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Sample records for fibroepithelial polyp treated

  1. Laparoscopic management of large ureteral fibroepithelial polyp.

    PubMed

    Kijvikai, Kittinut; Maynes, Lincoln J; Herrell, S Duke

    2007-08-01

    Fibroepithelial polyps of the ureter are rare benign mesothelial tumors. Most polyps are small; however, very rare large polyps have also been reported. Currently, most investigators encourage endoscopic management in these patients. Nevertheless, endoscopic resection can be difficult in patients with a long or large polypoid lesion. We describe our experience and laparoscopic technique for treatment of a symptomatic 42-year-old woman who presented with a 17-cm-long fibroepithelial polyp in the proximal ureter associated with ureteral obstruction. To our knowledge, this is the first reported case of laparoscopic management of a large ureteral fibroepithelial polyp.

  2. Laser Resection of Fibroepithelial Polyps with Digital Ureteroscopy

    PubMed Central

    Bagley, Demetrius H.

    2015-01-01

    Abstract Fibroepithelial polyps (FEPs) are rare benign upper urinary-tract neoplasms originating from mesodermal components of the ureteral wall covered in normal urothelial epithelium. Historically, these lesions have been treated with endoscopic, laparoscopic, or open means depending on the size, number, and morphology of the polyps. Digital ureteroscopy (DURS) offers many advantages over fiber-optic endoscopy, including superior resolution and potential ergonomic benefits, given the absence of external cameras and light cords. We describe a case involving multiple proximal ureteral FEPs treated with flexible DURS and the holmium (Ho) laser, in which the digital ureteroscope offered exceptional visualization of the FEP stalks allowing for straightforward resection and endoscopic removal. PMID:27579383

  3. Giant fibroepithelial stromal polyp of the vulva: largest case reported

    PubMed Central

    2013-01-01

    Background Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made. Case We present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date. Conclusion Fibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis. PMID:23842282

  4. Fibroepithelial Polyp of the Tonsil: Report of a Rare Case

    PubMed Central

    Ashish, Gaurav

    2015-01-01

    Pedunculated polyps of the palatine tonsil are rare benign tumours of tonsil. Most of the cases have been reported in adults with varying presenting symptoms. We report a 12-year-old male child who presented with 6 months history of difficulty in swallowing. There was no history of breathing difficulty, change in voice or history of trauma. Clinical examination revealed a 2x1 cm small pedunculated polyp arising from the superior pole of right tonsil which was excised under general anaesthesia. Left tonsil was normal. A diagnosis of fibroepithelial polyp of right palatine tonsil was made based on histopathological findings. An unusual presentation of a rare condition in a paediatric patient has been discussed along with the clinical and histopathological features of this lesion. PMID:26816905

  5. Fibroepithelial Polyp of the Tonsil: Report of a Rare Case.

    PubMed

    Telugu, Ramesh Babu; Ashish, Gaurav

    2015-12-01

    Pedunculated polyps of the palatine tonsil are rare benign tumours of tonsil. Most of the cases have been reported in adults with varying presenting symptoms. We report a 12-year-old male child who presented with 6 months history of difficulty in swallowing. There was no history of breathing difficulty, change in voice or history of trauma. Clinical examination revealed a 2x1 cm small pedunculated polyp arising from the superior pole of right tonsil which was excised under general anaesthesia. Left tonsil was normal. A diagnosis of fibroepithelial polyp of right palatine tonsil was made based on histopathological findings. An unusual presentation of a rare condition in a paediatric patient has been discussed along with the clinical and histopathological features of this lesion.

  6. Ureteral fibroepithelial polyp associated with urolithiasis induced by steroid therapy in a child: a case report.

    PubMed

    Taki, T; Matuura, O; Isobe, Y; Kamihira, O; Yamada, S; Kondo, A; Yamada, Y; Honda, N

    2001-08-01

    A 14-year-old boy complained of left flank pain. He had been given high-dose corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIDP). Retrograde pyelography revealed irregular defects at the left ureteropelvic junction (UPJ), and ureteroscopy demonstrated ureteral polyp. The polyp was removed and histologically diagnosed as fibroepithelial polyp. Hypercalciuria due to the corticosteroids and bedridden was assumed to have been a causative factor in the stone formation. To our knowledge, this is the first report of a ureteral fibroepithelial polyp in children associated with urolithiasis, and associated with CIDP.

  7. Benign Fibroepithelial Polyps: A Rare Cause of Ureteropelvic Junction Obstruction in Children

    PubMed Central

    Ezekiel, Anitha; Agrawal, Vaidehi; Romero, Elena; Smith-Harrison, Leon I.

    2015-01-01

    FEPs are rare, benign mucosal growths that may cause urinary tract obstruction in both adults and children. We present the case of a ten year old Hispanic male with recurring urinary tract infections and hydronephrosis diagnosed with fibroepithelial polyps (FEPs). Despite multiple radiographic procedures, we were unable to accurately preoperatively diagnose FEPs. Here we demonstrate the difficulties in preoperative diagnosis and suggest that perhaps a combination of US and MRI in the setting of persistent urinary tract infections and flank pain may be the best approach for early diagnosis and conservative management, including less invasive treatment protocols. PMID:26793521

  8. Endourologic Diagnosis and Robotic Treatment of a Giant Fibroepithelial Polyp of the Ureter

    PubMed Central

    Zattoni, Fabio; Meggiato, Luca; Valotto, Claudio; Dal Moro, Fabrizio; Gardiman, Marina Paola; Beltrami, Paolo; Zattoni, Filiberto

    2016-01-01

    Abstract Background: Fibroepithelial polyps (FEPs) are a rare cause of ureteropelvic junction (UPJ) obstruction. Radiologists and urologists are not always confident with this disease because of its rarity, complex diagnosis, and heterogeneity of the available treatment options. Case Presentation: We present the endourologic diagnosis and the robotic management of a ureteral polyp close to the left UPJ. A 16-year-old woman with a 12 years history of left lumbar pain was referred to our Center. A computed tomography scan detected a left hydronephrosis with no signs of obstructions at MAG-3 scintigraphy. The endourologic evaluation revealed a giant FEP of the left ureter, which was removed surgically with a videolaparoscopic robot-assisted approach. Conclusion: Considering that conventional radiologic imaging techniques can hardly detect a ureteral FEP, an endourologic study of the urinary tract is mandatory to directly observe the polyp. The mini-invasive treatment of ureteral FEPs is feasible and safe, and should be considered as first option in young patients. PMID:27868092

  9. Biopsy - polyps

    MedlinePlus

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  10. Neonatal urethral polyps associated with Beckwith-Wiedemann syndrome.

    PubMed

    Anzai, Yuko; Koshida, Shigeki; Yanagi, Takahide; Johnin, Kazuyoshi; Takeuchi, Yoshihiro

    2013-10-01

    We report the first case of Beckwith-Wiedemann syndrome without urinary obstruction, but with a congenital urethral polyp as a tumor protruding from the external urinary meatus. The present case suggests a possible relation between Beckwith-Wiedemann and the onset of fibroepithelial polyps in the reno-urinary system during the neonatal period.

  11. Intravitreal Anti-vascular Endothelial Growth Factor for Treating Polypoidal Choroidal Vasculopathy with Grape-like Polyp Clusters

    PubMed Central

    Chang, Young Suk; Kim, Jong Woo; Lee, Tae Gon; Kim, Chul Gu

    2016-01-01

    Purpose To evaluate 12-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with grape-like polyp clusters. Methods This retrospective observational study included 23 eyes of 23 patients who were newly diagnosed with PCV with grape-like polyp clusters, and who were subsequently treated with anti-VEGF monotherapy. The study compares the best-corrected visual acuity (BCVA) of the patients at diagnosis, at 3 months, and at 12 months after diagnosis. In addition, 12-month changes in BCVA values were compared between cases with subfoveal or juxtafoveal polyps and cases with extrafoveal polyps. Results The baseline, 3-month, and 12-month logarithm of the minimal angle of resolution BCVA was 0.62 ± 0.35, 0.50 ± 0.43, and 0.58 ± 0.48, respectively. Compared to the baseline, patient BCVA was not significantly different at 12 months after diagnosis (p = 0.764). Six eyes (26.1%) gained ≥0.2 logarithm of the minimal angle of resolution BCVA. In cases with subfoveal or juxtafoveal polyps, BCVA values at baseline and at 12 months after diagnosis were 0.66 ± 0.37 and 0.69 ± 0.53, respectively. In cases with extrafoveal polyps, the values were 0.54 ± 0.33 and 0.37 ± 0.31, respectively. Changes in BCVA values were significantly different between the two groups (p = 0.023). Conclusions Although anti-VEGF therapy has favorable short-term efficacy for treating PCV with grape-like polyp clusters, long-term visual improvements are generally limited in the majority of afflicted eyes. The presence of subfoveal or juxtafoveal polyps may suggest unfavorable treatment outcomes. PMID:27478354

  12. Chondroid Metaplasia in a Fibroepithelial Polyp of Gingiva.

    PubMed

    Tenorio, Fernando; Campos, Paola; Paramo, Juan Ignacio; Fuente, Javier De La; Pérez, Nancy

    2016-09-01

    Gingival masses are commonly encountered in clinical practice and can be a result of many conditions one of them could be metaplasia. Metaplasia is defined as the replacement of the lining of an organ with the type of lining normally found at another site. We are reporting a case of a 17-year-old Mexican male who presented with a pedunculated nodule associated to maxillary anterior gingiva. The histopatological examination revealed a chondroid material covered by stratified squamous epithelium and was diagnosed as chondroid metaplasia.

  13. Chondroid Metaplasia in a Fibroepithelial Polyp of Gingiva

    PubMed Central

    Campos, Paola; Paramo, Juan Ignacio; Fuente, Javier De La; Pérez, Nancy

    2016-01-01

    Gingival masses are commonly encountered in clinical practice and can be a result of many conditions one of them could be metaplasia. Metaplasia is defined as the replacement of the lining of an organ with the type of lining normally found at another site. We are reporting a case of a 17-year-old Mexican male who presented with a pedunculated nodule associated to maxillary anterior gingiva. The histopatological examination revealed a chondroid material covered by stratified squamous epithelium and was diagnosed as chondroid metaplasia. PMID:27790592

  14. Genomic landscapes of breast fibroepithelial tumors.

    PubMed

    Tan, Jing; Ong, Choon Kiat; Lim, Weng Khong; Ng, Cedric Chuan Young; Thike, Aye Aye; Ng, Ley Moy; Rajasegaran, Vikneswari; Myint, Swe Swe; Nagarajan, Sanjanaa; Thangaraju, Saranya; Dey, Sucharita; Nasir, Nur Diyana Md; Wijaya, Giovani Claresta; Lim, Jing Quan; Huang, Dachuan; Li, Zhimei; Wong, Bernice Huimin; Chan, Jason Yong Sheng; McPherson, John R; Cutcutache, Ioana; Poore, Gregory; Tay, Su Ting; Tan, Wai Jin; Putti, Thomas Choudary; Ahmad, Buhari Shaik; Iau, Philip; Chan, Ching Wan; Tang, Anthony P H; Yong, Wei Sean; Madhukumar, Preetha; Ho, Gay Hui; Tan, Veronique Kiak Mien; Wong, Chow Yin; Hartman, Mikael; Ong, Kong Wee; Tan, Benita K T; Rozen, Steven G; Tan, Patrick; Tan, Puay Hoon; Teh, Bin Tean

    2015-11-01

    Breast fibroepithelial tumors comprise a heterogeneous spectrum of pathological entities, from benign fibroadenomas to malignant phyllodes tumors. Although MED12 mutations have been frequently found in fibroadenomas and phyllodes tumors, the landscapes of genetic alterations across the fibroepithelial tumor spectrum remain unclear. Here, by performing exome sequencing of 22 phyllodes tumors followed by targeted sequencing of 100 breast fibroepithelial tumors, we observed three distinct somatic mutation patterns. First, we frequently observed MED12 and RARA mutations in both fibroadenomas and phyllodes tumors, emphasizing the importance of these mutations in fibroepithelial tumorigenesis. Second, phyllodes tumors exhibited mutations in FLNA, SETD2 and KMT2D, suggesting a role in driving phyllodes tumor development. Third, borderline and malignant phyllodes tumors harbored additional mutations in cancer-associated genes. RARA mutations exhibited clustering in the portion of the gene encoding the ligand-binding domain, functionally suppressed RARA-mediated transcriptional activation and enhanced RARA interactions with transcriptional co-repressors. This study provides insights into the molecular pathogenesis of breast fibroepithelial tumors, with potential clinical implications.

  15. Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.

    PubMed

    Kesan, Krushnakumar V; Gupta, Rahul Kumar; Kothari, Paras; Gupta, Abhaya; Mudkhedkar, Kedar; Kamble, Ravikiran; Dikshit, K Vishesh

    2014-06-01

    Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp.

  16. Stomach Polyps

    MedlinePlus

    ... polyps are common among people who regularly take proton pump inhibitors to reduce stomach acid. These polyps ... of cancer, so your doctor might recommend discontinuing proton pump inhibitors or removing the polyp or both. ...

  17. Nasal polyps

    MedlinePlus

    ... get rid of nasal polyps. Nasal steroid sprays shrink polyps. They help clear blocked nasal passages and ... is stopped. Corticosteroid pills or liquid may also shrink polyps, and can reduce swelling and nasal congestion. ...

  18. Colon Polyps

    MedlinePlus

    ... polyps important? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012. Elmunzer BJ. Endoscopic resection of sessile colon polyps. Gastroenterology. 2013;144:30. Baron TH, et al. Recommended intervals between screening and surveillance colonoscopies. Mayo Clinic Proceedings. ...

  19. Cervical polyps

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001494.htm Cervical polyps To use the sharing features on this page, please enable JavaScript. Cervical polyps are fingerlike growths on the lower part ...

  20. Endometrial polyps

    MedlinePlus

    ... cancer is higher if you are postmenopausal, on Tamoxifen, or have heavy or irregular periods. These factors may increase the risk for endometrial polyps: Obesity Tamoxifen, a treatment for breast cancer Postmenopausal hormone replacement ...

  1. Polyp Prevention Trial

    Cancer.gov

    The primary objective of the Polyp Prevention Trial (PPT) is to determine whether a low fat, high fiber, high vegetable and fruit eating plan will decrease the recurrence of adenomatous polyps of the large bowel.

  2. [Pharyngeal fibrovascular polyp].

    PubMed

    Dali, Hayet; Barry, Beatrix; Wassef, Michel; Mansouri, Dhouha; Hourseau, Muriel; Hénin, Dominique; Soufan, Ranya

    2011-06-01

    The giant fibrovascular polyp of the hypopharynx is a rare and benign tumor. We report one case in a 46-year-old man. This lesion, usually unique, affects predominantly men with an average age of 53 years. These polyps are located predominantly in the upper esophagus and rarely in the hypopharynx. They are usually asymptomatic and small, detected by endoscopy. They can grow to considerable length and cause digestive or respiratory symptoms. Histologically, fibrovascular polyps consist of a various mixture of fibrous and lipomatous elements with abundant vascularisation and they are covered by normal squamous epithelium. The lack of muscular support and the pressure difference in the peristaltic wave contribute to polyp formation.

  3. Polyps of the Cervix

    MedlinePlus

    ... Interest (Quiz) Breast Cancer (Video) Overview of the Female Reproductive System (News) Study: Plenty of IV Fluids May Make Childbirth Safer, Easier (News) Zejula Approved for Certain Female Cancers Additional Content Medical News Polyps of the ...

  4. [Giant esophageal fibrovascular polyp].

    PubMed

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro

    2003-01-01

    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  5. Chapter 6: Nasal polyps.

    PubMed

    Settipane, Russell A; Peters, Anju T; Chiu, Alexander G

    2013-01-01

    Nasal polyps occur in 1-4% of the population, usually occurring in the setting of an underlying local or systemic disease. The most common associated condition is chronic rhinosinusitis (CRS). A high prevalence of nasal polyps is also seen in allergic fungal rhinosinusitis, aspirin-exacerbated respiratory disease, Churg-Strauss syndrome, and cystic fibrosis. In the setting of CRS, nasal polyps are not likely to be cured by either medical or surgical therapy; however, control is generally attainable. The best medical evidence supports the use of intranasal corticosteroids for maintenance therapy and short courses of oral corticosteroids for exacerbations. The evidence for short- and long-term antibiotics is much less robust. For patients with symptomatic nasal polyposis nonresponsive to medical therapies, functional endoscopic sinus surgery provides an adjunctive therapeutic option.

  6. Second harmonic generation microscopy is a novel technique for differential diagnosis of breast fibroepithelial lesions.

    PubMed

    Tan, Wai Jin; Yan, Jie; Xu, Shuoyu; Thike, Aye Aye; Bay, Boon Huat; Yu, Hanry; Tan, Min-Han; Tan, Puay Hoon

    2015-12-01

    Breast fibroepithelial lesions, including fibroadenomas and phyllodes tumours, are commonly encountered in clinical practice. As histological differences between these two related entities may be subtle, resulting in a challenging differential diagnosis, pathological techniques to assist the differential diagnosis of these two entities are of high interest. An accurate diagnosis at biopsy is important given corresponding implications for clinical decision-making including surgical extent and monitoring. Second harmonic generation (SHG) microscopy is a recently developed optical imaging technique capable of robust, powerful and unbiased label-free direct detection of collagen fibril structure in tissue without the use of antibodies. We constructed tissue microarrays emulating limited materials on biopsy to investigate quantitative collagen signal in fibroepithelial lesions using SHG microscopy. Archived formalin-fixed paraffin-embedded materials of 47 fibroepithelial lesions (14 fibroadenomas and 33 phyllodes tumours) were evaluated. Higher collagen signal on SHG microscopy was observed in fibroadenomas than phyllodes tumours on SHG imaging (p<0.001, area under the curve 0.859). At an automated threshold (2.5 million positive pixels), the sensitivity and specificity of the SHG microscopy for fibroadenoma classification was 71.4% and 84.4%, respectively. To corroborate these findings, we performed immunohistochemistry on tissue array sections using collagen I and III primary antibodies. Both collagen I and III immunohistochemical expressions were also significantly higher in fibroadenomas than in phyllodes tumours (p<0.001). In conclusion, label-free collagen quantitation on SHG microscopy is a novel imaging approach that can aid the differential diagnosis of fibroepithelial lesions.

  7. Determining whether excision of all fibroepithelial lesions of the breast is needed to exclude phyllodes tumor: upgrade rate of fibroepithelial lesions of the breast to phyllodes tumor.

    PubMed

    Van Osdol, Andrew D; Landercasper, Jeffrey; Andersen, Jeremiah J; Ellis, Richard L; Gensch, Erin M; Johnson, Jeanne M; De Maiffe, Brooke; Marcou, Kristen A; Al-Hamadani, Mohammed; Vang, Choua A

    2014-10-01

    Fibroepithelial lesions (FELs) are a common histologic finding on core needle biopsy (CNB) of the breast. Fibroepithelial lesions include fibroadenoma and phyllodes tumor, which can be difficult to distinguish with an initial CNB. An institutional experience was reviewed from February 12, 2001, to January 4, 2007, to determine the safety of selective rather than routine excision of FELs and to determine the factors associated with upgrading diagnosis of FELs to phyllodes tumors without definitive phyllodes tumor diagnosis by CNB. Of 313 patients, 261 (83%) with FELs diagnosed by CNB received observation with long-term follow-up (mean, 8 years). Of the observed patients, 3 (1%) were diagnosed with phyllodes tumor on follow-up. Eighteen of 52 patients (35%) who received excision had an upgrade of diagnosis to phyllodes tumor. Sensitivity and specificity of the pathologist's comment of concern for phyllodes tumor on a CNB demonstrating FELs without definitive phyllodes tumor diagnosis were 82% and 93%, respectively. Our policy of selective excision of FELs without definitive phyllodes tumor diagnosis resulted in safe avoidance of many surgical procedures.

  8. Oculosporidial polyp infected secondarily by Enterobius vermicularis

    PubMed Central

    Anuradha, S.; Bharathi, K.; Khalique, Abdul

    2014-01-01

    Oculosporidiosis caused by Rhinosporidium seeberi is a common infectious disease of south India. Here we are reporting a rare case of oculosporidial polyp containing another parasite Enterobius vermicularis as a co infection. This is the first report of its kind in literature. A nine year old school going girl from a rural area presented with a reddish polypoidal lesion from conjunctiva along with complaints of severe itching over it. On examination, the polyp measured 5 mm × 5 mm in size, reddish, granular with a tendency to bleed on touch. Her vision was normal. All the basic investigations were within normal limits. A differential diagnosis of conjunctival papilloma, foreign body granuloma and oculosporidiosis were considered clinically. The polyp was removed completely using electro cautery with healthy margins around the lesion. To our surprise histopathological examination of the swelling revealed the presence of two different parasites in the conjunctival polyp. Sections showed sporangia of Rhinosporidium seeberi, fragments of Enterobius vermicularis and its eggs. She was then treated with anti helminthic drugs. Two months of follow up till now showed no recurrence of the lesion. PMID:25337525

  9. Giant fibrovascular polyp of the hypopharynx: surgical treatment with the biappoach.

    PubMed

    I, Hoseok; Kim, Jin Sun; Shim, Young Mog

    2006-08-01

    Fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract. The majority of these polyps are located in the upper part of the esophagus but the hypopharyngeal fibrovascular polyps are only rarely seen. Most of them are surgically treated and this is usually done through a cervical incision, although some of them have been removed endoscopically. The authors report here on a case of a 63-yr-old-man with a giant fibrovascular polyp of the hypopharynx that extended into the stomach; this polyp was removed through simultaneous transcervical and transabdominal approaches because of the huge size of the polyp. The man presented with progressive dysphagia of 1 yr duration. The preoperative assessment revealed a giant polyp arising from the left arytenoid and extending into the stomach. The dimension of the polyp was about 26 x 10 x 4 cm. The complete resection of the polyp with the simultaneous transcervical and transabdominal approaches was successful, and it was diagnosed as a fibrovascular polyp. The patient has been followed up without any recurrence for 6 month postoperatively.

  10. Inflammatory Myoglandular Polyps Causing Hematochezia

    PubMed Central

    Chung, Sook Hee; Park, Young Sook; Jo, Yun Ju; Kim, Seong Hwan; Jun, Dae Won; Cheong, Eun Sun; Lee, Won Mi; Ju, Jong Eun

    2010-01-01

    We report herein three cases of inflammatory myoglandular polyp (IMGP) presenting as hematochezia. The polyps had pedunculated, red, and smooth features, and were 12, 12, and 15 mm in diameter and located in the sigmoid colon, transverse colon, and rectum, respectively. Endoscopic polypectomies were performed. Histologic examination of the recovered specimens revealed inflammatory granulation in the lamina propria mucosa, proliferation of smooth muscle, and hyperplastic glands with cystic dilatation. The three colon polyps were finally diagnosed both clinically and histologically as IMGP. Endoscopists should bear in mind that a polyp featuring endoscopic findings of pedunculation or semipedunculation; a red, smooth, spherical, and hyperemic surface; and patchy mucosa exudation and erosion is likely to be an IMGP. PMID:20479930

  11. [Gastric epithelial polyps (part two)].

    PubMed

    Espejo Romero, Luis Hernán; Navarrete Siancas, Jesús

    2004-01-01

    The following is a statistical report regarding gastric polyps: Frequency determined through endoscopic examinations was 3.6%. The terms hyperplastic polyps and adenomas were used for the classification of epithelial polyps, considering the suprafoveal hyperplasias within the hyperplastic polyps, provided they were elevated lesions. Out of 2,283 polyps, 1,959 were hyperplastic (86%) and 324 were adenomas (14%). When analyzing 780 polyps, 86 (11%) were found to have the Nakamura III category. With regard to topography, in an examination of 2253 polyps, hyperplastic polyps were located as follows: 325 (17%) in the antrum, 1402 (73%) in the body and 202 (10%) in the fundus. Adenomas had a different distribution: 212 (65%) in the antrum, 100 (31%) in the body and 12 (4%) in the fundus. Out of 371 hyperplastic polyps examined, 49% were pediculate and 51% were sessile; on the contrary, 86 % of adenomas were sessile. The average age was 66.2 years in adenoma carriers, 58.5 in those having hyperplastic polyps, and 57.4 for suprafoveal hyperplasias. In 287 adenomas, 94.1% of carriers were over 40 years old. Out of 92 adenomas examined, 21.7% evidenced adenoma metaplasia and 72.8% evidenced metaplasia in adjacent areas. Only 5.5% had no metaplasia. In 105 hyperplastic polyps studied, intestinal metaplasia was found: 16.7% in the polyp and 60% in adjacent areas. No metaplasia was found in the remaining 23.3%. Average size of the adenomas was 14 mm and of hyperplastic polyps, 11 mm. A total of 195 adenomas were smaller than 10 mm. The percentage of malignization in 288 adenomas examined was closely related to their size: 214 (66%) smaller than 20 mm, had a malignization percentage of 7%; 74 (34%) larger than 20 mm, had 51% malignization, and 86.2% malignization was found in adenomas of over 40 mm. Global malignization percentage of adenomas was 18%. However, when adenomas with high grade dysplasia in the 4.1 category of the Viena classification (non-invasive high grade

  12. Gastric hyperplastic polyps causing upper gastrointestinal hemorrhage in a young adult.

    PubMed

    Secemsky, Brian J; Robinson, Kenika R; Krishnan, Kumar; Matkowskyj, Kristina A; Jung, Barbara H

    2013-04-16

    Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon cause of overt gastrointestinal bleeding. While most hyperplastic gastric polyps are asymptomatic, they may present with abdominal pain, iron deficiency anemia or gastric outlet obstruction. These polyps are associated with conditions such as Helicobacter pylori gastritis and atrophic autoimmune gastritis, which predispose the epithelium to chronic inflammation and epithelial repair. The patient presented to Northwestern Memorial Hospital in July 2011. The polyps were resected by clip-assisted snare polypectomy. Histopathologic assessment of the resected polyps demonstrated multiple, non-ulcerative hyperplastic polyps measuring 1.3-1.8 cm in size, without evidence of dysplasia or malignancy. This case describes a young adult patient with multiple, large gastric polyps causing overt gastrointestinal bleeding. This is a rare presentation in a young individual, as these polyps are typically identified in patients older than 60 years of age and less commonly, pediatric populations.

  13. Gallbladder Polyps: Can They Be Cancerous?

    MedlinePlus

    ... these polyps, your doctor may suggest follow-up examinations to look for changes that may be an indication of cancer. This can be done using standard abdominal ultrasound or endoscopic ultrasound. Gallbladder polyps larger ...

  14. Giant Antrochoanal Polyp-A Rare Presentation

    PubMed Central

    Siddappa, Shruti Malavalli; Shivakumar, Andanooru Mahalingappa

    2017-01-01

    Antrochoanal polyp (ACP), also called as Killian polyp, is an infrequent, benign lesion of maxillary origin in non-atopic patients. The antrochoanal polyp is shaped according to the anatomical constraints of the lateral nasal wall, particularly the middle meatus and antrum, resembling typically a dumbbell. Here presenting a common problem with unusual presentation.

  15. Polyp Resection - Controversial Practices and Unanswered Questions.

    PubMed

    von Renteln, Daniel; Pohl, Heiko

    2017-03-09

    Detection and complete removal of precancerous neoplastic polyps are central to effective colorectal cancer screening. The prevalence of neoplastic polyps in the screening population in the United States is likely >50%. However, most persons with neoplastic polyps are never destined to develop cancer, and do not benefit for finding and removing polyps, and may only be harmed by the procedure. Further 70-80% of polyps are diminutive (≤5 mm) and such polyps almost never contain cancer. Given the questionable benefit, the high-cost and the potential risk changing our approach to the management of diminutive polyps is currently debated. Deemphasizing diminutive polyps and shifting our efforts to detection and complete removal of larger and higher-risk polyps deserves discussion and study. This article explores three controversies, and emerging concepts related to endoscopic polyp resection. First, we discuss challenges of optical resect-and-discard strategy and possible alternatives. Second, we review recent studies that support the use of cold snare resection for ≥5 mm polyps. Thirdly, we examine current evidence for prophylactic clipping after resection of large polyps.

  16. [Neoplastic polyps of the colon].

    PubMed

    Gallo Reynoso, S; Candelaria Hernández, M G

    1992-01-01

    We report all patients with neoplastic polyps endoscopically excised during 10 years, performed in different hospitals in Mexico City. All ages, both sexes and socio-economic levels were seen in several endoscopy services both, public and private. We find 190 patients (100 females) with 268 polyps and a mean age of 54.5 (range 18-86). Tubulo-villous adenomas have the less frequency (8%). Villous adenomas were the largest and had a 11% frequency, almost all were confined to recto-sigmoid region its mean age was 6 years. Villous adenomas were the most frequent (69%) distributed in all colonic segments, its mean age was 54.5 years with the widest range (18-80 years); they have highest dysplasia rate (8.1%). Carcinomas arising in polyps were all located in recto-sigmoid region, with female predominance (2.3:1) and oldest mean age of presentation (66.3 years). Neoplastic polyps in Mexico City general population has a low frequency; endoscopic polypectomy is safe and had a low morbi-mortality rate.

  17. [Non-neoplastic polyps of the colon].

    PubMed

    Gallo Reynoso, S; Candelaria Hernández, M G

    1993-01-01

    Non-neoplastic colon polyps are benign lesions with normal histology components, we present our experience with colonoscopy polypectomy in 10 years. We resected 187 polyps in 96 patients (50 males) with medium age of 49.3 years and range 2-82. Most common indication was hemorrhage (37%) taking out the hyperplastic polyps who were found in asymptomatic patients with the highest frequency (41%). Juvenile polyps follows with 25%. 71% polyps were unique but hamaetomatous polyps of Peutz-Jeghers syndrome were multiple (39%). Juvenile (retention) polyps were found among the youngest patients (average 13.2 years) and frequently had hemorrhage (21-25). Lipomas were found in elder patients (range 52.5 years). We had no major complications with hemorrhage or mortality, minor complications were found in 3.09%.

  18. Molecular characteristics of colorectal serrated polyps and hyperplastic polyps

    PubMed Central

    Sambuudash, Otgontuya; Kim, Hee Man; Jo, Hannah; Kim, Hyun Sik; Lee, Kyong Joo; Park, Hong Jun; Kim, Jae Woo; Cho, Mee Yon; Kim, Hyun-Soo

    2016-01-01

    Abstract The serrated neoplasia pathway of colorectal carcinogenesis is characterized by BRAF mutation and aberrant DNA methylation, which have not been reported on Korean patients. The aim of this study was to investigate BRAF mutation and DNA methylation in colorectal serrated polyps and the right colon. Between 2005 and 2013, 146 colon polyps (47 tubular adenomas [TAs], 53 traditional serrated adenomas [TSAs], 17 sessile serrated adenomas/polyps [SSAs], and 29 hyperplastic polyps in the proximal colon [PHPs]) were collected from patients. Paraffin-embedded colon polyp tissue was used for DNA extraction. BRAF V600E mutation was identified through polymerase chain reaction (PCR) and pyrosequencing assay. The methylation status of the long interspersed nucleotide element-1, insulin-like growth factor binding protein 7 (IGFBP7), mutL homolog 1 (hMLH1), and CD133 genes were evaluated through disulfite conversion, PCR, and pyrosequencing assay. BRAF V600E mutation was found in 2.1% of TAs, 47.2% of TSAs, 41.2% of SSAs, and 20.7% of PHPs. TSA and SSA had higher BRAF mutation rates than did TA (P < 0.0001). TSA had higher BRAF mutation rates than did PHP (P = 0.018). IGFBP7 hypermethylation was found in 17% of TAs, 37.7% of TSAs, 88.2% of SSAs, and 37.5% of PHPs. TSA and SSA had higher hypermethylation of IGFBP7 than did TA (P = 0.021 and P < 0.0001, respectively). SSA had higher hypermethylation of IGFBP7 than did PHP (P = 0.002). hMLH1 hypermethylation was found in 2.1% of TAs, 5.7% of TSAs, 0% of SSAs, and 0% of PHPs. CD133 hypermethylation was found in 21.3% of TAs, 9.4% of TSAs, 35.3% of SSAs, and 17.4% of PHPs. BRAF mutation and methylation in TSA and SSA are different from those in PHP in Koreans. These findings suggested that PHP may have different molecular characteristics compared with other serrated polyps. PMID:27930579

  19. A phase Ib study of the effects of black raspberries on rectal polyps in patients with familial adenomatous polyposis.

    PubMed

    Wang, Li-Shu; Burke, Carol A; Hasson, Henrietta; Kuo, Chieh-Ti; Molmenti, Christine L Sardo; Seguin, Claire; Liu, Pengyuan; Huang, Tim H-M; Frankel, Wendy L; Stoner, Gary D

    2014-07-01

    Familial adenomatous polyposis (FAP) is characterized by the early onset of colonic polyposis and a high risk for colorectal cancer. FAP is treated by colectomy followed by lifelong removal of rectal polyps. This study determined whether black raspberries (BRBs) might regress rectal polyps in patients with FAP. Fourteen patients with FAP were treated with BRBs daily for 9 months. Seven patients received BRB powder orally plus two BRB suppositories inserted into the rectum at bedtime. The other 7 received an oral placebo plus the suppositories. Rectal polyp counts and polyp sizes were obtained at time zero and after 9 months of BRB treatment. Polyps and adjacent normal tissue were collected at both time points. The burden (P = 0.036) but not number (P = 0.069) of rectal polyps was significantly decreased. No benefit was noted with the addition of oral BRBs. Three patients were nonresponders. BRBs significantly decreased cellular proliferation, DNA methylation methyl transferase 1 protein expression, and p16 promoter methylation, but not promoter methylation of the Wnt pathway antagonists, SFRP2 and WIF1, in rectal polyps (adenomas) from responders but not from nonresponders. The MBD-seq assay revealed more demethylated transcription start sites (TSS), including those for miRNAs, in BRB-treated adenomas from the responders. In conclusion, BRB suppositories seem sufficient for regressing rectal polyps in patients with FAP.

  20. A new exploration for gallbladder polyps: gallbladder polypectomy by endolap technique.

    PubMed

    Wang, JingMin; Tan, YuYan; Zhao, Gang; Wang, Dong; Ji, ZhenLing

    2014-12-01

    Abstract Gallbladder polyps are most commonly treated with cholecystectomy, which is associated with various complications. For benign disease, preserving the gallbladder is preferable. Since 1994, we have been exploring percutaneous polypectomy and have recently developed an improved new technique. This study reports a new endoscopic-laparoscopic (Endolap) technique for the removal of polyps and the preservation of the gallbladder. Nine Chinese mini-pigs were used to observe mucosal regeneration. Microwaves of 50-70 mA for 9 seconds were safe, and the gallbladder mucosa of pigs recovered to nearly normal 2 weeks later. In the clinical cases, 60 patients with gallbladder polyps were studied. With the patient under general anesthesia, each polyp stem was coagulated, and then the polyp was removed. All procedures were successful at between 60 and 135 minutes. The success rate was 93.33% (56/60). A retrospective analysis was conducted to assess the recovery of gallbladder function. All patients were followed up and symptom-free, without recurrence of the polyps; 3 months after the operation, the volume and contraction of the gallbladder recovered to preoperative levels. Thus the Endolap technique is reliable for removing benign gallbladder polyps and is applicable to a wider range of clinical situations than percutaneous polypectomy.

  1. Endometrial polyps in 2 African pygmy hedgehogs.

    PubMed

    Phillips, Irene D; Taylor, Jacqueline J; Allen, Andrew L

    2005-06-01

    Reports of spontaneously occurring endometrial polyps in animals are rare and have only involved a few species. This report is intended to advise veterinarians that older African pygmy hedgehogs may develop endometrial polyps and that these lesions can be a cause of bloody vaginal discharge, sometimes interpreted as hematuria.

  2. Managing difficult polyps: techniques and pitfalls

    PubMed Central

    Tholoor, Shareef; Tsagkournis, Orestis; Basford, Peter; Bhandari, Pradeep

    2013-01-01

    There is no standardized definition of difficult polyps. However, polyps become difficult and challenging to remove endoscopically when they are large in size, flat in nature, situated in a high-risk location and when access to them is very awkward. Recently, an SMSA (Size, Morphology, Site, Access) classification has been proposed that helps to qualify the degree of difficulty by scoring on the above parameters. This article reviews the features that make polyps difficult to remove and provides some practical tips in managing these difficult polyps. We believe that ‘difficult polyp’ is a relative term and each endoscopist should define their own level of difficulty and what they would be able to handle safely. However, in expert trained hands, most difficult polyps can be safely removed by an endoscopic approach. PMID:24714799

  3. Computed tomographic features of feline nasopharyngeal polyps.

    PubMed

    Oliveira, Cintia R; O'Brien, Robert T; Matheson, Jodi S; Carrera, Inés

    2012-01-01

    The computed tomographic (CT) findings of histopathologically confirmed nasopharyngeal polyps are described in 13 cats. Most polyps were mildly hypoattenuating to adjacent muscles and isoattenuating to soft-tissue (n= 13), homogeneous (n = 12) and with ill-defined borders (n = 10) on precontrast images. After contrast medium administration, the polyps were homogeneous (n = 11), with well-defined borders (n = 13), oval (n = 13), and had rim enhancement (n = 13). Nasopharyngeal polyps were pedunculated in 11 cats with a stalk-like structure connecting the polyp through the auditory tube to an affected tympanic bulla. All cats had at least one tympanic bulla severely affected, with CT images identifying: (1) complete (n = 12) or partial (n = 1) obliteration of either the dorsal or ventral compartments with soft-tissue attenuating material; (2) pathologic expansion (n = 13) with wall thickening (n = 10) that was asymmetric in nine cats; and (3) identification of a polyp-associated stalk-like structure (n = 11). Nine cats had unilateral tympanic bulla disease ipsilateral to the polyp, and four cats had bilateral tympanic bulla disease, most severe ipsilateral to the polyp with milder contralateral pathologic changes. Two cats had minimal osteolysis of the tympanic bulla. Enlargement of the medial retropharyngeal lymph node was seen commonly (n = 8), and in all cats it was ipsilateral to the most affected tympanic bulla. One cat had bilateral lymphadenopathy. CT is an excellent imaging tool for the supportive diagnosis of nasopharyngeal polyps in cats. CT findings of a well-defined mass with strong rim enhancement, mass-associated stalk-like structure, and asymmetric tympanic bulla wall thickening with pathologic expansion of the tympanic bullae are highly indicative of an inflammatory polyp.

  4. Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery

    PubMed Central

    Byeon, Hyung Kwon; Han, Ji Hyuk; Choi, Byeong Il; Hwang, Hye Jin; Kim, Ji-Hoon; Choi, Hong-Shik

    2015-01-01

    Objective. Conventional surgical techniques of laryngomicrosurgery (LMS) on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL), which can effectively resect the polyp with vocal fold mucosa preservation. Methods. Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated. Results. A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20–73), and there were 20 males and 19 females (17 professional voice users). In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave. Conclusion. PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps. PMID:26557700

  5. Effect of voice training in the voice rehabilitation of patients with vocal cord polyps after surgery

    PubMed Central

    LIN, LI; SUN, NA; YANG, QIUHUA; ZHANG, YA; SHEN, JI; SHI, LIXIN; FANG, QIN; SUN, GUANGBIN

    2014-01-01

    The objective of the present study was to determine the effect of voice training on the vocal rehabilitation of patients with vocal cords polyps following phonomicrosurgery. A total of 60 cases of vocal cord polyps treated by laser phonomicrosurgery were randomly divided into training and control groups with 30 cases in each group. The patients were treated with laser phonomicrosurgery, routine postoperative treatment and nursing. The training group were additionally treated with vocal training, including relaxation training, breathing training, basic pronunciation training, chewing voice training and tone sandhi pronunciation training, and attention was paid to the training steps. Subjective and objective voice evaluations of the two groups were compared three months after the surgery and the differences between groups were statistically significant (P<0.05). Voice training may significantly improve the postoperative voice quality of patients with vocal cord polyps and support rehabilitation. PMID:24669244

  6. Cholesterol polyps in the distal common bile duct: a case report

    PubMed Central

    Tang, Rui; Zhao, Wen-ping; Zhang, Yan-ning; Tong, Xuan; Zeng, Jian-ping

    2016-01-01

    Abstract Rationale: Cholesterol polyps are rare in the common bile duct and difficult to diagnose. Patient concerns: The small polypoid lesions often go undetected when using routine imaging methods, such as ultrasonography. Diagnoses: We treated a patient with cholesterol polyps in the common bile duct. After failing to detect choleliths using ultrasonography, magnetic resonance cholangiopancreatography revealed mild dilation of the common bile duct. Choledochoscopy was performed during laparoscopic cholecystectomy, which revealed yellowish-white polyps circumferentially distributed across the luminal surface of the distal common bile duct. Histological examination of biopsy specimens indicated cholesterol polyps with characteristic foamy cells. Interventions: The patient was treated with ursodeoxycholic acid, and the number of polyps was found to have been reduced at the 6-week follow-up based on T-tube choledochoscopic examination. Outcomes: Recovery was unremarkable, and the ursodeoxycholic acid treatment was discontinued at the 6-month follow-up. Lessons subsections: Our findings suggest that this rare condition can be treated pharmacologically to avoid potential postsurgical complications following resection of the distal common bile duct. PMID:27828866

  7. Clipping prevents perforation in large, flat polyps

    PubMed Central

    Luba, Daniel; Raphael, Mona; Zimmerman, Dayna; Luba, Joseph; Detka, Jon; DiSario, James

    2017-01-01

    AIM To determine if prophylactic clipping of post-polypectomy endoscopic mucosal resection (EMR) mucosal defects of large, flat, right sided polyps prevents perforations. METHODS IRB approved review of all colonoscopies, and prospective data collection of grasp and snare EMR performed by 2 endoscopists between January 1, 2010 and March 31, 2014 in a community ambulatory endoscopy center. The study consisted of two phases. In the first phase, all right-sided, flat polyps greater than or equal to 1.2 cm in size were removed using the grasp and snare technique. Clipping was done at the discretion of the endoscopist. In the second phase, all mucosal defects were closed using resolution clips. Phase 2 of the study was powered to detect a statistically significant difference in perforation rate with 148 EMRs, if less than or equal to 2 perforations occurred. RESULTS In phase 1 of the study, 2121 colonoscopies were performed. Seventy-five patients had 95 large polyps removed. There were 4 perforations in 95 polypectomies (4.2%). The perforations occurred in polyps ranging in size from 1.5 cm to 2.5 cm. In phase 2, there were 2464 colonoscopies performed. One hundred and sixteen patients had 151 large polyps removed, and all mucosal defects were clipped. There were no perforations (P = 0.0016). There were no post-polypectomy hemorrhages in either phase. An average of 2.15 clips were required to close the mucosal defects. The median time to perform the polypectomy and clipping was 13 min, and the median procedure duration was 40 min. Five percent of all patients undergoing colonoscopy in our community based, ambulatory endoscopy center had flat, right sided polyps greater than or equal to 1.2 cm in size. CONCLUSION Prophylactic clipping of the mucosal resection defect of large, right-sided, flat polyps reduces the incidence of perforation. PMID:28360975

  8. Novel findings in colorectal polyp surveillance.

    PubMed

    Carballal, Sabela

    2016-09-01

    Colorectal adenomas and serrated polyps are the best characterised premalignant lesions involved in the development of colorectal cancer (CRC). Therefore, the identification and removal of these lesions, as well as post-polypectomy surveillance of affected patients, are key goals in the field of CRC prevention. Current post-polypectomy surveillance strategies differ among the various scientific societies and have several limitations that hamper their application in clinical practice. First, current surveillance intervals are based only on polyp characteristics, excluding other potential clinical conditions, such as diabetes or metabolic syndrome. Second, serrated polyps and adenomas are considered separately, but there is no recommendation in cases of the simultaneous occurrence of both types of lesion. Third, the incorporation of endoscopic technologies implies an increase in polyp detection, whose clinical impact is controversial and directly affects the number of scheduled colonoscopies with an indication of surveillance. Some of the studies presented at the AGA (American Gastroenterological Association) meeting aimed to provide new evidence on the follow-up of colorectal polyps, with a view to optimising the applicability and suitability of current surveillance strategies.

  9. The patient with multiple intestinal polyps.

    PubMed

    Schulmann, Karsten; Pox, Christian; Tannapfel, Andrea; Schmiegel, Wolff

    2007-01-01

    The management of patients with multiple intestinal polyps may be difficult and greatly depends on the correct classification. Polyposis syndromes account for less than 1% of newly diagnosed colorectal cancers. In addition the risk for extracolonic cancer is increased in most syndromes. Here we report the case of a difficult patient with severe gastric polyposis and we present a review of polyposis syndromes such as classical and attenuated familial adenomatous polyposis (FAP), MYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis as well as rare polyposis syndromes. The most practical approach for the diagnostic workup in patients with newly diagnosed gastrointestinal polyposis is based on the histological typing of polyps. In addition, a detailed family history regarding cancer, polyps and congenital abnormalities should be obtained from every polyposis patient. Patients with multiple adenomas are most likely to suffer from FAP, AFAP or MAP. Of these, younger age and higher polyp count are most likely a diagnosis of typical FAP. Older age and fewer polyps favour a diagnosis of AFAP or MAP. Germline testing of the APC gene is suggested, and if negative, MYH gene testing should be done. In patients with hamartomas, extraintestinal features should be evaluated and reference histology should be initiated. In addition panintestinal imaging should be performed with EGD, colonoscopy and small bowel imaging (PE, CE, and MR) enteroclysis. For diagnostic and therapeutic problems a familial colorectal cancer center should be consulted. Using this algorithm, correct classification and adequate treatment should be possible for every polyposis patient.

  10. Gastric hyperplastic polyp with focal cancer.

    PubMed

    Markowski, Adam Roman; Guzinska-Ustymowicz, Katarzyna

    2016-05-01

    This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp, that was completely resected during an endoscopic procedure, and discusses current recommendations in such cases. Endoscopic resection of polyps with focal dysplasia or cancer is commonly indicated, as long as the procedure can be performed safely. After complete excision of a polyp with atypical focal lesion, endoscopic surveillance is suggested. The frequency of surveillance endoscopy should depend on the precise histopathological diagnosis and possibility of confirming the completeness of the endoscopic resection. If the completeness of the procedure is confirmed both macro- and microscopically, gastric resection does not have to be performed. A follow-up esophago-gastroduodenoscopy should be performed at 1 year and then at 3 years.

  11. Gastric hyperplastic polyp with focal cancer

    PubMed Central

    Markowski, Adam Roman; Guzinska-Ustymowicz, Katarzyna

    2016-01-01

    This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp, that was completely resected during an endoscopic procedure, and discusses current recommendations in such cases. Endoscopic resection of polyps with focal dysplasia or cancer is commonly indicated, as long as the procedure can be performed safely. After complete excision of a polyp with atypical focal lesion, endoscopic surveillance is suggested. The frequency of surveillance endoscopy should depend on the precise histopathological diagnosis and possibility of confirming the completeness of the endoscopic resection. If the completeness of the procedure is confirmed both macro- and microscopically, gastric resection does not have to be performed. A follow-up esophago-gastroduodenoscopy should be performed at 1 year and then at 3 years. PMID:25361760

  12. Expression of Annexin A10 in Serrated Polyps Predicts the Development of Metachronous Serrated Polyps

    PubMed Central

    Macaron, Carole; Lopez, Rocio; Pai, Rish K; Burke, Carol A

    2016-01-01

    Objectives: The ability to differentiate histological characteristics between serrated polyps (SPs) and make a pathological diagnosis of a sessile serrated polyp (SSP) is highly variable. Recent studies have shown that immunohistochemical (IHC) expression of Annexin A10 (ANXA10) is a marker of a SSP. However, the clinical utility of ANXA10 expression in patients with SPs is unknown. The objective of this study was to evaluate the utility of ANXA10 expression in SPs in predicting the development of subsequent polyps at follow-up colonoscopy. Methods: Specimens from patients with SPs assessed in the Department of Pathology between 2006 and 2010 were identified. Patients whose colon harbored only SPs including either an SSP and/or hyperplastic polyp (HP) and who had complete polyp resection, no remaining polyps, and a follow-up colonoscopy were analyzed. ANXA10 IHC expression was performed in all baseline SPs. The rate of metachronous polyps on follow-up colonoscopy based on baseline maximal ANXA10 expression (low vs. high) was determined. Results: One hundred and seventy-nine patients were included. Sixty-seven patients had SPs with low ANXA10 expression (30 SSP and 37 HP) and 112 had polyps with high ANXA10 expression (105 SSP and 7 with HP). Individuals with SPs with high ANXA10 expression had a threefold higher risk of SSP on follow-up colonoscopy (hazard ratio (HR)=2.7; P=0.048) particularly, in the proximal colon (HR=4.0; P=0.02). ANXA10 expression did not predict patients at an increased risk of subsequent adenomas (18.8% vs. 19.4%, P=0.52). Conclusions: Individuals who harbor SPs with high ANXA10 expression are at an increased risk of metachronous serrated neoplasms. ANXA10 may be a reproducible tool to stratify patients with SPs into higher- and lower-risk groups of metachronous serrated neoplasia, allowing a more aggressive colonoscopic surveillance in patients at high risk. PMID:27906163

  13. Prevalence of Helicobacter pylori in Gastric Hyperplastic Polyps.

    PubMed

    Horvath, Bela; Pai, Rish K

    2016-12-01

    Hyperplastic polyps of the stomach are routinely encountered during upper endoscopy and often arise in the setting of abnormal surrounding mucosa, particularly Helicobacter pylori, autoimmune gastritis, and reactive gastropathy. Not infrequently gastroenterologists fail to biopsy the surrounding mucosa, thus determining the underlying etiology of the gastric hyperplastic polyp can be difficult. Recently, the Rodger C. Haggitt Gastrointestinal Pathology Society published guidelines on the use of special stains. The society guidelines indicate that H pylori are not usually present in hyperplastic polyps and special stains in this setting may have limited utility. We analyzed the histologic features of 32 gastric hyperplastic polyps in which the nonpolypoid mucosa demonstrated H pylori gastritis. A consecutive series of 50 hyperplastic polyps in which no surrounding mucosa was sampled was also analyzed. When H pylori are identified in biopsies of the nonpolypoid mucosa, it is also commonly present within the polyp tissue (22/32, 69%). The majority of H pylori organisms were identified on routine hematoxylin and eosin stain (16/22, 72%). In contrast, H pylori were only seen in 2/50 consecutive hyperplastic polyps in which the surrounding mucosa was not sampled. Compared with the hyperplastic polyps that lack the organisms, H pylori associated hyperplastic polyps more commonly had dense lymphoplasmacytic inflammation (P = .0001) and neutrophils within gastric epithelium (P = .036). Polyp location, number, size, and presence of intestinal metaplasia was not associated with H pylori These results provide empirical data to guide evaluation of hyperplastic polyps for H pylori.

  14. Computer-aided detection of polyps in optical colonoscopy images

    NASA Astrophysics Data System (ADS)

    Nadeem, Saad; Kaufman, Arie

    2016-03-01

    We present a computer-aided detection algorithm for polyps in optical colonoscopy images. Polyps are the precursors to colon cancer. In the US alone, 14 million optical colonoscopies are performed every year, mostly to screen for polyps. Optical colonoscopy has been shown to have an approximately 25% polyp miss rate due to the convoluted folds and bends present in the colon. In this work, we present an automatic detection algorithm to detect these polyps in the optical colonoscopy images. We use a machine learning algorithm to infer a depth map for a given optical colonoscopy image and then use a detailed pre-built polyp profile to detect and delineate the boundaries of polyps in this given image. We have achieved the best recall of 84.0% and the best specificity value of 83.4%.

  15. Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp: A Japanese collaborative study.

    PubMed

    Shida, Yosuke; Ichikawa, Kazuhito; Fujimori, Takahiro; Fujimori, Yukari; Tomita, Shigeki; Fujii, Takahiro; Sano, Yasushi; Oda, Yasushi; Goto, Hideyo; Ohta, Akihiko; Tanaka, Shinji; Sugai, Tamotsu; Yao, Takashi; Ohkura, Yasuo; Imura, Johji; Kato, Hiroyuki

    2013-01-01

    A hyperplastic polyp (HP) >10 mm is described as a large hyperplastic polyp (LHP). Previous studies have considered LHP and sessile serrated adenoma/polyp (SSA/P) as synonymous. Although HP and SSA/P have previously been morphologically distinguished, differences between LHP and SSA/P have not yet been reported. The present study aimed to define the differences between SSA/P and non-SSA/P in LHP using immunohistochemistry for Ki67. Colorectal serrated lesions (>10 mm) that were completely resected by endoscope and derived from 11 institutions in Japan [Dokkyo Medical University School of Medicine (Mibu), Takahiro Fujii Clinic (Tokyo), Sano Hospital (Kobe), Oda GI Clinic, Hattori GI Endoscopy and Oncology Clinic (Kumamoto), Ohta Clinic (Nagoya), Hiroshima University (Hiroshima), Iwate Medical University (Morioka), Juntendo and Kyorin Universities (Tokyo) as well as Toyama University (Toyama)] affiliated with the Japanese Society for Cancer of the Colon and Rectum (JSCCR) between January 2003 and December 2010 were selected. The histological criteria of the Japanese Society for Cancer of the Colon and Rectum (JSCCR, project meeting; editor-in chief, Takashi Yao) were used to distinguish SSA/P and non-SSA/P from LHP. Non-SSA/P comprises both incomplete SSA/P and HP. A total of 154 samples diagnosed as SSA/P or non-SSA/P from 148 patients were used. This study comprised 107 SSA/P and 47 non-SSA/P cases, whereby lesions were located on the right side of the colon (73.2 and 26.8%, respectively). Ki67-positivity in SSA/Ps was significantly higher compared to non-SSA/Ps. A greater number of SSA/Ps in LHP were located on the right side of the colon compared to the left side. SSA/Ps occurring on the right side of the colon may be precursor lesions of colorectal carcinoma in serrated neoplasia pathways. In conclusion, LHPs and SSA/Ps limited to the right side of the colon are suggested to be clinically treated as the same type of lesions.

  16. Are gastric hyperplastic polyps an additional manifestation in celiac disease?

    PubMed Central

    Dore, Maria Pina; Pes, Giovanni Mario; Rocchi, Chiara; Loria, Maria Francesca; Soro, Sara; Bassotti, Gabrio

    2017-01-01

    Abstract Gastric polyps are frequently reported in patients undergoing upper endoscopic procedures. In this retrospective study, the association between hyperplastic polyps and celiac disease in Northern Sardinia was estimated. Age, gender, body mass index, and medications taken in the 2 preceding months, including proton-pump inhibitors (PPIs), H2 receptor blockers (anti-H2), Helicobacter pylori status, endoscopic findings, and histology from charts of patients undergoing esophago-gastro-duodenoscopy were reviewed. Polyps were classified as hyperplastic, fundic gland, inflammatory, and adenomatous. 3.7% (423/11379) patients had celiac disease. Prevalence of gastric polyps was 4.2% (3.8% among celiac vs 4.2% nonceliac patients). Inflammatory polyp was the most common histotype (55.8% and 56.2%) followed by fundic gland polyps (31.4% and 43.7%), hyperplastic (8.7% and 0%), and adenomas, in celiac and nonceliac patients, respectively. Fundic gland polyps were more common in PPI users (odds ratio: 4.06) than in nonusers (2.65, P = 0.001) among celiac and nonceliac patients. Age older than 50, female gender, esophago-gastro-duodenoscopy year, and PPI use were associated with the presence of polyps, whereas active H pylori infection was not. Gastric polyps were common in Sardinian patients undergoing esophago-gastro-duodenoscopy. However, the previously reported association between hyperplastic polyps and celiac disease was not confirmed in our study. PMID:28151870

  17. The clinical impact of serrated colorectal polyps

    PubMed Central

    O’Connell, Brendon M; Crockett, Seth D

    2017-01-01

    Serrated polyps (SPs) of the colorectum pose a novel challenge to practicing gastroenterologists. Previously thought benign and unimportant, there is now compelling evidence that SPs are responsible for a significant percentage of incident colorectal cancer worldwide. In contrast to conventional adenomas, which tend to be slow growing and polypoid, SPs have unique features that undermine current screening and surveillance practices. For example, sessile serrated polyps (SSPs) are flat, predominately right-sided, and thought to have the potential for rapid growth. Moreover, SSPs are subject to wide variations in endoscopic detection and pathologic interpretation. Unfortunately, little is known about the natural history of SPs, and current guidelines are based largely on expert opinion. In this review, we outline the current taxonomy, epidemiology, and management of SPs with an emphasis on the clinical and public health impact of these lesions. PMID:28260946

  18. Hypertrophic gastropathy with transient sessile polyps.

    PubMed

    Pesce, F; Barabino, A; Dufour, C; Caffarena, P E; Callea, F; Gatti, R

    1992-04-01

    We report an 8-year-old boy with hypertrophic gastropathy (HG) associated with duodenal Giardia lamblia infestation. The follow-up was complicated by the development of gastric polyps at the site of previous biopsies that spontaneously disappeared within 15 months. Despite the histological similarity, the different course between Ménétrier's disease (MD) in adults (chronic, with frequent development of sessile or pedunculate polyps) and HG (uncomplicated and usually spontaneously resolving) suggests a different pathogenesis. Viral (cytomegalovirus) and bacterial (Helicobacter pylori) infections have been described in association with HG and they could play an important pathogenetic role. The term HG better defines the childhood disease in which a conservative management is recommended.

  19. Intestinal lymphangiectasia and colonic polyps: surgical intervention.

    PubMed

    Parsons, H G; Pencharz, P B

    1979-10-01

    A 36-mo-old boy with Milroy's Disease, intestinal lymphangiectasia, and an exudative enteropathy (EE), was shown to have four colonic polyps. A large adenomatous polyp was excised from the transverse colon in an effort to control his EE and hypoalbuminemia (1.95 g/dl). His clinical status then stabilized until age 50 mo when there was a marked exacerbation of his EE. Medical management resulted in a temporary stabilization of his condition. A partial resection (40 cm) of the visually worse affected jejunum was performed. There was no improvement in the EE as measured by 51Cr-tagged albumin study; however, his clinical response was dramatic. In the 10 mo since surgery, he has been well and has shown catchup in linear growth.

  20. Solitary gastric Peutz-Jeghers type stomach polyp mimicking a malignant gastric tumor.

    PubMed

    Jin, Jong-Shiaw; Yu, Ji-Kuen; Tsao, Tang-Yi; Lin, Lien-Fu

    2012-04-21

    Most cases of Peutz-Jeghers type polyps of the stomach are associated with mucocutaneous pigmentation and multiple intestinal polyposis. A solitary Peutz-Jeghers type polyp of the stomach is rare. We here report a case of a 71-year-old woman with a solitary Peutz-Jeghers type polyp of the stomach who presented with intolerable epigastric pain and weight loss of 5 kg over the prior two months. During the hospital treatment course for this patient, endoscopic examination revealed a bulging lesion with a central hole, mucosal ulceration, an asymmetrical wall thickness and a narrowing of the gastric lumen. A gastric biopsy further revealed ulceration with moderate dysplasia. The patient received endoscopic ultrasonography which showed a second subepithelial lesion that measured 4 cm × 3 cm. Computed tomography of the abdomen subsequently showed a thickened gastric wall with three visibly enlarged lymph nodes, all greater than 1 cm. The suspected diagnosis was malignant gastric cancer with lymph node metastases. The other lesion, which measured 2 cm × 2 cm × 1 cm was noted in the submucosa of the jejunum during surgery. The patient was treated using a subtotal gastrectomy and partial resection of the jejunal tumor. The final pathological report indicated a gastric Peutz-Jeghers type polyp with proliferation of smooth muscle bundles in the submucosal layer, and hyperplastic glands in the mucosal layer and ectopic pancreas of the jejunum. This is the first reported clinical case of a solitary Peutz-Jeghers type polyp of the stomach accompanying a lymph node enlargement and ectopic pancreas in the jejunum that simulates stomach cancer with lymph node metastases.

  1. Transanal Approach to Rectal Polyps and Cancer

    PubMed Central

    Rai, Vinay; Mishra, Nitin

    2016-01-01

    A transanal approach to rectal polyp and cancer excision is often an appropriate alternative to conventional rectal resection, and has a lower associated morbidity. There has been a steady evolution in the techniques of transanal surgery over the past 30 years. It started with traditional transanal excision and was revolutionized by introduction of transanal endoscopic microsurgery in early 1980s. Introduction of transanal minimally invasive surgery made it more accessible to surgeons around the world. Now robotic platforms are being tried in certain institutions. Concerns have been raised about recurrence rates of cancers with transanal approach and success of subsequent salvage operations. PMID:26929754

  2. Pathophysiological and clinical aspects of gastric hyperplastic polyps.

    PubMed

    Markowski, Adam Roman; Markowska, Agnieszka; Guzinska-Ustymowicz, Katarzyna

    2016-10-28

    Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori (H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.

  3. Pathophysiological and clinical aspects of gastric hyperplastic polyps

    PubMed Central

    Markowski, Adam Roman; Markowska, Agnieszka; Guzinska-Ustymowicz, Katarzyna

    2016-01-01

    Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori (H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later. PMID:27833379

  4. Hybrid Laparoendoscopic Approaches to Endoscopically Unresectable Colon Polyps.

    PubMed

    Aslani, Nava; Alkhamesi, Nawar A; Schlachta, Christopher M

    2016-08-01

    Secondary prevention of colorectal cancer relies on effective screening through colonoscopy and polypectomy. Resection of some polyps can present technical challenges particularly when polyps are large, flat, or behind colonic folds. Laparoscopy as an adjunct to endoscopy can aid in removing difficult colonic polyps without subjecting patients to radical segmental colectomy. Hybrid laparoendoscopic techniques are increasingly reported in literature as alternatives to segmental colectomy for the treatment of polyps that have a high likelihood of being benign. Laparoscopic-assisted colonoscopic polypectomy is the most frequently utilized technique; it harnesses the power of laparoscopy to aid endoscopic polypectomy by flattening folds, mobilizing flexures, and providing retraction. Colonoscopy-assisted laparoscopic wedge and transluminal resection are often reported in older studies and use the visualization provided by intraoperative colonoscopy to guide colonic resection that is limited to the area of the polyp. Laparoscopic-assisted endoscopic full-thickness resection (EFTR) is a relatively recent technique that provides laparoscopic monitoring of EFTR of polyp as well as endoscopic closure of the ensuing defect. Minimally invasive segmental colectomy based on oncologic principles should be utilized when none of the previous techniques are suitable or when malignancy is strongly suspected. The combined use of laparoscopy and endoscopy can expand the endoscopist's armamentarium when dealing with the most challenging polyps, while serving the patients' best interest by limiting the extent of colon resection.

  5. Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas

    PubMed Central

    Bretagne, Jean-François; Hamonic, Stéphanie; Piette, Christine; Viel, Jean-François; Bouguen, Guillaume

    2016-01-01

    AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS The observed detection rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure. PMID:27784967

  6. Associations between dietary fiber and colorectal polyp risk differ by polyp type and smoking status.

    PubMed

    Fu, Zhenming; Shrubsole, Martha J; Smalley, Walter E; Ness, Reid M; Zheng, Wei

    2014-05-01

    The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer.

  7. Colonoscopy Atlas of Colon Polyps and Neoplasms.

    PubMed

    Tang, Shou-Jiang; Sones, James Q

    2016-03-01

    Optical colonoscopy is the gold standard for colon cancer screening and adenoma detection and is the only screening option that can potentially provide therapeutic interventions and adenoma removal during the same session. When other screening strategies generate positive results, currently colonoscopy is the next step for definitive diagnosis and potentially curative therapy. For gastrointestinal endoscopists, the ileocecum is the finishing line during colonoscopy, and it is identified by three endoscopic landmarks: terminal ileum, ileocecal valve, and the appendiceal orifice. Careful and systematic examination should be stressed during endoscopic training and practice. In this pictorial review, the authors demonstrate common colon polyps and neoplasms that can be found during colonoscopy. Our aim is to educate gastroenterologists, endoscopy staff other health care providers, and interested patients on certain colon pathologies and common endoscopic interventions.

  8. Colonoscopic polyp detection using convolutional neural networks

    NASA Astrophysics Data System (ADS)

    Park, Sun Young; Sargent, Dusty

    2016-03-01

    Computer aided diagnosis (CAD) systems for medical image analysis rely on accurate and efficient feature extraction methods. Regardless of which type of classifier is used, the results will be limited if the input features are not diagnostically relevant and do not properly discriminate between the different classes of images. Thus, a large amount of research has been dedicated to creating feature sets that capture the salient features that physicians are able to observe in the images. Successful feature extraction reduces the semantic gap between the physician's interpretation and the computer representation of images, and helps to reduce the variability in diagnosis between physicians. Due to the complexity of many medical image classification tasks, feature extraction for each problem often requires domainspecific knowledge and a carefully constructed feature set for the specific type of images being classified. In this paper, we describe a method for automatic diagnostic feature extraction from colonoscopy images that may have general application and require a lower level of domain-specific knowledge. The work in this paper expands on our previous CAD algorithm for detecting polyps in colonoscopy video. In that work, we applied an eigenimage model to extract features representing polyps, normal tissue, diverticula, etc. from colonoscopy videos taken from various viewing angles and imaging conditions. Classification was performed using a conditional random field (CRF) model that accounted for the spatial and temporal adjacency relationships present in colonoscopy video. In this paper, we replace the eigenimage feature descriptor with features extracted from a convolutional neural network (CNN) trained to recognize the same image types in colonoscopy video. The CNN-derived features show greater invariance to viewing angles and image quality factors when compared to the eigenimage model. The CNN features are used as input to the CRF classifier as before. We report

  9. Maspin, a Marker of Serrated Colorectal Polyps.

    PubMed

    Rubio, Carlos A; Kaufeldt, Ann; Björk, Jan; Jaramillo, Edgar

    2015-07-01

    The serine proteinase inhibitor maspin is a tumor-suppressor protein that stimulates apoptosis and inhibits motility, invasion and cancer metastasis. Mutant maspin galvanises partial loss of tumor-suppressor function, reducing susceptibility to apoptosis and facilitating malignant progression. Mutant maspin has been reported in many tumor types. We recently analyzed maspin expression in 128 colorectal lesions: 39 hyperplastic polyps (HPs), 29 sessile serrated adenoma/polyps (SSA/Ps), three traditional serrated adenomas (TSAs), 20 conventional colorectal adenomas (CCRAs), 5 carcinomas evolving from CCRA, 12 active inflammatory bowel disease (IBD), 2 ulcerative colitis (UC) in remission, 4 solitary ulcers (rectum) and 12 normal colorectal mucosa. The topographic distribution of maspin in the cytoplasm was classified into i) extensive, ii) focal, or iii) negative. The intensity of maspin expression in the cytoplasm was classified into i) unquestionable or ii) negative. Cases with faint (questionable) maspin expression were also recorded as negative. Extensive maspin expression was recorded in 95% (39/41) of the HPs, in 100% (29/29) of the SSA/Ps (including one carcinoma arising in a SSA/P), in 66% (2/3) of the TSAs, but only in 10% (2/20) of the CCRAs. None of the specimens with carcinoma arising in CCRA, with UC in remission or with solitary ulcer exhibited extensive maspin expression. Importantly, maspin was not expressed in the normal mucosa (including that adjacent to HP, SSA/P, TSA and CCRA). It is submitted that extensive maspin expression might be a manifestation of mutant maspin in lesions central to the serrated pathway of colorectal carcinogenesis.

  10. Cronkhite-Canada syndrome polyps infiltrated with IgG4-positive plasma cells

    PubMed Central

    Fan, Ru-Ying; Wang, Xiao-Wei; Xue, Li-Jun; An, Ran; Sheng, Jian-Qiu

    2016-01-01

    Cronkhite-Canada syndrome (CCS) is a rare but serious protein-losing enteropathy, but little is known about the mechanism. Further more, misdiagnosis is common due to non-familiarity of its clinical manifestation. A 40-year-old male patient was admitted to our hospital because of diarrhea and hypogeusia associated with weight loss for 4 mo. On physical examination, skin pigmentation, dystrophic nail changes and alopecia were noted. He had no alike family history. Laboratory results revealed low levels of serum albumin (30.1 g/L, range: 35.0-55.0 g/L), serum potassium (2.61 mmol/L, range: 3.5-5.5 mmol/L) and blood glucose (2.6 mmol/L, range: 3.9-6.1 mmol/L). The erythrocyte sedimentation rate was elevated to 17 mm/h (range: 0-15 mm/h). X-ray of chest and mandible was normal. The endoscopic examination showed multiple sessile polyps in the stomach, small bowel and colorectum. Histopathologic examination of biopsies obtained from those polyps showed hyperplastic change, cystic dilatation and distortion of glands with inflammatory infiltration, eosinophilic predominance and stromal edema. Immune staining for IgG4 plasma cells was positive in polyps of stomach and colon. The patient was diagnosed of CCS and treated with steroid, he had a good response to steroid. Both histologic findings and treatment response to steroid suggested an autoimmune mechanism underling CCS. PMID:27574615

  11. An aposymbiotic primary coral polyp counteracts acidification by active pH regulation

    NASA Astrophysics Data System (ADS)

    Ohno, Yoshikazu; Iguchi, Akira; Shinzato, Chuya; Inoue, Mayuri; Suzuki, Atsushi; Sakai, Kazuhiko; Nakamura, Takashi

    2017-01-01

    Corals build their skeletons using extracellular calcifying fluid located in the tissue–skeleton interface. However, the mechanism by which corals control the transport of calcium and other ions from seawater and the mechanism of constant alkalization of calcifying fluid are largely unknown. To address these questions, we performed direct pH imaging at calcification sites (subcalicoblastic medium, SCM) to visualize active pH upregulation in live aposymbiotic primary coral polyps treated with HCl-acidified seawater. Active alkalization was observed in all individuals using vital staining method while the movement of HPTS and Alexa Fluor to SCM suggests that certain ions such as H+ could diffuse via a paracellular pathway to SCM. Among them, we discovered acid-induced oscillations in the pH of SCM (pHSCM), observed in 24% of polyps examined. In addition, we discovered acid-induced pH up-regulation waves in 21% of polyps examined, which propagated among SCMs after exposure to acidified seawater. Our results showed that corals can regulate pHSCM more dynamically than was previously believed. These observations will have important implications for determining how corals regulate pHSCM during calcification. We propose that corals can sense ambient seawater pH via their innate pH-sensitive systems and regulate pHSCM using several unknown pH-regulating ion transporters that coordinate with multicellular signaling occurring in coral tissue.

  12. An aposymbiotic primary coral polyp counteracts acidification by active pH regulation.

    PubMed

    Ohno, Yoshikazu; Iguchi, Akira; Shinzato, Chuya; Inoue, Mayuri; Suzuki, Atsushi; Sakai, Kazuhiko; Nakamura, Takashi

    2017-01-18

    Corals build their skeletons using extracellular calcifying fluid located in the tissue-skeleton interface. However, the mechanism by which corals control the transport of calcium and other ions from seawater and the mechanism of constant alkalization of calcifying fluid are largely unknown. To address these questions, we performed direct pH imaging at calcification sites (subcalicoblastic medium, SCM) to visualize active pH upregulation in live aposymbiotic primary coral polyps treated with HCl-acidified seawater. Active alkalization was observed in all individuals using vital staining method while the movement of HPTS and Alexa Fluor to SCM suggests that certain ions such as H(+) could diffuse via a paracellular pathway to SCM. Among them, we discovered acid-induced oscillations in the pH of SCM (pHSCM), observed in 24% of polyps examined. In addition, we discovered acid-induced pH up-regulation waves in 21% of polyps examined, which propagated among SCMs after exposure to acidified seawater. Our results showed that corals can regulate pHSCM more dynamically than was previously believed. These observations will have important implications for determining how corals regulate pHSCM during calcification. We propose that corals can sense ambient seawater pH via their innate pH-sensitive systems and regulate pHSCM using several unknown pH-regulating ion transporters that coordinate with multicellular signaling occurring in coral tissue.

  13. An aposymbiotic primary coral polyp counteracts acidification by active pH regulation

    PubMed Central

    Ohno, Yoshikazu; Iguchi, Akira; Shinzato, Chuya; Inoue, Mayuri; Suzuki, Atsushi; Sakai, Kazuhiko; Nakamura, Takashi

    2017-01-01

    Corals build their skeletons using extracellular calcifying fluid located in the tissue–skeleton interface. However, the mechanism by which corals control the transport of calcium and other ions from seawater and the mechanism of constant alkalization of calcifying fluid are largely unknown. To address these questions, we performed direct pH imaging at calcification sites (subcalicoblastic medium, SCM) to visualize active pH upregulation in live aposymbiotic primary coral polyps treated with HCl-acidified seawater. Active alkalization was observed in all individuals using vital staining method while the movement of HPTS and Alexa Fluor to SCM suggests that certain ions such as H+ could diffuse via a paracellular pathway to SCM. Among them, we discovered acid-induced oscillations in the pH of SCM (pHSCM), observed in 24% of polyps examined. In addition, we discovered acid-induced pH up-regulation waves in 21% of polyps examined, which propagated among SCMs after exposure to acidified seawater. Our results showed that corals can regulate pHSCM more dynamically than was previously believed. These observations will have important implications for determining how corals regulate pHSCM during calcification. We propose that corals can sense ambient seawater pH via their innate pH-sensitive systems and regulate pHSCM using several unknown pH-regulating ion transporters that coordinate with multicellular signaling occurring in coral tissue. PMID:28098180

  14. Candidate determination for computer aided detection of colon polyps

    NASA Astrophysics Data System (ADS)

    Bitter, Ingmar; Aslam, Bushra; Huang, Adam; Summers, Ronald M.

    2005-04-01

    Given a segmented CT scan data of the colon represented as a triangle mesh, our water-plane algorithm will detect polyp candidates. The water-plane method comprises of pouring water into a polyp protrusion from the outside of the colon and in raising the "water-plane" until it cannot be incremented any further without causing water leakage. The method starts at a vertex and uses average normal of all triangles adjacent to the starting vertex to generate the initial water-plane, which will make the starting vertex "wet" but leave its neighboring vertices "dry". The method will continue to wet neighboring vertices one by one and then their neighbors and so on until the water-plane cannot move any further without causing water leakage. The water-plane movement alternates between just raising the water level in completely convex regions and tilting about one or two anchor vertices that have neighbors that would get wet if the water level was raised any more. The final set of wet vertices is a cluster that is an initial polyp candidate. The water-plane method was compared against the current polyp candidate detection method in our Computer Aided Detection of Colon Polyps software pipeline, called the surface curvature method. It finds clusters of connected vertices that all exhibit elliptical curvature. The water-plane method showed multiple improvements in polyp candidate detection. It detected polyp candidates missed by the surface curvature method. It exhibited continuous polyp candidate regions instead of non-uniform or incomplete regions detected by the surface curvature method. And finally, it avoided some false positive detections reported by surface curvature method.

  15. Hypofibrinogenemia Caused by Hemocoagulase After Colon Polyps Excision

    PubMed Central

    Zhou, Hai-Bo

    2017-01-01

    Case series Patient: — Final Diagnosis: Routine use of hemocoagulase for injection for the prevention of late-onset bleeding is not recommended for patients who have undergone excision of colon polyps. Hemocoagulase following excision of colon polyps can cause hypofibrinogenemia and even l Symptoms: Hematochezia Medication: — Clinical Procedure: Three patients also had lower gastrointestinal bleeding Specialty: Gastroenterology and Hepatology Objective: Unusual or unexpected effect of treatment Background: In patients with large colon polyps, late-onset bleeding may be more likely to occur because of the larger cutting surface. In these patients, hemostatic agents may be applied to prevent the late-onset bleeding. A total of 7 patients developed hypofibrinogenemia caused by hemocoagulase following excision of colon polyps in our center from November to December 2015. Case Report: Seven patients underwent excision of colon polyps in our center from November to December 2015. The cutting face was large in these patients after surgery; therefore, hemocoagulase was used to prevent potential late-onset bleeding. Evaluation of clotting function showed that the fibrinogen level was normal before surgery in all 7 patients. Hemocoagulase was intravenously administered twice daily beginning from postoperative day 1. Hypofibrinogenemia of varying severity occurred 2–4 d later. Three patients also had lower-gastrointestinal bleeding. After drug withdrawal and infusion of fibrinogen, blood fibrinogen level gradually returned to normal. In contrast, among 13 patients who had not received hemocoagulase treatment for preventing hemorrhage following excision of colon polyps, detection of blood fibrinogen before surgery and 2–4 d after showed normal results. Conclusions: Routine use of Hemocoagulase For Injection for the prevention of late-onset bleeding is not recommended for patients who have undergone excision of colon polyps. Hemocoagulase following excision of colon

  16. A Complete System for Polyps Flagging in Virtual Colonoscopy

    DTIC Science & Technology

    2011-04-01

    in this paper) and curvedness as geometric features, applying fuzzy clustering and then using directional gradient concentration to reduce false...with a relative low false positives ( FP ) rate, using heuristic thresholds and texture features. Hong et al., [18], map the 3D surface to a rectangle...polyps submerged in fluid in the database, the results are very promising, achieving 96.4% sensitivity (over 28 polyps) with 1.1 FP per case. However

  17. Computer-aided detection of colonic polyps using volume rendering

    NASA Astrophysics Data System (ADS)

    Hong, Wei; Qiu, Feng; Marino, Joseph; Kaufman, Arie

    2007-03-01

    This work utilizes a novel pipeline for the computer-aided detection (CAD) of colonic polyps, assisting radiologists in locating polyps when using a virtual colonoscopy system. Our CAD pipeline automatically detects polyps while reducing the number of false positives (FPs). It integrates volume rendering and conformal colon flattening with texture and shape analysis. The colon is first digitally cleansed, segmented, and extracted from the CT dataset of the abdomen. The colon surface is then mapped to a 2D rectangle using conformal mapping. Using this colon flattening method, the CAD problem is converted from 3D into 2D. The flattened image is rendered using a direct volume rendering of the 3D colon dataset with a translucent transfer function. Suspicious polyps are detected by applying a clustering method on the 2D volume rendered image. The FPs are reduced by analyzing shape and texture features of the suspicious areas detected by the clustering step. Compared with shape-based methods, ours is much faster and much more efficient as it avoids computing curvature and other shape parameters for the whole colon wall. We tested our method with 178 datasets and found it to be 100% sensitive to adenomatous polyps with a low rate of FPs. The CAD results are seamlessly integrated into a virtual colonoscopy system, providing the radiologists with visual cues and likelihood indicators of areas likely to contain polyps, and allowing them to quickly inspect the suspicious areas and further exploit the flattened colon view for easy navigation and bookmark placement.

  18. Automated synthesis, insertion and detection of polyps for CT colonography

    NASA Astrophysics Data System (ADS)

    Sezille, Nicolas; Sadleir, Robert J. T.; Whelan, Paul F.

    2003-03-01

    CT Colonography (CTC) is a new non-invasive colon imaging technique which has the potential to replace conventional colonoscopy for colorectal cancer screening. A novel system which facilitates automated detection of colorectal polyps at CTC is introduced. As exhaustive testing of such a system using real patient data is not feasible, more complete testing is achieved through synthesis of artificial polyps and insertion into real datasets. The polyp insertion is semi-automatic: candidate points are manually selected using a custom GUI, suitable points are determined automatically from an analysis of the local neighborhood surrounding each of the candidate points. Local density and orientation information are used to generate polyps based on an elliptical model. Anomalies are identified from the modified dataset by analyzing the axial images. Detected anomalies are classified as potential polyps or natural features using 3D morphological techniques. The final results are flagged for review. The system was evaluated using 15 scenarios. The sensitivity of the system was found to be 65% with 34% false positive detections. Automated diagnosis at CTC is possible and thorough testing is facilitated by augmenting real patient data with computer generated polyps. Ultimately, automated diagnosis will enhance standard CTC and increase performance.

  19. Improvement of biochemical methods of polyP quantification

    PubMed Central

    Bru, Samuel; Jiménez, Javier; Canadell, David; Ariño, Joaquín; Clotet, Josep

    2016-01-01

    Polyphosphate (polyP) is an abundant and physiologically important biomolecule for virtually any living cell. Therefore, determination of changes in cellular content of polyP is crucial for its functional characterization. Determination of cellular polyP has been performed by many different methods, and the lack of a standardized procedure is possibly responsible for the large dispersion of results found in the relevant literature. For a relatively simple organism, such as the yeast Saccharomyces cerevisiae, this variation can be up to 12-fold. polyP extraction and determination of free phosphate released by enzymatic degradation of the polymer is a method quite common and relatively straightforward for polyP determination. By using the yeast S. cerevisiae as model, we have experimentally evaluated the different steps in this procedure in order to identify critical issues that might explain the disparate reported results. As the main output of this evaluation we propose a straightforward and robust procedure that can be used as gold standard protocol for cellular polyP purification and determination from unicellular organisms, thus providing consistency to measurements and facilitating inter-laboratory comparisons and biological interpretation of the results. PMID:28357384

  20. Probability model for estimating colorectal polyp progression rates.

    PubMed

    Gopalappa, Chaitra; Aydogan-Cremaschi, Selen; Das, Tapas K; Orcun, Seza

    2011-03-01

    According to the American Cancer Society, colorectal cancer (CRC) is the third most common cause of cancer related deaths in the United States. Experts estimate that about 85% of CRCs begin as precancerous polyps, early detection and treatment of which can significantly reduce the risk of CRC. Hence, it is imperative to develop population-wide intervention strategies for early detection of polyps. Development of such strategies requires precise values of population-specific rates of incidence of polyp and its progression to cancerous stage. There has been a considerable amount of research in recent years on developing screening based CRC intervention strategies. However, these are not supported by population-specific mathematical estimates of progression rates. This paper addresses this need by developing a probability model that estimates polyp progression rates considering race and family history of CRC; note that, it is ethically infeasible to obtain polyp progression rates through clinical trials. We use the estimated rates to simulate the progression of polyps in the population of the State of Indiana, and also the population of a clinical trial conducted in the State of Minnesota, which was obtained from literature. The results from the simulations are used to validate the probability model.

  1. Risk Factors for Self-Reported Colon Polyps

    PubMed Central

    Kahn, Henry S; Tatham, Lilith M; Thun, Michael J; Heath, Clark W

    1998-01-01

    OBJECTIVE Investigate risk factors for colon polyp using multivariate analyses. DESIGN In a group responding to a 1992 mail survey, we assessed the association between physician-diagnosed colon polyp and possible risk factors reported primarily 10 years earlier. SETTING Survey respondents within the Cancer Prevention Study II. PARTICIPANTS Respondents, 72,868 men and 81,356 women, who reported no polyp diagnosis when questioned in 1982 at ages 40 to 64 years. MEASUREMENTS AND MAIN RESULTS The characteristics of 7,504 men (10.3%) and 5,111 women (6.3%) reporting a first colon polyp were compared with those of participants who did not report a polyp. After adjustments for age, family history of colorectal cancer, and other potential risk factors, polyp occurrence was associated with 1982 histories of smoking, former smoking, alcohol use of at least two drinks per day (odds ratios [ORs] from 1.5 to 1.1; all p < .005), and a body mass index ≥ 28 kg/m 2(men's OR 1.06; 95% confidence interval [CI] 1.00, 1.13; women's OR 1.08; 95% CI 0.99, 1.17). Polyps were also associated with a diagnosis of gallbladder disease or gallstone at any time and with gallbladder surgery up to 1982 (OR from 2.7 to 1.3; all p < .001). Polyp occurrence was inversely associated with 1982 histories of high exercise level (men's OR 0.83; 95% CI 0.76, 0.91; women's OR 0.90; 95% CI 0.78, 1.03), frequent aspirin use in women (OR 0.85; 95% CI 0.77, 0.95), and high parity in women (OR 0.84; 95% CI 0.75, 0.94). Among participants lacking a clinically normal gallbladder, the polyp risks associated with smoking and high body mass index were reduced (p < .04 for interactions). CONCLUSIONS Despite the limitations and potential biases in these self-reported data, the risk factors described here may be useful for identifying persons at modestly increased risk of having a colon polyp. The effect-modifying role of gallbladder status deserves further investigation. PMID:9613885

  2. Epidemiology and differential diagnosis of nasal polyps

    PubMed Central

    Chaaban, Mohamad R.; Walsh, Erika M.

    2013-01-01

    Background: Chronic rhinosinusitis (CRS) is one of the most common chronic medical conditions, with a significant impact on patient quality of life. CRS is broadly classified into two groups: CRS with nasal polyposis (CRSwNP) and CRS without NP (CRSsNP). Clinically, the major subtypes of CRSwNP may be divided into eosinophilic chronic rhinosinusitis (e.g., allergic fungal rhinosinusitis and aspirin-exacerbated respiratory disease [AERD]) and nasal polyps associated with neutrophilic inflammation (e.g., cystic fibrosis [CF]). CF is characterized by mutation of the gene encoding the CF transmembrane conductance regulator. Functional endoscopic sinus surgery is usually required for most NP patients with increased frequency in patients with AERD. This study provides a review of the epidemiology and major classification of CRSwNP. Methods: A review was performed of the literature regarding different subtypes of CRSwNP. Results: Many definitions of CRSwNP exist and estimates of prevalence vary. Conclusion: CRSwNP is a clinical syndrome with a heterogeneous inflammatory profile. Of the subtypes associated with eosinophilic inflammation, AERD remains the most recalcitrant to medical and surgical therapeutic interventions. PMID:24274222

  3. Effect of intranasal treatment with capsaicin on the recurrence of polyps after polypectomy and ethmoidectomy.

    PubMed

    Zheng, C; Wang, Z; Lacroix, J S

    2000-01-01

    The aim of this study was to evaluate the influence of five intranasal applications of capsaicin, performed after endoscopic polypectomy associated with partial middle turbinectomy and anterior ethmoidectomy, on the recurrence of nasal polyps and the intensity of nasal obstruction and rhinorrhea. Fifty-one patients (19 females, 32 males, mean age 43 years) suffering from nasal polyposis for more than 1 year were included in this double blind, randomized, placebo-controlled study. During post-surgical controls, local anaesthesia and vasoconstriction of the middle meatus area were performed in all patients with a cotton pellet soaked with lidocain and adrenaline. In 29 patients, the same type of cotton pellet soaked with capsaicin (3 x 10(-6) mol. dissolved in 70% ethanol) was left into the middle meatus of both nostrils for 20 min. As a control group, 22 patients, matched for age and sex, were treated with the capsaicin vehicle alone (70% ethanol). All patients studied received the intranasal treatment once a week for 5 weeks. Subjective evaluations of nasal airway resistance (NAR) and rhinorrhea were recorded by means of a visual analogue scale. Clinical staging of the nasal polyposis (graded from stage 0 = absence of polyp to stage 3 = polyps occupying the entire nasal cavity) was evaluated by the same ENT specialist (ZW) using a 0 degrees endoscope. All parameters were recorded for each patient 1 week before surgery, then once a month for 9 months. Patients treated by endoscopic surgery followed by intranasal capsaicin application, reported a marked reduction in their NAR compared with the pretreatment evaluation (p<0.001). In contrast, patients treated with the vehicle alone did not have any significant improvement of their subjective NAR. Subjective rhinorrhea was not modified by either treatment. Patients treated with capsaicin showed a significant smaller staging of their nasal polyposis compared with the control group (p<0.001). These observations suggest

  4. Serrated polyps of right colon: guilty or innocent?

    PubMed Central

    Michalopoulos, George; Tzathas, Charalampos

    2013-01-01

    In recent years a lot of interest has been focused on a specific category of polyps, the so-called serrated polyps which until recently were categorized with the hyperplastic or mixed polyps and were thought to have no risk of malignant transformation. Recently though, the serrated pathway of carcinogenesis was discovered and destroyed this myth. It is believed that up to one third of all colorectal cancers arise through the serrated pathway; these cancers occur more often in the proximal colon and have specific molecular characteristics. Specific subtypes of serrated polyps (mainly the sessile serrated adenomas/polyps) are thought to be precursor lesions of these cancers. The prevention of these cancers is a challenge for gastroenterologists because their location and endoscopic characteristics renders them difficult to detect. Also, although there is a clear need for creating a specific post-polypectomy surveillance program for these lesions, to date there have been no guidelines for surveillance with a high level of evidence. In this article the main molecular, endoscopic, histological and epidemiologic characteristics of these lesions are presented, as well as recommendations for surveillance. PMID:24714424

  5. Visceral Obesity If Associated with Gallbladder Polyps

    PubMed Central

    Lee, Jun Kyu; Hahn, Suk Jae; Kang, Hyoun Woo; Jung, Jae Gu; Choi, Han Seok; Lee, Jin Ho; Han, In Woong; Jung, Jin-Hee; Kwon, Jae Hyun

    2016-01-01

    Background/Aims Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. Methods We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. Results Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for <200 mg/dL vs ≥240 mg/dL). Body mass index and waist circumference were not meaningful variables. Conclusions Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference. PMID:26260756

  6. Meat and meat-mutagen intake, doneness preference and the risk of colorectal polyps: the Tennessee Colorectal Polyp Study.

    PubMed

    Shin, Aesun; Shrubsole, Martha J; Ness, Reid M; Wu, Huiyun; Sinha, Rashmi; Smalley, Walter E; Shyr, Yu; Zheng, Wei

    2007-07-01

    Although meat intake has been fairly consistently linked to the risk of colorectal cancer, only a few studies have evaluated meat intake by doneness level and the heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) produced by high temperature cooking of meat in relation to colorectal adenomatous and hyperplastic polyps. We evaluated these associations in a large colonoscopy-based case-control study. Included in this study were participants with adenomatous polyp only (n = 573), hyperplastic polyp only (n = 256), or both adenomatous and hyperplastic polyps (n = 199), and 1,544 polyp-free controls. In addition to information related to demographic and other lifestyle factors, meat intake by cooking method and doneness preference were obtained through telephone interviews. Polytomous logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals for the association between exposures and colorectal polyp risks. Presence of hyperplastic polyp was found to be positively associated with high consumption of total meat (p(trend) = 0.076) or red meat (p(trend) = 0.060), with an approximate 50-60% elevated risk observed in the highest vs. the lowest intake group. High intake of 2-amino-I-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and 2-amino-3,4,8-trimethylimidazo [4,5]quinoxaline (DiMeIQx) were associated with increased risk for hyperplastic polyp (p(trend) = 0.036 and 0.038, respectively). With a possible exception of the intake of total well-done meats (p(trend) = 0.055) or well-done red meats (p(trend) = 0.074) with the risk of large adenomas, no other positive association was found specifically for the risk of adenomas with any of the exposure variables aforementioned. This study provides additional support for a positive association of high intake of red meat with colorectal adenomas, and suggests that high intake of meats and meat carcinogens may also be associated with hyperplastic polyps.

  7. Colorectal polyp model established by transplacental BMP4 RNAi

    PubMed Central

    JIN, XIN; CHEN, ZHONGMEI; XIANG, LI; LUO, QING; GUO, ZHENGHUA; DING, XIONGHUI; JIN, XIANQING

    2014-01-01

    Previous studies have shown that disruption of the bone morphogenetic protein (BMP) signaling pathway is an important cause of intestinal cancer in human and animal models. Thus, the purpose of this study was to construct a Balb/C model of colorectal polyps. Pregnant mice at 9.5 days gestation were injected via the tail vein with the pSES-Si BMP4 plasmid bearing a fluorochrome (DsRed) reporter, in order to silence the BMP4 gene in the first generation (F1); this group of mice was named the pSES-BMP4 group Intestinal fluorescence was detected at 1-, 4- and 8-week-old F1 mice, and reverse transcription-polymerase chain reaction (RT-PCR) and western-blotting assays were used to determine changes in the expression of BMP4. A dissecting microscope and hematoxylin and eosin (H&E) staining were used to observe the cell morphology and appearance of the polyps. DsRed fluorescence was observed in the intestines of 1-week-old F1 mice of the pSES-BMP4 group. BMP4 expression at the mRNA and protein level was reduced in 1-, 4- and 8-week-old F1 mice (P<0.05). However, the level of Smad4 mRNA was only reduced in 8-week-old F1 mice (P<0.05). Multiple hyperplasic polyps emerged in the colon and rectum of the intestines of 4-week-old F1 mice in the pSES-BMP4 group. The size of colorectal polyps increased at 8 weeks, when vessels and polyp pedicles became apparent. In conclusion, silencing of the BMP4 gene using transplacental RNAi injection can induce formation of colorectal polyps in mice. PMID:24806485

  8. Identification of non-neoplastic and neoplastic gastric polyps using multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Jiang, Shanghai; Kang, Deyong; Xu, Meifang; Zhu, Xiaoqin; Zhuo, Shuangmu; Chen, Jianxin

    2012-12-01

    Gastric polyps can be broadly defined as luminal lesions projecting above the plane of the mucosal surface. They are generally divided into non-neoplastic and neoplastic polyps. Accurate diagnosis of neoplastic polyps is important because of their well-known relationship with gastric cancer. Multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) is one of the most important recent inventions in biological imaging. In this study, we used MPM to image the microstructure of gastric polyps, including fundic gland polyps, hyperplastic polyps, inflammatory fibroid polyps and adenomas, then compared with gold-standard hematoxylin- eosin(H-E)-stained histopathology. MPM images showed that different gastric polyps have different gland architecture and cell morphology. Dilated, elongated or branch-like hyperplastic polyps are arranged by columnar epithelial cells. Inflammatory fibroid polyps are composed of small, thin-walled blood vessels surrounded by short spindle cells. Fundic glands polyps are lined by parietal cells and chief cells, admixed with normal glands. Gastric adenomas are generally composed of tubules or villi of dysplastic epithelium, which usually show some degree of intestinal-type differentiation toward absorptive cells, goblet cells, endocrine cells. Our results demonstrated that MPM can be used to identify non- neoplastic and neoplastic gastric polyps without the need of any staining procedure.

  9. Association of Gallbladder Polyp and Stroke

    PubMed Central

    Chen, Chien-Hua; Lin, Cheng-Li; Kao, Chia-Hung

    2015-01-01

    Abstract Gallbladder polyp (GP) and stroke share several metabolic disorders as risk factors. We assessed the association between GP and subsequent stroke risk. From 2000 to 2011, patients with GP aged >20 years were identified from the Longitudinal Health Insurance Database 2000. Of the 15,975 examined patients, 12,780 and 3195 were categorized into the non-GP and GP cohorts, respectively. The relative risks of stroke were estimated using the Cox proportional hazard model after adjusting for age, sex, and comorbidities. The overall incidence of stroke was higher in the GP cohort than in the non-GP cohort (6.66 vs 5.20/1000 person-yr), with an incidence rate ratio (IRR) of 1.28 (95% confidence interval [CI] = 1.15–1.42). The risk of stroke was 1.32-fold (95% CI = 1.06–1.63) in patients with GP compared with patients without GP after adjusting for age, sex, income level, urbanization level, occupation and comorbidities of gallstone, alcohol-related illness, diabetes, hyperlipidemia, hypertension, obesity, COPD, coronary heart disease, and asthma. Furthermore, the stroke risk was higher among elderly patients (with 1-yr intervals; adjusted HR [aHR] = 1.06, 95% CI = 1.05–1.07), the male sex (aHR = 1.62, 95% CI = 1.35–1.96), lower income level (aHR = 1.37, 95% CI = 1.02–1.85 for level I; aHR = 1.62, 95% CI = 1.25–2.10 for level II), living in second urbanized areas (aHR = 1.28, 95% CI = 1.00–1.63), alcohol-related illness (aHR = 1.56, 95% CI = 1.07–2.28), diabetes (aHR = 1.78, 95% CI = 1.41–2.24), and hypertension (aHR = 2.74, 95% CI = 2.19–3.42). GP is associated with stroke; however, GP may be less influential than other risk factors are, such as male sex, lower income level, alcohol-related illness, diabetes, and hypertension, on stroke development. Additional studies are required to clarify whether GP is a risk factor for or an epiphenomenon of stroke development. PMID

  10. Hamartomatous polyps - a clinical and molecular genetic study.

    PubMed

    Jelsig, Anne Marie

    2016-08-01

    Hamartomatous polyps (HPs) in the gastrointestinal (GI) tract are rare compared to other types of GI polyps, yet they are the most common type of polyp in children. The symptoms are usually rectal bleeding, abdominal pain, obstipation, anaemia, and/or small bowel obstruction. The polyps are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological appearance. Patients with one or a few juvenile polyps are usually not offered clinical follow-up as the polyp(s) are considered not to harbour any malignant potential. Nevertheless, it is important to note that juvenile polyps and HPs are also found in patients with hereditary hamartomatous polyposis syndromes (HPS). Patients with HPS have an increased risk of cancer, recurrences of polyps, and extraintestinal complications. The syndromes are important to diagnose, as patients should be offered surveillance from childhood or early adolescence. The syndromes include juvenile polyposis syndrome, Peutz-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing.   Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps in the colon and rectum in Denmark in 1995-2014. Based on the Danish Pathology Data Bank we found that 1772 patients had 2108 JPs examined in the period, and we

  11. Low rate of large polyps (>9 mm) within 10 years after an adequate baseline colonoscopy with no polyps

    PubMed Central

    Lieberman, David; Holub, Jennifer L.; Morris, Cynthia D.; Logan, Judith; Williams, J. Lucas; Carney, Patricia

    2014-01-01

    Background & Aims Guidelines recommend a 10 year interval between screening colonoscopies with negative results for average-risk individuals. However, many patients are examined at shorter intervals. We investigated outcomes of individuals with no polyps who had repeat colonoscopy in less than 10 years. Methods Data were collected using the National Endoscopic Database, from 69 gastroenterology centers, on 264,184 asymptomatic subjects who underwent screening colonoscopies from 2000 through 2006, were found to have no polyps, and received another colonoscopy examination within less than 10 years. Results No polyps were found in 147,375 patients during a baseline colonoscopy; 17,525 patients (11.9%) had a follow-up colonoscopy within less than 10 years, including 1806 (10.3%) who received the follow-up colonoscopy within less than 1 year. The most common reason for repeating the examination within 1 year was that the first was compromised by inadequate bowel preparation or incomplete examination. Of these patients, 6.5% (95% confidence interval [CI], 5.3–7.6) had large polyp(s) >9 mm—a proportion similar to the prevalence in the average-risk screening population. Reasons that examinations were repeated within 1–5 years included average-risk screening (15.7%), family history of colon polyps or cancer (30.1%), bleeding (31.2%), gastrointestinal symptoms (11.8%), or a positive result from a fecal blood test (5.5%). If the baseline exam was adequate, the incidence of large polyps within 1–5 years after baseline colonoscopy was 3.1% (95% CI, 2.7–3.5) and within years 5–10 years was 3.7% (95% CI, 3.3–4.1). Conclusions Repeat colonoscopies within 10 years are of no benefit to patients who had adequate examinations and were found to have no polyps. Repeat colonoscopies are beneficial to patients when the baseline examination was compromised. PMID:24768680

  12. Effects of filtering on colorectal polyp detection in ultra low dose CT

    NASA Astrophysics Data System (ADS)

    Schoonenberg, Gert A.; de Vries, Ayso; Grigorescu, Simona; Peters, Joost; Vilanova, Anna; Truyen, Roel; Stoker, Jaap; Gerritsen, Frans

    2006-03-01

    We have evaluated the feasibility of polyp detection on simulated ultra low dose CT Colonography data by a computer aided polyp detection (CAD) algorithm. We compared the results of ultra low dose to normal dose data. Twenty-three extensively prepared patients were scanned in prone and supine position at 25 to 100 mAs (average 70 mAs) depending on their waist circumference. Noise was added and the scans were reconstructed at 6.25 and 1.39 mAs. To evaluate the performance of the CAD system, polyps detected by an experienced reviewer and confirmed at colonoscopy were used as ground truth. Curvature, concavity and sphericity of the colon surface were used to detect polyp candidates. Bilateral filtering was used to reduce noise. We present the results for 40 polyps of 6 mm or larger as measured during colonoscopy. The by-polyp sensitivity was 80% for medium size polyps (6-9 mm) and 97% for large polyps (10 mm or larger) at an average value of 5 false-positives per scan for normal dose data. The by-polyp sensitivity was 81% for medium size polyps and 85% for large size polyps at an average value of 5 false-positives per scan for low dose data (6.25 mAs). Finally for the ultra low dose data (1.39 mAs) we achieved a by-polyp sensitivity of 75% for medium size polyps and 97% for large polyps at an average value of 5 false-positives per scan. The conclusion of our study is that CAD for polyp detection is feasible on ultra low dose CT colonography data.

  13. Racial variation in colorectal polyp and tumor location.

    PubMed Central

    Thornton, Julia Gore; Morris, Arden M.; Thornton, John Daryl; Flowers, Christopher R.; McCashland, Timothy M.

    2007-01-01

    OBJECTIVES: The incidence and mortality from colorectal cancer among whites have decreased, but they have remained unchanged among African Americans. To explain this disparity, we used the multicenter endoscopy database of the Clinical Outcomes Research Initiative to compare the prevalence of proximal polyps and tumors among asymptomatic African Americans and whites undergoing routine screening colonoscopy. METHODS: African Americans and whites undergoing colonoscopy between January 1, 2002 and September 30, 2003 were considered for analysis. RESULTS: There were 145,175 index colonoscopy reports on unique patients. After applying exclusion criteria, 46,726 patients remained for analysis. Adjusting for age, gender, American Society of Anesthesiologists level, bowel preparation and endoscopic setting, African Americans were less likely to have polyps [adjusted odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.70-0.84]. However, the odds of having proximal polyps was higher in African Americans (OR = 1.30; 95% CI: 1.11-1.52) compared to whites. In regards to tumors, African Americans were more likely to have tumors (OR = 1.78; 95% CI: 1.14-2.77) and more likely to have proximal tumors than whites (OR = 4.37; 95% CI: 1.16-16.42). CONCLUSIONS: After adjusting for confounders, African Americans undergoing screening colonoscopy in multiple practice settings had higher odds of proximal polyps and tumors than whites, suggesting current colorectal cancer screening recommendations in African Americans should be expanded. PMID:17668638

  14. Mast cells are an essential hematopoietic component for polyp development

    PubMed Central

    Gounaris, Elias; Erdman, Susan E.; Restaino, Clifford; Gurish, Michael F.; Friend, Daniel S.; Gounari, Fotini; Lee, David M.; Zhang, Guoying; Glickman, Jonathan N.; Shin, Kichul; Rao, Varada P.; Poutahidis, Theofilos; Weissleder, Ralph; McNagny, Kelly M.; Khazaie, Khashayarsha

    2007-01-01

    It is generally agreed that most colon cancers develop from adenomatous polyps, and it is this fact on which screening strategies are based. Although there is overwhelming evidence to link intrinsic genetic lesions with the formation of these preneoplastic lesions, recent data suggest that the tumor stromal environment also plays an essential role in this disease. In particular, it has been suggested that CD34+ immature myeloid precursor cells are required for tumor development and invasion. Here we have used mice conditional for the stabilization of β-catenin or defective for the adenomatous polyposis coli (APC) gene to reinvestigated the identity and importance of tumor-infiltrating hematopoietic cells in polyposis. We show that, from the onset, polyps are infiltrated with proinflammatory mast cells (MC) and their precursors. Depletion of MC either pharmacologically or through the generation of chimeric mice with genetic lesions in MC development leads to a profound remission of existing polyps. Our data suggest that MC are an essential hematopoietic component for preneoplastic polyp development and are a novel target for therapeutic intervention. PMID:18077429

  15. Glycoprotein expression by adenomatous polyps of the colon

    NASA Astrophysics Data System (ADS)

    Roney, Celeste A.; Xie, Jianwu; Xu, Biying; Jabour, Paul; Griffiths, Gary; Summers, Ronald M.

    2008-03-01

    Colon cancer is the second leading cause of cancer related deaths in the United States. Specificity in diagnostic imaging for detecting colorectal adenomas, which have a propensity towards malignancy, is desired. Adenomatous polyp specimens of the colon were obtained from the mouse model of colorectal cancer called adenomatous polyposis coli-multiple intestinal neoplasia (APC Min). Histological evaluation, by the legume protein Ulex europaeus agglutinin I (UEA-1), determined expression of the glycoprotein α-L-fucose. FITC-labelled UEA-1 confirmed overexpression of the glycoprotein by the polyps on fluorescence microscopy in 17/17 cases, of which 13/17 included paraffin-fixed mouse polyp specimens. In addition, FITC-UEA-1 ex vivo multispectral optical imaging of 4/17 colonic specimens displayed over-expression of the glycoprotein by the polyps, as compared to non-neoplastic mucosa. Here, we report the surface expression of α-L-fucosyl terminal residues by neoplastic mucosal cells of APC specimens of the mouse. Glycoprotein expression was validated by the carbohydrate binding protein UEA-1. Future applications of this method are the development of agents used to diagnose cancers by biomedical imaging modalities, including computed tomographic colonography (CTC). UEA-1 targeting to colonic adenomas may provide a new avenue for the diagnosis of colorectal carcinoma by CT imaging.

  16. [Sporadic colorectal polyps. Updated guidelines for endoscopic surveillance].

    PubMed

    Björk, Jan; Börjesson, Lars; Hertervig, Erik; Lindmark, Gudrun; Ost, Ake

    2003-08-21

    No surveillance is recommended after radical excision of low-risk adenomas (pedunculated adenoma irrespective of size, sessile adenoma < or = 10 mm, number < or = 2. An endoscopic check-up is recommended 3-6 months after radical excision of high-risk adenomas (sessile adenoma > 10 mm, number > or = 3), as well as after excision of a pedunculated or a sessile adenoma with an unclear resection margin. All above is irrespective of histopathological adenoma classification. An endoscopic check-up is recommended 3 months after radical excision of a highly or moderately differentiated malignant polyp with no sign of invasion into blood or lymph vessels and with a maximum invasion depth stage T1-sm1. Surgical resection is necessary if the malignant polyp is poorly differentiated, and/or invades into blood or lymph vessels, and/or is stage T1-sm3, or is excised with unclear resection margins. Treatment for stage T1-sm2 polyps may be individualized. Individuals with low-risk adenomas and a first degree relative with colorectal cancer, individuals having high-risk adenomas or malignant polyps removed, as well as individuals operated on for colorectal cancer should be subjected to colonoscopy after three years and then every fifth year when < or = 75 years of age.

  17. Automated classification of colon polyps in endoscopic image data

    NASA Astrophysics Data System (ADS)

    Gross, Sebastian; Palm, Stephan; Tischendorf, Jens J. W.; Behrens, Alexander; Trautwein, Christian; Aach, Til

    2012-03-01

    Colon cancer is the third most commonly diagnosed type of cancer in the US. In recent years, however, early diagnosis and treatment have caused a significant rise in the five year survival rate. Preventive screening is often performed by colonoscopy (endoscopic inspection of the colon mucosa). Narrow Band Imaging (NBI) is a novel diagnostic approach highlighting blood vessel structures on polyps which are an indicator for future cancer risk. In this paper, we review our automated inter- and intra-observer independent system for the automated classification of polyps into hyperplasias and adenomas based on vessel structures to further improve the classification performance. To surpass the performance limitations we derive a novel vessel segmentation approach, extract 22 features to describe complex vessel topologies, and apply three feature selection strategies. Tests are conducted on 286 NBI images with diagnostically important and challenging polyps (10mm or smaller) taken from our representative polyp database. Evaluations are based on ground truth data determined by histopathological analysis. Feature selection by Simulated Annealing yields the best result with a prediction accuracy of 96.2% (sensitivity: 97.6%, specificity: 94.2%) using eight features. Future development aims at implementing a demonstrator platform to begin clinical trials at University Hospital Aachen.

  18. Diagnostic value of high-resolution micro-endoscopy for the classification of colon polyps

    PubMed Central

    Tan, Tao; Qu, Ya-Wei; Shu, Juan; Liu, Min-Li; Zhang, Ling; Liu, Hai-Feng

    2016-01-01

    AIM: To study a new imaging equipment, high-resolution micro-endoscopy (HRME), in the diagnosis and pathological classification of colon polyps. METHODS: We selected 114 specimens of colon polyps, 30 of which were colon polyps with known pathological types and 84 that were prospective polyp specimens; 10 normal colon mucosa specimens served as controls. We obtained images of 30 colon polyp specimens with known pathological types using HRME and analyzed the characteristics of these images to develop HRME diagnostic criteria for different pathological types of colon polyps. Based on these criteria, we performed a prospective study of 84 colon polyp specimens using HRME and compared the results with those of the pathological examination to evaluate the diagnostic value of HRME in the pathological classification of different types of colon polyps. RESULTS: In the 30 cases of known pathological type of colon polyp samples, there were 21 cases of adenomatous polyps, which comprised nine cases of tubular adenoma, seven cases of villous adenoma and five cases of mixed adenomas. The nine cases of non-adenomatous polyps included four cases of inflammatory polyps and five cases of hyperplastic polyps five. Ten cases of normal colonic mucosa were confirmed pathologically. In a prospective study of 84 cases using HRME, 23 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 18 cases as tubular adenoma, eight cases as villous adenoma and 24 cases as mixed adenomas. After pathological examination, 24 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 19 cases as tubular adenoma, eight cases as villous adenoma and 22 cases as mixed adenomas. Compared with the pathological examinations, the sensitivities, specificities, accuracies, and positive and negative predictive values of HRME in diagnosing inflammatory polyps (87.5%, 96.7%, 94.0%, 91.3% and 95.1%), hyperplastic polyps (72.7%, 95.9%, 92.9%, 72.7% and 95.9%), tubular adenomas

  19. Phosphohistone H3 expression correlates with manual mitotic counts and aids in identification of "hot spots" in fibroepithelial tumors of the breast.

    PubMed

    Ginter, Paula S; Shin, Sandra J; Liu, Yifang; Chen, Zhengming; D'Alfonso, Timothy M

    2016-03-01

    Classification of mammary fibroepithelial tumors (FETs) relies on assessment of mitotic activity, among other histopathologic parameters. Routine hematoxylin and eosin (H&E) mitotic counts can be subjective and time consuming. Difficulty may arise in identifying "true" mitoses for a variety of reasons. Phosphorylation of histone H3 protein (PHH3) is correlated with mitotic chromatin condensation. The utility of PHH3 immunohistochemical staining to identify mitoses has been demonstrated in multiple organ systems. In this study, we examined the utility of PHH3 in assessing mitotic activity in FETs and compared PHH3- with H&E-determined mitotic counts. PHH3-stained mitoses were readily identifiable at ×10 magnification and allowed for rapid identification of mitotic "hot spots." Median mitotic counts/10 high-power fields for fibroadenoma, benign phyllodes tumor, borderline phyllodes tumor (BlnPT), and malignant phyllodes tumor (MPT) were 0, 0.5, 4.25, and 9, respectively on H&E, and 0, 0.75, 4.5, and 8, respectively for PHH3. Among all FETs, there was a strong positive correlation between H&E- and PHH3-determined mitotic counts (r=0.91, P<.001). Using PHH3, 2 cases would be reclassified, both from BlnPT to MPT. PHH3-determined counts correlated with H&E-determined counts in FETs. Using PHH3, a small number of cases were reclassified from BlnPT to MPT, for which treatment is similar. Although H&E-determined counts remain the criterion standard for assessing mitotic activity in FETs, PHH3 may be a useful adjunctive tool in some cases and is helpful in identifying mitotic hot spots.

  20. Preoperative predictive factors for gallbladder cholesterol polyp diagnosed after laparoscopic cholecystectomy for polypoid lesions of gallbladder

    PubMed Central

    Lee, Hyojin; Park, Inseok; Cho, Hyunjin; Gwak, Geumhee; Yang, Keunho; Bae, Byung-Noe; Kim, Hong-Ju; Kim, Young Duk

    2016-01-01

    Backgrounds/Aims We investigated patients' clinical and radiological data to determine preoperative factors that predict cholesterol gallbladder (GB) polyps of large size, which can be helpful for decision on further diagnostic tools. Methods In this study, we retrospectively analyzed 126 patients who underwent laparoscopic cholecystectomy for GB polyps >10 mm diagnosed preoperatively by abdominal ultrasonography between February 2002 and February 2016 in Department of Surgery, Sanggye Paik Hospital. Patients were divided into non-cholesterol polyps group and cholesterol polyps group, based on the postoperative pathologic diagnosis. Clinical and radiological data, such as gender, age, body weight, height, body mass index (BMI), laboratory findings, size, number and shape of the polypoid lesions, and presence of the concurrent GB stone were compared between the two groups. Results Of the 126 cases, 73 had cholesterol polyps (57.9%) and 53 cases were non-cholesterol polyps (42.1%). The younger age (<48.5 years), size of polyp <13.25 mm and multiple polyps were independent predictive variables for cholesterol polyps, with odd ratios (OR) of 2.352 (p=0.045), 5.429 (p<0.001) and 0.472 (p<0.001), respectively. Conclusions Age, size and polyp number were used to predict cholesterol GB polyp among polypoid lesions of the gallbladder >10 mm. For cases in which these factors are not applicable, it is strongly recommended to evaluate further diagnostic tools, such as computed tomography, endoscopic ultrasonography and tumor markers. PMID:28261697

  1. Polyp detection rate and pathological features in patients undergoing a comprehensive colonoscopy screening

    PubMed Central

    Asadzadeh Aghdaei, Hamid; Nazemalhosseini Mojarad, Ehsan; Ashtari, Sara; Pourhoseingholi, Mohmad Amin; Chaleshi, Vahid; Anaraki, Fakhrosadat; Haghazali, Mehrdad; Zali, Mohammad Reza

    2017-01-01

    AIM To identify the prevalence, and clinical and pathologic characteristic of colonic polyps among Iranian patients undergoing a comprehensive colonoscopy, and determine the polyp detection rate (PDR) and adenoma detection rate (ADR). METHODS In this cross-sectional study, demographics and epidemiologic characteristics of 531 persons who underwent colonoscopies between 2014 and 2015 at Mehrad gastrointestinal clinic were determined. Demographics, indication for colonoscopy, colonoscopy findings, number of polyps, and histopathological characteristics of the polyps were examined for each person. RESULTS Our sample included 295 (55.6%) women and 236 (44.4%) men, with a mean age of 50.25 ± 14.89 years. Overall PDR was 23.5% (125/531). ADR and colorectal cancer detection rate in this study were 12.8% and 1.5%, respectively. Polyps were detected more significantly frequently in men than in women (52.8% vs 47.2%, P < 0.05). Polyps can be seen in most patients after the age of 50. The average age of patients with cancer was significantly higher than that of patients with polyps (61.3 years vs 56.4 years, P < 0.05). The majority of the polyps were adenomatous. More than 50% of the polyps were found in the rectosigmoid part of the colon. CONCLUSION The prevalence of polyps and adenomas in this study is less than that reported in the Western populations. In our patients, distal colon is more susceptible to developing polyps and cancer than proximal colon. PMID:28251034

  2. A Prospective Multicenter Registry of Patients Undergoing Hysteroscopic Morcellation of Uterine Polyps and Myomas

    PubMed Central

    Chen, Serena H.

    2016-01-01

    Abstract Background: Hysteroscopic morcellation removes uterine pathology under direct visualization with continuous real-time tissue fragment removal. Objective: The aim of this study was to explore the feasibility of hysteroscopic morcellation across a diverse set of facilities, including both surgical and office-based settings. Design: This was a prospective, single-arm, multicenter registry development (Canadian Task Force classification II-3). Materials and Methods: Thirty-four U.S. obstetrics and gynecology facilities enrolled subjects into the registry. Inclusion criteria were women ages 18–65 with indications for hysteroscopic myomectomy and/or polypectomy who were treated with the MyoSure® Hysteroscopic Tissue Removal System (Hologic Inc., Marlborough, MA). Intrauterine lesion type/size and removal parameters, adverse events (AEs), and physician satisfaction ratings were recorded. Results: A total of 559 pathologies (187 fibroids; 372 polyps) were removed from 278 registered subjects (mean age: 43.9 ± 9.0 years), with 250 procedures (89.9%) performed in an ambulatory surgery center or hospital outpatient setting and 28 (10.1%) in a gynecologic office setting. Most patients (n = 206, 74.1%) were treated for abnormal uterine bleeding, and 42 (15.1%) were treated for infertility. Mean fibroid diameter was 2.2 ± 1.2 cm. Mean polyp diameter was 1.3 ± 1.0 cm. Overall mean percentage of pathology removed was 95.4% (polyps 99.3%, fibroids 86.8%). Five AEs included four incidents of blunt cervical trauma and a single postoperative case of pedal edema; all were considered mild and resolved spontaneously. Postprocedure surveys indicated that 95% of reporting physicians were “satisfied” or “highly satisfied” with device performance. Conclusions: Hysteroscopic morcellation of intrauterine pathology was accomplished safely with a high degree of physician satisfaction in 278 patients treated in diverse healthcare settings that are

  3. Analysis and evaluation of pyrolysis products collected during in vivo treatment of polyps using the Nd:YAG laser

    NASA Astrophysics Data System (ADS)

    Waesche, Wolfgang; Knappe, Verena; Linnartz, M.; Mueller, Gerhard J.

    1995-01-01

    A common application of the Neodymium:YAG laser (1064 nm) is the treatment of nasal polyps. The polyps are treated endoscopically with laser power settings of 5 to 10 watts delivered via a flexible fiber with a core diameter of 600 micrometers . Coagulation and vaporization are accompanied by a severe development of dust and plume during the treatment. These products are normally aspirated during the treatment together with cooling fluent via the working channel of the endoscope. Due to the rather low efficiency of the aspiration the products are partly aspirated by the patient. Volatile organic compounds (VOC) were adsorbed and evaluated with a gas chromatography system (GC). The calibration of the system together with geometrical considerations of the adsorption allows for a quantitative determination of several products. Among these toluene is used as a marker substance. Besides the plume samples collected during the treatment of polyps investigations of VOCs were carried out of samples received during Nd:YAG laser treatment of nasal warts and CO2 laser treatment of leucoplakia. The evaluated data led to an estimation of the patient's health risk assuming aspiration of the products by the patient. Improvements of the aspiration system are suggested.

  4. Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold

    PubMed Central

    Zhang, Ya; Liang, Gengtian; Sun, Na; Guan, Linlin; Meng, Yang; Zhao, Xiaoyan; Liu, Li; Sun, Guangbin

    2015-01-01

    The efficacies of CO2 laser and conventional laryngeal microsurgery for vocal cord benign (vocal cord polyp) and precancerous (vocal cord leukoplakia) lesions were compared. Patients with bilateral vocal cord polyps (n = 60) and leukoplakia (n = 30) were divided randomly into two groups. One group was treated with throat microsurgical instruments and underwent routine lesion resection (conventional group) and the other with CO2 laser (laser group). For the subjective assessment, the tools GRABS and VHI were used. The objective assessment, A multi-dimensional voice program module for voice spectrum analysis was used. The laser group was slightly worse than the conventional group 1 week post-surgery by stroboscopic findings. The subjective and objective data of the two groups pre-and post-surgery showed that the voice recovery of the laser group was significantly better than that of the conventional group (P < 0.05). CO2 laser laryngeal microsurgery for vocal cord polyp and leukoplakia can improve significantly the vocal cord morphology and pronunciation quality. The procedure is especially more effective than conventional surgery in patients with vocal cord leukoplakia. PMID:26770428

  5. Are gastric hyperplastic polyps an additional manifestation in celiac disease?: Results from a retrospective study.

    PubMed

    Dore, Maria Pina; Pes, Giovanni Mario; Rocchi, Chiara; Loria, Maria Francesca; Soro, Sara; Bassotti, Gabrio

    2017-02-01

    Gastric polyps are frequently reported in patients undergoing upper endoscopic procedures. In this retrospective study, the association between hyperplastic polyps and celiac disease in Northern Sardinia was estimated.Age, gender, body mass index, and medications taken in the 2 preceding months, including proton-pump inhibitors (PPIs), H2 receptor blockers (anti-H2), Helicobacter pylori status, endoscopic findings, and histology from charts of patients undergoing esophago-gastro-duodenoscopy were reviewed. Polyps were classified as hyperplastic, fundic gland, inflammatory, and adenomatous.3.7% (423/11379) patients had celiac disease. Prevalence of gastric polyps was 4.2% (3.8% among celiac vs 4.2% nonceliac patients). Inflammatory polyp was the most common histotype (55.8% and 56.2%) followed by fundic gland polyps (31.4% and 43.7%), hyperplastic (8.7% and 0%), and adenomas, in celiac and nonceliac patients, respectively. Fundic gland polyps were more common in PPI users (odds ratio: 4.06) than in nonusers (2.65, P = 0.001) among celiac and nonceliac patients. Age older than 50, female gender, esophago-gastro-duodenoscopy year, and PPI use were associated with the presence of polyps, whereas active H pylori infection was not.Gastric polyps were common in Sardinian patients undergoing esophago-gastro-duodenoscopy. However, the previously reported association between hyperplastic polyps and celiac disease was not confirmed in our study.

  6. [Detection of T-antigen in colorectal adenocarcinoma and polyps].

    PubMed

    Xu, S; Lu, Y; Wang, Q

    1995-10-01

    Galactose oxidase method was employed to detect the beta-D-Gal (1-->3) -D-Gal NAc residue of T-antigen present in the large intestinal mucus of 156 subjects. The positive rates of the test were 84.4%, 29.1%, and 7.2% in the mucus samples obtained from 32 patients with colorectal adenocarcinomas, 55 with polyps and 69 controls respectively. Chi-square test demonstrated that there were significant differences between the group of carcinoma and control (P < 0.001) as well as between also polyp and control (P < 0.01). The test had a high sensitivity (84.4%) and specificity (92.8%) in the diagnosis of colorectal cancer and may be used as a practical mass screening test for colorectal neoplasms.

  7. Discriminating dysplasia: Optical tomographic texture analysis of colorectal polyps.

    PubMed

    Li, Wenqi; Coats, Maria; Zhang, Jianguo; McKenna, Stephen J

    2015-12-01

    Optical projection tomography enables 3-D imaging of colorectal polyps at resolutions of 5-10 µm. This paper investigates the ability of image analysis based on 3-D texture features to discriminate diagnostic levels of dysplastic change from such images, specifically, low-grade dysplasia, high-grade dysplasia and invasive cancer. We build a patch-based recognition system and evaluate both multi-class classification and ordinal regression formulations on a 90 polyp dataset. 3-D texture representations computed with a hand-crafted feature extractor, random projection, and unsupervised image filter learning are compared using a bag-of-words framework. We measure performance in terms of error rates, F-measures, and ROC surfaces. Results demonstrate that randomly projected features are effective. Discrimination was improved by carefully manipulating various important aspects of the system, including class balancing, output calibration and approximation of non-linear kernels.

  8. Treatment and prognosis of nasal polyps in cystic fibrosis.

    PubMed

    Stern, R C; Boat, T F; Wood, R E; Matthews, L W; Doershuk, C F

    1982-12-01

    Nasal polyposis complicated the course of fibrosis in 157 (26%) of 605 patients. Onset before age 5 years or after age 20 years was rare. Polyposis was the initial symptom of cystic fibrosis in 13 patients. Common symptoms included obstruction to nasal air flow, mouth breathing, epistaxis, and rhinorrhea. Intranasal and oral corticosteroids and antihistamines were ineffective in preventing recurrences but did occasionally afford symptomatic relief of obstruction. Nineteen (31%) of 62 patients who never had surgery had spontaneous and permanent disappearance of polyps. Simple polypectomy was an adequate procedure for patients with substantial nasal symptoms. There were no visual complications. Other surgical complications were rare. Children and adolescents with nasal polyps should have sweat tests by pilocarpine iontophoresis to rule out cystic fibrosis.

  9. Knife-assisted snare resection (KAR) of large and refractory colonic polyps at a Western centre: Feasibility, safety and efficacy study to guide future practice

    PubMed Central

    Chedgy, Fergus JQ; Kandiah, Kesavan; Longcroft-Wheaton, Gaius; Bhandari, Pradeep

    2015-01-01

    Objective Endoscopic mucosal resection (EMR) is widely practiced in western countries. Endoscopic submucosal dissection (ESD) is very effective for treating complex polyps but colonic ESD in the western setting remains challenging. We have developed a novel technique of knife-assisted snare resection (KAR) for the resection of these complex lesions. Here we aim to describe the technique, evaluate its outcomes, identify outcome predictors and define its learning curve. Methods We conducted a prospective cohort study of patients who had large and refractory polyps resected by KAR at our institution from 2007 to 2013. Polyp characteristics and procedure details were recorded. Endoscopic follow-up was performed to identify recurrence. Results A total of 170 patients with polyps 20–170 mm in size were treated by KAR and followed up for a mean of 31.5 months (range 12–84 months). 29% of the polyps were >50 mm, 22% had fibrosis from previous unsuccessful interventions and 25% were in the right colon. The perforation rate (1.2%) and bleeding rate (4.7%) were acceptable and managed conservatively in most patients. Recurrence rate after the first attempt was 13.1%. Recurrence was significantly increased by polyp size >50 mm (p = 0.008; OR 5.03, 95% CI 1.54–16.48), presence of fibrosis (p = 0.002; OR 6.59, 95% CI 1.97–22.07) and piecemeal resection (p < 0.001; OR 0.31, CI 0.078–1.12). Cure rates were 87% after the first attempt, improving to 95.6% with further attempts. En bloc resection rate showed a linear increase and reached almost 80% as the endoscopist’s cumulative experience approached 100 cases. Conclusion This is the largest reported Western series on KAR in the colon. We have demonstrated the feasibility, efficacy and safety of this technique in the treatment of complex polyps, with or without fibrosis and at all sites. KAR has shown better outcomes than either EMR or ESD. We have also managed to identify significant outcome predictors

  10. Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen

    PubMed Central

    Jeon, Se Jeong; Lee, Jae Il; Kim, Hee Seung; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang

    2017-01-01

    Objective To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. Methods We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. Results Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. Conclusion For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients. PMID:28217668

  11. Thymosin ß4 expression in colorectal polyps and adenomas

    PubMed Central

    Nemolato, Sonia; Cabras, Tiziana; Restivo, Angelo; Zorcolo, Luigi; Di Felice, Eliana; Fanni, Daniela; Gerosa, Clara; Messana, Irene; Castagnola, Massimo; Faa, Gavino; Casula, Giuseppe

    2013-01-01

    OBJECTIVE: Thymosin beta 4 (Tβ4) is a ubiquitous peptide that plays pivotal roles in the cytoskeletal system and in cell differentiation. Recently, a role for Tβ4 has been proposed in experimental and human carcinogenesis, including gastrointestinal cancer. This study was aimed at evaluating the relationship between Tβ4 immunoreactivity and the initial steps of carcinogenesis. METHODS: In total, 60 intestinal biopsies, including 10 hyperplastic polyps, 10 sessile serrated adenomas/polyps, 15 colorectal adenomas with low-grade dysplasia, 15 adenomas with high-grade dysplasia, 15 adenocarcinomas and 10 samples of normal colon mucosa, were analyzed for Tβ4 expression by immunohistochemistry. RESULTS: Weak cytoplasmic reactivity for Tβ4 was detected in the normal colon mucosa. No reactivity for Tβ4 was found in hyperplastic and sessile serrated polyps/adenomas. Tβ4 expression was observed in 10/15 colorectal adenocarcinomas. In adenomas with low-grade dysplasia, Tβ4 immunoreactivity was mainly detected in dysplastic glands but was absent in hyperplastic glands. Tβ4 immunoreactivity was characterized by spot-like perinuclear staining. In high-grade dysplastic polyps, immunostaining for Tβ4 appeared diffuse throughout the entire cytoplasm of dysplastic cells. Spot-like perinuclear reactivity was detected in adenocarcinoma tumor cells. CONCLUSIONS: Our study shows for the first time that Tβ4 is expressed during different steps of colon carcinogenesis. The shift of Tβ4 immunolocalization from low-grade to high-grade dysplastic glands suggests a role for Tβ4 in colorectal carcinogenesis. However, the real meaning of Tβ4 reactivity in dysplastic intestinal epithelium remains unknown. PMID:24141838

  12. Comorbidity of recurrent aphthous stomatitis and polyps ventriculi.

    PubMed

    Pokupec, Josipa Sanja Gruden; Lukenda, Dolores Biocina

    2013-03-01

    As it is known, many diseases of gastric system cause changes in the oral cavity, with either pathological findings or subjective impressions. When these changes are of pathological nature, the most common finding is recurrent aphthous stomatitis on the tongue, which emerges as a consequence of gastric diseases. Recurrent aphthous stomatitis is a disorder characterised by recurrent ulcerations limited to the oral mucosa, without any other signs of diseases. According to their clinical form, they may be big, small and hyperform. Etiology of recurrent aphthae is genetic predisposition, systemic diseases (virus, certain vitamin deficiency, gastric disorders), and autoimmune disorder and psychogenesis. The symptoms include a prodromal burning sensation and ulceration emerging within 24-48 hours as round symmetrical lesions inflicting the entire oral cavity except for palate and gingiva. Polyps ventriculi are tumours on the gastric mucosa. They can lie on a broad background or hang on the stem, and may be both individual and clustered at the same time. They are more common with elderly male population. They may have a malignant alteration. According to WHO, they have been classified as hyperplastic and neoplastic polyps. Etiology of polyps is atrophic gastritis or H. pylori.

  13. Exploring Deep Learning and Transfer Learning for Colonic Polyp Classification

    PubMed Central

    Uhl, Andreas; Wimmer, Georg; Häfner, Michael

    2016-01-01

    Recently, Deep Learning, especially through Convolutional Neural Networks (CNNs) has been widely used to enable the extraction of highly representative features. This is done among the network layers by filtering, selecting, and using these features in the last fully connected layers for pattern classification. However, CNN training for automated endoscopic image classification still provides a challenge due to the lack of large and publicly available annotated databases. In this work we explore Deep Learning for the automated classification of colonic polyps using different configurations for training CNNs from scratch (or full training) and distinct architectures of pretrained CNNs tested on 8-HD-endoscopic image databases acquired using different modalities. We compare our results with some commonly used features for colonic polyp classification and the good results suggest that features learned by CNNs trained from scratch and the “off-the-shelf” CNNs features can be highly relevant for automated classification of colonic polyps. Moreover, we also show that the combination of classical features and “off-the-shelf” CNNs features can be a good approach to further improve the results. PMID:27847543

  14. Surveillance of colonic polyps: Are we getting it right?

    PubMed Central

    Bonnington, Stewart N; Rutter, Matthew D

    2016-01-01

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the precursor lesion of CRC. Following the finding and removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. This review examines the literature on post-polypectomy surveillance including current international clinical guidelines. The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patient’s advancing age. PMID:26877600

  15. Exploring Deep Learning and Transfer Learning for Colonic Polyp Classification.

    PubMed

    Ribeiro, Eduardo; Uhl, Andreas; Wimmer, Georg; Häfner, Michael

    2016-01-01

    Recently, Deep Learning, especially through Convolutional Neural Networks (CNNs) has been widely used to enable the extraction of highly representative features. This is done among the network layers by filtering, selecting, and using these features in the last fully connected layers for pattern classification. However, CNN training for automated endoscopic image classification still provides a challenge due to the lack of large and publicly available annotated databases. In this work we explore Deep Learning for the automated classification of colonic polyps using different configurations for training CNNs from scratch (or full training) and distinct architectures of pretrained CNNs tested on 8-HD-endoscopic image databases acquired using different modalities. We compare our results with some commonly used features for colonic polyp classification and the good results suggest that features learned by CNNs trained from scratch and the "off-the-shelf" CNNs features can be highly relevant for automated classification of colonic polyps. Moreover, we also show that the combination of classical features and "off-the-shelf" CNNs features can be a good approach to further improve the results.

  16. Automatic identification of colonic polyp in high-resolution CT images

    NASA Astrophysics Data System (ADS)

    Dehmeshki, Jamshid; Amin, Hamdan; Wong, Wing; Ebadian Dehkordi, Mandana; Kamangari, Nahid; Roddie, Mary; Costello, John

    2004-05-01

    Automatic polyp detection is a challenging task as polyps come in different sizes and shape. The detection generally consists of colon segmentation, identification of suspected polyps and classification. Classification involves discriminating polyps from among many suspected regions based on a number of features extracted from the detected regions. This paper presents the work on the first two stages of the detection. For the colon segmentation, the fuzzy connectivity region growing technique is used while for the identification of suspected polyps concave region searching is applied. A rule-based filtering based on 3D volumetric features is used to reduce a large number of non-polyp structures (false positives). The method is fast, robust and validated with a number of high-resolution colon datasets.

  17. Hyperplastic-like colon polyps that preceded microsatellite-unstable adenocarcinomas.

    PubMed

    Goldstein, Neal S; Bhanot, Punam; Odish, Eva; Hunter, Susan

    2003-06-01

    We compared hyperplastic-like polyps that preceded microsatellite-unstable adenocarcinomas to incidental hyperplastic polyps to identify distinguishing morphologic criteria. The study group included 106 hyperplastic-like, nonadenomatous, serrated polyps, most from the ascending colon in 91 patients; the control group included 106 rectosigmoid hyperplastic polyps from 106 patients in whom adenocarcinoma did not develop. Study group polyps had an expanded crypt proliferative zone, a serrated architectural outline that became apparent in the basilar crypt regions, basilar crypt dilation, inverted crypts, and a predominance of dysmaturational crypts (crypts with minimal cell maturation). In contrast, control group polyps had a proliferative zone confined to the basal crypt region, serrated architecture that became apparent in the superficial crypt region, rare to no basilar crypt dilation, and rare or no dysmaturational crypts. Hyperplastic-like polyps that preceded microsatellite-unstable adenocarcinomas had a distinctive constellation of morphologic features related to altered and decreased cell function and control that resulted in dysmaturational crypts. Dysmaturation constitutes a range of morphologic alterations, some of which overlap with incidental-type innocuous hyperplastic polyps. The morphologic features described herein provide initial guidelines to identify this potentially important subset of premalignant serrated-like polyps.

  18. Association of endotoxins and colon polyp: a case-control study.

    PubMed

    Lee, Kang-Kon; Yum, Keun-Sang

    2012-09-01

    Endotoxins are known to be associated with the occurrence of various chronic diseases. This study was conducted to investigate the role of endotoxins in the pathogenesis of colon polyps through a case-control study. A total of 145 subjects (74 subjects in the polyp group and 71 subjects in the control group) had undergone a colonoscopy. Age, body mass index (BMI) and endotoxin levels were found to be significantly higher in the polyp group than in the control group. The endotoxin level was still significantly higher in the polyp group than in the control group, even after age and BMI had been adjusted (polyp group 0.108 ± 0.007 EU/mL, control group 0.049 ± 0.008 EU/mL, P < 0.001). In subgroup analysis, the endotoxin level significantly increased in accordance with the number of colon polyps (one-polyp group, 0.088 ± 0.059 EU/mL; two-polyp group, 0.097 ± 0.071 EU/mL; three-or-more-polyp group, 0.149 ± 0.223 EU/mL). The endotoxin levels also significantly increased in groups with tubular adenoma with high-grade dysplasia (hyperplastic polyp group, 0.109 ± 0.121 EU/mL; tubular adenoma with low grade dysplasia group, 0.103 ± 0.059 EU/mL; tubular adenoma with high grade dysplasia group, 2.915 ± 0.072 EU/mL). In conclusion, the serum level of endotoxins is quantitatively correlated with colon polyps.

  19. Thymic stromal lymphopoietin activity is increased in nasal polyps of chronic rhinosinusitis

    PubMed Central

    Nagarkar, Deepti R.; Poposki, Julie A.; Tan, Bruce K.; Comeau, Michael R.; Peters, Anju T.; Hulse, Kathryn E.; Suh, Lydia A.; Norton, James; Harris, Kathleen E.; Grammer, Leslie C.; Chandra, Rakesh K.; Conley, David B.; Kern, Robert C.; Schleimer, Robert P.; Kato, Atsushi

    2013-01-01

    Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with Th2-dominant inflammation. Thymic stromal lymphopoietin (TSLP) is a cytokine that triggers dendritic cell-mediated Th2 inflammatory responses and that enhances IL-1-dependent Th2 cytokine production in mast cells. Although elevated levels of TSLP mRNA have been found in nasal polyps (NPs), expression of TSLP protein and its function in CRS have not been fully explored. Objectives The objective of this study was to investigate the role of TSLP in CRS. Methods We investigated the presence and stability of TSLP protein in NPs by ELISA and western blot, and the function of TSLP in nasal tissue extracts with a bioassay based upon activation of human mast cells. Results Although TSLP mRNA was significantly increased in NP tissue from patients with CRSwNP compared to uncinate tissue from patients with CRS or control subjects, TSLP protein was significantly decreased in NP tissue as detected by the commercial ELISA kit. We found that recombinant TSLP was time-dependently degraded by NP extracts and this degradation was completely inhibited by a protease inhibitor cocktail, suggesting that TSLP is sensitive to tissue proteases. Interestingly, NP extract-treated TSLP had higher activity in mast cells, although the amount of full length TSLP was reduced up to 85%. NP extracts significantly enhanced IL-1β-dependent IL-5 production in mast cells compared with uncinate tissue homogenates, and responses were significantly inhibited by anti-TSLP, suggesting that NP contain biologically relevant levels of TSLP activity. Conclusion TSLP and its metabolic products may play an important role in the inflammation in CRSwNP. PMID:23688414

  20. Modelling coral polyp calcification in relation to ocean acidification

    NASA Astrophysics Data System (ADS)

    Hohn, S.; Merico, A.

    2012-11-01

    Rising atmospheric CO2 concentrations due to anthropogenic emissions induce changes in the carbonate chemistry of the oceans and, ultimately, a drop in ocean pH. This acidification process can harm calcifying organisms like coccolithophores, molluscs, echinoderms, and corals. It is expected that ocean acidification in combination with other anthropogenic stressors will cause a severe decline in coral abundance by the end of this century, with associated disastrous effects on reef ecosystems. Despite the growing importance of the topic, little progress has been made with respect to modelling the impact of acidification on coral calcification. Here we present a model for a coral polyp that simulates the carbonate system in four different compartments: the seawater, the polyp tissue, the coelenteron, and the calcifying fluid. Precipitation of calcium carbonate takes place in the metabolically controlled calcifying fluid beneath the polyp tissue. The model is adjusted to a state of activity as observed by direct microsensor measurements in the calcifying fluid. We find that a transport mechanism for bicarbonate is required to supplement carbon into the calcifying fluid because CO2 diffusion alone is not sufficient to sustain the observed calcification rates. Simulated CO2 perturbation experiments reveal decreasing calcification rates under elevated pCO2 despite the strong metabolic control of the calcifying fluid. Diffusion of CO2 through the tissue into the calcifying fluid increases with increasing seawater pCO2, leading to decreased aragonite saturation in the calcifying fluid. Our modelling study provides important insights into the complexity of the calcification process at the organism level and helps to quantify the effect of ocean acidification on corals.

  1. Artificial substrates preference for proliferation and immigration in Aurelia aurita (s. l.) polyps

    NASA Astrophysics Data System (ADS)

    Feng, Song; Lin, Jianing; Sun, Song; Zhang, Fang

    2017-01-01

    The increasing amounts of artificial marine substrates, in many parts of the world have been proposed as a potential driver of Aurelia spp. blooms, on account of providing extra habitats for the settlement and the proliferation of the benthic stage (polyps). Previous experiments have mainly focused on the substrate choices of Aurelia spp. planulae. However, substrate preferences for the proliferation and immigration of polyps have not been reported. We monitored the propagation and immigration of Aurelia aurita (s. l.) polyps on two natural and nine artificial substrates at constant temperature (20±0.5°C) and salinity (30±0.5) in beakers and a glass aquarium in the laboratory, respectively. The results showed that, among artificial substrates, the highest number for polyp proliferation and immigration was found on nets, rigid polyvinyl chloride plates (RPVC), and wood. The lowest density of polyps was present on iron plates. Among natural substrates, the asexual reproduction rate of polyps on Patinopecten yessoensis (Jay, 1857) shells was significantly higher than Azumapecten farreri (Jones & Preston, 1904). On the account of the distinction in the roughness, chemical properties and biofilms of these material surfaces, bare artificial or natural substrates discriminatively affect the proliferation and the immigration of Aurelia spp. polyps at laboratory. These observations suggest that, even in the natural environment, different materials and texture may influence the composition and the abundance of the fouling communities and the assemblages of polyps and, indirectly, have effects on the amounts of released medusae.

  2. Phenotypic and functional characteristics of IL-21-expressing CD8+ T cells in human nasal polyps

    PubMed Central

    Xiao, Li; Jia, Lei; Bai, Lu; He, Long; Yang, Binyan; Wu, Changyou; Li, Huabin

    2016-01-01

    Although CD4+ T cells are recognized to play an important role in the inflammatory response of nasal polyps (NPs), the biological functions of CD8+ T cells in polypogenesis remain unclear. In this study, we analyzed cell markers, cytokine expression and transcription factors in IL-21-expressing CD8+ T cells in polyp tissues of NP patients. The results showed that the majority of IL-21-producing CD8+ T cells were effector memory cells and they co-expressed IFN-γ. IL-21-expressing CD8+ T cells in polyp tissues expressed higher CXCR5, PD-1, and ICOS levels than cells in control tissues and showed significantly higher T-bet and Bcl-6 expression levels compared with IL-21−CD8+ T cells. Purified polyp CD8+ T cells promoted IgG production from isolated polyp B cells in vitro, and recombinant IL-12 modulated the expression of IL-21, IFN-γ and CD40L in purified polyp CD8+ T cells. Moreover, the percentage of IL-21+CD8+ T cells in polyp tissues was positively correlated with endoscopic and CT scan scores in NP patients. These findings indicated that polyp CD8+ T cells, by co-expressing IL-21 and IFN-γ and other markers, display a Tfh cell functionality, which is associated with the clinical severity of NP patients. PMID:27468819

  3. WM-DOVA maps for accurate polyp highlighting in colonoscopy: Validation vs. saliency maps from physicians.

    PubMed

    Bernal, Jorge; Sánchez, F Javier; Fernández-Esparrach, Gloria; Gil, Debora; Rodríguez, Cristina; Vilariño, Fernando

    2015-07-01

    We introduce in this paper a novel polyp localization method for colonoscopy videos. Our method is based on a model of appearance for polyps which defines polyp boundaries in terms of valley information. We propose the integration of valley information in a robust way fostering complete, concave and continuous boundaries typically associated to polyps. This integration is done by using a window of radial sectors which accumulate valley information to create WM-DOVA (Window Median Depth of Valleys Accumulation) energy maps related with the likelihood of polyp presence. We perform a double validation of our maps, which include the introduction of two new databases, including the first, up to our knowledge, fully annotated database with clinical metadata associated. First we assess that the highest value corresponds with the location of the polyp in the image. Second, we show that WM-DOVA energy maps can be comparable with saliency maps obtained from physicians' fixations obtained via an eye-tracker. Finally, we prove that our method outperforms state-of-the-art computational saliency results. Our method shows good performance, particularly for small polyps which are reported to be the main sources of polyp miss-rate, which indicates the potential applicability of our method in clinical practice.

  4. Severe gastric impaction secondary to a gastric polyp in a horse

    PubMed Central

    Furness, Mary Catherine; Snyman, Heindrich Nicolaas; Abrahams, Miranda; Moore, Alison; Vince, Andrew; Anderson, Maureen E.C.

    2013-01-01

    A 13-year-old Percheron gelding was presented for refractory gastric impaction. At necropsy a pedunculated 10 cm × 11 cm × 14 cm mass, histologically identified as an inflammatory polyp, was suspected to have been partly obstructing the pylorus. This is the first report of a polyp resulting in gastric outflow obstruction in a horse. PMID:24155420

  5. A Longitudinal Study of Voice before and after Phonosurgery for Removal of a Polyp

    ERIC Educational Resources Information Center

    Stajner-Katusic, Smiljka; Horga, Damir; Zrinski, Karolina Vrban

    2008-01-01

    The aim of the present investigation was to evaluate the acoustic parameters, perceptual estimation, and self-estimation of voice before, 1 month after, and 6 years after surgical removal of a vocal fold polyp. Subjects were five male patients who came to the Phoniatric Clinic because of breathiness. For all patients, a polyp of one vocal fold was…

  6. A comparison of blood vessel features and local binary patterns for colorectal polyp classification

    NASA Astrophysics Data System (ADS)

    Gross, Sebastian; Stehle, Thomas; Behrens, Alexander; Auer, Roland; Aach, Til; Winograd, Ron; Trautwein, Christian; Tischendorf, Jens

    2009-02-01

    Colorectal cancer is the third leading cause of cancer deaths in the United States of America for both women and men. By means of early detection, the five year survival rate can be up to 90%. Polyps can to be grouped into three different classes: hyperplastic, adenomatous, and carcinomatous polyps. Hyperplastic polyps are benign and are not likely to develop into cancer. Adenomas, on the other hand, are known to grow into cancer (adenoma-carcinoma sequence). Carcinomas are fully developed cancers and can be easily distinguished from adenomas and hyperplastic polyps. A recent narrow band imaging (NBI) study by Tischendorf et al. has shown that hyperplastic polyps and adenomas can be discriminated by their blood vessel structure. We designed a computer-aided system for the differentiation between hyperplastic and adenomatous polyps. Our development aim is to provide the medical practitioner with an additional objective interpretation of the available image data as well as a confidence measure for the classification. We propose classification features calculated on the basis of the extracted blood vessel structure. We use the combined length of the detected blood vessels, the average perimeter of the vessels and their average gray level value. We achieve a successful classification rate of more than 90% on 102 polyps from our polyp data base. The classification results based on these features are compared to the results of Local Binary Patterns (LBP). The results indicate that the implemented features are superior to LBP.

  7. Computer-aided diagnosis in CT colonography: detection of polyps based on geometric and texture features

    NASA Astrophysics Data System (ADS)

    Yoshida, Hiroyuki; Naeppi, Janne J.; Frimmel, Hans; Dachman, Abraham H.

    2002-05-01

    A computer-aided diagnosis scheme for the detection of colonic polyps in CT colonography has been developed, and its performance has been assessed based on clinical cases with colonoscopy-confirmed polyps. In the scheme, the colon was automatically segmented by use of knowledge-guided segmentation from 3-dimensional isotropic volumes reconstructed from axial CT slices in CT colonography. Polyp candidates are detected by first computing of 3-dimensional geometric features that characterize polyps, and then segmenting of connected components corresponding to suspicious regions by hysteresis thresholding and fuzzy clustering based on these geometric features. False-positive detections are reduced by computation of 3-dimensional texture features characterizing the internal structures of the polyp candidates, followed by application of discriminant analysis to the feature space generated by the geometric and texture features. We applied our scheme to 43 CT colonographic cases with cleansed colon, including 12 polyps larger than 5 mm. In a by-dataset analysis, the CAD scheme yielded a sensitivity of 95% with 1.2 false positives per data set. The false negative was one of the two polyps in a single patient. Consequently, in by-patient analysis, our method yielded 100% sensitivity with 2.0 false positives per patient. The results indicate that our CAD scheme has the potential to detect clinically important polyp cases with a high sensitivity and a relatively low false-positive rate.

  8. Severe gastric impaction secondary to a gastric polyp in a horse.

    PubMed

    Furness, Mary Catherine; Snyman, Heindrich Nicolaas; Abrahams, Miranda; Moore, Alison; Vince, Andrew; Anderson, Maureen E C

    2013-10-01

    A 13-year-old Percheron gelding was presented for refractory gastric impaction. At necropsy a pedunculated 10 cm × 11 cm × 14 cm mass, histologically identified as an inflammatory polyp, was suspected to have been partly obstructing the pylorus. This is the first report of a polyp resulting in gastric outflow obstruction in a horse.

  9. Groups travel further: pelagic metamorphosis and polyp clustering allow higher dispersal potential in sun coral propagules

    NASA Astrophysics Data System (ADS)

    Mizrahi, Damián; Navarrete, Sergio A.; Flores, Augusto A. V.

    2014-06-01

    We report that planulae produced by Tubastraea coccinea can metamorphose and aggregate in groups of up to eight polyps in the water column, without previous settlement on benthic substrate. We also evaluated the survival of propagules to test whether different levels of aggregation allowed for longer planktonic life and, therefore, higher dispersal potential. Our results show that pelagic polyps live longer than planulae, probably because they can feed and meet the presumably high-energy demands of swimming. Clusters of two or more individuals lived longer than solitary polyps. However, mortality did not differ between small (2-3 polyps) and large (4-8 polyps) clusters, suggesting the existence of an upper limit to cluster size. Most swimming clusters (80 %) remained alive after 6 months, suggesting that pelagic metamorphosis and cluster formation can be a key life-history feature increasing dispersal potential, population connectivity, and the colonization of new habitats in this invasive species.

  10. Fecal dysbiosis in miniature dachshunds with inflammatory colorectal polyps.

    PubMed

    Igarashi, Hirotaka; Ohno, Koichi; Horigome, Ayako; Fujiwara-Igarashi, Aki; Kanemoto, Hideyuki; Fukushima, Kenjiro; Odamaki, Toshitaka; Tsujimoto, Hajime

    2016-04-01

    Chronic gastrointestinal disease is associated with the alteration of gastrointestinal microbiota. Inflammatory colorectal polyps (ICRPs) are commonly observed in miniature dachshunds (MDs) in Japan and are characterized by multiple polyps that are restricted in the colorectal mucosa with severe neutrophil infiltration. This study was aimed to compare the fecal microbiota of ICRP-affected MDs with that of healthy MDs. High-throughput sequencing of amplicons derived from the V3-V4 region of the 16S rRNA gene was applied using the Illumina MiSeq system. Principal coordinates analysis revealed that fecal microbiota of ICRP-affected MDs was significantly altered compared with that of healthy MDs. Proportions of Fusobacteriaceae, Helicobacteraceae, Porphyromonadaceae, and Turicibacteraceae were significantly more abundant in ICRP-affected MDs, while those of Lachnospiraceae were significantly less abundant in ICRP-affected MDs compared with healthy MDs. These results suggest that the dysbiosis is associated with ICRPs and is a potential therapeutic target, though further investigations are needed.

  11. Nasopharyngeal polyp causing sensory disturbances: a case report

    PubMed Central

    Sabeh, Abrar Majed; Ahmed, Iffat Mirza

    2016-01-01

    Nasopharyngeal polyps are benign abnormal mucosal protrusions associated with nasal and pharyngeal mucosa. They are commonly found in all age groups with various symptoms. This paper presents a case of a 52-year-old male who presented with constant numbness over the dental midline and extending along the right side of the maxilla for the past few weeks. The patient also reported difficulty in breathing, especially lying down. After a comprehensive head and neck examination, including muscle palpation and temporomandibular joint examination, all within normal limits, a CNS lesion was suspected. A cranial nerve screening examination disclosed hyposensitivity in the area of teeth # 7 to 10. A panoramic radiograph demonstrated right sinus abnormality. We determined the need for additional diagnostic testing, including cone beam computed tomography, which showed a thickened sinus membrane with a polypoid structure (extending posterior from the right inferior concha into the oropharynx). The patient was referred to an ear, nose, and throat (ENT) specialist for further evaluation. The ENT diagnosis was a nasal polyp, and the patient was prescribed a steroid spray to be used three times daily. On follow-up, the patient’s symptoms were reduced from constant numbness to intermittent “fading sensation” with no breathing difficulties lying down. Ancillary diagnostic testing, such as Cone Beam CT, is useful and may be required for the diagnosis of sensory disturbances in the Orofacial region. PMID:27279994

  12. Confocal laser endomicroscopy features of sessile serrated adenomas/polyps

    PubMed Central

    Parikh, Neil D; Gibson, Joanna; Nagar, Anil; Ahmed, Ali A

    2015-01-01

    Background and aims Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time “optical biopsy”. The aim of this study was to prospectively describe CLE features of SSA/Ps. Patients and methods Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist. Distinguishing CLE features of SSA/Ps were identified in conjunction with pathologic correlation. Results In total, 260 CLE images were generated from nine SSA/Ps evaluated in seven patients. Four consensus CLE features of SSA/P were identified: (1) a mucus cap with a bright, cloud-like appearance; (2) thin, branching crypts; (3) increased number of goblet cells and microvesicular mucin-containing cells; and (4) architectural disarray, with dystrophic goblet cells and lack of regular circular crypts Conclusion This is a novel description of characteristic CLE features of SSA/Ps. The four features we identified are easy to detect and may allow for CLE to serve as a diagnostic modality. PMID:27536371

  13. Nitrite/nitrate and malondialdehyde levels in nasal polyp.

    PubMed

    Bugdayci, G; Kaymakci, M

    2008-10-28

    The aim of this study was to examine the pathophysiological role of NO (nitric oxide) and MDA (malondialdehyde) in tissue in patients with nasal polyposis. We measured nitrite/nitrate (Nitrite/Nitrate; NO2-/NO3-) and MDA in tissue and plasma of NP patients (n=20) and controls (n=20). MDA level expressed as the concentration of substances reacting to thiobarbituric acid and production of NO (concentration of nitrite/nitrate in plasma) by the Griess reaction were determined. The level of NO2- and NO3- in tissue are higher than that of the normal tissue (p<0.05). The level of MDA in tissue are higher than that of the normal tissue (p<0.05). The level of NO2- and NO3- in plasma of two groups are similar (p>0.05). The level of MDA in plasma is higher than that in the normal controls (p<0.05). The change in NO2-/NO3- and MDA levels of nasal polyp patients was demonstrated. Further studies are required concerning the significance of changes in lipid peroxidation and nitrite levels in pathogenesis of nasal polyp.

  14. Associations among Pericolonic Fat, Visceral Fat, and Colorectal Polyps on CT Colonography

    PubMed Central

    Liu, Jiamin; Pattanaik, Sanket; Yao, Jianhua; Dwyer, Andrew J.; Pickhardt, Perry J.; Choi, J. Richard; Summers, Ronald M.

    2014-01-01

    OBJECTIVE To determine the association between pericolonic fat and colorectal polyps using CT colonography (CTC). METHODS 1169 patients who underwent CTC and same day optical colonoscopy were assessed. Pericolonic fat was measured on CTC in a band surrounding the colon. Visceral adipose tissue volume was measured at the L2-L3 levels. Student t-tests, odds ratio, logistic regression, binomial statistics and weighted-kappa were performed to ascertain associations with the incidence of colorectal polyps. RESULTS Pericolonic fat volume fractions (PFVF) were 61.5±11.0% versus 58.1±11.5%, 61.6 ±11.1% versus 58.7±11.5%, and 62.4±10.6% versus 58.8±11.5% for patients with and without any polyps, adenomatous polyps, and hyperplastic polyps, respectively (p<0.0001). Similar trends were observed when examining visceral fat volume fractions (VFVF). When patients were ordered by quintiles of PFVF or VFVF, there were 2.49, 2.19 and 2.39-fold increases in odds ratio for the presence of any polyp, adenomatous polyps, or hyperplastic polyps from the first to the fifth quintile for PFVF, and 1.92, 2.00 and 1.71-fold increases in odds ratio for VFVF. Polyps tended to occur more commonly in parts of the colon that had more PFVF than the spatially-adjusted average for patients in the highest quintile of VFVF. CONCLUSION Pericolonic fat accumulations, like visceral fat, are correlated with an increased risk of adenomatous and hyperplastic polyps. PMID:25558027

  15. Nasal polyps in patients with asthma: prevalence, impact, and management challenges

    PubMed Central

    Langdon, Cristobal; Mullol, Joaquim

    2016-01-01

    Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have coexisting asthma under the concept of “United Airway Disease”, being the combination of both diseases, which is one of the most challenging phenotypes to treat. Although clinicians have recognized this difficult-to-treat phenotype for many years, it remained poorly characterized. There is increasing epidemiological evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and the combined management is still lacking. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis, while asthmatic patients have a greater prevalence of CRSwNP than patients without asthma. The effect of CRSwNP treatment, whether medical or surgical, in asthma is today less controversial after some studies have shown improvement of asthma after medical and/or surgical treatment of CRSwNP. However, direct comparisons between surgical and medical treatments are limited. Further randomized clinical trials are, however, still needed to better understand the management when both asthma and CRSwNP occur together. This review aims at summarizing the prevalence, impact, and management challenges regarding both asthma and CRSwNP. PMID:27042129

  16. Utility of a Standardized Protocol for Submitting Clinically Suspected Endometrial Polyps to the Pathology Laboratory

    PubMed Central

    Safdar, Nida S.; Giannico, Giovanna; Desouki, Mohamed Mokhtar

    2016-01-01

    The purpose of the study is to assess whether a protocol for submitting clinically suspected endometrial polyps will improve the detection rate of polyps and evaluation of the background endometrium. A retrospective review from 1999– 2015 was performed. Cases were divided into: 1) polyps and curetting placed in 2 containers (separate, n=61) and 2) polyps and curettings placed in one container (combined, n=80). Polyps were identified in 100% of cases in the separate compared to 95% in the combined group (p=0.62). The background endometrium was evaluable in 79% in the combined compared to 90% in the separate group (p=0.07). The frequency of hyperplasia without atypia, atypical hyperplasia and carcinoma was 4.4%, 3.6% and 1.5%, respectively. In conclusion, the enhanced rate of polyp detection and evaluation of the background endometrium in the separate group is minimal. This supports the recommendation of submitting endometrial polyps and curetting combined in one container. PMID:27402220

  17. Automated polyp measurement based on colon structure decomposition for CT colonography

    NASA Astrophysics Data System (ADS)

    Wang, Huafeng; Li, Lihong C.; Han, Hao; Peng, Hao; Song, Bowen; Wei, Xinzhou; Liang, Zhengrong

    2014-03-01

    Accurate assessment of colorectal polyp size is of great significance for early diagnosis and management of colorectal cancers. Due to the complexity of colon structure, polyps with diverse geometric characteristics grow from different landform surfaces. In this paper, we present a new colon decomposition approach for polyp measurement. We first apply an efficient maximum a posteriori expectation-maximization (MAP-EM) partial volume segmentation algorithm to achieve an effective electronic cleansing on colon. The global colon structure is then decomposed into different kinds of morphological shapes, e.g. haustral folds or haustral wall. Meanwhile, the polyp location is identified by an automatic computer aided detection algorithm. By integrating the colon structure decomposition with the computer aided detection system, a patch volume of colon polyps is extracted. Thus, polyp size assessment can be achieved by finding abnormal protrusion on a relative uniform morphological surface from the decomposed colon landform. We evaluated our method via physical phantom and clinical datasets. Experiment results demonstrate the feasibility of our method in consistently quantifying the size of polyp volume and, therefore, facilitating characterizing for clinical management.

  18. A novel colonic polyp volume segmentation method for computer tomographic colonography

    NASA Astrophysics Data System (ADS)

    Wang, Huafeng; Li, Lihong C.; Han, Hao; Song, Bowen; Peng, Hao; Wang, Yunhong; Wang, Lihua; Liang, Zhengrong

    2014-03-01

    Colorectal cancer is the third most common type of cancer. However, this disease can be prevented by detection and removal of precursor adenomatous polyps after the diagnosis given by experts on computer tomographic colonography (CTC). During CTC diagnosis, the radiologist looks for colon polyps and measures not only the size but also the malignancy. It is a common sense that to segment polyp volumes from their complicated growing environment is of much significance for accomplishing the CTC based early diagnosis task. Previously, the polyp volumes are mainly given from the manually or semi-automatically drawing by the radiologists. As a result, some deviations cannot be avoided since the polyps are usually small (6~9mm) and the radiologists' experience and knowledge are varying from one to another. In order to achieve automatic polyp segmentation carried out by the machine, we proposed a new method based on the colon decomposition strategy. We evaluated our algorithm on both phantom and patient data. Experimental results demonstrate our approach is capable of segment the small polyps from their complicated growing background.

  19. Volume-based Feature Analysis of Mucosa for Automatic Initial Polyp Detection in Virtual Colonoscopy

    PubMed Central

    Wang, Su; Zhu, Hongbin; Lu, Hongbing; Liang, Zhengrong

    2009-01-01

    In this paper, we present a volume-based mucosa-based polyp candidate determination scheme for automatic polyp detection in computed colonography. Different from most of the existing computer-aided detection (CAD) methods where mucosa layer is a one-layer surface, a thick mucosa of 3-5 voxels wide fully reflecting partial volume effect is intentionally extracted, which excludes the direct applications of the traditional geometrical features. In order to address this dilemma, fast marching-based adaptive gradient/curvature and weighted integral curvature along normal directions (WICND) are developed for volume-based mucosa. In doing so, polyp candidates are optimally determined by computing and clustering these fast marching-based adaptive geometrical features. By testing on 52 patients datasets in which 26 patients were found with polyps of size 4-22 mm, both the locations and number of polyp candidates detected by WICND and previously developed linear integral curvature (LIC) were compared. The results were promising that WICND outperformed LIC mainly in two aspects: (1) the number of detected false positives was reduced from 706 to 132 on average, which significantly released our burden of machine learning in the feature space, and (2) both the sensitivity and accuracy of polyp detection have been slightly improved, especially for those polyps smaller than 5mm. PMID:19774204

  20. [Results of dynamic observation of patients with polyps in the stomach].

    PubMed

    Liapunova, V N; Nikiforov, P A; Brekhov, E I; Blokhin, A F; Burkov, S G; Gribunov, Iu P

    2013-01-01

    This work is based on the analysis of data doing 409 patients with polyps in the stomach. Among them 200 men (48.9%) and 209 women (51.1%) aged 18 to 91 years. The average age of men was 67.4 years, and women 66.8 years. All these patients were find 1034 neoplasms of various sizes. At all of this patients polyps were identified on a background of chronic gastritis, as a rule, has the character of atrophic process. Histological research was conducted 775 (74.6%) polyps, of which focal hyperplasia and hyperplastic polyps detected in 49% of cases, and adenomas in 51% (including adenomas with varying degrees of dyspiasia, and prostatic adenocarcinoma cells). Endoscopic polypectomy performed 367 patients, and the remaining 42 was merely the dynamic monitoring of the identified entities. In 79 (28.8%) patients after polypectomy noted relapse formations and in 10 cases (3.65%) diagnosed with cancer in the intervention area. 4 (0.98%) patients from 409 cancer in polyps detected during the initial survey and in 4 patients the cancer originated in the not associated with polyps of stomach. As a result of the research of the dependence of the size of neoplasms on the nature of destruction and histological structure. For most existing polyps characteristic of the stability of their morphological structure and the absence of its transformation.

  1. [A Case of Esophageal Polyp Regurgitated into the Pharynx at the Induction of General Anesthesia].

    PubMed

    Nishikawa, Haruko; Inagawa, Gaku

    2016-02-01

    We report the case of a mass in the pharynx found at the induction of general anesthesia that vanished postoperatively. A 46-year-old man underwent abdominal surgery. After the induction of general anesthesia, there was a mass occupying his pharynx and we could see neither the vocal cords nor the epiglottis using a Macintosh laryngoscope. Airwayscope (AWS) enabled us to successfully intubate the trachea. On postoperative examination, there was no mass on his pharynx. Imaging studies of the esophagus revealed a polyp suspected as being a fibrovascular polyp (FVP) arising from the upper esophagus. Three months later, excision of the polyp was planned. Awake intubation with AWS was planned so that if the polyp was regurgitated, he could swallow it Intubation was uneventful without regurgitation of the polyp. At the beginning of surgery, the polyp was not found in the pharynx, but was easily regurgitated by air supplied by the endoscope. FVPs are rare benign esophageal tumors and most originate from the cervical esophagus. If a polyp is regurgitated, obstruction of the airway may occur, and asphyxiation and sudden death have been reported. The fatal complication of airway obstruction requires anesthesiologists to be aware of FVP.

  2. EMPLOYING TOPOGRAPHICAL HEIGHT MAP IN COLONIC POLYP MEASUREMENT AND FALSE POSITIVE REDUCTION

    PubMed Central

    Yao, Jianhua; Li, Jiang; Summers, Ronald M.

    2008-01-01

    CT Colonography (CTC) is an emerging minimally invasive technique for screening and diagnosing colon cancers. Computer Aided Detection (CAD) techniques can increase sensitivity and reduce false positives. Inspired by the way radiologists detect polyps via 3D virtual fly-through in CTC, we borrowed the idea from geographic information systems to employ topographical height map in colonic polyp measurement and false positive reduction. After a curvature based filtering and a 3D CT feature classifier, a height map is computed for each detection using a ray-casting algorithm. We design a concentric index to characterize the concentric pattern in polyp height map based on the fact that polyps are protrusions from the colon wall and round in shape. The height map is optimized through a multi-scale spiral spherical search to maximize the concentric index. We derive several topographic features from the map and compute texture features based on wavelet decomposition. We then send the features to a committee of support vector machines for classification. We have trained our method on 394 patients (71 polyps) and tested it on 792 patients (226 polyps). Results showed that we can achieve 95% sensitivity at 2.4 false positives per patient and the height map features can reduce false positives by more than 50%. We compute the polyp height and width measurements and correlate them with manual measurements. The Pearson correlations are 0.74 (p=0.11) and 0.75 (p=0.17) for height and width, respectively. PMID:19578483

  3. PATHOLOGIC BASIS FOR RIM ENHANCEMENT OBSERVED IN COMPUTED TOMOGRAPHIC IMAGES OF FELINE NASOPHARYNGEAL POLYPS.

    PubMed

    Lamb, Christopher R; Sibbing, Kendall; Priestnall, Simon L

    2016-01-01

    In postcontrast computed tomographic (CT) images, feline nasopharyngeal polyps typically demonstrate enhancement of the peripheral rim. Computed tomographic images and histologic specimens of a case series of 22 cats with surgically removed nasopharyngeal polyps were reviewed retrospectively in an attempt to elucidate the origin of rim enhancement. Polyps were present in the tympanic cavity in 15 (68%) cats (three with extension into the nasopharynx), only in the nasopharynx in four (18%) cats, and only in the external ear canal in the remaining three (14%) cats. All polyps had variable degrees of epithelial injury. Hemorrhage and inflammatory infiltration were significantly more marked in the superficial stroma whereas edema was significantly more marked in the core stroma. In noncontrast CT images (n = 22), the tympanic bulla was thickened in all 15 cats with a polyp in the tympanic cavity and enlarged in eight (53%) of these cats. In postcontrast CT images (n = 15), an outer zone of relatively increased attenuation compatible with a rim was observed in 11 (73%) polyps. The magnitude and extent of rim enhancement in CT images was positively correlated with the histologic grade of inflammation in the superficial stroma and negatively correlated with the grade of edema in the superficial stroma. It appears that inflammation is the major determinant of contrast medium accumulation in feline nasopharyngeal polyps, and the tendency for inflammation to affect predominantly the superficial layers explains the frequent observation of a rim in postcontrast CT images.

  4. Time Lapse to Colorectal Cancer: Telomere Dynamics Define the Malignant Potential of Polyps

    PubMed Central

    Druliner, Brooke R; Ruan, Xiaoyang; Johnson, Ruth; Grill, Diane; O'Brien, Daniel; Lai, Tsung-Po; Rashtak, Shahrooz; Felmlee-Devine, Donna; Washechek-Aletto, Jill; Malykh, Andrei; Smyrk, Thomas; Oberg, Ann; Liu, Hongfang; Shay, Jerry W; Ahlquist, David A; Boardman, Lisa A

    2016-01-01

    Objective: Whereas few adenomas become cancer, most colorectal cancers arise from adenomas. Telomere length is a recognized biomarker in multiple cancers, and telomere maintenance mechanisms (TMM) are exploited by malignant cells. We sought to determine whether telomere length and TMM distinguish cancer-associated adenomas from those that are cancer-free. Methods: Tissues were identified as cancer-adjacent polyp (CAP)—residual adenoma contiguous with cancer—and cancer-free polyp (CFP)—adenomas without malignancy. Telomere length, TMM, and expression were measured in 102 tissues including peripheral blood leukocytes (PBLs), normal colon epithelium, adenoma, and cancer (in CAP cases) from 31 patients. Telomere length was measured in a separate cohort of 342 PBL from CAP and CFP patients. Results: The mean differences in telomere length between normal and adenoma were greater in CAP than in CFP cases, P=0.001; telomere length in PBL was 91.7 bp greater in CAP than in CFP, P=0.007. Each 100 bp telomere increase was associated with a 1.14 (1.04–1.26) increased odds of being a CAP, P=0.0063. The polyp tissue from CAP patients had shorter telomeres and higher Telomerase reverse transcriptase (hTERT) expression compared with polyps from CFP patients, P=0.05. There was a greater degree of alternative lengthening of telomere (ALT) level difference in CFP polyps than in CAP polyps. The polyp telomere lengths of aggressive CAPs were significantly different from the polyps of non-aggressive CAPs, P=0.01. Conclusions: Adenomas that progress to cancer exhibit distinct telomere length and TMM profiles. We report for the first time that PBL telomeres differ in patients with polyps that become malignant, and therefore may have clinical value in adenoma risk assessment and management. PMID:27584834

  5. Detection of colonic polyp candidates with level set-based thickness mapping over the colon wall

    NASA Astrophysics Data System (ADS)

    Han, Hao; Li, Lihong; Duan, Chaijie; Zhao, Yang; Wang, Huafeng; Liang, Zhengrong

    2015-03-01

    Further improvement of computer-aided detection (CADe) of colonic polyps is vital to advance computed tomographic colonography (CTC) toward a screening modality, where the detection of flat polyps is especially challenging because limited image features can be extracted from flat polyps, and the traditional geometric features-based CADe methods usually fail to detect such polyps. In this paper, we present a novel pipeline to automatically detect initial polyp candidates (IPCs), especially flat polyps, from CTC images. First, the colon wall mucosa was extracted via a partial volume segmentation approach as a volumetric layer, where the inner border of colon wall can be obtained by shrinking the volumetric layer using level set based adaptive convolution. Then the outer border of colon wall (or the colon wall serosa) was segmented via a combined implementation of geodesic active contour and Mumford-Shah functional in a coarse-to-fine manner. Finally, the wall thickness was estimated along a unique path between the segmented inner and outer borders with consideration of the volumetric layers and was mapped onto a patient-specific three-dimensional (3D) colon wall model. The IPC detection results can usually be better visualized in a 2D image flattened from the 3D model, where abnormalities were detected by Z-score transformation of the thickness values. The proposed IPC detection approach was validated on 11 patients with 22 CTC scans, and each scan has at least one flat poly annotation. The above presented novel pipeline was effective to detect some flat polyps that were missed by our CADe system while keeping false detections in a relative low level. This preliminary study indicates that the presented pipeline can be incorporated into an existing CADe system to enhance the polyp detection power, especially for flat polyps.

  6. Gastric inverted hyperplastic polyp: A rare cause of iron deficiency anemia

    PubMed Central

    Yun, Jin Tak; Lee, Seung Woo; Kim, Dong Pil; Choi, Seung Hwa; Kim, Seok-Hwan; Park, Jun Kyu; Jang, Sun Hee; Park, Yun Jung; Sung, Ye Gyu; Sul, Hae Jung

    2016-01-01

    Gastric inverted hyperplastic polyp (IHP) is a rare gastric polyp characterized by the downward growth of hyperplastic mucosal components into the submucosal layer. Macroscopically, a gastric IHP resembles a subepithelial tumor (SET); as a result, accurately diagnosing gastric IHP is difficult. This issue has clinical significance because gastric IHP can be misdiagnosed as SET or as malignant neoplasm In addition, adenocarcinoma can accompany benign gastric IHP. Although in most cases, gastric IHPs are asymptomatic and are found incidentally, these polyps may cause anemia secondary to chronic bleeding. Here, we report one case involving gastric IHP accompanied by chronic iron deficiency anemia that was successfully managed using endoscopic submucosal dissection. PMID:27099452

  7. Ileal inflammatory fibroid polyp causing chronic ileocolic intussusception and mimicking cecal carcinoma

    PubMed Central

    Gara, Naveen; Falzarano, John S; Limm, Whitney ML; Namiki, Thomas S; Tom, Laurie KS

    2009-01-01

    Inflammatory fibroid polyp (IFP) is a rare, idiopathic pseudotumorous lesion of the gastrointestinal tract. While mostly reported as solitary gastric lesions, multiple cases of small bowel IFPs are also reported. It is a documented cause of intussusception in adults. In the case reports of ileal inflammatory fibroid polyps with intussusception, an emergent presentation with small bowel obstruction has been most often described. Here we depict a case of ileal inflammatory fibroid polyp presenting with chronic intermittent ileocolic intussusception, anemia and weight loss with an endoscopic appearance mimicking necrotic cecal carcinoma. PMID:21160780

  8. Transvaginal ultrasonography and hysteroscopy as predictors of endometrial polyps in postmenopause.

    PubMed

    de Godoy Borges, Pítia Cárita; Dias, Rogério; Bonassi Machado, Rogério; Borges, João Bosco Ramos; Spadoto Dias, Daniel

    2015-01-01

    The study compared ultrasound and ambulatorial hysteroscopy as diagnostic methods detecting endometrial polyps in postmenopause women. 281 women aged 41-82 years who underwent ambulatorial hysteroscopy were analyzed for presence of uterine bleeding and/or altered transvaginal ultrasound (endometrial thickness ≥5 mm). Ultrasonography detected endometrial polyps in 22.8% of patients and endometrial thickening in the other 59.8%. Hysteroscopy diagnosed endometrial polyps in 80.8%. Ultrasonography showed sensitivity of 88.7%, specificity of 25.4%, positive predictive value of 81.7%, negative predictive value of 37.5% and accuracy of 75.4% in diagnosing endometrial polyps. Hysteroscopy showed 96.4% sensitivity, 74.6% specificity, 93.4% positive predictive value, 84.6% negative predictive value and 91.8% accuracy. Hysteroscopy demonstrated more accuracy than ultrasonography, which is not sufficient for accurate diagnosis.

  9. [The effect of smoking and forced use of the voice to development of the vocal polyps].

    PubMed

    Gnjatic, M; Stankovic, P; Djukić, V

    2009-01-01

    Dysphonia is often caused by polyps which are benign changes of pseudotumors. With their presence they are hampering with glotis oclusion. Laryngomicroscopy of general and endotracheal anaesthesia has been preformed on all of the patients. Microsurgical technique has been used to remove the polyps. Bioptic material was analyzed in pathophysiological laboratory of clinic of pathology in Banjaluka. All of the results were presented through tables and graphic representations. Frequency of polyps through age and sex groups, along with the examination of ethyological factors in emergence of polyps of vocal cords. Results are in accordance with the results of other authors who were involved in similar problematics. Through analysis of our data we percieve that the abuse of voice is part of ethiological factors that lead not only to emergence of vocal fold lesions but aswell as other benign changes.

  10. Complete Resolution of Pseudomalignant Erosion in a Reflux Gastroesophageal Polyp with Proton Pump Inhibitor

    PubMed Central

    Nakajima, Takahiko; Yagi, Haruo; Baba, Hayato; Minamisaka, Takashi; Miwa, Shigeharu; Hayashi, Shinichi; Nishida, Takeshi; Hatta, Hideki; Tsuneyama, Koichi; Imura, Johji

    2015-01-01

    Pseudomalignant erosion is a diagnostic pitfall for pathologists in the differential diagnosis of malignant neoplasms. Here, we present a challenging case of a biopsy specimen from the eroded head of a polyp at the esophagogastric junction. A malignant neoplasm could not be ruled out due to the presence of bizarre stromal cells. A second biopsy performed after the administration of a proton pump inhibitor (PPI) for 4 weeks revealed endoscopic resolution of the polyp along with the complete histological resolution of the bizarre stromal cells and led to the diagnosis of pseudomalignant erosion in a reflux gastroesophageal polyp. In conclusion, histological and endoscopic response to PPI therapy is an important clue for the correct diagnosis of reflux gastroesophageal polyps with pseudomalignant erosion. PMID:26688768

  11. Cold snare piecemeal resection of colonic and duodenal polyps ≥1 cm

    PubMed Central

    Choksi, Neel; Elmunzer, B. Joseph; Stidham, Ryan W.; Shuster, Dmitry; Piraka, Cyrus

    2015-01-01

    Background: Endoscopic removal of duodenal and colorectal adenomas is currently considered to be the standard of care for prevention of adenocarcinoma. The use of cautery carries a risk of delayed bleeding, post-polypectomy syndrome, and perforation. We examined the safety and feasibility of removing colonic and duodenal polyps ≥ 1 cm using a piecemeal cold snare polypectomy technique. Patients: The study included 15 patients with duodenal polyps ≥ 1 cm and 15 patients with colonic polyps ≥ 1 cm. Main outcome measurements: Bleeding, perforation, abdominal pain, or hospitalization occurring within 2 weeks of polypectomy. Results: Between 24 August 2011 and 29 April 2013, 15 patients had removal of duodenal polyps ≥ 1 cm. Mean patient age was 64 years and 9/15 patients were male. The mean polyp size was 24 mm (10 – 60 mm). All polyps were removed with a cold snare and some required cold biopsy forceps. One patient required hospitalization for gastrointestinal blood loss 7 days post-polypectomy; this patient was using Coumadin. Between 27 February 2012 and 30 May 2013, 15 patients underwent resection of a ≥ 1 cm colonic polyp. Mean patient age was 68 years and 9/15 were male. The mean polyp size was 20 mm (10 – 45 mm). All polyps were primarily removed with a cold snare. None of the patients required hemostatic clips for control of immediate bleeding. One patient presented to the emergency department with abdominal pain 1 day after initial endoscopy. CT scan showed no abnormalities and the patient was discharged. Conclusions: Cold snare polypectomy for large duodenal and colonic polyps is technically feasible and may have a favorable safety profile compared to standard electrocautery-based endoscopic resection. Comparative trials are required to determine the relative safety and efficacy of cold snare techniques for complete and durable resection of large polyps compared to standard hot snare methods. PMID:26528509

  12. Ultrasound virtual endoscopy: Polyp detection and reliability of measurement in an in vitro study with pig intestine specimens

    PubMed Central

    Liu, Jin-Ya; Chen, Li-Da; Cai, Hua-Song; Liang, Jin-Yu; Xu, Ming; Huang, Yang; Li, Wei; Feng, Shi-Ting; Xie, Xiao-Yan; Lu, Ming-De; Wang, Wei

    2016-01-01

    AIM: To present our initial experience regarding the feasibility of ultrasound virtual endoscopy (USVE) and its measurement reliability for polyp detection in an in vitro study using pig intestine specimens. METHODS: Six porcine intestine specimens containing 30 synthetic polyps underwent USVE, computed tomography colonography (CTC) and optical colonoscopy (OC) for polyp detection. The polyp measurement defined as the maximum polyp diameter on two-dimensional (2D) multiplanar reformatted (MPR) planes was obtained by USVE, and the absolute measurement error was analyzed using the direct measurement as the reference standard. RESULTS: USVE detected 29 (96.7%) of 30 polyps, remaining a 7-mm one missed. There was one false-positive finding. Twenty-six (89.7%) of 29 reconstructed images were clearly depicted, while 29 (96.7%) of 30 polyps were displayed on CTC with one false-negative finding. In OC, all the polyps were detected. The intraclass correlation coefficient was 0.876 (95%CI: 0.745-0.940) for measurements obtained with USVE. The pooled absolute measurement errors ± the standard deviations of the depicted polyps with actual sizes ≤ 5 mm, 6-9 mm, and ≥ 10 mm were 1.9 ± 0.8 mm, 0.9 ± 1.2 mm, and 1.0 ± 1.4 mm, respectively. CONCLUSION: USVE is reliable for polyp detection and measurement in in vitro study. PMID:27022217

  13. A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix.

    PubMed

    Yantiss, Rhonda K; Panczykowski, Andrea; Misdraji, Joseph; Hahn, Hejin P; Odze, Robert D; Rennert, Hanna; Chen, Yao-Tseng

    2007-11-01

    Serrated colorectal polyps often show DNA hypermethylation and/or BRAF mutations and have been implicated in the "serrated neoplastic pathway." Although similar lesions occur in the appendix, they have never been systematically investigated. We evaluated a study group of 56 serrated polyps, a control group of 17 mucinous cystadenomas, and 4 adenocarcinomas with adjacent serrated polyps of the appendix to better understand their pathogenesis. The study cases were classified as nondysplastic or dysplastic serrated polyps and evaluated for MLH-1, MSH-2, MGMT, beta-catenin, p53, and Ki-67 expression, BRAF and KRAS mutations, and microsatellite instability. Serrated polyps usually occurred in older adults with no sex predilection. Most (59%) lacked dysplasia, but all showed similar molecular features, regardless of the degree of dysplasia present. Decreased MLH-1 (50%, P<0.001) and/or MGMT (59%, P<0.001) expression and BRAF (29%, P=0.007) mutations were significantly more common in serrated polyps, but BRAF mutations were detected in a minority of the extracted DNA in 15/16 cases. Of the 28 cases with decreased MLH-1 expression, none showed high-frequency microsatellite instability. Loss of MLH-1 (25%) or MGMT (50%) expression and BRAF or KRAS mutations (50%) were inconsistently present in adenocarcinomas and were not identified in combination in any cases. We conclude that molecular features of the "serrated neoplastic pathway" are present with similar frequencies among dysplastic and nondysplastic serrated appendiceal polyps and are not highly prevalent in adjacent carcinomas. These features, including BRAF mutations, may be more closely related to a serrated morphology in appendiceal polyps rather than biologically important changes.

  14. Deep transfer learning of virtual endoluminal views for the detection of polyps in CT colonography

    NASA Astrophysics Data System (ADS)

    Näppi, Janne J.; Hironaka, Toru; Regge, Daniele; Yoshida, Hiroyuki

    2016-03-01

    Proper training of deep convolutional neural networks (DCNNs) requires large annotated image databases that are currently not available in CT colonography (CTC). In this study, we employed a deep transfer learning (DETALE) scheme to circumvent this problem in automated polyp detection for CTC. In our method, a DCNN that had been pre-trained with millions of non-medical images was adapted to identify polyps using virtual endoluminal images of the polyp candidates prompted by a computer-aided detection (CADe) system. For evaluation, 154 CTC cases with and without fecal tagging were divided randomly into a development set and an external validation set including 107 polyps >=6 mm in size. A CADe system was trained to detect polyp candidates using the development set, and the virtual endoluminal images of the polyp candidates were labeled manually into true-positive and several false-positive (FP) categories for transfer learning of the DCNN. Next, the trained CADe system was used to detect polyp candidates from the external validation set, and the DCNN reviewed their images to determine the final detections. The detection sensitivity of the standalone CADe system was 93% at 6.4 FPs per patient on average, whereas the DCNN reduced the number of FPs to 2.0 per patient without reducing detection sensitivity. Most of the remaining FP detections were caused by untagged stool. In fecal-tagged CTC cases, the detection sensitivity was 94% at only 0.78 FPs per patient on average. These preliminary results indicate that DETALE can yield substantial improvement in the accuracy of automated polyp detection in CTC.

  15. Efficacy of leflunomide for treatment of refractory inflammatory colorectal polyps in 15 Miniature Dachshunds.

    PubMed

    Fukushima, Kenjiro; Eguchi, Nozomi; Ohno, Koichi; Kanemoto, Hideyuki; Takahashi, Masashi; Igarashi, Hirotaka; Ohmi, Aki; Nakashima, Ko; Tsujimoto, Hajime

    2016-02-01

    Inflammatory colorectal polyp (ICRP), common in miniature dachshunds, presents with hematochezia, tenesmus and mucoid feces. Although an 80% response rate has been reported when treated with prednisolone and cyclosporine, effective treatment is needed for the remaining 20% of ICRP dogs. Leflunomide is an immunosuppressive drug reported as effective in several immune-mediated diseases. In the present study, we retrospectively evaluated the efficacy and adverse effects of leflunomide in 15 ICRP dogs that were refractory to treatment with prednisolone and cyclosporine. Treatment efficacy was assessed by endoscopy, clinical symptoms and rectal palpation. Adverse effects were determined by clinical symptoms and blood testing during follow-up. The leflunomide treatment response rate was 93.3%. The median dosage of leflunomide and the median response time were 3 mg/kg (range: 1.7-4.0 mg/kg) and 35 days (range: 20-119 days), respectively. Adverse effects observed included lethargy (3 dogs), anorexia (1 dog), respiratory symptoms (1 dog), leukocytopenia (2 dogs), thrombocytopenia (1 dog), anemia (1 dog) and liver enzyme elevation (8 dogs). Most of the adverse effects improved with symptomatic treatment and leflunomide discontinuation or dosage reduction. In conclusion, leflunomide treatment is effective in ICRP dogs refractory to treatment with prednisolone and cyclosporine. Because several adverse effects were observed, close monitoring is needed during leflunomide treatment follow-up.

  16. Seasonality in Polyps of a Tropical Cubozoan: A latina nr mordens

    PubMed Central

    Courtney, Robert; Seymour, Jamie

    2013-01-01

    A latina nr mordens have been located in large predictable spawning aggregations near Osprey Reef in the Coral Sea eight to ten days after a full moon; however, polyps have never been located in-situ. The polyp stage contributes to the abundance of medusae through asexual reproduction and metamorphosis, and may influence the periodicity of medusae by metamorphosis of the polyp. To elucidate the relationship between medusae periodicity and polyp ecology, polyps were exposed to thermal and osmotic treatments in order to determine the theoretical environmental limits to their distribution. Maximum fecundity occurred in thermal treatments of 21 to 25ºC and the theoretical minimum thermal requirement for population stability was approximately 17ºC. Polyps were also exposed to five feeding regimes and fecundity was found to be positively correlated with feeding frequency. Thermal and osmotic variations did not induce metamorphosis in this species, however, reduced food did. The implications of asexual reproduction and cues for metamorphosis in relation to population dynamics of this species are discussed. PMID:23922707

  17. Upregulation of COX‐1 and COX‐2 in nasal polyps in cystic fibrosis

    PubMed Central

    Roca‐Ferrer, J; Pujols, L; Gartner, S; Moreno, A; Pumarola, F; Mullol, J; Cobos, N; Picado, C

    2006-01-01

    Background Since abnormalities in prostanoid metabolism occur in the lower airway of patients with cystic fibrosis (CF), it is likely that they could also be detected in the nose. Methods The degree of mRNA and protein expression of cyclo‐oxygenase (COX) enzymes 1 (COX‐1) and 2 (COX‐2) was examined using quantitative reverse competitive polymerase chain reaction (RT‐PCR) and Western blot analysis in the nasal polyps from 10 patients with CF, nasal polyps from 10 non‐CF patients and 11 nasal mucosa specimens. The results are presented as 106 cDNA molecules/μg total RNA and the densitometric ratio between protein and β‐actin. Results COX‐1 mRNA levels were significantly higher in CF nasal polyps (median 2.34, 25–75th percentiles 1.6–3.2) than in the nasal mucosa (0.78, 0.11–1.21), while there was no difference with non‐CF nasal polyps (1.11, 0.80–3.15). COX‐1 protein levels were significantly higher in CF nasal polyps (3.63, 2.71–4.27) than in nasal mucosa (1.55, 0.66–2.33) and non‐CF nasal polyps (2.19, 1.72–3.68). COX‐2 mRNA was significantly higher in CF nasal polyps (3.34, 2.42–7.05) than in nasal mucosa (1.69, 0.19–3.50). No differences were found in COX‐2 mRNA expression between CF and non‐CF polyps (1.38, 0.12–6.07). COX‐2 protein levels were also significantly higher in CF nasal polyps (0.23, 0.04–0.34) than in non‐CF nasal polyps (0.011, 0.009–0.016) or nasal mucosa (0.014, 0.014–0.016). Conclusions Upregulation in the expression of COX‐1 and COX‐2 could explain the high production of prostanoids reported in CF. These findings raise questions regarding the potential use of selective or non‐selective COX‐2 non‐steroidal anti‐inflammatory treatment in CF. PMID:16517580

  18. Clinical outcomes of gastric polyps and neoplasms in patients with familial adenomatous polyposis

    PubMed Central

    Nakamura, Keiko; Nonaka, Satoru; Nakajima, Takeshi; Yachida, Tatsuo; Abe, Seiichiro; Sakamoto, Taku; Suzuki, Haruhisa; Yoshinaga, Shigetaka; Oda, Ichiro; Matsuda, Takahisa; Sekine, Shigeki; Kanemitsu, Yukihide; Katai, Hitoshi; Saito, Yutaka; Hirota, Seiichi

    2017-01-01

    Background and study aims Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome caused by a germline mutation in the adenomatous polyposis coli (APC) gene, characterized by the presence of more than 100 adenomatous polyps in the colorectum. The upper gastrointestinal tract is an extracolonic site for malignancy in patients with FAP. The frequency of death in Japanese patients with FAP because of gastric cancer is 2.8 % and that because of colon cancer is 60.6 %. Few studies have reported upper gastrointestinal diseases in patients with FAP. In the present study, we investigated the clinical outcomes of patients with FAP diagnosed with gastric neoplasms. Patients and methods We enrolled 80 patients with FAP who underwent esophagogastroduodenoscopy from October 1997 to December 2011. We investigated patient characteristics, endoscopic findings of gastric lesions, treatment outcomes, and long-term courses. Results Fundic gland polyposis was observed in 51 patients (64 %) and gastric neoplasms in 22 patients (28 %), including 20 with non-invasive and 2 with invasive neoplasm. Of the 26 neoplasms, 11 were treated by endoscopic resection (ER) and 4 by surgical resection. Metachronous gastric neoplasms were observed in 7 patients (15 lesions) and treated by ER, except for in 1 patient. No patients died of gastric lesions during a median follow-up period of 6.5 years (range, 0 – 14). Conclusion Because gastric lesions including gastric cancers in patients with FAP did not cause any deaths, they can be considered to have favorable prognoses. Early detection of gastric neoplasms through an appropriate follow-up interval may have contributed to these good outcomes. PMID:28271094

  19. Clinical outcomes of gastric polyps and neoplasms in patients with familial adenomatous polyposis.

    PubMed

    Nakamura, Keiko; Nonaka, Satoru; Nakajima, Takeshi; Yachida, Tatsuo; Abe, Seiichiro; Sakamoto, Taku; Suzuki, Haruhisa; Yoshinaga, Shigetaka; Oda, Ichiro; Matsuda, Takahisa; Sekine, Shigeki; Kanemitsu, Yukihide; Katai, Hitoshi; Saito, Yutaka; Hirota, Seiichi

    2017-03-01

    Background and study aims Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome caused by a germline mutation in the adenomatous polyposis coli (APC) gene, characterized by the presence of more than 100 adenomatous polyps in the colorectum. The upper gastrointestinal tract is an extracolonic site for malignancy in patients with FAP. The frequency of death in Japanese patients with FAP because of gastric cancer is 2.8 % and that because of colon cancer is 60.6 %. Few studies have reported upper gastrointestinal diseases in patients with FAP. In the present study, we investigated the clinical outcomes of patients with FAP diagnosed with gastric neoplasms. Patients and methods We enrolled 80 patients with FAP who underwent esophagogastroduodenoscopy from October 1997 to December 2011. We investigated patient characteristics, endoscopic findings of gastric lesions, treatment outcomes, and long-term courses. Results Fundic gland polyposis was observed in 51 patients (64 %) and gastric neoplasms in 22 patients (28 %), including 20 with non-invasive and 2 with invasive neoplasm. Of the 26 neoplasms, 11 were treated by endoscopic resection (ER) and 4 by surgical resection. Metachronous gastric neoplasms were observed in 7 patients (15 lesions) and treated by ER, except for in 1 patient. No patients died of gastric lesions during a median follow-up period of 6.5 years (range, 0 - 14). Conclusion Because gastric lesions including gastric cancers in patients with FAP did not cause any deaths, they can be considered to have favorable prognoses. Early detection of gastric neoplasms through an appropriate follow-up interval may have contributed to these good outcomes.

  20. Types and Patterns of Colonic Polyps Encountered at a Tertiary Care Center in a Developing Country in South Asia

    PubMed Central

    Wickramasinghe, Dakshitha Praneeth; Samaranayaka, Sanjeev F.; Lakmal, Chamila; Mathotaarachchi, Sashi; Kanishka Lal, Chula; Keppetiyagama, Chathuranga; Samarasekera, Dharmabandhu Nandadeva

    2014-01-01

    Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka. Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman's correlation coefficient and chi-square test were used to identify correlations. Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n = 1408) and flexible sigmoidoscopy (n = 2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology. Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps. PMID:25763316

  1. Low plasma selenium concentration is associated with elevated risk to neoplastic polyps of the colon

    SciTech Connect

    Clark, L.C.; Hixson, L.G.; Sampliner, R.E. ); Combs, G.F. Jr. )

    1991-03-11

    A cross-sectional study was conducted to examine the relationship of selenium (Se) status and polyps incidence in a sequential series of 100 patients undergoing outpatient colonoscopies at the Tucson VA Hospital. Se was measured in plasma samples by electrothermal atomic absorption spectrophotometry with Zeeman background correction using a reduced palladium matrix modified. The activities of the Se-dependent enzyme glutathione peroxidase (SeGSHpx) were measured using H{sub 2}O{sub 2} as substrate in all plasma samples and in colonic mucosal biopsies obtained from some patients. The mean plasma Se concentration of patients without polyps was 134 ng/ml. Mean plasma Se levels of patients with only diminutive or large polyps were 127 ng/ml and 125 ng/ml; while patients with polyps of both sizes had a mean plasma Se level of 121 ng/ml. Patients with no reported history of cancer, neoplastic polyps or prior colonoscopy, showed an inverse association of plasma Se level and risk of benign colonic neoplasms. The age-adjusted odds ratio for neoplastic polyps was 3.8 for patients with plasma Se levels below vs. above the median value. This association was stronger for patients under 68 yrs of age than for older patients. Activities of SeGSHpx in plasma or colonic mucosa were not related to plasma Se level; however, smokers showed greater SeGSHpx activities than non-smokers. This study is the first to detect an association of Se status and risk to neoplastic polyps of the colon.

  2. Computer-aided detection of polyps in CT colonography based on geometric features

    NASA Astrophysics Data System (ADS)

    Yoshida, Hiroyuki; Masutani, Yoshitaka; MacEneaney, Peter; Dachman, Abraham H.

    2001-05-01

    CT colonography is a promising technique with a long-term goal to provide mass screening for colorectal carcinoma. Colorectal screening by CT colonography requires that the examination be cost-effective. The correct interpretation time is excessive for a screening test. Therefore, a computerized detection method capable of indicating regions of suspicion is attractive as a diagnostic aid for radiologists. We have developed a new CAD scheme for automated detection of polyps based on CT colonographic data sets. Our method characterizes polyps by geometric features of volumetric data including the volumetric shape index and curvedness. Polyps were detected by fuzzy clustering in a feature space generated by the feature values and spatial coordinates, followed by a rule-based test in the feature space. In an analysis of 41 patients, 9 of whom had at least one biopsy-proved polyp, our CAD scheme detected 100% of polyps with 2.5 false positives per patient. Our preliminary result indicates that the CAD scheme is potentially useful for highlighting areas of suspicion in the colon and, therefore, facilitates widespread screening by reducing the reading time substantially.

  3. Investigating the Three-dimensional Flow Separation Induced by a Model Vocal Fold Polyp

    PubMed Central

    Stewart, Kelley C.; Erath, Byron D.; Plesniak, Michael W.

    2014-01-01

    The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. Polyps and nodules, which are geometric abnormalities that form on the medial surface of the vocal folds, can disrupt vocal fold dynamics and thus can have devastating consequences on a patient's ability to communicate. Our laboratory has reported particle image velocimetry (PIV) measurements, within an investigation of a model polyp located on the medial surface of an in vitro driven vocal fold model, which show that such a geometric abnormality considerably disrupts the glottal jet behavior. This flow field adjustment is a likely reason for the severe degradation of the vocal quality in patients with polyps. A more complete understanding of the formation and propagation of vortical structures from a geometric protuberance, such as a vocal fold polyp, and the resulting influence on the aerodynamic loadings that drive the vocal fold dynamics, is necessary for advancing the treatment of this pathological condition. The present investigation concerns the three-dimensional flow separation induced by a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, i.e. a model vocal fold polyp, using an oil-film visualization technique. Unsteady, three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements. PMID:24513707

  4. Long-Term Outcome and Surveillance Colonoscopy after Successful Endoscopic Treatment of Large Sessile Colorectal Polyps

    PubMed Central

    Kim, Bun; Choi, A Ra; Park, Soo Jung; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

    2016-01-01

    Purpose Although there is a consensus about the need for surveillance colonoscopy after endoscopic resection, the interval remains controversial for large sessile colorectal polyps. The aim of this study was to evaluate the long-term outcome and the adequate surveillance colonoscopy interval required for sessile and flat colorectal polyps larger than 20 mm. Materials and Methods A total of 204 patients with large sessile and flat polyps who received endoscopic treatment from May 2005 to November 2011 in a tertiary referral center were included. Results The mean age was 65.1 years and 62.7% of the patients were male. The mean follow-up duration was 44.2 months and the median tumor size was 25 mm. One hundred and ten patients (53.9%) received a short interval surveillance colonoscopy (median interval of 6.3 months with range of 1-11 months) and 94 patients (46.1%) received a long interval surveillance colonoscopy (median interval of 13.6 months with range of 12-66 months). There were 14 patients (6.9%) who had local recurrence at the surveillance colonoscopy. Using multivariate regression analysis, a polyp size greater than 40 mm was shown to be independent risk factor for local recurrence. However, piecemeal resection and surveillance colonoscopy interval did not significantly influence local recurrence. Conclusion Endoscopic treatment of large sessile colorectal polyps shows a favorable long-term outcome. Further prospective study is mandatory to define an adequate interval of surveillance colonoscopy. PMID:27401640

  5. Quantitative Diagnosis of Colorectal Polyps by Spectral Domain Optical Coherence Tomography

    PubMed Central

    Wang, Chen; Zhang, Qinqin; Wu, Xiaojing; Tang, Tao; Liu, Hong; Zhu, S. W.; Gao, Bruce Z.; Yuan, X.-C.

    2014-01-01

    The principal aim of this study is to investigate the scattering coefficient of colorectal polyp tissues using an optical coherence tomography (OCT) technique. It combines the existing scattering coefficient model and spectral domain OCT to achieve method of early diagnosis of colorectal polyp in hospitals. Seventeen patients were studied, and a total of 1456 data points were extracted by curve-fitting the OCT signals into a confocal single-backscattering model. The results show that the mean scattering coefficient value for colorectal polyps is 1.91 mm−1 (std: ±0.54 mm−1), which is between the values for normal and malignant tissues. In addition, we studied the difference between adenomatous polyps (n = 15) and inflammatory polyps (n = 2) quantitatively and found that the adenomatous tissues had lower scattering coefficients than the inflammatory ones. The quantitative measurements confirmed that OCT can be used in primary diagnosis to compensate for the deficiencies in methods of pathological diagnosis, with a great potential for early diagnosis of tissues. PMID:24818145

  6. Integrating Online and Offline 3D Deep Learning for Automated Polyp Detection in Colonoscopy Videos.

    PubMed

    Yu, Lequan; Chen, Hao; Dou, Qi; Qin, Jing; Heng, Pheng Ann

    2016-12-07

    Automated polyp detection in colonoscopy videos has been demonstrated to be a promising way for colorectal cancer (CRC) prevention and diagnosis. Traditional manual screening is time-consuming, operator-dependent and error-prone; hence, automated detection approach is highly demanded in clinical practice. However, automated polyp detection is very challenging due to high intra-class variations in polyp size, color, shape and texture and low inter-class variations between polyps and hard mimics. In this paper, we propose a novel offline and online 3D deep learning integration framework by leveraging the 3D fully convolutional network (3D-FCN) to tackle this challenging problem. Compared with previous methods employing hand-crafted features or 2D-CNNs, the 3D-FCN is capable of learning more representative spatio-temporal features from colonoscopy videos, and hence has more powerful discrimination capability. More importantly, we propose a novel online learning scheme to deal with the problem of limited training data by harnessing the specific information of an input video in the learning process. We integrate offline and online learning to effectively reduce the number of false positives generated by the offline network and further improve the detection performance. Extensive experiments on the dataset of MICCAI 2015 Challenge on Polyp Detection demonstrated the better performance of our method when compared with other competitors.

  7. Exploring Metabolic Profile Differences between Colorectal Polyp Patients and Controls Using Seemingly Unrelated Regression.

    PubMed

    Chen, Chen; Deng, Lingli; Wei, Siwei; Nagana Gowda, G A; Gu, Haiwei; Chiorean, Elena G; Abu Zaid, Mohammad; Harrison, Marietta L; Pekny, Joseph F; Loehrer, Patrick J; Zhang, Dabao; Zhang, Min; Raftery, Daniel

    2015-06-05

    Despite the fact that colorectal cancer (CRC) is one of the most prevalent and deadly cancers in the world, the development of improved and robust biomarkers to enable screening, surveillance, and therapy monitoring of CRC continues to be evasive. In particular, patients with colon polyps are at higher risk of developing colon cancer; however, noninvasive methods to identify these patients suffer from poor performance. In consideration of the challenges involved in identifying metabolite biomarkers in individuals with high risk for colon cancer, we have investigated NMR-based metabolite profiling in combination with numerous demographic parameters to investigate the ability of serum metabolites to differentiate polyp patients from healthy subjects. We also investigated the effect of disease risk on different groups of biologically related metabolites. A powerful statistical approach, seemingly unrelated regression (SUR), was used to model the correlated levels of metabolites in the same biological group. The metabolites were found to be significantly affected by demographic covariates such as gender, BMI, BMI(2), and smoking status. After accounting for the effects of the confounding factors, we then investigated potential of metabolites from serum to differentiate patients with polyps and age matched healthy controls. Our results showed that while only valine was slightly associated, individually, with polyp patients, a number of biologically related groups of metabolites were significantly associated with polyps. These results may explain some of the challenges and promise a novel avenue for future metabolite profiling methodologies.

  8. Carcinoma in situ in a 7 mm gallbladder polyp: Time to change current practice?

    PubMed

    Kasle, David; Rahnemai-Azar, Amir A; Bibi, Shahida; Gaduputi, Vinaya; Gilchrist, Brian F; Farkas, Daniel T

    2015-07-25

    Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic and/or greater than 10 mm are generally removed, while smaller, asymptomatic polyps simply monitored. Here, a case of carcinoma-in-situ is presented in a 7 mm gallbladder polyp. A 25-year-old woman, who had undergone a routine cholecystectomy, was found to have an incidental 7 mm polyp containing carcinoma in situ. She had few to no risk factors to alert to her condition. There are few reported cases of cancer transformation in gallbladder polyps smaller than 10 mm reported in the literature. The overwhelming consensus, barring significant risk factors for cancer being present, is that such lesions should be monitored until they become symptomatic or develop signs suspicious for malignancy. In our patient's case this could have led to the possibility of missing a neoplastic lesion, which could then have gone on to develop invasive cancer. As gallbladder carcinoma is an aggressive cancer, this may have led to a tragic outcome.

  9. Sinonasal Angiomatous Polyp: Evaluation With 2-Phase Helical Computed Tomography

    PubMed Central

    Ding, Changwei; Wang, Qiushi; Guo, Qiyong; Wang, Zhenhai; Lu, Xiaomei; Zhang, Jun

    2015-01-01

    Abstract Sinonasal angiomatous polyp (SAP) is a rare benign nontumorous lesion and previously considered lack of characteristic computed tomography (CT) findings. This study aimed to evaluate 2-phase helical CT for characterization of SAP. Twelve patients with pathologically confirmed SAP underwent 2-phase helical CT preoperatively. After injection of 80 mL contrast material at a rate of 3 mL/s, early and delayed phases were obtained with delays of 30 and 120 s, respectively. The degree and pattern of enhancement were visually analyzed. The attenuation changes were also analyzed quantitatively by measuring CT values and compared with those of the internal maxillary artery (IMA). All 12 cases showed vessel-like marked heterogeneous enhancement at both early and delayed phases. An irregular linear, nodular, and patchy enhancement pattern was found at the early phase, and enlarged and fused together, that is, progressive enhancement pattern was found at the delayed phase. There was no significant difference between the CT values of SAP and those of the IMA at the plain, arterial phase, and delayed phase (53 ± 6 Hounsfield units [HU] vs 56 ± 7 HU, 187 ± 56 HU vs 209 ± 71 HU, and 143 ± 22 HU vs 139 ± 19 HU, respectively, P = 0.361, 0.429, and 0.613, respectively). Vessel-like marked heterogeneous enhancement was a characteristic CT feature of SAP, and progressive enhancement on 2-phase helical CT could further convince the diagnosis. PMID:26200632

  10. A rare cause of tonsil mass in a child: Lymphoid polyp

    PubMed Central

    Ji, Hongzhao; Ulualp, Seckin O; Sengupta, Anita

    2017-01-01

    Objective: Solitary mass lesions of the palatine tonsils are rare in children. While a tonsillar mass can be concerning for a neoplasm, benign conditions may present with a mass arising from the surface of the palatine tonsils in children. We describe clinical and histopathological characteristics of a lymphoid polyp in a child with unilateral tonsillar mass. Methods: Retrospective chart review. Results: A 6-year-old girl presented for evaluation of recurrent acute tonsillitis and a mass on the left palatine tonsil. A pedunculated mass with the base attached to the left palatine tonsil was observed. The mass was completely removed by tonsillectomy. The final diagnosis was lymphoid polyp. Conclusion: Pediatricians, otolaryngologists, and pathologists should be aware of the occurrence of tonsillar lymphoid polyp in the pediatric age group. PMID:28228963

  11. A Recently Established Murine Model of Nasal Polyps Demonstrates Activation of B Cells, as Occurs in Human Nasal Polyps.

    PubMed

    Kim, Dong-Young; Lee, Sun Hye; Carter, Roderick G; Kato, Atsushi; Schleimer, Robert P; Cho, Seong H

    2016-08-01

    Animal model systems are invaluable for examining human diseases. Our laboratory recently established a mouse model of nasal polyps (NPs) and investigated similarities and differences between this mouse model and human NPs. We especially focus on the hypothesis that B cell activation occurs during NP generation in the murine model. After induction of ovalbumin-induced allergic rhinosinusitis, 6% ovalbumin and Staphylococcus aureus enterotoxin B (10 ng) were instilled into the nasal cavity of mice three times per week for 8 weeks. The development of structures that somewhat resemble NPs (which we will refer to as NPs) was confirmed by hematoxylin and eosin staining. The mRNA and protein levels of various inflammatory cell markers and mediators were measured by real-time PCR in nasal tissue and by ELISA in nasal lavage fluid (NLF), respectively. Total Ig isotype levels in NLF were also quantitated using the Mouse Ig Isotyping Multiplex kit (EMD Millipore, Billerica, MA) on a Luminex 200 instrument (Life Technologies, Grand Island, NY). Similar to human NPs, there were significant increases in gene expression of inflammatory cell markers, such as CD19, CD138, CD11c, and mast cell protease-6 in nasal tissue samples of the NP group compared with those of the control group. In further investigations of B cell activation, mRNA expressions of B cell activating factor and a proliferation-inducing ligand were found to be significantly increased in mouse NP tissue. B cell-activating factor protein concentration and IgA and IgG1 levels in NLF were significantly higher in the NP group compared with the control group. In this study, the NP mouse model demonstrated enhanced B cell responses, which are reminiscent of B cell responses in human NPs.

  12. Interaction of cigarette smoking and carcinogen-metabolizing polymorphisms in the risk of colorectal polyps

    PubMed Central

    Zheng, Wei

    2013-01-01

    The causal role of cigarette smoking in the risk of colorectal neoplasm has been suggested but not established. In a case–control study including 2060 colorectal polyp patients and 3336 polyp-free controls, we evaluated 21 functional genetic variants to construct a tobacco-carcinogen-metabolizing genetic risk score. Data regarding cigarette smoking were obtained through telephone interviews. Cigarette smoking was associated with an elevated risk of both adenomas and hyperplastic polyps. The association with smoking was stronger in participants with a high carcinogen-metabolizing risk score than those with a low risk score. Smoking 30 or more cigarettes per day was associated with a 1.7-fold elevated risk of any polyps (95% confidence interval = 1.3–2.2) among those with a low genetic risk score and 2.9-fold elevated risk (95% confidence interval = 1.8–4.8) among those with a high genetic risk score (P interaction = 0.025). A similar pattern of interaction was observed in analyses conducted separately for those with adenomas only (P interaction = 0.039) and hyperplastic polyps only (P interaction = 0.024). Interaction between carcinogen-metabolizing genetic risk and cigarette smoking was found in relation to high-risk adenomas (P interaction = 0.010) but not low-risk adenomas (P interaction = 0.791). No apparent interaction was found for duration of smoking. This study shows that the association between cigarette smoking and colorectal polyp risk is modified by tobacco-carcinogen-metabolizing polymorphisms, providing support for a causal role of cigarette smoking in the etiology of colorectal tumors. PMID:23299405

  13. Colorectal polyp type and the association with charred meat consumption, smoking, and microsomal epoxide hydrolase polymorphisms

    PubMed Central

    Burnett-Hartman, Andrea N.; Newcomb, Polly A.; Mandelson, Margaret T.; Adams, Scott V.; Wernli, Karen J.; Shadman, Mazyar; Wurscher, Michelle A.; Makar, Karen W.

    2011-01-01

    Objective We determined the association between charred meat consumption, cigarette smoking, microsomal epoxide hydrolase (mEH) polymorphisms [rs1051740 and rs2234922], and colorectal adenomas and hyperplastic polyps (HPs) and explored gene-environment interactions. Methods Men and women with colorectal adenomas (n=519), HPs (n=691), or concurrently with both types of polyps (n=227) and polyp-free controls (n=772) receiving a colonoscopy from 12/04-9/07 were recruited. Participants completed telephone interviews and provided buccal cell samples; genotyping of mEH was completed using Taqman assays. We conducted polytomous regression and calculated odd ratios (OR) and 95% confidence intervals. Interactions were evaluated using Wald chi-square tests. Results Consumption of >3 servings of charred meat per week was associated with distal HPs (OR=2.0, 1.2–3.4) but not adenomas nor either type of proximal polyp. Heavy cigarette smoking (≥22 pack-years) was associated with an increased risk for colorectal adenomas (OR=1.7, 95% CI 1.2–2.4), HPs (OR=2.4, 95% CI 1.7–3.3), and both types (OR=2.8, 95% CI 1.8–4.3) with the strongest association for distal polyps. There was no association between mEH genotype and colorectal polyps, nor were any statistically significant gene-environment interactions identified. Discussion Future investigation of BaP exposure and colorectal neoplasia should analyze whether associations are dependent upon anatomic location. PMID:21598178

  14. Interaction of cigarette smoking and carcinogen-metabolizing polymorphisms in the risk of colorectal polyps.

    PubMed

    Fu, Zhenming; Shrubsole, Martha J; Li, Guoliang; Smalley, Walter E; Hein, David W; Cai, Qiuyin; Ness, Reid M; Zheng, Wei

    2013-04-01

    The causal role of cigarette smoking in the risk of colorectal neoplasm has been suggested but not established. In a case-control study including 2060 colorectal polyp patients and 3336 polyp-free controls, we evaluated 21 functional genetic variants to construct a tobacco-carcinogen-metabolizing genetic risk score. Data regarding cigarette smoking were obtained through telephone interviews. Cigarette smoking was associated with an elevated risk of both adenomas and hyperplastic polyps. The association with smoking was stronger in participants with a high carcinogen-metabolizing risk score than those with a low risk score. Smoking 30 or more cigarettes per day was associated with a 1.7-fold elevated risk of any polyps (95% confidence interval = 1.3-2.2) among those with a low genetic risk score and 2.9-fold elevated risk (95% confidence interval = 1.8-4.8) among those with a high genetic risk score (P interaction = 0.025). A similar pattern of interaction was observed in analyses conducted separately for those with adenomas only (P interaction = 0.039) and hyperplastic polyps only (P interaction = 0.024). Interaction between carcinogen-metabolizing genetic risk and cigarette smoking was found in relation to high-risk adenomas (P interaction = 0.010) but not low-risk adenomas (P interaction = 0.791). No apparent interaction was found for duration of smoking. This study shows that the association between cigarette smoking and colorectal polyp risk is modified by tobacco-carcinogen-metabolizing polymorphisms, providing support for a causal role of cigarette smoking in the etiology of colorectal tumors.

  15. Case report—malignant transformation in Cronkhite–Canada syndrome polyp

    PubMed Central

    Zong, Ye; Zhao, Haiying; Yu, Li; Ji, Ming; Wu, Yongdong; Zhang, Shutian

    2017-01-01

    Abstract Rationale: Cronkhite–Canada syndrome (CCS) is a rare disease, the etiology of CCS is currently unknown. Although CCS is widely accepted as a benign disorder, the malignant potential of the polyps in CCS patients is yet controversial. Patient concerns: A 55-year-old Chinese male was first admitted to Beijing Friendship Hospital with a 3-month history of frequent watery diarrhea (10–15 times/day), loss of taste, and a weight loss of 10 kg in August 2010. The left heel bone fracture in the patient occurred about 2 weeks prior to his diarrhea. Diagnoses: He was diagnosed as Cronkhite–Canada syndrome. Interventions: Oral administration of prednisone was initiated at a dosage of 20 mg/day. Outcomes: After 3 months of treatment, the clinical manifestations disappeared, and colonoscopy showed sparsely distributed small polyps in the colon. Consequently, the dose of prednisone was reduced to 10mg. However, after 4 months, his fingernails were again found atrophic along with mild abdominal discomfort without diarrhea. Colonoscopy revealed a recurrence of the polyps in March 2011. The treatment was repeated with prednisone at a dosage of 20 mg/day resulting in subsided symptoms. In September 2011, he underwent colonoscopy although no significant clinical manifestations were observed. In addition, the polyp in the sigmoid colon was cancerated. Lessons: The present case indicated that the physical stress was related to CCS and malignant transformation occurred in Cronkhite–Canada syndrome polyp. After the diffused inflammatory polyps have responded to steroid therapy, other existing adenomas require endoscopic treatments, which can decrease the possibility of neoplastic transformation. PMID:28178153

  16. Nuclear accumulation of beta-catenin occurs commonly in the epithelial cells of juvenile polyps.

    PubMed

    Iwamoto, Michiko; Hoffenberg, Edward J; Carethers, John M; Doctolero, Ryan; Tajima, Akihiro; Sugano, Kentaro; Franklin, Wilbur A; Ahnen, Dennis J

    2005-01-01

    In the two conditions juvenile polyps (JPs) and juvenile polyposis coli (JPC), colonic polyps may have overlapping histologic and phenotypic appearance, but JPC confers a significant risk for colon adenocarcinoma. Although not thought to contain adenomatous polyposis coli (APC) mutations, the status of beta-catenin and full-length APC protein expression in JPs is not known. We evaluated beta-catenin and full-length APC protein expression in JPs from children with JPs and JPC. Cases were identified through endoscopic procedure records. Immunohistochemistry was performed for beta-catenin and full-length APC protein. Loss of heterozygosity at the APC gene locus on chromosome 5 was assessed using two APC-linked microsatellite markers. Polyp and normal colonic tissue were analyzed from 36 children with JPs and 9 with JPC. Both APC and beta-catenin immunoreactivity were present in epithelial cells from all samples but in different patterns. In all normal colon and polyp samples, APC expression was cytoplasmic with maximal immunoreactivity in the goblet cells. In contrast, beta-catenin immunoreactivity in epithelial cells was limited to the plasma membrane in normal colon but was both cytoplasmic and nuclear in all 45 JPs. No evidence of APC gene loss of heterozygosity was found. In polyps from children with JPs and JPC, nuclear beta-catenin accumulation is a consistent feature, and it is not due to APC gene mutation or loss of full-length APC protein expression. Thus, beta-catenin accumulation may be intrinsic to the formation of juvenile-type polyps through an as-yet-undefined mechanism.

  17. Role of CD146 Enrichment in Purification of Stem Cells Derived from Dental Pulp Polyp

    PubMed Central

    Tavangar, Maryam Sadat; Hosseini, Seyed-Mojtaba; Dehghani-Nazhvani, Ali; Monabati, Ahmad

    2017-01-01

    Introduction: Hyperplastic pulpitis (pulp polyp) tissues contains cells with stem cell properties similar to that of the dental pulp stem cells (DPSCs). It has also been shown that CD146 enrichment can homogenize the cultures of DPSCs and enhance the colony forming potentials of their cultures. This study determines whether CD146 enrichment can help purifying the stem cells from heterogeneous cultures of the pulp polyp derived stem cells (PPSCs). Methods and Materials: Healthy dental pulps and pulp polyp tissues were enzymatically digested and the harvested single cells were sorted according to the presence of CD146 marker. The sorted cells were seeded directly for colony forming unit (CFU) assays of the negative and positive portions. Flowcytometric antigen panel and differentiation assays were used to see if these cells conform with mesenchymal stems cells (MSCs) definition. Differences between the between groups was assessed using independent t-test. The level of significance was set at 0.05. Results: Normal pulp tissue derived cells formed higher colonies (42.5±16.8 per 104 cells) than the pulp polyp (17.75±8.9 per 104 cells) (P=0.015). The CD146 positive portion of the polyp derived cells formed an average of 91.5±29.7 per 104 cells per CFU. On the other hand, CD146 negative portion did not show any colonies (P<0.001). Both resources showed cells with flowcytometric antigen panel and differentiation potentials conforming to MSC definition. Conclusion: The entire CFU of PPSCs were formed within CD146 enriched portion. It seems that CD146 enrichment may reduce the number of possible fibroblasts of the pulp polyps and may further homogenize the culture of the PPSCs. PMID:28179933

  18. UTERINE ADENOMYOSIS AND AN ENDOMETRIAL POLYP IN A ROCK HYRAX (PROCAVIA CAPENSIS).

    PubMed

    Holman, Holly J; Gailbreath, Katherine

    2016-12-01

    An 8-yr-old nulliparous, female rock hyrax ( Procavia capensis ) had intermittent mucoid to bloody discharge late winter-early spring for two consecutive years. Fragments of necrotic tissue, suspected to be vaginal or rectal in origin, were passed on two occasions. Physical examination, radiographs, and ultrasound did not identify the source of the tissue. Exploratory laparotomy and ovariohysterectomy were performed. On histopathology, a diagnosis of adenomyosis with a uterine polyp was made. Postsurgical complications included incisional infection and renal compromise that were medically managed and resolved. No further vaginal discharge was observed. This is the first report of uterine adenomyosis and endometrial polyp in a rock hyrax.

  19. Inflammatory Fibroid Polyp of the Stomach Mimics Malignancy on 18F FDG PET/CT Imaging.

    PubMed

    Bilgin, Sabriye Sennur; Bilgin, Mehmet; Savas, Recep; Erdogan, Ezgi Basak

    2016-09-01

    Inflammatory fibroid polyps (IFPs) are rare non-neoplastic and proliferating submucosal lesions of the gastrointestinal tract. The classic IFP, which was first described by Vanek, consists of prominent blood vessels and is characterized by a heavy inflammatory infiltrate, which is rich in eosinophilic granulocytes. The clinical presentation depends on the size and location. Inflammatory fibroid polyps cannot be differentiated from malignancy without histological examination. We report a case of IFP in the stomach that mimicked a primary gastric malignancy showing an increased F-FDG uptake.

  20. Should prophylactic measures to prevent postpolypectomy bleeding after resection of large colorectal polyps be used?

    PubMed

    Gómez, Estanislao J; Izcovich, Ariel

    2016-08-03

    Post-polypectomy bleeding after colonoscopy with resection of large colorectal polyps can cause significant morbidity (readmission for monitoring, transfusion, repeat endoscopy and therapy) and a significant cost to hospitals and insurers. Nevertheless prophylactic endoscopic measures could reduce risk of post-polypectomy bleeding. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 10 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded prophylactic endoscopic measures could be effective in reducing post-polypectomy bleeding after resection of large colorectal polyps.

  1. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection

    PubMed Central

    Saiki, Hirotsugu; Nishida, Tsutomu; Yamamoto, Masashi; Hayashi, Shiro; Shimakoshi, Hiromi; Shimoda, Akiyoshi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Sugimoto, Aya; Takahashi, Kei; Mukai, Kaori; Matsubara, Tokuhiro; Nakajima, Sachiko; Fukui, Koji; Inada, Masami; Yamamoto, Katsumi; Tokuda, Ryozo; Adachi, Shiro

    2016-01-01

    Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) have a different potential than traditional adenomatous polyps for developing into malignant colorectal cancer. However, little is known about the coexistent cancer rate. Here, we evaluate the frequency of carcinoma in serrated polyps removed by endoscopic resection (ER). Patients and methods: This was a retrospective single-center cohort study of consecutive patients with colorectal polyps who underwent ER from March 2003 to October 2014. We determined the frequency of serrated polyps among all resected colorectal polyps and analyzed the clinicopathological findings as well as the frequency and characteristics of coexistent carcinoma in the serrated polyps resected by ER based on pathology reports. Results: A total of 21,048 polyps from 15,326 patients were identified, including 15,984 traditional adenomatous polyps (75.9 %), 621 SSA/Ps (3.0 %), 136 traditional serrated adenomas (TSAs) (0.6 %), 1,121 hyperplastic polyps (5.3 %), and 3,186 polyps of other types (15.1 %). The clinical and endoscopic findings of SSA/Ps revealed a male predominance (68.6 %), with 61.7 % of the polyps located in the proximal colon. Males accounted for 77.2 % of all patients with TSAs, and 77.2 % of these polyps were located in the distal colon. The mean sizes of the SSA/Ps and TSAs were 8.8 and 10.7 mm, respectively. Among the SSA/Ps, 8 (1.3 %) cases had coexistent carcinoma, and 1 (0.7 %) patient with TSA showed coexistent carcinoma. In the patients with SSA/Ps, female sex and a tumor size ≥ 10 mm were predictive factors for coexistent carcinoma. Conclusions: The frequency of SSA/Ps with carcinoma was lower than that for traditional adenoma. Female sex and tumor size ≥ 10 mm were significant predictive factors for coexistent carcinoma. PMID:27092327

  2. Prophylactic vaccination targeting ERBB3 decreases polyp burden in a mouse model of human colorectal cancer

    PubMed Central

    Bautz, David J.; Sherpa, Ang T.

    2017-01-01

    ABSTRACT Prophylactic vaccination is typically utilized for the prevention of communicable diseases such as measles and influenza but, with the exception of vaccines to prevent cervical cancer, is not widely used as a means of preventing or reducing the incidence of cancer. Here, we utilize a peptide-based immunotherapeutic approach targeting ERBB3, a pseudo-kinase member of the EGFR/ERBB family of receptor tyrosine kinases, as a means of preventing occurrence of colon polyps. Administration of the peptide resulted in a significant decrease in the development of intestinal polyps in C57BL/6J-ApcMin mice, a model of familial adenomatous polyposis (FAP). In addition, even though they were not vaccinated, ApcMin offspring born to vaccinated females developed significantly fewer polyps than offspring born to control females. Lastly, to validate ERBB as a valid target for vaccination, we found no overt toxicity, increases in apoptosis, or morphological changes in tissues where Erbb3 was ablated in adult mice. These results indicate that prophylactic vaccination targeting ERBB3 could prevent the development of colon polyps in an at-risk patient population. PMID:28197371

  3. Factors Associated with Colorectal Cancer Risk Perception: The Role of Polyps and Family History

    ERIC Educational Resources Information Center

    Stark, Jennifer Rider; Bertone-Johnson, Elizabeth R.; Costanza, Mary E.; Stoddard, Anne M.

    2006-01-01

    It is unclear how objective risk factors influence the factors associated with colorectal cancer (CRC) risk perception. The goals of this study were to investigate factors associated with perceived risk of CRC and to explore how these relationships were modified by personal history of polyps or family history of CRC. The study involved a mailed…

  4. A 3D endoscopy reconstruction as a saliency map for analysis of polyp shapes

    NASA Astrophysics Data System (ADS)

    Ruano, Josue; Martínez, Fabio; Gómez, Martín.; Romero, Eduardo

    2015-01-01

    A first diagnosis of colorectal cancer is performed by examination of polyp shape and appearance during an endoscopy routine procedure. However, the video-endoscopy is highly noisy because exacerbated physiological conditions like increased motility or secretion may limit the visual analysis of lesions. In this work a 3D reconstruction of the digestive tract is proposed, facilitating the polyp shape evaluation by highlighting its surface geometry and allowing an analysis from different perspectives. The method starts by a spatio-temporal map, constructed to group the different regions of the tract by their similar dynamic patterns during the sequence. Then, such map was convolved with a second derivative of a Gaussian kernel that emulates the camera distortion and allows to highlight the polyp surface. The position initialization in each frame of the kernel was computed from expert manual delineation and propagated along the sequence based on. Results show reliable reconstructions, with a salient 3D polyp structure that can then be better observed.

  5. Colon polyp model use for educating about colorectal cancer screening in the Iowa Research Network.

    PubMed

    Daly, Jeanette M; Xu, Yinghui; Levy, Barcey T

    2014-06-01

    Providing a model of a colon segment with an adenomatous polyp and cancer can help to educate patients about the adenoma to carcinoma sequence and how this sequence can be interrupted with appropriate testing. The purpose of this study was to assess the use of a three-dimensional colon model with polyps and cancer provided to family physicians or nurses in some Iowa Research Network family physician offices. Colon models were provided to 117 family medicine healthcare providers interested in colorectal cancer screening. Using a mailed survey and follow-up telephone calls to non-responders, 81 (69%) questionnaires were returned. Thirty-six (44%) of the respondents reported they had used the model, 33 (41%) reported they used the model for a mean 16% of their patients in a month's time, 31 (38%) reported using the model to teach patients about the colon and polyps prior to a colonoscopy. Other model use described by respondents included educating staff to promote patient willingness for colonoscopies, demonstrating the need for colon cancer screening, and teaching patients about annual fecal occult blood tests. Respondents agreed that anatomical models are helpful for patient education, the design of the colon model was good, and that it facilitated demonstration of colon polyps. Possible recommendations for an office-wide adoption of an anatomical model would be an in-service for all employees and a standard location for finding the model.

  6. Thermal and Osmotic Tolerance of ‘Irukandji’ Polyps: Cubozoa; Carukia barnesi

    PubMed Central

    Courtney, Robert; Browning, Sally; Northfield, Tobin; Seymour, Jamie

    2016-01-01

    This research explores the thermal and osmotic tolerance of the polyp stage of the Irukandji jellyfish Carukia barnesi, which provides new insights into potential polyp habitat suitability. The research also targets temperature, salinity, feeding frequency, and combinations thereof, as cues for synchronous medusae production. Primary findings revealed 100% survivorship in osmotic treatments between 19 and 46‰, with the highest proliferation at 26‰. As salinity levels of 26‰ do not occur within the waters of the Great Barrier Reef or Coral Sea, we conclude that the polyp stage of C. barnesi is probably found in estuarine environments, where these lower salinity conditions commonly occur, in comparison to the medusa stage, which is oceanic. Population stability was achieved at temperatures between 18 and 31°C, with an optimum temperature of 22.9°C. We surmise that C. barnesi polyps may be restricted to warmer estuarine areas where water temperatures do not drop below 18°C. Asexual reproduction was also positively correlated with feeding frequency. Temperature, salinity, feeding frequency, and combinations thereof did not induce medusae production, suggesting that this species may use a different cue, possibly photoperiod, to initiate medusae production. PMID:27441693

  7. Incidence and review of sessile serrated polyp reporting in a district general hospital in the UK.

    PubMed

    Dada, Mahomed; Wang, Lai Mun; Chetty, Runjan

    2013-11-01

    The aim of this 4-year audit was to establish whether sessile serrated polyps/adenomas (SSP/A) were diagnosed in a district general hospital in the UK. The study also explored whether SSP/A in the right colon were misdiagnosed as hyperplastic polyps. A retrospective search of the computer records from 2009 to 2012 inclusive for all lesions diagnosed and coded as SSP/A and/or hyperplastic polyps proximal to the splenic flexure was undertaken. All slides were reviewed and a diagnosis of SSP/A made using the criteria recently suggested by the American College of Gastroenterology. Over the study period, no cases of SSP/A were made. On review of all hyperplastic polyps proximal to the splenic flexure, 13/31 in 2009, 17/40 in 2010, 19/48 in 2011 and 16/48 in 2012 were re-classified as SSP/A. The most likely reason for the under-diagnosis of SSP/A is lack of awareness of the lesion both clinically and by pathologists. Adequate biopsies and deeper sections are important to help make the diagnosis of SSP/A. This study shows that SSP/A are reasonably frequently encountered in non-specialist practice settings and that both clinicians and pathologist in this setting need to be aware of its existence.

  8. Paraneoplastic leukocytosis associated with a rectal adenomatous polyp in a dog.

    PubMed

    Thompson, J P; Christopher, M M; Ellison, G W; Homer, B L; Buchanan, B A

    1992-09-01

    A dog with a rectal adenomatous polyp had extreme neutrophilic leukocytosis, monocytosis, and eosinophilia consistent with a paraneoplastic syndrome. Resolution of the leukogram abnormalities after tumor excision supported this belief. Except for a lack of circulating myeloblasts, the dog had leukogram findings consistent with a neutrophilic leukemoid reaction.

  9. Sessile serrated adenoma/polyps: Where are we at in 2016?

    PubMed Central

    Singh, Rajvinder; Zorrón Cheng Tao Pu, Leonardo; Koay, Doreen; Burt, Alastair

    2016-01-01

    It is currently known that colorectal cancers (CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway (50%-70%); the mutator “Lynch syndrome” route (3%-5%); and the serrated pathway (30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA), the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders, submucosal injection of a dye solution (for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions. PMID:27678358

  10. Colon Capsule Endoscopy for the Detection of Colorectal Polyps: An Evidence-Based Analysis

    PubMed Central

    2015-01-01

    Background Colorectal cancer, a leading cause of mortality and morbidity in Ontario, can be prevented through early diagnosis and removal of precancerous polyps. Colon capsule endoscopy is a relatively new, minimally invasive test for detecting colorectal polyps. Objective The objectives of this analysis were to evaluate the diagnostic accuracy and safety of colon capsule endoscopy for the detection of colorectal polyps among adult patients with signs or symptoms of colorectal cancer or with increased risk of colorectal cancer, and to compare colon capsule endoscopy with alternative procedures. Review Methods A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid EMBASE, the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published between 2006 and 2014. Data on diagnostic accuracy and safety were abstracted from included studies. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results The search yielded 2,189 citations. Five studies, all of which evaluated PillCam COLON 2 (PCC2), met the inclusion criteria. The per-patient sensitivity and specificity for detecting colorectal polyps were meta-analyzed. Colon capsule endoscopy, using PCC2, had a pooled sensitivity and specificity of 87% (95% confidence interval [CI] 77%–93%) and 76% (95% CI 60%–87%), respectively, for the detection of a colorectal polyp at least 6 mm in size (GRADE: very low). PCC2 had a pooled sensitivity and specificity of 89% (95% CI 77%–95%) and 91% (95% CI 86%–95%), respectively, for the detection of a colorectal polyp at least 10 mm in size (GRADE: low). One study directly compared PCC2 with computed tomographic (CT) colonography and found no statistically significant difference in accuracy (GRADE: low). Few adverse events were reported with PCC2; 3.9% of patients (95% CI 2.4%–6.5%) experienced adverse effects

  11. Investigation of the Roles of Cyclooxygenase-2 and Galectin-3 Expression in the Pathogenesis of Premenopausal Endometrial Polyps

    PubMed Central

    Kasap, Esin; Karaarslan, Serap; Gur, Esra Bahar; Genc, Mine; Sahin, Nur; Güclü, Serkan

    2016-01-01

    Background: The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2) during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium. Methods Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry. Results: The percentage of COX-2–positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase. Conclusions: Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3. PMID:27086598

  12. Cold snare polypectomy for non-pedunculated colon polyps greater than 1 cm

    PubMed Central

    Piraka, Cyrus; Saeed, Ahmed; Waljee, Akbar K.; Pillai, Ajish; Stidham, Ryan; Elmunzer, B. Joseph

    2017-01-01

    Background and study aims Colonic polyps > 1 cm in size are commonly managed using hot polypectomy techniques. The most frequent adverse events (delayed bleeding, post-polypectomy syndrome, and perforation) are related to electrocautery-induced injury. We hypothesized that cold resection of large polyps may have similar efficacy and improved safety compared to hot polypectomy. Our aims were to evaluate efficacy and safety of piecemeal cold snare resection of colonic polyps > 1 cm. Patients and methods Patients undergoing lift and piecemeal cold snare polypectomy of non-pedunculated colon polyps > 1 cm from October 2013 to September 2015 were identified retrospectively. Efficacy was defined by the absence of residual adenomatous tissue at endoscopic follow-up. Adverse events (AEs), including post-procedural bleeding, bowel perforation, or post-procedural pain requiring hospitalization were assessed by chart review and telephone follow-up.  Results Seventy-three patients underwent piecemeal cold snare polypectomy for 94 colon polyps > 1 cm with 56 of 73 patients completing follow-up on 72 polyps. Residual or recurrent adenoma was found in 7 cases (9.7 %). Median polyp size was significantly greater in those with residual/recurrent adenoma (37.1 vs. 19.1 mm, P < .0001). There were no AEs among all 73 patients enrolled. Conclusions Piecemeal cold snare resection of colon polyps > 1 cm is feasible, safe and efficacious when compared to published hot polypectomy data. Additional observational and randomized comparative effectiveness studies are necessary to demonstrate comparable adenoma eradication and improved safety advantage over existing hot snare polypectomy techniques. PMID:28331902

  13. Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease

    PubMed Central

    Chun, Eun Mi; Kim, Seo Woo; Lim, So Yeon

    2015-01-01

    Background Colorectal adenomatous polyps are precancerous lesions of colorectal cancer. The aim of this study was to assess the prevalence of colorectal adenomatous polyps in chronic obstructive pulmonary disease (COPD) patients and determine whether COPD is associated with colorectal malignant potential. Methods Subjects who had undergone post-bronchodilator spirometry and colonoscopy and were 40 years or older were selected from the hospital database. COPD was defined as a spirometry in which the ratio of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) is <0.7 in post-bronchodilator spirometry. The non-COPD group was matched for both age and sex, and were defined as having an FEV1, FVC, and FEV1/FVC ≥0.7 in spirometry. Finally, 333 patients were retrospectively reviewed; of this group, 82 patients had COPD. Results Among the subjects, 201 patients (60%) were nonsmokers, while 78 (23%) were current smokers. The prevalence of colorectal adenomatous polyps was 39% (98/251) in the non-COPD group and 66% (54/82) in the COPD group. Among 54 patients with adenomatous polyps in the COPD group, 47 had tubular adenoma and seven had villous adenoma. Multiple logistic regression analyses revealed that only COPD patients whom matched to the criteria of COPD by pulmonary function test (odds ratio 2.1, 95% confidence interval: 1.1–3.8; P=0.019) were independently associated with colorectal malignant potential. Conclusion The risk of colorectal malignant potential in the COPD group was higher than in the non-COPD group. We may suggest that COPD patients should consider regular colonoscopic evaluation to screen for premalignant colon polyps regardless of smoking. PMID:26028968

  14. Cold snare polypectomy for non-pedunculated colon polyps greater than 1 cm.

    PubMed

    Piraka, Cyrus; Saeed, Ahmed; Waljee, Akbar K; Pillai, Ajish; Stidham, Ryan; Elmunzer, B Joseph

    2017-03-01

    Background and study aims Colonic polyps > 1 cm in size are commonly managed using hot polypectomy techniques. The most frequent adverse events (delayed bleeding, post-polypectomy syndrome, and perforation) are related to electrocautery-induced injury. We hypothesized that cold resection of large polyps may have similar efficacy and improved safety compared to hot polypectomy. Our aims were to evaluate efficacy and safety of piecemeal cold snare resection of colonic polyps > 1 cm. Patients and methods Patients undergoing lift and piecemeal cold snare polypectomy of non-pedunculated colon polyps > 1 cm from October 2013 to September 2015 were identified retrospectively. Efficacy was defined by the absence of residual adenomatous tissue at endoscopic follow-up. Adverse events (AEs), including post-procedural bleeding, bowel perforation, or post-procedural pain requiring hospitalization were assessed by chart review and telephone follow-up.  Results Seventy-three patients underwent piecemeal cold snare polypectomy for 94 colon polyps > 1 cm with 56 of 73 patients completing follow-up on 72 polyps. Residual or recurrent adenoma was found in 7 cases (9.7 %). Median polyp size was significantly greater in those with residual/recurrent adenoma (37.1 vs. 19.1 mm, P < .0001). There were no AEs among all 73 patients enrolled. Conclusions Piecemeal cold snare resection of colon polyps > 1 cm is feasible, safe and efficacious when compared to published hot polypectomy data. Additional observational and randomized comparative effectiveness studies are necessary to demonstrate comparable adenoma eradication and improved safety advantage over existing hot snare polypectomy techniques.

  15. Initial US evaluation of second-generation capsule colonoscopy for detecting colon polyps

    PubMed Central

    Morgan, Douglas R; Malik, Pramod R; Romeo, David P; Rex, Douglas K

    2016-01-01

    Objectives Capsule colonoscopy is an additional screening modality for colorectal cancer. Second-generation capsule colonoscopy (CC2) may have improved efficacy in the detection of colon adenomas as compared with prior devices. The purpose of this study was to evaluate the performance of CC2 in the detection of polyps in symptomatic and screening patients in the USA. Design Prospective, multicentre study. Setting and participants Two academic medical centres and two private practice facilities, evaluating patients with indications for colonoscopy. Methods Patients underwent capsule colonoscopy procedure using magnesium citrate as a boost, followed by colonoscopy on the same day. The main outcome measurement was accuracy of CC2 for the detection of colorectal polyps ≥6 and ≥10 mm as compared with conventional colonoscopy. Results 51 patients were enrolled, 50 of whom had CC2 and colonoscopy examinations and were included in the accuracy analysis. 30% and 14% of patients had polyps ≥6 and ≥10 mm, respectively. For lesions ≥10 mm identified on conventional colonoscopy, CC2 sensitivity was 100% (95% CI 56.1% to 100%) with a specificity of 93.0% (79.9% to 98.2%). For polyps ≥6 mm, the CC2 sensitivity was 93.3% (66.0% to 99.7%) and the specificity was 80.0% (62.5% to 90.9%). There was a 61% adequate cleansing rate with 64% of CC2 procedures being complete. Conclusions In the initial US experience with CC2 there was adequate sensitivity for detecting patients with polyps ≥6 mm in size. Magnesium citrate was inadequate as a boost agent. Trial registration number NCT01087528. PMID:27195129

  16. Inflammatory fibroid polyp: a rare benign tumor of the alimentary tract in children presenting as intussusception-case report and review of literature.

    PubMed

    Siminas, Sotirios; Qasem, Eyas; Shukla, Rajeev; Turnock, Richard

    2014-06-01

    Inflammatory fibroid polyp (IFP) represents a rare cause of gastrointestinal polypoid disease in childhood. Τhe lesion has been described by various names beyond the currently accepted term, including "Vanek's tumour," eosinophilic or submucosal granuloma, gastric fibroma with eosinophilic infiltration, inflammatory pseudotumor, and hemangiopericytoma. The etiopathogenesis and origin of the mesenchymal spindle-shaped cells that comprise the polyp remains enigmatic. Recent studies have shown familial occurrence, expression of platelet-derived growth factor receptor (PDGFRA) and oncogenic PDGFRA mutations in the majority of lesions, suggestive of a neoplastic nature. We present a rare case of a 10-year-old boy with an IFP of the terminal ileum, who presented acutely with intussusception and was treated with a right hemicolectomy. Postoperative course was uneventful and the patient has been asymptomatic during follow-up. Histopathology and immunohistochemical analysis excluded inflammatory myofibroblastic tumor (negative for Alk1, desmin, smooth muscle actin [SMA]), gastrointerstinal stromal tumors (GIST) (negative for CD117) and schwannoma (negative for S100). The lesion was positive for CD34 and faintly for vimentin. Despite the classification of IFPs as a mesenchymal benign neoplasm, in the vast majority of cases, surgical excision alone was curative, and no reports exist of a malignant transformation. A cautious approach with periodic surveillance of the affected children seems reasonable though.

  17. Association of the DNMT3B polymorphism with colorectal adenomatous polyps and adenocarcinoma.

    PubMed

    Guo, Xiaoqing; Zhang, Liwei; Wu, Mingli; Wang, Na; Liu, Yanfeng; Er, Limian; Wang, Shunping; Gao, Yang; Yu, Weifang; Xue, Hui; Xu, Zhibin; Wang, Shijie

    2010-01-01

    DNMT3B is an important enzyme to modulate the methylation status in mammalian cells. The aim of this study is to investigate the correlation of the DNMT3B G39179T polymorphism with the susceptibilities of colorectal adenomatous polyps and adenocarcinoma. This case-control study included 146 colorectal adenomatous polyps, 170 colorectal adenocarcinoma patients, and 157 normal controls. DNMT3B polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism analysis. Family history of colorectal cancer significantly increases the risk of developing colorectal adenomatous polyps and adenocarcinoma. The genotype frequency of DNMT3B polymorphism (T/T and G/T + G/G) in adenocarcinoma patients was significantly different from that in controls (P value = 0.01). Compared with DNMT3B T/T genotype, the G allelotype (G/T + G/G genotype) had lower risk to develop colorectal adenocarcinoma (OR = 0.50, 95% CI = 0.29-0.87); while there was no significant difference between the colorectal adenomatous polyps patients and controls (OR = 0.63, 95% CI = 0.37-1.09), although descending tendency could be found in this polyps group. In the stratification analysis, a significant association was confined to subgroups of age < 55 (OR = 0.31, 95% CI = 0.12-0.84) and males (OR = 0.35, 95% CI = 0.17-0.71). Meanwhile, combined G/T + G/G genotypes were found to have a lower risk in non-drinkers to develop both colorectal adenomatous polyps and adenocarcinoma (OR = 0.54, 95% CI = 0.31-0.96 and OR = 0.48, 95% CI = 0.27-0.84, respectively). This study also showed a distinct difference in the distribution of DNMT3B G39179T SNP in different ethnics. DNMT3B G39179T SNP may be a potential genetic susceptibility factor for adenocarcinoma of the colon, especially in younger Chinese Han non-drinker men.

  18. Induction of segmentation in polyps of Aurelia aurita (Scyphozoa, Cnidaria) into medusae and formation of mirror-image medusa anlagen.

    PubMed

    Kroiher, M; Siefker, B; Berking, S

    2000-08-01

    Polyps of Aurelia aurita can transform into several medusae (jellyfish) in a process of sequential subdivision. During this transformation, two processes take place which are well known to play a key role in the formation of various higher metazoa: segmentation and metamorphosis. In order to compare these processes in bilaterians and cnidarians we studied the control and the kinetics of these processes in Aurelia aurita. Segmentation and metamorphosis visibly start at the polyp's head and proceed down the body column but do not reach the basal disc. The small piece of polyp which remains will develop into a new polyp. The commitment to the medusa stage moves down the body column and precedes the visible onset of segmentation by about one day. Segmentation and metamorphosis can start at the cut surface of transversely cut body columns, leading to a mirror-image pattern of sequentially developing medusae.

  19. In vivo diagnostic accuracy of high resolution microendoscopy in differentiating neoplastic from non-neoplastic colorectal polyps: a prospective study

    PubMed Central

    Parikh, Neil; Perl, Daniel; Lee, Michelle H.; Shah, Brijen; Young, Yuki; Chang, Shannon S.; Shukla, Richa; Polydorides, Alexandros D.; Moshier, Erin; Godbold, James; Zhou, Elinor; Mitchaml, Josephine; Richards-Kortum, Rebecca; Anandasabapathy, Sharmila

    2013-01-01

    High-resolution microendoscopy (HRME) is a low-cost, “optical biopsy” technology that allows for subcellular imaging. The purpose of this study was to determine the in vivo diagnostic accuracy of the HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps and compare it to that of high-definition white-light endoscopy (WLE) with histopathology as the gold standard. Three endoscopists prospectively detected a total of 171 polyps from 94 patients that were then imaged by HRME and classified in real-time as neoplastic (adenomatous, cancer) or non-neoplastic (normal, hyperplastic, inflammatory). HRME had a significantly higher accuracy (94%), specificity (95%), and positive predictive value (87%) for the determination of neoplastic colorectal polyps compared to WLE (65%, 39%, and 55%, respectively). When looking at small colorectal polyps (less than 10 mm), HRME continued to significantly outperform WLE in terms of accuracy (95% vs. 64%), specificity (98% vs. 40%) and positive predictive value (92% vs. 55%). These trends continued when evaluating diminutive polyps (less than 5 mm) as HRME's accuracy (95%), specificity (98%), and positive predictive value (93%) were all significantly greater than their WLE counterparts (62%, 41%, and 53%, respectively). In conclusion, this in vivo study demonstrates that HRME can be a very effective modality in the differentiation of neoplastic and non-neoplastic colorectal polyps. A combination of standard white-light colonoscopy for polyp detection and HRME for polyp classification has the potential to truly allow the endoscopist to selectively determine which lesions can be left in situ, which lesions can simply be discarded, and which lesions need formal histopathologic analysis. PMID:24296752

  20. Breakdown of coral colonial form under reduced pH conditions is initiated in polyps and mediated through apoptosis

    PubMed Central

    Kvitt, Hagit; Kramarsky-Winter, Esti; Maor-Landaw, Keren; Zandbank, Keren; Kushmaro, Ariel; Rosenfeld, Hanna; Fine, Maoz; Tchernov, Dan

    2015-01-01

    Certain stony corals can alternate between a calcifying colonial form and noncalcifying solitary polyps, supporting the hypothesis that corals have survived through geologic timescale periods of unfavorable calcification conditions. However, the mechanisms enabling this biological plasticity are yet to be identified. Here we show that incubation of two coral species (Pocillopora damicornis and Oculina patagonica) under reduced pH conditions (pH 7.2) simulating past ocean acidification induce tissue-specific apoptosis that leads to the dissociation of polyps from coenosarcs. This in turn leads to the breakdown of the coenosarc and, as a consequence, to loss of coloniality. Our data show that apoptosis is initiated in the polyps and that once dissociation between polyp and coenosarc terminates, apoptosis subsides. After reexposure of the resulting solitary polyps to normal pH (pH 8.2), both coral species regenerated coenosarc tissues and resumed calcification. These results indicate that regulation of coloniality is under the control of the polyp, the basic modular unit of the colony. A mechanistic explanation for several key evolutionarily important phenomena that occurred throughout coral evolution is proposed, including mechanisms that permitted species to survive the third tier of mass extinctions. PMID:25646434

  1. Giant colon polyp in a child with suspected inflammatory bowel disease: US findings.

    PubMed

    Vitale, Valerio; Di Serafino, Marco; Mercogliano, Carmela; Vallone, Gianfranco

    2016-03-01

    A 6-year-old boy with a history of diarrhea and rectal bleeding was referred to our department where he underwent ultrasound (US) examination for suspected inflammatory bowel disease. US showed the presence of an echoic oval mass measuring about 30 × 24 mm located at the transition between the transverse and descending colon. It moved with the peristaltic waves and was attached to the intestinal wall through a pedicle. Color Doppler showed intralesional blood flow. On the basis of these findings, the patient was suspected of having a colon polyp. This diagnosis was confirmed at subsequent colonoscopy. The mass was removed using a diathermy snare, and histologic examination revealed hamartomatous polyp measuring 32 mm.

  2. The effect of intranasal beclomethasone dipropionate on the recurrence of nasal polyps after ethmoidectomy.

    PubMed

    Virolainen, E; Puhakka, H

    1980-03-01

    The purpose of this work was to examine in a double blind study the ability of beclomethasone dipropionate to prevent recurrence of nasal polyps in patients in whom radical ethmoidectomy had been performed immediately before. It analyzes the results in terms of the patients subjective symptoms, clinical status and rhinomanometry. After the follow-up period of one year 86% of the patients in the beclomethasone group and 60% in the placebo group had no subjective nasal symptoms. In clinical examination polyps were absent in 54% in the beclomethasone group and in 13% in the placebo group. Rhinomanometrically there was normal nasal patency in 68% in the beclomethasone and in 33% in the placebo group.

  3. FICE vs Narrow Band Imaging for In Vivo Histologic Diagnosis of Polyps

    PubMed Central

    Sahbaz, Nuri Alper; Dural, Ahmet Cem; Unsal, Mustafa Gokhan; Kones, Osman; Kocatas, Ali; Halicioglu, Ilkay; Alis, Halil

    2016-01-01

    Background and Objectives: Gastrointestinal cancers are the most frequently occurring cancers worldwide. Diagnosis and removal of polyps during screening endoscopy decreases the prevalence of colon cancer and cancer-related mortality, and it is considered to be the gold standard in gastrointestinal system cancer prevention. Technological innovations in endoscopy have led to revolutionary developments in many areas. Flexible spectral imaging color enhancement (FICE) and narrow-band imaging (NBI) are forms of digital chromoendoscopy and enhance the endoscopic images without the need for a dye. This study seeks to evaluate the efficacy of FICE and NBI on polyp screening and real-time histologic diagnosis with endoscopy and to compare them. Methods: A total of 134 patients (male/female = 72/62) and 161 polyps were evaluated with FICE or NBI, and real-time histologic diagnosis predictions were classified as neoplastic or nonneoplastic, according to Kudo's pit pattern classification. Pathological results and real-time endoscopic diagnoses were statistically interpreted for both FICE and NBI. Positive predictive value, negative predictive value, sensitivity, specificity, and accuracy rates were calculated and compared for both modalities. Results: When both systems were compared, the negative predictive value of NBI was found to be higher than that of FICE statistically (P < .001). Specificity and positive predictive value in the FICE group were higher than in the NBI group, but the difference was not statistically significant (P = .082 and P = .153, respectively). Conclusions: Aside from being safe in polyp detection, digital chromoendoscopy also helps the endoscopist in selecting the type of simultaneous intervention (eg, polypectomy, endomucosal resection, or submucosal dissection) by enabling endoscopic histologic diagnosis. PMID:28028382

  4. Cultivation of polyps and medusae of Coronatae (Cnidaria, Scyphozoa) with a brief review of important characters

    NASA Astrophysics Data System (ADS)

    Jarms, Gerhard; Morandini, André Carrara; da Silveira, Fábio Lang

    2002-09-01

    This work is a concise guide to the methods, techniques and equipment needed for the collection and transport of specimens, for arranging, maintaining and controlling cultures, for handling polyps, ephyrae, medusae and/or planuloids, and for standardising species description on the basis of life-cycle studies of Scyphozoa Coronatae. Objective characteristics meaningful to systematics are listed and illustrated. Suggestions for important literature sources are given, mainly on the rearing of metagenetic cnidarians in the laboratory.

  5. [Omeprazole: a new treatment for paranasal sinus polyps in Widal syndrome. Preliminary study].

    PubMed

    Serra, J; Piñas, J; Arnaiz, J A; Quesada, P; Naches, S; Lorente, J; Carne, X

    1998-05-01

    A preliminary report is made of the potential therapeutic effect of omeprazol in reducing nasosinusal polyps. This study is based on the empirical observation of nasal airflow improvement in patients suffering from nasosinusal polyposis after administering omeprazol. Different phases of the study suggested that patients with Widal's syndrome benefited the most. Based on the results of this study, we have undertaken a randomized, parallel, double-blind, placebo-controlled clinical trial.

  6. Mixed T Helper Cell Signatures In Chronic Rhinosinusitis with and without Polyps

    PubMed Central

    Derycke, Lara; Eyerich, Stefanie; Van Crombruggen, Koen; Pérez-Novo, Claudina; Holtappels, Gabriele; Deruyck, Natalie; Gevaert, Philippe; Bachert, Claus

    2014-01-01

    In chronic rhinosinusitis (CRS) different phenotypes have been reported based on cytokine profile and inflammatory cell patterns. The aim of this study was to characterize the intracytoplasmatic cytokines ofTcells infiltrating theinflamed sinonasal mucosa. Methods Infiltrated T cells and tissue homogenates from sinonasal mucosal samples of 7 healthy subjects, 9 patients with CRS without nasal polyp (CRSsNP), 15 with CRS with nasal polyps (CRSwNP) and 5cystic fibrosis patients (CF-NP) were analyzed for cytokine expression using flow cytometry and multiplex analysis respectively. Intracytoplasmic cytokinesin T cells were analyzed after stimulation of nasal polyps with Staphylococcus aureus enterotoxin B for 24 hours. Results The number of T cellsper total living cells was significantly higher in patients with CRSwNP vs. CRSsNP and controls. 85% of the CD4+ Tcells showed to be memory T cells. The effector T cells present in all tissues have apredominantTh1 phenotype. Only in CRSwNP, a significantfraction of T cellsproduced the Th2 cytokinesIL-4 and IL-5, while nasal polyps from CF patients were characterized by a higher CD4/CD8 T cell ratio and an increased number of Th17 cells. 24 h stimulation with SEB resulted in a significant induction of CD4+ T cells producing IL-10 (Tr1 cells). Conclusion T cell cytokine patternsin healthy and inflamed sinonasal mucosa revealed that Th2 cells (IL-4 and IL-5 producing cells) are significantly increased in CRSwNP mucosal inflammation. Exposure to SEB stimulates Tr1 cellsthat may contribute to the Th2 bias in CRSwNP. PMID:24911279

  7. Performance of CT Colonography for Detecting Small Diminutive and Flat Polyps

    DTIC Science & Technology

    2010-04-01

    feature than villous histology. The serrated polyp pathway, which is distinct from the classic adenoma- carcinoma sequence, may account for about 15% of...dimensional (2D) evaluation, when oral contrast tagging has been applied, and when automated carbon dioxide delivery is used for colonic distention. When state...ascending colon , which proved to be a tubular adenoma after resection at same-day OC (C). With state-of-the-art CTC technique, the diagnostic

  8. Aural-pharyngeal polyps associated with Cryptosporidium infection in three iguanas (Iguana iguana).

    PubMed

    Uhl, E W; Jacobson, E; Bartick, T E; Micinilio, J; Schimdt, R

    2001-03-01

    Cryptosporidium spp. infection was associated with aural-pharyngeal polyps in three iguanas (Iguana iguana). All iguanas were presented for masses protruding from the ear canal, and the disease was characterized by a chronic clinical course. The masses consisted of nests of cystic glands surrounded by abundant fibrous connective tissue and lined by hyperplastic cuboidal to pseudostratified columnar epithelium that was moderately to heavily colonized by cryptosporidial organisms. Electron microscopy revealed that the majority of organisms were trophozoites.

  9. Common bile duct polyp mimicking choledocholithiasis: a case report with laparoscopic transcystic management.

    PubMed

    Hacking, Craig P; Taylor, Craig J; Nathanson, Leslie K

    2008-06-01

    Although polyps of the extrahepatic biliary system are rare, an awareness of their potential existence is important as they may closely mimic choledocholithiasis clinically and radiologically but require distinct measures for successful management. This report describes the presentation and successful laparoscopic transcystic management of this infrequently encountered condition. It also explores the literature and discovers the numerous potential presenting features of common bile duct calculi and the spectrum of possible management options.

  10. Irsogladine maleate, a gastric mucosal protectant, suppresses intestinal polyp development in Apc-mutant mice

    PubMed Central

    Onuma, Wakana; Tomono, Susumu; Miyamoto, Shinngo; Fujii, Gen; Hamoya, Takahiro; Fujimoto, Kyoko; Miyoshi, Noriyuki; Fukai, Fumio; Wakabayashi, Keiji; Mutoh, Michihiro

    2016-01-01

    This study aimed to identify gastric mucosal protectants that suppress intestinal tumorigenesis in a mouse model. We chose six gastric mucosal protectants (ecabet sodium hydrate, irsogladine maleate, rebamipide, sofalcone, teprenone and troxipide) and examined their effects on the activity of oxidative stress-related transcriptional factors, including AP-1, NF-jB, NRF2, p53 and STAT3, in Caco-2 cells using a luciferase reporter gene assay. Among the six protectants, irsogladine maleate clearly inhibited NF-jB and AP-1 transcriptional activity. Furthermore, the chemopreventive property of irsogladine maleate was examined in a Min mouse model of familial adenomatous polyposis. Treatment with irsogladine maleate at doses of 5 and 50 ppm significantly reduced the number of intestinal polyps to 69% and 66% of the untreated control value, respectively. In these polyps, mRNA levels of the downstream targets of NF-jB, such as IL-1β and IL-6, were decreased by irsogladine maleate treatment. Moreover, the levels of oxidative stress-related markers, reactive carbonyl species, in the livers of Min mice were clearly decreased following the administration of irsogladine maleate. This study demonstrated that irsogladine maleate suppresses intestinal polyp formation in Min mice partly through the NF-jB signaling pathway, thus reducing oxidative stress. PMID:26840084

  11. Giant Endometrial Polyp in a Postmenopausal Woman without Hormone/Drug Use and Vaginal Bleeding

    PubMed Central

    Ünal, Betül; Doğan, Selen; Karaveli, Fatma Şeyda; Şimşek, Tayup; Erdoğan, Gülgün; Candaner, Işıl

    2014-01-01

    The objective of this study is to determine and discuss the causes of a giant endometrial polyp in a postmenopausal woman without hormone/drug use and to submit interesting clinical presentation. Here we report a seventy-year-old female patient who was admitted to our hospital with lower back pain. There were no other complaints from her. Physical examination was normal. For further examination, computed tomography was performed and a heterogeneous mass, with a diameter of 10 × 9 centimeters, was detected in the uterine cavity. Hysterectomy because of suspected endometrial cancer was performed. Histopathological examination showed us a giant endometrial polyp with edematous and focal fibrotic stroma, large thick walled blood vessels between normal sized and cystically dilated endometrial glands. To the best of our knowledge, this is the first report of a giant endometrial polyp which is unrelated to use of drugs such as tamoxifen and raloxifene; however, based on the history of the patient it may be associated with long-term consumption of thyme, which is a kind of phytoestrogen. PMID:25093134

  12. Evaluation of Usefulness of hs-CRP and Ferritin Assays in Patients with Nasal Polyps

    PubMed Central

    Partyka, Robert; Pałac, Jacek; Paluch, Zbigniew; Szyguła-Jurkiewicz, Bożena; Namysłowski, Grzegorz; Misiołek, Maciej; Jałowiecki, Przemysław; Kokocińska, Danuta

    2014-01-01

    Background. Chronic nature of the nasal polyps, tendency to recurrence, and lack of satisfying treatment need the diagnostic's parameters which show early inflammatory state as ferritin and hs-CRP. The Aim of Study. Assessment of hs-CRP and ferritin blood levels in nasal polyps patients in evaluation of treatment efficacy. Methods. All 38 patients were divided into 2 groups. Group I included 19 patients with anti-inflammatory therapy 2 weeks after surgery. Group II included 19 patients without anti-inflammatory therapy 2 weeks after surgery. The levels of hs-CRP and ferritin have been assessed before and 2 and 6 weeks after surgical treatment. Results. Research showed statistically significant difference of ferritin's concentration between examined groups 6 weeks after surgery (P < 0.05) and statistically significant difference of hs-CRP concentration 2 and 6 weeks after surgery (P < 0.05). Conclusion. (1) The analysis of serum ferritin and hs-CRP concentrations can be useful in early postoperative detection of inflammatory state in patients with nasal polyps and for the effectiveness of therapy. (2) Lack of correlation between mean ferritin and hs-CRP serum levels, at each diagnostic and monitoring stage, shows that they are independent and cannot be determined interchangeably. PMID:24737923

  13. Sinonasal Delivery of Resveratrol via Mucoadhesive Nanostructured Microparticles in a Nasal Polyp Mouse Model

    PubMed Central

    Lee, Mingyu; Park, Chun Gwon; Huh, Beom Kang; Kim, Se-Na; Lee, Seung Ho; Khalmuratova, Roza; Park, Jong-Wan; Shin, Hyun-Woo; Choy, Young Bin

    2017-01-01

    Resveratrol (RSV) has been shown to effectively suppress chronic rhinosinusitis with nasal polyps in a mouse model; however, when locally administered to the sinonasal cavity, bolus RSV is limited by low drug bioavailability owing to its low aqueous solubility and relatively rapid clearance from the administration site. To address this limitation, we propose mucoadhesive nanostructured microparticles (PLGA/PEG NM) as a potential carrier for the sinonasal delivery of RSV. In this study, PLGA/PEG NM released RSV in a sustained manner. Owing to the enlarged specific surface area of the nanostructures, PLGA/PEG NM had synergistically enhanced mucoadhesiveness and thus showed improved in vivo retention properties in the sinonasal cavity. Therefore, when tested in a mouse nasal polyp model, PLGA/PEG NM mitigated polyp formation and restored epithelial integrity better than the control treatments. The therapeutic effect was similar at half the dose of PLGA/PEG NM, suggesting improved local bioavailability of RSV in the sinonasal cavity. PMID:28071713

  14. Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

    PubMed Central

    Abu-Elhija, Omar; Yassin, Tarik

    2017-01-01

    Aim. Our study aims to determine possible association between biopsy-proven nonalcoholic steatohepatitis (NASH) and hyperplastic polyps (HP) of the colon. Methods. A retrospective cohort observational study. All subjects underwent screening colonoscopy within two years. Data were extracted from the patient charts including demographic, anthropometric measurement, vital signs, underlying diseases, medical therapy, laboratory data, results of the liver biopsy with degree of fibrosis and necroinflammatory activity, the colonoscopy report, and the pathological report of the extracted polyp. Results. A total of 223 patients were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group matched for age. 14 colonic adenomas (11% of patients) were found in the NASH group compared with 16 adenomas (16% of patients) found in the control group (P = 0.9). 28 HPs were found in the NASH group (22.7%) compared with only 8 HPs in the control group (8%) (P < 0.05). 21 from the 28 (75%) HPs diagnosed in the NASH group were observed in the high degree fibrosis patients (Fibrosis Stages 3 and 4), 6 HPs (21%) were associated with Fibrosis Stages 1 and 2, and single HP (4%) was associated with Fibrosis Stage 0. Conclusions. Our study showed an association between biopsy-proven steatohepatitis and the burden of hyperplastic polyp. The severity of hepatic fibrosis may play important role in the increased occurrence of HPs. PMID:28127545

  15. A Case of a Giant Borderline Phyllodes Tumor Early in Pregnancy Treated with Mastectomy and Immediate Breast Reconstruction.

    PubMed

    Gentile, Lori F; Gaillard, William Foster; Wallace, Jodi-Ann; Spiguel, Lisa R P; Alizadeh, Layla; Lentz, Ashley; Shaw, Christiana

    2016-11-01

    Breast tumors in pregnancy are often times diagnosed at advanced stages secondary to difficulty distinguishing between pathologic from normal physiologic changes. Often benign, phyllodes tumors are rare fibroepithelial stromal tumors of the breast, most commonly diagnosed in the 4th and 5th decades of life. However, these tumors may be characterized by malignancy with metastases in 10% of cases. In this paper, we report a novel case of a young woman presenting at 8 weeks gestation with a large borderline phyllodes tumor. An exceedingly rare condition, with only nine previously reported cases, phyllodes tumors in pregnancy frequently display more aggressive characteristics with larger median tumor size, more malignant potential, and more rapid growth rate. Here, we describe our experience safely and effectively treating this rare condition in a young gravid women with mastectomy and immediate breast reconstruction in the second trimester.

  16. Enhanced release of IgE-dependent early phase mediators from nasal polyp tissue

    PubMed Central

    Patou, Joke; Holtappels, Gabriele; Affleck, Karen; Gevaert, Philippe; Perez-Novo, Claudina; Van Cauwenberge, Paul; Bachert, Claus

    2009-01-01

    Background The mast cell is a crucial effector cell in allergic rhinitis and other inflammatory diseases. During the acute allergic reaction preformed mediators such as histamine, but also de novo produced mediators such as leukotrienes (LTC4/D4/E4) and prostaglandins (PGD2) are released. Mast cells represent targets for therapeutic intervention, and thus a human ex-vivo model to stimulate mast cells taken from mucosal sites would be instrumental for drug intervention studies. We have aimed to activate mast cells within ex-vivo human nasal tissue by IgE/anti-IgE specific (ε chain specific) stimulations and in this respect to test the usability of nasal polyps versus inferior turbinates Methods Biopsy samples were collected from patients with nasal polyps and inferior turbinates from patients who underwent sinus or septal surgery. Tissue fragments were primed with IgE 1 μg/ml for 60 minutes and then stimulated for 30 minutes with tissue culture medium (negative control), anti-IgE 10 μg/ml, anti-IgE 30 μg/ml and ionomycin 10 μM (positive control). Histamine, leukotrienes and PGD2 were measured in supernatants. To help provide an understanding of the extent of the response, the number of tryptase and FcεRIα positive cells was evaluated by means of immunohistochemistry and the FcεRIα-chain was measured by means of quantitative PCR in the nasal polyp and inferior turbinate tissues. Finally, the correlation between IgE concentrations in the nasal tissue and the release of mediators was analysed. Results Stimulations with anti-IgE on IgE-primed nasal tissue fragments lead to a concentration-dependent release of histamine, leukotrienes and PGD2. The release of these early phase mediators was significantly higher in nasal polyps compared to inferior turbinates, although tryptase, FcεRIα positive cells and FcεRIα-chain transcripts were equally present in both groups. No correlation was found between baseline concentrations of IgE, and the release of histamine

  17. Comparison of the diagnostic ability of blue laser imaging magnification versus pit pattern analysis for colorectal polyps

    PubMed Central

    Nakano, Arihiro; Hirooka, Yoshiki; Yamamura, Takeshi; Watanabe, Osamu; Nakamura, Masanao; Funasaka, Kohei; Ohno, Eizaburo; Kawashima, Hiroki; Miyahara, Ryoji; Goto, Hidemi

    2017-01-01

    Background and study aims There have been few evaluations of the diagnostic ability of new narrow band light observation blue laser imaging (BLI). The present prospective study compared the diagnostic ability of BLI magnification and pit pattern analysis for colorectal polyps. Patients and methods We collected lesions prospectively, and the analysis of images was made by two endoscopists, retrospectively. A total of 799 colorectal polyps were examined by BLI magnification and pit pattern analysis at Nagoya University Hospital. The Hiroshima narrow-band imaging classification was used for BLI. Differentiation of neoplastic from non-neoplastic lesions and diagnosis of deeply invasive submucosal cancer (dSM) were compared between BLI magnification and pit pattern analysis. Type C2 in the Hiroshima classification was evaluated separately, because application of this category as an index of the depth of cancer invasion was considered difficult. Results We analyzed 748 colorectal polyps, excluding 51 polyps that were inflammatory polyps, sessile serrated adenoma/polyps, serrated adenomas, advanced colorectal cancers, or other lesions. The accuracy of differential diagnosis between neoplastic and non-neoplastic lesions was 98.4 % using BLI magnification and 98.7 % with pit pattern analysis. In addition, the diagnostic accuracy of BLI magnification and pit pattern analysis for dSM for cancer was 89.5 % and 92.1 %, respectively. When type C2 lesions were excluded, the diagnostic accuracy of BLI for dSM was 95.9 %. The 18 type C2 lesions comprised 1 adenoma, 9 intramucosal or slightly invasive submucosal cancers, and 8 dSM. Pit pattern analysis allowed accurate diagnosis of the depth of invasion in 13 lesions (72.2 %). Conclusions Most colorectal polyps could be diagnosed accurately by BLI magnification without pit pattern analysis, but we should add pit pattern analysis for type C2 lesions in the Hiroshima classification. PMID:28367494

  18. Race, Ethnicity, and Sex Affect Risk for Polyps Greater than 9 mm in Average-risk Individuals

    PubMed Central

    Lieberman, David A.; Williams, J. Lucas; Holub, Jennifer L.; Morris, Cynthia D.; Logan, Judith R.; Eisen, Glenn M.; Carney, Patricia

    2014-01-01

    Background & Aims Colorectal cancer risk differs based on patient demographics. We aimed to measure the prevalence of significant colorectal polyps in average-risk individuals and to determine differences based on age, sex, race, or ethnicity. Methods In a prospective study, colonoscopy data were collected, using an endoscopic report generator, from 327,785 average-risk adults who underwent colorectal cancer screening at 84 gastrointestinal practice sites from 2000 to 2011. Demographic characteristics included age, sex, race, and ethnicity. The primary outcome was the presence of suspected malignancy or large polyp(s) >9 mm. The benchmark risk for age to initiate screening was based on white men, 50–54 years old. Results Risk of large polyps and tumors increased progressively in men and women with age. Women had lower risks than men in every age group, regardless of race. Blacks had higher risk than whites from ages 50 through 65 years and Hispanics had lower risk than whites from ages 50 through 80 years. The prevalence of large polyps was 6.2% in white men 50–54 years old. The risk was similar among the groups of white women 65–69 years old, Black women 55–59 years old, Black men 50–54 years old, Hispanic women 70–74 years old, and Hispanic men 55–59 years old. The risk of proximal large polyps increased with age, female sex, and Black race. Conclusions There are differences in the prevalence and location of large polyp and tumors in average-risk individuals based on age, sex, race, and ethnicity. These findings could be used to select ages at which specific groups should begin colorectal cancer screening. PMID:24786894

  19. Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

    PubMed Central

    Komeda, Yoriaki; Kashida, Hiroshi; Sakurai, Toshiharu; Tribonias, George; Okamoto, Kazuki; Kono, Masashi; Yamada, Mitsunari; Adachi, Teppei; Mine, Hiromasa; Nagai, Tomoyuki; Asakuma, Yutaka; Hagiwara, Satoru; Matsui, Shigenaga; Watanabe, Tomohiro; Kitano, Masayuki; Chikugo, Takaaki; Chiba, Yasutaka; Kudo, Masatoshi

    2017-01-01

    AIM To compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps. METHODS This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn’t routinely performed. RESULTS Two hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2). CONCLUSION CSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required. PMID:28127206

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

    PubMed Central

    2010-01-01

    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

  1. A multi-mineral natural product from red marine algae reduces colon polyp formation in C57BL/6 mice

    PubMed Central

    Aslam, Muhammad N.; Bergin, Ingrid; Naik, Madhav; Paruchuri, Tejaswi; Hampton, Anna; Rehman, Muneeb; Dame, Michael K; Rush, Howard; Varani, James

    2013-01-01

    The goal of this study was to determine if a multi-mineral natural product derived from red marine algae, could reduce colon polyp formation in mice on a high fat diet. C57BL/6 mice were maintained for up to 18 months either on a high-fat “Western-style” diet or on a low-fat diet (AIN 76A), with or without the multi-mineral-supplement. To summarize, colon polyps were detected in 22 of 70 mice (31%) on the high-fat diet, but in only 2 of 70 mice (3%) receiving the mineral-supplemented high-fat diet (p<0.0001). Colon polyps were detected in 16 of 70 mice (23%) in the low-fat group; not significantly different from high-fat group but significantly higher than the high-fat-supplemented group (p=0.0006). This was in spite of the fact that the calcium level in the low-fat diet was comparable to the level of calcium in the high-fat diet containing the multi-mineral-product. Supplementation of the low-fat diet reduced the incidence to 8 of 70 mice (11% incidence). Taken together, these findings demonstrate that a multi-mineral natural product can protect mice on a high-fat diet against adenomatous polyp formation in the colon. These data suggest that increased calcium alone is insufficient to explain the lower incidence of colon polyps. PMID:23035966

  2. Association of meat intake and meat-derived mutagen exposure with the risk of colorectal polyps by histologic type.

    PubMed

    Fu, Zhenming; Shrubsole, Martha J; Smalley, Walter E; Wu, Huiyun; Chen, Zhi; Shyr, Yu; Ness, Reid M; Zheng, Wei

    2011-10-01

    The association of meat intake and meat-derived mutagens with colorectal tumor risk remains unclear. We evaluated this hypothesis in a large colonoscopy-based case-control study. Included in the study were 2,543 patients with polyp [(1,881 with adenomas and 622 with hyperplastic polyp (HPP)] and 3,764 polyp-free controls. Surveys obtained information about meat intake by cooking methods and doneness levels plus other suspected or known risk factors for colorectal tumors. Unconditional logistic regression was used to derive ORs after adjusting for potential confounders. High intake of red meat and processed meat (P(trend) < 0.05), particularly red meat cooked using high-temperature cooking methods (P(trend) ≤ 0.01), was associated with an elevated risk for colorectal polyps. A significant positive association between exposures to meat-derived heterocyclic amines (HCA) and risk of polyps was found for both adenomas and HPPs. Furthermore, the positive association with red meat intake and HCA exposure was stronger for multiple adenomas than for single adenoma as well as for serrated than for nonserrated adenomas. This study supports a role for red meat and meat-derived mutagen exposure in the development of colorectal tumor.

  3. Polyp detection rates using magnification with narrow band imaging and white light

    PubMed Central

    Gilani, Nooman; Stipho, Sally; Panetta, James D; Petre, Sorin; Young, Michele A; Ramirez, Francisco C

    2015-01-01

    AIM: To compare the yield of adenomas between narrow band imaging and white light when using high definition/magnification. METHODS: This prospective, non-randomized comparative study was performed at the endoscopy unit of veteran affairs medical center in Phoenix, Arizona. Consecutive patients undergoing first average risk colorectal cancer screening colonoscopy were selected. Two experienced gastroenterologists performed all the procedures that were blinded to each other’s findings. Demographic details were recorded. Data are presented as mean ± SEM. Proportional data were compared using the χ2 test and means were compared using the Student’s t test. Tandem colonoscopy was performed in a sequential and segmental fashion using one of 3 strategies: white light followed by narrow band imaging [Group A: white light (WL) → narrow band imaging (NBI)]; narrow band imaging followed by white light (Group B: NBI → WL) and, white light followed by white light (Group C: WL → WL). Detection rate of missed polyps and adenomas were evaluated in all three groups. RESULTS: Three hundred patients were studied (100 in each Group). Although the total time for the colonoscopy was similar in the 3 groups (23.8 ± 0.7, 22.2 ± 0.5 and 24.1 ± 0.7 min for Groups A, B and C, respectively), it reached statistical significance between Groups B and C (P < 0.05). The cecal intubation time in Groups B and C was longer than for Group A (6.5 ± 0.4 min and 6.5 ± 0.4 min vs 4.9 ± 0.3 min; P < 0.05). The withdrawal time for Groups A and C was longer than Group B (18.9 ± 0.7 min and 17.6 ± 0.6 min vs 15.7 ± 0.4 min; P < 0.05). Overall miss rate for polyps and adenomas detected in three groups during the second look was 18% and 17%, respectively (P = NS). Detection rate for polyps and adenomas after first look with white light was similar irrespective of the light used during the second look (WL → WL: 13.7% for polyps, 12.6% for adenomas; WL → NBI: 14.2% for polyps, 11.3% for

  4. Reduction of false positives by machine learning for computer-aided detection of colonic polyps

    NASA Astrophysics Data System (ADS)

    Zhao, Xin; Wang, Su; Zhu, Hongbin; Liang, Zhengrong

    2009-02-01

    With the development of computer-aided detection of polyps (CADpolyp), various features have been extracted to detect the initial polyp candidates (IPCs). In this paper, three approaches were utilized to reduce the number of false positives (FPs): the multiply linear regression (MLR) and two modified machine learning methods, i.e., neural network (NN) and support vector machine (SVM), based on their own characteristics and specific learning purposes. Compared to MLR, the two modified machine learning methods are much more sophisticated and well-adapted to the data provided. To achieve the optimal sensitivity and specificity, raw features were pre-processed by the principle component analysis (PCA) in the hope of removing the second-order statistical correlation prior to any learning actions. The gain by the use of PCA was evidenced by the collected 26 patient studies, which included 32 colonic polyps confirmed by both optical colonoscopy (OC) and virtual colonoscopy (VC). The learning and testing results showed that the two modified machine-learning methods can reduce the number of FPs by 48.9% (or 7.2 FPs per patient) and 45.3% (or 7.7 FPs per patient) respectively, at 100% detection sensitivity in comparison with that of traditional MLR method. Generally, more than necessary number of features were stacked as input vectors to machine learning algorithms, dimensionality reduction for a more compact feature combination, i.e., how to determine the remaining dimensionality via PCA linear transform was considered and discussed in this paper. In addition, we proposed a new PCA-scaled data pre-processing method to help reduce the FPs significantly. Finally, fROC (free-response receiver operating characteristic) curves corresponding to three FP-reduction approaches were acquired, and comparative analysis was conducted.

  5. PTT analysis of polyps from FAP patients reveals a great majority of APC truncating mutations

    SciTech Connect

    Luijt, R.B. van der; Khan, P.M.; Tops, C.M.J.

    1994-09-01

    The adenomatous polyposis coli (APC) gene plays an important role in colorectal carcinogenesis. Germline APC mutations are associated with familial adenomatous polyposis (FAP), an autosomal dominantly inherited predisposition to colorectal cancer, characterized by the development of numerous adenomatous polyps in the large intestine. In order to investigate whether somatic inactivation of the remaining APC allele is necessary for adenoma formation, we collected multiple adenomatous polyps from individual FAP patients and investigated the presence of somatic mutations in the APC gene. The analysis of somatic APC mutations in these tumor samples was performed using a rapid and sensitive assay, called the protein truncation test (PTT). Chain-terminating somatic APC mutations were detected in the great majority of the tumor samples investigated. As expected, these mutations were mainly located in the mutation cluster region (MCR) in exon 15. Our results confirm that somatic mutation of the second APC allele is required for adenoma formation in FAP. Interestingly, in the polyps investigated in our study, the second APC allele is somatically inactivated through point mutation leading to a stop codon rather than by loss of heterozygosity. The observation that somatic second hits in APC are required for tumor development in FAP is in apparent accordance with the Knudson hypothesis for classical tumor suppressor genes. However, it is yet unknown whether chain-terminating APC mutations lead to a truncated protein exerting a dominant-negative effect or whether these mutations result in a null allele. Further investigation of this important issue will hopefully provide a better understanding of the mechanism of action of the mutated APC alleles in colorectal carcinogenesis.

  6. Unilateral uterine torsion secondary to an inflammatory endometrial polyp in the bitch.

    PubMed

    Chambers, Ba; Laksito, Ma; Long, F; Yates, Gd

    2011-10-01

    A 9-year-old bitch was presented because of lethargy and abdominal distension. Abdominal ultrasound revealed an enlarged, fluid-filled uterus and associated mass. Subsequent exploratory laparotomy revealed unilateral uterine torsion involving the mass. Recovery following ovariohysterectomy was uneventful and the histopathological diagnosis was of a benign endometrial inflammatory polyp. Reports of uterine torsion in the English-language literature are reviewed to identify factors associated with the incidence of uterine torsion. The aetiology of the cystic endometrial hyperplasia/pyometra complex and its possible role in the development of inflammatory polypoid lesions in the bitch is also discussed.

  7. Evaluation of transvaginal sonography in detecting endometrial polyps and the pregnancy outcome following hysteroscopic polypectomy in infertile women

    PubMed Central

    Zhu, Huili; Fu, Jing; Lei, Haike; Song, Yong; Shen, Licong; Huang, Wei

    2016-01-01

    The aims of the present study were to evaluate the effectiveness of transvaginal sonography (TVS) in the detection of endometrial polyps (EPs), and to assess the pregnancy outcome in infertile women following hysteroscopic polypectomy. A total of 145 women diagnosed with primary or secondary infertility and intrauterine disorders by TVS and hysterosalpingography (HSG) were included in the current study. All subjects were divided into three groups based on hysteroscopic findings, including the EP, intrauterine adhesion and normal groups. EPs were removed for biopsy and intrauterine adhesions were treated. Pregnancy rates between groups were compared. In total, 34 EPs were detected by TVS, while 45 subjects were later confirmed with EP by hysteroscopy. The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the detection of EPs were 67, 96, 88.23 and 86.49%, respectively. Of the included patients, 120 subjects were followed up, including 40 patients diagnosed with EPs, 42 with intrauterine adhesions and 38 with normal cavities. The results indicated no statistically significant differences in the age, type and duration of infertility, least function (LF) score and classification of the extent of tubal disease with the distal fimbrial obstruction between the three groups. In addition, pregnancy rate and spontaneous abortion rate in the EP group following hysteroscopic polypectomy were 45 and 5.6%, respectively. No significant difference was observed in the fertility rate following surgery. In conclusion, TVS features high sensitivity, specificity and certain unique sonographic characteristics in diagnosing EPs, and may be used as a preliminary diagnostic procedure to select patients for hysteroscopy. Furthermore, hysteroscopic polypectomy is an important approach for the treatment of infertile patients with EPs and appears to help increase the pregnancy rate of previously infertile women. PMID:27446343

  8. Altered Th17/Treg Ratio in Nasal Polyps With Distinct Cytokine Profile: Association With Patterns of Inflammation and Mucosal Remodeling.

    PubMed

    Wu, Dawei; Wang, Jianting; Zhang, Min

    2016-03-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease that can be classified as eosinophilic or noneosinophilic. Nasal polyps can exhibit different types of mucosal inflammation and responses to treatment. Imbalanced ratios of T-helper 17(Th17) and regulatory T (Treg) cells may contribute to the pathogenesis of nasal polyps.This study assessed the frequency of Th17 and Treg cells and related cytokines in patients with nasal polyps and tested for associations with mucosal remodeling.Surgical samples from 12 controls and 33 CRSwNP patients were analyzed histopathologically. The frequency of Th17 and Treg cells in peripheral blood mononuclear cells (PBMCs) and tissues were determined using flow cytometry. Th17 and Treg cells-related cytokines in plasma were measured by Cytometric Bead Array (CBA) multiplex assays and enzyme-linked immunosorbent assays (ELISAs).Eosinophilic CRSwNP (ECRSwNP) patients exhibited robust eosinophilia, whereas non-ECRSwNP patients were characterized by neutrophilia. Compared with non-ECRSwNP, an increased Th17/Treg ratio in ECRSwNP was associated with a less increased frequency of Th17 cells and a more striking reduction of Treg cells. An altered Th17/Treg cell ratio was positively correlated with eosinophilic and neutrophilic infiltration, submucosal basement membrane thickness, and the degree of subepithelial collagen deposition. Compared with non-ECRSwNP, ECRSwNP had higher levels of IL-17A and IL-4, and lower levels of IL-10 and TGF-β1, whereas non-ECRSwNP showed higher levels of IFN-γ and IL-6.Th17/Treg cell imbalance in nasal polyps (both in tissues and PBMCs) with distinct cytokine profile may contribute to different inflammatory patterns (eosinophilic versus neutrophilic inflammation) and corresponding features of mucosal remodeling. Effective strategies can be designed to target a Th17/Treg imbalance to restore immune homeostasis in nasal polyps.

  9. Surviving but not thriving: inconsistent responses of zooxanthellate jellyfish polyps to ocean warming and future UV-B scenarios

    NASA Astrophysics Data System (ADS)

    Klein, Shannon G.; Pitt, Kylie A.; Carroll, Anthony R.

    2016-07-01

    Complex changes to UV radiation at the Earth’s surface are occurring concurrently with ocean warming. Despite few empirical tests, jellyfish are hypothesised to be increasing in some parts of the world because they are robust to environmental stressors. Here we examine the effects of UV-B and ocean warming projections on zooxanthellate jellyfish polyps. We exposed Cassiopea sp. polyps to three levels of UV-B (future-low (1.43 Wm2), current (1.60 Wm2), future-high (1.77 Wm2)) and two levels of temperature (current-day (25 °C) and future (28 °C)) over 6 weeks. The intensity of UV-B was varied throughout the day to mimic diel variation in UV-B irradiance. Polyp survival, asexual reproduction and YII were measured. In the current and future-high UV-B treatments, more polyps were produced in 25 °C than 28 °C. This pattern, however, was reversed under future-low UV-B conditions, where more polyps were produced at 28 °C. YII was highest under current summer conditions and future conditions of low UV-B and increased temperature. YII, however, was reduced under high UV-B conditions but was further reduced with warming. Our results suggest that although Cassiopea polyps may survive elevated UV-B and warming conditions, they are unlikely to thrive. If, however, UV-B radiation decreases then ocean warming may facilitate increases in Cassiopea populations.

  10. Race and prevalence of large bowel polyps among the low-income and uninsured in South Carolina

    PubMed Central

    Wallace, Kristin; Brandt, Heather M.; Bearden, James D.; Blankenship, Bridgette F.; Caldwell, Renay; Dunn, James; Hegedus, Patricia; Hoffman, Brenda J.; Marsh, Courtney H.; Marsh, William H.; Melvin, Cathy L.; Seabrook, March E.; Sterba, Ronald E.; Stinson, Mary Lou; Thibault, Annie; Berger, Franklin G.; Alberg, Anthony J.

    2015-01-01

    Background Compared to whites, blacks have higher colorectal cancer (CRC) incidence and mortality rates and are at greater risk for early onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be differences in access to high quality screening and medical care. Aims The present study was carried out to assess whether a racial difference in prevalence of large bowel polyps persists within a poor and uninsured population (n=233, 124 blacks, 91 whites, 18 other) undergoing screening colonoscopy. Methods Eligible patients were uninsured, asymptomatic, had no personal history of colorectal neoplasia, and were between the ages 45–64 years (blacks) or 50–64 years (whites, other). We examined the prevalence of any adenoma (conventional, serrated) and then difference in adenoma/polyp type by race and age categories. Results Prevalence for ≥ 1 adenoma was 37% (95% CI 31%–43%) for all races combined and 36% in blacks < 50 years, 38% in blacks ≥ 50 years, 35% in whites. When stratified by race, blacks had a higher prevalence of large conventional proximal neoplasia (8%) compared to whites (2%) (p-value =0.06) but a lower prevalence of any serrated-like polyp (blacks 18%, whites 32%); p-value=0.02) and sessile serrated adenomas/polyps (blacks 2%, whites 8% chi-square p-value; p=0.05). Conclusions Within this uninsured population the overall prevalence of adenomas was high and nearly equal by race, but the racial differences observed between serrated and conventional polyp types emphasizes the importance of taking polyp type into account in future research on this topic. PMID:26386856

  11. Surviving but not thriving: inconsistent responses of zooxanthellate jellyfish polyps to ocean warming and future UV-B scenarios

    PubMed Central

    Klein, Shannon G.; Pitt, Kylie A.; Carroll, Anthony R.

    2016-01-01

    Complex changes to UV radiation at the Earth’s surface are occurring concurrently with ocean warming. Despite few empirical tests, jellyfish are hypothesised to be increasing in some parts of the world because they are robust to environmental stressors. Here we examine the effects of UV-B and ocean warming projections on zooxanthellate jellyfish polyps. We exposed Cassiopea sp. polyps to three levels of UV-B (future-low (1.43 Wm2), current (1.60 Wm2), future-high (1.77 Wm2)) and two levels of temperature (current-day (25 °C) and future (28 °C)) over 6 weeks. The intensity of UV-B was varied throughout the day to mimic diel variation in UV-B irradiance. Polyp survival, asexual reproduction and YII were measured. In the current and future-high UV-B treatments, more polyps were produced in 25 °C than 28 °C. This pattern, however, was reversed under future-low UV-B conditions, where more polyps were produced at 28 °C. YII was highest under current summer conditions and future conditions of low UV-B and increased temperature. YII, however, was reduced under high UV-B conditions but was further reduced with warming. Our results suggest that although Cassiopea polyps may survive elevated UV-B and warming conditions, they are unlikely to thrive. If, however, UV-B radiation decreases then ocean warming may facilitate increases in Cassiopea populations. PMID:27374028

  12. Biomarkers for early detection of colorectal cancer and polyps: systematic review.

    PubMed

    Shah, Reena; Jones, Emma; Vidart, Victoire; Kuppen, Peter J K; Conti, John A; Francis, Nader K

    2014-09-01

    There is growing interest in early detection of colorectal cancer as current screening modalities lack compliance and specificity. This study systematically reviewed the literature to identify biomarkers for early detection of colorectal cancer and polyps. Literature searches were conducted for relevant papers since 2007. Human studies reporting on early detection of colorectal cancer and polyps using biomarkers were included. Methodologic quality was evaluated, and sensitivity, specificity, and the positive predictive value (PPV) were reported. The search strategy identified 3,348 abstracts. A total of 44 papers, examining 67 different tumor markers, were included. Overall sensitivities for colorectal cancer detection by fecal DNA markers ranged from 53% to 87%. Combining fecal DNA markers increased the sensitivity of colorectal cancer and adenoma detection. Canine scent detection had a sensitivity of detecting colorectal cancer of 99% and specificity of 97%. The PPV of immunochemical fecal occult blood test (iFOBT) is 1.26%, compared with 0.31% for the current screening method of guaiac fecal occult blood test (gFOBT). A panel of serum protein biomarkers provides a sensitivity and specificity above 85% for all stages of colorectal cancer, and a PPV of 0.72%. Combinations of fecal and serum biomarkers produce higher sensitivities, specificities, and PPVs for early detection of colorectal cancer and adenomas. Further research is required to validate these biomarkers in a well-structured population-based study.

  13. Hyper-Methylated Loci Persisting from Sessile Serrated Polyps to Serrated Cancers

    PubMed Central

    Andrew, Angeline S.; Baron, John A.; Butterly, Lynn F.; Suriawinata, Arief A.; Tsongalis, Gregory J.; Robinson, Christina M.; Amos, Christopher I.

    2017-01-01

    Although serrated polyps were historically considered to pose little risk, it is now understood that progression down the serrated pathway could account for as many as 15%–35% of colorectal cancers. The sessile serrated adenoma/polyp (SSA/P) is the most prevalent pre-invasive serrated lesion. Our objective was to identify the CpG loci that are persistently hyper-methylated during serrated carcinogenesis, from the early SSA/P lesion through the later cancer phases of neoplasia development. We queried the loci hyper-methylated in serrated cancers within our right-sided SSA/Ps from the New Hampshire Colonoscopy Registry, using the Illumina Infinium Human Methylation 450 k panel to comprehensively assess the DNA methylation status. We identified CpG loci and regions consistently hyper-methylated throughout the serrated carcinogenesis spectrum, in both our SSA/P specimens and in serrated cancers. Hyper-methylated CpG loci included the known the tumor suppressor gene RET (p = 5.72 × 10−10), as well as loci in differentially methylated regions for GSG1L, MIR4493, NTNG1, MCIDAS, ZNF568, and RERG. The hyper-methylated loci that we identified help characterize the biology of SSA/P development, and could be useful as therapeutic targets, or for future identification of patients who may benefit from shorter surveillance intervals. PMID:28257124

  14. Environmental Control of Phase Transition and Polyp Survival of a Massive-Outbreaker Jellyfish

    PubMed Central

    Prieto, Laura; Astorga, Diana; Navarro, Gabriel; Ruiz, Javier

    2010-01-01

    A number of causes have been proposed to account for the occurrence of gelatinous zooplankton (both jellyfish and ctenophore) blooms. Jellyfish species have a complex life history involving a benthic asexual phase (polyp) and a pelagic sexual phase (medusa). Strong environmental control of jellyfish life cycles is suspected, but not fully understood. This study presents a comprehensive analysis on the physicochemical conditions that control the survival and phase transition of Cotylorhiza tuberculata; a scyphozoan that generates large outbreaks in the Mediterranean Sea. Laboratory experiments indicated that the influence of temperature on strobilation and polyp survival was the critical factor controlling the capacity of this species to proliferate. Early life stages were less sensitive to other factors such as salinity variations or the competitive advantage provided by zooxanthellae in a context of coastal eutrophication. Coherently with laboratory results, the presence/absence of outbreaks of this jellyfish in a particular year seems to be driven by temperature. This is the first time the environmental forcing of the mechanism driving the life cycle of a jellyfish has been disentangled via laboratory experimentation. Projecting this understanding to a field population under climatological variability results in a pattern coherent with in situ records. PMID:21072185

  15. Environmental control of phase transition and polyp survival of a massive-outbreaker jellyfish.

    PubMed

    Prieto, Laura; Astorga, Diana; Navarro, Gabriel; Ruiz, Javier

    2010-11-03

    A number of causes have been proposed to account for the occurrence of gelatinous zooplankton (both jellyfish and ctenophore) blooms. Jellyfish species have a complex life history involving a benthic asexual phase (polyp) and a pelagic sexual phase (medusa). Strong environmental control of jellyfish life cycles is suspected, but not fully understood. This study presents a comprehensive analysis on the physicochemical conditions that control the survival and phase transition of Cotylorhiza tuberculata; a scyphozoan that generates large outbreaks in the Mediterranean Sea. Laboratory experiments indicated that the influence of temperature on strobilation and polyp survival was the critical factor controlling the capacity of this species to proliferate. Early life stages were less sensitive to other factors such as salinity variations or the competitive advantage provided by zooxanthellae in a context of coastal eutrophication. Coherently with laboratory results, the presence/absence of outbreaks of this jellyfish in a particular year seems to be driven by temperature. This is the first time the environmental forcing of the mechanism driving the life cycle of a jellyfish has been disentangled via laboratory experimentation. Projecting this understanding to a field population under climatological variability results in a pattern coherent with in situ records.

  16. Berberine Inhibits Intestinal Polyps Growth in Apc (min/+) Mice via Regulation of Macrophage Polarization

    PubMed Central

    Piao, Meiyu; Cao, Hailong; He, NaNa; Yang, Boli; Dong, Wenxiao; Xu, Mengque; Yan, Fang; Zhou, Bing

    2016-01-01

    Antitumor effect of berberine has been reported in a wide spectrum of cancer, however, the mechanisms of which are not fully understood. The aim of this study was to investigate the hypothesis that berberine suppresses tumorigenesis in the familial adenomatous polyposis (FAP) by regulating the macrophage polarization in Apc (min/+) mouse model. Berberine was given to Apc (min/+) mice for 12 weeks. Primary macrophages were isolated; after berberine treatment, the change in signaling cascade was determined. The total number and size of polyps were reduced remarkably in berberine group, compared with control group. A significant decrease in protein levels of F4/80, mannose receptor (MR), and COX-2 in stroma of intestinal polyps and an increase in the level of iNOS were observed after berberine treatment. The mRNA level of MR and Arg-1 in berberine group was significantly lower than those in IL-10 or IL-4 group, while no significant difference in mRNA levels of iNOS and CXCL10 was observed. The migration and invasiveness assays in vitro showed that berberine could reduce the capability of migration and invasiveness. These findings suggest that berberine attenuates intestinal tumorigenesis by inhibiting the migration and invasion of colorectal tumor cells via regulation of macrophage polarization. PMID:27493671

  17. Sinonasal glomangiopericytoma treated with preoperative embolisation and endoscopic sinus surgery

    PubMed Central

    Psoma, Elizabeth; Karkos, Petros D; Dova, Stamatia; Gavriilidis, Michail; Markou, Konstantinos; Kouskouras, Constantinos; Haritanti, Afroditi; Finitsis, Stefanos

    2016-01-01

    Sinonasal glomangiopericytoma is a benign rare tumour of pericytes that accounts for less than 0.5% of all sinonasal tumours. It is an indolent tumour with a macroscopic appearance of common inflammatory polyps. We report the case of a 55-year-old male who presented with right nasal obstruction. CT and MRI examinations demonstrated a soft-tissue mass that obstructed mainly the right nasal cavity. Biopsy revealed glomangiopericytoma. The tumour was treated with preoperative embolisation followed by complete endoscopic resection. Very few cases have been reported to be treated in this way. PMID:27994648

  18. Colorectal polyps

    MedlinePlus

    ... Your provider can order a colonoscopy or other screening tests : These tests help prevent colon cancer by ... on Colorectal Cancer. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US ...

  19. Aural polyps

    MedlinePlus

    ... you have bleeding from an ear. Images Ear anatomy References Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; ...

  20. Uterine Polyps

    MedlinePlus

    ... bleeding — for example, having frequent, unpredictable periods of variable length and heaviness Bleeding between menstrual periods Excessively ... policy Advertising and sponsorship opportunities Reprint Permissions A single copy of these materials may be reprinted for ...

  1. Expression of Wnt pathway genes in polyps and medusa-like structures of Ectopleura larynx (Cnidaria: Hydrozoa).

    PubMed

    Nawrocki, Annalise M; Cartwright, Paulyn

    2013-01-01

    The canonical Wnt signaling pathway is conserved in its role in axial patterning throughout Metazoa. In some hydrozoans (Phylum Cnidaria), Wnt signaling is implicated in oral-aboral patterning of the different life cycle stages-the planula, polyp and medusa. Unlike most hydrozoans, members of Aplanulata lack a planula larva and the polyp instead develops directly from a brooded or encysted embryo. The Aplanulata species Ectopleura larynx broods such embryos within gonophores. These gonophores are truncated medusae that remain attached to the polyps from which they bud, and retain evolutionary remnants of medusa structures. In E. larynx, gonophores differ between males and females in their degree of medusa truncation, making them an ideal system for examining truncated medusa development. Using next-generation sequencing, we isolated genes from Wnt signaling pathways and examined their expression in E. larynx. Our data are consistent with the Wnt pathway being involved in axial patterning of the polyp and truncated medusa. Changes in the spatial expression of Wnt pathway genes are correlated with the development of different oral structures in male and female gonophores. The absence of expression of components of the Wnt pathway and presence of a Wnt pathway antagonist SFRP in the developing anterior end of the gonophore suggest that downregulation of the Wnt pathway could play a role in medusa reduction in E. larynx.

  2. Coexistence of Juvenile-Like Polyp with Neurofibroma at the Gastroesophageal Junction in an Adult with Neurofibromatosis Type I

    PubMed Central

    Iqbal, Atif

    2017-01-01

    A 23-year-old Caucasian male with Neurofibromatosis Type I (NF-I) was found to have a submucosal nodule at the gastroesophageal junction (GEJ) and underwent endoscopic submucosal dissection. Histological examination revealed two different lesions within the nodule. The dominant lesion was inflammatory/hyperplastic (juvenile-like) polyp with obliterative vasculopathy while the smaller lesion was a neurofibroma. Gastric/GEJ lesions in NF-I are very rare with only seven cases reported in the literature. Three cases of juvenile-like gastric polyps (located in the antrum, greater curvature, and fundus) have been reported in adult NF-I patients. An inflammatory polyp associated with a neurofibroma has only been described once in the pediatric literature but never in an adult. Our case is unique from those previously described in the literature due to the age of the patient, the presence of 2 histologically separate lesions in one endoscopically evident lesion, and the presence of obliterative vasculopathy in the juvenile-like polyp. PMID:28168076

  3. Effects of cumene hydroperoxide on adenosine diphosphate ribosyl transferase in mononuclear leukocytes of patients with adenomatous polyps in the colon.

    PubMed

    Markowitz, M M; Johnson, D B; Pero, R W; Winawer, S J; Miller, D G

    1988-03-01

    We have studied the effects of plasma and of cumene hydroperoxide (CUM) on adenosine diphosphate ribosyl transferase (ADPRT) from mononuclear leukocytes (HML) of patients with colonic adenomatous polyps (n = 22), with colonic hyperplastic polyps (n = 5) and with neither type of polyp (controls) (n = 6). ADPRT was measured after incubation of HML with plasma alone (termed the plasma value), and with plasma plus CUM (50 microM) (the activated value); the difference elicited by CUM was termed the induced value. There was no significant difference in values between the control and hyperplastic polyp groups: these were combined for further analysis. The plasma (P = 0.038), activated (P = 0.009) and induced (P = 0.0024) values of the combined group all differed significantly from those of the adenoma group. At low exposures, CUM stimulated both ADPRT and unscheduled DNA synthesis and, at higher exposures, inactivated both. Pretreatment of HML with vitamin E protected against these effects of CUM, while pretreatment with diamide (which depletes GSH) accentuated the effects. This study demonstrates a differential reaction of ADPRT in patients harboring colonic adenomas and suggests that the origin of this difference may lie in cellular responses to oxidative stress.

  4. Comparative Validation of Polyp Detection Methods in Video Colonoscopy: Results from the MICCAI 2015 Endoscopic Vision Challenge.

    PubMed

    Bernal, Jorge; Tajbakhsh, Nima; Sanchez, F Javier; Matuszewski, Bogdan J; Chen, Hao; Yu, Lequan; Angermann, Quentin; Romain, Olivier; Rustad, Bjorn; Balasingham, Ilangko; Pogorelov, Konstantin; Choi, Sungbin; Debard, Quentin; Maier-Hein, L; Speidel, Stefanie; Stoyanov, Danail; Brandao, Patrick; Cordova, Henry; Sanchez-Montes, Cristina; Gurudu, Suryakanth R; Fernandez-Esparrach, Gloria; Dray, Xavier; Liang, Jianming; Histace, Aymeric

    2017-02-02

    Colonoscopy is the gold standard for colon cancer screening though still some polyps are missed, thus preventing early disease detection and treatment. Several computational systems have been proposed to assist polyp detection during colonoscopy but so far without consistent evaluation. The lack of publicly available annotated databases has made it difficult to compare methods and to assess if they achieve performance levels acceptable for clinical use. The Automatic Polyp Detection subchallenge, conducted as part of the Endoscopic Vision Challenge (http://endovis.grand-challenge.org) at the international conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2015, was an effort to address this need. In this paper, we report the results of this comparative evaluation of polyp detection methods, as well as describe additional experiments to further explore differences between methods. We define performance metrics and provide evaluation databases that allow comparison of multiple methodologies. Results show that convolutional neural networks (CNNs) are the state of the art. Nevertheless it is also demonstrated that combining different methodologies can lead to an improved overall performance.

  5. Insights on Coral Adaptation from Polyp and Colony Morphology, Skeletal Density Banding and Carbonate Depositional Facies

    NASA Astrophysics Data System (ADS)

    Oehlert, A. M.; Hill, C. A.; Piggot, A. M.; Fouke, B. W.

    2008-12-01

    As one of the core reservoirs of primary production in the world's oceans, tropical coral reefs support a complex ecosystem that directly impacts over ninety percent of marine organisms at some point in their life cycle. Corals themselves are highly complex organisms and exhibit a range of growth forms that range from branching to massive, foliaceous, columnar, encrusting, free living and laminar coralla. Fierce competition over scarce resources available to each individual coral species creates niche specialization. Throughout the Phanerozic geological record, this has driven speciation events and created distinct skeletal growth morphologies that have differential abilities in feeding strategy. In turn, this has presumably led to the development of niche specialization that can be quantitatively measured through hierarchical morphological differences from the micrometer to the meter scale. Porter (1976) observed significant differences in skeletal morphology between Caribbean coral species that reflects an adaptive geometry based on feeding strategy. Within the Montastraea species complex there are four major morphologies; columnar, bouldering, irregular mounding, and skirted. Each morphotype can be found forming high abundance along the bathymetric gradient of coral reefs that grow along the leeward coast of Curacao, Netherlands Antilles. We have undertaken a study to determine the relative relationships amongst coral morphology, skeletal density and feeding strategy by comparing the morphometric measurements of individual polyps as well as the entire colony along spatial and bathymetric gradients. Polyp diameter, mouth size, interpolyp area, and interpolyp distance were measured from high-resolution images taken on a stereoscope, and evaluated with AxioVision image analysis software. These high-resolution optical analyses have also revealed new observations regarding folded tissue structures of the outer margin of polyps in the Montastrea complex. Skeletal

  6. Café au lait macules and juvénile polyps.

    PubMed

    Pacheco, Theresa R; Scatena, Lisa S; Hoffenberg, Edward J; Gralla, Jane; Lee, Lela A

    2007-01-01

    Several hereditary and nonhereditary gastrointestinal tract polyposis syndromes exhibit extra-intestinal manifestations, including cutaneous findings. However, a lack of information exists regarding cutaneous features of juvenile polyposis. Our objective was to document the prevalence of cutaneous hyperpigmented lesions in children with juvenile polyposis coli or juvenile polyposis coli and their first degree relatives.Children seen in the gastroenterology practice at The Children's Hospital in Denver, Colorado with polyps (juvenile polyposis coli, sporadic juvenile polyps, and familial adenomatous polyposis coli) and their first degree relatives were invited to participate in the study. A comprehensive skin examination was performed on those who consented to participate. We found that 8 of 14 patients (eight with juvenile polyposis coli, four with juvenile polyposis, and two with familial adenomatous polyposis coli) had at least one café-au-lait macule, compared with three of 27 relatives (p=0.003).The prevalence of at least one café-au-lait macule in our patients (8/14 or 57.1%, CI: 28.9–82.3%) was significantly higher than the general population prevalence of 28.5% (p=0.023). However, if the two patients with familial adenomatous polyposis coli were excluded, the comparison with the general population prevalence did not reach statistical significance (p=0.095). The prevalence of multiple cafe´-au-lait macules in our patients (4/14 or 28.6%; CI:8.4–58.1%) was significantly higher than the general population prevalence of 5.2% (p ¼ 0.005). A notable finding was the presence of multiple café -au-lait macules in 4 of 12 juvenile polyposis coli/juvenile polyposis patients.Two patients with juvenile polyposis coli also had lentigines. In this selected case series, we observed single or multiple café-au-lait macules in a high proportion of children with the three types of polyps. Further studies are needed to assess a possible common pathway for hamartomatous

  7. Pattern of cell kinetics in colorectal mucosa of patients with different types of adenomatous polyps of the large bowel

    SciTech Connect

    Roncucci, L.; Scalmati, A.; Ponz de Leon, M. )

    1991-08-15

    It is generally accepted that adenomatous polyps represent the natural precursor of many colorectal malignancies. The sequence, however, which leads from a normally appearing mucosa to cancer is complex and involves many steps, including a hyperproliferative mucosa with an upward expansion of the replicative compartment. The current study evaluates cell replication in normal colorectal mucosa of patients with adenomatous polyps of various types and relates the observed findings to the main clinical and morphologic features of adenomas. Forty-four patients with polyps and 27 controls entered the study. Samples of colorectal mucosa were taken at endoscopy and cell replication was evaluated with a standard autoradiographic procedure. Cell replication was expressed as labeling index (LI), in the whole crypt and in each of the five longitudinal compartments in which the crypts were divided. Total LI and LI per crypt compartment were significantly higher (P less than 0.02 and P less than 0.01, respectively) than in controls. There was no appreciable difference of LI values between patients with single or multiple, tubular or tubulovillous, small or large adenomas, but in all of these subgroups LI was significantly higher than in controls. In conclusion, in normally appearing colorectal mucosa of patients with adenomatous polyps there was a significant increase of cell replication and a marked upward expansion of the proliferative zone; these changes were more evident in the left colon and in the rectum. Finally, cell replication did not seem to be related to the number of polyps, to the most common histotypes, or to the pattern of recurrence.

  8. Polyp detection rate in transverse and sigmoid colon significantly increases with longer withdrawal time during screening colonoscopy

    PubMed Central

    Inoue, Nagamu; Yoshida, Toshifumi; Bessyo, Rieko; Yoneno, Kazuaki; Imaeda, Hiroyuki; Ogata, Haruhiko; Kanai, Takanori; Sugino, Yoshinori; Iwao, Yasushi

    2017-01-01

    Background The guidelines for colonoscopy present withdrawal time (WT) and adenoma detection rate (ADR) as the quality indicator. The purpose of this retrospective study is to analyze the predicting factors with polyp detection rate (PDR) as a surrogate for ADR by using comprehensive health checkup data, and assess the correlation between PDR per each colonic segment and WT, and factors influencing WT. Methods One thousand and thirty six consecutive health checkup cases from April 2015 to March 2016 were enrolled in this study, and 880 subjects who undertook colonoscopy without polyp removal or biopsy were divided into the two groups (polyp not detected group vs polyp detected group). The two groups were compared by subjects and clinical characteristics with univariate analysis followed by multivariate analysis. Colonoscopies with longer WT (≥ 6 min) and those with shorter WT (< 6 min) were compared by PDR per each colonic segment, and also by subjects and clinical characteristics. Results A total of 1009 subjects included two incomplete colonoscopies (CIR, 99.9%) and overall PDR was 35.8%. A multiple logistic regression model demonstrated that age, gender, and WT were significantly related factors for polyp detection (odds ratio, 1.036; 1.771; 1.217). PDR showed a linear increase as WT increased from 3 min to 9 min (r = 0.989, p = 0.000) and PDR with long WT group was higher than that with short WT group per each colonic segment, significantly in transverse (2.3 times, p = 0.004) and sigmoid colon (2.1 times, p = 0.001). Not only bowel preparation quality but also insertion difficulty evaluated by endoscopist were significant factors relating with WT (odds ratio, 3.811; 1.679). Conclusion This study suggests that endoscopists should be recommended to take more time up to 9 min of WT to observe transverse and sigmoid colon, especially when they feel no difficulty during scope insertion. PMID:28328936

  9. Estimate of calcification responses to thermal and freshening stresses based on culture experiments with symbiotic and aposymbiotic primary polyps of a coral, Acropora digitifera

    NASA Astrophysics Data System (ADS)

    Inoue, Mayuri; Shinmen, Kotaro; Kawahata, Hodaka; Nakamura, Takashi; Tanaka, Yasuaki; Kato, Aki; Shinzato, Chuya; Iguchi, Akira; Kan, Hironobu; Suzuki, Atsushi; Sakai, Kazuhiko

    2012-07-01

    Although coral calcification is directly related to coral health, few studies have examined the responses of coral calcification to environmental stresses, with the exception of ocean acidification. In this study, we experimentally exposed aposymbiotic (lacking symbionts) and symbiotic primary polyps of the scleractinian coral Acropora digitifera to several seawater temperatures (27, 29, 31, and 33 °C) and salinities (26, 28, 30, 32, and 34) to investigate the effects of thermal and freshening stresses on coral calcification from the standpoint of coral-algal symbiosis. Calcification rates were higher for symbiotic versus aposymbiotic polyps in both sets of experiments, except for those reared at 31 °C and 33 °C. Calcification responses of symbiotic polyps were a non-linear function of temperature, and the threshold temperature affecting skeletal growth and bleaching was between 29 °C and 31 °C. Calcification rates of aposymbiotic polyps were also a non-linear function of temperature, with a maximum polyp weight at 31 °C, suggesting that thermal stress also did some damage to the coral host itself. In contrast, skeletal growth of both aposymbiotic and symbiotic polyps decreased linearly with increased salinity. Observations of the microstructure of polyp samples revealed a clearly cyclic feature of skeletal surfaces that was likely related to organo-mineral deposition of calcium carbonate even under lowered-salinity conditions. However, neither type of polyp reared at 33 °C evidenced this characteristic, suggesting that thermal stress had compromised the normal calcification process, which involves secretion of an organic matrix by the coral host. Our results suggest that the effects of future global warming will include a reduction in coral calcification itself and the collapse of coral-algal symbiosis, at least at the primary polyp stage. The present experiments showed that thermal stress would affect the host's physiological functionality, whereas

  10. [Inverted Hyperplastic Polyp in Stomach: A Case Report and Literature Review].

    PubMed

    Lee, Yeon Ho; Joo, Moon Kyung; Lee, Beom Jae; Lee, Ji-Ae; Kim, Taehyun; Yoon, Jin Gu; Lee, Jung Min; Park, Jong-Jae

    2016-02-01

    An inverted hyperplastic polyp (IHP) found in stomach is rare and characterized by downward growth of hyperplastic mucosal component into the submucosa. Because of such characteristic, IHP can be misdiagnosed as subepithelial tumor or malignant tumor. In fact, adenocarcinoma was reported to have coexisted with gastric IHP in several previous reports. Because only 18 cases on gastric IHP have been reported in English and Korean literature until now, pathogenesis and clinical features of gastric IHP and correlation with adenocarcinoma have not been clearly established. Herein, we report a case of gastric IHP which was initially misdiagnosed as gastrointestinal stromal tumor and resected using endoscopic submucosal dissection. Literature review of previously published case reports on gastric IHP is also presented.

  11. Localization of digestion activities in polyps of Nausithoe planulophora and Thecoscyphus zibrowii (Coronatae, Scyphozoa, Cnidaria)

    NASA Astrophysics Data System (ADS)

    Bumann, Dirk; Jarms, Gerhard

    1998-02-01

    Coronate polyps are unique among cnidarians in having a complete peridermal tube, a ring canal, and four radial canals or pores at their oral region. Moreover, most of these species possess tooth whorls that narrow the gastric cavity considerably. Using fluorescence-labeled prey, it was demonstrated that the ring canal is not involved in digestion or redistribution of nutrients but possibly serves as a hydrostatic flex point for the fast retraction of the tentacle crown into the exoskeleton. The tooth whorls considerably affect the localization of digestion activities by blocking the passage of large prey fragments. Hence, endocytosis in a coronate species with tooth whorls occurred around the uppermost tooth whorl whereas, in a species lacking tooth whorls endocytosis occurred at the basal end. To meet the high nutrient demands of the basal region, nutrients must be redistributed in the species with tooth whorls. The extra energy required for this redistribution could be an important disadvantage of tooth whorls.

  12. Endometrial polyps in the bitch: a retrospective study of 21 cases.

    PubMed

    Marino, G; Barna, A; Rizzo, S; Zanghì, A; Catone, G

    2013-11-01

    Endometrial polyps (EPs) are tumour-like lesions reported frequently in domestic carnivores. The present report describes the clinical and pathological features of EPs in 21 bitches. Most affected bitches had a regular reproductive history. Five bitches had no clinical signs and eleven showed clinical signs of pyometra. Four bitches had a large EP which resulted in compression of the abdominal viscera. One bitch had an acute uterine torsion. A clinical diagnosis of EPs was only made when the lesions were large and identified by abdominal palpation or ultrasound. Grossly, the EPs were 5-25 cm in diameter and were single, sessile or pedunculated. They were often associated with cystic endometrial hyperplasia. Microscopically, the EPs were fibroglandular with the stroma sometimes being haemorrhagic and infiltrated by inflammatory cells. In one case, there were areas of stromal smooth muscle and epithelial squamous metaplasia, which may have been consistent with preneoplastic change.

  13. Presenting symptoms of giant fibrovascular polyp of the oesophagus: case report and literature review

    PubMed Central

    Sestini, S; Gisabella, M; Pastorino, U; Billé, A

    2016-01-01

    Introduction Lipomas of the gastrointestinal tract are rare, slow-growing lesions that comprise 0.4% of all gastrointestinal neoplasms. They can cause dysphagia, dyspnoea or sudden choking. Case History Due to rarity of this condition and its uncommon presentation, a literature review was carried out (PubMed). This search revealed 290 articles, of which 74 were considered pertinent and were evaluated. We report a case of a 13cm pedunculated oesophageal lipoma that presented with increasing dysphagia and two episodes of suffocation. The patient underwent curative resection through a cervical approach. Conclusions Resection is recommended for large (>5 cm) or symptomatic polyps. Outcomes are excellent given that lesions are universally benign and oesophageal resection is not required. PMID:27087340

  14. [Incidence of cholelithiasis in patients with cancer of the colon and adenomatous polyp].

    PubMed

    Paniagua Estévez, M; González Calleja, I; González Lazo, N; Jimenéz Mesa, G; Hernández Miranda, W

    1992-01-01

    Recent international publications remark the association about carcinoma of the colon and cholelithiasis. These two entities with similar geographical distribution can be seen frequently in the modern western societies, being the cause as aetiological factors the low content in dietetics fiber. Different studies about the carcinoma of the colon and cholelithiasis pathogenesis had lead the possibility that the abnormal degradation of bile acids for the colonic bacterias, could be responsible of each one of these illness. The exposition of colonic mucosa to products of degradation of bile acids, specially secondary bile acids, may play a role in the etiopathogenic of colon carcinoma. It was analysed 135 patients with colon carcinoma or adenomatosis polyps, 42 with cholelithiasis or cholecystectomized for the same cause (31.1%), although in the control group, only 2(5%) had cholelithiasis. The female predominated the group of colon carcinoma and cholelithiasis, as well as cholecystectomized for that cause. The most frequent associated pathology was the diverticulosis.

  15. Serous carcinoma arising in endometrial polyps: clinicopathologic study of 4 cases.

    PubMed

    Idrees, Romana; Din, Nasir Ud; Fatima, Saira; Kayani, Naila

    2013-06-01

    Uterine serous carcinoma (USC) is a rare variant of endometrial cancer that is not related to increased estrogen level; rather, it arises in a background of atrophic endometrium. Our aim was to describe clinicopathologic features of 4 cases of USC arising in endometrial polyps (EPs). The mean age of the patients at presentation was 53 years (range, 50-61 years). All patients presented with postmenopausal bleeding. In 3 patients, endometrial curretings were done before surgery, which was reported as EP with superficial foci of USC, EP with few clusters of atypical cells, and high-grade serous carcinoma, respectively. All patients underwent hysterectomy with bilateral salpingo-oophorectomy and omental sampling. The uterine cavity showed an EP in all cases ranging in size from 2 to 3.5 cm (mean, 3 cm). The hysterectomy specimens revealed USC in EP as well as the adjacent endometrium in 3 patients. The nonneoplastic endometrium was atrophic in all cases. Residual tumor was not found in the endometrium in 1 case. Omental metastatic deposits were found in all cases. Tumor deposits were also seen in the serosa of uterus, fallopian tubes, and parametrium in 1 case. Two patients died of disease 2 years after diagnosis. The remaining 2 patients are alive after a follow-up of 3 years, respectively. In conclusion, USC is a rare aggressive tumor, and to establish the diagnosis, it is important to look for the small foci of the tumor in the atrophic endometrium and on the surface of the polyps as these patients are likely to harbor additional disease in the uterus or extrauterine sites. The postmenopausal group is at high risk for developing these tumors; therefore, all the endometrial biopsies/curettings and the EPs in this age group should be thoroughly sampled.

  16. Release of Type 2 Cytokines by Epithelial Cells of Nasal Polyps

    PubMed Central

    Bucca, Caterina; Rolla, Giovanni

    2016-01-01

    Background. T2 inflammation of chronic rhinosinusitis with nasal polyps (CRSwNP) may be influenced by epithelial cytokines release (TSLP, IL-25, and IL-33). We investigated the release of TSLP, IL-25, and IL-33 by epithelial CRSwNP cells compared to epithelial sinus mucosa cells of patients with chronic rhinosinusitis without nasal polyps (CRSsNP). Methods. IL-25, IL-33, and TSLP were measured by ELISA in the supernatant of cell cultures derived by CRSwNP (9 patients, 6 atopic) and CRSsNP (7 patients, 2 atopic) in baseline condition and following stimulation with Dermatophagoides pteronyssinus (DP), Aspergillus fumigatus (AF), and poly(I:C). Results. CRSwNP epithelial cells released increased levels of IL-25 (from 0.12 ± 0.06 pg/ml to 0.27 ± 0.1 pg/ml, p < 0.01) and TSLP (from 0.77 ± 0.5 pg/ml to 2.53 ± 1.17 pg/ml, p < 0.001) following poly(I:C) stimulation, while CRSsNP epithelial cells released increased levels of IL-25 and IL-33 following AF and DP stimulation, respectively (IL-25: from 0.18 ± 0.07 pg/ml to 0.51 ± 0.1 pg/ml, p < 0.001; IL-33: from 2.57 ± 1.3 pg/ml to 5.7 ± 3.1 pg/ml, p < 0.001). Conclusions. CRSwNP epithelial cells release TSLP and IL-25 when stimulated by poly(I:C) but not by DP or AF, suggesting that viral infection may contribute to maintain and amplify the T2 immune response seen in CRSwNP. PMID:28127565

  17. Evaluation of total oxidative stress parameters in patients with nasal polyps.

    PubMed

    Bozkus, F; San, I; Ulas, T; Iynen, I; Yesilova, Y; Guler, Y; Aksoy, N

    2013-08-01

    Oxidative stress, an imbalance between reactive oxygen species production and antioxidative defense activity, is believed to have a role in the development and pathogenesis of nasal polyps (NPs). Based on this assumption, several known oxidants and antioxidants have been studied in patients with NPs. The purpose of this study was to evaluate the association between oxidative stress parameters with a more valid and reliable method in patients with NPs. Seventy-three patients with NPs, septal deviations and middle concha hypertrophies were recruited. Patients were divided into two groups; group 1 (n = 38) consisted of patients with NPs, and group 2 (n = 35) included patients with septal deviations and middle concha hypertrophies. Polyp specimens were taken from all patients who underwent endoscopic surgery for NPs. Control specimens were obtained from patients who underwent an operation for septoplasty or middle concha hypertrophy. Blood and tissue samples were obtained to assess total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI). Compared to group 2, group 1 had significantly higher TOS and OSI and lower TAS levels both in serum and tissue samples (p < 0.001 for all). In group 1, tissue TOS and OSI levels were significantly higher, and TAS levels were significantly lower than in serum (p < 0.001 for all), whereas no significant difference was found in TOS, OSI and TAS levels either in serum or tissue samples in group 2 (p = 1.0; p = 1; p = 0.208, respectively). In group 1, serum OSI levels were significantly correlated with age (r = 0.442, p = 0.005). Our study demonstrated that oxidative stress, both in serum and tissues in patients with NPs, was higher than in patients without NPs. Our study differs from previous studies in that we used a more reliable method that measures both TOS and TAS.

  18. Reduction of intestinal polyp formation in min mice fed a high-fat diet with aloe vera gel extract.

    PubMed

    Chihara, Takeshi; Shimpo, Kan; Beppu, Hidehiko; Tomatsu, Akiko; Kaneko, Takaaki; Tanaka, Miyuki; Yamada, Muneo; Abe, Fumiaki; Sonoda, Shigeru

    2013-01-01

    Aloe vera gel supercritical CO2 extract (AVGE) has been shown to contain five phytosterols, reduce visceral fat accumulation, and influence the metabolism of glucose and lipids in animal model experiments. Recent epidemiologic studies have shown that obesity is an established risk factor for several cancers including colorectal cancer. Therefore, we examined the effects of AVGE on intestinal polyp formation in Apc-deficient Min mice fed a high-fat diet. Male Min mice were divided into normal diet (ND), high fat diet (HFD), low dose AVGE (HFD+LAVGE) and high dose AVGE (HFD+HAVGE) groups. The ND group received AIN-93G diet and the latter 3 groups were given modified high-fat AIN-93G diet (HFD) for 7 weeks. AVGE was suspended in 0.5% carboxymethyl cellulose (CMC) and administered orally to mice in HFD+LAVGE and HFD+HAVGE groups every day (except on Sunday) for 7 weeks at a dose of 3.75 and 12.5 mg/kg body weight, respectively. ND and HFD groups received 0.5% CMC alone. Between weeks 4 and 7, body weights in the HFD and HFD+LAVGE groups were reduced more than those in the ND group. However, body weights were not reduced in the HFD+HAVGE group. Mice were sacrificed at the end of the experiment and their intestines were scored for polyps. No significant differences were observed in either the incidence and multiplicity of intestinal polyps (≥0.5 mm in a diameter) among the three groups fed HFD. However, when intestinal polyps were categorized by their size into 0.5-1.4, 1.5-2.4, or ≥2.5 mm, the incidence and multiplicity of large polyps (≥2.5 mm) in the intestine in the HFD+HAVGE group were significantly lower than those in the HFD group. We measured plasma lipid (triglycerides and total cholesterol) and adipocytokine [interleukin-6 and high molecular weight (HMW) adiponectin] levels as possible indicators of mechanisms of inhibition. The results showed that HMW adiponectin levels in the HFD group were significantly lower than those in the ND group. However, the

  19. Challenging diagnostic issues in adenomatous polyps with epithelial misplacement in bowel cancer screening: 5 years' experience of the Bowel Cancer Screening Programme Expert Board.

    PubMed

    Griggs, Rebecca K L; Novelli, Marco R; Sanders, D Scott A; Warren, Bryan F; Williams, Geraint T; Quirke, Philip; Shepherd, Neil A

    2017-02-01

    The diagnostic difficulties of differentiating epithelial misplacement from invasive cancer in colorectal adenomatous polyps have been recognised for many years. Nevertheless, the introduction of population screening in the UK has resulted in extraordinary diagnostic problems. Larger sigmoid colonic adenomatous polyps, which are those most likely to show epithelial misplacement, are specifically selected into such screening programmes, because these polyps are likely to bleed and screening is based on the detection of occult blood. The diagnostic challenges associated with this particular phenomenon have necessitated the institution of an 'Expert Board': this is a review of the first five years of its practice, during which time 256 polyps from 249 patients have been assessed. Indeed, the Expert Board contains three pathologists, because those pathologists do not necessarily agree, and a consensus diagnosis is required to drive appropriate patient management. However, this study has shown substantial levels of agreement between the three Expert Board pathologists, whereby the ultimate diagnosis has been changed, from that of the original referral diagnosis, by the Expert Board for half of all the polyps, in the substantial majority from malignant to benign. In 3% of polyp cases, the Expert Board consensus has been the dual diagnosis of both epithelial misplacement and adenocarcinoma, further illustrating the diagnostic difficulties. The Expert Board of the Bowel Cancer Screening Programme in the UK represents a unique and successful development in response to an extraordinary diagnostic conundrum created by the particular characteristics of bowel cancer screening.

  20. Colon Capsule Endoscopy for the Detection of Colorectal Polyps: An Economic Analysis

    PubMed Central

    Palimaka, Stefan; Blackhouse, Gord; Goeree, Ron

    2015-01-01

    Background Colorectal cancer is a leading cause of mortality and morbidity in Ontario. Most cases of colorectal cancer are preventable through early diagnosis and the removal of precancerous polyps. Colon capsule endoscopy is a non-invasive test for detecting colorectal polyps. Objectives The objectives of this analysis were to evaluate the cost-effectiveness and the impact on the Ontario health budget of implementing colon capsule endoscopy for detecting advanced colorectal polyps among adult patients who have been referred for computed tomographic (CT) colonography. Methods We performed an original cost-effectiveness analysis to assess the additional cost of CT colonography and colon capsule endoscopy resulting from misdiagnoses. We generated diagnostic accuracy data from a clinical evidence-based analysis (reported separately), and we developed a deterministic Markov model to estimate the additional long-term costs and life-years lost due to false-negative results. We then also performed a budget impact analysis using data from Ontario administrative sources. One-year costs were estimated for CT colonography and colon capsule endoscopy (replacing all CT colonography procedures, and replacing only those CT colonography procedures in patients with an incomplete colonoscopy within the previous year). We conducted this analysis from the payer perspective. Results Using the point estimates of diagnostic accuracy from the head-to-head study between colon capsule endoscopy and CT colonography, we found the additional cost of false-positive results for colon capsule endoscopy to be $0.41 per patient, while additional false-negatives for the CT colonography arm generated an added cost of $116 per patient, with 0.0096 life-years lost per patient due to cancer. This results in an additional cost of $26,750 per life-year gained for colon capsule endoscopy compared with CT colonography. The total 1-year cost to replace all CT colonography procedures with colon capsule

  1. Role of human neutrophil gelatinase associated lipocalin (NGAL) and Matrix Metalloproteinase-9 (MMP-9) overexpression in neoplastic colon polyps.

    PubMed

    Odabasi, Mehmet; Yesil, Atakan; Ozkara, Selvinaz; Paker, Nurcan; Ozkan, Sevil; Eris, Cengiz; Yildiz, Mehmet Kamil; Abuoglu, Hacı Hasan; Gunay, Emre; Tekeşin, Kemal

    2014-01-01

    To explore the role of Human neutrophil gelatinase associated lipocalin (NGAL) and Matrix Metalloproteinase-9 (MMP-9) overexpression in neoplastic polyps and might used as a marker to separate those from non-noeplastic polyps. The study was performed on total 65 cases, 40% (n = 26) of them females and 60% (n = 39) of them males, in Haydarpasa Numune Education and Research Hospital between March 2012 and June 2012. The assessment of immunostained sections was performed by a random principle by one experinced pathologists to the clinico-pathological data. NGAL expression was based on the presence of cytoplasmic and membranous staining. The NGAL intensities of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). The NGAL prevalences of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). The NGAL ID scores of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). We could hypothesize that NGAL and MMP-9 overexpression in neoplastic polyps might be used as a marker to separate those from non-noeplastic polyps. However, in this study, we determined that NGAL overexpression could not distinguish dysplasia from adenocancer. Finally, we suggest NGAL and MMP-9 as an immunohistochemical marker for colonic dysplasia. To determine dysplasia in early steps of colorectal adenoma-carcinoma sequence, it could help to determine new targets in preventive cancer therapy for colorectal cancer. We suggest development of standards for study method, introduction to routine practice by investigating in future studies including many patients.

  2. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging.

    PubMed

    Budenz, Cameron L; Lesperance, Marci M; Gebarski, Stephen

    2005-11-01

    We report a case of hairy polyp of the pharynx diagnosed on brain MRI in order to stress the need to examine carefully all tissues included on an imaging study, even those outside the clinically stated region of interest, and to remind practitioners to consider unusual as well as common etiologies for neonatal respiratory distress. Our case is unique in that thorough examination of a brain MRI, ordered in the evaluation of presumed central apnea, led to the correct diagnosis.

  3. Age distribution, polyps and rectal cancer in the Egyptian population-based cancer registry

    PubMed Central

    Veruttipong, Darlene; Soliman, Amr S; Gilbert, Samuel F; Blachley, Taylor S; Hablas, Ahmed; Ramadan, Mohamed; Rozek, Laura S; Seifeldin, Ibrahim A

    2012-01-01

    AIM: To describe the clinical and epidemiologic profiles of the disease and to compare the findings with those generated from the previous hospital-based studies. METHODS: The Gharbiah cancer registry is the only population-based cancer registry in Egypt since 1998. We analyzed the data of all colorectal cancer patients included in the registry for the period of 1999-2007. All medical records of the 1364 patients diagnosed in Gharbiah during the study period were retrieved and the following information abstracted: age, residence, diagnosis date, grade, stage, topology, clinical characteristics, and histology variables. Egyptian census data for 1996 and 2006 were used to provide the general population’s statistics on age, sex, residence and other related demographic factors. In addition to age- and sex-specific incidence rate analyses, we analyze the data to explore the incidence distribution by rural-urban differences among the 8 districts of the province. We also compared the incidence rates of Gharbiah to the rates of the Surveillance Epidemiology and End Results (SEER) data of the United States. RESULTS: Over the 9 year-period, 1364 colorectal cancer cases were included. The disease incidence under age 40 years was relatively high (1.3/105) while the incidence in the age groups 40 and over was very low (12.0/105, 19.4/105 and 21.2/105 in the age groups 40-59 years, 60-69 years and > 70 years, respectively). The vast majority of tumors (97.2%) had no polyps and 37.2% of the patients presented with primary lesions in the rectum. Colorectal cancer was more common in patients from urban (55%) than rural (45%) areas. Regional differences in colon and rectal cancer incidence in the 8 districts of the study province may reflect different etiologic patterns in this population. The registry data of Egypt shows a slightly higher incidence of colorectal cancer than the United States in subjects under age 40 years. The results also shows significantly lower incidence of

  4. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps.

    PubMed

    Abu Dayyeh, Barham K; Thosani, Nirav; Konda, Vani; Wallace, Michael B; Rex, Douglas K; Chauhan, Shailendra S; Hwang, Joo Ha; Komanduri, Sri; Manfredi, Michael; Maple, John T; Murad, Faris M; Siddiqui, Uzma D; Banerjee, Subhas

    2015-03-01

    In vivo real-time assessment of the histology of diminutive (≤5 mm) colorectal polyps detected at colonoscopy can be achieved by means of an "optical biopsy" by using currently available endoscopic technologies. This systematic review and meta-analysis was performed by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee to specifically assess whether acceptable performance thresholds outlined by an ASGE Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) document for clinical adoption of these technologies have been met. We conducted direct meta-analyses calculating the pooled negative predictive value (NPV) for narrow-band imaging (NBI), i-SCAN, and Fujinon Intelligent Color Enhancement (FICE)-assisted optical biopsy for predicting adenomatous polyp histology of small/diminutive colorectal polyps. We also calculated the pooled percentage agreement with histopathology when assigning postpolypectomy surveillance intervals based on combining real-time optical biopsy of colorectal polyps 5 mm or smaller with histopathologic assessment of polyps larger than 5 mm. Random-effects meta-analysis models were used. Statistical heterogeneity was evaluated by means of I(2) statistics. Our meta-analyses indicate that optical biopsy with NBI, exceeds the NPV threshold for adenomatous polyp histology, supporting a "diagnose-and-leave" strategy for diminutive predicted nonneoplastic polyps in the rectosigmoid colon. The pooled NPV of NBI for adenomatous polyp histology by using the random-effects model was 91% (95% confidence interval [CI], 88-94). This finding was associated with a high degree of heterogeneity (I(2) = 89%). Subgroup analysis indicated that the pooled NPV was greater than 90% for academic medical centers (91.8%; 95% CI, 89-94), for experts (93%; 95% CI, 91-96), and when the optical biopsy assessment was made with high confidence (93%; 95% CI, 90-96). Our meta-analyses also indicate that the agreement in

  5. Synthesis and Properties of Poly[p-(2,5-dihydroxy)-phenylenebenzobisoxazole] Fiber

    PubMed Central

    Lin, Hong; Huang, Yu-Dong; Wang, Feng

    2008-01-01

    The novel polymer poly[p-(2,5-dihydroxy)-phenylenebenzobisoxazole] (PBOH) fiber was synthesized in the presence of 2,5-dihydroxyterephthalicacid (DHTA) and 4,6-diamino-1,3-benzenediol in poly(phosphoric acid) (PPA) using typical polycondensation conditions. The crystalline solutions of liquid PBOH in PPA were spun into fibers using dry-jet wet spinning. Furthermore, the thermostability and mechanical properties of PBOH were compared with poly(p-phenylene-2,6-benzoxazole) (PBO) in order to investigate the relationship between the chain structure and properties. The results indicated that the thermal degradation temperature of PBOH was above 750K and the tensile strength of the PBOH fiber was 3.1GPa, which were much lower than those of PBO fiber. The compressive strength of PBOH fiber was 331 M Pa, which was slightly higher than that of PBO fiber. In addition, molecular simulation was employed to explain why the compressive strength of PBOH fiber did not increase significantly compared to PBO fiber. PMID:19330065

  6. Inflammatory fibroid polyp in the duodenum of a common marmoset (Callithrix jacchus).

    PubMed

    Yokouchi, Yusuke; Imaoka, Masako; Sayama, Ayako; Jindo, Toshimasa; Sanbuissho, Atsushi

    2013-01-01

    A 32-month-old male common marmoset had a firm and white-colored mass in the duodenal wall. The cut surface was smooth and grayish white in color. Histologically, the mass consisted of a proliferation of spindle cells with an oval to spindle-shaped nucleus and scant eosinophilic cytoplasm in a loose myxoid or fibrotic background. Most of the lesion displayed no specific growth pattern whereas some of the cells concentrated around the vessels and created an onion-bulb structure. Additionally, marked inflammatory cellular infiltration, mainly eosinophils, was observed throughout the lesion. Immunohistochemically, the spindle cells were positive for vimentin, α-smooth muscle actin, fascin, and cyclin D1, and negative for S-100, factor VIII-related antigen, and c-kit. These histological and immunohistochemical features did not meet any differential diagnoses such as gastrointestinal stromal tumor, inflammatory myofibroblastic tumor, solitary fibrous tumor/hemangiopericytoma, smooth muscle tumor, schwannoma, and hemangiosarcoma. Collectively, the authors diagnosed the mass as a lesion that corresponded to an inflammatory fibroid polyp (IFP) in humans. IFP is defined as a mesenchymal proliferation composed of spindle stromal cells, small blood vessels, and inflammatory cells, particularly eosinophils, and is currently classified as a nonneoplastic lesion. To the best of our knowledge, this is the first case of spontaneous IFP in nonhuman primates.

  7. Transcriptome Analysis Reveals Distinct Gene Expression Profiles in Eosinophilic and Noneosinophilic Chronic Rhinosinusitis with Nasal Polyps

    PubMed Central

    Wang, Weiqing; Gao, Zhiqiang; Wang, Huaishan; Li, Taisheng; He, Wei; Lv, Wei; Zhang, Jianmin

    2016-01-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP), one of the most prevalent chronic diseases, is characterized by persistent inflammation of sinonasal mucosa. However, the pathogenesis of CRSwNP remains unclear. Here, we performed next-generation RNA sequencing and a comprehensive bioinformatics analyses to characterize the transcriptome profiles, including mRNAs and long noncoding RNAs (lncRNAs), in patients with eosinophilic and noneosinophilic CRSwNP. A total of 1917 novel lncRNAs and 280 known lncRNAs were identified. We showed eosinophilic CRSwNP (ECRSwNP) and noneosinophilic CRSwNP (non-ECRSwNP) display distinct transcriptome profiles. We identified crucial pathways, including inflammatory, immune response and extracellular microenvironment, connected to the pathogenetic mechanism of CRSwNP. We also discovered key lncRNAs differentially expressed, including lncRNA XLOC_010280, which regulates CCL18 and eosinophilic inflammation. The qRT-PCR and in situ RNA hybridization results verified the key differentially expressed genes. The feature of distinct transcriptomes between ECRSwNP and non-ECRSwNP suggests the necessity to develop specific biomarkers and personalized therapeutic strategies. Our findings lay a solid foundation for subsequent functional studies of mRNAs and lncRNAs as diagnostic and therapeutic targets in CRSwNP by providing a candidate reservoir. PMID:27216292

  8. A Machine-Learned Predictor of Colonic Polyps Based on Urinary Metabolomics

    PubMed Central

    Greiner, Russell; Wang, Haili; Fedorak, Richard N.

    2013-01-01

    We report an automated diagnostic test that uses the NMR spectrum of a single spot urine sample to accurately distinguish patients who require a colonoscopy from those who do not. Moreover, our approach can be adjusted to tradeoff between sensitivity and specificity. We developed our system using a group of 988 patients (633 normal and 355 who required colonoscopy) who were all at average or above-average risk for developing colorectal cancer. We obtained a metabolic profile of each subject, based on the urine samples collected from these subjects, analyzed via 1H-NMR and quantified using targeted profiling. Each subject then underwent a colonoscopy, the gold standard to determine whether he/she actually had an adenomatous polyp, a precursor to colorectal cancer. The metabolic profiles, colonoscopy outcomes, and medical histories were then analysed using machine learning to create a classifier that could predict whether a future patient requires a colonoscopy. Our empirical studies show that this classifier has a sensitivity of 64% and a specificity of 65% and, unlike the current fecal tests, allows the administrators of the test to adjust the tradeoff between the two. PMID:24307992

  9. Malignant transformation of foveolar hyperplastic polyp of the stomach: a histopathological study.

    PubMed

    Terada, Tadashi

    2011-12-01

    The author investigated histopathology of malignant changes of gastric foveolar hyperplastic polyps (GFHP). A total of 497 GFHP from 412 patients were retrospectively examined. Malignant changes were present in 11 GHP (2.2%). They were focal malignancies and well-differentiated adenocarcinoma without apparent invasion. In all the 11 GFHP, dysplastic glands were present in the vicinity of carcinomatous foci. Focal intestinal metaplasia was recognized in one case and was absent in the remaining 10 GFHP. Focal dysplastic glands were recognized in 51 GFHP (10%). Of these, four GFHP were associated with focal intestinal metaplasia, but the remaining 47 GFHP were not associated with intestinal metaplasia. Intestinal metaplasia alone was recognized in 23 GFHP (5%). Immunohistochemically, all carcinomatous foci within the 11 GFHP with malignant transformation showed positive p53 expression and high Ki-67 labeling. Of the 51 GFHP with dysplasia, 42 GFHP were positive for p53 protein, and the remaining 9 GFHP were negative for p53 protein. The dysplastic lesions of the 51 GFHP showed relatively high Ki-67 index. Intestinal metaplasia within GFHP was negative for p53 protein and showed low Ki-67 labeling. These results suggest that malignant transformation of GFHP may occur in 2.2% of cases, and that malignant changes develop via hyperplasia-dysplasia-carcinoma sequence in GFHP. Intestinal metaplasia within GFHP was not associated with carcinogenesis of GFHP.

  10. Differential Expression Patterns of EGF, EGFR, and ERBB4 in Nasal Polyp Epithelium

    PubMed Central

    Zhao, Li; Subramaniam, Somasundaram; Yu, Xue Min; Li, Ying Ying; Chen, De Hua; Li, Tian Ying; Shen, Liang; Shi, Li; Wang, De Yun

    2016-01-01

    Epidermal growth factor receptors play an important role in airway epithelial cell growth and differentiation. The current study investigates the expression profiles of EGF, EGFR and ERBB4 in patients with nasal polyps (NP), and their response to glucocorticosteroid (GC) treatment. Fifty patients with NP (40 without GC treatment and 10 with oral GC) and 20 control subjects with septal deviation were recruited into the study. Protein levels of EGF, EGFR, and ERBB4 were evaluated by immune-staining. In healthy nasal epithelium, EGF and EGFR localized within p63+ basal cells, while ERBB4 localized within ciliated cells. GC-naïve NP epithelium showed weak expression of EGF in 90% of samples versus 5% of controls. EGFR was significantly increased in the epithelium with basal cell hyperplasia from GC-naïve NPs (78%, 31/40) compared to controls (23%, 4/17). EGFR was also found in some degranulating goblet cells. ERBB4 expression was significantly higher in hyperplastic epithelium from GC-naïve NPs (65%, 26/40) than in controls (6%, 1/17). GC treatment restored the EGF expression and normalized the EGFR and ERBB4 expression in NPs. Differential expression patterns of EGF, EGFR, and ERBB4 are essential in epithelial restitution and remodeling in nasal epithelium. PMID:27285994

  11. [Clinico-pathological studies on Is, Ip polyps and flat elevations in the large intestine].

    PubMed

    Kida, M; Tanaka, K; Hattori, F; Kondou, S; Harada, W; Takagi, A; Itou, K; Matsumoto, H; Kojima, K; Taniyama, K

    1990-05-01

    We histologically compared 3 types of adenoma and cancer of the large intestine using 620 adenoma specimens (509 Is type lesions, 83 Ip type lesions, and 28 flat type lesions) and 113 specimens of early stage cancer (51 Is type lesions, 39 Ip type lesions, and 23 flat type lesions) obtained during the past 5-year period at our department. More than 90% of the Is and Ip type polyps were adenoma or carcinoma in adenoma while 25.5% of the flat elevations were m or sm carcinoma. Flat elevations even less than 10 mm in diameter were frequently carcinomas (26.3%) compared with the other types (both Is and Ip types, 6.7%), and all of those 10 mm or more in size were carcinomas. The distribution of the flat type early cancers in the large intestine was similar to that of advanced cancer with high percentages of carcinoma at each site compared with the other types. These results suggest that the carcinogenesis and progression of flat type early stage cancer differ from those of the other types.

  12. Retrospective measures on applying endoscopic YAG laser to treat alimentary canal diseases from 1983 to 1995

    NASA Astrophysics Data System (ADS)

    Wang, Rui-Zhong; Wu, Ning-Xiao; Gao, Su-ping; Rong, Zeng-Qin

    1996-05-01

    It was in 1983 when we started to apply YAG laser to do experiments on animal and fresh internal organs off the body to confirm its effectiveness. Then we started to use it in clinical practice. Up to October 1995, in the twelve years, we treated 1075 cases, 2574 person times. Seven-hundred-seventy-nine cases of various esophagostenosis. Four-hundred-fifty-six of them were malignant stenosis, 295 anastomostenosis, 15 stenosis after radiotherapeutics, 7 corrosive anastomostenosis, 6 inflammatory anastomostenosis, plus we cured 5 cardia losses of relax, and 241 polyps in the alimentary canal. Among the 2154 polyps cured, 6 were that of esophagus, 6 that of cardia, 25 that of stomach, 10 that of duodenum, 194 that of large intestine. In addition, we treated 15 alimentary canal bleeding and 35 malignant colon and tectum cancers. Our experience in laser operating on the coelom has become richer and richer. The methods we used are being widened. The range of our laser application is being enlarged. We have gained our own experience in preventing complications and keeping the endoscopy from being damaged. The cure rate of the non-malignant had raised up to 98.7%. Cure rate of the malignant had raised up to 91%. The alimentary canal polyps can be cured perfectly. It is hard to tell whether YAG laser or high frequency electroresection has the advantage over the other. Besides, this paper is going to put forward several questions to discuss.

  13. The role of symbiotic algae in the formation of the coral polyp skeleton: 3-D morphological study based on X-ray microcomputed tomography

    NASA Astrophysics Data System (ADS)

    Iwasaki, Shinya; Inoue, Mayuri; Suzuki, Atsushi; Sasaki, Osamu; Kano, Harumasa; Iguchi, Akira; Sakai, Kazuhiko; Kawahata, Hodaka

    2016-09-01

    Symbiotic algae of primary polyps play an important role in calcification of coral skeletons. However, the function of the symbiotic algae, including the way they influence the physical features of their host skeleton under various conditions, is not well understood. We used X-ray microcomputed tomography to observe skeletal shape characteristics in symbiotic and aposymbiotic primary polyps of Acropora digitifera that were cultured at various temperature and pCO2 levels (temperature 27, 29, 33°C; pCO2 400, 800, 1000 µatm). Symbiotic polyps had a basal plate with a well-developed folding margin supporting the branched skeleton, whereas aposymbiotic ones did not. The features of the folding margin suggest that it might be the initial growth stage of the epitheca. In addition, three-dimensional (3-D) morphological measurements made by X-ray microcomputed tomography show that the branched skeletons of symbiotic primary polyps were taller than those of aposymbiotic ones, suggesting that zooxanthellae in coral primary polyps play a critical role in the height growth of skeletal branches. Furthermore, results of the temperature- and pCO2-controlled experiments suggest that global warming might greatly affect the activity of zooxanthellae, whereas ocean acidification might reduce calcification by damaging the coral host itself. Our findings provide new knowledge about the role of zooxanthellae in coral calcification.

  14. Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps

    PubMed Central

    Fang, Rui-Li; Chen, Lin-Xing; Shu, Wen-Sheng; Yao, Shu-Zhong; Wang, Si-Wen; Chen, Yu-Qing

    2016-01-01

    Results of this study showed that the bacterial composition in vagina (V) greatly differed from intrauterine microbiome (I). Microbiomes were present in all intrauterine samples of healthy women (Group H (I)) and patients with endometrial polyps (EP) (including Group EP (I) and Group EP/chronic endometritis (CE) (I)). Indeed, the intrauterine bacteria population in Group EP/CE (I) were more diverse than those in Groups EP (I) and H (I). The result also confirmed the bacterial composition differences between vagina and uterus as well as the intrauterine microbiome alteration in the patients, compared to the healthy. Although bacteria of Proteobacteria, Firmicutes and Actinobacteria, dominated the intrauterine microbiome in all samples, however, proportions of Firmicutes from Group EP/CE (I) and Group EP (I) were much higher than that from Group H (I), in contrast, the proportions of Proteobacteria were far lower than the healthy. At the genus level, compared to Group H (I), it is found that proportions of Lactobacillus, Gardnerella, Bifidobacterium, Streptococcus, and Alteromonas were significantly higher, and that of Pseudomonas were significantly lower in Group EP/CE (I) or Group EP (I). In addition, lower proportions of Enterobacter and Sphingomonas and a higher proportion of Prevotella were also observed in Group EP/CE (I). In conclusion, uterine microbiomes between patients with EP and the healthy are significantly different and all the potentially important variation of uterine microbes may cause EP, but not definitively related to CE. Further experiments should be performed to test these relationships to endometritis occurrence. PMID:27186283

  15. Different roles of Staphylococcus aureus enterotoxin in different subtypes of nasal polyps

    PubMed Central

    Cheng, Ke-Jia; Wang, Shen-Qing; Xu, Ying-Ying

    2017-01-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease. The pathogenesis of CRSwNP remains unclear. This study was designed to investigate the role of inflammation and Staphylococcus aureus enterotoxin (SE) in this disease. The study included a total of 74 patients with CRSwNP and 6 controls. A serum Phadiatop assay was conducted to detect atopy status, and serum eosinophil cationic protein (ECP) and total immunoglobulin (Ig)E levels were determined using ELISA. SEA, SEB, total IgE, ECP and myeloperoxidase (MPO) levels in nasal tissue supernatant were measured using ELISA. The results indicated that 15 (22.1%) patients had systemic allergies. On the basis of the ECP/MPO ratio, the patients were divided into an eosinophilic CRSwNP group (n=18) and a non-eosinophilic CRSwNP group (n=56). The total ECP/MPO ratio was 0.572, with a notable bias toward neutrophilic inflammation. The supernatant ECP and MPO levels were elevated in the CRSwNP group compared with the control group, but no significant difference in the serum total IgE and ECP levels were observed between the CRSwNP and control groups. In addition, the non-eosinophilic and eosinophilic CRSwNP groups showed significant elevations in supernatant total IgE, SEA and SEB levels compared with the control group. Thus, it may be concluded that allergy is a common pathogenesis of CRSwNP, and neutrophilic inflammation is present in most Chinese CRSwNP patients. Additionally, local indicators reflect the inflammatory status more accurately than do serum indicators. SEs may act as an infection factor rather than as a superantigen in Chinese non-eosinophilic CRSwNP patients. Thus, long-term antibiotic therapy may be an option for Chinese non-eosinophilic CRSwNP patients. PMID:28123509

  16. Expression of apical junction complex proteins in colorectal mucosa of miniature dachshunds with inflammatory colorectal polyps

    PubMed Central

    YOKOYAMA, Nozomu; OHTA, Hiroshi; KAGAWA, Yumiko; LEELA-ARPORN, Rommaneeya; DERMLIM, Angkhana; NISA, Khoirun; MORITA, Tomoya; OSUGA, Tatsuyuki; SASAKI, Noboru; MORISHITA, Keitaro; NAKAMURA, Kensuke; TAKIGUCHI, Mitsuyoshi

    2017-01-01

    We examine the expression of tight junction and adherence junction proteins in the colorectal mucosa of miniature dachshunds (MDs) with inflammatory colorectal polyps (ICRPs). Colorectal mucosa samples were endoscopically obtained from 8 MDs with ICRPs and 8 control dogs for immunoblotting. Paraffin-embedded tissues of surgically resected inflamed lesions from another 5 MDs with ICRPs and full-thickness colorectal specimens from 5 healthy beagles were obtained for immunohistochemistry. The expression patterns of claudin-1, -2, -3, -4, -5, -7 and -8, E-cadherin and β-catenin were analyzed in the non-inflamed mucosa and inflamed mucosa of ICRPs and colorectal mucosa of control dogs by immunoblotting. The localization of these proteins in the inflamed lesions was analyzed by immunohistochemistry. The expressions of each of claudin, E-cadherin and β-catenin were not significantly different between control dogs and non-inflamed colonic mucosa from MDs with ICRPs. In contrast, only E-cadherin and β-catenin were detected in the inflamed lesions of MDs with ICRPs. By immunohistochemistry, claudin-2, -3, -4, -5 and -7, E-cadherin and β-catenin were expressed in the colorectal epithelium within the inflamed mucosa, but not in granulation tissue. Distributions of claudin-2, -3, -4, -5, and -7, E-cadherin and β-catenin in the colonic epithelium were not different between MDs with ICRPs and control dogs. These results indicated that no significant alteration was detected in several tight junction or adherence junction proteins expression in the colorectal epithelium of ICRPs. PMID:28090006

  17. Heavy metals in normal mucosa and nasal polyp tissues from Tunisian patients.

    PubMed

    Khlifi, Rim; Olmedo, Pablo; Gil, Fernando; Chakroun, Amine; Hammami, Boutheina; Hamza-Chaffai, Amel

    2015-01-01

    Despite growing evidence that bacteria, fungi, allergens, and superantigens play a prominent role in the pathophysiology of nasal polyps (NP), the exact cause of polyposis is still unknown. The etiology of NP is considered multifactorial. Until now, there is no information on the presence of heavy metals, such as cadmium (Cd), chromium (Cr), nickel (Ni), and arsenic (As) or of their role, in the pathogenesis of NP disease. In this study, concentrations of these four metals in tissue of NP were determined using Atomic Absorption Spectrometry. The Ni, Cr, and As levels in NP tissues were 2.1-, 3.2-, and 8.0-fold higher than those of normal mucosa (p < 0.05), respectively. A strong effect of cumulative smoking as expressed in the number of pack per year (PY), Ni, As, and Cd levels in NP tissue samples of patients ever-smokers (1-20 and >20 PY) are significantly higher than those of non-smokers (p = 0.006, 0.002, and < 0.001, respectively). The highest As concentrations among patients lived at polluted areas (1-25 and > 25 years) were observed in both nasal mucosa and NP tissues. The Ni and As in both nasal mucosa and NP tissues of patients occupationally exposed were significantly higher than non-exposed group. Cr and As levels were found to be associated with NP stage classification (p < 0.05). This is the first report to describe an association between concentrations of metals (Cr, As, and Ni) in human NP tissues and the risk of NP disease. Tissue metal levels have increased due to smoking, environmental, and occupational exposure. Therefore, heavy metal exposure may increase the risk of NP in the Tunisian population. The considerable risk in the category of highest cumulative exposure argues for an association between heavy metals exposure and nasal polyposis risk. Future investigations with larger samples should better elucidate this association.

  18. Gastric Proteins MUC5AC and TFF1 as Potential Diagnostic Markers of Colonic Sessile Serrated Adenomas/Polyps

    PubMed Central

    Khaidakov, Magomed; Lai, Keith K.; Roudachevski, D.; Sargsyan, Julietta; Goyne, Hannah E.; Pai, Rish K.; Lamps, Laura W.

    2016-01-01

    Objectives: A subset of colon cancers originates from sessile serrated adenomas/polyps (SSA/Ps). Our goal was to identify markers for SSA/Ps that could aid in distinguishing them from hyperplastic polyps (HPs). Methods: We performed immunostaining for gastric proteins MUC5AC and TFF1 in formalin-fixed, paraffin-embedded (FFPE) samples of HPs (n = 47), SSA/Ps (n = 37), and normal colon (n = 30). Results: Control mucosa expressed only trace amounts of MUC5AC and TFF1. HPs exhibited an 11.3- and 11.4-fold increase in MUC5AC and TFF1 expression confined to the upper segments of the crypts near the luminal surface of the polyps. SSA/Ps displayed on average 1.6-fold (MUC5AC, P < .008) and 1.4-fold (TFF1, P < .03) higher signal intensity for these markers than HPs, with a dramatic coexpression of MUC5AC and TFF1 typically occupying the entire length of the crypt. Immunoperoxidase results were similar to immunofluorescence staining for both MUC5AC and TFF1. Conclusions: Our results suggest that the analysis of expression of MUC5AC and TFF1 may be useful for differentiating SSA/Ps from HPs. We also suggest the possibility that crypt morphology may be at least partly due to overproduction of highly viscous gastric mucins and that these proteins may play a role in the serrated pathway to colon carcinogenesis.

  19. Gene Transcription Changes in Asthmatic Chronic Rhinosinusitis with Nasal Polyps and Comparison to Those in Atopic Dermatitis

    PubMed Central

    Plager, Douglas A.; Kahl, Jane C.; Asmann, Yan W.; Nilson, Allan E.; Pallanch, John F.; Friedman, Oren; Kita, Hirohito

    2010-01-01

    Background Asthmatic chronic rhinosinusitis with nasal polyps (aCRSwNP) is a common disruptive eosinophilic disease without effective medical treatment. Therefore, we sought to identify gene expression changes, particularly those occurring early, in aCRSwNP. To highlight expression changes associated with eosinophilic epithelial inflammation, we further compared the changes in aCRSwNP with those in a second eosinophilic epithelial disease, atopic dermatitis (AD), which is also closely related to asthma. Methods/Principal Findings Genome-wide mRNA levels measured by exon array in both nasosinus inflamed mucosa and adjacent polyp from 11 aCRSwNP patients were compared to those in nasosinus tissue from 17 normal or rhinitis subjects without polyps. Differential expression of selected genes was confirmed by qRT-PCR or immunoassay, and transcription changes common to AD were identified. Comparison of aCRSwNP inflamed mucosa and polyp to normal/rhinitis tissue identified 447 differentially transcribed genes at ≥2 fold-change and adjusted p-value<0.05. These included increased transcription of chemokines localized to chromosome 17q11.2 (CCL13, CCL2, CCL8, and CCL11) that favor eosinophil and monocyte chemotaxis and chemokines (CCL18, CCL22, and CXCL13) that alternatively-activated monocyte-derived cells have been shown to produce. Additional transcription changes likely associated with Th2-like eosinophilic inflammation were prominent and included increased IL1RL1 (IL33 receptor) and EMR1&3 and decreased CRISP2&3. A down-regulated PDGFB-centric network involving several smooth muscle-associated genes was also implicated. Genes at 17q11.2, genes associated with alternative activation or smooth muscle, and the IL1RL1 gene were also differentially transcribed in AD. Conclusions/Significance Our data implicate several genes or gene sets in aCRSwNP and eosinophilic epithelial inflammation, some that likely act in the earlier stages of inflammation. The identified gene

  20. Simultaneous fingerprint and high-wavenumber fiber-optic Raman spectroscopy enhances real-time in vivo diagnosis of adenomatous polyps during colonoscopy.

    PubMed

    Bergholt, Mads Sylvest; Lin, Kan; Wang, Jianfeng; Zheng, Wei; Xu, Hongzhi; Huang, Qingwen; Ren, Jian-Lin; Ho, Khek Yu; Teh, Ming; Srivastava, Supriya; Wong, Benjamin; Yeoh, Khay Guan; Huang, Zhiwei

    2016-04-01

    Colorectal cancer can be prevented if detected early (e.g., precancerous polyps-adenoma). Endoscopic differential diagnosis of hyperplastic polyps (that have little or no risk of malignant transformation) and adenomas (that have prominent malignant latency) remains an unambiguous clinical challenge. Raman spectroscopy is an optical vibrational technique capable of probing biomolecular changes of tissue associated with neoplastic transformation. This work aims to apply a fiber-optic simultaneous fingerprint (FP) and high wavenumber (HW) Raman spectroscopy technique for real-time in vivo assessment of adenomatous polyps during clinical colonoscopy. We have developed a fiber-optic Raman endoscopic technique capable of simultaneously acquiring both the FP (i.e., 800-1800 cm(-1)) and HW (i.e., 2800-3600 cm(-1)) Raman spectra from colorectal tissue subsurface (<200 µm) for real-time assessment of colorectal carcinogenesis. In vivo FP/HW Raman spectra were acquired from 50 patients with 17 colorectal polyps during clinical colonoscopy. Prominent Raman spectral differences (p < 0.001) were found between hyperplastic (n = 118 spectra), adenoma (n = 184 spectra) that could be attributed to changes in inter- and intra-cellular proteins, lipids, DNA and water structures and conformations. Simultaneous FP/HW Raman endoscopy provides a diagnostic sensitivity of 90.9% and specificity of 83.3% for differentiating adenoma from hyperplastic polyps, which is superior to either the FP or HW Raman technique alone. This study shows that simultaneous FP/HW Raman spectroscopy technique has the potential to be a clinically powerful tool for improving early diagnosis of adenomatous polyps in vivo during colonoscopic examination.

  1. Large-scale validation of a computer-aided polyp detection algorithm for CT colonography using cluster computing

    NASA Astrophysics Data System (ADS)

    Bitter, Ingmar; Brown, John E.; Brickman, Daniel; Summers, Ronald M.

    2004-04-01

    The presented method significantly reduces the time necessary to validate a computed tomographic colonography (CTC) computer aided detection (CAD) algorithm of colonic polyps applied to a large patient database. As the algorithm is being developed on Windows PCs and our target, a Beowulf cluster, is running on Linux PCs, we made the application dual platform compatible using a single source code tree. To maintain, share, and deploy source code, we used CVS (concurrent versions system) software. We built the libraries from their sources for each operating system. Next, we made the CTC CAD algorithm dual-platform compatible and validate that both Windows and Linux produced the same results. Eliminating system dependencies was mostly achieved using the Qt programming library, which encapsulates most of the system dependent functionality in order to present the same interface on either platform. Finally, we wrote scripts to execute the CTC CAD algorithm in parallel. Running hundreds of simultaneous copies of the CTC CAD algorithm on a Beowulf cluster computing network enables execution in less than four hours on our entire collection of over 2400 CT scans, as compared to a month a single PC. As a consequence, our complete patient database can be processed daily, boosting research productivity. Large scale validation of a computer aided polyp detection algorithm for CT colonography using cluster computing significantly improves the round trip time of algorithm improvement and revalidation.

  2. Antispasmodic drugs in colonoscopy: a review of their pharmacology, safety and efficacy in improving polyp detection and related outcomes

    PubMed Central

    Sanagapalli, Santosh; Agnihotri, Kriti; Leong, Rupert; Corte, Crispin John

    2016-01-01

    Antispasmodic drugs are cheap, effective and generally safe. They may improve outcomes in colonoscopy, however their use has not been consistent or widespread. This manuscript reviews the three most commonly used antispasmodics in colonoscopy, namely, hyoscine butylbromide (and related ammonium compounds), glucagon and peppermint oil. The pharmacology, action and safety of the agents, as well as the evidence for them improving colonoscopic outcomes will be discussed. In addition to polyp detection, other colonoscopic outcome endpoints of interest include cecal and ileal intubation, and patient comfort. The drugs studied were all found to be effective gastrointestinal antispasmodics with good safety profiles. There is insufficient evidence to conclude whether antispasmodics improve cecal intubation rate, predominantly because the baseline rates are already high. Antispasmodics probably have efficacy in reducing cecal intubation time especially in those with marked colonic spasm. Antispasmodics do not offer significant benefit in polyp detection or improving patient comfort during colonoscopy. Future studies should focus on inexperienced colonoscopists as well as those with marked colonic spasm, in whom the greatest benefit seems to lie. PMID:28286563

  3. High dry bean intake and reduced risk of advanced colorectal adenoma recurrence among participants in the polyp prevention trial.

    PubMed

    Lanza, Elaine; Hartman, Terryl J; Albert, Paul S; Shields, Rusty; Slattery, Martha; Caan, Bette; Paskett, Electra; Iber, Frank; Kikendall, James Walter; Lance, Peter; Daston, Cassandra; Schatzkin, Arthur

    2006-07-01

    Adequate fruit and vegetable intake was suggested to protect against colorectal cancer and colorectal adenomas; however, several recent prospective studies reported no association. We examined the association between fruits and vegetables and adenomatous polyp recurrence in the Polyp Prevention Trial (PPT). The PPT was a low-fat, high-fiber, high-fruit, and vegetable dietary intervention trial of adenoma recurrence, in which there were no differences in the rate of adenoma recurrence in participants in the intervention and control arms of the trial. In this analysis of the entire PPT trial-based cohort, multiple logistic regression analysis was used to estimate the odds ratio (OR) of advanced and nonadvanced adenoma recurrence within quartiles of baseline and change (baseline minus the mean over 3 y) in fruit and vegetable intake, after adjustment for age, total energyy intake, use of nonsteroidal anti-inflammatory drugs, BMI, and gender. There were no significant associations between nonadvanced adenoma recurrence and overall change in fruit and vegetable consumption; however, those in the highest quartile of change in dry bean intake (greatest increase) compared with those in the lowest had a significantly reduced OR for advanced adenoma recurrence (OR = 0.35; 95% CI, 0.18-0.69; P for trend = 0.001). The median in the highest quartile of change in dry bean intake was 370% higher than the baseline intake. The PPT trial-based cohort provides evidence that dry beans may be inversely associated with advanced adenoma recurrence.

  4. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding.

    PubMed

    Cooper, Natalie A M; Middleton, Lee; Smith, Paul; Denny, Elaine; Stobert, Lynda; Daniels, Jane; Clark, T Justin

    2016-01-01

    Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.

  5. Endoscopic resection of colorectal polyps in patients on antiplatelet therapy: an evidence-based guidance for clinicians.

    PubMed

    Plumé Gimeno, Gema; Bustamante-Balén, Marco; Satorres Paniagua, Carla; Díaz Jaime, Francia Carolina; Cejalvo Andújar, Maria José

    2017-01-01

    Due to the rising prevalence of coronary heart disease, endoscopists are more frequently performing a polypectomy in patients on antiplatelet therapy (APT) and dual antiplatelet therapy (DATP). Despite the availability of several guidelines with regard to the management of antiplatelet drugs during the periprocedure period, there is still variability in the current clinical practice. This may be influenced by the low quality of the evidence supporting recommendations, because most of the studies dealing with APT and polypectomy are observational and retrospective, and include mainly small (< 10 mm) polyps. However, some recommendations can still be made. An estimation of the bleeding and thrombotic risk of the patient should be made in advance. In the case of DAPT the procedure should be postponed, at least until clopidogrel can be safely withheld. If possible, non-aspirin antiplatelet drugs should be withheld 5-7 days before the procedure. Polyp size is the main factor related with post-polypectomy bleeding and it is the factor that should drive clinical decisions regarding the resection method and the use of endoscopic prophylactic measures. Non-aspirin antiplatelet agents can be reintroduced 24-48 hours after the procedure. In conclusion, there is little data with regard to the management of DAPT in patients with a scheduled polypectomy. Large randomized controlled trials are needed to support clinical recommendations.

  6. Treating Sludges

    ERIC Educational Resources Information Center

    Josephson, Julian

    1978-01-01

    Discussed are some of the ways to handle municipal and industrial wastewater treatment sludge presented at the 1978 American Chemical Society meeting. Suggestions include removing toxic materials, recovering metals, and disposing treated sewage sludge onto farm land. Arguments for and against land use are also given. (MA)

  7. Treating Syphilis

    PubMed Central

    Colby, W. David

    1992-01-01

    Background information on treating syphilis indicates that some currently recommended approaches to therapy are not optimal. There is no perfect drug schedule available, but penicillin remains the drug of choice. The author's recommendations for treatment and follow up are presented. PMID:21221354

  8. Dynamic enhanced computed tomography imaging findings of an inflammatory fibroid polyp with massive fibrosis in the stomach

    PubMed Central

    Shim, Eun Jung; Ahn, Sung Eun; Lee, Dong Ho; Park, Seong Jin; Kim, Youn Wha

    2017-01-01

    Inflammatory fibroid polyp (IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography (CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis. PMID:28373777

  9. Gender and plasma iron biomarkers, but not HFE gene mutations, increase the risk of colorectal cancer and polyps.

    PubMed

    Castiella, Agustin; Múgica, Fernando; Zapata, Eva; Zubiaurre, Leire; Iribarren, Arantxa; de Juan, M Dolores; Alzate, Luis; Gil, Ines; Urdapilleta, Gregorio; Otazua, Pedro; Emparanza, José Ignacio

    2015-09-01

    A cohort study of patients included in the Basque Country colorectal cancer (CRC) screening programme was carried out to assess the risk of adenomatous polyps and CRC (P-CRC) associated with HFE gene mutations, with gender and with iron biomarkers (serum ferritin (SF), iron (Fe) and transferrin saturation index (TSI)). Among 432 included patients (mean age 59.8 years), 263 were men (60.9 %) and 169 women (39.1 %). P-CRC were identified in 221 patients (51.2 %) and no polyps (NP) in 211 patients (48.8 %). HFE mutations were identified in 43.8 % of the patients. C282Y/wt genotypic frequency was 6.8 % in the P-CRC group and 1.4 % in the NP group (p < 0.05). The allelic frequency was 3.8 versus 1.2 % (p < 0.05). For laboratory, all three iron biomarkers showed a statistically significant difference: mean Fe, 91.29 ± 34 for P-CRC and 80.81 ± 30.59 for NP group. Mean TSI for P-CRC was 24.95 ± 8.90 and 22.74 ± 8.79 for NP group. Mean SF 308.09 ± 536.32 for P-CRC and 177.55 ± 159.95 for NP group. In a multivariate logistic regression analysis, only male gender (odds ratio (OR) = 2.04, 1.29-3.22), SF (OR = 1.001, 1.0004-1.003) and Fe (OR = 1.01, 1.004-1.02) were related with the presence of CRC and adenoma. Men gender and raised serum iron biomarkers increase the risk of P-CRC.

  10. Mucins and associated O-glycans based immunoprofile for stratification of colorectal polyps: clinical implication for improved colon surveillance

    PubMed Central

    Krishn, Shiv Ram; Kaur, Sukhwinder; Sheinin, Yuri M.; Smith, Lynette M.; Gautam, Shailendra K.; Patel, Asish; Jain, Maneesh; Juvvigunta, Vasthala; Pai, Priya; Lazenby, Audrey J.; Roy, Hemant K.; Batra, Surinder K.

    2017-01-01

    Sessile serrated adenoma/polyps (SSA/P) are premalignant lesions of colorectal cancer that are difficult to distinguish histologically from hyperplastic polyps (HP) of minimal to no malignant potential. Specific markers for differentiating SSA/P from HP can aid clinicians for optimizing colon surveillance intervals. The present study investigates the potential of mucins and associated O-glycans to distinguish SSA/P from HP. Expression of colonic mucins (MUC1, MUC4, MUC17, MUC2, and MUC5AC) and O-glycans [Sialyl LewisA (CA19-9) and Tn/Sialyl-Tn on MUC1] were analyzed in HP (n=33), SSA/P (n=39), and tubular adenoma (TA) (n=36) samples by immunohistochemistry. A significantly reduced expression of MUC4 (p=0.0066), elevated expression of MUC17 (p=0.0002), and MUC5AC (p<0.0001) was observed in SSA/P cases in comparison to HP cases. Interestingly, significantly higher number of SSA/P cases (p<0.0001) exhibited MUC5AC expression in the goblet cells as well as filled the crypt lumen compared to only goblet cells in majority of the HP cases. Improved diagnostic potential was revealed by multivariate logistic regression analysis where combinatorial panel of MUC5AC/MUC17 discriminated SSA/P from HP (SN/SP=85/82%). Finally, the decision tree model based marker panel (CA19-9/MUC17/MUC5AC) predicted HP, SSA/P and TA with SN/SP of 58%/95%, 79%/90% and 97%/83%, respectively. Overall, the mucin and associated O-glycan based panel defined in the present study could aid in discriminating SSA/P from HP to devise better colon surveillance strategies. PMID:27705923

  11. Colorectal cancer anatomic distribution patterns remain the same after sessile serrated adenoma/polyp considered cancer precursor: a 9-year comparison study from community-based endoscopy centers

    PubMed Central

    Yang, Juliana F.; Noffsinger, Amy E.; Agrawal, Deepak

    2016-01-01

    Background The overall incidence of colorectal cancer (CRC) in the United States has steadily decreased. However, the incidence of right-sided CRC remains unchanged for the past two decades. The serrated neoplastic pathway (sessile serrated adenoma/polyp, SSA/P) has been considered an important pathway of colorectal carcinogenesis, especially in the right-sided CRC. The aim of this study was to compare CRC anatomic distribution patterns in a 9-year interval in the general population before and after SSA/P was recognized and treated as a CRC precursor. Methods The Miraca Life Sciences (MLS) pathology database was queried for all primary CRCs diagnosed between 8/3/2000 to 12/31/2005 (control group) and 1/1/2014 to 12/31/2014 (current group). Patients’ demographics, clinical information, and pathology reports were collected and analyzed. Results A total of 5,602 patients with 5,685 CRCs were identified, of which 2,728 patients with 2,765 CRCs in current group and 2,874 patients with 2,920 CRCs in control group. Overall, there were no statistical differences in the current group in regards to the anatomical distribution patterns of CRCs in the proximal, right-sided, distal, and left-sided colon or genders compared with the control group (all P>0.05). Among the current group, there were 33 (1.2%) patients with 38 (1.4%) CRCs arising in SSA/Ps [serrated carcinomas (SCAs)], of which 33 (86.8%) were in the right-sided colon and 5 (13.2%) in the left-sided colon. Twenty-three (69.7%) SCA patients were female with significant advanced age than male (76.4 vs. 69.6, P=0.023). Conclusions The overall current CRC anatomic distribution patterns after SSA/Ps managed as CRC precursor remain the same in the patients’ population from the community-based endoscopy centers in the U.S. It is suggested that the current SSA/P management might need to be further modified. PMID:28078114

  12. An assessment of prognostic factors, adjuvant treatment and outcomes of stage IA polyp-limited versus endometrium-limited type II endometrial carcinoma

    PubMed Central

    Liang, Lusha W.; Perez, Alexendar R.; Cangemi, Nicholas A.; Zhou, Qin; Iasonos, Alexia; Abu-Rustum, Nadeem; Alektiar, Kaled M.; Makker, Vicky

    2015-01-01

    Objective To determine clinical outcomes in patients with stage IA polyp-limited versus endometrium-limited high-grade (type II) endometrial carcinoma (EC). Methods We identified all cases of stage IA polyp-limited or endometrium-limited high-grade EC (FIGO Grade 3 endometrioid, Serous, Clear Cell, or Mixed) who underwent simple hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, omental biopsy, and pelvic and paraaortic lymph node dissection and received adjuvant treatment at our institution from 10/1995–11/2012. Progression-free survival (PFS) and overall survival (OS) by histology, adjuvant therapy, and polyp-limited vs endometrium-limited disease status were determined using log-rank test. We analyzed three treatment groups: patients who received chemotherapy with or without Radiation Therapy (RT) (intravaginal or pelvic); patients who received RT (intravaginal RT or pelvic RT) alone; and patients who received no adjuvant treatment. Results In all, 85 women underwent hysterectomy/salpingo-oophorectomy; all were surgically staged with lymph node assessment and had stage IA EC with no lymphovascular or myometrial invasion. Median follow-up for survivors was 46.5 months (range, 1.98–188.8 months). Forty-nine patients (57.6%) had polyp-limited disease and 36 (42.4%) had endometrium-limited disease. There were no significant differences in clinicopathologic characteristics between patients within the three treatment groups with regards to age at diagnosis, mean BMI, ECOG performance status, polyp-limited, endometrium-limited disease, diabetes, or race. The 3-year PFS rate was 94.9% and the 3-year OS rate was 98.8%. Univariate PFS and OS analysis revealed that age was a relevant prognostic factor [(PFS:HR (95%CI):1.13(1.02–1.25); P=0.022 and OS HR (95%CI):1.19(1.02–1.38); P=0.03]. Adjuvant treatment did not impact outcomes. Conclusions Clinical outcomes of surgical stage IA, type II polyp- or endometrium-limited high-grade epithelial EC are

  13. Needle knife-assisted endoscopic polypectomy for a large inflammatory fibroid colon polyp by making its stalk into an omega shape using an endoloop.

    PubMed

    Kim, Byung Chang; Cheon, Jae Hee; Lee, Sang Kil; Kim, Tae Il; Kim, Hoguen; Kim, Won Ho

    2008-08-30

    Colonic inflammatory fibroid polyp (IFP) is an uncommon benign polypoid lesion, which is composed of fibroblasts, numerous small vessels and edematous connective tissue with marked eosinophilic inflammatory cell infiltration. This condition is frequently detected in the stomach and small intestine, but uncommon in the colon. Although IFP is a benign lesion, surgical resections are performed in most colonic cases because the polyps are usually too large to resect endoscopically. Only three patients underwent endoscopic polypectomy in our literature reviews. Here, we present a case of IFP in the descending colon successful endoscopically resected using a novel technique of trapping its stalk with an endoloop, forming the stalk into an omega shape, and then dissecting the stalk with a needle knife.

  14. Using gene-environment interaction analyses to clarify the role of well-done meat and heterocyclic amine exposure in the etiology of colorectal polyps123

    PubMed Central

    Fu, Zhenming; Shrubsole, Martha J; Li, Guoliang; Smalley, Walter E; Hein, David W; Chen, Zhi; Shyr, Yu; Cai, Qiuyin; Ness, Reid M

    2012-01-01

    Background: The role of well-done meat intake and meat-derived mutagen heterocyclic amine (HCA) exposure in the risk of colorectal neoplasm has been suggested but not yet established. Objective: With the use of gene-environment interaction analyses, we sought to clarify the association of HCA exposure with colorectal polyp risk. Design: In a case-control study including 2057 colorectal polyp patients and 3329 controls, we evaluated 16 functional genetic variants to construct an HCA-metabolizing score. To derive dietary HCA-exposure amount, data were collected regarding dietary intake of meat by cooking method and degree of doneness. Results: A 2-fold elevated risk associated with high red meat intake was found for colorectal polyps or adenomas in subjects with a high HCA-metabolizing risk score, whereas the risk was 1.3- to 1.4-fold among those with a low risk score (P-interaction ≤ 0.05). The interaction was stronger for the risk of advanced or multiple adenomas, in which an OR of 2.8 (95% CI: 1.8, 4.6) was observed for those with both a high HCA-risk score and high red meat intake (P-interaction = 0.01). No statistically significant interaction was found in analyses that used specific HCA exposure derived from dietary data. Conclusion: High red meat intake is associated with an elevated risk of colorectal polyps, and this association may be synergistically modified by genetic factors involved in HCA metabolism. PMID:23015320

  15. Nasal Polyp-Derived Mesenchymal Stromal Cells Exhibit Lack of Immune-Associated Molecules and High Levels of Stem/Progenitor Cells Markers

    PubMed Central

    de Oliveira, Pedro Wey Barbosa; Pezato, Rogério; Agudelo, Juan Sebastian Henao; Perez-Novo, Claudina Angela; Berghe, Wim Vanden; Câmara, Niels Olsen; de Almeida, Danilo Candido; Gregorio, Luís Carlos

    2017-01-01

    Mesenchymal stromal cells (MSCs) are considered adult progenitor stem cells and have been studied in a multitude of tissues. In this context, the microenvironment of nasal polyp tissue has several inflammatory cells, but their stroma compartment remains little elucidated. Hence, we isolated MSCs from nasal polyps Polyp-MSCs (PO-MSCs) and compared their molecular features and gene expression pattern with bone marrow-derived MSCs (BM-MSCs). Initially, both PO-MSCs and BM-MSCs were isolated, cultivated, and submitted to morphologic, differentiation, phenotypic, immunosuppressive, and gene expression assays. Compared to BM-MSCs, PO-MSCs showed normal morphology and similar osteogenic/adipogenic differentiation potential, but their immunophenotyping showed lack of immune-associated molecules (e.g., CD117, HLA-DR, PDL-1, and PDL-2), which was linked with less immunoregulatory abilities such as (i) inhibition of lymphocytes proliferation and (ii) regulatory T cell expansion. Furthermore, we detected in the PO-MSCs a distinct gene expression profile in comparison with BM-MSCs. PO-MSC expressed higher levels of progenitor stem cells specific markers (e.g., CD133 and ABCB1), while BM-MSCs showed elevated expression of cytokines and growth factors (e.g., FGF10, KDR, and GDF6). The gene ontology analysis showed that the differentially modulated genes in PO-MSC were related with matrix remodeling process and hexose and glucose transport. For BM-MSCs, the highly expressed genes were associated with behavior, angiogenesis, blood vessel morphogenesis, cell–cell signaling, and regulation of response to external stimulus. Thus, these results suggest that PO-MSCs, while sharing similar aspects with BM-MSCs, express a different profile of molecules, which presumably can be implicated in the development of nasal polyp tissue. PMID:28194153

  16. Adenocarcinoma arising in multiple hyperplastic polyps in a patient with Helicobacter pylori infection and hypergastrinemia during long-term proton pump inhibitor therapy.

    PubMed

    Anjiki, Hajime; Mukaisho, Ken-Ichi; Kadomoto, Yu; Doi, Hisakazu; Yoshikawa, Kunio; Nakayama, Takahisa; Vo, Diem Thi-Ngoc; Hattori, Takanori; Sugihara, Hiroyuki

    2017-04-01

    We report a case of developing multiple adenocarcinoma foci in multiple hyperplastic polyps in a patient with Helicobacter pylori infection and hypergastrinemia during long-term proton pump inhibitor (PPI) therapy. A 57-year-old man, who was undergoing hemodialysis for chronic renal failure, underwent an upper gastrointestinal endoscopy to elucidate the cause of anemia. Atrophic gastritis with H. pylori infection and multiple adenocarcinoma foci in multiple hyperplastic polyps were found in the endoscopic and histological examinations. Enterochromaffin-like micronests and parietal cell protrusion in the background of the polyps suggested the existence of hypergastrinemia. The serum gastrin level was markedly high-10,206 pg/ml (normal range 37-172 pg/ml). The cause of this marked hypergastrinemia was not autoimmune gastritis and gastrinoma. After discontinuing PPI therapy and successful eradication of H. pylori, the serum gastrin level decreased to normal range. These findings indicate that hypergastrinemia may be caused by long-term PPI therapy in patients with H. pylori infection. This case suggests that hypergastrinemia may mediate gastric carcinogenesis in patients with H. pylori infection.

  17. Blood test using surface-enhanced Raman spectroscopy with colloidal silver nanoparticle substrate to detect polyps and colorectal cancer (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Wang, Wenbo; Feng, Shangyuan; Tai, Isabella T.; Chen, Guannan; Chen, Rong; Zeng, Haishan

    2016-03-01

    Colorectal cancer (CRC) is the third most common type of cancer and forth leading cause of cancer-related death. Early diagnosis is the key to long-term patient survival. Programmatic screening for the general population has shown to be cost-effective in reducing the incidence and mortality from CRC. Current CRC screening strategy relies on a broad range of test techniques such as fecal based tests and endoscopic exams. Occult blood tests like fecal immunochemical test is a cost effective way to detect CRC but have limited diagnostic values in detecting adenomatous polyp, the most treatable precursor to CRC. In the present work, we proposed the use of surface enhanced Raman spectroscopy (SERS) with silver nanoparticles as substrate to analyze blood plasma for detecting both CRC and adenomatous polyps. Blood plasma samples collected from healthy subjects and patients diagnosed with adenomas and CRC were prepared with nanoparticles and measured using a real-time fiber optic probe based Raman system. The collected SERS spectra are analyzed with partial least squares-discriminant analysis. Classification of normal versus CRC plus adenomatous polyps achieved diagnostic sensitivity of 86.4% and specificity of 80%. This exploratory study suggests that blood plasma SERS analysis has potential to become a screening test for detecting both CRC and adenomas.

  18. IMPACT OF GENISTEIN AND PHYTIC ACID ON THE VIABILITY AND PROLIFERATION ACTIVITY OF NASAL POLYPS' CELLS IN AN IN VITRO MODEL.

    PubMed

    Frączek, Marcin; Kuśmierz, Dariusz; Rostkowska-Nadolska, Beata; Kręcicki, Tomasz; Latocha, Małgorzata T

    2015-01-01

    In developed countries, chronic rhinosinusitis with nasal polyps is one of the diseases that diminish patients' quality of life most significantly. Treatment of that often incurable disease is based on the steroids and surgery in patients who had failed thorough conservative management. It appears that the introduction of new treatment agents suppressing inflammation process and inhibiting cells' proliferation would be a valuable therapeutic option. The aim of the present study was to evaluate the in vitro effect of genistein and phytic acid on the viability and growth rate of fibroblasts derived from nasal polyps. Cells were incubated with various concentrations of genistein (5-500 μM) and phytic acid (100-20,000 μM). After 72 h incubation, cells survivability and cells' growth rate were estimated by combination of WST-1 and LDH methods. QRT-PCR technique was used to determine the expression of histone H3, BCL-2, BAX and P53 genes. Caspase-8 and -9 expressions were evaluated by ELISA assay. Genistein and phytic acid significantly and in dose-specific manner decreased nasal polyps fibroblasts survivability and growth rate. Both agents in similar way decreased cell proliferation as measured by the expression of histone H3. They induce apoptotic machinery by modulating the expression of BCL-2, BAX and caspase-8 activity. Genistein and phytic acid have significant potential for a therapeutic role in the treatment of chronic rhinosinusitis.

  19. Chemoprevention of benzo(a)pyrene-induced colon polyps in ApcMin mice by resveratrol

    PubMed Central

    Huderson, Ashley C.; Myers, Jeremy N.; Niaz, Mohammad S.; Washington, Mary K.; Ramesh, Aramandla

    2012-01-01

    Human dietary exposure to benzo(a)pyrene [BaP] has generated interest with regard to the association of BaP with gastrointestinal carcinogenesis. Since colon cancer ranks third among cancer-related mortalities, it is necessary to evaluate the effect of phytochemicals on colon cancer initiation and progression. In this study we investigated the preventive effects of resveratrol (RVT) on BaP-induced colon carcinogenesis in ApcMin mouse model. For the first group of mice, 100 μg BaP/kg bw was administered to mice in peanut oil via oral gavage over a 60 day period. For the second group, RVT was co-administered with BaP at a dose of 45 μg/kg. For the third group, RVT was administered for 1 week prior to BaP exposure for 60 days. Jejunum, colon and liver, were collected at 60 days post-BaP & RVT exposure; adenomas in jejunum and colon were counted and subjected to histopathology. Resveratrol reduced the number of colon adenomas in BaP + RVT-treated mice significantly compared to mice that received BaP alone. While dysplasia of varying degrees was noted in colon of BaP-treated mice, the dysplasias were of limited occurrence in RVT-treated mice. To ascertain whether the tumor inhibition is a result of altered BaP-induced toxicity of tumor cells, growth, apoptosis and proliferation of adenocarcinoma cells were assessed post treatment with RVT and BaP. Co-treatment with RVT increased apoptosis and decreased cell proliferation to a greater extent than with BaP alone. Overall, our observations reveal that RVT inhibits colon tumorigenesis when given together with BaP and holds promise as a therapeutic agent. PMID:22889612

  20. Accuracy of Colon Capsule Endoscopy in Detecting Colorectal Polyps in Individuals with Familial Colorectal Cancer: Could We Avoid Colonoscopies?

    PubMed

    Alvarez-Urturi, Cristina; Fernández-Esparrach, Gloria; Ibáñez, Inés Ana; Rodríguez De Miguel, Cristina; Dedeu, Josep Maria; Bessa, Xavier; Córdova, Henry; Pellisé, Maria; Balaguer, Francesc; Ginés, Angels; Barranco, Luis; Araujo, Isis K; Andreu, Montserrat; Llach, Josep; Castells, Antoni; González-Suarez, Begoña

    2017-01-01

    Background. Individuals with a family history of colorectal cancer (CRC) have an increased risk of CRC. We evaluated the diagnostic yield of CCE in the detection of lesions and also two different colon preparations. Methods. A prospective multicenter study was designed to assess CCE diagnostic yield in a cohort of asymptomatic individuals with a family history of CRC. CCE and colonoscopy were performed on the same day by 2 endoscopists who were blinded to the results of the other procedure. Results. Fifty-three participants were enrolled. The sensitivity, specificity, PPV, and NPV of CCE for detecting advanced adenomas were 100%, 98%, 67%, and 100%. Sensitivity, specificity, PPV, and NPV of CCE for the diagnosis of individuals with polyps were 87%, 97%, 93%, and 88%, respectively. CCE identify 100% of individuals with significant or advanced lesions. Overall cleanliness was adequate by 60.7% of them. The PEG-ascorbic boost seems to improve colon cleanliness, with similar colonic transit time. Conclusion. CCE is a promising tool, but it has to be considered as an alternative technique in this population in order to reduce the number of colonoscopies performed. More studies are needed to understand appropriate screening follow-up intervals and optimize the bowel preparation regimen.

  1. Accuracy of Colon Capsule Endoscopy in Detecting Colorectal Polyps in Individuals with Familial Colorectal Cancer: Could We Avoid Colonoscopies?

    PubMed Central

    Alvarez-Urturi, Cristina; Fernández-Esparrach, Gloria; Ibáñez, Inés Ana; Rodríguez De Miguel, Cristina; Dedeu, Josep Maria; Bessa, Xavier; Córdova, Henry; Pellisé, Maria; Balaguer, Francesc; Ginés, Angels; Barranco, Luis; Araujo, Isis K.; Andreu, Montserrat; Llach, Josep

    2017-01-01

    Background. Individuals with a family history of colorectal cancer (CRC) have an increased risk of CRC. We evaluated the diagnostic yield of CCE in the detection of lesions and also two different colon preparations. Methods. A prospective multicenter study was designed to assess CCE diagnostic yield in a cohort of asymptomatic individuals with a family history of CRC. CCE and colonoscopy were performed on the same day by 2 endoscopists who were blinded to the results of the other procedure. Results. Fifty-three participants were enrolled. The sensitivity, specificity, PPV, and NPV of CCE for detecting advanced adenomas were 100%, 98%, 67%, and 100%. Sensitivity, specificity, PPV, and NPV of CCE for the diagnosis of individuals with polyps were 87%, 97%, 93%, and 88%, respectively. CCE identify 100% of individuals with significant or advanced lesions. Overall cleanliness was adequate by 60.7% of them. The PEG-ascorbic boost seems to improve colon cleanliness, with similar colonic transit time. Conclusion. CCE is a promising tool, but it has to be considered as an alternative technique in this population in order to reduce the number of colonoscopies performed. More studies are needed to understand appropriate screening follow-up intervals and optimize the bowel preparation regimen. PMID:28265285

  2. IL-25/IL-33–responsive TH2 cells characterize nasal polyps with a default TH17 signature in nasal mucosa

    PubMed Central

    Lam, Emily P.S.; Kariyawasam, Harsha H.; Rana, Batika M.J.; Durham, Stephen R.; McKenzie, Andrew N.J.; Powell, Nicholas; Orban, Nara; Lennartz-Walker, Melissa; Hopkins, Claire; Ying, Sun; Rimmer, Joanne; Lund, Valerie J.; Cousins, David J.; Till, Stephen J.

    2016-01-01

    Background Chronic rhinosinusitis with nasal polyposis (CRSwNP) in Western countries is characterized by eosinophilia, IgE production, and TH2 cytokine expression. Type 2 innate lymphoid cells from polyps produce IL-5 and IL-13 in response to IL-25 and IL-33, although the relevance of this axis to local mucosal T-cell responses is unknown. Objective We sought to investigate the role of the IL-25/IL-33 axis in local mucosal T-cell responses in patients with CRSwNP. Methods Polyp tissue and blood were obtained from patients undergoing nasal polypectomy. Control nasal biopsy specimens and blood were obtained from healthy volunteers. Tissue was cultured in a short-term explant model. T-cell surface phenotype/intracellular cytokines were assessed by means of flow cytometry. T-cell receptor variable β-chain analysis was performed with the immunoSEQ assay. Microarrays were performed for gene expression analysis. Results IL-25 receptor (IL-17RB)–expressing TH2 effector cells were identified in nasal polyp tissue but not the healthy nasal mucosa or periphery. IL-17RB+CD4+ polyp–derived TH2 cells coexpressed ST2 (IL-33 receptor) and responded to IL-25 and IL-33 with enhanced IL-5 and IL-13 production. Within IL-17RB+CD4+ T cells, several identical T-cell receptor variable β-chain complementarity-determining region 3 sequences were identified in different subjects, suggesting clonal expansion driven by a common antigen. Abundant IL-17–producing T cells were observed in both healthy nasal mucosal and polyp populations, with TH17-related genes the most overexpressed compared with peripheral blood T cells. Conclusion IL-25 and IL-33 can interact locally with IL-17RB+ST2+ polyp T cells to augment TH2 responses in patients with CRSwNP. A local TH17 response might be important in healthy nasal mucosal immune homeostasis. PMID:26684290

  3. Overtube-assisted enteroscopy and capsule endoscopy for the diagnosis of small-bowel polyps and tumors: a systematic review and meta-analysis

    PubMed Central

    Sulbaran, Marianny; de Moura, Eduardo; Bernardo, Wanderley; Morais, Cintia; Oliveira, Joel; Bustamante-Lopez, Leonardo; Sakai, Paulo; Mönkemüller, Klaus; Safatle-Ribeiro, Adriana

    2016-01-01

    Background and study aims: Several studies have evaluated the utility of double-balloon enteroscopy (DBE) and capsule endoscopy (CE) for patients with small-bowel disease showing inconsistent results. The aim of this study was to determine the sensitivity and specificity of overtube-assisted enteroscopy (OAE) as well as the diagnostic concordance between OAE and CE for small-bowel polyps and tumors. Patients and methods: We conducted a systematic review and meta-analysis of studies in which the results of OAE were compared with the results of CE for the evaluation of small-bowel polyps and tumors. When data for surgically resected lesions were available, the histopathological results of OAE and surgical specimens were compared. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the diagnosis of small-bowel polyps and tumors were analyzed. Secondarily, the rates of diagnostic concordance and discordance between OAE and CE were calculated. Results: There were 15 full-length studies with a total of 821 patients that met the inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were as follows: 0.89 (95 % confidence interval [CI] 0.84 – 0.93), with heterogeneity χ2 = 41.23 (P = 0.0002) and inconsistency (I 2) = 66.0 %; 0.97 (95 %CI 0.95 – 0.98), with heterogeneity χ2 = 45.27 (P = 0.07) and inconsistency (I 2) = 69.1 %; 16.61 (95 %CI 3.74 – 73.82), with heterogeneity Cochrane’s Q = 225.19 (P < 0.01) and inconsistency (I 2) = 93.8 %; and 0.14 (95 %CI 0.05 – 0.35), with heterogeneity Cochrane’s Q = 81.01 (P < .01) and inconsistency (I 2) = 82.7 %, respectively. A summary receiver operating characteristic curve (SROC) curve was constructed, and the area under the curve (AUC) was 0.97. Conclusion: OAE is an accurate test for the detection of small-bowel polyps and tumors. OAE and CE

  4. Hyperplastic (serrated) polyps of the colorectum: relationship of CpG island methylator phenotype and K-ras mutation to location and histologic subtype.

    PubMed

    O'Brien, Michael J; Yang, Shi; Clebanoff, Jennifer L; Mulcahy, Elizabeth; Farraye, Francis A; Amorosino, Mark; Swan, Niall

    2004-04-01

    We investigated the frequency of promoter region CpG island methylation (CIM) of hMLH1, MGMT, MINT1, MINT2, and p16 and K-ras mutations in a total of 79 hyperplastic (serrated) polyps (HPs) from 75 patients and correlated the molecular profiles to polyp location in the colorectum, histologic variation, and other factors. Methylation-specific PCR (MS-PCR) was used to assay CIM status. HPs that showed CIM of one or more or two or more of the genes assayed were classified as CpG island methylator phenotype (CIMP) and CIMP-high (CIMP-H), respectively. PCR restriction fragment length polymorphism was used to assay K-ras codon 12 and 13 mutations. Logistic regression indicated a statistically significant trend for increasing odds for CIMP (P = 0.002) and CIMP-H (P < 0.001) according to proximity to the cecum or distance from the rectum. Conversely, K-ras codon 12 mutation was present in 13 of 40 (32.5%) distally located HPs compared with 2 of 39 (5.1%) proximal HPs (P = 0.006). Histologic subtype distribution varied by proximal and distal locations. Frequency of CIMP in serrated polyps with abnormal proliferation (SPAPs), differed significantly from goblet cell serrated polyps (GCSPs) (24 of 26, 92.3% vs. 6 of 13, 46.2%) (P = 0.003) and microvesicular serrated polyps (MVSPs) (26 of 38, 68.4%) (P = 0.03). Frequency of K-ras mutation in GCSPs (7 of 13, 54%) differed from that of MVSPs (6 of 38, 16%) (P = 0.01) and SPAPs (2 of 26, 8%) (P = 0.003). Location in the colorectum and histologic subtype were major determinants of the molecular profile of HPs. The molecular findings of CIMP and K-ras mutations appear to encompass most if not all HPs; CIMP profiles suggest that SPAP is the most advanced morphologic variant. We postulate that MVSP and GCSP may be precursor lesions that, if proximally located or larger, can progress to SPAP. Frequent K-ras mutations and infrequent CIMP distinguish the distal GCSP variant.

  5. Proteins with CHAD Domains (Conserved Histidine α-Helical Domain) Are Attached to Polyphosphate (polyP) Granules in vivo and Constitute a Novel Family of PolyP-Associated Proteins (Phosins).

    PubMed

    Tumlirsch, Tony; Jendrossek, Dieter

    2017-01-27

    Based on bioinformatic evidence, we suspected that proteins with a CYTH domain (CyaB thiamine tri-phosphatase) and/or a CHAD motif (conserved-histidine-α-helical-domain) could represent polyP granule-associated proteins. No evidence for a polyP-targeting function was found for proteins with CYTH domains. By contrast, the two CHAD motif-containing proteins of Ralstonia eutropha H16 (A0104 and B1017) co-localized with polyP granules when they were expressed as fusions with the enhanced-yellow-fluorescent-protein (eYFP). While B1017 was not detectably expressed the A0104 protein was specifically identified in an isolated polyP granule fraction by proteome analysis. Moreover, eYFP-fusions with the CHAD motif-containing proteins MGMSRV2-1987 of Magnetospirillum gryphiswaldense and PP2307 of Pseudomonas putida also co-localized with polyP granules in a trans-species-specific manner. These data indicated that CHAD-containing proteins generally are attached to polyP granules. Together with four previously polyP-attached proteins (polyP kinases) the results of this study raised the number of polyP-associated proteins in R. eutropha to six. We suggest to designate polyP granule-bound proteins with CHAD motifs as phosins (phosphate) in analogy to phasins and oleosins that are specifically bound to the surface of polyhydroxyalkanoate (PHA) granules in PHA accumulating bacteria or to oil droplets in oil seed plants, respectively.

  6. Cutaneous skin tag

    MedlinePlus

    Skin tag; Acrochordon; Fibroepithelial polyp ... have diabetes. They are thought to occur from skin rubbing against skin. ... The tag sticks out of the skin and may have a short, narrow stalk connecting it to the surface of the skin. Some skin tags are as long as ...

  7. Chronic rhinosinusitis with nasal polyps is characterized by B-cell inflammation and EBV-induced protein 2 expression

    PubMed Central

    Hulse, Kathryn E.; Norton, James E.; Suh, Lydia; Zhong, Qiu; Mahdavinia, Mahboobeh; Simon, Patrick; Kern, Robert C.; Conley, David B.; Chandra, Rakesh K.; Tan, Bruce K.; Peters, Anju T.; Grammer, Leslie C.; Harris, Kathleen E.; Carter, Roderick G.; Kato, Atsushi; Schleimer, Robert P.

    2013-01-01

    Background Despite the high prevalence and morbidity of chronic rhinosinusitis (CRS), little is known about the mechanisms that underlie its pathogenesis. Recent studies have suggested that B cells might play an important role in CRS. Objective We sought to thoroughly characterize B lineage cells within sinus tissues of patients with CRS and healthy control subjects and to determine whether levels of EBV-induced protein 2, which is known to play an important role in the development of B-cell responses, were increased in patients with CRS. Methods Cells isolated from sinus tissues of patients with CRS and healthy control subjects were characterized by means of flow cytometry and immunohistochemistry. Local production of antibodies was measured in tissue extracts, nasal lavage fluid, and sera by using multiplex bead arrays and ELISA. Quantitative RT-PCR, ELISA, and Western blotting were used to assess gene and protein expression from tissue extracts. Results Nasal polyps (NPs) from patients with CRS had increased levels of both B cells and plasma cells compared with uncinate tissue from healthy control subjects (P < .05). NPs also contained significantly increased levels of several antibody isotypes compared with normal uncinate tissue (P < .05), but no differences in circulating antibody levels were found. Interestingly, levels of EBV-induced protein 2 were also increased in NPs (P < .05) and were positively correlated with expression of plasma cell markers (CD138 and B lymphocyte–induced maturation protein) in sinus tissue. Conclusion B cells and plasma cells are enriched in NPs, actively produce antibodies locally, and might contribute to chronic inflammation in patients with CRS. Elucidating the mechanisms that underlie this excessive local B-cell response might provide novel insights for the development of improved therapeutic strategies. PMID:23473835

  8. Urinary Metabolites of Prostanoids and Risk of Recurrent Colorectal Adenomas in the Aspirin/Folate Polyp Prevention Study (AFPPS)

    PubMed Central

    Fedirko, Veronika; Bradshaw, Patrick T.; Figueiredo, Jane C.; Sandler, Robert S.; Barry, Elizabeth L.; Ahnen, Dennis J.; Milne, Ginger L.; Bresalier, Robert; Baron, John A.

    2015-01-01

    Aspirin has been shown to protect against colorectal neoplasms, however the optimal chemopreventive dose and underlying mechanisms are unclear. We aimed to study the relationship between prostanoid metabolites and aspirin’s effect on adenoma occurrence. We used data from the Aspirin/Folate Polyp Prevention Study, in which 1,121 participants with a recent adenoma were randomized to placebo or two doses of aspirin (81 or 325 mg/d) to be taken until the next surveillance colonoscopy, anticipated about 3 years later. Urinary metabolites of prostanoids (PGE-M, PGI-M, and dTxB2) were measured using LC/MS or GC/NICI-MS in 876 participants near the end of treatment follow-up. Poisson regression with a robust error variance was used to calculate relative risks and 95% confidence intervals. PGE-M, PGI-M, and dTxB2 levels were 28%, 37%, and 60% proportionately lower, respectively, in individuals who took 325 mg of aspirin compared to individuals who took placebo (all P<0.001). Similarly, among individuals who took 81 mg of aspirin, PGE-M, PGI-M, and dTxB2 were, respectively, 18%, 30%, and 57% proportionally lower compared to placebo (all P<0.005). None of the metabolites or their ratios were statistically significantly associated with the risk of adenoma occurrence. The effect of aspirin in reducing adenoma risk was independent of prostanoid levels. Aspirin use is associated with lower levels of urinary prostanoid metabolites. However, our findings do not support the hypothesis that these metabolites are associated with adenoma occurrence, suggesting that COX-dependent mechanisms may not completely explain the chemopreventive effect of aspirin on colorectal neoplasms. PMID:26304466

  9. Specific Induction of TSLP by the Viral RNA Analogue Poly(I:C) in Primary Epithelial Cells Derived from Nasal Polyps

    PubMed Central

    van Egmond, Danielle; de Groot, Esther J.; Fokkens, Wytske J.; van Drunen, Cornelis M.

    2016-01-01

    Introduction Chronic rhinosinusitis with nasal polyposis is an inflammatory disease that, although not directly linked to allergy, often displays a Th2-skewed inflammation characterized by elevated local IgE and IL-5 levels. The nasal cavity is constantly exposed to bacteria and viruses that may trigger epithelial inflammatory responses. To gain more insight into mechanisms by which such a biased inflammation might arise, we have investigated the epithelial expression of the Th2 skewing mediators (TSLP, IL-25, and IL-33) in relationship to disease and microbial triggers. Methods Epithelial cells were obtained from polyp tissues of nasal polyposis patients and from inferior turbinates of non-diseased controls. Cells were exposed to various TLR-specific triggers to study the effect on mRNA and protein expression level of TSLP, IL-25, and IL-33 and the potential regulatory mechanisms through the expression profile the transcription factors ATF-3, DUSP-1, EGR-1, and NFKB-1. Results The TLR3 agonist and viral analogue poly(I:C) induced TSLP mRNA 13.0 ± 3.1 fold (p < 0.05) and protein expression by 12.1 ± 2.3-fold (p < 0.05) higher in epithelium isolated from nasal polyposis patients than in epithelium form healthy controls. This enhanced induction of TSLP may be a consequence of a down-regulated expression of DUSP-1 in polyp epithelium. Conclusion The TLR3 induced expression of TSLP introduces a mechanism by which the Th2-skewed tissue environment might arise in nasal polyps and invites a further evaluation of the potential contribution of current or past viral infections to polyposis pathogenesis. PMID:27050744

  10. Chemoprevention of intestinal polyps in ApcMin/+ mice fed with western or balanced diets by drinking annurca apple polyphenol extract.

    PubMed

    Fini, Lucia; Piazzi, Giulia; Daoud, Yahya; Selgrad, Michael; Maegawa, Shinji; Garcia, Melissa; Fogliano, Vincenzo; Romano, Marco; Graziani, Giulia; Vitaglione, Paola; Carmack, Susanne W; Gasbarrini, Antonio; Genta, Robert M; Issa, Jean-Pierre; Boland, C Richard; Ricciardiello, Luigi

    2011-06-01

    The Western diet (WD) is associated with a higher incidence of colorectal cancer (CRC) than the Mediterranean diet. Polyphenols extracted from Annurca apple showed chemopreventive properties in CRC cells. A multifactorial, four-arm study by using wild-type (wt) and Apc(Min/+) mice was carried out to evaluate the effect on polyp number and growth of APE treatment (60 μmol/L) ad libitum in drinking water combined with a WD or a balanced diet (BD) for 12 weeks. Compared with APE treatment, we found a significant drop in body weight (P < 0.0001), severe rectal bleeding (P = 0.0076), presence of extraintestinal tumors, and poorer activity status (P = 0.0034) in water-drinking Apc(Min/+) mice, more remarkably in the WD arm. In the BD and WD groups, APE reduced polyp number (35% and 42%, respectively, P < 0.001) and growth (60% and 52%, respectively, P < 0.0001) in both colon and small intestine. Increased antioxidant activity was found in wt animals fed both diets and in Apc(Min/+) mice fed WD and drinking APE. Reduced lipid peroxidation was found in Apc(Min/+) mice drinking APE fed both diets and in wt mice fed WD. In normal mucosa, mice drinking water had lower global levels of DNA methylation than mice drinking APE. APE treatment is highly effective in reducing polyps in Apc(Min/+) mice and supports the concept that a mixture of phytochemicals, as they are naturally present in foods, represent a plausible chemopreventive agent for CRC, particularly in populations at high risk for colorectal neoplasia.

  11. Age-Related Decline of Neutrophilic Inflammation Is Associated with Better Postoperative Prognosis in Non-eosinophilic Nasal Polyps

    PubMed Central

    Kim, Dae Woo; Kim, Dong-Kyu; Jo, Ara; Jin, Hong Ryul; Eun, Kyoung Mi; Mo, Ji-Hun; Cho, Seong H.

    2016-01-01

    Background Innate and adaptive immune responses change with increasing age and affect the course of diseases. Previous study investigated immunologic alteration in Western nasal polyps (NP) which is mostly eosinophilic. However, there are no reports regarding age-related immune changes of non-eosinophilic NP (NE-NP) which is a predominant subtype in Asian population. Methods A total of 153 subjects, including 20 with control, 63 with chronic rhinosinusitis (CRS) without NP (CRSsNP), and 70 with CRS with NP were enrolled. Age-related changes in computed tomography (CT), cytokines and clinical information were investigated. Tissue samples were analyzed for protein levels of IL-5, IL-17A, IL-23, interferon (IFN)-γ, CCL-11, and CXCL-8, using Luminex immunoassay and for mRNA expression levels of interleukin (IL)-5, IL-17A, IL-23p19, IFN-γ, CCL-11, CXCL-1, CXCL-2, CXCL-8, and CXCR2 by quantitative RT-PCR. Immunohistochemistry (IHC) was performed for the number of inflammatory cells. Results We observed that Lund-Mackay CT scores decreased with age in NE-NP. The number of human neutrophil elastase-positive cells and myeloperoxidase gene expression decreased in older patients with NE-NP, but not in control subjects, CRSsNP, and E-NP. Neutrophil-associated cytokines including IL-17A and IL-23, were negatively correlated with age in NE-NP at the protein and mRNA levels. Additionally, the expression of CXCR2, a receptor for CXCL-1 and CXCL-2, was decreased with age in NE-NP. However, there were no age-related changes in blood neutrophil count, and neutrophil-recruiting chemokines such as CXCL-1, CXCL-2, and CXCL-8. Elderly NE-NP patients showed better endoscopic scores at 12 months after surgery compared with the non-elderly. Conclusion Age-related decline in neutrophil inflammation may favorably affect postoperative results in elderly patients with NE-NP. PMID:26849431

  12. Endoscopic resection is effective for the treatment of bleeding gastric hyperplastic polyps in patients with and without cirrhosis

    PubMed Central

    Nelson, Matthew; Ganger, Daniel; Keswani, Rajesh; Grande, David; Komanduri, Srinadh

    2016-01-01

    Background and study aims: Gastric hyperplastic polyps (GHP) have been identified as a cause of transfusion-dependent iron-deficiency anemia (tIDA) and transfusion-dependent gastrointestinal bleeding and are commonly identified in the setting of cirrhosis. The aim of this study was to assess the effectiveness of endoscopic resection (ER) for the treatment of tIDA or gastrointestinal bleeding due to GHP in patients with and without liver disease. Patients and methods: This was a single-center retrospective review. The primary outcome was clinical success of ER (no transfusion or repeat ER in the following 6 months after first ER). Secondary outcomes included technical success, recurrence of GHP with tIDA or gastrointestinal bleeding, and adverse events (AEs). Results: Sixty-three patients with GHP were included of whom 20 (31 %) had cirrhosis. The majority with cirrhosis presented with gastrointestinal bleeding (n = 13, 65 %, P = 0.52), whereas the majority of non-cirrhotics presented with tIDA (n = 30, 70 %, P = 0.01). Technical success was 100 % with no AEs. The clinical success rate was 94 % (95 % in cirrhotics, 93 % in non-cirrhotics, P = 0.46). The recurrence rate was 32 % (40 % in cirrhotics and 28 % in non-cirrhotics, P = 0.35) with mean time to recurrence of 17.3 ± 13.9 months (P = 0.22). Of those with recurrence, 75 % had no further tIDA or gastrointestinal bleeding after repeat ER (mean follow-up 20 ±11 months). Conclusions: ER is an effective treatment for GHP that causes tIDA or gastrointestinal bleeding. Patients with GHP and cirrhosis tend to present with bleeding rather than anemia and have more frequent recurrence. Symptomatic recurrence of GHP is common and should be recognized early as repeat ER appears to be effective. PMID:27540576

  13. Non-Eosinophilic Nasal Polyps Shows Increased Epithelial Proliferation and Localized Disease Pattern in the Early Stage

    PubMed Central

    Kim, Dong-Kyu; Jin, Hong Ryul; Eun, Kyoung Mi; Mutusamy, Somasundran; Cho, Seong H.; Oh, Sohee; Kim, Dae Woo

    2015-01-01

    Background Non-eosinophilic nasal polyps (NPs) show less inflammatory changes and are less commonly associated with lower airway inflammatory disorders such as asthma, compared with eosinophilic NPs. However, the development of non-eosinophilic NPs which is a predominant subtype in Asian population still remains unclear. Methods A total of 81 patients (45 with non-eosinophilic NPs and 36 with eosinophilic NPs) were enrolled. Clinical information and computed tomography (CT), endoscopic, and histological findings were investigated. Tissue samples were analyzed for total IgE levels and for mRNA expression levels of interleukin (IL)-4, IL–5, IL–13, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-17A, IL–22, IL-23p19, transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, and periostin. Immunostaining assessment of Ki–67 as a proliferation marker was performed. Results We found that epithelial in-growing patterns such as pseudocysts were more frequently observed in histological and endoscopic evaluations of non-eosinophilic NPs, which was linked to increase epithelial staining of Ki–67, a proliferating marker. Eosinophilic NPs were characterized by high infiltration of inflammatory cells, compared with non-eosinophilic NPs. To investigate the developmental course of each subtype, CT was analyzed according to CT scores and subtypes. Non-eosinophilic NPs showed more localized pattern and maxillary sinus involvement, but lesser olfactory involvement in early stage whereas eosinophilic NPs were characterized by diffuse ethmoidal and olfactory involvement. In addition, high ethmoidal/maxillary (E/M) CT scores, indicating ethmoidal dominant involvement, were one of surrogate markers for eosinophilic NP. E/M CT scores was positively correlated with levels of TH2 inflammatory markers, including IL–4, IL–5, periostin mRNA expression and total IgE levels in NPs, whereas levels of the TH1 cytokine, IFN- γ were inversely correlated. Moreover, if the

  14. Increased expression of chemokine receptors CCR1 and CCR3 in nasal polyps: molecular basis for recruitment of the granulocyte infiltrate.

    PubMed

    Fundová, P; Funda, D P; Kovář, D; Holý, R; Navara, M; Tlaskalová-Hogenová, H

    2013-05-01

    Inflammatory processes play an important role in the development of nasal polyps (NP), but the etiology and, to a high degree also, the pathogenesis of NP are not fully understood. The role of several cytokines and chemokines such as eotaxins, IL-4, IL-5, IL-6, IL-8, and RANTES has been reported in NP. Herewith, we investigated the expression and pattern of distribution of chemokine receptors CCR1 and CCR3 in nasal polyps. Immunohistochemical detection was carried out in frozen sections of biopsies from 22 NP and 18 nasal mucosa specimens in both the epithelial and stromal compartments. Fluorescence microscopy and computerized image analysis revealed a statistically significant increased number of CCR1 (45.2 ± 2.8 vs. 15.1 ± 1.9, p < 0.001)-positive as well as CCR3 (16.4 ± 1.4 vs. 9.7 ± 1.1, p < 0.001)-positive cells in the stroma of NP compared to nasal mucosa. In comparison to healthy nasal mucosa, increased positivity of CCR3 was detected in the epithelial compartment of NP. Our data suggest that increased expression of CCR1 and CCR3 chemokine receptors may, in accord with various chemokines, contribute to the pathogenesis of nasal polyposis by facilitating increased migration and prolonged accumulation of inflammatory cells, e.g., eosinophils, in the inflammatory infiltrate of NP.

  15. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

    PubMed

    Levin, Bernard; Lieberman, David A; McFarland, Beth; Andrews, Kimberly S; Brooks, Durado; Bond, John; Dash, Chiranjeev; Giardiello, Francis M; Glick, Seth; Johnson, David; Johnson, C Daniel; Levin, Theodore R; Pickhardt, Perry J; Rex, Douglas K; Smith, Robert A; Thorson, Alan; Winawer, Sidney J

    2008-05-01

    In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that primarily is effective at early cancer detection and a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening.

  16. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

    PubMed

    Levin, Bernard; Lieberman, David A; McFarland, Beth; Smith, Robert A; Brooks, Durado; Andrews, Kimberly S; Dash, Chiranjeev; Giardiello, Francis M; Glick, Seth; Levin, Theodore R; Pickhardt, Perry; Rex, Douglas K; Thorson, Alan; Winawer, Sidney J

    2008-01-01

    In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening.

  17. [A case of spontaneous dissection of the superior mesenteric artery treated by percutaneous stent placement].

    PubMed

    Ko, Geun Jun; Han, Ki Jun; Han, Seo Goo; Hwang, Sang Yon; Choi, Chang Hwan; Gham, Chang Woo; Cho, Hyeon Geun; Song, Soon-Young; Jung, Jin Ho

    2006-02-01

    Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature.

  18. Repellent-Treated Clothing

    EPA Pesticide Factsheets

    EPA regulates the pesticide permethrin to pre-treat clothing. We evaluate the safety and effectiveness of such insecticide uses, by exposure scenarios and risk assessment. Read and follow the label directions for use of permethrin-treated clothing.

  19. How Is Hemochromatosis Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Hemochromatosis Treated? Treatments for hemochromatosis include therapeutic phlebotomy (fleh-BOT-o-me), iron ... and treatment for complications. The goals of treating hemochromatosis include: Reducing the amount of iron in your ...

  20. How Is ARDS Treated?

    MedlinePlus

    ... that help relieve symptoms, prevent complications, or improve quality of life. Supportive approaches used to treat ARDS include: Medicines to help you relax, relieve discomfort, and treat pain. Ongoing monitoring of heart and lung function (including blood pressure ...

  1. Use of a frameless LNG-IUS as conservative treatment for a pre-malignant uterine polyp in a premenopausal woman - a case report.

    PubMed

    Janssens, D; Verbeeck, G; Wildemeersch, D

    2015-12-28

    Prevention of progression to invasive carcinoma in patients with a premalignant endometrial lesion using longterm treatment with levonorgestrel (LNG) releasing intrauterine systems (IUS) remains controversial, especially when manifest cellular atypia has been found in the endometrial biopsy specimen. We present a case of a 44-year old premenopausal woman with a premalignant uterine polyp who declined hysterectomy and was followed-up for more than 12 years after the first LNG-IUS was inserted. Endometrial atrophy installed, no pathology was detected and hysterectomy was thereby successfully avoided. The positive experience in this case should encourage further studies as literature data indicate that conservative treatment of premalignant endometrial pathology is a real option with a high success rate for women who have a contra-indication for surgery, refuse the classical approach for personal reasons or want to preserve their fertility.

  2. Antitumor activity of the MEK inhibitor trametinib on intestinal polyp formation in ApcΔ716 mice involves stromal COX-2

    PubMed Central

    Fujishita, Teruaki; Kajino-Sakamoto, Rie; Kojima, Yasushi; Taketo, Makoto Mark; Aoki, Masahiro

    2015-01-01

    Extracellular signal-regulated kinase is an MAPK that is most closely associated with cell proliferation, and the MEK/ERK signaling pathway is implicated in various human cancers. Although epidermal growth factor receptor, KRAS, and BRAF are considered major targets for colon cancer treatment, the precise roles of the MEK/ERK pathway, one of their major downstream effectors, during colon cancer development remain to be determined. Using ApcΔ716 mice, a mouse model of familial adenomatous polyposis and early-stage sporadic colon cancer formation, we show that MEK/ERK signaling is activated not only in adenoma epithelial cells, but also in tumor stromal cells including fibroblasts and vascular endothelial cells. Eight-week treatment of ApcΔ716 mice with trametinib, a small-molecule MEK inhibitor, significantly reduced the number of polyps in the large size class, accompanied by reduced angiogenesis and tumor cell proliferation. Trametinib treatment reduced the COX-2 level in ApcΔ716 tumors in vivo and in primary culture of intestinal fibroblasts in vitro. Antibody array analysis revealed that trametinib and the COX-2 inhibitor rofecoxib both reduced the level of CCL2, a chemokine known to be essential for the growth of Apc mutant polyps, in intestinal fibroblasts in vitro. Consistently, trametinib treatment reduced the Ccl2 mRNA level in ApcΔ716 tumors in vivo. These results suggest that MEK/ERK signaling plays key roles in intestinal adenoma formation in ApcΔ716 mice, at least in part, through COX-2 induction in tumor stromal cells. PMID:25855137

  3. Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points.

    PubMed

    O'Brien, Michael J; Yang, Shi; Mack, Charline; Xu, Huihong; Huang, Christopher S; Mulcahy, Elizabeth; Amorosino, Mark; Farraye, Francis A

    2006-12-01

    The aim of this study was to compare BRAF and KRAS, CpG island methylator phenotype (CIMP), and microsatellite instability (MSI) status in each of the histologic categories, including end-point carcinomas with residual adenoma, of the serrated polyp neoplasia pathway and the traditional (nonserrated) adenoma-carcinoma sequence. Deoxyribonucleic acid (DNA) was extracted from the selected samples and assayed for BRAF, KRAS2 codon12, 13, CIMP using markers hMLH1, MGMT, MINT1, MINT2, p16, and MSI using an assay for BAT25 and BAT26. A BRAF mutation was present in 82% of serrated carcinomas (SCas), 62% of serrated adenomas (SAs), 83% of serrated polyps with abnormal proliferation (SPAPs-syn. sessile serrated adenoma [SSA]), 76% of microvesicular serrated polyps (MVSPs), and was not found in any of the histologic categories of the traditional adenoma-carcinoma sequence. KRAS2 mutations were found in 43% of the goblet cell serrated polyp (GCSP) category, 13% of MVSPs, 7% of SPAPs, and 24% of SAs; in 26% of large traditional adenoma (lTAs) compared with small traditional adenomas (sTAs) (0/30; P<0.005) and in 37.3% of traditional carcinomas (TCa). CIMP-H (>1 marker positive) was significantly more frequent in SPAP, SA, and SCa compared with MVSP (P<0.05); CIMP-H was present in 10% of sTAs but was found more frequently in lTA (44.4%; OR 7.2; P=0.007) and TCa (38.9%; OR 5.8; P=0.007). Higher CIMP levels (4 or more markers positive) were significantly more frequent in advanced categories of the serrated pathway (SAs [31%] and SCas [30%]) compared with lTAs [0%] and TCAs [3.4%] (OR 12.2; P=0.02). MSI-H was identified only in the adenocarcinoma component of SCas (9/11) or in the contiguous SAs (3/7). The findings indicate that a BRAF mutation is a specific marker for a serrated polyp pathway that has its origin in a hyperplastic polyp (MVSP) and a potential end point as MSI carcinoma. CIMP-High (CIMP-H) develops early in this sequence and MSI-H develops late. The data provided a

  4. Treating Pain with Opioids

    MedlinePlus

    ... with using opioids to treat acute pain, or chronic pain if a Opioid p s a : t H ie o n w ... these options before you take an opioid because opioids alone are rarely enough to treat chronic pain over a long period of time. 2 Medicines ...

  5. Non-surgical management of chronic rhinosinusitis with nasal polyps based on clinical-cytological grading: a precision medicine-based approach.

    PubMed

    Gelardi, M; Iannuzzi, L; De Giosa, M; Taliente, S; De Candia, N; Quaranta, N; De Corso, E; Seccia, V; Ciprandi, G

    2017-02-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder that strongly impacts patients' quality of life. CRSwNP is still a challenge for ENT specialists due to its unknown pathogenesis, difficult control and frequent relapse. We tested the hypothesis that a new standardised therapeutic approach based on individual clinical-cytological grading (CCG), may improve control of the disease and prevent the needing for surgery. We analysed 204 patients suffering from bilateral CRSwNP, 145 patients of whom regularly assumed therapy, respecting the planned check-up, and were considered cases; 59 patients were not assuming therapy as indicated and were considered as controls. After five years of standardised treatment, 15 of 145 (10.5%) improved endoscopic staging, 61 of 145 (42%) did not change their endoscopic staging, and 69 of 145 (47.5%) were worse. In the control group, 49 of 59 (83%) were worse by at least two stages (p < 0.05). Patients and controls were stratified basing on clinical and cytological grading as mild, moderate and severe. After patient stratification, in the mild group (n = 27) 92% patients had a constant trend, with no worsening and no need for surgery over a 5-year period, whereas in the mild CCG control group 1 of 59 (1.6%) required surgery (p < 0.05). In moderate GCC (n = 83), 44% of patients did not modify or improve endoscopic staging and 3.6% needed surgery, compared to 13.6% of controls with moderate GCC (p < 0.05). In severe CCG (n = 35), even though no patients achieved significant amelioration of endoscopic grading, 40% of patients were considered as "clinically controlled" and 5.7% of patients underwent surgery, but the percentage was significantly higher (49%) in the control group significant (p = 0.0000). Finally, statistical analyses revealed a clear trend that polyp size increased at a faster rate in the control group than in the treatment group and for each subgroup (low, moderate and severe). The present

  6. A healthy lifestyle index is associated with reduced risk of colorectal adenomatous polyps among non-users of non-steroidal anti-inflammatory drugs.

    PubMed

    Tabung, Fred K; Steck, Susan E; Burch, James B; Chen, Chin-Fu; Zhang, Hongmei; Hurley, Thomas G; Cavicchia, Philip; Alexander, Melannie; Shivappa, Nitin; Creek, Kim E; Lloyd, Stephen C; Hebert, James R

    2015-02-01

    In a Columbia, South Carolina-based case-control study, we developed a healthy lifestyle index from five modifiable lifestyle factors (smoking, alcohol intake, physical activity, diet, and body mass index), and examined the association between this lifestyle index and the risk of colorectal adenomatous polyps (adenoma). Participants were recruited from a local endoscopy center and completed questionnaires related to lifestyle behaviors prior to colonoscopy. We scored responses on each of five lifestyle factors as unhealthy (0 point) or healthy (1 point) based on current evidence and recommendations. We added the five scores to produce a combined lifestyle index for each participant ranging from 0 (least healthy) to 5 (healthiest), which was dichotomized into unhealthy (0-2) and healthy (3-5) lifestyle scores. We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) for adenoma with adjustment for multiple covariates. We identified 47 adenoma cases and 91 controls. In the main analyses, there was a statistically nonsignificant inverse association between the dichotomous (OR 0.54; 95% CI 0.22, 1.29) and continuous (OR 0.75; 95% CI 0.51, 1.10) lifestyle index and adenoma. Odds of adenoma were significantly modified by the use of non-steroidal anti-inflammatory drugs (NSAIDs) (p(interaction) = 0.04). For participants who reported no use of NSAIDs, those in the healthy lifestyle category had a 72% lower odds of adenoma as compared to those in the unhealthy category (OR 0.28; 95% CI 0.08, 0.98), whereas a one-unit increase in the index significantly reduced odds of adenoma by 53% (OR 0.47; 95% CI 0.26, 0.88). Although these findings should be interpreted cautiously given our small sample size, our results suggest that higher scores from this index are associated with reduced odds of adenomas, especially in non-users of NSAIDs. Lifestyle interventions are required to test this approach as a strategy to prevent colorectal adenomatous

  7. How Is Bronchiectasis Treated?

    MedlinePlus

    ... with the bronchiectasis, such as cystic fibrosis or immunodeficiency, also should be treated. Medicines Your doctor may ... the mucus in your lungs. They often are combined with decongestants, which may provide extra relief. Mucus ...

  8. How Are Arrhythmias Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Are Arrhythmias Treated? Common arrhythmia treatments include medicines, medical procedures, and surgery. Your doctor may recommend treatment if your arrhythmia causes serious symptoms, such as dizziness, chest pain, ...

  9. Treating Arrhythmias in Children

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Treating Arrhythmias in Children Updated:Dec 21,2016 Many options ... card This content was last reviewed September 2016. Arrhythmia • Home • About Arrhythmia • Why Arrhythmia Matters • Understand Your ...

  10. Hyperthermia for treating cancer

    MedlinePlus

    ... tumors without surgery. Other types help radiation or chemotherapy work better. Only a few cancer centers in the ... as though they have a fever. This helps chemotherapy work better to treat cancer that has spread (metastasized). ...

  11. How Is Sarcoidosis Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Sarcoidosis Treated? Not everyone who has sarcoidosis needs treatment. ... Content: NEXT >> Featured Video Living With and Managing Sarcoidosis 05/18/2011 This video—presented by the ...

  12. Treating Children and Adolescents

    MedlinePlus

    ... Children and Adolescents Go Back Treating Children and Adolescents Email Print + Share For the most part, the ... tailored, based upon the child's weight. Children and adolescents are moving through a period of physical and ...

  13. How Is Atherosclerosis Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Atherosclerosis Treated? Treatments for atherosclerosis may include heart-healthy ... Rate This Content: NEXT >> Featured Video What is atherosclerosis? 05/22/2014 Describes how the build-up ...

  14. How Is Bronchitis Treated?

    MedlinePlus

    ... Bronchitis Treated? Explore Bronchitis What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics COPD Cough How the Lungs Work Oxygen Therapy Pulmonary ...

  15. How Is Angina Treated?

    MedlinePlus

    ... doctor prescribes, especially if you have diabetes . Medicines Nitrates are the medicines most commonly used to treat ... GLIS-er-in) is the most commonly used nitrate for angina. Nitroglycerin that dissolves under your tongue ...

  16. How Is Vaginitis Treated?

    MedlinePlus

    ... sex or use a condom during sex. 1 Yeast Infections Yeast infections are usually treated with a topical cream ... care provider can write a prescription for most yeast infection treatments. Although yeast infection treatments can be ...

  17. How Is Pneumonia Treated?

    MedlinePlus

    ... to cure the infection and prevent complications. Bacterial pneumonia Bacterial pneumonia is treated with medicines called antibiotics. ... fewer symptoms such as cough and fever. Viral pneumonia Antibiotics don't work when the cause of ...

  18. Electrolyte Concentrates Treat Dehydration

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Wellness Brands Inc. of Boulder, Colorado, exclusively licensed a unique electrolyte concentrate formula developed by Ames Research Center to treat and prevent dehydration in astronauts returning to Earth. Marketed as The Right Stuff, the company's NASA-derived formula is an ideal measure for athletes looking to combat dehydration and boost performance. Wellness Brands also plans to expand with products that make use of the formula's effective hydration properties to help treat conditions including heat stroke, altitude sickness, jet lag, and disease.

  19. Expression of the receptor for advanced glycation end products, a target for high mobility group box 1 protein, and its role in chronic recalcitrant rhinosinusitis with nasal polyps.

    PubMed

    Dzaman, Karolina; Szczepanski, Miroslaw J; Molinska-Glura, Marta; Krzeski, Antoni; Zagor, Mariola

    2015-06-01

    A receptor for advanced glycation end products (RAGE) and its ligand high mobility group box 1 (HMGB1) protein has been linked to several chronic diseases, and acts as a trigger for inflammation signaling. Here, we study RAGE and HMGB1 expression in chronic, recalcitrant rhinosinusitis with nasal polyps (CRSwNP) to determine its potential clinical significance, i.e., disease recurrence and severity. RAGE and HMGB1 expression in CRSwNP was evaluated by immunohistochemistry in epithelial cells of fresh sinonasal mucosa samples obtained from the patients diagnosed with recalcitrant CRSwNP (n = 25) and normal control mucosa (NC) (n = 26). RAGE and HMGB1 expression levels in tissues were correlated with disease severity assessed by nasal endoscopy, CT scan, number of previous sinus surgeries, allergy status and nasosinusal microbiology. RAGE and HMGB1 were moderately or strongly expressed in CRSwNP tissue. No or weak RAGE expression was found in NC. HMGB1 was equally strongly expressed in NC. We observed a strong correlation between RAGE and disease severity, recurrence, undergone operations, asthma and aspirin exacerbated respiratory disease (AERD). Elevated RAGE expression is associated with increased disease severity, as well as allergy and AERD in patients with recalcitrant CRSwNP. It is possible that the explanation for recurrent CRSwNP pathogenesis might be related to RAGE overexpression with subsequent sinus mucosa hyperproliferation, necessitating several operations.

  20. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps

    PubMed Central

    Rutter, Matthew D; Chattree, Amit; Barbour, Jamie A; Thomas-Gibson, Siwan; Bhandari, Pradeep; Saunders, Brian P; Veitch, Andrew M; Anderson, John; Rembacken, Bjorn J; Loughrey, Maurice B; Pullan, Rupert; Garrett, William V; Lewis, Gethin; Dolwani, Sunil

    2015-01-01

    These guidelines provide an evidence-based framework for the management of patients with large non-pedunculated colorectal polyps (LNPCPs), in addition to identifying key performance indicators (KPIs) that permit the audit of quality outcomes. These are areas not previously covered by British Society of Gastroenterology (BSG) Guidelines. A National Institute of Health and Care Excellence (NICE) compliant BSG guideline development process was used throughout and the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to structure the guideline development process. A systematic review of literature was conducted for English language articles up to May 2014 concerning the assessment and management of LNPCPs. Quality of evaluated studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist System. Proposed recommendation statements were evaluated by each member of the Guideline Development Group (GDG) on a scale from 1 (strongly agree) to 5 (strongly disagree) with >80% agreement required for consensus to be reached. Where consensus was not reached a modified Delphi process was used to re-evaluate and modify proposed statements until consensus was reached or the statement discarded. A round table meeting was subsequently held to finalise recommendations and to evaluate the strength of evidence discussed. The GRADE tool was used to assess the strength of evidence and strength of recommendation for finalised statements. KPIs, a training framework and potential research questions for the management of LNPCPs were also developed. It is hoped that these guidelines will improve the assessment and management of LNPCPs. PMID:26104751

  1. Process for treating biomass

    DOEpatents

    Campbell, Timothy J; Teymouri, Farzaneh

    2015-11-04

    This invention is directed to a process for treating biomass. The biomass is treated with a biomass swelling agent within the vessel to swell or rupture at least a portion of the biomass. A portion of the swelling agent is removed from a first end of the vessel following the treatment. Then steam is introduced into a second end of the vessel different from the first end to further remove swelling agent from the vessel in such a manner that the swelling agent exits the vessel at a relatively low water content.

  2. Process for treating biomass

    DOEpatents

    Campbell, Timothy J.; Teymouri, Farzaneh

    2015-08-11

    This invention is directed to a process for treating biomass. The biomass is treated with a biomass swelling agent within the vessel to swell or rupture at least a portion of the biomass. A portion of the swelling agent is removed from a first end of the vessel following the treatment. Then steam is introduced into a second end of the vessel different from the first end to further remove swelling agent from the vessel in such a manner that the swelling agent exits the vessel at a relatively low water content.

  3. Treating the Juvenile Offender

    ERIC Educational Resources Information Center

    Hoge, Robert D., Ed.; Guerra, Nancy G., Ed.; Boxer, Paul, Ed.

    2008-01-01

    This authoritative, highly readable reference and text is grounded in the latest knowledge on how antisocial and criminal behavior develops in youth and how it can effectively be treated. Contributors describe proven ways to reduce juvenile delinquency by targeting specific risk factors and strengthening young people's personal, family, and…

  4. Pentachlorophenol-Treated Materials

    DTIC Science & Technology

    1991-09-30

    mg/L. Because the EPA did not indicate when or to what extent they may lower the limit, closely monitor changes in the hazardous waste regulations . 2... hazardous waste regulations for the management of penta-treated materials. In those states, a Resource Conservation and Recovery Act (RCRA) permit

  5. Apparatus for treating garbage

    SciTech Connect

    Chen, C.L.; Chen, K.; Hsien, K.

    1994-01-11

    An apparatus for treating garbage is described. The apparatus has a conveyor, a continuous incinerator receiving garbage from the conveyor, a device for cooling ash carried out of the continuous incinerator, a device for filtering the ash, a pipe for inducing exhaust from the continuous incinerator to a water tank for removing particles and water-soluble components from the exhaust. 1 fig.

  6. Magnetic resonance imaging of female urethral and periurethral disorders.

    PubMed

    Surabhi, Venkateswar Rao; Menias, Christine O; George, Verghese; Siegel, Cary Lynn; Prasad, Srinivasa R

    2013-11-01

    This article reviews the normal anatomy of the female urethra, magnetic resonance (MR) imaging techniques, and the role of MR imaging in the evaluation of diverse urethral and periurethral diseases. Salient MR imaging findings of common and uncommon cystic urethral lesions (urethral diverticulum, Skene cyst, and vaginal cysts), and masses (urethral carcinoma, leiomyoma, melanoma, fibroepithelial polyp, caruncle, and mucosal prolapse) are presented. The evolving role of dynamic MR in the evaluation of stress urinary incontinence is reviewed.

  7. How Is Pulmonary Embolism Treated?

    MedlinePlus

    ... Twitter. How Is Pulmonary Embolism Treated? Pulmonary embolism (PE) is treated with medicines, procedures, and other therapies. The main goals of treating PE are to stop the blood clot from getting ...

  8. How Is Pernicious Anemia Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Pernicious Anemia Treated? Doctors treat pernicious anemia by replacing the missing vitamin B12 in the body. People who have pernicious anemia may need lifelong treatment. The goals of treating ...

  9. Correlation between microvascular characteristics and the expression of MVD, IGF-1 and STAT3 in the development of colonic polyps carcinogenesis

    PubMed Central

    Liu, Hong; Wu, Jing; Liu, Xiang-Chun; Wei, Nan; Liu, Kui-Liang; Ma, Yan-Hui; Chang, Hong; Zhou, Quan

    2017-01-01

    The aim of the present study was to investigate the correlation between vascular characteristics under narrow band imaging (NBI) and the expression of angiogenic factors of colorectal carcinoma and adenoma, and to evaluate the feasibility of NBI in vivo visualizing angiogenesis. Patients with colorectal polyps, which were pathologically confirmed as early carcinoma and adenoma, were recruited and examined by NBI. The vascular pattern was classified into type I (invisible or faintly visible vasculature), type II (clearly visible microvasculature that is regularly arranged in a round, oval honeycomb-like pattern) and type III (clearly visible microvasculature that is irregularly arranged in size and caliber or has irregular winding). Immunohistochemical staining was performed by cluster of differentiation (CD)34, insulin-like growth factor (IGF)-1 and signal transducer and activator of transcription 3 (STAT3). The histological results were compared with the vascular pattern under NBI. Overall, 64 sites (15 adenocarcinomas, 29 adenomas and 20 normal) from 58 patients were recruited in the study and examined by NBI. A higher proportion of adenomas (82.1%, 23/28) and adenocarcinomas (66.7%, 10/15) had vascular patterns II and III, respectively. The expression of microvessel density (MVD)-CD34 and IGF-1 in normal mucosa compared with adenomas and adenocarcinomas was significantly different (P<0.0001 and P=0.0062, respectively). MVD-CD34, IGF-1 and STAT3 expression in the sites displayed with vascular patterns I, II, and III was different significantly (P<0.0001, P=0.0010 and P=0.0055, respectively). The spearman correlation coefficient between NBI vascular pattern and MVD-CD34, IGF-1 and STAT3 expression was 0.67, 0.41 and 0.40, respectively. In conclusion, vascular-pattern analysis and the use of an NBI system may be a promising tool for evaluating angiogenesis of colorectal lesions in real-time endoscopy. PMID:28123467

  10. Interleukin-6 as a Potential Indicator for Prevention of High Risk Adenoma Recurrence by Dietary Flavonols in the Polyp Prevention Trial

    PubMed Central

    Bobe, Gerd; Albert, Paul S.; Sansbury, Leah B.; Lanza, Elaine; Schatzkin, Arthur; Colburn, Nancy H.; Cross, Amanda J.

    2010-01-01

    Serum interleukin (IL)-6, a pro-inflammatory cytokine, is considered an indicator of inflammation and may be an indicator of colorectal carcinogenesis given that inflammation can promote carcinogenesis. Flavonols, which can be found in fruits and vegetables, may inhibit colorectal carcinogenesis partly by inhibiting inflammation. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) to determine whether serum IL-6 was associated with colorectal adenoma recurrence and flavonol intake and, thus may serve as a risk indicator and as a response indicator to dietary flavonols. Serum IL-6 concentrations at baseline, year 1 and 3 were measured in 872 participants from the intervention arm of the Polyp Prevention Trial, a 4-year trial that examined the effectiveness of a low-fat, high-fiber, high-fruit and vegetable diet on adenoma recurrence. Intake of flavonols, especially of isorhamnetin, kaempferol, and quercetin, was inversely associated with serum IL-6 concentrations (highest vs. lowest flavonol intake quartile, 1.80 vs. 2.20 pg/mL) and high risk (OR = 0.51, 95% CI: 0.26–0.98) and advanced adenoma recurrence (OR = 0.17, 95% CI: 0.06–0.50). A decrease in IL-6 concentration during the trial was inversely associated with high risk (OR = 0.44, 95% CI: 0.23–0.84) and advanced adenoma recurrence (OR = 0.47, 95% CI: 0.19–1.18). Individuals with above median flavonol intake and equal or below median IL-6 change after baseline had the lowest risk of recurrence of high risk and advanced adenoma. Our results suggest that serum IL-6 may serve as a risk indicator and as a response indicator to dietary flavonols for colorectal cancer prevention. PMID:20484173

  11. Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion for the diagnosis of colorectal polyp and cancer

    PubMed Central

    Tomizawa, Minoru; Shinozaki, Fuminobu; Uchida, Yoshitaka; Uchiyama, Katsuhiro; Fugo, Kazunori; Sunaoshi, Takafumi; Ozaki, Aika; Sugiyama, Eriko; Baba, Akira; Kano, Daisuke; Shite, Misaki; Haga, Ryota; Fukamizu, Yoshiya; Kagayama, Satoshi; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Kishimoto, Takashi; Ishige, Naoki

    2017-01-01

    Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion (DWIBS/T2) is useful for the diagnosis of cancer as it presents a clear contrast between cancerous and non-cancerous tissue. The present study investigated the limitations and advantages of DWIBS/T2 with regards to the diagnosis of colorectal polyp (CP) or cancer (CRC). The current study included patients diagnosed with CP or CRC following colonoscopy, who were subjected to DWIBS/T2 between July 2012 and March 2015. Patient records were analyzed retrospectively. Patients were subjected to DWIBS/T2 when they presented with abdominal cancers or inflammation. Colonoscopy was performed as part of screening, or if patients had suspected colon cancer or inflammatory bowel disease. A total of 8 male and 7 female patients were enrolled in the present study. All patients, with the exception of one who had been diagnosed with CRC following colonoscopy, had positive results and all patients diagnosed with CP following a colonoscopy, with the exception of one, had negative results on DWIBS/T2. Thus, CRC was detected by DWIBS/T2, while CP was not (P=0.0028). The diameter of CRC lesions was significantly larger than that of CP (P<0.0001) and that of lesions positive on DWIBS/T2 was significantly larger than that of negative lesions (P=0.0004). The depth of invasion tended to be greater for lesions positive on DWIBS/T2 compared with that of negative ones. This indicated that DWIBS/T2 may be suitable for the detection of CRC but not for detection of CP. The results of DWIBS/T2 may also be affected by lesion diameter and depth of invasion. PMID:28352344

  12. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    PubMed Central

    Laban, Mohamed; Eisa, Marwa M.

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB. PMID:28003825

  13. Treating one's own ailments.

    PubMed

    Ibrahim, M I

    1996-01-01

    A small survey in Peninsular Malaysia indicates a marked tendency among the general population to treat minor ailments by self-medication with over-the-counter drugs and/or traditional medicines. The use of over-the-counter drugs appears to be favoured for skin conditions, general health care, aches and pains, and problems affecting the eyes, ears, mouth, gastrointestinal tract and respiratory tract. A doctor is usually consulted if self-medication fails.

  14. Method of treating depression

    DOEpatents

    Henn, Fritz [East Patchogue, NY

    2012-01-24

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  15. Method of treating depression

    DOEpatents

    Henn, Fritz

    2013-04-09

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  16. Fluidized bed heat treating system

    DOEpatents

    Ripley, Edward B; Pfennigwerth, Glenn L

    2014-05-06

    Systems for heat treating materials are presented. The systems typically involve a fluidized bed that contains granulated heat treating material. In some embodiments a fluid, such as an inert gas, is flowed through the granulated heat treating medium, which homogenizes the temperature of the heat treating medium. In some embodiments the fluid may be heated in a heating vessel and flowed into the process chamber where the fluid is then flowed through the granulated heat treating medium. In some embodiments the heat treating material may be liquid or granulated heat treating material and the heat treating material may be circulated through a heating vessel into a process chamber where the heat treating material contacts the material to be heat treated. Microwave energy may be used to provide the source of heat for heat treating systems.

  17. B-RAF mutation and accumulated gene methylation in aberrant crypt foci (ACF), sessile serrated adenoma/polyp (SSA/P) and cancer in SSA/P

    PubMed Central

    Inoue, A; Okamoto, K; Fujino, Y; Nakagawa, T; Muguruma, N; Sannomiya, K; Mitsui, Y; Takaoka, T; Kitamura, S; Miyamoto, H; Okahisa, T; Fujimori, T; Imoto, I; Takayama, T

    2015-01-01

    Background: Sessile serrated adenomas/polyps (SSA/Ps) are a putative precursor of colon cancer with microsatellite instability (MSI). However, the developmental mechanism of SSA/P remains unknown. We performed genetic analysis and genome-wide DNA methylation analysis in aberrant crypt foci (ACF), SSA/P, and cancer in SSA/P specimens to show a close association between ACF and the SSA/P-cancer sequence. We also evaluated the prevalence and number of ACF in SSA/P patients. Methods: ACF in the right-side colon were observed in 36 patients with SSA/Ps alone, 2 with cancers in SSA/P, and 20 normal subjects and biopsied under magnifying endoscopy. B-RAF mutation and MSI were analysed by PCR–restriction fragment length polymorphism (RFLP) and PCR–SSCP, respectively, in 15 ACF, 20 SSA/P, and 2 cancer specimens. DNA methylation array analysis of seven ACF, seven SSA/P, and two cancer in SSA/P specimens was performed using the microarray-based integrated analysis of methylation by isochizomers (MIAMI) method. Results: B-RAF mutations were frequently detected in ACF, SSA/P, and cancer in SSA/P tissues. The number of methylated genes increased significantly in the order of ACF

  18. Single Incision Laparoscopic Surgery in Treating Patients With Colorectal Disease

    ClinicalTrials.gov

    2013-11-04

    Adenomatous Polyp; Crohn Disease; Familial Adenomatous Polyposis; Hereditary Intestinal Polyposis Syndrome; Recurrent Colon Cancer; Stage I Colon Cancer; Stage IIA Colon Cancer; Stage IIB Colon Cancer; Stage IIC Colon Cancer; Stage IIIA Colon Cancer; Stage IIIB Colon Cancer; Stage IIIC Colon Cancer

  19. Method of treating tumors

    DOEpatents

    DeNardo, Sally J.; Burke, Patricia A.; DeNardo, Gerald L.; Goodman, Simon; Matzku, legal representative, Kerstin; Matzku, Siegfried

    2006-04-18

    A method of treating tumors, such as prostate tumors, breast tumors, non-Hodgkin's lymphoma, and the like, includes the sequential steps of administering to the patient at least one dose of an antiangiogenic cyclo-arginine-glycine-aspartic acid-containing pentapeptide (cRGD pentapeptide); administering to the patient an anti-tumor effective amount of a radioimmunotherapeutic agent (RIT); and then administering to the patient at least one additional dose of cRGD pentapeptide. The cRGD pentapeptide is preferably cyclo-(Arg-Gly-Asp-D-Phe-[N-Me]-Val), and the RIT is preferably a radionuclide-labeled chelating agent-ligand complex in which chelating agent is chemically bonded to a tumor-targeting molecule, such as a monoclonal antibody.

  20. Heat Treating Apparatus

    DOEpatents

    De Saro, Robert; Bateman, Willis

    2002-09-10

    Apparatus for heat treating a heat treatable material including a housing having an upper opening for receiving a heat treatable material at a first temperature, a lower opening, and a chamber therebetween for heating the heat treatable material to a second temperature higher than the first temperature as the heat treatable material moves through the chamber from the upper to the lower opening. A gas supply assembly is operatively engaged to the housing at the lower opening, and includes a source of gas, a gas delivery assembly for delivering the gas through a plurality of pathways into the housing in countercurrent flow to movement of the heat treatable material, whereby the heat treatable material passes through the lower opening at the second temperature, and a control assembly for controlling conditions within the chamber to enable the heat treatable material to reach the second temperature and pass through the lower opening at the second temperature as a heated material.

  1. How Is Cardiogenic Shock Treated?

    MedlinePlus

    ... muscle contracts Treat a heart attack Medical Devices Medical devices can help the heart pump and improve blood flow. Devices used to treat cardiogenic shock may include: An intra-aortic balloon pump. This device is placed in the aorta, ...

  2. Does Marijuana Help Treat Glaucoma?

    MedlinePlus

    ... Ophthalmologist Patient Stories Español Eye Health / Tips & Prevention Marijuana Sections Does Marijuana Help Treat Glaucoma? Why Eye ... Don't Recommend Marijuana for Glaucoma Infographic Does Marijuana Help Treat Glaucoma? Written by: David Turbert , contributing ...

  3. Dupixent Approved to Treat Eczema

    MedlinePlus

    ... news/fullstory_164333.html Dupixent Approved to Treat Eczema When topical medication doesn't work To use ... and Drug Administration to treat moderate-to-severe eczema that isn't well controlled by topical medication. ...

  4. Peculiar histiocytic lesions with massive lanthanum deposition in dialysis patients treated with lanthanum carbonate.

    PubMed

    Haratake, Joji; Yasunaga, Chikao; Ootani, Akifumi; Shimajiri, Shohei; Matsuyama, Atsuji; Hisaoka, Masanori

    2015-06-01

    Pathologic lesions caused by lanthanum carbonate (LC), a recently developed phosphate-binding agent, have not been recorded. A peculiar gastroduodenal histiocytic lesion associated with a mucosal lanthanum overload was reported. Our routine gastrointestinal biopsy series included 6 cases with heavy lanthanum burden in the gastroduodenal mucosa. In addition to routine histopathologic examinations, a series of immunohistochemical analysis and electron microscopic examinations associated with x-ray diffraction and elemental analysis were performed. Six cases, 3 of male and 3 of female individuals with ages from 59 to 69 years, were all patients of end-stage renal diseases managed under dialysis and treated with LC for >21 months. Endoscopic examinations demonstrated gastric erosions in 3, gastric polyps in 2, and duodenal ulcer in 1. In the mucosal layer, there were numerous non-Langerhans cell histiocytes, stained with CD68 but not S100 protein, engulfing a large amount of mineral-like materials. An electron microscopic and elemental analysis revealed a similar distribution of lanthanum and phosphorus in the histiocytes. Long-standing LC administration can cause massive mucosal accumulation of lanthanum in the tissue histiocytes associated with several forms of gastroduodenal lesions. A long-standing outcome is not clear at present; hence, careful follow-up studies of these patients may be needed.

  5. Treating Nodular Lymphocyte Predominant Hodgkin Disease (NLPHD)

    MedlinePlus

    ... for Hodgkin Disease Treating Classic Hodgkin Disease, by Stage Treating Nodular Lymphocyte Predominant Hodgkin Disease (NLPHD) Treating Hodgkin Disease in Children Hodgkin Disease in Pregnancy Hodgkin Disease Treating Hodgkin Disease Treating Nodular Lymphocyte ...

  6. Inflammatory aneurysms treated with EVAR.

    PubMed

    Stone, William M; Fankhauser, Grant T

    2012-12-01

    Inflammatory abdominal aortic aneurysms (IAAA) are being treated more frequently by endovascular aneurysm repair (EVAR). Some authors caution against treating IAAA by EVAR because retroperitoneal inflammation may not subside post-operatively. A recent experience of 69 IAAA treated by open and endovascular methods is presented with results supporting the use of EVAR for IAAA. Several other studies evaluating EVAR in the treatment of IAAA are discussed.

  7. Heat treating of manufactured components

    DOEpatents

    Ripley, Edward B [Knoxville, TN

    2012-05-22

    An apparatus for heat treating manufactured components using microwave energy and microwave susceptor material is disclosed. The system typically includes an insulating vessel placed within a microwave applicator chamber. A moderating material is positioned inside the insulating vessel so that a substantial portion of the exterior surface of each component for heat treating is in contact with the moderating material.

  8. Treating impetigo in primary care.

    PubMed

    2007-01-01

    Impetigo is a superficial, but contagious, bacterial infection of the skin that predominantly affects children and is common in primary care. In UK general practice, around half of the people with impetigo are treated with topical fusidic acid. However, bacterial resistance to this antibacterial drug is increasing. Here we discuss how patients with impetigo should be treated.

  9. How Is Fanconi Anemia Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Fanconi Anemia Treated? Doctors decide how to treat Fanconi anemia (FA) based on a person's age and how ... Long-term treatments for FA can: Cure the anemia. Damaged bone marrow cells are replaced with healthy ...

  10. Résection endoscopique des polypes colorectaux pédiculés en utilisant un lasso largable au fil catgut chromé: une alternative a la polypectomie conventionnelle? A propos d'une série de cas

    PubMed Central

    Ankouane, Firmin; Noah, Dominique Noah; Nonga, Bernadette Ngo; Tagni-Sartre, Michèle; Modjo, Gabriel; Ndam, Elie Claude Ndjitoyap

    2014-01-01

    L'intérêt de l'endoscopie dans la résection des polypes colorectaux a été rapporté dans plusieurs études. Les techniques de résection endoscopique sont multiples et maîtrisées dans les pays occidentaux. La technique de mucosectomie endoscopique et celle de la pose d'une anse largable en nylon (endoloop) ont élargi le champ des lésions résécables par endoscopie. Toutefois, malgré cette évolution, la vulgarisation de la polypectomie n'est pas effective. En Afrique subsaharienne, la prise en charge de ces polypes de grande taille nécessite souvent une intervention chirurgicale à ciel ouvert ou une évacuation sanitaire onéreuse dans un pays en Occident. Nous rapportons une nouvelle approche de polypectomie endoscopique des polypes pédiculés colorectaux, en utilisant un lasso largable au fil catgut chromé 2/0. Les polypes pédiculés étaient situés soit au niveau du sigmoïde soit au rectum. Après avoir passé le lasso autour du pédicule, le n'ud du lasso est serré autour de celui-ci pour strangulation. En moyenne 6 jours après la procédure, le polype est récupéré dans les selles. Une colonoscopie de contrôle est nécessaire pour confirmer la résection du polype. Cette technique peu coûteuse et accessible, devrait être vulgarisée dans les pays en voie de développement avec des plateaux techniques pauvres. Elle a ses limites et ses inconvénients qui doivent être connus de l'opérateur. PMID:25360198

  11. Treating metastatic cancer with nanotechnology.

    PubMed

    Schroeder, Avi; Heller, Daniel A; Winslow, Monte M; Dahlman, James E; Pratt, George W; Langer, Robert; Jacks, Tyler; Anderson, Daniel G

    2011-12-23

    Metastasis accounts for the vast majority of cancer deaths. The unique challenges for treating metastases include their small size, high multiplicity and dispersion to diverse organ environments. Nanoparticles have many potential benefits for diagnosing and treating metastatic cancer, including the ability to transport complex molecular cargoes to the major sites of metastasis, such as the lungs, liver and lymph nodes, as well as targeting to specific cell populations within these organs. This Review highlights the research, opportunities and challenges for integrating engineering sciences with cancer biology and medicine to develop nanotechnology-based tools for treating metastatic disease.

  12. How Is Immune Thrombocytopenia Treated?

    MedlinePlus

    ... For a platelet transfusion, donor platelets from a blood bank are injected into the recipient's bloodstream. This increases the platelet count for a short time. For more information about platelet transfusions, go to ... article. Treating Infections Some infections can briefly ...

  13. How Is Hypersensitivity Pneumonitis Treated?

    MedlinePlus

    ... treat severe chronic disease in some patients. Avoidance strategies If your doctor is able to identify the ... will recommend that you adopt the following avoidance strategies. Remove the causative substance if possible Replace workplace ...

  14. How Are Varicose Veins Treated?

    MedlinePlus

    ... and scarring. Sclerotherapy Sclerotherapy (SKLER-o-ther-ah-pe) uses a liquid chemical to close off a ... Microsclerotherapy Microsclerotherapy (MI-kro-SKLER-o-ther-ah-pe) is used to treat spider veins and other ...

  15. How Is Aplastic Anemia Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Treated? Treatments for aplastic anemia include blood transfusions , blood and marrow stem cell ... a transplant. Removing a known cause of aplastic anemia, such as exposure to a toxin, also may ...

  16. How Is Atrial Fibrillation Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Atrial Fibrillation Treated? Treatment for atrial fibrillation (AF) depends on ... much thyroid hormone). Who Needs Treatment for Atrial Fibrillation? People who have AF but don't have ...

  17. How Is Respiratory Failure Treated?

    MedlinePlus

    ... to treat the underlying cause of the condition. Oxygen Therapy and Ventilator Support If you have respiratory ... mask that fits over your nose and mouth. Oxygen Therapy The image shows how a nasal cannula ...

  18. How to Treat Gestational Diabetes

    MedlinePlus

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  19. Best Medications to Treat Fibromyalgia

    MedlinePlus

    ... privacy policy . A A Best medications to treat Fibromyalgia Comparing effectiveness, safety, and price Published: February 2014 ... be clearly more effective or safer. What is fibromyalgia? The symptoms of fibromyalgia include pain and tenderness ...

  20. How Is Rh Incompatibility Treated?

    MedlinePlus

    ... severe anemia may be treated with a blood exchange transfusion. The procedure involves slowly removing the newborn's ... compound forms when red blood cells break down. Rate This Content: NEXT >> Updated: January 1, 2011 Twitter ...

  1. Treating P.A.D.

    MedlinePlus

    ... Issue Past Issues Special Section Treating P.A.D. Past Issues / Summer 2008 Table of Contents For ... Illustration courtesy of NHLBI Treatment for P.A.D. is designed to reduce a patient's symptoms, prevent ...

  2. How Is Polycythemia Vera Treated?

    MedlinePlus

    ... for itching involves taking low doses of selective serotonin reuptake inhibitors (SSRIs). This type of medicine is used to treat depression. In clinical trials , SSRIs reduced itching in people ...

  3. How Is an Aneurysm Treated?

    MedlinePlus

    ... body structures Preventing or treating a rupture or dissection Allowing you to continue doing your normal daily ... quickly or is at risk of rupture or dissection. The two main types of surgery to repair ...

  4. Evaluating and Treating Transverse Myelitis

    MedlinePlus

    ... myelitis (TM). Neurologists from the American Academy of Neurology are doctors who identify and treat diseases of ... an educational service of the American Academy of Neurology. It is based on an assessment of current ...

  5. Consumer Products Treated with Pesticides

    EPA Pesticide Factsheets

    Many products (e.g., cutting boards, kitchen sponges, cat litter, toothbrushes and juvenile toys) are being treated with antimicrobial pesticides. Learn about requirements that apply to such products.

  6. System of treating flue gas

    DOEpatents

    Ziegler, D.L.

    1975-12-01

    A system is described for treating or cleaning incinerator flue gas containing acid gases and radioactive and fissionable contaminants. Flue gas and a quench solution are fed into a venturi and then tangentially into the lower portion of a receptacle for restricting volumetric content of the solution. The upper portion of the receptacle contains a scrub bed to further treat or clean the flue gas.

  7. Vγ1+ γδT Cells Are Correlated With Increasing Expression of Eosinophil Cationic Protein and Metalloproteinase-7 in Chronic Rhinosinusitis With Nasal Polyps Inducing the Formation of Edema

    PubMed Central

    Yang, Luo-ying; Li, Xia; Li, Wen-ting; Huang, Jian-cong; Wang, Zhi-yuan; Huang, Zi-zhen

    2017-01-01

    Purpose We have found that expression of γδT cells is increased in pathological mucosa of chronic rhinosinusitis with nasal polyps (CRSwNP) compared with normal nasal mucosa. This increase is correlated with the infiltration of eosinophils in CRSwNP. Here, we investigated the expression of γδT cells, inflammation and tissue remodeling factors as well as their probable relationships in different types of chronic rhinosinusitis (CRS) in China. Methods A total of 76 surgical tissue samples that included 43 CRSwNP samples (15 eosinophilic and 28 non-eosinophilic), 17 CRS samples without nasal polyps (CRSsNP), and 16 controls were obtained. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression levels of Vγ1+ γδT cells, Vγ4+ γδT cells, eosinophil cationic protein (ECP), interleukin (IL)-8, transforming growth factor (TGF)-β2, metalloproteinase (MMP)-7, tissue inhibitor of metalloproteinase (TIMP)-4 and hypoxia-inducible factor (HIF)-1α. Enzyme linked immunosorbent assay (ELISA) was used to measure the protein level of ECP and MMP-7 in CRSwNP. The eosinophils were counted and the level of edema was analyzed with HE staining. Results The mRNA expression levels of the Vγ1 subset, ECP and MMP-7 were significantly increased in CRSwNP with histological characteristics of eosinophilic infiltration and edema. The expression of the Vγ1 gene in CRSwNP correlated positively with the expression of both ECP and MMP-7. No significant decreases in the mRNA expression levels of TGF-β2, TIMP-4 or HIF-1α were observed in the CRSwNP samples. The expression levels of Vγ1 gene, ECP and MMP-7 were significantly increased in eosinophilic CRSwNP compared to non-eosinophilic CRSwNP. Conclusions Our results suggest the associations between Vγ1+ γδT cells, ECP and MMP-7 in CRSwNP, indicating that Vγ1+ γδT cells can induce the eosinophilic inflammation, which has a further effect on the formation of edema. PMID:28102059

  8. The heat treating source book

    SciTech Connect

    Gupton, P.S.

    1986-01-01

    The first section of this book reviews current trends and is followed by an article describing how to design for lower cost and high-quality heat treatment. Two separate sections deal with ferrous materials and non-ferrous metals. Coverage includes stress-relief heat treating, normalizing and cold treating of steel; ultrahigh-strength steels; tool steels; maraging steels; austenitic stainless steels and cast irons, as well as aluminum alloys, titanium and its alloys, nickel-base superalloys, special purpose alloys and lead and its alloys. Other topics discussed are carburizing, carbonitriding and nitriding; vacuum methods; salt bath processing; methods of measuring case depth; and atmosphere control and nitrogen as all-purpose atmosphere. Also, information is provided on energy-efficient operations, production systems, selecting and handling quenching fluids, furnace control instrumentation, and guidelines for heat treating powdered metal parts.

  9. Erythrodermic Psoriasis Treated with Apremilast

    PubMed Central

    Arcilla, John; Joe, Daniel; Kim, Johnathan; Kim, Yohanan; Truong, VuAnh N.; Jaipaul, Navin

    2016-01-01

    Erythroderma is a rare potentially deadly exfoliative dermatitis characterized by diffuse cutaneous erythema which may be associated with multi-organ dysfunction. Therefore, it is imperative to recognize and treat it promptly. Erythrodermic psoriasis is the most common form of erythroderma. Management of this condition is largely based on aggressive supportive care and the use of anti-inflammatory immunosuppressive and biologic agents. We describe a case of psoriatic erythroderma which was triggered by withdrawal from systemic steroids and successfully treated with apremilast and cyclosporine. Apremilast induced atrial fibrillation limited its continued use after the initial response period. PMID:27942369

  10. Method for treating contaminated wastewater

    SciTech Connect

    Fochtman, E.G.; Forbes, F.S.; Koch, R.L.

    1983-09-06

    A method is disclosed for treating hydrazine-fuel contaminated wastewater in which hydrazine, monomethyl hydrazine, unsymmetrical dimethyl hydrazine and dimethylnitrosamine pollutants are effectively decomposed at a controlled pH of about 5 by an ultraviolet induced chlorination treatment of the wastewater.

  11. Method for treating waste water

    SciTech Connect

    Masaki, Y.; Odawara, Y.; Shimizu, N.

    1982-10-26

    The invention relates to an improvement of the floc-formation property of activated sludge contained in waste water. A waste water treatment process comprises steps culturing a novel strain-alcaligenes faecalis hrl-1-and adding the cultured cells to to-be-treated waste water.

  12. Current Concepts of Treating Vaginitis

    PubMed Central

    Robinson, Theresa

    1977-01-01

    Vaginitis can be a frustrating entity to treat, since the incidence of recurrence is high. This paper examines evidence from the literature concerning diagnosis and treatment of Candida albicans, Trichomonas vaginalis, Corynebacterium vaginale, herpes simplex type 2 and gonorrhea. A protocol based on these readings is outlined. PMID:21304797

  13. How Is Metabolic Syndrome Treated?

    MedlinePlus

    ... by controlling all of your risk factors. Heart-Healthy Lifestyle Changes Heart-healthy lifestyle changes include heart-healthy eating , aiming for a ... you to. You should still follow a heart-healthy lifestyle, even if you take medicines to treat your ...

  14. Preventing and Treating Blood Clots

    MedlinePlus

    ... of blood clots. Heparin is recommended to treat DVT and PE for the first five to ten days, as well as for preventing blood clots ... risk of bleeding. For patients who develop a deep vein thrombosis, and/or a ... blood clot prevention will be included in your overall treatment plan, ...

  15. Contribution of bi-allelic germline MUTYH mutations to early-onset and familial colorectal cancer and to low number of adenomatous polyps: case-series and literature review.

    PubMed

    Knopperts, A P; Nielsen, M; Niessen, R C; Tops, C M J; Jorritsma, B; Varkevisser, J; Wijnen, J; Siezen, C L E; Heine-Bröring, R C; van Kranen, H J; Vos, Y J; Westers, H; Kampman, E; Sijmons, R H; Hes, F J

    2013-03-01

    In the absence of a polyposis phenotype, colorectal cancer (CRC) patients referred for genetic testing because of early-onset disease and/or a positive family history, typically undergo testing for molecular signs of Lynch syndrome in their tumors. In the absence of these signs, DNA testing for germline mutations associated with other known tumor syndromes is usually not performed. However, a few studies in large series of CRC patients suggest that in a small percentage of CRC cases, bi-allelic MUTYH germline mutations can be found in the absence of the MUTYH-associated polyposis phenotype. This has not been studied in the Dutch population. Therefore, we analyzed the MUTYH gene for mutations in 89 patients with microsatellite-low or stable CRC cancer diagnosed before the age of 40 years or otherwise meeting the Bethesda criteria, all of them without a polyposis phenotype. In addition, we studied a series of 693 non-CRC patients with 1-13 adenomatous colorectal polyps for the MUTYH hotspot mutations Y179C, G396D and P405L. No bi-allelic MUTYH mutations were observed. Our data suggest that the contribution of bi-allelic MUTYH mutations to the development of CRC in Dutch non-polyposis patients that meet clinical genetic referral criteria, and to the development of low number of colorectal adenomas in non-CRC patients, is likely to be low.

  16. Integrated system for treating soil contaminated with wood treating wastes

    SciTech Connect

    Acheson, C.M.; Brenner, R.C.; Khodadoust, A.P.

    1995-10-01

    Approximately 20% of the hazardous waste sites undergoing bioremediation are contaminated with wood treating wastes, primarily compounds such as pentachlorophenol (PCP), creosote, polycyclic aromatic hydrocarbons (PAHs), and other hydrocarbons. A process that combines soil washing with sequential anaerobic and aerobic biotreatment is being integrated to remediate soil contaminated with these wood treating wastes. By extracting the target compound from the soil, soil washing facilitates degradation by mobilizing the target compound and expanding the range of feasible remediation technologies. Additional flexibility is possible since soil washing can be conducted in an in-situ or ex-situ format. In this process, the wash solution is initially bioremediated in an anaerobic environment. Mineralization of the target compound is completed aerobically. Based on preliminary results, the integrated process could meet the target cleanup level for PCP in approximately 45% of the bioremediation sites. Process development began by independently evaluating soil washing and target compound degradation. PCP contaminated soils were the initial focus, but this work is currently being extended to include soils contaminated with both PCP and PAHs. In addition, based on promising results from the soil washing and degradation evaluations, these individual unit operations are being integrated to form a complete process to remediate soils contaminated with wood treating wastes. This complete process incorporates soil washing, soil wash solution recycling, and biodegradation of the target compounds and is outlined.

  17. Treating Depression: Should You Consider an Antidepressant?

    MedlinePlus

    Treating Depression: Should You Consider An Antidepressant? What are antidepressants? Antidepressants are drugs used to treat the symptoms of depression. Do I need an antidepressant? You probably do ...

  18. Method for treating liquid wastes

    DOEpatents

    Katti, K.V.; Volkert, W.A.; Singh, P.; Ketring, A.R.

    1995-12-26

    The method of treating liquid waste in a media is accomplished by exposing the media to phosphinimines and sequestering {sup 99}Tc from the media by the phosphinimine (PN) functionalities. The system for treating the liquid waste in the media includes extraction of {sup 99}TcO{sub 4}{sup {minus}} from aqueous solutions into organic solvents or mixed organic/polar media, extraction of {sup 99}Tc from solutions on a solid matrix by using a container containing PN functionalities on solid matrices including an inlet and outlet for allowing flow of media through an immobilized phosphinimine ligand system contained within the container. Also, insoluble suspensions of phosphinimine functionalities on solid matrices in liquid solutions or present on supported liquid membranes (SLM) can be used to sequester {sup 99}Tc from those liquids. 6 figs.

  19. Partial Priapism Treated with Pentoxifylline

    PubMed Central

    Cooper, Meghan A.; Carrion, Rafael E.; Yang, Christopher

    2015-01-01

    ABSTRACT Main findings: A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease. Case hypothesis: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic. Promising future implications: This case report supports the utilization of pentoxifylline in patients with partial priapism due to its anti-fibrogenic and anti-thrombotic properties. PMID:26401875

  20. Male anorgasmia treated with oxytocin.

    PubMed

    Ishak, Waguih William; Berman, Daniel S; Peters, Anne

    2008-04-01

    Introduction. This is a case report on male anorgasmia that was successfully treated with oxytocin. Oxytocin is increased during arousal and peaks during orgasm. More recently, a study on humans published in Nature has shown its value in social bonding, increasing trust, and enhancing the sense of well-being. Aim. To test the effectiveness of administering oxytocin in a case of treatment-resistant anorgasmia. Methods. The patient underwent a biopsychosocial evaluation by a psychiatrist trained in sexual medicine and sex therapy for male orgasmic disorder, acquired type. Medical conditions, effect of substances, and psychological issues were ruled out. The patient was properly consented to using oxytocin as an off-label trial. Oxytocin was administered using a nasal spray intracoitally because of its ultra-short half-life. Results. Oxytocin was effective in restoring ejaculation. Conclusions. A case of treatment-resistant male anorgasmia was successfully treated with intracoital administration of intranasal oxytocin.

  1. Method for treating liquid wastes

    DOEpatents

    Katti, Kattesh V.; Volkert, Wynn A.; Singh, Prahlad; Ketring, Alan R.

    1995-01-01

    The method of treating liquid waste in a media is accomplished by exposing the media to phosphinimines and sequestering .sup.99 Tc from the media by the phosphinimine (PN) functionalities. The system for treating the liquid waste in the media includes extraction of .sup.99 TcO.sub.4.sup.- from aqueous solutions into organic solvents or mixed organic/polar media, extraction of .sup.99 Tc from solutions on a solid matrix by using a container containing PN functionalities on solid matrices including an inlet and outlet for allowing flow of media through an immobilized phosphinimine ligand system contained within the container. Also, insoluble suspensions of phosphinimine functionalities on solid matrices in liquid solutions or present on supported liquid membranes (SLM) can be used to sequester .sup.99 Tc from those liquids.

  2. Treating urine by Spirulina platensis

    NASA Astrophysics Data System (ADS)

    Yang, Chenliang; Liu, Hong; Li, Ming; Yu, Chengying; Yu, Gurevich

    In this paper Spirulina platensis with relatively high nutrition was cultivated to treat human urine. Batch culture showed that the consumption of N in human urine could reach to 99%, and the consumption of P was more than 99.9%, and 1.05 g biomass was obtained by treating 12.5 ml synthetic human urine; continuous culture showed that S. platensis could consume N, Cl, K and S in human urine effectively, and the consumption could reach to 99.9%, 75.0%, 83.7% and 96.0%, respectively, and the consumption of P was over 99.9%, which is very important to increase the closure and safety of the bioregenerative life support system (BLSS).

  3. Well treating process and composition

    SciTech Connect

    Holland, A.C.

    1984-09-11

    A process is disclosed for treating a subterranean zone by emplacing therein a hardenable aqueous slurry and then permitting the slurry to harden, where the slurry comprises a hydraulic cement, water, sodium bentonite, sodium metasilicate, and a hydroxyethyl cellulose. The composition and process employing same is particularly useful in the treatment of oil and gas wells where cementing of a weak formation of very long string cementing, in a single stage, is desired.

  4. [Two treated cases of botulism].

    PubMed

    Işik, N; Elibol, B; Oztekin, N S; Zileli, T

    1990-01-01

    Botulism is a severe neuroparalytic disease caused by the neurotoxins of Clostridium botulinum which exert their effects on peripheral nerve junctions. Guillain-Barre syndrome, Myasthenia Gravis, acute Poliomyelitis and diphtheria must be considered in the differential diagnosis. In this study we have discussed two patients who were treated in our clinic, the differential diagnosis and the role of anti-Cholinesterase drugs in the treatment.

  5. [Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with].

    PubMed

    Kladenský, J

    2012-04-01

    Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. Bacteriuria in pregnancy accounts for a significantly higher number of newborns with a low birth weight, low gestational age and higher neonatal mortality rate. Therefore, it is necessary to perform screening for bacteriuria in pregnant women and, when the finding is positive, to treat this bacteriuria. The selection of an appropriate antimicrobial agent to treat urinary tract infection in pregnancy is limited by the safety of a given drug not only for the woman, but particularly for the fetus. The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women.

  6. Not ''just'' pump and treat

    SciTech Connect

    Angleberger, K; Bainer, R W

    2000-12-12

    The Lawrence Livermore National Laboratory (LLNL) has been consistently improving the site cleanup methods by adopting new philosophies, strategies and technologies to address constrained or declining budgets, lack of useable space due to a highly industrialized site, and significant technical challenges. As identified in the ROD, the preferred remedy at the LLNL Livermore Site is pump and treat, although LLNL has improved this strategy to bring the remediation of the ground water to closure as soon as possible. LLNL took the logical progression from a pump and treat system to the philosophy of ''Smart Pump and Treat'' coupled with the concepts of ''Hydrostratigraphic Unit Analysis,'' ''Engineered Plume Collapse,'' and ''Phased Source Remediation,'' which led to the development of new, more cost-effective technologies which have accelerated the attainment of cleanup goals significantly. Modeling is also incorporated to constantly develop new, cost-effective methodologies to accelerate cleanup and communicate the progress of cleanup to stakeholders. In addition, LLNL improved on the efficiency and flexibility of ground water treatment facilities. Ground water cleanup has traditionally relied on costly and obtrusive fixed treatment facilities. LLNL has designed and implemented various portable ground water treatment units to replace the fixed facilities; the application of each type of facility is determined by the amount of ground water flow and contaminant concentrations. These treatment units have allowed for aggressive ground water cleanup, increased cleanup flexibility, and reduced capital and electrical costs. After a treatment unit has completed ground water cleanup at one location, it can easily be moved to another location for additional ground water cleanup.

  7. Recycling of treated wood poles

    SciTech Connect

    Fansham, P.

    1995-11-01

    There are approximately 150 million utilities poles in service in North America. Of the 3 million poles removed from service each year, many poles still contain a sound and structurally intact core and only the outer layer has deteriorated. Since most of the old poles are treated with either pentachlorophenol or creosote there are limited disposal options available to pole users. The practice of giving old poles away to farmers or other interested parties in falling into disfavour since this practice does not absolve the utility of the environmental liability associated with the treated wood. TWT has commercialised a thermolysis (Pyrolysis) based process capable of removing oil based preservatives from treated wood. The patented process involves: the shaving of the weathered pole exterior; the rapid distillation of oil based preservatives in an oxygen depleted environment; condensation of the vapours; and separation of liquids. TWT has constructed a 30,000 pole per year facility east of Calgary and has provided recycled poles for the construction of two power lines now in use by TransAlta Utilities Corporation, Canada`s largest investor owned electric utility. TWT has tested two thermolysis (Pyrolysis) technologies and has determined that contact thermolysis using a heated auger design performed better and with less plugging than a fast fluid bed reactor. The fluid bed reactor is prone to coke formation and contamination of the oil by fine char particles. Residual PCP concentration in the shavings was reduced from 9500 ppm to 10 ppm. Leachate testing on the char yielded a PCP concentration of 1.43 ppm in the Leachate, well below the EPA standard maximum of 100 ppm.

  8. The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis?

    PubMed

    Cosway, Ben; Tomkinson, Alun; Owens, David

    2013-03-01

    Rhinosinusitis is a common condition with adults experiencing 2-5 episodes per year. The European Positional Paper on Rhinosinusitis and Nasal Polyps (EP3OS) published in 2005 and updated in 2007 provided evidence-based guidelines on the management of sinus disease promoting a conservative approach to treatment. This study examines the effect of EP3OS on sinus surgery uptake and acute admissions for sinusitis in England and Wales. A retrospective study using the national electronic health databases of England (Hospital Episodes Statistics, HES online) and Wales (Patient Episodes Database of Wales, PEDW) was undertaken from 2000 to 2010 using the OPCS-4 codes E12-E17 (sinus surgery) and ICD10 code J01 (acute admission for sinusitis). Data were analysed for effect following the introduction of the EP3OS in 2005 using linear regression and Chi squared analysis. 116,370 sinus procedures and 10,916 acute admissions for sinusitis were made during the study period. No significant decrease in sinus surgery procedures occurred following the introduction of the EP3OS as may have been expected (p > 0.05), although subgroup analysis suggested a significant increase in Wales (p < 0.05). In addition, significant increases in acute admissions for sinusitis were observed following the introduction of EP3OS (p < 0.05). However, subgroup analysis suggested this was not the case in Wales (p > 0.05). The EP3OS appears to have had little impact on the rates of sinus surgery but more conservative approaches to managing of sinus disease may have led to an increase in acute admissions. Further research is required to investigate whether changes in practice were adopted.

  9. Elemental concentrations in skin of patients with fibroeptelial polip using synchrotron radiation total reflection x-ray fluorescence

    NASA Astrophysics Data System (ADS)

    Soares, Júlio C. A. C. R.; Anjos, Marcelino J.; Canellas, Catarine G. L.; Lopes, Ricardo T.

    2012-05-01

    In this work, the concentrations of trace elements were measured in acrochordon, a skin lesion also known as skin tag or fibroepithelial polyp, as well as in normal skin from the same patient. The samples were analyzed by Synchrotron Radiation Total Reflection X-ray Fluorescence (SRTXRF) in the Synchrotron Light National Laboratory (LNLS) in Campinas/São Paulo-Brazil. The collection of lesion and healthy skin samples, including papillary dermis and epidermis, has involved 17 patients. It was evaluated the presence of P, S, Cl, K, Ca, Fe, Cu and Zn in the paired samples, which were compared, and significant differences were found in some of them.

  10. Erlotinib Hydrochloride in Treating Patients With Stage I-III Colorectal Cancer or Adenoma

    ClinicalTrials.gov

    2014-12-22

    Adenomatous Polyp; Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage I Colon Cancer; Stage I Rectal Cancer; Stage IIA Colon Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer

  11. Treating malnutrition in the community.

    PubMed

    Dera, Merceline; Woodham, Diane

    2016-11-02

    Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.

  12. Nanotherapies for treating prostate cancer

    NASA Astrophysics Data System (ADS)

    Danquah, Michael

    Current prostate cancer treatment remains ineffective primarily due to ineffectual therapeutic strategies and numerous tumor-associated physiological barriers which hinder efficacy of anticancer agents. Therefore, the focus of this study was to investigate a new combination therapy approach for treating prostate cancer and develop polymeric nanocarriers to facilitate anticancer drug and nucleic acid delivery. It was hypothesized that simultaneously targeting androgen-androgen receptor (AR) and X-linked inhibitor of apoptosis protein (XIAP) signaling pathways would be effective in treating prostate cancer. The effect of bicalutamide (antiandrogen) and embelin (XIAP inhibitor) on the growth of prostate cancer cells in vitro and in vivo was first examined. Embelin induced caspase 3 and 9 activation in LNCaP and C4-2 cells by decreasing XIAP expression and was more potent than bicalutamide in killing prostate tumor cells irrespective of their androgen status. Using a combination of MTT assay and isobologram analyses, combination of bicalutamide and embelin was observed to be cell line and schedule dependent. Since bicalutamide and embelin are extremely hydrophobic, polymeric micelles were fabricated using polyethylene glycol-b-polylactic acid (PEG-b-PLA) copolymer to improve drug solubility. Micellar formulations were found to result in at least 60-fold increase in the aqueous solubility of bicalutamide and embelin. Tumor growth was also effectively regressed upon treatment with bicalutamide, but the extent of tumor regression was significantly higher when bicalutamide was formulated in micelles. To further improve bicalutamide aqueous solubility, a series of novel biodegradable copolymers for the systematic micellar delivery of bicalutamide was designed and synthesized. Flory-Huggins interaction parameter (χFH) was used to assess compatibility between bicalutamide and poly (L-lactide) or poly (carbonate-co-lactide) polymer pairs. Polyethylene glycol-b-poly (carbonate

  13. Simple Solutions for Treating Dry Mouth

    MedlinePlus

    Patient Education Sheet Simple Solutions for Treating Dry Mouth Clinicians: Please make as many copies of this ... Philadelphia, for authoring “Simple Solutions for Treating Dry Mouth.” Ask your family doctor to discontinue or provide ...

  14. How Is High Blood Cholesterol Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is High Blood Cholesterol Treated? High blood cholesterol is treated with lifestyle ... need to follow a heart healthy diet . Lowering Cholesterol Using Therapeutic Lifestyle Changes TLC is a set ...

  15. Vagus Nerve Stimulation for Treating Epilepsy

    MedlinePlus

    ... Evidence-based Guideline for PATIENTS and their FAMILIES VAGUS NERVE STIMULATION FOR TREATING EPILEPSY This information sheet is provided to help you understand how vagus nerve stimulation (VNS) may help treat epilepsy. The American ...

  16. How Are Holes in the Heart Treated?

    MedlinePlus

    ... do. Those that do often are repaired during infancy or early childhood. Sometimes adults are treated for ... enlarged heart chambers are treated with surgery after infancy. However, most VSDs that require surgery are repaired ...

  17. Treating Chronic Myeloid Leukemia by Phase

    MedlinePlus

    ... CML) Treating Chronic Myeloid Leukemia Treating Chronic Myeloid Leukemia by Phase Treatment options for people with chronic ... Myeloid Leukemia by Phase More In Chronic Myeloid Leukemia About Chronic Myeloid Leukemia Causes, Risk Factors, and ...

  18. Common cold - how to treat at home

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000466.htm Common cold - how to treat at home To use the ... Antibiotics are almost never needed to treat a common cold. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower ...

  19. How Are Genetic Conditions Treated or Managed?

    MedlinePlus

    ... are genetic conditions treated or managed? How are genetic conditions treated or managed? Many genetic disorders result ... out more about the treatment and management of genetic conditions: Links to information about the treatment of ...

  20. METHOD FOR TREATING GRAPHITE PRODUCT

    DOEpatents

    Gurinsky, D.H.

    1961-08-01

    A method is described for treating a carbon body with a carbonyl consisting of nickel, iron, and mixtures thereof. The carbonyl is decomposed in a non-oxidizing atmosphere into a mixture of the metal and carbon monoxide on the surface of a carbon body heated to above the decomposition point of the carbonyl. The temperature is increased of the carbon body to an elevated temperature above the point at which a liquid eutectic mixture of the metal and carbon of the carbon body is formed at the surface and below that at which substantial carburization occurs. The elevated temperature is maintained whereby the liquid mixture flows over the surface of the carbon body. The carbon body is cooled below the decomposition temperature of the carbonyl of the metal and to a temperature suitable for forming the carbonyl of the metal. The carbon body is then contacted with carbon monoxide at the carbonyl-forming temperature, whereby carbonyl of the metal is formed in and on the carbon body. The carbonyl is removed from the carbon body by gasifying the carbonyl. (AEC)

  1. Antimicrobial drugs for treating cholera

    PubMed Central

    Leibovici-Weissman, Ya'ara; Neuberger, Ami; Bitterman, Roni; Sinclair, David; Salam, Mohammed Abdus; Paul, Mical

    2014-01-01

    Background Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional benefits of treating cholera with antimicrobial drugs. Objectives To quantify the benefit of antimicrobial treatment for patients with cholera, and determine whether there are differences between classes of antimicrobials or dosing schedules. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; African Index Medicus; LILACS; Science Citation Index; metaRegister of Controlled Trials; WHO International Clinical Trials Registry Platform; conference proceedings; and reference lists to March 2014. Selection criteria Randomized and quasi-randomized controlled clinical trials in adults and children with cholera that compared: 1) any antimicrobial treatment with placebo or no treatment; 2) different antimicrobials head-to-head; or 3) different dosing schedules or different durations of treatment with the same antimicrobial. Data collection and analysis Two reviewers independently applied inclusion and exclusion criteria, and extracted data from included trials. Diarrhoea duration and stool volume were defined as primary outcomes. We calculated mean difference (MD) or ratio of means (ROM) for continuous outcomes, with 95% confidence intervals (CI), and pooled data using a random-effects meta-analysis. The quality of evidence was assessed using the GRADE approach. Main results Thirty-nine trials were included in this review with 4623 participants. Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD -36.77 hours, 95% CI -43

  2. Method of treating waste water

    DOEpatents

    Deininger, James P.; Chatfield, Linda K.

    1995-01-01

    A process of treating water to remove metal ion contaminants contained therein, said metal ion contaminants selected from the group consisting of metals in Groups 8, 1b, 2b, 4a, 5a, or 6a of the periodic table, lanthanide metals, and actinide metals including transuranic element metals, by adjusting the pH of a metal ion contaminant-containing water source to within the range of about 6.5 to about 14.0, admixing the water source with a mixture of an alkali or alkaline earth ferrate and a water soluble salt, e.g., a zirconium salt, in an amount sufficient to form a precipitate within the water source, the amount the mixture of ferrate and water soluble salt effective to reduce the metal ion contaminant concentration in the water source, permitting the precipitate in the admixture to separate and thereby yield a supernatant liquid having a reduced metal ion contaminant concentration, and separating the supernatant liquid having the reduced metal ion contaminant concentration from the admixture is provided. A composition of matter including an alkali or alkaline earth ferrate and a water soluble salt, e.g., a zirconium salt, is also provided.

  3. Method of treating waste water

    DOEpatents

    Deininger, J. Paul; Chatfield, Linda K.

    1991-01-01

    A process of treating water to remove transuranic elements contained therein by adjusting the pH of a transuranic element-containing water source to within the range of about 6.5 to about 14.0, admixing the water source with an alkali or alkaline earth ferrate in an amount sufficient to form a precipitate within the water source, the amount of ferrate effective to reduce the transuranic element concentration in the water source, permitting the precipitate in the admixture to separate and thereby yield a supernatant liquid having a reduced transuranic element concentration, and separating the supernatant liquid having the reduced transuranic element concentration from the admixture is provided. Additionally, a water soluble salt, e.g., a zirconium salt, can be added with the alkali or alkaline earth ferrate in the process to provide greater removal efficiencies. A composition of matter including an alkali or alkaline earth ferrate and a water soluble salt, e.g., a zirconium salt, is also provided.

  4. Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection

    PubMed Central

    Kohga, Atsushi; Kawabe, Akihiro; Hasegawa, Yuto; Yajima, Kiyoshige; Okumura, Takuya; Yamashita, Kimihiro; Isogaki, Jun; Suzuki, Kenji; Komiyama, Akira

    2017-01-01

    Intraabdominal lymphangiomas are uncommon; additionally, those affecting the gastrointestinal tract are rare and account for less than 1% of cases. Intussusception caused by a cystic lymphangioma of the small bowel is extremely rare. The patient was a 20-year-old woman who visited our emergency room with a complaint of abdominal pain. A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a diameter. Single-incision laparoscopic-assisted ileal resection was performed. The surgical specimen consisted of a soft polycystic mass. Macroscopically, a pedunculated polyp with a convolutional pattern was found. Microscopically, the inner surfaces of the cysts were covered with a single layer of endothelial cells. On immunohistochemical examination, the endothelial cells were partially positive for D2-40 and CD34. Smooth muscle cells were also found around the cysts. The lesion was diagnosed as a cystic lymphangioma. Dozens of cases of small bowel lymphangiomas have previously been reported. Of these, cases with intussusception were very rare. This is the first case of small bowel intussusception due to lymphangioma treated by single-incision laparoscopic-assisted surgery. PMID:28104992

  5. Monoclonal antibodies for treating cancer

    SciTech Connect

    Dillman, R.O. )

    1989-10-01

    The purpose of this study is to assess the current status of in-vivo use of monoclonal antibodies for treating cancer. Publications appearing between 1980 and 1988 were identified by computer searches using MEDLINE and CANCERLIT, by reviewing the table of contents of recently published journals, and by searching bibliographies of identified books and articles. More than 700 articles, including peer-reviewed articles and book chapters, were identified and selected for analysis. The literature was reviewed and 235 articles were selected as relevant and representative of the current issues and future applications for in-vivo monoclonal antibodies for cancer therapy and of the toxicity and efficacy which has been associated with clinical trials. Approaches include using antibody alone (interacting with complement or effector cells or binding directly with certain cell receptors) and immunoconjugates (antibody coupled to radioisotopes, drugs, toxins, or other biologicals). Most experience has been with murine antibodies. Trials of antibody alone and radiolabeled antibodies have confirmed the feasibility of this approach and the in-vivo trafficking of antibodies to tumor cells. However, tumor cell heterogeneity, lack of cytotoxicity, and the development of human antimouse antibodies have limited clinical efficacy. Although the immunoconjugates are very promising, heterogeneity and the antimouse immune response have hampered this approach as has the additional challenge of chemically or genetically coupling antibody to cytotoxic agents. As a therapeutic modality, monoclonal antibodies are still promising but their general use will be delayed for several years. New approaches using human antibodies and reducing the human antiglobulin response should facilitate treatment. 235 references.

  6. Drugs for treating urinary schistosomiasis

    PubMed Central

    Kramer, Christine V; Zhang, Fan; Sinclair, David; Olliaro, Piero L

    2014-01-01

    Background Urinary schistosomiasis is caused by an intravascular infection with parasitic Schistosoma haematobium worms. The adult worms typically migrate to the venous plexus of the human bladder and excrete eggs which the infected person passes in their urine. Chronic infection can cause substantial morbidity and long-term complications as the eggs become trapped in human tissues causing inflammation and fibrosis. We summarised evidence of drugs active against the infection. This is new edition of a review first published in 1997. Objectives To evaluate the efficacy and safety of drugs for treating urinary schistosomiasis. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, CENTRAL, EMBASE and LILACS and reference lists of articles up to 23 May 2014. Selection criteria Randomized controlled trials (RCTs) of antischistosomal drugs and drug combinations compared to placebo, no intervention, or each other. Data collection and analysis Two researchers independently screened the records, extracted the data and assessed risk of bias. The primary efficacy outcomes were parasitological failure (defined as the continued presence of S. haematobium eggs in the urine at time points greater than one month after treatment), and percent reduction of egg counts from baseline. We presented dichotomous data as risk ratios (RR), and continuous data as mean difference (MD), alongside their 95% confidence intervals (CIs). Where appropriate we combined trials in meta analyses or tables. We assessed the quality of evidence using the GRADE approach. Main results We included 30 RCTs enrolling 8165 participants in this review. Twenty-four trials were conducted in children in sub-Saharan Africa, and 21 trials were over 20 years old. Many studies were assessed as being at unclear risk of bias due to inadequate descriptions of study methods. Praziquantel On average, a single 40 mg/kg dose of praziquantel reduced the proportion of people still

  7. Treating incarcerated women: gender matters.

    PubMed

    Lewis, Catherine

    2006-09-01

    Research on incarcerated women has shown they have a high degree of comorbid psychopathology, including substance dependence, posttraumatic stress disorder (PTSD), antisocial personality disorder (ASPD), and major depression. Incarcerated women differ from their community peers by having more symptoms related to addiction, ASPD, and PTSD. At the same time, incarcerated women are every bit as likely as incarcerated men to be dependent on drugs and almost as likely to be dependent on alcohol. What emerges is a picture of the incarcerated woman far more likely to have had traumatic experiences, including early sexual and physical abuse, than her male peers but every bit as likely to have substance dependence and, in some correctional populations (eg, sentenced felons), antisocial personality disorder. Central to the discussion of how best to treat female offenders is the need to address how programs would best be structured for women with severe substance dependence, substantial trauma histories, and personality pathology, including ASPD. Incarcerated women are a population with complex medical and mental health needs and are likely to be high users of services within the correctional system. This poses challenges to a system already stretched thin in caring for these complex inmates. This article emphasizes that gender differences need to be appreciated, and that service delivery to male and female inmates needs to be structured with gender in mind. The article recommends case management, treatment in highly structured therapeutic communities, and emphasizing abstinence from substances and development of skill sets to engage in healthy relationships.A major future challenge lies in researching treatment interventions for women in the correctional system. There are few existing trials of treatment efficacy and, as previously noted, the incarcerated female population differs from populations of incarcerated men and women in the community. Opiate-dependent women

  8. Method for melting and treating waste

    SciTech Connect

    Fujimoto, T.; Fujiuchi, H.; Shimizu, K.; Veda, S.

    1983-11-29

    A method for melting and treating waste to be treated such as waste water treatment slude and incinerated ash of garbage involves mixing the waste to be treated with an auxiliary fuel in powder, granular or solid form or in the form of mixture thereof which has its own calorie value. Powder coal, coal, coke, waste plastic material, saw-dust, waste paper, and carbonized material are used as an auxiliary fuel. In addition to the auxiliary fuel, an additive is admixed for adjusting the composition of the waste to have treated so as to be a specific composition ratio.

  9. Tests to Detect Colorectal Cancer and Polyps

    MedlinePlus

    ... may trigger unnecessary procedures or follow-up. Does health insurance pay for colorectal cancer screening? The Affordable Care ... other federal laws.) People should check with their health insurance provider to determine their colorectal cancer screening coverage. ...

  10. Polyps of the Colon and Rectum

    MedlinePlus

    ... and Conditions Find A Surgeon Patients ASCRS Non-Discrimination Statement Privacy Policy Research Foundation of the ASCRS Non-Discrimination Statement About Us ASCRS News Video Disclaimer Social ...

  11. Vocal Cord Nodules, Polyps, and Cysts

    MedlinePlus

    ... of the voice, including voice misuse such as speaking in an improper pitch, speaking excessively, screaming or yelling, or using the voice ... of the voice problem and an evaluation of speaking method. The otolaryngologist will perform a careful examination ...

  12. Simple techniques to treat medical phobias.

    PubMed Central

    Taylor, C. B.; Ferguson, J. M.; Wermuth, B. M.

    1977-01-01

    Participant modelling, a behaviourally-orientated treatment technique, is an effect method of treating phobias associated with minor medical procedures or apparatus such as needles or intravenous catheters. The steps in this technique are described and two cases of severe needle phobias successfully treated with participant modelling are presented to illustrate further its application. PMID:876910

  13. Giant right atrial thrombi treated with thrombolysis.

    PubMed

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Ramos Cuadra, José Angel; Lara Toral, Juan; Lozano Cabezas, Cristobal; Fernández Guerrero, Juan Carlos

    2008-04-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery.

  14. Giant right atrial thrombi treated with thrombolysis

    PubMed Central

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Cuadra, José Ángel Ramos; Toral, Juan Lara; Cabezas, Cristobal Lozano; Guerrero, Juan Carlos Fernández

    2008-01-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery. PMID:18401474

  15. Microwave heat treating of manufactured components

    DOEpatents

    Ripley, Edward B.

    2007-01-09

    An apparatus for heat treating manufactured components using microwave energy and microwave susceptor material. Heat treating medium such as eutectic salts may be employed. A fluidized bed introduces process gases which may include carburizing or nitriding gases. The process may be operated in a batch mode or continuous process mode. A microwave heating probe may be used to restart a frozen eutectic salt bath.

  16. Gas treating alternatives for LNG plants

    SciTech Connect

    Clarke, D.S.; Sibal, P.W.

    1998-12-31

    This paper covers the various gas treating processes available for treating sour natural gas to specifications required for LNG production. The LNG product specification requires that the total sulfur level be less than 30--40 ppmv, the CO{sub 2} level be less than 50 ppmv and the water level be less than 100 ppmv to prevent freezing problems in the LNG cryogenic column. A wide variety of natural gas compositions are encountered in the various fields and the gas treating process selection is dependent on the type of impurities present in the gas, namely, levels of H{sub 2}S, CO{sub 2}, mercaptans and other organic sulfur compounds. This paper discusses the implications various components in the feed to the LNG plant can have on process selection, and the various treating processes that are available to condition the gas. Process selection criteria, design and operating philosophies are discussed. An economic comparison for two treating schemes is provided.

  17. Malignant familial adenomatous polyposis treated by laparoscopic colectomy and ileal pouch anal anastomosis: a case report.

    PubMed

    Zaharie, Florin; Ciorogar, George; Zaharie, Roxana; Tantau, Marcel; Iancu, Cornel; Mocan, Lucian

    2014-12-01

    The mean age of colorectal cancer in untreated familial adenomatous polyposis (FAP) is 39 years. We present the case of a 21-year-old patient with FAP and colorectal cancer. The patient was detected with significant family history: her mother died at age 45 with colon cancer; two uncles were diagnosed with colon cancer at the age of 40 and 43 and one aunt at the age of 45 with colon cancer and gastric cancer. The treatment was laparoscopic restorative proctocolectomy with total excision of the mesorectum and ileal pouch anal anastomosis completed with endoanal excision of inferior rectal polyps. The histopathological report described a well differentiated rectal adenocarcinoma T1N1aMx developed on a tubulo-villous adenoma located on the rectosigmoid jonction, the rest of the polyps with benign histology.

  18. A Mouse Model for Osseous Heteroplasia

    PubMed Central

    Cheeseman, Michael T.; Vowell, Kate; Hough, Tertius A.; Jones, Lynn; Pathak, Paras; Tyrer, Hayley E.; Kelly, Michelle; Cox, Roger; Warren, Madhuri V.; Peters, Jo

    2012-01-01

    GNAS/Gnas encodes Gsα that is mainly biallelically expressed but shows imprinted expression in some tissues. In Albright Hereditary Osteodystrophy (AHO) heterozygous loss of function mutations of GNAS can result in ectopic ossification that tends to be superficial and attributable to haploinsufficiency of biallelically expressed Gsα. Oed-Sml is a point missense mutation in exon 6 of the orthologous mouse locus Gnas. We report here both the late onset ossification and occurrence of benign cutaneous fibroepithelial polyps in Oed-Sml. These phenotypes are seen on both maternal and paternal inheritance of the mutant allele and are therefore due to an effect on biallelically expressed Gsα. The ossification is confined to subcutaneous tissues and so resembles the ossification observed with AHO. Our mouse model is the first with both subcutaneous ossification and fibroepithelial polyps related to Gsα deficiency. It is also the first mouse model described with a clinically relevant phenotype associated with a point mutation in Gsα and may be useful in investigations of the mechanisms of heterotopic bone formation. Together with earlier results, our findings indicate that Gsα signalling pathways play a vital role in repressing ectopic bone formation. PMID:23284784

  19. How Is Carotid Artery Disease Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Carotid Artery Disease Treated? Treatments for carotid artery disease may ... plaque removed and normal blood flow restored. Carotid Artery Angioplasty and Stenting Doctors use a procedure called ...

  20. Medications Used to Treat Heart Failure

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Medications Used to Treat Heart Failure Updated:Sep 28, ... Download a printable medicine tracker . Quick Tips for Medication Use Understand your medication. Know what it's for, ...

  1. How Is Antiphospholipid Antibody Syndrome Treated?

    MedlinePlus

    ... Is Antiphospholipid Antibody Syndrome Treated? Antiphospholipid antibody syndrome (APS) has no cure. However, medicines can help prevent ... existing clots from getting larger. You may have APS and another autoimmune disorder, such as lupus . If ...

  2. Treating Male Breast Cancer by Stage

    MedlinePlus

    ... Men Treating Breast Cancer in Men Treatment of Breast Cancer in Men, by Stage Because there have been ... Doctor About Breast Cancer in Men? More In Breast Cancer In Men About Breast Cancer in Men Causes, ...

  3. How Is Alpha-1 Antitrypsin Deficiency Treated?

    MedlinePlus

    ... Alpha-1 Antitrypsin Deficiency Treated? Alpha-1 antitrypsin (AAT) deficiency has no cure, but its related lung ... pulmonary disease). If you have symptoms related to AAT deficiency, your doctor may recommend: Medicines called inhaled ...

  4. How Is Iron-Deficiency Anemia Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Iron-Deficiency Anemia Treated? Treatment for iron-deficiency anemia will depend ... may be advised. Treatments for Severe Iron-Deficiency Anemia Blood Transfusion If your iron-deficiency anemia is ...

  5. How Is Diabetic Heart Disease Treated?

    MedlinePlus

    ... more information about medical procedures used to treat diabetes-related heart diseases, go to the treatment sections of the Health Topics Coronary Heart Disease , Heart Failure , and Cardiomyopathy articles. Diabetes-Specific Treatment Issues The treatments described above are ...

  6. How Is a Heart Attack Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is a Heart Attack Treated? Early treatment for a heart attack can ... or years after the procedure. Other Treatments for Heart Attack Other treatments for heart attack include: Medicines Medical ...

  7. Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS)

    MedlinePlus

    ... CDC.gov . Hantavirus Share Compartir Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS) Diagnosing HPS Diagnosing HPS in ... of patients that develop HPS from New World Hantaviruses recover completely. No chronic infection has been detected ...

  8. How Is Thrombotic Thrombocytopenic Purpura Treated?

    MedlinePlus

    ... and surgery. Treatments are done in a hospital. Plasma Therapy Plasma is the liquid part of your blood. It ... nutrients to your body. TTP is treated with plasma therapy. This includes: Fresh frozen plasma for people ...

  9. Best Drugs to Treat Inflammatory Bowel Disease

    MedlinePlus

    ... effects such as fungal and bacterial infections, including tuberculosis, pneumonia, or staph, which rarely could be life- ... to prescribe a biologic if: You have had tuberculosis in the past that has not been treated. ...

  10. How Is Diabetes Treated in Children?

    MedlinePlus

    ... Consumers Home For Consumers Consumer Updates How Is Diabetes Treated in Children? Share Tweet Linkedin Pin it ... worse over time. back to top Type 2 Diabetes Type 2 diabetes is most often diagnosed in ...

  11. How Is Mitral Valve Prolapse Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Mitral Valve Prolapse Treated? Most people who have mitral valve ... all hospitals offer this method. Valve Repair and Valve Replacement In mitral valve surgery, the valve is repaired or replaced. ...

  12. How Is Childhood Interstitial Lung Disease Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Childhood Interstitial Lung Disease Treated? Childhood interstitial lung disease (chILD) is ... prevent acid reflux, which can lead to aspiration. Lung Transplant A lung transplant may be an option ...

  13. Thalidomide in Treating Patients With Myelodysplastic Syndrome

    ClinicalTrials.gov

    2013-01-23

    Chronic Myelomonocytic Leukemia; de Novo Myelodysplastic Syndromes; Previously Treated Myelodysplastic Syndromes; Refractory Anemia; Refractory Anemia With Excess Blasts; Refractory Anemia With Excess Blasts in Transformation; Refractory Anemia With Ringed Sideroblasts; Secondary Myelodysplastic Syndromes

  14. Cleaning Up Contaminated Wood-Treating Sites

    DTIC Science & Technology

    1995-09-01

    treating sites throughout the United States. OTA found that there are many Superfund wood-treatment sites located in this country that are very...hazardous waste cleanup at wood- pany Superfund site, in Texarkana, Texas. The treating sites throughout the country. OTA has 25-acre site, a former...could be applied to mental Protection Agency (EPA) Superfund site other sites in the future. OTA has not recom- in 1986 (27). Wood products had been

  15. Cytological studies of lunar treated tissue cultures

    NASA Technical Reports Server (NTRS)

    Halliwell, R. S.

    1972-01-01

    An electron microscopic study was made of botanical materials, particularly pine tissues, treated with lunar materials collected by Apollo 12 quarantine mission. Results show unusual structural changes within several of the treated tissues. The bodies, as yet unidentified, resemble virus particles observed within infected plant cells. Although the size and shape of the structures are comparable to rod shaped virus particles such as Tobacco mosaic, the numerical distribution, affinity for stains, and intercellular location are different.

  16. Practical approaches to treating acute bronchospasm.

    PubMed

    Cline, Douglas C

    2005-12-01

    Both the National Asthma Education Prevention Program (NAEPP) guidelines for asthma and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) stress the importance of treating acute bronchospasm. Important steps for each disease are making a differential diagnosis, assessing the possibility of future exacerbations, applying disease management principles to prevent and/or treat bronchospasm exacerbations, identifying acutely ill patients, and determining when hospitalization or specialist referrals are appropriate.

  17. Branding to treat jaundice in India.

    PubMed

    John, Selva Inita; Balekuduru, Ainash; Zachariah, Uday; Eapen, C E; Chandy, George

    2009-01-01

    Jaundice is regarded as a mysterious disease rather than a symptom of disease in several parts of India. We describe 8 cases that underwent branding to treat jaundice and subsequently presented to our centre. The causes for jaundice in these patients included a variety of benign and malignant disorders. Our report suggests that despite being literate, strong cultural beliefs lead people to seek potentially harmful procedures like branding to treat jaundice in parts of India.

  18. Intracellular Protein Delivery for Treating Breast Cancer

    DTIC Science & Technology

    2014-08-01

    nanocapsules with specific cancer cell targeting ligands; Task 3. Preparing and testing of MMP activatable cell penetrating peptides (ACCPs)-coupled...AD_________________ Award Number: W81XWH-11-1-0371 TITLE: Intracellular Protein Delivery for Treating Breast Cancer PRINCIPAL INVESTIGATOR: Dr...SUBTITLE Intracellular Protein Delivery for Treating Breast Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0371 5c. PROGRAM ELEMENT NUMBER 6

  19. Thermal Analysis of a TREAT Fuel Assembly

    SciTech Connect

    Papadias, Dionissios; Wright, Arthur E.

    2014-07-09

    The objective of this study was to explore options as to reduce peak cladding temperatures despite an increase in peak fuel temperatures. A 3D thermal-hydraulic model for a single TREAT fuel assembly was benchmarked to reproduce results obtained with previous thermal models developed for a TREAT HEU fuel assembly. In exercising this model, and variants thereof depending on the scope of analysis, various options were explored to reduce the peak cladding temperatures.

  20. Underused options for preventing and treating influenza.

    PubMed

    Mossad, S B

    1999-01-01

    Both amantadine and rimantadine are effective for preventing and treating influenza A, particularly in high-risk patients. However, they should be used judiciously due to the risk of central nervous system side effects and drug interactions. Zanamivir, a new agent for treating influenza, offers promise but needs further study and approval by the Food and Drug Administration before it can be recommended for routine use. Influenza vaccine, the most effective preventive measure, is widely underused.

  1. Use of treated woods in roof assembly.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Long, William B; Gubler, K Dean; Britt, L D

    2005-01-01

    On February 12, 2002, the US Environmental Protection Agency (EPA) announced a voluntary decision by industry to move consumer use of treated lumber products away from a variety of pressure-treated wood that contains Arsenate (As) by December 31, 2003, in favor of new alternative wood preservatives. It is the purpose of this report to outline legislative efforts to ban the use of chromated copper arsenate (CCA)-treated wood for residential roofing in the State of Oregon. At the time that the legislation was introduced, it was coincidental that the National Roofing Contractors Association (NRCA) recommended that CCA-treated wood should not be used in residential roofing. A summary of the report is included in this review. Finally, we discuss some of the potentially harmful environmental hazards of wood preservatives on the environment. In addition to the toxicity of pressure-treated wood on our environment, we point out that wood as well as pressure-treated wood assemblies are highly flammable. Consequently, we recommend the use of residential roofing systems that have Class A fire protection for the homeowner. Because residential roof fires remain a life-threatening danger to residential homeowners in the United States, we describe a national fire prevention program for reducing residential roof fires by use of an Underwriters Laboratories Inc. (UL) and National Fire Protection Association Class A fire-rated roof system.

  2. Nanotechnology for treating osteoporotic vertebral fractures

    PubMed Central

    Gao, Chunxia; Wei, Donglei; Yang, Huilin; Chen, Tao; Yang, Lei

    2015-01-01

    Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided. PMID:26316746

  3. Nanotechnology for treating osteoporotic vertebral fractures.

    PubMed

    Gao, Chunxia; Wei, Donglei; Yang, Huilin; Chen, Tao; Yang, Lei

    2015-01-01

    Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided.

  4. Perianal Paget disease treated definitively with radiotherapy.

    PubMed

    Mann, J; Lavaf, A; Tejwani, A; Ross, P; Ashamalla, H

    2012-12-01

    Extramammary Paget disease (empd) is a relatively rare cutaneous disorder described as an apocrine gland tumour occurring in both a benign and a malignant form with metastatic potential. The areas of the body affected are the vulva, perianal region, penis, scrotum, perineum, and axilla, all of which contain apocrine glands. When empd affects the perianal region, it is called perianal Paget disease (ppd). All forms of empd, including ppd, are typically treated by wide surgical excision. Perianal Paget disease usually occurs later in life in patients who are often poor surgical candidates, but the available literature is scarce regarding other treatment modalities, including definitive radiotherapy. We contend that ppd can be safely and effectively treated with radiotherapy, and here, we present the case of a 75-year-old woman with ppd who was successfully so treated. A brief review of the literature concerning the diagnosis, natural history, and treatment of ppd is also included.

  5. HIV: seek, test, treat, and retain.

    PubMed

    Normand, Jacques; Montaner, Julio; Fang, Chi-Tai; Wu, Zunyou; Chen, Yi-Ming

    2013-12-01

    The "HIV: Seek, Test, Treat, and Retain" session was chaired by Dr. Jacques Normand, the Director of AIDS Research at the U.S. National Institute on Drug Abuse. Dr. Yi-Ming Chen served as the discussant. The three presenters (and their presentation topics) were: Dr. Julio Montaner (Treatment as Prevention-The Key to an AIDS-free Generation), Dr. Chi-Tai Fang (Population-level Effect of Free Access to HAART on Reducing HIV Transmission in Taiwan), and Dr. Zunyou Wu (Challenges in Promoting HIV Test & Treat Strategy in China).

  6. [Brachioradial pruritus effectively treated with gabapentin].

    PubMed

    Uldall Pallesen, Kristine Appel; Bygum, Anette

    2012-06-25

    Brachioradial pruritus is a characteristic clinical condition with a deep intense itching, tingling or burning sensation localized to the dorsolateral part of the upper extremities. The symptoms occur primarily in the late summer in fair skin type people who are extensively sun-exposed. The condition is difficult to treat and does not respond to topical steroids and antihistamines. We describe a 57-year-old woman with longstanding brachioradial itching due to cervical radiculopathy and sun exposure, which was successfully treated with gabapentin.

  7. Leaching behaviour of wood treated with creosote.

    PubMed

    Becker, L; Matuschek, G; Lenoir, D; Kettrup, A

    2001-01-01

    The results of a laboratory investigation on the leaching behaviour of wood treated with creosote and of untreated wood are reported. A special leaching test derived from the German standard method DEV S4 test (DIN 38414) has been developed. Samples were leached in deionized water, in a solution buffered at pH 4.7 and in a solution of humic substances. The organic fraction of the leachate was extracted using liquid-liquid extraction. The extracts were analysed qualitatively with GC/MSD and quantified with GC/FID. The results were compared with those of Soxhlet-extracts from creosote-treated wood.

  8. Misconceptions and facts about treating hypertension.

    PubMed

    Argulian, Edgar; Grossman, Ehud; Messerli, Franz H

    2015-05-01

    Hypertension is a powerful risk factor strongly linked to adverse cardiovascular outcomes. Because of its high prevalence, health care providers at many levels are involved in treating hypertension. Distinct progress has been made in improving the rates of hypertension awareness and treatment over years, but the overall control of hypertension remains inadequate. Several recent guidelines from different sources have been put forward in an attempt to bridge the gap between existing evidence and clinical practice. Despite this effort, several misconceptions about treating hypertensive cardiovascular disease continue to persist among clinicians. This review highlights some of the misconceptions regarding antihypertensive therapy.

  9. Compositions and methods for treating nuclear fuel

    DOEpatents

    Soderquist, Chuck Z; Johnsen, Amanda M; McNamara, Bruce K; Hanson, Brady D; Smith, Steven C; Peper, Shane M

    2013-08-13

    Compositions are provided that include nuclear fuel. Methods for treating nuclear fuel are provided which can include exposing the fuel to a carbonate-peroxide solution. Methods can also include exposing the fuel to an ammonium solution. Methods for acquiring molybdenum from a uranium comprising material are provided.

  10. Compositions and methods for treating nuclear fuel

    DOEpatents

    Soderquist, Chuck Z; Johnsen, Amanda M; McNamara, Bruce K; Hanson, Brady D; Smith, Steven C; Peper, Shane M

    2014-01-28

    Compositions are provided that include nuclear fuel. Methods for treating nuclear fuel are provided which can include exposing the fuel to a carbonate-peroxide solution. Methods can also include exposing the fuel to an ammonium solution. Methods for acquiring molybdenum from a uranium comprising material are provided.

  11. Advanced lymphosarcoma treated by total body irradiation.

    PubMed Central

    Chaffey, J. T.; Rosenthal, D. S.; Pinkus, F.; Hellman, S.

    1975-01-01

    Twenty-five cases of clinical Stage III and Stage IV lymphosarcoma primarily treated by total body irradiation (TBI) are reported. Fifteen cases demonstrated nodular histology and 10 demonstrated diffuse histology by the Rappaport criteria. Treatments were 15 rad given twice weekly, calculated to midpelvis, to a total dose of 150 rad. Toxicity was confined to thrombocytopenia, one-third of patients requiring interruptions in the treatment course to allow platelet count recovery. Five patients had additional local irradiation. Complete responses were seen in 80% of patients and partial responses in 20%. Sixteen patients (64%) have been in continuous, unmaintained remission since treatments for variable periods to 39 months. Of 9 patients with clinically recurrent disease, 3 received further TBI and are in remission, 3 are in remission on chemotherapy, one patient has died, failing on all therapy, and 2 have not been treated. One patient died of pneumonia at 12 months, without clinical evidence of disease. Overall, actuarial survival is 87% at 2 years and compares well with survival in a sequential combination drug treated group of patients matched for age, sex, and histology, though differences are not statistically significant in these small groups. Total body irradiation is an effective systemic agent in the management of advanced lymphosarcoma and should be considered in treating this disease. PMID:810155

  12. TREAT (TREe-based Association Test)

    Cancer.gov

    TREAT is an R package for detecting complex joint effects in case-control studies. The test statistic is derived from a tree-structure model by recursive partitioning the data. Ultra-fast algorithm is designed to evaluate the significance of association be

  13. Neuropsychological Deficits in Early Treated Phenylketonuric Children.

    ERIC Educational Resources Information Center

    Pennington, Bruce F.; And Others

    1985-01-01

    Six early treated children with phenylketonuria (PKU) were compared at 9 to 14 years of age on a neuropsychological measure with three groups of children with documented neurological disorders. PKU Ss had overall level of neuropsychological impairment similar to that of brain-damaged groups. PKU Ss did not show consistent pattern of…

  14. Early-Treated Phenylketonuria: Neuropsychologic Consequences.

    ERIC Educational Resources Information Center

    Brunner, Robert L.; And Others

    1983-01-01

    The neuropsychologic performance of 27 children (about 6 to 13 years old) with early-treated phenylketonuria (PKU) was evaluated and correlated with their serum phenylalanine concentrations at several ages. (Author/SEW) Journal Availability: The Journal of Pediatrics; The C. V. Mosby Company, 11830 Westline Industrial Drive, St. Louis, MO 63141.

  15. TR's Role in Treating Substance Abuse.

    ERIC Educational Resources Information Center

    Kunstler, Robin

    1992-01-01

    Therapeutic recreation is important in treating substance abuse problems. It addresses attitudes and behaviors leading to substance abuse (inability to experience pleasure or control). It encourages participation in activities that help abusers cope and obtain enjoyable states, reducing reliance on drugs. The article discusses the theory of flow…

  16. Treating the Treatment: Toxicity of Cancer Chemotherapy

    PubMed Central

    Plenderleith, Ian H.

    1990-01-01

    Many cancer chemotherapeutic agents can produce toxicity, even at the usual therapeutic doses. Family physicians are often called upon to treat symptoms of these toxicities and to advise patients about them. This brief discussion may help family physicians to anticipate some of the problems, to avoid some, and to manage others more effectively. PMID:21234006

  17. Peptide therapeutics for treating ocular surface infections.

    PubMed

    Brandt, Curtis R

    2014-11-01

    Microbial pathogens-bacteria, viruses, fungi, and parasites-are significant causes of blindness, particularly in developing countries. For bacterial and some viral infections a number of antimicrobial drugs are available for therapy but there are fewer available for use in treating fungal and parasitic keratitis. There are also problems with current antimicrobials, such as limited efficacy and the presence of drug-resistant microbes. Thus, there is a need to develop additional drugs. Nature has given us an example of 1 potential source of new antimicrobials: antimicrobial peptides and proteins that are either present in bodily fluids and tissues constitutively or are induced upon infection. Given the nature of peptides, topical applications are the most likely use to be successful and this is ideal for treating keratitis. Such peptides would also be active against drug-resistant pathogens and might act synergistically if used in combination therapy. Hundreds of peptides with antimicrobial properties have been isolated or synthesized but only a handful have been tested against ocular pathogens and even fewer have been tested in animal models. This review summarizes the currently available information on the use of peptides to treat keratitis, outlines some of the problems that have been identified, and discusses future studies that will be needed. Most of the peptides that have been tested have shown activity at concentrations that do not warrant further development, but 1 or 2 have promising activity raising the possibility that peptides can be developed to treat keratitis.

  18. Treating burns caused by hydrofluoric acid.

    PubMed

    Summers, Anthony

    2011-06-01

    Hydrofluoric acid is an ingredient of many common household and industrial solutions. Even seemingly minor burns caused by this acid can have catastrophic effects if they are treated inappropriately or late. This article describes the signs and symptoms, the pathophysiology and the emergency management of hydrofluoric acid burns.

  19. Acupuncture laser in treating headache pain

    NASA Astrophysics Data System (ADS)

    Smesny, Dunja B.

    1990-09-01

    Cervicoocipital headache observed in 112 patient were treated, half of them with acupuncture, and other 50% with He-e laser (con tinuous emission- lo mW, 633nm: IEC). With this treatment was also combined an exercise program ne cesary for the mobilisation of functionaly blocked vertebral segment.

  20. Treating Child Obesity and Associated Medical Conditions

    ERIC Educational Resources Information Center

    Caprio, Sonia

    2006-01-01

    With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most…

  1. Treating poultry litter with aluminum sulfate (alum)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This is a USDA/ARS factsheet on how to treat poultry litter with aluminum sulfate (alum) to reduce ammonia emissions. Over half of the nitrogen excreted from chickens is lost to the atmosphere as ammonia before the manure is removed from the poultry houses. Research has shown that additions of alu...

  2. Selective Mutism: Treating the Silent Child

    ERIC Educational Resources Information Center

    Shott, Elizabeth F.; Warren, Mary Ellen

    2011-01-01

    Infant mental health specialists are increasingly expected to treat complex mental health disorders in very young children. Selective mutism is an anxiety disorder which can lead to functional impairment across home, preschool, and community settings. The authors share their experiences with Keylah, a preschooler with significant social anxiety…

  3. NANOFILTRATION FOULANTS FROM A TREATED SURFACE WATER

    EPA Science Inventory

    The foulant from pilot nanofiltration membrane elements fed conventionally-treated surface water for 15 months was analyzed for organic, inorganic, and biological parameters. The foulant responsible for flux loss was shown to be a film layer 20 to 80 um thick with the greatest de...

  4. Treating Depression and Oppositional Behavior in Adolescents

    ERIC Educational Resources Information Center

    Jacobs, Rachel H.; Becker-Weidman, Emily G.; Reinecke, Mark A.; Jordan, Neil; Silva, Susan G.; Rohde, Paul; March, John S.

    2010-01-01

    Adolescents with depression and high levels of oppositionality often are particularly difficult to treat. Few studies, however, have examined treatment outcomes among youth with both externalizing and internalizing problems. This study examines the effect of fluoxetine, cognitive behavior therapy (CBT), the combination of fluoxetine and CBT, and…

  5. Medicines to Treat Muscle Spasms and Pain

    MedlinePlus

    Medicines to Treat Muscle Spasms and Pain Do you have a lot of muscle pain? Are your muscles extremely stiff and tense? If the answer is ... factsheet to learn about two conditions that cause muscle pain and stiffness, and the medicines used to ...

  6. Tuberculosis Facts - TB Can Be Treated

    MedlinePlus

    Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Page 1 of 2 TB Facts: TB ...

  7. Treating tar sands formations with karsted zones

    DOEpatents

    Vinegar, Harold J.; Karanikas, John Michael

    2010-03-09

    Methods for treating a tar sands formation are described herein. The tar sands formation may have one or more karsted zones. Methods may include providing heat from one or more heaters to one or more karsted zones of the tar sands formation to mobilize fluids in the formation. At least some of the mobilized fluids may be produced from the formation.

  8. Peptide Therapeutics for Treating Ocular Surface Infections

    PubMed Central

    2014-01-01

    Abstract Microbial pathogens—bacteria, viruses, fungi, and parasites—are significant causes of blindness, particularly in developing countries. For bacterial and some viral infections a number of antimicrobial drugs are available for therapy but there are fewer available for use in treating fungal and parasitic keratitis. There are also problems with current antimicrobials, such as limited efficacy and the presence of drug-resistant microbes. Thus, there is a need to develop additional drugs. Nature has given us an example of 1 potential source of new antimicrobials: antimicrobial peptides and proteins that are either present in bodily fluids and tissues constitutively or are induced upon infection. Given the nature of peptides, topical applications are the most likely use to be successful and this is ideal for treating keratitis. Such peptides would also be active against drug-resistant pathogens and might act synergistically if used in combination therapy. Hundreds of peptides with antimicrobial properties have been isolated or synthesized but only a handful have been tested against ocular pathogens and even fewer have been tested in animal models. This review summarizes the currently available information on the use of peptides to treat keratitis, outlines some of the problems that have been identified, and discusses future studies that will be needed. Most of the peptides that have been tested have shown activity at concentrations that do not warrant further development, but 1 or 2 have promising activity raising the possibility that peptides can be developed to treat keratitis. PMID:25250986

  9. Hyperplastic polyp? Look again... the impact of the new classification for serrated polyps.

    PubMed

    Fidalgo, Catarina; Santos, Liliana; Rosa, Isadora; Fonseca, Ricardo; Lage, Pedro; Claro, Isabel; Chaves, Paula; Dias Pereira, António

    2014-01-01

    Introdução: A Organização Mundial de Saúde reviu a classificação para os pólipos serreados do cólon em 2010. Uma nova entidade, o adenoma serreado séssil, foi incluída com duas variantes: com e sem displasia citológica. O potencial de malignização desta lesão foi reconhecido e, de acordo com a nova classificação, muitos pólipos poderão ser reclassificados. O impacto desta mudança ainda não foi aferido. Objectivo: Analisar a proporção de lesões reclassificadas de acordo com a nova classificação da Organização Mundial de Saúde e as variáveis que a influenciaram. Material e Métodos: Todos os doentes com pelo menos um adenoma serreado séssil diagnosticado num período de cinco anos foram incluídos. Todos os pólipos (independentemente do tipo histológico) ressecados durante o período considerado foram revistos. Recolhidas variáveis dos pólipos e dados dos doentes. Incluídos 40 doentes consecutivos [13 mulheres, idade média no diagnóstico do 1º adenoma serreado séssil - 59 anos (34-80)]. Resultados: Revistos 247 pólipos: hiperplásicos - 42%; adenomas convencionais - 29%; adenoma serreado séssil - 24%; adenomas serreados-5%. Reclassificados 63 pólipos: 43 hiperplásicos, 12 adenomas serreados, 7 adenoma serreado séssil e 1 adenoma convencional com displasia de baixo brau. A reclassificação foi significativamente mais provável para os pólipos hiperplásicos em relação aos outros subtipos. 41% (43/104) dos pólipos hiperplásicos foram reclassificados como adenoma serreado séssil. Para estes pólipos a probabilidade de reclassificação foi independente da localização mas maior se a dimensão ≥ 5 mm. Discussão: Este é um estudo rectrospectivo que foi conduzido num único Centro Oncológico de Referenciação com uma Clínica de Risco Familiar associada, o que pode ter influenciado os resultados. No entanto, a elevada taxa de reclassificação para os pólipos hiperplásicos e o facto de estes terem sido reclassificados quase sempre como adenomas serreados tornam estes resultados relevantes para a prática do dia a dia. Conclusão: Os nossos resultados mostram que, de acordo com a nova classificação da Organização Mundial de Saúde para os pólipos serreados, uma proporção considerável de pólipos hiperplásicos seria reclassificada. A via serreada de carcinogénese colorectal tem sido provavelmente subestimada e doentes em risco podem estar sob vigilância inadequada.

  10. Detecting and Treating Gout | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Feature: Detecting and Treating Gout Detecting and Treating Gout Past Issues / Winter 2012 Table of Contents Stephen ... how to diagnose and treat it.” What Is Gout? Gout is a form of arthritis that causes ...

  11. A novel way to treat skin tears.

    PubMed

    Moradian, Scott; Klapper, Andrew M

    2016-04-01

    Skin tears are one of the most commonly treated wounds in the elderly population. In their most basic form, they are essentially traumatic random pattern flaps. We postulate that the injured blood flow to these skin flaps should be ignored and the tissue should be treated as a skin graft. A case report is presented of an 86-year-old female with an 8 × 3·5 cm skin tear to her right upper extremity after a hip fracture. In addition to conventional wound closure strips re-approximating the tissues, a disposable negative pressure wound therapy device was placed to act as bolster. Upon its removal on day 5, the opposed skin tear tissue was found to be 100% viable. We therefore propose that this update may be an improvement over classical skin tear treatments and should be followed up with a case series.

  12. Young Children Treat Robots as Informants.

    PubMed

    Breazeal, Cynthia; Harris, Paul L; DeSteno, David; Kory Westlund, Jacqueline M; Dickens, Leah; Jeong, Sooyeon

    2016-04-01

    Children ranging from 3 to 5 years were introduced to two anthropomorphic robots that provided them with information about unfamiliar animals. Children treated the robots as interlocutors. They supplied information to the robots and retained what the robots told them. Children also treated the robots as informants from whom they could seek information. Consistent with studies of children's early sensitivity to an interlocutor's non-verbal signals, children were especially attentive and receptive to whichever robot displayed the greater non-verbal contingency. Such selective information seeking is consistent with recent findings showing that although young children learn from others, they are selective with respect to the informants that they question or endorse.

  13. Treating substance abuse: partner and family approaches.

    PubMed

    Klostermann, Keith; O'Farrell, Timothy J

    2013-01-01

    Historically, alcohol and other substance use disorders were viewed as individual-based problems that were most effectively treated by focusing on the diagnosed individual. However, in response to numerous clinical trials demonstrating the efficacy (and often superiority) of couple and family treatments for alcoholism and drug abuse, this emphasis on treating the individual has slowly given way to a greater awareness of family members' crucial roles in the etiology, maintenance, and long-term course of substance use and addictive behavior. As a result, clinicians are increasingly interested in understanding substance misuse from a systemic perspective and exploring how partner- and family-involved interventions may be used to address individuals' substance abuse.

  14. Failure to Treat Torsades de Pointes

    PubMed Central

    Yazdan-Ashoori, Payam; Digby, Genevieve; Baranchuk, Adrian

    2012-01-01

    A healthy 22 year old male with no history of cardiac disease was admitted with severe community acquired pneumonia that was initially treated with moxifloxacin and azithromycin. At admission, he was found to be hypokalemic and hypomagnesemic. Two days after admission, he experienced several episodes of Torsades de Pointes (TdP). He was initially treated with isoproterenol. A temporary transvenous pacemaker was inserted and set at a rate of 100 bpm. After correction of electrolytes, withdrawal of QT-prolonging medications and ventricular pacing at the mentioned heart rate, another episode of TdP ensued.We report and discuss a case of recurrent TdP in spite of conventional acute management for this condition.

  15. Biologic Approaches to Treat Substance Use Disorders

    PubMed Central

    Skolnick, Phil

    2015-01-01

    In contrast to traditional pharmacodynamic approaches to treat substance use disorders, the use of biologics (vaccines, monoclonal antibodies, genetically modified enzymes) is based on a pharmacokinetic principle: reduce the amount of (and in the ideal, eliminate) abused drug entering the central nervous system. Preclinical studies indicate biologics are effective in both facilitating abstinence and preventing relapse to abused substances ranging from nicotine to heroin. While data are still emerging, the results from multiple clinical trials can best be described as mixed. Nonetheless, these clinical studies have already provided important insights using “first generation” tools that may inform the development of effective and commercially viable biologics to treat tobacco, cocaine, and methamphetamine use disorders. PMID:26435208

  16. Recurrent Oligodendroglioma Treated with Acupuncture and Pharmacopuncture.

    PubMed

    Kim, Jae Soo; Lee, Hyun Jong; Lee, Sang Hoon; Lee, Bong Hyo

    2015-06-01

    Acupuncture and pharmacopuncture have been shown to be effective in tumor treatment. However, their effectiveness for treating oligodendroglioma has not been reported yet. The purpose of this study was to provide an initial report on the effectiveness of acupuncture and pharmacopuncture for the treatment of an oligodendroglioma by presenting a case that was treated successfully. A 54-year-old man, who had experienced intracranial hemorrhage, was diagnosed with recurrent oligodendroglioma. His expected survival period was 3-6 months. The patient received daily acupuncture and weekly pharmacopuncture of mountain ginseng and bee venom. After treatment for 18 months, the tumor size was decreased markedly on brain magnetic resonance imaging, and severe seizures had disappeared. In this case, a combination of acupuncture and pharmacopuncture was shown to be effective for the treatment of recurrent oligodendroglioma.

  17. Diagnosing and treating benign paroxysmal positional vertigo.

    PubMed

    Kovar, Mary; Jepson, Terry; Jones, Susan

    2006-12-01

    Gerontological nurses play a critical role in the early recognition of benign paroxysmal positional vertigo (BPPV), a condition that accounts for approximately 50% of vertigo in older adults. BPPV results in vertigo when debris collects in one or more of the semicircular canals, most typically the posterior canal. It may be differentiated from other forms of vertigo because it results in dizziness when recumbent or with head position changes. BPPV may be successfully treated with repositioning therapy, such as the Epley maneuver. Nurses working in medical offices, longterm care facilities, and assisted living may be called on to perform this maneuver. Gerontological nurses play a key role in assessing and treating BPPV, therefore minimizing unnecessary testing and medication and reducing the suffering and expense for patients with this condition.

  18. Understanding and Treating the Snapping Hip

    PubMed Central

    Yen, Yi-Meng; Lewis, Cara L.; Kim, Young-Jo

    2016-01-01

    Snapping hip, or coxa saltans is a palpable or auditory snapping with movement of the hip joint. Extra-articular snapping is divided into external and internal types, and is caused laterally by the iliotibial band and anteriorly by the iliopsoas tendon. Snapping of the iliopsoas usually requires contraction of the hip flexors and may be difficult to distinguish from intra-articualar coxa saltans. Ultrasound can be a useful modality to dynamically detect tendon translation during hip movement to support the diagnosis of extra-articular snapping. Coxa saltans is typically treated with conservative measures including anti-inflammatories, stretching and avoidance of inciting activities. Recalcitrant cases are treated with surgery to lengthen the iliopsoas or iliotibial band. PMID:26524554

  19. Nanoparticles for imaging and treating brain cancer

    PubMed Central

    Meyers, Joseph D; Doane, Tennyson; Burda, Clemens; Basilion, James P

    2013-01-01

    Brain cancer tumors cause disruption of the selective properties of vascular endothelia, even causing disruptions in the very selective blood–brain barrier, which are collectively referred to as the blood–brain–tumor barrier. Nanoparticles (NPs) have previously shown great promise in taking advantage of this increased vascular permeability in other cancers, which results in increased accumulation in these cancers over time due to the accompanying loss of an effective lymph system. NPs have therefore attracted increased attention for treating brain cancer. While this research is just beginning, there have been many successes demonstrated thus far in both the laboratory and clinical setting. This review serves to present the reader with an overview of NPs for treating brain cancer and to provide an outlook on what may come in the future. For NPs, just like the blood–brain–tumor barrier, the future is wide open. PMID:23256496

  20. Method for treating beta-spodumene ceramics

    DOEpatents

    Day, J. Paul; Hickman, David L.

    1994-09-27

    A vapor-phase method for treating a beta-spodumene ceramic article to achieve a substitution of exchangeable hydrogen ions for the lithium present in the beta-spodumene crystals, wherein a barrier between the ceramic article and the source of exchangeable hydrogen ions is maintained in order to prevent lithium contamination of the hydrogen ion source and to generate highly recoverable lithium salts, is provided.