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1

Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment.  

PubMed

Small bowel adenocarcinomas are rare tumours, but their incidence is increasing. Their most common primary location is the duodenum. The few studies that have collected data regarding small bowel adenocarcinoma are not homogeneous and are widely spread over time. Even though these tumours are most often sporadic, some predisposing diseases have been identified, among which Crohn's disease and genetic syndromes. Early diagnosis of small bowel adenocarcinoma remains difficult despite significant radiological and endoscopic progress. After surgical resection the main prognostic factor is node invasion; in this case, adjuvant chemotherapy can be expected to be beneficial, although this has not been established by randomised trials. For metastatic disease, platinum-based chemotherapy seems to be the most effective treatment. Targeted therapies have not yet been evaluated in this type of cancer. PMID:23796552

Aparicio, Thomas; Zaanan, Aziz; Svrcek, Magali; Laurent-Puig, Pierre; Carrere, Nicolas; Manfredi, Sylvain; Locher, Christophe; Afchain, Pauline

2014-02-01

2

Unusually early presentation of small-bowel adenocarcinoma in a patient with Peutz-Jeghers syndrome  

PubMed Central

Peutz-Jeghers (PJS) syndrome is an autosomal dominant cancer predisposition syndrome characterized by melanotic macules, and hamartomatous polyps. Small-bowel surveillance in the pediatric PJS population is not designed to identify small-bowel malignancy which is thought to arise in adulthood. A 13 year old male presented with lead-point intussusception, requiring emergent surgical resection. A mucinous adenocarcinoma was found arising from high-grade dysplasia within a polyp. Based on these findings and mucosal pigmentation he was diagnosed with PJS. DNA sequencing revealed a heterozygous c.921-1G>T STK11 mutation. This case is the earliest onset of small-bowel carcinoma in PJS, an observation relevant to surveillance guidelines. PMID:23426006

Wangler, Michael F.; Chavan, Rishikesh; Hicks, M. John; Nuchtern, Jed.G.; Hegde, Madhuri; Plon, Sharon E.; Thompson, Patrick A.

2013-01-01

3

Small bowel adenocarcinoma - terra incognita: A demand for cross-national pooling of data  

PubMed Central

To date, due to the rarity, tumor biology and carcinogenesis of small bowel adenocarcinoma (SBA), the disease has been explored insufficiently and immunophenotyping and molecular characterization have not been finalized. This knowledge gap consecutively leads to an overt lack of diagnostic and therapeutic recommendations. In the current study, we provide our experience with the treatment of SBA, and demand for cross-national data pooling to enable unlimited information transfer and higher powered study. A comprehensive database of all patients with SBA was established and consecutively reviewed for clinicopathohistological data, information concerning preoperative evaluation, surgical and chemotherapeutical treatment, as well as outcome parameters. Patients underwent curative intended surgery (42.4%; n=14), adjuvant chemotherapy (CTX) following resection (36.4%; n=12) or palliative care (21.2%; n=7). The majority of patients were diagnosed at an advanced disease stage (pT3, 36.4%; pT4, 39.4%) and the duodenum was the most common tumor site (57.1%; n=20). Complete surgical resection was achieved in 88.5% of patients, while postoperative complications occurred in 19.4%. Within a mean follow-up period of 31.4 months, 17 patients succumbed to the disease following a median survival time of 11 months. Mean overall survival (OS) was 47.4, 25.3 and 9.8 months for surgically, surgically and chemotherapeutically and palliatively treated patients, respectively. Early surgical resection remains the mainstay in the treatment of localized SBA, since it is associated with a prolongation of OS. The role of neoadjuvant and adjuvant CTX has not yet been defined. Thus, since no consensus exists on the adequate treatment of these malignancies, we demand an international collaboration and cross-national data pooling to pave the way for the implementation of evidence-based standard care operating procedures. PMID:24765188

SCHWAMEIS, KATRIN; SCHOPPMANN, SEBASTIAN FRIEDRICH; STIFT, JUDITH; SCHWAMEIS, MICHAEL; STIFT, ANTON

2014-01-01

4

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

PubMed Central

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

Coco, Danilo; Leanza, Silvana; Boccoli, Gianfranco

2014-01-01

5

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

6

Laparoscopic harvesting of small bowel graft for small bowel transplantation  

Microsoft Academic Search

  Background: Small bowel transplantation represents a valid therapeutic option for patients with intestinal failure, obviating\\u000a the need for long-term total parenteral nutrition. Recently, reports have shown the feasibility of performing living related\\u000a intestinal transplantation using segmental small bowel grafts. The limitations of this technique include inadequate harvested\\u000a small bowel lengths, as compared with the lengths obtained in cadaveric small bowel

W. W. Kim; M. Gagner; S. Fukuyama; T. I. Hung; L. Biertho; B. P. Jacob; P. Gentileschi

2002-01-01

7

Incidence of Small Bowel Cancer in the United States and Worldwide: Geographic, Temporal, and Racial Differences  

Microsoft Academic Search

Objective: To examine the demographic and geographic patterns of small bowel cancer incidence in the United States and worldwide. Methods: Incidence data from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 to 2000 were used to analyze the four histologic types of small bowel cancer, adenocarcinomas, carcinoid tumors, lymphomas, and sarcomas. International comparisons were made using data from

Tmirah Haselkorn; Alice S. Whittemore; David E. Lilienfeld

2005-01-01

8

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

9

X-ray-induced water vaporization  

SciTech Connect

We present quantitative evidence for x-ray-induced water vaporization: water is vaporized at a rate of 5.5 pL/s with the 1-A-wavelength x-ray irradiation of {approx}0.1 photons per A{sup 2}; moreover, water vapor is reversibly condensed during pauses in irradiation. This result fundamentally suggests that photoionization induces vaporization. This phenomenon is attributed to surface-tension reduction by ionization and would be universally important in radiological and electrohydrodynamic situations.

Weon, B. M.; Lee, J. S.; Je, J. H. [X-ray Imaging Center, Department of Materials Science and Engineering,Pohang University of Science and Technology, San 31, Pohang 790-784 (Korea, Republic of); Fezzaa, K. [X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, 9700 South Cass Avenue, Argonne, Illinois 60439 (United States)

2011-09-15

10

Magnetic resonance imaging of small bowel neoplasms  

PubMed Central

Abstract Magnetic resonance (MR) imaging is rapidly increasing clinical acceptance to evaluate the small bowel and can be the initial imaging method to investigate small bowel diseases. MR examinations may provide the first opportunity to detect and characterize tumours of the small bowel. Intra- and extraluminal MR findings, combined with contrast enhancement and functional information, help to make an accurate diagnosis and consequently characterize small bowel neoplasms. MR enteroclysis should be recommended for the initial investigation in patients suspected of having small bowel tumours. In this article, the MR findings of primary small bowel neoplasms are described and the MR findings for the differential diagnosis are discussed. PMID:23524074

Casciani, Emanuele; Polettini, Elisabetta; Laghi, Francesca; Gualdi, Gianfranco

2013-01-01

11

Acute small bowel obstruction owing to undiagnosed lung cancer.  

PubMed

Lung cancer is the leading cause of cancer related deaths in the United States. Most patients with lung cancer present with advanced disease at the time of diagnosis owing to multiple metastases. However, metastases to the duodenum are extremely rare. We present a case of acute small bowel obstruction in a patient owing to metastatic disease to the duodenum from previously undiagnosed lung adenocarcinoma. PMID:25372366

Erokhina, Katerina; Sharak, Nazar; Cai, Wayne; Pierre, Berry; Schultz, Allen

2014-08-01

12

Appendiceal knotting causing small bowel strangulation  

PubMed Central

Small bowel obstruction is a common cause of an emergency admission in the surgical wards. Acute appendicitis presenting with small bowel obstruction due to appendiceal knotting is a very rare and unsuspected condition in an emergency scenario. We report a case of acute small bowel obstruction in a 26-year-old male who, on exploration was found to have small bowel strangulation due to appendiceal knotting. Though rare, the possibilities of such a diagnosis should be kept in mind in patients with small bowel obstruction with no known identifiable etiology.

Chatterjee, Chandan; Dash, Suvashis; Gupta, Sahana; Ghosh, Shibajyoti

2014-01-01

13

Utility of positron emission tomography/CT in the evaluation of small bowel pathology  

PubMed Central

We describe the management principles and different roles of positron emission tomography (PET)/CT in the evaluation of patients with small bowel tumours (adenocarcinoma, gastrointestinal stromal tumour, lymphoma, metastases) from initial staging, monitoring response to treatment, to detection of recurrent disease. We also discuss the various non-malignant aetiologies of small bowel fludeoxyglucose (FDG) PET uptake, and other pitfalls in FDG PET/CT interpretation. Awareness of the imaging appearances of small bowel tumours, patterns of disease spread and potential PET/CT interpretation pitfalls are of paramount importance to optimise diagnostic accuracy. PMID:22919004

Cronin, C G; Scott, J; Kambadakone, A; Catalano, O A; Sahani, D; Blake, M A; Mcdermott, S

2012-01-01

14

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

15

Living Related Small Bowel Transplantation  

PubMed Central

Objective: To describe a standardized technique for ileal graft procurement in the setting of living related bowel transplantation. Summary Background Data: Living donor transplantation has been successfully developed for kidney, liver, pancreas, and lung transplantation. More recently, living related small bowel transplantation (LR-SBTx) has been developed with the aim of expanding the pool of intestinal graft donors and reducing the mortality in patients on the waiting list. To date, a total of 25 LR-SBTx worldwide have been reported to the international registry. We herein report the largest single center experience. Methods: A segment of ileum, 150 to 200 cm, is resected 20 cm proximal to the ileocecal valve (ICV), which is always preserved. The arterial inflow is given by the terminal branch of the superior mesenteric artery and venous outflow by a proximal segment of the superior mesenteric vein. The entire bowel is measured intraoperatively and at least 60% of intestine length is left in the donor. Results: Since 1998, we have performed 9 terminal ileum resections for small bowel donation. None of the donors has experienced persistent alteration of bowel habits or malabsorption; only 1 minor wound complication has occurred. Conclusions: Terminal ileal resection with preservation of the ICV seems to assure fast functional recovery of the donor and has minimal postoperative complications. PMID:15492558

Testa, Giuliano; Panaro, Fabrizio; Schena, Stefano; Holterman, Mark; Abcarian, Herand; Benedetti, Enrico

2004-01-01

16

Small Bowel Dissemination of Coccidioidomycosis  

PubMed Central

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

Zhou, Shengmei; Ma, Yanling; Chandrasoma, Parakrama

2015-01-01

17

Small bowel endometriosis masquerading as regional enteritis  

Microsoft Academic Search

Summary A 35-year-old female presented with recurrent right lower quadrant pain, nausea, and vomiting. She was afebrile with diffuse abdominal tenderness. Plain x-ray of abdomen revealed small bowel obstruction. A barium x-ray of the small bowel showed stricture of the terminal ileum. A CT scan of the abdomen showed a 6-cm mass in right lower quadrant. She was empirically managed

Anil Minocha; Michael S. Davis; Richard A. Wright

1994-01-01

18

Bellyboard device reduces small bowel displacement  

SciTech Connect

The ability to cure several pelvic malignancies is hampered by the inability to deliver doses greater than 45 to 50 Gy, beyond which radiation enteritis becomes dose-limiting. The design and fabrication of a device that allows exclusion of small bowel from the pelvis during radiation therapy are described in this study. A prospective dose-volume analysis conducted on 30 patients reveals a 66 percent reduction in the volume of small bowel within the radiation portals.

Bertelrud, K.; Mehta, M.; Shanahan, T.; Utrie, P.; Gehring, M. (Mercy Regional Medical Cancer Center, Janesville, WI (USA))

1991-03-01

19

Bacteria, bile and the small bowel  

PubMed Central

Microbial populations of the small bowel and bile salt metabolism were studied in 15 patients with lesions of the stomach and small intestine. These types of microorganism could be correlated with the site and extent of stasis in the small bowel and the presence of a normally functioning stomach. The presence of obligate anaerobes (bacteroides) and free bile acids could be correlated with areas of stagnation. When these abnormalities were detected throughout the small bowel, steatorrhoea was also noted. However, bacteroides and free bile acids in localized regions of either proximal or distal small bowel were generally associated with normal faecal fat excretion. Vitamin B12 malabsorption appeared to be related to the total number of bacteria colonizing the small bowel rather than to any specific type of microorganisms. The effect of antibiotics on intestinal function and bacteriology was studied in three patients. In one patient, the broad-spectrum antibiotic tetracycline was effective in eradicating an abnormal bacterial flora. In the other two, lincomycin, which is specifically effective in eradicating the anaerobic flora, restored intestinal function to normal. PMID:4983639

Gorbach, Sherwood L.; Tabaqchali, Soad

1969-01-01

20

Arteriovenous malformation detected by small bowel endoscopy.  

PubMed

Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine. PMID:25473391

Fujii, Takaaki; Morita, Hiroki; Sutoh, Toshinaga; Takada, Takahiro; Tsutsumi, Soichi; Kuwano, Hiroyuki

2014-09-01

21

Feasibility of laparoscopy for small bowel obstruction  

PubMed Central

Background Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity. Methods We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and Cochrane Library. We analyzed the reference lists of the key manuscripts. We also added a review based on international non-indexed sources. Results The feasibility of diagnostic laparoscopy is high (60–100%), while that of therapeutic laparoscopy is low (40–88%). The frequency of laparotomic conversions is variable ranging from 0 to 52%, depending on patient selection and surgical skill. The first cause of laparotomic conversion is a difficult exposition and treatment of band adhesions. The incidence of laparotomic conversions is major in patients with anterior peritoneal band adhesions. Other main causes for laparotomic conversion are the presence of bowel necrosis and accidental enterotomies. The predictive factors for successful laparoscopic adhesiolysis are: number of previous laparotomies ? 2, non-median previous laparotomy, appendectomy as previous surgical treatment causing adherences, unique band adhesion as phatogenetic mechanism of small bowel obstruction, early laparoscopic management within 24 hours from the onset of symptoms, no signs of peritonitis on physical examination, experience of the surgeon. Conclusion Laparoscopic adhesiolysis in small bowel obstruction is feasible but can be convenient only if performed by skilled surgeons in selected patients. The laparoscopic adhesiolysis for small bowel obstruction is satisfactorily carried out when early indicated in patients with a low number of laparotomies resulting in a short hospital stay and a lower postoperative morbidity. Although a higher small bowel obstruction recurrence remains the major postoperative risk of the laparoscopic management of these patients. PMID:19152695

Farinella, Eriberto; Cirocchi, Roberto; La Mura, Francesco; Morelli, Umberto; Cattorini, Lorenzo; Delmonaco, Pamela; Migliaccio, Carla; De Sol, Angelo A; Cozzaglio, Luca; Sciannameo, Francesco

2009-01-01

22

Laparoscopic management of acute small bowel obstruction  

Microsoft Academic Search

Background: The use of laparoscopy has expanded to include the management of acute abdomen. This study describes the author's experience\\u000a with laparoscopic management of acute small bowel obstruction.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: From February 1994 through March 1998, 19 patients underwent laparoscopic intervention for acute small bowel obstruction.\\u000a Their clinical data were analyzed to evaluate the outcome.\\u000a \\u000a \\u000a \\u000a \\u000a Results: A total of 19 patients

A. A. Al-Mulhim

2000-01-01

23

Primary small bowel melanoma: a case report.  

PubMed

The small intestine is the most common site of gastrointestinal metastasis from cutaneous melanoma. However, the small intestine itself is rarely the site of a primary melanotic tumour. We describe a case of primary small bowel melanoma in a 70-year-old man, and discuss the features of primary and metasttic melanoma. PMID:15912983

Sanyal, Sudip; Kaman, Lileswar; Behera, Arunanshu; Kakkar, Nandita

2004-01-01

24

Laparoscopic-assisted small bowel resection for treatment of adult small bowel intussusception: a case report  

PubMed Central

Background Intussuception is a rare cause of intestinal obstruction in adults. Diagnosis is often difficult due to the variable and sometimes episodic nature of symptoms. Surgery is the recommended treatment option in adults if the diagnosis is proven. Case presentation We present a case of a 33 year old Caucasian female admitted with a small bowel obstruction and no history of previous abdominal surgery. Patient did not improve with medical management consisting of bowel rest and nasogastric tube decompression. Surgery was consulted and patient was taken to the operating room for a laparoscopic-assisted small bowel resection for a small bowel intussusception caused by a submucosal fibroma. Conclusion Our case highlights the feasibility and potential benefits of laparoscopy in assisting the diagnosis and treatment of small bowel obstructions. PMID:19117512

Stewart, Donald; Hughes, Michael; Hope, William W

2008-01-01

25

Small bowel Crohn's disease MRI pictorial essay.  

PubMed

The focus of this article includes 1 Revision of normal small bowel anatomy on sequences performed at our institution, with advantages and disadvantages. 2 Brief summary of the disease. 3 Appearance of acute active disease. 4 Usefulness of ancillary findings of active disease. 5 Appearance of chronic disease both active and inactive. 6 Complications of Crohn's disease. 7 Pitfalls and limitations of interpretation. 8 Clinically relevant reporting through clinician feedback. PMID:22697329

Lui, Belinda; Sutherland, Tom; Lasocki, Arian; Hennessy, Oliver

2012-06-01

26

An Animal Model for the Study of Small-Bowel Tumors1  

Microsoft Academic Search

SUMMARY An animal model for the study of small-bowel tumors has been investigated. Tumors were induced in male Holtzman rats by X-irradiation of only the hypoxic, temporarily exteriorized ileum and jejunum. Following an exposure of 2000 R, 56% of the rats developed adenocarcinoma some where in the irradiated segment. Macroscopic métastases were not observed outside the small intestine: however, métastases

Kenneth L. Coop; J. Graham Sharp; James W. Osborne; George R. Zimmerman

27

Small Bowel Imaging in Managing Crohn's Disease Patients  

PubMed Central

The small bowel is essential to sustain alimentation and small bowel Crohn's disease (CD) may severely limit its function. Small bowel imaging is a crucial element in diagnosing small bowel CD, and treatment control with imaging is increasingly used to optimize the patients outcome. Thereby, capsule endoscopy, Balloon-assisted enteroscopy, and Magnetic resonance imaging have become key players to manage CD patients. In this review, role of small bowel imaging is detailed discussed for use in diagnosing and managing Crohn's disease patients. PMID:22474438

Albert, Jörg G.

2012-01-01

28

Laparoscopic Resection of a Small Bowel Lipoma with Incidental Intussusception  

PubMed Central

Background: Small bowel tumors are rare entities that often present with nonspecific symptoms. The diagnosis is more likely in patients with occult gastrointestinal bleeding of unknown origin or in adults with small bowel intussusception. Even with exhaustive diagnostic testing, small bowel tumors are often not diagnosed preoperatively. Because 60% to 70% of small bowel tumors are malignant, surgical excision is always recommended. Methods: We report the case of a 73-year-old man with occult gastrointestinal bleeding. A small bowel tumor was discovered only after video capsule endoscopy, computed tomography, and multiple endoscopies were performed. Results: The patient underwent laparoscopic exploration. An incidental intussusception made the tumor simple to identify. By extending the umbilical port, the tumor was easily removed. The final pathology demonstrated a submucosal lipoma. Conclusions: Small bowel lipomas can cause intussusception and gastrointestinal bleeding. When diagnosed preoperatively, laparoscopic resection is feasible. PMID:21605536

Fass, Ronnie; Krouse, Robert S.

2010-01-01

29

Small bowel Crohn's disease: an emerging disease phenotype?  

PubMed

An increasing understanding of the pathogenesis of Crohn's disease (CD), coupled with improvements in therapeutic options, has promoted the concept of stratifying patients with CD into distinct disease phenotypes according to risk. Small bowel CD, due to the numerous non-specific potential symptoms and the anatomical location of the disease, is a particularly difficult phenotype to identify. The fact that the majority of de novo strictures occur in the ileum/ileo-colonic region ensures that recognition of small bowel involvement is essential. Certainly, it is becoming increasingly recognised due to improvements in imaging and endoscopic techniques. Both CT and MR enterography appear capable of accurately diagnosing small bowel CD. Furthermore, the development of capsule endoscopy and balloon-assisted enteroscopy allow direct visualisation of the small bowel. Limited data to date would suggest that small bowel CD is a difficult entity to treat even in the current era of the ever-expanding field of biological therapies. Further long-term follow-up studies are necessary using both small bowel capsule endoscopy and cross-sectional imaging to truly assess, firstly, whether small bowel CD is more resistant to treatment and, secondly, whether it has an effect over time in terms of complications. In the future, serological and genetic tests, coupled with the aforementioned investigations, will permit early diagnosis and early treatment of small bowel CD. © 2014 S. Karger AG, Basel. PMID:25531496

Hall, Barry; Holleran, Grainne; McNamara, Deirdre

2015-01-01

30

Local radiotherapy of exposed murine small bowel: Apoptosis and inflammation  

Microsoft Academic Search

BACKGROUND: Preoperative radiotherapy of the pelvic abdomen presents with complications mostly affecting the small bowel. The aim of this study was to define the features of early radiation-induced injury on small bowel. METHODS: 54 mice were divided into two groups (36 irradiated and 18 sham irradiated). Animals were placed on a special frame and (in the radiated group) the exteriorized

Andrea Polistena; Louis Banka Johnson; Salomé Ohiami-Masseron; Lena Wittgren; Sven Bäck; Charlotte Thornberg; Virgil Gadaleanu; Diya Adawi; Bengt Jeppsson

2008-01-01

31

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

EPA Science Inventory

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

32

Diarrhoea due to small bowel diseases  

PubMed Central

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

Murray, Joseph A.; Rubio-Tapia, Alberto

2012-01-01

33

Orthotopic Small Bowel Transplantation in Rats  

PubMed Central

Small bowel transplantation has become an accepted clinical option for patients with short gut syndrome and failure of parenteral nutrition (irreversible intestinal failure). In specialized centers improved operative and managing strategies have led to excellent short- and intermediate term patient and graft survival while providing high quality of life 1,3. Unlike in the more common transplantation of other solid organs (i.e. heart, liver) many underlying mechanisms of graft function and immunologic alterations induced by intestinal transplantation are not entirely known6,7. Episodes of acute rejection, sepsis and chronic graft failure are the main obstacles still contributing to less favorable long term outcome and hindering a more widespread employment of the procedure despite a growing number of patients on home parenteral nutrition who would potentially benefit from such a transplant. The small intestine contains a large number of passenger leucocytes commonly referred to as part of the gut associated lymphoid system (GALT) this being part of the reason for the high immunogenity of the intestinal graft. The presence and close proximity of many commensals and pathogens in the gut explains the severity of sepsis episodes once graft mucosal integrity is compromised (for example by rejection). To advance the field of intestinal- and multiorgan transplantation more data generated from reliable and feasible animal models is needed. The model provided herein combines both reliability and feasibility once established in a standardized manner and can provide valuable insight in the underlying complex molecular, cellular and functional mechanisms that are triggered by intestinal transplantation. We have successfully used and refined the described procedure over more than 5 years in our laboratory 8-11. The JoVE video-based format is especially useful to demonstrate the complex procedure and avoid initial pitfalls for groups planning to establish an orthotopic rodent model investigating intestinal transplantation. PMID:23168906

Ohsawa, Ichiro; Jaffari, Azin; Pech, Thomas C.; Vilz, Tim; Wehner, Sven; Uemoto, Shinji; Kalff, Joerg C.; Schaefer, Nico

2012-01-01

34

Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma  

PubMed Central

Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well. PMID:21103257

Shiba, Hiroaki; Mitsuyama, Yoshinobu; Hanyu, Ken; Ikeuchi, Kenji; Hayashi, Hirotaka; Yanaga, Katsuhiko

2009-01-01

35

OMOM capsule endoscopy in diagnosis of small bowel disease  

PubMed Central

Objective: To assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications. Methods: Data from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who underwent OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients’ indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results: CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for patients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea (85.7% vs 53.3%, P<0.005). Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion: OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB (small bowel) CE (Given Imaging, Yoqneam, Israel). PMID:18988304

Li, Chen-yi; Zhang, Bing-ling; Chen, Chun-xiao; Li, You-ming

2008-01-01

36

CADAVERIC SMALL BOWEL AND SMALL BOWEL–LIVER TRANSPLANTATION IN HUMANS1,2  

PubMed Central

Five patients had complete cadaveric small bowel transplants under FK506 immunosuppression, one as an isolated graft and the other 4 in continuity with a liver. Three were children and two were adults. The five patients are living 2–13 months posttransplantation with complete alimentation by the intestine. The typical postoperative course was stormy, with sluggish resumption of gastrointestinal function. The patient with small intestinal transplantation alone had the most difficult course of the five, including two severe rejections, bacterial and fungal translocation with bacteremia, renal failure with the rejections, and permanent consignment to renal dialysis. The first four patients (studies on the fifth were incomplete) had replacement of the lymphoreticular cells in the graft lamina propria by their own lymphoreticular cells. Although the surgical and aftercare of these patients was difficult, the eventual uniform success suggests that intestinal transplantation has moved toward becoming a practical clinical service. PMID:1738932

Todo, Satoru; Tzakis, Andreas G.; Abu-Elmagd, Kareem; Reyes, Jorge; Fung, John J.; Casavilla, Adrian; Nakamura, Kenjiro; Yagihashi, Atsuhito; Jain, Ashok; Murase, Noriko; Iwaki, Yuichi; Demetris, Anthony J.; Van Thiel, David; Starzl, Thomas E.

2010-01-01

37

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

PubMed Central

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

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

2007-01-01

38

Mesenteric air embolism following enteroscopic small bowel tattooing procedure.  

PubMed

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

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

2012-01-01

39

Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure  

PubMed Central

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

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

2012-01-01

40

Small bowel endoscopy: cost-effectiveness of the different approaches.  

PubMed

Obscure gastrointestinal haemorrhage is defined the presence of overt or occult bleeding in the setting of a normal endoscopic examination of the upper and lower gastrointestinal tracts. While obscure bleeding is not common, the evaluation and management of these patients often incurs considerable expense. Potential options for small bowel evaluation include traditional radiographic studies, push enteroscopy, video capsule endoscopy, deep enteroscopy, tagged red blood cell scans, angiography, and enterography examinations with either computed tomography and/or magnetic resonance imaging. The decision regarding which modality to employ depends on the cost of the procedure, its effectiveness in rendering a diagnosis, and the potential for administration of therapy. This article will discuss determination of costs associated with technology for small bowel imaging, quality of life data associated with chronic GI haemorrhage, and available cost-effectiveness studies comparing the options for small bowel exploration. PMID:22704574

Gerson, Lauren B

2012-06-01

41

Relationship of small bowel motility to ileoanal reservoir function.  

PubMed Central

Some patients with an ileoanal reservoir have a high defecation frequency, despite a good anatomical result and the absence of pouchitis. This study aimed to determine whether variation in function is related to a difference in small bowel motility proximal to the reservoir and if small bowel motility is propagated into the reservoir. Ambulatory small bowel and reservoir motility was studied for 24 hours in five patients with good function (median bowel frequency 4 per day, range 3-6) and seven subjects with poor function (median bowel frequency 12 per day, range 10-20). Five solid state pressure sensors were positioned in the small bowel and one in the reservoir. During the fasting nocturnal period (2300-0800 h), patients with poor function had a median of 10 (range 5-13) migrating motor complexes (MMC), significantly greater (p = 0.03) than the corresponding median number of 3 (range 2-7) in patients with good function. A total of 120 MMCs were observed in the whole series of 12 patients. Of these only two were propagated from the small bowel into the reservoir. Discrete clustered contractions were not propagated into the reservoir, although prolonged propagated contractions did pass into the reservoir in one patient. Patients with poor function had similar 24 hour stool output and radiological reservoir size to those with good function, but the median maximum tolerated volume on reservoir distension was 290 ml (range 160-450) for patients with poor function compared with 475 ml (range 460-550) for patients with good function (p = 0.005). Small bowel motility proximal to the reservoir bears an important relationship to pouch function and defecation frequency. Propagation of coordinated proximal small intestinal motility into the reservoir is rare. PMID:8174992

Groom, J S; Kamm, M A; Nicholls, R J

1994-01-01

42

Enteroscopy in small bowel Crohn’s disease: A review  

PubMed Central

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

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

2013-01-01

43

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

E-print Network

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

Downs, Robert T.

44

Multidetector row computed tomography of small bowel obstruction.  

PubMed

Small bowel obstruction (SBO) is a common clinical problem, and clinical signs and symptoms often do not provide sufficient information for diagnosis or to guide management. During the past two decades, computed tomography has become a mainstay in the evaluation of patients with known or suspected small bowel obstruction. Computed tomography scans should be performed and interpreted with attention to establishing the diagnosis of small bowel obstruction, locating the transition point indicating the site of obstruction, and determining the cause of the obstruction. Complications that suggest the need for urgent surgical intervention, such as closed loop obstruction with superimposed ischemia and/or volvulus, should be sought in every case. Current generation multidetector row computed tomography scanners, with their isotropic resolution, now permit high-quality reformatted images to be obtained in multiple planes and facilitate identification of the transition point and other findings in SBO. Radiologists should be familiar with the myriad features of uncomplicated and complicated small bowel obstruction, which are reviewed in this article. PMID:18853838

Desser, Terry S; Gross, Megan

2008-10-01

45

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

46

Accuracy of computed tomography in small bowel obstruction.  

PubMed

Small bowel obstruction is a common clinical occurrence, primarily caused by adhesions. The diagnosis is usually made on the clinical findings and the presence of dilated bowel loops on plain abdominal radiograph. Computed tomography (CT) is increasingly used to diagnose the cause and location of the obstruction to aid in the timing of surgical intervention. We used a retrospective chart review to identify patients with a diagnosis of small bowel obstruction between 2009 and 2012. We compared the findings on CT with the findings at operative intervention. Sixty patients had abdominal CT and subsequent surgical intervention. Eighty-three per cent of CTs were correct for small intestine involvement and 80 per cent for colon involvement. The presence of adhesions or perforation was correctly identified in 21 and 50 per cent, respectively. Sixty-four per cent correctly identified a transition point. The presence of a mass was correctly identified in 69 per cent. Twenty per cent of the patients who had ischemic small bowel at surgery were identified on CT. CT has a role in the clinical assessment of patients with small bowel obstruction, identifying with reasonable accuracy the extent of bowel involvement and the presence of masses and transition points. It is less reliable at identifying adhesions, perforations, or ischemic bowel. PMID:23711277

Barnett, Rebecca E; Younga, Jason; Harris, Brady; Keskey, Robert C; Nisbett, Daryl; Perry, Jonathan; Cheadle, William G

2013-06-01

47

Terminal ileum duplication: an unusual case of small bowel obstruction.  

PubMed

Duplications of the alimentary tract are uncommon congenital anomalies that usually present during infancy and early childhood. The case of an adolescent presenting with small bowel obstruction secondary to a duplication cyst is presented and the challenges in the management described. PMID:24564069

Newnham, M S; Coard, K C; Brown, B R; Martin, A C

2013-02-01

48

HNPCC-associated small bowel cancer: Clinical and molecular characteristics  

Microsoft Academic Search

Background & Aims: The risk for small bowel cancer (SBC) is significantly increased in hereditary nonpoly- posis colorectal cancer (HNPCC). HNPCC-associated SBCs are poorly characterized. Methods: Thirty-two SBCs were characterized according to clinical, patho- logic, and germline mutation data. Histomorphologic characteristics, microsatellite instability (MSI) testing, mismatch repair (MMR) protein expression, and frameshift mutations of 7 coding mononucleotide re- peats were

Karsten Schulmann; Frank E. Brasch; Erdmute Kunstmann; Christoph Engel; Constanze Pagenstecher; Holger Vogelsang; Stefan Krüger; Tilman Vogel; Hanns-Peter Knaebel; Josef Rüschoff; Stephan A. Hahn; Magnus V. Knebel-Doeberitz; Gabriela Moeslein; Stephen J. Meltzer; Hans K. Schackert; Christiane Tympner; Elisabeth Mangold; Wolff Schmiegel

2005-01-01

49

Effect of small bowel preparation with simethicone on capsule endoscopy*  

PubMed Central

Background: Capsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition of simethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators. Methods: Sixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol (PEG) solution (Group 1) and both PEG solution and simethicone (Group 2). The PEG solution and simethicone were taken the night before and 20 min prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded. Results: Simethicone significantly reduced luminal bubbles both in the proximal and distal small intestines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% (P<0.001) and 68.8% (P<0.001) in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 min in Group 2 compared with 30.88 min in Group 1 (P=0.868), but it did increase mean small intestinal transit time from 227.28 to 281.84 min (P=0.003). Conclusion: Bowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed. PMID:19198022

Fang, You-hong; Chen, Chun-xiao; Zhang, Bing-ling

2009-01-01

50

Primary Malignancies of the Small Bowel: A Report of 96 Cases and Review of the Literature  

PubMed Central

The clinical records and histologic sections of 96 cases of primary small bowel malignancies (excluding lymphomas and periamullary lesions) were reviewed. The location, clinical presentation, pathologic findings, treatment and outcome are compared to the collected published experience, approximately 2400 cases. There were 48 adenocarcinomas, 37 carcinoids, and 11 leiomyosarcomas. Fifty-one men and 45 women ranged from 31 to 83 years old. Eighty-four caused symptoms leading to operative diagnosis; 12 carcinoids were incidental autopsy findings. The most common presentation was pain (33%) followed by weight loss (23%) obstruction (16%), hemorrhage (15%), jaundice (5%), intussusception (3%) and perforation (3%). Masses were felt in 30% of the cases, but were usually dilated bowel or intussusception rather than the tumor per se. Curative resection was attempted in 80 of 84 operatively diagnosed tumors. The 80% mortality among patients followed 5 years is attributed to the late appearance of symptoms and anatomic obstacles to a truly radical operation. PMID:4843046

Wilson, James M.; Melvin, David B.; Gray, George F.; Thorbjarnarson, Bjorn

1974-01-01

51

Secondary lymphangiectasia of the small bowel: utility of double balloon enteroscopy for diagnosis and management.  

PubMed

Sporadic lymphangiectasias are commonly found throughout the small bowel and are considered to be normal. Not uncommonly, lymphangiectasias are pathologic and can lead to mid-gastrointestinal bleeding, abdominal pain and protein-losing enteropathy. Pathologic lymphangiectasias of the small bowel include primary lymphangiectasia, secondary lymphangiectasia and lymphaticovenous malformations. In this report we present three different cases of small bowel lymphangiectasia detected by double balloon enteroscopy. The patients were diagnosed with South American blastomycosis, tuberculosis and primary small bowel lymphangioma. PMID:19188732

Safatle-Ribeiro, Adriana Vaz; Iriya, Kiyoshi; Couto, Décio Sampaio; Kawaguti, Fábio Shiguehiss; Retes, Felipe; Ribeiro, Ulysses; Sakai, Paulo

2008-01-01

52

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

Microsoft Academic Search

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

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

2001-01-01

53

Strangulation Caused by a Small Bowel Epiploic Appendage: Report of a Case  

Microsoft Academic Search

While many recent cases of colonic epiploic appendage causing acute abdomen have been reported, such appendages of the small bowel are extremely rare. We present a 59-year-old woman in whom a small bowel epiploic appendage caused volvulus. She presented with abdominal pain and vomiting in the absence of previous abdominal operations. A diagnosis of small bowel obstruction from strangulation was

Hiroshi Nemoto; Yasuo Yoshizawa; Kenji Hibi; Mitsuo Saito; Kazuyoshi Ishibashi; Yutaka Sanada; Genshu Tate

2008-01-01

54

Late small bowel toxicity after adjuvant treatment for rectal cancer  

Microsoft Academic Search

Background  For locally advanced rectal cancer surgery as sole treatment results in poor local control and survival. After adjuvant radiotherapy for locally advanced rectal cancer, small bowel toxicity has been the most frequent and serious side effect. The gain in survival and local control was accompanied by severe late chronic toxicity reducing the benefit of adjuvant treatment.Review  Clinical factors, pathology and treatment

Matthias Guckenberger; Michael Flentje

2006-01-01

55

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

56

Small bowel Diverticulitis of the Roux Loop after Gastric Bypass  

Microsoft Academic Search

The epidemic of obesity and the introduction of laparoscopic techniques have greatly increased the popularity of bariatric\\u000a operations such as Roux-en-Y gastric bypass (RYGBP). Acquired diverticular disease of the small bowel is a rare condition\\u000a that becomes symptomatic in about 10% of the cases. We report a 48-year-old morbidly obese woman who presented 2 months after\\u000a laparoscopic RYGBP with a

Antonio Iannelli; Thierry Piche; Sebastien Novellas; Jean Gugenheim

2006-01-01

57

Diospyrobezoar as a Cause of Small Bowel Obstruction  

PubMed Central

Phytobezoar, a concretion of indigestible fibers derived from ingested vegetables and fruits, is the most common type of bezoar. Diospyrobezoar is a subtype of phytobezoar formed after excessive intake of persimmons (Diospyros kaki). We report the case of a diabetic man with a 5-day history of abdominal pain after massive ingestion of persimmons who developed signs of complicated small bowel obstruction. The patient had a previous history of Billroth II hemigastrectomy associated with truncal vagotomy to treat a chronic duodenal ulcer 14 years earlier. Since intestinal obstruction was suspected, he underwent emergency laparotomy that revealed an ileal obstruction with small bowel perforation and local peritonitis due to a phytobezoar that was impacted 15 cm above the ileocecal valve. After segmental intestinal resection, the patient had a good recovery and was discharged on the 6th postoperative day. This report provides evidence that diospyrobezoar should be considered as a possible cause of small bowel obstruction in patients who have previously undergone gastric surgery. PMID:23271989

de Toledo, Andréia Padilha; Rodrigues, Fernanda Hurtado; Rodrigues, Murilo Rocha; Sato, Daniela Tiemi; Nonose, Ronaldo; Nascimento, Enzo Fabrício; Martinez, Carlos Augusto Real

2012-01-01

58

MR enterography for assessment and management of small bowel Crohn disease.  

PubMed

Magnetic resonance enterography (MRE) utilization has increased for the evaluation of small bowel diseases over the last several years. In addition to performing similarly to computed tomography enterography (CTE) in the evaluation of inflammatory bowel disease, MRE lacks ionizing radiation, can image the small bowel dynamically, and provides excellent soft tissue contrast resolution. This article reviews imaging protocols for MRE, normal MR imaging appearance of small bowel, and the imaging findings of small bowel Crohn disease. The importance of imaging findings for directing management in patients with small bowel Crohn disease is emphasized throughout. PMID:24889172

Allen, Brian C; Leyendecker, John R

2014-07-01

59

Small Bowel Stent-in-Stent Placement for Malignant Small Bowel Obstruction Using a Balloon-Assisted Overtube Technique  

PubMed Central

Self-expanding metal stents are a useful therapy to palliate malignant and benign luminal gastrointestinal obstruction. Self-expanding metal stents has been widely reported for colonic, esophageal, and gastric obstruction. However, endoscopic delivery and placement to the small bowel is more challenging and difficult. This case illustrates the usefulness and technical advantages of the balloon-overtube and enteroscopy technique for the palliative treatment of neoplastic stenosis affecting the small intestine. PMID:24570892

Popa, Daniel; Ramesh, Jayapal; Peter, Shajan; Wilcox, C. Mel

2014-01-01

60

Fecal calprotectin in patients with suspected small bowel disease - a selection tool for small bowel capsule endoscopy?  

PubMed

Abstract Objective. Fecal calprotectin (FC) has been proposed as a selection tool for gastrointestinal examinations, but the use of FC in the diagnosis of small bowel disease in particular is less studied. The aim of this study was to assess if FC could be used to predict findings on small bowel capsule endoscopy (SBCE). Material and methods. We retrospectively collected FC values, SBCE findings and clinical data in 161 patients with suspected small bowel disease referred for SBCE. Findings on SBCE were correlated with FC levels and the diagnostic value of FC was assessed. Results. Of the 161 patients, 37.3% had a positive FC and 29.8% had a finding on SBCE. Overall there was a significant difference in FC values between patients with any finding on SBCE and patients with a normal SBCE, but patients with ulcers/erosions was the only subgroup of patients with FC values significantly higher than patients with a normal SBCE. The proportion of patients with findings on SBCE increased with increasing FC value. A positive FC (?50 mg/kg) had a sensitivity, specificity, positive predictive value and negative predictive value of 54.2%, 69.9%, 43.3% and 78.2%, respectively, for predicting findings on SBCE. Conclusions. FC alone cannot be used as a selection tool for SBCE in patients with suspected small bowel disease in a specialist setting. However, a high FC value implies a higher probability of finding significant pathology on SBCE, and thus strengthens the indication for performing the examination. PMID:25591948

Olsen, Paul A S; Fossmark, Reidar; Qvigstad, Gunnar

2015-03-01

61

Roles of oxidative stress in synchrotron radiation X-ray-induced testicular damage of rodents  

PubMed Central

Synchrotron radiation (SR) X-ray has characteristic properties such as coherence and high photon flux, which has excellent potential for its applications in medical imaging and cancer treatment. However, there is little information regarding the mechanisms underlying the damaging effects of SR X-ray on biological tissues. Oxidative stress plays an important role in the tissue damage induced by conventional X-ray, while the role of oxidative stress in the tissue injury induced by SR X-ray remains unknown. In this study we used the male gonads of rats as a model to study the roles of oxidative stress in SR X-ray-induced tissue damage. Exposures of the testes to SR X-ray at various radiation doses did not significantly increase the lipid peroxidation of the tissues, assessed at one day after the irradiation. No significant decreases in the levels of GSH or total antioxidation capacity were found in the SR X-ray-irradiated testes. However, the SR X-ray at 40 Gy induced a marked increase in phosphorylated H2AX – a marker of double-strand DNA damage, which was significantly decreased by the antioxidant N-acetyl cysteine (NAC). NAC also attenuated the SR X-ray-induced decreases in the cell layer number of seminiferous tubules. Collectively, our observations have provided the first characterization of SR X-ray-induced oxidative damage of biological tissues: SR X-ray at high doses can induce DNA damage and certain tissue damage during the acute phase of the irradiation, at least partially by generating oxidative stress. However, SR X-ray of various radiation doses did not increase lipid peroxidation. PMID:22837810

Ma, Yingxin; Nie, Hui; Sheng, Caibin; Chen, Heyu; Wang, Ban; Liu, Tengyuan; Shao, Jiaxiang; He, Xin; Zhang, Tingting; Zheng, Chaobo; Xia, Weiliang; Ying, Weihai

2012-01-01

62

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

63

X-ray-Induced Shortwave Infrared Biomedical Imaging Using Rare-Earth Nanoprobes.  

PubMed

Shortwave infrared (SWIR or NIR-II) light provides significant advantages for imaging biological structures due to reduced autofluorescence and photon scattering. Here, we report on the development of rare-earth nanoprobes that exhibit SWIR luminescence following X-ray irradiation. We demonstrate the ability of X-ray-induced SWIR luminescence (X-IR) to monitor biodistribution and map lymphatic drainage. Our results indicate X-IR imaging is a promising new modality for preclinical applications and has potential for dual-modality molecular disease imaging. PMID:25485705

Naczynski, Dominik Jan; Sun, Conroy; Türkcan, Silvan; Jenkins, Cesare; Koh, Ai Leen; Ikeda, Debra; Pratx, Guillem; Xing, Lei

2015-01-14

64

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

SciTech Connect

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

Preston, R.J.

1981-01-01

65

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

66

Prediction of radiation-related small-bowel damage  

SciTech Connect

In order to predict which patients have a high risk for radiation-related small-bowel damage, the concept of the dose-response curve was applied to the predisposing factors (number of previous laparotomies, extent of surgery, thin physique, hypertension, age, cancer stage, number of treatment days, fractionation, and weight change during radiotherapy) present in 92 patients receiving identical radiation doses and volumes This analysis allows an estimate of the probability of complication to be assigned to individual patients. The utility and limitations of the dose-response concept are discussed.

Potish, R.A.

1980-04-01

67

Deflated intragastric balloon-induced small bowel obstruction.  

PubMed

We describe the rare case of a 49-year-old man who had an air-filled intragastric balloon placed for weight control 11 months ago which had been lost of sight for follow-up and presented six months after the last radiologic control with acute small bowel obstruction. Computed tomography confirmed the migration of the deflated balloon in the small bowel. It was impacted in the ileum so an enterostomy-suture was performed for removal. Intragastric balloons are temporarily used to obtain weight reduction in the super-obese prior to bariatric surgery and in patients who are not fit for surgery. They were shown to be effective in restoring the metabolic syndrome as well. The use of fluid-filled balloons seems preferable for early migration diagnosis and management. If the intragastric balloon remains inside longer than recommended, it tends to deflate and is prone for migration and intestinal obstruction. Follow-up investigations (monthly X-rays) are mandatory for early migration diagnosis. PMID:21783455

Moszkowicz, David; Lefevre, Jérémie H

2012-02-01

68

Endoscopic band ligation for bleeding lesions in the small bowel  

PubMed Central

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

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

2014-01-01

69

Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report  

PubMed Central

Introduction Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation. Case presentation A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery. Conclusion Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction. PMID:21951579

2011-01-01

70

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

PubMed Central

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

2014-01-01

71

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

PubMed Central

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

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

2015-01-01

72

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

73

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

74

Small bowel obstruction caused by congenital transmesenteric defect.  

PubMed

Transmesenteric hernias are extremely rare. A strangulated hernia through a mesenteric opening is a rare operative finding. Preoperative diagnosis still is difficult in spite of the imaging techniques currently available. The authors describe two cases of paediatric patients presenting with bowel obstruction resulting from a congenital mesenteric hernia. The first patient had a 3-cm wide congenital defect in the ileal mesentery through which the sigmoid colon had herniated. The second patient is a newborn infant who presented with symptoms and radiographic evidence of neonatal occlusion. At surgical exploration, a long segment of the small bowel had herniated in a defect in the ileal mesentery. A brief review of epidemiology and anatomy of transmesenteric hernias is included, along with a discussion of the difficulties in diagnosis and treatment of this condition. PMID:21478592

Nouira, F; Dhaou, Ben M; Charieg, A; Ghorbel, S; Jlidi, S; Chaouachi, B

2011-01-01

75

Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction  

PubMed Central

Background Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel. PMID:16978402

Tiwary, Satyendra K; Singh, Manish K; Khanna, Rahul; Khanna, Ajay K

2006-01-01

76

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

PubMed

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

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

2015-01-01

77

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

78

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

79

Postheparin plasma diamine oxidase values in the follow up of patients with small bowel Crohn's disease  

Microsoft Academic Search

Measurement of postheparin plasma diamine oxidase (PHD) activity has been proposed to assess mucosal integrity in several diseases of the small intestine. In Crohn's disease, PHD values identify a group of patients with predominantly small bowel mucosal damage. To determine the role of mucosal involvement in the progression of small bowel Crohn's disease and whether different PHD values can predict

L DAgostino; S Pignata; B Daniele; M Visconti; C Ferraro; G DAdamo; G Tritto; G Ambrogio; G Mazzacca

1991-01-01

80

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

PubMed

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

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

2015-01-16

81

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

PubMed Central

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

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

2015-01-01

82

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

83

NAD+ administration significantly attenuates synchrotron radiation X-ray-induced DNA damage and structural alterations of rodent testes  

PubMed Central

Synchrotron radiation (SR) X-ray has great potential for its applications in medical imaging and cancer treatment. In order to apply SR X-ray in clinical settings, it is necessary to elucidate the mechanisms underlying the damaging effects of SR X-ray on normal tissues, and to search for the strategies to reduce the detrimental effects of SR X-ray on normal tissues. However, so far there has been little information on these topics. In this study we used the testes of rats as a model to characterize SR X-ray-induced tissue damage, and to test our hypothesis that NAD+ administration can prevent SR X-ray-induced injury of the testes. We first determined the effects of SR X-ray at the doses of 0, 0.5, 1.3, 4 and 40 Gy on the biochemical and structural properties of the testes one day after SR X-ray exposures. We found that 40 Gy of SR X-ray induced a massive increase in double-strand DNA damage, as assessed by both immunostaining and Western blot of phosphorylated H2AX levels, which was significantly decreased by intraperitoneally (i.p.) administered NAD+ at doses of 125 and 625 mg/kg. Forty Gy of SR X-ray can also induce marked increases in abnormal cell nuclei as well as significant decreases in the cell layers of the seminiferous tubules one day after SR X-ray exposures, which were also ameliorated by the NAD+ administration. In summary, our study has shown that SR X-ray can produce both molecular and structural alterations of the testes, which can be significantly attenuated by NAD+ administration. These results have provided not only the first evidence that SR X-ray-induced tissue damage can be ameliorated by certain approaches, but also a valuable basis for elucidating the mechanisms underlying SR X-ray-induced tissue injury. PMID:22518270

Sheng, Caibin; Chen, Heyu; Wang, Ban; Liu, Tengyuan; Hong, Yunyi; Shao, Jiaxiang; He, Xin; Ma, Yingxin; Nie, Hui; Liu, Na; Xia, Weiliang; Ying, Weihai

2012-01-01

84

Intestinal Adaptation Following Small Bowel Resection in Human Infants  

PubMed Central

Purpose In animal models, the small intestine responds to massive small bowel resection (SBR) through a compensatory process termed adaptation, characterized by increases in both villus height and crypt depth. This study seeks to determine whether similar morphologic alterations occur in humans following SBR. Methods Clinical data and pathologic specimens of infants who had both a SBR for necrotizing enterocolitis (NEC) and an ostomy takedown from 1999–2009 were reviewed. Small intestine mucosal morphology was compared in the same patients at the time of SBR and the time of ostomy takedown. Results For all samples, there was greater villus height (453.6±20.4 vs. 341.2±12.4 ?m, p<0.0001) and crypt depth (178.6±7.2 vs. 152.6±6 ?m, p<0.01) in the ostomy specimens compared to the SBR specimens. In infants with paired specimens, there was an increase of 31.7±8.3% and 22.1±10.0% in villus height and crypt depth, respectively. There was a significant correlation between the amount of intestine resected and the percent change in villus height (r=0.36, p<0.05). Conclusion Mucosal adaptation after SBR in human infants is similar to what is observed in animal models. These findings validate the use of animal models of SBR utilized to understand the molecular mechanisms of this important response. PMID:21683196

McDuffie, Lucas A.; Bucher, Brian T.; Erwin, Christopher R.; Wakeman, Derek; White, Francis V.; Warner, Brad W.

2011-01-01

85

Laparoscopy for Small Bowel Obstruction in Children-An Update.  

PubMed

Abstract Introduction: We evaluated the current role of minimally invasive surgery (MIS) in children with small bowel obstruction (SBO) at our institution. Subjects and Methods: A retrospective review of patients undergoing MIS for acute SBO was performed from 2008 to 2013. The study population was compared with a historical control including patients from 2001 to 2008. Results: There were 71 patients who met inclusion criteria; 35 were male, and 36 were female. Sixty-two children underwent laparoscopy for their first episode of SBO, and 12 underwent laparoscopy for recurrent SBO, accounting for 74 episodes of SBO managed with MIS. The most common etiology of SBO was adhesions (n=40). Laparoscopy and laparoscopic-assisted procedures were associated with shorter nasogastric tube decompression (1.4±2 days [P<.001] and 1.5±2.7 days [P=.002], respectively) and time to regular diet (3.9±4 days [P=.002] and 4.6±2.8 days [P=.024], respectively) compared with those converted to laparotomy (5.1±4.9 days of nasogastric tube decompressions and 8±4.7 days to regular diet). There was no difference in postoperative morbidity comparing laparoscopy (11%), laparoscopic-assisted (5%), and laparoscopic converted to open procedures (18%) (P=.48). Conclusions: Laparoscopy continues to be a safe diagnostic and therapeutic tool in the management of pediatric SBO. PMID:25423020

Alemayehu, Hanna; David, Bryan; Desai, Amita A; Iqbal, Corey W; St Peter, Shawn D

2014-11-25

86

Where are we at with short bowel syndrome and small bowel transplant  

PubMed Central

Intestinal failure can be defined as the critical reduction of functional gut mass below the minimal amount necessary for adequate digestion and absorption to satisfy body nutrient and fluid requirements in adults or children. Short bowel syndrome (SBS) is characterized by a state of malabsorption following extensive resection of the small bowel. SBS may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel is left. Several treatment modalities other than total parenteral nutrition, including hormones (recombinant human growth hormone, glucagon-like peptide-2) and tailoring surgeries (Bianchi procedure, serial transverse enteroplasty), had been proposed, however these were either experimental or inefficient. Small bowel transplant is a rather new approach for SBS. The once feared field of solid organ transplantation is nowadays becoming more and more popular, even in developing countries. This is partially secondary to the developments in immunosuppressive strategy. In this regard, alemtuzumab deserves special attention. There are more complex surgeries, such as multivisceral transplantation, for multi-organ involvement including small bowel. This latter technique is relatively new when compared to small bowel transplant, and is performed in certain centers worldwide. In this review, an attempt is made to give an insight into small bowel syndrome, small bowel transplantation, and related issues. PMID:24175201

Yildiz, Baris Dogu

2012-01-01

87

Mesenteric Vasculature-guided Small Bowel Segmentation on 3D CT  

PubMed Central

Due to its importance and possible applications in visualization, tumor detection and pre-operative planning, automatic small bowel segmentation is essential for computer-aided diagnosis of small bowel pathology. However, segmenting the small bowel directly on 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.

2014-01-01

88

Reducing false positives of small bowel segmentation on CT scans by localizing colon regions  

NASA Astrophysics Data System (ADS)

Automated small bowel segmentation is essential for computer-aided diagnosis (CAD) of small bowel pathology, such as tumor detection and pre-operative planning. We previously proposed a method to segment the small bowel using the mesenteric vasculature as a roadmap. The method performed well on small bowel segmentation but produced many false positives, most of which were located on the colon. To improve the accuracy of small bowel segmentation, we propose a semi-automated method with minimum interaction to distinguish the colon from the small bowel. The method utilizes anatomic knowledge about the mesenteric vasculature and a statistical method of colon detection. First, anatomic labeling of the mesenteric arteries is used to identify the arteries supplying the colon. Second, a statistical detector is created by combining two colon probability maps. One probability map is of the colon location and is generated from colon centerlines generated from CT colonography (CTC) data. Another probability map is of 3D colon texture using Haralick features and support vector machine (SVM) classifiers. The two probability maps are combined to localize colon regions, i.e., voxels having high probabilities on both maps were labeled as colon. Third, colon regions identified by anatomical labeling and the statistical detector are removed from the original results of small bowel segmentation. The method was evaluated on 11 abdominal CT scans of patients suspected of having carcinoid tumors. The reference standard consisted of manually-labeled small bowel segmentation. The method reduced the voxel-based false positive rate of small bowel segmentation from 19.7%±3.9% to 5.9%±2.3%, with two-tailed P-value < 0.0001.

Zhang, Weidong; Liu, Jiamin; Yao, Jianhua; Summers, Ronald M.

2014-03-01

89

Hyperthermia, polyamine depletion, and inhibition of X-ray-induced DNA strand break repair  

SciTech Connect

We have recently demonstrated that HeLa cells that had been depleted of polyamines by treatment with inhibitors of polyamine biosynthesis were deficient in their ability to repair X-ray-induced DNA strand breaks. Since it had previously been demonstrated that hyperthermic shock also inhibited strand break repair following X irradiation and that hyperthermia resulted in a leakage of polyamines from cells, it seemed of interest to examine whether the inhibition of repair by hyperthermia was related to this loss of cellular polyamines. In the present paper it is demonstrated that both polyamine depletion and hyperthermia inhibit strand closure, and that a combined treatment further reduces the rate of repair. In cells not depleted of polyamines, repair is restored to normal levels if hyperthermia treatment is followed by a 4-h incubation at 37 degrees C before X irradiation. In polyamine-depleted cells, this 37 degrees C incubation does not result in a return of repair ability. Polyamine supplementation was not effective in reversing hyperthermia-dependent repair inhibition, and, in fact, restoration of repair in control cells following hyperthermic shock corresponded to a time at which polyamines show a maximum decrease in those cells. These results suggest that the inhibition of repair and the increased radiosensitivity observed in hyperthermically treated cells is not related to polyamine depletion. However, data further suggest that polyamine-depleted cells may have other alterations, perhaps in chromatin, which render them more sensitive to thermal inhibition of repair.

Snyder, R.D.; Lachmann, P.J. (Merrell Dow Research Institute, Cincinnati, OH (USA))

1989-10-01

90

XPS and IR study of X-ray induced degradation of PVA polymer film  

NASA Astrophysics Data System (ADS)

The X-ray induced compositional modification of a solvent cast polyvinyl alcohol [PVA, -(CH 2-HCOH) n-] polymer film was studied using X-ray photoelectron (XPS) and transmission infra-red (IR) spectroscopies. While the -CH 2 group was stable, the alcoholic -COH moiety was unstable under the X-ray beam (Mg K ? radiation: 1253.6 eV) and reached continuosly to produce three new C(1s) peaks assignable to carbonyl C=O (oxidation), carboxylate -COO (oxidative chain scission) and ether C-O-C linkages (crosslinking, dehydroxylation). Transmission FT-IR spectra of X-ray treated films showed the carbonyl stretch at 1700 cm -1 and a loss of intensity in the O-H stretching mode near 3340 cm -1. The results indicate that degradation occurs throughout the polymer bulk and is caused either directly, by X-ray photons, or by the secondary electrons generated within the polymer. The ease with which degration can be detected is sensitive to analyzer resolution, X-ray flux and precautionary measures.

Akhter, S.; Allan, K.; Buchanan, D.; Cook, J. A.; Campion, A.; White, J. M.

1988-12-01

91

X-ray-induced deterioration of disulfide bridges at atomic resolution.  

PubMed

Overall and site-specific X-ray-induced damage to porcine pancreatic elastase was studied at atomic resolution at temperatures of 100 and 15 K. The experiments confirmed that irradiation causes small movements of protein domains and bound water molecules in protein crystals. These structural changes occur not only at 100 K but also at temperatures as low as 15 K. An investigation of the deterioration of disulfide bridges demonstrated the following. (i) A decrease in the occupancy of S(?) atoms and the appearance of new cysteine rotamers occur simultaneously. (ii) The occupancy decrease is observed for all S(?) atoms, while new rotamers arise for some of the cysteine residues; the appearance of new conformations correlates with the accessibility to solvent. (iii) The sum of the occupancies of the initial and new conformations of a cysteine residue is approximately equal to the occupancy of the second cysteine residue in the bridge. (iv) The most pronounced changes occur at doses below 1.4 × 10(7) Gy, with only small changes occurring at higher doses. Comparison of the radiation-induced changes in an elastase crystal at 100 and 15 K suggested that the dose needed to induce a similar level of deterioration of the disulfide bonds and atomic displacements at 15 K to those seen at 100 K is more than two times higher. PMID:20944241

Petrova, Tatiana; Ginell, Stephan; Mitschler, Andre; Kim, Youngchang; Lunin, Vladimir Y; Joachimiak, Grazyna; Cousido-Siah, Alexandra; Hazemann, Isabelle; Podjarny, Alberto; Lazarski, Krzysztof; Joachimiak, Andrzej

2010-10-01

92

Small bowel perforation after drawing a blood sample in the femoral artery: a case report.  

PubMed

Small bowel perforation is a rare complication of femoral artery access in cases of femoral hernia. A 48-year-old woman was admitted to the intensive care unit due to pulmonary insufficiency. After a routine femoral arterial blood gas analysis, severe abdominal pain and nausea began. She underwent emergency laparotomy due to acute abdomen. Laparotomy revealed small bowel perforation. Segmental resection and end-to-end anastomosis were performed. The femoral canal was closed using plaque mesh. Special attention is needed during femoral artery access to avoid accidental small bowel perforation. As seen in this case, a careful examination should be done in cases of femoral hernia. PMID:20517757

Ara, Cengiz; Coban, Sacid; I?ik, Burak; Ozcan, Canan Ceran; Yilmaz, Sezai

2010-05-01

93

CT of nonneoplastic diseases of the small bowel: spectrum of disease.  

PubMed

This article reviews the CT imaging features of a variety of nonneoplastic conditions that affect the small bowel and stresses important distinctive patterns that may help distinguish specific entities. Various inflammatory conditions (Crohn disease, radiation enteritis, graft versus host disease, celiac disease, Whipple disease, eosinophilic gastroenteritis, Behçet disease) as well as infiltrative disorders (amyloidosis, lymphangiectasia) and infectious diseases (Mycobacterium avium intracellulare, cytomegalovirus, cryptosporidiosis) are reviewed, with key differential points emphasized. In addition, miscellaneous conditions such as ischemia, small bowel diverticulitis, and small bowel hemorrhage are discussed. PMID:10348449

Horton, K M; Corl, F M; Fishman, E K

1999-01-01

94

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

95

Small bowel obstruction due to an enterolith originating in a jejunal diverticulum.  

PubMed Central

A case of small bowel obstruction caused by an enterolith from a jejunal diverticulum is reported. As such diverticula are usually asymptomatic, the diagnosis was not entertained pre-operatively. Images Figure 1 Figure 2 PMID:3934654

Clarke, P. J.; Kettlewell, M. G.

1985-01-01

96

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

97

Effect of Portal Hypertension in the Small Bowel: An Endoscopic Approach  

Microsoft Academic Search

Background and aim The effects of portal hypertension in the small bowel are largely unknown. The aim of the study was to prospectively assess\\u000a portal hypertension manifestations in the small bowel. Methods We compared, by performing enteroscopy with capsule endoscopy, the endoscopic findings of 36 patients with portal hypertension,\\u000a 25 cirrhotic and 11 non-cirrhotic, with 30 controls. Results Varices, defined

Pedro Figueiredo; Nuno Almeida; Clotilde Lérias; Sandra Lopes; Hermano Gouveia; Maximino C. Leitão; Diniz Freitas

2008-01-01

98

Foreign body ingestion of blister pill pack causing small bowel obstruction  

Microsoft Academic Search

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

Angela W. Tai; Aaron Sodickson

2007-01-01

99

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

100

Reduction of Acute Rejection by Bone Marrow Mesenchymal Stem Cells during Rat Small Bowel Transplantation  

PubMed Central

Background Bone marrow mesenchymal stem cells (BMMSCs) have shown immunosuppressive activity in transplantation. This study was designed to determine whether BMMSCs could improve outcomes of small bowel transplantation in rats. Methods Heterotopic small bowel transplantation was performed from Brown Norway to Lewis rats, followed by infusion of BMMSCs through the superficial dorsal veins of the penis. Controls included rats infused with normal saline (allogeneic control), isogeneically transplanted rats (BN-BN) and nontransplanted animals. The animals were sacrificed after 1, 5, 7 or 10 days. Small bowel histology and apoptosis, cytokine concentrations in serum and intestinal grafts, and numbers of T regulatory (Treg) cells were assessed at each time point. Results Acute cellular rejection occurred soon after transplantation and became aggravated over time in the allogeneic control rats, with increase in apoptosis, inflammatory response, and T helper (Th)1/Th2 and Th17/Treg-related cytokines. BMMSCs significantly attenuated acute cellular rejection, reduced apoptosis and suppressed the concentrations of interleukin (IL)-2, IL-6, IL-17, IL-23, tumor necrosis factor (TNF)-?, and interferon (IFN)-? while upregulating IL-10 and transforming growth factor (TGF)-? expression and increasing Treg levels. Conclusion BMMSCs improve the outcomes of allogeneic small bowel transplantation by attenuating the inflammatory response and acute cellular rejection. Treatment with BMMSCs may overcome acute cellular rejection in small bowel transplantation. PMID:25500836

Zhang, Wen; Wu, Ben-Juan; Fu, Nan-Nan; Zheng, Wei-Ping; Don, Chong; Shen, Zhong-Yang

2014-01-01

101

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

SciTech Connect

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

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

1993-07-01

102

Strangulation Caused by a Small Bowel Epiploic Appendage: Report of a Case  

PubMed Central

While many recent cases of colonic epiploic appendage causing acute abdomen have been reported, such appendages of the small bowel are extremely rare. We present a 59-year-old woman in whom a small bowel epiploic appendage caused volvulus. She presented with abdominal pain and vomiting in the absence of previous abdominal operations. A diagnosis of small bowel obstruction from strangulation was made. Laparotomy disclosed bloody peritoneal fluid and a closed loop of strangulated small intestine. An adherent band composed of an epiploic appendage and intestine had completely encircled a loop of jejunum, leading to obstruction. This band was released, and approximately 80 cm of gangrenous bowel was resected. Four epiploic appendages 5–6 cm in length were attached to the ileum at the mesenteric border, beginning at a point 70 cm proximal to the terminal ileum. PMID:21490891

Nemoto, Hiroshi; Yoshizawa, Yasuo; Hibi, Kenji; Saito, Mitsuo; Ishibashi, Kazuyoshi; Sanada, Yutaka; Tate, Genshu

2008-01-01

103

Small bowel tumors detected and missed during capsule endoscopy: Single center experience  

PubMed Central

AIM: To characterize small bowel (SB) tumors detected by capsule endoscopy (CE), and identify missed tumors. METHODS: The study included 145 consecutive patients in whom 150 CEs were performed. Following CE, the medical records of the study population were reviewed. Results of double- or single-balloon enteroscopy performed after CE and the results of surgery in all patients operated on were retrieved. The patients were contacted through telephone interviews or postal mail. In addition, the national cancer registry and the polish clinical gastrointestinal stromal tumor (GIST) Registry were searched to identify missed neoplasms. RESULTS: Indications for CE included overt and occult obscure gastrointestinal bleeding (n = 81, 53.7%), anemia (n = 19, 12.7%), malabsorption (n = 18, 12%), abnormal CB follow through (n = 9, 6%), abdominal pain (n = 7, 5%), celiac disease (n = 5, 3%), neuroendocrine tumor (n = 3, 2%), Crohn’s disease (n = 2, < 2%), Peutz-Jeghers syndrome (n = 2, < 2%), other polyposes (n = 2, < 2%), and diarrhea (n = 2, < 2%). The capsule reached the colon in 115 (76.6%) examinations. In 150 investigations, CE identified 15 SB tumors (10%), 14 of which were operated on or treated endoscopically. Malignancies included metastatic melanoma (n = 1), adenocarcinoma (n = 2), and GIST (n = 3). Benign neoplasms included dysplastic Peutz-Jeghers polyps (n = 4). Non-neoplastic masses included venous malformation (n = 1), inflammatory tumors (n = 2), and a mass of unknown histology (n = 1). During the follow-up period, three additional SB tumors were found (2 GISTs and one mesenteric tumor of undefined nature). The National Cancer Registry and Polish Clinical GIST Registry revealed no additional SB neoplasms in the post-examination period (follow-up: range 4.2-102.5 mo, median 39 mo). The sensitivity of CE for tumor detection was 83.3%, and the negative predictive value was 97.6%. The specificity and positive predictive value were both 100%. CONCLUSION: Neoplasms may be missed by CE, especially in the proximal SB. In overt obscure gastrointestinal bleeding, complementary endoscopic and/or radiologic diagnostic tests are indicated. PMID:24379629

Zagorowicz, Edyta S; Pietrzak, Anna M; Wronska, Ewa; Pachlewski, Jacek; Rutkowski, Piotr; Kraszewska, Ewa; Regula, Jaroslaw

2013-01-01

104

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

PubMed Central

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

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

2013-01-01

105

Extraskeletal Ewings sarcoma of the small bowel: case report and literature review.  

PubMed

Extraskeletal Ewings sarcoma is a tumour of neuroectodermal origin sharing close similarities with Ewings sarcoma of bone. We report the case of a 21 year old 16 week pregnant woman presenting with vomiting and weight loss and found to have an extraskeletal Ewings sarcoma of the small bowel. In a review of the literature there are no previous reports of extraskeletal Ewings sarcoma occurring in the small bowel. The diagnosis of extraskeletal Ewings sarcoma and the complicated management of a young pregnant woman with a malignant tumour are described. PMID:11768578

Adair, A; Harris, S A; Coppen, M J; Hurley, P R

2001-12-01

106

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

SciTech Connect

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

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

1983-01-01

107

Effect of beta-carotene on spontaneous and X-ray-induced chromosomal damage in bone marrow cells of mice.  

PubMed

The effect of beta-carotene on spontaneous and X-ray-induced chromosomal damage in bone marrow cells of mice was studied. As a source of beta-carotene, dried Dunaliella bardawil (containing 6% beta-carotene) or oil suspension of Dunaliella beta-carotene was used. In Experiment 1, mice were given a basal diet, a 0.5% Dunaliella diet, or a 4% Dunaliella diet for four weeks. In Experiment 2, mice were given an oil suspension of Dunaliella beta-carotene (300 mg/kg body wt) by gavage for seven days while being fed a fat-rich diet. After beta-carotene treatment for the indicated time, spontaneous and X-ray (0.3 Gy, whole-body)-induced chromosomal damage in bone marrow cells was evaluated in terms of the percentages of micronucleated reticulocytes in their peripheral blood. The beta-carotene treatment slightly lowered the spontaneous and X-ray-induced chromosomal damage in bone marrow cells. Despite the higher doses of beta-carotene, the concentrations of beta-carotene in bone marrow, liver, and serum were much lower than those of vitamin E. In addition, the beta-carotene treatment markedly lowered the concentration of vitamin E in the tissues. PMID:7877897

Umegaki, K; Takeuchi, N; Ikegami, S; Ichikawa, T

1994-01-01

108

Relationship between enteral glucose load and adaptive mucosal growth in the small bowel  

Microsoft Academic Search

Infusion of hyperosmolar glucose solutions into small bowel will prevent mucosal atrophy or stimulate mucosal growth in rats otherwise maintained on total parenteral nutrition (TPN). It is not certain whether this growth effect is related to the osmolarity of the solution or its total molecular load. Therefore, various concentrations of glucose and sodium salt solutions were studied for comparative effects

Elliot Weser; Joanna Babbitt; Ann Vandeventer

1985-01-01

109

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

Microsoft Academic Search

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

Idan Burstein; Ran Steinberg; Michael Zer

2000-01-01

110

Modifications in ornithine decarboxylase and diamine oxidase in small bowel mucosa of starved and refed rats  

Microsoft Academic Search

Starvation followed by refeeding, which provides a model of intestinal adaptation characterised by proliferative and biochemical changes, was used to clarify the biological roles of ornithine decarboxylase (ODC) and diamine oxidase (DAO)--enzymes involved in polyamines metabolism. Ornithine decarboxylase and DAO were assayed in the proximal and distal small bowel mucosa of 55 rats, starved for four days and then refed.

L DAgostino; B Daniele; S Pignata; M V Barone; G DArgenio; G Mazzacca

1987-01-01

111

Histological abnormalities of the small bowel mucosa in cirrhosis and portal hypertension  

Microsoft Academic Search

AIM: To study the small bowel (SB) mucosa on biopsy in cirrhotic patients with portal hypertension and in non-cirrhotic controls and grade findings according to the Marsh criteria. METHODS: We prospectively enrolled 51 consecutive patients undergoing an upper endoscopy for their routine medical care. Twenty five patients with cirrhosis and portal hypertension were compared to 26 controls. We obtained coeliac

Wakim-Fleming J; Zein NN; Bennett A; Lopez R; Santisi J; Nizar N Zein; William D Carey

112

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

PubMed Central

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

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

2014-01-01

113

Postheparin plasma diamine oxidase in subjects with small bowel mucosal atrophy  

Microsoft Academic Search

Diamine oxidase (DAO) is an enzyme whose low plasma values are enhanced by an intravenous injection of heparin, which releases the enzyme from the enterocytes of the villous tips. In 20 normal controls and 15 untreated subjects affected with an overt malabsorption syndrome and subtotal atrophy shown by Crosby jejunal mucosa biopsy (12 suspected celiac disease and three small bowel

Luciano D'agostino; Carolina Ciacci; Bruno Daniele; Maria Vittoria Barone; Rosa Sollazzo; Gabriele Mazzacca

1987-01-01

114

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

Microsoft Academic Search

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

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

1991-01-01

115

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

116

Multidetector CT of the small bowel: evaluation after oral hyperhydration with isotonic solution.  

PubMed

PURPOSE: The aim of our study was to assess the diagnostic capabilities of multidetector CT in the evaluation of the small bowel in different pathological conditions, with the use of oral hyperhydration with isotonic solution. MATERIALS AND METHODS: The study retrospectively evaluated 106 patients who underwent multidetector CT of the small bowel. Four groups were considered on the basis of the clinical findings: group A (48 cases), with suspected or certain chronic inflammatory disease of the small bowel; group B (16 cases), with suspected neoplastic lesion of the small bowel; group C (17 cases), patients affected by malabsorption; group D (25 cases), others: 13 cases with non-specific abdominal pain, 4 cases with occult bleeding, 8 cases affected by fever of unknown origin. Thirteen patients had previously undergone surgical intestinal resection. In all cases the CT examination was performed after the oral administration of 2000 mL polyethylene glycol electrolyte balanced solution; before the scan, N-butyl scopolamine or glucagon were administered intravenously to obtain rapid inhibition of bowel peristalsis. All multidetector CT scans were acquired at baseline and 50 seconds after the I.V. administration of 110-130 ml high-concentration non-ionic iodinated contrast medium. The images were subsequently processed on a dedicated workstation (Advantage Windows 4.0, GE Medical Systems) to obtain multiplanar reconstruction (MPR). We considered the following CT findings: fold distribution, wall thickening and stratification and contrast enhancement, extraparietal involvement and abnormalities of the abdominal organs. The CT diagnoses were compared with the clinical and laboratory findings (86 cases) and with the results of barium follow-through (55 cases), ileo-colonoscopy (45 cases) or surgery (28 cases). RESULTS: CT examination allowed the correct diagnosis in 86/106 cases (89%); 20 patients were not included in the study because of a poor (11 cases) or absent (9 cases) small bowel loop distension. The final diagnoses in the 86 patients were: Crohn's disease of the small bowel (38 cases), Crohn's disease of the duodenum (1 case), granulomatous colitis (3 cases), malabsorption (8 cases), neoplastic lesion (4 cases), post-radiation conglomeration of ileal loops (1 case), intestinal lymphangiectasia (1 case), ulceration of the last ileal loop (1 case). In 29 cases no abnormalities of the small bowel were found. Spiral CT yielded 52 true positive cases, 5 false negative cases, 2 false positive cases, and 27 true negative RESULTS: The sensitivity of the technique was 91%, specificity 93% and diagnostic accuracy 92%. CONCLUSIONS: Multidetector CT of the small bowel performed after oral hyperhydration with isosmotic solution, proved to be an accurate and thorough technique. It can be considered a safe and effective alternative to conventional radiographic studies and to small bowel spiral CT enema in patients that refuse the nasojejunal balloon catheter or the administration of methylcellulose. PMID:15973225

Mazzeo, S; Caramella, D; Belcari, A; Melai, L; Cappelli, C; Fontana, F; Bertini, R; Caproni, G; Giusti, P; Bartolozzi, C

2005-01-01

117

Pulmonary aspiration complicating intraoperative small-bowel decompression: a case report and literature review  

PubMed Central

When conservative management of intestinal obstruction fails, the surgeon has two operative choices for decompression: the open procedure with enterotomies and suction and the closed procedure consisting of retrograde stripping and nasogastric suction. A previously undocumented complication of the latter procedure — pulmonary aspiration — is reported in a 20-year-old man with small-bowel obstruction. Practical modifications to the technique of small-bowel decompression are suggested. They include feeding the nasogastric tube into the distal duodenum, using a wider bore tube, inserting an esophageal balloon before extubation, using a nasogastric tube with suction throughout extubation and, immediately postoperatively, making a more conscious effort to remove all gastric contents before extubation, and milking the contents distally through the ileocecal valve. PMID:8956817

Phillips, Ian; Jamieson, Christopher G.

1996-01-01

118

Imaging of the small bowel: Crohn’s disease in paediatric patients  

PubMed Central

In more than 20% of all patients, the Crohn’s disease presents before the age of 18years. The diagnosis and management of Crohn’s disease in children has changed dramatically over the last decade, mainly due to increased awareness, availability of newer diagnostic modalities such as magnetic resonance imaging (MRI) and newer, more powerful treatments such as biologics. Imaging of the small bowel is needed for diagnosis, management, follow-up and also evaluation of the disease in terms of location, extent, activity and complications. We review all the methods (barium examinations, ultrasonography, computed tomography, MR, and computed tomography- positron emission tomography) commonly used for imaging the small bowel in paediatric patients with Crohn’s disease analyzing the advantages and disadvantages of each modality, with particular emphasis on MR imaging. PMID:24976933

Casciani, Emanuele; De Vincentiis, Chiara; Polettini, Elisabetta; Masselli, Gabriele; Di Nardo, Giovanni; Civitelli, Fortunata; Cucchiara, Salvatore; Gualdi, Gian Franco

2014-01-01

119

Perforation of the small bowel due to metastasis from tongue cancer.  

PubMed

Distant small bowel metastases from head and neck squamous cell carcinomas are extremely rare, and tongue cancer metastasizing to the small bowel has not been previously reported. We describe a 40-year-old male patient who underwent subtotal gross laryngectomy for squamous cell carcinoma of the tongue in February 2007 and then presented in November 2008 with severe abdominal pain. Abdominal computed tomography (CT) and X-rays revealed free air, suggesting intestinal perforation. Emergency surgery revealed a 10-mm perforation at the ileum and a palpable hard tumor at the perforation site. The ileum was resected, and pathologic findings showed squamous cell carcinoma at the perforation site, which was consistent with metastasis from tongue cancer. PMID:21675628

Aoyagi, Yoshiko; Matsuda, Keiji; Shimada, Ryu; Horiuchi, Atsushi; Shibuya, Hajime; Nakamura, Keisuke; Iinuma, Hisae; Hayama, Tamuro; Yamada, Hideki; Nozawa, Keijiro; Ishihara, Soichiro; Watanabe, Toshiaki

2011-01-01

120

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

121

Small bowel involvement in blue rubber bleb nevus syndrome: MR imaging features  

Microsoft Academic Search

Blue rubber bleb nevus syndrome (BRBNS) is a rare condition which is characterized by multiple venous malformations that may\\u000a affect several organs. Gastrointestinal lesions, which mostly involve the small bowel and distal colon, may be responsible\\u000a for gastrointestinal bleeding, causing more frequently chronic anemia. We report herein two cases of BRBNS causing gastrointestinal\\u000a bleeding which were investigated by means of

Myriam Mechri; Philippe Soyer; Mourad Boudiaf; Florent Duchat; Lounis Hamzi; Roland Rymer

2009-01-01

122

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

123

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

PubMed Central

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

Cavaness, Keith; Celinski, Scott; Preskitt, John

2014-01-01

124

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

PubMed

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

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

2014-11-01

125

The barrier function of CYP3A4 and P-glycoprotein in the small bowel  

Microsoft Academic Search

CYP3A4 present in small bowel enterocytes can catalyze substantial metabolism of some orally administered drugs and, thus, exerts a first-pass effect. Recent data indicate that the P-glycoprotein (the MDR 1 gene product) in the enterocyte brush border also limits the bioavailability of many of the same drugs that interact with CYP3A. It has been proposed that P-glycoprotein and CYP3A4 may

Paul B Watkins

1997-01-01

126

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

Microsoft Academic Search

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

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

1994-01-01

127

Small bowel intussussception due to metastatic melanoma of unknown primary site. Case report  

PubMed Central

Malignant melanoma is characterized by metastases also to the gastrointestinal tract, especially in the small bowel. The diagnosis is often delayed because unspecific clinical presentation (frequently as chronic iron deficiency anemia, rectal bleeding or intestinal obstruction). We present a case of melanoma of unknown primary site, with clinical presentation of intestinal obstruction. A segmental resection of the ileum was performed including mesentery with lymph nodes. Histology revealed metastatic melanoma from unknown primary. PET and MRI confirmed disseminated disease without brain metastasis. PMID:25419593

STAGNITTI, F.; ORSINI, S.; MARTELLUCCI, A.; TUDISCO, A.; AVALLONE, M.; AIUTI, F.; DI GIROLAMO, V.; STEFANELLI, F.; DE ANGELIS, F.; COSTANTINO, A.; DI GRAZIA, C.; NAPOLEONI, A.; NICODEMI, S.; CIPRIANI, B.; CECI, F.; MOSILLO, R.; CORELLI, S.; CASCIARO, G.; SPAZIANI, E.

2014-01-01

128

Small bowel intussussception due to metastatic melanoma of unknown primary site. Case report.  

PubMed

Malignant melanoma is characterized by metastases also to the gastrointestinal tract, especially in the small bowel. The diagnosis is often delayed because unspecific clinical presentation (frequently as chronic iron deficiency anemia, rectal bleeding or intestinal obstruction). We present a case of melanoma of unknown primary site, with clinical presentation of intestinal obstruction. A segmental resection of the ileum was performed including mesentery with lymph nodes. Histology revealed metastatic melanoma from unknown primary. PET and MRI confirmed disseminated disease without brain metastasis. PMID:25419593

Stagnitti, F; Orsini, S; Martellucci, A; Tudisco, A; Avallone, M; Aiuti, F; Di Girolamo, V; Stefanelli, F; De Angelis, Francesco; Di Grazia, C; Napoleoni, A; Nicodemi, S; Cipriani, B; Ceci, F; Mosillo, R; Corelli, S; Casciaro, G; Spaziani, E

2014-01-01

129

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

PubMed Central

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

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

2014-01-01

130

Effect of massive small bowel resection on the bax\\/bcl- w ratio and enterocyte apoptosis  

Microsoft Academic Search

Following small bowel resection (SBR), the remnant intestine undergoes adaptation. Enterocyte proliferation is increased and\\u000a counterbalanced by increased rates of apoptosis. To elucidate a mechanism for increased enterocyte apoptosis, this study tested\\u000a the hypothesis that the ratio between pro-apoptotic Bax and pro-survival Bcl- w correlates with the apoptosis that occurs following SBR. Mice (C57B1\\/6; n = 76) underwent a 50%

Lawrence E. Stern; Richard A. Falcone; Christopher J. Kemp; Lorie A. Stuart; Christopher R. Erwin; Brad W. Warner

2000-01-01

131

Metastatic squamous cell carcinoma from hand skin causing small bowel obstruction: an unusual case presentation  

PubMed Central

The small bowel rarely suffers from metastatic tumors from outside the abdomen. Small bowel obstructions caused by the metastatic spread of squamous cell carcinoma (SCC) of the hand to the intestines are even rarer. A 71-year-old man with intermittent abdominal distension and pain for 4 months was diagnosed with partial bowel obstruction. The patient underwent a video capsule endoscopic examination; however, the patient was unable to pass the capsule, which worsened the abdominal distension. He was transferred to our department for acute intestinal obstruction, and an emergency exploratory laparotomy was performed. Intraoperatively, a tumoral stricture of the intestine at a distance of 150 cm from the ileo-cecum and dilation of the proximal bowel was found. The involved segment was resected, and ileo-ileal anastomosis was performed. The pathological sections confirmed the lesion to be a moderately differentiated SCC with whole bowel layer infiltration. Immunohistochemical staining showed positive expression of cytokeratin 5/6 and p63. The patient had an uneventful recovery. However, 6 months later, he was hospitalized again with intestinal obstruction. Reoperation was performed and revealed multiple metastases in the small bowel. He died 4 months later. In this unusual case, metastasizing SCC of the hand skin led to intestinal obstruction and poor prognosis. Therefore, follow-up procedures regarding intestinal spread should be performed in patients with SCC who present with abdominal symptoms. PMID:24885006

2014-01-01

132

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

PubMed Central

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

Al Beteddini, Osama S.; Sherkawi, Emad

2014-01-01

133

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

PubMed

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

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

2015-01-01

134

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

PubMed Central

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

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

1996-01-01

135

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

PubMed Central

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

Koulaouzidis, Anastasios; Rondonotti, Emanuele; Karargyris, Alexandros

2013-01-01

136

Angiosarcoma of Small Bowel Presenting with Obstruction: Novel Observations on a Rare Diagnostic Entity with Unique Clinical Presentation  

PubMed Central

We present a case of angiosarcoma in small bowel, presenting with partial small bowel obstruction in a 79-year-old man with no history of radiation, chemotherapy, toxin exposure, or previous operative intervention. Angiosarcoma of small bowel is a rare entity which may present with nausea, abdominal pain, recurrent bleeding, and usually a history of prior radiation or exposure to specific toxins (polyvinyl chloride). Angiosarcoma of small bowel tends to spread rapidly and has a poor prognosis. We review the surgical and oncologic challenges. We report unique macroscopic findings of raised hyperemic margins, which are suggestive of a vasogenic lesion and the histologic feature of a partially retiform pattern with dense basement membrane material in an otherwise poorly differentiated lesion. PMID:23198186

Siderits, Richard; Poblete, Frederick; Saraiya, Biren; Rimmer, Cheryl; Hazra, Anup; Aye, Le

2012-01-01

137

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

PubMed Central

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

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

2014-01-01

138

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

139

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

PubMed

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; Tan, Benjamin R

2014-02-01

140

Method for assessing X-ray-induced hydroxyl radical-scavenging activity of biological compounds/materials  

PubMed Central

A method for correctly assessing hydroxyl radical scavenging activity of antioxidative chemicals and/or biological compounds/materials was proposed. This method can simultaneously assess two factors, i.e. hydroxyl radical-scavenging and 5,5-dimethyl-2-hydroxy-1-pyrrolidine-N-oxide (hydroxyl radical adduct of 5,5-dimethyl-1-pyrroline-N-oxide)-reducing ability, as antioxidative properties. In this paper, some biologically common hydrophilic molecules, cell culture media, and rat plasma were tested. X-ray-induced hydroxyl radical can be detected using the electron paramagnetic resonance spin trapping technique. Using X-ray irradiation of the reaction mixture as the hydroxyl radical source, the true hydroxyl radical-scavenging ability of the subjected antioxidant can be assessed. In addition, the method simultaneously measures the reduction of 5,5-dimethyl-2-hydroxy-1-pyrrolidine-N-oxide, to estimate the reducing ability of the antioxidant. Biological materials, such as sugars and proteins, could abolish hydroxyl radical at the biological concentration. Ascorbic acid showed reducing ability at the biological concentration. The simultaneous assessment of hydroxyl radical-scavenging and reducing ability of antioxidants can be an informative index for antioxidants. PMID:23525190

Ueno, Megumi; Nakanishi, Ikuo; Matsumoto, Ken-ichiro

2013-01-01

141

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

PubMed Central

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

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

2015-01-01

142

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

143

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

SciTech Connect

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

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

2009-05-01

144

CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease  

PubMed Central

Objective The aim of the study is to compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease. Methods 145 patients underwent abdominal contrast-enhanced 16-row multidetector CT after administration of 2000 ml of PEG by mouth (n = 75) or after administration of 2000 ml of methylcellulose by nasojejunal tube (n = 70). Small bowel distension, luminal and extraluminal findings were evaluated and compared with small bowel follow-through examination in 60 patients, double contrast enema in 50, surgery in 25 and endoscopy in 35. Statistical evaluation was carried out by ?2 testing. For both techniques we have also calculated the effective dose and the equivalent dose in a standard patient. Results Crohn's disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p<0.05: statistically significant difference). No significant difference was present for others sites (p>0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv). Conclusion PEG-CT shows findings of Crohn's disease as well as CT-E does, although CT-E gives better bowel distension, especially in the jejunum, and has higher specificity than PEG-CT. PMID:20959377

Minordi, L M; Vecchioli, A; Mirk, P; Bonomo, L

2011-01-01

145

Non-operative successful management of a perforated small bowel diverticulum  

PubMed Central

Jejunoileal diverticula are rare and generally asymptomatic. In the few cases of patients who develop complications such as diverticulitis, perforation, obstruction, and/or hemorrhage, conventional treatment consists of surgical resection. We describe a case of perforated jejunoileal diverticulum with localized abscess and highlight the merits of surgical vs medical management. The patient is a 77-year-old male who presented with sharp, constant abdominal pain just inferior to the umbilicus. Administration of intravenous antibiotics results in complete and long-term resolution of the patient’s symptoms. In this report, we establish a framework for safely treating perforated small bowel diverticulum without surgical exploration.

Levack, Melissa M; Madariaga, Maria Lucia; Kaafarani, Haytham MA

2014-01-01

146

Can we improve the diagnostic yield of small bowel video-capsule endoscopy?  

PubMed Central

Video-capsule endoscopy has revolutionized the examination of small bowel mucosa. However, this modality is relatively young and its diagnostic yield is low. Herein, we discuss different approaches to improve examination’s diagnostic yield. There are strong data supporting some of them while there is speculation about the rest. As capsule endoscopy continues to evolve there is also a strong belief that technology will overcome at least some of the obstacles that hamper capsule endoscopy’s diagnostic yield sometime in the near future. PMID:21160741

Triantafyllou, Konstantinos

2010-01-01

147

Small bowel parasitosis as cause of obscure gastrointestinal bleeding diagnosed by capsule endoscopy  

PubMed Central

Hookworm infection is a relatively common cause of anemia in endemic areas. However, it is rarely encountered in Europe. In this report we describe the case of a 24-year old patient originating from an endemic area who was admitted due to severe anemia, with an Hct of 15.6% and eosinophilia (Eosinophils: 22.4%). While both esophagogastroduodenoscopy and colonoscopy were non-diagnostic, capsule endoscopy revealed a large number of hookworms infesting his small bowel and withdrawing blood. The patient was successfully treated with Albendazole. Capsule endoscopy was proven an important tool in diagnosing intestinal parasitosis. PMID:21173914

Christodoulou, Dimitrios K; Sigounas, Dimitrios E; Katsanos, Konstantinos H; Dimos, Georgios; Tsianos, Epameinondas V

2010-01-01

148

Chylopericardium in a child with impaired venous access following small bowel transplantation.  

PubMed

A 10-yr-old child with impaired venous access (bilateral occlusion of internal jugular veins, subclavian veins, and inominate veins) underwent an isolated small bowel transplant. He presented with lethargy, shortness of breath 13 months into his follow-up and was diagnosed to have chylopericardium. MR venography and lymphangiography could not demonstrate the site of lymphatic leak. His chyloperciardium was treated with pericardiocentesis and MCT diet. The most likely cause for the chylopericardium was venous occlusion of the subclavian veins with backpressure resulting in a lymphatic leak. A brief review of literature along with treatment options is discussed. PMID:19843235

Bhole, V; Gozzini, S; Stumper, O; Advani, S; Sullivan, P B; Rodrigues, A F; Gupte, G L

2011-05-01

149

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

PubMed Central

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

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

2014-01-01

150

Occurrence of mutations in the epidermal growth factor receptor gene in X-ray-induced rat lung tumors.  

PubMed

Epidermal growth factor receptor (EGFR) gene alterations have been found in human lung cancers. However, there is no information on the factors inducing EGFR mutations. In rodents, K-ras mutations are frequently found in many lung carcinogenesis models, but hitherto, Egfr mutations have not been reported. Their presence was therefore investigated in representative lung carcinogenesis models with 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosobis(2-hydroxypropyl)amine (BHP), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and ethyl carbamate (urethane), as well as X-ray irradiation. With the chemical carcinogenesis models, no mutations were detected in Egfr, which is in clear contrast to the high rates observed in either codon 12 or 61 of K-ras (21/23 of the lung tumors induced with NNK, 4/5 with MeIQx, 1/4 with urethane and 7/18 with BHP). However, in the X-ray-induced lung tumors, Egfr mutations with amino acid substitution were observed in exons 18 and 21 (4/12, 33%), but no activating mutation of K-ras was detected. In addition, one and four silent mutations were identified in K-ras (exon 1) and Egfr (exons 18, 20 and 21), respectively. Most mutations in both Egfr and K-ras were G/C-->A/T transitions (7/8, 88% and 31/34, 91%, respectively). Although, the mutational patterns in equivalent human lesions were not completely coincident, this first report of Egfr mutations in an experimental lung tumor model suggests that X-rays or other factors producing oxygen radicals could cause EGFR mutations in some proportion of lung cancers in humans. PMID:18271921

Kitahashi, Tsukasa; Takahashi, Mami; Yamada, Yutaka; Oghiso, Yoichi; Yokohira, Masanao; Imaida, Katsumi; Tsutsumi, Masahiro; Takasuka, Nobuo; Sugimura, Takashi; Wakabayashi, Keiji

2008-02-01

151

Cellular proliferation in the skin of X-rayed newt limbs (with a note on x-ray-induced limb regression)  

SciTech Connect

Left hind limbs, including the pelvis, of adult newts (Notophthalmus viridescens) were locally irradiated with a dose of x-rays that inhibited regeneration (2,000 R). This x-ray dose and other doses (700-2,000 R) capable of inhibiting limb regeneration also cause limb regression prior to amputation. Before limb regression occurred, there was a latent period of 3 to 6 weeks. Limb regression was characterized by necrotic wasting and resorption of distal elements. The degree of loss was variable and dependent upon dosage. After this further degenerative changes were not noted. Proliferation of epidermal cells was examined 4 days after irradiation prior to limb regression or after x-ray-induced degeneration of the limbs had ended. Proliferative activity in x-rayed limbs was also compared at various stages of contralateral control limb regeneration. Limbs examined after x-ray-induced limb regression had ended showed levels of (/sup 3/H)-thymidine incorporation into DNA comparable to normal epidermis. In contrast, limbs examined 4 days after irradiation had lower levels of DNA synthesis (P much less than 0.01). Amputation of limbs in both groups caused an increase in DNA synthesis (P much less than 0.01). Histological examination showed that cellular proliferation was associated primarily with the epidermis. These results indicate that epidermal cell proliferation was not resistant to x-rays. However, levels of normal cell division were observed after amputation of after cessation of x-ray-induced limb regression.

Wertz, R.L.

1982-07-01

152

Small Bowel Obstruction Caused by an Incarcerated Hernia after Iliac Crest Bone Harvest  

PubMed Central

The iliac crest has become an often used site for autogenous bone graft, because of the easy access it affords. One of the less common complications that can occur after removal is a graft-site hernia. It was first reported in 1945 (see the work by Oldfield, 1945). We report a case of iliac crest bone hernia in a 53-year-old male who was admitted for elective resection of a pseudarthrosis and reconstruction of the left femur with iliac crest bone from the right side. One and a half months after initial surgery, the patient presented with increasing abdominal pain and signs of bowel obstruction. A CT scan of the abdominal cavity showed an obstruction of the small bowel caused by the bone defect of the right iliac crest. A laparoscopy showed a herniation of the small bowel. Due to collateral vessels of the peritoneum caused by portal hypertension, an IPOM (intraperitoneal onlay-mesh) occlusion could not be performed. We performed a conventional ventral hernia repair with an onlay mesh. The recovery was uneventful. PMID:22084778

d'Hondt, Steven; Soysal, Savas; Kirchhoff, Philipp; Oertli, Daniel; Heizmann, Oleg

2011-01-01

153

Small bowel polypectomy by double balloon enteroscopy: Correlation with prior capsule endoscopy  

PubMed Central

AIM: To investigate the feasibility of small bowel polypectomy using double balloon enteroscopy and to evaluate the correlation with capsule endoscopy (CE). METHODS: This is a retrospective review of a single tertiary hospital. Twenty-five patients treated by enteroscopy for small bowel polyps diagnosed by CE or other imaging techniques were included. The correlation between CE and enteroscopy (correlation coefficient of Kendall for the number of polyps, intra-class coefficient for the size and coefficient of correlation kappa for the location) was evaluated. RESULTS: There were 31 polypectomies and 12 endoscopic mucosal resections with limited morbidity and no mortality. Histological analysis revealed 27 hamartomas, 6 adenomas and 3 lipomas. Strong agreement between CE and optical enteroscopy was observed for both location (Kappa value: 0.90) and polyp size (Kappa value: 0.76), but only moderate agreement was found for the number of polyps (Kendall value: 0.47). CONCLUSION: Double balloon enteroscopy is safe for performing polypectomy. Previous CE is useful in selecting the endoscopic approach and to predicting the difficulty of the procedure. PMID:23678374

Rahmi, Gabriel; Samaha, Elia; Lorenceau-Savale, Camille; Landi, Bruno; Edery, Joël; Manière, Thibault; Canard, Jean-Marc; Malamut, Georgia; Chatellier, Gilles; Cellier, Christophe

2013-01-01

154

[Recurrent small-bowel intussusceptions revealing a disseminated BCG infection related to severe combined immunodeficiency].  

PubMed

Infant small-bowel intussusceptions, most of the time idiopathic, may exceptionally reveal a severe digestive disease. We report the case of a 4-month-old infant who presented multiple and simultaneous ileal intussusceptions associated with severe acute gastroenteritis. Initially, the infant showed a protein-losing enteropathy with a clear alteration of the general state of health and undocumented fever, resistant to broad-spectrum antibiotic therapy. Skin and splenic nodules associated with hepatosplenomegaly and pancytopenia set in progressively. The etiologic evaluation led to the diagnosis of a Mycobacterium bovis BCG infection related to severe combined immune deficiency. The treatment consisted in anti-tuberculosis quadruple therapy in association with immunoglobin supplementation. Secondarily, the patient underwent gene therapy in a clinical trial. An early BCG vaccine in the first weeks of life, before the outbreak of infection revealing the immune deficiency, is a risk factor in triggering a disseminated BCG infection in immunodepressed infants. This clinical case is the first reported of severe combined immune deficiency revealed by small-bowel intussusceptions related to a disseminated BCG infection. PMID:24962783

Venaille, A; Viola, S; Peycelon, M; Grand d'Esnon, A; Fasola, S; Audry, G; Ducou Le Pointe, H; Tounian, P

2014-08-01

155

Nonoperative management of small-bowel obstruction with endoscopic long intestinal tube placement.  

PubMed

Intestinal obstruction remains a major cause of morbidity and mortality in surgical patients. We reviewed the records of 77 patients with mechanical small-bowel obstruction who were treated with endoscopically and fluoroscopically placed Leonard long intestinal tube decompression. Most patients (59%) had failed a trial of nasogastric tube or Miller-Abbott tube decompression. Overall, 29 per cent of patients were able to resolve their obstruction with Leonard tube decompression alone. Subdivision of patients on the basis of the etiology of their obstruction demonstrated a much higher rate of success for tube decompression in adhesive obstruction (37%) versus malignant obstruction (12%) or inflammatory obstruction (no successes). Patients with radiographic and clinical evidence of complete intestinal obstruction were significantly less likely to respond to long intestinal tube treatment (13%). The long intestinal tube was easily passed in all patients. There were no complications of the intubation procedure in our series, and the incidence of tube-related complications was four per cent. We conclude that an initial period of long intestinal tube decompression allows a significant percentage of patients with mechanical small-bowel obstruction to be treated nonoperatively, particularly if a partial obstruction from postoperative adhesions is present. Patients who have failed a trial of nasogastric tube decompression and are poor operative risks should also be considered for long intestinal tube placement. PMID:2221605

Snyder, C L; Ferrell, K L; Goodale, R L; Leonard, A S

1990-10-01

156

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

PubMed Central

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

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

2014-01-01

157

The weekend effect: does time of admission impact management and outcomes of small bowel obstruction?  

PubMed Central

Aims: To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction. Methods: A retrospective database review was carried out, covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004–2011. Results: A total of 404 patients met the inclusion criteria. One hundred and thirty-nine were admitted during the day, 93 at night and 172 on the weekend. Overall 30.2% of the patients were managed operatively with no significant difference between the groups (P = 0.89); however, of patients taken to the operating room, patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend, 0.79 days vs 1.90 days, respectively (P = 0.05). Overall mortality was low at 1.7%, with no difference noted between the groups (P = 0.35). Likewise there was no difference in morbidity rates between the three groups (P = 0.90). Conclusions: Despite a faster time to operative intervention in those patients admitted during the day, our study revealed that time of admission does not appear to correlate to patient outcome or mortality. PMID:25008263

McVay, Derek P.; Walker, Avery S.; Nelson, Daniel W.; Porta, Christopher R.; Causey, Marlin W.; Brown, Tommy A.

2014-01-01

158

An unusual case of biliary bezoar causing small bowel obstruction in a patient with ampullary diverticulum and stapled gastroplasty.  

PubMed

Primary small bowel bezoars constitute 0.44% of small bowel obstructions (SBO). We report a case of a man with a history of gastroplasty who presented with lower abdominal pain. Initial examination revealed leucocytosis and serum lipase. CT of the abdomen/pelvis was consistent with pancreatitis, cholelithiasis and a stable, 3.8?cm, ampullary diverticulum, without obstruction of the pancreatic/common bile duct. Considering this was the patient's first episode of pancreatitis with evidence of cholelithiasis, it seemed prudent that he would benefit from cholecystectomy but not diverticulectomy. Post-cholecystectomy he represented to the hospital with biliary emesis. CT of the abdomen/pelvis revealed postsurgical changes. Owing to non-resolution of the symptoms, 48?h later a small bowel follow-through was obtained that suggested partial SBO. Ultimately, the patient was taken for exploratory laparoscopy and small bowel resection, after a large intramural mass was encountered in the small bowel. Final pathology revealed a 3?cm biliary bezoar causing obstruction and stercoral ulceration. PMID:25498113

Ashfaq, Awais; Madura, James A; Chapital, Alyssa B

2014-01-01

159

The diagnostic value of double-balloon enteroscopy in children with small bowel disease: Report of 31 cases  

PubMed Central

BACKGROUND AND OBJECTIVE: Before the introduction of double-balloon enteroscopy (DBE), it was impossible to visualize the entire small bowel. Its diagnostic yield has been assessed in adults, but not yet in children. The present retrospective study evaluated the diagnostic usefulness and safety of DBE in children with suspected small bowel disease. METHODS: Between June 2003 and June 2007, 31 patients (19 boys and 12 girls, age range three to 14 years) with suspected small bowel disease underwent DBE after receiving negative evaluations using other diagnostic modalities. RESULTS: There were no severe complications. In two patients, the entire small bowel was viewed using oral and anal approaches, and for the remaining 29 patients, only one approach was used. The sites of disease in were identified in 25 of 31 cases (80.65%). The bleeding source was found in 21 of 27 patients with obscure gastrointestinal bleeding (diagnostic rate of 77.78%). Different diseases were identified in four children with chronic diarrhea. CONCLUSION: DBE is a safe and effective method to diagnose patients with suspected small bowel disorders. PMID:19816629

Liu, Wei; Xu, Chundi; Zhong, Jie

2009-01-01

160

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

PubMed

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

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

2015-01-01

161

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

PubMed Central

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

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

2014-01-01

162

Optimizing lesion detection in small-bowel capsule endoscopy: from present problems to future solutions.  

PubMed

This review presents issues pertaining to lesion detection in small-bowel capsule endoscopy (SBCE). The use of prokinetics, chromoendoscopy, diagnostic yield indicators, localization issues and the use of 3D reconstruction are presented. The authors also review the current status (and future expectations) in automatic lesion detection software development. Automatic lesion detection and reporting, and development of an accurate lesion localization system are the main software challenges of our time. The 'smart', selective and judicious use (before as well as during SBCE) of prokinetics in combination with other modalities (such as real time and/or purge) improves the completion rate of SBCE. The tracking of the capsule within the body is important for the localization of abnormal findings and planning of further therapeutic interventions. Currently, localization is based on transit time. Recently proposed software and hardware solutions are proposed herein. Moreover, the feasibility of software-based 3D representation (attempt for 3D reconstruction) is examined. PMID:25169106

Koulaouzidis, Anastasios; Iakovidis, Dimitris K; Karargyris, Alexandros; Plevris, John N

2015-02-01

163

Strongyloides stercoralis hyperinfection presenting as subacute small bowel obstruction following immunosuppressive chemotherapy for multiple myeloma.  

PubMed

We report the case of a 59-year-old Afro-Caribbean woman who presented with symptoms of anorexia, lethargy, abdominal distension and vomiting on the background of newly diagnosed multiple myeloma, treated with one cycle of cyclophosphamide-thalidomide-dexamethasone chemotherapy 20 days previously. A diagnosis of subacute bowel obstruction was made; however, the aetiology of the obstruction remained elusive. Common electrolyte abnormalities were excluded and a midline laparotomy revealed minimal intra-abdominal adhesions. Histological examination of a small bowel mesentery biopsy showed inflammatory cell infiltrate composed of lymphocytes, eosinophils and occasional plasma cells with a foreign body giant cell reaction suggestive of worm infection. A postoperative stool sample revealed heavy infestation with the rhabditiform larvae of Strongyloides stercoralis. The patient recovered following ivermectin treatment. In the absence of other causality, we attribute the subacute bowel obstruction to S stercoralis hyperinfection, triggered by immunosuppression secondary to chemotherapy and multiple myeloma. PMID:24469840

Shields, Adrian Matthew; Goderya, Rashida; Atta, Mustafa; Sinha, Prakash

2014-01-01

164

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

PubMed Central

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

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

2014-01-01

165

Influence of glutamine-supplemented parenteral nutrition on intestinal amino acid metabolism in rats after small bowel resection  

Microsoft Academic Search

Glutamine (Gln)-supplemented total parenteral nutrition (TPN) has been shown to improve mucosal adaptation after massive small bowel resection (SBR); however, its influences on intestinal amino acid metabolism remain unknown. In this study, intestinal amino acid flux, circulating plasma aminogram, mucosal glutaminase activity and protein, and DNA content were measured 7 days after massive SBR in rats receiving either standard (Std)

Kai Chen; Riichiro Nezu; Kinya Sando; S. M. Manzurul Haque; Yasuhiko Iiboshi; Akira Masunari; Hiroshi Yoshida; Shinkichi Kamata; Yoji Takagi; Akira Okada

1996-01-01

166

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

PubMed

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

Xiao, Li; Tsutsui, Takeki; Miwa, Nobuhiko

2014-09-01

167

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

PubMed

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

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

2004-04-01

168

Roles of NAD+, PARP-1, and Sirtuins in Cell Death, Ischemic Brain Injury, and Synchrotron Radiation X-Ray-Induced Tissue Injury  

PubMed Central

NAD+ plays crucial roles in a variety of biological processes including energy metabolism, aging, and calcium homeostasis. Multiple studies have also shown that NAD+ administration can profoundly decrease oxidative cell death and ischemic brain injury. A number of recent studies have further indicated that NAD+ administration can decrease ischemic brain damage, traumatic brain damage and synchrotron radiation X-ray-induced tissue injury by such mechanisms as inhibiting inflammation, decreasing autophagy, and reducing DNA damage. Our latest study that applies nano-particles as a NAD+ carrier has also provided first direct evidence demonstrating a key role of NAD+ depletion in oxidative stress-induced ATP depletion. Poly(ADP-ribose) polymerase-1 (PARP-1) and sirtuins are key NAD+-consuming enzymes that mediate multiple biological processes. Recent studies have provided new information regarding PARP-1 and sirtuins in cell death, ischemic brain damage and synchrotron radiation X-ray-induced tissue damage. These findings have collectively supported the hypothesis that NAD+ metabolism, PARP-1 and sirtuins play fundamental roles in oxidative stress-induced cell death, ischemic brain injury, and radiation injury. The findings have also supported “the Central Regulatory Network Hypothesis”, which proposes that a fundamental network that consists of ATP, NAD+ and Ca2+ as its key components is the essential network regulating various biological processes. PMID:24386592

2013-01-01

169

Effects of trimebutine on intestinal motility after massive small bowel resection.  

PubMed

Effects of trimebutine maleate (TM) on intestinal motility in short bowel syndrome (SBS) were studied in conscious canines in both acute and chronic phases following 80% massive distal small bowel resection (MSBR). TM was administered orally to beagles with MSBR or as controls in the postprandial and fasting states, and given simultaneously with meals. Intestinal motility was measured using bipolar electrodes for approximately 1 month after the electrodes were implanted in each beagle and the data compared between treatment groups. When TM was given with meals, the postprandial period without duodenal migrating myoelectric (or motor) complexes (MMCs) was shorter than in those given meals only. When TM was given in the postprandial state in short bowel beagles, the initial duodenal MMCs occurred earlier, i.e. the postprandial period was shorter. Diarrhea did not occur in these beagles. When TM was given in the fasting state, duodenal MMCs occurred and propagated to the distal intestine. In conclusion, oral TM administration can produce a more appropriate intestinal condition for the next food intake and make enteral nutrition possible even in the acute phase after MSBR. Such feeding can be carried out without overloading gut function as a result of the modulation of gastrointestinal motility by TM. PMID:11286295

Uchiyama, M; Iwafuchi, M; Yagi, M; Iinuma, Y; Kanada, S; Ohtaki, M; Homma, S

2000-08-01

170

Evaluation of c4d deposition and circulating antibody in small bowel transplantation.  

PubMed

Antibody-mediated rejection (AMR) consensus criteria are defined in kidney and heart transplantation by histological changes, circulating donor-specific antibody (DSA), and C4d deposition in affected tissue. AMR consensus criteria are not yet identified in small bowel transplantation (SBTx). We investigated those three criteria in 12 children undergoing SBTx, including one retransplantation and four combined liver-SBTx (SBTx), with a follow-up of 12 days to 2 years. All biopsies (91) were evaluated with a standardized grading scheme for acute rejection (AR), vascular lesions and C4d expression. Sera were obtained at day 0 and during the follow-up. C4d was expressed in 37% of biopsies with or without AR, but in 50% of biopsies with severe vascular lesions. In addition, vascular lesions were always associated with AR and a poor outcome. All children with AR (grade 2 or 3) observed before the third month died or lost the graft. DSA were never found in any studied sera. We found no evidence that C4d deposition was of any clinical relevance to the outcome of SBTx. However, the grading of vascular lesions may constitute a useful marker to identify AR that is potentially resistant to standard treatment, and for which an alternative therapy should be considered. PMID:18444932

de Serre, N Patey-Mariaud; Canioni, D; Lacaille, F; Talbotec, C; Dion, D; Brousse, N; Goulet, O

2008-06-01

171

Histamine-degrading enzymes as cellular markers of acute small bowel allograft rejection.  

PubMed

Intestinal histamine-degrading enzymes diamine oxidase (DAO) and histamine N-methyltransferase (HNMT) activities are relatively constant per individual and bowel segment, and they reflect the functional integrity of the intestinal mucosa. It was, therefore, hypothesised that a decrease in these enzymes could be indicative of acute rejection of an intestinal allograft. Enzymatic activities of DAO and HNMT were determined in mucosal biopsies of isogeneic (Lewis-to-Lewis, n=48) and allogeneic (Brown Norway-to-Lewis, n=48) heterotopic small bowel transplants in a rat model at various time periods. Allograft recipients were not given any immunosuppression. While no changes in enzyme activities were observed in isografts up to day 8 following transplantation, significantly reduced activities of both enzymes were found in all allografts 6-8 days after transplantation. Activities of both DAO and HNMT exhibited a strong negative correlation with the histological rejection score ( P<0.01). We can conclude that DAO and HNMT activities in gut mucosa are reliable quantitative markers of acute intestinal allograft rejection in the rat that support histopathological analysis. PMID:12719803

Klaus, Alexander; Weiss, Helmut; Nguyen, Justin H; Margreiter, Raimund; Obrist, Peter; Schwelberger, Hubert G

2003-08-01

172

Report of video-capsule endoscopy disruption producing episodic small bowel obstruction after prolonged retention  

PubMed Central

INTRODUCTION Wireless video-capsule endoscopy is a procedure which provides direct visualization of the gastrointestinal tract, particularly the jejunum and ileum. Capsule retention is the main risk associated with capsule endoscopy, occurring at a significantly elevated incidence in patients with known or suspected Crohn's disease. PRESENTATION OF CASE A case of a prolonged retained capsule with subsequent fragmentation producing a multicentric complete small bowel obstruction in a 39 year old male patient who had undergone wireless video capsule-endoscopy approximately three years prior. Management required surgical resection of the strictured jejunum and removal of retained capsule fragments under fluoroscopic guidance. DISCUSSION Although capsule endoscopy is capable of diagnosis, evaluation, and monitoring inflammatory bowel disease, understanding the elevated risk for capsule retention is important in this population. Specifically, prolonged capsule retention appears to increase the risk of capsule disruption, and likely the potential for intestinal perforation. CONCLUSION Patients should therefore be carefully selected for monitoring based upon treatment compliance and offered early endoscopic or surgical intervention in the setting of questionable compliance due to the risk for capsule disruption and subsequent intestinal perforation. PMID:25460458

Royall, Nelson A.; Fiscina, Creighton D.

2014-01-01

173

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

174

Small bowel transplantation complicated by cytomegalovirus tissue invasive disease without viremia.  

PubMed

We report on a small bowel transplant patient, donor/recipient seropositive (D+/R+) for cytomegalovirus (CMV), with a clinical course complicated by CMV disease. Anti-CMV prophylaxis was given for 100 days. Immunosuppression consisted of alemtuzumab, tacrolimus, mycophenolate mofetil and prednisolone. Five months posttransplant, CMV tissue invasive disease of the upper gastrointestinal tract was evident without the presence of viremia, tested by quantitative polymerase chain reaction (PCR). Complete viral load suppression was achieved with intravenous ganciclovir, followed by valganciclovir for secondary prophylaxis. Mycophenolate mofetil and prednisolone were discontinued. Shortly thereafter the patient presented with recurrent CMV and candida esophagitis. While on ganciclovir and caspofungin, the patient developed CMV tissue invasive disease of the ileal graft, with persistent absence of viremia. Foscarnet and CMV immunoglobulin were added. Viral load declined to undetectable levels; however, clinical improvement did not occur due to occurrence of graft rejection. Despite infliximab and high dose prednisolone, graft rejection was progressive, requiring surgical explantation of the graft. This case highlights the importance of additional diagnostic tools such as endoscopy including PCR analysis of tissue samples. Extension of primary antiviral prophylaxis interval up to 6 months and prolonged retreatment for recurrent CMV disease may be useful to avoid severe CMV-related complications. PMID:24703746

Avsar, Yesim; Cicinnati, Vito R; Kabar, Iyad; Wolters, Heiner; Anthoni, Christoph; Schmidt, Hartmut H J; Beckebaum, Susanne

2014-06-01

175

Routine nasogastric decompression in small bowel obstruction: is it really necessary?  

PubMed

Bowel rest, nasogastric (NG) decompression, and intravenous hydration are used to treat small bowel obstruction (SBO) conservatively; however, there are no data to support nasogastric tube (NGT) use in patients without active emesis. We aim to evaluate the use of nasogastric decompression in SBO and the safety of managing patients with SBO without the use of a NGT. A retrospective chart review was conducted of adult patients admitted to Yale New Haven Hospital over five years with the diagnosis of SBO. We compared patients who received NG decompression with those who did not. Outcome variables assessed were days to resolution, associated complications, hospital length of stay, and disposition. Of 290 patients who fit the criteria, 190 patients (65.52%) were managed conservatively. Fifty-five patients (18.97%) did not receive NGTs. Sixty-eight patients (23.45%) did not present with emesis; however, nearly 75 per cent of these patients received NGTs. Development of pneumonia and respiratory failure was significantly associated with NGT placement. Time to resolution and hospital length of stay were significantly higher in patients with NGTs. Patients with NG decompression had a significantly increased risk of pneumonia and respiratory failure as well as increased time to resolution and hospital length of stay. PMID:23574854

Fonseca, Annabelle L; Schuster, Kevin M; Maung, Adrian A; Kaplan, Lewis J; Davis, Kimberly A

2013-04-01

176

Mechanisms of Ileal Adaptation for Glucose Absorption after Proximal-Based Small Bowel Resection  

PubMed Central

INTRODUCTION The hexose transmembrane transporters SGLT1 and GLUT2 are present in low quantities in ileum where little glucose absorption occurs normally; however, glucose uptake in ileum is highly adaptable after small bowel resection. HYPOTHESIS Ileal adaptability for glucose absorption after jejunal resection is mediated predominately by upregulation of GLUT2. METHODS Rats underwent 70%, proximal-based jejunoileal resection. Transporter-mediated glucose uptake was measured in proximal and distal remnant ileum 1 and 4 wk postoperatively (n=6 rats, each) and in corresponding ileal segments in control and 1 wk sham laparotomy rats (n=6, each) without and with selective inhibitors of SGLT1 and GLUT2. In separate groups of rats (n=6, each), protein (Western blots), mRNA (RT-PCR), and villus height (histomorphology) were measured. RESULTS After 70% proximal intestinal resection, there was no dramatic change in protein or mRNA expression per cell of either SGLT1 or GLUT2, but median glucose uptake (nmol/cm/min) increased markedly from 52 (range, 28-63) in controls to 118 (range, 80-171) at 1 wk, and 203 (range, 93-248) at 4 wk (p?0.04 each) correlating with change in villus height (p?0.03). CONCLUSIONS Ileal adaptation for glucose transport occurs through cellular proliferation (hyperplasia) and not through cellular upregulation of glucose transporters. PMID:18766411

Iqbal, CW; Qandeel, HG; Zheng, Y; Duenes, JA; Sarr, MG

2009-01-01

177

Remaining Small Bowel Length: Association with Catheter Sepsis in Patients Receiving Home Total Parenteral Nutrition: Evidence of Bacterial Translocation  

Microsoft Academic Search

.   Patients with short bowel syndrome (SBS) receiving total parenteral nutrition (TPN) have a high incidence of catheter-related\\u000a sepsis, one of its major complications. The aim of this study was to correlate the length of remaining small bowel (RSB) with\\u000a septic episodes related to the central venous catheter in a group of patients with severe SBS with home TPN. The

Ricardo M. Terra; Caio Plopper; Dan L. Waitzberg; Celso Cukier; Sérgio Santoro; Juliana R. Martins; Rubens J. Song; Joaquim Gama-Rodrigues

2000-01-01

178

Preoperative Helical Tomotherapy and Megavoltage Computed Tomography for Rectal Cancer: Impact on the Irradiated Volume of Small Bowel  

SciTech Connect

Purpose: Preoperative (chemo)radiotherapy is considered to be standard of care in locally advanced rectal cancer, but is associated with significant small-bowel toxicity. The aim of this study was to explore to what extent helical tomotherapy and daily megavolt (MV) CT imaging may reduce the irradiated volume of small bowel. Methods and Materials: A 3D-conformal radiotherapy (3D-CRT) plan with CTV-PTV margins adjusted for laser-skin marks (15, 15, and 10 mm for X, Y, and Z directions, respectively) was compared with helical tomotherapy (IMRT) using the same CTV-PTV margins, and to helical tomotherapy with margins adapted to daily MV-CT imaging (IMRT/IGRT; 8, 11, 7, and 10 mm for X, Y{sub ant}, Y{sub post} and Z resp.) for 11 consecutive patients. The planning goals were to prescribe 43.7 Gy to 95% of the PTV, while minimizing the volume of small bowel receiving more than 15 Gy (V{sub 15} {sub SB}). Results: The mean PTV was reduced from 1857.4 {+-} 256.6 cc to 1462.0 {+-} 222.3 cc, when the CTV-PTV margins were adapted from laser-skin marks to daily MV-CT imaging (p < 0.01). The V{sub 15} {sub SB} decreased from 160.7 {+-} 102.9 cc to 110.9 {+-} 74.0 cc with IMRT and to 81.4 {+-} 53.9 cc with IMRT/IGRT (p < 0.01). The normal tissue complication probability (NTCP) for developing Grade 2+ diarrhea was reduced from 39.5% to 26.5% with IMRT and to 18.0% with IMRT/IGRT (p < 0.01). Conclusion: The combination of helical tomotherapy and daily MV-CT imaging significantly decreases the irradiated volume of small bowel and its NTCP.

Engels, Benedikt [Department of Radiation Oncology, Oncologisch Centrum UZ Brussel, Brussels (Belgium); De Ridder, Mark [Department of Radiation Oncology, Oncologisch Centrum UZ Brussel, Brussels (Belgium)], E-mail: mark.deridder@uzbrussel.be; Tournel, Koen [Department of Radiation Oncology, Oncologisch Centrum UZ Brussel, Brussels (Belgium); Sermeus, Alexandra [Department of Gastroenterology, Oncologisch Centrum UZ Brussel, Brussels (Belgium); De Coninck, Peter; Verellen, Dirk; Storme, Guy A. [Department of Radiation Oncology, Oncologisch Centrum UZ Brussel, Brussels (Belgium)

2009-08-01

179

Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps  

PubMed Central

Background Familial adenomatous polyposis (FAP) is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE) may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. Method 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI) of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1) to two (2) weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. Results Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. Conclusion CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000616370 PMID:20361877

2010-01-01

180

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

181

An unusual cause of small bowel obstruction caused by a Richter's-type hernia into the urinary bladder  

PubMed Central

INTRODUCTION The authors present an unusual case of small bowel obstruction in a 62-year-old man. PRESENTATION OF CASE A 62-year-old man with a background of transitional cell carcinoma (TCC) of the bladder presented to the emergency department with abdominal pain, distension, vomiting and had not opened his bowels for three days. 3 weeks previously he had a repeat Transurtheral resection of bladder tumour (TURBT), during which there was an iatrogenic perforation of the bladder. A CT scan of the abdomen and pelvis revealed small bowel obstruction but did not identify a cause. At laparotomy the cause of the obstruction was identified as a section of the small bowel that had partially herniated into the bladder, via the perforation. The defect was repaired and the patient made an uneventful recovery. DISCUSSION Herniation of the bowel into a defect in the bladder wall is a rare event with only 6 previous cases reported in the literature. It can cause signs and symptoms of bowel obstruction. CONCLUSION In patients with known bladder perforations who present with symptoms and signs of bowel obstruction, bowel herniation into the bladder should be considered. Early surgical intervention may be necessary if the patient is clinically unwell with appropriate symptoms and signs and imaging does not provide conclusive answer. PMID:24858979

Sakai, Naomi S.; Acharya, Vikas; Mansour, Sami; Saleemi, Mohammed A.; Cheslyn-Curtis, Sarah

2014-01-01

182

Non-Occlusive Small Bowel Necrosis in Association with Feeding Jejunostomy After Elective Upper Gastrointestinal Surgery  

PubMed Central

INTRODUCTION Non-occlusive small bowel necrosis (NOSBN) has been associated with early postoperative enteral feeding. The purpose of this study was to determine the incidence of this complication in an elective upper gastrointestinal (GI) surgical patient population and the influence of both patient selection and type of feeding jejunostomy (FJ) inserted, based on the experience of two surgical units in affiliated hospitals. PATIENTS AND METHODS The records were reviewed of 524 consecutive patients who underwent elective upper GI operations with insertion of a FJ for benign or malignant disease between 1997 and 2006. One unit routinely inserted needle catheter jejunostomies (NCJ), whilst the other selectively inserted tube jejunostomies (TJ). RESULTS Six cases of NOSBN were identified over 120 months in 524 patients (1.15%), with no difference in incidence between routine NCJ (n = 5; 1.16%) and selective TJ (n = 1; 1.06%). Median rate of feeding at time of diagnosis was 105 ml/h (range, 75–125 ml/h), and diagnosis was made at a median of 6 days (range, 4–18 days) postoperatively. All patients developed abdominal distension, hypotension and tachycardia in the 24 h before re-exploratory laparotomy. Five patients died and one patient survived. CONCLUSIONS The understanding of the pathophysiology of NOSBN is still rudimentary; nevertheless, its 1% incidence in the present study does call into question its routine postoperative use especially in those at high risk with an open abdomen, planned repeat laparotomies or marked bowel oedema. Patients should be fully resuscitated before initiating any enteral feeding, and feeding should be interrupted if there is any evidence of feed intolerance. PMID:19558785

Spalding, Duncan RC; Behranwala, Kasim A; Straker, Peter; Thompson, Jeremy N; Williamson, Robin CN

2009-01-01

183

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

184

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

185

Bradykinin B2 receptor antagonist FR173657 ameliorates small bowel ischemia-reperfusion injury in dogs.  

PubMed

Bradykinin mediates acute inflammation by increasing microvascular permeability, vasodilation, leukocyte migration and accumulation, and the production of arachidonic acid via phospholipase A2 activation. Arachidonic acid metabolites, or eicosanoids, are potent modulators of biological functions, particularly inflammation. Bradykinin exerts its inflammatory effects via the bradykinin B2 receptor. The aim of this study was to evaluate the effect of a bradykinin B2 receptor antagonist, FR173657 (FR), on intestinal ischemia-reperfusion (I/R) injury. Twenty-eight mongrel dogs were divided into four groups (n = 7 per group). Group I underwent I/R alone, Group II underwent I/R and received FR treatment, Group III was sham operated, and Group IV was sham operated and received FR treatment. The FR treatment consisted of FR continuously from 30 min prior to ischemia to 2 hr after reperfusion. In the I/R procedure, the superior mesenteric artery (SMA) and vein were clamped for 2 hr and then released to permit reperfusion for 12 hr. The intramucosal pH (pHi), SMA blood flow, and mucosal tissue blood flow were measured during the reperfusion period. The serum thromboxane B2 and 6-keto-prostaglandin F1alpha levels were determined, and tissue samples were examined histologically. Results showed that tissue blood flow, pHi, and SMA blood flow after reperfusion were maintained in Group II in comparison with Group I. Histopathological examination showed less severe mucosal damage after reperfusion in Group II than in Group I. The serum thromboxane B2 and 6-keto-prostagland in F1alpha levels were significantly lower in Group II than in Group I (P < 0.05). We conclude that FR treatment appears to have clear protective effects on small bowel I/R injury by inhibiting the release of eicosanoids. PMID:15712633

Arakawa, Kazuhisa; Takeyoshi, Izumi; Akao, Yoshihiko; Totsuka, Osamu; Matsumoto, Koshi; Morishita, Yasuo

2005-01-01

186

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

NASA Astrophysics Data System (ADS)

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

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

2012-02-01

187

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; Bäck, Sven; Thornberg, Charlotte; Osman, Nadia; Gadaleanu, Virgil; Thorlacius, Henrik; Jeppsson, Bengt

2004-01-01

188

Muscovite is protective against non-steroidal anti-inflammatory drug-induced small bowel injury  

PubMed Central

AIM: To evaluate the effect of muscovite in preventing small bowel injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: We recruited and screened thirty-two healthy volunteers who were randomly allocated equally into two groups: an NSAID control group, who received 75 mg slow-release diclofenac, twice daily for 14 d; and an NSAID-muscovite group, who received 3 g of muscovite in addition to the 75 mg of slow-release diclofenac, twice daily for 14 d. For gastroprotection, both groups were administered 20 mg/d of the proton pump inhibitor omeprazole. All eligible subjects underwent video capsule endoscopy (CE) prior to and 14 d after treatment. RESULTS: Thirty subjects (NSAID-muscovite group, n =16; NSAID control group, n =14) finally completed the whole trail. At the baseline CE examination, no statistically significant differences between the two groups have been observed. However, after 14 d of drug treatment, a significant difference was observed in the percentage of subjects with mucosal breaks when comparing the NSAID-muscovite group with the NSAID control group. While 71.4% (10/14) of subjects in the NSAID control group had at least one mucosal break, co-administration of muscovite in the NSAID-muscovite group reduced the rate to 31.3% (5/16) (P = 0.028). Moreover, higher number of mucosal breaks was found in the NSAID control group vs that in the NSAID-muscovite group (P < 0.05). CONCLUSION: Muscovite co-therapy reduced the incidence of small intestinal injury after 14 d of diclofenac administration. PMID:25152605

Huang, Chen; Lu, Bin; Fan, Yi-Hong; Zhang, Lu; Jiang, Ning; Zhang, Shuo; Meng, Li-Na

2014-01-01

189

Gene expression accurately distinguishes liver metastases of small bowel and pancreas neuroendocrine tumors.  

PubMed

Small bowel (SBNETs) and pancreatic neuroendocrine tumors (PNETs) often present with liver metastases. Although liver biopsy establishes a neuroendocrine diagnosis, the primary tumor site is frequently unknown without exploratory surgery. Gene expression differences in metastases may distinguish primary SBNETs and PNETs. This study sought to determine expression differences of four genes in neuroendocrine metastases and to create a gene expression algorithm to distinguish the primary site. Nodal and liver metastases from SBNETs and PNETs (n = 136) were collected at surgery under an Institutional Review Board-approved protocol. Quantitative PCR measured expression of bombesin-like receptor-3, opioid receptor kappa-1, oxytocin receptor, and secretin receptor in metastases. Logistic regression models defined an algorithm predicting the primary tumor site. Models were developed on a training set of 21 nodal metastases and performance was validated on an independent set of nodal and liver metastases. Expression of all four genes was significantly different in SBNET compared to PNET metastases. The optimal model employed expression of bombesin-like receptor-3 and opioid receptor kappa-1. When these genes did not amplify, the algorithm used oxytocin receptor and secretin receptor expression, which allowed classification of all 136 metastases with 94.1 % accuracy. In the independent liver metastasis validation set, 52/56 (92.9 %) were correctly classified. Positive predictive values were 92.5 % for SBNETs and 93.8 % for PNETs. This validated algorithm accurately distinguishes SBNET and PNET metastases based on their expression of four genes. High accuracy in liver metastases demonstrates applicability to the clinical setting. Studies assessing this algorithm's utility in prospective clinical decision-making are warranted. PMID:25241033

Sherman, Scott K; Maxwell, Jessica E; Carr, Jennifer C; Wang, Donghong; Bellizzi, Andrew M; Sue O'Dorisio, M; O'Dorisio, Thomas M; Howe, James R

2014-12-01

190

Exposure to extremely low frequency magnetic fields suppresses x-ray-induced transformation in mouse C3H10T1/2 cells.  

PubMed

We designed and manufactured equipment for exposure of cultured cells to extremely low frequency magnetic fields (ELFMF) at 5, 50, and 400 mT and examined the effect of ELFMF on cellular transformation in mouse C3H10T1/2 cells (clone 8). Transformed foci, Type II and Type III, were independently counted as transformants. The cells were exposed to ELFMF alone at 5, 50, and 400 mT for 24 h or X-irradiated with 3 Gy followed by the ELFMF exposure. No significant difference in the transformation was observed between sham-exposed control and the ELFMF exposure from 5 to 400 mT. The transformation frequency for X-rays plus ELFMF was decreasing compared with X-rays alone. When 12-O-tetra-decanoylphorbol-13-acetate (TPA) was contained in the medium throughout the experiment, the transformation frequency by X-rays alone was elevated more. In the combined treatment with X-rays followed by ELFMF, the transformation frequency was slightly decreased at 50 and 400 mT even in the medium containing TPA. The long-term exposure at 5 mT suppressed both spontaneous and X-ray-induced transformations significantly. It is well known that overexpressing protein kinase C (PKC) failed to yield identifiable transformation of foci induced by ionizing radiation. We demonstrated previously that exposure to high-density ELFMF induced expression of several genes through an increase in PKC activity. From these results, it is suggested that ELFMF might suppress X-ray-induced transformation through activation of PKC by ELFMF. PMID:10799295

Miyakoshi, J; Yoshida, M; Yaguchi, H; Ding, G R

2000-05-10

191

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

192

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

193

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

194

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

195

Application of PIXE, RBS and high energy proton microbeams to the elemental analysis of coal and coal waste. [Proton and x-ray induced x-ray emission and Rutherford backscattering  

Microsoft Academic Search

Proton and x-ray induced x-ray emission have proved to be sensitive and convenient methods to measure major trace element concentrations in bulk quantities of coal and coal waste materials. These techniques are complementary in their sensitivities as a function of atomic number, and both require little sample preparation. The PIXE measurements were made with the proton beam in air in

H. W. Kraner; A. L. Hanson; K. W. Jones; S. A. Oakley; I. W. Duedall; P. M. J. Woodhead

1980-01-01

196

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

197

Small bowel video capsule endoscopy in Crohn’s disease: What have we learned in the last ten years?  

PubMed Central

Since its introduction in 2001, capsule endoscopy (CE) has become the most important advance in the study of small bowel disease, including Crohn’s disease (CD). This technique has been demonstrated to be superior to all other current forms of radiological investigation in detecting mucosal abnormalities of small bowel nonstricturing CD. CE has proven to be extremely useful in diagnosing CD in patients with inconclusive findings from ileocolonoscopy and x-ray-based studies. Almost half of all patients with CD involving the ileum also present lesions in proximal intestinal segments, with the small bowel being exclusively involved in up to 30% of all CD cases. Despite the widespread use of CE, several questions concerning the utility of this technique remain unanswered. The lack of commonly agreed diagnostic criteria for defining CD lesions with the aid of CE may have had an influence on the variation in diagnostic results for CE reported in the literature. The utility of CE in monitoring CD and in guiding therapy has also been proposed. Furthermore, CE could be a useful second-line technique for patients with an established diagnosis of CD and unexplained symptoms. Finally, as no threshold for CD diagnosis has been agreed upon, a severity scale of mucosal disease activity has not been universally followed. None of the available activity indexes based on CE findings has been independently validated. This article discusses several cutting-edge aspects of the usefulness of CE in CD 10 years after its introduction as a sensible method to study the small intestine. PMID:21403813

Lucendo, Alfredo J; Guagnozzi, Danila

2011-01-01

198

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

199

A Novel Weight-Reducing Operation: Lateral Subtotal Gastrectomy with Silastic Ring Plus Small Bowel Reduction with Omentectomy  

Microsoft Academic Search

Background  “The ideal bariatric operation should preserve normal gastroduodenal continuity, reduce food intake, and allow the addition\\u000a of intestinal short-circuiting that would stimulate GLP-1 secretion” (Mason, Surg Obes Rel Dis, 1:123–125, 2005).\\u000a \\u000a \\u000a \\u000a Methods  246 obese patients underwent a subtotal lateral gastric resection with silastic gastric ring placement, plus a moderate mid-small-bowel\\u000a resection with omentectomy. This configuration preserves the pylorus, duodenum, 50–200 cm of

Adrian J. Heap; David E. Cummings

2008-01-01

200

Enterolith ileus: liberated large jejunal diverticulum enterolith causing small bowel obstruction in the setting of jejunal diverticulitis  

PubMed Central

We present an 80-year-old man with multiple medical problems, and acute abdominal pain with feculent emesis. An unenhanced CT examination of the abdomen and pelvis demonstrated jejunal diverticulitis and findings of high-grade small bowel obstruction caused by a large enterolith. Enterolith ileus has rarely been reported in the radiology literature. This phenomenon has occasionally been reported in the surgical and gastroenterology literature. We highlight the CT findings associated with enterolith ileus in the setting of jejunal diverticulitis, to alert radiologists to this unusual diagnosis. PMID:21750131

Garnet, D J; Scalcione, L R; Barkan, A; Katz, D S

2011-01-01

201

Radiation doses from small-bowel follow-through and abdomen\\/pelvis MDCT in pediatric Crohn disease  

Microsoft Academic Search

Background  The onset of Crohn disease (CD) can occur in childhood. Imaging, which often involves radiation, is frequent in CD both for\\u000a disease diagnosis and follow-up. However, information regarding radiation dose for contemporary CT and fluoroscopy is not\\u000a available for determining the cost\\/benefit ratio for imaging strategies.\\u000a \\u000a \\u000a \\u000a Objective  To compare effective dose (ED) for small-bowel follow-through (SBFT) and abdomen\\/pelvis MDCT in pediatric

Ana Maria Gaca; Tracy A. Jaffe; Susan Delaney; Terry Yoshizumi; Greta Toncheva; Giao Nguyen; Donald P. Frush

2008-01-01

202

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

PubMed Central

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

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

2015-01-01

203

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

PubMed

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

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

2015-01-01

204

Effects of massive small bowel resection on metabolism of bile acids and vitamin D3 and gastrin release in dogs.  

PubMed

The effects of ursodeoxycholic acid (UDCA) and 1 alpha-hydroxyvitamin D3 on pathophysiological changes following massive resection of the distal small bowel (75%) were investigated by using adult beagle dogs. After surgery, body weight decreased, watery diarrhea occurred, and the transit time of the alimentary tract shortened. These undesirable consequences lessened markedly after oral administration of UDCA, though 1 alpha-hydroxyvitamin D3 was not effective. Plasma levels of both 25-hydroxyvitamin D3 and 24, 25-dihydroxyvitamin D3 decreased after surgery, while plasma 1 alpha, 25-dihydroxyvitamin D3 concentrations remained unchanged during the observation period of six months. Although fasting plasma concentrations of total bile acid were not reduced, the integrated response to a meal decreased significantly after surgery in spite of the administration of UDCA. The concentration of UDCA in the gallbladder bile increased markedly in dogs which received UDCA. Taurine-conjugated bile acids accounted for more than 90% of the gallbladder bile. Postprandial hypergastrinemia occurred following the massive small bowel resection in the control group and in the group which received 1 alpha-hydroxyvitamin D3 alone, while it did not occur in the group given UDCA together with 1 alpha-hydroxyvitamin D3. These results indicate that administration of UDCA after massive resection of the small intestine is effective in maintaining good nutritional state. PMID:1339002

Imamura, M; Yamauchi, H

1992-11-01

205

Immediate Alterations in Intestinal Oxygen Saturation and Blood Flow Following Massive Small Bowel Resection As Measured By Photoacoustic Microscopy  

PubMed Central

Purpose Massive small bowel resection (SBR) results in villus angiogenesis and a critical adaptation response within the remnant bowel. Previous ex vivo studies of intestinal blood flow after SBR are conflicting. We sought to determine the effect of SBR on intestinal hemodynamics using photoacoustic microscopy, a non-invasive, label-free, high-resolution in vivo hybrid imaging modality. Methods Photoacoustic microscopy was used to image the intestine microvascular system and measure blood flow and oxygen saturation (sO2) of the terminal mesenteric arteriole and accompanying vein in C57BL6 mice (n=7) prior to and immediately following a 50% proximal small bowel resection. A p value of less than 0.05 was considered significant. Results Prior to SBR, arterial and venous sO2 were similar. Immediately following SBR, the venous sO2 decreased with an increase in the oxygen extraction fraction. In addition, the arterial and venous blood flow significantly decreased. Conclusion Massive SBR results in an immediate reduction in intestinal blood flow and increase in tissue oxygen utilization. These physiologic changes are observed throughout the remnant small intestine. The contribution of these early hemodynamic alterations may contribute to the induction of villus angiogenesis and the pathogenesis of normal intestinal adaptation responses. PMID:22703784

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

2012-01-01

206

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

207

A pedunculated polyp-shaped small-bowel lymphangioma causing gastrointestinal bleeding and treated by double-balloon enteroscopy  

PubMed Central

We report a rare case of a small-bowel lymphangioma causing massive gastrointestinal (GI) bleeding that we successfully diagnosed and treated using double-balloon enteroscopy (DBE). An 81-year-old woman suffering from repeated GI bleeding of unknown origin underwent a capsule endoscopy at a previous hospital. She was suspected of having bleeding from the jejunum, and was referred to our department for diagnosis and treatment. An oral DBE revealed a 20 mm × 10 mm, regularly surfaced, white to yellowish, elongated, pedunculated jejunal polyp with small erosions at 10 cm distal to the ligament of Treiz. Since no other source of bleeding was identified by endoscopy in the deep jejunum, an endoscopic polypectomy (EP) was performed for this lesion. A subsequent histopathological examination of the resected polyp showed clusters of lymphatic vessels with marked cystic dilatation in the submucosa and the deep layer of the lamina propria mucosae. These characteristics are consistent with the typical features of small-bowel lymphangioma with erosions. Although clipping hemostasis was performed during EP, re-bleeding occurred. Finally, a complete hemostasis was achieved by performing an additional argon plasma coagulation. PMID:23002353

Kida, Akihiko; Matsuda, Koichiro; Hirai, Satoshi; Shimatani, Akiyoshi; Horita, Yousuke; Hiramatsu, Katsushi; Matsuda, Mitsuru; Ogino, Hidero; Ishizawa, Shin; Noda, Yatsugi

2012-01-01

208

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

PubMed

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

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

2013-09-01

209

Continuous-time photon-stimulated desorption spectroscopy studies on soft x-ray-induced reactions of CF3Br adsorbed on Si(111)-7×7  

NASA Astrophysics Data System (ADS)

Continuous-time core-level photon-stimulated desorption (PSD) spectroscopy was used to study the soft x-ray-induced reactions of CF3Br molecules adsorbed on Si(111)-7×7 near the Si(2p) edge (98-110 eV). The monochromatic synchrotron radiation was employed as a soft x-ray light source in the photon-induced reactions and also as a probe for investigating the produced fluorination states of the bonding surface Si atom in the positive-ion PSD spectroscopy. Several different surface coverages were investigated. The PSD spectra from the low-CF3Br-covered surfaces show the production of surface SiF species, while those from the high-CF3Br-covered surfaces depict the formation of surface SiF, SiF2, and SiF3 species. The photolysis cross section of the submonolayer CF3Br-covered surface is determined as ˜4.3×10-18 cm2. A comparison with the results on CF3Cl/Si(111)-7×7 surface is discussed.

Tsai, W.-C.; Wang, S.-K.; He, T.-M.; Chou, L.-C.; Hsieh, Y.-C.; Liao, K.-Y.; Chen, H.-C.; Wen, C.-R.

2011-10-01

210

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

211

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

212

Antibiotic-induced enterococcal expansion in the mouse intestine occurs throughout the small bowel and correlates poorly with suppression of competing flora.  

PubMed

To test the hypothesis that establishing gastrointestinal colonization with multiresistant Enterococcus faecium (VRE) C68 results from expansion of the enterococcal population in the upper small bowel, we compared VRE quantities recovered from the proximal, middle, and distal segments of the small bowel from mice treated with different antimicrobial agents. Antibiotics associated with high-level VRE fecal colonization (cefotetan, ceftriaxone, clindamycin, and ticarcillin-clavulanic acid) increased VRE quantities in all small-bowel segments, whereas cefepime and piperacillin-tazobactam did not. Enterococcal expansion did not correlate with reductions in numbers of native gram-negative or anaerobic flora. Green fluorescence protein-expressing E. faecium bacteria were found adjacent to the small bowel epithelial lining in colonized mice. These data indicate that enterococcal bowel colonization begins within the proximal small bowel and does not correlate with inhibition of other cultivable flora. Host or enterococcal factors induced by exposures to certain antibiotics may play a role in facilitating E. faecium colonization of the mammalian gastrointestinal tract. PMID:16940110

Lakticová, Viera; Hutton-Thomas, Rebecca; Meyer, Matthew; Gurkan, Evren; Rice, Louis B

2006-09-01

213

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

PubMed Central

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

2013-01-01

214

In vivo radioprotective effects of angiogenic growth factors on the small bowel of C3H mice.  

PubMed

This study was undertaken to determine if acidic or basic fibroblast growth factor (FGF1 or FGF2) or vascular endothelial growth factor (VEGF) alters the radiation response of small bowel after total-body irradiation (TBI). Female C3H mice were treated with various doses of angiogenic growth factor administered intravenously 24 h before or 1 h after TBI. Radiation doses ranged from 7 to 18 Gy. End points measured were the number of crypts in three portions of the small bowel, the frequency of apoptosis of crypt cells at various times after TBI, and the LD50/30 (bone marrow syndrome) and LD50/6 (GI syndrome). Fibroblast growth factors alone, without TBI, decreased the number of crypts per circumference significantly. Among the factors tested, FGF2 caused the greatest decline in baseline crypt number. Despite this decrease in the baseline crypt number, after irradiation the number of surviving crypts was greater in animals treated with growth factor. The greatest radioprotection occurred at intermediate doses of growth factor (6 to 18 pg/mouse). Mice treated with FGF1 and FGF2 had crypt survival curves with a slope that was more shallow than that for saline-treated animals, indicating radiation resistance of crypt stem cells in FGF-treated mice. The LD50/6 was increased by approximately 10% for all treatments with angiogenic growth factors, whether given before or after TBI. Apoptosis of crypt cells was maximum at 4 to 8 h after TBI. The cumulative apoptosis was decreased significantly in animals treated with angiogenic growth factors, and the greatest protection against apoptosis was seen in animals treated with FGF2 prior to TBI. All three angiogenic growth factors tested were radioprotective in small bowel whether given 24 h before or 1 h after irradiation. The mechanism of protection is unlikely to involve proliferation of crypt stem cells, but probably does involve prevention of radiation-induced apoptosis or enhanced repair of DNA damage of crypt cells. PMID:9692366

Okunieff, P; Mester, M; Wang, J; Maddox, T; Gong, X; Tang, D; Coffee, M; Ding, I

1998-08-01

215

Protons offer reduced bone marrow, small bowel, and urinary bladder exposure for patients receiving neoadjuvant radiotherapy for resectable rectal cancer  

PubMed Central

Background To assess the potential benefit of proton therapy (PT) over photon therapy, we compared 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and PT plans in patients undergoing neoadjuvant chemoradiation for resectable rectal cancer at our institution. Methods Eight consecutive patients with resectable (T2-T3) rectal cancers underwent 3DCRT, IMRT, and 3-dimensional conformal PT treatment planning. Initial target volumes (PTV1) were contoured using the Radiation Therapy Oncology Group anorectal atlas guidelines. Boost target volumes (PTV2) consisted of the gross rectal tumor plus a uniform 2-cm expansion. Plans delivered 45 Gray (Gy) or Cobalt Gray Equivalent (CGE) to the PTV1 and a 5.4-Gy (CGE) boost to the PTV2. Ninety-five percent of the PTVs received 100% of the target dose and 100% of the PTVs received 95% of the target dose. Standard normal-tissue constraints were utilized. Wilcoxon paired t-tests were performed to compare various dosimetric points between the 3 plans for each patient. Results All plans met all normal-tissue constraints and were isoeffective in terms of PTV coverage. The proton plans offered significantly reduced median normal-tissue exposure over the 3DCRT and IMRT plans with respect to pelvic bone marrow at the V5Gy, V10Gy, V15Gy, and V20Gy levels and the small bowel space at the V10Gy and V20Gy levels. The proton plans also offered significantly reduced median normal-tissue exposure over the 3DCRT plans with respect to the small bowel at the V30Gy and V40Gy levels and the urinary bladder at the V40Gy level. Conclusions By reducing bone marrow exposure, PT may reduce the acute hematologic toxicity of neoadjuvant chemoradiation and increase the likelihood of uninterrupted chemotherapy delivery. Bone marrow sparing may also facilitate the delivery of salvage chemotherapy for patients who subsequently develop hematogenous metastasis. Reduced small bowel exposure using PT may also reduce toxicity and possibly facilitate the use of more-aggressive chemotherapy with radiotherapy. PMID:24490037

Colaco, Rovel J.; Huh, Soon; Getman, Nataliya; Ho, Meng Wei; Li, Zuofeng; Morris, Christopher G.; Mendenhall, William M.; Mendenhall, Nancy P.; Hoppe, Bradford S.

2014-01-01

216

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

PubMed

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

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

2014-07-01

217

Laparoscopic management of a small bowel herniation from an ileal conduit: report of a case and review of the literature.  

PubMed

Bladder carcinoma can be treated with cystectomy and urinary diversion. Ileal conduit is a popular technique, originally performed with closure of all mesenteric and peritoneal defects to minimize internal herniation. Recent advances in laparoscopic and robotic techniques often leave these defects open. We present a case of a 75-year-old gentleman with a small bowel entrapment underneath an intraperitoneal ileal conduit and ureter causing obstruction. This internal hernia occurred 2 months after undergoing a DaVinci robotic-assisted laparoscopic cystoprostatectomy with an ileal conduit. Bowel obstruction is an important complication associated with the need for reoperation and patient mortality. Historical review shows a precedent for closure of the mesenteric defect, obliterating the peritoneal defect in the right lumbar gutter, and suturing the ileal conduit to the posterior peritoneum to prevent potential internal hernias. The literature involving ileal conduits is examined for consensus on the preferred method of treating these potential spaces. PMID:23579536

Coughlin, Lisa M; Orr, Dennis P

2013-04-01

218

An elective combined caesarean section and small bowel GIST resection during the third trimester of pregnancy: Report of a case  

PubMed Central

INTRODUCTION Gastro-Intestinal Stromal Tumours (GISTs) are rare with an estimated incidence of only 11–15 per million. In pregnancy, GISTs are an extremely rare occurrence and are thus complex to manage from an ethical, surgical and oncological perspective. PRESENTATION OF CASE We present the first reported case in the literature of a successful combined lower segment caesarean section (LSCS) and a tumour resection in a 31-year-old pregnant patient presenting with a small bowel GIST. DISCUSSION We compare and contrast our case with other reported cases of GIST resection in pregnancy and discuss the challenges faced by both patients and clinicians. CONCLUSION Our case demonstrates that a combined LSCS and GIST resection is feasible. In addition, our case highlights the importance of both the multidisciplinary setting and the consideration of patients’ wishes in the successful management of this complex group of patients. PMID:23174524

Haloob, N.; Slesser, A.A.P.; Haloob, A.R.; Khan, F.; Bostanci, G.; Abdulla, A.

2012-01-01

219

Case report: transient small bowel intussusception presenting as right lower quadrant pain in a 6-year-old male  

PubMed Central

In children presenting to the emergency room with right lower quadrant pain, ultrasound is the preferred initial modality. In our patient, a 6-year-old male with a sudden onset of severe right lower quadrant pain, the differential is broad, including appendicitis and intussusception. In order to narrow our differential and secure the diagnosis, our first modality was ultrasonography. With the increased use of point-of-care ultrasound in the emergency department, the diagnosis of appendicitis and ileo-colic intussusception has been made more frequently. In addition, other entities such as transient small bowel intussusception may be identified. As in our case, obstruction secondary to intussusception must be ruled out with observation, serial abdominal exams, clinical improvement, or further imaging. PMID:24982750

2014-01-01

220

Localized intra-abdominal fibromatosis of the small bowel mimicking a gastrointestinal stromal tumor: A case report  

PubMed Central

Intra-abdominal fibromatosis (IAF) is a benign mesenchymal lesion that can occur throughout the gastrointestinal tract. Although rare, it is the most common primary tumor of the mesentery and can develop at any age. We describe a rare case of primary IAF involving the mesentery and small bowel which clinically, macroscopically and histologically mimicked malignant gastrointestinal stromal tumor (GIST). This report highlights the fact that benign IAF can be misdiagnosed as a malignant GIST localized in the mesentery or arising from the intestinal wall. Their diagnostic discrimination is essential because of their very different biological behaviors and the fact that the introduction of effective therapies involving tyrosine kinase inhibitor STI571 (imatinib mesylate) has greatly changed the clinical approach to intra-abdominal stromal spindle cell tumors. PMID:16127758

Colombo, Pierigiuseppe; Rahal, Daoud; Grizzi, Fabio; Quagliuolo, Vittorio; Roncalli, Massimo

2005-01-01

221

Small bowel volvulus in mid and late pregnancy: can early diagnosis be established to avoid catastrophic outcomes?  

PubMed Central

Volvulus in pregnancy is rare and difficult to diagnose. Delayed diagnosis would result in high maternal and fetal mortality. Here we present an unusual case of small bowel volvulus in late pregnancy timely managed by emergency Cesarean section and derotation with excellent maternal and fetal outcomes. Volvulus should be considered in patients complaining ongoing abdominal pain, nausea, vomiting, constipation even diarrhea. Imaging is essential for early and precise diagnosis, including plain abdominal film, MRI and/or ultrasound. Once highly suspected or diagnosed of volvulus or ileus, emergency laparotomy should be performed immediately to avoid catastrophic outcomes, because the maternal and fetal prognosis is dependent on the interval from volvulus to operation apart from the degree of volvulus.

Cong, Qing; Li, Xilian; Ye, Xuping; Sun, Li; Jiang, Wei; Han, Zhigang; Lu, Weiqi; Xu, Huan

2014-01-01

222

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

PubMed Central

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

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

1999-01-01

223

The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection  

PubMed Central

Background—Medium chain C8-C10 triglycerides (MCTs) improve fat absorption in short bowel patients. Effects on overall energy absorption remain unknown. ?Aims—To determine whether MCTs and medium chain fatty acids (MCFAs) are absorbed in the colon like the short chain fatty acids (SCFAs) or are lost in faeces similarly to long chain fatty acids (LCFAs). ?Methods—Nine small bowel resected patients without and 10 with a colon in continuity excreted 2-6 MJ/day and were randomised and crossed over between two high fat diets (10 MJ/day, 50% as fat), based on either long chain triglycerides (LCT) alone or equal quantities of LCT and MCT. ?Results—Patients with a colon absorbed C8-C10 fatty acids considerably better than patients without a colon at similar and extreme levels of LCFA malabsorption; the colonic impact on absorption of C14-18 fatty acids was negligible. MCT redoubled fat (MCT+LCT) absorption from 23% to 58% in patients with a colon, and increased overall bomb calorimetric energy absorption from 46% to 58%. The increase in fat absorption from 37% to 46% in patients without a colon did not improve overall energy absorption because malabsorption of carbohydrate and protein increased. ?Conclusion—In small bowel resected patients, the colon seems to serve as a digestive organ for medium chain fat, probably absorbed as MCFAs, perhaps because like the SCFAs, they are water soluble. Only patients with a colon gained from MCT treatment. ?? Keywords: absorption; medium chain fatty acid; colon; short bowel PMID:9824573

Jeppesen, P; Mortensen, P

1998-01-01

224

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

PubMed Central

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

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

2013-01-01

225

Lung Adenocarcinoma  

Cancer.gov

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

226

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

227

Management of a small bowel transplant with complicated central venous access in a patient with asymptomatic superior and inferior vena cava obstruction  

Microsoft Academic Search

During the past few years, small bowel transplantation (SBT) has become a realistic alternative for patients with irreversible intestinal failure who have or will develop severe complications from total parenteral nutrition (TPN). Transplantation can be associated with large fluid shifts and massive blood loss necessitating rapid infusions of large quantities of crystalloid and\\/or blood products. Invasive monitoring and large-bore venous

T. T Mims; T. M Fishbein; D. E Feierman

2004-01-01

228

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

PubMed Central

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

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

2007-01-01

229

Prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation  

Microsoft Academic Search

The volume, distribution, and mobility of opacified pelvic small bowel (PSB) were determined by fluoroscopy and orthogonal radiographs in 150 consecutive patients undergoing pelvic irradiation. Various techniques including uteropexy, omental transposition, bladder distention, inclining the patient, and anterior abdominal wall compression in the supine and prone treatment position were studied for their effect on the volume and location of small

Michael J. Gallagher; Harmar D. Brereton; Robert A. Rostock; Jeffrey M. Zero; Debbie A. Zekoski; Leo F. Poyss; Melvyn P. Richter; Morton M. Kligerman

1986-01-01

230

The use of Seprafilm Adhesion Barrier in Adult Patients Undergoing Laparotomy to Reduce the Incidence of Post-Operative Small Bowel Obstruction  

Microsoft Academic Search

Background: Post-operative adhesions are an expected outcome with nearly every abdominal operation. Adhesions are not always symptomatic, but when they are, they can cause a variety of problems. Small bowel obstructions are a potential complication and are caused by abdominal adhesions in 75% of cases. This complication would be one best avoided, and as a result numerous prophylactic agents have

Erin Call

2012-01-01

231

Lung Adenocarcinoma  

MedlinePLUS

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

232

An Intestinal Occlusion Device for Prevention of Small Bowel Distention During Transgastric Natural Orifice Transluminal Endoscopic Surgery  

PubMed Central

Background and Objectives: Bowel distention from luminal gas insufflation reduces the peritoneal operative domain during natural orifice transluminal endoscopic surgery (NOTES) procedures, increases the risk for iatrogenic injury, and leads to postoperative patient discomfort. Methods: A prototype duodenal occlusion device was placed in the duodenum before NOTES in 28 female pigs. The occlusion balloon was inflated and left in place during the procedure, and small bowel distension was subjectively graded. One animal had no balloon occlusion, and 4 animals had a noncompliant balloon placed. Results: The balloon maintained its position and duodenal occlusion in 22 animals (79%) in which the bowel distention was rated as none (15), minor (4), moderate (3), or severe (0). The intestinal occlusion catheter failed in 6 animals (21%) because of balloon leak (5) or back-migration into the stomach (1), with distention rated as severe in 5 of these 6 cases. Conclusion: The intestinal occlusion catheter that maintains duodenal occlusion significantly improves the intra-abdominal working domain with enhanced visualization of the viscera during the NOTES procedure while requiring minimal time and expense. PMID:23925026

Tomasko, Jonathan M.; Moyer, Matthew T.; Haluck, Randy S.; Pauli, Eric M.

2013-01-01

233

Small bowel obstruction due to an unconjugated ursodeoxycholic acid enterolith following living donor liver transplantation: Report of a case.  

PubMed

We report an unusual case of small bowel obstruction due to an ursodeoxycholic acid (UDCA) enterolith that occurred 7?years after liver transplantation. A 70-year-old man had undergone multiple operations, including a living donor liver transplantation (LDLT) and hepaticojejunostomy. Four years after the LDLT, cholestasis developed, for which oral UDCA was administrated. Seven years after the LDLT, he was admitted to our hospital because of pneumonia; intestinal obstruction occurred following its resolution. A radiographic contrast study and computed tomographic scan indicated a movable mass as the cause of the ileus, suggesting a giant stone. We were unable to observe or remove the stone by double balloon enteroscopy owing to the presence of severe adhesion; thus, we surgically removed the mass. The patient's postoperative course was uneventful. He was discharged 20?days after the operation. An infrared spectrophotometric analysis revealed that the stone was a true enterolith, primarily composed of unconjugated UDCA. An ileus caused by a true enterolith is a rare clinical complication of LDLT. Nevertheless, it must be considered in the differential diagnosis of intestinal obstructions in liver transplant recipients with Roux-en-Y hepaticojejunostomies and/or bowel stasis. PMID:25091893

Mukai, Shoichiro; Onoe, Takashi; Tashiro, Hirotaka; Ohdan, Hideki

2014-08-01

234

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

Microsoft Academic Search

Background  A strong dose-volume relationship exists between the amount of small bowel receiving low- to intermediate-doses of radiation\\u000a and the rates of acute, severe gastrointestinal toxicity, principally diarrhea. There is considerable interest in the application\\u000a of highly conformal treatment approaches, such as intensity-modulated radiation therapy (IMRT), to reduce dose to adjacent\\u000a organs-at-risk in the treatment of carcinoma of the rectum. Therefore,

Henry Mok; Christopher H Crane; Matthew B Palmer; Tina M Briere; Sam Beddar; Marc E Delclos; Sunil Krishnan; Prajnan Das

2011-01-01

235

[Acute abdomen in children: a continuous challenge. Two cases report: Meckel's diverticulum with small bowel volvolus and internal herniation related to epiploic appendagitis mimicking acute appendicitis].  

PubMed

Acute abdomen is a continuous clinical challenge in pediatric age. The aim of our study is to describe two pediatric rare cases: the first case is a small bowel volvolus related to Meckel's diverticulum confused with an intestinal intussusception; the second an internal herniation related to epiploic appendagitis with intestinal obstruction mimic acute appendicitis in two years old children. We review the current literature. PMID:25004643

Gasparella, M; Ferro, M; Marzaro, M; Benetton, C; Zanatta, C; Zoppellaro, F; Gasparella, M

2014-01-01

236

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

PubMed Central

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

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

2014-01-01

237

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

PubMed

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

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

2014-01-01

238

Lubiprostone Decreases the Small Bowel Transit Time by Capsule Endoscopy: An Exploratory, Randomised, Double-Blind, Placebo-Controlled 3-Way Crossover Study  

PubMed Central

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

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

2014-01-01

239

Primary clear cell adenocarcinoma of the colon presenting as a huge extracolic mass: A case report  

PubMed Central

A primary clear cell adenocarcinoma of the colon is a rare oncologic entity. The current study presents a case of such a tumor in the transverse colon of a 26-year-old male, and describes the computed tomography features of the neoplasm. The tumor appeared as an extensive extracolic mass, which displaced the loop of the small bowel and pancreas, and invaded the spleen. A laparotomy was performed and a huge mass measuring 12 cm maximally was revealed, arising from the transverse colon close to the left colonic flexure, with invasion of the spleen. The tumor and the spleen were resected concurrently. Histopathological examination of the excised mass revealed features of clear cell adenocarcinoma. A primary clear cell adenocarcinoma of the colon is a rare tumor, with only 13 cases reported in the English literature at present. The present case is reported here due to its rarity. PMID:25202428

WANG, WEIWEI; LI, XUEHUA; QU, GUIMEI; LENG, TIANGANG; GENG, JUNZU

2014-01-01

240

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

241

Impact of antimouse CD52 monoclonal antibody on graft's ?? intraepithelial lymphocytes after orthotopic small bowel transplantation in mice.  

PubMed

Alemtuzumab, a humanized CD52 monoclonal antibody (mAb), has been used for immune induction in clinical small bowel transplantation (SBT). However, the local impact of CD52 mAb on the transplanted intestine is not known. In this study, we investigated the effects of CD52 mAb on the intestinal intraepithelial lymphocytes (iIELs) in grafts using a murine orthotopic SBT model. The antimouse CD52 mAb was used as a surrogate antibody. Graft rejection was assessed by histopathologic analysis, iIELs were isolated for flow cytometric analysis, the mucosal keratinocyte growth factor (KGF) expression was evaluated by real-time polymerase chain reaction, and epithelial cell (EC) proliferation (percent bromodeoxyuridine incorporation) was measured by immunohistochemistry. No mice showed evidence of rejection. Seven days after SBT, when the CD52 mAb was used, the numbers of iIELs and both T-cell receptor (TCR) ?? and TCR?? subpopulations were decreased, and the number of TCR?? iIELs of donor origin was prominently reduced in the allografts. Furthermore, TCR?? iIEL-derived KGF messenger RNA expression and EC proliferation decreased significantly after CD52 mAb application. These data demonstrate that the antimouse CD52 mAb could deplete iIELs in the transplanted intestine, especially the TCR?? subset of donor origin. The reduction of TCR?? iIELs accompanied the decrease in mucosal KGF expression and EC proliferation, which may slow down the epithelial turnover and retard the repair of the damaged epithelium. PMID:23503501

Shen, Bo; Yu, Hong; Hao, Xianhua; Qu, Linlin; Cai, Xiujun; Li, Ning

2013-03-15

242

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

PubMed Central

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

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

2014-01-01

243

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

PubMed Central

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

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

2011-01-01

244

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

245

Small bowel tissue smear  

MedlinePLUS

A sample of tissue from the small intestine is removed during a procedure called esophagogastroduodenoscopy (EGD ). The sample is sent to a laboratory. There it is sliced, stained, and placed on a microscope slide to be examined.

246

Small bowel resection - discharge  

MedlinePLUS

... your exercise slowly. Your doctor will give you pain medicines to take at home. If you are taking ... other heavy machines if you are taking narcotic pain medicines. These medicines may slow your reaction time. Try ...

247

Small bowel resection  

MedlinePLUS

Small intestine surgery; Bowel resection - small intestine; Resection of part of the small intestine; Enterectomy ... a hand inside your belly to feel the intestine or remove the diseased segment. Your belly will ...

248

Small bowel bacterial overgrowth  

MedlinePLUS

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

249

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

250

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

PubMed Central

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

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

2012-01-01

251

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

252

Electronic structure studies of Ni-X (X: B, S, P) alloys using x-ray photoelectron spectroscopy, x-ray induced Auger electron spectroscopy and density functional theory calculations.  

PubMed

The electronic structure of Ni-X (X = B, S, P) alloys was studied using x-ray photoelectron spectroscopy, x-ray induced Auger electron spectroscopy and density functional theory. The spectroscopic data in the form of the Ni 2p shake-up satellite and the Ni 2p LMM, P 2p KLL and S 2p KLL Auger parameters combined with density of states (DOS) and charge difference plots suggest an overall charge transfer from the Ni sites towards the alloying addition sites. However, this is masked, with intra-atomic charge redistribution leading to an increased occupancy of the Ni 3d states in the alloys. The Ni 3d DOS shows strong similarity to that of Pt which is the best catalyst for hydrogen evolution. PMID:21693949

Diplas, S; Løvvik, O M

2009-06-17

253

Usefulness of known computed tomography and clinical criteria for diagnosing strangulation in small-bowel obstruction: analysis of true and false interpretation groups in computed tomography.  

PubMed

Computed tomography (CT) criteria have proven useful, but not sufficient, for diagnosis of bowel strangulation. The purpose of the present study was to evaluate the use of clinical criteria in the interpretation of CT scans as a means of improving the diagnostic accuracy of CT, especially in patients whose CT scans are equivocal for distinguishing simple obstruction from strangulated obstruction. We analyzed the CT scans of 136 patients with simple (n=70) or strangulated (n=66) small-bowel obstruction. Three radiologists interpreted the CT scans independently for the presence of intestinal strangulation. According to their interpretation, 136 patients were divided into two groups, i.e., a false and a true interpretation group. The diagnostic value of known CT and four clinical criteria (tenderness, tachycardia, fever, and leukocytosis) were compared in the two groups. The diagnostic accuracy of CT criteria for distinguishing simple obstructions from strangulated small-bowel obstructions ranged between 73% and 80%. Of the 136 patients, 31 belonged to the false group and 105 to the true group. The CT criteria that were highly specific in both groups included severe mesenteric haziness, serrated beak, and poor bowel wall enhancement. Among the clinical criteria, both tachycardia and leukocytosis were highly specific in both groups. The number of positive clinical criteria was helpful in making a diagnosis; none or one clinical criterion indicated a simple obstruction, whereas three or four criteria indicated a strangulated obstruction; when this result was applied retrospectively to the false group, the CT diagnostic accuracy improved in 19 of the 31 patients. The use of clinical criteria when CT findings are equivocal, may overcome the inherent limitations of CT for diagnosing strangulated small-bowel obstruction. PMID:14648046

Kim, Jung Hoon; Ha, Hyun Kwon; Kim, Jeong Kon; Eun, Hyo Won; Park, Kwang Bo; Kim, Bong Soo; Kim, Tae Kyoung; Kim, Jin Chen; Auh, Yong Ho

2004-01-01

254

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

255

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

256

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

PubMed Central

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

Koyuncuer, Ali

2014-01-01

257

Small bowel obstruction secondary to strangulation through a defect in the falciform ligament after blunt abdominal trauma in a pediatric patient.  

PubMed

Obstruction caused by strangulation internal hernia secondary to incarceration within the falciform ligament, although rare, has been previously reported in the literature. These cases, however, were unrelated to trauma. We report on the first case in the pediatric literature of a strangulated internal hernia secondary to incarceration in the falciform ligament precipitated by blunt abdominal trauma. A 12-year-old girl presented to the emergency room less than 24 hours after sustaining a kick to the right upper quadrant. She described sharp, nonradiating, right-upper-quadrant abdominal pain, which was associated with nausea and vomiting. A KUB (kidney, ureter, bladder) view showed a paucity of bowel in the right upper quadrant with distended adjacent bowel. An ultrasound showed a small amount of abdominal ascites and a prominent liver. Computed tomography scan revealed a linear hypodensity at the tip of the right lobe of the liver, suggestive of a laceration. Moderate abdominal and pelvic ascites and multiple collapsed small-bowel loops with diffuse wall thickening and poor enhancement were seen in the right upper quadrant. Significantly, pneumatosis was noted, raising the question of obstruction/volvulus and/or bowel ischemia. An exploratory laparotomy revealed incarcerated small bowel herniated into a defect in the falciform ligament, which was resected. The defect was repaired. Seemingly trivial trauma may play a precipitating role in strangulation in a patient who already has a defect in the falciform ligament. PMID:20531130

Sykes, Joseph A; Norton, Karen I; Bhattacharya, Nishith; Stombaugh, Lauretta

2010-06-01

258

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

PubMed Central

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

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

2014-01-01

259

Computed tomography enterography and 18F-FDG PET/CT features of primary signet ring cell carcinoma of the small bowel in a patient with Crohn's disease.  

PubMed

We report a case of a primary signet ring cell carcinoma (PSRCC) of the small bowel in a patient with long-standing Crohn's disease, describing computed tomography (CT)-enterography (CTE) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT features of this rare tumor. CTE demonstrated submucosal thickening of a long ileal segment with preserved mural stratification. PET/CT examination showed increased 18F-FDG uptake in the affected ileal loop, hypermetabolic abdominal and mediastinal lymphadenopathies, and multiple hypermetabolic bone lesions. Iliac crest osteo-medullary biopsy revealed bone marrow infiltration by "signet ring" cells with intestinal differentiation. Double-balloon enteroscopy was used to obtain biopsies that confirmed the ileal origin of the PSRCC. PMID:23768742

Paparo, Francesco; Piccardo, Arnoldo; Clavarezza, Matteo; Piccazzo, Riccardo; Bacigalupo, Lorenzo; Cevasco, Luca; Marinaro, Eugenio; Rollandi, Gian Andrea

2013-01-01

260

Management of a small bowel transplant with complicated central venous access in a patient with asymptomatic superior and inferior vena cava obstruction.  

PubMed

During the past few years, small bowel transplantation (SBT) has become a realistic alternative for patients with irreversible intestinal failure who have or will develop severe complications from total parenteral nutrition (TPN). Transplantation can be associated with large fluid shifts and massive blood loss necessitating rapid infusions of large quantities of crystalloid and/or blood products. Invasive monitoring and large-bore venous access are necessary in order to manage these patients intraoperatively. Because patients with irreversible intestinal failure are often managed with total parenteral nutrition via a central venous catheter, thrombotic intraluminal obstruction of major vessels may develop over time. Additionally, this may lead to superior vena cava (SVC) syndrome as well as challenging problems with vascular access. We present a 34-year-old woman with a past medical history for long-standing Crohn's disease with multiple small bowel resections and short gut syndrome who presented for an SBT. The patient had a long history of TPN use, complicated by SVC syndrome and inferior vena cava (IVC) obstruction. She was presently asymptomatic from her SVC obstruction. Central venous access was obtained by an interventional radiologist. A 7-French double-lumen Hickman minicatheter was placed in the left femoral vein with the tip of the catheter positioned just distal to the IVC narrowing. A left radial 20-gauge arterial line was placed for hemodynamic monitoring and frequent blood sampling. The patient's left and right dorsal-saphenous veins were cannulated with 16-guage catheters and adequate flow was observed. Lower extremity pressure was measured via the Hickman catheter in the left femoral vein. A multiplane transesophageal echo was used to assess ventricular volume. The options and intraoperative management of such patients are discussed. PMID:15050169

Mims, T T; Fishbein, T M; Feierman, D E

2004-03-01

261

Delayed gastric emptying and reduced postprandial small bowel water content of equicaloric whole meal bread versus rice meals in healthy subjects: novel MRI insights  

PubMed Central

Background/Objectives: Postprandial bloating is a common symptom in patients with functional gastrointestinal (GI) diseases. Whole meal bread (WMB) often aggravates such symptoms though the mechanisms are unclear. We used magnetic resonance imaging (MRI) to monitor the intragastric fate of a WMB meal (11% bran) compared with a rice pudding (RP) meal. Subjects/Methods: Twelve healthy volunteers completed this randomised crossover study. They fasted overnight and after an initial MRI scan consumed a glass of orange juice with a 2267?kJ WMB or an equicaloric RP meal. Subjects underwent serial MRI scans every 45?min up to 270?min to assess gastric volumes and small bowel water content, and completed a GI symptom questionnaire. Results: The MRI intragastric appearance of the two meals was markedly different. The WMB meal formed a homogeneous dark bolus with brighter liquid signal surrounding it. The RP meal separated into an upper liquid layer and a lower particulate layer allowing more rapid emptying of the liquid compared with solid phase (sieving). The WMB meal had longer gastric half-emptying times (132±8?min) compared with the RP meal (104±7?min), P<0.008. The WMB meal was associated with markedly reduced MRI-visible small bowel free mobile water content compared with the RP meal, P<0.0001. Conclusions: WMB bread forms a homogeneous bolus in the stomach, which inhibits gastric sieving and hence empties slower than the equicaloric rice meal. These properties may explain why wheat causes postprandial bloating and could be exploited to design foods that prolong satiation. PMID:23594839

Marciani, L; Pritchard, S E; Hellier-Woods, C; Costigan, C; Hoad, C L; Gowland, P A; Spiller, R C

2013-01-01

262

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

263

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

264

X-ray induced optical reflectivity  

DOE PAGESBeta

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

Durbin, Stephen M.

2012-01-01

265

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

Microsoft Academic Search

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

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

1992-01-01

266

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

267

Crohn's disease of the small bowel, complicated by primary biliary cirrhosis, Hashimoto thyroiditis, and Raynaud's phenomenon: favorable response of all disorders to adalimumab treatment  

PubMed Central

We describe the case of a male patient suffering from long-lasting Crohn's disease of the small bowel who developed thyroiditis Hassimoto, Raynaud's phenomenon, and primary biliary cirrhosis, during the course of the underlying bowel disease. It is not clear whether these co-morbidities appeared coincidentally, or because they share some common immunopathogenetic mechanisms. In this patient, Crohn's disease favorably responded to the treatment with an anti-TNF-? agent (adalimumab). The serum titers of antimitochondrial antibodyies and cholestatic enzymes considerably reduced during the 3-year treatment with the biologic agent. Raynaud's phenomenon, also, completely disappeared. Bearing in mind the possible involvement of TNF-? in the pathogenesis of primary biliary cirrhosis, it could be argued that the clinical and laboratory improvement of liver disease, as well as the reduction in serum titers of antimitochondrial antibodies, might be due to the anti-TNF-? action of adalimumab. We suggest that it would be worth further investigating the role of biologic agents in the treatment of patients with primary biliary cirrhosis. PMID:24834253

Durakis, Spyros; Merikas, Emmanuel

2013-01-01

268

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

PubMed Central

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

Muhammad, Adnan; Vidyarthi, Gitanjali; Brady, Patrick

2014-01-01

269

The Different Dose-Volume Effects of Normal Tissue Complication Probability Using LASSO for Acute Small-Bowel Toxicity during Radiotherapy in Gynecological Patients with or without Prior Abdominal Surgery  

PubMed Central

Purpose. To develop normal tissue complication probability (NTCP) model with least absolute shrinkage and selection operator (LASSO) to analyze dose-volume effects that influence the incidence of acute diarrhea among gynecological patients with/without prior abdominal surgery. Methods and Materials. Ninety-five patients receiving gynecologic radiotherapy (RT) were enrolled. The endpoint was defined as the grade 2+ acute diarrhea toxicity during treatment. We obtained the range of small-bowel volume in V4?Gy to V40?Gy of dose. Results. The number of patients experiencing grade 2+ acute diarrhea toxicity was 23/61 (38%) in the group without abdominal surgery (group 0) and 17/34 (50%) patients with abdominal surgery (group 1). The most significant predictor was found for the logistic NTCP model with V16?Gy as the cutoff dose for group 0 and V40?Gy for group 1. Logistic regression NTCP model parameters were TV10 ? 290?cc for V16?Gy and TV10 ? 75?cc for V40?Gy, respectively. Conclusion. To keep the incidence of grade 2+ acute small-bowel toxicity below 10%, we suggest that small-bowel volume above the prescription dose (V16?Gy) should be held to <290?cc for patients without abdominal surgery, and the prescription dose (V40?Gy) should be maintained <75?cc for patients with abdominal surgery. PMID:25136554

2014-01-01

270

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

SciTech Connect

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

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

2007-11-01

271

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

PubMed

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

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

2014-12-01

272

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

273

Adenocarcinoma of the pancreas  

PubMed Central

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

Hruban, Ralph H.; Klimstra, David S.

2015-01-01

274

Metastatic primary duodenal adeno-carcinoma responding to metronomic oral cyclophosphamide chemotherapy.  

PubMed

Primary adenocarcinoma of duodenum is a very rare tumour with a prevalence of only 0.3 to 1% of among all the tumours of gastrointestinal tracts. Localised tumours, if resected have good prognosis but those with metastates entails a poor prognosis, where generally palliation may be the only feasible option. Low dose continous cytotoxic treatment or metronomic chemotherapy prevents neoangiogenesis and chemoresistance thereby, provides excellent symptom relief and palliation in many advanced heavily pretreated solid malignancies. It offers as an affordable, less toxic therapy with moderate to good efficacy. Here we report a case of a 52 year female who, presented with history of maleana, pallor and pedal edema for last 2 months. Her performance status was poor (KPS 40) and she had enlarged left supraclavicular lymph node, palpable liver and vague mass in paraumbilical region. Upper GI endoscopy revealed large ulceroproliferative growth in the D2 segment and HPE showed moderately differentiated adenocarcinoma. CT scan revealed paratracheal and retroperitoneal lymphadenopathy and bone scan revealed vertebral metastasis. Patient received oral cyclophosphamide and hematinic and vitamin support, along with radiation to spine. There was near complete clinical response, and progression free period of about 32 weeks. Thus, single agent cyclophosphamide in the present case provided near total clinical response and prolonged period of freedom from disease progression with excellent palliation of symptoms. Hence in patient of advanced and metastatic small bowel cancer, with poor performance status metronomic therapy with single agent cyclophosphamide may provide viable option both for treatment and palliation. PMID:25191014

Bandyopadhyay, Anis; Das, Mou; Kundu, Subhra Kanti

2014-09-01

275

Metastatic Primary Duodenal Adeno-Carcinoma Responding to Metronomic Oral Cyclophosphamide Chemotherapy  

PubMed Central

Primary adenocarcinoma of duodenum is a very rare tumour with a prevalence of only 0.3 to 1% of among all the tumours of gastrointestinal tracts. Localised tumours, if resected have good prognosis but those with metastates entails a poor prognosis, where generally palliation may be the only feasible option. Low dose continous cytotoxic treatment or metronomic chemotherapy prevents neoangiogenesis and chemoresistance thereby, provides excellent symptom relief and palliation in many advanced heavily pretreated solid malignancies. It offers as an affordable, less toxic therapy with moderate to good efficacy. Here we report a case of a 52 year female who, presented with history of maleana, pallor and pedal edema for last 2 months. Her performance status was poor (KPS 40) and she had enlarged left supraclavicular lymph node, palpable liver and vague mass in paraumbilical region. Upper GI endoscopy revealed large ulceroproliferative growth in the D2 segment and HPE showed moderately differentiated adenocarcinoma. CT scan revealed paratracheal and retroperitoneal lymphadenopathy and bone scan revealed vertebral metastasis. Patient received oral cyclophosphamide and hematinic and vitamin support, along with radiation to spine. There was near complete clinical response, and progression free period of about 32 weeks. Thus, single agent cyclophosphamide in the present case provided near total clinical response and prolonged period of freedom from disease progression with excellent palliation of symptoms. Hence in patient of advanced and metastatic small bowel cancer, with poor performance status metronomic therapy with single agent cyclophosphamide may provide viable option both for treatment and palliation. PMID:25191014

Bandyopadhyay, Anis; Das, Mou; Kundu, Subhra Kanti

2014-01-01

276

Biomarkers in pancreatic adenocarcinoma.  

PubMed

Pancreatic adenocarcinoma is a highly aggressive cancer, with a median patient survival of less than one year. Clinically useful biomarkers capable of accurately assessing prognosis, as well as response to therapy, are urgently needed. At the 2014 ASCO Annual Meeting, Maus et al. (Abstract #e15199) and Neuzillet et al. (Abstract #e15200) present data on use of c-met as a prognostic biomarker, and Shultz et al. (Abstract #4133) use a multiplex antibody panel to identify predictive markers of response to gemcitabine and erlotinib. PMID:25076328

Joza, Nicholas; Saif, Muhammad Wasif

2014-07-01

277

Cytological screening of endocervical adenocarcinoma.  

PubMed

Invasive endocervical adenocarcinoma represents on average 15% of cervical carcinomas and it is associated with the human papillomavirus infection high risk types 16 and 18 in most cases. Its detection has some special features compared to squamous cell carcinoma; glandular precancerous lesions are less known and only adenocarcinoma in situ is diagnosed by consensus among pathologists; adenocarcinoma in situ develops in the squamocolumnar junction by reserve cells but it is hard to be located by colposcopy in the endocervical canal or in the deep glandular recess. Sampling of endocervical cells requires brushes rather than an Ayre spatula. Cytological diagnosis of glandular cells abnormalities is based on the Bethesda System 2001 terminology which redefined endocervical cells abnormalities and also introduced the entity of adenocarcinoma in situ. This entity is characterized by specific morphological features, such as the radial arrangement of nuclei in the periphery, like "at the end of the feathers of a bird's wing"(feathering of cells), images of nuclei palissading or rosette without tumoral diathesis. Glandular cells abnormalities are rare and represent less than 0.1% of all smears and less than 5% of abnormal smears. By improving the collection and the interpretation of abnormal endocervical cells, cytological screening should allow the diagnosis of in situ adenocarcinoma and detection of invasive adenocarcinoma at a very early stage. This will lead to a decrease in mortality from endocervical adenocarcinoma, especially in young women. PMID:23244488

Di Bonito, Luigi; Bergeron, Christine

2012-12-01

278

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

279

Adenocarcinoma of the cervical stump  

SciTech Connect

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

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

1989-11-01

280

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

281

X-ray induced electrostatic charging of helium films  

Microsoft Academic Search

It is well known that free electrons can be held onto the free surface of liquid helium through either their own image charges or through the effect of an externally applied electric field. The resultant electrostatic pressure causes films to thin. We have recently measured x-ray reflectivity from static films of isotopic mixtures of helium with an intense x-ray beam

K. Penanen; P. S. Pershan; M. J. Regan; Isaac F. Silvera

1995-01-01

282

Chemistry-dependent X-ray-induced surface charging.  

PubMed

Materials science in general, and surface/interface science in particular, have greatly benefited from the development of high energy synchrotron radiation facilities. Irradiation with intense ionizing beams can however influence relevant sample properties. Permanent radiation damage and irradiation-induced sample modifications have been investigated in detail during the last decades. Conversely, reversible sample alterations taking place only during irradiation are still lacking comprehensive in situ characterization. Irradiation-induced surface charging phenomena are particularly relevant for a wide range of interface science investigations, in particular those involving surfaces of solid substrates in contact with gaseous or liquid phases. Here, we demonstrate partially reversible radiation-induced surface charging phenomena, which extend far beyond the spatial dimensions of the X-ray beam mainly as a consequence of the interaction between the surface and ionized ambient molecules. The charging magnitude and sign are found to be surface chemistry specific and dependent on the substrates' bulk conductivity and grounding conditions. These results are obtained by combining a scanning Kelvin probe with a synchrotron surface diffractometer to allow simultaneous in situ work function measurements during precisely controlled hard X-ray micro-beam irradiation. PMID:25219347

Salg?n, Bekir; Pontoni, Diego; Vogel, Dirk; Schröder, Heiko; Keil, Patrick; Stratmann, Martin; Reichert, Harald; Rohwerder, Michael

2014-10-28

283

X-RAY-INDUCED CHANGE IN THE LEUCOCYTE REACTION  

Microsoft Academic Search

Three dogs were subjected to a light electrical skin shock, and three to ; a heavy electrical shock, in order to induce an increase in the leukocyte blood ; count as a conditioned or unconditioned, defensive reflex action. The ; conditioned reflex was stimulated by applying the electrical shock five seconds ; after starting a metronome. The dogs were subjected

Ulyanov

1962-01-01

284

Protocol for a phase III randomised trial of image-guided intensity modulated radiotherapy (IG-IMRT) and conventional radiotherapy for late small bowel toxicity reduction after postoperative adjuvant radiation in Ca cervix  

PubMed Central

Introduction External beam radiation followed by vaginal brachytherapy (±chemotherapy) leads to reduction in the risk of local recurrence and improves progression-free survival in patients with adverse risk factors following Wertheim's hysterectomy albeit at the risk of late bowel toxicity. Intensity Modulated Radiotherapy (IMRT) results in reduction in bowel doses and has potential to reduce late morbidity, however, needs to be confirmed prospectively in a randomised trial. The present randomised trial tests reduction if any in late small bowel toxicity with the use of IMRT in postoperative setting. Methods and analysis Patients more than 18?years of age who need adjuvant (chemo) radiation will be eligible. Patients with residual pelvic or para-aortic nodal disease, history of multiple abdominal surgeries or any other medical bowel condition will be excluded. The trial will randomise patients into standard radiation or IMRT. The primary aim is to compare differences in late grades II–IV bowel toxicity between the two arms. The secondary aims of the study focus on evaluating correlation of dose–volume parameters and late toxicity and quality of life. The trial is planned as a multicentre randomised study. The trial is designed to detect a 13% difference in late grades II–IV bowel toxicity with an ? of 0.05 and ? of 0.80. A total of 240 patients will be required to demonstrate the aforesaid difference. Ethics and dissemination The trial is approved by institutional ethics review board and will be routinely monitored as per standard guidelines. The study results will be disseminated via peer reviewed scientific journals, conference presentations and submission to regulatory authorities. Registration The trial is registered with clinicaltrials.gov (NCT 01279135). PMID:23242243

Chopra, Supriya; Engineer, Reena; Mahantshetty, Umesh; Misra, Shagun; Phurailatpam, Reena; Paul, Siji N; Kannan, Sadhna; Kerkar, Rajendra; Maheshwari, Amita; Shylasree, TS; Ghosh, Jaya; Gupta, Sudeep; Thomas, Biji; Singh, Shalini; Sharma, Sanjiv; Chilikuri, Srinivas; Shrivastava, Shyam Kishore

2012-01-01

285

Unusual presentation of metastatic adenocarcinoma  

PubMed Central

Background The most common tumours of the adrenal gland are adenoma, pheochromocytoma, adrenocortical carcinoma, and metastases. Although the imaging features of these tumours are established, the imaging characteristics of uncommon adrenal masses are less well known. In patients with extradrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy. Case presentation A 52 year-old female was diagnosed with oesophageal adenocarcinoma and treated with oesophagectomy and adjuvant chemotherapy. Sixteen months later on staging CT scan a 2 × 2 cm adrenal mass was detected, which increased in size over a period of time to 3 × 3 cm in size. Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma. Conclusion The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma. PMID:17949483

Bagwan, Izhar N; Cook, Gary; Mudan, Satvinder; Wotherspoon, Andrew

2007-01-01

286

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

287

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

PubMed Central

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

2013-01-01

288

Genome profiling of pancreatic adenocarcinoma.  

PubMed

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

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

2011-06-01

289

Vitiligo Associated with Esophageal Adenocarcinoma  

PubMed Central

Vitiligo is a disease that results in depigmented areas in the skin. It may develop at any age but the average age at onset is 20 years. Association of vitiligo and melanoma has been commonly reported, but malignancies other than melanoma have been rarely associated with vitiligo. We report a 73-year-old patient with new onset vitiligo who developed esophageal adenocarcinoma in the following years. PMID:23671783

Asilian, Ali; Momeni, Iman; Khosravani, Parastou

2013-01-01

290

Adenocarcinoma of the uterine cervix.  

PubMed

In Finland, the incidence of cervical cancer has shown a decreasing tendency since the 1960s. The same trend, however, has not been noticed in the incidence of cervical adenocarcinoma. The reason for this is not known, although many studies have shown differences in the cause, epidemiology, and biology of the epidermoid and adenocarcinoma of the uterine cervix. A total of 106 new patients with cervical adenocarcinoma were treated at our institution from 1976 to 1980, which represents 20.4% of all cervical carcinomas treated. The mean age of the patients was 58.1 years (range, 29 to 82 years) and the peak incidence was in the group 60 to 69 years of age. Most of the patients were postmenopausal (71.7%) and the main symptom was abnormal vaginal bleeding (78.3%). The proportion of Stage I was 61.3%. Combined operative and radiation therapy was used in 74.5% of the patients. The overall 5-year survival rate was 65.1% (corrected 74.5%), which did not differ from that of patients with squamous cell carcinoma. The most significant prognostic factors were the size of the tumor, presence of pelvic lymph node metastases, and the stage of the disease. PMID:2293870

Leminen, A; Paavonen, J; Forss, M; Wahlström, T; Vesterinen, E

1990-01-01

291

Extended external hemipelvectomy for sigmoid adenocarcinoma treatment.  

PubMed

Surgery is the most effective way of treating a locally advanced colorectal carcinoma and an extended en bloc resection is necessary to achieve the best overall survival rate. In this rare case, a multi-visceral resection was performed along with the entire lower left limb and left iliac bone for a sigmoid carcinoma. The T4N0M0 (B3) tumor involved the left iliac vessels, left pelvic wall, small bowel and both rectus muscles, besides presenting with a skin fistula. A Hartmann colostomy was also performed. Chemotherapy was interrupted because of toxicity. The patient is free of disease after 38 months. There are very few cases that describe an extended hemipelvectomy as part of a colorectal carcinoma treatment. PMID:21181006

Reis, Rodrigo Ribas Dias dos; Schiavinatto, Luciane; Telles, Mário Luis; Moreira, Adriana Eliza Brasil; Mainardi, João Paulo Aguiar Jordão

2010-10-01

292

MYC and gastric adenocarcinoma carcinogenesis  

PubMed Central

MYC is an oncogene involved in cell cycle regulation, cell growth arrest, cell adhesion, metabolism, ribosome biogenesis, protein synthesis, and mitochondrial function. It has been described as a key element of several carcinogenesis processes in humans. Many studies have shown an association between MYC deregulation and gastric cancer. MYC deregulation is also seen in gastric preneoplastic lesions and thus it may have a role in early gastric carcinogenesis. Several studies have suggested that amplification is the main mechanism of MYC deregulation in gastric cancer. In the present review, we focus on the deregulation of the MYC oncogene in gastric adenocarcinoma carcinogenesis, including its association with Helicobacter pylori (H pylori) and clinical applications. PMID:18932273

Calcagno, Danielle Queiroz; Leal, Mariana Ferreira; Assumpção, Paulo Pimentel; Smith, Marília de Arruda Cardoso; Burbano, Rommel Rodríguez

2008-01-01

293

How Is Small Intestine Adenocarcinoma Staged?  

MedlinePLUS

... found in 4 or more nearby lymph nodes M categories for small intestine adenocarcinoma M categories indicate whether or not the cancer has ... or tissues. Stage grouping The T, N, and M categories are combined (in a process called stage ...

294

Oncocytic adenocarcinoma of the lacrimal sac.  

PubMed

A well-differentiated, oncocytic adenocarcinoma of the lacrimal sac recurred locally in a patient during a period of 13 years. This appears to be the second documented instance of such a neoplasm. PMID:629677

Peretz, W L; Ettinghausen, S E; Gray, G F

1978-02-01

295

Epigenetics in the Pathogenesis of Esophageal Adenocarcinoma.  

PubMed

Epigenetic influences, such as DNA methylation, histone acetylation, and up-regulation/down-regulation of genes by microRNAs, change the genetic makeup of an individual without affecting DNA base-pair sequences. Indeed, epigenetic changes play an integral role in the progression from normal esophageal mucosa to Barrett's esophagus to esophageal adenocarcinoma via dysplasia-metaplasia-neoplasia sequence. Many genes involved in esophageal adenocarcinoma display hypermethylation, leading to their down-regulation. The classes of these genes include cell cycle control, DNA and growth factor repair, tumor suppressors, antimetastasis, Wnt-related genes, and proapoptotic genes. Histone acetylation in the pathophysiology of esophageal diseases has not been thoroughly investigated, and its critical role in the development of esophageal adenocarcinoma is less defined. Many microRNAs have been associated with the development of Barrett's esophagus and esophageal adenocarcinoma. Here, we critically addressed the specific steps most closely influenced by microRNAs in the progression from Barrett's esophagus to esophageal adenocarcinoma. However, microRNAs can target up to hundreds of genes, making it difficult to correlate directly with a given phenotype of the disease. Esophageal adenocarcinoma progressing from premalignant condition of Barrett's esophagus carries an extremely poor prognosis. Risk stratification for patients based on their epigenetic profiles may be useful in providing more targeted and directed treatment to patients. PMID:25388215

Kailasam, Aparna; Mittal, Sumeet K; Agrawal, Devendra K

2014-11-12

296

Targeting metastatic upper gastrointestinal adenocarcinomas  

PubMed Central

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

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

2011-01-01

297

Risk factors for adenocarcinoma of the lung  

SciTech Connect

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

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

1987-01-01

298

Increased BRAF copy number in lung adenocarcinoma  

PubMed Central

Point mutation of the BRAF gene is a genetic event that occurs in a subset of lung adenocarcinoma cases. For example, BRAF V600E is a driver mutation that can be effectively targeted using selective BRAF and/or MEK inhibitors. The present study hypothesized that an increase in BRAF copy number may be correlated with certain clinicopathological features of lung adenocarcinoma in Japanese patients. The BRAF gene copy number was analyzed using quantitative polymerase chain reaction amplifications in 29 surgically treated lung adenocarcinoma cases without EGFR or Kras mutations from Nagoya City University Hospital (Nagoya, Japan). Seven BRAF-mutant cases were included. Increased BRAF gene copy number was identified in three lung adenocarcinoma patients (10.3%), all of which exhibited the V600E mutation. Using fluorescence in situ hybridization with BRAF-specific and chromosome 7 centromeric probes, increased copy number status was associated with gene amplification or gain of chromosome 7. Although increased BRAF copy number was correlated with BRAF V600E mutations, numerical changes in BRAF copy number were rare and mild in lung adenocarcinoma, resulting in no significant difference in pathological tumor status or tumor stage.

SASAKI, HIDEFUMI; MAEKAWA, MASAHIKO; TATEMATSU, TSUTOMU; OKUDA, KATSUHIRO; MORIYAMA, SATORU; YANO, MOTOKI; FUJII, YOSHITAKA

2015-01-01

299

A human gallbladder adenocarcinoma cell line.  

PubMed

A cell strain (FU-GBC-1) was established from cancerous ascites of a 68-year-old male patient with well-differentiated adenocarcinoma of the gallbladder. By light and electron microscopy, the cultured cells showed the morphologic features of adenocarcinoma characterized by gland-like structures, intracellular microcystic spaces, and mucous production. Immunoperoxidase stains showed that FU-GBC-1 cells expressed several epithelial tumor antigens including CA 19-9, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA). The cell strain has been in continuous culture up to passage 44 for 1 1/2 years, with the population doubling time of 120 hours. The cytogenetic analysis by a G-band technique showed a constant loss of chromosome Y in FU-GBC-1 cells. The modal chromosome number at passage 12 was 82 with a range of 77 to 85. Flow cytometry with an ethidium bromide technique additionally confirmed aneuploid DNA content (4C) in the cultured cells at passage 12 and 35. Inoculation of FU-GBC-1 cells into the dermis of BALB/c nude mice produced transplantable adenocarcinoma identical to the original tumor. Because no continuous cell lines of the well-differentiated type of gallbladder adenocarcinoma have been reported in the literature currently, the newly established cell strain we report may yield a useful system for studying the morphologic and biologic characteristics of gallbladder adenocarcinoma. PMID:2680052

Johzaki, H; Iwasaki, H; Nishida, T; Isayama, T; Kikuchi, M

1989-12-01

300

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.

301

Nucleolar organiser regions in adenocarcinoma in situ and invasive adenocarcinoma of the cervix.  

PubMed Central

Silver binding nucleolar regions (AgNORs) were evaluated in normal endocervix, adenocarcinoma, and its potential precursor, adenocarcinoma in situ (AIS), in an attempt to increase an understanding of the natural history of cervical adenocarcinoma and to identify a marker for abnormal endocervical (atypical glandular) cells which could aid diagnosis and follow up of endocervical lesions. For every 50 cells the mean AgNOR counts were as follows: normal endocervical cells (n = 15) 79.8 (95% Cl 68-91); AIS (n = 20) 200.7 (95% Cl 182-219); and invasive adenocarcinoma (n = 30) 299 (271-328). There was no overlap between the groups of normal endocervical cells and invasive adenocarcinoma, but there was significant overlap between cases of invasive adenocarcinoma and carcinoma in situ. In six out of 17 cases with AIS, NOR count in adjacent morphologically normal glandular cells ("internal" controls) was increased when compared with the "external" (normal endocervical) control group. This suggests the presence of wider field changes not previously identified using routine histological methods. The findings suggest that AIS is a potential premalignant precursor of invasive adenocarcinoma, but that assessment of NORs is of no practical use in discriminating between the histological types of cervical carcinoma. Images PMID:2401734

Darne, J F; Polacarz, S V; Sheridan, E; Anderson, D; Ginsberg, R; Sharp, F

1990-01-01

302

Primary Gastric Malignant Melanoma Mimicking Adenocarcinoma  

PubMed Central

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

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

2014-01-01

303

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

304

Survival After Curative Resection for Mucinous Adenocarcinoma of the Colorectum  

Microsoft Academic Search

PURPOSE: Previous reports have suggested that mucinous colorectal adenocarcinomas are more advanced at diagnosis and have a poorer prognosis than nonmucinous colorectal adenocarcinomas. The purpose of this study was to clarify whether the mucin-producing histologic type of carcinoma is associated with a worse prognosis than nonmucinous, differentiated colorectal adenocarcinoma for patients who undergo curative surgery. METHODS: Using a database of

Yukihide Kanemitsu; Tomoyuki Kato; Takashi Hirai; Kenzo Yasui; Takeshi Morimoto; Yasuhiro Shimizu; Yasuhiro Kodera; Yoshitaka Yamamura

2003-01-01

305

Pulmonary adenocarcinoma occurring 5 years after resection of a primary pancreatic adenocarcinoma: a relevant differential diagnosis.  

PubMed

Ductal adenocarcinoma of the pancreas is a lethal disease. Surgical extirpation only offers the slim chance for long-term survival in localized disease. We report on a 73 year old female patient who initially underwent successful resection of pancreatic adenocarcinoma in May 2005. She was treated with adjuvant chemotherapy with gemcitabine. In October 2010 the patient noticed increasing dyspnea with haemoptysis. She was soon referred to our center. After the diagnosis of pulmonary adenocarcinoma with widespread metastasis, she was treated with systemic chemotherapy. For a period of next three years, she was treated with different chemotherapy regimens due to repeated episodes of tumor progression. To the best of our knowledge after reviewing the literature, this case represents an unusually clinical course with metachronous pulmonary adenocarcinoma arising after treatment of a primary pancreatic cancer after a long latency period. PMID:24716048

Falkenstern-Ge, R F; Wohlleber, M; Kimmich, M; Huettl, K; Friedel, G; Ott, G; Kohlhäufl, M

2014-01-01

306

Large retroperitoneal paraganglioma concurrent with periampullary adenocarcinoma  

PubMed Central

Paragangliomas are tumors that originate from extra-adrenal medullary neural crest derivatives. They are rarely located in retroperitoneal space. These tumors are often discovered incidentally during imaging studies performed for other reasons. Periampullary cancers include adenocarcinomas arising from the pancreas, ampulla of Vater, duodenum or distal common bile duct. The exact site of origin of periampullary tumors is often difficult to ascertain pre-operatively. We report the case of a patient who had a retroperitoneal non-functional paraganglioma, concurrent with periampullary adenocarcinoma. An 81-year-old woman was admitted with progressive abdominal fullness. There was an upper paramedian, left sided, large, palpable mass on the physical examination. Laboratory investigations showed an increase in liver enzyme levels. On abdominal computed tomography the patient found to have a large retroperitoneal mass and dilation in biliary tract, which was confirmed by magnetic resonance cholangiopancreatography. She had a tumoral papi in Endoscopic Retrograde cholangiopancreatography. Which biopsy revealed adenocarcinoma. She underwent surgery for excision of abdominal mass and pancreaticoduodenectomy. And pathologic study showed paraganglioma. This is the first ever reported case of concurrent paraganglioma and periampullary adenocarcinoma. PMID:24523807

Hakimian, Seyed Mohammadreza; Naimi, Azar; Emami, Seyed Mohammadhasan; Rozatii, Golnar; Goharian, Vahid

2013-01-01

307

Image analysis and grading of prostate adenocarcinoma  

Microsoft Academic Search

The multitude of grading systems proposed for prostate adenocarcinoma illustrate the putative value of tumor grading as a predictor of prognosis. However, it also indicates the uncertainty and subjectivity of visual grading, as is confirmed by the results of several studies. Recent computer techniques enable fast image processing of microscoping images. Hence, a quantitative assessment of cellular and nuclear features

H. G. van der Poel; J. A. Schalken; F. M. J. Debruyne

1991-01-01

308

Adenocarcinoma - chest x-ray (image)  

MedlinePLUS

This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

309

Gene expression profiling in sinonasal adenocarcinoma  

Microsoft Academic Search

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

Dominique Tripodi; Sylvia Quéméner; Karine Renaudin; Christophe Ferron; Olivier Malard; Isabelle Guisle-Marsollier; Véronique Sébille-Rivain; Christian Verger; Christian Géraut; Catherine Gratas-Rabbia-Ré

2009-01-01

310

Pancreatic Adenocarcinoma: New Strategies for Success  

PubMed Central

Pancreatic adenocarcinoma ranks as the most challenging of human malignancies, with overall 5-year survivorship being measured in a couple of percent. Major progress has occurred regarding the molecular underpinnings and pathogenesis of pancreatic adenocarcinoma, definition of the epidemiology and genetics of this disease, identification of individuals at risk, and in 2008, the preliminary description of the pancreatic genome. However, clinical developments over the past decade have been modest and incremental at most. The core drug and the backbone of treatment in all settings of pancreatic adenocarcinoma— adjuvant, locally advanced, and metastatic—remains gemcitabine. The past decade of research focused initially on combining cytotoxic therapies with gemcitabine, and more recently, on combining newer “targeted agents.” Some success has been observed by combining the platinum analogs and the fluoropyrimidines with gemcitabine in the advanced pancreatic cancer setting. Three- and four-drug combinations have also been assessed, but the data are limited and the major trade-off becomes a toxicity-benefit equation. In relative terms, more limited incremental gains have been observed by combining erlotinib with gemcitabine, while other randomized phase III trials of targeted agents combined with gemcitabine have essentially shown no benefit. Several of the newer generation anti-vascular agents (VEGF-trap, axitinib) are being evaluated in ongoing phase III trials. In the short-term, expectations for advances in pancreatic adenocarcinoma therapy are reserved, with most progress likely to be made in therapy refinement and patient selection. However, it is reasonable to surmise that major progress will evolve as the molecular biology of pancreatic adenocarcinoma continues to be unraveled, as the infrastructure for translational research is strengthened with new preclinical models, and with recognition of the prerequisite requirement for intensive cross-disciplinary collaboration. PMID:19461915

2009-01-01

311

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

2015-01-22

312

Endometrioid adenocarcinoma of caecum causing intussusception.  

PubMed

Malignant transformation of endometriosis is rare and is usually seen in ovarian endometriosis. The colon and rectum are the most common sites for extragonadal endometriosis, and although serosal involvement is commonly seen, mucosal involvement is rare. Malignant transformation of endometriosis is a rare but a well-known complication of endometriosis. We report an unusual presentation of endometrioid adenocarcinoma with lymph node metastasis, arising from endometriosis in the caecal wall and causing ileocaecal intussusception. The patient presented with sudden onset of abdominal pain with features suggestive of acute appendicitis. Diagnostic laparoscopy revealed an ileocaecal intussusception. Conversion to open surgery confirmed a caecal mass causing ileocaecal intussusception, and a radical right hemicolectomy was performed. Histology revealed endometrioid adenocarcinoma arising in a focus of endometriosis in the muscularis propria and involving the mucosa, with one regional metastatic lymph node. PMID:23710407

Verma, Rashmi; Osborn, Sally; Horgan, Kieran

2013-01-01

313

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

314

[Predisposing factors for development of cardial adenocarcinoma].  

PubMed

After a careful revision of the various papers and on the basis of their personal experience, the persons responsible for this project analyse the factors that, today, influence the development of an adenocarcinoma in the region of the gastro-esophageal junction. They also study therapeutic strategies on the basis of new findings in anatomic-physiological matters of this region. From this analysis, specialists notice an increase in adenocarcinomas which affect the gastric region of the cardia, in comparison with carcinomas which affects the gastric region in toto. By considering Barrett, Hayward, Riedel and Ruol's studies, they maintain that the fundamental factor which causes the development of cardial adenocarcinoma is the gastroesophageal reflux. This reflux acts as a chronic irritative stimulus on the esophageal wall and therefore it provokes an increase in mucous secretion and the formation of metaplasia. This metaplasia is initially mucosecreting, acid-secreting and in the end it becomes intestinal. This also leads to the appearance of absorbent calciform cells; the absorption of toxic or mutagenic substance for the cell itself, will be the next step for the development of an adenocarcinoma. Nowadays the therapy of intestinal metaplasia provides for different therapeutic levels: from the endoscopic monitoring (which is used for the most serious cases of dysplasia), to the PPI medical treatment(today in disuse), to the surgical laparoscopic treatment with non-refluxing plasty (Nissen, Toupet). This last treatment is today associated with endoscopic esophageal mucosectomy in order to achieve a better effectiveness. This happens through the use of various methodologies, for example the multipolar electrocoagulation. PMID:12692493

Tosato, F; Carnevale, L; Corsini, F; Marano, S; Palermo, S; Piraino, A; Leonardo, G; Monsellato, I; Paolini, A

2003-02-01

315

Single cerebral metastasis from colorectal adenocarcinoma.  

PubMed

Single cases are described in 50% of reported intracranial metastases. Single cerebral metastasis from colorectal adenocarcinoma is not very common, with a frequency varying between 0.5% and 1%. In our institute between 1960 and 2000, 44 patients affected by single metastasis from colorectal carcinoma were surgically treated. Surgical treatment with postoperative radiant therapy is necessary. These patients show improved quality of life, above all in relation to the maintenance of functional autonomy during the survival period. PMID:12884056

D'Andrea, Giancarlo; Isidori, Alessandra; Caroli, Emanuela; Orlando, Epimenio Ramundo; Salvati, Maurizio

2004-01-01

316

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

317

Epidemiology of adenocarcinoma of the cervix.  

PubMed

Three hundred thirty-three patients who presented with cervical carcinoma from November 1980 through June 1985 were compared for potential factors associated with histology. Sixteen percent of all patients presenting with cervical carcinoma during this 5-year period had an adenocarcinomatous histology. Emphasis was placed on demographic and socioeconomic factors. The histologic distribution was the following: epidermoid carcinoma 279, adenocarcinoma 28, and adenoepidermoid carcinoma 26. The latter two histologies were not different for any factors and therefore combined for statistical comparison with epidermoid carcinoma. When epidermoid (E) carcinoma of the cervix was compared with the histologies having an adenocarcinomatous component (A), the following demographic and socioeconomic factors were statistically, different (P less than 0.05): Unemployment (E 69% vs. A 46%) P less than 0.002; Income less than $6000/yr (E 48% vs. A 26%) P less than 0.005; Less than a 12th-grade education (E 85% vs. A 72%) P less than 0.05; Smokers (E 67% vs. A 40%) P less than 0.001; First coital experience less than 18 years (E 58% vs. A 39%) P less than 0.05. Age, parity, and number of sexual partners were not significantly different between the epidermoid and adenocarcinoma groups. The number of patients with stages II, III, and IV was too small to provide a meaningful statistical comparison of survival for the two histologies. Our data suggest that epidermoid and adenocarcinoma of the cervix may represent diseases with distinct populations at risk. PMID:3410353

Horowitz, I R; Jacobson, L P; Zucker, P K; Currie, J L; Rosenshein, N B

1988-09-01

318

Comprehensive molecular profiling of lung adenocarcinoma.  

PubMed

Adenocarcinoma of the lung is the leading cause of cancer death worldwide. Here we report molecular profiling of 230 resected lung adenocarcinomas using messenger RNA, microRNA and DNA sequencing integrated with copy number, methylation and proteomic analyses. High rates of somatic mutation were seen (mean 8.9 mutations per megabase). Eighteen genes were statistically significantly mutated, including RIT1 activating mutations and newly described loss-of-function MGA mutations which are mutually exclusive with focal MYC amplification. EGFR mutations were more frequent in female patients, whereas mutations in RBM10 were more common in males. Aberrations in NF1, MET, ERBB2 and RIT1 occurred in 13% of cases and were enriched in samples otherwise lacking an activated oncogene, suggesting a driver role for these events in certain tumours. DNA and mRNA sequence from the same tumour highlighted splicing alterations driven by somatic genomic changes, including exon 14 skipping in MET mRNA in 4% of cases. MAPK and PI(3)K pathway activity, when measured at the protein level, was explained by known mutations in only a fraction of cases, suggesting additional, unexplained mechanisms of pathway activation. These data establish a foundation for classification and further investigations of lung adenocarcinoma molecular pathogenesis. PMID:25079552

2014-07-31

319

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 Simão; Oshima, Celina Tizuko Fujiyama; Forones, Nora Manoukian; De Oliveira Lima, Flávio; Ribeiro, Daniel Araki

2014-01-01

320

Gastric choriocarcinoma admixed with an ?-fetoprotein-producing adenocarcinoma and separated adenocarcinoma  

PubMed Central

We report a case of gastric choriocarcinoma admixed with an ?-fetoprotein (AFP)-producing adenocarcinoma. A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum. The patient underwent radical subtotal gastrectomy with D2 lymph node dissection and Billroth II gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively. PMID:19860007

Eom, Bang Wool; Jung, So-Youn; Yoon, Hongman; Kook, Myeong-Cherl; Ryu, Keun Won; Lee, Jun Ho; Kim, Young-Woo

2009-01-01

321

Combined choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma in the oesophagus.  

PubMed

We describe an oesophageal tumour composed of choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma. The choriocarcinomatous areas and hepatoid adenocarcinomatous areas contained beta human chorionic gonadotropin-positive cells and alpha fetoprotein-positive cells, respectively. The small cell carcinomatous areas contained cells positive for serotonin or adrenocorticotrophic hormone, while the tubular adenocarcinomatous areas contained cells positive for carcinoembryonic antigen. Non-neoplastic gastric type columnar epithelium was found directly adjoing the tumour at the oral side. This tumour, with its unprecedented histology combination of tissues may have originated in Barrett's oesophagus, although we could not confirm a history of chronic gastro-oesophageal reflux. PMID:8548132

Motoyama, T; Higuchi, M; Taguchi, J

1995-01-01

322

Lymphocyte subpopulations after extensive small bowel resection in the rat  

Microsoft Academic Search

The increased risk of infection after massive intestinal resection (MIR) may be attributable to impaired nutrition, loss of intestinal lymphoid tissue, or both. This study examines whether MIR itsefl changes the immune cell populations in laboratory animals when nutritional status is preserved. The authors studied cellular immunity (lymphocyte subsets T4 and T8 and the T4:T8 ratio) and humoral immunity (IgG,

M. J Barrena; I Eizaguirre; P Aldazabal; E Cuadrado; P Bachiller; W Wang; J. A Tovar

1995-01-01

323

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

324

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

325

Snapshots in surgery: small bowel intussusception following ileojejunal bypass  

PubMed Central

Key Clinical Message Jejunal intussusception is a known complication of ileojejunal bypass surgery for obesity that may present as an acute abdomen. It can be avoided if the jejunum is anchored to the transverse mesocolon intra-operatively. PMID:25548643

Ward, Joseph; Jaber, Basel; Leaman, Charlotte; Barry, Jonathan; Khot, Umesh

2014-01-01

326

Regeneration of Sympathetic Activities in Small Bowel Transplants  

Microsoft Academic Search

In order to study the activity of noradrenergic nerve fibres along mesenteric arteries in small-intestinal grafts, the entire jejunoileum was transplanted heterotopically in an isogeneic rat model (group I, n = 12). To assess their influence on graft motility, 9 cm of jejunum were transplanted in an orthotopic position and three bipolar electrodes sutured to the seromuscular layer of the

H. Pernthaler; G. Pfurtscheller; G. Klima; R. Plattner; Th. Schmid; M. Kofler; R. Margreiter

1993-01-01

327

Recent advances in small bowel diseases: Part?I  

PubMed Central

As is the case in all parts of gastroenterology and hepatology, there have been many advances in our knowledge and understanding of small intestinal diseases. Over 1000 publications were reviewed for 2008 and 2009, and the important advances in basic science as well as clinical applications were considered. In Part?I?of this Editorial Review, seven topics are considered: intestinal development; proliferation and repair; intestinal permeability; microbiotica, infectious diarrhea and probiotics; diarrhea; salt and water absorption; necrotizing enterocolitis; and immunology/allergy. These topics were chosen because of their importance to the practicing physician. PMID:22807604

Thomson, Alan BR; Chopra, Angeli; Clandinin, Michael Tom; Freeman, Hugh

2012-01-01

328

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

329

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

330

[A necrobiotic nodule indistinguishable from lung adenocarcinoma].  

PubMed

A 43-year-old woman was referred for examination because of an abnormal shadow on a chest X-ray film. She had a 12-year history of seropositive rheumatoid arthritis. Chest X-ray films and CT scans showed a pleurabased solitary nodule without a cavity. Cytological examination of a transbronchial biopsy specimen did not lead to a diagnosis, so thoracoscopic enucleation was performed. Histologically, the nodule consisted of lymphocytes and fibroblasts surrounding a central necrotic area, which indicated that it was a rheumatoid nodule. This solitary necrobiotic nodule was radiographically indistinguishable from lung adenocarcinoma, so histologic confirmation was necessary. PMID:7739185

Hanada, T; Hizawa, N; Ogura, S; Isobe, H; Miyamoto, K; Narita, Y; Kawakami, Y

1995-03-01

331

Microbiome, innate immunity, and esophageal adenocarcinoma.  

PubMed

With the development of culture-independent technique, a complex microbiome has been established and described in the distal esophagus. The incidence of esophageal adenocarcinoma (EAC) has increased dramatically in the United States. Studies documenting an altered microbiome associated with EAC and its precedents suggest that dysbiosis may be contributing to carcinogenesis, potentially mediated by interactions with toll-like receptors. Investigations attempting to associate viruses with EAC have not been as consistent. Currently available data are cross-sectional and therefore cannot prove causal relationships. Prospectively, microbiome studies open a new avenue to the understanding of the etiology and pathogenesis of reflux disorders and EAC. PMID:25439272

Baghdadi, Jonathan; Chaudhary, Noami; Pei, Zhiheng; Yang, Liying

2014-12-01

332

Renal paraneoplastic vasculitis complicating lung adenocarcinoma.  

PubMed

Renal paraneoplastic vasculitis (RNPV) is rare. It can be revealed by glomerulonephritis, microaneurysms or renal failure. RPNV may precede the onset of the primary tumor, and treatment and prognosis depend on the etiology (primary tumor). A 54-year-old man who had a primary lung adenocarcinoma was admitted for nephrotic syndrome. The investigations revealed RNPV. The patient was treated with corticosteroids at high dose and cyclophosphamide with improvement of the renal condition; however, the patient died from worsening of his pulmonary neoplasia. PMID:25193910

Dhaou, Besma Ben; Boussema, Fatma; Aydi, Zohra; Ketari, Sonia; Baili, Lilia; Moussa, Fatma Ben; Rokbani, Lilia

2014-09-01

333

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

334

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

335

Nucleolar organiser regions in adenocarcinoma in situ of the endocervix.  

PubMed Central

The AgNOR technique was used to analyse 11 cases of adenocarcinoma in situ of the endocervix and five examples of healthy cervices to assess whether areas of "increased nuclear activity" could be located adjacent to the malignant tissue. Areas of adenocarcinoma in situ had significantly more AgNOR staining dots than apparently normal bordering areas ("transitional areas") and areas of endocervical epithelium remote from adenocarcinoma in situ. There were no significant differences between AgNOR counts in transitional areas and areas remote from adenocarcinoma in situ, and between these areas and histologically normal cervices. These observations provide no support for the hypothesis that areas of glandular atypia of lesser severity or zones of "increased nuclear activity" exist adjacent to adenocarcinoma in situ. Images PMID:2613921

Cullimore, J E; Rollason, T P; Marshall, T

1989-01-01

336

Telomerase activity in different clinical staging of colorectal adenocarcinoma.  

PubMed

Increased telomerase activity is proposed to be related with the proliferation of some gastrointestinal cancers, including colorectal adenocarcinoma. To date, little is known about the activity of telomerase in different clinical stagings of colorectal adenocarcinoma, which may reflect its association with the progression of colorectal adenocarcinoma. We will examine the activity of telomerase enzyme in different clinical stagings of colorectal adenocarcinoma to know whether it has diagnostic and prognostic value as a tumor marker in the management of colorectal adenocarcinoma. The telomerase activities of primary tumor and normal adjacent mucosa in 17 cases with different clinical stagings of colorectal adenocarcinoma were measured by TRAP assay during the period of 28 September 1998 to 28 February 1999. The activities of the enzyme were measured both qualitatively and quantitatively, and the diagnostic value was assessed by diagnostic test using 2 x 2 table contingency. The association between telomerase activities and other related factors were assessed by multivariate analysis. Increased telomerase activities were found in 82.4% (14/17) of colorectal adenocarcinoma, but in only 23.5% (4/17) of normal adjacent mucosa, which was significantly higher (p = 0.008) compared to that of normal mucosa. The mean values of telomerase activity between different clinical stagings were 0, 0.661, and 1.449 units/410 (g protein for Dukes' stage B, C, and D, respectively, which gave p value of 0.025 with ANOVA. Using a cut off level of 0.2-units/410 (g protein for positive activity, we revealed that the accuracy, sensitivity, and specificity were 77.77%, 82.35%, and 76.47%, respectively. There was no association found between the histopathologic grading of the tumor and telomerase activity. Increased telomerase activity was found in colorectal adenocarcinoma compared to the adjacent normal mucosa. Telomerase activity correlates well with the progression of colorectal adenocarcinoma. Therefore, telomerase enzyme may have a potential diagnostic and prognostic values in the management of colorectal adenocarcinoma. PMID:10895200

Lukman, K; Maskoen, A M; Achmad, T H; Hanafi, B; Karnadihardja, W

2000-05-01

337

Malignant pleural effusion from prostate adenocarcinoma  

PubMed Central

Prostate adenocarcinoma is the most common newly diagnosed cancer in males. Pulmonary and pleural metastasis are not uncommon on autopsy, but malignant effusions are not common clinical findings. There are no current recommendations to guide prostate specific antigen level assessment in pleural fluid. A 73 yo w/prostate cancer presented with complaints of subacute worsening of exertional dyspnea. He underwent a CT of the chest which excluded pulmonary emboli but did show moderate to large bilateral pleural effusions. The patient had a thoracentesis performed which confirmed an exudative effusion with atypical cells and elevated PSA levels. Metastatic visceral & parietal foci of prostate adenocarcinoma were found on medical pleuroscopy. The patient was symptomatically treated with bilateral tunneled chest tube catheters for intermittent drainage. Pulmonary metastasis secondary to prostate cancer is commonly found on autopsy, with pulmonary metastasis in 46% of patients and pleural metastasis in 21% of patients. Pleural effusions are not common, in one series, only 6/620 (1%) were found to have pleural masses/nodules or effusions. Diagnosis of pleural effusion secondary to metastatic prostate cancer can be achieved by direct cytology evaluation and/or PSA level elevation in the fluid. While specific, the sensitivity is not high enough to rule out disease if negative. Elevated pleural fluid PSA levels may aid in the diagnosis; however, there are no current recommendations as to what level may be considered diagnostic. Further studies are needed to define the sensitivity and specificity of PSA in pleural fluid.

Knight, James C.; Ray, Malia A.; Benzaquen, Sadia

2014-01-01

338

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

339

An improved model for ultraviolet- and x-ray-induced electron emission from CsI  

NASA Astrophysics Data System (ADS)

A microscopic theoretical model is proposed for calculating the characteristics of ultraviolet photoemission and x-ray secondary electron emission induced from CsI photoconverters. This approach is based on a realistic picture of the basic interactions of photons and induced electrons within the material. Both differential and integral emission characteristics, such as energy spectra and quantum efficiencies, are estimated according to the model and are found to agree, in general, with experimental data. The model-calculated photoemission enhancement under high external electric fields is also considered and is fairly compatible with measured values. The applicability of the model in the field of radiation detectors incorporating solid photoconverters is discussed.

Boutboul, T.; Akkerman, A.; Gibrekhterman, A.; Breskin, A.; Chechik, R.

1999-11-01

340

X-ray-induced cell death by apoptosis in the immature rat cerebellum  

SciTech Connect

The cells of the external granular layer (EGL) of the developing cerebellum are known to be particularly sensitive to radiation. In the past, changes induced in this layer by irradiation have been referred to by non-specific terms such as pyknotic cells and the mode of cell death has been assumed to be necrosis. However, in published light micrographs of these dying cells, the appearance is suggestive of apoptosis, a distinctive mode of cell death which occurs spontaneously in normal adult and embryonic tissues and can also be triggered by certain pathological stimuli. This light and transmission electron microscopic study of control and irradiated (7 h post-irradiation) rat cerebellum from 18 day fetuses and 5 day-old neonates showed that the cell death was effected by apoptosis. The apoptosis was markedly enhanced by x-irradiation and quantification of the cell death in the EGL of 5 day-old rats exposed to 4, 8, 25, 100, and 400 cGy x-irradiation demonstrated that there was a positive dose response relationship. The extent of cell death by apoptosis which was 0.2% in control, ranged from 0.8% after 4 cGy to 62.3% after 400 cGy x-irradiation. The recognition that cell death by apoptosis can be a major component of x-irradiation damage has important implications for radiobiological studies.

Harmon, B.V.; Allan, D.J.

1988-03-01

341

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

Microsoft Academic Search

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 ½}:2--20 mins) to increase the survival of X-irradiated cells by mending the vast array of DNA

Boothman

1992-01-01

342

INVOLVEMENT OF P53 IN X-RAY INDUCED INTRACHROMOSOMAL RECOMBINATION IN MICE. (R825359)  

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

343

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

Sjöblom, Björn; Polentarutti, Maurizio; Djinovi?-Carugo, Kristina

2009-01-01

344

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

345

Simulation of ultrasoft X-rays induced DNA damage using the Geant4 Monte Carlo toolkit  

NASA Astrophysics Data System (ADS)

In this study, the total yields of SSB and DSB induced by monoenergetic electrons with energies of 0.28-4.55 keV, corresponding to ultrasoft X-rays energies, have been calculated in Charlton and Humm volume model using the Geant4-DNA toolkit and compared with theoretical and experimental data. A reasonable agreement between the obtained results in the present study and experimental and theoretical data of previous studies showed the efficiency of this model in estimating the total yield of strand breaks in spite of its simplicity. Also, it has been found that in the low energy region, the yield of the total SSB remains nearly constant while the DSB yield increases with decreasing energy. Moreover, a direct dependency between DSB induction, RBE value and the mean lineal energy as a microdosimetry quantity has been observed. In addition, it has become clear that the use of the threshold energy of 10.79 eV to calculate the total strand breaks yields results in a better agreement with the experiments, while the threshold of 17.5 eV shows a big difference.

Tajik, Marjan; Rozatian, Amir S. H.; Semsarha, Farid

2015-01-01

346

Three-dimensional model of x-ray induced microchannel plate output  

SciTech Connect

Microchannel plates are an important component in a type of imaging diagnostic known as an x-ray framing camera, used in x-ray radiography of high-energy-density physics experiments. A microchannel plate is responsible for detecting x rays and then converting them into amplified bursts of electrons, which are then imaged onto a phosphor-coated fiber optic screen. We present the preliminary development of a three-dimensional model of a single microchannel plate channel in attempt to simulate the pulse height distribution of the microchannel plate electron output. Using a novel technique, initial simulations are compared with experimental data from an ungated x-ray framing camera.

Harding, E. C.; Drake, R. P. [University of Michigan, 2455 Hayward Street, Ann Arbor, Michigan 48109 (United States)

2006-10-15

347

X-ray induced color change on dense yttria samples obtained by spark plasma sintering  

NASA Astrophysics Data System (ADS)

This work focuses on a particular behavior of dense yttria samples fabricated by spark plasma sintering, which display a reddish coloration when subjected to X-ray irradiation. The reddish coloration appears exclusively in sintered material. Optical measurements, X-ray photoelectron spectroscopy and chemical methods have been used to investigate the properties of consolidated yttria. The results obtained suggest that the sintered material exhibits a relatively high concentration of oxygen vacancies. Thermoluminescence measurements indicate that they act as electronic trapping sites. A generalized-order kinetic analysis suggests that at least five different shallow traps can be identified.

Attia, Mohammed A. A.; Garroni, Sebastiano; Chiriu, Daniele; Ricci, Carlo; Delogu, Francesco; Orrù, Roberto; Cao, Giacomo

2015-01-01

348

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

PubMed

Although static magnetic fields (SMFs) are used extensively in the occupational and medical fields, few comprehensive studies have investigated their possible genotoxic effect and the findings are controversial. With the advent of magnetic resonance imaging-guided radiation therapy, the potential effects of SMFs on ionizing radiation (IR) have become increasingly important. In this study we focused on the genotoxic effect of 80 mT SMFs, both alone and in combination with (i.e. preceding or following) X-ray (XR) irradiation, on primary glioblastoma cells in culture. The cells were exposed to: (i) SMFs alone; (ii) XRs alone; (iii) XR, with SMFs applied during recovery; (iv) SMFs both before and after XR irradiation. XR-induced DNA damage was analyzed by Single Cell Gel Electrophoresis assay (comet assay) using statistical tools designed to assess the tail DNA (TD) and tail length (TL) as indicators of DNA fragmentation. Mitochondrial membrane potential, known to be affected by IR, was assessed using the JC-1 mitochondrial probe. Our results showed that exposure of cells to 5 Gy of XR irradiation alone led to extensive DNA damage, which was significantly reduced by post-irradiation exposure to SMFs. The XR-induced loss of mitochondrial membrane potential was to a large extent averted by exposure to SMFs. These data suggest that SMFs modulate DNA damage and/or damage repair, possibly through a mechanism that affects mitochondria. PMID:24345558

Teodori, Laura; Giovanetti, Anna; Albertini, Maria Cristina; Rocchi, Marco; Perniconi, Barbara; Valente, Maria Giovanna; Coletti, Dario

2014-03-01

349

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

350

X-Ray-Induced Chromosome Aberrations in Mouse Dictyate Oocytes. II. Fractionation and Dose Rate Effects  

PubMed Central

Split-dose experiments were done on maturing dictyate oocytes to determine if the magnitude of the first dose influenced the "rejoining time" of radiation-induced chromosomal lesions. A total dose of 400r was split into various combinations with varying fractionation intervals. The data derived from analyzing interchanges indicate that there is no difference in the rejoining time whether the first dose was 100, 200, or 300r. It thus appears that the radiation dose in the ranges studied does not significantly alter the rate of repair of the chromosomal lesions. This conclusion is contrary to that which has been propounded to explain the nonlinear dose curves obtained for specific locus mutations. Chronic 60Co ?-ray exposures were given to female mice over an 8-day period. The exposures were delivered during the period of peak sensitivity, i.e., 8–16 days prior to ovulation. The doses given were 117, 240, 348, and 483r. The aberration yields observed were dramatically lower than for comparable doses of acute X rays even when the RBE of ? rays compared with X rays is taken into account. The large drop in yields at the low dose rates is interpreted as resulting from a large two-track component in the acute curve, and as being independent of effects on repair systems. PMID:604163

Brewen, J. G.; Payne, H. S.; Adler, I. D.

1977-01-01

351

Resveratrol affects X-ray induced apoptosis and cell cycle delay in human cells in vitro.  

PubMed

Many studies in human and mammalian cells have shown the involvement of resveratrol in the modulation of several biological processes, including the regulation of carcinogenesis. However, the molecular mechanisms underlying its antitumorigenic activity are still not defined. There is great interest in developing new agents that can modify the efficacy of radiation therapy. The aim of the present study was to investigate the cellular response to treatments with X rays and resveratrol, alone or in combination, in terms of DNA damage, cell cycle delays and induction of apoptosis. Lymphoblastoid cells AHH-1 were treated and analysed at successive sampling times in order to study the induction of DNA breaks using the Comet assay and the induction of apoptosis and cell cycle modulation through cytofluorimetric analysis. Our results suggest that resveratrol causes the induction of apoptosis and a block of cell cycle progression at an early step of S-phase. Furthermore, resveratrol mitigates the apoptotic clearance of irradiated cells and prevents the G2 phase cell cycle arrest induced by X-rays. PMID:15870907

Fiore, Mario; Festa, Fabiola; Cornetta, Tommaso; Ricordy, Ruggero; Cozzi, Renata

2005-06-01

352

p53-dependent X-ray-induced modulation of cytokine mRNA levels in vivo.  

PubMed

In vitro studies have shown that ionizing radiation can cause increases in some cytokine mRNA levels and activation of the nuclear NF-kappa B and/or AP1 transcription factors which have been implicated in the transcriptional regulation of many cytokine genes. Thus, radiation-induced upregulation of cytokine mRNAs appeared to be in part a direct consequence of transcription factor activation. To test this in vitro model in vivo, the effects of whole-body X-irradiation (0-10 Gy) on cytokine and other gene mRNA levels have been examined in mice. Increases and decreases in cytokine mRNA levels were detected in tissues which underwent an early wave of apoptosis (bone marrow and/or spleen), but not in more radioresistant tissues (kidney, liver, brain, and heart). Some mouse strain-specific differences were observed, but none of the changes in mRNA level was detected in p53-/- mice. As activation of the NF-kappa B and AP1 transcription factors was not detected in early-(spleen) or late-(liver) responding tissues in 10 Gy X-irradiated p53+/+ mice in vivo, it is concluded that the modulation of cytokine gene expression in vivo is p53-dependent and indirectly associated with apoptosis. PMID:9875136

Kerr, N C; Wright, E G; Plumb, M A

1998-09-01

353

Effects of mobile phone radiation on X-ray-induced tumorigenesis in mice.  

PubMed

The increased use of mobile phones has raised the question of possible health effects of such devices, particularly the risk of cancer. It seems unlikely that the low-level radiofrequency (RF) radiation emitted by them would damage DNA directly, but its ability to act as a tumor promoter is less well characterized. In the current study, we evaluated the effect of low-level RF radiation on the development of cancer initiated in mice by ionizing radiation. Two hundred female CBA/S mice were randomized into four equal groups at the age of 3 to 5 weeks. The mice in all groups except the cage-control group were exposed to ionizing radiation at the beginning of the study and then to RF radiation for 1.5 h per day, 5 days a week for 78 weeks. One group was exposed to continuous NMT (Nordic Mobile Telephones)-type frequency-modulated RF radiation at a frequency of 902.5 MHz and a nominal average specific absorption rate (SAR) of 1.5 W/kg. Another group was exposed to pulsed GSM (Global System for Mobile)-type RF radiation (carrier-wave frequency 902.4 MHz, pulse frequency 217 Hz) at a nominal average SAR of 0.35 W/kg. The control animals were sham-exposed. Body weight, clinical signs, and food and water consumption were recorded regularly. Hematological examinations and histopathological analyses of all lesions and major tissues were performed on all animals. The RF-radiation exposures did not increase the incidence of any neoplastic lesion significantly. We conclude that the results do not provide evidence for cancer promotion by RF radiation emitted by mobile phones. PMID:11741502

Heikkinen, P; Kosma, V M; Hongisto, T; Huuskonen, H; Hyysalo, P; Komulainen, H; Kumlin, T; Lahtinen, T; Lang, S; Puranen, L; Juutilainen, J

2001-12-01

354

An X-ray-induced insulator-metal transition in a magnetoresistive manganite  

Microsoft Academic Search

Manganese oxides of the general formula A1-xBxMnO3 (where A and B are trivalent and divalent cations, respectively) have recently attracted considerable attention by virtue of their unusual magnetic and electronic properties1-9. For example, in some of these materials magnetic fields can drive insulator-to-metal transitions where both the conductivity and magnetization change dramatically-an effect termed 'colossal magneto-resistance'1-3-raising hopes for application of

V. Kiryukhin; D. Casa; J. P. Hill; B. Keimer; A. Vigliante; Y. Tomioka; Y. Tokura

1997-01-01

355

X-ray-induced dicentric yields in lymphocytes of the teleost, Umbra limi.  

PubMed

A microculture technique was applied to the study of lymphocytes of Umbra limi, which have a low number of large meta- and submetacentric chromosomes (2n = 22). On the 5th day (90h) and later after initiation of culture at 20 degrees C, some cultures provided well spread metaphase chromosomes for analyses. After initiation, cultures were irradiated with 50, 100, 150 and 200 R of 200 kVp X-rays. The cultures were harvested on the 5th day, at which time all arrested metaphase chromosomes were in their first division. The dicentric yields induced in X-irradiated Umbra lymphocytes were observed to be significantly (P = 0.05) lower than those in human lymphocytes. The resulting dose-response relationship for dicentric yield was described by the quadratic equation Y = aD + bD2. The advantage of this method lies in the fact that small amounts (0.1 ml) of blood can be repeatedly withdrawn from the fish after a minimal interval of 2 weeks. The microculture technique with Umbra lymphocytes is thought to have a wide range of applications in studies of the potential genotoxic effects of clastogenic agents in the aquatic environment. PMID:6828033

Suyama, I; Etoh, H

1983-01-01

356

X-ray-induced sterility in Aedes albopictus (Diptera: Culicidae) and male longevity following irradiation.  

PubMed

The mosquito Aedes albopictus (Skuse, 1895) is a potent vector of several arboviral diseases, most notably chikungunya and dengue fever. In the context of the sterile insect technique (SIT), the sterilization of the male mosquitoes before their release can be achieved by gamma-ray irradiation. As gamma-ray irradiators are becoming increasingly problematic to purchase and transport, the suitability of an X-ray irradiator as an alternative for the sterilization of Ae. albopictus males was studied. The sterilization of up to 200,000 pupae at one time can be achieved with relative ease, and the sterility results obtained were comparable with those achieved by gamma irradiation, where 99% sterility is induced with a dose of 40 Gy. A significant reduction of longevity was observed in the latter stages of the males' life after irradiation treatments, especially at doses > 40 Gy, which is consistent with the negative effects on longevity induced by similar radiation doses using gamma rays. Females irradiated at 40 Gy were not only 100% sterile, but also failed to oviposit entirely, i.e., all of the females laid 0 eggs. Overall, it was found that the X-ray irradiator is generally suitable for the sterilization process for sterile insect technique programs, as it showed a high processing capacity, practicality, high effectiveness, and reproducibility. PMID:25118413

Yamada, H; Parker, A G; Oliva, C F; Balestrino, F; Gilles, J R L

2014-07-01

357

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

358

Insights into the mechanism of X-ray induced structural perturbation of macromolecules  

NASA Astrophysics Data System (ADS)

This dissertation focuses on the structural changes induced by X-rays during macromolecular crystallographic data collection. This damage cannot be prevented and often leads to degradation in the data quality, which can affect the resulting structure and thus the biological interpretation. The aim of this research was to understand the radiation chemistry of the damage process. This includes the protein components most susceptible to damage, the disulfide bond and metal atoms. By providing some insight into the mechanism for disulfide bond cleavage and the role the active site metal and its surrounding environment plays in the extent of the damage that occurs we have proposed an initial, generalized model for radiation damage. The results indicate that this multi-track process is due to the overlap of two one-electron reductions or two one-electron oxidations. A reaction scheme for the most susceptible residues (cystine, cysteine, methionine, aspartate, glutamate and tyrosine) is provided with experimental evidence of the predicted damage from crystallographic data collected on lysozyme and xylose isomerase.

Sutton, Kristin A.

359

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

NASA Astrophysics Data System (ADS)

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 damages at the metabolic level, without great interference with DNA activity. The use of a laser-plasma source allowed a fast deposition of high doses. Monitoring of CO2 production allowed us to measure cell metabolic response immediately after irradiation in a continuous and noninvasive way. Also a simple model was developed to calculate X-ray doses delivered to the different cell compartments following a Lambert Bouguet Beer law. Results obtained on Saccharomyces cerevisiae yeast cells in experiments performed at Rutherford Appleton Laboratory are presented.

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

2004-07-01

360

X-ray induced photocurrent characteristics of CVD diamond detectors with different carbon electrodes  

NASA Astrophysics Data System (ADS)

Diamond has unique properties which make it suitable for a broad range of radiation detection applications ranging from particle timing and spectroscopy, to neutron, UV and X-ray sensors. In X-ray dosimetry, the atomic number of diamond (Z = 6) close to that of the human tissues (Z = 7.42) allows to mimic the real absorbed dose avoiding off-line recalculations. Moreover, its low atomic number and the capability to withstand high radiation fluxes make possible its use as beam monitor without altering significantly the properties of the interacting beam. To preserve the tissue equivalence of the diamond and minimize the perturbation and absorption of the incident beam, diamond detectors based on low thickness and low atomic number electrodes become a requirement. In this paper we present the X-ray detection characteristics of electronic grade CVD diamond sensors prepared in house with thin amorphous carbon electrodes fabricated by Pulsed Laser Deposition (PLD) technique in the fluence range of 2.3-3.6 J·cm-2. The devices showed a linear dependence of the induced photocurrent respect to the dose rate. Also, best dynamic response and better stability of the signals were achieved for applied bias up to ±50 V with signal to noise ratio (SNR) of ~ 300.

Schirru, F.; Lohstroh, A.; Jayawardena, K. D. G. I.; Henley, S. J.; Sellin, P. J.

2013-12-01

361

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

362

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

363

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

364

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

365

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

366

Molecular Characteristics of Pancreatic Ductal Adenocarcinoma  

PubMed Central

Pancreatic cancer is an almost universally lethal disease and despite extensive research over the last decades, this has not changed significantly. Nevertheless, much progress has been made in understanding the pathogenesis of pancreatic ductal adenocarcinoma (PDAC) suggesting that different therapeutic strategies based on these new insights are forthcoming. Increasing focus exists on designing the so-called targeted treatment strategies in which the genetic characteristics of a tumor guide therapy. In the past, the focus of research was on identifying the most frequently affected genes in PDAC, but with the complete sequencing of the pancreatic cancer genome the focus has shifted to defining the biological function that the altered genes play. In this paper we aimed to put the genetic alterations present in pancreatic cancer in the context of their role in signaling pathways. In addition, this paper provides an update of the recent advances made in the development of the targeted treatment approach in PDAC. PMID:21512581

Ottenhof, Niki A.; de Wilde, Roeland F.; Maitra, Anirban; Hruban, Ralph H.; Offerhaus, G. Johan A.

2011-01-01

367

Targeting Pancreatic Ductal Adenocarcinoma Acidic Microenvironment  

NASA Astrophysics Data System (ADS)

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the USA, accounting for ~40,000 deaths annually. The dismal prognosis for PDAC is largely due to its late diagnosis. Currently, the most sensitive diagnosis of PDAC requires invasive procedures, such as endoscopic ultrasonography, which has inherent risks and accuracy that is highly operator dependent. Here we took advantage of a general characteristic of solid tumors, the acidic microenvironment that is generated as a by-product of metabolism, to develop a novel approach of using pH (Low) Insertion Peptides (pHLIPs) for imaging of PDAC. We show that fluorescently labeled pHLIPs can localize and specifically detect PDAC in human xenografts as well as PDAC and PanIN lesions in genetically engineered mouse models. This novel approach may improve detection, differential diagnosis and staging of PDAC.

Cruz-Monserrate, Zobeida; Roland, Christina L.; Deng, Defeng; Arumugam, Thiruvengadam; Moshnikova, Anna; Andreev, Oleg A.; Reshetnyak, Yana K.; Logsdon, Craig D.

2014-03-01

368

Mandible Bone Metastases Secondary to Pulmonary Adenocarcinoma  

PubMed Central

ABSTRACT Objective: Metastatic tumors of the mandible are rare and usually present clinically as growths. The prognosis of lung cancer patients with bone metastases is poor. Case Report: This article shows a metastasis from adenocarcinoma of the lung affecting the mandible of a 75-year-old female patient where the metastatic lesion was detected before primary tumor. The patient were treated with radiation therapy with palliative and antalgic intent. But the patient died 8 weeks after the diagnosis. Conclusion: Radiation therapy was effective and well tolerated in the case. Bone metastases particularly mandible metastasis of lung cancer has poor prognosis. Palliative and supportive therapy may be firstly chose because of poor prognosis. PMID:25568572

Dirican¹, Nigar; Gunes, Sedat; Karakaya, Yeliz; Kaya, Vildan; Cerci, Sureyya; Dirican, Ahmet

2014-01-01

369

Cutaneous metastatic adenocarcinoma - a case report.  

PubMed

Cutaneous metastases from carcinoma are relatively uncommon in clinical practice but they are very important to recognize. Cutaneous metastases may herald the diagnoses, can lead to accurate diagnoses and timely treatment. A high index of suspicion is required because the clinical finding may be subtle. The patient of cutaneous metastases may present with rapidly developing nodules or tumors. Although asymptomatic in most instances, Pain and tenderness may be noted. Here we described a 38 year old male who presented with fever, anorexia, weight loss and multiple painful nodules, plaques and tumors on his scalp, face, upper trunk and proximal portion of the upper limbs. This case present with cutaneous metastatic adenocarcinoma with atypical presentation and detection of cutaneous metastasis before primary tumor detection. PMID:24292321

Asaduzzaman, A M; Azad, A K; Arafat, S M; Rashid, F B; Islam, M S; Rahman, M M; Abdullah, S; Ahmed, M U; Abdullah, A M

2013-10-01

370

TGF? signaling in pancreatic ductal adenocarcinoma.  

PubMed

Transforming growth factor ? (TGF?) receptor signaling plays a paradoxical effect in the tumorigenesis of pancreatic ductal adenocarcinoma (PDAC), in which its tumor-inhibitory role at early stages turns into a tumor-promoting role at later stages. The underlying mechanism remains far from clear. Here we provide strong evidence that the activation of TGF? receptor signaling in PDAC cells increased SMAD3 phosphorylation and nuclear translocation to inhibit cell growth. Meanwhile, it also activated SMAD7 to induce nuclear translocation and retention of ?-catenin, which not only attenuated the inhibition of cell growth by nuclear SMAD3 but also activated vascular endothelial growth factor A (VEGF-A) to promote vascularization. Our data thus support a model involving crosstalk of the TGF? and Wnt signaling pathways, for regulating the complicated effect of TGF? signaling on the tumorigenesis of PDAC. PMID:25355597

Zhang, Hui; Liu, Chengli; Kong, Yalin; Huang, Hui; Wang, Cheng; Zhang, Hongyi

2014-10-31

371

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

372

Clinicopathological features of gallbladder papillary adenocarcinoma.  

PubMed

Although patients with gallbladder papillary adenocarcinoma (GBPA) appear to have better prognoses than patients with other pathological subtypes of gallbladder carcinoma (GBC), the clinicopathological features and outcomes of GBPA have not been fully explored. This study therefore analyzed the clinicopathological characteristics and outcomes of GBPA.This study included 16 patients with GBPA and 101 with gallbladder adenocarcinoma (GBA) not otherwise specified (NOS), all diagnosed pathologically after surgical resection. Clinicopathological and survival data were retrospectively collected and compared.Fever was significantly more common in GBPA (7/16 vs 10/101; P?=?0.000). Serum carbohydrate antigen 19-9 level was increased in 1 of 9 patients with GBPA and 39 of 76 with GBA (P?=?0.022). More patients with GBPA underwent curative resection (15/16 vs 54/101; P?=?0.009). Pathologically, patients with GBPA were at much earlier tumor (T) (4 in situ, 8 T1; P?=?0.000) and Tumor, Node, Metastases (TNM) stages (P?=?0.000). The overall 1-, 3-, and 5-year survival rates were significantly higher in patients with GBPA (100%, 76.9%, and 76.9%, respectively), than in patients with GBA (72.2%, 38.8%, and 31.0%, respectively; P?=?0.001). Preoperative jaundice (odds ratio 7.69; 95% confidence interval, 1.53-38.76; P?=?0.013) was a significant prognostic factor in patients with GBA, but was no longer significant when the patients with GBA and GBPA were pooled together.The clinicopathological features of patients with GBPA differed from those in patients with GBA (not otherwise specified). Pooling of patients may mask prognostic factors in each group. PMID:25501049

Wan, Xueshuai; Zhang, Haohai; Chen, Cuimin; Yang, Xiaobo; Wang, Anqiang; Zhu, Chengpei; Fu, Lilan; Miao, Ruoyu; He, Lian; Yang, Huayu; Zhao, Haitao; Sang, Xinting

2014-12-01

373

Enteric adenocarcinoma lung: a rare presentation in an Omani woman  

PubMed Central

Pulmonary adenocarcinoma is a common neoplasm, yet the one with enteric or intestinal differentiation poses a diagnostic challenge to pathologists as it shares a common immunohistochemical profile with metastatic colorectal carcinoma. We report a case of a 61-year-old woman. She was on surveillance when incidentally she was discovered to have multiple bilateral lung nodules on imaging; the largest was surgically removed for histological examination. Morphology was consistent with a moderately differentiated adenocarcinoma .The tumour cells were positive for cytokeratin (CK) 7, CDX2, CK20 and were negative for thyroid transcription factor 1. The morphology and immune histochemical profile raised the differential diagnosis of a metastatic colorectal carcinoma and a primary lung adenocarcinoma with enteric differentiation. On the basis of morphology and CK7 positivity we established the diagnosis of enteric-type adenocarcinoma of primary lung origin. She has completed planned courses of palliative chemotherapy and remains on surveillance. PMID:23355573

Qureshi, Asim; Furrukh, Muhammad

2013-01-01

374

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

375

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

376

Notch signaling drives stemness and tumorigenicity of esophageal adenocarcinoma.  

PubMed

Esophageal adenocarcinoma ranks sixth in cancer mortality in the world and its incidence has risen dramatically in the Western population over the last decades. Data presented herein strongly suggest that Notch signaling is critical for esophageal adenocarcinoma and underlies resistance to chemotherapy. We present evidence that Notch signaling drives a cancer stem cell phenotype by regulating genes that establish stemness. Using patient-derived xenograft models, we demonstrate that inhibition of Notch by gamma-secretase inhibitors (GSI) is efficacious in downsizing tumor growth. Moreover, we demonstrate that Notch activity in a patient's ultrasound-assisted endoscopic-derived biopsy might predict outcome to chemotherapy. Therefore, this study provides a proof of concept that inhibition of Notch activity will have efficacy in treating esophageal adenocarcinoma, offering a rationale to lay the foundation for a clinical trial to evaluate the efficacy of GSI in esophageal adenocarcinoma treatment. PMID:25164006

Wang, Zhiqiang; Da Silva, Thiago G; Jin, Ke; Han, Xiaoqing; Ranganathan, Prathibha; Zhu, Xiaoxia; Sanchez-Mejias, Avencia; Bai, Feng; Li, Bin; Fei, Dennis Liang; Weaver, Kelly; Carpio, Rodrigo Vasquez-Del; Moscowitz, Anna E; Koshenkov, Vadim P; Sanchez, Lilly; Sparling, Lynne; Pei, Xin-Hai; Franceschi, Dido; Ribeiro, Afonso; Robbins, David J; Livingstone, Alan S; Capobianco, Anthony J

2014-11-01

377

PAX8 expression in uterine adenocarcinomas and mesonephric proliferations.  

PubMed

PAX8 is a useful immunohistochemical marker for the diagnosis of gynecologic tract malignancies. Several studies have described PAX8 expression in a wide variety of epithelial neoplasms, including ovarian and endometrial carcinomas. The goal of this study was to evaluate PAX8 expression in various types of uterine adenocarcinomas and mesonephric proliferations. Ninety-four cases of uterine adenocarcinomas (52 endometrial endometrioid carcinomas, 21 endometrial serous carcinomas, and 21 human papillomavirus-related endocervical carcinomas), 11 cases of benign mesonephric proliferations (remnants/hyperplasia), and normal endometrial and endocervical glandular epithelium in 58 cases were studied. Immunohistochemical staining was performed with the rabbit polyclonal anti-PAX8 antibody. All adenocarcinoma groups demonstrated a high frequency of PAX8 expression but with relatively high variability in the extent of staining among different subtypes. Both serous carcinomas and endometrioid carcinomas were positive in most cases (95% and 96%, respectively), but serous carcinomas displayed a significantly higher level of expression (immunohistochemical composite scores based on combined extent and intensity of expression) compared with endometrioid carcinomas (mean immunohistochemical composite scores: 8.3 vs. 5.3, respectively; P<0.006). Endocervical adenocarcinomas also had a high frequency of PAX8 expression (86% of cases), but the level of expression was significantly less than that of endometrial adenocarcinomas (mean immunohistochemical composite scores: 2.9 vs. 5.3-8.3, respectively; P<0.004). Among benign glandular epithelia, normal endocervical glands exhibited a significantly lower level of expression compared with either normal endometrial glands or benign mesonephric proliferations (mean immunohistochemical composite scores: 2.6 vs. 6.6-11.2, respectively; P<0.0006). We conclude that PAX8 is expressed in the vast majority of uterine adenocarcinomas, including those of both endometrial and endocervical origin, and that the level of expression based on combined extent and intensity is highest in endometrial serous carcinoma and lowest in endocervical adenocarcinoma. However, the high prevalence of PAX8 expression in the various types of uterine adenocarcinomas precludes use of this marker for distinguishing these tumors. In extrauterine sites, PAX8 can serve as a useful marker for adenocarcinomas of uterine origin (also positive in the majority of ovarian carcinomas), being most sensitive for identification of endometrial adenocarcinomas (both serous and endometrioid). The sensitivity for identifying metastatic endocervical adenocarcinomas is likely less and dependent on the degree to which the significantly lower extent of expression in these tumors is maintained in metastatic sites. PMID:25083965

Yemelyanova, Anna; Gown, Allen M; Wu, Lee-Shu-Fune; Holmes, Brittany J; Ronnett, Brigitte M; Vang, Russell

2014-09-01

378

A case of periampullary adenocarcinoma in neurofibromatosis type 1.  

PubMed

Neurofibromatosis type 1 (NF-1) is an autosomal dominant genetic disorder with a known predisposition to gastrointestinal neoplasms such as stromal tumors and carcinoids. Adenocarcinomas (ACs) of the gastrointestinal tract are relatively rare in patients with NF-1, especially those found in the periampullary region. We present a case report of periampullary adenocarcinoma in a 56-year-old woman with NF-1 who presented with abdominal pain and obstructive jaundice. PMID:25436139

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

2014-12-01

379

Prognostic value of HMGB1 overexpression in resectable gastric adenocarcinomas  

PubMed Central

Introduction HMGB1(High mobility group box 1), originally described as a nuclear protein, is now regarded as a multifunctional protein with a paradoxical dual effect in tumors. In the present study, HMGB1 overexpression and its correlation with the clinicopathologic characteristics and recurrence-free survival were evaluated in gastric adenocarcinomas. Methods 76 gastric adenocarcinomas surgically removed entered the study. The immunohistochemical staining was used to assess HMGB1 expression through tissue microarray procedure. The clinicopathologic characteristics of all patients were recorded, and the regular follow-up was made for all patients. Results Almost all the gastric adenocarcinomas showed HMGB1 positive staining mainly in the nucleus, and the overexpression of HMGB1 was found in cancerous tissues with higher strong reactivity rate, compared with non-cancerous tissues (total expression score ? 9, 42.0% vs. 9.0%, P < 0.001). Survival analysis revealed that tumor stage negatively correlated with cancer-free survival (P = 0.022). Furthermore, HMGB1 overexpression positively associated with cancer-free survival of resectable gastric adenocarcinomas (P = 0.023). Conclusions The overexpression of HMGB1 protein indicates that HMGB1 may play a role in the tumorigenesis of gastric adenocarcinomas. And the overexpression of HMGB1 may be a marker of good prognosis of gastric adenocarcinoma given curative resection combined with adjuvant chemotherapy. PMID:20579387

2010-01-01

380

Metastatic prostate adenocarcinoma to the penis: a series of 29 cases with predilection for ductal adenocarcinoma.  

PubMed

Twenty-nine men with metastatic prostate adenocarcinoma to the penis were identified at our institution between 1993 and 2013. Of the 29 patients, 19 had a prior history of adenocarcinoma of the prostate, and 8 of those had ductal features in the primary lesion. Sixteen of 29 revealed ductal features in the metastasis. Seven of the 8 cases with ductal features in the primary had ductal features in the penile metastasis. Seven penile metastases were proven to be of prostatic origin solely by immunohistochemistry. Three cases were originally misdiagnosed as urothelial carcinoma upon review of the penile lesion. Other variant morphologies in the metastases included sarcomatoid carcinoma, small cell carcinoma, and adenosquamous carcinoma. In summary, prostate carcinoma involving the penis displays ductal features considerably more often than prostate cancer in general. Features that can cause difficulty in recognizing metastatic prostate adenocarcinoma to the penis include the unusual anatomic site for prostate cancer, poor differentiation, an increased prevalence of variant morphology, a long interval from the primary lesion, and, in some cases, no documented history of a primary prostatic lesion. Immunohistochemical analysis should be performed to rule out prostate carcinoma in penile/penile urethral tumors with morphology that differs from typical squamous or urothelial carcinoma. Even in the setting of metastatic disease, there is a critical need for an accurate diagnosis so that the appropriate therapy can be initiated, symptomatic relief can be provided, and long-term survival achieved in some cases, while at the same time avoiding penectomy for a misdiagnosis of a primary penile cancer. PMID:25025445

Ellis, Carla L; Epstein, Jonathan I

2015-01-01

381

Hepatoid adenocarcinoma of the stomach - a different histology for not so different gastric adenocarcinoma: a case report.  

PubMed

Hepatoid adenocarcinoma is an extrahepatic tumor characterized by morphological similarities to hepatocellular carcinoma. Hepatoid adenocarcinoma of the stomach is a cancer with an extremely poor prognosis with few cases reported. Here, we describe a 75-year-old Spanish man referred to our hospital with a history of abdominal pain, general fatigue, anorexia and sickness. Initial study revealed anemia, and computed tomography scan and abdominal ultrasonography showed multiple metastases to the liver with hepatocellular carcinoma characteristics in a liver with no cirrhotic change. Further study included a serum level of alpha-fetoprotein (AFP), which resulted markedly elevated, and a conclusive esophagogastroduodenoscopy describing an elevated tumour growing through the cardia and gastroesophageal junction with foci of necrosis and haemorrhage. Gastric biopsies of the tumor revealed poorly differenciated adenocarcinoma, with hepatoid differentiation. After a diagnosis of AFP-producing hepatoid adenocarcinoma of the stomach with multiple liver metastases was made, pallitive total gastrectomy, without liver resection, was performed. Patient recovered well after surgery, and entered into a palliative systemich chemotherapy protocol. Although this illness is recognized as having poor prognosis, the patient remains alive 8 months after the operation. Accurate diagnosis of hepatoid adenocarcinoma of the stomach is important, and should be suspected under certain circumstances. We describe this rare case of hepatoid adenocarcinoma of the stomach, and review the literature concerning the clinicopathological aspects. PMID:19674468

Gálvez-Muñoz, Elisa; Gallego-Plazas, Javier; Gonzalez-Orozco, Verónica; Menarguez-Pina, Francisco; Ruiz-Maciá, José A; Morcillo, Miguel A

2009-01-01

382

Expression and Diagnostic Value of HE4 in Pancreatic Adenocarcinoma.  

PubMed

Human epididymis protein 4 (HE4) is a recognized biomarker in ovarian and endometrial cancer and over-expressed in pancreatic adenocarcinoma. The diagnostic value of HE4 in pancreatic adenocarcinoma remains unknown. Here we elucidate mRNA, protein and serum level of HE4 in pancreatic adenocarcinoma. HE4 mRNA level in tumor adjacent tissues and pancreatic adenocarcinoma tissues were tested by real time-PCR. Tissue microarray containing normal, adenocarcinoma, and adjacent pancreatic tissue was tested by immunohistochemistry (IHC). Serum level of HE4, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3) and carbohydrate antigen 125 (CA125) were detected by ELISA assay in control and tumor patients. Further we compared the sensitivity and specificity of determining HE4, CA19-9, CA15-3, and CA125 for diagnosis of pancreatic adenocarcinoma and assessed the complementary diagnostic value of HE4, CA19-9, CA15-3 and CA125. Real time PCR showed significantly increased HE4 mRNA level in pancreatic adenocarcinoma compared with control. Result of IHC showed that HE4 significantly higher expressed in the human pancreatic carcinoma tissues than in both normal and adjacent non-tumorous pancreatic tissues, and the staining intensity is inversely correlated with the clinical stage. HE4 was highly expressed in early stage of pancreatic adenocarcinoma. Serum HE4 level is higher in cases with pancreatic adenocarcinoma than in the controls. Serum HE4 levels could research to a sensitivity of 45.83% and specificity of 93.75% when the Cutoff was set at 4.59 ng/mL. The Combined HE4 and CA19-9 increased the sensitivity to 83.33%; and interestingly, the combination of HE4 with CA15-3 led to the most powerful sensitivity of 87.5%. Combined with CA19-9 and CA15-3, HE4 could be a potential biomarker to improve the diagnostic power for pancreatic adenocarcinoma. PMID:25642754

Huang, Tianhe; Jiang, Shi-Wen; Qin, Liangyi; Senkowski, Christopher; Lyle, Christian; Terry, Karen; Brower, Steven; Chen, Haibin; Glasgow, Wayne; Wei, Yongchang; Li, Jinping

2015-01-01

383

Systemic therapy for metastatic pancreatic adenocarcinoma  

PubMed Central

Systemic treatment of metastatic pancreatic adenocarcinoma achieves only modest benefits, with evidence indicating a survival advantage with 5-fluorouracil (5-FU) over best supportive care alone, and further advantage of single-agent gemcitabine over 5-FU. There are very few regimens better than single-agent gemcitabine despite multiple trials of cytotoxic and targeted agents. The addition of a platinum agent has improved response rate but not survival. The addition of erlotinib has improved survival but only by a small margin. The use of gemcitabine in multidrug regimens containing one or more of: a platinum agent; fluoropyrimidine; anthracycline; and taxane has demonstrated advantages in response rate, progression-free survival and, in one randomized study, overall survival. After gemcitabine failure, second-line therapy with oxaliplatin and 5-FU provides a further survival advantage. Further advances depend upon the current and future clinical trials investigating enhanced delivery of current agents, new agents and novel modalities, improved supportive care, and treatment more tailored to the individual patient and tumour. PMID:21789129

Lawrence, Ben; Findlay, Michael

2010-01-01

384

Mucinous adenocarcinoma in an ovarian remnant.  

PubMed

The ovarian remnant syndrome, a complication of bilateral salpingo-oophorectomy, is progressively receiving more attention in the gynecological surgery literature. The syndrome is manifested by pelvic pain and a palpable or sonographic finding of a pelvic mass. However, in rare cases, patients can present with large masses and radiographic suggestion of malignancy. We present the case of a 76-year-old white female, 23 months after bilateral salpino-oophorectomy at the same institution, complaining of 3.5 months of right flank and abdominal pain. Clinical and radiological evidence of a right ovarian remnant was discovered. Subsequent laparoscopic resection was consistent with a well-encapsulated mucinous adenocarcinoma in a right ovarian remnant. Curiously, this patient had no history of endometriosis, dense pelvic adhesions, pelvic inflammatory disease, or difficulty encountered during the original hysterectomy. This is the seventh published case report in the international literature about carcinoma developing in an ovarian remnant. However, this case differs in that the patient had no preexisting gynecologic conditions at the time of hysterectomy and bilateral salpingo-oophorectomy to account for residual ovarian tissue. Additionally, the oophorectomy was performed vaginally, in contrast to multiple previous case reports. PMID:15304167

Dereska, N H; Cornella, J; Hibner, M; Magrina, J F

2004-01-01

385

Enzootic Nasal Adenocarcinoma of Sheep in Canada  

PubMed Central

A survey of veterinary diagnostic laboratories revealed that intranasal tumors occur in sheep in most provinces of Canada. Tumors were diagnosed in 44 sheep of several breeds including Polled Dorset, Suffolk, Cheviot, Rambouillet and various crossbreeds. Twenty-seven percent of tumors occurred in sheep that were less than two years old. Most tumors were sporadic but 33% of cases occurred in six related flocks, indicating that this disease can be an enzootic problem. The clinical signs were persistent serous, mucous or mucopurulent nasal discharge and stridor. Affected sheep progressively developed anorexia, dyspnea and mouth breathing and most died from effects of asphyxia and inanition within 90 days of the onset of clinical signs. Tumors originated unilaterally or occasionally bilaterally in the olfactory mucosa of the ethmoid turbinates. They were expansive and sometimes locally invasive but metastases were not found. Histologically, the tumors were classified as adenomas or, more frequently, adenocarcinomas. The etiology was not established but retrovirus like particles were observed in tumor tissue from one affected sheep. ImagesFigure 1.Figure 2.Figure 3.Figure 4. PMID:17422121

McKinnon, A.O.; Thorsen, J.; Hayes, M.A.; Misener, C.R.

1982-01-01

386

Pseudohyperplastic prostatic adenocarcinoma in transurethral resections of the prostate.  

PubMed

Pseudohyperplastic prostatic adenocarcinoma is a recently described variety of adenocarcinoma that has been studied in core-needle biopsies and prostatectomy specimens. It is characterized by malignant glands that simulate benign hyperplastic glands with complex, medium to large-sized glands with papillary infoldings, luminal undulations, branching or cystic dilatations, and columnar cells with macronucleoli and nuclear enlargement. Our aim was to define frequency, tumor volume, and histologic features of pseudohyperplastic prostatic adenocarcinoma in transurethral resections of prostate. We studied 250 specimens from transurethral resections; 150 specimens were originally diagnosed as benign glandular hyperplasia, and 100 as conventional prostate adenocarcinomas. Of the 150 biopsies originally diagnosed as benign glandular hyperplasia, two (1.3%) had areas of pseudohyperplastic carcinoma. In both cases the neoplasm was limited to two chips and measured 3 and 4 mm in diameter, respectively. Both patients were asymptomatic 2 and 4 years after diagnosis. Of the 100 biopsies with adenocarcinoma, areas of pseudohyperplastic carcinoma were found in three cases. In the first two these areas were found in two fragments, and in the other case they were found in three chips, and measured 3, 4, and 6 mm, respectively. The clinical course in these cases was unfavorable, and two patients had metastasis. Main histologic findings included crowded glands (5/5), papillary projections (5/5), nuclear enlargement (5/5) macronucleoli (4/5) cystic glandular dilatation (4/5) straight luminal borders (4/5), pink amorphous secretions (4/5) nuclear hyperchromasia (3/5) and transition to small acinar pattern of adenocarcinoma (3/5). In conclusion, pseudohyperplastic prostate carcinoma is rare in transurethral resection specimens and is found in scarce chips. Frequency of false negative results in biopsies originally diagnosed as benign glandular hyperplasia was 1.3%. In biopsies diagnosed as carcinoma, this frequency was 3%. These patients had an adverse clinical course, apparently due to association with areas of conventional adenocarcinoma. PMID:14688829

Arista-Nasr, Julián; Martinez-Benitez, Braulio; Valdes, Samuel; Hernández, Mercedes; Bornstein-Quevedo, Leticia

2003-01-01

387

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. PMID:25349707

Mello, Evandro Sobroza; Younes, Riad N.

2014-01-01

388

Multigene deletions in lung adenocarcinomas from irradiated and control mice  

SciTech Connect

K-ras codon 12 point mutations mRb and p53 gene deletions were examined in tissues from 120 normal lungs and lung adenocarcinomas that were Formalin-treated and paraffin-embedded 25 years ago. The results showed that 12 of 60 (20%) lung adenocarcinomas had mRb deletions. All lung adenocarcinomas that were initially found bearing deleted mRb had p53 deletions (15 of 15; 100%). A significantly higher mutation frequency for K-ras codon 12 point mutations was also found in the lung adenocarcinomas from mice exposed to 24 once-weekly neutron irradiation (10 of 10; 100%) compared with those exposed to 24 or 60 once-weekly {gamma}-ray doses (5 of 10; 50%). The data suggested that p53 and K-ras gene alterations were two contributory factors responsible for the increased incidence of lung adenocarcinoma in B6CF{sub 1} male mice exposed to protracted neutron radiation.

Zhang, Y.; Woloschak, G.E. [Argonne National Lab., IL (United States). Center for Mechanistic Biology and Biotechnology

1996-06-01

389

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

390

Mechanisms behind the inhibition of lung adenocarcinoma cell by shikonin.  

PubMed

Shikonin, a natural naphthoquinone isolated from a traditional Chinese medicinal herb, can exert inhibitory effect on tumor cell growth. However, little has been known concerning the effect of shikonin on lung adenocarcinoma cell and underlying mechanisms. In the present study, we investigated the effect of shikonin on the proliferation, cell cycle arrest, and apoptosis in human lung adenocarcinoma cells. We found that shikonin significantly suppressed the proliferation of lung adenocarcinoma cells compared with control in dose- and time-dependent manner (P < 0.05). In the meantime, our results showed that shikonin markedly increased the proportion of A549 cells at stage G1 as well as induced apoptosis in A549 cells. Furthermore, suppressed CCND1 and elevated caspase3 and caspase7 expression levels at mRNA were found in this study, indicating that shikonin may inhibit the growth of lung adenocarcinoma cell by changing cell cycle and promoting cell apoptosis through the regulation of CCND1, caspase3, and caspase7. Although more studies are needed, this study suggests that shikonin has the potential to be used as an anti-cancer agent in the treatment of lung adenocarcinoma. PMID:24972691

Lan, Wenjing; Wan, Shengbang; Gu, Weiqing; Wang, Heyong; Zhou, Songwen

2014-11-01

391

Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass, TCGA Scientific Symposium 2014  

Cancer.gov

Home News and Events Multimedia Library Videos Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass Comprehensive Molecular Characterization of Gastric Adenocarcinoma - Adam Bass, TCGA Scientific Symposium 2014 You will

392

Transcriptional regulatory networks in human lung adenocarcinoma.  

PubMed

Lung adenocarcinoma (AC) is the most common histological subtype of lung cancer worldwide and its absolute incidence is increasing markedly. Transcriptional regulation is one of the most fundamental processes in lung AC development. However, high-throughput functional analyses of multiple transcription factors and their target genes in lung AC are rare. Thus, the objective of our study was to interpret the mechanisms of human AC through the regulatory network using the GSE2514 microarray data. Our results identified the genes peroxisome proliferator activated receptor-? (PPARG), CCAAT/enhancer binding protein ? (CEBPB), ets variant 4 (ETV4), Friend leukemia virus integration 1 (FLI1), T-cell acute lymphocytic leukemia 1 (TAL1) and nuclear factor of kappa light polypeptide gene enhancer in B-cells 1 (NFKB1) as hub nodes in the transcriptome network. Among these genes, it appears that: PPARG promotes the PPAR signaling pathway via the upregulation of lipoprotein lipase (LPL) expression, but suppresses the cell cycle pathway via downregulation of growth arrest and DNA-damage-inducible, ? (GADD45G) expression; ETV4 stimulates matrix metallopeptidase 9 (MMP9) expression to induce the bladder cancer pathway; FLI upregulates transforming growth factor, ? receptor II (TGFBR2) expression to activate TGF-? signaling and upregulates cyclin D3 (CCND3) expression to promote the cell cycle pathway; NFKB1 upregulates interleukin 1, ? (IL-1B) expression and initiates the prostate cancer pathway; CEBPB upregulates IL-6 expression and promotes pathways in cancer; and TAL1 promotes kinase insert domain receptor (KDR) expression to promote the TGF-? signaling pathway. This transcriptional regulation analysis may provide an improved understanding of the molecular mechanisms and potential therapeutic targets in the treatment of lung AC. PMID:22895549

Meng, Xiangrui; Lu, Peng; Bai, Hua; Xiao, Peng; Fan, Qingxia

2012-11-01

393

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. PMID:25400997

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

2014-01-01

394

Papillary adenocarcinoma in situ of the skin: report of four cases.  

PubMed

Although rare isolated cases of adenocarcinoma in situ of skin have been reported in the literature, adenocarcinoma in situ of skin as a concept and as a diagnostic category has not been established in the field of dermatopathology. In this work, four cases of papillary adenocarcinoma in situ of the skin are presented. In addition, the notion that lesions previously reported in the medical literature under the term of "papillary eccrine adenoma" are actually adenocarcinoma in situ is discussed. PMID:24855569

Chen, Sheng; Asgari, Masoud

2014-04-01

395

Papillary adenocarcinoma in situ of the skin: report of four cases  

PubMed Central

Although rare isolated cases of adenocarcinoma in situ of skin have been reported in the literature, adenocarcinoma in situ of skin as a concept and as a diagnostic category has not been established in the field of dermatopathology. In this work, four cases of papillary adenocarcinoma in situ of the skin are presented. In addition, the notion that lesions previously reported in the medical literature under the term of “papillary eccrine adenoma” are actually adenocarcinoma in situ is discussed. PMID:24855569

Chen, Sheng; Asgari, Masoud

2014-01-01

396

Adenocarcinoma arising from intrahepatic heterotopic pancreas: A case report and literature review  

PubMed Central

Heterotopic pancreas is mostly found incidentally, and adenocarcinoma arising from heterotopic pancreas appears to be extremely rare. A case of a 46-year-old woman with adenocarcinoma arising from intrahepatic heterotopic pancreas is reported herein. Computed tomography demonstrated a mass located in the bile duct of the left hepatic lobe. Pathological examination revealed a moderately differentiated adenocarcinoma arising from intrahepatic heterotopic pancreas with nerve infiltration. This may be the first reported case of adenocarcinoma arising from intrahepatic heterotopic pancreas. PMID:22719201

Yan, Mao-Lin; Wang, Yao-Dong; Tian, Yi-Feng; Lin, Ying

2012-01-01

397

Dome-Type: A Distinctive Variant of Colonic Adenocarcinoma  

PubMed Central

Introduction. Ten cases of dome-type adenocarcinoma of the colon have been reported so far. Most of them were presented as early lesions, with endoscopic and microscopic distinguishing features. Methods and Results. A raised plaque was removed from the right colon during colonoscopy in a 56-year-old man. Histopathological examination showed a cancerized adenoma invading the submucosa with several typical features of dome-type adenocarcinoma, in particular the associated prominent lymphoid tissue. Immunohistochemistry showed retention of the mismatch repair proteins MLH-1, MSH-2, MLH-6, and PMS-2. Conclusion. We report an additional case of dome-type adenocarcinoma of the colon as an early, low-risk, and microsatellite stable tumor, indicating that this particular histotype may deserve specific consideration for both classification and management. PMID:23213588

Puppa, Giacomo; Molaro, Mariella

2012-01-01

398

Synchronous occurrence of pulmonary adenocarcinoma and pleural diffuse malignant mesothelioma.  

PubMed

We report a rare case of diffuse malignant pleural mesothelioma synchronous with a localized adenocarcinoma of lung in a 68-year old man with a suspicious history of asbestos exposure. Computed tomography revealed a sub-pleural mass in the lower lobe and an irregular dense area of medium lobe of right lung with thickening of pleura encasing the lung parenchyma and homolateral pleural effusion 1 cm thick. The patient underwent surgery and a right medium and lower lobectomy was performed. Upon frozen sections, intraoperative diagnosis was adenocarcinoma with a poorly differentiated component of lung infiltrating the pleura. The postoperative histological definitive diagnosis with an important contribution of immunostaining was synchronous pulmonary adenocarcinoma and pleural diffuse malignant epithelioid mesothelioma. PMID:24730341

Imenpour, H; Ivaldi, G P; Brianti, A; Pastorino, G; Biggi, S; Auriati, L; Simonassi, C

2013-12-01

399

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. PMID:25349704

Gardiner, Natasha; Jogai, Sanjay

2014-01-01

400

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

401

[A case of adenocarcinoma arising in an ileal conduit].  

PubMed

We report a rare case of adenocarcinoma developing in an ileal conduit. A 78-year-old woman was referred complaining of abdominal pain. She had undergone radical cystectomy and ileal conduit formation for invasive bladder cancer 8 years previously. The pathological diagnosis was urothelial carcinoma, and distant metastasis was not found. She was lost to follow-up over 2 years postoperatively. Computed tomography at this time showed bilateral hydronephrosis. Metastasis was not revealed. Because renal failure progressed and gross hematuria developed, endoscopic examination through the stoma was performed. A mass adjacent to the ureteroileal anastomosis site was found. Biopsy led to a diagnosis of moderately differentiated adenocarcinoma. She died of renal failure 1.5 months after admission. To our knowledge, 9 cases of adenocarcinoma arising in an ileal conduit have previously been reported. PMID:23719138

Mizusawa, Hiroya; Mimura, Yuji; Saito, Tetsuichi

2013-05-01

402

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

403

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

404

Differential expression of VASP in normal lung tissue and lung adenocarcinomas  

PubMed Central

Background: Vasodilator stimulated phosphoprotein (VASP) is associated with focal adhesions and is thought to have an important role in actin filament assembly and cell motility. We hypothesise that an increase in the expression of VASP is involved in the progression and invasion of lung adenocarcinomas in parallel to tumour progression. A study was undertaken to analyse VASP expression in normal lung tissue and lung adenocarcinomas. Methods: Human lung tissues with adenocarcinomas (n = 26) were used. Normal lung tissue specimens (n = 14) were taken from areas a standard distance (3 cm) from resected adenocarcinomas of patients who underwent surgical lung resection. Adenocarcinomas were classified according to pathological staging and histopathological grades. Tissues were stained for VASP using immunohistochemistry. Results: Normal lung pneumocytes showed no VASP expression while alveolar macrophages had the strongest immunoreactivity for VASP. Bronchial epithelium (surface epithelium, goblet cells) and bronchial gland cells had a very weak immunoreactivity for VASP. Adenocarcinomas had significantly greater VASP expression than normal epithelium (p<0.001). Moreover, VASP expression in adenocarcinomas increased significantly with more advanced tumour stage (p<0.001). Conclusions: The spatial and differential expression of VASP in normal lung tissue and lung adenocarcinomas suggests that it is likely to be involved in the differentiation of normal lung cells to adenocarcinomas. The significant increase in the expression of VASP in adenocarcinomas in parallel to pathological staging suggests that it may regulate the invasive behaviour of lung adenocarcinomas as adenocarcinoma invasion is increased in more advanced tumours. PMID:15994266

Dertsiz, L; Ozbilim, G; Kayisli, Y; Gokhan, G; Demircan, A; Kayisli, U

2005-01-01

405

Advanced Ethmoid Sinus Adenocarcinoma Presenting as Temporary Exudative Retinal Detachment  

PubMed Central

We describe the case of a 70-year-old male patient with ethmoid sinus adenocarcinoma who developed an exudative retinal detachment (ERD) in the right eye as the first manifestation. Two weeks after presentation, total regression of the ERD was noted. Extensive investigations for local causes of ERD were unrewarding. Finally, we performed a computed tomography scanning of the head that revealed an ethmoidal mass extending to the orbit. The diagnosis of adenocarcinoma was confirmed by biopsy. Neoplastic phenomena should be considered in patients presenting with temporary ERD. PMID:23898291

Marcos-Fernández, M.A.; Asensio-Sánchez, V.M.; Peña, D.; Pastor-Idoate, S.

2013-01-01

406

Diversity of gene expression in adenocarcinoma of the lung  

PubMed Central

The global gene expression profiles for 67 human lung tumors representing 56 patients were examined by using 24,000-element cDNA microarrays. Subdivision of the tumors based on gene expression patterns faithfully recapitulated morphological classification of the tumors into squamous, large cell, small cell, and adenocarcinoma. The gene expression patterns made possible the subclassification of adenocarcinoma into subgroups that correlated with the degree of tumor differentiation as well as patient survival. Gene expression analysis thus promises to extend and refine standard pathologic analysis. PMID:11707590

Garber, Mitchell E.; Troyanskaya, Olga G.; Schluens, Karsten; Petersen, Simone; Thaesler, Zsuzsanna; Pacyna-Gengelbach, Manuela; van de Rijn, Matt; Rosen, Glenn D.; Perou, Charles M.; Whyte, Richard I.; Altman, Russ B.; Brown, Patrick O.; Botstein, David; Petersen, Iver

2001-01-01

407

Thyroid adenocarcinoma in a bald eagle (Haliaeetus leukocephalus).  

PubMed

Thyroid adenocarcinoma was diagnosed in an adult bald eagle (Haliaeetus leukocephalus) with clinical signs of weakness manifested by inability to fly. Physical examination at the time of admission revealed dried blood in the pharynx and glottis and the presence of pharyngeal trichomonads. Radiographs revealed a large soft tissue mass in the area of the left coracoid and clavicular bones. One month following successful treatment for trichomoniasis, the bird suffered an acute episode of tracheal hemorrhage and died. Necropsy revealed a large mass within the interclavicular air sac. The histologic features were consistent with thyroid adenocarcinoma. This is the first report of thyroid neoplasia in a member of the order Falconiformes. PMID:10572872

Bates, G; Tucker, R L; Ford, S; Mattix, M E

1999-09-01

408

The association between cancers of the small and large bowel.  

PubMed

Malignant tumors of the small bowel are rare and little is known about their etiology, although adenocarcinomas share certain epidemiological features with colorectal cancer. This study investigated what cancers, if any, occurred as second neoplasms following adenocarcinomas, malignant carcinoid tumors, lymphomas, and sarcomas of the small bowel. For all 2581 cases of small bowel malignancy registered in one of the Surveillance, Epidemiology, and End-Results program areas, 1973-1988, the relative risk of a second malignancy was determined. The risk of colorectal cancer was increased following adenocarcinoma of the small bowel, and the risk of adenocarcinoma of the small bowel was increased following colorectal cancer in both males and females. This study also found an association between small bowel sarcomas and malignant melanoma in males, consistent with earlier studies, and an association between prostate cancer and malignant carcinoid tumors of the small bowel, a new observation. We conclude that adenocarcinomas of the small bowel may share risk factors with colorectal cancer. PMID:8268772

Neugut, A I; Santos, J

1993-01-01

409

Immunophenotype of High-Grade Prostatic Adenocarcinoma and Urothelial Carcinoma  

Microsoft Academic Search

Morphologic features alone can usually be used to distinguish prostatic adenocarcinoma and urothelial carcinoma of the urinary bladder. Poorly differentiated tumors, however, can occasionally have features of both neoplasms, making determination of site of origin difficult. No study has provided a panel of antibodies to assist in the distinction of these two tumors. For this study, 73 examples of moderately

Elizabeth M. Genega; Brian Hutchinson; Victor E. Reuter; Paul B. Gaudin

2000-01-01

410

DOK2 Inhibits EGFR-Mutated Lung Adenocarcinoma  

PubMed Central

Somatic mutations in the EGFR proto-oncogene occur in ~15% of human lung adenocarcinomas and the importance of EGFR mutations for the initiation and maintenance of lung cancer is well established from mouse models and cancer therapy trials in human lung cancer patients. Recently, we identified DOK2 as a lung adenocarcinoma tumor suppressor gene. Here we show that genomic loss of DOK2 is associated with EGFR mutations in human lung adenocarcinoma, and we hypothesized that loss of DOK2 might therefore cooperate with EGFR mutations to promote lung tumorigenesis. We tested this hypothesis using genetically engineered mouse models and find that loss of Dok2 in the mouse accelerates lung tumorigenesis initiated by oncogenic EGFR, but not that initiated by mutated Kras. Moreover, we find that DOK2 participates in a negative feedback loop that opposes mutated EGFR; EGFR mutation leads to recruitment of DOK2 to EGFR and DOK2-mediated inhibition of downstream activation of RAS. These data identify DOK2 as a tumor suppressor in EGFR-mutant lung adenocarcinoma. PMID:24255704

Berger, Alice H.; Chen, Ming; Morotti, Alessandro; Janas, Justyna A.; Niki, Masaru; Bronson, Roderick T.; Taylor, Barry S.; Ladanyi, Marc; Van Aelst, Linda; Politi, Katerina; Varmus, Harold E.; Pandolfi, Pier Paolo

2013-01-01

411

Allelotype analysis of adenocarcinoma of the gastric cardia.  

PubMed Central

To identify chromosomal loci involved in the development of proximal gastric adenocarcinoma, this study delineated the pattern of allelic imbalance in a series of 38