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1

Spermatic cord metastasis as early manifestation of small bowel adenocarcinoma  

PubMed Central

Malignant tumors of the spermatic cord are rare. There are a few case reports on spermatic cord metastasis from colonic, gastric, pancreas, and prostatic cancer. Here, we report a 36-year-old man with brucellosis presenting with spermatic cord metastasis as early manifestation of small bowel adenocarcinoma. PMID:23662014

Valizadeh, Nasim; Oskuie, Ali Eishi; Tehranchi, Ali

2013-01-01

2

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

3

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

PubMed Central

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 is surgical resection. No standard treatment protocol has been defined for unresectable or metastatic disease. Here, we report a case of a 56-year-old woman who presented with unexplained iron deficiency anemia. Extensive initial studies with serial CT scans of the abdomen, esophagogastroduodenoscopy, small bowel capsule endoscopy and colonoscopy were noncontributory. She was later found to have a metastatic small bowel adenocarcinoma and treated with palliative chemotherapy. She achieved a modest response to the treatment. Interestingly, in our case, the sole presentation was unexplained iron deficiency anemia. Physician's awareness regarding the possibility of small bowel cancer especially in the setting of iron deficiency and its workup has been emphasized. This enhances the chance of early detection and hence better survival. PMID:22087098

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

2011-01-01

4

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

Microsoft Academic Search

OBJECTIVESBecause 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.METHODSA European multicentre case-control study was conducted in 1995–7, inclusive. Incident cases aged 35–69 years with SBA (n=168) were recruited

Linda Kaerlev; Peter Stubbe Teglbjaerg; Svend Sabroe; Henrik A Kolstad; Wolfgang Ahrens; Mikael Eriksson; Agustin Llopis González; Pascal Guénel; Lennart Hardell; Guy Launoy; Enzo Merler; Franco Merletti; María M Morales Suárez-Varela; Andreas Stang

2000-01-01

5

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

6

COX2, Inflammatory Secreted PLA2, and Cytoplasmic PLA2 Protein Expression in Small Bowel Adenocarcinomas Compared with Colorectal Adenocarcinomas  

Microsoft Academic Search

Cyclooxygenase-2 (COX-2), human synovial inflammatory secreted phospholipase A2 (sPLA2) and cytoplasmic phospholipase A2 (cPLA2) are involved in eicosanoid production and also seem to participate in colorectal tumorigenesis. As there are no data regarding these enzymes in human small bowel tumors, we wanted to determine whether they were involved in human small bowel tumorigenesis, and whether their expression was different in

Dominique Wendum; Magali Svrcek; Valérie Rigau; Pierre-Yves Boëlle; Nicole Sebbagh; Rolland Parc; Joëlle Masliah; Germain Trugnan; Jean-François Fléjou

2003-01-01

7

Small bowel radiology  

SciTech Connect

This book deals mainly with technique, experiences and results of the biphasic small bowel enema (enteroclysis) with barium and methyl cellulose. The method allows the evaluation of both morphology and function of the small bowel. The introduction describes the examination technique, basic patterns, interpretation and indications, while the atlas shows a broad spectrum of small bowel diseases (Crohn's disease, other inflammatory diseases, tumors, motility disorders, obstructions and malformations). The possibilities of small bowel radiology are demonstrated with reference to clinical findings and differential diagnoses.

Antes, G.; Eggemann, F.

1987-01-01

8

Small Bowel Transplant  

PubMed Central

EXECUTIVE SUMMARY Objective The Medical Advisory Secretariat undertook a review of the evidence on the effectiveness and cost-effectiveness of small bowel transplant in the treatment of intestinal failure. Small Bowel Transplantation Intestinal failure is the loss of absorptive capacity of the small intestine that results in an inability to meet the nutrient and fluid requirements of the body via the enteral route. Patients with intestinal failure usually receive nutrients intravenously, a procedure known as parenteral nutrition. However, long-term parenteral nutrition is associated with complications including liver failure and loss of venous access due to recurrent infections. Small bowel transplant is the transplantation of a cadaveric intestinal allograft for the purpose of restoring intestinal function in patients with irreversible intestinal failure. The transplant may involve the small intestine alone (isolated small bowel ISB), the small intestine and the liver (SB-L) when there is irreversible liver failure, or multiple organs including the small bowel (multivisceral MV or cluster). Although living related donor transplant is being investigated at a limited number of centres, cadaveric donors have been used in most small bowel transplants. The actual transplant procedure takes approximately 12-18 hours. After intestinal transplant, the patient is generally placed on prophylactic antibiotic medication and immunosuppressive regimen that, in the majority of cases, would include tacrolimus, corticosteroids and an induction agent. Close monitoring for infection and rejection are essential for early treatment. Medical Advisory Secretariat Review The Medical Advisory Secretariat undertook a review of 35 reports from 9 case series and 1 international registry. Sample size of the individual studies ranged from 9 to 155. As of May 2001, 651 patients had received small bowel transplant procedures worldwide. According to information from the Canadian Organ Replacement Register, a total of 27 small bowel transplants were performed in Canada from 1988 to 2002. Patient Outcomes The experience in small bowel transplant is still limited. International data showed that during the last decade, patient survival and graft survival rates from SBT have improved, mainly because of improved immunosuppression therapy and earlier detection and treatment of infection and rejection. The Intestinal Transplant Registry reported 1-year actuarial patient survival rates of 69% for isolated small bowel transplant, 66% for small bowel-liver transplant, and 63% for multivisceral transplant, and a graft survival rate of 55% for ISB and 63% for SB-L and MV. The range of 1-year patient survival rates reported ranged from 33%-87%. Reported 1-year graft survival rates ranged from 46-71%. Regression analysis performed by the International Transplant Registry in 1997 indicated that centres that have performed at least 10 small bowel transplants had better patient and graft survival rates than centres that performed less than 10 transplants. However, analysis of the data up to May 2001 suggests that the critical mass of 10 transplants no longer holds true for transplants after 1995, and that good results can be achieved at any multiorgan transplant program with moderate patient volumes. The largest Centre reported an overall 1-year patient and graft survival rate of 72% and 64% respectively, and 5-year patient and graft survival of 48% and 40% respectively. The overall 1-year patient survival rate reported for Ontario pediatric small bowel transplants was 61% with the highest survival rate of 83% for ISB. The majority (70% or higher) of surviving small bowel transplant recipients was able to wean from parenteral nutrition and meet all caloric needs enterally. Some may need enteral or parenteral supplementation during periods of illness. Growth and weight gain in children after ISB were reported by two studies while two other studies reported a decrease in growth velocity with no catch-up growth. The quality of life after SBT was reported to be comparable t

2003-01-01

9

Pediatric small bowel transplantation.  

PubMed

The multivisceral liver-intestine-pancreas-stomach allograft was first described by Starzl nearly 50 years ago. Since then, over 1000 children have received small bowel transplantation (SBTx), alone or with the liver and other organs, for refractory short gut syndrome (SGS) because of a variety of congenital conditions. In 2001, SBTx was approved as definitive therapy for SGS by Medicare. Currently, 1- and 5-year graft survival routinely exceeds 90% and 80%, respectively. The expected outcomes also include freedom from parenteral nutrition, normalization of growth parameters, and quality of life. However, recurrent rejection, complications of high-dose immunosuppression, or chronic rejection, which is more likely to occur after SBTx without a liver graft, account for differences between early and late survival. Future efforts aimed at overcoming such challenges include preventing SBTx through early referral to comprehensive SGS management programs and understanding why the liver protects the small bowel allograft from rejection. Finally, inflammatory mechanisms, which predispose the highly immunogenic small bowel allograft to a protracted risk of resistant rejection must be elucidated, in order to ensure durable success. PMID:20123276

Nayyar, Navdeep; Mazariegos, George; Ranganathan, Sarangarajan; Soltys, Kyle; Bond, Geoffrey; Jaffe, Ronald; Sun, Qing; Nucci, Anita; Kosmach, Beverly; Squires, Robert; Abu-Elmagd, Kareem; Sindhi, Rakesh

2010-02-01

10

Clinical applications of small bowel capsule endoscopy  

PubMed Central

Video capsule endoscopy has revolutionized our ability to visualize the entire small bowel mucosa. This modality is established as a valuable tool for the diagnosis of obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, and other conditions involving the small bowel mucosa. This review includes an overview of the current and potential future clinical applications of small bowel video endoscopy. PMID:23983481

Kopylov, Uri; Seidman, Ernest G

2013-01-01

11

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

12

Biomechanics of small bowel motility.  

PubMed

A biomechanical model and results of numerical simulation of the propagation of electromechanical waves of deformation along the small bowel are presented. The organ is modelled as a soft orthotropic cylindrical biological shell reinforced by orthogonally interwoven smooth muscle elements, embedded in a connective tissue network. The dynamic reaction starts as a response to the propagation of a depolarization wave along the smooth muscle layers. The muscle layers contract independently but in a coordinated way with the generation of active forces. The mechanical properties of the wall are assumed to be nonlinear. Deformations of the bioshell are finite. The governing system of equations is obtained and solved numerically. The finite-difference method of the second order accuracy over the time and space variables was used. The dynamics of strain distribution in the biological shell and shape changes are analysed. PMID:7952679

Miftakhov, R N; Wingate, D L

1994-09-01

13

Perforation from endoscopic small bowel biopsy.  

PubMed Central

Two patients, having undergone an apparently straightforward endoscopy with small bowel biopsy, developed a perforation. One, who proved to have normal small bowel mucosa, needed laparotomy and suturing of the duodenal perforation. The other, who had coeliac disease, settled with conservative management. PMID:8432444

Scott, B; Holmes, G

1993-01-01

14

Perforated Small Bowel Diverticulitis After Gastric Bypass  

PubMed Central

We report a rare case of complicated jejunal diverticulitis in a patient with previous bariatric surgery. Small bowel diverticulosis is generally considered an inoffensive disease. In this report we describe a case of small bowel perforation in an obese subject who had undergone laparoscopic Roux-en-Y gastric bypass. PMID:24680159

Pavel, Mihai; Lacy, Antonio

2014-01-01

15

X-ray-induced thinning of 3 He mixture films  

E-print Network

X-ray-induced thinning of 3 He and 3 HeÃ?4 He mixture films Konstantin Penanen,* Masafumi Fukuto, Massachusetts 02138 Received 22 February 2000 Films of isotopic mixtures of helium have been studied using x in the thickness of 4 He films above the superfluid transition as well as films of pure 3 He and 3 He/4 He mixtures

Fukuto, Masafumi

16

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; Kopacova, Marcela

2013-01-01

17

A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease  

Microsoft Academic Search

Background & Aims: This study was undertaken to prospectively compare the clinical outcomes of small bowel radiographs with the wireless capsule endoscopy. Methods: Twenty-two patients were selected consecutively because of suspected small bowel disease. Two patients were excluded owing to ileal stenosis. Thus, the results of barium follow-through and the Given M2A wireless video capsule (Given Imaging Ltd., Yoqneam, Israel)

Guido Costamagna; Saumil K. Shah; Maria Elena Riccioni; Francesca Foschia; Massimiliano Mutignani; Vincenzo Perri; Amorino Vecchioli; Maria Gabriella Brizi; Aurelio Picciocchi; Pasquale Marano

2002-01-01

18

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

19

Absorptive capacity of the transplanted small bowel.  

PubMed Central

Small bowel transplantation (SBT) has been carried out in man in several cases without success, because immunologic problems were unsolved. In experimental SBT a 'two step' model was developed, which enables long term observation of immunologic phenomena. In this model the graft is in a heterotopic position to the recipient's own small bowel. After 35 days the recipient's own bowel is removed and replaced by the graft, now in orthotopic position and again in contact with luminal chymus. To investigate functional and morphological changes, which result from the procedure, the resorption of glucose and water was measured in syngeneic transplanted rats by an in vivo recirculation system and the mucosa was evaluated three dimensionally. The graft mucosa showed a significant reduction in villus height, crypt length and villus surface and a corresponding decrease in glucose and water absorption during heterotopic position. If the graft came into the orthotopic position, the mucosa did regenerate which was expressed by the significant longer crypts of the graft compared with those of the controls, although the graft's villus height and surface are still smaller. Glucose and water absorption increased and were higher in orthotopic transplanted animals, when absorption was expressed per unit intestinal length. The results indicate that in the 'two step' model of SBT the absorption of water and glucose is influenced to such an extent, that recovery is possible after three weeks, thus enabling orthotopic SBT. This almost complete recovery of the mucosa is further evidence of the regeneratory capacity of the small bowel, which enables clinical small bowel transplantation. PMID:3500897

Schroeder, P; Deltz, E; Seifert, J; Sandforth, F; Thiede, A

1987-01-01

20

Determining small bowel integrity following drug treatment  

PubMed Central

Intestinal integrity is maintained by a delicate balance between mucosal defence and luminal aggressors that cause damage if exposed to the mucosa. The intestinal barrier function appears to be the gatekeeper for controlling this balance. It is becoming increasingly clear that if the intestinal barrier is disrupted the consequences are low grade intestinal inflammation which carry with it the risk of significant blood and protein loss both of which may cause clinical management problems. We review the strength and weaknesses of methods for assessing small bowel function that are useful for assessing drug-induced intestinal toxicity. There are a number of imaging methods for assessing intestinal integrity but these do not provide functional information. Intestinal permeability measurements have been optimized for specificity and there are now ways of measuring intestinal permeability regionally, but marker analyses continue to be cumbersome. Recent developments of faecal inflammatory markers make it a matter of routine to assess this in any routine chemical pathology laboratory. Bleeding, protein loss and other complications of inflammation can also be measured with good specificity, but again the methods are cumbersome. Using a combination of functional and imaging techniques it is now possible to characterize and define with precision, the small bowel side-effects of drugs, the best example being the small bowel side-effects of nonsteroidal anti-inflammatory drugs (NSAIDs). PMID:12919176

Smale, Simon; Bjarnason, Ingvar

2003-01-01

21

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

22

X-ray-induced changes in growth of Mozambique tilapia  

SciTech Connect

Early fry (30 d postfertilization) and 7-8-week-old Mozambique tilapias (Tilapia mossambica) were exposed to X rays in dosages of 50, 100, 200, 300, 400 or 500 roentgens and reared in outdoor culture tanks between May 1981 and October 1988. Fish of either sex that were irradiated as fry grew faster than controls at all test X-ray doses. Among fish irradiated at 7-8 weeks, males grew significantly faster, but females grew significantly slower, than controls at all test doses. X-ray-induced changes in growth were dose-dependent: growth rates of fry (both sexes) and of juvenile males rose relative to those of controls with increased radiation dose. The growth increase per unit of radiation dose was higher for fry than for older juveniles. The length-weight regression was steeper for irradiated males than for controls. The average weights of F{sub 1} offspring of irradiated fish were greatly reduced as compared with controls, which suggests the transfer of the detrimental effects of X rays from irradiated parents to their offspring. 39 refs., 3 figs., 3 tabs.

Jana, B.B. [Univ. of Kalyani, West Bengal (India)] [Univ. of Kalyani, West Bengal (India); Basu, M. [Univ. of Maiduguri (Nigeria)] [Univ. of Maiduguri (Nigeria)

1995-01-01

23

Current Advance in Small Bowel Tumors  

PubMed Central

Small intestinal tumors are difficult challenge to gastroenterologists. The difficulty in making a diagnosis of small intestinal tumor lies in the relative inaccessibility and absence of typical presentation. New endoscopic and radiologic technologies provide clear and fine anatomical visualization of the small bowel and are approved to improve the diagnostic sensitivity and accuracy. Patients at risk of small intestinal tumors might gain a benefit from proper surveillance with this new technology. Minimally invasive therapy is now available with advance of balloon assisted enteroscopy. This review describes the general aspect of the small intestinal tumors, focusing on the new modalities for diagnosis. PMID:22741107

Cheung, Dae Young

2011-01-01

24

Double-balloon enteroscopy in small bowel tumors: A Chinese single-center study  

PubMed Central

AIM: To analyze the clinical characteristics of small bowel tumors detected by double-balloon enteroscopy (DBE) and to evaluate the diagnostic value of DBE in tumors. METHODS: Four hundred and forty consecutive DBE examinations were performed in 400 patients (250 males and 150 females, mean age 46.9 ± 16.3 years, range 14-86 years) between January 2007 and April 2012. Of these, 252 patients underwent the antegrade approach, and 188 patients underwent the retrograde approach. All the patients enrolled in our study were suspected of having small bowel diseases with a negative etiological diagnosis following other routine examinations, such as upper and lower gastrointestinal endoscopy and radiography tests. Data on tumors, such as clinical information, endoscopic findings and operation results, were retrospectively collected. RESULTS: Small bowel tumors were diagnosed in 78 patients, of whom 67 were diagnosed using DBE, resulting in a diagnostic yield of 16.8% (67/400); the other 11 patients had negative DBE findings and were diagnosed through surgery or capsule endoscopy. Adenocarcinoma (29.5%, 23/78), gastrointestinal stromal tumor (24.4%, 19/78) and lymphoma (15.4%, 12/78) were the most common tumors. Among the 78 tumors, 60.3% (47/78) were located in the jejunum, and the overall number of malignant tumors was 74.4% (58/78). DBE examinations were frequently performed in patients with obscure gastrointestinal bleeding (47.4%) and abdominal pain (24.4%). The positive detection rate for DBE in the 78 patients with small bowel tumors was 85.9% (67/78), which was higher than that of a computed tomography scan (72.9%, 51/70). Based on the operation results, the accuracy rates of DBE for locating small bowel neoplasms, such as adenocarcinoma, gastrointestinal stromal tumor and lymphoma, were 94.4%, 100% and 100%, respectively. The positive biopsy rates for adenocarcinoma and lymphoma were 71.4% and 60%, respectively. CONCLUSION: DBE is a useful diagnostic tool with high clinical practice value and should be considered the gold standard for the investigation of small bowel tumors. PMID:23801870

Chen, Wen-Guo; Shan, Guo-Dong; Zhang, Hong; Li, Lin; Yue, Min; Xiang, Zun; Cheng, Ying; Wu, Chen-Jiao; Fang, Ying; Chen, Li-Hua

2013-01-01

25

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

26

[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

27

Advances in radiologic evaluation of small bowel diseases.  

PubMed

There are various methods that could be used for small bowel imaging. Although conventional enteroclysis has a high sensitivity in the diagnosis of most of the small bowel diseases, it cannot provide any direct information about the mural-extramural diseases and the other abdominal structures. Besides, enteroclysis-based techniques have risk of additional radiation exposure, and they are poorly tolerated because placement of nasojejunal tube is required. New enterographic methods have been developed, and the number of enterographic techniques increased significantly in the recent years to overcome those limitations. The other modalities including ultrasound, small bowel follow-through, or capsule-endoscopy are often used as complementary methods in evaluation of the small bowel diseases. In this review, technique and clinic details, advantages, and disadvantages of the radiologic techniques that are used in the diagnosis of small bowel diseases, and the imaging findings of common pathologic conditions were discussed in the light of current literature. PMID:24270107

Algin, Oktay; Evrimler, Sehnaz; Arslan, Halil

2013-01-01

28

Perforation of the mesenteric small bowel: etiologies and CT findings.  

PubMed

The purpose of this article is to illustrate and discuss the various etiologies of perforation of the mesenteric small bowel and associated findings on abdominal CT. Perforation of the mesenteric small bowel is an uncommon cause of an acute abdomen and can be due to various etiologies. In underdeveloped countries, infection is probably the most common cause, while in industrialized nations, perforation may be due to Crohn disease, diverticulitis, foreign body, trauma, tumor, mechanical obstruction, primary ischemic event, or iatrogenic causes. CT is usually the initial imaging examination in patients with an acute abdomen and is sensitive in diagnosing small bowel perforation. CT findings in the setting of small bowel perforation are often subtle, but when present, may help the radiologist determine a specific cause of perforation. The aims of this pictorial essay are to review the various causes of mesenteric small bowel perforation and to discuss and illustrate the CT findings that can help arrive at the diagnosis. PMID:23212537

Hines, John; Rosenblat, Juliana; Duncan, Dameon R; Friedman, Barak; Katz, Douglas S

2013-04-01

29

Small bowel feces sign in association with occlusive mesenteric ischemia  

PubMed Central

Small bowel feces sign (SBFS) is a computed tomography (CT) finding that appears as fecal like material in dilated small bowel loops. This sign is usually seen in association with gradually progressive small bowel obstruction. We present a case of occlusive mesenteric ischemia in which the SBFS appeared on CT scan early on in the course of the disease. We put forward a suggested alternative mechanism to the appearance of this sign in association with mesenteric ischemia. The SBFS might have the potential to serve as an early sign of mesenteric ischemia on CT scan.

Bismar, Hayan A; Hamid, Abdullgabbar M

2014-01-01

30

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

31

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

32

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

33

A rare cause of small bowel obstruction: Abdominal cocoon  

PubMed Central

INTRODUCTION The clinical manifestations of abdominal ‘cocoon’ are non-specific and hence its diagnosis is rarely made preoperatively and the management is often delayed. Surgery remains the main stay of treatment with satisfactory outcome and comprises excision of the fibrous membrane, meticulous adhesionolysis and release of the entrapped small bowel. PRESENTATION OF CASE A 45-year-old male patient presented with 6-month history of progressive subacute small bowel obstruction. After initial radiological investigations, he underwent diagnostic laparoscopy and was misdiagnosed as abdominal tuberculosis. He was started on anti-tuberculous therapy, but exploratory laparotomy was carried out after failure to respond to anti-tuberculous therapy. At laparotomy, the abdominal ‘cocoon’ which was encapsulating the entire small bowel was excised, and the adhesions were carefully lysed. The patient remained well and without recurrence at 1-year follow-up. DISCUSSION Abdominal ‘cocoon’ is a rare cause of subacute, acute and chronic small bowel obstruction. Its diagnosis is rarely made preoperatively. CONCLUSION Abdominal ‘cocoon’ should be thought of as a rare cause of small bowel obstruction. It may be mistaken with abdominal tuberculosis. Surgery remains the mainstay of curative treatment. PMID:22522743

Meshikhes, Abdul-Wahed; Bojal, Shoukat

2012-01-01

34

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; Huser, Norbert; Gertler, Ralf; Schmid, Roland M.; von Delius, Stefan

2014-01-01

35

REVIEW: Small Bowel Review: Diseases of the Small Intestine  

Microsoft Academic Search

In the past year there have been many advances in the area of small bowel physiology and pathology and therapy. In preparation for this review, over 1500 papers were assessed. The focus is on presenting clinically useful information for the practicing gastroenterologist. Selected important clinical learning points include the following: (1) glutamine may restore the AIDs-associated increased intestinal permeability to

A. B. R. Thomson; M. Keelan; A. Thiesen; M. T. Clandinin; M. Ropeleski; G. E. Wild

2001-01-01

36

Fading behavior of X-ray induced color centers in soda-lime silicate glass  

Microsoft Academic Search

The X-ray induced color centers in soda-lime silicate glass were unstable at room temperature. There was a rapid fading at short-term stage and a slow fading at long-term stage. In the short-term stage, both first-order and second-order fading kinetics played roles in the fading process, while only the first-order fading controlled the long-term stage fading.

Jiawei Sheng; Kohei Kadono; Tetsuo Yazawa

2002-01-01

37

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

38

Small bowel anisakiosis: A report of two cases  

PubMed Central

Small bowel stenosis is a serious complication of intestinal anisakiosis. The aim of this report is to investigate whether severe stenosis of the small intestine can be conservatively managed. We treated two patients with severe stenosis of the small intestine caused by anisakiosis. Surgical intervention was eventually performed on the 23rd and 35th in the hospital, respectively. Histopathological examination of the resected specimens revealed that the intestinal wall had been completely damaged by the inflammatory reaction of anisakiosis, and that the damage was irreversible, thereby suggesting that laparotomy is needed in cases of severe small bowel stenosis caused by intestinal anisakiosis, even if a long period of conservative treatment for the intestinal anisakiosis allowed the patient to pass successfully through the acute phase. PMID:16810773

Matsuo, Shigetoshi; Azuma, Takashi; Susumu, Seiya; Yamaguchi, Satoshi; Obata, Shirou; Hayashi, Tomayoshi

2006-01-01

39

Small bowel obstruction caused by sigmoid mesocolic hernia  

PubMed Central

Internal hernia is an unusual cause of small bowel obstruction and classified several types according to locations. Sigmoid mesocolic hernia is an uncommon condition and among others intramesosigmoid hernia was rarely reported in the literature. We report the case of a 49-year-old female with a rare type of congenital internal hernia, through the mesosigmoid, causing small bowel obstruction. She suffered from obstructive symptoms but with no previous history of laparotomy. The diagnosis of internal hernia was suggested by computed tomography, but the type of internal hernia was confirmed by laparoscopic exploration. She underwent laparoscopic detachment of peritoneal attachment comprising hernia sac without defect repair. The postoperative course was uneventful and the patient is free from symptoms and recurrence. This report presents a case of intrasigmoid hernia managed successfully by the laparoscopic approach and shows another surgical technique according to hernia types. PMID:24876507

Yang, Chunseok; Kim, Daedong

2014-01-01

40

Sonographic diagnosis of ascariasis causing small bowel obstruction.  

PubMed

Acute right lower quadrant pain is a common, but nonspecific presenting symptom of a wide variety of diseases in children. Sonography (US) can play a significant role in the accurate and early diagnosis of right lower quadrant pain. In this article, we report a case of small bowel obstruction due to intestinal ascariasis diagnosed at bedside US and confirmed by MRI and describe a new US sign of intestinal ascariasis. PMID:24132881

Aydin, Ramazan; Bekci, Tumay; Bilgici, Meltem Ceyhan; Polat, Ahmet Veysel

2014-05-01

41

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

42

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

43

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

44

Uncommon Metastasis of Laryngeal Cancer to Small Bowel Causing Intestinal Obstruction Treated by Laparoscopic Approach  

PubMed Central

Metastatic laryngeal cancer to the small bowel is extremely rare. Management of small bowel obstruction used to constitute a relative contraindication for the use of laparoscopic modality. We are reporting a case of an elderly man known to have laryngeal cancer who presented with small bowel obstruction due to metastatic deposit to the small bowel. The condition was successfully treated by laparoscopic assisted approach. A review of the natural history of advanced laryngeal cancer, common and uncommon sites of metastasis, and the rare presentation as small bowel obstruction is illustrated in this review. PMID:25254135

Al Nuaimi, Lateefa; El Salhat, Haytham; Sharma, Vasudev; Nowrasteh, Ghodratollah; Al Rawi, Sadir J.

2014-01-01

45

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

46

The Contribution of the Video Capsule Endoscopy in Establishing the Indication of Surgical Treatment in the Tumoral Pathology of the Small Bowel  

PubMed Central

Background and aims: Capsule endoscopy (CE) represents a novel method which allows safe, non-invasive and rapid exploration of the small bowel. Our aim was to determine the feasibility CE has in assessing tumoral pathology of the small bowel and aiding surgical teams in determining appropriate treatment. Material and Method Our study was conducted on 11 patients who presented tumoral pathology of the small bowel, from a total of 50 patients investigated by VCE. Malignancy was determined on the surgical resection piece, by histological exam. Statistic analysis of the data was conducted using Fisher’s Exact Test. Results Tumoral pathology was represented by: 3 intestinal polyps, 2 benign stromal tumors, 2 malign stromal tumors, 2 adenocarcinomas, one neuroendocrine malign tumor and one duodenal papilla carcinoma. We followed the presence of malign tumors in regards to age. All malign tumors (n=6) were recorded in patients over 60 years old, while benign tumors were recorded in most cases (80%, n=4) in people under 60 years old. One case of benign tumor (intestinal polyp) was observed above 60 years old. Conclusion Capsule endoscopy represents a real help for the surgeon, as it allows identification of small bowel pathology, giving information regarding the approximate localization of lesions, their size and orienting on their nature. Tumoral pathology is encountered mainly with the old age population and can be presented under a multitude of forms. We believe that an efficient method for incipient detection and a protocol to establish malignity is necessary. PMID:24778844

Vere, C.C.; Streba, C.T.; Rogoveanu, I.; Georgescu, M.; Pirvu, D.; Iordache, Sevastita; Gheonea, D.I.; Saftoiu, A.; Ciurea, T.

2012-01-01

47

Laparoscopic management of acute small-bowel obstruction  

Microsoft Academic Search

Background: A retrospective review is given of the authors' experience with a consecutive series of acute small-bowel obstruction unresponsive\\u000a to medical management.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: There were 33 exploratory laparoscopies. The etiology was accurately diagnosed in 100% of the cases. Twenty-five (76%) were\\u000a secondary to postoperative adhesions, of which 18 (72%) were successfully treated by laparoscopic lysis of adhesions. Minilaparotomy\\u000a was needed

I. M. Ibrahim; F. Wolodiger; B. Sussman; M. Kahn; F. Silvestri; A. Sabar

1996-01-01

48

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

49

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

50

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

NASA Astrophysics Data System (ADS)

We have successfully loaded molecular fluorine into a diamond anvil cell at high pressure using the synchrotron x-ray induced decomposition of perfluorohexane (C6F14). "White" x-ray radiation from the Advanced Photon Source was used to initiate the chemical decomposition of C6F14, which resulted in the in situ production of F2 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; Sneed, Daniel; White, Melanie; Wang, Yonggang

2014-08-01

51

Measurement of equilibrium elemental vapor pressures using x-ray induced fluorescense.  

SciTech Connect

X-ray induced fluorescence is demonstrated as a novel and fast method for measuring vapor pressures at high temperatures and high pressures. As such, it is an excellent complement to the effusion method, which is limited to lower pressures. High-energy synchrotron radiation was used to measure the total densities of Dy in the equilibrium vapor over condensed DyI{sub 3} and Tm in the equilibrium vapor over condensed TmI{sub 3}. Corresponding vapor pressures were determined with measured vapor cell temperatures across a range of vapor pressures of nearly three orders of magnitude, from less than 10{sup 2} Pa to more than 10{sup 4} Pa. Individual data points were obtained in time periods ranging from 10 to 30 s each.

Curry, J. J; Henins, A.; Estupinan, E. G.; Lapatovich, W. P.; Shastri, S. D. (X-Ray Science Division); (NIST); (Osram Sylvania, Inc.)

2011-04-29

52

Spray and gaseous jet diagnostics using x-ray-induced fluorescence imaging and flash radiography  

NASA Astrophysics Data System (ADS)

The characterization of near nozzle dense sprays and axisymmetric gas jets using X-ray flash techniques is presented. Flash radiography and X-ray induced fluorescence imaging (X.I.F. imaging), using a flash X-ray developed at GREMI, offer two complementary diagnostics particularly efficient in high pressure conditions. In this work, a compact flash X-ray device is used to freeze fluid motions. Single shot radiographs of argon jets and water sprays expanding in ambient air have been performed. Radial density profiles were measured and quantitative density measurements have been extracted for argon, nitrogen-argon mixture and water jets, using flash X-ray radiography. UV fluorescence emissions due to X-ray excitation of the jet species were imaged on a gated intensified CCD camera.

Hure, Laurent; Robert, Eric; Cachoncinlle, Christophe; Viladrosa, Raymond; Pouvesle, Jean-Michel; Michou, Y.; Gokalp, Iskender

2001-04-01

53

[Indications and results of small bowel transplantation in adults].  

PubMed

Optimised home parenteral nutrition is still, after 35 years of progress, the "gold standard "for benign but chronic intestinal failure. better recognition of chronic intestinal failure, in its multiple facets, is needed to improve Home Parenteral Nutrition by adding associated treatments such as intestinal trophic factors, rehabilitative surgery (reestablishment of colonic continuity, reverse jejunal segment in severe short gut type II) and/or reconstructive surgery (intestinal transplantation for end-stage intestinal failure). Intestinal transplantation is now a mature therapy with formal indications, especially in case of failure of Home Parenteral Nutrition (mainly Home Parenteral Nutrition-associated severe liver disease), where combined Liver-intestine transplantation is indicated before end-stage liver failure occurs. For high-risk patients, 'preemptive' intestinal transplantation alone should be discussed before home parenteral nutrition-related complications occur. Even, if the results in terms of patient survival have improved over the past 20 years, the 5-year survival rate still does not exceed 50%. Thus, each case should be discussed in a dedicated tertiary center. The ESPEN Home Artificial Nutrition Working Group conducted a survey in 2004 to assess potential candidates for intestinal transplantation in France, among the adult population of patients with home parenteral nutrition. The prevalence of potential candidates for intestinal transplantation was estimated at about 20% (about 40 new adult cases per year). Even though surgical techniques for isolated intestine, liver-intestine, and multivisceral transplantation were developed in the 1960s, very few patients were transplanted before 1990, because of inadequate initial immunosuppressive regimens. most patients died within days or months after Intestine transplantation. The discouraging results of the first clinical trials were due to technical complications, sepsis, and the failure of conventional immunosuppression to control rejection. By 1990, the development of tacrolimus-based immunosuppression, as well as improved surgical techniques, the increased array of potent immunosuppressive medications, infection prophylaxis, and better patient selection helped to improve actuarial graft and patient survival rates for all types of intestine transplantation. In adult intestinal transplantation, three kinds of graft can be proposed: isolated small bowel, combined liver and small bowel, and multivisceral transplantation. In isolated small bowel transplantation, the length of the graft ranges between 1.5 and 2 meters, but depends on the size of the recipient (and the abdominal cavity volume, which is reduced). The graft is anastomosed with the recipient's duodenum or remnant proximal jejunum. the distal part of the small bowel graft is on a temporary stoma, in order to allow biopsies for early detection of rejection. Vascular anastomoses are usually performed directly on the aorta for the superior mesenteric artery and either the recipient's portal vein or vena cava for the donor superior mesenteric vein. In combined liver and intestinal transplantation, one venous anastomosis is avoided because the graft is in one piece. Finally, one specificity of this transplantation is the fact that it usually concerns patients with numerous previous abdominal operations and with total or subtotal enterectomy. Thus, the residual abdominal cavity is usually very small, and this can be a major problem for graft insertion. For this reason, abdominal closure is performed with a temporary prosthesis, because even cutaneous closure remains impossible if a compartment syndrome is to be avoided. PMID:23420959

Joly, Francisca; Panis, Yves

2012-02-01

54

Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen.  

PubMed

Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT). The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB) complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass. PMID:24288645

Colak, Tahsin; Olmez, Tolga; Turkmenoglu, Ozgur; Dag, Ahmet

2013-01-01

55

A Look into the Small Bowel in Crohn's Disease  

PubMed Central

Crohn's disease (CD) is an inflammatory bowel disease that can affect the entire gastrointestinal tract, with the small bowel (SB) being the most commonly affected site. In some patients, refractory inflammation or chronic strictures of the SB are responsible for a debilitating course of the disease that might lead to severely reduced quality of life. Therefore, SB imaging is a crucial element in diagnosing and/or managing SB CD, and continues to evolve because of technologic advances. SB endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become key players to diagnose and/or manage CD. In everyday practice, the choice of the imaging modalities is based on the presence and availability of the techniques and of experienced operators in each institute, clinical usefulness, safety, and cost. Here, SB endoscopy and radiologic imaging in suspected or known CD patients will be addressed and discussed. PMID:22977814

Park, Soo Jung

2012-01-01

56

Isochronal annealing study of X-ray induced defects in single- and double-walled carbon nanotubes  

SciTech Connect

X-ray induced defects in single-walled (SWCNTs) and double-walled carbon nanotubes (DWCNTs) were characterized by Raman scattering spectroscopy. Frenkel defects, interstitial-vacancy pairs, were revealed to form in both SWCNTs and DWCNTs after X-ray irradiation because these defects were entirely healed by thermal annealing. In order to clarify the structure of the X-ray induced defect in SWCNT and DWCNT, isochronal-annealing experiments were performed on the irradiated samples and the activation energy for defect healing was estimated. The intensity of D band (defect induced band) on Raman spectra was used as a measure of the density of X-ray induced defects. The experimental results were in good agreement with the simulated values using second order reaction model, which indicated that the defect healing was determined by the migration energy of interstitials on the carbon layer. We also found that the activation energy for defect healing of SWCNT and DWCNT were around 0.5 eV and 0.32 eV, respectively. The X-ray induced defects in SWCNTs were more stable than those in DWCNTs. Compared these estimated activation energies to previous theoretical reports, we concluded that bridge and/or dumbbell interstitials are formed in both SWCNT and DWCNT by X-ray irradiation.

Murakami, Toshiya; Yamamoto, Yuki; Itoh, Chihiro [Department of Materials Science and Chemistry, Wakayama University, Wakayama 640-8510 (Japan)] [Department of Materials Science and Chemistry, Wakayama University, Wakayama 640-8510 (Japan); Kisoda, Kenji [Department of Physics, Wakayama University, Wakayama 640-8510 (Japan)] [Department of Physics, Wakayama University, Wakayama 640-8510 (Japan)

2013-09-21

57

Acute small bowel volvulus in a 2-month-old infant  

PubMed Central

Key Clinical Message Abdominal cystic lymphangiomas are rare and occur secondary to congenital malformation of the lymphatics, mostly in the mesenterium. Acute or chronic volvulus of the small bowel may occur by traction of the lymphangioma. Therapy includes resection of the lymphangioma and of the small bowel involved. PMID:25356264

Wouters, Roderick; Raber, Menno; van Baren, Robertine

2014-01-01

58

Gold nanoparticles enhance the X-ray-induced degradation of human centrin 2 protein  

NASA Astrophysics Data System (ADS)

In the war against cancer, radiotherapy is a prominent tool but counterbalanced by the fact that it also induces damages in healthy tissues. Nanotechnologies could open a new possibility to decrease these side effects. In particular, gold nanoparticles (GNPs) could be used as radio-sensitizers. As the role of proteins in the processes leading to cell death cannot be neglected, their radio-sensitization by GNPs is of great interest. This is particularly true in the case of the human centrin 2 protein, which has been proposed to be involved in DNA repair processes. To investigate this effect, we quantified for the first time the degradation of this protein in a gold colloidal solution when submitted to X-rays. We showed that the X-ray-induced degradation of the human centrin 2 protein is enhanced 1.5-fold in the presence of GNPs, even though no covalent bond exists between protein and GNPs. Among the conditions tested, the maximum enhancement was found with the higher GNP:protein ratio of 2×10 -4 and with the higher X-ray energy of 49 keV.

Brun, Emilie; Duchambon, Patricia; Blouquit, Yves; Keller, Gérard; Sanche, Léon; Sicard-Roselli, Cécile

2009-03-01

59

Dose response of soft X-ray-induced bystander cell killing affected by p53 status.  

PubMed

A radiation-induced bystander response, which is generally defined as a cellular response that is induced in nonirradiated cells that received bystander signals from directly irradiated cells within an irradiated cell population. In our earlier X-ray microbeam studies, bystander cell killing in normal human fibroblasts had a parabolic relationship to the irradiation dose. To elucidate the role of p53 in the bystander cell killing, the effects were assessed using human non-small cell lung cancer cells expressing wild-type or temperature-sensitive mutated p53. The surviving fraction of bystander wild-type p53 cells showed a parabolic relationship to the irradiation dose; survival was steeply reduced up to 0.45 Gy, recovered toward to 2 Gy, and remained at control levels up to 5 Gy. In contrast, in the mutated p53 cells at a nonpermissive temperature, the surviving fraction was steeply reduced up to 1 Gy and remained at the reduced level up to 5 Gy. When the mutated p53 cells were incubated at a permissive temperature, the decrease in the surviving fraction at 2 Gy was suppressed. The wild-type p53 cells were not only restrained in releasing bystander signals at 2 Gy, but were also resistant to the signals released by the mutated p53 cells. These results suggest that the X-ray-induced bystander cell killing depends on both the irradiation dose and the p53 status of the targeted cells and the bystander cells. PMID:23289390

Tomita, Masanori; Maeda, Munetoshi; Kobayashi, Katsumi; Matsumoto, Hideki

2013-02-01

60

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications  

PubMed Central

High soft tissue contrast resolution, acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease. The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn’s disease (CD) are studied most frequently, which are prevalent among children and young adults. MRI, using modern equipment and a rigorous technical approach, can offer detailed morphologic information and functional data on the small bowel. This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases, such as CD and small bowel neoplasms. PMID:18528938

Zhu, Jiong; Xu, Jian-Rong; Gong, Hong-Xia; Zhou, Yan

2008-01-01

61

Alveolar Soft Part Sarcoma Metastatic to Small Bowel Mucosa Causing Polyposis and Intussuseption  

PubMed Central

A report of alveolar soft part sarcoma metastatic to the small bowel is presented. Hematogenous metastases to the small bowel from primary tumors outside the abdominal cavity are uncommon, and most remain asymptomatic and are not discovered until autopsy. However, small bowel metastases can lead to intestinal obstruction, intussuseption or even perforation. While metastases to the small bowel have been described for other tumor types, including melanoma and lung cancer, this is extremely uncommon for sarcoma, especially alveolar soft part sarcoma. We describe a 42-year-old male with a long history of alveolar soft part sarcoma, metastatic to the lung and brain, who developed an intussuseption from metastases to the small bowel. PMID:18521439

Sabel, Michael S.; Litwin, Allan; Mcgrath, Brian; Kraybill, William B.; Brooks, John J.

2001-01-01

62

Biomagnetic Techniques for Assessing Gastric and Small Bowel Electrical Activity  

NASA Astrophysics Data System (ADS)

Recent advances in electrophysiology of the gastrointestinal tract have emphasized the need for methods of noninvasive assessment of gastric and small intestinal electrical activity (GEA and IEA). While the cutaneous electrogastrogram (EGG) may reveal the frequency dynamics of gastric electrical activity, other parameters important for characterizing the propagating electrical activity are not available from EGG recordings. Recent studies on the electroenterogram (EENG) are promising, but low-conductivity abdominal layers have complicated the identification of small intestinal electrical rhythms in cutaneous recordings. The magnetogastrogram (MGG) and magnetoenterogram (MENG) are able to characterize gastric and intestinal electrical activity noninvasively in terms of its frequency, power and characteristics of its propagation. Superconducting QUantum Interference Device (SQUID) magnetometers are used to detect the minute magnetic fields associated with electrical activity of the gastrointestinal syncytium formed by interstitial cells of Cajal and smooth muscle networks. Changes in GEA and IEA that occur in response to disease or abnormal conditions are reflected in MGG and MENG signals. Magnetic methods for assessing the electrical activity of the stomach and small bowel thus show great clinical promise.

Bradshaw, L. Alan

2004-09-01

63

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

64

Role of x-ray-induced transcripts in adaptive responses following x-rays  

SciTech Connect

Potentially lethal damage repair (PLDR) and sublethal damage repair, may be the same manifestations of a series of common enzymatic steps. PLDR, has two distinct phases based upon DNA lesion repair and survival recovery studies. The first phase of PLDR occurs very quickly (t{sub {1/2}}:2--20 mins) to increase the survival of X-irradiated cells by mending the vast array of DNA lesions created by ionizing radiation. The second slower phase of PLDR proceeds much later (i.e., >1--2 hrs) following X-irradiation, during which the remaining double-stranded DNA breaks are completely repaired. This second phase of repair closely corresponds to the restructuring of gross chromosomal damage, and can be partially blocked in some human cells by inhibiting protein synthesis. This slower phase of PLDR correlated with a rapid decline in X-ray-induced transformation of normal cells. The fast component of PLDR may be due to constitutively synthesized DNA ligases, topoisomerases, or polymerases, which act immediately to repair damaged, DNA. In contrast, the slow phase of PLDR in human cells may require the induction of specific genes and gene product's involved in the repair of potentially lethal or carcinogenic DNA lesions. Induced gene products (i.e., proteins) specifically synthesized in response to physiological doses of ionizing radiation in radioresistant human melanoma (U1-Mel) cells, and in a variety of other human normal and cancer-prone cells, were identified using two-dimensional gel electrophoresis. We identified and partially characterized ten proteins synthesized by U1-Mel cells. The synthesis of eight of these proteins were specifically induced by ionizing radiation and two proteins were repressed Neither heat shock, UV-irradiation, nor bifunctional alkylating agent treatments resulted in the induction of these proteins. The expression of one protein, XIP269, correlated very well with PLDR capacity.

Boothman, D.A.

1992-01-01

65

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

66

Mesenteric vasculature-guided small bowel segmentation on 3-D CT.  

PubMed

Due to its importance and possible applications in visualization, tumor detection and preoperative planning, automatic small bowel segmentation is essential for computer-aided diagnosis of small bowel pathology. However, segmenting the small bowel directly on computed tomography (CT) scans is very difficult because of the low image contrast on CT scans and high tortuosity of the small bowel and its close proximity to other abdominal organs. Motivated by the intensity characteristics of abdominal CT images, the anatomic relationship between the mesenteric vasculature and the small bowel, and potential usefulness of the mesenteric vasculature for establishing the path of the small bowel, we propose a novel mesenteric vasculature map-guided method for small bowel segmentation on high-resolution CT angiography scans. The major mesenteric arteries are first segmented using a vessel tracing method based on multi-linear subspace vessel model and Bayesian inference. Second, multi-view, multi-scale vesselness enhancement filters are used to segment small vessels, and vessels directly or indirectly connecting to the superior mesenteric artery are classified as mesenteric vessels. Third, a mesenteric vasculature map is built by linking vessel bifurcation points, and the small bowel is segmented by employing the mesenteric vessel map and fuzzy connectness. The method was evaluated on 11 abdominal CT scans of patients suspected of having carcinoid tumors with manually labeled reference standard. The result, 82.5% volume overlap accuracy compared with the reference standard, shows it is feasible to segment the small bowel on CT scans using the mesenteric vasculature as a roadmap. PMID:23807437

Zhang, Weidong; Liu, Jiamin; Yao, Jianhua; Louie, Adeline; Nguyen, Tan B; Wank, Stephen; Nowinski, Wieslaw L; Summers, Ronald M

2013-11-01

67

Small-angle X-ray scattering studies on the X-ray induced aggregation of malate synthase  

Microsoft Academic Search

Summary Malate synthase was investigated by the small-angle X-ray scattering technique in aqueous solution. Measurements extending for several hours revealed a continuous increase of the intensity in the innermost portion of the scattering curve. There is clear evidence that this increase was caused by an X-ray induced aggregation of enzyme particles during the performance of the small-angle X-ray scattering experiment.

P. Zipper; H. Durchschlag

1980-01-01

68

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

69

Torsion of Meckel's diverticulum as a cause of small bowel obstruction: A case report  

PubMed Central

Axial torsion and necrosis of Meckel’s diverticulum causing simultaneous mechanical small bowel obstruction are the rarest complications of this congenital anomaly. This kind of pathology has been reported only eleven times. Our case report presents this very unusual case of Meckel’s diverticulum. A 41-year-old man presented at the emergency department with complaints of crampy abdominal pain, nausea and retention of stool and gases. Clinical diagnosis was small bowel obstruction. Because the origin of obstruction was unknown, computer tomography was indicated. Computed tomography (CT)-scan revealed dilated small bowel loops with multiple air-fluid levels; the oral contrast medium had reached the jejunum and proximal parts of the ileum but not the distal small bowel loops or the large bowel; in the right mid-abdomen there was a 11 cm × 6.4 cm × 7.8 cm fluid containing cavity with thickened wall, which was considered a dilated bowel-loop or cyst or diverticulum. Initially the patient was treated conservatively. Because of persistent abdominal pain emergency laparotomy was indicated. Abdominal exploration revealed distended small bowel loops proximal to the obstruction, and a large (12 cm × 14 cm) Meckel’s diverticulum at the site of obstruction. Meckel’s diverticulum was axially rotated by 720°, which caused small bowel obstruction and diverticular necrosis. About 20 cm of the small bowel with Meckel’s diverticulum was resected. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day. We recommend CT-scan as the most useful diagnostic tool in bowel obstruction of unknown origin. In cases of Meckel’s diverticulum causing small bowel obstruction, prompt surgical treatment is indicated; delay in diagnosis and in adequate treatment may lead to bowel necrosis and peritonitis.

Murruste, Marko; Rajaste, Geidi; Kase, Karri

2014-01-01

70

Sonography of Pediatric Small-Bowel Intussusception: Differentiating Surgical from Nonsurgical Cases  

Microsoft Academic Search

OBJECTIVE. The purpose of this study was to determine whether there are clinical or sonographic findings that can be used to differentiate benign self-limited small-bowel intussus- ception from pathologic small-bowel intussusception that necessitates surgical intervention. MATERIALS AND METHODS. A retrospective search was performed of abdominal sonograms obtained at two institutions between January 1996 and June 2005. Sonographic findings were correlated

Martha M. Munden; John F. Bruzzi; Brian D. Coley; Reginald F. Munden; Munden MM; Bruzzi JF; Coley BD; Munden RF

71

Do Clinical Characteristics Predict the Presence of Small Bowel Angioectasias on Capsule Endoscopy?  

Microsoft Academic Search

Background and Aims  Angioectasias (AVMs) are the most common vascular anomaly of the gastrointestinal (GI) tract, and these lesions are often\\u000a associated with obscure gastrointestinal bleeding (OGIB). It is unknown if the presence of upper and\\/or lower gastrointestinal\\u000a AVMs are predictive of small bowel AVMs. The aims of this study are to define the small bowel segmental distribution of AVMs\\u000a and

Anthony T. DeBenedet; Sameer D. Saini; Mimi Takami; Laurel R. Fisher

2011-01-01

72

Variation in Small Bowel Biopsy Performance among Diverse Endoscopy Settings: Results from a National Endoscopic Database  

Microsoft Academic Search

BACKGROUND:The diagnostic gold standard for celiac sprue requires performance of small bowel biopsy to identify characteristic mucosal changes. The current biopsy practice among endoscopists for celiac sprue is unknown.METHODS:The CORI (Clinical Outcomes Research Initiative) national endoscopic database was analyzed to determine the rate of small bowel biopsy in patients undergoing EGD for the evaluation of anemia, iron deficiency without anemia,

Gavin C. Harewood; Jennifer L. Holub; David A. Lieberman

2004-01-01

73

Torsion of Meckel's diverticulum as a cause of small bowel obstruction: A case report.  

PubMed

Axial torsion and necrosis of Meckel's diverticulum causing simultaneous mechanical small bowel obstruction are the rarest complications of this congenital anomaly. This kind of pathology has been reported only eleven times. Our case report presents this very unusual case of Meckel's diverticulum. A 41-year-old man presented at the emergency department with complaints of crampy abdominal pain, nausea and retention of stool and gases. Clinical diagnosis was small bowel obstruction. Because the origin of obstruction was unknown, computer tomography was indicated. Computed tomography (CT)-scan revealed dilated small bowel loops with multiple air-fluid levels; the oral contrast medium had reached the jejunum and proximal parts of the ileum but not the distal small bowel loops or the large bowel; in the right mid-abdomen there was a 11 cm × 6.4 cm × 7.8 cm fluid containing cavity with thickened wall, which was considered a dilated bowel-loop or cyst or diverticulum. Initially the patient was treated conservatively. Because of persistent abdominal pain emergency laparotomy was indicated. Abdominal exploration revealed distended small bowel loops proximal to the obstruction, and a large (12 cm × 14 cm) Meckel's diverticulum at the site of obstruction. Meckel's diverticulum was axially rotated by 720°, which caused small bowel obstruction and diverticular necrosis. About 20 cm of the small bowel with Meckel's diverticulum was resected. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day. We recommend CT-scan as the most useful diagnostic tool in bowel obstruction of unknown origin. In cases of Meckel's diverticulum causing small bowel obstruction, prompt surgical treatment is indicated; delay in diagnosis and in adequate treatment may lead to bowel necrosis and peritonitis. PMID:25346803

Murruste, Marko; Rajaste, Geidi; Kase, Karri

2014-10-27

74

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

75

Dietary calcium does not reduce experimental colorectal carcinogenesis after small bowel resection despite reducing cellular proliferation.  

PubMed Central

It has been proposed that colorectal carcinogenesis is accompanied by increased mucosal cell proliferation and that the converse may also apply. To examine this thesis, the crypt cell production rate (CCPR) was measured in eight groups of rats (n = 187) that had received 1,2 dimethylhydrazine, 70% small bowel resection, supplemental dietary calcium, or a combination of these. Analysis of variance showed the following: (1) the CCPR decreased between the ileum and distal colon; (2) the CCPR decreased between 16 and 32 weeks; (3) 1,2 dimethylhydrazine and small bowel resection increased the CCPR and calcium decreased the CCPR independently of one another; (4) the CCPR interacted with 1,2 dimethylhydrazine x small bowel resection, calcium x 1,2 dimethylhydrazine and interacted between the site of bowel and calcium, 1,2 dimethylhydrazine, small bowel resection, and 1,2 dimethylhydrazine x small bowel resection (p = 0.014 to p < 0.001). The tumour yield was reduced by calcium in 1,2 dimethylhydrazine treated animals (chi 2 = 14.1, df = 3, p < 0.01) but was unaffected by calcium in 1,2 dimethylhydrazine and small bowel resection treated animals despite significant differences in the CCPR. An increase of the CCPR both preceded and accompanied colorectal carcinogenesis but reduction of the CCPR was not invariably accompanied by reduced carcinogenes. PMID:1452077

Barsoum, G H; Thompson, H; Neoptolemos, J P; Keighley, M R

1992-01-01

76

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

77

Small bowel transglutaminase 2-specific IgA deposits in dermatitis herpetiformis.  

PubMed

Dermatitis herpetiformis (DH) is an extraintestinal manifestation of coeliac disease. Untreated coeliac disease patients are known to have transglutaminase 2 (TG2)-targeted IgA deposits in the small bowel mucosa. To evaluate whether similar intestinal IgA deposits are also present in DH and whether the deposits disappear with gluten-free diet, 47 untreated and 27 treated DH patients were studied. Seventy-nine percent of untreated and 41% of the treated DH patients had TG2-specific IgA deposits in the small bowel, and the presence of the deposits showed a significant association with the degree of small bowel villous atrophy (p < 0.001). Other coeliac-disease related inflammatory markers were also investigated, and the density of small bowel mucosal intraepithelial ??(+) T cells was increased in 91% of untreated and 73% of treated DH patients. The results show that the majority of untreated DH patients have similar gluten-dependent TG2-specific IgA deposits the small bowel mucosa as coeliac disease patients. PMID:24352382

Salmi, Teea T; Hervonen, Kaisa; Laurila, Kaija; Collin, Pekka; Mäki, Markku; Koskinen, Outi; Huhtala, Heini; Kaukinen, Katri; Reunala, Timo

2014-07-01

78

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

79

Small bowel diverticulosis in patient with early gastric cancer.  

PubMed

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; Bang, Ho Yoon

2014-10-01

80

Small Bowel Dose Parameters Predicting Grade ?3 Acute Toxicity in Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation: An Independent Validation Study Comparing Peritoneal Space Versus Small Bowel Loop Contouring Techniques  

SciTech Connect

Purpose: To determine whether volumes based on contours of the peritoneal space can be used instead of individual small bowel loops to predict for grade ?3 acute small bowel toxicity in patients with rectal cancer treated with neoadjuvant chemoradiation therapy. Methods and Materials: A standardized contouring method was developed for the peritoneal space and retrospectively applied to the radiation treatment plans of 67 patients treated with neoadjuvant chemoradiation therapy for rectal cancer. Dose-volume histogram (DVH) data were extracted and analyzed against patient toxicity. Receiver operating characteristic analysis and logistic regression were carried out for both contouring methods. Results: Grade ?3 small bowel toxicity occurred in 16% (11/67) of patients in the study. A highly significant dose-volume relationship between small bowel irradiation and acute small bowel toxicity was supported by the use of both small bowel loop and peritoneal space contouring techniques. Receiver operating characteristic analysis demonstrated that, for both contouring methods, the greatest sensitivity for predicting toxicity was associated with the volume receiving between 15 and 25 Gy. Conclusion: DVH analysis of peritoneal space volumes accurately predicts grade ?3 small bowel toxicity in patients with rectal cancer receiving neoadjuvant chemoradiation therapy, suggesting that the contours of the peritoneal space provide a reasonable surrogate for the contours of individual small bowel loops. The study finds that a small bowel V15 less than 275 cc and a peritoneal space V15 less than 830 cc are associated with a less than 10% risk of grade ?3 acute toxicity.

Banerjee, Robyn, E-mail: robynbanerjee@gmail.com [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada)] [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Chakraborty, Santam; Nygren, Ian; Sinha, Richie [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada)] [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada)

2013-04-01

81

MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis  

Microsoft Academic Search

.   The aim of the study was to evaluate the additional findings of MRI following small bowel enteroclysis and to compare the\\u000a efficacy of negative and positive intraluminal contrast agents. Fifty patients with inflammatory or tumorous small bowel disease\\u000a were investigated by small bowel enteroclysis and consecutive MRI using breathhold protocol (T1-weighted fast low-angle shot,\\u000a T2-weighted turbo spin echo). Patients

A. Rieber; A. Aschoff; K. Nüssle; D. Wruk; R. Tomczak; M. Reinshagen; G. Adler; H.-J. Brambs

2000-01-01

82

Squamous cell carcinoma arising from ovarian mature cystic teratoma and causing small bowel obstruction.  

PubMed

Malignant transformation of mature cystic teratoma (MCT) is a rare phenomenon with incidence of approximately 1-3%. We report a 48-year-old woman who presented to the emergency room with symptoms of bowel obstruction. She underwent computed tomography scan for the evaluation of obstruction, which demonstrated diffuse ascites accompanying a cystic pelvic to lower abdominal mass which had invaded into the adjacent small bowel causing partial small bowel obstruction. Histologically, the mass demonstrated a MCT within which aroused a well-differentiated squamous cell carcinoma. Exploratory laparotomy was performed to confirm the diagnosis and debulking of the mass was performed. PMID:25313782

Yarmohammadi, Hooman; Mansoori, Bahar; Wong, Vince; Tacher, Vania; Wilkins, Luke R; Pavlidakey, Peter G; Haaga, John R

2014-01-01

83

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

84

Duodeno-jejunal adenocarcinoma as a first presentation of coeliac disease  

Microsoft Academic Search

Long standing coeliac disease is associated with an increased risk of malignancy, not only of intestinal lymphoma but also small intestinal adenocarcinoma. Two patients whose initial presentation was adenocarcinoma of the small bowel, but who were subsequently found to have coeliac disease after Whipple's resection, are described. The diagnosis was made early in the postoperative period in the first patient

D J MacGowan; D O Hourihane; W A Tanner; C OMorain

1996-01-01

85

Coffee enema for preparation for small bowel video capsule endoscopy: a pilot study.  

PubMed

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

2014-07-01

86

Laparoscopic versus open adhesiolysis for small bowel obstruction - a multicenter, prospective, randomized, controlled trial  

PubMed Central

Background Laparoscopic adhesiolysis is emerging as an alternative for open surgery in adhesive small bowel obstruction. Retrospective studies suggest that laparoscopic approach shortens hospital stay and reduces complications in these patients. However, no prospective, randomized, controlled trials comparing laparoscopy to open surgery have been published. Methods/Design This is a multicenter, prospective, open label, randomized, controlled trial comparing laparoscopic adhesiolysis to open surgery in patients with computed-tomography diagnosed adhesive small bowel obstruction that is not resolving with conservative management. The primary study endpoint is the length of postoperative hospital stay in days. Sample size was estimated based on preliminary retrospective cohort, which suggested that 102 patients would provide 80% power to detect a difference of 2.5 days in the length of postoperative hospital stay with significance level of 0.05. Secondary endpoints include passage of stool, commencement of enteral nutrition, 30-day mortality, complications, postoperative pain, and the length of sick leave. Tertiary endpoints consist of the rate of ventral hernia and the recurrence of small bowel obstruction during long-term follow-up. Long-term follow-up by letter or telephone interview will take place at 1, 5, and 10 years. Discussion To the best of our knowledge, this trial is the first one aiming to provide level Ib evidence to assess the use of laparoscopy in the treatment of adhesive small bowel obstruction. Trial registration ClinicalTrials.gov identifier: NCT01867528. Date of registration May 26th 2013. PMID:25306234

2014-01-01

87

Ume (Japanese Apricot)Induced Small Bowel Obstruction with Chronic Radiation Enteritis  

Microsoft Academic Search

Stricture formation is recognized as one of the complications of chronic radiation enteritis. Here, we present a case of a 73-year-old woman who presented with small bowel obstruction 16 years after pelvic irradiation for uterine cancer. Computed tomographic (CT) scan of the abdomen demonstrated a 1-cm foreign body in the terminal ileum. Laparotomy revealed a stone of ume (Japanese apricot)

Takuya Hashimoto; Joji Kitayama; Akio Hidemura; Hironori Ishigami; Shoichi Kaizaki; Noriyoshi Fukushima; Tetsuro Miyata; Hirokazu Nagawa

2007-01-01

88

Penetrating ectopic peptic ulcer in the absence of Meckel's diverticulum ultimately presenting as small bowel obstruction  

PubMed Central

We report here how a heterotopic penetrating peptic ulcer progressed to cause small bowel obstruction in a patient with multiple previous negative investigations. The clinical presentation, radiographic features and pathological findings of this case are described, along with the salient lessons learnt. The added value of wireless capsule endoscopy (WCE) in such circumstances is debated. PMID:18069775

Hurley, Hilary; Cahill, Ronan A; Ryan, Paul; Morcos, Ashraf I; Redmond, Henry P; Kiely, Helen M

2007-01-01

89

The Replacement of Large Veins with Free Inverted Segments of Small Bowel.  

National Technical Information Service (NTIS)

Experimental work indicates that inverted free segments of small bowel can be used successfully as autografts in the replacement of segments of major veins in dogs. Success has been obtained using a graft in which the mucosa, muscularis, and serosa have b...

T. Matsumoto, R. H. Holmes, C. O. Burdick, C. A. Heisterkamp, T. J. O'Connell

1966-01-01

90

Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach  

Microsoft Academic Search

IntroductionAdhesive small bowel obstruction (SBO) is a common postoperative complication. Published data in the pediatric literature characterizing SBO are scant. Furthermore, the relationship between the risk of SBO for a given procedure is not well described. To evaluate these parameters, we reviewed the incidence of SBO after laparoscopic appendectomy (LA) and open appendectomy (OA) performed at our institution.

Kuo Jen Tsao; Shawn D. St Peter; Patricia A. Valusek; Scott J. Keckler; Susan Sharp; George W. Holcomb; Charles L. Snyder; Daniel J. Ostlie

2007-01-01

91

Sclerosing mesenteritis in small bowel transplantation: possible manifestation of acute vascular rejection  

Microsoft Academic Search

BackgroundAcute rejection of human small bowel allografts is characterized by clinical symptoms combined with characteristic morphologic alterations. The typical geographic distribution of acute rejection in the bowel is involvement of the intestinal parenchyma, which can be transmural, particularly when the rejection is more severe. However, little is known concerning the potential for donor-derived soft tissue adjacent to the bowel to

P Ruiz; M Suarez; S Nishida; V de la Cruz; M Nicolas; D Weppler; A Khaled; P Bejarano; T Kato; N Mittal; M Icardi; A Tzakis

2003-01-01

92

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

93

Effects of immunosuppressive therapy after experimental small bowel transplantation in rats  

Microsoft Academic Search

Significant improvements of graft and patient survival have been achieved over the past 20years in the field of intestinal transplantation. Tacrolimus monotherapy with corticosteroids, or in combination with sirolimus is the most commonly used immunosuppressive regimen. Early (24h) after experimental allogenic small bowel transplantation in rats, sirolimus reduces the cellular and molecular inflammatory response with subsequent graft dysmotility more efficiently

Thomas Pech; Jun Fujishiro; Tobias Finger; Martin von Websky; Burkhard Stoffels; Sven Wehner; Kareem Abu-Elmagd; Joerg C. Kalff; Nico Schaefer

2011-01-01

94

Ethanol inhibition of glucose absorption in isolated, perfused small bowel of rats  

SciTech Connect

There is evidence for both humans and rats that malnutrition frequently occurs when ethanol is chronically ingested. Small bowel /sup 14/C-labelled glucose absorption was measured with an ex vivo system in which the small bowel of the rat was surgically removed and then arterially perfused with an artificial medium. Glucose absorption for a control group of seven rats was 248 +/- 8 microM/min/gm dry weight of small bowel (mean +/- SEM). This was significantly greater than the value 112 +/- 12 microM/min/gm dry weight (P less than 0.005) for a group of five rats in which a competitive inhibitor of glucose absorption, phlorizin (0.2 mM), was added to the bowel lumen. In the presence of 3% ethanol within the gut lumen of five rats, glucose absorption was also reduced (to 131 +/- 12 microM/min/gm dry weight) compared to absorption in the control group (P less than 0.005). The calculated amount of glucose absorbed was corrected for metabolism to lactate and carbon dioxide. We conclude that both phlorizin and ethanol inhibit glucose absorption in the isolated and perfused small bowel of rats and that probably at least part of the malnutrition in ethanol-fed rats is due to glucose malabsorption.

Cobb, C.F.; Van Thiel, D.H.; Wargo, J.

1983-08-01

95

Small bowel exclusion from the pelvis by a polyglycolic acid mesh sling  

Microsoft Academic Search

Radiation enteritis is seen in patients receiving radiation therapy for various pelvic malignancies. Attempts to prevent this have included various surgical as well as nutritional approaches with little success. The use of a polyglycolic acid mesh sling sewn above the pelvic inlet has prevented small bowel descent into the true pelvis in rats and in humans. The technique has been

Dennis F. Devereux; Maureen T. Kavanah; Merrill I. Feldman; Edward Kondi; David Hull; M. OBrien; Peter J. Deckers; Peter J. Mozden

1984-01-01

96

Burn and Starvation Increase Programmed Cell Death in Small Bowel Epithelial Cells  

Microsoft Academic Search

Maintenance of gut mucosal homeostasis depends on a balance between cell proliferation and cell death. Gut mucosal integrity is impaired after severe burn and during starvation. We determined the effect of burn, starvation, and the combination of both on small bowel epithelial apoptosis and proliferation. Fifty adult male Fischer 344 rats (260–300 g) received a 60% full-thickness scald burn and

Marc G. Jeschke; Meelie A. Debroy; Steven E. Wolf; Srinivasan Rajaraman; James C. Thompson

2000-01-01

97

Intestinal prolapse through a persistent omphalomesenteric duct causing small-bowel obstruction.  

PubMed

Persistent omphalomesenteric duct as a cause of small-bowel obstruction is an exceptional finding. A neonate presented with occlusion due to intestinal prolapse through a persistent omphalomesenteric duct. Remnants of the duct were successfully resected, and the postoperative course was uneventful. We discuss the presentation of omphalomesenteric duct and its management. PMID:22856450

Pauleau, Ghislain; Commandeur, Diane; Andro, Christophe; Chapellier, Xavier

2012-08-01

98

Value of in vivo electrophysiological measurements to evaluate canine small bowel autotransplants.  

PubMed Central

This study aimed to develop a non-invasive method for in vivo measurement of the transepithelial potential difference in the canine small bowel and to evaluate this parameter in small bowel autotransplants. In group 0 (control group, n = 4), two intestinal loops were created without disturbing their vascular, neural, and lymphatic supplies. In group I (successful autotransplants, n = 11), two heterotopic small bowel loops were constructed. Long term functional sequelae of vascular, neural, and lymphatic division were studied. Group II (n = 6) consisted of dogs with unsuccessful autotransplants suffering thrombosis of the vascular anastomosis, which resulted in ischaemic small bowel autografts. In group I, values of spontaneous transepithelial potential difference, an index of base line active electrolyte transport, were significantly lower compared with group 0 (p less than 0.05), probably as a result of denervation of the autotransplants. Both theophylline and glucose stimulated potential difference responses, measuring cyclic adenosine monophosphate mediated chloride secretion and sodium coupled glucose absorption respectively, showed negative luminal values in group I at all time points after transplantation. These transepithelial potential difference responses diminished progressively with time. From day 21 onwards both theophylline and glucose stimulated potential difference responses were significantly less than the corresponding responses at day seven (p less than 0.05). Morphometric analysis showed that the reduction of transepithelial potential difference responses preceded degenerative mucosal changes in the heterotopic small bowel autografts. In group II, potential difference responses to theophylline and glucose showed positive luminal values (p<0.01 v group I), probably as a result of passive potassium effusion from necrotic enterocytes. Images Figure 3 PMID:1752464

Meijssen, M A; Heineman, E; de Bruin, R W; Veeze, H J; Bijman, J; de Jonge, H R; ten Kate, F J; Marquet, R L; Molenaar, J C

1991-01-01

99

Decreasing gastrointestinal morbidity with the use of small bowel contrast during treatment planning for pelvic irradiation  

SciTech Connect

Small bowel tolerance is a major dose-limiting factor in treating the pelvis with radiation therapy (RT). The use of small bowel contrast during RT simulation is one technique used to localize the bowel and identify the treatment plan that would exclude the greatest volume. To determine the influence of treatment planning with oral contrast on gastrointestinal injury, acute and chronic small bowel morbidity was analyzed in 115 patients with endometrial and rectal carcinoma who received postoperative radiation therapy at the Fox Chase Cancer Center. Mean and median time of follow-up were 31 and 27 months, respectively. Acute diarrhea was seen in 82% of the patient population. Ten percent of patients experienced major complications requiring hospitalization. Ninety-three percent of patients simulated without contrast experienced side effects compared to 77% of patients simulated with contrast (p = .026). There was an increased incidence of chronic complications in patients who were not simulated with contrast dye (50% vs 23%, p = .014). Median duration of minor side effects was 4 months for patients planned without oral contrast and 1 month for patients who had contrast at the time of simulation (p = .036). The superior aspect of the treatment field was determined to be at a more inferior location in patients simulated with contrast, thereby excluding small bowel from treatment. Seventy-four percent of patients simulated without contrast had the upper border of the field placed at the superior aspect of the sacroiliac joint or above, compared to only 40% of patients planned with oral contrast (p = .002). This study has demonstrated decreased complications (both overall and chronic) as well as a change in the location of the treatment field with the use of small bowel contrast.

Herbert, S.H.; Curran, W.J. Jr.; Solin, L.J.; Stafford, P.M.; Lanciano, R.M.; Hanks, G.E. (Fox Chase Cancer Center, Philadelphia, PA (USA))

1991-04-01

100

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

101

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

102

Oesophageal stent migration following Billroth I gastrectomy: an unusual cause of small bowel obstruction  

PubMed Central

We report the case of an elderly female patient with a history of a previous Billroth I gastrectomy who presented with small bowel obstruction secondary to a migrated oesophageal stent. This patient had an iatrogenic oesophageal perforation following therapeutic endoscopy for a benign stricture 4 months prior to presentation. This was treated endoscopically with a covered stent that was not removed as planned. The stent migrated distally lodging in the terminal ileum, causing small bowel obstruction. Oesophageal stent migration is a rare but well-recognized complication of stent placement. Endoscopic stenting is an effective treatment for oesophageal perforation with lower morbidity and mortality than operative repair. Clinicians should be aware that although patients with a history of previous gastric surgery are at no greater risk of stent migration than others, the altered anatomy can affect the final resting place of the migrated stent and hence the clinical effects and sequalae. PMID:24964415

Quinn, Morgan; Luke, David

2013-01-01

103

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

104

Small bowel perforation caused by a sharp bone: laparoscopic diagnosis and treatment.  

PubMed

Small bowel perforation caused by sharp or pointed foreign bodies rarely is diagnosed preoperatively because clinical symptoms usually are nonspecific and can mimic other surgical conditions such as appendicitis and cecal diverticulitis. We report the case of a 57-year-old man who underwent diagnostic laparoscopy for abdominal pain of unknown etiology. Swelling and erythema were noted in a segment of small bowel in the right lower abdomen. A tiny sharp-pointed object was found penetrating the inflamed portion of the bowel. This foreign body was removed and the perforation immediately repaired under laparoscopic guidance. The postoperative course was uneventful. We believe that in cases of lower abdominal pain with peritoneal irritation, laparoscopy can provide not only a wide field of examination to localize intraabdominal pathology, but in some instances it can aid in case management. PMID:10804008

Yao, C C; Yang, C C; Liew, S C; Lin, C S

1999-06-01

105

Small bowel perforation after duodenal stent migration: An interesting case of a rare complication  

PubMed Central

Duodenal stents are frequently used for palliating malignant gastric outlet obstruction. Successful stent placement relieves obstructive symptoms, is cost effective, and has a relatively low complication rate. However, enteral stents have the potential of migrating distally and rarely, even lead to bowel perforation. We present a rare case of a duodenal stent placed as a palliative measure for gastric outlet obstruction due to unresectable pancreatic cancer that migrated distally after a gastrojejunostomy resulting in small bowel perforation. PMID:21860709

Lee, Peter HU; Moore, Robert; Raizada, Akshay; Grotz, Richard

2011-01-01

106

Renal Cell Carcinoma presenting as small bowel obstruction secondary to a metastatic ileal intussusception  

PubMed Central

We report a rare clinical presentation of renal cell carcinoma in the form of small bowel obstruction which was secondary to a metastatic ileal intussusception. Intussusception in the elderly is most commonly due to an underlying neoplasm, however metastases from a renal cell carcinoma is very uncommon. We present clinical details, radiological and pathological findings of the case followed by a discussion of the diagnosis and management of intussusception in the adult population. PMID:24967032

Hegde, Rahul G; Gowda, Harish K; Agrawal, Rachana D; Yadav, Vikas K; Khadse, Gopal J

2014-01-01

107

Small Bowel Obstruction and Internal Hernias during Pregnancy after Gastric Bypass Surgery  

Microsoft Academic Search

Small bowel obstruction (SBO) is a recognized complication of Roux-en-Y gastric bypass (RYGB) surgery. Internal hernia (IH)\\u000a a potential problem associated with RYGB, can have severe consequences if not diagnosed. We present two cases of SBO due to\\u000a IH during pregnancy after laparoscopic RYGB (LRYGB). Both patients underwent an antecolic, antegastric LRYGB. In both patients\\u000a a Petersen’s type IH was

Gonzalo M. Torres-Villalobos; Todd A. Kellogg; Daniel B. Leslie; Gintaras Antanavicius; Rafael S. Andrade; Bridget Slusarek; Tracy L. Prosen; Sayeed Ikramuddin

2009-01-01

108

Crohn's disease complicated by multiple stenoses and internal fistulas clinically mimicking small bowel endometriosis  

PubMed Central

We report a 31-year-old woman with Crohn’s disease complicated by multiple stenoses and internal fistulas clinically misdiagnosed as small bowell endometriosis, due to the patient’s perimenstrual symptoms of mechanical subileus for 3 years; at first monthly, but later continuous, and gradually increasing in severity. We performed an exploratory laparotomy for small bowel obstruction, and found multiple ileal strictures and internal enteric fistulas. Because intraoperative findings were thought to indicate Crohn’s disease, a right hemicolectomy and partial distal ileum resection were performed for obstructive Crohn’s ileitis. Histopathology of the resected specimen revealed Crohn’s disease without endometrial tissue. The patient made an uneventful recovery from this procedure and was discharged home 10 d post-operatively. The differential diagnosis of Crohn’s diease with intestinal endometriosis may be difficult pre-operatively. The two entities share many overlapping clinical, radiological and pathological features. Nevertheless, when it is difficult to identify the cause of intestinal obstruction in a woman of child-bearing age with cyclical symptoms suggestive of small bowel endometriosis, Crohn’s disease should be included in the differential diagnosis. PMID:18176980

Teke, Zafer; Aytekin, Faruk Onder; Atalay, Ali Ozgur; Demirkan, Nese Calli

2008-01-01

109

Multifocal small bowel stromal tumours presenting with peritonitis in an HIV positive patient  

PubMed Central

INTRODUCTION The most common mesenchymal tumour of the gastrointestinal tract is stromal tumours (GISTs). Symptomatic GISTs can present with complications such as haemorrhage, obstruction and perforation. Complete surgical resection with negative margins is the mainstay of treatment but may be imprudent on emergent occasion. Tyrosine-kinase inhibitors (TKIs) have been revolutionary in the treatment of GISTs and have resulted in improved outcomes. PRESENTATION OF CASE A 41 year old HIV positive male presented with an acute history of abdominal pain and obstructive symptoms. Clinical examination revealed sepsis and peritonitis. One of the several small bowel tumours discovered at exploratory laparotomy was necrotic and perforated. The perforated tumour alone was resected and a small bowel internal hernia reduced. The patient made an uneventful recovery and will be considered for TKI therapy with a view to later re-operation. DISCUSSION GISTs very rarely perforate. The pathophysiology of stromal tumour necrosis is poorly understood. Multifocality and small bowel location are poor prognosticators and may occur in the setting of familial GISTs, specific syndromes and sporadic cases. There is no established association between HIV and GISTs. CONCLUSION Perforation occurs infrequently in ?8% of symptomatic cases and poses increased risk of local recurrence. The surgical management of perforation takes precedence in an emergency. The surgeon must however take cognisance of the adherence to ideal oncologic principles where feasible. TKI therapy is invaluable if a re-exploration is to be later considered. PMID:24705193

Mansoor, Ebrahim

2014-01-01

110

Efficacy of an absorbable mesh in keeping the small bowel out of the human pelvis following surgery  

Microsoft Academic Search

Patients with pelvic malignancies frequently require postoperative radiation therapy either as adjunctive or palliative treatment.\\u000a Tumoricidal doses, however, are frequently associated with small-bowel damage. Animal experiments demonstrated tolerance to\\u000a high-dose radiation therapy and protection from radiation enteritis by use of an absorbable polymer polyglycolic acid (PGA)\\u000a that is used as an intestinal sling to elevate the small bowel away from

Dennis F. Devereux; James J. Chandler; Theodore Eisenstat; Lewis Zinkin

1988-01-01

111

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

112

Role of x-ray-induced transcripts in adaptive responses following x-rays. Progress report, year 1  

SciTech Connect

Potentially lethal damage repair (PLDR) and sublethal damage repair, may be the same manifestations of a series of common enzymatic steps. PLDR, has two distinct phases based upon DNA lesion repair and survival recovery studies. The first phase of PLDR occurs very quickly (t{sub {1/2}}:2--20 mins) to increase the survival of X-irradiated cells by mending the vast array of DNA lesions created by ionizing radiation. The second slower phase of PLDR proceeds much later (i.e., >1--2 hrs) following X-irradiation, during which the remaining double-stranded DNA breaks are completely repaired. This second phase of repair closely corresponds to the restructuring of gross chromosomal damage, and can be partially blocked in some human cells by inhibiting protein synthesis. This slower phase of PLDR correlated with a rapid decline in X-ray-induced transformation of normal cells. The fast component of PLDR may be due to constitutively synthesized DNA ligases, topoisomerases, or polymerases, which act immediately to repair damaged, DNA. In contrast, the slow phase of PLDR in human cells may require the induction of specific genes and gene product`s involved in the repair of potentially lethal or carcinogenic DNA lesions. Induced gene products (i.e., proteins) specifically synthesized in response to physiological doses of ionizing radiation in radioresistant human melanoma (U1-Mel) cells, and in a variety of other human normal and cancer-prone cells, were identified using two-dimensional gel electrophoresis. We identified and partially characterized ten proteins synthesized by U1-Mel cells. The synthesis of eight of these proteins were specifically induced by ionizing radiation and two proteins were repressed Neither heat shock, UV-irradiation, nor bifunctional alkylating agent treatments resulted in the induction of these proteins. The expression of one protein, XIP269, correlated very well with PLDR capacity.

Boothman, D.A.

1992-09-01

113

Effect of parenteral nutrition supplemented with short-chain fatty acids on adaptation to massive small bowel resection.  

PubMed

After massive small bowel resection, total parenteral nutrition (TPN) is prescribed to maintain nutritional status. However, TPN reduces the mass of the remaining intestinal mucosa, whereas adaptation to small bowel resection is associated with increased mucosal mass. Short-chain fatty acids (SCFAs) have been shown to stimulate mucosal cell mitotic activity. This study determined whether the addition of SCFAs to TPN following small bowel resection would prevent intestinal mucosal atrophy produced by TPN. Adult rats underwent an 80% small bowel resection and then received either standard TPN or TPN supplemented with SCFAs (sodium acetate, propionate, and butyrate). After 1 wk, jejunal and ileal mucosal weights, deoxyribonucleic acid, ribonucleic acid, and protein contents were measured and compared with the parameters obtained at the time of resection. Animals receiving TPN showed significant loss of jejunal mucosal weight, deoxyribonucleic acid, ribonucleic acid, and protein and ileal mucosal weight and deoxyribonucleic acid after small bowel resection, whereas animals receiving SCFA-supplemented TPN showed no significant change in the jejunal mucosal parameters and a significant increase in ileal mucosal protein. These data demonstrate that SCFA-supplemented TPN reduces the mucosal atrophy associated with TPN after massive bowel resection and thys may facilitate adaptation to small bowel resection. PMID:2456244

Koruda, M J; Rolandelli, R H; Settle, R G; Zimmaro, D M; Rombeau, J L

1988-09-01

114

X-ray-induced thermally stimulated luminescence study of the degradation of high-temperature superconductors upon exposure to moisture: A deuteration effect  

SciTech Connect

One of the disadvantages of high-temperature superconductors (HTSC) that hinder their wide application is low moisture and carbon dioxide resistance of HTSC materials. In this work, the authors consider an approach that allows the authors to judge the degree of degradation of the HTSC ceramic surface upon exposure to a humid atmosphere by monitoring X-ray-induced thermally stimulated luminescence (TSL) parameters of HTSC samples.

Lotnik, S.V.; Khamdullina, L.A. [Institute of Organic Chemistry, Bashkortostan (Russian Federation)

1995-07-01

115

X-Ray Induced Formation of ?-H2AX Foci after Full-Field Digital Mammography and Digital Breast-Tomosynthesis  

PubMed Central

Purpose To determine in-vivo formation of x-ray induced ?-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM) and to estimate foci after FFDM and digital breast-tomosynthesis (DBT) using a biological phantom model. Materials and Methods The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant ?-H2AX, and foci representing distinct DNA damages were quantified. Results Median in-vivo foci level/cell was 0.086 (range 0.067–0.116) before and 0.094 (0.076–0.126) after FFDM (p?=?0.0004). In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086–0.140) at skin level and 0.035 (range 0.030–0.050) at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040–0.081) at skin level and 0.015 (range 0.006–0.020) at glandular level. Conclusion In patients, mammography induces a slight but significant increase of ?-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques. PMID:23936236

Schwab, Siegfried A.; Brand, Michael; Schlude, Ina-Kristin; Wuest, Wolfgang; Meier-Meitinger, Martina; Distel, Luitpold; Schulz-Wendtland, Ruediger; Uder, Michael; Kuefner, Michael A.

2013-01-01

116

Complete response and prolonged disease-free survival in a patient with recurrent duodenal adenocarcinoma treated with bevacizumab plus FOLFOX6  

PubMed Central

Small bowel adenocarcinoma is an uncommon gastrointestinal malignancy with limited data on effective chemotherapy in the adjuvant setting, as well as for advanced disease. We present a case report of a patient with recurrent duodenal adenocarcinoma after resection and adjuvant chemotherapy who experienced a complete response to bevacizumab with oxaliplatin and 5FU (FOLFOX) followed by bevacizumab/capecitabine maintenance therapy for 2 years. The patient continues to be disease-free 8 years after his recurrence. This case highlights the potential of vascular endothelial growth factor (VEGF) inhibitors to enhance chemotherapeutic regimens for advanced small bowel adenocarcinoma. PMID:24490045

Nagaraj, Gayathri; Zarbalian, Yousef; Flora, Karin

2014-01-01

117

Serial intralesional injections of infliximab in small bowel Crohn's strictures are feasible and might lower inflammation  

PubMed Central

Background Crohn’s disease can cause strictures throughout the gastrointestinal tract. Endoscopic balloon dilatation is a well-established treatment, but recurrence is seen in up to three out of four cases. Infliximab is playing an increasingly important role in the modern systemic treatment of severe Crohn’s disease. Combining the anti-inflammatory effects of infliximab with the proven effect of endoscopic balloon dilatation could possibly improve outcome. In small studies, intralesional injections in perianal fistulas have been effective and endoscopic injection therapy in colonic strictures is feasible. Objective We wanted to assess whether serial intralesional injection of infliximab in small bowel strictures is feasible and reduces local inflammation. Methods We included six patients with Crohn’s disease and inflammatory small bowel strictures. They were treated with endoscopic serial balloon dilatation. Subsequent to each dilatation, 40 mg infliximab was injected submucosally. A modified simplified endoscopic score for Crohn’s disease was used for the involved area before the initial treatment and at the final follow-up after six months. Complications and development of symptoms were registered. Results Balloon dilatation and serial injection of infliximab were accomplished in five out of six patients. One patient completed the serial balloon dilatations and follow-up but received only one infliximab injection. The modified simplified endoscopic score for Crohn’s disease decreased in all patients. There were no adverse events registered and all patients described themselves as feeling well. Conclusions Combining balloon dilatation of strictures with serial intralesional injection of infliximab in Crohn’s disease of the small bowel is feasible and seems successful in reducing inflammation. PMID:25360319

Hendel, Jakob; Vilmann, Peter

2014-01-01

118

Management of small-bowel polyps at double-balloon enteroscopy  

PubMed Central

Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.

Nakamura, Masanao; Tahara, Tomomitsu; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Shibata, Tomoyuki; Hirooka, Yoshiki; Goto, Hidemi; Hirata, Ichiro

2014-01-01

119

Low-dose azathioprine effectively improves mucosal healing in Chinese patients with small bowel Crohn's disease  

PubMed Central

Objective To evaluate mucosal healing after 24-month low-dose azathioprine (AZA) treatment in Chinese patients with moderate small bowel Crohn's disease (CD). Methods Patients with lesions mainly located at the ileum were screened by baseline multislice computed tomography enterography and anal-route double-balloon enteroscopy (DBE). They were naive to any immunomodulators and biological agents before the enrollment. Lesions from 150 cm of the terminal ileum proximal to ileocecal valve were assessed by DBE with the simple endoscopic score for CD (SES-CD) after 12 and 24 months of low-dose AZA treatment, respectively. Results The average maximal tolerance dose of AZA was 61.8 ± 17.2 mg/day. The total rates of complete, near-complete, partial and no mucosal healing in 36 patients were 19.4%, 5.6%, 27.8% and 47.2% at month 12 and 30.6%, 25.0%, 33.3% and 11.1% at month 24, respectively. The baseline SES-CD (odds ratio [OR] 2.71, 95% confidence interval [CI] 1.11–6.63, P = 0.029) and duration of disease (OR 1.27, 95% CI 1.10–1.47, P = 0.001) were two relevant factors associated with the mucosal healing of patients with small bowel CD. Conclusion A 24-month low-dose AZA regimen as maintenance treatment in moderate small bowel CD could achieve a higher mucosal healing rate than that of 12-month treatment in Chinese patients, especially in those with duration of disease less than 12 months and a baseline SES-CD of 5 or 6. PMID:24387287

Yu, Li Fen; Zhong, Jie; Cheng, Shi Dan; Tang, Yong Hua; Miao, Fei

2014-01-01

120

Small bowel mucosal damage in familial Mediterranean fever: results of capsule endoscopy screening.  

PubMed

Abstract Objective. Familial Mediterranean fever (FMF) is the most common form of autoinflammatory diseases. We aimed to evaluate the small bowel mucosa by capsule endoscopy (CE) in FMF patients for investigation of other possible causes of abdominal pain. Material and methods. The study group consisted of 41 patients with FMF. A standard questionnaire was used to record the gastrointestinal symptoms, other clinical findings, Mediterranean fever gene (MEFV) mutations, and history of medications including non-steroidal anti-inflammatory drugs (NSAIDs). Gastroscopy, colonoscopy and small bowel CE were performed in all patients, and biopsies were taken from terminal ileum and duodenum. Results. The mean age of the patients was 34 ± 11 years, 63% of them were female, and 76.5% of them were carrying MEFV exon 10 mutations. Only one patient used NSAIDs in addition to colchicine. In endoscopic investigations, gastric erosion was detected in only one patient, and no significant findings were detected in colonoscopy. CE showed small bowel mucosal defects in 44% (erosions in 26.8%, ulcer in 17.1%) and edema in 29.3% of the patients. Most (64%) of the ulcer and erosions were localized to jejunum, and only 24% were in ileum. Mitotic changes as an indirect finding of colchicine toxicity were not different from the changes observed in samples of independent group of patients with irritable bowel syndrome. Conclusion. Mucosal defect was observed in half of the FMF patients, which may be associated with underlying inflammation or chronic colchicine exposure. Detection of nonspecific chronic inflammation without mitotic changes supports that mucosal defects may be associated with the autoinflammatory process. PMID:25369738

Demir, Abdurrahman; Akyüz, Filiz; Göktürk, Suut; Evirgen, Sami; Akyüz, Umit; Ormeci, Asl?; Soyer, Ozlem; Karaca, Cetin; Demir, Kadir; Gundogdu, Gökcen; Güllüo?lu, Mine; Erer, Burak; Kamal?, Sevil; Kaymakoglu, Sabahattin; Besisik, Fatih; Gül, Ahmet

2014-12-01

121

Disruption of interstitial cells of Cajal networks after massive small bowel resection  

PubMed Central

AIM: To investigate the disruptions of interstitial cells of Cajal (ICC) in the remaining bowel in rats after massive small bowel resection (mSBR). METHODS: Thirty male Sprague-Dawley rats fitting entry criteria were divided randomly into three experimental groups (n = 10 each): Group A rats underwent bowel transection and re-anastomosis (sham) and tissue samples were harvested at day 7 post-surgery. Group B and C rats underwent 80% small bowel resection with tissue harvested from Group B rats at day 7 post-surgery, and from Group C rats at day 14 post-surgery. The distribution of ICC at the site of the residual small bowel was evaluated by immunohistochemical analysis of small intestine samples. The ultrastructural changes of ICC in the remnant ileum of model rats 7 and 14 d after mSBR were analyzed by transmission electron microscopy. Intracellular recordings of slow wave oscillations were used to evaluate electrical pacemaking. The protein expression of c-kit, ICC phenotypic markers, and membrane-bound stem cell factor (mSCF) in intestinal smooth muscle of each group were detected by Western blotting. RESULTS: After mSBR, immunohistochemical analysis indicated that the number of c-kit-positive cells was dramatically decreased in Group B rats compared with sham tissues. Significant ultrastructural changes in ICC with associated smooth muscle hypertrophy were also observed. Disordered spontaneous rhythmic contractions with reduced amplitude (8.5 ± 1.4 mV vs 24.8 ± 1.3 mV, P = 0.037) and increased slow wave frequency (39.5 ± 2.1 cycles/min vs 33.0 ± 1.3 cycles/min, P = 0.044) were found in the residual intestinal smooth muscle 7 d post mSBR. The contractile function and electrical activity of intestinal circular smooth muscle returned to normal levels at 14 d post mSBR (amplitude, 14.9 ± 1.6 mV vs 24.8 ± 1.3 mV; frequency, 30.7 ± 1.7 cycles/min vs 33.0 ± 1.3 cycles/min). The expression of Mscf and c-kit protein was decreased at 7 d (P = 0.026), but gradually returned to normal levels at 14 d. The ICC and associated neural networks were disrupted, which was associated with the phenotype alterations of ICC. CONCLUSION: Massive small bowel resection in rats triggered damage to ICC networks and decreased the number of ICC leading to disordered intestinal rhythmicity. The mSCF/c-kit signaling pathway plays a role in the regulation and maintenance of ICC phenotypes. PMID:23801833

Chen, Jie; Du, Lei; Xiao, Yong-Tao; Cai, Wei

2013-01-01

122

Enteropathy associated T-cell lymphoma presenting with multiple episodes of small bowel haemorrhage and perforation  

PubMed Central

Enteropathy-associated T cell lymphoma (EATCL) is an intestinal neoplasm of intra-epithelial T lymphocytes associated with coeliac disease. Although the incidence is rare, EATCL runs an aggressive disease course and produces multi-focal ulcerative lesions most commonly in the proximal small bowel. As such, patients may present with intestinal perforation, obstruction or haemorrhage. Management of EATCL requires a combination of early diagnosis and treatment by surgical resection followed by chemotherapy to achieve treatment success. Overall however, the treatment completion rate remains at 50% and EATCL carries a poor prognosis with a 5-year survival rate of <20%. PMID:24876396

Pun, Amy H.; Kasmeridis, Harry; Rieger, Nicholas; Loganathan, Arun

2014-01-01

123

Adhesional Small Bowel Obstruction in the Absence of Previous Operations: Management and Outcomes  

Microsoft Academic Search

Background  The majority of small bowel obstructions (SBO) are the result of adhesions caused by a previous abdominal operation. On rare\\u000a occasions, adhesional SBO occurs in the absence of such an operation. Our objective was to describe the management, findings,\\u000a and outcomes of unexplained adhesional SBO (UA-SBO) and examine whether preoperative diagnostic uncertainty leads to delays\\u000a in therapy and complications.\\u000a \\u000a \\u000a \\u000a Methods  The

Muhammad U. Butt; George C. Velmahos; Nikos Zacharias; Hasan B. Alam; Marc de Moya; David R. King

2009-01-01

124

Port Site Herniation of the Small Bowel following Laparoscopic-Myomectomy  

PubMed Central

Bowel herniation, through fascial defects secondary to laparoscopic surgery at the site of trocar entry, is a rare, but potentially serious, complication. Closure of the fascia at port sites measuring 10mm or more has been highly recommended to avoid such complications. We report a case of a small bowel which herniated and strangulated through the port site immediately after laparoscopic myomectomy. Resection of the strangulated bowel with primary anastomosis was required to manage this complication. We present this case report with literature review to discuss the risk factors and the methods to prevent such a complication post laparoscopic surgery. PMID:21509090

Elshafie, Ghazi A; Al-Wahaibi, Khalifa; Al-Azri, Ahmed; Al-Qadhi, Hani; Al-Harthi, Abdullah

2010-01-01

125

Preliminary mechanical characterization of the small bowel for in vivo robotic mobility.  

PubMed

In this work we present test methods, devices, and preliminary results for the mechanical characterization of the small bowel for intra luminal robotic mobility. Both active and passive forces that affect mobility are investigated. Four investigative devices and testing methods to characterize the active and passive forces are presented in this work: (1) a novel manometer and a force sensor array that measure force per cm of axial length generated by the migrating motor complex, (2) a biaxial test apparatus and method for characterizing the biomechanical properties of the duodenum, jejunum, and ileum, (3) a novel in vitro device and protocol designed to measure the energy required to overcome the self-adhesivity of the mucosa, and (4) a novel tribometer that measures the in vivo coefficient of friction between the mucus membrane and the robot surface. The four devices are tested on a single porcine model to validate the approach and protocols. Mean force readings per cm of axial length of intestine that occurred over a 15?min interval in vivo were 1.34?±?0.14 and 1.18?±?0.22?N cm(-1) in the middle and distal regions, respectively. Based on the biaxial stress/stretch tests, the tissue behaves anisotropically with the circumferential direction being more compliant than the axial direction. The mean work per unit area for mucoseparation of the small bowel is 0.08?±?0.03 mJ cm(-2). The total energy to overcome mucoadhesion over the entire length of the porcine small bowel is approximately 0.55?J. The mean in vivo coefficient of friction (COF) of a curved 6.97 cm(2) polycarbonate sled on live mucosa traveling at 1?mm s(-1) is 0.016?±?0.002. This is slightly lower than the COF on excised tissue, given the same input parameters. We have initiated a comprehensive program and suite of test devices and protocols for mechanically characterizing the small bowel for in vivo mobility. Results show that each of the four protocols and associated test devices has successfully gathered preliminary data to confirm the validity of our test approach. PMID:22010745

Terry, Benjamin S; Lyle, Allison B; Schoen, Jonathan A; Rentschler, Mark E

2011-09-01

126

The interdigestive myo-electric complex of the stomach and small bowel of dogs.  

PubMed Central

1. Szurszewski (1969) described a cyclic recurring, caudally migrating band of intense action potential activity, the activity fromt, in the small bowel of dogs fasted 18-21 hr. The finding has been confirmed by Carlson, Bedi & Code (1972) and by Grivel & Ruckebusch (1972). The objectives of the present study were to extend these observations first by indentifying the full sequence of myo-electric events in the stomach and small bowel of healthy conscious dogs fasted for 24-48 hr and for longer periods and second by determining the effect of ingestion of mild and of saline solution on the complex and the role of gastric distension in their action. 2. Under surgical anaesthesia, silver-silver chloride electrodes were implanted on the serosal surface of the stomach and small bowel of seven dogs, and recordings of electric activity were started when the dogs had recovered. One hundred and nine interdigestive complexes were studied in detail in five of the dogs during period ranging from 5 to 14 months. All observations were made while the dogs were healthy, conscious, and fasted. 3. The period of intense action potential activity, the activity frot or band, was found to be one phase of a cyclic-recurring sequence of changes in action potential activity. The entire sequence, composed of four phases, occured almost simultaneously in the stomach and duodenun and then migrated distally in sequence over the entire small bowel. As one cycle terminated in the distal ileum, another had started in the stomach and duodenum, and this cyclic recurrence continued during fasts of 4 and 5 days. 4. The cycles of the interdigestive complex tended to recur at the same time each day in three of the dogs. The mean periods of the cycles ranged from 90 to 114 min, and the mean time of their propagation from stomach to terminal ileim ranged from 105 to 134 min. The mean velocity of the activity fronts (phase III of the cycles) was 5-7-11-7 cm/min in the orad portion of the small bowel and 0-9-2-5 cm/min in the distal half. The mean calculated length of the activity front diminished from a range of 42-62 cm in the duodenum to 5-10 cm in the ileum. 5. Intragastric instillation of 400 ml. milk always interrupted the complex present in the bowel at the time of instillation and usually suppressed the next, whereas 400 ml. saline solution interrupted the complex present in the bowel only at the time of instillation. Distension of the stomach with a ballon always suppressed the interdigestive complex in the stomach and duodenum but sometimes failed to interrupt its migration along the bowe. PMID:1142245

Code, C F; Marlett, J A

1975-01-01

127

The interdigestive myo-electric complex of the stomach and small bowel of dogs.  

PubMed

1. Szurszewski (1969) described a cyclic recurring, caudally migrating band of intense action potential activity, the activity fromt, in the small bowel of dogs fasted 18-21 hr. The finding has been confirmed by Carlson, Bedi & Code (1972) and by Grivel & Ruckebusch (1972). The objectives of the present study were to extend these observations first by indentifying the full sequence of myo-electric events in the stomach and small bowel of healthy conscious dogs fasted for 24-48 hr and for longer periods and second by determining the effect of ingestion of mild and of saline solution on the complex and the role of gastric distension in their action. 2. Under surgical anaesthesia, silver-silver chloride electrodes were implanted on the serosal surface of the stomach and small bowel of seven dogs, and recordings of electric activity were started when the dogs had recovered. One hundred and nine interdigestive complexes were studied in detail in five of the dogs during period ranging from 5 to 14 months. All observations were made while the dogs were healthy, conscious, and fasted. 3. The period of intense action potential activity, the activity frot or band, was found to be one phase of a cyclic-recurring sequence of changes in action potential activity. The entire sequence, composed of four phases, occured almost simultaneously in the stomach and duodenun and then migrated distally in sequence over the entire small bowel. As one cycle terminated in the distal ileum, another had started in the stomach and duodenum, and this cyclic recurrence continued during fasts of 4 and 5 days. 4. The cycles of the interdigestive complex tended to recur at the same time each day in three of the dogs. The mean periods of the cycles ranged from 90 to 114 min, and the mean time of their propagation from stomach to terminal ileim ranged from 105 to 134 min. The mean velocity of the activity fronts (phase III of the cycles) was 5-7-11-7 cm/min in the orad portion of the small bowel and 0-9-2-5 cm/min in the distal half. The mean calculated length of the activity front diminished from a range of 42-62 cm in the duodenum to 5-10 cm in the ileum. 5. Intragastric instillation of 400 ml. milk always interrupted the complex present in the bowel at the time of instillation and usually suppressed the next, whereas 400 ml. saline solution interrupted the complex present in the bowel only at the time of instillation. Distension of the stomach with a ballon always suppressed the interdigestive complex in the stomach and duodenum but sometimes failed to interrupt its migration along the bowe. PMID:1142245

Code, C F; Marlett, J A

1975-03-01

128

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

129

CT-Enterography May Identify Small Bowel Tumors Not Detected by Capsule Endoscopy: Eight Years Experience at Mayo Clinic Rochester  

Microsoft Academic Search

Background  Capsule endoscopy (CE) is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases. However,\\u000a small bowel tumors (SBT) are sometimes missed by CE. Preliminary studies suggest that CT-enterography (CTE) may play a role\\u000a in detecting SBT.\\u000a \\u000a \\u000a \\u000a \\u000a Aims  The purpose of this study was to compare the performance of CE and CTE in detecting SBT\\u000a \\u000a \\u000a \\u000a Methods  This was

Fayaz A. Hakim; Jeffrey A. Alexander; James E. Huprich; Madhusudan Grover; Felicity T. Enders

130

MDCT of Small Bowel Obstruction: How Reliable Are Oblique Reformatted Images in Localizing Point of Transition?  

PubMed Central

The goal of this study is to prospectively assess the additional value of oblique reformatted images for localizing POT, having surgery as a reference standard. Materials and Methods. 102 consecutive patients with suspected small bowel obstruction (SBO) underwent 64-slice multidetector row CT (MDCT) using surgical findings as reference standard. Two independent GI radiologists reviewed the CT scans to localize the exact POT by evaluating axial images (data set A) followed by axial, coronal, and oblique MPR images. CT findings were compared to surgical findings in terms of diagnostic performance. McNemar's test was used to detect any statistical difference in POT evaluation between datasets A and B. Kappa statistics were applied for measuring agreement between two readers. Results. There was a diagnostic improvement of 9.9% in the case of the less experienced radiologist in localizing POT by using oblique reformatted images. The more experienced radiologist showed diagnostic improvement by 12.9%. PMID:24883057

Memon, Wasim; Khattak, Yasir Jamil; Alam, Tariq; Anwar, Shayan Sirat Maheen

2014-01-01

131

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

132

Acute small bowel obstruction caused by endometriosis: a case report and review of the literature.  

PubMed

Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare (1%-7%). Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction, ranging from 7% to 23% of all cases with intestinal involvement. We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery, in a woman whose symptoms were not related to menses. Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration. Endometrial lymph node involvement, with a cystic glandular pattern was also detected. PMID:18528943

De Ceglie, Antonella; Bilardi, Claudio; Blanchi, Sabrina; Picasso, Massimo; Di Muzio, Marcello; Trimarchi, Alberto; Conio, Massimo

2008-06-01

133

Case report of small bowel obstruction caused by small intestinal metastasis of bilateral breast cancer  

PubMed Central

A 41-year-old female was admitted into hospital due to recurrent abdominal pain with bloating. An enteroscopy was carried out and stenosis in the lower jejunal lumen was identified. This led to a diagnosis of small bowel obstruction caused by inflammation. During the laparotomy, the resection and anastomosis of a narrow segment of small intestine was performed. In combination with the results of immunohistochemical analysis, the postoperative pathology indicated the presence of a poorly differentiated/undifferentiated carcinoma of the small intestine, which was considered to have arisen from breast cancer. Postoperative examination showed bilateral breast masses, and the pathology of the right breast tumor biopsy prompted the diagnosis of invasive lobular carcinoma. A breast MRI was reviewed following five cycles of XT chemotherapy and the evaluation was stable disease (SD). Since the mass was not sensitive to chemotherapy, a bilateral modified radical mastectomy was performed, and postoperative pathology confirmed the mass to be primary bilateral invasive lobular carcinoma. PMID:24137245

LV, LIQIONG; ZHAO, YUN; LIU, HUI; PENG, ZHONGYI

2013-01-01

134

International Grading Scheme for Acute Rejection in Small Bowel Transplantation: Implementation and Experience at the University of Miami  

Microsoft Academic Search

In 2003, an international collection of pathologists and clinicians proposed a unified grading system for acute cellular rejection in endoscopically derived small intestine allograft biopsies. This grading system was implemented at the University of Miami over the past 2 years and the results are presented herein. A total of 1136 small bowel allograft biopsies with sufficient tissue for analysis were

P. Ruiz; D. Weppler; S. Nishida; T. Kato; G. Selvaggi; D. Levi; P. Bejarano; A. Khaled; P. Tryphonopoulos; S. Tuteja; M. Garcia; A. Tzakis

2006-01-01

135

Can Tissue Transglutaminase Antibody Titers Replace Small-Bowel Biopsy to Diagnose Celiac Disease in Select Pediatric Populations?  

Microsoft Academic Search

Objectives. The use of screening tests for celiac disease has increased the number of patients referred for evaluation. We proposed that the subgroup of patients with very high tissue transglutaminase anti- body (TTG) titers is positive for celiac disease and a small-bowel biopsy is not necessary to make the diagno- sis. A gluten-free diet should be attempted and, if the

Collin C. Barker; Craig Mitton; Gareth Jevon; Thomas Mock

2010-01-01

136

A double isotope technique for the evaluation of drug action on gastric evacuation and small bowel propulsion studied in the rat  

PubMed Central

A method to measure simultaneously gastric evacuation and small bowel propulsion in the rat is presented. The value of the method in testing drug action is described. The effect of an antidiarrhoeal agent, diphenoxylate, was analysed and it was shown that it retarded small bowel propulsion without influencing gastric evacuation. PMID:4719215

Nilsson, Folke; Johansson, Henry

1973-01-01

137

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

138

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

139

IGF-2 Is Necessary for Retinoblastoma-Mediated Enhanced Adaptation after Small-Bowel Resection.  

PubMed

Previously, we have demonstrated that genetically disrupting retinoblastoma protein (Rb) expression in enterocytes results in taller villi, mimicking resection-induced adaption responses. Rb deficiency also results in elevated insulin-like growth factor-2 (IGF-2) expression in villus enterocytes. We propose that postoperative disruption of Rb results in enhanced adaptation which is driven by IGF-2. Inducible, intestine-specific Rb-null mice (iRbIKO) and wild-type (WT) littermates underwent a 50 % proximal small-bowel resection (SBR) at 7-9 weeks of age. They were then given tamoxifen on postoperative days (PODs) 4-6 and harvested on POD 28. The experiment was then repeated on double knockouts of both IGF-2 and Rb (IGF-2 null/iRbIKO). iRbIKO mice demonstrated enhanced resection-induced adaptive villus growth after SBR and increased IGF-2 messenger RNA (mRNA) in ileal villus enterocytes compared to their WT littermates. In the IGF-2 null/iRbIKO double-knockout mice, there was no additional villus growth beyond what was expected of normal resection-induced adaptation. Adult mice in which Rb is inducibly deleted from the intestinal epithelium following SBR have augmented adaptive growth. IGF-2 expression is necessary for enhanced adaptation associated with acute intestinal Rb deficiency. PMID:25002022

Choi, Pamela M; Sun, Raphael C; Sommovilla, Josh; Diaz-Miron, Jose; Guo, Jun; Erwin, Christopher R; Warner, Brad W

2014-11-01

140

Computerized analysis of bowel sounds in normal and small bowel obstructed rats  

NASA Astrophysics Data System (ADS)

Small bowel obstruction (SBO) is a common surgical emergency which may be mimicked by ileus or other nonsurgical conditions. The aims of this work is to delineate gastrointestinal sound (GIS) correlates in a rat model. Seven rats were studied in paired SBO and control states. Computerized analysis of GIS was performed under continuous IV sedation. After adaptive filtering, every GIS event was isolated and analyzed for duration and dominant frequency. It was found that long duration sounds (greater than 100 ms) occurred in each of the obstructed, but in none of the nonobstructed cases (p=0.02). The overall mean event duration and dominant frequency in SBO compared to control states was both significantly longer and lower (22.42.6 vs 7.0+/-2.6 ms, p=0.001 for duration; and 296+/-34 vs 427+/-33, p=0.001 for frequency). Besides these mean differences, there was also a clear evolution with time in GIS characteristics, with lengthening of the duration (+0.56 ms/min, p=0.001) and lowering of the dominant frequency (-3.3 Hz/min, p=0.01). It is concluded that GIS analysis may prove useful in the noninvasive, rapid, and accurate diagnosis of SBO.

Sandler, Richard; Mansy, Hansen; Uhing, Michael; Meyer, Peter; Kimura, Robert

2003-04-01

141

RENAL HISTOPATHOLOGY AND CRYSTAL DEPOSITS IN PATIENTS WITH SMALL BOWEL RESECTION AND CALCIUM OXALATE STONE DISEASE  

PubMed Central

To date, the surgical anatomy and histopathology of kidneys from patients with stones and small bowel resection have not been studied. We present here materials from 11 cases, 10 Crohn’s disease and one with resection in infancy for unknown cause. Stones are predominantly calcium oxalate (CaOx). Urine stone risks included hyperoxaluria (urine oxalate excretion > 45 mg/day) in half of the cases, and reduced urine volume and pH. As in ileostomy and obesity bypass, inner medullary collecting ducts (IMCD) contain crystal deposits with associated cell injury, interstitial inflammation and papillary deformity. Cortical changes include modest glomerular sclerosis, tubular atrophy, and interstitial fibrosis. Interstitial papillary apatite (Randall’s) plaque is abundant, and CaOx stones grow over deposits as in ileostomy, idiopathic CaOx stone formers, and primary hyperparathyroidism. Abundant plaque is compatible with the low urine volume and pH. IMCD deposits all contain apatite; in 3 cases CaOx is also present. This is similar to findings in obesity bypass but not ileostomy. Mechanisms for CaOx in IMCD appear to include elevated urine, and presumably tubule fluid CaOx SS with a low calcium to oxalate ratio; mechanisms for the universal presence of IMCD apatite are unknown. PMID:20428098

Evan, Andrew P.; Lingeman, James E.; Worcester, Elaine M.; Bledsoe, Sharon B.; Sommer, Andre J.; Williams, James C.; Krambeck, Amy E.; Philips, Carrie L.; Coe, Fredric L

2013-01-01

142

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

143

Mucosal vascular alterations in isolated small-bowel allografts: relationship to humoral sensitization.  

PubMed

Acute vascular rejection (AVR) in human small-bowel transplantation is an inadequately characterized entity whose frequency and severity is not well understood. As compared to severe AVR, changes identifying early, mild or evolving AVR are not known. We created a scoring system to evaluate subtle mucosal vascular changes and examined 188 biopsies from 21 patients obtained in the first 3 months post transplant. A majority of patients had a transient rise in vascular injury, often within 30 days of transplant. Small-vessel congestion and erythrocyte extravasation were the most common alterations. The vascular injury score was not related to acute cellular rejection, HLA type or HLA antigen disparities. However, the patients with the vascular changes had significantly higher peak panel reactive antibodies (PRA) and a higher incidence of positive T-cell and B-cell crossmatch. Finally, graft survival was significantly lower in the patients demonstrating the early vascular lesions. These data suggest that the vascular injury is partially associated with humoral presensitization of the recipient and may be a form of acute vascular rejection. Since these vascular changes are frequent, we advocate early post-transplant monitoring to identify and manage potentially high-risk patients. PMID:12492709

Ruiz, Phillip; Garcia, Monica; Pappas, Peter; Berney, Thierry; Esquenazi, Violet; Kato, Tomoaki; Mittal, Naveen; Weppler, Deborah; Levi, David; Nishida, Seigo; Nery, Jose; Miller, Joshua; Tzakis, Andreas

2003-01-01

144

Secondary extramedullary plasmacytoma causing small bowel intussusception in a patient with multiple myeloma - A case report  

PubMed Central

INTRODUCTION Multiple myeloma is a monoclonal, immunoproliferative plasma-cell neoplasm of the B lymphoid cells. Extramedullary plasmacytoma is a type of plasma-cell neoplasm that can present as a primary tumour or secondary to another plasma-cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease with ileum involvement being very rare. PRESENTATION OF CASE We report a rare case of a 58-year-old man, with known multiple myeloma, re-presenting with evidence of small bowel obstruction, secondary to an intussusception due to a malignant plasma cell deposit, which was successfully resected at laparotomy. Previous two similar admissions, prior to this index admission, failed to arrive at this difficult rare diagnosis. DISCUSSION Primary and secondary extramedullary plasmacytoma mainly affects the upper aero-digestive tract. Involvement of the ileum, as in this case, is a rare complication. Prognosis of secondary extramedullary plasmacytoma affecting the gastrointestinal tracts is unknown, due to the small number of cases reported in the literature, but suggestive of a poor prognosis. The role of surgery is often palliative to deal with resolvable life-threatening emergencies and where possible to prolong life. CONCLUSION The case adds to the current literature of the rare event of visceral secondary extramedullary plasmacytoma involving the gastrointestinal tract, in the course of multiple myeloma and highlights the need for a high index of suspicion for such uncommon complications, to avoid delay in diagnosis and treatment. PMID:23562898

Ariyarathenam, Arun; Galvin, Nick; Akoh, Jacob A.

2013-01-01

145

Microbeam studies of soft X-ray induced bystander cell killing using microbeam X-ray cell irradiation system at CRIEPI.  

PubMed

The radiation induced bystander response is defined as a response in cells which have not been directly targeted by radiation, but which are in the neighborhood of cells which have been directly exposed. In many cases, the bystander response is saturated with increasing dose and is observed when only one cell in a population is targeted by high-LET particle radiations or ultrasoft X-rays (278 eV). However, in our studies using synchrotron X-ray microbeams (5.35 keV), the bystander cell killing effect in normal human fibroblast WI-38 cells had a parabolic relationship to the irradiating dose and was detected if 5 or more cell nuclei were irradiated. To evaluate the feature of the X-ray-induced bystander cell killing effect at a wider dose range and the existence of photon energy dependence, the effects were assessed by irradiating cell nuclei in confluent WI-38 cells with AlK X-ray microbeams (1.49 keV). The surviving fraction decreased when only a single cell nucleus was irradiated, suggesting the minimal number of targeted cells to induce the effect may depend on the energy of photons used. In this study, we found that the bystander cell killing effect showed a biphasic relationship to the irradiating dose. The decrease in bystander cell survival at the doses higher than 0.23 Gy was partially suppressed between 2.3 and 7.0 Gy, followed by level-off around 90% above 14 Gy, suggesting that the X-ray-induced bystander response is dose dependent. In addition, NO is one of chief initiators/mediators of the effect at least 0.47 Gy. PMID:22510578

Tomita, Masanori; Kobayashi, Katsumi; Maeda, Munetoshi

2012-01-01

146

Efficacy of an absorbable mesh in keeping the small bowel out of the human pelvis following surgery  

SciTech Connect

Patients with pelvic malignancies frequently require postoperative radiation therapy either as adjunctive or palliative treatment. Tumoricidal doses, however, are frequently associated with small-bowel damage. Animal experiments demonstrated tolerance to high-dose radiation therapy and protection from radiation enteritis by use of an absorbable polymer polyglycolic acid (PGA) that is used as an intestinal sling to elevate the small bowel away from the operated site. Sixty patients (42 with rectal carcinomas and 18 with gynecologic malignancies) underwent surgical treatment that included the intestinal sling procedure. Postoperative radiation was begun within three weeks following surgery and patients received a mean approximating 5500 rads in fractionated doses. A mean follow-up time of 28 months has not revealed a single case of radiation enteritis (by either contrast studies or physiologic studies) or PGA mesh-related complications. The authors believe that this surgical technique should be employed in patients who may require postoperative radiation treatment for pelvic malignancy.

Devereux, D.F.; Chandler, J.J.; Eisenstat, T.; Zinkin, L.

1988-01-01

147

Parenteral nutrition supplemented with short-chain fatty acids: effect on the small-bowel mucosa in normal rats.  

PubMed

When enteral nutrition is excluded from animals maintained solely with total parenteral nutrition (TPN), atrophy of the intestinal mucosa is observed. Short-chain fatty acids (SCFAs) are produced in the colon by the fermentation of dietary carbohydrates and fiber polysaccharides and have been shown to stimulate mucosal-cell mitotic activity in the intestine. This study compared the effects of an intravenous and an intracecal infusion of SCFAs on the small-bowel mucosa. Rats received standard TPN, TPN with SCFAs (sodium acetate, propionate, and butyrate), TPN with an intracecal infusion of SCFAs, or rat food. After 7 d jejunal and ileal mucosal weights, DNA, RNA, and protein were determined. Standard TPN produced significant atrophy of the jejunal and ileal mucosa. Both the intracecal and intravenous infusion of SCFAs significantly reduced the mucosal atrophy associated with TPN. The intravenous and intracolonic infusion of SCFAs were equally effective in inhibiting small-bowel mucosal atrophy. PMID:1690948

Koruda, M J; Rolandelli, R H; Bliss, D Z; Hastings, J; Rombeau, J L; Settle, R G

1990-04-01

148

Prospective Comparison of Small Bowel Meal with Pneumocolon versus Ileo-Colonoscopy for the Diagnosis of Ileal Crohn's Disease  

Microsoft Academic Search

BACKGROUND AND AIMS:Both endoscopy and barium radiography are used routinely to diagnose terminal ileal (TI) Crohn's disease (CD). A prospective study was undertaken to compare ileoscopy with biopsy to small bowel meal with pneumocolon (SBMP) in patients with suspected TI CD.METHODS:A cohort of outpatients investigated for diarrhea with features of TI disease underwent SBMP followed by colonoscopy with ileal intubation

John K. Marshall; Ruth Cawdron; Ian Zealley; Robert H. Riddell; Sat Somers; E. Jan Irvine

2004-01-01

149

Effect of intestinal P-glycoprotein on daily tacrolimus trough level in a living-donor small bowel recipient  

Microsoft Academic Search

We have examined whether the expression levels of the intestinal absorptive barriers, MDR1 gene product P-glycoprotein and cytochrome P450 IIIA4 (CYP3A4), correlate with the trough levels of orally administered tacrolimus in a recipient of small bowel transplant for 4 months. By using a competitive polymerase chain reaction, the expression of MDR1 messenger RNA (mRNA) and CYP3A4 mRNA by intestinal cells

Satohiro Masuda; Shinji Uemoto; Tohru Hashida; Yukihiro Inomata; Koichi Tanaka; Ken-ichi Inui

2000-01-01

150

Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease  

PubMed Central

Background Due to the restrictive nature of a gluten-free diet, celiac patients are looking for alternative therapies. While drug-development programs include gluten challenges, knowledge regarding the duration of gluten challenge and gluten dosage is insufficient. We challenged adult celiac patients with gluten with a view to assessing the amount needed to cause some small-bowel mucosal deterioration. Methods Twenty-five celiac disease adults were challenged with low (1-3 g) or moderate (3-5g) doses of gluten daily for 12 weeks. Symptoms, small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs) and celiac serology were determined. Results Both moderate and low amounts of gluten induced small-bowel morphological damage in 67% of celiac patients. Moderate gluten doses also triggered mucosal inflammation and more gastrointestinal symptoms leading to premature withdrawals in seven cases. In 22% of those who developed significant small- intestinal damage, symptoms remained absent. Celiac antibodies seroconverted in 43% of the patients. Conclusions Low amounts of gluten can also cause significant mucosal deterioration in the majority of the patients. As there are always some celiac disease patients who will not respond within these conditions, sample sizes must be sufficiently large to attain to statistical power in analysis. PMID:22115041

2011-01-01

151

Acute Small Bowel Hemorrhage in Three Patients with End-Stage Renal Disease: Diagnosis and Management by Angiographic Intervention  

SciTech Connect

Three patients who had undergone hemodialysis for end-stage renal disease, presented with acute small bowel hemorrhage,and were treated with superselective transcatheter arterial embolization via coaxial microcatheters. In all patients pre-procedure upper gastrointestinal (GI) endoscopy and colonoscopy had failed to demonstrate the source of the hemorrhage. Selective diagnostic angiography revealed frank extravasations of contrast from the small bowel arteries (one jejunal artery and two ileal arteries). After superselection of feeding arteries with a microcatheter, transcatheter embolization using Gelfoam and microcoils was performed in all three patients. Immediate hemostasis was achieved in all patients and the patients were discharged free from symptoms 3-5 days after embolization. No evidence of intestinal ischemia or infarction was noted, with the time from procedure to last follow-up ranging from 4 to 12 months. We conclude that superselective angiography is a valuable tool for diagnosing and treating acute small bowel hemorrhage inpatients with end-stage renal disease when endoscopic evaluation has failed.

Yoon, Woong; Kim, Jae Kyu [Department of Radiology, Chonnam National University Hospital, 8 Hak-1-dong, Dongku, Gwangju, 501-757 (Korea, Republic of); Kim, Heoung Kil [Departmentof Radiology, St. Carollo Hospital, 1742 Jo-Rye dong, Sun-Cheon, 540-320 (Korea, Republic of); Han, Young Min [Department of Radiology, ChunbukNational University Hospital, San 2-20 Keumamdong, Deokjingu, Chonju, 560-182 (Korea, Republic of); Kang, Heoung Keun [Department of Radiology, Chonnam National University Hospital, 8 Hak-1-dong, Dongku, Gwangju, 501-757 (Korea, Republic of)

2002-03-15

152

Conservative treatment of early postoperative small bowel obstruction with obliterative peritonitis  

PubMed Central

AIM: To investigate the effect of somatostatin and dexamethasone on early postoperative small bowel obstruction with obliterative peritonitis (EPSBO-OP). METHODS: This prospective randomized study included 70 patients diagnosed with EPSBO-OP from June 2002 to January 2009. Patients were randomized into two groups: a control group received total parenteral nutrition and nasogastric (NG) tube feeding; and an intervention group received, in addition, somatostatin and dexamethasone treatment. The primary endpoints were time to resolution of bowel obstruction and length of hospital stay, and the secondary endpoints were daily NG output and NG feeding duration, treatment-related complications, postoperative obstruction relapse, and patient satisfaction. RESULTS: Thirty-six patients were allocated to the intervention group and 34 to the control group. No patient needed to undergo surgery. Patients in the intervention group had an earlier resolution of bowel obstruction (22.4 ± 9.1 vs 29.9 ± 10.1 d, P = 0.002). Lower daily NG output (583 ± 208 vs 922 ± 399 mL/d, P < 0.001), shorter duration of NG tube use (16.7 ± 8.8 vs 27.7 ± 9.9 d, P < 0.001), and shorter length of hospital stay (25.8 vs 34.9 d, P = 0.001) were observed in the intervention group. The rate of treatment-related complications (P = 0.770) and relapse of obstruction (P = 0.357) were comparable between the two groups. There were no significant differences in postoperative satisfaction at 1, 2 and 3 years between the two groups. CONCLUSION: Somatostatin and dexamethasone for EPSBO-OP promote resolution of obstruction and shorten hospital stay, and are safe for symptom control without increasing obstruction relapse. PMID:24379592

Gong, Jian-Feng; Zhu, Wei-Ming; Yu, Wen-Kui; Li, Ning; Li, Jie-Shou

2013-01-01

153

Radiation enteropathy and leucocyte-endothelial cell reactions in a refined small bowel model  

PubMed Central

Background Leucocyte recruitment and inflammation are key features of high dose radiation-induced tissue injury. The inflammatory response in the gut may be more pronounced following radiotherapy due to its high bacterial load in comparison to the response in other organs. We designed a model to enable us to study the effects of radiation on leucocyte-endothelium interactions and on intestinal microflora in the murine ileum. This model enables us to study specifically the local effects of radiation therapy. Method A midline laparotomy was performed in male C57/Bl6 mice and a five-centimetre segment of ileum is irradiated using the chamber. Leucocyte responses (rolling and adhesion) were then analysed in ileal venules 2 – 48 hours after high dose irradiation, made possible by an inverted approach using intravital fluorescence microscopy. Furthermore, intestinal microflora, myeloperoxidase (MPO) and cell histology were analysed. Results The highest and most reproducible increase in leucocyte rolling was exhibited 2 hours after high dose irradiation whereas leucocyte adhesion was greatest after 16 hours. Radiation reduced the intestinal microflora count compared to sham animals with a significant decrease in the aerobic count after 2 hours of radiation. Further, the total aerobic counts, Enterobacteriaceae and Lactobacillus decreased significantly after 16 hours. In the radiation groups, the bacterial count showed a progressive increase from 2 to 24 hours after radiation. Conclusion This study presents a refinement of a previous method of examining mechanisms of radiation enteropathy, and a new approach at investigating radiation induced leucocyte responses in the ileal microcirculation. Radiation induced maximum leucocyte rolling at 2 hours and adhesion peaked at 16 hours. It also reduces the microflora count, which then starts to increase steadily afterwards. This model may be instrumental in developing strategies against pathological recruitment of leucocytes and changes in intestinal microflora in the small bowel after radiotherapy. PMID:15363103

Johnson, Louis Banka; Riaz, Amjid Ali; Adawi, Diya; Wittgren, Lena; Back, Sven; Thornberg, Charlotte; Osman, Nadia; Gadaleanu, Virgil; Thorlacius, Henrik; Jeppsson, Bengt

2004-01-01

154

Effects of immunosuppressive therapy after experimental small bowel transplantation in rats.  

PubMed

Significant improvements of graft and patient survival have been achieved over the past 20 years in the field of intestinal transplantation. Tacrolimus monotherapy with corticosteroids, or in combination with sirolimus is the most commonly used immunosuppressive regimen. Early (24h) after experimental allogenic small bowel transplantation in rats, sirolimus reduces the cellular and molecular inflammatory response with subsequent graft dysmotility more efficiently than tacrolimus, with contrary effects at 7 days after transplantation. This study evaluates three immunosuppressive strategies in the post-acute phase after intestinal transplantation - tacrolimus or sirolimus monotherapy and the combination therapy of tacrolimus with infliximab. After orthotopic intestinal transplantation between Brown Norway and Lewis rats, animals received 14 days of immunosuppressive treatment. Histology, infiltration of neutrophils, monocytes and macrophages, cytokine and mediator mRNA expression (real time RT-PCR) and smooth muscle function in a standard organ bath were assessed at 14 days after transplantation in all treatment groups and isogenic controls. Allogenic transplanted rats without immunosuppressive therapy and non-transplanted animals served as further control. Tacrolimus prevented acute rejection and graft dysmotility more effectively (p ? 0.05) than sirolimus. Reduced mRNA expression levels of CD4, IFN-?, IL-6, IL-10, iNOS, NF?B, TNF-? and MCP-1 (p ? 0.05) were observed in tacrolimus treated animals compared to sirolimus. Additional infliximab application did not influence the cellular and molecular inflammatory response in the post-acute phase after transplantation. In conclusion, the severe cellular and molecular inflammatory response in allogenic transplanted grafts without immunosuppressive therapy is ameliorated by all three immunosuppressive regimens, but tacrolimus was found to be more efficient than sirolimus at 14 days after transplantation. Our findings do not rule out the usage of sirolimus as single immunosuppressive therapy, but indicate and confirm the potency and effectivity of tacrolimus as basis immunosuppressant in the field of intestinal transplantation. PMID:21820512

Pech, Thomas; Fujishiro, Jun; Finger, Tobias; von Websky, Martin; Stoffels, Burkhard; Wehner, Sven; Abu-Elmagd, Kareem; Kalff, Joerg C; Schaefer, Nico

2011-09-01

155

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

156

Pathobiological implications of mucin (MUC) expression in the outcome of small bowel cancer.  

PubMed

Mucins have been associated with survival in various cancer patients, but there have been no studies of mucins in small bowel carcinoma (SBC). In this study, we investigated the relationships between mucin expression and clinicopathologic factors in 60 SBC cases, in which expression profiles of MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC6 and MUC16 in cancer and normal tissues were examined by immunohistochemistry. MUC1, MUC5AC and MUC16 expression was increased in SBC lesions compared to the normal epithelium, and expression of these mucins was related to clinicopathologic factors, as follows: MUC1 [tumor location (p?=?0.019), depth (p?=?0.017) and curability (p?=?0.007)], MUC5AC [tumor location (p?=?0.063) and lymph node metastasis (p?=?0.059)], and MUC16 [venous invasion (p?=?0.016) and curability (p?=?0.016)]. Analysis of 58 cases with survival data revealed five factors associated with a poor prognosis: poorly-differentiated or neuroendocrine histological type (p<0.001), lymph node metastasis (p<0.001), lymphatic invasion (p?=?0.026), venous invasion (p<0.001) and curative resection (p<0.001), in addition to expression of MUC1 (p?=?0.042), MUC5AC (p?=?0.007) and MUC16 (p<0.001). In subsequent multivariate analysis with curability as the covariate, lymph node metastasis, venous invasion, and MUC5AC and/or MUC16 expression were significantly related to the prognosis. Multivariate analysis in curative cases (n?=?45) showed that SBC with MUC5AC and/or MUC16 expression had a significantly independent high hazard risk after adjusting for the effects of venous invasion (hazard ratio: 5.6, 95% confidence interval: 1.8-17). In conclusion, the study shows that a MUC5AC-positive and/or MUC16-positive status is useful as a predictor of a poor outcome in patients with SBC. PMID:24722639

Shibahara, Hiroaki; Higashi, Michiyo; Koriyama, Chihaya; Yokoyama, Seiya; Kitazono, Iwao; Kurumiya, Yasuhiro; Narita, Michihiko; Kuze, Shingo; Kyokane, Takanori; Mita, Saburo; Arai, Toshiyuki; Kato, Takehito; Yuasa, Norihiro; Yamaguchi, Ryuzo; Kubota, Hitoshi; Suzuki, Hideaki; Baba, Satoshi; Rousseau, Karine; Batra, Surinder K; Yonezawa, Suguru

2014-01-01

157

Pathobiological Implications of Mucin (MUC) Expression in the Outcome of Small Bowel Cancer  

PubMed Central

Mucins have been associated with survival in various cancer patients, but there have been no studies of mucins in small bowel carcinoma (SBC). In this study, we investigated the relationships between mucin expression and clinicopathologic factors in 60 SBC cases, in which expression profiles of MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC6 and MUC16 in cancer and normal tissues were examined by immunohistochemistry. MUC1, MUC5AC and MUC16 expression was increased in SBC lesions compared to the normal epithelium, and expression of these mucins was related to clinicopathologic factors, as follows: MUC1 [tumor location (p?=?0.019), depth (p?=?0.017) and curability (p?=?0.007)], MUC5AC [tumor location (p?=?0.063) and lymph node metastasis (p?=?0.059)], and MUC16 [venous invasion (p?=?0.016) and curability (p?=?0.016)]. Analysis of 58 cases with survival data revealed five factors associated with a poor prognosis: poorly-differentiated or neuroendocrine histological type (p<0.001), lymph node metastasis (p<0.001), lymphatic invasion (p?=?0.026), venous invasion (p<0.001) and curative resection (p<0.001), in addition to expression of MUC1 (p?=?0.042), MUC5AC (p?=?0.007) and MUC16 (p<0.001). In subsequent multivariate analysis with curability as the covariate, lymph node metastasis, venous invasion, and MUC5AC and/or MUC16 expression were significantly related to the prognosis. Multivariate analysis in curative cases (n?=?45) showed that SBC with MUC5AC and/or MUC16 expression had a significantly independent high hazard risk after adjusting for the effects of venous invasion (hazard ratio: 5.6, 95% confidence interval: 1.8–17). In conclusion, the study shows that a MUC5AC-positive and/or MUC16-positive status is useful as a predictor of a poor outcome in patients with SBC. PMID:24722639

Shibahara, Hiroaki; Higashi, Michiyo; Koriyama, Chihaya; Yokoyama, Seiya; Kitazono, Iwao; Kurumiya, Yasuhiro; Narita, Michihiko; Kuze, Shingo; Kyokane, Takanori; Mita, Saburo; Arai, Toshiyuki; Kato, Takehito; Yuasa, Norihiro; Yamaguchi, Ryuzo; Kubota, Hitoshi; Suzuki, Hideaki; Baba, Satoshi; Rousseau, Karine; Batra, Surinder K.; Yonezawa, Suguru

2014-01-01

158

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

159

Insights into the mechanism of X-ray-induced disulfide-bond cleavage in lysozyme crystals based on EPR, optical absorption and X-ray diffraction studies  

PubMed Central

Electron paramagnetic resonance (EPR) and online UV–visible absorption microspectrophotometry with X-ray crystallography have been used in a complementary manner to follow X-ray-induced disulfide-bond cleavage. Online UV–visible spectroscopy showed that upon X-irradiation, disulfide radicalization appeared to saturate at an absorbed dose of approximately 0.5–0.8?MGy, in contrast to the saturating dose of ?0.2?MGy observed using EPR at much lower dose rates. The observations suggest that a multi-track model involving product formation owing to the interaction of two separate tracks is a valid model for radiation damage in protein crystals. The saturation levels are remarkably consistent given the widely different experimental parameters and the range of total absorbed doses studied. The results indicate that even at the lowest doses used for structural investigations disulfide bonds are already radicalized. Multi-track considerations offer the first step in a comprehensive model of radiation damage that could potentially lead to a combined computational and experimental approach to identifying when damage is likely to be present, to quantitate it and to provide the ability to recover the native unperturbed structure. PMID:24311579

Sutton, Kristin A.; Black, Paul J.; Mercer, Kermit R.; Garman, Elspeth F.; Owen, Robin L.; Snell, Edward H.; Bernhard, William A.

2013-01-01

160

X-ray-induced photoconductivity in YBa{sub 2}Cu{sub 3}O{sub 6} between 70 and 300 K  

SciTech Connect

The x-ray-induced photoconductivity in bulk ceramic samples of YBa{sub 2}Cu{sub 3}O{sub 6+{ital x}}, with {ital x}{approx_equal}0, at temperatures between 70 and 300 K has been studied. In addition to a prompt current, which occurs at the beginning of the irradiation, the photocurrent exhibits a saturation growth stage up to values quite larger than the prompt. The amplitude of the saturating stage depends on dose and dose rate. The photocurrent level also increases with the irradiation temperature, but the fractional change in electric carriers decreases as the irradiation temperature increases. It has been found that after irradiation the samples show a persistent photoconductivity (PPC). The isothermal decay curves at the irradiation temperature of the PPC show that its thermal stability increases for an increase of either the irradiation dose or the irradiation temperature. Above 200 K the thermal stability decreases and the sample completely recovers after several hours at room temperature. The possible relation between this PPC and the well known PPC induced by laser illumination in thin films of this material is discussed. {copyright} {ital 1996 The American Physical Society.}

Jimenez de Castro, M.; Alvarez Rivas, J.L. [Instituto de Ciencia de Materiales, Consejo Superior de Investigaciones Cientificas, Serrano 113, 28006 Madrid (Spain)

1996-04-01

161

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

SciTech Connect

The dynamics of the soft x-ray induced excited spin state trapping (SOXIESST) effect of Fe(phen){sub 2}(NCS){sub 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([Me{sub 2}Pyrz]{sub 3}BH){sub 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. [Institut de Physique et de Chimie des Matériaux de Strasbourg, Université de Strasbourg, CNRS UMR 7504 23 rue du Loess, 67034 Strasbourg (France) [Institut de Physique et de Chimie des Matériaux de Strasbourg, Université de Strasbourg, CNRS UMR 7504 23 rue du Loess, 67034 Strasbourg (France); Physikalisches Institut, Karlsruhe Institut of Technology, Wolfgang-Gaede-Str. 1, 76131 Karlsruhe (Germany); Miyamachi, T. [Institute for Solid State Physics, University of Tokyo, 5-1-5 Kashiwanoha, Kashiwashi, Chiba 277-8581 (Japan)] [Institute for Solid State Physics, University of Tokyo, 5-1-5 Kashiwanoha, Kashiwashi, Chiba 277-8581 (Japan); Da Costa, V.; Boukari, S.; Scheurer, F.; Joly, L.; Bowen, M.; Beaurepaire, E. [Institut de Physique et de Chimie des Matériaux de Strasbourg, Université de Strasbourg, CNRS UMR 7504 23 rue du Loess, 67034 Strasbourg (France)] [Institut de Physique et de Chimie des Matériaux de Strasbourg, Université de Strasbourg, CNRS UMR 7504 23 rue du Loess, 67034 Strasbourg (France); Ohresser, P.; Otero, E.; Choueikani, F. [Synchrotron SOLEIL, L’Orme des Merisiers, Saint-Aubin, BP48, 91192 Gif-sur-Yvette (France)] [Synchrotron SOLEIL, L’Orme des Merisiers, Saint-Aubin, BP48, 91192 Gif-sur-Yvette (France); Gaspar, A. B.; Real, J. A. [Institut of Molecular Science, Universitat de València, Edifici de Instituts de Paterna, Apartat de Correus 22085, 46071 València (Spain)] [Institut of Molecular Science, Universitat de València, Edifici de Instituts de Paterna, Apartat de Correus 22085, 46071 València (Spain); Wulfhekel, W. [Physikalisches Institut, Karlsruhe Institut of Technology, Wolfgang-Gaede-Str. 1, 76131 Karlsruhe (Germany)] [Physikalisches Institut, Karlsruhe Institut of Technology, Wolfgang-Gaede-Str. 1, 76131 Karlsruhe (Germany)

2013-08-21

162

Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma.  

PubMed

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3(rd) portion of duodenum with reduced aortomesentric angle consistent with Wilkie's syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Devadass, Clement Wilfred; Okaly, Geetha V Patil; Hm, Sudha; Pai, Sreekar Agumbe; Sridher, H

2014-08-01

163

Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma  

PubMed Central

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3rd portion of duodenum with reduced aortomesentric angle consistent with Wilkie’s syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Okaly, Geetha V Patil; HM, Sudha; Pai, Sreekar Agumbe; Sridher, H.

2014-01-01

164

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

165

Adhesive Small-Bowel Obstruction: Value of CT in Identifying Findings Associated with the Effectiveness of Nonsurgical Treatment.  

PubMed

Purpose To identify computed tomographic (CT) findings that are associated with the effectiveness of nonsurgical treatment in patients with adhesive small-bowel obstruction ( SBO small-bowel obstruction ) that was initially treated medically. Materials and Methods The local institutional review board approved this retrospective study; the informed consent requirement was waived. Multi-detector row CT studies in 159 patients (64 women, 95 men; median age, 69 years) with adhesive SBO small-bowel obstruction that was initially treated medically were reviewed retrospectively and independently by two emergency radiologists to identify numerous CT findings that could be associated with the effectiveness of nonsurgical treatment. Results were compared according to the success or failure of nonsurgical treatment. Univariate statistical analyses were performed for qualitative and quantitative data, as appropriate, and each significant parameter was entered in a multivariate logistic regression analysis. The ? statistic and correlation coefficients were used to assess interobserver agreement, as appropriate. Results Nonsurgical treatment succeeded in 113 patients (71%) and failed in 46 patients (29%). At univariate analysis, an anterior parietal adhesion, a feces sign, and the lack of a beak sign were associated with successful nonsurgical treatment, whereas two beak signs or more, a whirl sign, a C- or U-shaped appearance of the bowel loop, and a high degree of obstruction were associated with nonsurgical treatment failure. At multivariate analysis, fewer than two beak signs and the presence of an anterior parietal adhesion were independent predictors of the effectiveness of nonsurgical treatment, with odds ratios of 0.27 and 0.11, respectively. Conclusion The number of beak signs and the location of the transition zone in relation to the anterior peritoneal layer are independent signs associated with the success or failure of nonsurgical treatment. © RSNA, 2014. PMID:24991990

Millet, Ingrid; Ruyer, Alban; Alili, Chakib; Curros Doyon, Fernanda; Molinari, Nicolas; Pages, Emmanuelle; Zins, Marc; Taourel, Patrice

2014-11-01

166

Prostate Adenocarcinoma  

Cancer.gov

Home Cancers Selected for Study Prostate Adenocarcinoma Prostate Adenocarcinoma Last Updated: April 01, 2013 What is prostate cancer? Prostate cancer is a disease of the prostate, a walnut-size gland in the male reproductive system.  Nearly all prostate

167

An unusual case of small bowel obstruction in a child caused by ingestion of water-storing gel beads.  

PubMed

Foreign body ingestion occurs most commonly in the pediatric population. Small bowel obstruction is a rare complication that can occur, and surgical intervention is required. We present the first report of a case of an 18-month-old child with a jejunal obstruction caused by ingestion of water-storing gel beads used for botanical arrangements. The child presented with obstipation and nonbloody, nonbilious emesis. Symptoms resolved after a large bead 3 cm in diameter was retrieved via laparoscopic-assisted excision. This case suggests that water-storing gel beads are particularly dangerous foreign bodies and should be kept out of the reach of children. PMID:22974630

Moon, Jane S; Bliss, David; Hunter, Catherine J

2012-09-01

168

Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review  

PubMed Central

AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE). METHODS: Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008. authors searched for unexplained electrocardiogram (ECG) findings, changes in CP and ICD set parameters, any abnormality in transmitted capsule data, and adverse clinical events. RESULTS: There were no adverse events or hemodynamically significant arrhythmias reported. CP and ICD set parameters were preserved. The majority of ECG abnormalities were also found in pre- or post- SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate. Two patients seemed to have episodes of undersensing by the CP. However, similar findings were documented in ECGs taken outside the time frame of the SBCE. One patient was observed to have a low signal encountered from the capsule resulting in lack of localization, but no images were lost. CONCLUSION: Capsule-induced EMI remains a possibility but is unlikely to be clinically important. CP-induced interference of SBCE is also possible, but is infrequent and does not result in loss of images transmitted by the capsule. PMID:22442746

Cuschieri, Justin R; Osman, Mohammed N; Wong, Richard CK; Chak, Amitabh; Isenberg, Gerard A

2012-01-01

169

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

170

Two cases of post-coital vaginal cuff dehiscence with small bowel evisceration after robotic-assisted laparoscopic hysterectomy  

PubMed Central

INTRODUCTION Vaginal cuff dehiscence following robotic surgery is uncommon. Published reports of vaginal cuff dehiscence following robotic surgery are increasing, but the true incidence is unknown. PRESENTATION OF CASE Case 1. A 45 year old female had sexual intercourse and presented with a vaginal cuff dehiscence complicated by small bowel evisceration 4 months after RA-TLH. Case 2. A 44 year old female had sexual intercourse and presented with a vaginal cuff dehiscence with small bowel evisceration 6 weeks after RA-TLH. DISCUSSION We discuss the rate of vaginal cuff dehiscence by mode of hysterectomy, surgical and non-surgical risk factors that may contribute to vaginal cuff dehiscence, and proposed preventative methods at the time of RA-TLH to reduce this complication. CONCLUSION Vaginal cuff dehiscence with associated evisceration of intraabdominal contents is a potentially severe complication of hysterectomy. We recommend counseling patients who undergo RA-TLH to abstain from vaginal intercourse for a minimum of 8–12 weeks. PMID:23708306

Nguyen, My-Linh T.; Kapoor, Monica; Pradhan, Tana S.; Pua, Tarah L.; Tedjarati, Sean S.

2013-01-01

171

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

172

The ABC System: a simplified classification system for small bowel obstruction after laparoscopic Roux-en-Y gastric bypass.  

PubMed

Small bowel obstruction (SBO) after bariatric surgery is well documented. Although infrequent, it can be associated with considerable morbidity and mortality. The laparoscopic approach to Roux-en-Y gastric bypass (LRYGB) has gained widespread popularity for the treatment of morbid obesity since its first description in 1994. One of the theoretical advantages of a minimally invasive technique is reduced intraabdominal adhesions and, consequently, diminution in the incidence of SBO. However, the laparoscopic approach demonstrates a similar rate of obstruction to the open procedure. In this review, an electronic literature search was undertaken of Medline, Embase, and Cochrane databases for the period January 1990 to October 2006 on the history, presentation, clinical evaluation, preoperative diagnostic techniques, and management of SBO after LRYGB compared to the open approach. PMID:18040752

Tucker, Olga N; Escalante-Tattersfield, Tomas; Szomstein, Samuel; Rosenthal, Raul J

2007-12-01

173

Aperistaltic effect of hyoscine N-butylbromide versus glucagon on the small bowel assessed by magnetic resonance imaging.  

PubMed

The aim of this prospective study was to compare the intraindividual aperistaltic effect of 40 mg hyoscine N-butylbromide (HBB/Buscopan) with that of 1 mg glucagon on small bowel motility by using magnetic resonance imaging (MRI). Ten healthy volunteers underwent two separate 1.5-T MRI studies (HBB/glucagon) after a standardized oral preparation with an aqueous solution of Gd-DOTA and ispaghula (Metamucil). A 2D T1-w GRE sequence was acquired (TR 2.7 ms/TE 1.3 ms, temporal resolution 0.25 s) before and after intravenous (i.v.) drug administration and motility was followed over 1 h. On the resulting images the cross-sectional luminal diameters were assessed and plotted over time. Baseline motility frequency, onset of aperistalsis, duration of arrest, reappearance of motility and return to normal motility were analysed. Significant differences regarding reliability and duration of aperistalsis were observed. In the HBB group aperistalsis lasted a mean of 6.8 +/- 5.3 min compared with 18.3 +/- 7 min after glucagon (p < 0.0001). In 50% of cases HBB did not accomplish aperistalsis, whereas glucagon always succeeded (p = 0.05). There were no significant differences in terms of baseline and end frequencies for the onset of aperistalsis (22.2 +/- 37.5 s HBB/13.4 +/- 9.2 s glucagon, p = 0.1), nor for the return to normal motility. Arrest of small bowel motion is achieved more reliably and lasts significantly longer after i.v. administration of 1 mg glucagon compared with 40 mg HBB. PMID:19190916

Froehlich, Johannes M; Daenzer, Muriel; von Weymarn, Constantin; Erturk, S Mehmet; Zollikofer, Christoph L; Patak, Michael A

2009-06-01

174

New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding  

PubMed Central

Objectives. Small bowel capsule endoscopy (SBCE) plays a decisive role in the obscure gastrointestinal bleeding (OGIB) diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE. Methods. Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential), P1 (uncertain bleeding potential: erosions), and P2 (high bleeding potential: angioectasias, ulcers, and tumors). We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE. Results. One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4%) were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11, P = 0.026). We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE. Conclusions. Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

Rosa, Bruno; Moreira, Maria João; Cotter, José

2014-01-01

175

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

176

A Meta-Analysis of the Yield of Capsule Endoscopy Compared to Other Diagnostic Modalities in Patients with Non-Stricturing Small Bowel Crohn's Disease  

Microsoft Academic Search

OBJECTIVES:Capsule endoscopy (CE) allows for direct evaluation of the small bowel mucosa in patients with Crohn's disease (CD). A number of studies have revealed significantly improved yield for CE over other modalities for the diagnosis of CD, but as sample sizes have been small, the true degree of benefit is uncertain. Additionally, it is not clear whether patients with a

Stuart L. Triester; Jonathan A. Leighton; Grigoris I. Leontiadis; Suryakanth R. Gurudu; David E. Fleischer; Amy K. Hara; Russell I. Heigh; Arthur D. Shiff; Virender K. Sharma

2006-01-01

177

A Peterson's hernia and subsequent small bowel volvulus: surgical reconstruction utilizing transverse colon as a new Roux-en-Y limb - 1 case  

PubMed Central

Peterson's hernia is an internal hernia that can occur after Roux-en-Y anastomosis. It often accompanies small bowel volvulus and is prone to strangulation. Reconstruction of intestinal continuity after massive small bowel resection in a patient who undergoes near total gastrectomy and Roux-en-Y anastomosis can be difficult. A 74-year-old man who had undergone a near total gastrectomy and Roux-en-Y gastrojejunostomy for stomach cancer presented with abdominal pain. The preoperative computed tomography showed strangulated small bowel volvulus. During the emergent laparotomy, we found a strangulated Peterson's hernia with small bowel volvulus. After resection of the necrotized intestine, we made a new Roux-en-Y anastomosis connecting the remnant stomach and the jejunum with a transverse colon segment. We were safely able to connect the remnant stomach and the jejunum by making a new Roux-en-Y anastomosis utilizing a transverse colon segment as a new Roux-limb by two stage operation. PMID:24368991

Jang, Jae Seong

2013-01-01

178

Duodenal adenocarcinoma: why the extreme rarity of duodenal bulb primary tumors?  

PubMed

Adenocarcinoma of the small bowel accounts for only one per cent of all gastrointestinal malignancies. Duodenal adenocarcinoma accounts for half of all small bowel adenocarcinomas. The duodenum is divided into four segments: D1 (proximal horizontal 5 cm beginning with the 3-cm duodenal bulb), D2 (descending), D3 (distal horizontal), and D4 (ascending). The most common location of duodenal adenocarcinomas is the ampullary region of D2. Based on observational experience, our hypothesis was that primary adenocarcinomas arising from the mucosa of the duodenal bulb are extremely rare or possibly nonexistent. Our institutional cancer registry provided a list of patients for the years 1990 through 2012 who had small bowel cancers. Only those patients with primary adenocarcinomas of the duodenal mucosa were reviewed. Ampullary cancers arising from bile duct mucosa were specifically excluded. Medical records were abstracted to obtain patient age, sex, race, anatomic location of the tumor, disease stage (as per American Joint Committee on Cancer 7th edition staging guidelines), operation performed, and current vital status. A total of 30 patients with primary duodenal adenocarcinomas were identified. The mean age was 58 years and 17 (57%) patients were male. The tumor locations were: D2 in 26 (87%), D3 in two (7%), and D4 in two (7%). No tumors arose from D1. The patients presented with the following stages of disease: Stage 0is in three (10%), Stage I in three (10%), Stage II in five (17%), Stage III in 15 (50%), and Stage IV in four (13%). These findings combined with a diligent review of 724 reported cases in the English language literature yielded only five clearly defined cases of adenocarcinoma arising from the mucosa of the duodenal bulb. Although a 1991 published multicenter tumor registry series of 128 localized duodenal adenocarcinomas reported 29 D1 tumors, no anatomic distinction was made between duodenal bulb and more distal D1 tumors. Earlier reports used nonanatomic divisions of the duodenum or a simple breakdown into supra-ampullary, periampullary, and infra-ampullary portions. These data beg the question as to why primary duodenal bulb adenocarcinomas are so exceedingly rare. The obvious implication is that the duodenal bulb mucosa may be physiologically, immunologically, or otherwise uniquely privileged to virtually escape oncogenic transformation. The scientific challenge and opportunity is to explore and understand the important phenomena responsible for this finding. PMID:25264638

Goldner, Bryan; Stabile, Bruce E

2014-10-01

179

Colon Adenocarcinoma  

MedlinePLUS

... tests include colonoscopy, flexible sigmoidoscopy, or double-contrast barium enema. How does a pathologist diagnose colon adenocarcinoma? ... of these treatment options? • What are the side effects? • Should I receive a second opinion? • Is your ...

180

[Urachal adenocarcinoma].  

PubMed

Cancer of the urachus is very unusual. The lesion is a mucosecretory adenocarcinoma. The diagnosis is usually established late, and has a serious prognosis because of a long clinical latency. We report a case of metastatic adenocarcinoma of the urachus revealed by hematuria. A review of the literature allows us to demonstrate the rarity of this tumour and to demonstrate its various clinical, histological, radiological and therapeutical aspects. PMID:11761694

Dakir, M; Dahami, Z; Sarf, I; Tahri, A; Elmrini, M; Benjelloun, S

2001-09-01

181

International grading scheme for acute rejection in small bowel transplantation: implementation and experience at the University of Miami.  

PubMed

In 2003, an international collection of pathologists and clinicians proposed a unified grading system for acute cellular rejection in endoscopically derived small intestine allograft biopsies. This grading system was implemented at the University of Miami over the past 2 years and the results are presented herein. A total of 1136 small bowel allograft biopsies with sufficient tissue for analysis were obtained from 123 hospitalized, clinic, and referral patients. The overall most common diagnosis assessing all time periods was grade IND (40%), and grade 1 rejection or greater was present in 19% percent of biopsies. A suspected vascular component to the acute rejection as identified by specific mucosal vascular changes was present in 6% of cases. Clinical decision making was very consistent with different grades. Our experience has confirmed that this new grading system is reliable and identifies clinical subsets of patients that can receive different therapy. We recommend that this international grading system be implemented for acute cellular rejection in bowel allografts as a means to standardize pathological assessment of alloimmune-induced graft injury, which will allow comparisons between different centers and clinical trials. PMID:16908246

Ruiz, P; Weppler, D; Nishida, S; Kato, T; Selvaggi, G; Levi, D; Bejarano, P; Khaled, A; Tryphonopoulos, P; Tuteja, S; Garcia, M; Tzakis, A

2006-01-01

182

["Uncompensated" small bowel obstruction in adults. Ultrasonographic findings of free fluid between loops and its prognostic value].  

PubMed

Plain abdominal film is the method of choice in the assessment of intestinal obstruction. This technique exhibits some limitations and must be frequently correlated with other diagnostic tools. Of them, US has been recently reported to allow the morphofunctional study of intestinal loops with high accuracy. Nevertheless, the literature on the usefulness of US disregards a sign of great interest, i.e., extraluminal fluid between bowel loops. Our personal experience in 56 adult patients with surgically confirmed small bowel obstruction suggests that this findings, demonstrated by US in 43 patients (73%), identifies early intestinal wall damage with high sensitivity. US, depicting fluid between bowel loops, can distinguish the various stages of obstruction, with major consequences on clinical management. US and plain abdominal film findings allowed us to distinguish three stages of obstruction: simple obstruction (15/56 patients, 27%), uncompensated obstruction (26/56 patients, 46%), and complicated obstruction (15/56 patients, 27%). These three evolutive stages exhibit different severity and require different surgical approaches. PMID:7644729

Di Mizio, R; Grassi, R; Marchese, E; Basti, M; Di Campli, G; Catalano, O; Rotondo, A; Fanucci, A

1995-06-01

183

The role of angiotensin II type 1a receptor on intestinal epithelial cells following small bowel resection in a mouse model  

Microsoft Academic Search

Aim  We have previously shown that inhibition of angiotensin converting enzyme (ACE) significantly reduced intestinal epithelial\\u000a cell (EC) apoptosis and improved morphometric intestinal adaptation in a mouse model of massive small-bowel resection (SBR).\\u000a This study attempted to further examine the downstream signaling factors in this system by blocking the action of angiotensin\\u000a II (ATII), hypothesizing that this would lead to similar

Hiroyuki Koga; Hua Yang; Emir Q. Haxhija; Daniel H. Teitelbaum

2008-01-01

184

Altered Transcription of Murine Genes Induced in the Small Bowel by Administration of Probiotic Strain Lactobacillus rhamnosus HN001  

PubMed Central

Lactobacillus rhamnosus HN001 is a probiotic strain reported to increase resistance to epithelium-adherent and -invasive intestinal pathogens in experimental animals. To increase understanding of the relationship between strain HN001 and the bowel, transcription of selected genes in the mucosa of the murine small bowel was measured. Mice previously naive to lactobacilli (Lactobacillus-free mice) were examined after daily exposure to HN001 in drinking water. Comparisons were made to results from matched Lactobacillus-free mice. Infant and adult mice were investigated to provide a temporal view of gene expression in response to exposure to HN001. Genes sgk1, angptl4, and hspa1b, associated with the apoptosis pathway, were selected for investigation by reverse transcription-quantitative PCR on the basis of a preliminary duodenal DNA microarray screen. Normalized to gapdh gene transcription, these three genes were upregulated after 6 to 10 days exposure of adult mice to HN001. Angptl4 was shown by immunofluorescence to be upregulated in duodenal epithelial cells of mucosal samples. Epithelial cell migration was faster in HN001-exposed mice than in the Lactobacillus-free controls. Transcriptional responses in infant mice differed according to bowel region and age. For example, sgk1 was upregulated in duodenal, jejunal, and ileal mucosa of mice less than 25 days old, whereas angptl4 and hspa1b were upregulated at 10 days in the duodenum but downregulated in the jejunal mucosa until mice were 25 days old. Overall, the results provide links between a probiotic strain, mucosal gene expression, and host phenotype, which may be useful in delineating mechanisms of probiotic action. PMID:24584241

Taylor, Corinda; Lawley, Blair; Loach, Diane; Gould, Maree; Dunn, Amy C.; McLellan, Alexander D.; Black, Michael A.; McNoe, Les; Dekker, James; Gopal, Pramod; Collett, Michael A.

2014-01-01

185

Small Bowel Bleeding  

MedlinePLUS

... now be preformed using special scopes with inflatable balloons and/or overtubes. The final option is intraoperative ... to treat the lesion is known as double balloon enteroscopy. Double balloon enteroscopy uses two balloons attached ...

186

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

187

Letting the sun set on small bowel obstruction: can a simple risk score tell us when nonoperative care is inappropriate?  

PubMed

Controversy remains as to which patients with small bowel obstruction (SBO) need immediate surgery and which may be managed conservatively. This study evaluated the ability of clinical risk factors to predict the failure of nonoperative management of SBO. The electronic medical record was used to identify all patients with SBO over one year. Clinical, laboratory, and imaging data were recorded. Univariate and multivariable analyses were performed to identify risk factors predicting need for surgery. Cox proportional hazards regression was used to identify risk factors that influence need and timing for surgery. Two hundred nineteen consecutive patients were included. Most patients did not have a prior history of SBO (75%), radiation therapy (92%), or cancer (70%). The majority had undergone previous abdominal or pelvic surgery (82%). Thirty-five per cent of patients ultimately underwent laparotomy. Univariate analysis showed that persistent abdominal pain, abdominal distention, nausea and vomiting, guarding, obstipation, elevated white blood cell count, fever present 48 hours after hospitalization, and high-grade obstruction on computed tomography (CT) scan were significant predictors of the need for surgery. Multivariable analysis revealed that persistent abdominal pain or distention (hazard ratio [HR], 3.04; P = 0.013), both persistent abdominal pain and distention (HR, 4.96; P < 0.001), fever at 48 hours (HR, 3.66; P = 0.038), and CT-determined high-grade obstruction (HR, 3.45; P = 0.017) independently predicted the need for surgery. Eighty-five per cent of patients with none of these four significant risk factors were successfully managed nonoperatively. Conversely, 92 per cent of patients with three or more risk factors required laparotomy. This analysis revealed four readily evaluable clinical parameters that may be used to predict the need for surgery in patients presenting with SBO: persistent abdominal pain, abdominal distention, fever at 48 hours, and CT findings of high-grade obstruction. These factors were combined into a predictive model that may of use in predicting failure of nonoperative SBO management. Early operation in these patients should decrease length of stay and diagnostic costs. PMID:24887795

O'Leary, Elizabeth A; Desale, Sameer Y; Yi, William S; Fujita, Kari A; Hynes, Conor F; Chandra, Suma K; Sava, Jack A

2014-06-01

188

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

189

Small bowel feeding and risk of pneumonia in adult critically ill patients: a systematic review and meta-analysis of randomized trials  

PubMed Central

Introduction This systematic review and meta-analysis aimed to evaluate the effect of small bowel feeding compared with gastric feeding on the frequency of pneumonia and other patient-important outcomes in critically ill patients. Methods We searched EMBASE, MEDLINE, clinicaltrials.gov and personal files from 1980 to Dec 2012, and conferences and proceedings from 1993 to Dec 2012 for randomized trials of adult critically ill patients in the intensive care unit (ICU) comparing small bowel feeding to gastric feeding, and evaluating risk of pneumonia, mortality, length of ICU stay, achievement of caloric requirements, duration of mechanical ventilation, vomiting, and aspiration. Independently, in duplicate, we abstracted trial characteristics, outcomes and risk of bias. Results We included 19 trials with 1394 patients. Small bowel feeding compared to gastric feeding was associated with reduced risk of pneumonia (risk ratio [RR] 0.70; 95% CI, 0.55, 0.90; P = 0.004; I2 = 0%) and ventilator-associated pneumonia (RR 0.68; 95% CI 0.53, 0.89; P = 0.005; I2 = 0%), with no difference in mortality (RR 1.08; 95% CI 0.90, 1.29; P = 0.43; I2 = 0%), length of ICU stay (WMD -0.57; 95%CI -1.79, 0.66; P = 0.37; I2 = 0%), duration of mechanical ventilation (WMD -1.01; 95%CI -3.37, 1.35; P = 0.40; I2 = 17%), gastrointestinal bleeding (RR 0.89; 95% CI 0.56, 1.42; P = 0.64; I2 = 0%), aspiration (RR 0.92; 95% CI 0.52, 1.65; P = 0.79; I2 = 0%), and vomiting (RR 0.91; 95% CI 0.53, 1.54; P = 0.72; I2 = 57%). The overall quality of evidence was low for pneumonia outcome. Conclusions Small bowel feeding, in comparison with gastric feeding, reduces the risk of pneumonia in critically ill patients without affecting mortality, length of ICU stay or duration of mechanical ventilation. These observations are limited by variation in pneumonia definition, imprecision, risk of bias and small sample size of individual trials. PMID:23820047

2013-01-01

190

'Little old lady's hernia' causing small bowel obstruction in a man: a case report with a review of literature on the pathophysiology of obturator hernias.  

PubMed

Commonly known as 'little old lady's hernia', obturator hernias are usually seen in frail, octogenarian multiparous women reporting non-specific nausea and vomiting, abdominal pain and anteromedial thigh pain. They are exceedingly rare; even less frequently are they diagnosed preoperatively, with the vast majority being found incidentally at laparotomy for small bowel obstruction. This case report describes an atypical presentation of a 'little old lady's hernia' in a man, in whom, thanks to high degree of clinical suspicion, an incarcerated obturator hernia was diagnosed preoperatively and treated successfully. PMID:25391824

Blach, Ola; Ghosh, Anil

2014-01-01

191

Intensity modulated radiation therapy (IMRT): differences in target volumes and improvement in clinically relevant doses to small bowel in rectal carcinoma  

PubMed Central

Background A strong dose-volume relationship exists between the amount of small bowel receiving low- to intermediate-doses of radiation and the rates of acute, severe gastrointestinal toxicity, principally diarrhea. There is considerable interest in the application of highly conformal treatment approaches, such as intensity-modulated radiation therapy (IMRT), to reduce dose to adjacent organs-at-risk in the treatment of carcinoma of the rectum. Therefore, we performed a comprehensive dosimetric evaluation of IMRT compared to 3-dimensional conformal radiation therapy (3DCRT) in standard, preoperative treatment for rectal cancer. Methods Using RTOG consensus anorectal contouring guidelines, treatment volumes were generated for ten patients treated preoperatively at our institution for rectal carcinoma, with IMRT plans compared to plans derived from classic anatomic landmarks, as well as 3DCRT plans treating the RTOG consensus volume. The patients were all T3, were node-negative (N = 1) or node-positive (N = 9), and were planned to a total dose of 45-Gy. Pairwise comparisons were made between IMRT and 3DCRT plans with respect to dose-volume histogram parameters. Results IMRT plans had superior PTV coverage, dose homogeneity, and conformality in treatment of the gross disease and at-risk nodal volume, in comparison to 3DCRT. Additionally, in comparison to the 3DCRT plans, IMRT achieved a concomitant reduction in doses to the bowel (small bowel mean dose: 18.6-Gy IMRT versus 25.2-Gy 3DCRT; p = 0.005), bladder (V40Gy: 56.8% IMRT versus 75.4% 3DCRT; p = 0.005), pelvic bones (V40Gy: 47.0% IMRT versus 56.9% 3DCRT; p = 0.005), and femoral heads (V40Gy: 3.4% IMRT versus 9.1% 3DCRT; p = 0.005), with an improvement in absolute volumes of small bowel receiving dose levels known to induce clinically-relevant acute toxicity (small bowel V15Gy: 138-cc IMRT versus 157-cc 3DCRT; p = 0.005). We found that the IMRT treatment volumes were typically larger than that covered by classic bony landmark-derived fields, without incurring penalty with respect to adjacent organs-at-risk. Conclusions For rectal carcinoma, IMRT, compared to 3DCRT, yielded plans superior with respect to target coverage, homogeneity, and conformality, while lowering dose to adjacent organs-at-risk. This is achieved despite treating larger volumes, raising the possibility of a clinically-relevant improvement in the therapeutic ratio through the use of IMRT with a belly-board apparatus. PMID:21651775

2011-01-01

192

Segmental difference in epithelial and mucosal barrier functions between the jejunum and the ileum in cold storage small bowel grafts in the rat.  

PubMed

The purpose of this study was to determine the differences in epithelial and mucosal barrier function between the jejunum and the ileum at transplantation. Rat small bowel was preserved in cold University of Wisconsin solution for 0, 12 or 24 hrs. Time-related segmental differences in the potential differences, at rest (rPD) and upon glucose stimulation (PDgs), and in the permeation rates of phenolsulfonphtalein (PSP) and polyethylene glycol 4000 (PEG) as non-absorbable markers were studied after a 20-min reoxygenation period following cold preservation. Time-related histologic damage during cold preservation was also evaluated. After 24 hrs of preservation, when the villi were denuded both in jejunum and ileum, the rPD (1.4 +/- 0.3 mV/cm2) and PDgs (1.4 +/- 0.3 mV/cm2) of the jejunum were significantly lower than those of the ileum (1.9 +/- 0.3 mV/cm2 and 2.1 +/- 0.3 mV/cm2, respectively). A difference in PEG permeation rates occurred after 24 hrs of preservation. The permeation rate of PSP in the jejunum was 10.5 +/- 1.0%, which was significantly higher than that in the ileum (8.6 +/- 1.0%) after 12 of preservation, when subepithelial edema occurred both in the jejunum and ileum. Our functional study demonstrated that, in the rat small bowel, the ileumis more resistant than the jejunum to cold preservation. PMID:15150898

Matsuno, Katsunori

2004-01-01

193

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

194

A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis.  

PubMed

The aim was to compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral contrast (MRI per OS) with magnetic resonance enteroclysis (MRE). Forty patients with suspected Crohn's disease (CD) were examined with both MRI methods. MRI per OS was performed with a 6% mannitol solution and MRE with nasojejunal intubation and a polyethylenglycol solution. MRI protocol consisted of balanced fast field echo (B-FFE), T2 and T1 sequences with and without gadolinium. Two experienced radiologists individually evaluated bowel distension and pathological findings including wall thickness (BWT), contrast enhancement (BWE), ulcer (BWU), stenosis (BWS) and edema (EDM). The diameter of the small bowel was smaller with MRI per OS than with MRE (difference jejunum: 0.55 cm, p < 0.001; ileum: 0.35 cm, p < 0.001, terminal ileum: 0.09 cm, p = 0.08). However, CD was diagnosed with high diagnostic accuracy (sensitivity, specificity, positive and negative predictive values: MRI per OS 88%, 89%, 89%, 89%; MRE 88%, 84%, 82%, 89%) and inter-observer agreement (MRI per OS k = 0.95; MRE k = 1). In conclusion, bowel distension was inferior in MRI per OS compared to MRE. However, both methods diagnosed CD with a high diagnostic accuracy and reproducibility. PMID:17483955

Negaard, Anne; Paulsen, Vemund; Sandvik, Leiv; Berstad, Audun Elnaes; Borthne, Arne; Try, Kirsti; Lygren, Idar; Storaas, Tryggve; Klow, Nils-Einar

2007-09-01

195

Surgical complications of nonsteroidal antiinflammatory drug-induced small bowel ulceration 1 1 Presented in part at the 35th annual meeting of the North Texas Chapter of the American College of Surgeons where WFK received the Resident Research Award for the best clinical paper  

Microsoft Academic Search

Background:The association between nonsteroidal antiinflammatory drug (NSAID) intake and gastroduodenal peptic ulceration is well recognized. Recent experimental data implicate NSAIDs in the development of a similar spectrum of pathologic lesions of the small bowel. However, clinically significant NSAID-induced small bowel ulcerations have been reported infrequently. This study sought to examine small bowel complications of NSAID use requiring surgical intervention.Study Design:A

William F Kessler; G. Tom Shires; Thomas J Fahey

1997-01-01

196

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

197

Esophageal and small bowel obstruction from guar gum-containing "diet pills": analysis of 26 cases reported to the Food and Drug Administration.  

PubMed

Twenty-six domestic reports of suspected adverse reactions from the guar gum-containing diet pill, Cal-Ban 3000 (filed with the FDA) were reviewed. There were 18 instances of esophageal obstruction, seven instances of small bowel obstruction, and one individual who was reported to have died after ingestion of Cal-Ban 3000, but for whom insufficient details were provided to assess causation. There were 14 women and 11 men (mean age 46.3 yr; range 17 to 67 yr) for whom sufficient information was available. Preexisting esophageal or gastric disorders were present in 50% of those with esophageal obstruction, including peptic stricture, pyrosis, hiatal hernia, esophagitis, gastric stapling procedure, Schatzki ring, and muscular dystrophy. Fourteen of these 18 patients with esophageal obstruction were treated successfully by endoscopy, although the tenacious gel-like consistency of the material was often difficult to remove. Two patients required rigid esophagoscopy when flexible endoscopy was unsuccessful. This resulted in the death of one patient who developed a pulmonary embolism after surgical repair of an intraoperative esophageal tear. For the seven patients with small bowel obstruction, no specific predisposing factors were mentioned. One individual required exploratory laparotomy, and inspissated tablets were found in the ileum. These cases, spontaneously reported to the FDA, are very similar to those reported in the literature. The water-holding capacity and gel-forming tendency of guar gum permits it to swell in size 10- to 20-fold, and may lead to luminal obstruction, especially when an anatomic predisposition exists. Such products have been banned in Australia, and Cal-Ban 3000 has recently been removed from the market in the United States. However, unsuspecting patients who are still in possession of the product should be apprised of the potential complications that may arise with its use. PMID:1329494

Lewis, J H

1992-10-01

198

Interplay of nutrients and microbial metabolites in intestinal immune homeostasis: distinct and common mechanisms of immune regulation in the small bowel and colon.  

PubMed

The intestinal mucosa is the largest body surface exposed to the environment. While there are common features when comparing immune responses along the intestinal mucosa, the small bowel and colon exhibit striking differences in their mechanisms driving immune regulation. The vitamin A (VA) metabolite all-trans retinoic acid (RA) signaling via RA nuclear receptors plays a key role in immune homeostasis in the small bowel, and recent work indicates that RA is required for establishing immune tolerance to dietary antigens in the upper intestinal tract by inducing ?4?7(+)CCR9(+) gut-tropic TREG. In contrast, microbiota-specific TREG in the colon do not appear to require RA, but can be regulated by short-chain fatty acids (SCFA), microbial metabolites that signal through the G protein-coupled receptor GPR43. Moreover, TREG do not need CCR9 to home to the colon, but utilize another G protein-coupled receptor, GPR15, which is upregulated by SCFA. Thus, the mechanisms governing intestinal tolerance to dietary antigens in the upper digestive tract differ from those controlling tolerance to the microbiota in the colon, with RA and SCFA playing key complementary roles in their respective compartments. In addition to VA and SCFA, recent studies have highlighted the roles of other dietary and microbial metabolites that influence immune cell homeostasis across the small and large bowel including dietary ligands for aryl hydrocarbon receptor and microbiota-modified bile acids. Understanding the complex and dynamic interplay between dietary metabolites and commensal microbiota within the intestinal microenvironment could therefore inform novel strategies for the treatment of food allergies and inflammatory bowel diseases. © 2014 Nestec Ltd., Vevey/S. Karger AG, Basel. PMID:25227295

Perrigoue, Jacqueline; Das, Anuk; Mora, J Rodrigo

2014-01-01

199

The utility of single-balloon enteroscopy for the diagnosis and management of small bowel disorders according to their clinical manifestations: a retrospective review  

PubMed Central

Background The advent of double-balloon enteroscopy has enabled more accurate diagnosis and treatment of small bowel disorders. Single-balloon enteroscopy permits visualization of the entire small intestine less often than does double-balloon enteroscopy. However, the relative clinical advantages of the 2 methods remain controversial. This study therefore aimed to identify the indications for and therapeutic impact of performing single-balloon enteroscopy. Methods We retrospectively reviewed prospectively collected data from adults who underwent single-balloon enteroscopy from January 2007 through November 2011 and analyzed their baseline characteristics, endoscopic findings, pathological diagnoses, and clinical outcomes. Results A total of 145 procedures were performed in 116 patients with a mean age of 58.1?±?17.7 years (range, 18–89 years). The most common indications for performing single-balloon enteroscopy were overt gastrointestinal (GI) bleeding, chronic diarrhea, and occult GI bleeding, accounting for 57.9%, 12.4%, and 9.7% of the patients, respectively. The area of interest was achieved in 80.7% of the cases, with a 5.5% rate of technical failure. An overall positive finding was detected in 65.5% of the cases, of which 33.8% were ulcers and erosions; 8.3%, masses; and 3.4%, angiodysplasia. The diagnostic yields were 42.9%, 52.4%, 78.6%, 50.0%, and 25.0% for patients with overt GI bleeding, occult GI bleeding, abdominal pain, chronic diarrhea, and abnormal imaging results, respectively. Therapeutic procedures were performed in 11% of patients with GI bleeding and achieved a therapeutic yield of 14.6% with a minor complication rate of 11.7%. Conclusions Single-balloon enteroscopy was effective for the diagnosis and treatment of small bowel disorders, especially in patients who presented with abdominal pain, GI bleeding, or focal abnormalities on imaging scans. PMID:23800178

2013-01-01

200

X-ray induced optical reflectivity  

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

201

Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en- Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: review of 1400 consecutive cases  

Microsoft Academic Search

BackgroundIt is common practice to close mesenteric defects in abdominal surgery to prevent postoperative herniation and subsequent closed-loop obstruction. The aim of this study was to review our experience with antecolic antegastric laparoscopic Roux-en-Y gastric bypass (AA-LRYGBP) without division of the small bowel mesentery or closure of potential mesenteric defects.

Minyoung Cho; David Pinto; Lester Carrodeguas; Charles Lascano; Flavia Soto; Oliver Whipple; Conrad Simpfendorfer; John Paul Gonzalvo; Nathan Zundel; Samuel Szomstein; Raul J. Rosenthal

2006-01-01

202

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

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

2014-07-14

203

Duodenal atresia associated with "apple peel" small bowel without deletion of fibroblast growth factor-10 or fibroblast growth factor receptor 2IIIb: report of a case.  

PubMed

We report a case of duodenal membranous atresia associated with "apple peel" small bowel in a baby girl. The patient's mother and sibling had also undergone surgery for duodenal atresia. Familial duodenal atresia is sometimes the result of genetic, inherited abnormalities. Fibroblast growth factor (FGF) receptor 2IIIb (Fgfr2b) and Fgf10 are known regulatory molecules relevant to mesenchymal-epithelial interactions. The involvement of the Fgf10/Fgfr2b pathway in the pathogenesis of intestinal atresia are related to tissue-specific transcription factors, which regulate the expression of Fgf10 according to the organ system and the stage of gestation. Furthermore, a spontaneous somatic mutation or a point mutation of Fgf10 early in development would result in a genetic mosaic pattern. Fluorescent in situ hybridization did not show homozygous or heterozygous deletion of the Fgf10 or Fgfr2b gene in this case. It is necessary to study the occurrence of duodenal atresia in posterity and investigate the deletion of the Fgfr2b or Fgf10 genes if possible. PMID:17468828

Tatekawa, Yukihiro; Kanehiro, Hiromichi; Nakajima, Yoshiyuki

2007-01-01

204

The rate of bloodstream infection is high in infants with short bowel syndrome: Relationship with small bowel bacterial overgrowth, enteral feeding and inflammatory and immune responses  

PubMed Central

Objective This pilot study in parenteral nutrition (PN) dependent infants with short bowel syndrome (SBS) evaluated the impact of feeding route and intestinal permeability on bloodstream infection (BSI), small bowel bacterial overgrowth (SBBO) and systemic immune responses, and fecal calprotectin as a biomarker for SBBO. Study design 10 infants (ages 4.2-15.4 months) with SBS due to necrotizing enterocolitis were evaluated. Nutritional assessment, breath hydrogen testing, intestinal permeability, fecal calprotectin, serum flagellin- and LPS- specific antibody titers, and proinflammatory cytokine concentrations (TNF-?, IL-1 ?, IL-6, IL-8) were performed at baseline, 60 and 120 days. Healthy, age-matched controls (n=5) were recruited. Results BSI incidence was high (80%) and SBBO was common (50%). SBBO increased the odds for BSI (> 7-fold; p=0.009). Calprotectin levels were higher in children with SBS and SBBO versus those without SBBO and healthy controls (p<0.05). Serum TNF-?, was elevated at baseline versus controls. Serum TNF-?, IL-1 ?, IL-6 and IL-8 levels diminished with increased enteral nutrition. Anti-flagellin and anti-LPS IgG levels in children with SBSwere lower versus controls and rose over time. Conclusion In children with SBS, SBBO increases the risk for BSI and systemic proinflammatory response decreases with increasing enteral feeding and weaning PN. PMID:20171649

Cole, Conrad R.; Frem, Juliana C.; Schmotzer, Brian; Gewirtz, Andrew T.; Meddings, Jonathan B.; Gold, Benjamin D.; Ziegler, Thomas R.

2009-01-01

205

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

206

Complete Small-Bowel Obstruction from a Migrated Intra-Gastric Balloon: Emergency Laparoscopy for Retrieval via Enterotomy and Intra-Corporeal Repair.  

PubMed

A 49-year-old female (weight 81 kg, height 161 cm, BMI 31.2) presented at the emergency department complaining of 2-day history of worsening cramp-like abdominal pain and vomiting. She had not passed stools or flatus in the last 36 h and reported to have had an intra-gastric balloon (BioEnterics Intra-gastric Balloon, Allergan. Inc, Irvine, Calif) inserted 9 months earlier to treat grade I obesity. The balloon was introduced during an upper endoscopy at another institution in Latin America, and she denied having any follow-up since moving to Europe. While in the E.R., an abdominal x-ray and abdominal triple contrast CT scan (with oral water-soluble contrast) showed a complete small-bowel obstruction caused by the distal migration of a foreign body. This was consistent with the intra-gastric balloon impacted in the distal jejunum. Free fluid was also evident. Emergency surgery was mandatory, and a laparoscopic approach was chosen. After identification of the cecum and ileocecal valve, the small intestine was carefully inspected starting from the distal ileum by "run-the-bowel", proximally. An evident transition point between collapsed and distended bowel loops was identified, and a clear bulging of the bowel wall caused by the deflated and impacted balloon was observed at the site. A transverse enterotomy 3.5 cm in length was performed with laparoscopic scissors, distally to the obstruction site. The balloon was gently pulled out, taking care not to tear or damage the bowel and once removed was placed within an endobag. Laparoscopic enterorrhaphy was performed with double-layer intra-corporeal suture. The postoperative course was uneventful. PMID:24777561

Di Saverio, Salomone; Bianchini Massoni, Claudio; Boschi, Sergio; Biscardi, Andrea; Tugnoli, Gregorio; Masetti, Michele; Jovine, Elio

2014-10-01

207

Adenocarcinoma villoglandular de cérvix  

Microsoft Academic Search

Villoglandular adenocarcinoma of the uterine cervix is a rare neoplasm, with histological and clinical features that distinguish it from other types of cervical adenocarcinomas. Until 1994, this entity was not included with the cervical carcinoma classification of the World Health Organization. The prognosis of this tumor is favorable and consequently treatment should be conservative as far as possible if the

Sonia M. García Rodríguez; Rosa Rodríguez Rodríguez; Nazaret Villalba Martín; José Luis Trujillo Carrillo; Javier De La Torre Fdez De Vega

2011-01-01

208

Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery  

PubMed Central

Background There is no consensus on diagnosis and management of ASBO. Initial conservative management is usually safe, however proper timing for discontinuing non operative treatment is still controversial. Open surgery or laparoscopy are used without standardized indications. Methods A panel of 13 international experts with interest and background in ASBO and peritoneal diseases, participated in a consensus conference during the 1st International Congress of the World Society of Emergency Surgery and 9th Peritoneum and Surgery Society meeting, in Bologna, July 1-3, 2010, for developing evidence-based recommendations for diagnosis and management of ASBO. Whenever was a lack of high-level evidence, the working group formulated guidelines by obtaining consensus. Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT scan signs (free fluid, mesenteric oedema, small bowel faeces sign, devascularized bowel) patients with partial ASBO can be managed safely with NOM and tube decompression (either with long or NG) should be attempted. These patients are good candidates for Water Soluble Contrast Medium (WSCM) with both diagnostic and therapeutic purposes. The appearance of water-soluble contrast in the colon on X-ray within 24 hours from administration predicts resolution. WSCM may be administered either orally or via NGT (50-150 ml) both immediately at admission or after an initial attempt of conservative treatment of 48 hours. The use of WSCM for ASBO 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 affect recurrence rates or recurrences needing surgery when compared to traditional conservative treatment. Open surgery is the preferred method for surgical treatment of strangulating ASBO as well as after failed conservative management. In selected patients and with appropriate skills, laparoscopic approach can be attempted using open access technique. Access in the left upper quadrant should be safe. Laparoscopic adhesiolysis should be attempted preferably in case of 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 can reduce incidence of adhesions. Icodextrin may reduce the risk of re-obstruction. HA cannot reduce need of surgery. PMID:21255429

2011-01-01

209

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

PubMed

The (13)C-acetate breath test ((13)C-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 (13)C-ABT/H2-LBT. Twenty two healthy volunteers participated (HV, 12 females, age: 26.5? ± ?4.7(?)years, BMI: 22? ± ?2.1?kg(?)m(-2)). Fasting subjects received 200?ml of an aequous solution containing 150?mg (13)C-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 (13)C measurements sampling intervals were prolonged to 15?min after the first hour. LGET was defined as time of maximal (13)C-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 (R(2) = 0.019; p = 0.546). By contrast, there was a very tight and highly significant correlation between SBTT and OCTT (R(2) = 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 (R(2) = 0.240; p = 0.021). In conclusion, the combined (13)C-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

2014-01-01

210

Urinary Bladder Adenocarcinoma  

MedlinePLUS

... channels. Healing begins with the pathologist’s diagnosis. Pathologists are core members of your patient care team. (continued from ... oncologists, radiologists and others. What kinds of treatments are ... most common treatment for urinary bladder adenocarcinoma is surgery, which ...

211

Atomic configurations and local order in laser-synthesized Si, Si-N, Si-C, and Si-C-N nanometric powders, as studied by x-ray-induced photoelectron spectroscopy and extended x-ray-absorption fine-structure analysis  

NASA Astrophysics Data System (ADS)

The chemical bonding and local order in Si, Si-N, Si-C, and Si-C-N nanometric powders prepared by laser synthesis have been investigated by using two experimental methods. The local environment of Si, C, and N atoms have been studied by x-ray-induced photoelectron spectroscopy, from a detailed analysis of the Si 2p, C 1s, and N 1s core levels. Complementary information concerning the structural arrangement around Si atoms has been deduced from extended x-ray-absorption fine-structure analysis performed at the Si K edge. The results show that the Si and Si-C powders prepared with a 600 W laser power are pure, well-crystallized materials; the Si-N sample prepared with the same laser power has a disordered structure, although chemical order exists. For the composite samples, the results reveal that, in particular preparation conditions, a local C-Si-N3 structure is formed.

Gheorghiu, A.; Sénémaud, C.; Roulet, H.; Dufour, G.; Moreno, T.; Bodeur, S.; Reynaud, C.; Cauchetier, M.; Luce, M.

1992-05-01

212

Prostatic adenocarcinoma with glomeruloid features  

Microsoft Academic Search

A wide variety of architectural patterns of adenocarcinoma may be seen in the prostate. We have recently encountered a hithertoundescribed pattern of growth characterized by intraluminal ball-like clusters of cancer cells reminiscent of renal glomeruli, which we refer to as prostatic adenocarcinoma with glomeruloid features. To define the architectural features, frequency, and distribution of prostatic adenocarcinoma with glomeruloid features, we

Anna Pacelli; Antonio Lopez-Beltran; A. J. Matthew Egan; David G Bostwick

1998-01-01

213

Pancreatic Ductal Adenocarcinoma  

Cancer.gov

Because pancreatic cancer is often diagnosed at a late stage, surgical removal of the tumor or the organ is often difficult, if not impossible. Pancreatic ductal adenocarcinoma, or PDAC, is by far the most common type of pancreatic malignancy. PDAC is distinct from other cancers due to the biological barrier the tumor builds around itself.

214

Chemoprevention of Esophageal Adenocarcinoma  

PubMed Central

The incidence of esophageal adenocarcinoma (EAC) is rising rapidly in Western countries, and effective chemoprevention for this malignancy is lacking. Endoscopic surveillance of patients with Barrett's esophagus is currently employed to diagnose EAC at earlier stages, but this strategy has several limitations. Non-steroidal anti-inflammatory drugs and proton pump inhibitors are the most promising agents for prevention of EAC, and a randomized controlled trial of aspirin and esomeprazole is ongoing. Other agents under investigation include green tea, berries, and antioxidants. Cost-effectiveness analyses have shown that chemopreventive agents need to be highly effective at preventing EAC in order to have benefit beyond endoscopic surveillance. PMID:21180511

2008-01-01

215

Extra-ampullary Duodenal Adenocarcinoma.  

PubMed

Extra-ampullary duodenal adenocarcinomas are rare, and when studied, frequently have been grouped with jejunoileal adenocarcinomas. Nevertheless, anecdotal experiences suggest that these neoplasms may present 2 or more distinct phenotypes. To better characterize these neoplasms, we performed a retrospective review of 38 cases with a special focus on the morphologic and immunophenotypic characteristics and their clinicopathologic significance. Our cohort of extra-ampullary duodenal adenocarcinomas was classified on the basis of the morphologic features into gastric type (n=19, 50%), intestinal type (n=14, 37%), pancreaticobiliary type (n=2, 5%), and others (n=3, 8%). Most gastric-type adenocarcinomas (n=18, 95%) developed in the proximal duodenum, whereas the other types were located equally in the proximal and distal duodenum. Intestinal-type dysplasia was present at the periphery of 8 (57%) intestinal-type adenocarcinomas, and 8 (42%) gastric-type adenocarcinoma were associated with gastric-type dysplasia. Gastric foveolar metaplasia (n=12) and Brunner gland hyperplasia (n=10) were exclusively recognized adjacent to gastric-type adenocarcinomas. Notably, intestinal-type histology and the absence of lymph node metastasis were significantly associated with favorable disease-free survival in univariate and multivariate analyses. In summary, this study demonstrated that 2 major subsets of extra-ampullary duodenal adenocarcinoma, intestinal type and gastric type, are associated with distinct histopathologic features and clinical behavior. PMID:25310836

Ushiku, Tetsuo; Arnason, Thomas; Fukayama, Masashi; Lauwers, Gregory Y

2014-11-01

216

Villoglandular papillary adenocarcinoma of the cervix  

Microsoft Academic Search

Villoglandular papillary adenocarcinoma of the cervix is a well differentiated form of cervical adenocarcinoma with a favourable prognosis and a conservative procedure is suggested. We present three cases of villoglandular papillary adenocarcinoma of the cervix. Histological examination of a biopsy of each cervix showed well differentiated villoglandular papillary adenocarcinoma, stage Ib according to FIGO classification. In all cases the disease

Annechien Bouman; G. Jurjen E. Oosterhuis; Gijs A. van Doorn

1999-01-01

217

X-RAY INDUCED CHROMOSOMAL ABERRATIONS IN RICE PLANTS  

Microsoft Academic Search

The effect of gamma -irradiation on the phosphorus (acid soluble ; fractions) metabolism of mouse strain L cells in culture was studied in an ; attempt to shed light on the mechanisms of radiation inhibition of cell ; multiplication. Content and incorporation of P³² into the acid-soluble ; fractions of the cells were measured following a Co⁶° gamma dose of

Taira KATAYAMA

1963-01-01

218

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

219

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

220

Biological identification of ampullary adenocarcinomas.  

PubMed

Ampullary adenocarcinomas have unique biologic and clinical features that result in its improved prognosis versus adenocarcinomas that arise from the distal bile ducts and pancreas. However the histological differentiation and identification of these tumors is not easily accomplished. Two abstracts at this year's ASCO Annual Meeting describe attempts to identify unique methods for distinguishing these tumors. Abstract #4141 described a 92 gene RT-PCR assay that was used for molecular classification of patients with ampullary adenocarcinomas while Abstract #e15175 looked at mutational status of K-ras in patients with these tumors. The results of their abstracts will be discussed. PMID:25076327

Relias, Valerie; Saif, Muhammad Wasif

2014-07-01

221

Pancreatic adenocarcinoma: epidemiology and genetics.  

PubMed Central

Pancreatic adenocarcinoma is an important cause of death from cancer throughout the developed world. There are few established environmental risk factors, but a previous history of pancreatitis and exposure to tobacco and salted food appear to be the most important. A family history of pancreatic adenocarcinoma is not common in patients with this disease, but recent research has shown that pancreatic adenocarcinoma can be a feature of cancer susceptibility syndromes associated with germline mutations in p16, BRCA1, BRCA2, and APC. This highlights the need for a full family history in apparently sporadic cases. Somatic mutations in p16, BRCA2, and APC have also been reported in pancreatic cancer; however, K-RAS mutations appear to be the commonest oncogenic alteration. Recent advances in our understanding of the basis of hereditary cancer syndromes may be applicable to the diagnosis, treatment, and possibly prevention of pancreatic adenocarcinoma in the future. PMID:8950667

Flanders, T Y; Foulkes, W D

1996-01-01

222

Villoglandular Adenocarcinoma of the Vulva  

Microsoft Academic Search

Background. Only two previous cases of villoglandular adenocarcinoma of the vulva, an entity morphologically similar to tumors found in the uterine cervix and colorectum, have been reported. This paper communicates the first complete immunohistochemical study in villoglandular adenocarcinoma in order to determine its phenotype and histogenesis.Case. A 69-year-old woman had a 1.5-cm nodule in the right labium majus. Histologically, it

Antonio Rodriguez; Mar??a Alejandra Isaac; Esther Hidalgo; Bélgica Márquez; Francisco F. Nogales

2001-01-01

223

Pancreatic ductal adenocarcinoma staging  

PubMed Central

Abstract In addition to clinical history and evaluations, the results of laboratory tests and imaging studies help clinicians in determining treatment strategies. Imaging plays a central role in the management of oncology patients including the initial diagnosis, staging, and follow-up to assess treatment response. Historically, radiologists have relied on free-style dictations to convey the results of imaging findings in radiology reports to referring clinicians. These unstructured free-style dictations can potentially be a source of frustration as the pertinent information needed to guide treatment may be omitted or difficult to extract from the report, thereby limiting its completeness and usefulness. These limitations can be overcome by adopting a structured and reproducible form of reporting imaging studies to help clinicians in deciding the best treatment strategy for each patient. There is a growing need to establish standardized radiology reporting templates for specific disease processes. One such example involves patients with pancreatic ductal adenocarcinoma, as imaging findings determine the treatment arm to which the patient is assigned. In this presentation, we outline a list of essential features that need to be included in a structured report and highlight this with illustrative case examples. PMID:24060977

Francis, Isaac R.

2013-01-01

224

Small bowel perforation caused by advanced melanoma.  

PubMed

The incidence of melanoma has been increasing over the years and it remains, despite the heterogeneous survival for different stages, a disease with high mortality. Dissemination occurs primarily by the lymphatic route, followed by the hematogenous route. Gastrointestinal metastases do occur, but they are mainly intraluminal mucosal melanomas. Peritoneal or primary mucosal melanomas are rare. Only a few cases have been described of patients presenting with acute abdominal pain due to a melanoma. In this report we present a young patient with no prior health problems. Due to silent progression of disease at first, and secondarily avoidance of medical consultation, she finally presented to our emergency department with signs of intestinal perforation. In the operating theater a massive metastasis in the intestines with perforation was seen, as well as many smaller intra-abdominal and cutaneous lesions. Approximately 35 cm of jejunum had to be resected. Furthermore, the primary melanoma on the left forearm was excised and turned out to be in almost complete regression. Although initial recovery after surgery was good, the patient died only one month after presentation due to the advanced nature of her disease, which points to the devastating effect of undiagnosed melanoma and gastrointestinal metastasis. Since the melanoma incidence is rising, similar cases may present in the near future. This emphasizes the importance of proper full physical examination in patients with atypical abdominal symptoms. PMID:25296605

den Uil, Sjoerd H; Thomassen, Irene; Vermeulen, Erik Gj; Vuylsteke, Ronald Jclm; Stockmann, Hein Bac; de Vries, Mattijs

2014-01-01

225

Bacterial Translocation in Adult Small Bowel Transplantation  

Microsoft Academic Search

The application of intestinal transplantation is limited by the high rate of infectious complications that can occur; the migration of enteric microorganisms to extraintestinal sites (bacterial translocation) has been suggested to be responsible for this event. We reviewed 95 intestinal biopsies performed on 28 transplanted patients to identify histologic features predictive of isolation of enteric microorganisms in extraintestinal sites within

A. Cucchetti; A. Siniscalchi; A. Bagni; A. Lauro; M. Cescon; N. Zucchini; A. Dazzi; C. Zanfi; S. Faenza; A. D. Pinna

2009-01-01

226

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

227

Diverticular Disease of the Small Bowel  

PubMed Central

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; Gutierrez-Vega, Rafael; Galvez-Molina, Yolanda; Ontiveros-Nevares, Patricia; Athie-Gutierrez, Cesar; Montalvo-Jave, Eduardo E.

2012-01-01

228

Plasmacytoid adenocarcinoma of the lung.  

PubMed

Plasmacytoid adenocarcinoma of the lung has not been reported. Herein reported is the first case of plasmacytoid adenocarcinoma of the lung. A 68-year-old man presented with cough and sputum. X-P and CT demonstrated a large tumor (10 x 10 x 9 cm) in the right upper lobe. CT-guided needle biopsy was performed. The biopsy showed plasmacytoid malignant cells. The malignant cells were small, had eccentrically located nuclei, perinuclear halo, and basophilic cytoplasm. No mucins were observed by mucins stains. Immunohistochemical study showed that the tumor cells were positive for pancytokeratin AE1/3, pancytokeratin CAM5.2, TTF-1, Ki-67 (labeling 70%), CA19-9, and p53. They were negative for neuron specific enolase, CEA, CD45, CD68, chromogranin, synaptophysin, surfactant apoprotein A, CDX-2, ?-chain, ?-chain, KIT, and PDGFRA. Since epithelial markers and adenocarcinoma markers were positive, the pathological diagnosis was plasmacytoid adenocarcinoma of lung. The patient is now treated with chemotherapy. PMID:22670180

Terada, Tadashi

2012-01-01

229

Endotracheal metastases from colon adenocarcinoma  

Microsoft Academic Search

Endotracheal metastases (ETM) from non-lung cancer are seldom seen. Their main clinical symptoms are cough, haemoptysis and\\u000a dyspnoea, although occasionally an incidental finding is made during a bronchoscopy. Breast, colon and kidney adenocarcinoma\\u000a might be associated with ETM, lung cancer being the most frequent cause. Its finding is associated with advanced disease but\\u000a survival will depend on the primary origin,

José M. Galbis Caravajal; Jesús G. Sales Badía; Carlos Trescolí Serrano; Pedro Cordero Rodríguez; Carlos Jordá Aragón; Elsa Naval Sendra

2008-01-01

230

Exclusively Endoscopic Resection of Nasopharyngeal Adenocarcinoma  

PubMed Central

We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma. PMID:24353869

Lai, Yu-Shih

2013-01-01

231

Gestational lung adenocarcinoma: case report.  

PubMed

Gestational cancer is a dramatic situation, with a deep impact on the patient and family, with an overall incidence of 1 per 100 pregnancies. Lung cancers are extremely rare during pregnancy but have become more frequent in past years, as the mean age of pregnancy has increased. The purpose of this case report is to present a gestational lung adenocarcinoma, with metastasis in the liver and ovaries, diagnosed in the third trimester, with a fatal outcome in days after birth through cesarean section. PMID:24771256

Ceau?u, Mihai; Hostiuc, Sorin; Sajin, Maria; Roman, Gheorghe; Nicodin, Ovidiu; Dermengiu, Dan

2014-10-01

232

Villoglandular papillary adenocarcinoma of the uterine cervix  

Microsoft Academic Search

Villoglandular papillary adenocarcinoma of the uterine cervix was recently (1989) described by three main histological features: exophytic proliferation, papillary architecture and mild to moderate cellular atypicality. The authors report a case of villoglandular papillary adenocarcinoma, clinical stage IB, which was peculiar because of its association with a co-existing and simultaneously discovered invasive squamous cell carcinoma. These two patterns were juxtaposed

Pierre Collinet; Jean-François Prolongeau; Sylvie Vaneecloo

1999-01-01

233

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.

234

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

2014-04-08

235

Villoglandular papillary adenocarcinoma of the uterine cervix.  

PubMed

Villoglandular papillary adenocarcinoma of the uterine cervix was recently (1989) described by three main histological features: exophytic proliferation, papillary architecture and mild to moderate cellular atypicality. The authors report a case of villoglandular papillary adenocarcinoma, clinical stage IB, which was peculiar because of its association with a co-existing and simultaneously discovered invasive squamous cell carcinoma. These two patterns were juxtaposed and not intermingled. The patient was treated with radical hysterectomy followed by vaginal radiation therapy. She remains without evidence of recurrence after 12 months of follow-up. Five main clinicopathological features of the villoglandular papillary adenocarcinoma could be stressed: rare histological variant (72 described cases), young age of patients (25-45 years old), superficial stromal invasion, usual association with other tumoral patterns (in situ or invasive adenocarcinoma as well as in situ or invasive squamous cell carcinoma) and excellent prognosis. For selected cases, a conservative surgical approach (cervical conization) was possible. PMID:10471150

Collinet, P; Prolongeau, J F; Vaneecloo, S

1999-09-01

236

Pulmonary adenocarcinoma: A renewed entity in 2011  

PubMed Central

Lung cancer, of which non-small-cell lung cancer comprises the majority, is the leading cause of cancer-related deaths in the United States and worldwide. Lung adenocarcinomas are a major subtype of non-small-cell lung cancers, are increasing in incidence globally in both males and females and in smokers and non-smokers, and are the cause for almost 50% of deaths attributable to lung cancer. Lung adenocarcinoma is a tumour with complex biology that we have recently started to understand with the advent of various histological, transcriptomic, genomic and proteomic technologies. However, the histological and molecular pathogenesis of this malignancy is still largely unknown. This review will describe advances in the molecular pathology of lung adenocarcinoma with emphasis on genomics and DNA alterations of this disease. Moreover, the review will discuss recognized lung adenocarcinoma preneoplastic lesions and current concepts of the early pathogenesis and progression of the disease. We will also portray the field cancerization phenomenon and lineage-specific oncogene expression pattern in lung cancer and how both remerging concepts can be exploited to increase our understanding of lung adenocarcinoma pathogenesis for subsequent development of biomarkers for early detection of adenocarcinomas and possibly personalized prevention. PMID:22040022

Kadara, Humam; Kabbout, Mohamed; Wistuba, Ignacio I.

2014-01-01

237

Mimics of pancreatic ductal adenocarcinoma  

PubMed Central

Abstract Several uncommon primary pancreatic tumors, inflammatory conditions, metastasis to the pancreas and peripancreatic masses can mimic the appearance of pancreatic ductal adenocarcinoma (PDA). Differentiation between these lesions and PDA can be challenging, due to the overlap in imaging features; however, familiarity with their typical imaging features and clinical presentation may be helpful in their differentiation, as in some cases, invasive diagnostic tests or unnecessary surgery can be avoided. The different pathologies that can mimic PDA include inflammatory conditions such as the various forms of pancreatitis (chronic-focal mass-forming, autoimmune and groove pancreatitis), pancreatic neuroendocrine tumors, solid pseudopapillary tumors, metastasis (solid non-lymphomatous and hematologic), congenital variants (annular pancreas), as well as peripancreatic lesions (accessory spleen, adrenal masses, duodenal masses, lymph nodes and vascular lesions), and certain rare pancreatic tumors (e.g., acinar cell tumors, solid serous tumors, hamartoma and solitary fibrous tumors). The clinical presentation and imaging features of the most commonly encountered mimics of PDA are discussed in this presentation with representative illustrations. PMID:24060833

Kaza, Ravi K.; Azar, Shadi F.; Ruma, Julie A.; Francis, Isaac R.

2013-01-01

238

Multiple lung adenocarcinomas associated with von hippel-lindau disease.  

PubMed

Lung adenocarcinoma has never before been reported to be associated with von Hippel-Lindau (VHL) disease. Here, we report a case of VHL disease in a patient who had metachronous multiple lung adenocarcinomas. The patient is a 64-year-old-woman with VHL disease. She underwent surgical resection of one adenocarcinoma and one atypical adenomatous hyperplasia. A second lung adenocarcinoma developed metachronously. A point mutation in the VHL gene was confirmed in DNA from a blood sample, and loss of heterozygosity at the VHL locus was detected in the lung adenocarcinoma. The VHL dysfunction may have a role in the development of multiple lung adenocarcinomas. PMID:25282218

Ikeda, Koei; Osumi, Hironobu; Matsuishi, Kentaro; Matsubara, Eri; Fujino, Kousuke; Shibata, Hidekatsu; Yoshimoto, Kentaro; Shiraishi, Kenji; Mori, Takeshi; Suzuki, Makoto

2014-10-01

239

Case of mucinous adenocarcinoma with porcelain gallbladder.  

PubMed

Histologically, the majority of gallbladder cancers are adenocarcinomas. Among the adenocarcinomas, the mucinous adenocarcinoma is relatively uncommon. Porcelain gallbladder is a rare finding and the risk of gallbladder cancer is significantly increased in porcelain gallbladder. We describe a rare case of mucinous adenocarcinoma with porcelain gallbladder. A 46-year-old man was admitted to Chonnam National University Hospital with a 2-week history of right upper quadrant pain. Three and 2 years previously, he had two episodes of cholecystitis with gallstones. An abdominal computed tomography revealed a contracted gallbladder with circumferential mural calcification, and the possibility of gallbladder cancer and porcelain gallbladder were considered. At laparotomy, cholecystectomy, liver wedge resection, and radical lymph node dissection were performed. The resected gallbladder showed thickened wall, luminal narrowing and mucosal irregularity. A histological examination of the resected gallbladder showed a mucinous adenocarcinoma composed of poorly differentiated glandular cells with mucin lakes. Porcelain gallbladder may be an end result of a chronic inflammatory reaction, and this change is associated with the development of gallbladder cancer. PMID:12859733

Joo, Young-Eun; Kim, Hyun-Soo; Choi, Sung-Kyu; Rew, Jong-Sun; Kim, Hyun-Jong; Kang, Heoung-Keun; Juhng, Sang-Woo; Kim, Sei-Jong

2003-08-01

240

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.

241

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

242

Advances in Barrett's esophagus and esophageal adenocarcinoma.  

PubMed

Despite advances in diagnosis and therapy, esophageal adenocarcinoma remains an aggressive and usually lethal tumor. This review focuses on the epidemiology of esophageal adenocarcinoma and its presumed precursor lesion, Barrett's esophagus; the pathogenesis of the cancer; advances in treatment of adenocarcinoma and Barrett's esophagus; and strategies for cancer prevention. Emphasis is placed on recent literature. Although the absolute number of cases of adenocarcinoma in the United States is still small, the incidence of this cancer has increased dramatically in the last 40 years, and adenocarcinoma is now the predominant form of esophageal cancer in this country. Recent evidence suggests that Barrett's esophagus is more prevalent in asymptomatic individuals than previously appreciated. The pathogenesis of Barrett's esophagus is poorly understood. Given that some subjects will have repeated bouts of severe erosive esophagitis and never develop Barrett's esophagus, host factors must play an important role. The utility of neoadjuvant radiation and chemotherapy in those with adenocarcinoma, although they are widely practiced, is not of clear benefit, and some authorities recommend against it. Ablative therapies, as well as endoscopic mucosal resection, hold promise for those with superficial cancer or high-grade dysplasia. Most series using these modalities feature relatively short follow-up, and longer-term data will be necessary to better describe the effects of these therapies. The value of chemoprevention in subjects with dysplastic Barrett's esophagus by use of cyclooxygenase 2 inhibitors, nonsteroidal anti-inflammatory drugs, or proton pump inhibitors is unknown. Similarly, although endoscopic screening is widely practiced, its value in patients with chronic gastroesophageal reflux disease symptoms is of unproven value, and recommending bodies are divided as to its practice. PMID:15887151

Shaheen, Nicholas J

2005-05-01

243

Detection of Early-Stage Pancreatic Adenocarcinoma  

PubMed Central

Background Pancreatic adenocarcinoma is an almost universally lethal disease, in large part, due to our inability to detect early-stage disease. Monoclonal antibody PAM4 is reactive with a unique biomarker expressed by greater than 85% of pancreatic adenocarcinomas. In this report, we examined the ability of a PAM4-based immunoassay to detect early-stage disease. Methods The PAM4-based immunoassay was used to quantitate antigen in the serum of healthy volunteers (N=19), patients with known pancreatic adenocarcinoma (N=68), and patients with a primary diagnosis of chronic pancreatitis (N=29). Results Sensitivity for detection of pancreatic adenocarcinoma was 82%, with a false-positive rate of 5% for healthy controls. Patients with advanced disease had significantly higher antigen levels than those with early-stage disease (P<0.01), with a diagnostic sensitivity of 91%, 86%, and 62% for stage 3/4 advanced disease, stage-2, and stage-1, respectively. We also evaluated chronic pancreatitis sera, finding 38% positive for antigen; however, this was discordant with immunohistochemical findings that suggest the PAM4-antigen is not produced by inflamed pancreatic tissue. Furthermore, several of the serum-positive pancreatitis patients, for whom tissue specimens were available for pathological interpretation, had evidence of neoplastic precursor lesions. Conclusions These results suggest the use of the PAM4-serum assay to detect early-stage pancreatic adenocarcinoma, and that positive levels of PAM4-antigen are not derived from inflamed pancreatic tissues, but rather may provide evidence of subclinical pancreatic neoplasia. Impact The ability to detect pancreatic adenocarcinoma at an early stage could provide for early therapeutic intervention with potentially improved patient outcomes. PMID:20810605

Gold, David V.; Goggins, Michael; Modrak, David E.; Newsome, Guy; Liu, Mengling; Shi, Chanjuan; Hruban, Ralph H.; Goldenberg, David M.

2010-01-01

244

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

245

Primary appendicular adenocarcinoma presenting as haematuria.  

PubMed

Adenocarcinoma of the vermiform appendix is a rare malignant neoplasm of the gastrointestinal tract encountered rarely within general surgical practice. We present the case of a 49-year-old man who, while undergoing investigations for haematuria, was diagnosed with an appendicular adenocarcinoma following bladder biopsy. Consequently he underwent right hemicolectomy and partial cystectomy followed by adjuvant chemotherapy. By discussing this case we hope to raise awareness within the medical profession of this rare presentation so that it may be considered within clinicians' differential diagnoses. PMID:25358831

Amr, Bassem; Santana-Vaz, Natasha; Munir, Komal

2014-01-01

246

Genomics and pharmacogenomics of pancreatic adenocarcinoma  

Microsoft Academic Search

The last decade has brought significant advances in the development of molecularly targeted therapies for treatment of a variety of human malignancies. In contrast to other solid tumors, however, the impact of novel therapeutic strategies on clinical outcomes in patients with pancreas adenocarcinoma (PAC) has been limited to date. Gemcitabine was established as a standard of care for treatment of

M A Lowery; E M O'Reilly

2012-01-01

247

Primary retroperitoneal Müllerian adenocarcinoma arising from endometriosis.  

PubMed

Primary retroperitoneal Müllerian adenocarcinoma (PRMA) is an extremely rare tumor and the cause remains unknown. We report a case of PRMA arising from endometriosis. A 52-year-old woman with a history of malignant lymphoma underwent a follow-up computed tomography scan, which revealed a retroperitoneal tumor. Immunohistochemical analysis of tumor resected during laparoscopic surgery showed adenocarcinoma positive for cytokeratin 7 and negative for cytokeratin 20. The patient had undergone hysterectomy and bilateral salpingo-oophorectomy 14 years ago for myoma uteri and endometrial cysts and was treated with estrogen-replacement therapy. The size of the tumor increased and laparotomy was performed. Histopathological examination showed adenocarcinoma resembling endometrial adenocarcinoma, which stained positive for cancer antigen 125, cancer antigen 19-9, estrogen receptor, and progesterone receptor immunohistochemically. The focus of the endometriosis was found at the edge of the tumor, and the stromal cells around the tumor cells were CD10 positive. The patient was diagnosed as having PRMA arising from endometriosis, and treated with adjuvant chemotherapy. PMID:24888958

Tanaka, Kei; Kobayashi, Yoichi; Shibuya, Hiromi; Nishigaya, Yoshiko; Momomura, Mai; Matsumoto, Hironori; Iwashita, Mitsutoshi

2014-06-01

248

Rare coexistence of sarcoidosis and lung adenocarcinoma  

PubMed Central

Case An eighty year old African-American female was evaluated for cough, chest pain, asymptomatic anemia and 21 pound weight loss over a six month period. Computerized tomography (CT) revealed a spiculated 2.8 cm right upper lobe lung nodule, other smaller nodules and lymphadenopathy. Gallium scan revealed abnormal uptake of radiotracer in lacrimal, hilar and mediastinal glands. Broncho-alveolar lavage showed CD4/CD8 ratio of 2:1 with 15% lymphocytes. Biopsy of right upper lobe lesion and mediastinoscopic lymph node biopsy showed numerous matured uniform non-caseating granulomatous inflammation, however stains and culture for Acid fast bacilli (AFB)/fungal organisms were negative. Patient improved on oral steroids. Six months later she returned with worsening dyspnea and chest X-ray showed bilateral pleural effusions. Thoracocentesis revealed Thyroid transcription factor 1 (TTF1) positive adenocarcinoma cells and Video assisted thoracic surgery (VATS) procedure revealed numerous pleural, pericardial, diaphragmatic metastasis. Biopsy also was positive for TTF1 adenocarcinoma and positive for Epidermal Growth Factor receptor (EGFR) mutation, however negative for Anaplastic Lymphoma Kinase (ALK). Talc pleurodesis was performed. She was treated with erlotinib while steroid was kept on hold. Initial tumor burden decreased but follow-up PET scan six months later showed progression of tumor with lymphadenopathy. After discussion with patient and family, patient opted for hospice care. Discussion Oncocentric theory postulates sarcoidosis as an immunological reaction to dispersal of tumor antigen. Sarcocentric theory postulates that cell-mediated immune abnormalities induced by sarcoidosis in CD4 and CD8 cells is involved in the onset of lung cancer. Thus considerable controversy exists regarding sarcoidosis and malignancy. In our case, TTF1 adenocarcinoma cells from thoracocentesis suggest peripheral nodules in right upper lobe and lingula were likely metastatic, presenting as malignant pleural effusions. However if noncaseating granulomatous inflammation is expected as an immunological reaction to tumor antigen, it is very interesting to observe that initial tissue biopsy of primary right upper lobe mass and mediastinal lymph nodes showed matured uniform non-caseating granulomatous inflammation and no evidence of adenocarcinoma. This being said, it would be highly unlikely for sarcoidosis to progress to lung adenocarcinoma within six months. This adds further controversy to whether granulomatous inflammation is a precursor to future malignancy or whether this elderly African-American female was predisposed to develop granulomatous inflammation in presence of a tumor antigen. One can also speculate whether repeat tissue sampling from right upper lobe mass would have shown granulomatous inflammation or TTF1 adenocarcinoma. Conclusion While evidence is still lacking regarding association between sarcoidosis and lung adenocarcinoma, it is important for clinicians to exclude metastatic malignancy in patients exhibiting clinical and radiographic findings consistent with sarcoidosis.

Kachalia, Amit Girish; Ochieng, Pius; Kachalia, Kinjal; Rahman, Habibur

2014-01-01

249

FOLFOX-6 Induction Chemotherapy Followed by Esophagectomy and Post-operative Chemoradiotherapy in Patients With Esophageal Adenocarcinoma  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Adenocarcinoma of the Gastric Cardia; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer; Stage IIIC Esophageal Cancer

2014-07-21

250

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

251

Adenocarcinoma associated with tail gut cyst  

PubMed Central

Primary adenocarcinomas of the presacral (retrorectal) space are rare. The diagnosis is usually delayed because of non-specific symptoms, and is made after a biopsy or surgery. These carcinomas arise from cystic lesions developing from remnants of the embryological postanal gut containing mucous-secreting epithelium, known as tail gut cysts. The potential for infection, perianal fistulas and most importantly, malignant change warrants an early complete surgical resection. From an oncologist’s perspective, the management of these carcinomas has varied, and has included adjuvant chemotherapy and/or radiation therapy. We describe here a rare case of adenocarcinoma associated with a tail gut cyst that was discovered incidentally and resected by a posterior approach (Kraske procedure). The patient has had clinical and periodic radiologic surveillance without any evidence of cancer recurrence for over a year and a half. PMID:23450681

Wise, Susannah; Maloney-Patel, Nell; Rezac, Craig; Poplin, Elizabeth

2013-01-01

252

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

253

Isolated sphenoid sinus adenocarcinoma: a case report  

Microsoft Academic Search

While solitary sphenoid sinus disease is uncommon, primary isolated sphenoid sinus carcinoma is extremely rare. We describe a case of isolated sphenoid sinus adenocarcinoma in a 68-year-old man. The patient presented with a persistent headache and with diplopia secondary to complete ophthalmoplegia. Paranasal sinus tomography showed a soft-tissue mass obliterating the sphenoid sinus and infiltrating the cavernous sinuses. The histological

Ozcan Cakmak; Tan N. Ergin; Volkan M. Aydin

2002-01-01

254

Helicobacter pylori and gastrointestinal tract adenocarcinomas  

Microsoft Academic Search

Although gastric adenocarcinoma is associated with the presence of Helicobacter pylori in the stomach, only a small fraction of colonized individuals develop this common malignancy. H. pylori strain and host genotypes probably influence the risk of carcinogenesis by differentially affecting host inflammatory responses and epithelial-cell physiology. Understanding the host–microbial interactions that lead to neoplasia will improve cancer-targeted therapeutics and diagnostics,

Martin J. Blaser; Richard M. Peek

2002-01-01

255

HELICOBACTER PYLORI AND GASTROINTESTINAL TRACT ADENOCARCINOMAS  

Microsoft Academic Search

Although gastric adenocarcinoma is associated with the presence of Helicobacter pylori in the stomach, only a small fraction of colonized individuals develop this common malignancy. H. pylori strain and host genotypes probably influence the risk of carcinogenesis by differentially affecting host inflammatory responses and epithelial-cell physiology. Understanding the host-microbial interactions that lead to neoplasia will improve cancer-targeted therapeutics and diagnostics,

Richard M. Peek Jr; Martin J. Blaser

256

An incidentally diagnosed prostatic ductal adenocarcinoma  

PubMed Central

Ductal adenocarcinoma of the prostate was initially described in 1967 by Melicow and Patcher. It was given the erroneous name endometrioid carcinoma, however, further studies confirmed the prostatic origin of this tumor. Currently DAP is classified as a histological variant of prostatic carcinoma. Compared with “classic” acinar carcinoma of the prostate, DAP is a rare histological finding. It's prevalence in prostatectomy and biopsy specimens varies from less than 1% for pure ductal adenocarcinoma up to 5% for mixed DAP. Because of its typical periurethral location, the tumor usually manifests itself clinically with urinary obstruction, urinary urgency, urinary frequency and hematuria. DAP is associated with more aggressive natural history and worse prognosis than pure AA – patients presented at more advanced stage, with poorly differentiated and distant disease. DAP has a tendency to spread to regional lymph nodes, axial skeleton, and visceral organs. We report a case of a 90–year old man who presented to our clinic with acute urinary retention and gross hematuria. He underwent suprapubic transvesical adenomectomy to diminish the urinary obstruction. The pathological examination of the specimens revealed a dominant focus of DAP, which was located near the intraprostatic urethra and a coexisting, smaller component of “classic” acinar adenocarcinoma. PMID:24579020

Kalinowski, Tomasz; Ligaj, Marcin; Demkow, Tomasz

2013-01-01

257

Characterizing the cancer genome in lung adenocarcinoma  

PubMed Central

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 of tumors (n = 371) using dense single nucleotide polymorphism arrays, we identify a total of 57 significantly recurrent events. We find that 26 of 39 autosomal chromosome arms show consistent large-scale copy-number gain or loss, of which only a handful have been linked to a specific gene. We also identify 31 recurrent focal events, including 24 amplifications and 7 homozygous deletions. Only six of these focal events are currently associated with known mutations in lung carcinomas. The most common event, amplification of chromosome 14q13.3, is found in ~12% of samples. On the basis of genomic and functional analyses, we identify NKX2-1 (NK2 homeobox 1, also called TITF1), which lies in the minimal 14q13.3 amplification interval and encodes a lineage-specific transcription factor, as a novel candidate proto-oncogene involved in a significant fraction of lung adenocarcinomas. More generally, our results indicate that many of the genes that are involved in lung adenocarcinoma remain to be discovered. PMID:17982442

Weir, Barbara A.; Woo, Michele S.; Getz, Gad; Perner, Sven; Ding, Li; Beroukhim, Rameen; Lin, William M.; Province, Michael A.; Kraja, Aldi; Johnson, Laura A.; Shah, Kinjal; Sato, Mitsuo; Thomas, Roman K.; Barletta, Justine A.; Borecki, Ingrid B.; Broderick, Stephen; Chang, Andrew C.; Chiang, Derek Y.; Chirieac, Lucian R.; Cho, Jeonghee; Fujii, Yoshitaka; Gazdar, Adi F.; Giordano, Thomas; Greulich, Heidi; Hanna, Megan; Johnson, Bruce E.; Kris, Mark G.; Lash, Alex; Lin, Ling; Lindeman, Neal; Mardis, Elaine R.; McPherson, John D.; Minna, John D.; Morgan, Margaret B.; Nadel, Mark; Orringer, Mark B.; Osborne, John R.; Ozenberger, Brad; Ramos, Alex H.; Robinson, James; Roth, Jack A.; Rusch, Valerie; Sasaki, Hidefumi; Shepherd, Frances; Sougnez, Carrie; Spitz, Margaret R.; Tsao, Ming-Sound; Twomey, David; Verhaak, Roel G. W.; Weinstock, George M.; Wheeler, David A.; Winckler, Wendy; Yoshizawa, Akihiko; Yu, Soyoung; Zakowski, Maureen F.; Zhang, Qunyuan; Beer, David G.; Wistuba, Ignacio I.; Watson, Mark A.; Garraway, Levi A.; Ladanyi, Marc; Travis, William D.; Pao, William; Rubin, Mark A.; Gabriel, Stacey B.; Gibbs, Richard A.; Varmus, Harold E.; Wilson, Richard K.; Lander, Eric S.; Meyerson, Matthew

2008-01-01

258

Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma  

PubMed Central

Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations. PMID:25309762

Gharaibeh, Kamel A.; Yousuf, Tauqeer

2014-01-01

259

Expression of galectin-3 in gastric adenocarcinoma  

PubMed Central

Background & objectives: Galectin-3 a member of the galectin family is an endogenous ?-galactoside binding lectin. It has been found to be associated with cell adhesion, recognition, proliferation, differentiation, immunomodulation, angiogenesis, apoptosis and can be a reliable marker for cancer aggressiveness. The aim of this study was to verify protein expression in gastric adenocarcinoma tissues and correlate the results with the clinical aspects in the study population. Methods: Galectin-3 expression was examined by immunohistochemistry in 57 samples of gastric adenocarcinomas tissues. Galectin-3 protein expression was observed in the cytoplasm and the nucleus of examined tissues. Results: Thirty one (54.4%) samples had strong or moderate staining and 26 (45.6%) tumours had negative or weak staining. The galectin-3 did not show association with the sex (P=0.347), age (P=0.999), Lauren's classification (P=0.731) and TNM stage (P=0.222). Regarding the TNM stage, 66.7 per cent of stage I tumours had strong or moderate staining; with tumours stage IV this percentage was 33.3 per cent. Interpretation & conclusion: Our results suggest that gal-3 is not a reliable biomarker for prognosis of the gastric adenocarcinoma by immunohistochemistry. Further studies need to be done on a large sample of tumour tissues in different clinical staging. PMID:25222780

Gomes, Thiago Simao; Oshima, Celina Tizuko Fujiyama; Forones, Nora Manoukian; De Oliveira Lima, Flavio; Ribeiro, Daniel Araki

2014-01-01

260

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

261

Gene expression profiling in sinonasal adenocarcinoma  

PubMed Central

Background Sinonasal adenocarcinomas are uncommon tumors which develop in the ethmoid sinus after exposure to wood dust. Although the etiology of these tumors is well defined, very little is known about their molecular basis and no diagnostic tool exists for their early detection in high-risk workers. Methods To identify genes involved in this disease, we performed gene expression profiling using cancer-dedicated microarrays, on nine matched samples of sinonasal adenocarcinomas and non-tumor sinusal tissue. Microarray results were validated by quantitative RT-PCR and immunohistochemistry on two additional sets of tumors. Results Among the genes with significant differential expression we selected LGALS4, ACS5, CLU, SRI and CCT5 for further exploration. The overexpression of LGALS4, ACS5, SRI, CCT5 and the downregulation of CLU were confirmed by quantitative RT-PCR. Immunohistochemistry was performed for LGALS4 (Galectin 4), ACS5 (Acyl-CoA synthetase) and CLU (Clusterin) proteins: LGALS4 was highly up-regulated, particularly in the most differentiated tumors, while CLU was lost in all tumors. The expression of ACS5, was more heterogeneous and no correlation was observed with the tumor type. Conclusion Within our microarray study in sinonasal adenocarcinoma we identified two proteins, LGALS4 and CLU, that were significantly differentially expressed in tumors compared to normal tissue. A further evaluation on a new set of tissues, including precancerous stages and low grade tumors, is necessary to evaluate the possibility of using them as diagnostic markers. PMID:19903339

2009-01-01

262

Psoas muscle infiltration masquerading distant adenocarcinoma.  

PubMed

Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations. PMID:25309762

Gharaibeh, Kamel A; Lopez-Ruiz, Arnaldo; Yousuf, Tauqeer

2014-01-01

263

Case report: differential diagnosis between primary cutaneous apocrine adenocarcinoma versus extramammary or metastatic breast adenocarcinoma.  

PubMed

: Cutaneous apocrine adenocarcinoma (CAA) is a rare adnexal neoplasm that histologically can mimic breast carcinoma metastatic to the skin or apocrine carcinoma arising in ectopic breast tissue. It can present with a wide range of clinical modalities and can often simulate many benign processes, which delays its diagnosis and hinders its prognosis. We describe a case of a 33-year-old man who had a short-evolution small nodule in the right axilla with local lymph node metastases. The immunohistochemical characterization was closer to that of breast adenocarcinoma than to an adnexal neoplasm. This was established as the main differential diagnosis. Diagnosis of cutaneous apocrine adenocarcinoma may be difficult and immunomarkers are not specific. The anatomical criteria and systemic investigation are mandatory to establish the correct diagnosis. PMID:23863550

Toledo-Pastrana, Tomás; Llombart-Cussac, Beatriz; Traves-Zapata, Victor; Requena-Caballero, Celia; Sanmartín-Jimenez, Onofre; Angeles-Sales, María; Cabezas, María; Guillén-Barona, Carlos

2014-10-01

264

HER2 amplification, overexpression and score criteria in esophageal adenocarcinoma  

PubMed Central

The HER2 oncogene was recently reported to be amplified and overexpressed in esophageal adenocarcinoma. However, the relationship of HER2 amplification in esophageal adenocarcinoma with prognosis has not been well defined. The scoring systems for clinically evaluating HER2 in esophageal adenocarcinoma are not established. The aims of the study were to establish a HER2 scoring system and comprehensively investigate HER2 amplification and overexpression in esophageal adenocarcinoma and its precursor lesion. Using a tissue microarray, containing 116 cases of esophageal adenocarcinoma, 34 cases of BE, 18 cases of low grade dysplasia and 15 cases of high grade dysplasia, HER2 amplification and overexpression were analyzed by HercepTest and CISH methods. The amplification frequency in an independent series of 116 esophageal adenocarcinoma samples was also analyzed using Affymetrix SNP 6.0 microarrays. In our studies, we have found that HER2 amplification does not associate with poor prognosis in total 232 esophageal adenocarcinoma patients by CISH and high density microarrays. We further confirm the similar frequency of HER2 amplification by CISH (18.10%; 21/116) and SNP 6.0 microarrays (16.4%, 19/116) in esophageal adenocarcinoma. HER2 protein overexpression was observed in 12.1 % (14/116) of esophageal adenocarcinoma and 6.67% (1/15) of HGD. No HER2 amplification or overexpression was identified in BE or LGD. All HER2 protein overexpression cases showed HER2 gene amplification. Gene amplification was found to be more frequent by CISH than protein overexpression in esophageal adenocarcinoma (18.10% vs 12.9%). A modified two-step model for esophageal adenocarcinoma HER-2 testing is recommend for clinical esophageal adenocarcinoma HER-2 trial. PMID:21460800

Hu, Yingchuan; Bandla, Santhoshi; Godfrey, Tony E.; Tan, Dongfeng; Luketich, James D.; Pennathur, Arjun; Qiu, Xing; Hicks, David G.; Peters, Jeffrey; Zhou, Zhongren

2011-01-01

265

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

266

Small-Bowel Ulceration-Iatrogenic or Multifactorial Origin.  

National Technical Information Service (NTIS)

Fifty-nine cases of nonspecific ulceration of the small intestine are presented from the files of the Armed Forces Institute of Pathology. Eighteen patients gave a history of ingestion of enteric-coated hydrochlorothiazide and potassium chloride. The clin...

D. M. Wayte, E. B. Helwig

1968-01-01

267

In vivo thermography during small bowel fusion using radiofrequency energy  

Microsoft Academic Search

Background  Radiofrequency-controlled tissue fusion is a novel technology but the associated lateral thermal damage has not been determined.\\u000a \\u000a \\u000a \\u000a Methods  Lateral thermal spread of in vivo and ex vivo bowel in a live porcine model fused by radiofrequency energy was evaluated using\\u000a dynamic infrared thermography and histology.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Mean maximum thermal spread measured on histology was <1.2 mm, with no significant difference between thermal spreads

C. Beverly B. Lim; Robert D. Goldin; Daniel S. Elson; Ara Darzi; George B. Hanna

2010-01-01

268

Small Bowel Bypass as Treatment for Functional Gastric Obstruction  

Microsoft Academic Search

Multiple bariatric operations performed on the same patient can cause loss of normal peristaltic function of the stomach.\\u000a Bariatric revisions, especially when combined with previous truncal vagotomy, can lead to functional gastric obstruction.\\u000a These patients complain of severe nausea and intractable vomiting. This can cause excessive weight loss and malnutrition,\\u000a requiring at times total parenteral nutrition (TPN) or forms of

Marek Lutrzykowski

2008-01-01

269

Small bowel obstruction in percutaneous fixation of traumatic pelvic fractures  

PubMed Central

The use of external fixation for the initial treatment of unstable, complex pelvic injuries with hemodynamic instability remains an effective treatment for multiply injured patients. Bowel entrapment within a pelvic fracture is a rarely reported, potentially fatal complication. Here, we report a polytrauma patient with pelvic fractures who developed an intestinal obstruction after an external fixation. At an explorative laparotomy, we found an ileum segment trapped in the sacral fracture. Reported cases of bowel entrapment in pelvic fractures, especially in sacral fractures, are exceedingly rare. The diagnosis is often delayed due to difficulty distinguishing entrapment from the more common adynamic ileus. In conclusion, clinicians and radiologists should be aware of this potentially lethal complication of pelvic fractures treatment. To exclude bowel entrapment, patients with persistent ileus or sepsis should undergo early investigations. PMID:23960383

Bini, Roberto; Quiriconi, Fabrizio; Viora, Tiziana; Leli, Renzo

2013-01-01

270

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

271

Soft X-ray-induced decomposition of amino acids: An XPS, massspectrometry, and NEXAFS study  

SciTech Connect

Decomposition of five amino acids, alanine, serine, cysteine, aspartic acid, and asparagine, under irradiation with soft X-rays (magnesium Ka X-ray source) in ultra-high vacuum was studied by means of X-ray photoelectron spectrometry (XPS) and mass spectrometry. A comparative analysis of changes in XPS line shapes, stoichiometry and residual gas composition indicates that the molecules decompose by several pathways. Dehydration, decarboxylation, decarbonylation,deamination and desulfurization of pristine molecules accompanied by desorption of H2, H2O, CO2, CO, NH3and H2S are observed with rates depending on the specific amino acid. NEXAFS spectra of cysteine at the carbon, oxygen and nitrogen K-shell and sulfur L2,3 edges complement the XPS and mass spectrometry data and show that the exposure of the sample to an intense soft X-ray synchrotron beam results in the formation of C-C and C-N double and triple bonds. Qualitatively, the amino acids studied can be arranged in the following ascending order of radiation stability:serine

Zubavichus, Yan; Fuchs, Oliver; Weinhardt, Lothar; Heske,Clemens; Umbach, Eberhard; Denlinger, Jonathan D.; Grunze, Michael

2003-09-15

272

Soft X-ray-induced decomposition of amino acids: An XPS, massspectrometry, and NEXAFS study  

SciTech Connect

Decomposition of five amino acids, viz. alanine, serine,cysteine, aspartic acid, and asparagine under soft X-ray irradiation (MgK? X-ray source) in ultra-high vacuum has been studied by meansof XPS and mass-spectrometry. A comparative analysis of changes in XPSline shapes, stoichiometry, and residual gas composition indicates thatthe molecules decompose via severalpathways. Dehydration,decarboxylation, decarbonylation, deamination, and desulfurization ofpristine molecules accompanied by desorption of H2, H2O, CO2, CO, NH3,H2S are observed with rates depending on the specific amino acid. NEXAFSspectra of cysteine at the C, O, N K- and S L2,3-edges complement the XPSand mass-spectrometry data and show that exposure of the sample to anintense soft X-ray synchrotron beam results in a formation of C-C and C-Ndouble and triple bonds. Qualitatively, the studied amino acids can bearranged in the following ascending order for radiation stability: serine

Zubavichus, Y.; Fuchs, O.; Weinhardt, L.; Heske, C.; Umbach, E.; Denlinger, J.D.; Grunze, M.

2003-02-26

273

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

274

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

275

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

276

Structural study of X-ray induced activation of carbonic anhydrase  

PubMed Central

Carbonic anhydrase, a zinc metalloenzyme, catalyzes the reversible hydration of carbon dioxide to bicarbonate. It is involved in processes connected with acid–base homeostasis, respiration, and photosynthesis. More than 100 distinct human carbonic anhydrase II (HCAII) 3D structures have been generated in last 3 decades [Liljas A, et al. (1972) Nat New Biol 235:131–137], but a structure of an HCAII in complex with CO2 or HCO3? has remained elusive. Here, we report previously undescribed structures of HCAII:CO2 and HCAII:HCO3? complexes, together with a 3D molecular film of the enzymatic reaction observed successively in the same crystal after extended exposure to X-ray. We demonstrate that the unexpected enzyme activation was caused in an X-ray dose-dependent manner. Although X-ray damage to macromolecular samples has long been recognized [Ravelli RB, Garman EF (2006) Curr Opin Struct Biol 16:624–629], the detailed structural analysis reports on X-ray-driven reactions have been very rare in literature to date. Here, we report on enzyme activation and the associated chemical reaction in a crystal at 100 K. We propose mechanisms based on water photoradiolysis and/or electron radiolysis as the main cause of enzyme activation. PMID:19520834

Sjoblom, Bjorn; Polentarutti, Maurizio; Djinovic-Carugo, Kristina

2009-01-01

277

An ensemble of new techniques to study soft-X-ray-induced variations in cellular metabolism  

Microsoft Academic Search

An ensemble of new techniques has been developed to study cell metabolism. These include: CO2 production monitoring, cell irradiation with soft X rays produced with a laser-plasma source, and study of oscillations in cell metabolic activity via spectral analysis of experimental records. Soft X-rays at about 0.9 keV, with a very low penetration in biological material, were chosen to produce

Edmond Turcu; Rick Allot; Nicola Lisi; Dimitri Batani; Fulvia Bortolotto; Alessandra Masini; Marziale Milani; Monica Ballerini; Lorenzo Ferraro; Achille Pozzi; Fabio Previdi; Lorenzo Rebonato

2004-01-01

278

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

279

Proton-induces and x-ray induced fluorescence analysis of scoliotic tissue  

SciTech Connect

Adolescent idiopathic scoliosis is characterized by a curvature or assymetry of the spine which may become progressively more severe, with clinical symptoms appearing just prior to, or during, puberty. The incidence for scoliosis in the age group from 12 to 14 years of age has been reported as high as 8 to 10%, with more than 80% of the cases occurring in females. Although pathologic changes exist in muscles from both sides of the spinal curvature, and no statistically significant side differences have been reported, morphologic changes suggest that the concanve side is the most affected. This paper reports our preliminary data on the elemental composition of individual muscle fibers derived from convex, concave and gluteal scoliotic muscle, and erythrocytes from scoliotic and normal patients, analyzed by proton induced x-ray emission (PIXE) and x-ray fluorescence spectroscopy (XRF). A new type of specimen holder was designed for this study which offers low x-ray background, minimal absorption and maintenance of a moist environment around the specimen.

Panessa-Warren, B J; Kraner, H W; Jones, K W; Weiss, L S

1980-02-01

280

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

281

X-ray induced mass loss effects on exoplanets orbiting dM stars  

Microsoft Academic Search

Aims:We study the influence of the X-ray luminosity distribution of dM stars on mass loss from planets on close-in orbits. Methods: Using the X-ray luminosity of the Pleiades, the Hyades, and field dM stars, we construct a scaling law for the radiation environment of dM stars for ages between 0.1 and 10 Gyr. An energy-limited escape approach is used to

T. Penz; G. Micela

2008-01-01

282

Quantitative analysis by X-ray induced total electron yield (TEY) compared to XRFA  

Microsoft Academic Search

The theoretical concepts of the two methods are similar. Consequently, comparable fundamental parameter algorithms can be developed and applied to quantitative analysis of bulk specimens and to investigation of thin layers by TEY and by XRFA. Whereas the sampling depth of XRFA is determined by photoelectric absorption, for TEY the escape probability of electrons reduces this quantity to values of

Horst Ebel

2004-01-01

283

Mapping of X-ray induced luminescence using a SNOM probe  

NASA Astrophysics Data System (ADS)

In this work we show the feasibility of simultaneous topographic and luminescence mapping with an home-built Shear-Force Microscope under X-ray irradiation with a tabletop microfocused X-ray source (maximum electric power of 30 W). A commercial fluorescent screen, containing europium uranyl compounds, is used as test sample. Simultaneous topography and luminescence maps on the fluorescent screen are first obtained with the apparatus. The two images totally overlap, however the luminescence is not homogeneous on the whole scanned area. Moreover, a photoluminescence spectrum is presented with a good signal-to-noise ratio under X-ray irradiation on a grain of the fluorescent screen and shows peaks in agreement with Europium uranyl compounds. A ZnO/ZnS powder mixture embedded in PMMA is then studied with the same equipment. A 20 ?m-wide grain is clearly visible on the topographic image. With the instrument, the grain could be unambiguously identified as containing mainly ZnO.

Jandard, F.; Fauquet, C.; Dehlinger, M.; Ranguis, A.; Bjeoumikhov, A.; Ferrero, S.; Pailharey, D.; Dahmani, B.; Tonneau, D.

2013-02-01

284

Recent experiments at LCLS: Multidimensional imaging of X-ray induced ultrafast reactions  

Microsoft Academic Search

In the first decade of the 21 sl century rapid development of laser- and accelerator- based light sources (high­ harmonic generation and free-electron lasers (FEL)) enabled generating ultra-intense and ultra-short extreme­ ultra-violet (EUV) or soft X-ray pulses. This substantially extended the borders of the ultrafast science, providing a basis for a variety of novel time-resolved schemes (including e.g., attosecond soft

Artem Rudenko

2011-01-01

285

Static magnetic fields modulate X-ray-induced DNA damage in human glioblastoma primary cells  

PubMed Central

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

2014-01-01

286

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

E-print Network

). Recently, carbon nanotubes have been compressed to over 100 GPa, creating a single hard hexagonal phase at the CHESS (Cornell High Energy Synchrotron Source) wiggler beam line.[12] Low- magnification Transmission known, SiC has a rich phase diagram with a large number of polymorphs and polytypes.[13

Downs, Robert T.

287

X-ray induced insulator-metal transitions in CMR manganites  

SciTech Connect

In this work the authors report a study of the photoinduced insulator-to-metal transition in manganese oxide perovskites of the formula Pr{sub 1{minus}x}Ca{sub x}MnO{sub 3}. The transition is closely related to the magnetic field induced insulator-to-metal transition (CMR effect) observed in these materials. It is accompanied by a dramatic change in the magnetic properties and lattice structure: the material changes from an insulating charge-ordered canted antiferromagnet to a ferromagnetic metal. The authors present an investigation of the transport and structural properties of these materials over the course of the transition (which usually takes about an hour to complete). The current-voltage characteristics exhibited by the material during the transition are highly nonlinear, indicating a large inhomogeneity of the transitional state. Possible practical applications of this novel type of transition are briefly discussed. They also report a high resolution X-ray diffraction study of the charge ordering in these materials. The temperature dependent charge ordering structure observed in these compounds is more complex than previously reported.

Kiryukhin, V.; Casa, D.; Keimer, B. [Princeton Univ., NJ (United States). Dept. of Physics; Hill, J.P.; Vigliante, A. [Brookhaven National Lab., Upton, NY (United States). Dept. of Physics; Tomioka, Y. [Joint Research Center for Atom Technology, Tsukuba, Ibaraki (Japan); Tokura, Y. [Joint Research Center for Atom Technology, Tsukuba, Ibaraki (Japan)]|[Univ. of Tokyo (Japan). Dept. of Applied Physics

1997-12-01

288

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

289

Mrad9 and atm haploinsufficiency enhance spontaneous and X-ray-induced cataractogenesis in mice.  

PubMed

Rad9 and Atm regulate multiple cellular responses to DNA damage, including cell cycle checkpoints, DNA repair and apoptosis. However, the impact of dual heterozygosity for Atm and Rad9 is unknown. Using 50 cGy of X rays as an environmental insult and cataractogenesis as an end point, this study examined the effect of heterozygosity for one or both genes in mice. Posterior subcapsular cataracts, characteristic of radiation exposure, developed earlier in X-irradiated double heterozygotes than in single heterozygotes, which were more prone to cataractogenesis than wild-type controls. Cataract onset time and progression in single or double heterozygotes were accelerated even in unirradiated eyes. These findings indicate that the cataractogenic effect of combined heterozygosity is greater than for each gene alone and are the first to demonstrate the impact of multiple haploinsufficiency on radiation effects in an intact mammal. These observations may help explain observed interindividual differential radiosensitivity in human populations and have important implications for those undergoing radiotherapy or exposed to elevated levels of cosmic radiation, such as the astronaut corps. These findings demonstrate that Mrad9 and Atm are important determinants of lens opacification and, given the roles of Atm and Rad9 in maintaining genomic stability, are consistent with a genotoxic basis for radiation cataractogenesis. PMID:17973559

Kleiman, Norman J; David, Janice; Elliston, Carl D; Hopkins, Kevin M; Smilenov, Lubomir B; Brenner, David J; Worgul, Basil V; Hall, Eric J; Lieberman, Howard B

2007-11-01

290

X-ray-induced bystander responses reduce spontaneous mutations in V79 cells.  

PubMed

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 µm(2) 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

2013-11-01

291

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

292

Mucinous adenocarcinoma of the renal pelvis with adenocarcinoma in situ of the ureter.  

PubMed

Primary epithelial tumor of the renal pelvis is rare, and adenocarcinomas account for less than 1% of malignancies arising from the epithelium of the renal pelvis. We describe in this study a case of a 56-year old male patient who presented with an abdominal mass and dull aching pain for one year. A diagnosis of hydronephrosis of the right kidney was made based on imaging studies. Grossly, the entire kidney was converted into a cystic mass measuring 16 × 12 × 10 cm and filled with gelatinous material along with staghorn calculi in the pelvis measuring 7 × 4 × 3 cm. Histological examination of the tumor showed glands, cysts, and papillae lined by pseudostratified columnar epithelium with hyperchromatic nuclei. Scattered signet ring-type cells were also seen floating in large pools of extracellular mucin. Sections from the ureter showed a component of adenocarcinoma in situ. No invasive tumor was identified in ureteric tissue. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made. PMID:21976933

Raphael, Vandana; Sailo, Stephan; Bhuyan, Ashim; Phukan, Mandeep

2011-09-01

293

Adenocarcinoma of the upper esophagus arising in heterotopic gastric mucosa: common pathogenesis with Barrett's adenocarcinoma?  

Microsoft Academic Search

Adenocarcinoma of the upper esophagus arising in heterotopic gastric mucosa is a rare tumor, with only 15 cases reported to date. We report a case in a 61-year-old man complaining of dysphagia. The upper endoscopy revealed that the tumor measured 3 cm and was 22 cm distant from the incisivors. A hiatal hernia with erosive esophagitis of the distal esophagus

Denis Chatelain; Anne-Sophie de Lajarte-Thirouard; Emmanuel Tiret; Jean-François Flejou

2002-01-01

294

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

295

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

296

Primary Mucinous Adenocarcinoma of the Testis  

PubMed Central

Ovarian-type surface epithelial neoplasms of the testis and paratestis are uncommon, and the mucinous subtype is particularly rare. These tumors represent a counterpart to ovarian cancer. Malignant tumors have the potential for metastatic spread and are often fatal. The case of a 59-year-old man with testicular mucinous adenocarcinoma is presented. Computed tomography indicated involvement of the paraaortic and pelvic lymph nodes, so chemotherapy was initiated. To the best of our knowledge, this is the second paper regarding responsiveness to chemotherapies used in ovarian cancer. PMID:22550498

Azuma, Takeshi; Matayoshi, Yukihide; Nagase, Yasushi

2012-01-01

297

Bony metaplasia in a caecum adenocarcinoma.  

PubMed

Ectopic bone formation in the digestive tract is a very rare phenomenon in pathology. Most cases of bone metaplasia were found in distal colon tumors, rectum and sigmoid respectively. We present a case of well-differentiated adenocarcinoma of the caecum (the second case of literature) associated with bone metaplasia, which debuted atypical, with symptoms of infectious enterocolitis, in a 72-year-old female patient, with no history of digestive pathology. Highlighting bone metaplasia was achieved by current histological techniques. Patient's evolution was favorable with surgical treatment and chemotherapy. PMID:23188448

Mogoant?, S S; Me?in?, C; Streba, Liliana; Predescu, Anca; Mateescu, Garofi?a Olivia; Mu?iu, Gabriela; Mogoant?, L

2012-01-01

298

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.; Huth, Joseph

2009-03-27

299

Gastric adenocarcinoma in a patient with common variable immunodeficiency.  

PubMed

We describe a 46-year-old man with a 20-year history of common variable immunodeficiency (CVID) who developed adenocarcinoma of the stomach. Although the mechanism is still debated, there is an increased frequency of gastric adenocarcinoma of the stomach in patients with CVID. Consequently, gastric complaints in patients with CVID should be pursued aggressively. PMID:7820019

Cox, J E; Ott, D J

1994-01-01

300

Gynecomastia and mammary gland adenocarcinoma in a Nubian buck.  

PubMed Central

A 6-year-old Nubian buck was presented for bilateral mammary gland enlargement. Gynecomastia and mastitis were diagnosed, and bilateral mastectomy was performed. Histological examination showed mammary adenocarcinoma, active lactation, hyperplasia, and abscessation. Karyotyping showed a normal male. Clinical, therapeutic, etiologic, and epidemiologic aspects of gynecomastia and mammary gland adenocarcinoma are discussed. Images Figure 1. PMID:10495911

Wooldridge, A A; Gill, M S; Lemarchand, T; Eilts, B; Taylor, H W; Otterson, T

1999-01-01

301

Barrett's oesophagus and oesophageal adenocarcinoma: time for a new synthesis  

Microsoft Academic Search

The public health importance of Barrett's oesophagus lies in its association with oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma has risen at an alarming rate over the past four decades in many regions of the Western world, and there are indications that the incidence of this disease is on the rise in Asian populations in which it has been rare.

Xiaohong Li; Patricia C. Galipeau; Thomas L. Vaughan; Brian J. Reid

2010-01-01

302

Adenocarcinoma of the esophagogastric junction and Barrett's esophagus  

Microsoft Academic Search

Background & Aims Barrett's esophagus is associated with adenocarcinoma of the esophagus. The aim of this study was to find the prevalence of Barrett's esophagus in patients with adenocarcinoma of the esophagogastric junction. Methods Consecutive, freshly resected surgical esophagogastrectomy specimens were examined, and multiple histological sections were made around the tumor periphery. Barrett's esophagus was defined as specialized columnar epithelium

Alan J. Cameron; Clifford T. Lomboy; Manuel Pera; Herschel A. Carpenter

1995-01-01

303

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

304

Discordant Protein and mRNA Expression in Lung Adenocarcinomas  

Microsoft Academic Search

The relationship between gene expression measured at the mRNA level and the corresponding protein level is not well characterized in human cancer. In this study, we compared mRNA and protein expression for a cohort of genes in the same lung adenocarcinomas. The abun- dance of 165 protein spots representing 98 individual genes was analyzed in 76 lung adenocarcinomas and nine

Guoan Chen; Tarek G. Gharib; Chiang-Ching Huang; Jeremy M. G. Taylor; David E. Misek; Sharon L. R. Kardia; Thomas J. Giordano; Mark D. Iannettoni; Mark B. Orringer; Samir M. Hanash; David G. Beer

2002-01-01

305

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

306

Endocervical adenocarcinoma and its variants: their morphology and differential diagnosis.  

PubMed

Adenocarcinoma of the uterine cervix and its variants account for a much greater number of cases in routine practice of histopathology than they did several decades ago. The varied morphology of these tumours results in diverse problems in differential diagnosis. The overall area of glandular pathology of the cervix, of which invasive adenocarcinoma is only one subset, is further complicated by the fact that there are many benign glandular proliferations of the cervix that can potentially be misinterpreted as adenocarcinoma. In this review the histopathology of endocervical adenocarcinoma and its variants is presented with the emphasis on evaluation of routinely stained sections, still the bedrock of routine practice, relatively little aid being provided by immunohistochemistry or other new techniques, contrary to what is sometimes implied in the literature. Description of the appearance of each subtype of adenocarcinoma or variant thereof is followed by a section on their differential diagnosis. Eighty percent of endocervical carcinomas are of the so-called usual type being characterized by cells with eosinophilic cytoplasm and generally brisk mitotic activity. It is sometimes stated that endocervical adenocarcinomas are mucinous but the usual form just noted often has little or no mucin. Pure or almost pure mucinous adenocarcinoma do occur, however, and have an important subtype, the so-called adenoma malignum (minimal deviation adenocarcinoma). Although treacherous because of its bland cytological features and sometimes deceptive pattern, a cone biopsy or hysterectomy specimen showing this neoplasm typically has easily recognizable features that indicate the presence of an infiltrative adenocarcinoma. An important variant of usual endocervical adenocarcinoma is the well differentiated villoglandular papillary adenocarcinoma, a designation that should be reserved for tumours with grade 1 cytologic features as usual endocervical adenocarcinoma, which is typically grade 2, may have papillae. In our opinion all other variants of pure adenocarcinoma, including endometrioid, are rare and include in addition to the latter clear cell, serous and mesonephric neoplasms. Tumours with a glandular and nonglandular component are also reviewed: adenosquamous carcinoma, glassy cell carcinoma, adenoid basal carcinoma, 'adenoid cystic' carcinoma and adenocarcinoma admixed with a neuroendocrine tumour. PMID:12207781

Young, R H; Clement, P B

2002-09-01

307

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

308

Chemoradiation in Pancreatic Adenocarcinoma: A Literature Review  

PubMed Central

Adenocarcinoma of the exocrine pancreas has an annual incidence of 7,400 cases in the U.K. In comparison with other common cancers of solid organs, namely, breast, colorectal, and prostate cancer, pancreatic cancer has a high morbidity and mortality. Radical resection is possible in only 15%–20% of patients, and only 3%–4% of all patients presenting with this condition achieve long-term control and cure. Various strategies in the form of neoadjuvant and adjuvant treatment have been employed over the years to improve outcome, with limited success. Systemic chemotherapy remains the gold standard in the metastatic setting in good performance status patients, and adjuvant chemotherapy after resection of localized and locally advanced cancer has been found to improve outcome. The role of radiotherapy, however, remains controversial and is an area that merits further investigation in well-conducted multicenter trials at various stages of the disease in combination with systemic agents and exploiting recent advances in the delivery of radiotherapy. In this article, we review the published literature on the use of chemoradiation as a modality in various stages of pancreatic adenocarcinoma and highlight areas that future trials in this field should target for a way forward in this malignancy. PMID:20203172

Roy, Rajarshi

2010-01-01

309

An unusual cause of hematospermia: Primary adenocarcinoma of the seminal vesicle  

PubMed Central

Adenocarcinoma of the seminal vesicles is one of the rare causes of hematospermia. Primary seminal vesicle adenocarcinoma is extremely rare and difficult to diagnose due to frequent invasion of adenocarcinomas of the surrounding organs, especially the prostate. In the present study, a case of a primary seminal vesicle adenocarcinoma will be discussed in the light of the current literature. PMID:23283099

Eken, Alper; Izol, Volkan; Aridogan, I. Atilla; Erdogan, Seyda; Ac?kal?n, Arbil; Tansug, Zuhtu

2012-01-01

310

Cervical implant from villoglandular endometrial adenocarcinoma masquerading as cervical villoglandular adenocarcinoma.  

PubMed

This is an unusual presentation of a rare subtype of endometrial adenocarcinoma (villoglandular papillary carcinoma, VGPC) in a 71-year-old woman, which was initially diagnosed on cervical biopsy as being primary cervical VGPC. Loop excision failed to show any evidence of residual disease. Subsequent hysterectomy revealed a localized villoglandular carcinoma involving the uterine fundus and invading the inner one-third of the myometrium, the background endometrium was atrophic. The remaining cervix contained a focus of papillary forming endometrial type adenocarcinoma involving the surface epithelium and the superficial subepithelial glands. In conclusion, VGPC of cervix occurs mainly in young women and can be treated conservatively, pathologists should be cautious in making such a diagnosis in a postmenopausal woman before ruling out a primary endometrial origin. PMID:12060454

Al-Nafussi, A; Obafunwa, J; Jordan, L B; Fulton, I; Martin, C; Beattie, G

2002-01-01

311

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, Cecile; Jankowski, Roger

2012-01-01

312

Villoglandular papillary adenocarcinoma of the uterine cervix diagnosed during pregnancy.  

PubMed

Villoglandular papillary adenocarcinoma (VPA) is a very rare subtype of adenocarcinoma of the uterine cervix but a well recognized variant of cervical adenocarcinoma with a favorable prognosis generally occurring in women of child-bearing age. Only five cases of VPA and pregnancy have been reported. Herein, we report a case of VPA diagnosed during pregnancy and this patient delivered a healthy baby. A successful pregnancy can be completed in patients with VPA without lymph-vascular invasion, when treated conservatively. This management is particularly desirable in young women to preserve reproductive capability. PMID:21061805

Takai, N; Hayashita, C; Nakamura, S; Narahara, H; Matsumoto, H

2010-01-01

313

Abiraterone Acetate and Castration Resistant Ductal Adenocarcinoma of the Prostate  

PubMed Central

Ductal adenocarcinoma of the prostate is a rare histological variant that only represents <1% of prostate tumors. This histological variant has several important clinical implications with respect to their evolution, clinical prognosis, and treatment. We report the case of a 64-year-old patient with ductal adenocarcinoma of the prostate, which progresses to castration-resistant prostate cancer, that was treated with abiraterone acetate with good clinical response, to our knowledge, the first case of ductal adenocarcinoma of the prostate in treatment with abiraterone acetate. PMID:24891969

Linden-Castro, Edgar; Pelayo-Nieto, Marcela; Alias-Melgar, Alejandro; Espinosa-Perezgrovas, Daniel; Ramirez-Galindo, Ivan; Catalan-Quinto, Gabriel

2014-01-01

314

Biological appraisal of liver status in adenocarcinomas.  

PubMed

A prospective study of the ability of laboratory tests to detect or to exclude hepatic metastases was performed. Seventy-four patients who underwent liver biopsies were divided into 3 groups: 1) 33 patients with secondary liver involvement from adenocarcinoma; 2) 21 subjects suffering from a non-malignant hepatic disease, and 3) 20 cancerous patients free of overt hepatic metastases. They were investigated with 7 laboratory tests. No single test had a positive predictive value higher than 75%. This percentage was increased to 84% by combining the results of both CEA and rapidly migrating liver alkaline phosphatase isoenzyme ALP 1. More important was the fact that when those parameters were both normal, the negative predictive value was 93%, thus tending to exclude a liver metastatic involvement with an acceptable confidence limit. PMID:6665874

Canal, P; Bugat, R; Fernet, P; Cassigneul, J; Soula, G

1983-12-31

315

Coexisting Mantle Cell Lymphoma and Prostate Adenocarcinoma  

PubMed Central

Prostatic mantle cell lymphoma (MCL) is a very rare entity with only 5 reported cases in the literature. We report a case of coexisting MCL and prostate adenocarcinoma (PCa) in an elderly male and review the morphologic features of classic and rare prostatic MCL subtypes. Careful morphologic evaluation and immunohistochemical findings of positive CD5, CD20, and cyclin D1 and negative CD23 and CD3 can guide us to the diagnosis of MCL. Given the fact that transurethral resection of prostate is done quite routinely, this paper draws attention to the manner in which long standing bladder outlet obstruction and postbiopsy prostate specimens with dense lymphoid infiltration can masquerade as lymphoma. It highlights the importance of exercising care while reviewing prostate specimens with evidence of chronic prostatitis so as not to miss this rare neoplasm. PMID:25386194

Rajput, Ashish B.; Burns, Bruce; Gerridzen, Ronald; van der Jagt, Richard

2014-01-01

316

Lung adenocarcinoma masquerading as refractory Klebsiella pneumoniae.  

PubMed

We report the case of a middle-aged man where a diagnosis of Klebsiella pneumoniae obscured the underlying malignancy. The patient was hospitalised for management of a presumed refractory community-acquired pneumonia with radiological features of right lower lobe consolidation. Bronchoscopy did not identify an endobronchial lesion and washings grew K pneumoniae. CT-guided fine-needle aspirate samples did not detect any malignancy. However, despite appropriate antibiotic treatment there was no improvement in the patient's clinical condition. Consequently, a CT-guided lung core biopsy was performed to obtain more tissue for histopathology, which was diagnostic of primary lung adenocarcinoma. This case highlights the need to continue to investigate a patient who is not progressing as clinically appropriate to their original diagnosis. PMID:24706703

McCartney, Clair; Moghadam, Afshin; Sriram, Krishna B

2014-01-01

317

Primary adenocarcinoma of the frontal sinus.  

PubMed

When tumor involvement of the frontal sinus occurs, it is usually the result of the direct spread of the mass from the nasal cavity or anterior ethmoid sinuses. Primary frontal sinus tumors are extremely rare. We describe a case of primary adenocarcinoma of the frontal sinus in a 53-year-old man. The patient refused surgery, so he was treated with chemotherapy followed by radiotherapy. At the 1-year follow-up, only a slight reduction of the swelling was noted. Thereafter, he was lost to follow-up. This case represents a typical example of a paranasal cancer extending beyond the bony margins, with a silent onset that simulated benign disease. The best hope for an early diagnosis of such a tumor lies in the greater use of computed tomography to assess chronic rhinosinusitis. PMID:22033968

Wadhera, Raman; Gulati, S P; Garg, Ajay; Ghai, Anju; Kumar, Sanjay

2011-10-01

318

Streptococcus viridians bacteraemia and colonic adenocarcinoma.  

PubMed

Even though Streptococcus bacteraemia is an infrequent presentation of colonic malignancies, there is a well-established link between Streptococcus bovis bacteraemia and colonic malignancies. Most of the physicians are well aware of this correlation and further workup is pursued in most of the cases. However, many physicians may not be aware that other species of Streptococcus viridians, other than S. bovis, can be associated with colonic malignancies. In this case report, we present a case of Streptococcus viridians (anginosus) bacteraemia as a complication of an undiagnosed sigmoid adenocarcinoma. While further evidence is needed to warrant a gastrointestinal (GI) workup in a patient with other species of Streptococcus viridians bacteraemia, we would like to increase the awareness in the physicians' community regarding Streptococcus viridians, other than S. bovis bacteraemia. This would be especially relevant for patients who have no GI screening, as Streptococcus viridians bacteraemia can be an early sign of colonic neoplasm. PMID:24876211

Mulita, Avenir; Ajayi, Tokunbo

2014-01-01

319

Histopathological diagnosis of adenocarcinoma in Barrett's esophagus.  

PubMed

The present review describes the histological markers of Barrett's esophagus (BE) that make it possible to distinguish between Barrett's carcinoma (BC) and gastric carcinoma. With regard to high-grade dysplasia, the indications for endoscopic resection (ER) or major surgery for management of BC cannot be decided on the basis of biopsy histology, and the choice between them should be made according to BC invasion depth. Therefore, we recommend that the term 'well-differentiated tubular adenocarcinoma' be used rather than 'high-grade dysplasia' (intraepithelial neoplasia). High-grade dysplasia is regarded as BC in Japan and other countries such as Germany. Such lesions should not be treated by endoscopic ablation but by ER, because components of invasive carcinoma are frequently present in the mucosa and submucosa, and knowledge obtained from ER samples is needed for additional therapy. Further studies on the relationship between the incidence of nodal metastasis and mucosal depth in mucosal BC are needed to decide the indications for ER. Suchstudies should involve subserial microscopic examination of slices 2-3 mm thick. To resolve the issue of regression of high-grade dysplasia, international experts in gastroenterological pathology need to conduct histopathological reviews of the first and last samples taken from such cases, as there are large differences between North American, European, and Japanese pathologists in the criteria used for histological diagnosis of dysplasia and adenocarcinoma without clear invasion, and both interobserver and intraobserver variations have been reported. Future studies will need to focus on which carcinomas are curable by ER. PMID:23981237

Takubo, Kaiyo; Vieth, Michael; Aida, Junko; Matsutani, Takeshi; Hagiwara, Nobutoshi; Iwakiri, Katsuhiko; Kumagai, Yoichi; Hongo, Michio; Hoshihara, Yoshio; Arai, Tomio

2014-05-01

320

Letter: Adenocarcinoma of the lung associated with pityriasis rubra pilaris.  

PubMed

We describe a case of pityriasis rubra pilaris refractory to conventional treatment, found to be associated with an unrecognized primary adenocarcinoma of the lung. Complete resolution of the eruption followed surgical resection of the tumor. PMID:22136870

Garretson, Cara B; Machan, Mac L; Krejci-Manwaring, Jennifer; Aires, Daniel; Tonkovic-Capin, Viseslav

2011-01-01

321

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. Cancer Res; 74(21); 6364-74. ©2014 AACR. 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

322

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

323

Villoglandular papillary adenocarcinoma of the cervix: case report.  

PubMed

The incidence of cervical adenocarcinoma is on the rise over the last several decades. It generally carries a worse prognosis than squamous carcinoma. Villoglandular papillary adenocarcinoma (VGA) of the cervix has been identified as a distinct subset of cervical adenocarcinoma that occurs in young women and supposedly carries an excellent prognosis. We report a case of adenocarcinoma of the cervix in a young woman that had classical histological features of VGA but at operation showed presence of tumor cells in the peritoneal wash. A review of world literature on the 56 cases reported so far is presented where occasional cases showing disease spread have been reported, suggesting caution in the management and follow-up of this clinicopathologic entity. PMID:10962465

Lakhtakia, R; Singh, M K; Taneja, P; Kapila, K; Kumar, S

2000-08-01

324

Vertebroepidural metastasis of an ethmoid adenocarcinoma: A case report  

PubMed Central

Ethmoid adenocarcinoma is the most frequent ethmoid tumor. To date, only a single case of spinal cord compression resulting from ethmoid adenocarcinoma has been reported. The current case study presents a recent case of vertebroepidural metastasis of an ethmoid adenocarcinoma leading to spinal cord compression. Modern imaging studies, including magnetic resonance imaging (MRI) and 18 fludeoxyglucose positron emission tomography (FDG PET), as well as histological and immunohistochemical analyses, have led to diagnoses of a metastasis of an ethmoid adenocarcinoma, which is a mucinous variant, dedifferentiated when compared to the primary tumor. The present case discusses current diagnostic and treatment protocols of this condition. Since survival rates associated with the primary tumor are improving, the incidence of spinal metastasis of ethmoid carcinomas is likely to increase in the future, therefore requiring appropriate diagnostic and therapeutic management. PMID:24137454

MBAYE, MAGUETTE; POPA, CLAUDIU; SIGNORELLI, FRANCESCO; STREICHENBERGER, NATHALIE; COSMIDIS, ALAIN; POZZI, FABIO; GUYOTAT, JACQUES

2013-01-01

325

[Gastric signet ring cell adenocarcinoma: A distinct entity].  

PubMed

Gastric signet ring cell carcinoma (GSRC) is a distinct entity. Their incidence is increasing. The pathologist plays a central role in the identification of this entity. Diagnosis is based on an adenocarcinoma containing a majority of signet ring cells (above 50 %). The prognosis of GSRC is the same as gastric adenocarcinoma while GSRC appeared more aggressive. Signet ring cells present a low sensitivity to chemotherapy. This review aimed to discuss the histological, the prognostic and the therapeutic aspect of this entity. PMID:24440764

Tabouret, Tessa; Dhooge, Marion; Rouquette, Alexandre; Brezault, Catherine; Beuvon, Frédéric; Chaussade, Stanislas; Coriat, Romain

2014-04-01

326

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

327

Multiple urinary bladder masses from metastatic prostate adenocarcinoma.  

PubMed

We present an unusual case of metastatic prostate adenocarcinoma that manifested with multiple exophytic intravesical masses, mimicking a multifocal primary bladder tumor. Biopsy with immunohistochemical analysis confirmed metastatic prostate adenocarcinoma. The patient was treated palliatively with external beam radiotherapy to prevent possible symptoms from local tumor progression. This case illustrates that when a patient with known prostate cancer presents with multifocal bladder tumors, the possibility of metastatic prostate cancer should be considered. PMID:21234257

Hallemeier, Christopher L; Kohli, Manish; Chandan, Vishal S; Miller, Robert C; Choo, Richard

2010-01-01

328

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.

Kistler, C. Andrew; Johnson, Jennifer M.; Winter, Jordan M.; Baliff, Jeffrey P.; Siddiqui, Ali A.

2014-01-01

329

Cervical adenocarcinoma: a retrospective clinicopathologic study of 16 cases.  

PubMed

Endocervical adenocarcinomas account for about 10-30% of cancers of the uterine cervix and display a variety of disparate morphologies. As an objective of the present work, we analyzed the clinicopathologic characteristics and prognostic factor of cervical adenocarcinoma. Clinicomorphological data of 16 cases of endocervical adenocarcinoma were reviewed during 2006-2011. Histopathologically, seven cases were of mucinous endocervical type, one intestinal type, two mucinous villoglandular type, four endometrioid type and two of serous type. The immunohistochemical investigation showed a tipically endocervical carcinoma profile ER-/PR-/Vim-/CEA+ in 10 cases (62.5%), which morphologically corresponded to: five mucinous endocervical type, one villoglandular type, three endometrioid type and one serous type. Regarding the prognosis we established that endometrioid endocervical adenocarcinoma is the histological variant with the worst prognosis, most cases been diagnosed in advanced stages (IIIA and IIIB) while at the opposite pole were papillary villoglandular and serous endocervical adenocarcinomas, diagnosed in less advanced stages of disease (IB and IIB). We concluded that the clinicomorphological diagnosis of endocervical adenocarcinoma is a challenging task, given to its multitude of histological variants and to the fact that immunohistochemistry investigations proved to be useful in only 63% of cases. In addition, we confirmed that the clinical stage is the most important prognostic factor and to some extent, the histomorphologic features can condition the biological behavior of these tumors. PMID:22990556

Barbu, Ileana; Cr?i?oiu, Stefania; M?rg?ritescu, Cl

2012-01-01

330

Intestinal Type of Lung Adenocarcinoma in Younger Adults  

PubMed Central

Intestinal type of lung adenocarcinoma (ILADC) was initially described by Tsao and Fraser in 1991. Morphology and immunophenotype of ILADC are the same as in colorectal adenocarcinoma. Rectocolonoscopy must be performed to exclude colorectal origin of adenocarcinoma. Colorectal adenocarcinoma claimed to be genetically similar to an ILADC. Patients. We describe 24- and 26-year-old patients of both genders who went under surgery because of a lung tumor mass detected on CT scan. ILADC was diagnosed on resected lung specimens. According to positivity of Cytokeratin20, CDX-2, and Villin, respectively, and negativity of Cytokeratin7, TTF-1, Napsin-A, SurfactantB, MUC-1, and MUC-2, respectively, ILADC was diagnosed. KRAS mutation was detected in tumor tissue of the male patient. Conclusion. Rectocolonoscopy is the only relevant method for distinguishing the intestinal type of lung adenocarcinoma from metastatic colorectal carcinoma because immunohistochemistry and detection of mutation status are frequently the same in both types of adenocarcinoma. More investigations are needed for further understanding of ILADC in purpose of personalized lung carcinoma therapy particularly introducing detection of mutation status, especially in younger patients. PMID:24782938

Stojsic, Jelena; Kontic, Milica; Subotic, Dragan; Popovic, Marko; Tomasevic, Dragana; Lukic, Jelena

2014-01-01

331

Intestinal type of lung adenocarcinoma in younger adults.  

PubMed

Intestinal type of lung adenocarcinoma (ILADC) was initially described by Tsao and Fraser in 1991. Morphology and immunophenotype of ILADC are the same as in colorectal adenocarcinoma. Rectocolonoscopy must be performed to exclude colorectal origin of adenocarcinoma. Colorectal adenocarcinoma claimed to be genetically similar to an ILADC. Patients. We describe 24- and 26-year-old patients of both genders who went under surgery because of a lung tumor mass detected on CT scan. ILADC was diagnosed on resected lung specimens. According to positivity of Cytokeratin20, CDX-2, and Villin, respectively, and negativity of Cytokeratin7, TTF-1, Napsin-A, SurfactantB, MUC-1, and MUC-2, respectively, ILADC was diagnosed. KRAS mutation was detected in tumor tissue of the male patient. Conclusion. Rectocolonoscopy is the only relevant method for distinguishing the intestinal type of lung adenocarcinoma from metastatic colorectal carcinoma because immunohistochemistry and detection of mutation status are frequently the same in both types of adenocarcinoma. More investigations are needed for further understanding of ILADC in purpose of personalized lung carcinoma therapy particularly introducing detection of mutation status, especially in younger patients. PMID:24782938

Stojsic, Jelena; Kontic, Milica; Subotic, Dragan; Popovic, Marko; Tomasevic, Dragana; Lukic, Jelena

2014-01-01

332

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; Sahin, Davut; Akyuz, Umit; Vatansever, Sezai

2014-01-01

333

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

334

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

335

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, Vesteinn; 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; LaYniak, Radoslaw; Leporowska, Ewa; Mackiewicz, Andrzej; Murawa, Dawid; Murawa, Pawel; Spychala, Arkadiusz; Suchorska, Wiktoria M.; Tatka, Honorata; Teresiak, Marek; Wiznerowicz, Maciej; Abdel-Misih, Raafat; Bennett, Joseph; Brown, Jennifer; Iacocca, Mary; Rabeno, Brenda; Kwon, Sun-Young; Penny, Robert; Gardner, Johanna

2014-01-01

336

Radiation and chemoradiation therapy for esophageal adenocarcinoma.  

PubMed

The aims of preoperative chemoradiation therapy (preop-CRT) for esophageal adenocarcinoma are to reduce incomplete local resection (R1,R2), local and systemic recurrences that are reported in up to 30% of patients who undergo surgery alone. Phase II studies of preop-CRT, with radiation doses in the 40-50 Gy range, and concurrent chemotherapy with 5-fluorouracil (5-FU)-cisplatin +/- paclitaxel, or cisplatin-paclitaxel, have reported subsequent RO resection rates of 80%-100%, with tumor sterilization achieved in 8%-49% of cases, and consequently improved local control. New chemotherapy regimens omitting 5-FU have reduced the incidence of severe esophagitis, unplanned hospitalization, with comparable efficacy. Among three randomised trials that compared preop-CRT to surgery alone, one shown a debatable survival advantage. Reducing local recurrence rates lead to a switch to more distant failures, and increasing the radiation dose beyond 45 Gy appears to be of little value. However, it should be remembered that preop-CRT has associated toxicity, and may increase postoperative mortality. Novel strategies, which include induction with chemotherapy followed by preop-CRT, and for radiation therapy, three dimensional conformation techniques, image fusioning, and improved definition of treatment volumes, are still considered experimental and should be tested in specialized centers. PMID:16299784

Bosset, Jean-François; Lorchel, F; Mantion, G; Buffet, J; Créhange, G; Bosset, M; Chaigneau, L; Servagi, S

2005-12-01

337

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

338

Reclassification of early stage pulmonary adenocarcinoma and its consequences  

PubMed Central

The classification of pulmonary adenocarcinoma has recently undergone several proposed changes. Among these, the most striking pertains to the discontinuation of the term “bronchioloalveolar carcinoma (BAC)” and its replacement by the terms “adenocarcinoma in situ (AIS)” or “minimally invasive adenocarcinoma (MIA)” for small solitary adenocarcinomas with either pure bronchiolalveolar growth or predominant bronchioloalveolar growth and ?5 mm invasion, respectively, in resection specimens. The recommendation for these new concepts was based on discussion and review of the literature by a panel of experts from multiple disciplines. However, the results of a recent study investigating the topic of early stage adenocarcinoma (pT1N0M0) which was based on an actual series of cases, have raised questions as to the concept, validity and justification of such new terminology and have reinforced the need to evaluate actual cases that meet the newly proposed definitions and compare them in terms of patient outcome. This is even more important when proposing terminology that implies benign behavior and that could result in a false sense of security putting patients at risk for suboptimal treatment approaches. The controversies surrounding these issues are the subject of this work. PMID:25349709

Moran, Cesar A.

2014-01-01

339

Primary adenocarcinoma of the nasal cavity and paranasal sinuses.  

PubMed

Eight cases of primary adenocarcinoma of the nasal cavity associated with wood dust exposure are reported. The patients include seven men and one woman between the ages of 31 and 81 years. All the patients had a history of wood dust exposure. Carpentry was the occupation in four patients; inspector for railroad boxcars in one; teacher in a wood-work shop in another and worker in a desk factory in the other. The only female patient was a school teacher whose husband had a wood-work shop at home. Clinically, epistaxis and/or nasal obstruction were the most common symptoms. The histology of the tumors varied and consisted of well differentiated adenocarcinoma, clear cell adenocarcinoma, papillary-mucinous adenocarcinoma, and "colonic-type" adenocarcinoma. Follow-up data showed that three patients were alive of whom two had either recurrent or metastatic disease at one and three years following the initial diagnosis, respectively. The third patient was alive and well four years after initial diagnosis. Three other patients died but a direct cause of death was not identified. The remaining two patients were lost to follow-up. PMID:1819530

Moran, C A; Wenig, B M; Mullick, F G

1991-12-01

340

[Ductal adenocarcinoma of the prostate: a report of 7 cases].  

PubMed

Ductal adenocarcinoma of the prostate is a rare subtype of prostatic adenocarcinoma, defined by morphological criteria as one that has papillary or cribriform architecture composed of high columnar cells with pseudostratified nuclei. We clinically evaluated 7 cases of ductal adenocarcinoma of the prostate in our hospital. The median age was 69 years old and median initial serum PSA level was 22.8 ng/ml. Two cases presented with dysuria, two with macrohematuria and one with abnormality on chest radiograph. Five cases were diagnosed on prostate biopsy, one on TUR-P and one on radical prostatectomy. Two had pure ductal adenocarcinoma and five had mixed ductal adenocarcinoma. Four had metastatic disease, and were treated by hormonal therapy. Among three with non-metastatic disease, two underwent radical prostatectomy with adjuvant radiotherapy and one underwent external beam radiotherapy with hormonal therapy. Three cases with non-metastatic disease have no biochemical recurrence. Among four with metastatic disease, one underwent chemotherapy of Docetaxel and one had found a new lesion in lung. PMID:23342927

Hiramatsu, Kanae; Tsuzaka, Yasuo; Kaneko, Tomoyuki; Matsushima, Hisashi; Homma, Yukio

2012-09-01

341

The lung adenocarcinoma guidelines: what to be considered by surgeons  

PubMed Central

In 2011 the International Association for the Study of Lung Cancer (IASLC), the American Thoracic Society (ATS), and the European Respiratory Society (ERS), have proposed a new subclassification of lung adenocarcinomas. This new classification was founded on an evidence-based approach to a systematic review of 11,368 citations from the related literature. Validation has involved projects relating to histologic and cytologic analysis of small biopsy specimens, histologic subtyping, grading, and observer variation among expert pathologists. As enormous resources are being spent on trials involving molecular and therapeutic aspects of adenocarcinoma of the lung, the development of standardized criteria is of great importance and should help advance the field, increasing the impact of research, and improving patient care. This classification is needed to assist in determining patient therapy and predicting outcome. The 2011 IASLC/ATS/ERS adenocarcinoma classification can have an impact on TNM staging. It may help in comparing histologic characteristics of multiple lung adenocarcinomas to determine whether they are intrapulmonary metastases versus separate primaries. Use of comprehensive histologic subtyping along with other histologic characteristics has been shown to have good correlation with molecular analyses and clinical behavior. Also, it may be more meaningful clinically to measure tumor size in lung adenocarcinomas that have a lepidic component by using invasive size rather than total size to determine the size T factor.

Mello, Evandro Sobroza; Younes, Riad N.

2014-01-01

342

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma.  

PubMed

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett's esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett's-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett's cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits. PMID:25400997

Alexandre, Leo; Long, Elizabeth; Beales, Ian Lp

2014-11-15

343

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma  

PubMed Central

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett’s esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett’s-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett’s cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits.

Alexandre, Leo; Long, Elizabeth; Beales, Ian LP

2014-01-01

344

Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson, TCGA Scientific Symposium 2012  

Cancer.gov

Home News and Events Multimedia Library Videos Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson Comprehensive Analysis of Lung Adenocarcinoma - Matthew Meyerson, TCGA Scientific Symposium 2012 You will need Adobe Flash Player 8 or

345

High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall, TCGA Scientific Symposium 2012  

Cancer.gov

Home News and Events Multimedia Library Videos High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall High-Grade Serous Ovarian Adenocarcinoma Transcriptome Sequencing - Andrew Mungall, TCGA Scientific Symposium 2012 You

346

Adenocarcinoma Involving the Tongue and the Epiglottis in a Horse  

PubMed Central

ABSTRACT Tumors involving the oral cavity of the horse are uncommon. No cases of equine adenocarcinoma on the dorsum of the tongue have been reported in the literature. We report a case of adenocarcinoma located on the dorsum of the posterior one-third of the tongue in a 29-year-old gelding with severe dysphagia. Endoscopy revealed an epiglottis involvement, and histology was consistent with adenocarcinoma arising from minor salivary glands, which was associated with a severe fungal colonization of affected tissues. The goals of this report are to present an uncommon case of dorsum of the tongue-associated neoplasia and to highlight the association with atypical fungal colonization, to review the literature and to discuss possible clinical approach and prognosis. PMID:24284972

LAUS, Fulvio; ROSSI, Giacomo; PAGGI, Emanuele; BORDICCHIA, Matteo; FRATINI, Margherita; TESEI, Beniamino

2013-01-01

347

Adenocarcinoma involving the tongue and the epiglottis in a horse.  

PubMed

Tumors involving the oral cavity of the horse are uncommon. No cases of equine adenocarcinoma on the dorsum of the tongue have been reported in the literature. We report a case of adenocarcinoma located on the dorsum of the posterior one-third of the tongue in a 29-year-old gelding with severe dysphagia. Endoscopy revealed an epiglottis involvement, and histology was consistent with adenocarcinoma arising from minor salivary glands, which was associated with a severe fungal colonization of affected tissues. The goals of this report are to present an uncommon case of dorsum of the tongue-associated neoplasia and to highlight the association with atypical fungal colonization, to review the literature and to discuss possible clinical approach and prognosis. PMID:24284972

Laus, Fulvio; Rossi, Giacomo; Paggi, Emanuele; Bordicchia, Matteo; Fratini, Margherita; Tesei, Beniamino

2014-03-01

348

CD44 promotes Kras-dependent lung adenocarcinoma.  

PubMed

Kras-induced non-small-cell lung adenocarcinoma is the major subtype of lung cancers and is associated with poor prognosis. Using a lung cancer mouse model that expresses a cre-mediated KrasG12D mutant, we identified a critical role for the cell surface molecule CD44 in mediating cell proliferation downstream of oncogenic Kras signaling. The deletion of CD44 attenuates lung adenocarcinoma formation and prolongs the survival of these mice. Mechanistically, CD44 is required for the activation of Kras-mediated signaling through the mitogen-activated protein kinase (MAPK) pathway and thus promotes tumor cell proliferation. Together, these results reveal an unrecognized role for CD44 in oncogenic Kras-induced lung adenocarcinoma and suggest that targeting CD44 could be an effective strategy for halting Kras-dependent carcinomas. PMID:23208496

Zhao, P; Damerow, M S; Stern, P; Liu, A H; Sweet-Cordero, A; Siziopikou, K; Neilson, J R; Sharp, P A; Cheng, C

2013-10-24

349

Absorption spectra of adenocarcinoma and squamous cell carcinoma cervical tissues  

NASA Astrophysics Data System (ADS)

We studied a methods of assessment of a connective tissue of cervix in terms of specific volume of fibrous component and an optical density of staining of connective tissue fibers in the stroma of squamous cancer and cervix adenocarcinoma. An absorption spectra of blood plasma of the patients suffering from squamous cancer and cervix adenocarcinoma both before the surgery and in postsurgical periods were obtained. Linear dichroism measurements transmittance in polarized light at different orientations of the polarization plane relative to the direction of the dominant orientation in the structure of the sample of biotissues of stroma of squamous cancer and cervix adenocarcinoma were carried. Results of the investigation of the tumor tissues showed that the magnitude of the linear dichroism ? is insignificant in the researched spectral range ?=280-840 nm and specific regularities in its change observed short-wave ranges.

Ivashko, Pavlo; Peresunko, Olexander; Zelinska, Natalia; Alonova, Marina

2014-08-01

350

Well-differentiated papillary villoglandular adenocarcinoma of the uterine cervix.  

PubMed

This article presents a rare case of well-differentiated papillary villoglandular adenocarcima of the uterine cervix. This patient had vaginal bleeding and her disease was limited to the cervix. Since 1989, a total of 41 cases have been reported in the literature as a distinct entity. In the past, this tumor was included with other varieties of adenocarcinomas of the cervix and not as a separate entity. Due to its excellent prognosis, papillary villoglandular adenocarcinoma of the cervix, may be treated by a procedure less radical than a hysterectomy when the tumor is superficial with no vascular or lymphatic invasion. Recognition of this entity and separation from other varieties of adenocarcinomas of the uterine cervix are warranted. PMID:9274143

Datta, C K

1997-01-01

351

Intratumor heterogeneity in localized lung adenocarcinomas delineated by multiregion sequencing.  

PubMed

Cancers are composed of populations of cells with distinct molecular and phenotypic features, a phenomenon termed intratumor heterogeneity (ITH). ITH in lung cancers has not been well studied. We applied multiregion whole-exome sequencing (WES) on 11 localized lung adenocarcinomas. All tumors showed clear evidence of ITH. On average, 76% of all mutations and 20 out of 21 known cancer gene mutations were identified in all regions of individual tumors, which suggested that single-region sequencing may be adequate to identify the majority of known cancer gene mutations in localized lung adenocarcinomas. With a median follow-up of 21 months after surgery, three patients have relapsed, and all three patients had significantly larger fractions of subclonal mutations in their primary tumors than patients without relapse. These data indicate that a larger subclonal mutation fraction may be associated with increased likelihood of postsurgical relapse in patients with localized lung adenocarcinomas. PMID:25301631

Zhang, Jianjun; Fujimoto, Junya; Zhang, Jianhua; Wedge, David C; Song, Xingzhi; Zhang, Jiexin; Seth, Sahil; Chow, Chi-Wan; Cao, Yu; Gumbs, Curtis; Gold, Kathryn A; Kalhor, Neda; Little, Latasha; Mahadeshwar, Harshad; Moran, Cesar; Protopopov, Alexei; Sun, Huandong; Tang, Jiabin; Wu, Xifeng; Ye, Yuanqing; William, William N; Lee, J Jack; Heymach, John V; Hong, Waun Ki; Swisher, Stephen; Wistuba, Ignacio I; Futreal, P Andrew

2014-10-10

352

Oncogenic and sorafenib-sensitive ARAF mutations in lung adenocarcinoma  

PubMed Central

Targeted cancer therapies often induce “outlier” responses in molecularly defined patient subsets. One patient with advanced-stage lung adenocarcinoma, who was treated with oral sorafenib, demonstrated a near-complete clinical and radiographic remission for 5 years. Whole-genome sequencing and RNA sequencing of primary tumor and normal samples from this patient identified a somatic mutation, ARAF S214C, present in the cancer genome and expressed at high levels. Additional mutations affecting this residue of ARAF and a nearby residue in the related kinase RAF1 were demonstrated across 1% of an independent cohort of lung adenocarcinoma cases. The ARAF mutations were shown to transform immortalized human airway epithelial cells in a sorafenib-sensitive manner. These results suggest that mutant ARAF is an oncogenic driver in lung adenocarcinoma and an indicator of sorafenib response. PMID:24569458

Imielinski, Marcin; Greulich, Heidi; Kaplan, Bethany; Araujo, Luiz; Amann, Joseph; Horn, Leora; Schiller, Joan; Villalona-Calero, Miguel A.; Meyerson, Matthew; Carbone, David P.

2014-01-01

353

CD44 promotes Kras-dependent lung adenocarcinoma  

PubMed Central

Kras-induced non-small-cell lung adenocarcinoma is the major subtype of lung cancers and is associated with poor prognosis. Using a lung cancer mouse model that expresses a cre-mediated KrasG12D mutant, we identified a critical role for the cell surface molecule CD44 in mediating cell proliferation downstream of oncogenic Kras signaling. The deletion of CD44 attenuates lung adenocarcinoma formation and prolongs the survival of these mice. Mechanistically, CD44 is required for the activation of Krasmediated signaling through the mitogen-activated protein kinase (MAPK) pathway and thus promotes tumor cell proliferation. Together, these results reveal an unrecognized role for CD44 in oncogenic Kras-induced lung adenocarcinoma and suggest that targeting CD44 could be an effective strategy for halting Kras-dependent carcinomas. PMID:23208496

Zhao, P; Damerow, MS; Stern, P; Liu, AH; Sweet-Cordero, A; Siziopikou, K; Neilson, JR; Sharp, PA; Cheng, C

2014-01-01

354

The revised lung adenocarcinoma classification--an imaging guide  

PubMed Central

Advances in our understanding of the pathology, radiology and clinical behaviour of peripheral lung adenocarcinomas facilitated a more robust terminology and classification of these lesions. The International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification introduced new terminology to better reflect this heterogeneous group of adenocarcinomas formerly known as bronchoalveolar cell carcinoma (BAC). There is now a clear distinction between pre-invasive, minimally invasive and frankly invasive lesions. The radiographic appearance of these ranges from pure ground glass nodules to solid mass lesions. Radiologists must be aware of the new classification in order to work alongside multidisciplinary colleagues to allow accurate staging and treatment. This article reviews the new classification of lung adenocarcinomas. Management options of these lesions with particular focus on radiological implications of the new classification will be reviewed.

Gardiner, Natasha; Jogai, Sanjay

2014-01-01

355

Small adenocarcinomas of the esophagogastric junction: association with intestinal metaplasia and dysplasia  

Microsoft Academic Search

OBJECTIVES:Intestinal metaplasia in Barrett's esophagus predisposes to esophageal adenocarcinoma. Intestinal metaplasia of the cardia is a common finding in persons without cancer. Many adenocarcinomas of the esophagogastric junction are large enough to obliterate any underlying intestinal metaplasia. To estimate how often adenocarcinoma of the esophagogastric junction arises in intestinal metaplasia, we studied small adenocarcinomas of the esophagogastric junction.METHODS:Resection patients had

Alan J. Cameron; Enrico O. Souto; Thomas C. Smyrk

2002-01-01

356

Exploratory investigation of plasma metabolomics in human lung adenocarcinoma.  

PubMed

Globally lung cancer is common among males and recently also noted with increasing incidences in females, especially adenocarcinoma. Further, most lung cancers are not easily detected until the late stage. Metabolic profiling of plasma low molecular weight metabolites may help unveil the complex pathophysiological changes during early lung adenocarcinoma development. Here we used a combination of gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) methods to investigate the metabolic signatures in the plasma of 31 stage I human lung adenocarcinoma patients and 28 healthy controls. The metabolic profiles were assayed using orthogonal projections to latent structures discriminant analysis (OPLS-DA), and were further analyzed to identify the associated marker metabolites. The OPLS-DA models derived from both GC-MS and LC-MS showed significant discriminations in metabolic profiles between cases and healthy controls. It was found that around 37 metabolites contributed to the differences. The alterations of these metabolites implied disturbances in amino acids, lipids, fatty acids and glutaminolysis metabolism in human lung adenocarcinoma, even after removal of influencing factors such as age, gender and smoking habits. Of particular interest, the sex hormone metabolic pathway involving the sulfate conjugate of testosterone, androsterone and pregnenolone was found to be disturbed considerably. All these metabolic perturbations occur at an early stage of lung adenocarcinoma and thus could act as biomarkers for its early diagnosis. These exploratory findings suggest that integration of two sensitive and complementary metabolomic approaches enables a comprehensive metabolite profiling for human lung adenocarcinoma, although a more extensive study is needed to confirm the findings. PMID:23857124

Wen, Tao; Gao, Liang; Wen, Zongmei; Wu, Chunyan; Tan, Chuen Seng; Toh, Wei Zhong; Ong, Choon Nam

2013-09-01

357

Clonality analysis of neuroendocrine cells in gastric adenocarcinoma  

PubMed Central

AIM: To achieve a better understanding of the origination of neuroendocrine (NE) cells in gastric adenocarcinoma. METHODS: In this study, 120 cases of gastric adenocarcinoma were obtained. First, frozen section-immunohistochemistrical samples were selected from a large quantity of neuroendocrine cells. Second, laser capture microdissection was used to get target cells from gastric adenocarcinoma and whole genome amplification was applied to get a large quantity of DNA for further study. Third, genome-wide microsatellite abnormalities [microsatellite instability (MSI), loss of heterozygosity (LOH)] and p53 mutation were detected by polymerase chain reaction (PCR)-single-strand conformation polymer- phism-silver staining and PCR-sequencing in order to identify the clonality of NE cells. RESULTS: The total incidence rate of MSI was 27.4%, while LOH was 17.9%. Ten cases had a highest concordance for the two types of cells. The other samples had similar microsatellite changes, except for cases 7 and 10. Concordant p53 mutations exhibited in sample 4, 14, 21 and 27, and there were different mutations between two kinds of cells in case 7. In case 17, mutation took place only in adenocarcinoma cells. p53 mutation was closely related with degree of differentiation, tumor-node-metastasis stage, vessel invasion and lymph node metastasis. In brief, NE and adenocarcinoma cells showed the same MSI, LOH or p53 mutation in most cases (27/30). In the other three cases, different MSI, LOH or p53 mutation occurred. CONCLUSION: NE and the gastric adenocarcinoma cells may mainly derive from the same stem cells, but the remaining cases showing different origin needs further investigation. PMID:23983439

Wang, Ling-Ling; Yao, Gen-You; Zhao, Zhong-Sheng; Wei, Xiao-Li; Xu, Ru-Jun

2013-01-01

358

Lung adenocarcinoma metastasis to frontal sinus mimicking Pott's puffy tumor.  

PubMed

Metastasis of the lung adenocarcinoma to the paranasal sinuses is a rare clinical entity. We present a 75-year-old male patient who presented with swelling of the forehead and left upper eyelid with proptosis in left eye due to metastasis from lung adenocarcinoma. It appears as a puffy swelling of the forehead like a Pott's puffy tumor. Pott's puffy tumor is a subperiostal abscess of the frontal bone associated with osteomyelitis and usually occurs as a complication of sinusitis or trauma. PMID:24220459

Koktekir, Ender; Koktekir, Bengu Ekinci; Recber, Fahri; Akdemir, Gokhan

2013-11-01

359

Computer-assisted grading of adenocarcinoma in prostatic aspirates.  

PubMed

Conventional cytologic grading of fine needle aspirates of prostatic adenocarcinoma has been shown neither to be reproducible nor to correlate well with histologic grading. This study developed a tumor grade classification based on computerized cytomorphometric features and compared the results to conventional grading of companion tissue sections. The image analysis system evaluated architectural features of the aspirates (mainly cell cluster features and interrelationships) as well as nuclear features. Thirty-five prostatic adenocarcinomas (8 well, 19 moderately and 8 poorly differentiated) were evaluated. Discriminant functions based on data collected at medium and high resolution distinguished between aspirates from low-grade (well-differentiated) and high-grade (poorly differentiated) adenocarcinomas with 81% accuracy. Moderately differentiated cancers could not be classified as a distinct group. This study suggests that accurate grading of prostatic adenocarcinoma in fine needle aspirate smears requires the evaluation of medium-resolution features related to specimen cellularity and uniformity or crowding of cell clusters as well as of high-resolution features of nuclear area, perimeter and coarseness of chromatin texture. These findings are compared to those of other schemes for the cytologic grading of prostatic aspirates. PMID:2190568

Schultz, D S; Harry, T; Wong, K L; Stilmant, M M; Zahniser, D J; Hutchinson, M L

1990-04-01

360

Adenocarcinomas arising in tongues or short segments of Barrett's esophagus  

Microsoft Academic Search

Summary The diagnosis of Barrett's esophagus is established when the esophageal mucosa is lined by 2–3 cm of columnar epithelium or when specialized (intestinal type) columnar epithelium of any length is present. Emphasis is frequently placed on long segments of Barrett's because these patients reportedly are at higher risk of developing adenocarcinoma than patients with shorter segments. We present four

Thomas G. Schnell; Stephen J. Sontag; Gregorio Chejfec

1992-01-01

361

Laparoscopic distal pancreatectomy for adenocarcinoma of the pancreas  

PubMed Central

Since the first report on laparoscopic distal pancreatectomy (LDP) appeared in the 1990s, the procedure has been performed increasingly frequently to treat both benign and malignant lesions of the pancreas. Many earlier publications have shown LDP to be a good alternative to open distal pancreatectomy for benign lesions, although this has never been studied in a prospective, randomized manner. The evidence for the use of LDP to treat adenocarcinoma of the pancreas is not as well established. The purpose of this review is to evaluate the current evidence for LDP in cases of pancreatic adenocarcinoma. We conducted a review of English language publications reporting LDP results between 1990 and 2013. All studies reporting results in patients with histologically proven pancreatic adenocarcinoma were included. Thirty-nine publications were found and included in the results for a total of 309 cases of pancreatic adenocarcinoma (potential double publications were not eliminated). Most LDP procedures are performed in selected cases and generally involve smaller tumors than open distal pancreatectomy (ODP) procedures. Some of the papers report unselected cases and include procedures on larger tumors. The number of lymph nodes harvested using LDP is comparable to the number obtained with ODP, as is the frequency of R0 resections. Current data suggest that similar short term oncological results can be obtained using LDP as those obtained using ODP. PMID:25309072

Bjornsson, Bergthor; Sandstrom, Per

2014-01-01

362

Functional expression of TWEAK in human colonic adenocarcinoma cells.  

PubMed

The TNF-like weak inducer of apoptosis (TWEAK) can induce diverse cellular responses, including cell death, inflammation, migration, and proliferation in various transformed cell lines. We investigated TWEAK sensitivity, TWEAK effects on nuclear factor-kappaB activation, and expression of TWEAK in the HT-29, LS180, SK-CO-1 and SW480 human colonic adenocarcinoma cell lines, all of which express the TWEAK receptor (Fn14). TWEAK alone induced cell death in SW480 cells and induced cell death of HT-29 cells after addition of IFN-gamma, actinomycin D or cycloheximide. TWEAK did not affect cell viability of LS-180 or SK-CO-1 cells. Activation of NF-kappaB was not obviously influenced by TWEAK in any of the cell lines. All four human colonic adenocarcinoma cell lines constitutively expressed TWEAK mRNA, protein and membrane-bound TWEAK antigen, as detected by RT-PCR, Western blotting and flow cytometry. Stimulation by an anticancer drug (camptothecin) augmented cell surface expression of TWEAK and all human colonic adenocarcinoma tissue samples studied (n=59) demonstrated positive staining for TWEAK antigen. Soluble TWEAK was detected in culture medium of these cell lines by ELISA and conditioned medium from SW480 cells incubated with anti-TWEAK antibody significantly inhibited endothelial cell tube formation in Matrigels. Thus, functional expression of TWEAK from human colonic adenocarcinoma cells may contribute to neovascularization. PMID:15586228

Kawakita, Tomoyuki; Shiraki, Katsuya; Yamanaka, Yutaka; Yamaguchi, Yumi; Saitou, Yukiko; Enokimura, Naoyuki; Yamamoto, Norihiko; Okano, Hiroshi; Sugimoto, Kazushi; Murata, Kazumoto; Nakano, Takeshi

2005-01-01

363

Pancreatic body adenocarcinoma with neuroendocrine tumor characteristics: A case report  

PubMed Central

A 61-year-old female with pancreatic body cancer underwent a distal pancreatectomy. The tumor was a moderately- to poorly-differentiated adenocarcinoma. Tumor growth filled the dilated main pancreatic duct (MPD) and infiltrated the surrounding area. Six months later, metastases to the left diaphragm and MPD of the remnant pancreatic head were detected. Chemoradiotherapy was administered, but the patient succumbed 22 months after surgery. An autopsy demonstrated that a moderately- to poorly-differentiated adenocarcinoma had arisen from the pancreatic head and infiltrated the duodenum and bile duct. Huge liver metastases and multiple peritoneal disseminations were also present. Microscopically, a portion of the tumor had a pseudo-rosette appearance in the adenocarcinoma component, while another section showed characteristics of a neuroendocrine tumor (NET) immunohistochemically. The original surgically-resected tumor also showed NET characteristics immunohistochemically. It is therefore necessary to search for NET components in pancreatic cancer with atypical growth and metastases, even when adenocarcinoma has been diagnosed histologically. PMID:24944667

TAJIMA, HIDEHIRO; KITAGAWA, HIROHISA; SHOJI, MASATOSHI; WATANABE, TOSHIFUMI; NAKANUMA, SHINICHI; OKAMOTO, KOICHI; SAKAI, SEISHO; KINOSHITA, JUN; MAKINO, ISAMU; FURUKAWA, HIROYUKI; NAKAMURA, KEISHI; HAYASHI, HIRONORI; OYAMA, KATSUNOBU; INOKUCHI, MASAFUMI; NAKAGAWARA, HISATOSHI; MIYASHITA, TOMOHARU; ITOH, HIROSHI; TAKAMURA, HIROYUKI; NINOMIYA, ITASU; FUSHIDA, SACHIO; FUJIMURA, TAKASHI; OHTA, TETSUO; SATOH, HIROHIDE; IKEDA, HIROKO; HARADA, KENICHI; NAKANUMA, YASUNI

2014-01-01

364

Clinicopathologic features of villoglandular papillary adenocarcinoma of the uterine cervix  

Microsoft Academic Search

Objectives. The objectives of this study are to analyze the clinicopathologic features of villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix and to discuss the management thereof. We examined 13 patients with VGPA.Methods. Clinical profiles, including patient age, clinical stage, surgical procedure, and outcome, were recorded. Pathologically, macroscopic features, polypoid tumor size, horizontal spread and depth of endophytic tumor, nuclear

Kuniko Utsugi; Yoshio Shimizu; Futoshi Akiyama; Satoshi Umezawa; Katsuhiko Hasumi

2004-01-01

365

Sonic hedgehog-Gli1 pathway in colorectal adenocarcinomas  

PubMed Central

AIM: To determine the role of Sonic hedgehog (Shh) pathway in colorectal adenocarcinomas through analysis of the expression of Shh pathway-related molecules, Shh, Ptch1, hedgehog-interacting protein (Hip), Gli1, Gli3 and PDGFR?. METHODS: Expression of Shh in 25 colorectal adeno-carcinomas was detected by RT-PCR, in situ hybridization and immunohistochemistry. Expression of Ptch1 was observed by in situ hybridization and immunohistochemistry. Expression of Hip, Gli1, Gli3 and PDGFR? was analyzed by in situ hybridization. RESULTS: Expression of cytokeratin AE1/AE3 was observed in the cytoplasm of colorectal crypts. Members of the Hh signaling pathway were expressed in colorectal epithelium. Shh was expressed in cytoplasm of dysplastic epithelial cells, while expression of Ptch1, Hip and Gli1 were mainly detected in the malignant crypts of adenocarcinomas. In contrast, PDGFR? was expressed highly in aberrant crypts and moderately in the stroma. Expression of Gli3 could not be detected in colorectal adenocarcinomas. CONCLUSION: These data suggest that Shh-Ptch1-Gli1 signaling pathway may play a role in the progression of colorectal tumor. PMID:17461467

Bian, Yue-Hong; Huang, Shu-Hong; Yang, Ling; Ma, Xiao-Li; Xie, Jing-Wu; Zhang, Hong-Wei

2007-01-01

366

Treatment of Metastatic Prostate Adenocarcinoma to the Calcaneus  

Microsoft Academic Search

Metastatic skeletal adenocarcinoma is an all too common and unfortunate complication of advanced oncologic states. Mortality rates are usually elevated when bony metastasis are evident, as this signifies advanced disease. The foot and ankle are uncommon sites for metastatic deposits, but may occur. As such, the foot and ankle surgeon must be aware of the potential for such disease, and

Christopher Bibbo; Shawn P. Hatfield; Justin T. Albright

2010-01-01

367

Primary proximal urethral adenocarcinoma: Case report and brief review  

PubMed Central

Primary urethral cancer in females is rare. It has a poor prognosis. The published data on this topic are limited, composed mostly of small case series. This paper presents a case of an advanced adenocarcinoma of the urethra, intestinal type, treated with anterior exenteration. PMID:23914268

Siosaki, Marcos Duarte; Machado, Roberto Dias; Souza, Ana Tarsila Fonseca; Magnabosco, Wesley Justino; Santos, Alexandre Cesar; Goncalves, Fernando Zapparoli; Pereira, Fernando Coutinho; de Araujo Silva, Carlos Flavio; Faria, Eliney Ferreira

2013-01-01

368

Polymorphous low-grade adenocarcinoma: a case report.  

PubMed

We present a case of de novo polymorphous low-grade adenocarcinoma (PLGA) arising in a minor salivary gland with a relatively large radiographic extent compared with that of most of the PLGAs reported. This paper describes the radiographic extent of the lesion and the findings of CT imaging. PMID:22184472

Potluri, A; Prasad, J; Levine, S; Bastaki, Jm

2013-01-01

369

Lymphangitic Pulmonary Metastases in Castrate-Resistant Prostate Adenocarcinoma  

PubMed Central

A 63-year-old man with castrate-resistant metastatic prostate adenocarcinoma with known osseous and pelvic nodal involvement presented with progressive dyspnea for one week. Complete cardiopulmonary evaluation revealed a restrictive lung defect that could not be attributed to any of his previous therapies. On presentation, physical examination revealed coarse breath sounds diffusely with hypoxemia. Computed tomography of the chest showed severe bilateral airspace opacities and ground-glass appearance most consistent with interstitial pneumonitis. The patient was intubated due to progressive hypoxemia and worsening respiratory status despite empiric antibiotics and high dose steroids. Subsequent emergent bronchoscopy with transbronchial biopsies revealed atypical intralymphatic cells that stained positively for prostate-specific antigen and prostatic-specific acid phosphatase, confirming the diagnosis of intralymphatic pulmonary metastasis from prostate adenocarcinoma. Lymphangitic pulmonary metastasis from prostate adenocarcinoma is exceedingly rare, with few reported cases that are biopsy-proven. Herein, we describe a rare case of biopsy-proven lymphangitic pulmonary metastasis in the setting of castrate-resistant prostate adenocarcinoma and provide a comprehensive literature review. PMID:22924050

Meyer, Andrew; Angelica Mariani, Rachel; Nabhan, Chadi

2012-01-01

370

Lymphangitic pulmonary metastases in castrate-resistant prostate adenocarcinoma.  

PubMed

A 63-year-old man with castrate-resistant metastatic prostate adenocarcinoma with known osseous and pelvic nodal involvement presented with progressive dyspnea for one week. Complete cardiopulmonary evaluation revealed a restrictive lung defect that could not be attributed to any of his previous therapies. On presentation, physical examination revealed coarse breath sounds diffusely with hypoxemia. Computed tomography of the chest showed severe bilateral airspace opacities and ground-glass appearance most consistent with interstitial pneumonitis. The patient was intubated due to progressive hypoxemia and worsening respiratory status despite empiric antibiotics and high dose steroids. Subsequent emergent bronchoscopy with transbronchial biopsies revealed atypical intralymphatic cells that stained positively for prostate-specific antigen and prostatic-specific acid phosphatase, confirming the diagnosis of intralymphatic pulmonary metastasis from prostate adenocarcinoma. Lymphangitic pulmonary metastasis from prostate adenocarcinoma is exceedingly rare, with few reported cases that are biopsy-proven. Herein, we describe a rare case of biopsy-proven lymphangitic pulmonary metastasis in the setting of castrate-resistant prostate adenocarcinoma and provide a comprehensive literature review. PMID:22924050

Meyer, Andrew; Angelica Mariani, Rachel; Nabhan, Chadi

2012-01-01

371

Studies on rat mammary adenocarcinomas: a model for metastasis  

Microsoft Academic Search

Studies carried out by the authors on the rat mammary adenocarcinoma cell lines MAT 13762 and DMBA-8 are summarized. A series of variants and somatic cell hybrids have been prepared and partially characterized in terms of phenotypic properties which may correlate with metastatic potential. These include measurement of in vitro migration, lectin binding properties, expression of procoagulant activity and shedding

Ian A. Ramshaw; Peter Badenoch-Jones

1985-01-01

372

Human papillomavirus 16 infection in adenocarcinoma of the cervix  

Microsoft Academic Search

The impact of the success of organised cervical screening programme results in a steady decline of the incidence of squamous cell carcinoma of the cervix but a concomitant increase in the incidence of the less common histological subtypes, particularly adenocarcinoma of the cervix (ACC). Although Human papillomavirus (HPV) infection is believed to be a necessary cause of cervical cancer, its

G K Chew; M E Cruickshank; P H Rooney; I D Miller; D E Parkin; G I Murray

2005-01-01

373

Lymph node metastasis in gastric cardiac adenocarcinoma in male patients  

PubMed Central

AIM: To reveal the clinicopathological features and risk factors for lymph node metastases in gastric cardiac adenocarcinoma of male patients. METHODS: We retrospective reviewed a total of 146 male and female patients with gastric cardiac adenocarcinoma who had undergone curative gastrectomy with lymphadenectomy in the Department of Surgery, Xin Hua Hospital and Rui Jin Hospital of Shanghai Jiaotong University Medical School between November 2001 and May 2012. Both the surgical procedure and extent of lymph node dissection were based on the recommendations of Japanese gastric cancer treatment guidelines. Univariate and multivariate analyses of lymph node metastases and the clinicopathological features were undertaken. RESULTS: The rate of lymph node metastases in male patients with gastric cardiac adenocarcinoma was 72.1%. Univariate analysis showed an obvious correlation between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, and lymphatic invasion in male patients. Multivariate logistic regression analysis revealed that tumor differentiation and pathological tumor depth were the independent risk factors for lymph node metastases in male patients. There was an obvious relationship between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, lymphatic invasion at pN1 and pN2, and nerve invasion at pN3 in male patients. There were no significant differences in clinicopathological features or lymph node metastases between female and male patients. CONCLUSION: Tumor differentiation and tumor depth were risk factors for lymph node metastases in male patients with gastric cardiac adenocarcinoma and should be considered when choosing surgery. PMID:24115823

Ren, Gang; Chen, Ying-Wei; Cai, Rong; Zhang, Wen-Jie; Wu, Xiang-Ru; Jin, Ye-Ning

2013-01-01

374

Villoglandular papillary adenocarcinoma of the cervix. Beware of a wolf in sheep's clothing.  

PubMed

Villoglandular papillary adenocarcinoma of the cervix is a well differentiated form of cervical adenocarcinoma with a favourable prognosis and a conservative procedure is suggested. We present three cases of villoglandular papillary adenocarcinoma of the cervix. Histological examination of a biopsy of each cervix showed well differentiated villoglandular papillary adenocarcinoma, stage Ib according to FIGO classification. In all cases the disease was limited to the cervix. Nevertheless, histopathological examination of the surgical specimen revealed an infiltrating component with squamous differentiation in one case, while in a second case histopathological examination revealed a moderately differentiated papillary adenocarcinoma with a superficially infiltrating growth-pattern besides the villoglandular papillary adenocarcinoma. Before conservative therapy is considered, careful evaluation of the presence of poor prognostic features must be made. One should consider whether conservative therapy is sufficient because of the predominance of concomitance of other carcinoma besides the villoglandular papillary adenocarcinoma. PMID:10597972

Bouman, A; Oosterhuis, G J; Naudin ten Cate, L; van Doorn, G A

1999-12-01

375

Adenocarcinoma of the paraurethral glands: a case report.  

PubMed

Adenocarcinoma of the paraurethral glands represents a very rare neoplasm of the urinary tract. Due to the rarity of this disease, there is no standard therapeutic approach. We report a case of adenocarcinoma of the paraurethral glands in a 56-year-old woman, presenting with abnormal serous vaginal discharges. The radiologic examination revealed a 5-cm mass around the urethra, which underwent surgical resection. After surgical resection, the histology revealed a moderately differentiated adenocarcinoma, probably arising from the paraurethral glands. One month later, a pelvic recurrent mass was radiologically diagnosed; consequently, an anterior pelvic exenteration with lymph node dissection was performed. Histological examination revealed a moderately differentiated adenocarcinoma, with glandular and micropapillary architecture, with multiple lymph node metastases. The absence of modifications such as urethritis cystic glandularis on the urethral mucosa, as well as the lack of a lesion in situ, associated with the immunohistochemical expression of PAX8 and negativity for GATA3 and S100p, suggested that the adenocarcinoma originated from the paraurethral glands rather than from the urethral mucosa. Post-surgery CT scans revealed no evidence of metastatic disease. The patient received 6 courses of adjuvant chemotherapy with carboplatin and paclitaxel. One year after the pelvic exenteration, because of inguinal lymph node progression, an inguinal lymphadenectomy was performed. Four months later, a TC-PET revealed a multidistrectual lymph node and a lung micronodule disease progression. Invasive micropapillary carcinomas have been characterized as a rare distinctive variant of carcinomas in several anatomic sites and are distinguished by a marked tendency to lymphovascular invasion, justifying the association with high-stage disease and poor prognosis. In the present case, both the poor prognosis connected with micropapillary structure and the lymph node involvement, encouraged adjuvant cisplatinum-based chemotherapy. PMID:24604416

Massari, Francesco; Ciccarese, Chiara; Modena, Alessandra; Maines, Francesca; Segala, Diego; Luchini, Claudio; Marcolini, Lisa; Cavicchioli, Francesca; Cavalleri, Stefano; Bria, Emilio; Brunelli, Matteo; Martignoni, Guido; Artibani, Walter; Tortora, Giampaolo

2014-10-01

376

Opium; an emerging risk factor for gastric adenocarcinoma  

PubMed Central

Opium use has been associated with higher risk of cancers of the esophagus, bladder, larynx, and lung; however, no previous study has examined its association with gastric cancer. There is also little information on the associations between hookah (water pipe) smoking or the chewing of tobacco products and the risk of gastric cancer. In a case-control study in Golestan Province of Iran, we enrolled 309 cases of gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-location adenocarcinomas) and 613 matched controls. Detailed information on long-term use of opium, tobacco products, and other covariates were collected using structured and validated lifestyle and food frequency questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models. Opium use was associated with an increased risk of gastric adenocarcinoma, with an adjusted OR (95% CI) of 3.1 (1.9 – 5.1), and this increased risk was apparent for both anatomic subsites (cardia and noncardia). There was a dose-response effect, and individuals with the highest cumulative opium use had the strongest association (OR: 4.5; 95%CI: 2.3-8.5). We did not find a statistically significant association between the use of any of the tobacco products and risk of gastric adenocarcinoma, overall or by anatomic subsite. We showed, for the first time, an association between opium use and gastric adenocarcinoma. Given that opium use is a traditional practice in many parts of the world, these results are of public health significance. PMID:23319416

Shakeri, Ramin; Malekzadeh, Reza; Etemadi, Arash; Nasrollahzadeh, Dariush; Aghcheli, Karim; Sotoudeh, Masoud; Islami, Farhad; Pourshams, Akram; Pawlita, Michael; Boffetta, Paolo; Dawsey, Sanford M.; Abnet, Christian C.; Kamangar, Farin

2013-01-01

377

Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance  

PubMed Central

Introduction To investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate. Methods The clinicopathological and immunohistochemical data of seven patients with ductal adenocarcinoma of the prostate were retrospectively analyzed. All patients underwent physical examination, magnetic resonance imaging (MRI), bone scan, cystoscopy, and computed tomography (CT) scan. The level of prostate-specific antigen (PSA) before and after surgery was assessed. Different prostate cancer markers were used for immunohistochemical staining. Results The mean age of the seven patients diagnosed with prostatic ductal adenocarcinoma in this study was 76.2 years (range 57–88). Five patients presented with intermittent and painless gross hematuria, one patient with progressive dysuria, and one patient with elevated serum PSA on routine health examination. The level of PSA before surgery ranged from 1.3 to 45.0 ng/mL. Immunohistochemical staining results of the prostatic ductal adenocarcinoma confirmed positivity for PSA, prostatic acid phosphatase, androgen receptor, and alpha-methyacyl co-enzyme A (CoA)-reductase markers. Two of the patients underwent bilateral orchiectomy combined with anti-androgen therapy, three underwent transurethral resection of prostate, one received radical prostatectomy, and one received medical castration therapy. The clinical outcomes of all patients were satisfactory, based on follow-up data. The symptoms of hematuria and dysuria were ameliorated well, and the postoperative PSA level decreased below 4.0 ng/mL. Recurrence or metastasis of disease was not detected on MRI and bone scan. Conclusion Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma, the diagnosis of which could be based on pathological and immunohistochemical examination. Earlier management promises better prognosis. PMID:24187500

Sha, Jianjun; Bo, Juanjie; Pan, Jiahua; Zhang, Lianhua; Xuan, Hanqing; Chen, Wei; Li, Dong; Wang, Zhaoliang; Liu, Dongming; Huang, Yiran

2013-01-01

378

Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma  

PubMed Central

Background There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma. Methods The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population. Results There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma. Conclusion There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma, especially of diffuse large B-cell lymphoma. PMID:24159918

2013-01-01

379

[The morphological features of the uterine body adenocarcinoma].  

PubMed

The anthors studied the morphological features of uterine adenocarcinoma using immunohistochemical methods. The endometrial tissue was studed resulting from surgery - hysterectomy with oophorectomy in 103 patients aged 45-76 years with a clinical diagnosis of endometrial cancer. To exclude false-positive and false-negative results, we carry out same investigation on 12 patients with morphological diagnosis easy-glandular hyperplasia of the endometrium. The results showed that the endometrioid adenocarcinomas exhibit the high and moderate expression of estrogen and progesterone receptors and low rate of the proliferation marker Ki-67. For serous-paapillary andenocarcionoma of the uterine body the negative ER-PR-receptor over expression phenotype and proliferation marker Ki-67 superexpression are characteristic. The results showed that in a simple-glandular endometrial hyperplasia is determined a moderate expression of estrogen and progesterone receptors, as for the Ki-67 proliferation marker an expression was found only in the single arears with an average of 5-8% of findings. Based at shis study it may be concluded thate the use of immunohistochemical studies particularly a detection of negative estrogen and progesterone resceptor phenotype and high expression of the proliferation marker Ki-67 is an additional defferential diagnostic eriterion for the diagnosis of serous papillary adenocarcinoma of the uterine body thet will ensure adepuate therapeutis approach to patients suffering from this disorder. Given he fact that serous papillary carcinoma of the endometrium is the most common neoplesm of the rarer forms of endometrial cancer with an extremely peculiar aggressive coures a ssurgical treatment as in overian cancer is recommended for this parthology, including a hysterectomy with bilateral oophorectomy, lymphadenectomy, omentektomy, cytological examination of the abdomend and biopsy of suspicious areas of the abdominal cavity, with adjuvant treatment including chemotherapy and radiation therapy. The absence of estrogen and progesterone receptors on serous-papilary adenocarcinoma of the uterine body justifies the inadvisability of hormone therapy in these patients. Since the patients with serous-papillary adenocarcinoma of the uterine body need a larger voluve surgical treatment the patients with ?ndometrioid adenocarcinoma of the uterine body. We consider that this morphological type of uterine cancer should be diagnosed preoperatively. PMID:25020177

2014-06-01

380

Bisdemethoxycurcumin attenuates gastric adenocarcinoma growth by inducing mitochondrial dysfunction  

PubMed Central

Bisdemethoxycurcumin (BDMC) is a demethoxy derivative of curcumin. In this study, a human gastric adenocarcinoma xenograft model was generated in vivo using nude mice and BDMC was observed to suppress the growth and activity of tumors, in addition to improving the physical and mental capacity of the mice. An increased number of apoptotic cells, decreased ratio of B-cell lymphoma 2 (Bcl-2)/Bcl-2-associated X protein and increased caspase-3 expression was also observed following treatment with BDMC, indicating that BDMC may promote apoptosis in tumors via mitochondrial modulation. The growth of SGC 7901 gastric cancer cells was inhibited and arrested at G1 phase. Specific indicators of mitochondrial dysfunction, a reduction in adenosine triphosphate generation, the inner mitochondrial membrane potential, augmentation of reactive oxygen species production and cytochrome c were also detected in the mitochondria following treatment with BDMC. These results indicate that BDMC attenuates gastric adenocarcinoma growth by inducing mitochondrial dysfunction.

LUO, CHANGJIANG; DU, ZHIXING; WEI, XING; CHEN, GANG; FU, ZHONGXUE

2015-01-01

381

Minute localized malignant pleural mesothelioma coexisting with multiple adenocarcinomas.  

PubMed

We report an extremely rare case of minute localized malignant pleural mesothelioma (LMPM) coexisting with multiple lung adenocarcinomas in a 64-year-old woman without a history of smoking or asbestos exposure. A computed tomography scan of the chest displayed total five ground-glass opacities in the lung. Transbronchial lung biopsy from a ground-glass opacity in the posterior segment revealed a bronchioloalveolar carcinoma. With a diagnosis of primary lung cancer, right upper lobectomy and wedge resection of the right lower lobe with systematic lymph node dissection was performed using video-assisted thoracoscopic surgery. Incidentally, a minute gray-white nodule measuring 6 mm was detected on the visceral pleural surface of the right upper lobe. The postoperative histological diagnosis was minute LMPM coexisting with multiple adenocarcinomas. PMID:20155346

Maeda, Ryo; Isowa, Noritaka; Onuma, Hideyuki; Miura, Hiroshi; Tokuyasu, Hirokazu; Kawasaki, Yuji

2010-02-01

382

Adenocarcinoma arising in warthin tumor of the parotid gland.  

PubMed

Warthin tumor is a well-defined benign salivary gland neoplasm consisting of both epithelial and lymphoid components. The tumor is the second most common benign tumor next to pleomorphic adenoma. We present a case of adenocarcinoma, not otherwise classified, arising in unilateral Warthin tumor of the parotid gland in a 63-year-old male patient. Carcinomas arising in or from the epithelial component of a preexisting parotid Warthin tumor are rare and differential diagnosis of metastasis from an adenocarcinoma in Warthin tumor is important. The patient underwent a complete and thorough work-up, and no other primary malignant lesion was found. No other primary malignant lesion had manifested at the last one year follow-up period. PMID:23011833

Sayar, Hamide; Öztarakçi, Hüseyin; Sayar, Ça?da?; A?irba?, ?ule

2012-01-01

383

Paraneoplastic cerebellar degeneration associated with serous adenocarcinoma of the ovary.  

PubMed

We report a case of a 68-year-old woman who presented with symptoms of cerebellar degeneration which initiated a suspicion of underlying malignancy. The patient presented with progressive ataxia and dysarthria and after excluding primary cerebellar pathology, paraneoplastic syndrome was suspected and she was investigated for a malignancy. CT scan of the pelvis showed a left-sided ovarian mass later diagnosed as serous adenocarcinoma of the ovary. She underwent surgery and histology of the mass showed poorly-differentiated serous adenocarcinoma. Paraneoplastic neurological syndrome encompasses several neurological disorders including paraneoplastic cerebellar degeneration (PCD) caused by an immune-mediated mechanism in patients with an underlying malignancy. PCD is a rare condition that occurs in less than 1% of patients with cancer and is associated with specific groups of cancer. It is important to identify PCD due to its association with certain cancers and also to limit the disabilities associated with the syndrome. PMID:25432905

Saeed, Duaa B; Gupta, Limci

2014-01-01

384

Association Between Markers of Obesity and Progression From Barrett's Esophagus to Esophageal Adenocarcinoma Adenocarcinoma  

PubMed Central

BACKGROUND & AIMS Individuals with Barrett’s esophagus (BE) have an increased risk of developing esophageal adenocarcinoma (EA). Obesity contributes to development of BE and its progression to cancer. We investigated the roles of obesity-induced hyperinsulinemia and dysregulation of adipokines in these processes. METHODS We measured fasting levels of glucose, insulin, leptin, and adiponectin in 392 patients enrolled in the Seattle BE Study. We calculated homeostatic model assessment (HOMA) scores (a measure of insulin sensitivity) and identified subjects with metabolic syndrome. We evaluated the association between these measures and risk of EA using Cox regression models adjusted for known risk factors. RESULTS Increasing HOMA scores were associated with increasing risk for EA; the strongest association was observed within the first 3 years after participants entered the study (hazard ratio (HR)=2.45; 95% confidence interval [CI], 1.43–4.1; Ptrend=.001). Leptin level was also significantly associated with increased risk of EA within 3 y (HR=2.51; 95% CI 1.09–5.81; Ptrend =0.03) and 6 y (HR=2.07; 95% CI 1.01–4.26; Ptrend=0.048) of baseline. The level of high molecular weight adiponectin had a non-linear inverse association with risk of EA; the strongest associations were observed in the second tertile (HR=0.34; 95% CI, 0.14–0.82). Metabolic syndrome was not associated with risk of EA. CONCLUSIONS Among patients with BE, increased levels of leptin and insulin resistance are associated with increased risk for EA, whereas increased level of high molecular weight adiponectin is inversely associated with EA. These biomarkers might be used to determine cancer risk among patients with BE. PMID:23466711

Duggan, Catherine; Onstad, Lynn; Hardikar, Sheetal; Blount, Patricia L; Reid, Brian J; Vaughan, Thomas L

2013-01-01

385

Adenocarcinoma of the stomach with common variable immunodeficiency syndrome.  

PubMed

Two patients had adenocarcinoma of the stomach in association with common variable immunodeficiency syndrome. There has been an increased prevalence of malignancy in this late-onset immunodeficient state. Similar to five previously reported cases, our patients had gastric carcinoma as a late complication. Further documentation of this association stresses the need for long-term follow-up in this premalignant condition. PMID:718318

Battle, W M; Brooks, F P

1978-11-01

386

Increased risk of oesophageal adenocarcinoma among upstream petroleum workers  

PubMed Central

Objectives To investigate cancer risk, particularly oesophageal cancer, among male upstream petroleum workers offshore potentially exposed to various carcinogenic agents. Methods Using the Norwegian Registry of Employers and Employees, 24 765 male offshore workers registered from 1981 to 2003 was compared with 283 002 male referents from the general working population matched by age and community of residence. The historical cohort was linked to the Cancer Registry of Norway and the Norwegian Cause of Death Registry. Results Male offshore workers had excess risk of oesophageal cancer (RR 2.6, 95% CI 1.4 to 4.8) compared with the reference population. Only the adenocarcinoma type had a significantly increased risk (RR 2.7, 95% CI 1.0 to 7.0), mainly because of an increased risk among upstream operators (RR 4.3, 95% CI 1.3 to 14.5). Upstream operators did not have significant excess of respiratory system or colon cancer or mortality from any other lifestyle-related diseases investigated. Conclusion We found a fourfold excess risk of oesophageal adenocarcinoma among male workers assumed to have had the most extensive contact with crude oil. Due to the small number of cases, and a lack of detailed data on occupational exposure and lifestyle factors associated with oesophageal adenocarcinoma, the results must be interpreted with caution. Nevertheless, given the low risk of lifestyle-related cancers and causes of death in this working group, the results add to the observations in other low-powered studies on oesophageal cancer, further suggesting that factors related to the petroleum stream or carcinogenic agents used in the production process might be associated with risk of oesophageal adenocarcinoma. PMID:19858535

Kirkeleit, Jorunn; Riise, Trond; Bj?rge, Tone; Moen, Bente E; Bratveit, Magne; Christiani, David C

2013-01-01

387

Takotsubo Cardiomyopathy in a Patient with Lung Adenocarcinoma  

PubMed Central

Takotsubo cardiomyopathy (TC) is a rare and usually physical or emotional stress-induced clinical disorder characterized by transient left ventricular dysfunction and apical segment ballooning. Much is still unknown regarding risk factors and clinical relationships. Recently, an association between TC and malignancies has been proposed. We present a case of lung adenocarcinoma whose initial hospital admission was due to TC. We contribute this case report to the growing set of literature on the association between TC and malignancies. PMID:23181180

Kepez, Alper; Yesildag, Osman; Erdogan, Okan; Aktas, Bilge

2012-01-01

388

Polymorphous low-grade adenocarcinoma of the maxillary sinus.  

PubMed

Polymorphous low-grade adenocarcinoma (PLGA) is a rare tumor, mostly affecting the minor salivary glands of the oral cavity. We report a case of PLGA which occurred within the maxillary sinus in a 59-year-old woman. The tumor was resected through a transnasal endoscopic approach with wide margins. To the best of our knowledge, this is the first reported case with primary PLGA of the maxillary sinus. PMID:23714964

Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

2013-05-01

389

Bronchogenic cyst of the stomach involved with gastric adenocarcinoma  

Microsoft Academic Search

Bronchogenic cyst, a congenital anomaly mostly found in the mediastinum, rarely arises in the stomach. A 43-year-old man had\\u000a epigastric pain and was diagnosed as having gastric adenocarcinoma. Abdominal ultrasonography showed hepatic cyst, and computed\\u000a tomography and magnetic resonance imaging revealed a cystic lesion near the stomach. At surgery, the cystic lesion was found\\u000a to be located at the lesser

Hiroaki Shibahara; Toshiyuki Arai; Shunpei Yokoi; Seijun Hayakawa

2009-01-01

390

Spectral karyotyping indicates complex rearrangements in lung adenocarcinoma of nonsmokers  

Microsoft Academic Search

Adenocarcinoma (AdC) of the lung represents a common histologic subtype of non–small cell lung cancer. While there is a rising incidence of AdC in nonsmoking women, information on the cytogenetic changes involved has been minimal to date. In the present study, spectral karyotyping analysis uncovered the genome-wide chromosomal aberrations in two AdC tumors derived from women who were lifelong nonsmokers.

Shirley Ming-Hui Sy; Boli Fan; Tak-Wai Lee; Tony S.-K. Mok; Elizabeth Pang; Anthony Yim; Nathalie Wong

2004-01-01

391

Fluopsin C induces oncosis of human breast adenocarcinoma cells  

PubMed Central

Aim: Fluopsin C, an antibiotic isolated from Pseudomonas jinanesis, has shown antitumor effects on several cancer cell lines. In the current study, the oncotic cell death induced by fluopsin C was investigated in human breast adenocarcinoma cells in vitro. Methods: Human breast adenocarcinoma cell lines MCF-7 and MD-MBA-231 were used. The cytotoxicity was evaluated using MTT assay. Time-lapse microscopy and transmission electron microscopy were used to observe the morphological changes. Cell membrane integrity was assessed with propidium iodide (PI) uptake and lactate dehydrogenase (LDH) assay. Flow cytometry was used to measure reactive oxygen species (ROS) level and mitochondrial membrane potential (??m). A multimode microplate reader was used to analyze the intracellular ATP level. The changes in cytoskeletal system were investigated with Western blotting and immunostaining. Results: Fluopsin C (0.5-8 ?mol/L) reduced the cell viability in dose- and time-dependent manners. Its IC50 values in MCF-7 and MD-MBA-231 cells at 24 h were 0.9 and 1.03 ?mol/L, respectively. Fluopsin C (2 ?mol/L) induced oncosis in both the breast adenocarcinoma cells characterized by membrane blebbing and swelling, which was blocked by pretreatment with the pan-caspase inhibitor Z-VAD-fmk. In MCF-7 cells, fluopsin C caused PI uptake into the cells, significantly increased LDH release, induced cytoskeletal system degradation and ROS accumulation, decreased the intracellular ATP level and ??m. Noticeably, fluopsin C exerted comparable cytotoxicity against the normal human hepatocytes (HL7702) and human mammary epithelial cells with the IC50 values at 24 h of 2.7 and 2.4 ?mol/L, respectively. Conclusion: Oncotic cell death was involved in the anticancer effects of fluopsin C on human breast adenocarcinoma cells in vitro. The hepatoxicity of fluopsin C should not be ignored. PMID:23708552

Ma, Li-sha; Jiang, Chang-you; Cui, Min; Lu, Rong; Liu, Shan-shan; Zheng, Bei-bei; Li, Lin; Li, Xia

2013-01-01

392

An Unusual Case of Isolated Peritoneal Metastases from Lung Adenocarcinoma  

PubMed Central

Introduction Peritoneal metastases from lung cancer are a rare event. In this paper, we report the case of a patient with adenocarcinoma of the lungs who had isolated peritoneal metastases at the time of diagnosis. Case Report We report a 55-year-old female who presented with shortness of breath, decreased effort tolerance, cough, and weight loss. Her initial chest X-ray and subsequent chest CT showed a 12 × 9 × 8 cm mass in the middle lobe of the right lung. The histopathological examination of her biopsy material was consistent with a thyroid transcription factor-1 positive lung adenocarcinoma. In the abdomen, a 5.3-cm mass was identified. A biopsy and immunohistochemistry revealed a lung adenocarcinoma. The patient was administered chemotherapy based on carboplatin-paclitaxel-bevacizumab, but only with a partial response. Six months later, the patient showed brain metastases. Therefore, a second-line treatment based on pemetrexed was administered for 9 courses, and a clinical and radiological response was observed. The chemotherapy was stopped and the patient did not exhibit any symptoms of progression while waiting for a new evaluation. Discussion The incidence of peritoneal involvement of lung cancer without metastases in other parts of the body is scarcely encountered in clinical practice. Out of the different types of lung cancers, adenocarcinoma and large cell carcinoma are most likely to metastasize in the peritoneum. Immunohistochemical staining patterns were important in the differential diagnosis with the other etiologies for peritoneal metastasis and the mesothelioma. Peritoneal metastases are indicative of a disseminated disease and prognosis is extremely poor.

Bazine, Aziz; Fetohi, Mohamed; Khmamouch, Med Reda; Namad, Tarik; Ichou, Mohamed; Errihani, Hassan

2014-01-01

393

Reversible postvaccination paraneoplastic encephalomyelitis in a patient with lung adenocarcinoma.  

PubMed

Encephalomyelitis occurs in paraneoplastic syndrome and acute disseminated encephalomyelitis through different autoimmune mechanisms. No postvaccinal encephalomyelitis other than acute disseminated encephalomyelitis has been reported in patients with malignancy. A 68-year-old woman was admitted because of a headache followed by a gait disturbance and psychomotor retardation 2 days after she had received an influenza vaccination followed by abulia, limb rigidity and hyperreflexia of both legs, and meningeal irritation. Cerebrospinal fluid studies showed increased intracranial pressure, elevated immunoglobulins G and A, and pleocytosis. Contrasted brain magnetic resonance imaging revealed ventriculomegaly and multiple symmetric leptomeningeal enhancement, without demyelinating changes or cortical ribbon signs. Somatosensory evoked potentials and nerve conduction velocity studies suggested myelitis. Encephalomyelitis was diagnosed on the basis of clinical and laboratory examinations. The etiological survey identified a lung adenocarcinoma. Both the encephalomyelitis and the lung adenocarcinoma simultaneously progressed after the vaccination and then, after targeted therapy for lung cancer, simultaneously subsided. In conclusion, postinfluenza-vaccination paraneoplastic encephalomyelitis may occur in patients with lung adenocarcinoma. PMID:20964557

Wu, Yi-Jen; Lai, Ming-Liang; Huang, Chin-Wei

2010-12-01

394

[Solitary metachronous metastasis of the sternum from pancreatic adenocarcinoma].  

PubMed

Sternal metastases from adenocarcinoma of the pancreas are extremely rare, and even more so when solitary. Two years earlier, the patient reported on here, a 67-year-old man with a solitary osteolytic lesion of the sternal manubrium, had undergone a duodeno-cephalopancreatectomy for adenocarcinoma of the pancreas (G2, pY3, pN1) followed by adjuvant radio-chemotherapy. PET/CT scans, in response to the onset of burning pain in the sternal region, revealed a hypermetabolic area only at the level of the manubrium, while MRI showed a bulging manubrium due to the presence of extensive solid pathological tissue towards the right articulations of the ribs. Abnormal tumour markers were: CEA = 12, n.v. 0-4; Ca 15-3 = 512, n.v. 0-51, Ca 19-9 = 8777, n.v. 0-18. A partial sternectomy was performed with en-bloc resection of the hemiclavicles and the anterior tract of the 1st and 2nd ribs bilaterally with a mediastinic lymphadenectomy and repair with a sandwich prosthesis of prolene mesh and methacrylate, protecting the supra-aortic trunks and the anonymous vein with a polytetrafluoroethylene patch. The histological examination revealed secondary adenocarcinoma with 3 mediastinal metastatic lymph nodes. In view of the severe prognosis, a resection with palliative intent was also performed, which, when carried out in specialised centres, presents no contraindications in terms of cost-benefits. PMID:18361001

Lequaglie, Cosimo; Della Morte, Aniello; Feudale, Elisa; Giudice, Gabriella

2007-01-01

395

Prediction of distant metastasis in follicular adenocarcinoma of the thyroid.  

PubMed

Follicular adenocarcinoma of the thyroid sometimes displays distant metastasis in spite of its low histological grade of malignancy. We have studied whether distant metastasis can be detected by the presence of blood vessel invasion. We have also examined the problem from the viewpoint of cell-to-cell conjugation. This study examined 160 cases of follicular adenocarcinoma of the thyroid. Histological specimens were made by sectioning tumors at their largest diameter. Blood vessel endothelia were specifically stained immunohistochemically with factor VIII-related antigen and Ulex europeaus agglutinin I (UEA-1). Then, the presence of blood vessel invasion was examined in detail. Furthermore, the conjugation of lectin-derived wheat germ agglutinin (WGA) to tumor cells was examined. Conjugation of tumor cells was also examined using sialic acid as a marker. Blood vessel invasion was recognized in 95 (59.4%) of 160 cases. Distant metastases were identified in 25 cases (15.6%) in which blood vessel invasion was also found. Relative to the group without distant metastases, the group with distant metastases showed not only a significantly higher sialic acid content but also higher levels of WGA-binding protein in the tissues. The risk of distant metastasis in patients with follicular adenocarcinoma of the thyroid appears to be related both to the extent and to the frequency of blood vessel invasion. Furthermore, assessment of the conjugation of cells appears to have predictive value for occurrence of distant metastases. PMID:2368447

Iwasaki, H; Matsumoto, A; Ito, K; Kure, Y; Suzuki, A; Sugino, K; Ozaki, O; Noh, J

1990-01-01

396

Endoscopic assessment and management of early esophageal adenocarcinoma.  

PubMed

Esophageal carcinoma affects more than 450000 people worldwide and the incidence is rapidly increasing. In the United States and Europe, esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence. Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages. Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett's esophagus. These risk factors include chronic gastroesophageal reflux disease, hiatal hernia, advanced age, male sex, white race, cigarette smoking, and obesity. The annual risk of esophageal cancer is approximately 0.25% for patients without dysplasia and 6% for patients with high-grade dysplasia. Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa. The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option. The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia. Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation, photodynamic therapy and cryoablation. Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion. Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor, positive lymph node and submucosal invasion. Surgical resection should be offered to patients with deep submucosal invasion. PMID:25132925

Hammoud, Ghassan M; Hammad, Hazem; Ibdah, Jamal A

2014-08-15

397

Minimally invasive ablation treatment for locally advanced pancreatic adenocarcinoma.  

PubMed

Pancreatic adenocarcinoma is an aggressive tumour with an extremely poor prognosis, which has not changed significantly during the last 30 years. Prolonged survival is achieved only by R0 resection with macroscopic tumour clearance. However, the majority of the cases are considered inoperable at diagnosis due to local spread or presence of metastatic disease. Chemoradiotherapy is not tolerated by all patients and still fails to prolong survival significantly; neoadjuvant treatment also has limited results on pain control or tumour downstaging. In recent years, there has been a growing interest in the use of ablation therapy for the treatment of nonresectable tumours in various organs. Ablation techniques are based on direct application of chemical, thermal, or electrical energy to a tumour, which leads to cellular necrosis. With ablation, tumour cytoreduction, local control, and relief from symptoms are obtained in the majority of the patients. Inoperable cases of pancreatic adenocarcinoma have been treated by various ablation techniques in the last few years with promising results. The purpose of this review is to present the current status of local ablative therapies in the treatment of pancreatic adenocarcinoma and to investigate on the efficiency and the future trends. PMID:23989503

Rossi, Michele; Orgera, Gianluigi; Hatzidakis, Adam; Krokidis, Miltiadis

2014-06-01

398

Obstructive jaundice caused by intraductal metastasis of lung adenocarcinoma  

PubMed Central

Obstructive jaundice caused by metastases to the porta hepatis is often observed in patients with various advanced cancers; however, metastasis of lung cancer to the common bile duct with subsequent development of jaundice is rare. A 75-year-old female with lung adenocarcinoma harboring epidermal growth factor receptor (EGFR) mutation (15-bp in-frame deletion in exon 19 and T790M in exon 20) developed obstructive jaundice during therapy. Obstruction of the common bile duct caused by an intraductal tumor was identified by computed tomography, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography. Although primary cholangiocarcinoma was highly suspected according to the imaging findings, immunohistochemical evaluation of the intraductal tumor demonstrated thyroid transcription factor-1 positive adenocarcinoma. Furthermore, peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp analysis showed that the tumor contained the same EGFR mutation as that in the primary lung cancer. Thus, we confirmed intraductal metastasis from a lung adenocarcinoma. To our knowledge, this is the second report of obstructive jaundice caused by intraductal metastasis of lung cancer. PMID:25336976

Ochi, Nobuaki; Goto, Daisuke; Yamane, Hiromichi; Yamagishi, Tomoko; Honda, Yoshihiro; Monobe, Yasumasa; Kawamoto, Hirofumi; Takigawa, Nagio

2014-01-01

399

Villoglandular papillary adenocarcinoma of the uterine cervix: a diagnostic challenge.  

PubMed

Villoglandular papillary adenocarcinoma (VGA) is a rare subtype of cervical adenocarcinoma. It tends to appear in younger women and its indolent behavior permits fertility-preserving treatments. Pathologically, VGA presents a diagnostic challenge. The aim of our study was to evaluate the reliability of histological assessment for pre-treatment diagnosis of VGA. The data from the outpatient files of 12 patients in whom VGA had been diagnosed were reviewed. Median age at diagnosis was 38.8 years (range 27-65). Final pathology results confirmed VGA in nine patients. Of these, only two had been correctly diagnosed preoperatively, while in three, the initial biopsies were benign or pre-malignant. In four patients, the biopsy results had been interpreted as an invasive malignant tumor necessitating hysterectomy. The final histological report on the remaining three patients was invasive cervical adenocarcinoma. We conclude that pre-treatment diagnosis should not be based solely on a simple punch biopsy because of its low rate of diagnostic accuracy. PMID:19172445

Korach, Jacob; Machtinger, Ronit; Perri, Tamar; Vicus, Daniel; Segal, Jacob; Fridman, Eddie; Ben-Baruch, Gilad

2009-01-01

400

Prevention of adenocarcinoma by reversing Barrett's esophagus with mucosal ablation.  

PubMed

The ultimate goal of therapy in patients with Barrett's esophagus (BE) is to reduce the risk of developing adenocarcinoma of the esophagus. Neither pharmacologic nor surgical therapy has been documented to reduce this risk. There is preliminary evidence that many forms of mucosal ablation combined with acid reduction therapy result in restitution of normal squamous epithelium in patients with BE. Acid reduction can be accomplished with high-dose proton pump inhibitor therapy or antireflux surgery. Endoscopic ablation can be accomplished with photodynamic therapy, laser, multipolar electrocoagulation, a heater probe, and argon plasma coagulation. These techniques require further study so the complication rates can be compared. The success of reversing BE must be evaluated in a standard way utilizing large-capacity biopsy forceps through a therapeutic endoscope. Ideally, patients at high risk of developing adenocarcinoma of the esophagus can be treated with ablation therapy and followed to document a reduction in the development of adenocarcinoma of the esophagus. A validated biomarker would help select high risk patients appropriate for reversal therapy. Currently, patients who are at prohibitive risk for surgery or who refuse surgery are candidates for combination therapy including mucosal ablation to reverse their BE. This therapy offers the promise of less morbidity and greater quality of life than resection. PMID:12917762

Sampliner, Richard E

2003-09-01

401

Survival of patients with stomach adenocarcinoma in North of Iran  

PubMed Central

Aim: This study was proposed for estimation of survival time in patients with stomach adenocarcinoma. Background: North of Iran has a high mortality rate of stomach adenocarcinoma. Patients and methods: The study was historical cohort. The samples were the patients with stomach adenocarcinoma referred to Tooba Clinic between three years (2007-2010). Survival estimates were calculated using the Kaplan-Meier method the effects of covariates on survival time were assessed by, using survival parametric regression model with gamma frailty. Results: The survival probability of more than two years of patients was calculated 27.7% by using Kaplan Mayer method. The stage, metastasis, surgery, and age were the variables which affect the survival probability of patients, by using survival parametric regression model with gamma frailty and hazard ratio of patients with three treatment protocol was 0.43 times of others (P<0.01) and increasing of patients ages decrease life time of them significantly as per year increasing patient age, risk of death increased by 4% (P<0.04) and patients with staging disease lower 4 had hazard ratio lower than 0.46 times of stage 4 (P<0.01). Conclusion: The survival time of our patients is much lower than the developed countries, which are related to latency in diagnosis and therapeutic limitations. PMID:25289135

Yazdani-Charati, Jamshid; Janbabaei, Ghasem; Etemadinejad, Siavosh; Sadeghi, Samaneh; Haghighi, Firoozeh

2014-01-01

402

Perianal Paget's Disease Co-Associated with Anorectal Adenocarcinoma: Primary or Secondary Disease?  

PubMed Central

Perianal Paget's disease (PPD) represents a skin neoplasm which can be either primary or secondary to carcinoma from an adjacent internal organ. PPD with underlying colorectal adenocarcinoma is usually looked upon as a secondary disease. We report a rare case of co-associated PPD and anorectal adenocarcinoma. The PPD was found to be located near the anorectal adenocarcinoma with normal tissues between them. Immunohistochemical stains demonstrated that the Paget's cells were CK7+/GCDFP-15–/CK20–/MUC2–/CDX2–, whereas the anorectal adenocarcinoma was shown to be CK7+/GCDFP-15–/CK20+/MUC2+/CDX2+. This immunological phenotypic profile supported the notion that PPD and anorectal adenocarcinoma were of different origins, but could not define the exact origins of PPD. In our determination, this case was a primary PPD with anorectal adenocarcinoma. PPD remains a heterogeneous and complex pathology, and additional studies are required to differentiate between the various possible origins. PMID:24932167

Liao, Xiujun; Mao, Weiming; Lin, A'Li

2014-01-01

403

Combination Treatment of Hydrogen Peroxide and X-Rays Induces Apoptosis in Human Prostate Cancer PC-3 Cells  

SciTech Connect

Purpose: To study the effect of hydrogen peroxide (H{sub 2}O{sub 2}) on radiation-induced apoptosis in human prostate cancer PC-3 cells. Methods and Materials: At 4h before the irradiation, PC-3 cells were exposed to 10mM ammonium chloride (NH{sub 4}Cl) concentrations. Subsequently, cells were exposed to 0.1mM H{sub 2}O{sub 2} just before the irradiations, which were administered with 10-MV X-rays at doses of 10Gy. Results: The percentage of apoptotic cells at 48h after X-irradiation alone, H{sub 2}O{sub 2} alone, and combined X-irradiation and H{sub 2}O{sub 2} was 1.85%, 4.85%, and 28.4%, respectively. With use of combined X-irradiation and H{sub 2}O{sub 2}, production of reactive oxygen species (ROS) occurred 4h after the irradiation. This resulted in lysosomal rupturing, mitochondrial fragmentation, and the release of cytochrome c into the cytoplasm from the mitochondria. In contrast, when cells were exposed to NH{sub 4}Cl before the X-irradiation and H{sub 2}O{sub 2} administration, apoptosis was almost completely suppressed, ROS production did not occur, lysosomal rupture and mitochondrial fragmentation were blocked, and cytochrome c was not released. Conclusions: Hydrogen peroxide strongly enhanced lysosome-dependent radiation-induced apoptosis in human prostate cancer PC-3 cells. A combined use of X-rays and H{sub 2}O{sub 2} can also injure the mitochondrial cytoplasmic organelles and lead to the production of ROS that in and of itself might possibly induce apoptosis.

Kariya, Shinji [Department of Diagnostic Radiology and Radiation Oncology, Kochi Medical School, Kochi (Japan)], E-mail: kariyas@kochi-u.ac.jp; Sawada, Ken [Department of Psychiatry, Geiyo Hospital, Kochi (Japan); Kobayashi, Toshihiro [Department of Neurobiology and Anatomy, Kochi Medical School, Kochi (Japan); Karashima, Takashi; Shuin, Taro [Department of Urology, Kochi Medical School, Kochi (Japan); Nishioka, Akihito; Ogawa, Yasuhiro [Department of Diagnostic Radiology and Radiation Oncology, Kochi Medical School, Kochi (Japan)

2009-10-01

404

Role of x-ray-induced transcripts in adaptive responses following x-rays. Progress report, Year 2  

SciTech Connect

I will describe our recent data in which we have extracted and purified a sufficient amount of RNA from primed and unprimed U1-Mel cells to begin the search for new genes which are modulated by priming or high dose irradiation during the establishment and/or challenge of adapted cells, respectively. Gene transcripts which are altered during ASRs now include alterations in xip5 (a gene with homology to human growth hormone), xipl2 (a gene with homology to human angiogenesis factor and a gene which may be involved in apoptosis due to its possible RNase activity), cyclin A (which is altered in primed cells only after a high dose of ionizing radiation), cyclin B (which is also altered in a similar manner as cyclin A), p53 (a tumor suppressor gene involved in cell division control in G{sub 1} following ionizing radiation), and glutathionine S transferase-pi (a gene product which has been demonstrated to be involved in DNA repair and redox c