of cycloidal magnetic order in a multiferroic perovskite manganite  

NASA Astrophysics Data System (ADS)

We report the x-ray photoexcitation effects on cycloidal magnetic order in a multiferroic perovskite-type manganite Gd0.5Tb0.5MnO3 . The material exhibits a competition between the P (electric polarization )||a ferroelectric state with the commensurate (C) a b -plane cycloidal and the P ||c ferroelectric state with the incommensurate (IC) b c -plane cycloidal spin structure. The phase transition between these two phases can be induced by an application of a magnetic field. We found that the x-ray irradiation can induce the bidirectional and persistent phase transition between IC and C phases. The nonresonant x-ray magnetic diffraction revealed that both the initial and the x-ray induced phases have the b c -plane cycloidal magnetic structure, whereas the magnetic wave number varies between IC and C. The x-ray induced b c -plane cycloidal C phase is thus the hidden multiferroic phase in the Gd1 -xTbxMnO3 system, which does not show up with the application of any static field.

Yamasaki, Y.; Nakao, H.; Murakami, Y.; Nakajima, T.; Sampietro, A. Lafuente; Ohsumi, H.; Takata, M.; Arima, T.; Tokura, Y.

2015-03-01

118

/sup 20/neon ion- and x-ray-induced mammary carcinogenesis in female rats  

SciTech Connect

One of the proposed uses of heavy ion irradiation is to image lesions of the human female breast. The rat model system was chosen to assess the carcinogenic potential of heavy ion irradiation in the belief that data obtained from rat studies would have a qualitatively predictive value for the human female. Accordingly, female rats were exposed to /sup 20/Ne ions at the BEVALAC and studied for the development of mammary neoplasia for 312 +- 2 days at Brookhaven along with rats exposed concurrently to x-irradiation or to no irradiation. As the dose of either type of radiation was increased the percent of rats with mammary adenocarcinomas, and the percent of rats with mammary fibroadenomas, tended to increase. At a prevalence of 20%, the RBE for /sup 20/Neon ions for mammary adenocarcinomas was estimated to be larger than 5 and for mammary fibroadenomas the RBE was estimated to be less than 2. No conclusion was reached concerning whether or not the RBE might vary with dose. We suggest that /sup 20/Ne ions do have a carcinogenic potential for rat mammary tissue and that this carcinogenic potential is likely to be greater than for x-irradiation. (DT)

Shellabarger, C.J.; Baum, J.W.; Holtzman, S.; Stone, J.P.

1983-01-01

119

Progressive Increase of Bowel Wall Thickness Is a Reliable Indicator for Surgery in Patients With Adhesive Small Bowel Obstruction  

Microsoft Academic Search

PURPOSE: The aim of this study was to determine whether progressive increase of bowel wall thickness during nonoperative treatment is a reliable indicator for surgery in patients with adhesive small bowel obstruction. METHODS: The study consisted of a prospective case series of 121 patients with adhesive small bowel obstruction who underwent an abdominal ultrasonographic examination. The results of ultrasonographic examinations

Shyr-Chyr Chen; Chien-Chang Lee; Chiung-Yuan Hsu; Zui-Shen Yen; Cheng-Chung Fang; Matthew H.-M. Ma; Wen-Jone Chen; Hong-Shiee Lai; Po-Huang Lee; Fang-Yue Lin; Wei-Jao Chen

2005-01-01

120

Heads or tails, does it make a difference? Capsule endoscope direction in small bowel studies is important.  

PubMed

Capsule endoscopy has opened the small bowel for direct inspection. However, the diagnostic sensitivity of capsule endoscopy is not 100 %. We have observed that forward orientation and backward orientation of the camera in the small bowel provide different information on pathological findings. Double-head capsule endoscopy may offer the answer to this problem. PMID:17968808

Adler, S N; Metzger, Y C

2007-10-01

121

Towards a less costly but accurate test of gastric emptying and small bowel transit  

Microsoft Academic Search

Our aim is to develop a less costly but accurate test of stomach emptying and small bowel transit by utilizing selected scintigraphic observations 1–6 hr after ingestion of a radiolabeled solid meal. These selected data were compared with more detailed analyses that require multiple scans and labor-intensive technical support. A logistic discriminant analysis was used to estimate the sensitivity and

Michael Camilleri; Alan R. Zinsmeister; Martin P. Greydanus; Manuel L. Brown; Maritza Proano

1991-01-01

122

Sclerosing mesenteritis presenting with complete small bowel obstruction, abdominal mass and hydronephrosis.  

PubMed

Sclerosing mesenteritis is an uncommon and poorly understood inflammatory condition of the bowel mesentery which can often be confused with neoplasia, Crohn's disease and other inflammatory conditions. We describe a case of complete small bowel obstruction and right sided hydronephrosis due to sclerosing mesenteritis. PMID:20506043

Hassan, T; Balsitis, M; Rawlings, D; Shah, A A

2012-09-01

123

Treatment planning for colorectal cancer: radiation and surgical techniques and value of small-bowel films  

Microsoft Academic Search

For colorectal cancer, the adjuvant radiation dose levels required to achieve a high incidence of local control closely parallel the radiation tolerance of small bowel (4500-5000 rad), and for patients with partially resected or unresected disease, the dose levels exceed tolerance (6000-7000 rad). Therefore, both the surgeon and the radiation oncologist should use techniques that localize tumor volumes and decrease

Leonard L. Gunderson; Anthony H. Russell; Henry J. Llewellyn; Karen P. Doppke; Joel E. Tepper

1985-01-01

124

Small Bowel Perforation Secondary to Metastatic Lung Cancer: A Case Report and Review of the Literature  

Microsoft Academic Search

Small bowel perforation is a rare complication of metastatic lung cancer. We were able to document 35 such cases in the literature in English. Aggressive investigation and early surgery is the only method for providing palliation to these patients. However, morbidity and mortality remain high and the prognosis is dire.

GEORGE H. SAKORAFAS; GEORGE PAVLAKIS; KYRIAKOS D. GRIGORIADIS

125

Coffee Enema for Preparation for Small Bowel Video Capsule Endoscopy: A Pilot Study  

PubMed Central

Coffee enemas are believed to cause dilatation of bile ducts and excretion of bile through the colon wall. Proponents of coffee enemas claim that the cafestol palmitate in coffee enhances the activity of glutathione S-transferase, an enzyme that stimulates bile excretion. During video capsule endoscopy (VCE), excreted bile is one of the causes of poor preparation of the small bowel. This study aimed to evaluate the feasibility and effect of coffee enema for preparation of the small bowel during VCE. In this pilot study, 17 of 34 patients were assigned to the coffee enema plus polyethylene glycol (PEG) 2 L ingestion group, whereas the 17 remaining control patients received 2 L of PEG only. The quality of bowel preparation was evaluated in the two patient groups. Bowel preparations in the proximal segments of small bowel were not differ between two groups. In the mid and distal segments of the small intestine, bowel preparations tend to be better in patients who received coffee enemas plus PEG than in patients who received PEG only. The coffee enema group did not experience any complications or side effects. Coffee enemas may be a feasible option, and there were no clinically significant adverse events related to coffee enemas. More prospective randomized studies are warranted to improve small bowel preparation for VCE. PMID:25136541

Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

2014-01-01

126

Small Bowel Obstruction and Covered Perforation in Childhood Caused by Bizarre Bezoars and Foreign Bodies  

Microsoft Academic Search

Background: Small bowel obstruction with perforation is an unusual and rare complication of bezoars. Objective: To describe our use of emergency laparotomy to treat intestinal obstruction caused by bizarre bezoars. Conclusions: An aggressive surgical approach to intes- tinal obstruction in the pediatric disabled or mentally re- tarded population is recommended. IMAJ 2000;2:129-131 Bezoars are impactions of swallowed material along the

Idan Burstein; Ran Steinberg; Michael Zer

2000-01-01

127

Small bowel intussusception secondary to metastatic melanoma 15 years after complete excision of the primary tumor  

PubMed Central

INTRODUCTION Primary intestinal melanoma is a rare entity, however the gastrointestinal tract, and particularly the small bowel, is a common site of recurrence from cutaneous melanoma. PRESENTATION OF CASE We report the case of a 48 year old woman with small bowel intussusception secondary to metastatic cutaneous melanoma, 15 years after excision of the primary tumor. The patient underwent an emergency small bowel resection with negative margins on final pathology. DISCUSSION Surgical resection is a palliative, yet necessary, procedure in the setting of small bowel obstruction due to intussusception secondary to intestinal metastatic melanoma. In case of bowel metastasis, presenting symptoms are nonspecific and do not provide significant clues to the differential diagnosis of the underlying disease. In some patients, complete surgical resection of early diagnosed bowel metastases is associated with prolonged survival. Systemic chemotherapy in these patients does not provide survival benefit. CONCLUSION The occurrence of bowel relapse after very long disease free interval, while highly unlikely in most tumors, should always be considered in the differential diagnosis of patients with previous history of cutaneous malignant melanoma presenting with gastrointestinal symptoms. PMID:25506846

Vigorita, Vincenzo; Ausania, Fabio; Bertucci Zoccali, Marco; Alvarez, Cristina Facal; Nadal, Blanca De Urrutia; Nuñez, Jose Enrique Casal

2014-01-01

128

Differential reversal of drug-induced small bowel paralysis by cerulein and neostigmine  

Microsoft Academic Search

Objective: Cerulein and neostigmine are prokinetic drugs whose potency and effective dose range are barely known. The aim of this study was to assess their benefit for normal and compromised peristalsis. Design: In vitro, isolated segments of guinea pig small intestine. Setting : University laboratory. Interventions: Small bowel segments were mounted in tissue baths and luminally perfused with Tyrode solution.

Sonja Fruhwald; Eva Herk; Heinz F. Hammer; Peter Holzer; Helfried Metzler

2004-01-01

129

Non-invasive quantification of small bowel water content by MRI: a validation study  

NASA Astrophysics Data System (ADS)

Substantial water fluxes across the small intestine occur during digestion of food, but so far measuring these has required invasive intubation techniques. This paper describes a non-invasive magnetic resonance imaging (MRI) technique for measuring small bowel water content which has been validated using naso-duodenal infusion. Eighteen healthy volunteers were intubated, with the tube position being verified by MRI. After a baseline MRI scan, each volunteer had eight 40 ml boluses of a non-absorbable mannitol and saline solution infused into their proximal small bowel with an MRI scan being acquired after each bolus. The MRI sequence used was an adapted magnetic resonance cholangiopancreatography sequence. The image data were thresholded to allow for intra- and inter-subject signal variations. The MRI measured volumes were then compared to the known infused volumes. This MRI technique gave excellent images of the small bowel, which closely resemble those obtained using conventional radiology with barium contrast. The mean difference between the measured MRI volumes and infused volumes was 2% with a standard deviation of 10%. The maximum 95% limits of agreement between observers were -15% to +17% while measurements by the same operator on separate occasions differed by only 4%. This new technique can now be applied to study alterations in small bowel fluid absorption and secretion due to gastrointestinal disease or drug intervention.

Hoad, C. L.; Marciani, L.; Foley, S.; Totman, J. J.; Wright, J.; Bush, D.; Cox, E. F.; Campbell, E.; Spiller, R. C.; Gowland, P. A.

2007-12-01

130

Yeast mediates lactic acidosis suppression after antibiotic cocktail treatment in short small bowel?  

Microsoft Academic Search

During acidotic periods in a girl with a short small bowel, very high D-lactic acid concentrations were measured in blood and urine; the patient's characteristic faecal flora contained mainly lactobacilli, and during antibiotic cocktail treatment also many yeasts. In this case report we sought to understand the beneficial effect of the antibiotic cocktail. Microbiological analysis was performed in faecal samples.

G. P. A. Bongaerts; R. S. V. M. Severijnen; Daniela Skladal; J. A. J. Bakkeren; Wolfgang Sperl

2005-01-01

131

Glutamine Reduces Bacterial Translocation after Small Bowel Transplantation in Cyclosporine-Treated Rats  

Microsoft Academic Search

Bacterial translocation (BT) of enteric organisms is a major cause of sepsis in patients undergoing small bowel transplantation (SBT). Cyclosporine (CsA) may be toxic to intestinal epithelium and increase the risk of BT. Glutamine (Gln) is the preferred enterocyte fuel and maintains graft epithelial integrity in experimental SBT. This study determined the effects of CsA on mucosal structure and function

W. Zhang; W. L. Frankel; A. Bain; D. Choi; D. M. Klurfeld; J. L. Rombeau

1995-01-01

132

Note: Experiments in hard x-ray chemistry: In situ production of molecular hydrogen and x-ray induced combustion  

SciTech Connect

We have successfully loaded H{sub 2} into a diamond anvil cell at high pressure using the synchrotron x-ray induced decomposition of NH{sub 3}BH{sub 3}. In a second set of studies, radiation-assisted release of O{sub 2} from KCLO{sub 3}, H{sub 2} release from NH{sub 3}BH{sub 3}, and reaction of these gases in a mixture of the reactants to form liquid water using x-rays at ambient conditions was observed. Similar observations were made using a KCLO{sub 3} and NaBH{sub 4} mixture. Depending on reaction conditions, an explosive or far slower reaction producing water was observed.

Pravica, Michael; Bai Ligang; Liu Yu; Galley, Martin; Robinson, John [High Pressure Science and Engineering Center (HiPSEC) and Department of Physics, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada 89154-4002 (United States); Park, Changyong [HPCAT, Geophysical Laboratory, Carnegie Institution of Washington, 9700 South Cass Ave., Argonne, Illinois 60437 (United States); Hatchett, David [Department of Chemistry, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada 89154-4003 (United States)

2012-03-15

133

Effect of viscous fiber (guar) on postprandial motor activity in human small bowel.  

PubMed

Both caloric value and chemical composition of a meal have been shown to regulate postprandial small bowel motility in dog. In the same species, duration of and contractile activity within the postprandial period also depends on mean viscosity. It is unknown, however, whether meal viscosity and fiber content also regulate small bowel motor activity in man. In human volunteers, we therefore studied the effect of guar gum on small bowel motor response to liquid and solid meals. Twenty-six prolonged ambulatory small bowel manometry studies were performed in 12 volunteers. A total of 620 hr of recording were analyzed visually for phase III of the MMC and a validated computer program calculated the incidence and amplitude of contractions after ingestion of water (300 ml), a pure glucose drink (300 ml/330 kcal) or a solid meal (530 kcal) with and without 5 g of guar gum. Addition of 5 g of guar gum did not significantly delay reappearance of phase III after ingestion of water (59 +/- 11 vs 106 +/- 21 min; P = 0.09). However, guar gum significantly prolonged duration of postprandial motility pattern both after the glucose drink (123 +/- 19 vs 199 +/- 24 min; P < 0.05) and after the solid meal (310 +/- 92 vs 419 +/- 22 min; P = 0.005). Contractile activity during these periods was not affected by guar gum. This was true for mean incidence of contractions after water (1.9 +/- 0.3 vs 1.8 +/- 0.5 min-1), after the glucose drink (1.6 +/- 0.4 vs. 1.7 +/- 0.3 min-1) and after the solid meal (2.4 +/- 0.4 vs 2.6 +/- 0.4 min-1). Likewise, mean amplitude of contractions was not affected by guar gum after water (22.8 +/- 1.4 vs 20.9 +/- 1.9 mm Hg), after the glucose drink (20.5 +/- 1.4 vs 21.3 +/- 1.2), and after the solid meal (20.3 +/- 1.5 vs 21.5 +/- 1.6 mm Hg). Thus a guar gum-induced increase in chyme viscosity markedly prolonged duration of postprandial motor activity in the human small bowel. Contractile activity within the postprandial period, however, was not affected. We suggest that the postprandial motility pattern persisted longer after the more viscous meals, because gastric emptying and intestinal transit were delayed by guar gum. We conclude that it is essential to define meal viscosity and fiber contents when studying postprandial small bowel motility. PMID:9286225

Schönfeld, J; Evans, D F; Wingate, D L

1997-08-01

134

Radiation Dose-Volume Effects in the Stomach and Small Bowel  

SciTech Connect

Published data suggest that the risk of moderately severe (>=Grade 3) radiation-induced acute small-bowel toxicity can be predicted with a threshold model whereby for a given dose level, D, if the volume receiving that dose or greater (VD) exceeds a threshold quantity, the risk of toxicity escalates. Estimates of VD depend on the means of structure segmenting (e.g., V15 = 120 cc if individual bowel loops are outlined or V45 = 195 cc if entire peritoneal potential space of bowel is outlined). A similar predictive model of acute toxicity is not available for stomach. Late small-bowel/stomach toxicity is likely related to maximum dose and/or volume threshold parameters qualitatively similar to those related to acute toxicity risk. Concurrent chemotherapy has been associated with a higher risk of acute toxicity, and a history of abdominal surgery has been associated with a higher risk of late toxicity.

Kavanagh, Brian D., E-mail: Brian.Kavanagh@ucdenver.ed [Department of Radiation Oncology, University of Colorado-Denver School of Medicine, Aurora, CO (United States); Pan, Charlie C. [Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (United States); Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Das, Shiva K. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Ten Haken, Randall K.; Miften, Moyed [Department of Radiation Oncology, University of Colorado-Denver School of Medicine, Aurora, CO (United States)

2010-03-01

135

Peritonitis with small bowel perforation caused by a fish bone in a healthy patient.  

PubMed

Perforation of the gastrointestinal tract by ingested foreign bodies is extremely rare in otherwise healthy patients, accounting for < 1% of cases. Accidentally ingested foreign bodies could cause small bowel perforation through a hernia sac, Meckel's diverticulum, or the appendix, all of which are uncommon. Despite their sharp ends and elongated shape, bowel perforation caused by ingested fish bones is rarely reported, particularly in patients without intestinal disease. We report a case of 57-year-old female who visited the emergency room with periumbilical pain and no history of underlying intestinal disease or intra-abdominal surgery. Abdominal computed tomography and exploratory laparotomy revealed a small bowel micro-perforation with a 2.7-cm fish bone penetrating the jejunal wall. PMID:24587641

Choi, Yonghoon; Kim, Gyuwon; Shim, Chansup; Kim, Dongkeun; Kim, Dongju

2014-02-14

136

Small bowel perforation in a hernia sac after TVT placement at the time of colpocleisis.  

PubMed

Tension-free vaginal tape (TVT) is commonly considered as the first line of treatment for stress urinary incontinence (SUI) with demonstrated efficacy and limited complications. An 82-year-old woman with complete uterine procidentia and SUI underwent a Le Forte colpocleisis, TVT, posterior repair, and cystoscopy. A 4-cm bulge was noted over the site of the left TVT incision on postoperative day 1. On postoperative day 3, she developed bilious vomiting with slight abdominal distention. Computed tomography scan showed a strangulated left inguinal hernia. An immediate exploratory laparotomy noted an inguinal hernia displaced medially with loops of small bowel in the hernia sac. Although properly positioned, one loop of bowel was perforated by the sling mesh. A small bowel resection was performed and the mesh trimmed below the resection on involved side. At 2 months postoperative visit, the patient was asymptomatic, denied stress or urge incontinence. Vaginal examination noted well-supported vaginal walls. PMID:19641837

Gurshumov, Emil L; Klapper, Allan S; Sierecki, Ava R

2010-03-01

137

Congenital Internal Hernia Presented with Life Threatening Extensive Small Bowel Strangulation  

PubMed Central

Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation. PMID:24224153

Lee, Narae; Kim, Su-Gon; Park, Jae-Hong; Son, Seung-Kook; Kim, Soo-Hong; Hwang, Jae-Yeon

2013-01-01

138

Radiation-induced small bowel disease: latest developments and clinical guidance  

PubMed Central

Ionizing radiation is commonly used to treat a number of malignancies. Although highly effective and now more targeted, many patients suffer side effects. The number of cancer survivors has increased and so there are more patients presenting with symptoms that have arisen as a result of radiotherapy. Radiation damage to small bowel tissue can cause acute or chronic radiation enteritis producing symptoms such as pain, bloating, nausea, faecal urgency, diarrhoea and rectal bleeding which can have a significant impact on patient’s quality of life. This review outlines the pathogenesis of radiation injury to the small bowel along with the prevention of radiation damage via radiotherapy techniques plus medications such as angiotensin-converting enzyme inhibitors, statins and probiotics. It also covers the treatment of both acute and chronic radiation enteritis via a variety of medical (including hyperbaric oxygen), dietetic, endoscopic and surgical therapies. PMID:24381725

Stacey, Rhodri

2014-01-01

139

Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding  

PubMed Central

AIM: To retrospectively evaluate the diagnostic efficacy of interventional digital subtraction angiography (DSA) for bleeding small bowel gastrointestinal stromal tumors (GISTs). METHODS: Between January 2006 and December 2013, small bowel tumors in 25 consecutive patients undergoing emergency interventional DSA were histopathologically confirmed as GIST after surgical resection. The medical records of these patients and the effects of interventional DSA and the presentation and management of the condition were retrospectively reviewed. RESULTS: Of the 25 patients with an age range from 34- to 70-year-old (mean: 54 ± 12 years), 8 were male and 17 were female. Obscure gastrointestinal bleeding, including tarry or bloody stool and intermittent melena, was observed in all cases, and one case also involved hematemesis. Nineteen patients required acute blood transfusion. There were a total of 28 small bowel tumors detected by DSA. Among these, 20 were located in the jejunum and 8 were located in the ileum. The DSA characteristics of the GISTs included a hypervascular mass of well-defined, homogeneous enhancement and early developed draining veins. One case involved a complication of intussusception of the small intestine that was discovered during surgery. No pseudoaneurysms, arteriovenous malformations or fistulae, or arterial rupture were observed. The completely excised size was approximately 1.20 to 5.50 cm (mean: 3.05 ± 1.25 cm) in maximum diameter based on measurements after the resection. There were ulcerations (n = 8), erosions (n = 10), hyperemia and edema (n = 10) on the intra-luminal side of the tumors. Eight tumors in patients with a large amount of blood loss were treated with transcatheter arterial embolization with gelfoam particles during interventional DSA. CONCLUSION: Emergency interventional DSA is a useful imaging option for locating and diagnosing small bowel GISTs in patients with bleeding, and is an effective treatment modality. PMID:25548494

Chen, Yao-Ting; Sun, Hong-Liang; Luo, Jiang-Hong; Ni, Jia-Yan; Chen, Dong; Jiang, Xiong-Ying; Zhou, Jing-Xing; Xu, Lin-Feng

2014-01-01

140

Small bowell perforation and mesentery injury after an unusual blunt abdominal trauma–Case report  

PubMed Central

Introduction In blunt abdominal trauma, lesions of the small bowell and mesentery are often underdiagnosed; although unusual, they represent the third most injured organ, with increasing morbidity and mortality. Presentation of case The authors present the case of a 68 years old male, admitted to the emergency department after being hit by a bale of straw, weighing around 300 kg, in the abdomen. After successful ressuscitation, a CT scan was performed, suggesting hemoperitoneum because of vascular lesion of the right colon bleeding. An exploratory laparotomy was performed, confirming the presence of blood in the abdominal cavity and identifying jejunal perforation, an apparently innocent hematoma of the small bowel mesentery (beside the bowel wall) distally to the first lesion and a laceration of the sigmoid serosa; a segmental jejunal resection and suture of the colon serosa were performed. In the early post-operative period, an enteric discharge was noticed, mandating surgical reexploration; a previously unnoticed bowel perforation, in the mesenteric border where the hematoma was identified, justified an additional enterectomy, after what the patients recovery progressed uneventfully. Discussion In this case, a sudden increase in abdominal pressure could explain that missed rupture of the mesenteric border of the jejunum, also causing the mesenteric hematoma, or, in spite of that, a state of low perfusion could have lead to total wall ischemia of an already irrigation compromised segment. Only noted after surgical exploration, despite prior evaluation with a computed tomography. Small bowell and mesenteric injuries are potentially missed due to decreased exploratory laparotomies for blunt abdominal trauma. Conclusion Although uncommon, small bowel and mesenteric injuries are associated with high morbidity and mortality. High clinical suspicion is essential for an early diagnosis PMID:25576959

Pimenta de Castro, J.; Gomes, G.; Mateus, N.; Escrevente, R.; Pereira, L.; Jácome, P.

2014-01-01

141

Biochemical prognostic indicators for pancreatic neuroendocrine tumors and small bowel neuroendocrine tumors.  

PubMed

Pancreatic neuroendocrine tumors (PNETs) and small bowel neuroendocrine tumors (SBNETs) are rare tumors that are frequently diagnosed late in the course of the disease. Several biomarkers have been proposed in the literature as prognostic factors for patients with these tumors. This article discusses a recent publication in Annals of Surgical Oncology from the University of Iowa analyzing the effect of different biomarkers on survival in patients with PNETs and SBNETs. PMID:25493250

Landry, Christine S; Cavaness, Keith; Celinski, Scott; Preskitt, John

2014-11-01

142

Posttransplant lymphoproliferative disorder presenting as a small bowel obstruction in a patient with pancreas transplantation alone  

PubMed Central

Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication associated with the transplant recipient. We chronicle a case of PTLD in a failed graft presenting as a small bowel obstruction in a pancreas-only transplant patient. While typical symptoms may be elusive in the complex immunosuppressed patient, graft pain along with persistent graft pancreatitis and a positive Epstein-Barr viremia should raise suspicion for an underlying PTLD. PMID:25484508

Kruel, Cleber R.; Shiller, S. Michelle; Anthony, Tiffany L.; Goldstein, Robert M.; Kim, Peter T. W.; Levy, Marlon F.; McKenna, Gregory J.; Onaca, Nicholas; Testa, Giuliano; Klintmalm, Goran B.

2014-01-01

143

Atypical small bowel obstruction following repair of inguinal hernia: a case of intestinal stenosis of Garre.  

PubMed

We report an atypical case of small bowel obstruction 10 days after the repair of an inguinal hernia that had been recurrently reduced. A preoperative diagnosis of the rare intestinal stenosis of Garre is difficult, and was based on the clinical, operative and pathological findings. Forced reduction of a hernia is not recommended because of the risk of rendering its contents ischaemic with subsequent fibrotic stenosis, or reducing a strangulated bowel into the abdominal cavity with subsequent perforation and peritonitis. PMID:23796681

Weledji, Elroy P; Theophile, Nana

2013-04-01

144

Comparative analysis of adenosine triphosphate-magnesium chloride and allopurinol following small-bowel ischemia  

Microsoft Academic Search

The intestinal lesions caused by ischemia and reperfusion may lead to grave sequelae. To study the efficacy of adenosine triphosphate magnesium chloride (ATP-MgCl2) and allopurinol (ALLO) in protecting the small bowel from ischemia, rabbits in two groups, 1 (n = 7) and 2 (n = 7), were pretreated with either 1 ml saline or ATP-MgCl2 just prior to intestinal ischemia

Xian-ping Liao; Ya-xiong She; Cheng-ren Shi; Zong-de Zhang; Min Li

1994-01-01

145

Pathological and clinical significance of increased intraepithelial lymphocytes (IELs) in small bowel mucosa.  

PubMed

Intestinal intraepithelial lymphocytes (IELs) belong to a unique T-cell population interspersed between epithelial cells of both the small and large intestine. It is becoming increasingly recognised that an increased number of IELs with a normal villous architecture is within the wide spectrum of histological abnormalities observed in coeliac disease. An increased number of IELs is the earliest pathological change following gluten challenge and a high IEL count may be the only sign of gluten sensitivity. Therefore, the finding of a raised IEL count with normal villous architecture is of sufficient clinical importance to be reported in routine small bowel biopsies. However, it is evident that not all small intestinal biopsy specimens showing increased IELs are explained by gluten sensitivity. Increased IELs in small bowel mucosa have also been associated with autoimmune disorders, tropical sprue, food protein intolerance, Helicobacter pylori-associated gastritis, peptic duodenitis, parasitic and viral infections, as well as the development of intestinal lymphoma. Histological examination of a biopsy specimen of the small bowel remains the diagnostic gold standard for coeliac disease. There will be an ever increasing demand for histological confirmation of gluten sensitivity in patients in whom the classic microscopic appearance of flattened villi may not have fully developed. The more widespread recognition by histopathologists of the pattern of injury manifested by increased numbers of IELs in intestinal biopsy specimens will certainly help in early diagnosis of coeliac disease, lessen diagnostic confusion and influence the modern practice of gastrointestinal tract medicine. This review discusses some of the recent developments in clinical pathology pertaining to increased IELs in small bowel mucosal biopsies. PMID:15996156

Chang, Fuju; Mahadeva, Ula; Deere, Harriet

2005-06-01

146

Small bowel stricture as a late sequela of superior mesenteric vein thrombosis  

PubMed Central

Introduction The increasing frequency of use of CT in patients with acute abdomen is likely to improve the diagnosis of rarely occurring conditions/causes such as superior mesenteric vein thrombosis (MVT). Despite its severe consequences, MVT often presents with nonspecific clinical features. Presentation of case AD, a 64-year-old man was an emergency admission with vague abdominal discomfort of two weeks duration, acute upper abdominal pain, loose stools, fresh rectal bleeding and vomiting. A contrast enhanced abdominal CT showed thrombosis of the proximal portal vein and the entire length of the superior mesenteric vein (SMV) with small bowel ischaemia extending from the terminal ileum to the mid jejunal loops. Tests for paroxysmal nocturnal haemoglobinuria and Janus kinase 2 mutation yielded negative results. AD was readmitted seven months later with small bowel obstruction requiring segmental small bowel resection with end-to-end anastomosis. Abdominal CT had shown complete resolution of MVT but a small bowel stricture. Discussion Thrombosis limited to mesenteric veins results in earlier and more frequent development of infarction compared to portal combined with mesenteric venous thrombosis. Most patients may be successfully treated with anti-coagulation therapy alone. However, surgery may be required to deal with intestinal infarction or late sequela of MVT. Conclusion This case demonstrates that MVT can be reversed by effective anticoagulation. However, the price paid for a mild to moderate effect on the bowel may be significant stricture later on. Patients escaping early bowel resection due to massive MVT leading to bowel infarction may still require resection later due to stricture. PMID:25544479

Paraskeva, Panoraia; Akoh, Jacob A.

2014-01-01

147

Amnesia in modern surgery: revisiting Wangensteen’s landmark studies of small bowel obstruction  

PubMed Central

Summary Before the publications of Owen Wangensteen and his colleagues in the early 1930s, bowel obstruction was almost always fatal, and its treatment was ineffectual. Patients rarely survived surgical attempts to relieve the obstruction. Although other investigators were active in the field, the understanding of the pathophysiology of obstruction belongs almost entirely to Wangensteen. In this commentary, we review Wangensteen’s landmark studies of small bowel obstruction and how they shaped the treatment of this condition. PMID:25598179

Faryniuk, Andrea; MacDonald, Allan; van Boxel, Paul

2015-01-01

148

The role of the arachidonic acid cascade in the species-specific X-ray-induced inflammation of the rabbit eye  

SciTech Connect

To identify the mediator(s) of the apparently species-specific X-ray-induced inflammation of the rabbit eye, inhibitors of the synthesis and/or release of known or putative mediators of ocular inflammation were administered prior to irradiation. The X-ray-induced ocular inflammation, particularly the rise in intraocular pressure, was found to be inhibited by intravenous pretreatment of rabbits with flurbiprofen, indomethacin, or imidazole (1, 10, and 100 mg/kg i.v., respectively), or by combined intravitreal and topical administration of flurbiprofen. Systemic, intravitreal, and/or topical pretreatment with prednisolone or disodium cromoglycate or the retrobulbar injection of ethyl alcohol or capsaicin failed to block the inflammatory response, whereas vitamin E apparently exerted some protective effect. These findings show that the X-ray-induced inflammation of the rabbit eye is mediated, at least in part, by prostaglandins (PGs) and/or related autacoids. In addition, these results suggest that the unique sensitivity of the rabbit eye to X-ray-induced inflammation is due either to the presence in this species of a unique or uniquely effective triggering mechanism for the release of PG precursors or to the greater sensitivity of this species to the ocular inflammatory effects of PGs. Thus the rabbit eye may provide a unique model for studying some aspects of arachidonic acid release or ocular PG effects, but extreme caution must be exercised in generalizing such findings to other species.

Bito, L.Z.; Klein, E.M.

1982-05-01

149

Spectrum of imaging findings on MDCT enterography in patients with small bowel tuberculosis.  

PubMed

Abdominal tuberculosis (TB) is the sixth most common extrapulmonary site of involvement. The sites of involvement in abdominal tuberculosis, in descending order of frequency, are lymph nodes, genitourinary tract, peritoneal cavity, and gastrointestinal tract. The radiological armamentarium for evaluating tuberculosis of the small bowel (SBTB) includes barium studies (small bowel follow-through, SBFT), CT (multidetector CT, CT enterography, and CT enteroclysis), ultrasound (sonoenteroclysis), and magnetic resonance imaging (MRI; enterography and enteroclysis). In this review, we illustrate the abnormalities at MDCT enterography in 20 consecutive patients with SB TB and also describe extraluminal findings in these patients. MDCT enterography allows non-invasive good-quality assessment of well-distended bowel loops and the adjacent soft tissues. It displays the thickness and enhancement of the entire bowel wall in all three planes and allows examination of all bowel loops, especially the ileal loops, which are mostly superimposed. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement in intestinal TB. The most common abnormality is short-segment strictures with symmetrical concentric mural thickening and homogeneous mural enhancement. Other findings include lymphadenopathy, ascites, enteroliths, peritoneal thickening, and enhancement. In conclusion, MDCT enterography is a comprehensive technique for the evaluation of SB TB. PMID:24290774

Kalra, N; Agrawal, P; Mittal, V; Kochhar, R; Gupta, V; Nada, R; Singh, R; Khandelwal, N

2014-03-01

150

Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding  

PubMed Central

AIM: To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their significance. METHODS: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during DBE. RESULTS: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular lesions. CONCLUSION: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required. PMID:20397267

Tee, Hoi-Poh; Kaffes, Arthur J

2010-01-01

151

Small bowel volvulus with no malrotation after laparoscopic appendicectomy: Case report and literature review  

PubMed Central

INTRODUCTION Small bowel volvulus, as a complication of laparoscopic surgery, is a rarely reported clinical entity. We present a case of a young female who developed small intestinal volvulus after laparoscopic appendicectomy. She had this complication in the absence of malrotation or other previous abdominal operations. PRESENTATION OF CASE A 17-year-old woman presented with acute appendicitis. After an uneventful laparoscopic appendicectomy, she developed acute small intestinal obstruction on the second post-operative day. A prompt laparotomy showed small bowel volvulus, which was reduced, with no evidence of malrotation. She had an uneventful recovery and was discharged within 3 days of the second operation, in a stable condition. DISCUSSION This article presents a review of the literature of this rare cause of small intestinal obstruction after laparoscopic surgery, stressing on the importance of early diagnosis and treatment. A discussion of the potential factors predisposing to this entity is presented, emphasising the need of a higher-evidence study as to its aetiology and prevalence. CONCLUSION Small bowel volvulus is a rare complication of laparoscopic surgery, but its early diagnosis and prompt treatment is essential to avoid morbid outcomes. Surgery is the therapeutic mainstay. PMID:25460470

Al Beteddini, Osama S.; Sherkawi, Emad

2014-01-01

152

No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls.  

PubMed

Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy volunteers (11 females) aged 20-(32)-48 years. Sequences were analysed based on taxonomic classification. The phyla with the highest total abundance across all samples were: Firmicutes (43%), Proteobacteria (23%), Bacteroidetes (15%), Actinobacteria (9.3%) and Fusobacteria (7.0%). The most abundant genera were: Streptococcus (19%), Veillonella (13%), Prevotella (12%), Rothia (6.4%), Haemophilus (5.7%), Actinobacillus (5.5%), Escherichia (4.6%) and Fusobacterium (4.3%). We found no difference among major phyla or genera between patients with IBS and controls. We identified a cluster of samples in the small bowel microbiota dominated by Prevotella, which may represent a common enterotype of the upper small intestine. The remaining samples formed a gradient, dominated by Streptococcus at one end and Escherichia at the other. PMID:25687743

Dlugosz, Aldona; Winckler, Björn; Lundin, Elin; Zakikhany, Katherina; Sandström, Gunnar; Ye, Weimin; Engstrand, Lars; Lindberg, Greger

2015-01-01

153

No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls  

PubMed Central

Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy volunteers (11 females) aged 20-(32)-48 years. Sequences were analysed based on taxonomic classification. The phyla with the highest total abundance across all samples were: Firmicutes (43%), Proteobacteria (23%), Bacteroidetes (15%), Actinobacteria (9.3%) and Fusobacteria (7.0%). The most abundant genera were: Streptococcus (19%), Veillonella (13%), Prevotella (12%), Rothia (6.4%), Haemophilus (5.7%), Actinobacillus (5.5%), Escherichia (4.6%) and Fusobacterium (4.3%). We found no difference among major phyla or genera between patients with IBS and controls. We identified a cluster of samples in the small bowel microbiota dominated by Prevotella, which may represent a common enterotype of the upper small intestine. The remaining samples formed a gradient, dominated by Streptococcus at one end and Escherichia at the other. PMID:25687743

Dlugosz, Aldona; Winckler, Björn; Lundin, Elin; Zakikhany, Katherina; Sandström, Gunnar; Ye, Weimin; Engstrand, Lars; Lindberg, Greger

2015-01-01

154

Rapid distal small bowel transit associated with sympathetic denervation in type I diabetes mellitus.  

PubMed Central

BACKGROUND: The pattern of progression of a meal from the stomach to the caecum in diabetes mellitus is controversial and the differential roles of transit through the jejunum and the ileum have not been investigated in diabetes. AIMS: To determine gastric emptying and transit rates through proximal and distal regions of the small bowel in type I diabetic patients. SUBJECTS: The study included six diabetic patients with evidence of autonomic neuropathy (DM-AN group), 11 diabetics without autonomic dysfunction (DM group), and 15 control volunteers. METHODS: Gastric emptying and small bowel transit of a liquid meal were evaluated scintigraphically in these subjects. Transit through regions of interest corresponding to the proximal and distal small intestine up to the caecum was determined and correlated with gastric emptying rates, cardiovascular measurements of autonomic function, and the occurrence of diarrhoea. RESULTS: Gastric emptying and transit through the proximal small bowel were similar in the three groups. The meal arrived to the caecum significantly earlier in DM-AN patients (median; range: 55 min; 22-->180 min) than in the DM group (100 min; 44-->180 min, p < 0.05) or in controls (120 min; 80-->180 min, p < 0.02). Accumulation of chyme in the distal small bowel was decreased in DM-AN patients, who showed values for peak activity (30%; 10-55%) significantly lower than in the DM group (49%; 25-77%, p = 0.02) and controls (50%; 30-81%, p = 0.02). In DM patients (n = 17), the time of meal arrival to the caecum was significantly correlated with both orthostatic hypotension (coefficient of contingency, C = 0.53, p < 0.01) and diarrhoea (C = 0.47, p < 0.05), but not with gastric emptying rates. CONCLUSIONS: Patients with type I diabetes mellitus and sympathetic denervation have abnormally rapid transit of a liquid meal through the distal small bowel, which may play a part in diarrhoea production. Images Figure 1 Figure 2 PMID:9014777

Rosa-e-Silva, L; Troncon, L E; Oliveira, R B; Foss, M C; Braga, F J; Gallo Júnior, L

1996-01-01

155

Small-bowel capsule endoscopy: A ten-point contemporary review  

PubMed Central

The introduction of capsule endoscopy (CE) in clinical practice increased the interest for the study of the small-bowel. Consequently, in about 10 years, an impressive quantity of literature on indications, diagnostic yield (DY), safety profile and technical evolution of CE has been published as well as several reviews. At present time, there are 5 small-bowel capsule enteroscopy (SBCE) models in the worldwide market. Head-to-head trials have showed in the great majority of studies comparable results in terms of DY, image quality and completion rate. CE meta-analyses formed the basis of national/international guidelines; these guidelines place CE in a prime position for the diagnostic work-up of patients with obscure gastrointestinal bleeding, known and/or suspected Crohn’s disease and possible small-bowel neoplasia. A 2-L polyethylene glycol-based purge, administered the day before the procedure, is the most widely practiced preparation regimen. Whether this regimen can be further improved (i.e., by further decreasing its volume, changing the timing of administration, coupling it with prokinetics and/or other factors) or if it can really affect the DY, is still under discussion. Faecal calprotectin has been used in SBCE studies in two settings: in patients taking non-steroidal anti-inflammatory drugs, to evaluate the type and extent of mucosal damage and, more importantly from a clinical point of view, in patients with known or suspected Crohn’s disease for assessment of inflammation activity. Although there is still a lot of debate around the exact reasons of SBCE poor performance in various small-bowel segments, it is worth to remember that the capsule progress is non-steerable, hence more rapid in the proximal than in lower segments of the small-bowel. Capsule aspiration, a relatively unexpected complication, has been reported with increasing frequency. This is probably related with the increase in the mean age of patients undergoing CE. CE video review is a time-consuming procedure. Therefore, several attempts have been made to develop technical software features, in order to make CE video analysis easier and shorter (without jeopardizing its accuracy). Suspected Blood Indicator, QuickView and Fujinon Intelligent Chromo Endoscopy are some of the software tools that have been checked in various clinical studies to date. PMID:23840112

Koulaouzidis, Anastasios; Rondonotti, Emanuele; Karargyris, Alexandros

2013-01-01

156

A salvage procedure for an accidentally twisted small bowel in orthotopic duodenal reconstruction after pylorus-preserving partial pancreatoduodenectomy.  

PubMed

A case of pylorus-preserving Whipple procedure with an accidentally clockwise 360° rotated small bowel limb in orthotopic duodenal reconstruction is presented. A simple salvage procedure is proposed. PMID:21544872

Käser, S A; Glauser, P M; Dätwiler, S; Maurer, C A

2011-10-01

157

Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology  

Microsoft Academic Search

OBJECTIVE:Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology.METHODS:We used the Given (M2A) system in 35 patients, aged

Eitan Scapa; Harold Jacob; Shlomo Lewkowicz; Michal Migdal; Daniel Gat; Arkady Gluckhovski; Nurit Gutmann; Zvi Fireman

2002-01-01

158

Enterogenous cyst of the small bowel causing intussusception in an adult: Case report and review of literature  

PubMed Central

Small bowel intussusception is a rare congenital disease entity, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction. In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions and they can occur idiopathically in adults or due to an intraluminal tumor mass. We report a case of an enterogenous cyst causing intussusception and iron deficiency anemia in an adult treated by surgical excision and resection of the small bowel.

Shah, Nihar; Lizardo-Escaño, Therese; Shaaban, Hamid; Dhadham, Gautamy; Karki, Arya; Spira, Robert

2015-01-01

159

Small bowel obstruction following computed tomography and magnetic resonance enterography using psyllium seed husk as an oral contrast agent  

PubMed Central

The authors report a case series describing four patients who developed small bowel obstruction following the use of psyllium seed husk as an oral contrast agent for computed tomography or magnetic resonance enterography. Radiologists who oversee computed tomography and magnetic resonance enterography should be aware of this potential complication when using psyllium seed husk and other bulking agents, particularly when imaging patients with known or suspected small bowel strictures or active inflammation. PMID:25157531

Chen, Yingming Amy; Cervini, Patrick; Kirpalani, Anish; Vlachou, Paraskevi A; Grover, Samir C; Colak, Errol

2014-01-01

160

Duodenal adenocarcinoma presenting as a mass with aneurismal dilatation.  

PubMed

Duodenal adenocarcinoma is frequent. Aneurysmal dilatation of the small bowel is reported to be a lymphoma characteristic imaging finding. A 57-year-old male was found to have a duodenal adenocarcinoma with aneurismal dilatation on imaging which is an exceptional feature. On laparotomy, the wall thickening of the dilated duodenum extended to the first jejunal loop, with multiple mesenteric lymph nodes and ascites. Segmental palliative resection with gastro-entero-anastomosis was done. Histopathology revealed a moderately differentiated adenocarcinoma with neuro-endocrine differentiation foci. Wide areas of necrosis and vascular emboli were responsible for the radiological feature of the dilated duodenum with wall thickening. PMID:24411203

Mama, Nadia; Ben Slama, Aïda; Arifa, Nadia; Kadri, Khaled; Sriha, Badreddine; Ksiaa, Mehdi; Jemni, Hela; Tlili-Graiess, Kalthoum

2014-01-01

161

X-ray induced fluorescence measurement of segregation in a DyI3-Hg metal-halide lamp.  

SciTech Connect

Segregation of elemental Dy in a DyI{sub 3}-Hg metal-halide high-intensity discharge lamp has been observed with x-ray induced fluorescence. Significant radial and axial Dy segregation are seen, with the axial segregation characterized by a Fischer parameter value of {lambda} = 0.215 {+-} 0.002 mm{sup -1}. This is within 7% of the value ({lambda} = 0.20 {+-} 0.01 mm{sup -1}) obtained by Flikweert et al based on laser absorption by neutral Dy atoms. Elemental I is seen to exhibit considerably less axial and radial segregation. Some aspects of the observed radial segregation are compatible with a simplified fluid picture describing two main transition regions in the radial coordinate. The first transition occurs in the region where DyI{sub 3} molecules are in equilibrium with neutral Dy atoms. The second transition occurs where neutral Dy atoms are in equilibrium with ionized Dy. These measurements are part of a larger study on segregation in metal-halide lamps under a variety of conditions.

Nimalasuriya , T.; Curry, J. J.; Sansonetti, C. J.; Ridderhof, E. J.; Shastri, S. D.; Filkweert, A. J.; Stoffels, W. W.; Haverlag, M.; van der Mullen, J. J.; Eindhoven Univ. of Technology; NIST

2007-05-07

162

Search for x-ray induced decay of the 31-yr isomer of {sup 178}Hf using synchrotron radiation  

SciTech Connect

Isomeric {sup 178}Hf (t{sub 1/2}=31 yr, E{sub x}=2.446 MeV, J{sup {pi}}=16{sup +}) was bombarded by a white beam of x rays from the Advanced Photon Source at Argonne National Laboratory. A search was made for x-ray induced decay of the isomer by detecting prompt and delayed {gamma} rays associated with the decay. No induced decay was observed. Upper limits for such a process for x-ray energies between 7 and 100 keV were set. The limits between 7 and 30 keV are below {approx_equal}3x10{sup -27} cm{sup 2} keV for induced decay that bypasses the 4-s isomer and {approx_equal}5x10{sup -27} cm{sup 2} keV for induced decay that is delayed through this isomer, which are orders of magnitude below values at which induced decay was reported previously. These limits are consistent with what is known about the properties of atomic nuclei.

Ahmad, I.; Gemmell, D.S.; Moore, E.F.; Schiffer, J.P. [Physics Division, Argonne National Laboratory, Argonne, Illinois 60439 (United States); Banar, J.C.; Bredeweg, T.A.; Miller, G.G.; Palmer, P.; Pangault, L.N.; Rundberg, R.S.; Wilhelmy, J.B. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Becker, J.A.; Cooper, J.R.; Kraemer, A.; McNabb, D.P.; Wang, T.-F. [Lawrence Livermore National Laboratory, Livermore, California 94550 (United States); Mashayekhi, A.; Shastri, S.D. [Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439 (United States)

2005-02-01

163

Increased density of tolerogenic dendritic cells in the small bowel mucosa of celiac patients  

PubMed Central

AIM: To investigate the densities of dendritic cells (DCs) and FOXP3+ regulatory T cells (Tregs) and their interrelations in the small bowel mucosa in untreated celiac disease (CD) patients with and without type 1 diabetes (T1D). METHODS: Seventy-four patients (45 female, 29 male, mean age 11.1 ± 6.8 years) who underwent small bowel biopsy were studied. CD without T1D was diagnosed in 18 patients, and CD with T1D was diagnosed in 15 patients. Normal small bowel mucosa was found in two T1D patients. Thirty-nine patients (mean age 12.8 ± 4.9 years) with other diagnoses (functional dyspepsia, duodenal ulcer, erosive gastritis, etc.) formed the control group. All CD patients had partial or subtotal villous atrophy according to the Marsh classification: Marsh grade IIIa in 9, grade IIIb in 21 and grade IIIc in 3 cases. Thirty-nine patients without CD and 2 with T1D had normal small bowel mucosa (Marsh grade 0). The densities of CD11c+, IDO+, CD103+, Langerin (CD207+) DCs and FOXP3+ Tregs were investigated by immunohistochemistry (on paraffin-embedded specimens) and immunofluorescence (on cryostat sections) methods using a combination of mono- and double-staining. Sixty-six serum samples were tested for IgA-tissue transglutaminase (tTG) using a fully automated EliA™ Celikey® IgA assay (Pharmacia Diagnostics, Freiburg, Germany). RESULTS: The density of CD11c+ DCs was significantly increased in CD patients compared with patients with normal mucosa (21.67 ± 2.49 vs 13.58 ± 1.51, P = 0.007). The numbers of FOXP3+ cells were significantly higher in CD patients (10.66 ± 1.50 vs 1.92 ± 0.37, P = 0.0002) and in patients with CD and coexisting T1D (8.11 ± 1.64 vs 1.92 ± 0.37, P = 0.002) compared with patients with normal mucosa. The density of FOXP3+ cells significantly correlated with the histological grade of atrophic changes in the small bowel mucosa according to the March classification (r = 0.62; P < 0.0001) and with levels of IgA antibody (r = 0.55; P < 0.0001). The densities of IDO+ DCs were significantly higher in CD patients (21.6 ± 2.67 vs 6.26 ± 0.84, P = 0.00003) and in patients with CD and coexisting T1D (19.08 ± 3.61 vs 6.26 ± 0.84, P = 0.004) compared with patients with normal mucosa. A significant correlation was identified between the densities of IDO+ DCs and FOXP3+ T cells (r = 0.76; P = 0.0001). The mean values of CD103+ DCs were significantly higher in CD patients (10.66 ± 1.53 vs 6.34 ± 0.61, P = 0.01) and in patients with CD and associated T1D (11.13 ± 0.72 vs 6.34 ± 0.61, P = 0.00002) compared with subjects with normal small bowel mucosa. The mean value of Langerin+ DCs was higher in CD patients compared with persons with normal mucosa (7.4 ± 0.92 vs 5.64 ± 0.46, P = 0.04). CONCLUSION: The participation of diverse DC subsets in the pathological processes of CD and the possible involvement of tolerogenic DCs in Tregs development to maintain intestinal immunological tolerance in CD patients are revealed. PMID:25593459

Vorobjova, Tamara; Uibo, Oivi; Heilman, Kaire; Uibo, Raivo

2015-01-01

164

Aminoguanidine Alleviates Radiation-Induced Small-Bowel Damage Through Its Antioxidant Effect  

SciTech Connect

Purpose: To evaluate the effect and its mechanism of aminoguanidine (AG) on small-bowel protection after whole-abdominal irradiation (WAI) in rats. Methods and Materials: Male Sprague-Dawley rats (300-400 g) subjected to 12 Gy WAI were used for the study. Aminoguanidine at a dose of 50-800 mg/kg was administered by the gavage route 2 h before WAI. Mucosal damage of small bowel was evaluated by the grade of diarrhea and crypt survival; oxidative stress was determined by the level of 8-hydroxy 2'-deoxyguanosine (8-OHdG) with immunohistochemistry (IHC). Nitrosative stress was evaluated by the expression of inducible nitric oxide synthase (iNOS) and 3-nitrotyrosine (3-NT) with IHC, and systemic and portal vein NOx (nitrite + nitrate) levels were measured and compared with and without AG treatment after WAI. Results: Aminoguanidine showed a dose-dependent effect against WAI-induced diarrhea. Aminoguanidine at a dose of 400 mg/kg had the best protective effect, from 92% to 17% (p = 0.002). Aminoguanidine increased crypt survival from 23% to 46% (p = 0.003). It also significantly attenuated 8-OHdG expression but not 3-NT and iNOS expression at both 4 and 8 h after 12-Gy WAI. Aminoguanidine did not alter the portal vein NOx levels 4 and 8 h after 12-Gy WAI. Conclusion: Aminoguanidine has a radioprotective effect against radiation-induced small-bowel damage due to its antioxidant effect but not inhibition of nitric oxide production. Dietary AG may have a potentially protective effect on the small intestine of patients subjected to pelvic and abdominal radiotherapies.

Huang, E.-Y. [Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Wang, F.-S. [Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Department of Medical Research, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Lin, I-H. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Yang, Kuender D. [Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Department of Medical Research, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China)], E-mail: yangkd@adm.cgmh.org.tw

2009-05-01

165

A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction  

PubMed Central

AIM: To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction. METHODS: A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study. The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube (NGT) was used in 90 patients. The therapeutic efficacy was compared between the two groups. RESULTS: Compared with the NGT group, the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph (4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests (P < 0.01). The overall effectiveness rate was up to 89.6% in the ileus tube group and 46.7% in the NGT group (P < 0.01). And 10.4% of the patients in the ileus tube group and 53.3% of the NGT group underwent surgery. For recurrent adhesive bowel obstruction, ileus tube was also significantly more effective than NGT (95.8% vs 31.6%). In the ileus tube group, the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure (P < 0.05). The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery. CONCLUSION: Ileus tube can be used for adhesive small bowel obstruction. Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks. PMID:22563179

Chen, Xiao-Li; Ji, Feng; Lin, Qi; Chen, Yi-Peng; Lin, Jian-Jiang; Ye, Feng; Yu, Ji-Ren; Wu, Yi-Jun

2012-01-01

166

Primary Pneumatosis Intestinalis of Small Bowel: A Case of a Rare Disease  

PubMed Central

Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts are located in the bowel wall; it can represent a wide spectrum of diseases and a variety of underlying diagnoses. The present report describes the case of an 86-year-old man with symptomatic primary PI of small bowel treated with surgical approach after periodic episodes of cysts rupture and superimposed inflammation revealed on the basis of a clinical suspicion thanks to abdominal computed tomography. Moreover, after one year of followup, there has been no recurrence of digestive symptoms. PMID:25478280

Crincoli, Raffaello; Iasiello, Francesca; Pizza, Nunzia Luisa; Musto, Lanfranco

2014-01-01

167

Kaposi's Sarcoma Presenting as Acute Small Bowel Obstruction Diagnosed on Multidetector Computed Tomography with Histopathological Correlation  

PubMed Central

Kaposi's sarcoma was originally described by Moritz Kaposi in 1872 as a rare form of multiple hemorrhagic skin lesions. Today it is well documented as a systemic, multifocal, steadily progressive reticuloendothelial system tumor with a predilection for skin and visceral involvement. It occasionally presents as a visceral disease without skin manifestations. We report a case of Kaposi's sarcoma of the small bowel in a seropositive patient who presented with acute right lower quadrant pain and was diagnosed with intestinal obstruction with perforation on contrast-enhanced multidetector computed tomography (MDCT). The diagnosis was confirmed as Kaposi's sarcoma on postoperative histopathological analysis.

Halankar, Jaydeep; Martinovic, Elaine; Hamilton, Paul

2015-01-01

168

Transvaginal Small Bowel Evisceration in Known Case of Uterine Prolapse Due to Trauma  

PubMed Central

Spontaneous transvaginal bowel evisceration is a rare surgical emergency with only a few cases reported and particularly postmenopausal, posthysterectomy, multiparous elderly women are considered to be at higher risk for development of bowel evisceration. It is difficult to manage such a patient for any surgeon and poses significant challenges especially intraoperatively. Here, we report a case of vaginal vault rupture with small bowel evisceration through the vagina in a known case of uterine prolapse and highlight the risk factors, clinical presentation, and treatment options for this rare surgical emergency PMID:25738028

Gheewala, Umesh; Shukla, Radha; Bhatt, Ravi; Srivastava, Shirish

2015-01-01

169

Small bowel tumors detection in capsule endoscopy by Gaussian modeling of color curvelet covariance coefficients.  

PubMed

This paper is concerned with the classification of tumoral tissue in the small bowel by using capsule endoscopic images. The followed approach is based on texture classification. Texture descriptors are derived from selected scales of the Discrete Curvelet Transform (DCT). The goal is to take advantage of the high directional sensitivity of the DCT (16 directions) when compared with the Discrete Wavelet Transform (DWT) (3 directions). Second order statistics are then computed in the HSV color space and named Color Curvelet Covariance (3C) coefficients. Finally, these coefficients are modeled by a Gaussian Mixture Model (GMM). Sensitivity of 99% and specificity of 95.19% are obtained in the testing set. PMID:21096477

Martins, Maria M; Barbosa, Daniel J; Ramos, Jaime; Lima, Carlos S

2010-01-01

170

Novel applications of diagnostic x-rays in activating photo-agents through x-ray induced visible luminescence from rare-earth particles: an in vitro study  

NASA Astrophysics Data System (ADS)

Photodynamic agents such as Photofrin II (Photo II) utilized in photodynamic therapy (PDT) possess a remarkable property to become preferentially retained within the tumor's micro-environment. Upon the photo-agent's activation through visible light photon absorption, the agents exert their cellular cytotoxicity through type II and type I mechanistic pathways through extensive generation of reactive oxygen species (ROS): singlet oxygen 1O2, superoxide anion O2 -, and hydrogen peroxide H2O2, within the intratumoral environment. Unfortunately, due to shallow visible light penetration depth (~2mm to 5mm) in tissues, the PDT strategy currently has largely been restricted to the treatments of surface tumors, such as the melanomas. Additional invasive strategies through optical fibers are currently utilized in getting the visible light into the intended deep seated targets within the body for PDT. In this communication, we report on a novel strategy in utilizing "soft" energy diagnostic X-rays to indirectly activate Photo II through X-ray induced luminescence from Gadolinium oxysulfide (20 micron dimension) particles doped with Terbium: Gd2O2S:Tb. X-ray induced visible luminescence from Gd2O2S:Tb particles was spectroscopically characterized and the ROS production levels from clinically relevant concentration (10 ?g/ml) of Photo II was quantified through changes in the Vitamin C absorbance. ROS kinetics through X-ray induced luminescence was found to be similar to the ROS kinetics from red He-Ne laser exposures used in the clinics. Taken together, in-vitro findings herein provide the basis for future studies in determining the safety and efficacy of this non-invasive X-ray induced luminescence strategy in activating photo-agent in deep seated tumors.

Abliz, Erkinay; Collins, Joshua E.; Friedberg, Joseph S.; Kumar, Ajith; Bell, Howard; Waynant, Ronald W.; Tata, Darrell B.

2010-02-01

171

The Discovery of X-ray Induced H_2 Flourescence in the Disk of a T Tauri Star  

NASA Astrophysics Data System (ADS)

We present high resolution, near-IR spectroscopic observations of three T Tauri stars in the v = 1-0 S(1) 2.1218 mu m emission line of molecular hydrogen. Our data were collected using CSHELL on the IRTF on 1999, February 23, UT. All three stars searched for H_2 (TW Hya, HD 98800, and CD-33(deg) 7795) reside in the nearby (D ~ 50 pc) TW Hya Association (Kastner et al. 1997, Science, 277, 67). We find that one of the three, TW Hya, likely displays H_2 emission in the 2.1218 mu m line. TW Hya is apparently surrounded by a circumstellar disk containing gas (Zuckerman et al. 1995, Nature 373, 494) and dust (Weintraub et al. 1989, ApJ, 340, L69), but shows no optical jets, molecular outflow, or other phenomena that would produce shocked H_2 emission. In addition, the central velocity of the apparent H_2 line falls, to within the measurement errors, at the velocity of disk molecular emission previously detected toward TW Hya (Kastner et al. 1997), and the H_2 line is not obviously resolved. Thus, it appears that the H_2 emission is not excited by shocks. Rather, the 2.1218 mu m emission likely originates in the disk of TW Hya and is excited via flourescence, due either to direct UV photoexcitation (e.g., Black and van Dishoeck 1987, ApJ, 322, 412) or to X-ray ionization of H_2 (Maloney et al. 1996, ApJ, 466, 561; Tine et al. 1997, Ap J, 481, 282). The latter possibility is especially appealing, as TW Hya is a bright X-ray source (Kastner et al. 1997). Hence, we propose that our detection of H_2 emission toward TW Hya demonstrates that X-ray induced flourescence can occur in gaseous disks around X-ray bright T Tauri stars.

Bary, J. S.; Weintraub, D. A.; Kastner, J. H.

1999-05-01

172

Adenocarcinoma of the small intestine: 21Year review of diagnosis, treatment, and prognosis  

Microsoft Academic Search

Background: The purpose of this study was to evaluate the tumor characteristics and treatment associated with an improved overall survival in patients with adenocarcinoma of the small intestine.\\u000aMethods: The records of all patients with primary adenocarcinoma of the small bowel seen between January 1971 and December 1991 were reviewed retrospectively. The study comprised 38 patients, 22 (58%) with duodenal

Ronald L. Bauer; Michael L. Palmer; Andrea M. Bauer; Hector R. Nava; Harold O. Douglass

1994-01-01

173

Adult intussusception caused by myoepithelial hamartoma in the small bowel: A case report  

PubMed Central

Introduction Intussusception is rare in adults and can have acute, intermittent or chronic presentations. We present an unusual case of intussusception in an adult. Presentation of case A 25 year old male presented with sudden severe abdominal pain and vomiting. He had no relevant medical history. Mechanical small bowel obstruction was confirmed on imaging and laparotomy revealed a nodular lead point in the submucosa of the ileum. He had resection of a segment of small bowel with a primary anastamosis. Histopathology of the lesion demonstrated myoepithelial hamartoma (MEH), a rare cause of intussusception. Discussion Although intussusception is not uncommon in children, it is rare in adults. Management delays are a major cause of morbidity. This report details our management of a case of intussusception caused by MEH in an otherwise healthy adult. Conclusion Intussusception caused by MEH is a rare but serious cause of mechanical bowel obstruction. We propose that surgeons should consider this diagnosis in atypical cases of bowel obstruction and expedite laparotomy when it is suspected. PMID:25644557

Adetunji, Adeyanju; Healy, Donagh; O’Donnell, Nessa; Davitt, Stephen; O’Hanrahan, Tim

2015-01-01

174

Effect of acetylcysteine on adaptation of intestinal smooth muscle after small bowel bypass  

SciTech Connect

The authors have postulated that the adaptive changes in function and structure of bypassed segments of small bowel are due in part to the change in intestinal contents following operation. The purpose of these experiments was to determine if a mucolytic agent could alter the adaptation. Rats were anesthetized and a 70% jejunoileal bypass was performed. The bypassed segments then were perfused with either saline or acetylcysteine for 3-12 days. Then, either intestinal transit was determined using Cr-51, or segments were taken for morphometric analysis. Transit, as assessed by the geometric center, was increased 32% by acetylcysteine treatment. Treatment also caused a decrease in hypertrophy of the muscularis. Muscle wet weight, muscle cross-sectional area, and muscle layer thickness all were significantly less in those animals infused with acetyl-cysteine. No decreases in hypertrophy were seen in the in-continuity segments. These data indicate that alterations in intestinal content can affect the course of adaptation of intestinal muscle in response to small bowel bypass.

Weisbrodt, N.W.; Belloso, R.M.; Biskin, L.C.; Dudrick, P.S.; Dudrick, S.J.

1986-03-05

175

Perforation of small bowel caused by Schistosoma japonicum: A case report.  

PubMed

A 67-year-old man from Jingzhou was admitted to the First Hospital Affiliated to Yangtze University in July 2013 with sudden onset of abdominal pain with dizziness for 12 h. The patient had sign of peritoneal irritation. Ultrasonography of the abdomen and pelvis showed hepatic fibrosis due to schistosomiasis. Computed tomography showed free gas in the peritoneal cavity. Plain abdominal radiography showed bilateral subdiaphragmatic accumulation of gas, perforation of the viscus, and radio-opacity in the left renal area. The patient underwent emergency exploratory laparotomy. At laparotomy, a moderate amount of muddy yellow pus was found in the intra-abdominal cavity. At the junction of the jejunum and ileum, about 250 cm from Treitz's ligament, there was an about 10-cm length of inflamed small bowel with perforation (3 mm in diameter) along the mesenteric border at the middle of the lesion. The patient underwent resection of the affected intestinal segment, along with end-to-end intestinal anastomosis. Histopathological examination revealed mucosal necrosis and hemorrhage with a large number of infiltrating eosinophils and neutrophils, and acute submucosal inflammation with a large number of infiltrating eosinophils and neutrophils associated with Schistosoma japonicum (S. japonicum) eggs. No intravascular adult parasite was found. Postoperatively, the patient was treated with praziquantel (30 mg/kg daily) for 4 d. The patient progressed well. To the best of our knowledge, this is the first case of small bowel perforation associated with eggs of S. japonicum. PMID:25759563

Xiang, Jin-Jian; Cheng, Ben-Jing; Tian, Fu; Li, Mi; Jiang, Xue-Feng; Zhao, Hui-Chuan; Hu, Xiao-Miao; Xiao, Bao-Lai; Xie, Jian-Ping; Shrestha, Arpana

2015-03-01

176

Small bowel perforation due to CMV enteritis infection in an HIV-positive patient  

PubMed Central

Background Cytomegalovirus infection of the gastrointestinal tract is common and is more often seen in patients with acquired immunodeficiency syndrome (AIDS). Although small bowel infection is less common than infection of other parts of the gastrointestinal system, it may lead to perforation, an acute complication, with dreadful results. Case presentation This article reports a case of Cytomegalovirus ileitis with multiple small bowel perforations in a young man with human immunodeficiency virus (HIV) infection. The patient developed abdominal pain with diarrhea and fever, and eventually acute abdomen with pneumoperitoneum. The patient had poor prognosis and deceased despite the prompt surgical intervention and the antiviral therapy he received. At pathology a remarkable finding was the presence of viral inclusions in smooth muscle fibers. The destruction of muscle cells was the main cause of perforation. Conclusion Morbidity and mortality associated with perforation from CMV enteritis in AIDS patients are high and the life expectancy is short. Cytomegalovirus disease is multifocal; therefore, excision of one portion of the gastrointestinal tract may be followed by a complication elsewhere. Our case elucidate that muscle cell destruction by the virus is a significant cause leading to perforation. PMID:23379792

2013-01-01

177

Perforation of small bowel caused by Schistosoma japonicum: A case report  

PubMed Central

A 67-year-old man from Jingzhou was admitted to the First Hospital Affiliated to Yangtze University in July 2013 with sudden onset of abdominal pain with dizziness for 12 h. The patient had sign of peritoneal irritation. Ultrasonography of the abdomen and pelvis showed hepatic fibrosis due to schistosomiasis. Computed tomography showed free gas in the peritoneal cavity. Plain abdominal radiography showed bilateral subdiaphragmatic accumulation of gas, perforation of the viscus, and radio-opacity in the left renal area. The patient underwent emergency exploratory laparotomy. At laparotomy, a moderate amount of muddy yellow pus was found in the intra-abdominal cavity. At the junction of the jejunum and ileum, about 250 cm from Treitz’s ligament, there was an about 10-cm length of inflamed small bowel with perforation (3 mm in diameter) along the mesenteric border at the middle of the lesion. The patient underwent resection of the affected intestinal segment, along with end-to-end intestinal anastomosis. Histopathological examination revealed mucosal necrosis and hemorrhage with a large number of infiltrating eosinophils and neutrophils, and acute submucosal inflammation with a large number of infiltrating eosinophils and neutrophils associated with Schistosoma japonicum (S. japonicum) eggs. No intravascular adult parasite was found. Postoperatively, the patient was treated with praziquantel (30 mg/kg daily) for 4 d. The patient progressed well. To the best of our knowledge, this is the first case of small bowel perforation associated with eggs of S. japonicum. PMID:25759563

Xiang, Jin-Jian; Cheng, Ben-Jing; Tian, Fu; Li, Mi; Jiang, Xue-Feng; Zhao, Hui-Chuan; Hu, Xiao-Miao; Xiao, Bao-Lai; Xie, Jian-Ping; Shrestha, Arpana

2015-01-01

178

Computed tomography features associated with operative management for nonstrangulating small bowel obstruction  

PubMed Central

Background The management of nonstrangulating small bowel obstruction (SBO) may require surgery, but the need for and timing of surgical intervention isn’t always apparent. We sought to determine whether specific features on computed tomography (CT) can predict the necessity for operative management. Methods Two radiologists independently reviewed CT scans from all patients admitted to hospital with SBO between 2004 and 2006. We examined the association between radiographic features and operative management by univariate analysis using the ?2 or Fisher exact test. Significant factors with high concordance between radiologists were entered into a multivariable stepwise logistic regression model. Results There were 228 patients with SBO, 63 of whom met our inclusion criteria and had CT scans available for review. Three CT features were frequently associated with operative management and had good concordance between radiologists: complete bowel obstruction, small bowel dilation greater than 4 cm and transition point. Transition point was the only significant factor predictive of operative management for SBO on multivariable logistic regression analysis (OR 19, 95% confidence interval 1.8–201, p = 0.014). Conclusion In patients with nonstrangulating SBO, the presence of a transition point on CT scan should alert the surgeon to the increased likelihood that operative management may be required. PMID:25078930

Suri, Rakesh R.; Vora, Parag; Kirby, John M.; Ruo, Leyo

2014-01-01

179

Current state of knowledge on neuroendocrine small bowel tumours: non-systematic review of the literature based on one case  

PubMed Central

More than 60% of neuroendocrine tumours, also called carcinoids, are localised within the gastrointestinal tract. Small bowel neuroendocrine tumours have been diagnosed with increasing frequency over the past 35?years, being the second most frequent tumours of the small intestine. Ileal neuroendocrine tumours diagnosis is late because patients have non-specific symptoms. We have proposed to illustrate as an example the case of a patient, and on its basis, to make a brief review of the literature on small bowel neuroendocrine tumours, resuming several recent changes in the field, concerning classification criteria of these tumours and new recommendations and current advances in diagnosis and treatment. This patient came to our emergency department with a complete bowel obstruction, along with a 2-year history of peristaltic abdominal pain, vomits and diarrhoea episodes. During emergency laparotomy, an ileal stricture was observed, that showed to be a neuroendocrine tumour of the small bowel. PMID:23329706

Simion, Nicolae Irinel; Muntean, Valentin; Fabian, Ovidiu

2013-01-01

180

Quantitative in vivo analysis of small bowel motility using MRI examinations in mice--proof of concept study.  

PubMed

Small bowel motility analyses using magnetic resonance imaging (MRI) could reduce current invasive techniques in animal studies and comply with the 'three Rs' rule for human animal experimentation. Thus we investigated the feasibility of in vivo small bowel motility analyses in mice using dynamic MRI acquisitions. All experimental procedures were approved by the institutional animal care committee. Six C57BL/6 mice underwent MRI without additional preparation after isoflurane anaesthetization in the prone position on a 4.7 T small animal imager equipped with a linear polarized hydrogen birdcage whole-body mouse coil. Motility was assessed using a true fast imaging in a steady precession sequence in the coronal orientation (acquisition time per slice 512?ms, in-plane resolution 234?×?234?µm, matrix size 128?×?128, slice thickness 1?mm) over 30?s corresponding to 60 acquisitions. Motility was manually assessed measuring the small bowel diameter change over time. The resulting motility curves were analysed for the following parameters: contraction frequency per minute (cpm), maximal contraction amplitude (maximum to minimum [mm]), luminal diameter (mm) and luminal occlusion rate. Small bowel motility quantification was found to be possible in all animals with a mean small bowel contraction frequency of 10.67?cpm (SD?±?3.84), a mean amplitude of the contractions of 1.33?mm (SD?±?0.43) and a mean luminal diameter of 1.37?mm (SD?±?0.42). The mean luminal occlusion rate was 1.044 (SD?±?0.45%/100). The mean duration needed for a single motility assessment was 185?s (SD?±?54.02). Thus our study demonstrated the feasibility of an easy and time-sparing functional assessment for in vivo small bowel motility analyses in mice. This could improve the development of small animal models of intestinal diseases and provide a method similar to clinical MR examinations that is in concordance with the 'three Rs' for humane animal experimentation. PMID:25266965

Bickelhaupt, S; Wurnig, M C; Lesurtel, M; Patak, M A; Boss, A

2015-01-01

181

Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patients with Crohn's disease  

Microsoft Academic Search

Background: To evaluate the capability of a computed tomographic (CT) technique that combines distention of the small bowel loops with\\u000a a transparent enema with contrast-enhanced spiral CT of the abdomen in patients with Crohn's disease.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: We evaluated the abdomen with spiral CT after distention of the small bowel loops with a transparent enema of methylcellulose\\u000a in 40 patients consecutively

G. A. Rollandi; P. F. Curone; E. Biscaldi; F. Nardi; E. Bonifacino; R. Conzi; L. E. Derchi

1999-01-01

182

Obturator Hernia, a Rare Cause of Small Bowel Obstruction: Case Report  

PubMed Central

Obturator hernia is a rare hernia in the world, diagnosed late since it has no specific symptoms and findings and generally occur in thin and old women with comorbidity.For this reason obturator hernia has high morbidity and mortality rates. In this study, we present an obturator hernia case that Howship-Romberg sign is positive and has typical appearance in computerized tomography. Laparotomy was performed on 89 years old female patient with body mass index 18.08 kg/m2 by low middle line incision. Following the segmentectomy to the strangulated small bowel loop, obturator canal is repaired by retroperitoneal application. No complication occurred in the postoperative period. Obturator hernia should be taken into consideration in old and thin female patients with intestinal obstruction. Computerized tomography should be performed for early diagnosis of the obturator hernia. PMID:25610330

Kisaoglu, Abdullah; Ozogul, Bunyami; Yuce, Ihsan; Bayramoglu, Atif; Atamanalp, Sabri Selcuk

2014-01-01

183

[Management of typhoid perforation of the small bowel: a case series in Western French Guiana].  

PubMed

The purpose of this retrospective study of a five-year period in western French Guiana is to report our experience in the management of small bowel perforation due to Salmonella typhi and to underline the main diagnostic and therapeutic pitfalls. Even if clinical and laboratory findings were compatible, final diagnosis was reserved until confirmation by postoperative bacteriological findings. In patients without advanced peritonitis, excellent results can be achieved by excision of the edges of the lesion followed by direct suture in cases involving single perforations and by segmental resection followed by end-to-end anastomosis in cases involving multiple perforations. However these techniques cannot be extended to patients presenting severe peritonitis who must be treated by bowel diversion. PMID:11980398

Mallick, S; Klein, J F

2001-01-01

184

Vomiting gallstones as a presenting feature of small bowel obstruction secondary to inflammatory stricture.  

PubMed

Patients presenting with symptoms caused by gallstones are common on a surgical take. Understanding the different ways in which this common condition can present is important to enable the correct diagnosis and thus management plan. The immediate management of gallstones depends on the presenting features and can range from analgesia to surgical intervention. Obstructive cases require intervention, either by ERCP or surgery; the non-obstructive cases are usually left to settle before an elective operation at a later date. In surgery, the presence of a clinical sign where it 'should not be' can be a sign of another underlying pathology and this is the embodiment of surgery-to assimilate seemingly disparate pieces of information and act in a way to treat the cause. This case study highlights a rare presentation of one disease state, in vomiting of gallstones, that raised the diagnosis of another pathology, a small bowel obstruction. PMID:23608850

McGowan, David Ross; Norris, Joseph M; Zia, Khawaja

2013-01-01

185

Vomiting gallstones as a presenting feature of small bowel obstruction secondary to inflammatory stricture  

PubMed Central

Patients presenting with symptoms caused by gallstones are common on a surgical take. Understanding the different ways in which this common condition can present is important to enable the correct diagnosis and thus management plan. The immediate management of gallstones depends on the presenting features and can range from analgesia to surgical intervention. Obstructive cases require intervention, either by ERCP or surgery; the non-obstructive cases are usually left to settle before an elective operation at a later date. In surgery, the presence of a clinical sign where it ‘should not be’ can be a sign of another underlying pathology and this is the embodiment of surgery—to assimilate seemingly disparate pieces of information and act in a way to treat the cause. This case study highlights a rare presentation of one disease state, in vomiting of gallstones, that raised the diagnosis of another pathology, a small bowel obstruction. PMID:23608850

McGowan, David Ross; Norris, Joseph M; Zia, Khawaja

2013-01-01

186

Small bowel injury after suprapubic catheter insertion presenting 3 years after initial insertion.  

PubMed

A 77-year-old woman was referred to urology with blockages of her suprapubic catheter (SPC). The catheter was replaced easily in the emergency department, however, no urine was draining, only a cloudy green fluid was visible. On cystoscopy bilious material was identified in the bladder. There was no catheter visible. There seemed to be a fistulous tract entering the bladder at the left dome. The urethra was dilated, a urethral catheter was placed and the SPC was removed. A CT demonstrated that the SPC tract transfixed a loop of pelvic small bowel and entered the bladder with no intraperitoneal contrast leak. The patient recovered well and did not require laparotomy. This case emphasises that bowel perforation, although rare, must be considered as a complication of SPC placement even years after initial insertion when catheter problems arise. Unusually, we learn that this complication may not present with abdominal pain or peritonism. PMID:24326435

Gallagher, Kevin M; Good, Daniel W; Brush, John P; Alhasso, Ammar; Al-hasso, Ammar; Stewart, Grant D

2013-01-01

187

Carcinoid syndrome from small bowel endocrine carcinoma in the absence of hepatic metastasis.  

PubMed

An 80-year-old male patient presented with abdominal pain, paroxysmal diaphoresis, diarrhoea and vomiting. CT scan revealed a small bowel endocrine carcinoma (or 'carcinoid' tumour), but the absence of hepatic disease. The lesion was excised 'en-bloc'. Intra-operatively, there was wide fluctuation in blood pressure associated with tumour manipulation, with hyper- and hypotension. Carcinoid syndrome usually occurs from gastrointestinal tumours when hepatic metastases occur, causing flushing, diarrhoea, bronchoconstriction and murmurs from cardiac valvular lesions. This patient did not have radiological evidence of hepatic metastasis, but the syndrome could still occur with midgut tumours via local invasion of the retroperitoneal circulation, or by action of substances other than serotonin that do not undergo hepatic metabolism. PMID:21903639

Datta, Sayan; Williams, Nigel; Suortamo, Sari; Mahmood, Asif; Oliver, Colin; Hedley, Nicholas; Ray, Pijush

2011-11-01

188

The creation of a small bowel pouch by tissue expansion--an experimental study in pigs.  

PubMed

Tissue expanders (inflatable silicone balloons) were implanted into a bypassed ileum segment of seven pigs and consecutively filled over 8 to 12 weeks. The mean increase of the volume of the small bowel loops was 12 fold with a maximum of 22.8 times the original volume. The final volume 9 weeks after expander removal still presented an increase of 500%. Histologically there was an increase of the thickness of all layers of the bowel wall, especially in the tunica muscularis. The mucosa showed a value above normal in mean in vitro 14C-resorption capacity per surface area in the reintegrated bowel. Possible clinical applications of the augmentation of the gut by expansion as a rectum substitute after proctocolectomy, as a urinary bladder or stomach substitute, and for the treatment of short bowel syndrome are discussed. PMID:2355788

Stark, G B; Dorer, A; Walgenbach, K J; Grünwald, F; Jaeger, K

1990-01-01

189

Influence of PACAP on oxidative stress and tissue injury following small-bowel autotransplantation.  

PubMed

Tissue injury caused by cold preservation and reperfusion remains an unsolved problem during small-bowel transplantation. Pituitary adenylate cyclase-activating polypeptide (PACAP) is present and plays a central role in the intestinal physiology. This study investigated effect of PACAP-38 on the oxidative stress and tissue damage in autotransplanted intestine. Sham-operated, ischemia/reperfusion, and autotransplanted groups were established in Wistar rats. In ischemia/reperfusion groups, 1 h (group A), 2 h (group B), and 3 h (group C) ischemia followed by 3 h of reperfusion was applied. In autotransplanted groups, total orthotopic intestinal autotransplantation was performed. Grafts were preserved in University of Wisconsin (UW) solution and in UW containing 30 microg PACAP-38 for 1, 2, 3, and 6 h. Reperfusion lasted 3 h in all groups. Endogenous PACAP-38 concentration was measured by radioimmunoassay. To determine oxidative stress parameters, malondialdehyde, reduced glutathione, and superoxide dismutase were measured in tissue samples. Tissue damage was analyzed by qualitative and quantitative methods on hematoxylin/eosin-stained sections. Concentration of endogenous PACAP-38 significantly decreased in groups B and C compared to sham-operated group. Preservation solution containing PACAP-38 ameliorated bowel tissue oxidative injury induced by cold ischemia and reperfusion. Histological results showed that preservation caused destruction of the mucous, submucous, and muscular layers, which were further deteriorated by the end of reperfusion. In contrast, PACAP-38 significantly protected the intestinal structure. Ischemia/reperfusion decreased the endogenous PACAP-38 concentration in the intestinal tissue. Administration of PACAP-38 mitigated the oxidative injury and histological lesions in small-bowel autotransplantation model. PMID:18651248

Ferencz, Andrea; Racz, Boglarka; Tamas, Andrea; Reglodi, Dora; Lubics, Andrea; Nemeth, Jozsef; Nedvig, Klara; Kalmar-Nagy, Karoly; Horvath, Ors Peter; Weber, Gyorgy; Roth, Erzsebet

2009-02-01

190

Glutamine reduces bacterial translocation after small bowel transplantation in cyclosporine-treated rats.  

PubMed

Bacterial translocation (BT) of enteric organisms is a major cause of sepsis in patients undergoing small bowel transplantation (SBT). Cyclosporine (CsA) may be toxic to intestinal epithelium and increase the risk of BT. Glutamine (Gln) is the preferred enterocyte fuel and maintains graft epithelial integrity in experimental SBT. This study determined the effects of CsA on mucosal structure and function of transplanted intestinal isograft and examined whether Gln-enriched diet reversed CsA-induced intestinal toxicity. Thirty-three adult Lewis rats underwent resection of the distal 60% of small bowel and received an orthotopic jejunal isograft. Rats received either elemental diet with 2% Gln or the same diet with balanced nonessential amino acids (non-Gln) by gastrostomy for 10 days. CsA (15 mg/kg, im) or olive oil was injected daily. Rats were assigned to four groups: non-Gln with vehicle, non-Gln with CsA, Gln with vehicle, and Gln with CsA. Mucosal villous height, surface area, crypt depth, 14C glucose absorption, BT to mesenteric lymph nodes (MLN), and body weight change were evaluated. The non-Gln with CsA group had the highest incidence of BT (P < 0.001). Gln groups had significantly decreased BT (P < 0.01) and increased crypt depth and villous surface area (P < 0.01) when compared to non-Gln groups. Body weight significantly decreased in CsA groups when compared to non-CsA groups (P < 0.01). These results indicate at CsA significantly decreased body weight and increased BT without decreasing mucosal structure and glucose absorption of intestinal isografts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7861767

Zhang, W; Frankel, W L; Bain, A; Choi, D; Klurfeld, D M; Rombeau, J L

1995-02-01

191

Mesenchymal stem cell therapy in patients with small bowel transplantation: Single center experience  

PubMed Central

AIM: To study the effects of mesenchymal stem cell (MSC) therapy on the prevention of acute rejection and graft vs host disease following small bowel transplantation. METHODS: In our transplantation center, 6 isolated intestinal transplants have been performed with MSC therapy since 2009. The primary reasons for transplants were short gut syndrome caused by surgical intestine resection for superior mesenteric artery thrombosis (n = 4), Crohn’s disease (n = 1) and intestinal aganglionosis (n = 1). Two of the patients were children. At the time of reperfusion, the first dose of MSCs cultured from the patient’s bone marrow was passed into the transplanted intestinal artery at a dose of 1000000 cells/kg. The second and third doses of MSCs were given directly into the mesenteric artery through the arterial anastomosis using an angiography catheter on day 15 and 30 post-transplant. RESULTS: The median follow-up for these patients was 10.6 mo (min: 2 mo-max: 30 mo). Three of the patients developed severe acute rejection. One of these patients did not respond to bolus steroid therapy. Although the other two patients did respond to anti-rejection treatment, they developed severe fungal and bacterial infections. All of these patients died in the 2nd and 3rd months post-transplant due to sepsis. The remaining patients who did not have acute rejection had good quality of life with no complications observed during the follow-up period. In addition, their intestinal grafts were functioning properly in the 13th, 25th and 30th month post-transplant. The patients who survived did not encounter any problems related to MSC transplantation. CONCLUSION: Although this is a small case series and not a randomized study, it is our opinion that small bowel transplantation is an effective treatment for intestinal failure, and MSC therapy may help to prevent acute rejection and graft vs host disease following intestinal transplantation. PMID:25009395

Do?an, Sait Murat; K?l?nç, Selçuk; Kebapç?, Eyüp; Tu?men, Cem; Gürkan, Alp; Baran, Ma?allah; Kurtulmu?, Yusuf; Ölmez, Mustafa; Karaca, Cezmi

2014-01-01

192

Usefulness of Intestinal Fatty Acid-Binding Protein in Predicting Strangulated Small Bowel Obstruction  

PubMed Central

Background The level of intestinal fatty acid-binding protein (I-FABP) is considered to be useful diagnostic markers of small bowel ischemia. The purpose of this retrospective study was to investigate whether the serum I-FABP level is a predictive marker of strangulation in patients with small bowel obstruction (SBO). Methods A total of 37 patients diagnosed with SBO were included in this study. The serum I-FABP levels were retrospectively compared between the patients with strangulation and those with simple obstruction, and cut-off values for the diagnosis of strangulation were calculated using a receiver operating characteristic curve. In addition, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Twenty-one patients were diagnosed with strangulated SBO. The serum I-FABP levels were significantly higher in the patients with strangulation compared with those observed in the patients with simple obstruction (18.5 vs. 1.6 ng/ml p<0.001). Using a cut-off value of 6.5 ng/ml, the sensitivity, specificity, PPV and NPV were 71.4%, 93.8%, 93.8% and 71.4%, respectively. An I-FABP level greater than 6.5 ng/ml was found to be the only independent significant factor for a higher likelihood of strangulated SBO (P?=? 0.02; odds ratio: 19.826; 95% confidence interval: 2.1560 – 488.300). Conclusions The I-FABP level is a useful marker for discriminating between strangulated SBO and simple SBO in patients with SBO. PMID:24926782

Kittaka, Hirotada; Akimoto, Hiroshi; Takeshita, Hitoshi; Funaoka, Hiroyuki; Hazui, Hiroshi; Okamoto, Masao; Kobata, Hitoshi; Ohishi, Yasuo

2014-01-01

193

Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease  

PubMed Central

Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy. PMID:24834228

Rajabalinia, Hassan; Dabiri, Reza; Shahbazi, Shahin; Ghobakhlou, Mehdi; Bahreiny, Rasoul; Molaei, Mahsa; Nejad, Mohammad Rostami

2012-01-01

194

Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease.  

PubMed

Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy. PMID:24834228

Rajabalinia, Hassan; Dabiri, Reza; Shahbazi, Shahin; Ghobakhlou, Mehdi; Bahreiny, Rasoul; Molaei, Mahsa; Rostami Nejad, Mohammad; Fatemi, Seyed Reza

2012-01-01

195

Metabolic effects of 3'-deoxyadenosine (cordycepin) and 2-halo-3'-deoxyadenosine on repair of X-ray-induced potentially lethal damage in Chinese hamster V79 cells  

SciTech Connect

Using cultured Chinese hamster V79 cells, an attempt has been made to examine the phosphorylation of cordycepin and its 2-halo derivatives (2-chloro-3'-deoxyadenosine, 2-bromo-3'-deoxyadenosine, and 2-iodo-3'-deoxyadenosine) by adenosine kinase, within the cells, and to correlate it with their cytotoxicities and abilities to inhibit the repair of X-ray-induced potentially lethal damage (PLDR). Of all compounds, only cordycepin was found to be phosphorylated and showed both potent cytotoxicity and ability to inhibit PLDR.

Hiraoka, W.; Tanabe, K.; Kuwabara, M.; Sato, F.; Matsuda, A.; Ueda, T.

1988-05-01

196

The lipophilic vitamin C derivative, 6-o-palmitoylascorbate, protects human lymphocytes, preferentially over ascorbate, against X-ray-induced DNA damage, lipid peroxidation, and protein carbonylation.  

PubMed

The aim of this study was to investigate protective effects of the lipophilic vitamin C derivative, 6-o-palmitoylascorbate (PlmtVC), against X-ray radiation-induced damages including cell death, DNA double-strand breaks (DSBs), lipid peroxidation, and protein carbonylation in human lymphocytes HEV0082, and the stability of PlmtVC under cell-cultured or cell-free condition. Irradiation with X-ray (1.5 Gy) diminished the cell viability and induced apoptosis, both of which were protected by pre-irradiational administration with PlmtVC. Gamma-H2A.X foci as a hallmark of DSBs were markedly enhanced in the irradiated cells. PlmtVC prevented X-ray-induced DSBs more appreciably than L-ascorbic acid (L-AA). Intracellular ROS production, lipid peroxidation, and protein carbonylation in HEV0082 cells were increased by X-ray at 1.5 Gy, all of which were significantly repressed by PlmtVC. PlmtVC also elevated endogenous reduced glutathione (GSH) in HEV0082 cells, and prevented X-ray-induced GSH depletion that are more appreciably over L-AA. Thus, PlmtVC prevents X-ray-induced cell death through its antioxidative activity. Stability tests showed that after being kept under physiological conditions (pH 7.4, 37 °C) for 14 days, vitamin C residual rates in PlmtVC solutions (62.2-82.0 %) were significantly higher than those in L-AA solutions (20.5-28.7 %). When PlmtVC or L-AA was added to HEV0082 lymphocytes, intracellular vitamin C in L-AA-treated cells was not detectable after 24 h, whereas PlmtVC-treated cells could keep a high level of intracellular vitamin C, suggesting an excellent stability of PlmtVC. Thus, X-ray-induced diverse harmful effects could be prevented by PlmtVC, which was suggested to ensue intrinsically from the persistent enrichment of intracellular vitamin C, resulting in relief to X-ray-caused oxidative stress. PMID:24898782

Xiao, Li; Tsutsui, Takeki; Miwa, Nobuhiko

2014-09-01

197

Protective effect of water yam (Dioscorea alata L.) extract on the copper-driven fenton reaction and X-ray induced DNA damage in vitro.  

PubMed

The rhizome extract of Dioscorea has been shown to possess radical scavenging activity. In this study, the protective effect of water yam (Dioscorea alata L.) rhizome extract on calf thymus DNA and plasmid DNA strand breakage by the copper-driven Fenton reaction and X-irradiation was examined. The protective activity in vitro of four lyophilized extracts obtained from yam rhizomes: (1) aqueous extract (YAE); (2) 30% ethanolic extract (YEE); (3) aqueous extract boiled for 30 min (BYAE); and (4) 30% ethanolic extract boiled for 30 min (BYEE) were evaluated by ethidium bromide binding assay and DNA nicking assay. The YAE, YEE, and BYEE effectively inhibited the copper-driven Fenton reaction-induced damage of calf thymus DNA, while inhibition was less pronounced in the case of X-ray induced strand breakage of plasmid DNA. While BYAE potently inhibited X-ray induced strand breaks in plasmid pGL3 DNA, it failed to inhibit, and even greatly enhanced copper-H(2)O(2) induced damage of calf thymus DNA. The present results demonstrate strong copper chelating and weak hydroxyl radical scavenging activities in yam rhizome extracts, and these activities may vary depending on the procedures used in preparing the extract. PMID:15162369

Wang, Tsu-Shing; Liang, Shih-Jyue; Lii, Chong-Kuei; Liu, Sin-Yie

2004-04-01

198

Conservative treatment of adhesive small bowel obstruction in children: a systematic review  

PubMed Central

Objective To assess the effectiveness of conservative treatment for adhesive small bowel obstruction (ASBO) in children. Design Systematic review of studies involved children with ASBO who received initial conservative/non-operative treatment. Setting The search was performed in April 2013 using PubMed (see online supplementary file 1), current contents, and the Cochrane database. Participants Children with ASBO. Interventions Conservative treatment included nasogastric decompression, parenteral fluids and correction of electrolyte and fluid imbalance. Primary outcome Treatment success. Secondary outcomes Length of hospital stay and the time to first feeding after hospital admission. Results 7 studies (six retrospective, one prospective), involving 8–109 patients (age: 1?month to 16?years) treated conservatively, were included in the review. The nature of conservative treatment was generally consistent between studies (nasogastric decompression, parenteral fluids and correction of electrolyte and fluid imbalance), although patients in one study also received Gastrografin. The rate of conservative treatment success ranged from 16% to 75% among the five studies, but one trial showed 0% successful rate. The hospital length of stay ranged from 3 to 6.5?days for conservative treatment (vs 10.2–13?days for operative treatment). The time to first feeding ranged from 31 to 84?h for conservative treatment. Conclusions In conclusion, in the majority of cases, conservative treatment is an effective means of managing ASBO in children. PMID:25223569

Lin, Lung-Huang; Lee, Chee-Yew; Hung, Min-Hsuan; Chen, Der-Fang

2014-01-01

199

Features on MDCT That Predict Surgery in Patients with Adhesive-Related Small Bowel Obstruction  

PubMed Central

Purpose The purpose of this study was to determine the contribution of multidetector-row computed tomography (MDCT) in the management of adhesion-related small bowel obstruction (SBO) and to identify its predictive value for surgery. Methods We conducted a retrospective review of 151 patients over a 5-year period with the diagnosis of SBO caused by adhesion. These patients were divided into two groups: surgery (n?=? 63) and observation group (n?=? 88). Two radiologists blinded to the outcome of the patients evaluated MDCT images retrospectively, recording the bowel diameter, bowel wall thickness, degree of obstruction, air-fluid level, mesenteric fatty stranding, transitional zone, intraperitoneal fluid, close loop, whirl sign, and faeces sign. Statistical analyses were performed using univariate and multivariable analyses. Results Multivariable analysis showed that MDCT demonstrated presence of intraperitoneal fluid (Odds ratio, OR, 4.38), high-grade or complete obstruction (OR, 3.19) and mesenteric fatty stranding (OR, 2.81), and absence of faeces sign (OR, 2.11) were the most significant predictors. When all of the four criteria were used in combination, high sensitivity of 98.4% and specificity of 90.9% were achieved for the prediction for surgery. Conclusion MDCT is useful to evaluate adhesion-related SBO and to predict accurately patients who require surgery. Use of the four MDCT features in combination is highly suggestive of the need for early surgical intervention. PMID:24587047

Chang, Wei-Chou; Ko, Kai-Hsiung; Lin, Chun-Shu; Hsu, Hsian-He; Tsai, Shih-Hung; Fan, Hsiu-Lung; Tung, Ho-Jui; Huang, Guo-Shu; Chen, Ran-Chou

2014-01-01

200

Bacteria and the mucus blanket in experimental small bowel bacterial overgrowth.  

PubMed Central

Self-filling blind loops were created experimentally in jejunal segments of specific pathogen-free male Wistar rats, and the loop contents and mucosa were examined over an 8-week period for evaluation of the interaction between mucus and luminal bacteria. Corresponding jejunal segments from rats that did not undergo surgery were used as controls. Proliferation of anaerobic bacteria developed in the test animals by the first week after surgery. Despite anaerobic bacterial proliferation, no adherence by bacteria to the intestinal microvillus surface was observed by scanning or transmission electron microscopy. Rather, bacteria were present within the mucus layer overlying the intestinal mucosal surface. Immunoassay of goblet cell mucin demonstrated an increase in the proportion of mucin present in the intestinal lumen and a decrease in mucin levels in the jejunal mucosa. These results suggest that the interaction of bacteria with mucus is an important mechanism of protection of the mucosal surface in experimental small bowel bacterial overgrowth. Images Figure 3 Figure 4 Figure 1 Figure 2 Figure 5 PMID:2950765

Sherman, P.; Fleming, N.; Forstner, J.; Roomi, N.; Forstner, G.

1987-01-01

201

Segmental small bowel necrosis associated with antiphospholipid syndrome: A case report  

PubMed Central

Antiphospholipid syndrome is a multi-system disease characterized by the formation of thromboembolic complications and/or pregnancy morbidity, and with persistently increased titers of antiphospholipid antibodies. We report the case of a 50-year-old, previously healthy man who presented with fever and new-onset, dull abdominal pain. A contrast-enhanced computed tomography scan showed segmental small bowel obstruction, for which an emergency laparotomy was performed. Histopathologic examination of resected tissues revealed multiple intestinal and mesenteric thromboses of small vessels. Laboratory tests for serum antiphospholipid (anticardiolipin IgM) and anti-?2-glycoprotein I antibodies were positive. Despite proactive implementation of anticoagulation, steroid, and antibiotic therapies, the patient’s condition rapidly deteriorated, and he died 22 d after admission. This case highlights that antiphospholipid syndrome should be suspected in patients with unexplainable ischemic bowel and intestinal necrosis presenting with insidious clinical features that may be secondary to the disease, as early diagnosis is critical to implement timely treatments in order to ameliorate the disease course. PMID:25852299

Wang, Qun-Ying; Ye, Xiao-Hua; Ding, Jin; Wu, Xiao-Kang

2015-01-01

202

Longitudinal mechanical tension induces growth in the small bowel of juvenile rats  

PubMed Central

Introduction: The aim of our study was to apply longitudinal force to the small bowel to increase the length of intestine in juvenile rats. Methods: Fifty juvenile rats had double barrelled, blind loop ostomies created using an isolated segment of bowel. Our intestinal lengthening device was inserted into one of the loops and the second loop served as a control. Once the device was deployed, the experimental, control, and in situ segments of bowel were evaluated for length, weight, histology, and disaccharidase enzyme activity. Results: Mechanical tension increased intestinal length by 149%. The lengthened bowel also exhibited a greater total weight (218%), greater mucosal weight (122%), and increased protein mass (164%) compared with the control limb of bowel. Histologically, there was a markedly increased thickness of the muscularis propria in the lengthened bowel (200% increase compared with the control limb). Functionally, we found increased total disaccharidase activity in the lengthened bowel (between 47% and 350%, depending on the particular enzyme tested; p<0.01). Conclusion: Mechanical tension induces intestinal growth by increasing length, weight of the bowel and mucosa, and protein mass. Histological changes, such as increases in Paneth cells, suggest that increased proliferation and reorganisation of the mucosa and muscularis propria are a response to mechanical tension. Functionally, increased intestinal length corresponds with increased disaccharidase activity, thus implying potential increased absorptive capacity of the lengthened bowel. PMID:15840689

Safford, S D; Freemerman, A J; Safford, K M; Bentley, R; Skinner, M A

2005-01-01

203

Influence of different protocols of antibiotic prophylaxis on endoluminal bacterial overgrowth and translocation following small-bowel or combined liver-small-bowel transplantation in a large-animal model  

Microsoft Academic Search

Bacterial translocation from the intestinal tract can cause systemic sepsis and multiple-organ failure in traumatized and immunocompromised patients. Compared to transplantation of other organs, small-bowel transplantation (SBT) is at higher risk of bacterial sepsis. Septic episodes are probably related to the overgrowth of endoluminal microflora and bacterial translocation.Translocation may be secondary to mucosal damage, immunologic impairment, and changes in microflora;

G. Privitera; R. Biffi; G. Rossi; E. Conte; B. Andreoni; S. Gatti

1997-01-01

204

Laparoscopic treatment of mucinous adenocarcinoma of jejunum associated with celiac disease. Case report.  

PubMed

Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described in the literature. Association of this tumor with celiac disease has never been published. The authors report a unique case of jejunal mucinous adenocarcinoma in which a concomitant celiac disease has been histologically recognized. The difficult diagnosis, the role of laparoscopic surgery and the relationship between small bowel tumors and celiac disease are discussed. A 49-year-old man presented with recurrent melena, nausea, vomiting and anemia. A stenosis of the jejunum was documented by means of CT scan and video capsule enteroscopy. A laparoscopy was scheduled. A tumor, found in the first jejunal loop, was removed by laparoscopic surgery. Histopathology revealed a rare mucinous adenocarcinoma associated with epithelial changes secondary to celiac disease. Although small bowel tumors are rare entity, in patients with celiac disease complaining of symptoms related to altered intestinal transit or occult bleeding, an appropriate work-up should be planned for diagnosis. Mucinous type intestinal adenocarcinoma, even if never published before, could be observed. Laparoscopic surgery is often essential for the diagnosis and treatment. PMID:22668531

Vecchio, R; Marchese, S; Gangemi, P; Alongi, G; Ferla, F; Spataro, C; Intagliata, E

2012-04-01

205

Small bowel stricture characterization and outcomes of dilatation by double-balloon enteroscopy: a single-centre experience  

PubMed Central

Background: There is little data on the role of balloon enteroscopy and small bowel strictures. We aim to characterize the diagnostic role of double balloon enteroscopy (DBE) in small bowel strictures and document the outcomes of dilatation. Methods: This is a retrospective review from a single tertiary referral centre DBE database from July 2004 to September 2012. All patients with suspected strictures in the small bowel undergoing DBE were included. The position of the small bowel strictures considered for dilatation was determined by diagnostic imaging, i.e. CT enterography, MR enterography or capsule endoscopy in the workup before DBE. Endpoints included stricture description, dilatation parameters and response to treatment. Main outcome measurements were the safety and efficacy of DBE and dilatation. Results: From our DBE database of 594 patients, a total of 32 patients underwent 44 DBE procedures for suspected or known strictures. Stricture aetiology included Crohn’s disease (CD), nonsteroidal anti-inflammatory drugs (NSAIDs), surgical, Beçhets disease and one unknown. A total of 17 patients did not undergo dilatation as the strictures were ulcerated, nonobstructing or of uncertain aetiology. From the total of 25 dilatations in 15 patients that were attempted, 8/15 (53%) patients had 1 dilatation, 5 patients had 2 dilatations, 1 had 3 dilatations and 1 had 4 dilatations. The mean dilatation diameter was 14 mm. Three patients underwent surgery post-dilatation (2 for perforation). Mean follow up was 16 months. Conclusion: DBE is a useful method in determining the need for dilatation by assessing for active ulceration. Dilatation is effective in the 10–18 mm range, however perforation does occur. PMID:24790641

Gill, Raghubinder S.

2014-01-01

206

Ventriculoperitoneal shunt with a rare twist: small-bowel ischemia and necrosis secondary to knotting of peritoneal catheter.  

PubMed

Small-bowel ischemia and necrosis due to knotting of the peritoneal catheter is an extremely rare complication related to a ventriculoperitoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal catheter from the scalp incision were met with resistance, the distal catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal catheter must be carefully managed with immediate abdominal exploration to remove the distal catheter to avoid bowel necrosis as pulling of a knotted peritoneal catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality. PMID:24995817

Tan, Lee A; Kasliwal, Manish K; Moftakhar, Roham; Munoz, Lorenzo F

2014-09-01

207

Percutaneous endoscopic gastrojejunostomy for a patient with an intractable small bowel injury after repeat surgeries: a case report  

PubMed Central

Introduction The management of intestinal injury can be challenging, because of the intractable nature of the condition. Surgical treatment for patients with severe adhesions sometimes results in further intestinal injury. We report a conservative management strategy using percutaneous endoscopic gastrojejunostomy for an intractable small bowel surgical injury after repeated surgeries. Case presentation A 78-year-old Japanese woman had undergone several abdominal surgeries including urinary cystectomy for bladder cancer. After this operation, she developed peritonitis as a result of a small bowel perforation thought to be due to an injury sustained during the operation, with signs consistent with systemic inflammatory response syndrome: body temperature 38.5°C, heart rate 92 beats/minute, respiratory rate 23 breaths/minute, white blood cell count 11.7 × 109/L (normal range 4-11 × 109/?L). Two further surgical interventions failed to control the leak, and our patient's clinical condition and nutritional status continued to deteriorate. We then performed percutaneous endoscopic gastrojejunostomy, and continuous suction was applied as an alternative to a third surgical intervention. With this endoscopic intervention, the intestinal leak gradually closed and oral feeding became possible. Conclusion We suggest that the technique of percutaneous endoscopic gastrojejunostomy combined with a somatostatin analog is a feasible alternative to surgical treatment for small bowel leakage, and is less invasive than a nasojejunal tube. PMID:21310033

2011-01-01

208

Diffuse mesenterial sclerosis: a characteristic feature of chronic small-bowel allograft rejection.  

PubMed

Chronic rejection is the major cause of late intestinal allograft dysfunction. The aim of this study was to analyze in detail the histopathological features of chronic rejection in the ACI-to-Lewis rat model of intestinal transplantation. Chronic rejection was achieved in orthotopic small-bowel allografts (ACI-Lewis) by limited immunosuppression with cyclosporin A (CyA). Isogeneic transplants (ACI-ACI) as well as native bowels (ACI) with and without immunosuppression served as controls. Bowels were removed together with the mesenteries 90 days postoperatively and analyzed using sections stained with hematoxylin and eosin as well as Masson's trichrome. The slides were coded, randomized and analyzed by grading of histological abnormalities. The most striking alterations of the allografts were noticed in the mesenteries exhibiting an extensive infiltration by mononuclear cells accompanied by a progressive diffuse fibrosis with shrinking of the mesenteries. These changes were most pronounced in the perivascular areas of the mesenteric arteriae and venae rectae. Three of five allografts showed vasculitis with myointimal proliferation of the arteriae rectae. Focally, there was spill-over of the inflammatory cells onto the intestinal muscularis propria. The mucosa of the allografts showed mild blunting, lymphocytic infiltration of the crypt epithelium and increased crypt cell apoptoses. The submucosa was unaffected, and there were no detectable abnormalities of the enteric ganglion cells. The present data support the view that chronic rejection of intestinal allografts is characterized by a diffuse sclerosing mesenteritis which may significantly contribute to late graft dysfunction. The present model may be useful to study the pathomechanisms of this inflammatory fibrosing process. PMID:12536314

Klaus, Alexander; Margreiter, Raimund; Pernthaler, Heinz; Klima, Günther; Offner, Felix A

2003-01-01

209

Threshold level of NF-kB activation in small bowel ischemic preconditioning procedure.  

PubMed

Ischemic preconditioning (IPC), which is obtained by exposure to brief periods of vascular occlusion, improves organ tolerance to prolonged ischemia. The aim of this study was to evaluate the threshold level of NF-kB activation in small intestine during an IPC procedure. Various intestinal IPC were performed on 20 Wistar rats in seven groups: group I (GI, nonpreconditioned); group II (GII, 1-minute ischemia and 1-minute reperfusion); group III (GIII, two cycles of 1-minute ischemia and 1-minute reperfusion); group IV (GIV, 2-minutes ischemia and 2-minutes reperfusion); group V (GV, two cycles of 2-minute ischemia and 2-minute reperfusion); group VI (GVI, 5-minute ischemia and 10-minute reperfusion); group VII (GVII, two cycles of 5-minute ischemia and 10-minute reperfusion). Bowel biopsies were collected after laparotomy (control) as well as at 30, 60, and 120 minutes following IPC. We determined the cytoplasmic and nuclear NF-kB by a chemiluminescence-based ELISA method. Our results showed low, constant NF-kB levels in GI. In the preconditioned groups (GII-GVII), NF-kB was significantly elevated at 30 minutes following IPC (P < .05 vs control). After 1 hour, NF-kB activity decreased to the control level. However, 2 hours after IPC both forms of NF-kB were elevated significantly again, which was independent of the number of IPC cycles (P < .05 vs control). Our experiments revealed that one cycle of 1-minute ischemia and 1-minute reperfusion is a critical threshold level for NF-kB activation during small bowel IPC. Longer and more IPC cycles did not result in further elevation of NF-kB activation. PMID:16908285

Ferencz, A; Rácz, B; Gasz, B; Kalmár-Nagy, K; Horváth, O P; Röth, E

2006-01-01

210

Postoperative Irradiation for Rectal Cancer Increases the Risk of Small Bowel Obstruction After Surgery  

PubMed Central

Objective: To determine the risk of small bowel obstruction (SBO) after irradiation (RT) for rectal cancer Background: SBO is a frequent complication after standard resection of rectal cancer. Although the use of RT is increasing, the effect of RT on risk of SBO is unknown. Methods: We conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims data to determine the effect of RT on risk of SBO. Patients 65 years of age and older diagnosed with nonmetastatic invasive rectal cancer treated with standard resection from 1986 through 1999 were included. We determined whether patients had undergone RT and evaluated the effect of RT and timing of RT on the incidence of admission to hospital for SBO, adjusting for potential confounders using a proportional hazards model. Results: We identified a total of 5606 patients who met our selection criteria: 1994 (36%) underwent RT, 74% postoperatively. Patients were followed for a mean of 3.8 years. A total of 614 patients were admitted for SBO over the study period; 15% of patients in the RT group and 9% of patients in the nonirradiated group (P < 0.001). After controlling for age, sex, race, diagnosis year, type of surgery, and stage, we found that patients who underwent postoperative RT were at higher risk of SBO, hazard ratio 1.69 (95% CI, 1.3–2.1). However, the long-term risk associated with preoperative irradiation was not statistically significant (hazard ratio, 0.89; 95% CI, 0.55–1.46). Conclusions: Postoperative but not preoperative RT after standard resection of rectal cancer results in an increased risk of SBO over time. PMID:17414603

Baxter, Nancy N.; Hartman, Lacey K.; Tepper, Joel E.; Ricciardi, Rocco; Durham, Sara B.; Virnig, Beth A.

2007-01-01

211

Double-illumination photoacoustic microscopy of intestinal hemodynamics following massive small bowel resection  

NASA Astrophysics Data System (ADS)

Massive small bowel resection (SBR) results in villus angiogenesis and intestinal adaptation. The exact mechanism that causes intestinal villus angiogenesis remains unknown. We hypothesize that hemodynamic changes within the remnant bowel after SBR will trigger intestinal angiogenesis. To validate this, we used photoacoustic microscopy (PAM) to image the microvascular system of the intestine in C57B6 mice and to measure blood flow and oxygen saturation (sO2) of a supplying artery and vein. Baseline measurements were made 6 cm proximal to the ileal-cecal junction (ICJ) prior to resection. A 50% proximal bowel resection was then performed, and measurements were again recorded at the same location immediately, 1, 3 and 7 days following resection. The results show that arterial and venous sO2 were similar prior to SBR. Immediately following SBR, the arterial and venous sO2 decreased by 14.3 +/- 2.7% and 32.7 +/- 6.6%, respectively, while the arterial and venous flow speed decreased by 62.9 +/- 17.3% and 60.0 +/- 20.1%, respectively. Such significant decreases in sO2 and blood flow indicate a hypoxic state after SBR. Within one week after SBR, both sO2 and blood flow speed had gradually recovered. By 7 days after SBR, arterial and venous sO2 had increased to 101.0 +/- 2.9% and 82.7 +/- 7.3% of the baseline values, respectively, while arterial and venous flow speed had increased to 106.0 +/- 21.4% and 150.0 +/- 29.6% of the baseline values, respectively. Such increases in sO2 and blood flow may result from angiogenesis following SBR.

Yao, Junjie; Rowland, Kathryn J.; Wang, Lidai; Maslov, Konstantin I.; Warner, Brad W.; Wang, Lihong V.

2012-02-01

212

Small Bowel Obstruction After Laparoscopic Gastric Bypass with Nonclosure of Mesenteric Defects  

PubMed Central

Background and Objectives: There is a wide variation of reported incidence of small bowel obstruction (SBO) after laparoscopic Roux-en-Y gastric bypass (LGB). There is also wide variation in technique, not only in placement of the Roux limb, but also regarding closure or nonclosure of the mesenteric defects. The objective of this study was to examine the incidence and characteristics of SBO after antecolic antegastric bypass with nonclosure of the mesenteric defect of the jejunojejunal anastomosis. Methods: This is a retrospective review of a series of consecutive LGBs over a 3-year period. All procedures were performed by the same surgeon using the same technique. In no case was the mesenteric defect closed. A prospectively maintained database was used for data collection. Patients who returned with an SBO were the study group, and those who underwent revisional bariatric surgery or conversion to open operation were excluded. Results: There were 249 primary LGBs performed during the study period; 15 of the operations were followed by SBO, for an incidence of 6.0%. Four cases were caused by an internal hernia (IH), for an incidence of 1.6%, and 11 were caused by adhesions, which accounted for 73% of the SBOs. Conclusions: SBO after LGB is a relatively common complication. The incidence of SBO from IH with nonclosure of the mesenteric defect is similar to that in other series where the defect is closed. Regardless of the cause of the SBO, operative treatment of the patient who has a gastric bypass remains the definitive standard and should not be delayed.

2015-01-01

213

Small-bowel mucosal injuries in low-dose aspirin users with obscure gastrointestinal bleeding  

PubMed Central

AIM: To investigate the clinical differences between small intestinal injuries in low-dose aspirin (LDA) users and in non-steroidal anti-inflammatory drug (NSAID) users who were examined by capsule endoscopy (CE) for obscure gastrointestinal bleeding (OGIB). METHODS: A total of 181 patients who underwent CE for OGIB were included in this study. Based on clinical records, laboratory data such as hemoglobin levels, major symptoms, underlying diseases, the types and duration of LDA and NSAID use, and endoscopic characteristics of CE were reviewed. RESULTS: Out of a total of 45 cases of erosive lesions, 27 cases were taking LDA or NSAIDs (7 were on NSAIDs, 9 were on LDA alone, 9 were on LDA and thienopyridine, and 2 were on LDA and warfarin).The prevalence of ulcers or erosion during chronic use of LDA, LDA and the anti-platelet drug thienopyridine (clopidogrel or ticlopidine), and NSAIDs were 64.3%, 80.0%, and 75.0%, respectively. Erosive lesions were observed predominantly in chronic LDA users, while ulcerative lesions were detected mainly in NSAID users. However, concomitant use of thienopyridine such as clopidogrel with LDA increased the proportion of ulcers. The erosive lesions were located in the whole of the small intestine (jejunum and ileum), whereas ulcerative lesions were mainly observed in the ileum (P < 0.05). CONCLUSION: Our CE findings indicate that chronic LDA users and NSAID users show different types and locations of small-bowel mucosal injuries. The concomitant use of anti-platelet drugs with LDA tends to exacerbate the injuries from LDA-type to NSAID-type injuries. PMID:25278707

Iwamoto, Junichi; Mizokami, Yuji; Saito, Yoshifumi; Shimokobe, Koichi; Honda, Akira; Ikegami, Tadashi; Matsuzaki, Yasushi

2014-01-01

214

Challenging diagnosis of a jejunal adenocarcinoma with ovarian metastasis: report of an unusual case  

PubMed Central

We report the first documented case of ovarian metastasis from a jejunal primary adenocarcinoma in an Australian patient. The presentation was unusual, initially a suspicious abdominal nodule in the epigastric area, which turned out to be an adenocarcinoma of possible intestinal origin. Gastroscopy and colonoscopy were performed with no suspicious lesion identified. Abdominal and pelvic ultrasound imaging showed a complex pelvic mass suspicious of ovarian cancer. Laparoscopy was performed to exclude possibility of ovarian cancer and small bowel cancer. The ovarian mass showed similar features from the epigastric nodule, again suggestive of intestinal primary. Definitive diagnosis was obtained when the patient represented 2?months later with malignant bowel obstruction requiring palliative resection of the proximal jejunum. This case demonstrates the difficulty in diagnosing ovarian metastasis from a small bowel primary, which has the potential to mimic an ovarian primary tumour clinically, and a large bowel or ovarian primary pathologically. PMID:23580681

Huang, Yang Yang; Pratt, Jeremy John; Dabner, Marcus; Tjhin, William

2013-01-01

215

Enterogenesis in a clinically feasible model of mechanical small-bowel lengthening  

PubMed Central

Background Recent work indicates that mechanical force induces small-bowel growth, although methods reported do not have direct clinical application. We report a clinically feasible technique of enterogenesis and describe intestinal function in this model. Methods Using a pig model (n = 11), we stretched isolated small intestinal segments mechanically for 7 days in vivo with an intraluminal device. Control segments were not stretched. Morphology, histology, and epithelial proliferation were assessed. Absorption and epithelial barrier function were examined in an Ussing chamber. Results Stretch segments were significantly longer than Control segments and had nearly 2-fold greater surface area (P < .001). Mucosal thickness was much greater in Stretch than Control segments (772 ± 134 vs. 647 ± 75 ?m, P = .02). Although villus height was reduced in Stretch and Control segments (353 ± 76 vs. 324 ± 76 ?m, P = .6) versus native jejunum (522 ± 87, P < .0005), crypt depth was increased dramatically in Stretch (450 ± 95 ?m) versus Control segments (341 ± 64, P = .005). This observation was accompanied by a 2-fold increase in cellular proliferation (26.3 ± 3.8 vs 12.1 ± 6.6 % bromodeoxyuridine+, P < .05). Barrier function was intact ([3H]-mannitol permeation, 0.16 ± 0.08%, vs native jejunum, 0.17 ± 0.08%, P = .81). Glucose-mediated sodium transport was similar in Stretch versus native jejunum segments (60.0 ± 23.5 vs 82.3 ± 47.3 ?A/ cm2, P = .31), as was carbachol-induced chloride transport (82.4 ± 72.2 vs 57.2 ± 33.4 ?A/cm2, P = .54) and alanine absorption (16.46 ± 12.94 vs 23.53 ± 21.31 ?A/cm2, P = .53). Conclusions Mechanical stretching induces small intestinal growth, while maintaining function. Epithelial architecture does change, such that a decrease in villus height is offset by a marked increase in crypt depth and a 2-fold increase in epithelial proliferation. Epithelial barrier and absorptive functions remain intact. The device described may have direct clinical applicability. PMID:16904972

Spencer, Ariel U.; Sun, Xiaoyi; El-Sawaf, Mohammed; Haxhija, Emir Q.; Brei, Diann; Luntz, Jonathan; Yang, Hua; Teitelbaum, Daniel H.

2007-01-01

216

Gastric vs Small Bowel Feeding in Critically Ill Neurologically Injured Patients: Results of a Multicenter Observational Study.  

PubMed

Background: To evaluate gastric compared with small bowel feeding on nutrition and clinical outcomes in critically ill, neurologically injured patients. Materials and Methods: International, prospective observational studies involving 353 intensive care units (ICUs) were included. Eligible patients were critically ill, mechanically ventilated with neurological diagnoses who remained in the ICU and received enteral nutrition (EN) exclusively for at least 3 days. Sites provided data, including patient characteristics, nutrition practices, and 60-day outcomes. Patients receiving gastric or small bowel feeding were compared. Covariates including age, sex, body mass index, and Acute Physiology and Chronic Health Evaluation II score were used in the adjusted analyses. Results: Of the 1691 patients who met our inclusion criteria, 1407 (94.1%) received gastric feeding and 88 (5.9%) received small bowel feeding. Adequacy of calories from EN was highest in the gastric group (60.2% and 52.3%, respectively, unadjusted analysis; P = .001), but this was not significant in the adjusted model (P = .428). The likelihood of EN interruptions due to gastrointestinal (GI) complications was higher for the gastric group (19.6% vs 4.7%, unadjusted model; P = .015). There were no significant differences in the rate of discontinuation of mechanical ventilation (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.66-1.12; P = .270) or the rate of being discharged alive from the ICU (HR, 0.94; 95% CI, 0.72-1.23; P = .641) and hospital (HR, 1.16; 95% CI, 0.87-1.55; P = .307) after adjusting for confounders. Conclusions: Despite a higher likelihood of EN interruptions due to GI complications, gastric feeding may be associated with better nutrition adequacy, but neither route is associated with better clinical outcomes. PMID:24947058

Saran, Delara; Brody, Rebecca A; Stankorb, Susan M; Parrott, Scott J; Heyland, Daren K

2014-06-19

217

Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: Investigating dose-volume relationships and role for inverse planning  

SciTech Connect

Purpose: The relationship between volume of irradiated small bowel (VSB) and acute toxicity in rectal cancer radiotherapy is poorly quantified, particularly in patients receiving concurrent preoperative chemoradiotherapy. Using treatment planning data, we studied a series of such patients. Methods and Materials: Details of 41 patients with locally advanced rectal cancer were reviewed. All received 45 Gy in 25 fractions over 5 weeks, 3-4 fields three-dimensional conformal radiotherapy with daily 5-fluorouracil and folinic acid during Weeks 1 and 5. Toxicity was assessed prospectively in a weekly clinic. Using computed tomography planning software, the VSB was determined at 5 Gy dose intervals (V{sub 5}, V{sub 1}, etc.). Eight patients with maximal VSB had dosimetry and radiobiological modeling outcomes compared between inverse and conformal three-dimensional planning. Results: VSB correlated strongly with diarrheal severity at every dose level (p < 0.03), with strongest correlation at lowest doses. Median VSB differed significantly between patients experiencing Grade 0-1 and Grade 2-4 diarrhea (p {<=} 0.05). No correlation was found with anorexia, nausea, vomiting, abdominal cramps, age, body mass index, sex, tumor position, or number of fields. Analysis of 8 patients showed that inverse planning reduced median dose to small bowel by 5.1 Gy (p = 0.008) and calculated late normal tissue complication probability (NTCP) by 67% (p = 0.016). We constructed a model using mathematical analysis to predict for acute diarrhea occurring at V{sub 5} and V{sub 15}. Conclusions: A strong dose-volume relationship exists between VSB and acute diarrhea at all dose levels during preoperative chemoradiotherapy. Our constructed model may be useful in predicting toxicity, and this has been derived without the confounding influence of surgical excision on bowel function. Inverse planning can reduce calculated dose to small bowel and late NTCP, and its clinical role warrants further investigation.

Tho, Lye Mun [Colorectal Cancer Team, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom)]. E-mail: l.tho@beatson.gla.ac.uk; Glegg, Martin [Department of Radiation Physics, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); Paterson, Jennifer [Department of Radiation Physics, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); Yap, Christina [Robertson Centre for Biostatistics, University of Glasgow, Glasgow (United Kingdom); MacLeod, Alice [Colorectal Cancer Team, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); McCabe, Marie [Colorectal Cancer Team, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); McDonald, Alexander C. [Colorectal Cancer Team, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom)

2006-10-01

218

Jejunal adenocarcinoma with concomitant enterolith presenting as acute intestinal obstruction.  

PubMed

An enterolith is an infrequent clinical entity. It is generally diagnosed on imaging or at surgery. It is usually associated with underlying benign lesions like intestinal tuberculosis or Crohn's disease. Here, we report an unusual case of an elderly lady presenting with an acute small-bowel obstruction. On admission, her abdominal X-ray revealed a radio-opacity obstructing the jejunum. Her subsequent abdominal contrast-enhanced computed tomography revealed a big enterolith entrapped in a stricturous jejunal lesion. However, there was no pneumobilia. Consequently, she underwent an exploratory laparotomy followed by an "en-block" jejunal resection for suspiciously malignant impassable jejunal stricture. The cutopen specimen revealed 5 x 4 cm enterolith embedded in a tight ulcero-proliferative stricture. Histopathology confirmed jejunal adenocarcinoma. It is always prudent to suspect an underlying small-bowel malignancy while managing a seemingly straightforward case of small-bowel obstruction. The policy of prophylactic radical oncologic clearance may avoid inadvertent R1/R2 resections. PMID:24717991

Yadav, Sudeep Pradeep; Jategaonkar, Priyadarshan Anand; Goyal, Aayush; Kamath, Dinesh

2014-03-01

219

Lassoing of the small bowel mesentery and abdominal pain caused by band tubing after "band on bypass".  

PubMed

Weight regain after laparoscopic gastric bypass can be difficult to manage. A common finding is an enlarged gastrojejunal complex (dilated gastric pouch and/or jejunum, dilated gastrojejunal anastomosis). Revision of the gastrojejunal complex can be accomplished by surgical resection, endoscopic plication techniques, or more recently, placement of an adjustable band around the dilated gastric pouch ("band on bypass," BoB). We present an unusual complication of the BoB procedure, in which the band tubing looped around the small bowel causing severe abdominal pain. PMID:23219587

Magee, Conor; Saha, Shopon; Kerrigan, David D

2013-01-01

220

Double and synchronous trichobezoars causing small-bowel obstruction and detected by multidetector computed tomography: report of two cases.  

PubMed

A trichobezoar is a rare mass formed by the ingestion and accumulation of hair within the gastrointestinal tract, especially the stomach. Cases of an isolated gastric trichobezoar with extension into the duodenum or the jejunum have been reported; however, synchronous gastric and intestinal trichobezoars causing a small-bowel obstruction is very unusual. We report our experience of two such cases to demonstrate the efficiency of preoperative multidetector computed tomography in locating the double bezoars and assisting us in surgical decision making. Open surgery is inevitable for symptomatic bezoars, because the masses are too hard and large to break up with endoscopic devices. PMID:24823943

Aoi, Shigeyoshi; Kimura, Kouseki; Tsuda, Tomoki

2015-05-01

221

An unusual case of candidemia presenting as acute respiratory distress syndrome after a small bowel bezoar removal operation  

PubMed Central

We report a rare case of sepsis with acute respiratory distress syndrome (ARDS) caused by Candida parapsilosis and Candida famata after a small bowel bezoar operation. The patient was successfully treated with intensive care including mechanical ventilation and systemic antifungal therapy. A strong association was observed between the intestinal obstruction caused by the bezoar and candidemia presenting as ARDS. This is the first case in which candidemia has led to ARDS after a bezoar removal operation in a patient who was neither immunocompromised nor self-administering an illicit intravenous drug. PMID:25553325

Mun, Yun Su; Park, Joo Seung; Lee, Jun Wan; Jung, Sun-Young; Yoon, Hee Jung; Han, Hyun-Young

2015-01-01

222

[Molecular changes in adenocarcinoma of the small intestine associated with Peutz-Jeghers syndrome].  

PubMed

The presence of molecular alterations in the c-K-ras and p53 genes in a small bowel adenocarcinoma arising in a case of Peutz-Jeghers syndrome is reported. The absence of mutations at codon 12 and 13 of the c-K-ras gene in the hamartoma and carcinoma indicates that this oncogene does not contribute to its development. On the other hand, p53 protein overexpression was detected in a small proportion (5-10%) of adenocarcinoma cells. Our findings suggest that p53 inactivation occur in late stages of tumour progression. PMID:8664070

Hidalgo, L; Villanueva, A; Soler, T; Matías Guiu, X; Capellá, G

1996-02-01

223

First glimpse of the soft x-ray induced excited spin-state trapping effect dynamics on spin cross-over molecules  

NASA Astrophysics Data System (ADS)

The dynamics of the soft x-ray induced excited spin state trapping (SOXIESST) effect of Fe(phen)2(NCS)2 (Fe-phen) powder have been investigated by x-ray absorption spectroscopy (XAS) using the total electron yield method, in a wide temperature range. The low-spin (LS) state is excited into the metastable high-spin (HS) state at a rate that depends on the intensity of the x-ray illumination it receives, and both the temperature and the intensity of the x-ray illumination will affect the maximum HS proportion that is reached. We find that the SOXIESST HS spin state transforms back to the LS state at a rate that is similar to that found for the light induced excited spin state trapping (LIESST) effect. We show that it is possible to use the SOXIESST effect in combination with the LIESST effect to investigate the influence of cooperative behavior on the dynamics of both effects. To investigate the impact of molecular cooperativity, we compare our results on Fe-phen with those obtained for Fe{[Me2Pyrz]3BH}2 (Fe-pyrz) powder, which exhibits a similar thermal transition temperature but with a hysteresis. We find that, while the time constant of the dynamic is identical for both molecules, the SOXIESST effect is less efficient at exciting the HS state in Fe-pyrz than in Fe-phen.

Davesne, V.; Gruber, M.; Miyamachi, T.; Da Costa, V.; Boukari, S.; Scheurer, F.; Joly, L.; Ohresser, P.; Otero, E.; Choueikani, F.; Gaspar, A. B.; Real, J. A.; Wulfhekel, W.; Bowen, M.; Beaurepaire, E.

2013-08-01

224

X-ray induced Sm3+ to Sm2+ conversion in fluorophosphate and fluoroaluminate glasses for the monitoring of high-doses in microbeam radiation therapy  

NASA Astrophysics Data System (ADS)

Fluorophosphate and fluoroaluminate glasses doped with trivalent samarium were evaluated as sensors of x-ray radiation for microbeam radiation therapy at the Canadian Light Source using the conversion of trivalent Sm3+ to the divalent form Sm2+. Both types of glasses show similar conversion rates and may be used as a linear sensor up to ˜150 Gy and as a nonlinear sensor up to ˜2400 Gy, where saturation is reached. Experiments with a multi-slit collimator show high spatial resolution of the conversion pattern; the pattern was acquired by a confocal fluorescence microscopy technique. The effects of previous x-ray exposure may be erased by annealing at temperatures exceeding the glass transition temperature Tg while annealing at TA < Tg enhances the Sm conversion. This enhancement is explained by a thermally stimulated relaxation of host glass ionic matrix surrounding x-ray induced Sm2+ ions. In addition, some of the Sm3+-doped glasses were codoped with Eu2+-ions but the results show that there is no marked improvement in the conversion efficiency by the introduction of Eu2+.

Vahedi, Shahrzad; Okada, Go; Morrell, Brian; Muzar, Edward; Koughia, Cyril; Edgar, Andy; Varoy, Chris; Belev, George; Wysokinski, Tomasz; Chapman, Dean; Kasap, Safa

2012-10-01

225

X-ray-induced reduction of Au ions in an aqueous solution in the presence of support materials and in situ time-resolved XANES measurements  

PubMed Central

Synchrotron X-ray-induced reduction of Au ions in an aqueous solution with or without support materials is reported. To clarify the process of radiation-induced reduction of metal ions in aqueous solutions in the presence of carbon particles as support materials, in situ time-resolved XANES measurements of Au ions were performed under synchrotron X-ray irradiation. XANES spectra were obtained only when hydrophobic carbon particles were added to the precursor solution containing Au ions. Changes in the shape of the XANES spectra indicated a rapid reduction from ionic to metallic Au in the precursor solution owing to synchrotron X-ray irradiation. In addition, the effects of the wettability of the carbon particles on the deposited Au metallic spots were examined. The deposited Au metallic spots were different depending on the relationship of surface charges between metal precursors and support materials. Moreover, a Au film was obtained as a by-product only when hydrophilic carbon particles were added to the precursor solution containing the Au ions. PMID:25178005

Ohkubo, Yuji; Nakagawa, Takashi; Seino, Satoshi; Kugai, Junichiro; Yamamoto, Takao A.; Nitani, Hiroaki; Niwa, Yasuhiro

2014-01-01

226

X-ray-induced reduction of Au ions in an aqueous solution in the presence of support materials and in situ time-resolved XANES measurements.  

PubMed

Synchrotron X-ray-induced reduction of Au ions in an aqueous solution with or without support materials is reported. To clarify the process of radiation-induced reduction of metal ions in aqueous solutions in the presence of carbon particles as support materials, in situ time-resolved XANES measurements of Au ions were performed under synchrotron X-ray irradiation. XANES spectra were obtained only when hydrophobic carbon particles were added to the precursor solution containing Au ions. Changes in the shape of the XANES spectra indicated a rapid reduction from ionic to metallic Au in the precursor solution owing to synchrotron X-ray irradiation. In addition, the effects of the wettability of the carbon particles on the deposited Au metallic spots were examined. The deposited Au metallic spots were different depending on the relationship of surface charges between metal precursors and support materials. Moreover, a Au film was obtained as a by-product only when hydrophilic carbon particles were added to the precursor solution containing the Au ions. PMID:25178005

Ohkubo, Yuji; Nakagawa, Takashi; Seino, Satoshi; Kugai, Junichiro; Yamamoto, Takao A; Nitani, Hiroaki; Niwa, Yasuhiro

2014-09-01

227

Mechanisms for dominance: Adh heterodimer formation in heterozygotes between ENU or x-ray induced null alleles and normal alleles in drosophila melanogaster  

SciTech Connect

To study mechanisms for dominance of phenotype, eight ENU- and four x-ray-induced mutations at the alcohol dehydrogenase (Adh) locus were analyzed for partial dominance in their interaction with normal alleles. All ENU and one of the x-ray mutations were single base substitutions; the other three x-ray mutations were 9-21 base deletions. All but one of the 12 mutant alleles were selected for this study because they produced detectable mutant polypeptides, but seven of the 11 producing a peptide could not form dimers with the normal peptide and the enzyme activity of heterozygotes was about half that of normal homozygotes. Four mutations formed dimers with a decreased catalytic efficiency and two of these were near the limit of detectability; these two also inhibited the formation of normal homodimers. The mutant alleles therefore show multiple mechanisms leading to partial enzyme expression in heterozygotes and a wide range of dominance ranging from almost complete recessive to nearly dominant. All amino acid changes in mutant peptides that form dimers are located between amino acids 182 and 194, so this region is not critical for dimerization. It may, however, be an important surface domain for catalyzation. 34 refs., 8 figs., 2 tabs.

Jiang, J.C.; Lee, W.R.; Chang, S.H.; Silverman, H. (Louisiana State Univ., Baton Rouge (United States))

1992-01-01

228

Contrasting effects of Krüppel-like factor 4 on X-ray-induced double-strand and single-strand DNA breaks in mouse astrocytes.  

PubMed

Astrocytes, the most common cell type in the brain, play a principal role in the repair of damaged brain tissues during external radiotherapy of brain tumours. As a downstream gene of p53, the effects of Krüppel-like factor 4 (KLF4) in response to X-ray-induced DNA damage in astrocytes are unclear. In the present study, KLF4 expression was upregulated after the exposure of astrocytes isolated from the murine brain. Inhibition of KLF4 expression using lentiviral transduction produced less double-strand DNA breaks (DSB) determined by a neutral comet assay and flow cytometric analysis of phosphorylated histone family 2A variant and more single-strand DNA breaks (SSB) determined by a basic comet assay when the astrocytes were exposed to 4?Gy of X-ray radiation. These data suggest that radiation exposure of the tissues around brain tumour during radiation therapy causes KLF4 overexpression in astrocytes, which induces more DSB and reduces SSB. This causes the adverse effects of radiation therapy in the treatment of brain tumours. PMID:24114958

Zhang, Ji; Cui, Fengmei; Li, Lei; Yang, Jiangtao; Zhang, Liyuan; Chen, Qiu; Tian, Ye

2014-04-01

229

Intestinal Adaptation for Oligopeptide Absorption via PepT1 After Massive (70%) Mid Small Bowel Resection  

PubMed Central

Introduction Proteins are absorbed primarily as short peptides via PepT1. Hypothesis Intestinal adaptation for peptide absorption after massive mid-small intestinal resection occurs by increased expression of PepT1 in the remnant small intestine and colon. Methods Peptide uptake was measured in duodenum, jejunum, ileum, and colon using Glycyl-Sarcosine 1 wk (n=9) and 4 wk (n=11) after 70% mid-small bowel resection, and in corresponding segments from unoperated rats (n=12) and after transection and reanastomosis of jejunum and ileum (n=8). Expression of PepT1 (mRNA, protein) and villus height were measured. Results Intestinal transection/reanastomosis did not alter gene expression. Compared to non-operated controls, 70% mid-small bowel resection increased jejunal peptide uptake (p<0.05) associated with increased villus height (1.13 vs 1.77 and 1.50 mm resp, p<0.01). In ileum although villus height increased at 1 and 4 wk (1.03 vs 1.21 and 1.35 mm resp; p<0.01), peptide uptake was not altered. PepT1 mRNA and protein were decreased at 1 wk, and PepT1 protein continued low at 4 wk. Gene expression, peptide uptake, and histomorphology were unchanged in the colon. Conclusions Jejunal adaptation for peptide absorption occurs by hyperplasia. Distal Ileum and colon do not have a substantive role in adaptation for peptide absorption. PMID:21170601

Madhavan, Srivats; Scow, Jeffrey S.; Nagao, Munenori; Zheng, Ye; Duenes, Judith A; Sarr, Michael G.

2010-01-01

230

A technique of extending small-bowel mesentery for ileal pouch-anal anastomosis: report of a case.  

PubMed

One of the keys to success in proctocolectomy with ileal pouch-anal anastomosis is obtaining adequate mesenteric length to allow the pouch to reach the anorectum without tension. A multitude of techniques have been described in the literature to gain mesenteric length; however, in most cases these techniques only allow for the correction of a small deficit in the mesenteric length. We encountered a case in which the small-bowel mesentery was severely foreshortened because of a previous small-bowel volvulus just proximal to the loop ileostomy during recovery from the initial stage of his ileal pouch procedure. In this case, the deficit in length required an interposition vein graft to the superior mesenteric artery to facilitate adequate mesenteric length and allow completion of the ileal pouch-anal anastomosis. We report this technique to add another method of mesenteric lengthening to the armamentarium of surgeons performing ileal pouch-anal anastomoses. This technique should only be used as a last resort. PMID:18213491

Metcalf, Dan R; Nivatvongs, Santhat; Sullivan, Timothy M; Suwanthanma, Weerapat

2008-03-01

231

Effectiveness of polaprezinc for low-dose aspirin-induced small-bowel mucosal injuries as evaluated by capsule endoscopy: a pilot randomized controlled study  

PubMed Central

Background Treatment of low-dose aspirin (LDA)-induced small-bowel injury has not been established. Polaprezinc, a chelate of zinc and L-carnosine, may be efficacious for such injury. We conducted a pilot randomized controlled study to investigate whether polaprezinc is effective against LDA-induced small-bowel injuries. Methods Consecutive patients under long-term (>3 months) LDA treatment and who agreed to participate in our study underwent initial capsule endoscopy (CE). Patients with LDA-induced small-bowel injury apparent upon initial CE (n?=?20) were randomized into a polaprezinc (150 mg/day for 4 weeks) group and a control (no polaprezinc treatment) group. All underwent follow-up CE after 4 weeks. Changes in the number and characteristics of small-bowel mucosal injuries were compared within and between the two groups. Results The median number of reddened lesions and erosions/ulcers upon follow-up CE in the polaprezinc group significantly decreased (P?small-bowel mucosal injury associated with long-term LDA therapy. Trial registration UMIN Clinical Trials Registry UMIN000003687. PMID:23826914

2013-01-01

232

Lung Adenocarcinoma  

Cancer.gov

Home Cancers Selected for Study Lung Adenocarcinoma Lung Adenocarcinoma Last Updated: November 19, 2012 What is lung cancer? Lung cancer accounts for more deaths than any other cancer in both men and women, about 28 percent of all cancer deaths. In

233

Duodenal Adenocarcinoma: Clinicopathologic Analysis and Implications for Treatment  

PubMed Central

Background Duodenal adenocarcinoma is a rare cancer usually studied as a group with periampullary or small bowel adenocarcinoma; therefore, its natural history is poorly understood. Methods Patients with duodenal adenocarcinoma were identified from a single-institution pancreaticoduodenectomy database. Patients with adenocarcinoma arising from the ampulla of Vater were excluded. Univariate and multivariate analyses were performed to identify clinicopathologic variables associated with survival and recurrence after resection. Results From 1984 to 2006, a total of 122 patients with duodenal adenocarcinoma underwent pancreaticoduodenectomy. Overall survival after resection was 48% at 5 years and 41% at 10 years. Five-year survival decreased as the number of lymph nodes involved by metastasis increased from 0 to 1–3 to ?4 (68%, 58%, 17%, respectively, P < 0.01) and as the lymph node ratio increased from 0 to >0–0.2 to >0.2–0.4 to >0.4 (68%, 57%, 14%, 14%, respectively, P < 0.01). Lymph node metastasis was the only independent predictor of decreased survival in multivariate analysis. Recurrence after resection was predominantly distant (81%). Adjuvant chemoradiation did not decrease local recurrence or prolong overall survival; however, patients who received chemoradiation more commonly had nodal metastasis (P = 0.03). Conclusions The prognostic significance of both the absolute number and ratio of involved lymph nodes emphasizes the need for adequate lymphadenectomy to accurately stage duodenal adenocarcinoma. The mostly distant pattern of recurrence underscores the need for the development of effective systemic therapies. PMID:22167476

Poultsides, George A.; Huang, Lyen C.; Cameron, John L.; Tuli, Richard; Lan, Leslie; Hruban, Ralph H.; Pawlik, Timothy M.; Herman, Joseph M.; Edil, Barish H.; Ahuja, Nita; Choti, Michael A.; Wolfgang, Christopher L.; Schulick, Richard D.

2013-01-01

234

A severe bleeding diathesis in a 6-year-old girl secondary to a composite diagnosis of splenic hemangiomatosis and small bowel lymphangiomatosis.  

PubMed

A 6-year-old girl presented with presumed relapse of childhood immune thrombocytopenia. Investigations revealed deranged coagulation parameters, abnormal small bowel thickening, and splenomegaly. A clinically significant bleeding diathesis emerged which was refractory to most hemostatic interventions. Laparatomy revealed a composite diagnosis of splenic hemangiomatosis and small bowel lymphangiomatosis. Splenectomy resulted in complete resolution of the coagulopathy. The diagnosis and management of these conditions is inherently complex and without clear guidance. We discuss our perioperative management of the bleeding diathesis. There is a need for long-term follow-up of the underlying pathologies particularly as potentially useful therapeutic agents have emerged. PMID:24136025

Elder, Patrick T; Cairns, Carole; Dick, Alistair; McCallion, William A; McCarthy, Anthony; Smith, Owen P; Macartney, Christine

2014-07-01

235

Phase distinction in semi-insulating polycrystalline silicon by pattern recognition of X-ray photoelectron spectroscopy/X-ray-induced Auger electron spectroscopy data  

NASA Astrophysics Data System (ADS)

X-ray photoelectron spectroscopy (XPS) and X-ray-induced Auger electron spectroscopy (XAES) supported with the lineshape analysis by the pattern recognition (PR) method and the fuzzy k-nearest neighbor rule ( kNN FR) were applied to study semiinsulating polycrystalline silicon layers (SIPOS). The aim of the present work was to obtain the qualitative and quantitative information about the surface region of as-received SIPOS layers. For the purpose of qualitative analysis the binding energies (BE), binding energy shifts (?BE), the half widths (FWHM) and the lineshapes of the Si 2p, O 1s and O KLL lines were analysed. The quantitative analysis was performed on the basis of the XPS using sensitivity factor method, multiline (ML) approach and the kNN FR. The performance of the kNN rule is possible after selecting the proper set of reference standard materials to which the rule refers during identification of an ambiguous chemical state. By selecting the reference samples supplying the information about the chemical state of Si, SiO x and SiO 2, the kNN rule allowed to distinguish qualitatively these three different phases in SIPOS samples. The particular application of the kNN FR makes possible the quantitative analysis by referring the fuzzy probability of classification for the given chemical state to the concentration of particular constituents in the investigated SIPOS. All the methods applied are consistent in revealing the quantitative results and show that SIPOS is a deeply non-homogeneous material, consisting of two phases: silicon and silicon oxide.

Lesiak, Beata; Zemek, Jozef; Jozwik, Adam

1998-09-01

236

SEMS vs cSEMS in duodenal and small bowel obstruction: High risk of migration in the covered stent group  

PubMed Central

AIM: To compare clinical success and complications of uncovered self-expanding metal stents (SEMS) vs covered SEMS (cSEMS) in obstruction of the small bowel. METHODS: Technical success, complications and outcome of endoscopic SEMS or cSEMS placement in tumor related obstruction of the duodenum or jejunum were retrospectively assessed. The primary end points were rates of stent migration and overgrowth. Secondary end points were the effect of concomitant biliary drainage on migration rate and overall survival. The data was analyzed according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS: Thirty-two SEMS were implanted in 20 patients. In all patients, endoscopic stent implantation was successful. Stent migration was observed in 9 of 16 cSEMS (56%) in comparison to 0/16 SEMS (0%) implantations (P = 0.002). Stent overgrowth did not significantly differ between the two stent types (SEMS: 3/16, 19%; cSEMS: 2/16, 13%). One cSEMS dislodged and had to be recovered from the jejunum by way of laparotomy. Time until migration between SEMS and cSEMS in patients with and without concomitant biliary stents did not significantly differ (HR = 1.530, 95%CI 0.731-6.306; P = 0.556). The mean follow-up was 57 ± 71 d (range: 1-275 d). CONCLUSION: SEMS and cSEMS placement is safe in small bowel tumor obstruction. However, cSEMS is accompanied with a high rate of migration in comparison to uncovered SEMS. PMID:24115817

Waidmann, Oliver; Trojan, Jörg; Friedrich-Rust, Mireen; Sarrazin, Christoph; Bechstein, Wolf Otto; Ulrich, Frank; Zeuzem, Stefan; Albert, Jörg Gerhard

2013-01-01

237

Effect of different treatment plans on irradiated small-bowel volume in gynecologic patients undergoing whole-pelvic irradiation  

PubMed Central

To evaluate the effect of different treatment plans for whole-pelvic irradiation on small-bowel volumes (SBVs) in patients with gynecologic malignancies, 40 patients were enrolled in this study. Computed tomography (CT) simulations were performed, and the small bowel of each patient was outlined manually. Treatment plans with equal-weighted (EW) and non-equal-weighted (NEW) (70% in bilateral directions) techniques of four-field and intensity-modulated radiation therapy (IMRT) were performed. The V10–V100 represented the volume (cm3) at different levels of the prescribed doses (10–100%). The V10–V100 was compared among the different treatment planning techniques, and patients who were suitable for IMRT or NEW were identified. IMRT and NEW significantly reduced the V50–V100 and V40–V60 levels compared with EW, respectively. NEW caused a significant reduction in the V30–V60 levels in patients with a BMI ?26 kg/m2. Patients with IMRT demonstrated lower V70–V100 levels compared with those with NEW. In patients with a BMI ?26 kg/m2 or an age ?55 years, lower V20–V50 levels were noted using NEW compared with IMRT. Treatment planning with larger weighting in the bilateral directions in four-field radiotherapy reduces the low-dose SBV in patients with gynecologic malignancies, especially in those with a high BMI or the elderly. IMRT effectively reduces high-dose SBV, especially in patients with a low BMI. PMID:23536544

Chang, Shih-Chen; Lee, Hsiao-Fei; Ting, Hui-Min; Pan, Tzu-Chao; Liu, Shu-Yu; Chen, Chien-Fu; Wang, Teng-Yi; Juan, Kuo-Jung; Liao, Tsung-I; Huang, Eng-Yen

2013-01-01

238

Interstitial cells of Cajal in the human fetal small bowel as shown by c-kit immunohistochemistry  

PubMed Central

Background—Interstitial cells of Cajal (ICCs) express the tyrosine kinase receptor c-kit, which is required for their development and spontaneous pacemaker activity in the bowel. From murine models it has been proposed that ICCs do not develop until after birth, but more recent findings indicate that c-kit is expressed early in the embryonic period. The temporal development of ICCs in the human gut remains unknown. ?Aim—To investigate ICCs in the human fetal small bowel using c-kit immunohistochemistry. ?Subjects—Small bowel specimens were obtained at post mortem examination of 16 fetuses and nine neonates, eight of whom were premature, born at gestational ages of 13 to 41 weeks, without gastrointestinal disorders. ?Methods—Immunohistochemical analysis was performed on material fixed in formalin and embedded in paraffin. The specimens were exposed to antibodies raised against c-kit (an ICC marker) and neurone specific enolase (a general neuronal marker). The ABC complex method was used to visualise binding of antibodies to the corresponding antigens. ?Results—c-kit immunoreactive cells were visualised from 13 weeks of gestation. The immunoreactivity was mainly localised in association with the myenteric plexus. From about 17-18 weeks of gestation, the ICCs formed a layer along the myenteric plexus, whereas this layer appeared to be disrupted at 13-16 weeks of gestation. ?Conclusions—ICCs are c-kit immunoreactive at least from a gestational age of 13 weeks in the human fetal small intestine. From 17-18 weeks of gestation until birth, they form a continuous layer around the myenteric ganglia. ?? Keywords: interstitial cells of Cajal; c-kit; myenteric plexus; human; fetal; development PMID:9862827

Wester, T; Eriksson, L; Olsson, Y; Olsen, L

1999-01-01

239

Stomal adenocarcinoma in Crohn's disease.  

PubMed Central

Malignant change occurring at the site of a stoma in two patients with proved Crohn's disease is described. Patients with ulcerative colitis have an increased risk of colonic malignancy and Crohn's disease is also associated with both small and large bowel carcinoma. Most previous reports of stomal carcinoma have been associated with ulcerative colitis although Crohn's disease seems to carry a greater risk of associated small bowel carcinomas. This is the first report of stomal carcinoma complicating Crohn's disease. Epithelial dysplasia is associated with gastrointestinal carcinomas in both ulcerative colitis and Crohn's disease and a dysplasia-carcinoma sequence has been suggested as the origin of these tumours. In both our patients with stomal adenocarcinoma, dysplasia was identified in adjacent tissues, which suggests a similar mechanism. Malignant change should be suspected if epithelial dysplasia is discovered in a biopsy specimen from the mucosa of an ileostomy in Crohn's disease, and this risk is increased if the dysplasia is of a high grade. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:2253921

Sherlock, D J; Suarez, V; Gray, J G

1990-01-01

240

Lung Adenocarcinoma  

MedlinePLUS

... quit smoking, your risk decreases over time. Secondary risk factors include age, family history, and exposure to secondhand smoke, mineral and metal dust, asbestos, or radon. What characterizes lung adenocarcinoma? This ...

241

Effect of Oral Administration of Freeze-Dried Lactobacillus acidophilus on Small Bowel Bacterial Overgrowth in Patients with End Stage Kidney Disease: Reducing Uremic Toxins and Improving Nutrition  

Microsoft Academic Search

Small bowel bacterial overgrowth (SBBO), a condition found in patients with advanced chronic kidney failure, contributes to pathophysiology and decreased nutrition in the chronic dialysis population. Elevated levels of toxins including dimethylamine (DMA) and a carcinogen, nitrosodimethylamine (NDMA) for which DMA is a precursor, are found in the blood and body fluids in patients with this condition, and are generated

Stephen R. Dunn; Michael L. Simenhoff; Kamal E. Ahmed; William J. Gaughan; Babikar O. Eltayeb; Mary-Ellen D. Fitzpatrick; Susan M. Emery; James W. Ayres; Kris E. Holt

1998-01-01

242

Radiographic plain film and CT findings in lipoid pneumonia in infants following aspiration of mineral oil used in the treatment of partial small bowel obstruction by Ascaris lumbricoides  

Microsoft Academic Search

Four children developed lipoid pneumonia following ingestion of mineral oil for the treatment of partial small bowel obstruction\\u000a byAscaris lumbricoides whorl. CT of the chest showed negative Hounsfield numbers which may prove useful in diagnosis.

G. A. de Oliveira; S. R. Del Caro; C. M. Bender Lamego; P. R. Merçon Vargas; V. E. C. Vervloet

1985-01-01

243

Experimental small bowel preservation using Polysol: A new alternative to University of Wisconsin solution, Celsior and histidine-tryptophan-ketoglutarate solution?  

PubMed Central

AIM: To evaluate the potential of Polysol, a newly developed preservation solution, in cold storage of small bowel grafts, compared with the current standards, University of Wisconsin solution (UW), Celsior and histidine-tryptophan-ketoglutarate solution (HTK). METHODS: Male Wistar rats were used as donors. Small bowels were retrieved, flushed and then stored in the respective 4 solutions for 18 h at 4°C. Functional integrity of the grafts was evaluated by isolated reperfusion with oxygenated Krebs-Henseleit buffer at 37°C for 30 min in all 4 groups. RESULTS: Polysol preservation exhibited the highest tissue ATP concentration and the lowest release of LDH. Malondialdehyde, an index for tissue lipid peroxidation, was also the lowest in Polysol. Tissue oxygen consumption was significantly higher in Polysol than in the others. Of interest, UW-storage promoted 10-fold higher apoptosis than in the others. Moreover, electron microscopy revealed that the mucosal villi/micro-villi formation and the cell organelles, including mitochondria, were both significantly better preserved in Polysol, while deleterious alterations were apparent in the others, most notably in UW. Although Celsior and HTK exhibited the better trend of results than UW in some parameters, but could not reach the over-all superiority to UW. CONCLUSION: Cold storage using Polysol resulted in significantly better integrity and function of small bowel grafts than UW. Hence, Polysol may be a novel alternative for the small bowel preservation. PMID:17659727

Wei, Lai; Hata, Koichiro; Doorschodt, Benedict Marie; Büttner, Reinhard; Minor, Thomas; Tolba, René H

2007-01-01

244

Effects of hydroxyethyl starch-deferoxamine on arachidonic acid metabolism and small bowel wall perfusion in early sepsis.  

PubMed

The effects of hydroxyethyl starch-conjugated deferoxamine (HES-DFO), a macromolecular iron chelator, were investigated on eicosanoid release and bowel wall perfusion following cecal ligation puncture (CLP) in rats. Animals were randomly given an intravenous dose of 3.0 ml of HES-DFO or either vehicle (HES) or 9.0 ml saline immediately following completion of the CLP procedure. At 30, 60, 120, and 240 min after sepsis induction, blood pressure and bowel perfusion were measured. The animals were sacrificed and blood was collected for subsequent analysis of thromboxane, prostacyclin, and prostaglandin F2 alpha. The tissue content of energy-rich phosphates was determined in small-bowel samples at each time point. The antioxidative HES-DFO therapy did not diminish the eicosanoid release after CLP when compared with either HES-treated or saline-infused rats. However, treatment with the polymeric iron chelator resulted in an impaired bowel wall perfusion that was not reflected in alterations in total adenine nucleotide content or in energy charge. Considering hemodynamic and biochemical endpoints, these results are contradictory to the hypothesis that iron-driven oxygen radicals are major determinants of the eicosanoid release that is elevated following CLP-induced sepsis. PMID:9284001

Schröppel, B; Moch, D; Marzinzig, M; Brückner, U B

1997-01-01

245

Multiple, persistent gastropancreato-neuroendocrine tumours accompanying sigmoid bowel adenocarcinoma: A rare case report  

PubMed Central

Introduction Gastropancreato-neuroendocrine tumours (GETs) are rare, especially when they occur alongside colorectal adenocarcinoma. Furthermore, multiple GETs occurring within the small bowel are less frequent with only two cases described within the literature. Presentation of case A healthy 58-year old woman presented with severe gastrointestinal pain and faecal incontinence. Family history revealed consanguineous parents and a brother who had recently died of a gastric GET. First biopsy showed a sigmoid adenocarcinoma. Histology of the resected sigmoid revealed both adenocarcinoma and GET. After this, she presented with small bowel obstruction secondary to multiple ileal and jejunal GETs, also treated with resection. All imaging modalities gave no evidence of extra-intestinal metastasis. The patient received multiple operations and chemotherapy but died 18 months after the original presentation. Discussion A case of such persistent and multiple small bowel GET without extra-intestinal metastasis has yet to be reported within the literature. GETs are rare and typically asymptomatic with a small proportion giving the classical carcinoid syndrome. Surgery is usually reserved for smaller GETs with high five-year survival. Despite this, surgery and chemotherapy were performed and both proved to be ineffective. Furthermore, a genetic basis for GETs is supported in this case with her brother suffering a similar fatal tumour. Conclusion This case highlights a rare GET that has a likely underlying familial origin. It illustrates the non-specific presentation of these tumours and the importance of taking a thorough family history. It also demonstrates that these tumours can be fatal even in the absence of extra-intestinal metastasis. PMID:25568786

Hotchen, Andrew James; Naidoo, Khimara; Lanzon-Miller, Sandro

2014-01-01

246

Comparison of quantitative and qualitative duodenal fluid versus duodenal mucosa cultures in German Shepherd Dogs with spontaneous small bowel bacterial overgrowth  

E-print Network

of Texas A8 M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE August 1993 Major Subject: Veterinary Medicine and Surgery COMPARISON OF QUANTITATIVE AND QUALITATIVE DUODENAL FLUID VERSUS DUODENAL MUCOSA...' . Rogers ( ember) John R. A st (Head of Department) August 1993 ABSTRACT Comparison of Quantitative and Qualitative Duodenal Fluid Versus Duodenal Mucosa Cultures in German Shepherd Dogs with Spontaneous Small Bowel Bacterial Overgrowth. (August...

Delles, Edward Kevin

1993-01-01

247

Lubiprostone decreases the small bowel transit time by capsule endoscopy: an exploratory, randomised, double-blind, placebo-controlled 3-way crossover study.  

PubMed

The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 ?g tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24??g tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117-407) minutes in the P-P regimen, 122.5 (27-282) minutes in the L-P regimen, and 110.5 (11-331) minutes in the P-L regimen (P = 0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE. PMID:25614738

Matsuura, Mizue; Inamori, Masahiko; Endo, Hiroki; Matsuura, Tetsuya; Kanoshima, Kenji; Inoh, Yumi; Fujita, Yuji; Umezawa, Shotaro; Fuyuki, Akiko; Uchiyama, Shiori; Higurashi, Takuma; Ohkubo, Hidenori; Sakai, Eiji; Iida, Hiroshi; Nonaka, Takashi; Futagami, Seiji; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

2014-01-01

248

Preoperative Radiation Treatment for Rectal Cancer: Comparison of Target Coverage and Small Bowel NTCP in Conventional vs. 3D-Conformal Planning  

SciTech Connect

A prospective study was undertaken to evaluate the improvement in rectal cancer radiation treatment achieved with the implementation of target delineation for conformal radiotherapy, replacing conventional technique using standard radiological anatomy for target volume definition. In 10 patients receiving preoperative pelvic irradiation for rectal cancer, a 3-field technique was designed by a 3-dimensional (3D) planning system. Two plans were simulated for each patient, one with the fields designed in the conventional way based on radiological anatomy, and the other with the fields designed on the basis of a computed tomography (CT) delineated planning target volume (PTV). A total dose of 45 Gy in 25-daily fractions of 1.8 Gy in 5 weeks was planned. Dose-volume histograms (DVHs) of PTV, small bowel, anal sphincter, and urinary bladder were analyzed to compare plans. The minimum, maximum, and mean dose in the PTV and in critical organs were also evaluated. The inhomogeneity coefficient (IC) and the target coverage (TC) were calculated. The normal tissue complication probability (NTCP) for each organ at risk (OAR) was determined. NTCP for small bowel and urinary bladder was not statistically different, while the PTV coverage was significantly lower with conventional treatment relative to conformal treatment (median IC = 7.2, median TC = 0.91 vs. median IC = 0.14 and median TC = 1, p < 0.005). The 3D conformal treatment plan in preoperative radiotherapy for rectal cancer improves target coverage without significantly affecting small bowel and urinary bladder NTCP.

Cella, Laura; Ciscognetti, Nunzia; Martin, Giuseppe; Liuzzi, Raffaele; Punzo, Giorgio; Solla, Raffaele; Farella, Antonio; Salvatore, Marco [Dipartimento di Diagnostica per Immagini e Radioterapia, Universita 'Federico II' and Istituto di Biostrutture e Bioimmagini - Consiglio Nazionale delle Ricerche (C.N.R), Napoli (Italy); Pacelli, Roberto [Dipartimento di Diagnostica per Immagini e Radioterapia, Universita 'Federico II' and Istituto di Biostrutture e Bioimmagini - Consiglio Nazionale delle Ricerche (C.N.R), Napoli (Italy)], E-mail: roberto.pacelli@ibb.cnr.it

2009-04-01

249

Amifostine alleviates radiation-induced lethal small bowel damage via promotion of 14-3-3?-mediated nuclear p53 accumulation  

PubMed Central

Amifostine (AM) is a radioprotector that scavenges free radicals and is used in patients undergoing radiotherapy. p53 has long been implicated in cell cycle arrest for cellular repair after radiation exposure. We therefore investigated the protective p53-dependent mechanism of AM on small bowel damage after lethal whole-abdominal irradiation (WAI). AM increased both the survival rate of rats and crypt survival following lethal 18 Gy WAI. The p53 inhibitor PFT-? compromised AM-mediated effects when administered prior to AM administration. AM significantly increased clonogenic survival in IEC-6 cells expressing wild type p53 but not in p53 knockdown cells. AM significantly increased p53 nuclear accumulation and p53 tetramer expression before irradiation through the inhibition of p53 degradation. AM inhibited p53 interactions with MDM2 but enhanced p53 interactions with 14-3-3?. Knockdown of 14-3-3? also compromised the effect of AM on clonogenic survival and p53 nuclear accumulation in IEC-6 cells. For the first time, our data reveal that AM alleviates lethal small bowel damage through the induction of 14-3-3? and subsequent accumulation of p53. Enhancement of the p53/14-3-3? interaction results in p53 tetramerization in the nucleus that rescues lethal small bowel damage. PMID:25230151

Chen, Yu-Min; Chen, Yi-Fan; Wang, Chung-Chi; Lin, I-Hui; Huang, Yu-Jie; Yang, Kuender D.

2014-01-01

250

Use of small bowel imaging for the diagnosis and staging of Crohn’s disease—a survey of current UK practice  

PubMed Central

Objectives This study used a postal survey to assess the current use of small bowel imaging investigations for Crohn’s disease within National Health Service (NHS) radiological practice and to gauge gastroenterological referral patterns. Methods Similar questionnaires were posted to departments of radiology (n = 240) and gastroenterology (n = 254) identified, by the databases of the Royal College of Radiologists and British Society of Gastroenterologists. Questionnaires enquired about the use of small bowel imaging in the assessment of Crohn’s disease. In particular, questionnaires described clinical scenarios including first diagnosis, disease staging and assessment of suspected extraluminal complications, obstruction and disease flare. The data were stratified according to patient age. Results 63 (27%) departments of radiology (20 in teaching hospitals and 43 in district general hospitals (DGHs)) and 73 (29%) departments of gastroenterology replied. These departments were in 119 institutions. Of the 63 departments of radiology, 55 (90%) routinely performed barium follow-though (BaFT), 50 (80%) CT, 29 (46%) small bowel ultrasound (SbUS) and 24 (38%) small bowel MRI. BaFT was the most commonly used investigation across all age groups and indications. SbUS was used mostly for patients younger than 40 years of age with low index of clinical suspicion for Crohn’s disease (in 44% of radiology departments (28/63)). MRI was most frequently used in patients under 20 years of age for staging new disease (in 27% of radiology departments (17/63)) or in whom obstruction was suspected (in 29% of radiology departments (18/63)). CT was preferred for suspected extraluminal complications or obstruction (in 73% (46/63) and 46% (29/63) of radiology departments, respectively). Gastroenterological referrals largely concurred with the imaging modalities chosen by radiologists, although gastroenterologists were less likely to request SbUS and MRI. Conclusion BaFT remains the mainstay investigation for luminal small bowel Crohn’s disease, with CT dominating for suspected extraluminal complications. There has been only moderate dissemination of the use of MRI and SbUS. PMID:21081570

Hafeez, R; Greenhalgh, R; Rajan, J; Bloom, S; McCartney, S; Halligan, S; Taylor, S A

2011-01-01

251

Embolization for Acute Small-Bowel Bleeding from the Collateral Artery of the Superior Mesenteric Left Deep Circumflex Iliac Artery Associated with Narrowing of the Bilateral Common External Iliac Arteries  

SciTech Connect

We present a case of acute small-bowel bleeding from the collateral artery of the superior mesenteric-left deep circumflex iliac artery that was successfully managed by transarterial coil embolization.

Shimohira, Masashi, E-mail: m_shimohira@yahoo.co.jp; Ogino, Hiroyuki; Sasaki, Shigeru; Nishikawa, Hiroko; Shibamoto, Yuta [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan)

2009-03-15

252

Small bowel tissue smear  

MedlinePLUS

... HA, Gress FG, Bowne WB. Laboratory diagnosis of gastrointestinal and pancreatic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. ...

253

Small bowel resection  

MedlinePLUS

... you asleep and pain-free. If you have laparoscopic surgery: You will have three to five small ... Bulging tissue through the incision, called an incisional hernia Damage to nearby organs in the body Many ...

254

Small bowel bacterial overgrowth  

MedlinePLUS

Overgrowth - intestinal bacteria; Bacterial overgrowth - intestine ... Unlike the large intestine, the small intestine does not have a high number of bacteria. When there are too many bacteria in the ...

255

Small Bowel Polyposis Syndromes  

Microsoft Academic Search

Intestinal polyposis syndromes are relatively rare. However, it is important for clinicians to recognize the potential risks\\u000a of these syndromes. Based on histology, these syndromes can be classified mainly into hamartomatous polyposis syndromes and\\u000a familial adenomatous polyposis (FAP), which affects mainly the large intestine. This review discusses the clinical manifestations\\u000a and underlying genetics of the most common small intestinal polyposis

Nadir Arber; Menachem Moshkowitz

256

Pancreatic Ductal Adenocarcinoma  

Cancer.gov

Home Cancers Selected for Study Pancreatic Ductal Adenocarcinoma Pancreatic Ductal Adenocarcinoma Last Updated: May 15, 2013 What is pancreatic cancer?Pancreatic ductal adenocarcinoma is the most common form of pancreatic cancer, making up more than

257

Early Small-Bowel Ischemia: Dual-Energy CT Improves Conspicuity Compared with Conventional CT in a Swine Model.  

PubMed

Purpose To compare dual-energy computed tomography (CT) with conventional CT for the detection of small-bowel ischemia in an experimental animal model. Materials and Methods The study was approved by the animal care and use committee and was performed in accordance with the Guide for Care and Use of Laboratory Animals issued by the National Research Council. Ischemic bowel segments (n = 8) were created in swine (n = 4) by means of surgical occlusion of distal mesenteric arteries and veins. Contrast material-enhanced dual-energy CT and conventional single-energy CT (120 kVp) sequences were performed during the portal venous phase with a single-source fast-switching dual-energy CT scanner. Attenuation values and contrast-to-noise ratios of ischemic and perfused segments on iodine material-density, monospectral dual-energy CT (51 keV, 65 keV, and 70 keV), and conventional 120-kVp CT images were compared. Linear mixed-effects models were used for comparisons. Results The attenuation difference between ischemic and perfused segments was significantly greater on dual-energy 51-keV CT images than on conventional 120-kVp CT images (mean difference, 91.7 HU vs 47.6 HU; P < .0001). Conspicuity of ischemic segments was significantly greater on dual-energy iodine material-density and 51-keV CT images than on 120-kVp CT images (mean contrast-to-noise ratios, 4.9, 4.3, and 2.1, respectively; P < .0001). Although attenuation differences on dual-energy 65- and 70-keV CT images were not significantly different from those on 120-kVp images (55.0 HU, 45.8 HU, and 47.6 HU, respectively; 65 keV vs 120 kVp, P = .15; 70 keV vs 120 kVp, P = .46), the contrast-to-noise ratio was greater for the 65- and 70-keV images than for the 120-kVp images (4.4, 4.1, and 2.1 respectively; P < .0005). Conclusion Dual-energy CT significantly improved the conspicuity of the ischemic bowel compared with conventional CT by increasing attenuation differences between ischemic and perfused segments on low-kiloelectron volt and iodine material density images. PMID:25426772

Potretzke, Theodora A; Brace, Christopher L; Lubner, Meghan G; Sampson, Lisa A; Willey, Bridgett J; Lee, Fred T

2015-04-01

258

IMPAIRED SMALL BOWEL BARRIER INTEGRITY IN THE PRESENCE OF LUMENAL PANCREATIC DIGESTIVE ENZYMES LEADS TO CIRCULATORY SHOCK  

PubMed Central

In bowel ischemia, impaired mucosal integrity may allow intestinal pancreatic enzyme products to become systemic and precipitate irreversible shock and death. This can be attenuated by pancreatic enzyme inhibition in the small bowel lumen. It is unresolved, however, whether ischemically-mediated mucosal disruption is the key event allowing pancreatic enzyme products systemic access, and whether intestinal digestive enzyme activity in concert with increased mucosal permeability leads to shock in the absence of ischemia. To test this possibility, the small intestinal lumen of non-ischemic rats was perfused for two hours with either digestive enzymes, a mucin disruption strategy (i.e., mucolytics) designed to increase mucosal permeability, or both, and animals were observed for shock. Digestive enzymes perfused included trypsin, chymotrypsin, elastase, amylase and lipase. Control (n=6) and experimental animals perfused with pancreatic enzymes only (n=6) or single enzymes (n=3 for each of the five enzyme groups) maintained stable hemodynamics. After mucin disruption using a combination of enteral N-acetylcysteine, atropine, and increased flow rates, rats (n=6) developed mild hypotension (p<0.001 compared to groups perfused with pancreatic enzymes only after 90 minutes) and increased intestinal permeability to intralumenally perfused FITC-dextrans-20kD (p<0.05) compared to control and enzyme-only groups, but there were no deaths. All animals perfused with both digestive enzymes and subjected to mucin disruption (n=6) developed hypotension and increased intestinal permeability (p<0.001 after 90 minutes). Pancreatic enzymes were measured in the intestinal wall of both groups subjected to mucin disruption, but not in the enzyme-only or control groups. Depletion of plasma protease inhibitors was found only in animals perfused with pancreatic enzymes plus mucin disruption, implicating increased permeability and intralumenal pancreatic enzyme egress in this group. These experiments demonstrate that increased bowel permeability via mucin disruption in the presence of pancreatic enzymes can induce shock and increase systemic protease activation in the absence of ischemia, implicating bowel mucin disruption as a key event in early ischemia. Digestive enzymes and their products, if allowed to penetrate the gut wall may trigger multiorgan failure and death. PMID:22576000

Kistler, Erik B.; Alsaigh, Tom; Chang, Marisol; Schmid-Schönbein, Geert W.

2012-01-01

259

Comparison of Gonadal Radiation Doses From CT Enterography and Small-Bowel Follow-Through in Pediatric Patients.  

PubMed

OBJECTIVE. CT enterography is superior to small-bowel follow-through (SBFT) for diagnosis of inflammatory bowel disease (IBD). It is widely assumed that the radiation dose from CT enterography is greater than that from SBFT in the pediatric patient. This study was designed to compare gonadal doses from CT enterography and SBFT to verify the best imaging choice for IBD evaluation in children. This study also challenges the assumption that CT enterography imparts a higher radiation dose through comparison of calculated radiation doses from CT enterography and SBFT. MATERIALS AND METHODS. Patients 0-18 years old who underwent either CT enterography or SBFT over a 2-year period were included. The CT enterography group consisted of 39 boys and 51 girls, whereas the SBFT group consisted of 89 boys and 113 girls. CT enterography was performed at 120 kVp and approximately 132 mAs (range, 54-330 mAs) using weight-based protocols. SBFT used automated control of kilovoltage and tube current-exposure time product. Patient demographics and technical parameters were collected for CT enterography and SBFT, data were cross-paired between CT enterography and SBFT, and gonadal dose was calculated. RESULTS. Mean (± SD) CT enterography testis and ovarian doses were 0.93 ± 0.3 cGy (n = 39) and 0.64 ± 0.2 cGy (n = 51), respectively. Mean SBFT testis and ovarian doses were 2.3 ± 1.6 cGy (n = 89) and 1.49 ± 0.3 cGy (n = 113), respectively. Mean fluoroscopy time for SBFT was 2.6 ± 2 minutes. Gonadal dose for CT enterography was significantly lower than that for SBFT in boys and girls (p < 0.001). SBFT dose was lower in girls than boys (p < 0.001), whereas CT enterography dose was higher in boys than girls (p < 0.001). CONCLUSION. Gonadal dose for CT enterography was lower than that for SBFT for boys and girls of all sizes and age. Controlled exposure time made CT enterography dose more consistent, whereas the range of dose for SBFT was highly operator dependent and related to extent of disease. Thus, for IBD, CT enterography is preferred over SBFT for all children. PMID:25714293

Reid, Janet R; Pozzuto, Jessica; Morrison, Stuart; Obuchowski, Nancy; Davros, William

2015-03-01

260

Small bowel volvulus after transabdominal preperitoneal hernia repair due to improper use of V-Loc™ barbed absorbable wire – do we always “read the instructions first”?  

PubMed Central

Introduction Transabdominal preperitoneal endoscopic hernia repair (TAPP) is part of primary surgical health care. While both, the reported recurrence rate and procedure specific morbidity are consistently low, rare serious complications occur. Presentiation of case A 36-year-old male patient developed bowel obstruction three days after both-sided TAPP for inguinal hernia repair. A computer tomography scan of the abdomen revealed a small bowel volvulus in the right lower quadrant of the abdomen requiring urgent revisional surgery. Intraoperatively, the small bowel and its mesenterial vessels were found to be twisted around a 5 cm long V-Loc™ barbed absorbable suturing wire. After successful laparoscopic adhesiolysis, removal of the wire and detorquing of the bowel conglomerate, resection of small intestine was not necessary. The patient's further postoperative recovery was uneventful. Discussion Due to the barbed configuration of the V-Loc™ wire, a gapless continuous suturing of the peritoneum without laparoscopic knotting is easily and fast to accomplish. In this case the recommendation of the manufacturer to shorten the wire was not strictly followed and neither had the suture stump been extraperitonealized in order to avoid such rare complications. Conclusion Surgeons need to be aware of relevant “tricks and traps” of routinely performed procedures and have to know all tools and material they use very well. This case may therefore increase our attention when it comes to little things which actually do matter. PMID:25704567

Filser, Joerg; Reibetanz, Joachim; Krajinovic, Katica; Germer, Christoph-Thomas; Dietz, Ulrich Andreas; Seyfried, Florian

2015-01-01

261

Ex-vivo Resection and Small-Bowel Auto-transplantation for the Treatment of Tumors at the Root of the Mesentery  

PubMed Central

Background: Tumors involving the root of the mesentery are generally regarded as “unresectable” with conventional surgical techniques. Resection with conventional surgery may end in life-threatening complications in these patients. Ex-vivo resection and auto-transplantation avoids excessive bleeding and prevents ischemic related damage to the small intestine and other organs. Objective: To share our experience of ex-vivo resection of the tumors with involvement of small bowel mesentery followed by small bowel auto-transplantation. Methods: In this study, medical records of all the patients who underwent ex-vivo resection and auto-transplantation at our center were retrospectively analyzed. Results: The most common indication for the procedure in our series was locally advanced pancreatic carcinoma. Our survival rate was 50% with a mean±SD follow-up of 10.1±9.8 (range: 0–26) months. Causes of early in-hospital mortality were multi-organ failure, sepsis, and cerebrovascular accident. Recurrence of disease was noted in one patient while one patient developed hepatic metastasis after 20 months of surgery. Conclusion: Ex-vivo resection of the tumor and auto-transplantation is the surgical treatment of choice for the locally advanced abdominal tumors involving the root of the mesentery. PMID:25184032

Nikeghbalian, S.; Aliakbarian, M.; Kazemi, K.; Shamsaeefar, A. R.; Mehdi, S. H.; Bahreini, A.; Malek-Hosseini, S. A.

2014-01-01

262

Surgical therapy of radiation-induced small-bowel lesions. Report of 34 cases with a high share of patients with combined chemotherapy  

SciTech Connect

Operations on irradiation-injured bowel are rare, bear a high postoperative mortality, and the procedure of choice (resection vs bypass) is still controversial. Thirty-seven operations on small bowel for late effects of irradiation in 16 years were analyzed retrospectively. Fifty-one percent of the operations were performed in the last four years. Ovarian cancer treated by a combination of radiotherapy and chemotherapy was the most frequent underlying disease of 20 patients (58%) followed by carcinoma of the cervix (eight (24%) of the patients). The median latent period between irradiation and surgery was eight months after the combined radiotherapy/chemotherapy, and 12 months after radiotherapy alone. Thirty operations (81%) were done for small-bowel stricture, four for fistula, and three for perforation. Bypass was performed in 17 patients and resection in 16. Complications (fistula, peritonitis, perforation) occurred after 13 operations (35%). All three patients who developed peritonitis died (mortality, 8.1%): two after resection and one after bypass. Suture-associated complications occurred in three (23%) of 13 cases after single-layer and in three (35%) of 17 cases after two-layer anastomoses. Ten patients are still alive two to 76 months (median, 32 months) after operation, six of them free of tumor. All are underweight and suffer from diarrhea (four to 12 stools per day). Pernicious anemia developed in all six patients surviving more than two years.

Miholic, J.; Schlappack, O.; Klepetko, W.; Koelbl, H.S.; Szepesi, T.; Moeschl, P.

1987-08-01

263

Inflammatory myofibroblastic tumor of the small-bowel mesentery: A case report of nonspecific clinical presentation and a review of the literature  

PubMed Central

INTRODUCTION Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm of various anatomical sites, which is histopathologically characterized by spindle-shaped cells with myofibroblastic proliferation and inflammatory infiltration. PRESENTATION OF CASE In this case report, a 37-year-old man presented with nonspecific systemic symptoms, including abdominal pain and weakness, which was diagnosed by multislice computed tomography and ultrasonography. An 8 cm × 5 cm × 5 cm nodular gray-white firm noninfiltrative mass, which was well localized in the mesentery tissues of small bowel, was observed and the patient underwent surgical resection. DISCUSSION A review of the literature on IMT of the small-bowel mesentery yielded a small number of previously described cases. This tumor most frequently involves the lungs and arises most commonly in extrapulmonary locations such as the mesentery and omentum. The etiopathogenesis and the clinical course of the disease are unclear. The histological and clinical differential diagnosis of IMT also includes reactive processes and mesenchymal tumors of the gastrointestinal tract. Follow-up after surgical removal documented local recurrence and metastasis. CONCLUSION The preferred primary treatment is complete surgical excision, and patients require close clinicoradiological follow-up. In general, cases treated with complete surgical resection have a good prognosis. PMID:25437679

Koyuncuer, Ali

2014-01-01

264

X-ray induced Sm{sup 3+} to Sm{sup 2+} conversion in fluorophosphate and fluoroaluminate glasses for the monitoring of high-doses in microbeam radiation therapy  

SciTech Connect

Fluorophosphate and fluoroaluminate glasses doped with trivalent samarium were evaluated as sensors of x-ray radiation for microbeam radiation therapy at the Canadian Light Source using the conversion of trivalent Sm{sup 3+} to the divalent form Sm{sup 2+}. Both types of glasses show similar conversion rates and may be used as a linear sensor up to {approx}150 Gy and as a nonlinear sensor up to {approx}2400 Gy, where saturation is reached. Experiments with a multi-slit collimator show high spatial resolution of the conversion pattern; the pattern was acquired by a confocal fluorescence microscopy technique. The effects of previous x-ray exposure may be erased by annealing at temperatures exceeding the glass transition temperature T{sub g} while annealing at T{sub A} < T{sub g} enhances the Sm conversion. This enhancement is explained by a thermally stimulated relaxation of host glass ionic matrix surrounding x-ray induced Sm{sup 2+} ions. In addition, some of the Sm{sup 3+}-doped glasses were codoped with Eu{sup 2+}-ions but the results show that there is no marked improvement in the conversion efficiency by the introduction of Eu{sup 2+}.

Vahedi, Shahrzad; Okada, Go; Morrell, Brian; Muzar, Edward; Koughia, Cyril; Kasap, Safa [Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5A9 (Canada); Edgar, Andy; Varoy, Chris [School of Chemical and Physical Sciences and MacDiarmid Institute, Victoria University of Wellington, Kelburn Parade (New Zealand); Belev, George; Wysokinski, Tomasz [Canadian Light Source, Inc., University of Saskatchewan, Saskatoon, Saskatchewan S7N 0X4 (Canada); Chapman, Dean [Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5 (Canada)

2012-10-01

265

Electronic structure and soft-X-ray-induced photoreduction studies of iron-based magnetic polyoxometalates of type {(M)M5}12Fe(III)30 (M = Mo(VI), W(VI)).  

PubMed

Giant Keplerate-type molecules with a {Mo72Fe30} core show a number of very interesting properties, making them particularly promising for various applications. So far, only limited data on the electronic structure of these molecules from X-ray spectra and electronic structure calculations have been available. Here we present a combined electronic and magnetic structure study of three Keplerate-type nanospheres--two with a {Mo72Fe30} core and one with a {W72Fe30} core by means of X-ray absorption spectroscopy, X-ray magnetic circular dichroism (XMCD), SQUID magnetometry, and complementary theoretical approaches. Furthermore, we present detailed studies of the Fe(3+)-to-Fe(2+) photoreduction process, which is induced under soft X-ray radiation in these molecules. We observe that the photoreduction rate greatly depends on the ligand structure surrounding the Fe ions, with negatively charged ligands leading to a dramatically reduced photoreduction rate. This opens the possibility of tailoring such polyoxometalates by X-ray spectroscopic studies and also for potential applications in the field of X-ray induced photochemistry. PMID:23403844

Kuepper, Karsten; Derks, Christine; Taubitz, Christian; Prinz, Manuel; Joly, Loïc; Kappler, Jean-Paul; Postnikov, Andrei; Yang, Wanli; Kuznetsova, Tatyana V; Wiedwald, Ulf; Ziemann, Paul; Neumann, Manfred

2013-06-14

266

Suppression of Radiation-Induced Testicular Germ Cell Apoptosis by 2,5-Hexanedione Pretreatment. III. Candidate Gene Analysis Identifies a Role for Fas in the Attenuation of X-ray–Induced Apoptosis  

PubMed Central

Germ cell apoptosis directly induced by x-radiation (x-ray) exposure is stage specific, with a higher incidence in stage II/III seminiferous tubules. A priming exposure to the Sertoli cell toxicant 2,5-hexanedione (HD) results in a marked reduction in x-ray–induced germ cell apoptosis in these affected stages. Because of the stage specificity of these responses, examination of associated gene expression in whole testis tissue has clear limitations. Laser capture microdissection (LCM) of specific cell populations in the testis is a valuable technique for investigating the responses of different cell types following toxicant exposure. LCM coupled with quantitative real-time PCR was performed to examine the expression of apoptosis-related genes at both early (3 h) and later (12 h) time points after x-ray exposure, with or without the priming exposure to HD. The mRNAs examined include Fas, FasL, caspase 3, bcl-2, p53, PUMA, and AEN, which were identified either by literature searches or microarray analysis. Group 1 seminiferous tubules (stages I–VI) exhibited the greatest changes in gene expression. Further analysis of this stage group (SG) revealed that Fas induction by x-ray is significantly attenuated by HD co-exposure. Selecting only for germ cells from seminiferous tubules of the most sensitive SG has provided further insight into the mechanisms involved in the co-exposure response. It is hypothesized that following co-exposure, germ cells adapt to the lack of Sertoli cell support by reducing the Fas response to normal FasL signals. These findings provide a better understanding and appreciation of the tissue complexity and technical difficulties associated with examining gene expression in the testis. PMID:20616204

Campion, Sarah N.; Sandrof, Moses A.; Yamasaki, Hideki; Boekelheide, Kim

2010-01-01

267

X-ray induced optical reflectivity  

DOE PAGESBeta

The change in optical reflectivity induced by intense x-ray pulses can now be used to study ultrafast many body responses in solids in the femtosecond time domain. X-ray absorption creates photoelectrons and core level holes subsequently filled by Auger or fluorescence processes, and these excitations ultimately add conduction and valence band carriers that perturb optical reflectivity.Optical absorption associated with band filling and band gap narrowing is shown to explain the basic features found in recent measurements on an insulator (silicon nitride, Si3N4), a semiconductor(gallium arsenide,GaAs), and a metal (gold,Au), obtained with ?100 fs x-ray pulses at 500-2000 eV and probed with 800 nm laser pulses. In particular GaAs exhibits an abrupt drop in reflectivity, persisting only for a time comparable to the x-ray excitation pulse duration, consistent with prompt band gap narrowing.

Durbin, Stephen M.

2012-01-01

268

Low-Dose Radiotherapy as a Chemopotentiator of Gemcitabine in Tumors of the Pancreas or Small Bowel: A Phase I Study Exploring a New Treatment Paradigm  

SciTech Connect

Purpose: To determine the maximum tolerated dose of upper abdominal low-dose fractionated radiotherapy (<1.0 Gy per fraction) given in combination with, and as a chemopotentiator for, gemcitabine. Methods and Materials: Gemcitabine was given at 1,250 mg/m{sup 2} at 10 mg/m{sup 2}/min on Days 1 and 8 of a 3-week cycle. Low-dose fractionated radiotherapy was tested at two dose levels: 60 cGy per fraction and 70 cGy per fraction. Radiotherapy was given b.i.d. on Days 1, 2, 8, and 9. Four cycles were planned. Results: Twenty-seven patients have been put on study. Ten patients have been entered in Phase I: 6 with metastatic/recurrent pancreatic carcinoma and 4 with unresectable pancreatic/small bowel carcinoma. Two of four patients at Dose Level 2 experienced dose-limiting toxicity. The overall radiographic response was 30%, and median survival was 11 months (range, 4-37 months). Conclusion: Low-dose fractionated radiotherapy to the upper abdomen is well tolerated at 60 cGy per fraction when combined with gemcitabine. Phase II evaluation is ongoing.

Regine, William F. [Department of Radiation Oncology, University of Maryland, Baltimore, MD (United States)]. E-mail: wregine@umm.edu; Hanna, Nader [Department of Surgery, University of Maryland, Baltimore, MD (United States); Garofalo, Michael C. [Department of Radiation Oncology, University of Maryland, Baltimore, MD (United States); Doyle, Austin [Department of Medicine, University of Maryland, Baltimore, MD (United States); Arnold, Susanne [Division of Hematology-Oncology, University of Kentucky, Lexington, KY (United States); Kataria, Ritesh [Department of Radiation Oncology, University of Maryland, Baltimore, MD (United States); Sims, Jacqueline [Department of Radiation Medicine, University of Kentucky, Lexington, KY (United States); Tan Ming [Department of Biostatistics, University of Maryland, Baltimore, MD (United States); Mohiuddin, Mohammed [Geisinger-Fox Chase Cancer Center, Wilkes-Barre, PA (United States)

2007-05-01

269

Role of small bowel capsule endoscopy in the diagnosis and management of iron deficiency anemia in elderly: A comprehensive review of the current literature  

PubMed Central

Iron deficiency anemia (IDA) is common and often under recognized problem in the elderly. It may be the result of multiple factors including a bleeding lesion in the gastrointestinal tract. Twenty percent of elderly patients with IDA have a negative upper and lower endoscopy and two-thirds of these have a lesion in the small bowel (SB). Capsule endoscopy (CE) provides direct visualization of entire SB mucosa, which was not possible before. It is superior to push enteroscopy, enteroclysis and barium radiography for diagnosing clinically significant SB pathology resulting in IDA. Angioectasia is one of the commonest lesions seen on the CE in elderly with IDA. The diagnostic yield of CE for IDA progressively increases with advancing age, and is highest among patients over 85 years of age. Balloon assisted enteroscopy is used to treat the lesions seen on CE. CE has some limitations mainly lack of therapeutic capability, inability to provide precise location of the lesion and false positive results. Overall CE is a very safe and effective procedure for the evaluation of IDA in elderly. PMID:25024599

Muhammad, Adnan; Vidyarthi, Gitanjali; Brady, Patrick

2014-01-01

270

Intussusception and volvulus secondary to jejunal adenocarcinoma in an adult Nigerian male: a case report.  

PubMed

A 31 year-old Nigerian man with jejuno-jejunal intussusception with the lead point being an adenocarcinoma complicated by small intestinal volvulus is presented. The subtle clinical features of an underlying small bowel malignancy were masked by the overwhelming clinical and radiological features of intussusception. rare case is reported to remind clinicians to have an increased index of suspicion of malignancy in patients who present with the usual features of chronic anemia, weight loss and loss of appetite with an intra-abdominal mass. The presentation of acute intestinal obstruction, with mesenteric vein thrombosis probably due to intussusception or volvulus should not however lower the suspicion. Histological evaluation of surgical biopsies is of immense importance. PMID:21220868

Okolo, C A; Afolabi, A O; Sahabi, S M

2010-12-01

271

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus.  

PubMed

Crohn's disease and ulcerative colitis are lifelong diseases seen predominantly in the developed countries of the world. Whereas ulcerative colitis is a chronic inflammatory condition causing diffuse and continuous mucosal inflammation of the colon, Crohn's disease is a heterogeneous entity comprised of several different phenotypes, but can affect the entire gastrointestinal tract. A change in diagnosis from Crohn's disease to ulcerative colitis during the first year of illness occurs in about 10 % - 15 % of cases. Inflammatory bowel disease (IBD) restricted to the colon that cannot be characterized as either ulcerative colitis or Crohn's disease is termed IBD-unclassified (IBDU). The advent of capsule and both single- and double-balloon-assisted enteroscopy is revolutionizing small-bowel imaging and has major implications for diagnosis, classification, therapeutic decision making and outcomes in the management of IBD. The role of these investigations in the diagnosis and management of IBD, however, is unclear. This document sets out the current Consensus reached by a group of international experts in the fields of endoscopy and IBD at a meeting held in Brussels, 12-13th December 2008, organised jointly by the European Crohn's and Colitis Organisation (ECCO) and the Organisation Mondiale d'Endoscopie Digestive (OMED). The Consensus is grouped into seven sections: definitions and diagnosis; suspected Crohn's disease; established Crohn's disease; IBDU; ulcerative colitis (including ileal pouch-anal anastomosis [IPAA]); paediatric practice; and complications and unresolved questions. Consensus guideline statements are followed by comments on the evidence and opinion. Statements are intended to be read in context with qualifying comments and not read in isolation. PMID:19588292

Bourreille, A; Ignjatovic, A; Aabakken, L; Loftus, E V; Eliakim, R; Pennazio, M; Bouhnik, Y; Seidman, E; Keuchel, M; Albert, J G; Ardizzone, S; Bar-Meir, S; Bisschops, R; Despott, E J; Fortun, P F; Heuschkel, R; Kammermeier, J; Leighton, J A; Mantzaris, G J; Moussata, D; Lo, S; Paulsen, V; Panés, J; Radford-Smith, G; Reinisch, W; Rondonotti, E; Sanders, D S; Swoger, J M; Yamamoto, H; Travis, S; Colombel, J-F; Van Gossum, A

2009-07-01

272

The Different Volume Effects of Small-Bowel Toxicity During Pelvic Irradiation Between Gynecologic Patients With and Without Abdominal Surgery: A Prospective Study With Computed Tomography-Based Dosimetry  

SciTech Connect

Purpose: To evaluate the effect of abdominal surgery on the volume effects of small-bowel toxicity during whole-pelvic irradiation in patients with gynecologic malignancies. Methods and Materials: From May 2003 through November 2006, 80 gynecologic patients without (Group I) or with (Group II) prior abdominal surgery were analyzed. We used a computed tomography (CT) planning system to measure the small-bowel volume and dosimetry. We acquired the range of small-bowel volume in 10% (V10) to 100% (V100) of dose, at 10% intervals. The onset and grade of diarrhea during whole-pelvic irradiation were recorded as small-bowel toxicity up to 39.6 Gy in 22 fractions. Results: The volume effect of Grade 2-3 diarrhea existed from V10 to V100 in Group I patients and from V60 to V100 in Group II patients on univariate analyses. The V40 of Group I and the V100 of Group II achieved most statistical significance. The mean V40 was 281 {+-} 27 cm{sup 3} and 489 {+-} 34 cm{sup 3} (p < 0.001) in Group I patients with Grade 0-1 and Grade 2-3 diarrhea, respectively. The corresponding mean V100 of Group II patients was 56 {+-} 14 cm{sup 3} and 132 {+-} 19 cm{sup 3} (p = 0.003). Multivariate analyses revealed that V40 (p = 0.001) and V100 (p = 0.027) were independent factors for the development of Grade 2-3 diarrhea in Groups I and II, respectively. Conclusions: Gynecologic patients without and with abdominal surgery have different volume effects on small-bowel toxicity during whole-pelvic irradiation. Low-dose volume can be used as a predictive index of Grade 2 or greater diarrhea in patients without abdominal surgery. Full-dose volume is more important than low-dose volume for Grade 2 or greater diarrhea in patients with abdominal surgery.

Huang, E.-Y. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan (China); Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Sung, C.-C. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan (China); Ko, S.-F. [School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan (China); Wang, C.-J. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan (China); Yang, Kuender D. [Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China)], E-mail: yangkd@adm.cgmh.org.tw

2007-11-01

273

Simultaneous non-invasive measurement of liquid gastric emptying and small bowel transit by combined 13C-acetate and H2-lactulose breath test.  

PubMed

The 13C-acetate breath test (13C-ABT) allows noninasive measurement of liquid gastric emptying time (LGET), the H2-lactulose breath (H2-LBT) measures orocecal transit time (OCTT). Because of different test principles, both tests can generally be combined. This would not only spare time and resources but may also deliver additional information on the integrated regulation of gastrointestinal motor functions. Our aim was to define an adequate test protocol and to generate normal values for the combined 13C-ABT/H2-LBT. Twenty two healthy volunteers participated (HV, 12 females, age: 26.5? ± ?4.7 years, BMI: 22? ± ?2.1?kgm(-2). Fasting subjects received 200?ml of an aequous solution containing 150?mg 13C-acetate and 10?g lactulose. Breath samples for H2 measurements were collected before ingestion of the test solution and afterwards at 5 min intervals for 180 min, for 13C measurements sampling intervals were prolonged to 15?min after the first hour. LGET was defined as time of maximal 13C-exhalation, OCTT as increase in H2 of ? 20?ppm above basal. Small bowel transit time (SBTT) was calculated as the difference between OCTT and LGET. Mean [95% CI] values for LGET, OCTT and SBTT were 26 [23-30] min, 85 [68-102] min and 60 [44-76] min, respectively. Normal values for LGET and OCTT corresponded with published data. SBTT was not correlated with LGET (R2 = 0.019; p = 0.546). By contrast, there was a very tight and highly significant correlation between SBTT and OCTT (R2 = 0.933; p < 0.001). Multivariate linear regression analyses confirmed that age, sex and BMI had no significant effects on OCTT or SBTT while LGET was weakly correlated with BMI (R2 = 0.240; p = 0.021). In conclusion, the combined 13C-ABT/H2-LBT allows simultaneous measurement of LGET and OCTT as well as calculation of SBTT. PMID:25417651

Bertram, Franziska; Andresen, Viola; Layer, Peter; Keller, Jutta

2014-12-01

274

Adenocarcinoma of the pancreas  

PubMed Central

Infiltrating ductal adenocarcinoma of the pancreas is a real enigma. On one hand, it is one of the most deadly of all of the solid malignancies. On the other hand, the neoplastic glands can be remarkably well-differentiated, and it can be difficult to distinguish between a reactive non-neoplastic gland and a gland of invasive adenocarcinoma. In this review, we will present diagnostic criteria that one can “hang your hat on” when establishing the diagnosis of infiltrating ductal adenocarcinoma of the pancreas. We will also review clinically important features of the disease, and, with the impending incorporation of molecular genetics into everyday practice, we will emphasize clinical applications of cancer genetics. PMID:25441308

Hruban, Ralph H.; Klimstra, David S.

2015-01-01

275

Malakoplakia and colorectal adenocarcinoma.  

PubMed Central

We report a case of malakoplakia in association with colonic adenocarcinoma. Tumour-associated malakoplakia in the gastrointestinal tract is a rare finding, generally confined to the colon. It may be locally aggressive, with invasion of pericolic tissues, but is always located adjacent to the tumour. This contrasts with the often more diffuse, multifocal distribution of colonic malakoplakia in association with other pathologies. Images Figure PMID:9135837

Bates, A. W.; Dev, S.; Baithun, S. I.

1997-01-01

276

Adenocarcinoma of the sphenoid sinus  

PubMed Central

Adenocarcinomas of the sphenoid sinus are exceptional. In this paper, we report a new case with a review of the literature. Our patient was a 45-year-old man who presented with isolated retro orbital headache. CT and MRI suspected a malignat tumor of the sphenoid sinus. The patient underwent a debulking surgery. The final pathology carried out the diagnosis of primary adenocarcinoma. The patient died several months later from radiotherapy complications. Even if adenocarcinomas of the sphenoid sinus are exceptional, they should be considered in the differential diagnosis of sphenoid sinus masses. The prognosis is poor. PMID:25469178

Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Nadour, Karim; Ammar, Haddou; Bouaity, Brahim

2014-01-01

277

Adenocarcinoma of the cervical stump  

SciTech Connect

Sixteen women with adenocarcinoma of the cervical stump were treated over a 15-year period. The median survivals of 40 months for stage IB and 17 months for stages II and III were significantly worse compared with those for patients treated for cervical adenocarcinoma of the intact uterus or squamous carcinoma of the cervical stump. The poor results were due to both local and distant failure. Implications regarding tumor radiosensitivity and adjuvant therapy in these high-risk patients are discussed.

Goodman, H.M.; Niloff, J.M.; Buttlar, C.A.; Welch, W.R.; Marck, A.; Feuer, E.J.; Lahman, E.A.; Jenison, E.; Knapp, R.C. (Brigham and Women's Hospital, Boston, MA (USA))

1989-11-01

278

[Ocular metastasis heralding gastric adenocarcinoma].  

PubMed

Ocular metastasis is a rare presenting feature of gastric adenocarcinoma. We report a 48-year-old woman who presented with a decrease in visual acuity of the right eye leading to the discovery of an ocular metastasis. Diagnostic work-up identified a gastric adenocarcinoma with pulmonary metastases. She received four cycles of chemotherapy combining epirubicin, cisplatin and fluorouracil. The patient died 6 months after the diagnosis of respiratory failure. PMID:20554090

Chekrine, T; Tawfiq, N; Bouchbika, Z; Benchakroun, N; Jouhadi, H; Sahraoui, S; Benider, A

2010-10-01

279

FAP related periampullary adenocarcinoma  

PubMed Central

INTRODUCTION The risk of periampullary neoplasia in patients with familial adenomatous polyposis (FAP) is significantly increased compared to the general population. PRESENTATION OF CASE We herein report the case of a 47-year-old woman with classic familial adenomatous polyposis with a history of total proctocolectomy for FAP who presented with an ulcerous ampullary lesion 8 years after primary colorectal surgery. Interestingly, the patient had not enrolled to optimal postoperative upper endoscopy follow-up. The patient underwent a Whipple procedure. Histology demonstrated a T2N0 ampullary adenocarcinoma. DISCUSSION Periampullary disease in patients with familial adenomatous polyposis occurs increasingly, especially in the subset of patients without proper endoscopic follow-up. Current recommendations concerning upper endoscopy and appropriate management are herein discussed; the importance of optimal postoperative endoscopy after total proctocolectomy in the FAP setting is discussed. CONCLUSION Periampullary cancer carries a significant risk in patients with FAP and proper endoscopic follow-up should be applied in this special patient group in order to manage ampullary manifestations of the disease in a timely manner. PMID:23792481

Mantas, Dimitrios; Charalampoudis, Petros; Nikiteas, Nikolaos

2013-01-01

280

Comprehensive molecular profiling of lung adenocarcinoma  

E-print Network

Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, ...

Lander, Eric S.

281

Hepatoid adenocarcinoma of the colon.  

PubMed

Hepatoid adenocarcinoma (HAC) is a rare extrahepatic adenocarcinoma that morphologically and immunophenotypically mimics hepatocellular carcinoma (HCC). We report the case of a 42-year-old woman with an extensive cancer history who presented with right-sided abdominal pain and lower gastrointestinal (GI) bleeding, and was ultimately diagnosed with colon adenocarcinoma. She underwent sigmoidectomy and adjuvant chemotherapy. Approximately 1?month after completion of chemotherapy, positron emission tomography showed presence of a 1.8?cm×1.4?cm mesenteric lymph node. She underwent treatment with chemotherapy and radiation followed by lymph node resection. Pathological findings from the lymph node were consistent with poorly differentiated carcinoma with hepatocellular differentiation. When compared with pathology from the colonic resection, both specimens showed histomorphological features and immunohistochemical profiles consistent with hepatocellular differentiation. Given these findings, a diagnosis of HAC of the colon with metastasis to a mesenteric lymph node was made. PMID:25883249

Armaghani, Avan; Gonzalo, David Hernandez; Daily, Karen

2015-01-01

282

Gastric adenocarcinoma associated with isolated granulomatous gastritis  

Microsoft Academic Search

Background: Granulomatous gastritis is a rarely observed pathological diagnosis. This condition often mimics gastric adenocarcinoma clinically, resulting in gastric resection. However, granulomatous gastritis has long been viewed as a benign process not observed in association with adenocarcinoma of the stomach. This article describes a patient with granulomatous gastritis occurring in close proximity to an area of superficially invading gastric adenocarcinoma.

Christopher Newton; Lucien Nochomovitz; Jonathan M. Sackier

1998-01-01

283

X-Ray Induced Mutations in the Physiology of Ophiostoma  

Microsoft Academic Search

Tatum's and Beadle's1 investigations on Neurospora inspired me to attempt to induce physiological mutations in Ophiostoma multiannulatum (Hedge, and Davids.) by means of X-ray treatment. Normal strains of this fungus grew optimally on a synthetic medium containing glucose, ammonium tartrate, inorganic salts, aneurin (= vitamin B1) and pyridoxin (= vitamin B6)2. Out of 775 monosporous mycelia which were obtained from

Nils Fries

1945-01-01

284

X-ray induced demagnetization of single-molecule magnets  

SciTech Connect

Low-temperature x-ray magnetic circular dichroism measurements on the endohedral single-molecule magnet DySc{sub 2}N@C{sub 80} at the Dy M{sub 4,5} edges reveal a shrinking of the opening of the observed hysteresis with increasing x-ray flux. Time-dependent measurements show that the exposure of the molecules to x-rays resonant with the Dy M{sub 5} edge accelerates the relaxation of magnetization more than off-resonant x-rays. The results cannot be explained by a homogeneous temperature rise due to x-ray absorption. Moreover, the observed large demagnetization cross sections indicate that the resonant absorption of one x-ray photon induces the demagnetization of many molecules.

Dreiser, Jan, E-mail: jan.dreiser@epfl.ch [Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI (Switzerland); Institute of Condensed Matter Physics, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne (Switzerland); Westerström, Rasmus [Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI (Switzerland); Physik-Institut, Universität Zürich, 8057 Zürich (Switzerland); Department of Physics and Astronomy, Uppsala University, 751 20 Uppsala (Sweden); Piamonteze, Cinthia; Nolting, Frithjof [Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI (Switzerland); Rusponi, Stefano; Brune, Harald [Institute of Condensed Matter Physics, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne (Switzerland); Yang, Shangfeng [Hefei National Laboratory for Physical Sciences at Microscale, Department of Materials Science and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei 230026 (China); Popov, Alexey; Dunsch, Lothar [Department of Electrochemistry and Conducting Polymers, Leibniz Institute of Solid State and Materials Research, 01069 Dresden (Germany); Greber, Thomas, E-mail: greber@physik.uzh.ch [Physik-Institut, Universität Zürich, 8057 Zürich (Switzerland)

2014-07-21

285

X-ray-induced persistent photoconductivity in vanadium dioxide  

NASA Astrophysics Data System (ADS)

The resistivity of vanadium dioxide (VO2) decreased by over one order of magnitude upon localized illumination with x rays at room temperature. Despite this reduction, the structure remained in the monoclinic phase and had no signature of the high-temperature tetragonal phase that is usually associated with the lower resistance. Once illumination ceased, relaxation to the insulating state took tens of hours near room temperature. However, a full recovery of the insulating state was achieved within minutes by thermal cycling. We show that this behavior is consistent with random local-potential fluctuations and random distribution of discrete recombination sites used to model residual photoconductivity.

Dietze, S. H.; Marsh, M. J.; Wang, Siming; Ramírez, J.-G.; Cai, Z.-H.; Mohanty, J. R.; Schuller, Ivan K.; Shpyrko, O. G.

2014-10-01

286

X-ray induced damage observations in ZERODUR mirrors  

SciTech Connect

Catastrophic damage has been observed in some ZERODUR mirrors used as first mirrors in two beam lines at the National Synchrotron Light Source (NSLS). Despite the high reflectivity of the coatings used on these mirrors, a significant flux of high energy photons penetrates below the coating and is absorbed in the substrate. Although model calculations indicate that the local temperature does not increase significantly, the authors suspect that over long time periods the absorbed flux produces structural changes in the material, leading to a build-up of surface stress, gross figure changes, and growth of fractures. These changes are probably related to the nature of the two-phase glass-ceramic composition of the ZERODUR material. Metal mirrors and single-phase materials do not exhibit such catastrophic damage under similar exposure conditions.

Takacs, P.Z.; Furenlid, K.; Furenlid, L.

1997-07-01

287

Diverticular disease of the small bowel.  

PubMed

A diverticulum is a bulging sack in any portion of the gastrointestinal tract. The most common site for the formation of diverticula is the large intestine. Small intestine diverticular disease is much less common than colonic diverticular disease. The most common symptom is non-specific epigastric pain and a bloating sensation. Major complications include diverticulitis, gastrointestinal bleeding, acute perforation, pancreatic or biliary (in the case of duodenal diverticula) disease, intestinal obstruction, intestinal perforation, localized abscess, malabsorption, anemia, volvulus and bacterial overgrowth. We describe the clinical case of a 65-year-old female patient with a diagnosis on hospital admittance of acute appendicitis and a intraoperative finding of diverticular disease of the small intestine, accompanied by complications such as intestinal perforation, bleeding and abdominal sepsis. This was surgically treated with intestinal resection and ileostomy and a subsequent re-intervention comprising perforation of the ileostomy and stomal remodeling. The patient remained hospitalized for approximately 1 month with antibiotics and local surgical wound healing, as well as changes in her diet with food supplements and metabolic control. She showed a favorable clinical evolution and was dismissed from the hospital to her home. We include here a discussion on trends in medical and surgical aspects as well as early handling or appropriate management to reduce the risk of fatal complications. PMID:23185148

Ferreira-Aparicio, Francisco Emilio; Gutiérrez-Vega, Rafael; Gálvez-Molina, Yolanda; Ontiveros-Nevares, Patricia; Athie-Gútierrez, César; Montalvo-Javé, Eduardo E

2012-09-01

288

Pathology Case Study: Small Bowel Malabsorption  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a child developed bowel transplantation. Visitors are given the microscopic descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pediatric pathology.

Agostini, Rocco

289

Upper GI and small bowel series  

MedlinePLUS

... Ulcers In the stomach, abnormal results may mean: Gastric cancer Gastric ulcer - benign Gastritis Polyps (a tumor that is usually noncancerous and grows on the mucus membrane ) Pyloric stenosis ... ring Primary or idiopathic intestinal pseudo-obstruction

290

[Small bowel perforation caused by magnetic toys].  

PubMed

Accidental ingestion of foreign bodies is a common problem in infants and childhood, but ingestion of magnetic construction toys is very rare. In the case of ingestion of multiple parts of these magnetic construction toys, they may attract each other through the intestinal walls, causing pressure necrosis, perforation, fistula formation or intestinal obstruction. A 20-month-old boy presented with a three-day history of abdominal pain and bilious vomiting. Physical examination revealed a slighted distended abdomen. The -white blood cell count was increased, but the C-reactive protein was normal. Ultrasound and X-ray of the abdomen showed a distended bowel loop in the right upper quadrant, a moderate amount of free intraperitoneal liquid and 4 foreign bodies. Emergency laparotomy was performed and 2 perforations in the ileum were detected. The perforations were caused by a magnetic construction toy and 2 iron globes. The fourth foreign body was a glass marble. The foreign bodies were removed, both perforations were primarily sutured. The child was discharged on postoperative day 10 after an uneventful recovery. Parents should be warned against the potential dangers of children's constructions toys that contain these kinds of magnets. PMID:20549590

Schroepfer, E; Siauw, C; Hoecht, B; Meyer, T

2010-06-01

291

Assessment of invasion in lung adenocarcinoma classification, including adenocarcinoma in situ and minimally invasive adenocarcinoma  

Microsoft Academic Search

Classification of adenocarcinoma has undergone recent evaluation to better align histological classification with clinical outcomes. One terminology, in particular, that of bronchioloalveolar carcinoma (BAC), has been debated for many decades. Although initial discussion surrounded the cell-of-origin of this tumor, more recent confusion has been generated from the use of this term both as a pattern of growth within an otherwise

Alain C Borczuk

2012-01-01

292

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group  

PubMed Central

Background In 2013 Guidelines on diagnosis and management of ASBO have been revised and updated by the WSES Working Group on ASBO to develop current evidence-based algorithms and focus indications and safety of conservative treatment, timing of surgery and indications for laparoscopy. Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT-scan signs (free fluid, mesenteric edema, small-bowel feces sign, devascularization) patients with partial ASBO can be managed safely with NOM and tube decompression should be attempted. These patients are good candidates for Water-Soluble-Contrast-Medium (WSCM) with both diagnostic and therapeutic purposes. The radiologic appearance of WSCM in the colon within 24 hours from administration predicts resolution. WSCM maybe administered either orally or via NGT both immediately at admission or after failed conservative treatment for 48 hours. The use of WSCM is safe and reduces need for surgery, time to resolution and hospital stay. NOM, in absence of signs of strangulation or peritonitis, can be prolonged up to 72 hours. After 72 hours of NOM without resolution, surgery is recommended. Patients treated non-operatively have shorter hospital stay, but higher recurrence rate and shorter time to re-admission, although the risk of new surgically treated episodes of ASBO is unchanged. Risk factors for recurrences are age <40 years and matted adhesions. WSCM does not decrease recurrence rates or recurrences needing surgery. Open surgery is often used for strangulating ASBO as well as after failed conservative management. In selected patients and with appropriate skills, laparoscopic approach is advisable using open access technique. Access in left upper quadrant or left flank is the safest and only completely obstructing adhesions should be identified and lysed with cold scissors. Laparoscopic adhesiolysis should be attempted preferably if first episode of SBO and/or anticipated single band. A low threshold for open conversion should be maintained. Peritoneal adhesions should be prevented. Hyaluronic acid-carboxycellulose membrane and icodextrin decrease incidence of adhesions. Icodextrin may reduce the risk of re-obstruction. HA cannot reduce need of surgery. Adhesions quantification and scoring maybe useful for achieving standardized assessment of adhesions severity and for further research in diagnosis and treatment of ASBO. PMID:24112637

2013-01-01

293

Adenocarcinoma of the anal ducts  

Microsoft Academic Search

The records of 21 patients treated for adenocarcinoma of the anal ducts between 1943 and 1982 were reviewed. The patients\\u000a were followed until death or current status in April 1987. The median follow-up period was eight months (range, 3 to 144 months).\\u000a Fifteen patients had an erroneous diagnosis made at first physician visit resulting in a media doctor's delay of

S. Lindkaer Jensen; M. H. Shokouh-Amiri; K. Hagen; H. Harling; O. Vagn Nielsen

1988-01-01

294

Genome profiling of pancreatic adenocarcinoma.  

PubMed

Pancreatic adenocarcinoma is one of the most aggressive human cancers. It displays many different chromosomal abnormalities and mutations. By using 244 K high-resolution array-comparative genomic hybridization (aCGH) we studied the genome alterations of 39 fine-needle aspirations from pancreatic adenocarcinoma and eight human adenocarcinoma pancreatic cell lines. Using both visual inspection and GISTIC analysis, recurrent losses were observed on 1p, 3p, 4p, 6, 8p, 9, 10, 11q, 15q, 17, 18, 19p, 20p, 21, and 22 and comprised several known or suspected tumor suppressor genes such as ARHGEF10, ARID1A, CDKN2A/B, FHIT, PTEN, RB1, RUNX1-3, SMAD4, STK11/LKB1, TP53, and TUSC3. Heterozygous deletion of the 1p35-p36 chromosomal region was identified in one-third of the tumors and three of the cell lines. This region, commonly deleted in human cancers, contains several tumor suppressor genes including ARID1A and RUNX3. We identified frequent genetic gains on chromosome arms 1q, 3q, 5p, 6p, 7q, 8q, 12q, 15q, 18q, 19q, and 20q. Amplifications were observed in 16 tumors. AKT2, CCND3, CDK4, FOXA2, GATA6, MDM2, MYC, and SMURF1 genes were gained or amplified. The most obvious amplification was located at 18q11.2 and targeted the GATA6 gene, which plays a predominant role in the initial specification of the pancreas and in pancreatic cell type differentiation. In conclusion, we have identified novel biomarkers and potential therapeutic targets in pancreatic adenocarcinoma. PMID:21412932

Birnbaum, David J; Adélaïde, José; Mamessier, Emilie; Finetti, Pascal; Lagarde, Arnaud; Monges, Geneviève; Viret, Frédéric; Gonçalvès, Anthony; Turrini, Olivier; Delpero, Jean-Robert; Iovanna, Juan; Giovannini, Marc; Birnbaum, Daniel; Chaffanet, Max

2011-06-01

295

Barrett’s and Esophageal Adenocarcinoma Consortium  

Cancer.gov

An international consortium with epidemiologic studies of Barrett's Esophagus and esophageal adenocarcinoma. Analyses so far have included alcohol consumption, anthropometry, cigarette smoking, excess risk models, gastroesophageal reflux disease, non-steroidal anti-inflammatory drugs, reproductive factors, and genome-wide studies to identify susceptibility loci associated with Barrett’s esophagus and/or adenocarcinomas of the esophagus.

296

[The new classification of lung adenocarcinoma].  

PubMed

The new, interdisciplinary IASLC/ATS/ERS classification of lung adenocarcinoma has achieved a considerable impact since its publication in the year 2011. It separates tumours into preinvasive, minimally invasive and invasive subtypes. The preinvasive lesions atypical, adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS) together with the minimally invasive adenocarcinoma (MIA), have an excellent prognosis after complete resection with 100 % survival. It enables a reproducible tumour grading by the determination of the predominant histological growth pattern which could be confirmed in several follow-up studies. Thereby the mixed subtype was eliminated which formerly represented about 80 % of all adenocarcinomas. Similarly, the terms bronchioloalveolar adenocarcinoma and bronchioloalveolar tumour growth were eliminated because they represented several distinct entities, specifically the in-situ lesions AAH and ACIS as well as the non-in-situ/invasive tumours like minimally invasive adenocarcinoma, lepidic predominant adenocarcinoma (LPA) and invasive mucinous adenocarcinoma (IMA). Although the classification is based on data from tumour resections it accommodates the fact that most tumours are diagnosed on biopsies and cytological specimens and includes recommendations for an efficient work-up to preserve tissue for molecular testing. Furthermore, the morphological analysis may provide hints for molecular changes including mutations with therapeutic relevance that may enable targeted molecular diagnostics. This review presents essentials facts of the new classification that will be part of the next WHO classification of lung tumors and its follow-up publications. PMID:24150851

Petersen, I

2013-10-01

297

Obligate progression precedes lung adenocarcinoma dissemination  

PubMed Central

Despite its clinical importance, very little is known about the natural history and molecular underpinnings of lung cancer dissemination and metastasis. Here we employed a genetically-engineered mouse model of metastatic lung adenocarcinoma in which cancer cells are fluorescently marked to determine whether dissemination is an inherent ability or a major acquired phenotype during lung adenocarcinoma metastasis. We find very little evidence for dissemination from oncogenic Kras-driven hyperplasias or most adenocarcinomas. p53 loss is insufficient to drive dissemination but rather enables rare cancer cells in a small fraction of primary adenocarcinomas to gain alterations that drive dissemination. Molecular characterization of disseminated tumors cells indicates that down-regulation of the transcription factor Nkx2-1 precedes dissemination. Finally, we show that metastatic primary tumors possess a highly proliferative sub-population of cells with characteristics matching those of disseminating cells. We propose that dissemination is a major hurdle during the natural course of lung adenocarcinoma metastasis. PMID:24740995

Caswell, Deborah R.; Chuang, Chen-Hua; Yang, Dian; Chiou, Shin-Heng; Cheemalavagu, Shashank; Kim-Kiselak, Caroline; Connolly, Andrew; Winslow, Monte M.

2014-01-01

298

MLN0264 in Previously Treated Asian Patients With Advanced Gastrointestinal Carcinoma or Metastatic or Recurrent Gastric or Gastroesophageal Junction Adenocarcinoma Expressing Guanylyl Cyclase C  

ClinicalTrials.gov

Advanced Gastrointestinal Carcinoma; Gastroesophageal Junction Adenocarcinoma; Recurrent Gastric Adenocarcinoma; Recurrent Gastroesophageal Junction Adenocarcinoma; Metastatic Gastric Adenocarcinoma; Metastatic Gastroesophageal Junction Adenocarcinoma; Recurrent Gastrointestinal Carcinoma

2015-03-11

299

Longterm survival after pancreaticoduodenectomy for periampullary adenocarcinomas  

PubMed Central

Objectives The aim of this study was to identify predictors for longterm survival following pancreaticoduodenectomy (PD) for pancreatic and other periampullary adenocarcinomas. Methods Clinicopathological factors were compared between short-term (<5 years) and longterm (?5 years) survival groups. Rates of actual 5-year and actuarial 10-year survival were determined. Results There were 109 (21.8%) longterm survivors among a sample of 501 patients. Patients with ampullary adenocarcinoma represented 76.1% of the longterm survivors. Favourable factors for longterm survival included female gender, lack of jaundice, lower blood loss, classical PD, absence of postoperative bleeding or intra-abdominal abscess, non-pancreatic primary cancer, earlier tumour stage, smaller tumour size (?2 cm), curative resection, negative lymph node involvement, well-differentiated tumours, and absence of perineural invasion. Independent factors associated with longterm survival were diagnosis of primary tumour, jaundice, intra-abdominal abscess, tumour stage, tumour size, radicality, lymph node status and cell differentiation. The prognosis was best for ampullary adenocarcinoma, for which the rate of actual 5-year survival was 32.8%, and poorest for pancreatic head adenocarcinoma, for which actual 5-year survival was only 6.5%. Conclusions The majority of longterm survivors after PD for periampullary adenocarcinomas are patients with ampullary adenocarcinoma. The longterm prognosis in pancreatic head adenocarcinoma remains dismal. PMID:23472708

Chen, Shih-Chin; Shyr, Yi-Ming; Wang, Shin-E

2013-01-01

300

Adenoma, adenocarcinoma and mixed carcinoid-adenocarcinoma arising in a small lesion of the colon.  

PubMed

A unique tumor measuring 8 x 8 x 5 mm and composed of adenoma, adenocarcinoma and mixed carcinoid-adenocarcinoma arising in the ascending colon is reported. The mixed carcinoid-adenocarcinoma, in which adenocarcinomatous and carcinoid components intermingled, originated in the mucosa, penetrated the muscularis mucosa and extended into the submucosa. Immunohistochemically, carcinoid cells were positive for neuroendocrine markers and adenocarcinoma cells were intracytoplasmicly positive for carcinoembryonic antigen. Ultrastructurally, membrane-bound electron dense granules varying in shape, size and electron density were detected in the cytoplasm of carcinoid cells. No mutations of p53 and k-ras genes were detected in adenomatous, adenocarcinomatous or mixed carcinoid-adenocarcinoma components. The morphological appearances of the present case strongly suggests the histogenesis of this tumor in an adenoma-adenocarcinoma-carcinoid tumor sequence. PMID:12828611

Jiao, Yu-Fei; Nakamura, Shin-ichi; Arai, Tomio; Sugai, Tamotsu; Uesugi, Noriuki; Habano, Wataru; Suzuki, Masamichi; Tazawa, Hideki; Goukon, Yuji

2003-07-01

301

Colorectal adenocarcinoma in Crohn's disease.  

PubMed Central

OBJECTIVE: The authors' aim was to review the clinical features and estimate the long-term survival of patients with colorectal carcinoma complicating Crohn's disease. SUMMARY BACKGROUND DATA: Recent studies have demonstrated a significantly increased risk of colorectal carcinoma in patients with Crohns disease. METHODS: The authors reviewed retrospectively the medical records of 30 patients with Crohn's disease admitted to The Mount Sinai Hospital between 1960 and 1989 in whom colorectal adenocarcinoma developed. All patients were operated on and follow-up was complete for all patients to 10 years after operation, to the time of death, or to the closing date of the study in December 1989. RESULTS: The 30 patients in the series had 33 colorectal adenocarcinomas; three patients (10%) presented with two synchronous cancers. The patients were relatively young (mean age, 53 years) and had long-standing Crohn's disease (duration >20 years in 87%). The 5-year actuarial survival was 44% for the overall series: 100% for stage A, 86% for stage B, 60% for stage C. All five patients with excluded bowel tumor died of large bowel cancer within 2.4 years; by contrast, the actuarial 5-year survival for patients with in-continuity tumors was 56%. CONCLUSIONS: The incidence, characteristics, and prognosis of colorectal carcinoma complicating Crohn's disease are similar to the features of cancer in ulcerative colitis, including young age, multiple neoplasms, long duration of disease, and greater than a 50% 5-year survival rate (without excluded loops). These observations suggest the advisability of surveillance programs for Crohn's disease of the colon similar to those for ulcerative colitis of comparable duration and extent. PMID:8597513

Ribeiro, M B; Greenstein, A J; Sachar, D B; Barth, J; Balasubramanian, S; Harpaz, N; Heimann, T M; Aufses, A H

1996-01-01

302

Microsatellite instability in esophageal adenocarcinoma.  

PubMed

The frequency of microsatellite instability (MSI), a result of defective mismatch repair during DNA replication, has been reported inconsistently in primary esophageal adenocarcinoma (EADC). Using a panel of 15 markers, the primary aim of this study was to analyze the frequency of MSI in a well-characterized series of 27 primary EADCs, defined according to strict clinicopathologic criteria. Polymerase chain reaction was used to amplify the following microsatellite repeat loci: D2S123, D10S197, D2S119, D11S904, D2S147, D3S1764, D7S1830, D7S1805, D2S434, D9S299, BAT25, BAT26, D5S346, D17S250, and TGF-beta-RII. Tumors were classified as microsatellite-stable (MSS) when no alterations were seen in tumor DNA compared to matched normal tissues, low-level MSI (MSI-L) when 1-5 of 15 markers were altered, and high-level MSI (MSI-H) when more than five markers were altered. Using these stringent criteria, 9/27 (33%) tumors were MSS, 18/27 (67%) tumors were MSI-L, and no tumor was MSI-H. Immunohistochemistry demonstrated cell nuclear expression of DNA mismatch repair proteins (both hMLH1 and hMSH2) in 78% (21/27) of tumors. No associations were seen between MSI and immunohistochemical expression of hMLH1, hMSH2, alterations in p53 or MBD4, tumor grade, pathologic stage, or patient survival. In conclusion, the finding of low levels of MSI in most tumors suggests an inherent baseline genomic instability, and potentially increased susceptibility to mutations during the progression of esophageal adenocarcinoma. PMID:15279904

Evans, Susan C; Gillis, Amy; Geldenhuys, Laurette; Vaninetti, Nadine M; Malatjalian, Dickran A; Porter, Geoffrey A; Guernsey, Duane L; Casson, Alan G

2004-08-30

303

Curative Resection for Esophageal Adenocarcinoma  

PubMed Central

Objective To document what can be accomplished with surgical resection done according to the classical principles of surgical oncology. Methods One hundred consecutive patients underwent en bloc esophagectomy for esophageal adenocarcinoma. No patient received pre- or postoperative chemotherapy or radiation therapy. Tumor depth and number and location of involved lymph nodes were recorded. A lymph node ratio was calculated by dividing the number of involved nodes by the total number removed. Follow-up was complete in all patients. The median follow-up of surviving patients was 40 months, with 23 patients surviving 5 years or more. Results The overall actuarial survival rate at 5 years was 52%. Survival rates by American Joint Commission on Cancer (AJCC) stage were stage 1 (n = 26), 94%; stage 2a (n = 11), 65%; stage 2b (n = 13), 65%; stage 3 (n = 32), 23%; and stage 4 (n = 18), 27%. Sixteen tumors were confined to the mucosa, 16 to the submucosa, and 13 to the muscularis propria, and 55 were transmural. Tumor depth and the number and ratio of involved nodes were predictors of survival. Metastases to celiac (n = 16) or other distant node sites (n = 26) were not associated with decreased survival. Local recurrence was seen in only one patient. Latent nodal recurrence outside the surgical field occurred in 9 patients and systemic metastases in 31. Tumor depth, the number of involved nodes, and the lymph node ratio were important predictors of systemic recurrence. The surgical death rate was 6%. Conclusion Long-term survival from adenocarcinoma of the esophagus can be achieved in more than half the patients who undergo en bloc resection. One third of patients with lymph node involvement survived 5 years. Local control is excellent after en bloc resection. The extent of disease associated with tumors confined to the mucosa and submucosa provides justification for more limited and less morbid resections. PMID:11573045

Hagen, Jeffrey A.; DeMeester, Steven R.; Peters, Jeffrey H.; Chandrasoma, Para; DeMeester, Tom R.

2001-01-01

304

Catumaxomab for Treatment of Peritoneal Carcinomatosis in Patients With Gastric Adenocarcinomas  

ClinicalTrials.gov

Gastric Adenocarcinoma With Peritoneal Carcinomatosis; Siewert Type II Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis; Siewert Type III Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis

2014-12-17

305

Prostatic ductal adenocarcinoma showing Bcl-2 expression.  

PubMed

Prostatic ductal adenocarcinoma represents a rare histological variant of prostatic carcinoma with features of a papillary lesion at cystoscopy. There are conflicts regarding the existence, origin, staging, grading, treatment and clinical behavior of this tumor. The aim of the present study is to examine the expression of Bcl-2 and p53 in prostatic ductal adenocarcinoma and to evaluate its origin by analyzing prostate specific antigen, prostate specific acid phosphatase, cytokeratins, epithelial membrane antigen and carcinoembryonic antigen expressions. The results confirmed the expression of prostate specific antigen and prostate specific acid phosphatase in prostatic ductal adenocarcinoma. The demonstrated expression of Bcl-2 was predominant in the better-differentiated tumor. Bcl-2 expression appears not to be associated with neuroendocrine differentiation as assessed by chromogranin A reactivity. Thus, the first case of a prostatic ductal adenocarcinoma showing Bcl-2 expression is presented. The tumor was negative for p53. PMID:15379952

Tulunay, Ozden; Orhan, Diclehan; Baltaci, Sümer; Gögü?, Cagatay; Müftüoglu, Yusuf Z

2004-09-01

306

Primary peritoneal adenocarcinoma causes pleural effusion  

PubMed Central

Context: The most common malignancies associated with malignant pleural effusions are carcinomas of the breast, lung, gastrointestinal tract, ovary and lymphomas. Primary peritoneal adenocarcinoma is a very rare cause of malignant pleural effusion. Case Report: A 72-year old female patient presented to us with shortness of breath for the last 2 months. A contrast-enhanced computed tomography (CECT) scan of her-thorax revealed only bilateral pleural effusion with absence of any mass lesion or any mediastinal lymphadenopathy. A cytologic examination of pleural fluid revealed adenocarcinoma cells. A CECT of her abdomen and pelvis revealed heterogenous thickening of omentum with nodular appearances and small amount of ascites. Her ovaries were normal and no other mass lesion was detected. A histological examination of a peritoneal lesion was suggestive of adenocarcinoma. Conclusions: The patient was diagnosed with a rare case of primary peritoneal adenocarcinoma with bilateral pleural effusion. PMID:22574304

Shameem, Mohammad; Akhtar, Jamal; Baneen, Ummul; Bhargava, Rakesh; Ahmed, Zuber; Sharma, Prakhar; Khan, Nafees Ahmad; Hassan, Mohd Jaseem

2010-01-01

307

Paraneoplastic cerebellar degeneration heralding fallopian tube adenocarcinoma.  

PubMed

The objective of this paper is to describe an 81-year-old woman with subacute cerebellar degeneration due to fallopian tube adenocarcinoma. Serum anti-Yo antibodies were used to screen for pelvic malignancy. Their presence led to a meticulous search, which included bilateral salpingoophorectomy. Subsequently an occult fallopian tube adenocarcinoma was discovered. This case report highlights the diagnostic value of antineuroneal antibodies in females with subacute neurologic impairment in the form of paraneoplastic syndrome. PMID:11328418

Levite, R; Fishman, A; Kesler, A; Altaras, M; Gadoth, N

2001-01-01

308

Periampullary Adenocarcinoma: Diagnosis and Survival After Pancreaticoduodenectomy  

Microsoft Academic Search

Periampullary adenocarcinomas arise within 2 cm of the major papilla in the duodenum. They arise from different tissues in\\u000a the periampullary region: the head\\/neck\\/uncinate process of the pancreas, the distal common bile duct, the duodenum, and the\\u000a ampulla of Vater. Pancreatic cancer is the most common periampullary adenocarcinoma, followed by distal bile duct cancers,\\u000a ampullary cancers, and duodenal cancers (Jemal

Kanika A. Bowen; Taylor S. Riall

309

Ureteral metastasis of a prostatic adenocarcinoma  

PubMed Central

The ureter is a rare location of metastasis for any kind of primary tumour. The first case of truly ureteral metastasis was described by Stow in 1909. Regarding prostatic metastasis, the frequency is much lower with only 43 cases reported in the last century. We present a case of an exceedingly rare ureteral metastasis of a prostatic adenocarcinoma. In spite of its low incidence, it should be considered in patients with ureteral obstruction and concurrent prostatic adenocarcinoma.

Otta, Renan Javier; Gordillo, Carlos; Fernández, Inmaculada

2015-01-01

310

METRIC (MREnterography or ulTRasound in Crohn’s disease): a study protocol for a multicentre, non-randomised, single-arm, prospective comparison study of magnetic resonance enterography and small bowel ultrasound compared to a reference standard in those aged 16 and over  

PubMed Central

Background Crohn’s disease (CD) is a lifelong, relapsing and remitting inflammatory condition of the intestine. Medical imaging is crucial for diagnosis, phenotyping, activity assessment and detecting complications. Diverse small bowel imaging tests are available but a standard algorithm for deployment is lacking. Many hospitals employ tests that impart ionising radiation, of particular concern to this young patient population. Magnetic resonance enterography (MRE) and small bowel ultrasound (USS) are attractive options, as they do not use ionising radiation. However, their comparative diagnostic accuracy has not been compared in large head to head trials. METRIC aims to compare the diagnostic efficacy, therapeutic impact and cost effectiveness of MRE and USS in newly diagnosed and relapsing CD. Methods METRIC (ISRCTN03982913) is a multicentre, non-randomised, single-arm, prospective comparison study. Two patient cohorts will be recruited; those newly diagnosed with CD, and those with suspected relapse. Both will undergo MRE and USS in addition to other imaging tests performed as part of clinical care. Strict blinding protocols will be enforced for those interpreting MRE and USS. The Harvey Bradshaw index, C-reactive protein and faecal calprotectin will be collected at recruitment and 3 months, and patient experience will be assessed via questionnaires. A multidisciplinary consensus panel will assess all available clinical and imaging data up to 6 months after recruitment of each patient and will define the standard of reference for the presence, localisation and activity of disease against which the diagnostic accuracy of MRE and USS will be judged. Diagnostic impact of MRE and USS will be evaluated and cost effectiveness will be assessed. The primary outcome measure is the difference in per patient sensitivity between MRE and USS for the correct identification and localisation of small bowel CD. Discussion The trial is open at 5 centres with 46 patients recruited. We highlight the importance of stringent blinding protocols in order to delineate the true diagnostic accuracy of both imaging tests and discuss the difficulties of diagnostic accuracy studies in the absence of a single standard of reference, describing our approach utilising a consensus panel whilst minimising incorporation bias. Trial registration METRIC - ISRCTN03982913 – 05.11.13. PMID:25110044

2014-01-01

311

Targeting metastatic upper gastrointestinal adenocarcinomas  

PubMed Central

Upper gastrointestinal (GI) tumors, including adenocarcinoma of the esophagus, stomach, pancreas, and biliary tree, have traditionally been difficult to treat with cytotoxic chemotherapeutic agents. There has been little drug development success in treating these cancers over the last 20 years, perhaps a reflection of a combination of the aggressive biology of these tumors, the void in effective and specific drug development for these varied tumors, and the lack of properly designed, biologically-based clinical trials. Recently, so called “targeted agents” have risen to the forefront in the care of cancer patients and have made strong impacts in many areas of oncology, particularly gastrointestinal stromal tumors (GIST), colon, breast, and lung cancers. Unfortunately, slow progress has been made using such agents in upper GI tumors. However, more recently, trials in some tumor types have demonstrated gains in progression free survival and overall survival. In this review, we discuss the drugs and pathways that have been most successful in the treatment of upper GI tumors and present the relevant data supporting their use for each tumor site. Additionally, we will explore a few novel pathways that may prove effective in the treatment of upper GI malignancies in the near future. PMID:21611088

Spratlin, Jennifer L; Chu, Quincy; Koski, Sheryl; King, Karen; Mulder, Karen

2011-01-01

312

Recent developments in esophageal adenocarcinoma.  

PubMed

Answer questions and earn CME/CNE Esophageal adenocarcinoma (EAC) is characterized by 6 striking features: increasing incidence, male predominance, lack of preventive measures, opportunities for early detection, demanding surgical therapy and care, and poor prognosis. Reasons for its rapidly increasing incidence include the rising prevalence of gastroesophageal reflux and obesity, combined with the decreasing prevalence of Helicobacter pylori infection. The strong male predominance remains unexplained, but hormonal influence might play an important role. Future prevention might include the treatment of reflux or obesity or chemoprevention with nonsteroidal antiinflammatory drugs or statins, but no evidence-based preventive measures are currently available. Likely future developments include endoscopic screening of better defined high-risk groups for EAC. Individuals with Barrett esophagus might benefit from surveillance, at least those with dysplasia, but screening and surveillance strategies need careful evaluation to be feasible and cost-effective. The surgery for EAC is more extensive than virtually any other standard procedure, and postoperative survival, health-related quality of life, and nutrition need to be improved (eg, by improved treatment, better decision-making, and more individually tailored follow-up). Promising clinical developments include increased survival after preoperative chemoradiotherapy, the potentially reduced impact on health-related quality of life after minimally invasive surgery, and the new endoscopic therapies for dysplastic Barrett esophagus or early EAC. The overall survival rates are improving slightly, but poor prognosis remains a challenge. PMID:23818335

Lagergren, Jesper; Lagergren, Pernilla

2013-01-01

313

Risk factors for adenocarcinoma of the lung  

SciTech Connect

The relation between various risk factors and adenocarcinoma of the lung was evaluated in a case-control study. Subjects were selected from the Colorado Central Cancer Registry from 1979-1982 in the Denver metropolitan area. A total of 102 (50 males and 52 females) adenocarcinoma case interviews and 131 (65 males and 66 females) control interviews were completed. The control group consisted of persons with cancers of the colon and bone marrow. The risk estimates associated with cigarette smoking were significantly elevated among males (odds ratio (OR) = 4.49) and females (OR = 3.95) and were found to increase significantly (p less than 0.01) with increasing levels of cigarette smoking for both males and females. For adenocarcinoma in females, the age- and smoking-adjusted odds ratios at different levels of passive smoke exposure followed an increasing overall trend (p = 0.05). After additional adjustment for potential confounders, prior cigarette use remained the most significant predictor of risk of adenocarcinoma among males and females. Analysis restricted to nonsmoking females revealed a risk of adenocarcinoma of 1.68 (95% confidence interval (Cl) = 0.39-2.97) for passive smoke exposure of four or more hours per day. Neither sex showed significantly elevated risk for occupational exposures, although males bordered on significance (OR = 2.23, 95% Cl = 0.97-5.12). The results suggest the need to develop cell type-specific etiologic hypotheses.

Brownson, R.C.; Reif, J.S.; Keefe, T.J.; Ferguson, S.W.; Pritzl, J.A.

1987-01-01

314

What Should You Ask Your Doctor About Small Intestine Adenocarcinoma?  

MedlinePLUS

... small intestine adenocarcinoma? What should you ask your doctor about small intestine adenocarcinoma? It’s important to have ... Staging Treating Small Intestine Cancer Talking With Your Doctor After Treatment What`s New in Small Intestine Cancer ...

315

Mapping the Hallmarks of Lung Adenocarcinoma with Massively Parallel Sequencing  

E-print Network

Lung adenocarcinoma, the most common subtype of non-small cell lung cancer, is responsible for more than 500,000 deaths per year worldwide. Here, we report exome and genome sequences of 183 lung adenocarcinoma tumor/normal ...

Lander, Eric S.

316

Well-differentiated adenocarcinoma-bronchioloalveolar carcinoma-in situ adenocarcinoma: a conundrum.  

PubMed

Over the last decade, considerable changes have been made to the classification of pulmonary adenocarcinoma, mainly with respect to the classification of small solitary tumors. The main goal seems to have been the identification of tumors that not only follow an indolent clinical course but that can also be treated more conservatively. Thus, the most important change to the classification of lung adenocarcinoma was proposed for a tumor no greater than 3.0 cm in size with a pure lepidic growth pattern and lacking stromal, vascular, or pleural invasion, which should now be categorized as in situ adenocarcinoma. At the same time, a category of minimally invasive adenocarcinoma was proposed for tumors with a predominantly lepidic growth pattern, <3 cm in size, and with <5 mm invasion in greatest dimension in any 1 focus. What is interesting about all these developments is the fact that all the publications on this issue have been presented under the terms of small adenocarcinomas or bronchioloalveolar carcinoma. Unfortunately, the literature reviews that have proposed the change in nomenclature to in situ adenocarcinoma have not offered a more in-depth assessment of these neoplasms. More recently, a publication of a large series of cases of small adenocarcinomas has offered a different view and underscored some of the important issues that need to be taken into account before a serious change in the nomenclature can be considered. PMID:23939151

Weissferdt, Annikka; Kalhor, Neda; Moran, Cesar A

2013-09-01

317

Stepwise progression of pulmonary adenocarcinoma—clinical and molecular implications  

Microsoft Academic Search

Stepwise progression of pulmonary adenocarcinoma is described from the viewpoint of both pathology and molecular biology.\\u000a Pulmonary adenocarcinoma develops to invasive carcinoma through atypical adenomatous hyperplasia, adenocarcinoma in situ and minimally invasive adenocarcinoma. The Noguchi classification is well correlated with this sequential histological progression.\\u000a On the other hand, in terms of molecular biology, p16 gene inactivation, EGFR mutation and KRAS

Masayuki Noguchi

2010-01-01

318

Primary Gastric Malignant Melanoma Mimicking Adenocarcinoma  

PubMed Central

We report a case of primary gastric malignant melanoma that was diagnosed after curative resection but initially misdiagnosed as adenocarcinoma. A 68-year-old woman was referred to our department for surgery for gastric adenocarcinoma presenting as a polypoid lesion with central ulceration located in the upper body of the stomach. The preoperative diagnosis was confirmed by endoscopic biopsy. We performed laparoscopic total gastrectomy, and the final pathologic evaluation led to the diagnosis of primary gastric malignant melanoma without a primary lesion detected in the body. To the best of our knowledge, primary gastric malignant melanoma is extremely rare, and this is the first case reported in our country. According to the literature, it has aggressive biologic activity compared with adenocarcinoma, and curative resection is the only promising treatment strategy. In our case, the patient received an early diagnosis and underwent curative gastrectomy with radical lymphadenectomy, and no recurrence was noted for about two years. PMID:25580362

Cho, Jun-Min; Lee, Chang Min; Jang, You-Jin; Park, Sung-Soo; Park, Seong-Heum; Kim, Seung-Joo; Mok, Young-Jae; Kim, Chong-Suk; Lee, Ju-Han

2014-01-01

319

Urachal mucinous adenocarcinoma: a case report.  

PubMed

Adenocarcinomas account for 0.5-2% of all bladder cancers. Urachal carcinoma is a rare neoplasm which represents 0.01% of all cancers in adults and account for one third of bladder adenocarcinomas. A 65-year-old white man with an urachal mucinous adenocarcinoma is reported. None of the known predisposing risk factors for bladder cancer -such as tobacco use and professional exposure to chemicals -were identified in his past medical history. The patient suffered from multiple sclerosis for almost 11 years and in the last 6 years he was treated with low doses of mitoxantrone. He underwent a partial cystectomy and en block excision of the umbilical ligament and remains disease-free after one year. The development of this rare neoplasm should not be clearly dissociated from multiple sclerosis, either aetiologically sharing an unidentified common causative factor or due to its treatment with mitoxantrone. PMID:18067216

Kountourakis, P; Ardavanis, A; Mantzaris, I; Mitsaka, D; Rigatos, G

2007-01-01

320

Pathologic classification of adenocarcinoma of lung.  

PubMed

Recently, the 1999/2004 World Health Organization (WHO) classification of adenocarcinoma became less useful from a clinical standpoint as most adenocarcinomas belonged to the mixed subtype and the term bronchioloalveolar carcinoma (BAC) gave rise to much confusion among clinicians. For these reasons a new adenocarcinoma classification was introduced in 2011 by a joint working group of the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS). This represents an international, multidisciplinary effort joining pathologists, molecular biologists, pulmonary physicians, thoracic oncologists, radiologists, and thoracic surgeons. Currently, a distinction is made between pre-invasive lesions, minimally invasive and invasive lesions. The confusing term BAC is not used anymore and new subcategories include adenocarcinoma in situ and minimally invasive adenocarcinoma. Several aspects of this classification are discussed with main emphasis on its correlation with imaging techniques and its impact on diagnosis, treatment and prognosis. On chest computed tomography (CT) a distinction is made between solid and subsolid nodules, the latter comprising ground glass opacities (GGO), and partly solid lesions. Several studies incorporating CT and positron emission tomographic (PET) data show a good imaging-pathologic correlation. With the implementation of screening programs early lung cancer has become a hotly debated topic and sublobar resection is currently reconsidered for early lesions without lymph node involvement. This new classification will also have an impact on the TNM classification. Thoracic surgeons will continue to play a major role in the application, evaluation and further refinement of this new adenocarcinoma classification. PMID:24006216

Van Schil, Paul E; Sihoe, Alan D L; Travis, William D

2013-10-01

321

Comparison of the Effects of Carbon Ion and Photon Irradiation on the Angiogenic Response in Human Lung Adenocarcinoma Cells  

SciTech Connect

Purpose: Radiotherapy resistance is a commonly encountered problem in cancer treatment. In this regard, stabilization of endothelial cells and release of angiogenic factors by cancer cells contribute to this problem. In this study, we used human lung adenocarcinoma (A549) cells to compare the effects of carbon ion and X-ray irradiation on the cells' angiogenic response. Methods and Materials: A549 cells were irradiated with biologically equivalent doses for cell survival of either carbon ions (linear energy transfer, 170 keV/{mu}m; energy of 9.8 MeV/u on target) or X-rays and injected with basement membrane matrix into BALB/c nu/nu mice to generate a plug, allowing quantification of angiogenesis by blood vessel enumeration. The expression of angiogenic factors (VEGF, PlGF, SDF-1, and SCF) was assessed at the mRNA and secreted protein levels by using real-time reverse transcription-PCR and enzyme-linked immunosorbent assay. Signal transduction mediated by stem cell factor (SCF) was assessed by phosphorylation of its receptor c-Kit. For inhibition of SCF/c-Kit signaling, a specific SCF/c-Kit inhibitor (ISCK03) was used. Results: Irradiation of A549 cells with X-rays (6 Gy) but not carbon ions (2 Gy) resulted in a significant increase in blood vessel density (control, 20.71 {+-} 1.55; X-ray, 36.44 {+-} 3.44; carbon ion, 16.33 {+-} 1.03; number per microscopic field). Concordantly, irradiation with X-rays but not with carbon ions increased the expression of SCF and subsequently caused phosphorylation of c-Kit in endothelial cells. ISCK03 treatment of A549 cells irradiated with X-rays (6 Gy) resulted in a significant decrease in blood vessel density (X-ray, 36.44 {+-} 3.44; X-ray and ISCK03, 4.33 {+-} 0.71; number of microscopic field). These data indicate that irradiation of A549 cells with X-rays but not with carbon ions promotes angiogenesis. Conclusions: The present study provides evidence that SCF is an X-ray-induced mediator of angiogenesis in A549 cells, a phenomenon that could not be observed with carbon ion irradiation. Thus, in this model system evaluating angiogenesis, carbon ion irradiation may have a therapeutic advantage. This observation should be confirmed in orthotopic lung tumor models.

Kamlah, Florentine, E-mail: Kamlah@staff.uni-marburg.de [Department of Radiotherapy and Radiooncology, Philipps-University, Marburg (Germany); Haenze, Joerg [Department of Urology and Pediatric Urology, Philipps-University, Marburg (Germany); Arenz, Andrea [Department of Radiotherapy and Radiooncology, Philipps-University, Marburg (Germany); Seay, Ulrike; Hasan, Diya [Department of Internal Medicine II/V, Justus-Liebig-University, Giessen (Germany); Juricko, Janko; Bischoff, Birgit [Department of Radiotherapy and Radiooncology, Philipps-University, Marburg (Germany); Gottschald, Oana R. [Department of Internal Medicine II/V, Justus-Liebig-University, Giessen (Germany); Fournier, Claudia; Taucher-Scholz, Gisela; Scholz, Michael [GSI Helmholtzzentrum fuer Schwerionenforschung, Darmstadt (Germany); Seeger, Werner [Department of Internal Medicine II/V, Justus-Liebig-University, Giessen (Germany); Engenhart-Cabillic, Rita [Department of Radiotherapy and Radiooncology, Philipps-University, Marburg (Germany); Department of Radiotherapy, Justus-Liebig-University, Giessen (Germany); Rose, Frank [Department of Radiotherapy and Radiooncology, Philipps-University, Marburg (Germany)

2011-08-01

322

Is neuroendocrine differentiation useful to discriminate primary sinonasal intestinal-type adenocarcinomas from metastatic colorectal adenocarcinomas?  

PubMed

Primary sinonasal intestinal-type adenocarcinomas (ITAC) are defined on the basis of their morphological similarities to colorectal adenocarcinomas (CRA). Thus, differential diagnosis with sinonasal metastasis of CRA could be a real challenge. Neuroendocrine differentiation has been variably described in several types of adenocarcinomas and notably in ITACs and CRAs. In a series of 25 ITACs and 25 lymph node metastasis of CRAs (nmCRA), we analysed neuroendocrine differentiation by immunohistochemistry with anti-chromogranin A and synaptophysin antibodies. Neuroendocrine differentiation (chromogranin A and/or synaptophysin positivity) was significantly different (p=0.0002) in ITACs (72%) and in nmCRAs (20%). In conclusion, presence of neuroendocrine cells seems more in favour of a sinonasal intestinal-type adenocarcinoma, than metastatic CRA. This immunohistochemical study could be useful in difficult cases and should be an interesting complement in a clinical discussion. PMID:25294889

Projetti, Fabrice; Serrano, Elie; Vergez, Sebastien; Bissainthe, Anne-Charlotte; Delisle, Marie-Bernadette; Uro-Coste, Emmanuelle

2015-01-01

323

Cardiac metastasis of rectal adenocarcinoma. Surgical treatment.  

PubMed Central

The authors report a case of cardiac metastasis of a rectal adenocarcinoma that infiltrated the right ventricle and partially obstructed its outflow tract. Surgical treatment was performed because of syncopal attacks. The differential diagnosis between organized thrombi and intracardiac tumor is considered. Images PMID:8298329

Parravicini, R; Fahim, N A; Cocconcelli, F; Barchetti, M; Nafeh, M; Benassi, A; Grisendi, A; Garuti, W; Benimeo, A

1993-01-01

324

Cardiac metastasis of rectal adenocarcinoma. Surgical treatment.  

PubMed

The authors report a case of cardiac metastasis of a rectal adenocarcinoma that infiltrated the right ventricle and partially obstructed its outflow tract. Surgical treatment was performed because of syncopal attacks. The differential diagnosis between organized thrombi and intracardiac tumor is considered. PMID:8298329

Parravicini, R; Fahim, N A; Cocconcelli, F; Barchetti, M; Nafeh, M; Benassi, A; Grisendi, A; Garuti, W; Benimeo, A

1993-01-01

325

[Osseous metaplasia in a colonic adenocarcinoma].  

PubMed

Osseous metaplasia is rare in tumors of the gastrointestinal tract. We report the case of a 76-year-old man presenting with an adenocarcinoma of the transverse colon containing osseous tissue. Calcifications were seen on the abdominal CT-scan. Pathogenesis of the osseous metaplasia is still unknown. PMID:14732851

Nassif, Tania; Zanditenas, David; Lazure, Thierry; Paterne, Daniel; Kuhl, Emmanuel; Buffet, Catherine

2003-11-01

326

Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers.  

PubMed

Glandular neoplasms involving the urinary bladder carry a challenging differential diagnosis including primary and secondary processes. We investigated the potential diagnostic utility of cadherin-17 and GATA3 in 25 primary adenocarcinomas of the urinary bladder, as compared with other commonly used markers including ?-catenin and p63. Urothelial carcinoma with glandular differentiation (11), colorectal adenocarcinoma secondarily involving the bladder (25), and primary colorectal adenocarcinoma (22) were also analyzed and the results were compared using a Fisher exact test. Cadherin-17 was expressed in 23/25 primary bladder adenocarcinomas (92%), 23/25 colorectal adenocarcinomas involving the bladder (92%), 21/22 primary colorectal adenocarcinomas (95%) and entirely negative (0/11) in both components of urothelial carcinoma with glandular differentiation (P<0.001). In urothelial carcinoma with glandular differentiation, positive nuclear staining for GATA3 was evident in the urothelial component for 18% (2/11) and the glandular component for 9% (1/11) with additional tumors showing only cytoplasmic staining. Nuclear reactivity for GATA3 was not present in primary bladder adenocarcinoma and primary/secondary colorectal adenocarcinoma (P<0.05). Positive nuclear and cytoplasmic immunostaining for ?-catenin was evident in 21/22 primary colorectal adenocarcinomas (95%) and 23/25 cases of secondary involvement by colorectal adenocarcinoma (92%). In contrast, positive membranous and cytoplasmic staining for ?-catenin was observed in 23/25 primary bladder adenocarcinomas (92%) and 11/11 urothelial carcinomas with glandular differentiation (100%, P<0.001). p63 was expressed only in the urothelial component of urothelial carcinoma with glandular differentiation and not in the glandular component (P<0.001). In summary, cadherin-17 is a relatively specific and sensitive marker for primary adenocarcinoma of the urinary bladder, distinguishing it from urothelial carcinoma with glandular differentiation. However, it does not distinguish primary bladder adenocarcinoma from secondary involvement by colorectal adenocarcinoma. The pattern of reactivity for ?-catenin remains the most useful marker for distinguishing these two tumors. PMID:23348900

Rao, Qiu; Williamson, Sean R; Lopez-Beltran, Antonio; Montironi, Rodolfo; Huang, Wenbin; Eble, John N; Grignon, David J; Koch, Michael O; Idrees, Muhammad T; Emerson, Robert E; Zhou, Xiao-Jun; Zhang, Shaobo; Baldridge, Lee Ann; Cheng, Liang

2013-05-01

327

Follistatin Is a Novel Biomarker for Lung Adenocarcinoma in Humans  

PubMed Central

Background Follistatin (FST), a single chain glycoprotein, is originally isolated from follicular fluid of ovary. Previous studies have revealed that serum FST served as a biomarker for pregnancy and ovarian mucinous tumor. However, whether FST can serve as a biomarker for diagnosis in lung adenocarcinoma of humans remains unclear. Methods and Results The study population consisted of 80 patients with lung adenocarcinoma, 40 patients with ovarian adenocarcinoma and 80 healthy subjects. Serum FST levels in patients and healthy subjects were measured using ELISA. The results showed that the positive ratio of serum FST levels was 51.3% (41/80), which was comparable to the sensitivity of FST in 40 patients with ovarian adenocarcinoma (60%, 24/40) using the 95th confidence interval for the healthy subject group as the cut-off value. FST expressions in lung adenocarcinoma were examined by immunohistochemical staining, we found that lung adenocarcinoma could produce FST and there was positive correlation between the level of FST expression and the differential degree of lung adenocarcinoma. Furthermore, the results showed that primary cultured lung adenocarcinoma cells could secrete FST, while cells derived from non-tumor lung tissues almost did not produce FST. In addition, the results of CCK8 assay and flow cytometry showed that using anti-FST monoclonal antibody to neutralize endogenous FST significantly augmented activin A-induced lung adenocarcinoma cells apoptosis. Conclusions These data indicate that lung adenocarcinoma cells can secret FST into serum, which may be beneficial to the survival of adenocarcinoma cells by neutralizing activin A action. Thus, FST can serve as a promising biomarker for diagnosis of lung adenocarcinoma and a useful biotherapy target for lung adenocarcinoma. PMID:25347573

Feng, Ye; Liu, Haiyan; Sun, Yang; Liu, Zhonghui; Ge, Jingyan; Cui, Xueling

2014-01-01

328

Primary retrorectal adenocarcinoma: report of a case.  

PubMed

Primary adenocarcinomas of the retrorectal (presacral) space are uncommon and usually arise from cystic lesions developing from remnants of the embryological postanal gut (tail gut cysts) containing mucous-secreting epithelium. A singular case of a patient who presented with a retrorectal mass is described. A 70-year-old previously healthy man had a four-month history of perianal pain during defecation. Preoperative colonoscopy showed external compression of the lower rectum with normal mucosa; pelvic computed tomography demonstrated a 5.5 x 4.5 cm(2) retrorectal oval mass, originating from the posterior lower rectal wall, containing cystic components and some small calcifications. The tumor, after complete resection via transanal approach, was shown to be a very rare case of primary adenocarcinoma of the presacral space. The patient had an uneventful postoperative course and he is free from disease 4 years after surgery. Clinicopathological features and surgical treatment of this unusual tumor are discussed. PMID:12750956

Puccio, F; Solazzo, M; Marcianò, P; Fadani, R; Regina, P; Benzi, F

2003-04-01

329

Characterizing the cancer genome in lung adenocarcinoma  

Microsoft Academic Search

Somatic alterations in cellular DNA underlie almost all human cancers1. The prospect of targeted therapies2 and the development of high-resolution, genome-wide approaches3-8 are now spurring systematic efforts to characterize cancer genomes. Here we report a large-scale project to characterize copy-number alterations in primary lung adenocarcinomas. By analysis of a large collection oftumours(n 5371)usingdensesinglenucleotidepolymorphism arrays, we identify a total of 57

Barbara A. Weir; Michele S. Woo; Gad Getz; Sven Perner; Li Ding; Rameen Beroukhim; William M. Lin; Michael A. Province; Aldi Kraja; Laura A. Johnson; Kinjal Shah; Mitsuo Sato; Roman K. Thomas; Justine A. Barletta; Ingrid B. Borecki; Stephen Broderick; Andrew C. Chang; Derek Y. Chiang; Lucian R. Chirieac; Jeonghee Cho; Yoshitaka Fujii; Adi F. Gazdar; Thomas Giordano; Heidi Greulich; Megan Hanna; Bruce E. Johnson; Mark G. Kris; Alex Lash; Ling Lin; Neal Lindeman; Elaine R. Mardis; John D. McPherson; John D. Minna; Margaret B. Morgan; Mark Nadel; Mark B. Orringer; John R. Osborne; Brad Ozenberger; Alex H. Ramos; James Robinson; Jack A. Roth; Valerie Rusch; Hidefumi Sasaki; Frances Shepherd; Carrie Sougnez; Margaret R. Spitz; Ming-Sound Tsao; David Twomey; Roel G. W. Verhaak; George M. Weinstock; David A. Wheeler; Wendy Winckler; Akihiko Yoshizawa; Soyoung Yu; Maureen F. Zakowski; Qunyuan Zhang; David G. Beer; Ignacio I. Wistuba; Mark A. Watson; Levi A. Garraway; Marc Ladanyi; William D. Travis; William Pao; Mark A. Rubin; Stacey B. Gabriel; Richard A. Gibbs; Harold E. Varmus; Richard K. Wilson; Eric S. Lander; Matthew Meyerson

2007-01-01

330

Characterizing the cancer genome in lung adenocarcinoma  

Microsoft Academic Search

Somatic alterations in cellular DNA underlie almost all human cancers. The prospect of targeted therapies and the development of high-resolution, genome-wide approaches are now spurring systematic efforts to characterize cancer genomes. Here we report a large-scale project to characterize copy-number alterations in primary lung adenocarcinomas. By analysis of a large collection of tumours (n = 371) using dense single nucleotide

Barbara A. Weir; Michele S. Woo; Gad Getz; Sven Perner; Li Ding; Rameen Beroukhim; William M. Lin; Michael A. Province; Aldi Kraja; Laura A. Johnson; Kinjal Shah; Mitsuo Sato; Roman K. Thomas; Justine A. Barletta; Ingrid B. Borecki; Stephen Broderick; Andrew C. Chang; Derek Y. Chiang; Lucian R. Chirieac; Jeonghee Cho; Yoshitaka Fujii; Adi F. Gazdar; Thomas Giordano; Heidi Greulich; Megan Hanna; Bruce E. Johnson; Mark G. Kris; Alex Lash; Ling Lin; Neal Lindeman; Elaine R. Mardis; John D. McPherson; John D. Minna; Margaret B. Morgan; Mark Nadel; Mark B. Orringer; John R. Osborne; Brad Ozenberger; Alex H. Ramos; James Robinson; Jack A. Roth; Valerie Rusch; Hidefumi Sasaki; Frances Shepherd; Carrie Sougnez; Margaret R. Spitz; Ming-Sound Tsao; David Twomey; Roel G. W. Verhaak; George M. Weinstock; David A. Wheeler; Wendy Winckler; Akihiko Yoshizawa; Soyoung Yu; Maureen F. Zakowski; Qunyuan Zhang; David G. Beer; Ignacio I. Wistuba; Mark A. Watson; Levi A. Garraway; Marc Ladanyi; William D. Travis; William Pao; Mark A. Rubin; Stacey B. Gabriel; Richard A. Gibbs; Harold E. Varmus; Richard K. Wilson; Eric S. Lander; Matthew Meyerson

2007-01-01

331

Female Urethral Adenocarcinoma Arising from Urethritis Glandularis  

Microsoft Academic Search

Introduction. Female urethral adenocarcinoma is extremely rare and more than one tissue of origin has been suggested other than the Skene's gland. Immunohistochemistry with cytokeratins (CK) 7 and 20 is used to define the origin of the tumor.Case report. A 72-year-old woman presented with a 2-cm polypoid tumor at the external urethral meatus and bleeding. Wide local excision and bilateral

Yik-Ming Chan; Danny Ka-Leung Cheng; Annie Nga-Yin Cheung; Hextan Yuen-Sheung Ngan; Ling-Chui Wong

2000-01-01

332

Aneuploid DNA content in pancreatic adenocarcinoma  

Microsoft Academic Search

Summary  DNA content measurements were performed by flow cytometry on eight ductal-type pancreatic adenocarcinomas. The majority of\\u000a the neoplasms contained an aneuploid DNA content, with hyperdiploid DNA content being the most common abnormality. Two neoplasms\\u000a had a diploid DNA content. These latter two patients are alive at 11 mo and 3 mo. The data suggest that a large percentage\\u000a of pancreatic

Thomas M. Wido; Jonathan L. Myles; Latha Pisharodi; Tom Sawyer; Kitai Kim; Amira F. Gohara; John M. Howard

1990-01-01

333

Primary clear cell adenocarcinoma of the lung  

Microsoft Academic Search

Primary clear cell adenocarcinoma of the lung is extremely rare. A 63-year-old Japanese man consulted to our hospital because\\u000a of cough and sputum. Imaging modalities including XP, CT and MRI revealed a tumor of the right middle lobe. They did not identify\\u000a other tumors in the body. Because clinical cytology and biopsy showed malignant cells, segmentectomy of the lobe was

Tadashi Terada

334

Surgical treatment of primary esophageal adenocarcinoma  

Microsoft Academic Search

Objective: To study the biocharacteristics of primary esophageal adenocarcinoma (PEAC) and factors influencing patients’ prognosis\\u000a and to find rational surgical indications and combined therapy. Methods: To analyze the clinical material of 106 patients\\u000a with PEAC and compared with that of patients with esophageal squamous-cell carcinoma (ESCC). Results: The overall resectability,\\u000a morbidity and 30-day mortality rates of PEAC were 92.5%, 23.5%

Yong-gang Wang; Da-wei Zhang; Liang-jun Wang; Ru-gang Zhang; De-chao Zhang; Gui-yu Cheng; Ke-lin Sun; Ping-jun Meng

1999-01-01

335

Comprehensive molecular profiling of lung adenocarcinoma  

PubMed Central

Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, methylation and proteomic analyses. High rates of somatic mutation were seen (mean 8.9 mutations per megabase). Eighteen genes were statistically significantly mutated, including RIT1 activating mutations and newly described loss-of-function MGA mutations which are mutually exclusive with focal MYC amplification. EGFR mutations were more frequent in female patients, whereas mutations in RBM10 were more common in males. Aberrations in NF1, MET, ERBB2 and RIT1 occurred in 13% of cases and were enriched in samples otherwise lacking an activated oncogene, suggesting a driver role for these events in certain tumours. DNA and mRNA sequence from the same tumour highlighted splicing alterations driven by somatic genomic changes, including exon 14 skipping in MET mRNA in 4% of cases. MAPK and PI(3)K pathway activity, when measured at the protein level, was explained by known mutations in only a fraction of cases, suggesting additional, unexplained mechanisms of pathway activation. These data establish a foundation for classification and further investigations of lung adenocarcinoma molecular pathogenesis. PMID:25079552

2014-01-01

336

Comprehensive molecular profiling of lung adenocarcinoma.  

PubMed

Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, methylation and proteomic analyses. High rates of somatic mutation were seen (mean 8.9 mutations per megabase). Eighteen genes were statistically significantly mutated, including RIT1 activating mutations and newly described loss-of-function MGA mutations which are mutually exclusive with focal MYC amplification. EGFR mutations were more frequent in female patients, whereas mutations in RBM10 were more common in males. Aberrations in NF1, MET, ERBB2 and RIT1 occurred in 13% of cases and were enriched in samples otherwise lacking an activated oncogene, suggesting a driver role for these events in certain tumours. DNA and mRNA sequence from the same tumour highlighted splicing alterations driven by somatic genomic changes, including exon 14 skipping in MET mRNA in 4% of cases. MAPK and PI(3)K pathway activity, when measured at the protein level, was explained by known mutations in only a fraction of cases, suggesting additional, unexplained mechanisms of pathway activation. These data establish a foundation for classification and further investigations of lung adenocarcinoma molecular pathogenesis. PMID:25079552

2014-07-31

337

Mesonephric adenocarcinoma of the uterine corpus  

PubMed Central

Mesonephric carcinomas are rare in the female genital tract and usually are found in sites where embryonic remnants of wolffian ducts are usually detected, such as the uterine cervix, broad ligament, mesosalpinx and exceptionally rarely in the uterine corpus. To date, only four cases of mesonephric carcinomas arising in the uterine corpus have been described in literature. Here we report two cases of mesonephric carcinomas arising in a deep intramural location of the uterine corpus in a 55-year-old woman and a 62-year-old woman in Chinese populations. It is believed to be the first report in China. Both cases presented with a little postmenopausal bleeding. Before hospitalized, uterine curettages were programmed for both cases. The pathology reports were mesonephric adenocarcinoma. A total hysterectomy and bilateral salpingo-oophorectomy were performed. On gross examination, the tumors of both cases were confined to the myometrium. Microscopic examination found both tumors of these two cases were adenocarcinomas mixed with spindle cell component. The most primary histologic patterns of the mesonephric adenocarcinomas were tubular glands that varied in size and were lined by one to several layers of columnar cells. Immunohistochemically, the tumor cells expressed positive with CD10, calretinin, vimentin, cytokeratin (AE1/AE3) and epithelial membrane antigen (EMA); but expressions of ER and PR were completely negative. The peculiar location of mesonephric carcinoma of the uterine corpus may be misinterpreted as other histological type neoplasms. Awareness of this rare phenomenon and immunostaining for markers of mesonephric carcinoma can prevent from making a false diagnosis. PMID:25400789

Wu, Haixia; Zhang, Lin; Cao, Wenfeng; Hu, Yuanjing; Liu, Yixin

2014-01-01

338

Intensity-Modulated Radiotherapy for Pancreatic Adenocarcinoma  

SciTech Connect

Purpose: To report the outcomes and toxicities in patients treated with intensity-modulated radiotherapy (IMRT) for pancreatic adenocarcinoma. Methods and Materials: Forty-seven patients with pancreatic adenocarcinoma were treated with IMRT between 2003 and 2008. Of these 47 patients, 29 were treated adjuvantly and 18 definitively. All received concurrent 5-fluorouracil chemotherapy. The treatment plans were optimized such that 95% of the planning target volume received the prescription dose. The median delivered dose for the adjuvant and definitive patients was 50.4 and 54.0 Gy, respectively. Results: The median age at diagnosis was 63.9 years. For adjuvant patients, the 1- and 2-year overall survival rate was 79% and 40%, respectively. The 1- and 2-year recurrence-free survival rate was 58% and 17%, respectively. The local-regional control rate at 1 and 2 years was 92% and 80%, respectively. For definitive patients, the 1-year overall survival, recurrence-free survival, and local-regional control rate was 24%, 16%, and 64%, respectively. Four patients developed Grade 3 or greater acute toxicity (9%) and four developed Grade 3 late toxicity (9%). Conclusions: Survival for patients with pancreatic cancer remains poor. A small percentage of adjuvant patients have durable disease control, and with improved therapies, this proportion will increase. Systemic therapy offers the greatest opportunity. The present results have demonstrated that IMRT is well tolerated. Compared with those who received three-dimensional conformal radiotherapy in previously reported prospective clinical trials, patients with pancreatic adenocarcinoma treated with IMRT in our series had improved acute toxicity.

Abelson, Jonathan A.; Murphy, James D.; Minn, Ann Yuriko; Chung, Melody [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Fisher, George A.; Ford, James M.; Kunz, Pamela [Department of Medical Oncology, Stanford University, Stanford, CA (United States); Norton, Jeffrey A.; Visser, Brendan C.; Poultsides, George A. [Department of Surgical Oncology, Stanford University, Stanford, CA (United States); Koong, Albert C. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chang, Daniel T., E-mail: dtchang@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, CA (United States)

2012-03-15

339

Renal paraneoplastic vasculitis complicating lung adenocarcinoma.  

PubMed

Renal paraneoplastic vasculitis (RNPV) is rare. It can be revealed by glomerulonephritis, microaneurysms or renal failure. RPNV may precede the onset of the primary tumor, and treatment and prognosis depend on the etiology (primary tumor). A 54-year-old man who had a primary lung adenocarcinoma was admitted for nephrotic syndrome. The investigations revealed RNPV. The patient was treated with corticosteroids at high dose and cyclophosphamide with improvement of the renal condition; however, the patient died from worsening of his pulmonary neoplasia. PMID:25193910

Dhaou, Besma Ben; Boussema, Fatma; Aydi, Zohra; Ketari, Sonia; Baili, Lilia; Moussa, Fatma Ben; Rokbani, Lilia

2014-09-01

340

Pathology Case Study: History of Colonic Adenocarcinoma  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 69-year-old man with a history of colonic adenocarcinoma has metastasis to the liver, bladder and rectum. Visitors are given the gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology.

Grant, Maurice R.

341

Strategies to improve outcomes in esophageal adenocarcinoma.  

PubMed

Esophageal adenocarcinoma is one of the fastest rising cancers in Western society. Incidence has increased by 600% within the last 30 years. Rates of diagnosis and death run parallel due to the poor prognosis and a lack of effective treatments. Potentially curative treatments are followed by high rates of disease recurrence. For the majority of patients, who present with advanced disease, we have no effective treatment. We discuss the key areas of progress in this demanding field and offer our views on the direction of future research and treatment. PMID:24621143

Cowie, Andrew; Noble, Fergus; Underwood, Timothy

2014-06-01

342

The laboratory diagnosis of prostatic adenocarcinoma.  

PubMed

At the close of each decade, we are reminded by medical statisticians that our longevity increases significantly. For the male, especially if he be of black race this statement has an ironic twist. Over age 70, prostatic "cancer" assumes the leadership list of "cancers" in general, supplanting lung and colo-rectal. One interesting point evolved by careful autopsy studies suggests that this incidence is found coincidentally and is not primarily responsible for the cause of death. This illustrates a different significance to other neoplasia, and offers useful opportunities to study the evolution of a neoplasm. In contrast to other "cancers" (for example pulmonary), the histological nature of the tumor is almost totally derived from the acinar lobules and designated adenocarcinoma. Neoplasia arising from the fibromuscular stroma (sarcoma) and metaplastic ductus (squamous cell carcinoma) constitute less than 1% of all prostate cancers. Histological appearances, however, are not as simple as hoped. As in many tumors the section may present a uniform well-differentiated adenocarcinoma in which the acinar structure is well maintained--yet at the opposing end of the spectrum show a fatally dedifferentiated picture whose organ origin is difficult to determine. Adding to the complication is the wide variation, far more commonly seen, of the mixed tumor with all variations presenting a composite panorama of histology. Indeed the pure type is rare. As with all neoplastic disease, early detection is critical, since opportunity for cure with the various forms of therapy from surgery through radiation to chemotherapy are increasing rapidly. The prostate gland is relatively accessible to the trained finger of the physician and later stages of the disease are palpable. However, the earliest Stage (I) is not discovered by rectal examination, hence provides an ideal opportunity for the serum tumor marker, to identify disease. Since 1938, disseminated prostatic adenocarcinoma has been associated with elevation of activity of an enzyme acid phosphatase. Although there are several isoenzymes the prostatic specific one has in the past been assayed by different spectrophotometric techniques using selective substrate and chemical inhibition. More recently various immunological methods have added a greater sensitivity and specificity to the early detection of prostatic adenocarcinoma. However is should be clearly stated that prostatic acid phosphatase is not cancer specific and can be associated with other nonmalignant lesions in the prostate gland.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6144453

Griffiths, J C

1983-01-01

343

Concomitant major vessel resection in pancreatic adenocarcinoma.  

PubMed

Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association with comparatively better pathologically negative surgical margins and postoperative survival. We have discussed the clinical relevance of concomitant major vessel resection mainly focusing on indications for such resection with borderline resectable tumor associated with chemoradiotherapy, distal pancreatectomy with en bloc celiac axis resection for pancreatic body and tail cancer, and adjuvant surgery for initially unresectable pancreatic cancer. PMID:25823640

Tsuchikawa, Takahiro; Hirano, Satoshi; Nakamura, Toru; Okamura, Keisuke; Tamoto, Eiji; Shichinohe, Toshiaki

2015-04-01

344

Total and subtotal laparoscopic gastrectomy for adenocarcinoma  

Microsoft Academic Search

Background  Laparoscopic gastrectomies are currently performed in many centers, but compliance with oncologic requirements still represents\\u000a a subject open to debate. The aim of this work was to compare the short-term and oncologic outcomes after laparoscopic and\\u000a open surgery in gastric adenocarcinoma.\\u000a \\u000a \\u000a \\u000a Methods  From June 2000 through June 2005, 147 patients in our institution underwent gastrectomy by open or mininvasive approach for

R. Pugliese; D. Maggioni; F. Sansonna; I. Scandroglio; G. C. Ferrari; S. Di Lernia; A. Costanzi; J. Pauna; P. de Martini

2007-01-01

345

Endometrial Adenocarcinoma Following Endometrial Ablation for Postmenopausal Bleeding  

Microsoft Academic Search

A case of metastatic adenocarcinoma of the endometrium following endometrial ablation is described. A discussion of the development and evolution of endometrial ablation procedures is presented. Recommendations for patient selection and postablation surveillance are suggested. The authors believe this case report to be the third described in the literature. (Background. A case of endometrial adenocarcinoma developing after transcervical endometrial ablation

Ira R. Horowitz; Pleas R. Copas; Michael Aaronoff; Cyril O. Spann; William P. McGuire

1995-01-01

346

Endometrial Adenocarcinoma Presenting in a Premenopausal Patient with Tuberous Sclerosis  

ERIC Educational Resources Information Center

Background: Endometrial adenocarcinoma is very uncommon in women under 40 years of age. Case: A 39-year-old woman with tuberous sclerosis and severe intellectual disability presented with irregular bleeding unresponsive to oral contraceptive therapy. She was subsequently found to have a deeply invasive endometrial adenocarcinoma. Conclusion:…

Jaffe, J. S.; Chambers, J. T.

2005-01-01

347

The role of human papillomavirus in cervical adenocarcinoma carcinogenesis  

Microsoft Academic Search

Human papillomavirus (HPV) is considered the single most important co-factor in the development of cervical squamous cell carcinomas. Adenocarcinomas of the cervix are also related to HPV, but the correlation is reported to be less pronounced. In the present study, 131 cervical adenocarcinomas were identified through the Swedish Cancer Registry, examined morphologically and then analysed with sensitive polymerase chain reaction

S Andersson; E Rylander; B Larsson; A Strand; C Silfversvärd; E Wilander

2001-01-01

348

Cervical adenocarcinoma identification by testing for chromosomal abnormalities.  

PubMed

We report on a case of cervical adenocarcinoma in situ in a 42-year-old woman with a history of human papillomavirus infection. Repeat cytology, human papillomavirus testing, and colposcopy failed to identify the lesion. Testing of the cervical cell DNA identified chromosomal abnormalities, prompting a cervical cone biopsy, which identified adenocarcinoma in situ. PMID:24283864

Dittus, Janet L; Dudley, Bunyan S; Upender, Madhvi; Endress, Gregory A

2013-12-01

349

Adenocarcinoma of the urinary bladder, mesonephroid type: a rare case  

PubMed Central

Primary adenocarcinoma of the urinary bladder is a rare disease. It occurs in 0.5–2% of all bladder cancers and is discussed as the malignant counterpart of nephrogenic adenomas. We report a 46-year-old white female presented with gross hematuria for clinical examination. Histopathology revealed pT2, Pn1, L1, G2 adenocarcinoma of the bladder and carcinoma in situ according to the TNM classification. Computed tomography scan diagnostic was unremarkable. Patients with adenocarcinoma of the urinary bladder should be treated vigorously and without time delay. Only 7 cases of adenocarcinoma in the urinary bladder (mesonephroid) have been described until now. We present a case of clear cell adenocarcinoma of the urinary bladder, mesonephroid type that early diagnosed and till now 3 months after the cystectomy without symptoms and without complications. PMID:23772302

Abbas, Mahmoud; Kramer, Mario W.; Wolters, Mathias; Herrman, Thomas R.W.; Becker, Jan U.; Kreipe, Hans-Heinrich

2013-01-01

350

Recurrent Barrett's esophagus and adenocarcinoma after esophagectomy  

PubMed Central

Background Esophagectomy is considered the gold standard for the treatment of high-grade dysplasia in Barrett's esophagus (BE) and for noninvasive adenocarcinoma (ACA) of the distal esophagus. If all of the metaplastic epithelium is removed, the patient is considered "cured". Despite this, BE has been reported in patients who have previously undergone esophagectomy. It is often debated whether this is "new" BE or the result of an esophagectomy that did not include a sufficiently proximal margin. Our aim was to determine if BE recurred in esophagectomy patients where the entire segment of BE had been removed. Methods Records were searched for patients who had undergone esophagectomy for cure at our institution. Records were reviewed for surgical, endoscopic, and histopathologic findings. The patients in whom we have endoscopic follow-up are the subjects of this report. Results Since 1995, 45 patients have undergone esophagectomy for cure for Barrett's dysplasia or localized ACA. Thirty-six of these 45 patients underwent endoscopy after surgery including 8/45 patients (18%) with recurrent Barrett's metaplasia or neoplasia after curative resection. Conclusion Recurrent Barrett's esophagus or adenocarcinoma after esophagectomy was common in our patients who underwent at least one endoscopy after surgery. This appears to represent the development of metachronous disease after complete resection of esophageal disease. Half of these patients have required subsequent treatment thus far, either repeat surgery or photodynamic therapy. These results support the use of endoscopic surveillance in patients who have undergone "curative" esophagectomy for Barrett's dysplasia or localized cancer. PMID:15327696

Wolfsen, Herbert C; Hemminger, Lois L; DeVault, Kenneth R

2004-01-01

351

Severe large and small bowel fibrosis clinically mimicking gross splenomegaly.  

PubMed

The case of an 18-year-old female, with mild left hypochondrial pain and an abdominal mass mimicking gross splenomegaly, with severe small and large bowel fibrosis and adhesions and numerous mononuclear cellular infiltrate on histology, is presented. A clear picture of intestinal obstruction only unfolded terminally. She died within 48 hours of presentation. Our patient illustrates the fact that severe intestinal adhesions may present with very mild symptoms and signs and therefore a high index of suspicion is necessary, to reduce the attendant high mortality in intestinal obstruction in our environment. PMID:8347448

Olubodun, J O; Ikerionwu, S E; Kuti, J A; Jaiyesimi, A E; Talabi, O A; Adefuye, B O

1993-01-01

352

Autoimmune retinopathy associated with carcinoid tumour of the small bowel.  

PubMed

Cancer associated retinopathy (CAR) is an immune mediated paraneoplastic condition associated with vision loss. It has been associated with a variety of systemic malignancies. The primary clinical presentation is rapid, progressive vision loss. Rod and cone dysfunction can cause other associated symptoms, such as nyctalopia. Electrophysiological testing and detection of anti-retinal antibodies are used to confirm the diagnosis. To our knowledge we describe the first patient with CAR associated with a carcinoid tumour of the gastrointestinal system. Auto-antibodies against alpha enolase and carbonic anhydrase II were detected with western blotting. Electroretinogram findings were consistent with rod and cone dysfunction. PMID:24126040

Ogra, Siddharth; Sharp, Dianne; Danesh-Meyer, Helen

2014-02-01

353

Recent advances in small bowel diseases: Part II  

PubMed Central

As is the case in all areas of gastroenterology and hepatology, in 2009 and 2010 there were many advances in our knowledge and understanding of small intestinal diseases. Over 1000 publications were reviewed, and the important advances in basic science as well as clinical applications were considered. In Part II we review six topics: absorption, short bowel syndrome, smooth muscle function and intestinal motility, tumors, diagnostic imaging, and cystic fibrosis. PMID:22807605

Thomson, Alan BR; Chopra, Angeli; Clandinin, Michael Tom; Freeman, Hugh

2012-01-01

354

Advances in small bowel neuroendocrine neoplasia Banck and Small intestine  

PubMed Central

Purpose of review this review aims at summarizing progress in clinical trials and basic science redefining the diagnosis and treatment of well differentiated small intestine neuroendocrine tumors (SI-NET). Recent findings Two clinical trials demonstrated antitumor activity of the long-acting somatostatin analogues octreotide LAR and lanreotide for advanced SI-NET. The mTOR inhibitor everolimus is another treatment option for patients with SI-NET, but awaits definitive proof of benefit in the ongoing RADIANT-4 study. Two whole exome/genome-sequencing studies reported in the past year provided the first genome-wide analysis of large sets of SI-NET at nucleotide resolution. Candidate therapeutically relevant alterations were found to affect SRC, SMAD genes, AURKA, EGFR, HSP90, and PDGFR as well as mutually exclusive amplification of AKT1 or AKT2 and other alterations of PI3K/Akt/mTOR signaling genes. The gene CDKN1B is inactivated by small insertions/deletions in 8% of patients with SI-NET suggesting cell cycle inhibitors as new candidate drugs for SI-NET. Circulating tumor cells and tumor-derived RNA in the blood are promising clinical tests for SI-NET. Summary Clinical and genomic research may merge in the near future to re-shape clinical trials and to define the ‘personalized’ treatment options for patients with SI-NET. PMID:24441281

Banck, Michaela S.; Beutler, Andreas S.

2015-01-01

355

Small Bowel Function after Surgery for Chronic Radiation Enteritis  

Microsoft Academic Search

The retention of the gamma-emitting 75Se-homotaurocholic acid (SeHCAT) after 72 and 168 h was assessed in 10 patients after ileal resection for radiation injury (group I). 6 patients suffering from chronic postirradiation diarrhea (group II) and 6 patients in whom the ileum had been resected for other indications (group III) were also examined. The retention of SeHCAT was abnormally low

Johannes Miholic; Harald Vogelsang; Otto Schlappack; Kurt Kletter; Tibor Szepesi; Peter Moeschl

1989-01-01

356

Recent advances in small bowel diseases: Part?I  

PubMed Central

As is the case in all parts of gastroenterology and hepatology, there have been many advances in our knowledge and understanding of small intestinal diseases. Over 1000 publications were reviewed for 2008 and 2009, and the important advances in basic science as well as clinical applications were considered. In Part?I?of this Editorial Review, seven topics are considered: intestinal development; proliferation and repair; intestinal permeability; microbiotica, infectious diarrhea and probiotics; diarrhea; salt and water absorption; necrotizing enterocolitis; and immunology/allergy. These topics were chosen because of their importance to the practicing physician. PMID:22807604

Thomson, Alan BR; Chopra, Angeli; Clandinin, Michael Tom; Freeman, Hugh

2012-01-01

357

Small bowel preservation for intestinal transplantation: a review.  

PubMed

Intestinal transplantation has become the therapy of choice for patients with intestinal failure and life-threatening complications from total parenteral nutrition. Results, however, remain inferior as compared with other transplant types with the quality of the organ graft as the most important factor of outcome after transplantation. The intestine is extremely sensitive to ischemia. Unfortunately, a relatively long ischemic preservation period is inevitable. The current standard in organ preservation [cold storage (CS) with University of Wisconsin solution] was developed for kidney/liver preservation and is suboptimal for the intestinal graft despite good results for other organs. This review aimed at appraising the results from the use of previously applied and recently developed preservation solutions and techniques to identify key areas for improvement. As the studies available do not reveal the most effective method for intestinal preservation, an optimal strategy will result from a synergistic effect of different vital elements identified from a review of published material from the literature. A key factor is the composition of the solution using a low-viscosity solution to facilitate washout of blood, including amino acids to improve viability, impermeants and colloids to prevent edema, and buffer for pH-homeostasis. Optimizing conditions include a vascular flush before CS and luminal preservation. The most effective composition of the luminal solution and a practical, clinically applicable optimal technique are yet to reach finality. Short-duration oxygenated arterial and/or luminal perfusion have to be considered. Thus, a tailor-made approach to luminal preservation solution and technique need further investigation in transplant models and the human setting to develop the ultimate technique meeting the physiologic demands of the intestinal graft during preservation. PMID:21083772

Roskott, Anne Margot C; Nieuwenhuijs, Vincent B; Dijkstra, Gerard; Koudstaal, Lyan G; Leuvenink, Henri G D; Ploeg, Rutger J

2011-02-01

358

Congenital segmental dilatation of the small bowel (CSD).  

PubMed

Congenital segmental dilatation (CSD) is a rare pathology of unknown etiology, usually with early-onset presentation in the neonatal age. We present a case of CSD of the jejunum of a 9-year-old boy with severe malnutrition. Its clinical, radiological and histological features are similar to those described in the literature but the remarkable aspect of this case lies in its late presentation. PMID:17806030

Daher, P; Ghanimeh, J; Riachy, E; Zeidan, S; Eid, B

2007-08-01

359

Clinicopathologic Features and Prognosis of Duodenal Adenocarcinoma and Comparison with Ampullary and Pancreatic Ductal Adenocarcinoma  

PubMed Central

Due to the rarity of duodenal adenocarcinoma (DAC), the clinicopathologic features and prognostication data for DAC are limited. There are no published studies directly comparing the prognosis of DAC to ampullary adenocarcinoma (AA) and pancreatic ductal adenocarcinoma (PDA) after resection. In this study, we examined the clinicopathologic features of 68 patients with DAC, 92 patients with AA and 126 patients with PDA, who underwent resection. Patient clinicopathologic and survival information were extracted from medical records. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) with two-sided significance level of 0.05. Patients with DAC had higher American Joint Committee on Cancer (AJCC) stage than AA patients (P=0.001). Lymph node metastasis (P=0.013) and AJCC stage (P=0.02) correlated with overall survival in DAC patients. Patients with DAC or AA had lower frequencies of lymph node metastasis and positive margin and better survival than those with PDA (P<0.05). However, no differences in nodal metastasis, margin status or survival were observed between DAC patients and those with AA. Our study showed that lymph node metastasis and AJCC stage are important prognostic factors for overall survival in DAC patients. Patients with DAC had less frequent nodal metastasis and better prognosis than those with PDA. There was no significant difference in prognosis between DAC and AA. PMID:24139211

Zenali, Maryam; Overman, Michael J.; Rashid, Asif; Broaddus, Russell B.; Wang, Hua; Katz, Matthew H.; Fleming, Jason B.; Abbruzzese, James L.; Wang, Huamin

2015-01-01

360

Chondroid Chordoma and Nasal Adenocarcinoma: An Exceptional Association  

PubMed Central

Collision tumors are exceptional, associating two independent tumoral contingents. We report a case of an association of two rare tumors: sinonasal adenocarcinoma and chondroid chordoma. Initially, only adenocarcinoma was diagnosed. The treatment consisted of endoscopic endonasal surgery followed by conventional radiotherapy. After 18 months, a local recurrence was diagnosed after a facial trauma, but the true histology was difficult to assess. The tumor was dual, associating adenocarcinoma and chondroid chordoma, with atypical localization in the ethmoid. Further evolution was particularly aggressive. We discuss the key points of this observation. PMID:23024872

Gallet, Patrice; Marcon, Nathalie; Georgel, Thomas; Vignaud, Jean-Marie; Parietti-Winkler, Cécile; Jankowski, Roger

2012-01-01

361

Primary mediastinal adenocarcinoma originating from a calcified nodule  

PubMed Central

Primary mediastinal adenocarcinoma is rare, but its originating from a calcified nodule is even more unusual. We present herein a 55-year-old female with a superior mediastinal mass, first discovered 2 years prior that changed dramatically from its original appearance as a calcified nodule. The mass was completely resected, and histopathological examination revealed a primary adenocarcinoma. The patient has been disease-free for over 13 months since surgery. To the best of our knowledge, this is the first reported case of mediastinal adenocarcinoma to demonstrate such a surprising course of development. PMID:25126198

Chen, Gang; Qiu, Xiaoming; Liu, Yi; Qiao, Yanjie; Shi, Tao; Chen, Jun; Zhou, Qinghua

2014-01-01

362

Targeting Pancreatic Ductal Adenocarcinoma Acidic Microenvironment  

NASA Astrophysics Data System (ADS)

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the USA, accounting for ~40,000 deaths annually. The dismal prognosis for PDAC is largely due to its late diagnosis. Currently, the most sensitive diagnosis of PDAC requires invasive procedures, such as endoscopic ultrasonography, which has inherent risks and accuracy that is highly operator dependent. Here we took advantage of a general characteristic of solid tumors, the acidic microenvironment that is generated as a by-product of metabolism, to develop a novel approach of using pH (Low) Insertion Peptides (pHLIPs) for imaging of PDAC. We show that fluorescently labeled pHLIPs can localize and specifically detect PDAC in human xenografts as well as PDAC and PanIN lesions in genetically engineered mouse models. This novel approach may improve detection, differential diagnosis and staging of PDAC.

Cruz-Monserrate, Zobeida; Roland, Christina L.; Deng, Defeng; Arumugam, Thiruvengadam; Moshnikova, Anna; Andreev, Oleg A.; Reshetnyak, Yana K.; Logsdon, Craig D.

2014-03-01

363

Mandible Bone Metastases Secondary to Pulmonary Adenocarcinoma  

PubMed Central

ABSTRACT Objective: Metastatic tumors of the mandible are rare and usually present clinically as growths. The prognosis of lung cancer patients with bone metastases is poor. Case Report: This article shows a metastasis from adenocarcinoma of the lung affecting the mandible of a 75-year-old female patient where the metastatic lesion was detected before primary tumor. The patient were treated with radiation therapy with palliative and antalgic intent. But the patient died 8 weeks after the diagnosis. Conclusion: Radiation therapy was effective and well tolerated in the case. Bone metastases particularly mandible metastasis of lung cancer has poor prognosis. Palliative and supportive therapy may be firstly chose because of poor prognosis. PMID:25568572

Dirican¹, Nigar; Gunes, Sedat; Karakaya, Yeliz; Kaya, Vildan; Cerci, Sureyya; Dirican, Ahmet

2014-01-01

364

Treatment of metastatic pancreatic adenocarcinoma: a review.  

PubMed

Gemcitabine monotherapy has been the standard of care for patients with metastatic pancreatic cancer for several decades. Despite recent advances in various chemotherapeutic regimens and in the development of targeted therapies, metastatic pancreatic cancer remains highly resistant to chemotherapy. Previous studies of several combination regimens showed minimal or no significant change in overall survival compared with gemcitabine alone. Secreted protein acidic and rich in cysteine (SPARC) overexpression in pancreatic stromal fibroblasts is considered one of the major causes of chemotherapy resistance. The nanoparticle albumin-bound formulation of paclitaxel (nab-paclitaxel) has been found to be superior to other formulations of paclitaxel because of its favorable pharmacokinetic properties. Initial preclinical studies showed its synergistic effect with gemcitabine in pancreatic cancer, in which nab-paclitaxel is sequestered by SPARC to cause stromal depletion and increasing microvasculature, resulting in higher gemcitabine concentration within the tumor. In the recent phase III multinational Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT), the combination of gemcitabine and nab-paclitaxel was shown to be superior to gemcitabine monotherapy, with an increase in median survival of 1.8 months. Combination therapy with gemcitabine plus erlotinib, or with gemcitabine plus nab-paclitaxel, or the multidrug regimen of leucovorin, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) can be considered as first-line chemotherapy for patients with metastatic pancreatic cancer. In this review we will discuss details of the recently approved combination of gemcitabine and nab-paclitaxel for first-line treatment of metastatic pancreatic adenocarcinoma and compare it with other therapeutic options. PMID:24683721

Thota, Ramya; Pauff, James M; Berlin, Jordan D

2014-01-01

365

BITC Sensitizes Pancreatic Adenocarcinomas to TRAIL-induced Apoptosis.  

PubMed

Pancreatic adenocarcinoma is an aggressive cancer with a greater than 95% mortality rate and short survival after diagnosis. Chemotherapeutic resistance hinders successful treatment. This resistance is often associated with mutations in codon 12 of the K-Ras gene (K-Ras 12), which is present in over 90% of all pancreatic adenocarcinomas. Codon 12 mutations maintain Ras in a constitutively active state leading to continuous cellular proliferation. Our study determined if TRAIL resistance in pancreatic adenocarcinomas with K-Ras 12 mutations could be overcome by first sensitizing the cells with Benzyl isothiocyanate (BITC). BITC is a component of cruciferous vegetables and a cell cycle inhibitor. BxPC3, MiaPaCa2 and Panc-1 human pancreatic adenocarcinoma cell lines were examined for TRAIL resistance. Our studies show BITC induced TRAIL sensitization by dual activation of both the extrinsic and intrinsic apoptotic pathways. PMID:20559452

Wicker, Christina A; Sahu, Ravi P; Kulkarni-Datar, Kashmira; Srivastava, Sanjay K; Brown, Thomas L

2010-01-20

366

Notch signaling drives stemness and tumorigenicity of esophageal adenocarcinoma.  

PubMed

Esophageal adenocarcinoma ranks sixth in cancer mortality in the world and its incidence has risen dramatically in the Western population over the last decades. Data presented herein strongly suggest that Notch signaling is critical for esophageal adenocarcinoma and underlies resistance to chemotherapy. We present evidence that Notch signaling drives a cancer stem cell phenotype by regulating genes that establish stemness. Using patient-derived xenograft models, we demonstrate that inhibition of Notch by gamma-secretase inhibitors (GSI) is efficacious in downsizing tumor growth. Moreover, we demonstrate that Notch activity in a patient's ultrasound-assisted endoscopic-derived biopsy might predict outcome to chemotherapy. Therefore, this study provides a proof of concept that inhibition of Notch activity will have efficacy in treating esophageal adenocarcinoma, offering a rationale to lay the foundation for a clinical trial to evaluate the efficacy of GSI in esophageal adenocarcinoma treatment. PMID:25164006

Wang, Zhiqiang; Da Silva, Thiago G; Jin, Ke; Han, Xiaoqing; Ranganathan, Prathibha; Zhu, Xiaoxia; Sanchez-Mejias, Avencia; Bai, Feng; Li, Bin; Fei, Dennis Liang; Weaver, Kelly; Carpio, Rodrigo Vasquez-Del; Moscowitz, Anna E; Koshenkov, Vadim P; Sanchez, Lilly; Sparling, Lynne; Pei, Xin-Hai; Franceschi, Dido; Ribeiro, Afonso; Robbins, David J; Livingstone, Alan S; Capobianco, Anthony J

2014-11-01

367

Gemcitabine and AMG 479 in Metastatic Adenocarcinoma of the Pancreas  

ClinicalTrials.gov

Adenocarcinoma of the Pancreas; Advanced Solid Tumors; Cancer; Cancer of Pancreas; Cancer of the Pancreas; Metastases; Metastatic Cancer; Metastatic Pancreatic Cancer; Pancreas Cancer; Pancreatic Cancer; Bone Metastases; Endocrine Cancer; Oncology; Oncology Patients; Solid Tumors; Advanced Malignancy

2014-03-28

368

Adenocarcinoma of the Minor Duodenal Papilla: Report of a Case  

PubMed Central

An 81-year-old male was found to have a duodenal tumor by screening upper gastrointestinal endoscopy. The tumor was located in the minor duodenal papilla. Pathological examination of the biopsy specimen revealed adenocarcinoma, and endoscopic ultrasound showed an elevated hypoechoic mass in the minor duodenal papilla. The preoperative diagnosis was therefore considered to be either adenocarcinoma of the minor duodenal papilla or duodenal cancer. We performed a subtotal stomach-preserving pancreaticoduodenectomy. Histopathological examination of the resected specimen showed the tumor cells to be primarily located in the submucosa of the minor duodenal papilla, with slight invasion into the pancreatic parenchyma through the accessory pancreatic duct. We therefore diagnosed a primary adenocarcima of the minor duodenal papilla. Adenocarcinoma of the minor duodenal papilla is considered to be a rare disease, but it may be underestimated because of the difficulty in distinguishing advanced adenocarcinoma of the minor duodenal papilla from primary duodenal cancer and cancer of the pancreatic head. PMID:21552440

Takami, Kazuhiro; Moriya, Takuya; Kamiga, Takahiro; Abe, Tomoya; Miseki, Tetsuya; Oku, Takatomi; Aoki, Yasutaka; Tominaga, Tsuyoshi

2011-01-01

369

Lethal endometrial recurrence after cone biopsy for microinvasive cervical adenocarcinoma.  

PubMed

The follow up of microinvasive cervical adenocarcinoma treated conservatively is difficult because recurrences are often out of range and Pap smears difficult to interpret. A 30-year-old woman with a microinvasive adenocarcinoma with clear, but narrow, margins on cone biopsy was treated conservatively. After 2 years of close follow up in which no recurrence was detected, dilatation and curettage performed for infertility revealed adenocarcinoma invading secretory endometrium. The carcinoma resembled her cervical adenocarcinoma histologically, immunohistochemically and was HPV DNA 16 positive. A radical hysterectomy showed carcinoma involving the entire endometrium and the uppermost 3 mm of the endocervical canal, but sparing the remainder of the cervix. The patient died of disseminated carcinoma at the age of 34 years. The location of the recurrence was the reason it escaped detection for so long despite close follow up. PMID:18588617

Singh, Piksi; Scurry, James; Proietto, Anthony

2008-06-01

370

Vaginal laparoscopically assisted radical trachelectomy in cervical clear cell adenocarcinoma  

PubMed Central

Adenocarcinoma of the cervix is a rare condition that has shown an increase in incidence, especially in the 20- to 34-year-old group. Adenocarcinoma represents about 5–10% of all tumours in this area, and, among these, the clear cell type accounts for 4–9%. This type of tumour affects mainly postmenopausal women but also occurs in young women with a history of prenatal exposure to diethylstilbestrol (DES). The prognosis for adenocarcinoma of the cervix is poor overall and worse for the clear cell variety. This article discusses a case of clear cell adenocarcinoma of the cervix, unrelated to intrauterine exposure to DES, in a woman of childbearing age who wished to preserve her fertility and was therefore treated by radical vaginal trachelectomy and pelvic lymphadenectomy. PMID:24244219

Iacoponi, Sara; Diestro, Maria Dolores; Zapardiel, Ignacio; Serrano, María; Santiago, Javier De

2013-01-01

371

POLARIZATION OF THE CHARGE-EXCHANGE X-RAYS INDUCED IN THE HELIOSPHERE  

SciTech Connect

We report results of a theoretical investigation of polarization of the X-ray emissions induced in charge-exchange collisions of fully stripped solar wind (SW) ions C{sup 6+} and O{sup 8+} with the heliospheric hydrogen atoms. The polarization of X-ray emissions has been computed for line-of-sight observations within the ecliptic plane as a function of SW ion velocities, including a range of velocities corresponding to the slow and fast SW, and coronal mass ejections. To determine the variability of polarization of heliospheric X-ray emissions, the polarization has been computed for solar minimum conditions with self-consistent parameters of the SW plasma and heliospheric gas and compared with the polarization calculated for an averaged solar activity. We predict the polarization of charge-exchange X-rays to be between 3% and 8%, depending on the line-of-sight geometry, SW ion velocity, and the selected emission lines.

Gacesa, M.; Kharchenko, V. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Mueller, H.-R. [Department of Physics and Astronomy, Dartmouth College, 6127 Wilder Laboratory, Hanover, NH 03755 (United States); Cote, R., E-mail: gacesa@phys.uconn.edu [Physics Department, University of Connecticut, 2152 Hillside Road, Storrs, CT 06269 (United States)

2011-05-10

372

Prevailing features of x-ray-induced molecular electron spectra revealed with fullerenes.  

PubMed

X-ray photoabsorption from intense short pulses by a molecule triggers complicated electron and subsequently ion dynamics, leading to photoelectron spectra, which are difficult to interpret. Illuminating fullerenes offers a way to separate out the electron dynamics since the cage structure confines spatially the origin of photo- and Auger electrons. Together with the sequential nature of the photoprocesses at intensities available at x-ray free-electron lasers, this allows for a remarkably detailed interpretation of the photoelectron spectra, as we will demonstrate. The general features derived can serve as a paradigm for less well-defined situations in other large molecules or clusters. PMID:25192093

Camacho Garibay, Abraham; Saalmann, Ulf; Rost, Jan M

2014-08-22

373

X-ray induced dysplasia in the developing telencephalic choroid plexus of mice exposed in utero  

SciTech Connect

Pregnant NMRI-mice were X-irradiated with single doses of 0.95 Gy (100 R) and 1.9 Gy (200 R) on day of gestation (dg) 12. For sampling, anesthetized animals were perfused with buffered glutaraldehyde solution or fixed by immersion in Karnovsky solution. LM, SEM, and TEM studies were carried out on brains prenatally and up to the age of 20 months to follow the radiation effects on the developing lateral choroid plexus. Radiation-induced changes were found using all three methods and at all stages studied. The normally sickle-shaped and stretched choroid plexus is shortened and irregular, and the dome-shaped plexus cells are flattened. Their superficial fine structures, i.e., the microvilli and cilia, are altered. Three stages of severity can be distinguished and the internal hydromicrocephalus increases from stage I to III. Intercellular spaces of the treated plexus epithelium are often dilated, but the tight junctions at the ventricular surface seem to be intact. The interstitium shows large dilations in comparison with the controls. Thus, gross changes and alterations in the fine structure can be induced in the choroid plexus by doses of 0.95 Gy and 1.9 Gy, which persist throughout postnatal life.

Heinzmann, U.

1982-08-01

374

X-ray-induced sterility in Aedes albopictus (Diptera: Culicidae) and male longevity following irradiation.  

PubMed

The mosquito Aedes albopictus (Skuse, 1895) is a potent vector of several arboviral diseases, most notably chikungunya and dengue fever. In the context of the sterile insect technique (SIT), the sterilization of the male mosquitoes before their release can be achieved by gamma-ray irradiation. As gamma-ray irradiators are becoming increasingly problematic to purchase and transport, the suitability of an X-ray irradiator as an alternative for the sterilization of Ae. albopictus males was studied. The sterilization of up to 200,000 pupae at one time can be achieved with relative ease, and the sterility results obtained were comparable with those achieved by gamma irradiation, where 99% sterility is induced with a dose of 40 Gy. A significant reduction of longevity was observed in the latter stages of the males' life after irradiation treatments, especially at doses > 40 Gy, which is consistent with the negative effects on longevity induced by similar radiation doses using gamma rays. Females irradiated at 40 Gy were not only 100% sterile, but also failed to oviposit entirely, i.e., all of the females laid 0 eggs. Overall, it was found that the X-ray irradiator is generally suitable for the sterilization process for sterile insect technique programs, as it showed a high processing capacity, practicality, high effectiveness, and reproducibility. PMID:25118413

Yamada, H; Parker, A G; Oliva, C F; Balestrino, F; Gilles, J R L

2014-07-01

375

Prevailing Features of X-Ray-Induced Molecular Electron Spectra Revealed with Fullerenes  

NASA Astrophysics Data System (ADS)

X-ray photoabsorption from intense short pulses by a molecule triggers complicated electron and subsequently ion dynamics, leading to photoelectron spectra, which are difficult to interpret. Illuminating fullerenes offers a way to separate out the electron dynamics since the cage structure confines spatially the origin of photo- and Auger electrons. Together with the sequential nature of the photoprocesses at intensities available at x-ray free-electron lasers, this allows for a remarkably detailed interpretation of the photoelectron spectra, as we will demonstrate. The general features derived can serve as a paradigm for less well-defined situations in other large molecules or clusters.

Camacho Garibay, Abraham; Saalmann, Ulf; Rost, Jan M.

2014-08-01

376

X-ray-induced dicentric yields in lymphocytes of the teleost, Umbra limi.  

PubMed

A microculture technique was applied to the study of lymphocytes of Umbra limi, which have a low number of large meta- and submetacentric chromosomes (2n = 22). On the 5th day (90h) and later after initiation of culture at 20 degrees C, some cultures provided well spread metaphase chromosomes for analyses. After initiation, cultures were irradiated with 50, 100, 150 and 200 R of 200 kVp X-rays. The cultures were harvested on the 5th day, at which time all arrested metaphase chromosomes were in their first division. The dicentric yields induced in X-irradiated Umbra lymphocytes were observed to be significantly (P = 0.05) lower than those in human lymphocytes. The resulting dose-response relationship for dicentric yield was described by the quadratic equation Y = aD + bD2. The advantage of this method lies in the fact that small amounts (0.1 ml) of blood can be repeatedly withdrawn from the fish after a minimal interval of 2 weeks. The microculture technique with Umbra lymphocytes is thought to have a wide range of applications in studies of the potential genotoxic effects of clastogenic agents in the aquatic environment. PMID:6828033

Suyama, I; Etoh, H

1983-01-01

377

Intense X-ray induced formation of silver nanoparticles stabilized by biocompatible polymers  

NASA Astrophysics Data System (ADS)

Colloidal Ag nanoparticles were formed by X-ray irradiation in the presence of a polymer. This new synthesis method is simple, rapid and leads to a high production yield. Compared to the citrate-reduced Ag colloidal, polymer-protected Ag nanoparticles are smaller in size and more stable—and therefore suitable for biomedical application—as verified by TEM observation, XAFS measurement and optical characterization. Ag nanoparticles so produced were also visualized in solution and in real time by a visible light microscope based on dark field light scattering. The color-derived size and distribution of Ag nanoparticles correlates well with the hydrodynamic size data.

Wang, Chang-Hai; Liu, Chi-Jen; Wang, Cheng-Liang; Chien, Chia-Chi; Hwu, Y.; Liu, Ru-Shi; Yang, Chung-Shi; Je, Jung-Ho; Lin, Hong-Ming; Margaritondo, G.

2009-11-01

378

X-ray induced alterations in the differentiation and mineralization potential of murine preosteoblastic cells  

NASA Astrophysics Data System (ADS)

To evaluate the effects of ionizing radiation (IR) on murine preosteoblastic cell differentiation, we directed OCT-1 cells to the osteoblastic lineage by treatment with a combination of ?-glycerophosphate (?-GP), ascorbic acid (AA), and dexamethasone (Dex). In vitro mineralization was evaluated based on histochemical staining and quantification of the hydroxyapatite content of the extracellular bone matrix. Expression of mRNA encoding Runx2, transforming growth factor ?1 (TGF-?1), osteocalcin (OCN), and p21CDKN1A was analyzed. Exposure to IR reduced the growth rate and diminished cell survival of OCT-1 cells under standard conditions. Notably, calcium content analysis revealed that deposition of mineralized matrix increased significantly under osteogenic conditions after X-ray exposure in a time-dependent manner. In this study, higher radiation doses exert significant overall effects on TGF-?1, OCN, and p21CDKN1A gene expression, suggesting that gene expression following X-ray treatment is affected in a dose-dependent manner. Additionally, we verified that Runx2 was suppressed within 24 h after irradiation at 2 and 4 Gy. Although further studies are required to verify the molecular mechanism, our observations strongly suggest that treatment with IR markedly alters the differentiation and mineralization process of preosteoblastic cells.

Hu, Yueyuan; Lau, Patrick; Baumstark-Khan, Christa; Hellweg, Christine E.; Reitz, Günther

2012-05-01

379

Distribution of X-ray-induced chromosome breakpoints in Down syndrome lymphocytes  

SciTech Connect

Down syndrome (DS) individuals are known to be predisposed to develop leukemia and their lymphocytes are highly sensitive to the induction of chromosome aberrations by X-rays. A study was conducted to identify the chromosome breakpoints and to evaluate whether site specificity for chromosome breakage and rearrangement may exist which may explain the predisposition phenomenon. DS lymphocytes at the G1 phase of the cell cycle were irradiated with 300, 450, and 600 rad of X-rays. Cells were harvested after 3 days in culture and 193 G-banded karyotypes were analyzed to identify the induced chromosome abnormalities. Out of 273 breakpoints identified, 122 were involved in the formation of stable chromosome rearrangements and 151 in the formation of unstable abnormalities. The Poisson analysis of these breakpoints demonstrated that 16 chromosome bands located in chromosomes 1, 3, 7, 12, 17, 19 and X were preferentially involved in breakage and rearrangement (P less than 0.05). These 16 bands are also found to be locations of cancer breakpoints, oncogenes, or fragile sites. Many abnormal cells were observed to carry stable chromosome rearrangements only. Therefore, these cells are presumed to be compatible with survival and to be initiated in the transformation process. We propose that similar stable and site-specific chromosome rearrangements may exist in proliferating cells in DS individuals after exposure to clastogens and that this abnormality predisposes them to develop leukemia.

Shafik, H.M.; Au, W.W.; Whorton, E.B. Jr.; Legator, M.S. (Univ. of Texas Medical Branch, Galveston (USA))

1990-01-01

380

INVOLVEMENT OF P53 IN X-RAY INDUCED INTRACHROMOSOMAL RECOMBINATION IN MICE. (R825359)  

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

381

X-ray induced damage in DNA monitored by X-ray photoelectron spectroscopy  

SciTech Connect

In this work, the chemical changes in calf thymus DNA samples were analyzed by X-ray photoelectron spectroscopy (XPS). The DNA samples were irradiated for over 5 h and spectra were taken repeatedly every 30 min. In this approach the X-ray beam both damages and probes the samples. In most cases, XPS spectra have complex shapes due to contributions of C, N, and O atoms bonded at several different sites. We show that from a comparative analysis of the modification in XPS line shapes of the C 1s, O 1s, N 1s, and P 2p peaks, one can gain insight into a number of reaction pathways leading to radiation damage to DNA.

Ptasinska, Sylwia; Stypczynska, Agnieszka; Nixon, Tony; Mason, Nigel J. [Department of Physics and Astronomy, Open University, Walton Hall, Milton Keynes, MK7 6AA (United Kingdom); Klyachko, Dimitri V.; Sanche, Leon [Groupe en Sciences des Radiations, Departement de Medecine Nucleaire et de Radiobiology, Faculte de Medecine, Universite de Sherbrooke, Sherbrooke, J1H 5N4 Quebec (Canada)

2008-08-14

382

MOLECULAR ANALYSIS OF X-RAY-INDUCED ALCOHOL DEHYDROGENASE (Am) NULL MUTATIONS IN DROSOPHILA MELANOGASTER  

Microsoft Academic Search

We have attempted to analyze at the molecular level mutants previously determined as having intragenic lesions caused by X-ray mutagenesis. C. S. Aaron isolated 33 null mutations at the Adh locus and in collaboration with other investigators classified 23 as deletions. Of the eight mutants analyzed here, only two produced a detectable ADH protein using the two-dimensional electrophoresis technique. Restriction

MARK R. KELLEY; INKA P. MIMS; CHRIS M. FARNET; SHERRY A. DICHARRY; WILLIAM R. LEE

383

X-ray-induced bystander responses reduce spontaneous mutations in V79 cells  

PubMed Central

The potential for carcinogenic risks is increased by radiation-induced bystander responses; these responses are the biological effects in unirradiated cells that receive signals from the neighboring irradiated cells. Bystander responses have attracted attention in modern radiobiology because they are characterized by non-linear responses to low-dose radiation. We used a synchrotron X-ray microbeam irradiation system developed at the Photon Factory, High Energy Accelerator Research Organization, KEK, and showed that nitric oxide (NO)-mediated bystander cell death increased biphasically in a dose-dependent manner. Here, we irradiated five cell nuclei using 10 × 10 µm2 5.35 keV X-ray beams and then measured the mutation frequency at the hypoxanthine-guanosine phosphoribosyl transferase (HPRT) locus in bystander cells. The mutation frequency with the null radiation dose was 2.6 × 10–5 (background level), and the frequency decreased to 5.3 × 10–6 with a dose of approximately 1 Gy (absorbed dose in the nucleus of irradiated cells). At high doses, the mutation frequency returned to the background level. A similar biphasic dose-response effect was observed for bystander cell death. Furthermore, we found that incubation with 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (carboxy-PTIO), a specific scavenger of NO, suppressed not only the biphasic increase in bystander cell death but also the biphasic reduction in mutation frequency of bystander cells. These results indicate that the increase in bystander cell death involves mechanisms that suppress mutagenesis. This study has thus shown that radiation-induced bystander responses could affect processes that protect the cell against naturally occurring alterations such as mutations. PMID:23660275

Maeda, Munetoshi; Kobayashi, Katsumi; Matsumoto, Hideki; Usami, Noriko; Tomita, Masanori

2013-01-01

384

X-Ray Induced DNA Damage and Repair in Germ Cells of PARP1?/? Male Mice  

PubMed Central

Poly(ADP-ribose)polymerase-1 (PARP1) is a nuclear protein implicated in DNA repair, recombination, replication, and chromatin remodeling. The aim of this study was to evaluate possible differences between PARP1?/? and wild-type mice regarding induction and repair of DNA lesions in irradiated male germ cells. Comet assay was applied to detect DNA damage in testicular cells immediately, and two hours after 4 Gy X-ray irradiation. A similar level of spontaneous and radiation-induced DNA damage was observed in PARP1?/? and wild-type mice. Conversely, two hours after irradiation, a significant level of residual damage was observed in PARP1?/? cells only. This finding was particularly evident in round spermatids. To evaluate if PARP1 had also a role in the dynamics of H2AX phosphorylation in round spermatids, in which ?-H2AX foci had been shown to persist after completion of DNA repair, we carried out a parallel analysis of ?-H2AX foci at 0.5, 2, and 48 h after irradiation in wild-type and PARP1?/? mice. No evidence was obtained of an effect of PARP1 depletion on H2AX phosphorylation induction and removal. Our results suggest that, in round spermatids, under the tested experimental conditions, PARP1 has a role in radiation-induced DNA damage repair rather than in long-term chromatin modifications signaled by phosphorylated H2AX. PMID:24009020

Villani, Paola; Fresegna, Anna Maria; Ranaldi, Roberto; Eleuteri, Patrizia; Paris, Lorena; Pacchierotti, Francesca; Cordelli, Eugenia

2013-01-01

385

Prevailing features of X-ray induced molecular electron spectra revealed with fullerenes  

E-print Network

Intense X-ray photo-absorption from short and intense pulses by a molecule triggers complicated electron and subsequently ion dynamics leading to photo-electron spectra which are difficult to interpret. Illuminating fullerenes offers a way to separate out the electron dynamics. Moreover, the fullerene cage confines spatially the origin of photo and Auger electrons. Together with the sequential nature of the photo processes at intensities available at X-ray free electron lasers, this allows for a remarkably detailed interpretation of the photo-electron spectra as we will demonstrate. The general features derived can serve as a paradigm for less well-defined situations in other large molecules or clusters.

Garibay, Abraham Camacho; Rost, Jan M

2014-01-01

386

Simulation of ultrasoft X-rays induced DNA damage using the Geant4 Monte Carlo toolkit  

NASA Astrophysics Data System (ADS)

In this study, the total yields of SSB and DSB induced by monoenergetic electrons with energies of 0.28-4.55 keV, corresponding to ultrasoft X-rays energies, have been calculated in Charlton and Humm volume model using the Geant4-DNA toolkit and compared with theoretical and experimental data. A reasonable agreement between the obtained results in the present study and experimental and theoretical data of previous studies showed the efficiency of this model in estimating the total yield of strand breaks in spite of its simplicity. Also, it has been found that in the low energy region, the yield of the total SSB remains nearly constant while the DSB yield increases with decreasing energy. Moreover, a direct dependency between DSB induction, RBE value and the mean lineal energy as a microdosimetry quantity has been observed. In addition, it has become clear that the use of the threshold energy of 10.79 eV to calculate the total strand breaks yields results in a better agreement with the experiments, while the threshold of 17.5 eV shows a big difference.

Tajik, Marjan; Rozatian, Amir S. H.; Semsarha, Farid

2015-01-01

387

X-ray induced mobility of molecular oxygen at extreme conditions  

SciTech Connect

We report an in situ Raman study of KClO{sub 4} irradiated with x-rays in a diamond anvil cell. Decomposition via KClO{sub 4} + hv ? KCl + 2O{sub 2} was monitored via the O{sub 2} vibron at 2 GPa, 6 GPa, and 9 GPa. For all pressures, the vibron grew in intensity and then diminished after successive irradiation suggesting that O{sub 2} was diffusing away from the irradiated region. Surprisingly, the diffusion rate accelerated with pressure increase, indicating that the nonhydrostatic pressure gradient was likely driving molecular diffusion of oxygen. At 9 GPa, the vibron bifurcated suggesting that O{sub 2} exists as two forms: interstitial and bulk solid. This method can be employed to study molecular diffusion under extreme conditions.

Pravica, Michael; Sneed, Daniel; Guardala, Griffin; Smith, Quinlan [High Pressure Science and Engineering Center (HiPSEC) and Department of Physics, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada 89154-4002 (United States)] [High Pressure Science and Engineering Center (HiPSEC) and Department of Physics, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada 89154-4002 (United States); Popov, Dmitry; Sinogeikin, Stanislav [HPCAT, Geophysical Laboratory, Carnegie Institution of Washington, 9700 South Cass Ave., Argonne, Illinois 60437 (United States)] [HPCAT, Geophysical Laboratory, Carnegie Institution of Washington, 9700 South Cass Ave., Argonne, Illinois 60437 (United States)

2013-11-25

388

Femtosecond X-ray-induced explosion of C60 at extreme intensity  

NASA Astrophysics Data System (ADS)

Understanding molecular femtosecond dynamics under intense X-ray exposure is critical to progress in biomolecular imaging and matter under extreme conditions. Imaging viruses and proteins at an atomic spatial scale and on the time scale of atomic motion requires rigorous, quantitative understanding of dynamical effects of intense X-ray exposure. Here we present an experimental and theoretical study of C60 molecules interacting with intense X-ray pulses from a free-electron laser, revealing the influence of processes not previously reported. Our work illustrates the successful use of classical mechanics to describe all moving particles in C60, an approach that scales well to larger systems, for example, biomolecules. Comparisons of the model with experimental data on C60 ion fragmentation show excellent agreement under a variety of laser conditions. The results indicate that this modelling is applicable for X-ray interactions with any extended system, even at higher X-ray dose rates expected with future light sources.

Murphy, B. F.; Osipov, T.; Jurek, Z.; Fang, L.; Son, S.-K.; Mucke, M.; Eland, J. H. D.; Zhaunerchyk, V.; Feifel, R.; Avaldi, L.; Bolognesi, P.; Bostedt, C.; Bozek, J. D.; Grilj, J.; Guehr, M.; Frasinski, L. J.; Glownia, J.; Ha, D. T.; Hoffmann, K.; Kukk, E.; McFarland, B. K.; Miron, C.; Sistrunk, E.; Squibb, R. J.; Ueda, K.; Santra, R.; Berrah, N.

2014-06-01

389

X-ray induced DNA damage and repair in germ cells of PARP1(-/-) male mice.  

PubMed

Poly(ADP-ribose)polymerase-1 (PARP1) is a nuclear protein implicated in DNA repair, recombination, replication, and chromatin remodeling. The aim of this study was to evaluate possible differences between PARP1(-/-) and wild-type mice regarding induction and repair of DNA lesions in irradiated male germ cells. Comet assay was applied to detect DNA damage in testicular cells immediately, and two hours after 4 Gy X-ray irradiation. A similar level of spontaneous and radiation-induced DNA damage was observed in PARP1(-/-) and wild-type mice. Conversely, two hours after irradiation, a significant level of residual damage was observed in PARP1(-/-) cells only. This finding was particularly evident in round spermatids. To evaluate if PARP1 had also a role in the dynamics of H2AX phosphorylation in round spermatids, in which ?-H2AX foci had been shown to persist after completion of DNA repair, we carried out a parallel analysis of ?-H2AX foci at 0.5, 2, and 48 h after irradiation in wild-type and PARP1(-/-) mice. No evidence was obtained of an effect of PARP1 depletion on H2AX phosphorylation induction and removal. Our results suggest that, in round spermatids, under the tested experimental conditions, PARP1 has a role in radiation-induced DNA damage repair rather than in long-term chromatin modifications signaled by phosphorylated H2AX. PMID:24009020

Villani, Paola; Fresegna, Anna Maria; Ranaldi, Roberto; Eleuteri, Patrizia; Paris, Lorena; Pacchierotti, Francesca; Cordelli, Eugenia

2013-01-01

390

Static magnetic fields modulate X-ray-induced DNA damage in human glioblastoma primary cells.  

PubMed

Although static magnetic fields (SMFs) are used extensively in the occupational and medical fields, few comprehensive studies have investigated their possible genotoxic effect and the findings are controversial. With the advent of magnetic resonance imaging-guided radiation therapy, the potential effects of SMFs on ionizing radiation (IR) have become increasingly important. In this study we focused on the genotoxic effect of 80 mT SMFs, both alone and in combination with (i.e. preceding or following) X-ray (XR) irradiation, on primary glioblastoma cells in culture. The cells were exposed to: (i) SMFs alone; (ii) XRs alone; (iii) XR, with SMFs applied during recovery; (iv) SMFs both before and after XR irradiation. XR-induced DNA damage was analyzed by Single Cell Gel Electrophoresis assay (comet assay) using statistical tools designed to assess the tail DNA (TD) and tail length (TL) as indicators of DNA fragmentation. Mitochondrial membrane potential, known to be affected by IR, was assessed using the JC-1 mitochondrial probe. Our results showed that exposure of cells to 5 Gy of XR irradiation alone led to extensive DNA damage, which was significantly reduced by post-irradiation exposure to SMFs. The XR-induced loss of mitochondrial membrane potential was to a large extent averted by exposure to SMFs. These data suggest that SMFs modulate DNA damage and/or damage repair, possibly through a mechanism that affects mitochondria. PMID:24345558

Teodori, Laura; Giovanetti, Anna; Albertini, Maria Cristina; Rocchi, Marco; Perniconi, Barbara; Valente, Maria Giovanna; Coletti, Dario

2014-03-01

391

Crucial role of thyroid hormone in x-ray-induced neoplastic transformation in cell culture  

Microsoft Academic Search

Incubation of mouse embryo fibroblasts (C3H\\/10T1\\/2) in media depleted of thyroidhormone for 1 week rendered the cells completely resistant to the trnsforming action of an x-ray dose, 4 grays, that yields transformation frequencies (no. foci per surviving cells) of approx. = 10kc in media supplemented with triiodothyronine (T3) (1 nM). Studies on the timing of the additions or removal of

D. L. Guernsey; C. Borek; I. S. Edelman

1981-01-01

392

X-ray induced photocurrent characteristics of CVD diamond detectors with different carbon electrodes  

NASA Astrophysics Data System (ADS)

Diamond has unique properties which make it suitable for a broad range of radiation detection applications ranging from particle timing and spectroscopy, to neutron, UV and X-ray sensors. In X-ray dosimetry, the atomic number of diamond (Z = 6) close to that of the human tissues (Z = 7.42) allows to mimic the real absorbed dose avoiding off-line recalculations. Moreover, its low atomic number and the capability to withstand high radiation fluxes make possible its use as beam monitor without altering significantly the properties of the interacting beam. To preserve the tissue equivalence of the diamond and minimize the perturbation and absorption of the incident beam, diamond detectors based on low thickness and low atomic number electrodes become a requirement. In this paper we present the X-ray detection characteristics of electronic grade CVD diamond sensors prepared in house with thin amorphous carbon electrodes fabricated by Pulsed Laser Deposition (PLD) technique in the fluence range of 2.3-3.6 J·cm-2. The devices showed a linear dependence of the induced photocurrent respect to the dose rate. Also, best dynamic response and better stability of the signals were achieved for applied bias up to ±50 V with signal to noise ratio (SNR) of ~ 300.

Schirru, F.; Lohstroh, A.; Jayawardena, K. D. G. I.; Henley, S. J.; Sellin, P. J.

2013-12-01

393

Metastatic signet ring adenocarcinoma: an unusual cause of cardiac constriction.  

PubMed

Pericardial constriction secondary to metastatic adenocarcinoma is exceedingly rare. We present the first recorded case of pericardial constriction secondary to metastatic signet-ring mucinous adenocarcinoma diagnosed by echocardiography. The cornerstones of echocardiographic diagnosis of constriction are the following: interventricular septal bounce phasic with respiration, M-mode recordings of the inferior vena cava, and the characteristic Doppler velocity patterns recorded from the mitral valve, hepatic veins, and mitral annulus. PMID:17117320

Anis, Ather; Narayan, Rajeev L; Kapa, Suraj; Klapholz, Marc; Saric, Muhamed

2006-10-01

394

Sphincter-Sparing Treatment for Distal Rectal Adenocarcinoma  

Microsoft Academic Search

Background: Studies suggest that the anal sphincter can be preserved in some patients with distal rectal adenocarcinoma (DRA), but this has not been validated in any prospective multi-institutional trial.Methods: To test the hypothesis that the anal sphincter can be preserved in some patients with DRA, the Cancer and Leukemia Group B and collaborators reviewed 177 patients who had T1\\/T2 adenocarcinomas

Glenn D. Steele; James E. Herndon; Ron Bleday; Anthony Russell; Al Benson III; Maha Hussain; Anne Burgess; Joel E. Tepper; Robert J. Mayer

1999-01-01

395

Adenocarcinoma of the anterior tongue: a case report.  

PubMed

Adenocarcinoma of the minor salivary gland more commonly involves the palate and base of tongue but rarely presents in the anterior tongue. We report a rare case of adenocarcinoma of the minor salivary gland located in the anterior togue of a 74-year-old man. Furthermore, we discuss the histopathological features of this neoplasm, the treatment plan, and a literature review of the current standard of care. PMID:23993709

Gehani, Neal C; Liu, Yi-Chun Carol; Stepnick, David W

2013-01-01

396

A case of periampullary adenocarcinoma in neurofibromatosis type 1  

PubMed Central

Neurofibromatosis type 1 (NF-1) is an autosomal dominant genetic disorder with a known predisposition to gastrointestinal neoplasms such as stromal tumors and carcinoids. Adenocarcinomas (ACs) of the gastrointestinal tract are relatively rare in patients with NF-1, especially those found in the periampullary region. We present a case report of periampullary adenocarcinoma in a 56-year-old woman with NF-1 who presented with abdominal pain and obstructive jaundice. PMID:25436139

Kistler, C. Andrew; Johnson, Jennifer M.; Winter, Jordan M.; Baliff, Jeffrey P.; Siddiqui, Ali A.

2014-01-01

397

Metastatic Uterine Adenocarcinoma in an 8-year-old Gilt  

PubMed Central

An 8-y-old gilt was evaluated after the onset of hemorrhagic perineal discharge. Uterine adenocarcinoma with metastases to the lungs and regional lymph nodes was diagnosed at necropsy. Tumor cells lacked expression of estrogen receptor ? and progesterone receptor. This case represents the first reported uterine adenocarcinoma in a research pig and the first swine uterine neoplasia in which steroid hormone receptor expression was evaluated. PMID:19930830

Cannon, Coralie Zegre; Godfrey, Virginia L; King-Herbert, Angela; Nielsen, Judith N

2009-01-01

398

Ureteric stricture secondary to unusual extension of prostatic adenocarcinoma.  

PubMed

This article describes an unusual finding in a patient who presented with an adenocarcinoma of the prostate and right hydronephrosis. A 68-year-old male presented with right hydronephrosis and a PSA of 96. DRE was consistent with cT3 carcinoma. Cystoscopy showed an exophytic superficial transitional cell carcinoma (TCC) of the bladder and a transrectal biopsy of the prostate confirmed adenocarcinoma Gleason score 4+3. Staging investigations (CT pelvis and bone scan) were negative; androgen deprivation therapy was therefore initiated for the prostatic adenocarcinoma. Upper tract imaging showed multiple filling defects in the proximal ureter. Ureteroscopy showed a stricture at the level of the iliac vessels. With a working diagnosis of upper tract TCC, right open nephroureterectomy was performed. Final histology showed prostatic adenocarcinoma infiltrating the adventitia of the entire ureter up to the level of the renal pelvis. A rare cause of ureteric stricture, contiguous spread of prostatic adenocarcinoma, should be considered in the differential diagnosis of patients presenting with upper tract obstruction and a known history of prostatic adenocarcinoma. Androgen deprivation therapy for several months did not seem to cause resolution of the tumor in the periureteric, ureteric and perihilar tissues. PMID:20156388

Chalasani, Venu; Macek, Petr; O'Neill, Gordon F; Barret, Wade

2010-02-01

399

Gastric metastasis from primary lung adenocarcinoma mimicking primary gastric cancer  

PubMed Central

Gastric metastases from lung adenocarcinoma are rare. Because gastric metastasis grossly resembles advanced gastric cancer, it is difficult to diagnose gastric metastasis especially when the histology of the primary lung cancer is adenocarcinoma. We describe a case of gastric metastasis from primary lung adenocarcinoma mimicking Borrmann type IV primary gastric cancer. A 68-year-old man with known lung adenocarcinoma with multiple bone metastases had been experiencing progressive epigastric pain and dyspepsia over one year. Esophagogastroduodenoscopy revealed linitis plastica-like lesions in the fundus of the stomach. Pathologic examination revealed a moderately differentiated adenocarcinoma with submucosal infiltration. Positive immunohistochemical staining for thyroid transcription factor-1 (TTF-1) and napsin A (Nap-A) confirmed that the metastasis was pulmonary in origin. The patient had been treated with palliative chemotherapy for the lung cancer and had lived for over fifteen months after the diagnosis of gastric metastasis. Clinicians should be aware of the possibility of gastric metastasis in patients with primary lung adenocarcinoma, and additional immunohistochemical staining for Nap-A as well as TTF-1 may help in differentiating its origin. PMID:25780510

Kim, Min Ji; Hong, Ji Hyung; Park, Eun Su; Byun, Jae Ho

2015-01-01

400

Gastric metastasis from primary lung adenocarcinoma mimicking primary gastric cancer.  

PubMed

Gastric metastases from lung adenocarcinoma are rare. Because gastric metastasis grossly resembles advanced gastric cancer, it is difficult to diagnose gastric metastasis especially when the histology of the primary lung cancer is adenocarcinoma. We describe a case of gastric metastasis from primary lung adenocarcinoma mimicking Borrmann type IV primary gastric cancer. A 68-year-old man with known lung adenocarcinoma with multiple bone metastases had been experiencing progressive epigastric pain and dyspepsia over one year. Esophagogastroduodenoscopy revealed linitis plastica-like lesions in the fundus of the stomach. Pathologic examination revealed a moderately differentiated adenocarcinoma with submucosal infiltration. Positive immunohistochemical staining for thyroid transcription factor-1 (TTF-1) and napsin A (Nap-A) confirmed that the metastasis was pulmonary in origin. The patient had been treated with palliative chemotherapy for the lung cancer and had lived for over fifteen months after the diagnosis of gastric metastasis. Clinicians should be aware of the possibility of gastric metastasis in patients with primary lung adenocarcinoma, and additional immunohistochemical staining for Nap-A as well as TTF-1 may help in differentiating its origin. PMID:25780510

Kim, Min Ji; Hong, Ji Hyung; Park, Eun Su; Byun, Jae Ho

2015-03-15

401

Diagnosis of canine gastric adenocarcinoma using squash preparation cytology.  

PubMed

Adenocarcinoma is the most common gastric tumour in dogs. Clinical signs and laboratory results are often non-specific, with histopathological examination of gastric biopsies being required to reach a definitive diagnosis. Use of cytology would potentially shorten the time to diagnosis and allow early interventional measures to be implemented. However, there are relatively few studies of the cytological features of gastric samples. The present study was designed to investigate whether cytology might be useful for diagnosis of canine gastric adenocarcinomas and to evaluate the performance of squash preparation cytology for this purpose. Squash preparations of gastric biopsies from 94 dogs were reviewed to determine the presence or absence of specific cytological features associated with adenocarcinomas and to compare findings with the results of histopathological examination of gastric biopsies. The presence of signet ring cells, microvacuolation, cellular pleomorphism and single cell distribution of epithelial cells were positively associated with a diagnosis of gastric adenocarcinoma. Combined evaluation (parallel testing) for the presence of signet ring cells and microvacuolation demonstrated excellent results for recognition of adenocarcinomas. Cytological examination of squash preparations from gastric biopsies and identification of signet ring cells and cytoplasmic vacuolation can allow rapid and reliable diagnosis of canine gastric adenocarcinomas. PMID:24923753

Riondato, Fulvio; Miniscalco, Barbara; Berio, Enrica; Lepri, Elvio; Rossi, Silvia; Bottero, Enrico

2014-09-01

402

Prognostic significance of adenocarcinoma in situ, minimally invasive adenocarcinoma, and nonmucinous lepidic predominant invasive adenocarcinoma of the lung in patients with stage I disease.  

PubMed

According to the IASLC/ATS/ERS classification, the lepidic predominant pattern consists of 3 subtypes: adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and nonmucinous lepidic predominant invasive adenocarcinoma. We reviewed tumor slides from 1038 patients with stage I lung adenocarcinoma, recording the percentage of each histologic pattern and measuring the invasive tumor size. Tumors were classified according to the IASLC/ATS/ERS classification: 2 were AIS, 34 MIA, and 103 lepidic predominant invasive. Cumulative incidence of recurrence (CIR) was used to estimate the probability of recurrence. Patients with AIS and MIA experienced no recurrences. Patients with lepidic predominant invasive tumors had a lower risk for recurrence (5-y CIR, 8%) than nonlepidic predominant tumors (n=899; 19%; P=0.003). Patients with >50% lepidic pattern tumors experienced no recurrences (n=84), those with >10% to 50% lepidic pattern tumors had an intermediate risk for recurrence (n=344; 5-y CIR, 12%), and those with ?10% lepidic pattern tumors had the highest risk (n=610; 22%; P<0.001). CIR was lower for patients with ?2 cm tumors than for those with >2 to 3 cm tumors (for both total and invasive tumor size), with the difference more pronounced for invasive tumor size (5-y CIR, 13% vs. 21% [total size; P=0.022] and 12% vs. 27% [invasive size; P<0.001]). Most patients with lepidic predominant adenocarcinoma who experienced a recurrence had potential risk factors, including sublobar resection with close margins (?0.5 cm; n=2), 20% to 30% micropapillary component (n=2), and lymphatic or vascular invasion (n=2). It therefore may be possible to identify lepidic predominant adenocarcinomas that carry a low or high risk for recurrence. PMID:24472852

Kadota, Kyuichi; Villena-Vargas, Jonathan; Yoshizawa, Akihiko; Motoi, Noriko; Sima, Camelia S; Riely, Gregory J; Rusch, Valerie W; Adusumilli, Prasad S; Travis, William D

2014-04-01

403

Association of pancreatic adenocarcinoma up-regulated factor expression in ovarian mucinous adenocarcinoma with poor prognosis  

PubMed Central

Pancreatic adenocarcinoma up-regulated factor (PAUF) expression is elevated in both ovarian tumors and pancreatic adenocarcinoma. However, PAUF expression in ovarian tumors according to histologic subtype and grade has not been investigated. In this study, we examined various clinicopathologic features of 24 patients with mucinous cystadenoma (MCA), 36 with mucinous borderline tumors (MBTs), and 46 with mucinous adenocarcinomas (MACs) according to PAUF expression status assessed using immunohistochemistry. We found that MACs more frequently stained positive for PAUF than did MCAs and MBTs (P < 0.0001). Although there was no significant differences with respect to other clinicopathologic characteristics of MACs according to PAUF expression status, patients with PAUF-weakly positive and PAUF-strongly positive MACs tended to have a shorter overall survival (OS) than those with PAUF-negative MAC, determined using a Kaplan–Meier analysis (P = 0.1885). After adjusting for various clinicopathologic parameters, PAUF positivity of MACs was a significant predictive factor for disease-free survival (DFS) (negative vs. weakly positive: P = 0.045, hazard ratio [HR] = 57.406, 95% confidence interval [CI]: 1.090-3022.596; and negative vs. strongly positive: P = 0.034, HR = 97.890, 95% CI: 1.412-6785.925). In conclusion, PAUF was more frequently expressed in MAC than in its benign and borderline counterparts, and was associated with a poor OS and DFS in MAC patients. Therefore, we suggest that PAUF may be a practical biomarker for histopathological categorization and a prognostic marker for patients with an ovarian mucinous tumor. PMID:25197383

Kim, Sang Kyum; Song, Si Young; Kim, Sunghoon; Cho, Nam Hoon; Yim, Ga Won; Kim, Sang Wun; Kim, Young Tae; Nam, Eun Ji

2014-01-01

404

Expression and Diagnostic Value of HE4 in Pancreatic Adenocarcinoma  

PubMed Central

Human epididymis protein 4 (HE4) is a recognized biomarker in ovarian and endometrial cancer and over-expressed in pancreatic adenocarcinoma. The diagnostic value of HE4 in pancreatic adenocarcinoma remains unknown. Here we elucidate mRNA, protein and serum level of HE4 in pancreatic adenocarcinoma. HE4 mRNA level in tumor adjacent tissues and pancreatic adenocarcinoma tissues were tested by real time-PCR. Tissue microarray containing normal, adenocarcinoma, and adjacent pancreatic tissue was tested by immunohistochemistry (IHC). Serum level of HE4, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3) and carbohydrate antigen 125 (CA125) were detected by ELISA assay in control and tumor patients. Further we compared the sensitivity and specificity of determining HE4, CA19-9, CA15-3, and CA125 for diagnosis of pancreatic adenocarcinoma and assessed the complementary diagnostic value of HE4, CA19-9, CA15-3 and CA125. Real time PCR showed significantly increased HE4 mRNA level in pancreatic adenocarcinoma compared with control. Result of IHC showed that HE4 significantly higher expressed in the human pancreatic carcinoma tissues than in both normal and adjacent non-tumorous pancreatic tissues, and the staining intensity is inversely correlated with the clinical stage. HE4 was highly expressed in early stage of pancreatic adenocarcinoma. Serum HE4 level is higher in cases with pancreatic adenocarcinoma than in the controls. Serum HE4 levels could research to a sensitivity of 45.83% and specificity of 93.75% when the Cutoff was set at 4.59 ng/mL. The Combined HE4 and CA19-9 increased the sensitivity to 83.33%; and interestingly, the combination of HE4 with CA15-3 led to the most powerful sensitivity of 87.5%. Combined with CA19-9 and CA15-3, HE4 could be a potential biomarker to improve the diagnostic power for pancreatic adenocarcinoma. PMID:25642754

Huang, Tianhe; Jiang, Shi-Wen; Qin, Liangyi; Senkowski, Christopher; Lyle, Christian; Terry, Karen; Brower, Steven; Chen, Haibin; Glasgow, Wayne; Wei, Yongchang; Li, Jinping

2015-01-01

405

Ovarian clear cell adenocarcinoma: a continuing enigma  

PubMed Central

Ovarian clear cell adenocarcinomas (OCCAs) account for <5% of all ovarian malignancies. Compared to other epithelial ovarian cancer (EOC) subtypes, when at an advanced stage, they are associated with a poorer prognosis and are relatively resistant to conventional platinum?based chemotherapy. By contrast, early?stage clear cell ovarian cancer carries a relatively good prognosis. Hence, there is a need to improve our understanding of its pathobiology in order to optimise currently available treatments and develop new therapeutic strategies. This review summarises the currently available literature regarding the pathogenesis of OCCA, its molecular genetic features and postulated molecular mechanisms that underlie its chemoresistant phenotype. Marked similarities with clear cell carcinomas of the kidney and endometrium have been noted by some investigators, raising interesting possibilities regarding novel therapeutic approaches. Unfortunately, most studies on OCCA have hitherto been hampered by insufficient sample sizes, leaving many key issues unresolved. It is envisaged that in the future, high?resolution genomic and gene?expression microarray studies incorporating larger sample sizes will lead to the characterisation of the key molecular players in OCCA biology, which may potentially lead to the identification of novel targets for therapeutic development. PMID:17018684

Tan, David S P; Kaye, Stan

2007-01-01

406

Primary clear cell adenocarcinoma of the lung.  

PubMed

Primary clear cell adenocarcinoma of the lung is extremely rare. A 63-year-old Japanese man consulted to our hospital because of cough and sputum. Imaging modalities including XP, CT and MRI revealed a tumor of the right middle lobe. They did not identify other tumors in the body. Because clinical cytology and biopsy showed malignant cells, segmentectomy of the lobe was performed. Grossly, the tumor was whitish tan tumor measuring 5 × 6 × 5 cm. Histologically, the tumor was composed entirely of clear cells arranged in papillary and tubular patterns. The tumor cells had hyperchromatic nuclei, and mitotic figure and nuclear stratification were scattered. Histochemically, glycogen and mucins were absent in tumor cell cytoplasm. Immunohistochemically, the tumor cells were positive for pancytokeratin (AE1/3, CAM5.2), cytokeratin (CK) 7, CK 8, CK18, CK19, EMA, CEA, CA19-9, CA125, p53, Ki-67 (labeling = 80%), TTF-1 and surfactant apoprotein A. In contrast, the tumor cells were negative for CK5/6, CK 34?E12, CK 14, CK 20, vimentin, desmin, S100 protein, ?-smooth muscle actin, AFP, HMB45, CD10, CD34, HER2/neu, CD56, p63, and synaptophysin. The tumor recurred 6 months after the operation, and right middle lobectomy was performed. Postoperative imaging modalities showed no tumors. The patient is alive free from tumor 9 years after the first manifestation. PMID:21082293

Terada, Tadashi

2011-12-01

407

Stromal expression of SPARC in pancreatic adenocarcinoma.  

PubMed

Pancreatic ductal adenocarcinoma (PDAC) stands as the poorest prognostic tumor of the digestive tract, with a 5-year survival rate of less than 5%. Therapeutic options for unresectable PDAC are extremely limited and there is a pressing need for expanded therapeutic approaches to improve current options available with gemcitabine-based regimens. With PDAC displaying one of the most prominent desmoplastic stromal reactions of all carcinomas, recent research has focused on the microenvironment surrounding PDAC cells. Secreted protein acid and rich in cysteine (SPARC), which is overexpressed in PDAC, may display tumor suppressor functions in several cancers (e.g., in colorectal, ovarian, prostate cancers, and acute myelogenous leukemia) but also appears to be overexpressed in other tumor types (e.g., breast cancer, melanoma, and glioblastoma). The apparent contradictory functions of SPARC may yield inhibition of angiogenesis via inhibition of vascular endothelial growth factor, while promoting epithelial-to-mesenchymal transition and invasion through matrix metalloprotease expression. This feature is of particular interest in PDAC where SPARC overexpression in the stroma stands along with inhibition of angiogenesis and promotion of cancer cell invasion and metastasis. Several therapeutic strategies to deplete stromal tissue have been developed. In this review, we focused on key preclinical and clinical data describing the role of SPARC in PDAC biology, the properties, and mechanisms of delivery of drugs that interact with SPARC and discuss the proof-of-concept clinical trials using nab-paclitaxel. PMID:23690170

Neuzillet, Cindy; Tijeras-Raballand, Annemilaï; Cros, Jérôme; Faivre, Sandrine; Hammel, Pascal; Raymond, Eric

2013-12-01

408

Systemic therapy for metastatic pancreatic adenocarcinoma  

PubMed Central

Systemic treatment of metastatic pancreatic adenocarcinoma achieves only modest benefits, with evidence indicating a survival advantage with 5-fluorouracil (5-FU) over best supportive care alone, and further advantage of single-agent gemcitabine over 5-FU. There are very few regimens better than single-agent gemcitabine despite multiple trials of cytotoxic and targeted agents. The addition of a platinum agent has improved response rate but not survival. The addition of erlotinib has improved survival but only by a small margin. The use of gemcitabine in multidrug regimens containing one or more of: a platinum agent; fluoropyrimidine; anthracycline; and taxane has demonstrated advantages in response rate, progression-free survival and, in one randomized study, overall survival. After gemcitabine failure, second-line therapy with oxaliplatin and 5-FU provides a further survival advantage. Further advances depend upon the current and future clinical trials investigating enhanced delivery of current agents, new agents and novel modalities, improved supportive care, and treatment more tailored to the individual patient and tumour. PMID:21789129

Lawrence, Ben; Findlay, Michael

2010-01-01

409

Targeting histone deacetylases in pancreatic ductal adenocarcinoma  

PubMed Central

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a dismal disease with a median survival below 6 months and a 5-year survival rate below 1%. Effective therapies for locally advanced or metastatic tumours are missing and curatively resected patients relapse in over 80% of the cases. Although histone deacetylases (HDACs) are involved in the control of proliferation, apoptosis, differentiation, migration and angiogenesis of cancer cells, knowledge about the expression patterns and functions of individual HDAC isoenzymes in pancreatic cancer is sparse. This review summarizes the roles of HDACs as novel therapeutic targets and the molecular mode of action of HDAC-inhibitors (HDACI) in PDACs. Success of HDACI in clinical settings will depend on an increased knowledge of HDAC functions as well as on a better understanding of the mode of action of HDACI. Pre-clinical experimental data that constitute the basis for rational therapeutic strategies to treat PDAC are described here. Translating these rational-based therapies into the clinic will finally increase our chance to establish an effective HDACI-containing combination therapy effective against PDAC. PMID:19929947

Schneider, Günter; Krämer, Oliver H; Fritsche, Petra; Schüler, Susanne; Schmid, Roland M; Saur, Dieter

2010-01-01

410

Rare pancreas tumor mimicking adenocarcinoma: Extramedullary plasmacytoma.  

PubMed

Neoplastic proliferation of plasma cells is called plasma cell dyscrasias, and these neoplasms can present as a solitary neoplasm or multiple myeloma. Extramedullary plasmacytoma, in particular pancreatic plasmacytoma, is a rare manifestation of multiple myeloma. Although computerized tomography is useful for the diagnosis of extramedullary plasmacytoma, there are no specific radiologic markers that distinguish it from adenocarcinoma. Histological confirmation by biopsy is necessary for accurate diagnosis and management of the tumor. Endosonography is the most sensitive method for the diagnosis of pancreatic tumors, and the use of fine needle aspiration by endosonography is associated with a lower risk for malignant seeding and complications. Here, we report a case of pancreatic plasmacytoma in newly identified multiple myeloma as diagnosed by endosonography. Endosonography is a reliable and rapid method for the diagnosis of extramedullary plasmacytoma. Therefore, endosonographic fine needle aspiration should be the first choice for histological evaluation when pancreatic plasmacytoma is suspected. Ideally, the pathology would be performed at the same site as endosonographic biopsy. PMID:24634714

Akyuz, Filiz; Sahin, Davut; Akyuz, Umit; Vatansever, Sezai

2014-03-16

411

Rare pancreas tumor mimicking adenocarcinoma: Extramedullary plasmacytoma  

PubMed Central

Neoplastic proliferation of plasma cells is called plasma cell dyscrasias, and these neoplasms can present as a solitary neoplasm or multiple myeloma. Extramedullary plasmacytoma, in particular pancreatic plasmacytoma, is a rare manifestation of multiple myeloma. Although computerized tomography is useful for the diagnosis of extramedullary plasmacytoma, there are no specific radiologic markers that distinguish it from adenocarcinoma. Histological confirmation by biopsy is necessary for accurate diagnosis and management of the tumor. Endosonography is the most sensitive method for the diagnosis of pancreatic tumors, and the use of fine needle aspiration by endosonography is associated with a lower risk for malignant seeding and complications. Here, we report a case of pancreatic plasmacytoma in newly identified multiple myeloma as diagnosed by endosonography. Endosonography is a reliable and rapid method for the diagnosis of extramedullary plasmacytoma. Therefore, endosonographic fine needle aspiration should be the first choice for histological evaluation when pancreatic plasmacytoma is suspected. Ideally, the pathology would be performed at the same site as endosonographic biopsy. PMID:24634714

Akyuz, Filiz; ?ahin, Davut; Akyuz, Umit; Vatansever, Sezai

2014-01-01

412

Comprehensive molecular characterization of gastric adenocarcinoma  

PubMed Central

Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies. PMID:25079317

Bass, Adam J.; Thorsson, Vesteinn; Shmulevich, Ilya; Reynolds, Sheila M.; Miller, Michael; Bernard, Brady; Hinoue, Toshinori; Laird, Peter W.; Curtis, Christina; Shen, Hui; Weisenberger, Daniel J.; Schultz, Nikolaus; Shen, Ronglai; Weinhold, Nils; Kelsen, David P.; Bowlby, Reanne; Chu, Andy; Kasaian, Katayoon; Mungall, Andrew J.; Robertson, A. Gordon; Sipahimalani, Payal; Cherniack, Andrew; Getz, Gad; Liu, Yingchun; Noble, Michael S.; Pedamallu, Chandra; Sougnez, Carrie; Taylor-Weiner, Amaro; Akbani, Rehan; Lee, Ju-Seog; Liu, Wenbin; Mills, Gordon B.; Yang, Da; Zhang, Wei; Pantazi, Angeliki; Parfenov, Michael; Gulley, Margaret; Piazuelo, M. Blanca; Schneider, Barbara G.; Kim, Jihun; Boussioutas, Alex; Sheth, Margi; Demchok, John A.; Rabkin, Charles S.; Willis, Joseph E.; Ng, Sam; Garman, Katherine; Beer, David G.; Pennathur, Arjun; Raphael, Benjamin J.; Wu, Hsin-Ta; Odze, Robert; Kim, Hark K.; Bowen, Jay; Leraas, Kristen M.; Lichtenberg, Tara M.; Weaver, Stephanie; McLellan, Michael; Wiznerowicz, Maciej; Sakai, Ryo; Getz, Gad; Sougnez, Carrie; Lawrence, Michael S.; Cibulskis, Kristian; Lichtenstein, Lee; Fisher, Sheila; Gabriel, Stacey B.; Lander, Eric S.; Ding, Li; Niu, Beifang; Ally, Adrian; Balasundaram, Miruna; Birol, Inanc; Bowlby, Reanne; Brooks, Denise; Butterfield, Yaron S. N.; Carlsen, Rebecca; Chu, Andy; Chu, Justin; Chuah, Eric; Chun, Hye-Jung E.; Clarke, Amanda; Dhalla, Noreen; Guin, Ranabir; Holt, Robert A.; Jones, Steven J.M.; Kasaian, Katayoon; Lee, Darlene; Li, Haiyan A.; Lim, Emilia; Ma, Yussanne; Marra, Marco A.; Mayo, Michael; Moore, Richard A.; Mungall, Andrew J.; Mungall, Karen L.; Nip, Ka Ming; Robertson, A. Gordon; Schein, Jacqueline E.; Sipahimalani, Payal; Tam, Angela; Thiessen, Nina; Beroukhim, Rameen; Carter, Scott L.; Cherniack, Andrew D.; Cho, Juok; Cibulskis, Kristian; DiCara, Daniel; Frazer, Scott; Fisher, Sheila; Gabriel, Stacey B.; Gehlenborg, Nils; Heiman, David I.; Jung, Joonil; Kim, Jaegil; Lander, Eric S.; Lawrence, Michael S.; Lichtenstein, Lee; Lin, Pei; Meyerson, Matthew; Ojesina, Akinyemi I.; Pedamallu, Chandra Sekhar; Saksena, Gordon; Schumacher, Steven E.; Sougnez, Carrie; Stojanov, Petar; Tabak, Barbara; Taylor-Weiner, Amaro; Voet, Doug; Rosenberg, Mara; Zack, Travis I.; Zhang, Hailei; Zou, Lihua; Protopopov, Alexei; Santoso, Netty; Parfenov, Michael; Lee, Semin; Zhang, Jianhua; Mahadeshwar, Harshad S.; Tang, Jiabin; Ren, Xiaojia; Seth, Sahil; Yang, Lixing; Xu, Andrew W.; Song, Xingzhi; Pantazi, Angeliki; Xi, Ruibin; Bristow, Christopher A.; Hadjipanayis, Angela; Seidman, Jonathan; Chin, Lynda; Park, Peter J.; Kucherlapati, Raju; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Kim, Sang-Bae; Lee, Ju-Seog; Lu, Yiling; Mills, Gordon; Laird, Peter W.; Hinoue, Toshinori; Weisenberger, Daniel J.; Bootwalla, Moiz S.; Lai, Phillip H.; Shen, Hui; Triche, Timothy; Van Den Berg, David J.; Baylin, Stephen B.; Herman, James G.; Getz, Gad; Chin, Lynda; Liu, Yingchun; Murray, Bradley A.; Noble, Michael S.; Askoy, B. Arman; Ciriello, Giovanni; Dresdner, Gideon; Gao, Jianjiong; Gross, Benjamin; Jacobsen, Anders; Lee, William; Ramirez, Ricardo; Sander, Chris; Schultz, Nikolaus; Senbabaoglu, Yasin; Sinha, Rileen; Sumer, S. Onur; Sun, Yichao; Weinhold, Nils; Thorsson, Vésteinn; Bernard, Brady; Iype, Lisa; Kramer, Roger W.; Kreisberg, Richard; Miller, Michael; Reynolds, Sheila M.; Rovira, Hector; Tasman, Natalie; Shmulevich, Ilya; Ng, Santa Cruz Sam; Haussler, David; Stuart, Josh M.; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Verhaak, Roeland G.W.; Mills, Gordon B.; Leiserson, Mark D. M.; Raphael, Benjamin J.; Wu, Hsin-Ta; Taylor, Barry S.; Black, Aaron D.; Bowen, Jay; Carney, Julie Ann; Gastier-Foster, Julie M.; Helsel, Carmen; Leraas, Kristen M.; Lichtenberg, Tara M.; McAllister, Cynthia; Ramirez, Nilsa C.; Tabler, Teresa R.; Wise, Lisa; Zmuda, Erik; Penny, Robert; Crain, Daniel; Gardner, Johanna; Lau, Kevin; Curely, Erin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Shelton, Troy; Shelton, Candace; Sherman, Mark; Benz, Christopher; Lee, Jae-Hyuk; Fedosenko, Konstantin; Manikhas, Georgy; Potapova, Olga; Voronina, Olga; Belyaev, Smitry; Dolzhansky, Oleg; Rathmell, W. Kimryn; Brzezinski, Jakub; Ibbs, Matthew; Korski, Konstanty; Kycler, Witold; ?aŸniak, Radoslaw; Leporowska, Ewa; Mackiewicz, Andrzej; Murawa, Dawid; Murawa, Pawel; Spycha?a, Arkadiusz; Suchorska, Wiktoria M.; Tatka, Honorata; Teresiak, Marek; Wiznerowicz, Maciej; Abdel-Misih, Raafat; Bennett, Joseph; Brown, Jennifer; Iacocca, Mary; Rabeno, Brenda; Kwon, Sun-Young

2014-01-01

413

Comprehensive molecular characterization of gastric adenocarcinoma.  

PubMed

Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein-Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also known as PD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies. PMID:25079317

2014-09-11

414

Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus  

PubMed Central

AIM: To investigate the lifetime risk of development of esophageal adenocarcinoma and/or high-grade dysplasia in patients diagnosed with Barrett’s esophagus. METHODS: Data were extracted from the United Kingdom National Barrett’s Oesophagus Registry on date of diagnosis, patient age and gender of 7877 patients from who had been registered from 35 United Kingdom centers. Life expectancy was evaluated from United Kingdom National Statistics data based upon gender and age at year at diagnosis. These data were then used with published estimates of annual adenocarcinoma and high-grade dysplasia incidences from meta-analyses and large population-based studies to estimate overall lifetime risk of development of these study endpoints. RESULTS: The mean age at diagnosis of Barrett’s esophagus was 61.6 years in males and 67.3 years in females. The mean life expectancy at diagnosis was 23.1 years in males, 20.7 years in females and 22.2 years overall. Using data from published meta-analyses, the lifetime risk of development of adenocarcinoma was between 1 in 8 and 1 in 14 and the lifetime risk of high-grade dysplasia or adenocarcinoma was 1 in 5 to 1 in 6. Using data from 3 large recent population-based cohort studies the lifetime risk of adenocarcinoma was between 1 in 10 and 1 in 37 and of the combined end-point of high-grade dysplasia and adenocarcinoma was between 1 in 8 and 1 in 20. Age at Barrett’s esophagus diagnosis is reducing and life expectancy is increasing, which will partially counter-balance lower annual cancer incidence. CONCLUSION: There is a significant lifetime risk of development of high-grade dysplasia and adenocarcinoma in Barrett’s esophagus. PMID:25071359

Gatenby, Piers; Caygill, Christine; Wall, Christine; Bhatacharjee, Santanu; Ramus, James; Watson, Anthony; Winslet, Marc

2014-01-01

415

Should the grading of colorectal adenocarcinoma include microsatellite instability status?  

PubMed

Adenocarcinomas of the colon and rectum are graded using a 2-tiered system into histologic low-grade and high-grade tumors based on the proportion of gland formation. The current grading system does not apply to subtypes of carcinomas associated with a high frequency of microsatellite instability (MSI), such as mucinous and medullary carcinomas. We investigated the combined effect of histologic grade and MSI status on survival for 738 patients with colorectal carcinoma (48% female; mean age at diagnosis 68.2 years). The proportion of high-grade adenocarcinoma was 18%. MSI was observed in 59 adenocarcinomas (9%), with higher frequency in high-grade tumors compared with low-grade tumors (20% versus 6%; P < .001). Using Cox regression models, adjusting for sex and age at diagnosis and stratifying by the American Joint Committee on Cancer stage, microsatellite stable (MSS) high-grade tumors were associated with increased hazard of all-cause and colorectal cancer-specific mortality: hazard ratio 2.09 (95% confidence interval [CI], 1.58-2.77) and 2.54 (95% CI, 1.86-3.47), respectively, both P < .001. A new grading system separating adenocarcinoma into low grade (all histologic low grade and MSI high grade) and high grade (MSS histologic high grade) gave a lower Akaike information criterion value when compared with the current grading system and thus represented a better model fit to stratify patients according to survival. We found that patients with a high-grade adenocarcinoma had significantly shorter survival than patients with low-grade adenocarcinoma only if the tumor was MSS, suggesting that the grading of colorectal adenocarcinoma with high-grade histologic features should be made according to the MSI status of the tumor. PMID:25149551

Rosty, Christophe; Williamson, Elizabeth J; Clendenning, Mark; Walters, Rhiannon J; Win, Aung K; Jenkins, Mark A; Hopper, John L; Winship, Ingrid M; Southey, Melissa C; Giles, Graham G; English, Dallas R; Buchanan, Daniel D

2014-10-01

416

Multigene deletions in lung adenocarcinomas from irradiated and control mice  

SciTech Connect

K-ras codon 12 point mutations mRb and p53 gene deletions were examined in tissues from 120 normal lungs and lung adenocarcinomas that were Formalin-treated and paraffin-embedded 25 years ago. The results showed that 12 of 60 (20%) lung adenocarcinomas had mRb deletions. All lung adenocarcinomas that were initially found bearing deleted mRb had p53 deletions (15 of 15; 100%). A significantly higher mutation frequency for K-ras codon 12 point mutations was also found in the lung adenocarcinomas from mice exposed to 24 once-weekly neutron irradiation (10 of 10; 100%) compared with those exposed to 24 or 60 once-weekly {gamma}-ray doses (5 of 10; 50%). The data suggested that p53 and K-ras gene alterations were two contributory factors responsible for the increased incidence of lung adenocarcinoma in B6CF{sub 1} male mice exposed to protracted neutron radiation.

Zhang, Y.; Woloschak, G.E. [Argonne National Lab., IL (United States). Center for Mechanistic Biology and Biotechnology

1996-06-01

417

Meningeal Carcinomatosis: A Metastasis from Gastroesophageal Junction Adenocarcinoma  

PubMed Central

Gastroesophageal adenocarcinoma is a malignant type of cancer, which can metastasize to multiple organs. However, there have not been many case reports in the literature pertaining the relationship of gastroesophageal adenocarcinoma and carcinomatous meningitis. In this case, a 65-year-old African American male with a history of dysphagia was initially diagnosed with adenocarcinoma at gastroesophageal junction. The patient was treated with both chemotherapy and radiation, but chemotherapy was interrupted due to significant weight loss, anemia, and sudden onset of change in mental status. Patient was admitted to our facility for further evaluation of his neurological symptoms. The patient became more confused and delirious during hospital stay, and symptoms could not be explained by radiological studies and laboratory values. Therefore, a lumbar puncture was done to search for infectious and neoplastic causes that were not shown up on Computed Tomography scan (CT) and Magnetic Resonance Imaging scan (MRI) of the brain. The cerebrospinal fluid (CSF) cytology showed metastatic poorly differentiated adenocarcinoma. The patient's prognosis was poor because there is no specific treatment recommendation for primary gastroesophageal cancer at this stage. The patient passed away 4 weeks later under hospice care. The goal of our case report is to raise awareness of the rare metastatic possibility in advanced stage of gastroesophageal adenocarcinoma. In doing so, physicians can help educate and prepare family for unfavorable outcomes. PMID:2445