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Sample records for fibroepithelial polyp treated

  1. 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

  2. Fibro-epithelial polyps in children: A report of two cases with a literature review

    PubMed Central

    Mishra, Apurva; Pandey, Ramesh Kumar

    2016-01-01

    Summary A fibro-epithelial polyp is the most common epithelial benign tumor of the oral cavity. Such a polyp is of mesodermal origin and it is a pink, red, or white knob-like painless growth that is sessile or pedunculated. A fibro-epithelial polyp commonly occurs on buccal mucosa, the tongue, or the gingiva. A fibro-epithelial polyp is an inflammatory hyperplastic lesion in response to chronic irritation due to calculus, sharp tooth edges, irregular denture borders, or overhanging restorations. Such a polyp rarely occurs before the fourth decade of life and its prevalence is not sex-specific. The current paper presents two cases where an intraoral fibro-epithelial polyp was successfully managed in children. Conservative surgical excision was performed in both cases. A follow-up at 3 months revealed uneventful healing of the site without reoccurrence of the lesion. PMID:27195199

  3. Fibro-epithelial polyps in children: A report of two cases with a literature review.

    PubMed

    Mishra, Apurva; Pandey, Ramesh Kumar

    2016-05-01

    A fibro-epithelial polyp is the most common epithelial benign tumor of the oral cavity. Such a polyp is of mesodermal origin and it is a pink, red, or white knob-like painless growth that is sessile or pedunculated. A fibro-epithelial polyp commonly occurs on buccal mucosa, the tongue, or the gingiva. A fibro-epithelial polyp is an inflammatory hyperplastic lesion in response to chronic irritation due to calculus, sharp tooth edges, irregular denture borders, or overhanging restorations. Such a polyp rarely occurs before the fourth decade of life and its prevalence is not sex-specific. The current paper presents two cases where an intraoral fibro-epithelial polyp was successfully managed in children. Conservative surgical excision was performed in both cases. A follow-up at 3 months revealed uneventful healing of the site without reoccurrence of the lesion. PMID:27195199

  4. Fibroepithelial Polyp of the External Auditory Canal: A Case Report and a Literature Review

    PubMed Central

    Tanaka, Nobuaki; Matsunobu, Takeshi; Shiotani, Akihiro

    2013-01-01

    This paper reports the first case of fibroepithelial polyp arising independently of the external auditory canal. A 16-year-old female patient presented to our clinic for aural fullness of the left side. Physical examination revealed a papillomatous tumor at the posterior wall of the inlet of the left external auditory canal. After biopsy, which yielded a diagnosis of benign papilloma, the patient underwent tumor excision. Final diagnosis was fibroepithelial polyp. One week after resection, aural fullness had resolved. Fibroepithelial polyp is a benign lesion and occurs mainly in the skin, ureteropelvic system, and genitals. In the head and neck area, there are reports on fibroepithelial polyp of the tongue, piriform fossa, inferior nasal turbinate, and tonsil, in addition to the skin, but none on independent fibroepithelial polyp of the external auditory canal. Excision of fibroepithelial polyp of the external auditory canal is advisable, especially in the presence of any symptoms, and should be preceded by confirmation of nonmalignancy by biopsy, if possible. PMID:23819092

  5. A rare cause of glans penis masses in childhood: Fibroepithelial polyp

    PubMed Central

    Şencan, Arzu; Şencan, Aydın; Günşar, Cüneyt; Çayırlı, Hasan; Neşe, Nalan

    2015-01-01

    Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature. PMID:25552832

  6. Giant fibroepithelial polyp of the glans penis not associated with condom-catheter use: A case report and literature review

    PubMed Central

    Yan, Hanmu; Treacy, Ann; Yousef, George; Stewart, Robert

    2013-01-01

    Fibroepithelial polyps are rare benign tumours of the glans penis; there are only a few reported cases. The pathogenesis is unknown. However, they have been linked with chronic condom catheter use or prior penile surgery. We report a case of a 62-year-old man with a large fibroepithelial polyp of the glans penis of 11 years duration, which was not associated with condom catheter use or prior surgery. The mass was large, measuring 7 × 5 × 3 cm. Fibroepithelial polyps have been reported in a range of genito-urinary sites in males and females, adults and children, and in rare cases may be associated with malignant transformation. They should be considered in the differential diagnosis of both cutaneous and mucosal genitourinary lesions. PMID:24069111

  7. Pedunculated hemangiopericytoma-like tumor: peculiar fibroepithelial polyp or fibrous histiocytoma variant.

    PubMed

    Brown, Jameel Ahmad; Morgan, Michael B

    2008-08-01

    Pathologists are continually challenged with the difficult task of discriminating between innocuous disease processes and potentially malignant entities. Apropos of this concern, we present a series of three cutaneous polypoid lesions that simulated fibroepithelial polyp, yet upon close scrutiny yielded histologic features of solitary fibrous tumor (SFT) or hemangiopericytoma. These pedunculated lesions showed a storiform pattern of spindled cells with interspersed gaping vascular channels reminiscent of SFT or hemangiopericytoma. Interestingly, the immunohistochemical staining profile of these lesions was negative for CD34 and positive for bcl-2 and factor XIIIa. These findings were discordant with SFT and suggest a relationship with fibrous histiocytoma. We propose that this entity represents a hitherto described variant of fibrous histiocytoma known as pedunculated hemangiopericytoma-like fibrous histiocytoma.

  8. A SEM analysis of DMSO treated hydra polyps.

    PubMed

    Bolzer, A; Melzer, R R; Bosch, T C

    1994-01-01

    Scanning electron microscopy revealed that exposure of hydra polyps to DMSO at concentrations used for permeabilizing tissue results in striking changes in epithelial cell morphology. Epithelial cells from treated polyps rounded up in shape and formed numerous large blebs at the cell surface. Along the borders of epithelial cells numerous small projections became detectable. The DMSO-induced changes at the cell surface corresponded to drastic changes in the intracellular organization. No evidence could be found for DMSO induced opening of cell junctions and/or opening of the interstitial space. The results demonstrate that DMSO affects the morphology and intracellular organization of hydra epithelial cells. Thus, caution is necessary in interpreting cell behavior in DMSO treated tissue.

  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. Fibroepothelial polyp of the glans penis due to pad use for urinary incontinence

    PubMed Central

    Kumsar, Şükrü; Sağlam, Hasan Salih; Köse, Osman; Budak, Salih; Adsan, Oztuğ

    2013-01-01

    A 78-year-old man was admitted to our urology polyclinic with painless penile mass. The lesion was 3.5 cm in size on the ventral aspect of the penis. He had been using a pad for urinary incontinance for 10 months and said that the lesion had been increasing in size for past 3 months. He underwent a wide local excision under local anesthesia. The histopathologic diagnosis was fibroepithelial polyp. A fibroepithelial polyp of the penis is very rare and strongly linked to long-term condom catheter use. We present a case of fibroepithelial polyp of the glans which is not associated with condom catheter use. PMID:23671539

  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 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

  13. 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. PMID:26437033

  14. 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.

  15. Colorectal polyps

    MedlinePlus

    ... Villous adenomas; Serrated polyp; Serrated adenoma; Precancerous polyps; Colon cancer - polyps ... 50. Those with a family history of colon cancer or colon polyps may need to be screened at an ...

  16. Fibro-epithelial hyperplasia mimicking mucocele.

    PubMed

    Jain, K; Singh, B D; Dubey, A; Avinash, A

    2014-01-01

    The effects of chronic local irritation have been seen commonly in the form of fibroma or mucocele in children. We report a ten year old girl with the chief complaint of swelling in the lower right region of labial mucosa which was diagnosed clinically as mucocele and histologically as fibro-epithelial hyperplasia. Surgical excision was done under local anesthesia with no post-operative complication. PMID:25552222

  17. Endometrial polyps

    MedlinePlus

    Uterine polyps ... one knows exactly why some women get endometrial polyps. They tend to grow when there is more ... the hormone estrogen in the body. Most endometrial polyps are not cancerous. About 5% can be cancerous ...

  18. Osteoma of the external auditory meatus presenting as an aural polyp.

    PubMed

    Toma, A G; Fisher, E W

    1993-10-01

    Isolated osteomata of the external auditory canal are benign and often symptomless lesions, and are distinct from the much commoner exostoses. A case is reported in which an osteoma presented as a recurrent 'aural polyp' due to a fibroepithelial polypoid reaction in the overlying skin. The polyp and the osteoma were excised surgically. We believe this to be the first reported case to present in this manner.

  19. Cervical polyps

    MedlinePlus

    Vaginal bleeding - polyps ... The exact cause of cervical polyps is not known. They may occur with: An abnormal response to increased levels of the female hormone estrogen Chronic inflammation Clogged ...

  20. Nasal polyps

    MedlinePlus

    ... BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 43. Becker SS. Surgical management of polyps in the treatment of nasal airway ...

  1. [Treatment of fibroepithelial hyperplasia (FEH) of the mammary gland in the cat with the progesterone antagonist Aglépristone (Alizine)].

    PubMed

    Meisl, D; Hubler, M; Arnold, S

    2003-03-01

    Three cases of fibroepithelial hyperplasia (FEH) of the mammary gland in the cat are reported. A one year old female cat had a distinct enlargement of the middle mammary glands, one on each side, 5 days after the first estrus. One week later the cat was treated with medroxyprogesterone acetate (Depo-Promone). The affected glands, along with the remaining glands, increased further in size. A five year old female cat was treated with Proligeston (Covinan) for the suppression of estrus. Two weeks later fibroepithelial hyperplasia occurred in two glands, one with a well demarcated ulceration. A seven months old male cat was treated with delmadinon acetate (Tarden) because of urine spraying. Two months later he had enlargement of all mammary glands. All three cats were treated with the progesterone antagonist Aglépristone (Alizine). Within 5 to 11 weeks the mammary glands had regressed to normal.

  2. Benign and low-grade fibroepithelial neoplasms of the breast have low recurrence rate after positive surgical margins.

    PubMed

    Cowan, Morgan L; Argani, Pedram; Cimino-Mathews, Ashley

    2016-03-01

    Breast phyllodes tumors are uncommon fibroepithelial neoplasms with a range of histologic features. Surgical excision is the primary management, but the need for excision to negative margins in benign and borderline phyllodes tumors is unclear. Here, we review the surgical management patterns and outcomes of 90 patients with benign and low-grade fibroepithelial lesions of the breast treated at our institution, including 19 borderline phyllodes tumors, 52 benign phyllodes tumors, and 19 representative neoplasms with overlapping features of fibroadenoma and benign phyllodes tumors, which were classified as 'fibroadenomas with phyllodal features'. In total, 52 (58%) had positive surgical margins on first excision, and of these 17 (33%) underwent re-excision to achieve negative margins. Residual tumor was identified in three (18%) re-excisions. Patients with fibroadenoma with phyllodal features were more likely to have a positive surgical margin than with benign phyllodes tumors or borderline phyllodes tumors (89 vs 49%, P=0.0015), and were less likely to undergo re-excision for positive margins (12 vs 43%, P=0.031). In total, there were three recurrences (3%), with one per fibroadenoma with phyllodal features, benign phyllodes tumor, and borderline phyllodes tumor. There was no statistically significant difference in recurrence rates between patients with positive or negative margins, or between patients with positive margin with or without re-excision. The extent of the positive margin did not predict recurrence. In conclusion, the recurrence rate of benign and low-grade fibroepithelial lesions is low and not associated with the original margin status. Patients with fibroadenomas with phyllodal features, benign phyllodes tumors, or selected borderline phyllodes tumors and positive margins on initial excision may be managed conservatively, with close follow-up and timely re-excision of any potential recurrence. PMID:26743469

  3. Sphenochoanal polyp presenting with concomitant nasal polyps.

    PubMed

    Tysome, James R; Saleh, Hesham A

    2007-01-01

    A sphenochoanal polyp is a rare lesion that originates in the sphenoid sinus. It occurs most often in adolescents and young adults. We present what to the best of our knowledge is the first reported case of a sphenochoanal polyp associated with concomitant nasal polyps. The patient was a 54-year-old man who presented with bilateral nasal obstruction, possible obstructive sleep apnea, and an altered voice, all of which had likely been caused by the presence of a massive left sphenochoanal polyp and bilateral grade III anterior and posterior ethmoid polyps. Because the patient had dilated cardiomyopathy, he was not a good candidate for general anesthesia. Therefore, the polyps were removed endoscopically under local anesthesia. The sphenochoanal polyp measured 7.5 cm in its greatest dimension and weighed 41 g. The patient remained symptom-free at the 1-year follow-up. The presentation of a sphenochoanal polyp is similar to that of the more common antrochoanal polyp, but the two can usually be differentiated on computed tomography. Endoscopic sinus surgery allows for complete removal of the polyp, including its site of origin, which minimizes the risk of recurrence.

  4. 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.

  5. Colon polyps (image)

    MedlinePlus

    When polyps are discovered in a sigmoidoscopy (an inspection of the lower third of the large intestine), they are ... tested for cancer. If a large amount of polyps are found, a more thorough examination of the ...

  6. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed Central

    Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-01-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient.

  7. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed Central

    Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-01-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient. PMID:27630887

  8. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    PubMed

    Rathi, Chetan Devendra; Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-07-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient. PMID:27630887

  9. Non-pharmacological management of nasal polyp: a case report.

    PubMed

    Rastogi, Rajiv; Murthy, B T C; Vinudha

    2009-01-01

    Nasal polyp causes difficulty in breathing due to blockage of nasal passage. The pathogenesis of nasal polyposis is not known. The primary medical therapy available for nasal polyposis is steroid administration. Antihistamines, decongestants and cromolyn sodium provide little benefit. With this background of nasal polyp pathophysiology and the existing management, a case of nasal polyp was treated with the cleansing process of yoga i.e. neti kriya and naturopathy with good result. This isolated case report warrants a need for controlled clinical trial of neti kriya to establish its role in the management of nasal polyposis.

  10. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    PubMed

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

    2015-06-01

    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  11. Lessening the Misery of Nasal Polyps

    PubMed Central

    Martin, G.F.

    1991-01-01

    Nasal polyps are characterized by progressive nasal obstruction, postnasal drip, rhinorrhea, and anosmia. Although their pathogenesis is unknown, key diagnostic signs include appearance, bilaterality, mobility, and insensitivity. Treating allergies and infections is important, while surgery is aimed at maintaining normal nasal structure and improving the airway so that intranasal steroids can be administered to keep the chronic disease under control. ImagesFigure 1Figure 2Figure 3 PMID:21229039

  12. Serrated polyps of the colon.

    PubMed

    Sugumar, Aravind; Sinicrope, Frank A

    2010-12-17

    Until recently, colonic polyps were traditionally classified as either hyperplastic or adenomatous, and only the latter were believed to have the potential to progress to carcinoma. However, it is now appreciated that a subset of serrated polyps also appear to have malignant potential. Serrated polyps are a heterogeneous group of colon polyps that include hyperplastic polyps, sessile serrated adenomas (SSAs), traditional serrated adenomas, and mixed polyps. Insights into these polyps were derived, in part, from studies of patients with the hyperplastic polyposis syndrome. SSAs show a predilection for the right colon, have a distinct histology, and their molecular genetic profile has recently been linked to a pathway for colon tumorigenesis that is characterized by microsatellite instability. Based upon available evidence, it is recommended that patients with serrated adenomas undergo colonoscopic follow-up at the same frequency as for conventional adenomas. It is important that physicians are aware of serrated polyps, particularly serrated adenomas and their relationship to colon cancer, and their proper clinical management.

  13. The clinicopathological features of sinonasal angiomatous polyps

    PubMed Central

    Tam, Yuan-Yun; Wu, Chia-Chen; Lee, Ta-Jen; Lin, Yang-Yu; Chen, Tai-Di; Huang, Chi-Che

    2016-01-01

    Background Sinonasal angiomatous polyp (SAP) is a rare subtype of sinonasal polyp that might be misdiagnosed as a malignant lesion due to its clinical symptoms. Methods We retrospectively enrolled the patients who were diagnosed with SAP in our hospital during 2008–2015. We analyzed the clinical symptoms, radiological findings, and pathological features of all patients diagnosed with SAP. Results Unilateral nasal obstruction, rhinorrhea, and epistaxis were the common symptoms. SAPs all originated from maxillary sinus and extended to nasal cavity with or without involving the nasopharynx. Expansile mass with surrounding bony destruction is typical on computed tomography imaging but specific for SAPs. The magnetic resonance revealed high signal intensity on T1-weighted images and hypointense rim on T2-weighted images. Conclusion Computed tomography and magnetic resonance together might give rise to more accurate diagnosis of SAP. Incisional biopsy does help if the clinician suspects a malignant lesion. To treat SAP, complete removal is the optimal choice. PMID:27382326

  14. Analysis of factors influencing voice quality and therapeutic approaches in vocal polyp patients.

    PubMed

    Cho, Kwang Jae; Nam, Inn Chul; Hwang, Yeon Shin; Shim, Mi Ran; Park, Jun Ook; Cho, Jung Hae; Joo, Young Hoon; Kim, Min Sik; Sun, Dong Il

    2011-09-01

    The task of the present study was to investigate the relationship between parameters and factors predictive of voice quality and to suggest treatment guidelines for patients suffering from vocal polyps. In total, 158 patients diagnosed with vocal polyps and who received voice therapy were enrolled. Clinicomorphological factors such as size, location, color, and type of the polyp were evaluated. Perceptive and acoustic voice evaluation was conducted and the relationship of these voice parameters with clinicomorphological factors was analyzed. Additionally, factors favorable for voice therapy were investigated. GRBAS scale grade was closely related to acoustic parameters, such as jitter and shimmer. Univariate analysis showed the size of the polyp, the color of the vocal fold, a history of voice abuse, associated muscle tension dysphonia (MTD), and opposing reactive scar affected voice quality. In multivariate analysis, only the size of the polyp was associated with voice quality. The patients in whom the voice quality improved with voice therapy initially had smaller polyps and whitish-colored vocal folds. Results of the present study indicate that although the most influential factor on voice quality in vocal polyp patients was the size, several other factors should be considered in evaluating and treating vocal polyps. The size of the polyp and the color of the vocal fold are indicative of success or failure in voice therapy.

  15. [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

  16. Polyp Segmentation in NBI Colonoscopy

    NASA Astrophysics Data System (ADS)

    Gross, Sebastian; Kennel, Manuel; Stehle, Thomas; Wulff, Jonas; Tischendorf, Jens; Trautwein, Christian; Aach, Til

    Endoscopic screening of the colon (colonoscopy) is performed to prevent cancer and to support therapy. During intervention colon polyps are located, inspected and, if need be, removed by the investigator. We propose a segmentation algorithm as a part of an automatic polyp classification system for colonoscopic Narrow-Band images. Our approach includes multi-scale filtering for noise reduction, suppression of small blood vessels, and enhancement of major edges. Results of the subsequent edge detection are compared to a set of elliptic templates and evaluated. We validated our algorithm on our polyp database with images acquired during routine colonoscopic examinations. The presented results show the reliable segmentation performance of our method and its robustness to image variations.

  17. Glial polyp of the cervix and endometrium. Report of a case and review of the literature.

    PubMed

    Roca, A N; Guajardo, M; Estrada, W J

    1980-05-01

    This paper describes the case of an 18-year-old woman who had recurrent inflammatory cervical endometrial polyps due to glial implantation after a spontaneous abortion treated with curettage. The lesion is considered benign.

  18. Global Quantitative Assessment of Colorectal Polyp Burden in Familial Adenomatous Polyposis Using a Web-based Tool

    PubMed Central

    Lynch, Patrick M.; Morris, Jeffrey S.; Ross, William A.; Rodriguez-Bigas, Miguel A.; Posadas, Juan; Khalaf, Rossa; Weber, Diane M.; Sepeda, Valerie O.; Levin, Bernard; Shureiqi, Imad

    2013-01-01

    Background Accurate measures of total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video. Objective To develop global quantitative tools of FAP colorectal adenoma burden. Design and Interventions A single-arm phase II trial in 27 FAP patients treated with celecoxib for 6 months, with pre- and post-treatment videos posted to intranet with interactive site for scoring. Main outcome measurements Global adenoma counts and sizes (grouped into categories: <2 mm, 2–4 mm, and >4 mm) were scored from videos using a novel web-based tool. Baseline and end-of-study adenoma burdens results were summarized using five models. Correlations between pairs of reviewers were analyzed for each model. RESULTS Interobserver agreement was high for all 5 measures of polyp burden. Measures employing both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2–4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement. (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced polyp burden by these measurements in 70–89% subjects (p<0.001). Limitations Phase II study. Conclusions This novel web-based polyp scoring method provides a convenient and reproducible way to quantify global colorectal adenoma burden in FAP patients and a framework for developing a clinical staging system for FAP. PMID:23332604

  19. Can problematic fibroepithelial lesions be accurately classified on core needle biopsies?

    PubMed

    Bandyopadhyay, Sudeshna; Barak, Stephanie; Hayek, Kinda; Thomas, Sumi; Saeed, Haleema; Beydoun, Rafic; Shi, Dongping; Arabi, Haitham; Ruterbusch, Julie; Cote, Michele; Ali-Fehmi, Rouba

    2016-01-01

    Fibroepithelial lesions (FEL) of the breast are notoriously difficult to classify on core needle biopsies. The goal of this study was to evaluate interobserver variability and accuracy of subclassifying difficult FELs into fibroadenoma (FA) and phyllodes tumors (PTs). We identified 50 breast core needle biopsies, initially diagnosed generically as FEL, with subsequent excision and final diagnosis of either FA or benign PT. Five surgical pathologists from one institution independently reviewed these in 3 rounds. The pathologists were blinded to the final excisional diagnosis. Two diagnostic categories were allowed: FA and PT. A set of histologic criteria was provided including the presence of subepithelial condensation, stromal heterogeneity, overgrowth, pleomorphism, fragmentation, cellularity, adipose tissue entrapment, and mitotic count and asked to review the slides for the second round. A third round of interpretations was conducted after each criterion was defined. Interobserver agreement for the diagnosis and each criterion was evaluated using the κ level of agreement. Accuracy of ratings to final diagnosis was calculated using Wilcoxon signed-rank test. κ Values for interobserver agreement were fair for the first and second rounds varying from 0.20 to 0.22, respectively. This increased to 0.27 in round 3. When considering each category, the κ value varied from 0.26 to 0.29 for FA and 0.28 to 0.14 for PT. Overall, there was fair agreement between the pathologists in all categories. The rate of correctly diagnosed cases ranged from 40% in the first round, to 48% in the second round, to 67% in round 3. Overall the pathologists performed better in identifying FA than PT. The accuracy of interpretations was significantly different between the first (40%), second (48%), and third rounds (67%). PMID:26521710

  20. Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

    PubMed Central

    Brigante, G.; Madeo, B.

    2016-01-01

    Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination. PMID:27022492

  1. 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.

  2. 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.

  3. Metamorphosis and acquisition of symbiotic algae in planula larvae and primary polyps of Acropora spp.

    NASA Astrophysics Data System (ADS)

    Hirose, M.; Yamamoto, H.; Nonaka, M.

    2008-06-01

    Coral planulae settle, then metamorphose and form polyps. This study examined the morphological process of metamorphosis from planulae into primary polyps in the scleractinian corals Acropora nobilis and Acropora microphthalma, using the cnidarian neuropeptide Hym-248 . These two species release eggs that do not contain Symbiodinium. The mode of acquisition of freshly isolated Symbiodinium (zooxanthellae) (FIZ) by the non-symbiotic polyp was also examined. Non-Hym-248 treated swimming Acropora planulae did not develop blastopore, mesenteries or coelenteron until the induction of metamorphosis 16 days after fertilization. The oral pore was formed by invagination of the epidermal layer after formation of the coelenteron in metamorphosing polyps. At 3 days after settlement and metamorphosis, primary polyps exposed to FIZ established symbioses with the Symbiodinium. Two-four days after exposure to FIZ, the distribution of Symbiodinium was limited to the gastrodermis of the pharynx and basal part of the polyps. Eight-ten days after exposure to FIZ, Symbiodinium were present in gastrodermal cells throughout the polyps.

  4. Pathogenesis of nasal polyps: an update.

    PubMed

    Pawliczak, Rafal; Lewandowska-Polak, Anna; Kowalski, Marek L

    2005-11-01

    The cause of nasal polyp formation is still unknown. Genetic predisposition has been suggested, but there are scanty data to support such theories. Activated epithelial cells may be the major source of mediators inducing influx of inflammatory cells (mostly eosinophils) and proliferation and activation of fibroblasts leading to nasal polyp formation. Infectious agents (including viruses, bacteria, or fungi) may be potential primary factors activating nasal epithelial cells. Proinflammatory cytokines and growth factors play important roles in the persistence of mucosal inflammation associated with nasal polyps. Arachidonic acid metabolites seem to be particularly important in the pathogenesis of nasal polyps in patients with aspirin hypersensitivity rhinosinusitis/asthma syndrome. PMID:16216171

  5. Portal hypertensive polyps, a new entity?

    PubMed

    Martín Domínguez, Verónica; Díaz Méndez, Ariel; Santander, Cecilio; García-Buey, Luisa

    2016-05-01

    We present a case of a 62 year old woman with history of liver cirrhosis secondary to autoimmune hepatitis, with portal hypertension and coagulopathy. Gastroscopy findings were a polypoid and polylobed lesions in the gastric antrum. These were removed and the pathological study described hyperplastic polyps with edema, vascular congestion and hyperplasia of smooth muscle, corresponding to "portal hypertensive polyps" (PHP). PMID:27188590

  6. 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

  7. Chronic Rhinosinusitis without Nasal Polyps.

    PubMed

    Cho, Seong Ho; Kim, Dae Woo; Gevaert, Philippe

    2016-01-01

    Chronic rhinosinusitis without nasal polyps (CRSsNP) is more prevalent than chronic rhinosinusitis with nasal polyps (CRSwNP). Certain diseases predispose to whereas others are associated with CRSsNP. Predisposing diseases include allergic and nonallergic upper and lower airway diseases, epithelial cell disorders, immunodeficiencies, autoimmune diseases, and some infectious diseases. In addition, environmental and host factors, examples of which include smoking, a higher incidence of abnormal biofilms, and innate immune defects, play a role in the pathogenesis of this disease. CRSsNP is characterized by histologic abnormalities, including basement membrane thickening (fibrosis) and goblet cell hyperplasia. Neutrophils and several chemokines, TGF-β and C-X-C motif chemokine ligand (CXCL)-8, play a role in CRSsNP remodeling. However, there are conflicting data about CRSsNP endotypes, for example, whether it is characterized by neutrophilia or eosinophilia or both. In spite of advancements and the understanding of the pathogenesis of this disease, additional study is necessary to better comprehend its underlying mechanisms, endotypes, and evidence-based treatment strategies. PMID:27393771

  8. Variation in the association between colorectal cancer susceptibility loci and colorectal polyps by polyp type.

    PubMed

    Burnett-Hartman, Andrea N; Newcomb, Polly A; Hutter, Carolyn M; Peters, Ulrike; Passarelli, Michael N; Schwartz, Malaika R; Upton, Melissa P; Zhu, Lee-Ching; Potter, John D; Makar, Karen W

    2014-07-15

    We conducted a case-control study of the association between subsets of colorectal polyps, including adenomas and serrated polyps, and single-nucleotide polymorphisms (SNPs) related to colorectal cancer through prior genome-wide association studies (GWAS). Participants were enrollees in the Group Health Cooperative (Seattle, Washington) aged 24-79 years who received a colonoscopy from 1998 to 2007, donated a buccal or blood sample, and completed a structured questionnaire. We performed genotyping of 13 colorectal cancer susceptibility SNPs. Polytomous logistic regression models were used to estimate odds ratios and 95% confidence intervals for associations between polyps and the colorectal cancer risk allele for each SNP under a log-additive model. Analyses included 781 controls, 489 cases with adenoma, 401 cases with serrated polyps, and 188 cases with both polyp types. The following SNPs were associated with advanced adenomas: rs10936599, rs10795668, rs16892766, and rs9929218 (P < 0.05). For nonadvanced adenomas and for serrated polyps overall, only rs961253 was statistically significant (P < 0.05). These associations were in the same directions as those in prior colorectal cancer GWAS. No SNP was significantly associated with hyperplastic polyps, and only rs6983267 was significantly associated with sessile serrated polyps, but this association was opposite of that found in colorectal cancer GWAS. Our results suggest that the association between colorectal cancer susceptibility SNPs and colorectal polyps varies by polyp type.

  9. 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

  10. Endoscopic management of nonlifting colon polyps.

    PubMed

    Friedland, Shai; Shelton, Andrew; Kothari, Shivangi; Kochar, Rajan; Chen, Ann; Banerjee, Subhas

    2013-01-01

    Background and Study Aims. The nonlifting polyp sign of invasive colon cancer is considered highly sensitive and specific for cancer extending beyond the mid-submucosa. However, prior interventions can cause adenomas to become nonlifting due to fibrosis. It is unclear whether nonlifting adenomas can be successfully treated endoscopically. The aim of this study was to evaluate outcomes in a referral practice incorporating a standardized protocol of attempted endoscopic resection of nonlifting lesions previously treated by biopsy, polypectomy, surgery, or tattoo placement. Patients and Methods. Retrospective review of patients undergoing colonoscopy by one endoscopist at two hospitals found to have nonlifting lesions from prior interventions. Lesions with biopsy proven invasive cancer or definite endoscopic features of invasive cancer were excluded. Lesions ≥ 8 mm were routinely injected with saline prior to attempted endoscopic resection. Polypectomy was performed using a stiff snare, followed by argon plasma coagulation (APC) if necessary. Results. 26 patients each had a single nonlifting lesion with a history of prior intervention. Endoscopic resection was completed in 25 (96%). 22 required snare resection and APC. 1 patient had invasive cancer and was referred for surgery. The recurrence rate on follow-up colonoscopy was 26%. All of the recurrences were successfully treated endoscopically. There was 1 postprocedure bleed (4%), no perforations, and no other complications. Conclusions. The majority of adenomas that are nonlifting after prior interventions can be treated successfully and safely by a combination of piecemeal polypectomy and ablation. Although recurrence rates are high at 26%, these too can be successfully treated endoscopically. PMID:23761952

  11. 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

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

    PubMed

    Lin, Li; Sun, Na; Yang, Qiuhua; Zhang, Ya; Shen, Ji; Shi, Lixin; Fang, Qin; Sun, Guangbin

    2014-04-01

    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.

  13. Differences in estrogen and progesterone receptor expression in endometrial polyps and atrophic endometrium of postmenopausal women with and without exposure to tamoxifen

    PubMed Central

    LEÃO, ROGERIO BARROS FERREIRA; ANDRADE, LILIANA; VASSALO, JOSE; ANTUNES, ARMANDO; PINTO-NETO, AARÃO; COSTA-PAIVA, LUCIA

    2013-01-01

    Postmenopausal women who use tamoxifen present with an increased incidence of endometrial alterations, such as polyps and hyperplasia, in addition to a higher risk of malignant endometrial neoplasms. Among these endometrial changes, polyps are the most common, with a pathogenesis associated with hormonal influence. The objective of this study was to compare the expression of estrogen receptors (ERs) and progesterone receptors (PRs) in endometrial polyps from tamoxifen users with that in endometrial polyps and the atrophic endometrium of postmenopausal tamoxifen non-users. Among women undergoing surgical hysteroscopy, 84 tamoxifen users with benign endometrial polyps were selected. This group was compared to 84 samples of atrophic endometrium and to 252 benign polyps from postmenopausal women who were not treated with tamoxifen. The expression of ER/PR was assessed by immunohistochemical analysis, according to the percentage of stained cells, intensity of nuclear staining and final score. The polyps from tamoxifen users exhibited a higher expression of ER and PR in the glandular epithelium and stroma compared to the atrophic endometrium (P<0.0001). Compared to the polyps from women not treated with tamoxifen, tamoxifen users exhibited a higher PR expression in the epithelium (P=0.0014) and stroma (P=0.0056), with no difference in the expression of ER. In conclusion, endometrial polyps frequently exhibit an increase in ER expression, regardless of tamoxifen use. High levels of PR expression appear to be consistent with the estrogen agonist effects of tamoxifen. PMID:24649292

  14. [Polypous rhinosinusitis in the children].

    PubMed

    Karpova, E P; Emel'yanova, M P; Tulupov, D A

    2016-01-01

    We present an overview of the modern literature concerningpolypous rhinosinusitis (PRS) in the children. The information thus derived is compared with the available results of the clinical investigations involving the adults patients with this pathology. Allergic diseases and mucoviscidosis appear to be the pathological conditions most likely leading to the development of polyps in the nasal cavity. The patients suffering from rhinosinusitis associated with the disorders of arachidonic acid metabolismare very rarely encountered in the pediatric practice unlike those among the adult population. Intranasal glucocorticosteroids (INGCS), especially in the form of the mometasonefuroate nasal spray, are considered to be the most promising medications for the treatment of the children presenting with PRS. However, further clinical studies are needed to confirm the effectiveness and safety of this therapeutic modality. PMID:27213662

  15. Polyp on ultrasound: now what? The association between gallbladder polyps and cancer.

    PubMed

    Donald, Graham; Sunjaya, Dharma; Donahue, Timothy; Hines, O Joe

    2013-10-01

    The association between gallbladder polyps (GBP) and gallbladder cancer (GBC) is unclear. We sought to determine the association between preoperative diagnosis of GBP on imaging and GBC. A retrospective review of patients over 9 years was conducted using International Classification of Diseases, 9th Revision codes for GBP and GBC who underwent cholecystectomy at our institution. Demographics, imaging findings, and pathology results were recorded. A total of 2416 patients underwent cholecystectomy during the study period. Twenty-seven had an operation for GBP either as a result of concern for size or symptoms. Polyp sizes were categorized as less than 1 cm, 1 to 2 cm, or 2 cm or greater. Twenty-four patients in this group (88.9%) had no evidence of high-grade dysplasia or cancer and all of these benign polyps were 2 cm or less on imaging. One patient with a 2.4-cm polyp had high-grade dysplasia, and two patients with polyps over 3 cm had adenocarcinoma. During the same period, 20 patients had an operation for GBC with two patients common to the polyp group. The group of patients with noncancerous polyps was significantly younger than the cancer group (polyps and no polyps). The cancer group was more likely to be symptomatic. Therefore, polyps over 2 cm should be removed given the risk of high-grade dysplasia and cancer above this size. Polyps less than 2 cm were not associated with high-grade dysplasia or cancer and thus surgery may not be required. Intermediate- and small-sized polyps can be monitored with serial ultrasound, especially in younger, asymptomatic patients in whom the risk of malignancy is low.

  16. Tests to Detect Colorectal Cancer and Polyps

    MedlinePlus

    ... be acceptable screening tests for colorectal cancer: High-sensitivity fecal occult blood tests (FOBT). Both polyps and ... higher than that of gFOBT or FIT. Test sensitivity for adenomas is low. False-positive test results ...

  17. Efficient detection of polyps in CT colonography

    NASA Astrophysics Data System (ADS)

    Wolf, Matthias; Cathier, Pascal; Lakare, Sarang; Dundar, Murat; Bogoni, Luca

    2007-03-01

    Colon cancer is a widespread disease and, according to the American Cancer Society, it is estimated that in 2006 more than 55,000 people will die of colon cancer in the US. However, early detection of colorectal polyps helps to drastically reduces mortality. Computer-Aided Detection (CAD) of colorectal polyps is a tool that could help physicians finding such lesions in CT scans of the colon. In this paper, we present the first phase, candidate generation (CG), of our technique for the detection of colonic polyp candidate locations in CT colonoscopy. Since polyps typically appear as protrusions on the surface of the colon, our cutting-plane algorithm identifies all those areas that can be "cut-off" using a plane. The key observation is that for any protruding lesion there is at least one plane that cuts a fragment off. Furthermore, the intersection between the plane and the polyp will typically be small and circular. On the other hand, a plane cannot cut a small circular cross-section from a wall or a fold, due to their concave or elongated paraboloid morphology, because these structures yield cross-sections that are much larger or non-circular. The algorithm has been incorporated as part of a prototype CAD system. An analysis on a test set of more than 400 patients yielded a high per-patient sensitivity of 95% and 90% in clean and tagged preparation respectively for polyps ranging from 6mm to 20mm in size.

  18. Effects of colony size and polyp position on polyp fecundity in the scleractinian coral genus Acropora

    NASA Astrophysics Data System (ADS)

    Nozawa, Yoko; Lin, Che-Hung

    2014-12-01

    This study examined the effects of colony size and polyp position on six variables of polyp fecundity [egg number, egg size, total egg volume, total testis volume, total gonad volume, and gonad ratio (egg volume/testis volume)] in three tabular Acropora corals (Scleractinia), A. hyacinthus, A. japonica, and A. solitaryensis. Samples were collected from various colony sizes ( n = 21-30 colonies species-1), just before the predicted spawning at Kochi, Japan, in 2009. Five replicate polyps were sampled at three positions (center, middle, and outer) from the center to the marginal area in each tabular colony. Results indicated effects of colony size and polyp position on both male and female gonads polyp-1. A positive effect of colony size was observed on variables of female gonads polyp-1 (egg number, total egg volume) in A. hyacinthus only, while the positive effect on the variable of male gonads polyp-1 (total testis volume) was common in all Acropora species, with total testis volume polyp-1 increasing 2-4-fold from the small (200-400 cm2) to the large size class (5,000-9,000 cm2). Among the polyp positions, lower values were observed mostly in center polyps in A. hyacinthus, while lower values were observed only in outer polyps in the other Acropora species. The distinct patterns between A. hyacinthus and the other two Acropora species suggest different reproductive strategies at the species level. Further studies are needed to confirm the prevalence of these effects in scleractinian corals, which will broaden our understanding of reproductive life history strategies and improve the estimation of reproductive performance.

  19. Clinical case report of a large antrochoanal polyp.

    PubMed

    Spadijer-Mirković, Cveta; Perić, Aleksandar; Vukomanović-Đurđević, Biserka; Stanojević, Ivan

    2014-01-01

    Antrochoanal polyps are benign lesions originating from the mucosa of the maxillary sinus. Nasal obstruction and rhinorrhea are their main symptoms. Their endoscopical and radiological appearance makes them relatively easy to diagnose. These polyps are usually presented unilaterally, although bilateral presentation is also possible. We described two cases of atypically giant antrochoanal polyps: in a 15-year-old child and in a 38-year-old man. In both cases, the diagnosis was done by nasal endoscopy and computed tomography (CT) of the paranasal sinuses and supported by histopathological analysis. In the first patient, the excised polyp had the histological characteristic of an angiomatous antrochoanal polyp. Because of their unusual dimension, the combined transoral and endonasal endoscopic approach was performed for complete polyp excision. We discussed the clinical, histopathological and immunohistochemical characteristics of choanal polyps in comparison to inflammatory nasal polyps, and the applicable surgical techniques for treatment of these polyps.

  20. The stem cell renewal and DNA damage response pathways are frequently altered in fibroepithelial tumors of breast in Indian patients.

    PubMed

    Mukherjee, Nupur; Islam, Md Saimul; Roychowdhury, Anirban; Bhattacharya, Rittwika; Chunder, Nilanjana; Bhattacharya, Nilanjana; Sinha, Satyabrata; Alam, Neyaz; Roy, Anup; Roychoudhury, Susanta; Panda, Chinmay Kumar

    2016-03-01

    Genetic and epigenetic alterations in genes associated with distinct cellular pathways were checked in fibroepithelial tumors, including fibroadenomas, benign and malignant phyllode and atypical ductal hyperplasia. A panel of 22 genes associated with different cellular pathways such as stem cell renewal (Wnt and Hedgehog), DNA damage response [homologous recombination (HR), mismatch repair (MMR) and nucleotide excision repair (NER)] and cell proliferation signaling pathway were tested. Alterations (genetic/epigenetic) of the genes associated with Wnt signaling pathway were detected in 100% (20/20) of the breast tumors for at least one out of the six Wnt antagonists tested. Frequent molecular alterations (57-64%) were detected in HR and MMR pathway and low frequency of alterations (8-25%) were seen in cell-proliferation and cell signaling pathways showing a differential pattern of alterations in different tumor types. The patterns of alterations, in particular the epigenetic alterations, differed little from that seen previously in breast carcinoma cells, suggesting epigenetic alterations to be an early event in the development of the tumors. In gene ontology analysis, it was evident that Wnt signaling pathway [GO: 0030111, Kegg: 04310], cell proliferation pathway [GO: 0008285] and pathways in cancer [Kegg: 05200] were significantly enriched by differentially altered genes in fibroadenoma and phyllode tumor types. All these results may provide a new breakthrough in early diagnosis, prognosis and treatment of these tumors. PMID:26774289

  1. Histamine, norepinephrine and serotonin content of nasal polyps.

    PubMed

    Bumsted, R M; El-Ackad, T; Smith, J M; Brody, M J

    1979-05-01

    Histamine, norepinephrine and serotonin were assayed and localized by fluorescence histochemistry in normal mucosa and nasal polyps because of their possible role in the development of inflammation and edema. Histamine was present in greater concentration in nasal polyps than in normal mucosa. Norepinephrine was present primarily in the base of nasal polyps and in greater concentration than in normal mucosa. Patients with aspirin sensitivity and asthma had much lower histamine concentrations in their nasal polyps than all other patients with nasal polyps. A proposal for a possible mechanism of formation of nasal polyps based on vascular and inflammatory mechanisms and incorporative roles for histamine and norepinephrine is presented.

  2. Improved bowel preparation increases polyp detection and unmasks significant polyp miss rate

    PubMed Central

    Papanikolaou, Ioannis S; Sioulas, Athanasios D; Magdalinos, Nektarios; Beintaris, Iosif; Lazaridis, Lazaros-Dimitrios; Polymeros, Dimitrios; Malli, Chrysoula; Dimitriadis, George D; Triantafyllou, Konstantinos

    2015-01-01

    AIM: To retrospectively compare previous-day vs split-dose preparation in terms of bowel cleanliness and polyp detection in patients referred for polypectomy. METHODS: Fifty patients underwent two colonoscopies: one diagnostic in a private clinic and a second for polypectomy in a University Hospital. The latter procedures were performed within 12 wk of the index ones. Examinations were accomplished by two experienced endoscopists, different in each facility. Twenty-seven patients underwent screening/surveillance colonoscopy, while the rest were symptomatic. Previous day bowel preparation was utilized initially and split-dose for polypectomy. Colon cleansing was evaluated using the Aronchick scale. We measured the number of detected polyps, and the polyp miss rates per-polyp. RESULTS: Excellent/good preparation was reported in 38 cases with previous-day preparation (76%) vs 46 with split-dose (92%), respectively (P = 0.03). One hundred and twenty-six polyps were detected initially and 169 subsequently (P < 0.0001); 88 vs 126 polyps were diminutive (P < 0.0001), 25 vs 29 small (P = 0.048) and 13 vs 14 equal or larger than 10 mm. The miss rates for total, diminutive, small and large polyps were 25.4%, 30.1%, 13.7% and 6.6%, respectively. Multivariate analysis revealed that split-dose preparation was significantly associated (OR, P) with increased number of polyps detected overall (0.869, P < 0.001), in the right (0.418, P = 0.008) and in the left colon (0.452, P = 0.02). CONCLUSION: Split-dose preparation improved colon cleansing, enhanced polyp detection and unmasked significant polyp miss rates. PMID:26488024

  3. Clinical Study of Endometrial Polyp and Role of Diagnostic Hysteroscopy and Blind Avulsion of Polyp

    PubMed Central

    Remadevi, Chithra; Sumathy, Sudha; Sharma, Deepti; Sreedhar, Sarala; Jose, Amrutha

    2016-01-01

    Introduction Endometrial polyp is one of the common causes of Abnormal Uterine Bleeding (AUB) in the reproductive age group as well as postmenopausal age group. Aim To study the clinical features of endometrial polyp and the safety and feasibility of blind polypectomy following diagnostic hysteroscopy. Materials and Methods Total of 256 women who were diagnosed to have endometrial polyp by transvaginal ultrasound and underwent diagnostic hysteroscopy and blind polypectomy by simple avulsion in the period of January 2008 to December 2014 were included in our study. Polyp was confirmed by the histopathology. Results The prevalence of polyp among women who underwent diagnostic hysteroscopy and blind polypectomy was more common in the age group of 40-49years. Polyps manifested as AUB in 45.6% of our study population. The mean size of the polyp was not significantly different between premenopausal and postmenopausal women and single and multiple polyps. Histopathological study of the polyp showed two malignant polyps in our study population. Premalignant lesions i.e., endometrial hyperplasia without atypia and with atypia was found in 33 women. There was one uterine perforation, one cervical tear; one false passage and one patient had mild bleeding after the procedure. In our study, in the mean follow-up period of 37.57±28.12 months, 3.9% (7 women) had recurrence. In the follow-up period of 16.56±18.96 months, 78.9% women didn’t have recurrence. Conclusion Diagnostic hysteroscopy and blind polypectomy has low complication rate and recurrence rate and technically feasible for the practicing gynaecologists which don’t need much training and is cost-effective also. PMID:27504357

  4. Active contours for localizing polyps in colonoscopic NBI image data

    NASA Astrophysics Data System (ADS)

    Breier, Matthias; Gross, Sebastian; Behrens, Alexander; Stehle, Thomas; Aach, Til

    2011-03-01

    Colon cancer is the third most common type of cancer in the United States of America. Every year about 140,000 people are newly diagnosed with colon cancer. Early detection is crucial for a successful therapy. The standard screening procedure is called colonoscopy. Using this endoscopic examination physicians can find colon polyps and remove them if necessary. Adenomatous colon polyps are deemed a preliminary stage of colon cancer. The removal of a polyp, though, can lead to complications like severe bleedings or colon perforation. Thus, only polyps diagnosed as adenomatous should be removed. To decide whether a polyp is adenomatous the polyp's surface structure including vascular patterns has to be inspected. Narrow-Band imaging (NBI) is a new tool to improve visibility of vascular patterns of the polyps. The first step for an automatic polyp classification system is the localization of the polyp. We investigate active contours for the localization of colon polyps in NBI image data. The shape of polyps, though roughly approximated by an elliptic form, is highly variable. Active contours offer the flexibility to adapt to polyp variation well. To avoid clustering of contour polygon points we propose the application of active rays. The quality of the results was evaluated based on manually segmented polyps as ground truth data. The results were compared to a template matching approach and to the Generalized Hough Transform. Active contours are superior to the Hough transform and perform equally well as the template matching approach.

  5. Lovastatin, but not orlistat, reduces intestinal polyp volume in an ApcMin/+ mouse model.

    PubMed

    Notarnicola, Maria; Barone, Michele; Francavilla, Antonio; Tutino, Valeria; Bianco, Giusy; Tafaro, Angela; Minoia, Mario; Polimeno, Lorenzo; Napoli, Anna; Scavo, Maria Principia; Caruso, Maria Gabriella

    2016-08-01

    The statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCoAR) and orlistat, an inhibitor of fatty acid synthase (FAS), inhibit tumor cell growth by restricting cholesterol and fatty acid synthesis, respectively. We previously demonstrated that an omega (ω)-3 polyunsaturated fatty acid (PUFA)- or olive oil-enriched diet reduced the polyp number and volume in ApcMin/+ mice. This phenomenon was associated with a significant inhibition of FAS and HMGCoAR, as well as an increase in the estrogen receptor (ER)β/α ratio. Herein, we evaluated the effect of lovastatin and orlistat on polyp development and ER expression in ApcMin/+ mice, in order to confirm previous data obtained with ω‑3-PUFAs and olive oil. As expected, the use of lovastatin and orlistat significantly reduced HMGCoAR and FAS enzymatic activities and gene expression in colonic tissues, but did not affect the number of intestinal polyps, while there was a statistically significant reduction in polyp volume only in the mouse group treated with lovastatin. In the mice receiving orlistat, we observed a significant increase in cell proliferation in the polyp tissue, as well as enhanced expression of ERα. Moreover, the overexpression of ERα was associated with a statistically significant increase in PES1, Shh and Gli1 protein levels, considered ERα-related molecular targets. PMID:27277576

  6. Posterior Urethral Polyp: First Holmium-YAG Laser Ablation on a 3-Month-Old Infant

    PubMed Central

    Keskin, Ercument; Yapanoglu, Turgut; Adanur, Senol; Ziypak, Tevfik; Altay, Mehmet Sefa; Aksoy, Yılmaz

    2016-01-01

    Abstract Background: Urethral polyps are rare benign pathologies seen in the male posterior urethra, more frequently originating from verumontanum. In this article, we aimed to discuss diagnosis and treatment of a urethral polyp causing hematuria and urinary infection in a 3-month-old male infant. This is the first case in the literature in which a urethral polyp is treated with Holmium yttrium-aluminum-garnet (YAG) laser. Case Presentation: The patient was a 3-month-old male infant, and complains were hematuria and crying during micturition. Ultrasonography and voiding cystourethrogram were used for diagnosis. Urethral polyp was observed on urethrocystoscopy. Ablation was performed with a newborn cystoscope. Conclusion: Urethral polyp can cause hematuria and urinary obstruction and should be considered in the differential diagnosis of pathologies such as posterior urethral valve and cecoureterocele that could cause infravesical obstruction. Holmium-YAG laser is a good choice of treatment with easy application possibilities using a newborn cystoscope, especially for newborns and infants who have thin urethra. PMID:27579428

  7. Accuracy of polyp localization at colonoscopy

    PubMed Central

    O’Connor, Sam A.; Hewett, David G.; Watson, Marcus O.; Kendall, Bradley J.; Hourigan, Luke F.; Holtmann, Gerald

    2016-01-01

    Background and study aims: Accurate documentation of lesion localization at the time of colonoscopic polypectomy is important for future surveillance, management of complications such as delayed bleeding, and for guiding surgical resection. We aimed to assess the accuracy of endoscopic localization of polyps during colonoscopy and examine variables that may influence this accuracy. Patients and methods: We conducted a prospective observational study in consecutive patients presenting for elective, outpatient colonoscopy. All procedures were performed by Australian certified colonoscopists. The endoscopic location of each polyp was reported by the colonoscopist at the time of resection and prospectively recorded. Magnetic endoscope imaging was used to determine polyp location, and colonoscopists were blinded to this image. Three experienced colonoscopists, blinded to the endoscopist’s assessment of polyp location, independently scored the magnetic endoscope images to obtain a reference standard for polyp location (Cronbach alpha 0.98). The accuracy of colonoscopist polyp localization using this reference standard was assessed, and colonoscopist, procedural and patient variables affecting accuracy were evaluated. Results: A total of 155 patients were enrolled and 282 polyps were resected in 95 patients by 14 colonoscopists. The overall accuracy of polyp localization was 85 % (95 % confidence interval, CI; 60 – 96 %). Accuracy varied significantly (P < 0.001) by colonic segment: caecum 100 %, ascending 77 % (CI;65 – 90), transverse 84 % (CI;75 – 92), descending 56 % (CI;32 – 81), sigmoid 88 % (CI;79 – 97), rectum 96 % (CI;90 – 101). There were significant differences in accuracy between colonoscopists (P < 0.001), and colonoscopist experience was a significant independent predictor of accuracy (OR 3.5, P = 0.028) after adjustment for patient and procedural variables. Conclusions: Accuracy of

  8. 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.

  9. Colorectal cancers occurring after colonoscopy with polyp detection: sites of polyps and sites of cancers.

    PubMed

    Brenner, Hermann; Chang-Claude, Jenny; Jansen, Lina; Seiler, Christoph M; Hoffmeister, Michael

    2013-10-01

    Colonoscopy with detection and removal of neoplasms strongly reduces risk of colorectal cancer (CRC). Nevertheless, CRCs occur after colonoscopic polypectomy. We assessed agreement beyond chance of location of polyps detected at colonoscopy and of subsequent CRCs to estimate the share of cancers that might be due to field effects or neoplasm recrudescence. In a population-based case-control study conducted in Germany (3,148 cases), detailed history and results of colonoscopies conducted within 10 years before cancer diagnosis were obtained by interview and from medical records. We determined the observed proportion of cancers for which a polyp had been detected at the same colorectal subsite at the preceding colonoscopy and compared it to the proportion expected by chance. A total of 155 cases with physician validated polyp detection at the preceding colonoscopy were identified. Among 148 cases with cancer restricted to a single subsite, 43 (29.1%) had a polyp detected in the same colorectal subsite at the preceding colonoscopy. Agreement of location of cancer occurrence and preceding polyp detection would have been expected by chance for 27 cases, and agreement beyond chance was estimated to account for 16 cases (10.8%, 95% confidence interval 2.7%-19.3%). Our study suggests that less than one of nine CRCs occurring within 10 years after colonoscopy with polyp detection may be due to field effects or polyp recrudescence.

  10. [Serrated polyps and serrated polyposis syndrome].

    PubMed

    Carballal, Sabela; Moreira, Leticia; Balaguer, Francesc

    2013-03-01

    Serrated polyps of the colorectum are a heterogeneous group of lesions with potential malignant transformation through the «serrated pathway» of carcinogenesis. The discovery of these lesions has been a paradigm shift in the concept of the adenoma-carcinoma sequence, so that up to 30% of tumors develop through this pathway. The main factors associated with an increased risk of malignancy in serrated polyps are size≥10mm, multiplicity, sessile serrated adenoma histology, presence of associated dysplasia and proximal location. Current evidence indicates that these lesions should be resected completely, and the patient requires an endoscopic surveillance program. Serrated polyposis syndrome is a clinicopathological entity characterized by multiple and/or large serrated polyps with an increased risk of developing colorectal cancer. These patients and their families, require multidisciplinary assessment in specialized high risk colorectal cancer units.

  11. Defined morphological criteria allow reliable diagnosis of colorectal serrated polyps and predict polyp genetics.

    PubMed

    Rau, Tilman T; Agaimy, Abbas; Gehoff, Anastasia; Geppert, Carol; Jung, Klaus; Knobloch, Katharina; Langner, Cord; Lugli, Alessandro; Groenbus-Lurkin, Irene; Nagtegaal, Iris D; Rüschoff, Josef; Saegert, Xavier; Sarbia, Mario; Schneider-Stock, Regine; Vieth, Michael; Zwarthoff, Ellen C; Hartmann, Arndt

    2014-06-01

    Criteria for the diagnosis of serrated colorectal lesions (hyperplastic polyp, sessile serrated adenoma without or with dysplasia--which we called mixed polyp--and traditional serrated adenoma) for which consensus has been reached should be validated for applicability in daily practice in terms of inter-observer reproducibility and their association with clinical features and (epi)genetic events. A study set was created from a consecutive series of colorectal polyps (n = 1,926) by selecting all sessile serrated adenomas, traditional serrated adenomas and mixed polyps. We added consecutive series of hyperplastic polyps, classical adenomas and normal mucosa samples for a total of 200 specimens. With this series, we conducted an inter-observer study, encompassing ten pathologists with gastrointestinal pathology experience from five European countries, in three rounds in which all cases were microscopically evaluated. An assessment of single morphological criteria was included, and these were correlated with clinical parameters and the mutation status of KRAS, BRAF and PIK3CA and the methylation status of MLH1. Gender, age and localisation were significantly associated with certain types of lesions. Kappa statistics revealed moderate to good inter-observer agreement for polyp classification (κ = 0.56 to 0.63), but for single criteria, this varied considerably (κ = 0.06 to 0.82). BRAF mutations were frequently found in hyperplastic polyps (86 %, 62/72) and sessile serrated adenomas (80 %, 41/51). KRAS mutations occurred more frequently in traditional serrated adenomas (78 %, 7/9) and less so in classical adenomas (20 %, 10/51). Single morphological criteria for sessile serrated adenomas showed significant correlation with BRAF mutation (all p ≤ 0.001), and those for classical adenomas or traditional serrated adenoma correlated significantly with KRAS mutation (all p < 0.001). Therefore, single well-defined morphological criteria are predictive for

  12. 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%.

  13. Polyp Detection via Imbalanced Learning and Discriminative Feature Learning.

    PubMed

    Bae, Seung-Hwan; Yoon, Kuk-Jin

    2015-11-01

    Recent achievement of the learning-based classification leads to the noticeable performance improvement in automatic polyp detection. Here, building large good datasets is very crucial for learning a reliable detector. However, it is practically challenging due to the diversity of polyp types, expensive inspection, and labor-intensive labeling tasks. For this reason, the polyp datasets usually tend to be imbalanced, i.e., the number of non-polyp samples is much larger than that of polyp samples, and learning with those imbalanced datasets results in a detector biased toward a non-polyp class. In this paper, we propose a data sampling-based boosting framework to learn an unbiased polyp detector from the imbalanced datasets. In our learning scheme, we learn multiple weak classifiers with the datasets rebalanced by up/down sampling, and generate a polyp detector by combining them. In addition, for enhancing discriminability between polyps and non-polyps that have similar appearances, we propose an effective feature learning method using partial least square analysis, and use it for learning compact and discriminative features. Experimental results using challenging datasets show obvious performance improvement over other detectors. We further prove effectiveness and usefulness of the proposed methods with extensive evaluation.

  14. Ablative Therapies for Colorectal Polyps and Malignancy

    PubMed Central

    Hochwald, Steven N.; Nurkin, Steven

    2014-01-01

    Endoscopic techniques are gaining popularity in the management of colorectal polyps and occasionally superficial cancers. While their use is in many times palliative, they have proven to be curative in carefully selected patients with polyps or malignancies, with less morbidity than radical resection. However, one should note that data supporting local and ablative therapies for colorectal cancer is scarce and may be subject to publication bias. Therefore, for curative intent, these techniques should only be considered in highly select cases as higher rates of local recurrences have also been reported. The aim of this review is to explain the different modalities of local and ablative therapies specific to colorectal neoplasia and explain the indications and circumstances where they have been most successful. PMID:25089281

  15. Evaluation and Management of Antrochoanal Polyps

    PubMed Central

    Yilmaz, Suleyman; Karali, Elif; Guclu, Ender; Ozturk, Ozcan

    2010-01-01

    Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence. PMID:20607082

  16. Gastroscopic removal of a giant fibrovascular polyp from the esophagus

    PubMed Central

    Li, Jie; Yu, Hua; Pu, Renfu

    2016-01-01

    Abstract Giant polyps in the esophagus are rarely occurring benign tumors and may contain lipomas, fibrovascular polyps, fibrolipomas or neurofibromas polyps. Clinical symptoms include dysphagia, vomiting, retrosternal pain, shortness of breath, and asthma. In some cases, the polyps are regurgitated into the oral cavity and represent a spectacular manifestation. The reported case in this study was of a 50‐year‐old man who complained of emesia for half a year and dysphagia for one month before being hospitalized. Occasionally, a fleshly mass reached into his mouth. The results of endoscopic ultrasonography, barium swallow in the upper digestive tract, and a computed tomography scan demonstrated a giant polyp in the esophagus, which was subsequently removed by gastroscopy. Pathological examination determined a fibrovascular polyp. PMID:27148424

  17. Gastric inflammatory fibroid polyp mimicking a gastrointestinal stromal tumour.

    PubMed

    Silva, Marco; Albuquerque, Andreia; Cardoso, Hélder; Costa, Jennifer; Macedo, Guilherme

    2016-08-01

    Inflammatory fibroid polyp of the gastrointestinal tract is a rare, benign neoplasm, most frequently located in the gastric antrum. Symptoms depend on the location and the size of the lesion. Biopsies are limited for the diagnosis of inflammatory fibroid polyps and diagnosis may not be possible until resection. The authors present a case of a 55-year-old woman, presenting with an upper gastrointestinal bleeding due to a large gastric inflammatory fibroid polyp imitating a gastrointestinal stromal tumor. PMID:27554383

  18. [The danger of serrated polyps in the colon: from sporadic polyp to polyposis syndrome].

    PubMed

    IJspeert, Joep E G; Bastiaansen, Barbara A J; Dekker, Evelien

    2015-01-01

    Up to 30% of colorectal cancers develop from sessile serrated polyps via the serrated neoplasia pathway. The clinical management of these lesions is challenging for both endoscopists and pathologists due to the difficulties in detection and recognition. As a result, more than half of all colonoscopy interval cancers, cancers detected after colonoscopy and before the next scheduled surveillance procedure, appear to develop from sessile serrated polyps. We describe the pitfalls in the clinical management of these lesions as well as potential solutions, illustrated by case reports of two patients, aged 28 and 65 years, with serrated polyposis syndrome and colorectal cancer.

  19. Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps.

    PubMed

    London, Nyall R; Reh, Douglas D

    2016-01-01

    Nasal polyps are semi-translucent mucosal outgrowths of the paranasal sinuses which typically arise in the setting of chronic rhinosinusitis (CRS). Nasal polyps are also associated with asthma, aspirin sensitivity, cystic fibrosis and allergic fungal rhinosinusitis (AFS). The majority of nasal polyps are bilateral and characterized by tissue edema and eosinophil infiltration. Patients with nasal polyps often present with complaints including nasal obstruction, congestion, rhinorrhea or altered sense of smell. The differential diagnosis ranges from benign masses such as schneiderian papilloma, antrochoanal polyp, angiofibroma and encephalocele to malignant neoplasms such as squamous cell carcinoma (SCC), esthesioneuroblastoma, nasal lymphoma and rhabdomyosarcoma. These lesions may have a similar appearance as nasal polyps and particular attention to an alternative diagnosis for nasal polyps should be entertained if the mass is unilateral or congenital in nature. Workup for patients with a unilateral mass should include radiographic imaging, possible biopsy and careful follow-up when appropriate. Here, we review the disease etiology of nasal polyps and describe the approach to the patient with nasal polyps with emphasis on differential diagnosis and workup. PMID:27466841

  20. Development of hyperplastic polyps following argon plasma coagulation of gastric antral vascular ectasia

    PubMed Central

    Shah, Nihar; Cavanagh, Yana; Kaswala, Dharmesh H.; Shaikh, Sohail

    2015-01-01

    The etiology of gastric antral vascular ectasia (GAVE) syndrome or gastric hyperplastic polyps (HPs) is not fully understood. We report a case of gastric HP arising in a patient treated with argon plasma coagulation (APC) for GAVE syndrome. Despite unclear etiologic progression, this and previously reported cases suggest a temporal relationship between the treatment of GAVE and HP. A 68-year-old male with a history of coronary artery disease, congestive heart failure and diabetes type II who initially presented with symptomatic anemia 2 weeks after starting aspirin and clopidogrel therapy. Diagnostic esophagogastroduodenoscopy (EGD) demonstrated diffuse GAVE. He was treated with 5 APC treatments, at 6-week intervals, over a 30 weeks period. 16 months after the initial APC treatment, an EGD performed secondary to persistent anemia demonstrated innumerable, large, bleeding polyps in the gastric antrum. Biopsy performed at that time confirmed hyperplastic gastric polyps. It has been proposed that HPs are regenerative lesions that arise at sites of severe mucosal injury. Our patient's treatment of GAVE with APC created significant mucosal injury, resulting in HP. Technique and genetic factors may have promoted hyperplastic changes during the regeneration of mucosa, at sites previously treated with APC. This case highlights the potential progression of GAVE to HP in a patient with persistent anemia after APC therapy. PMID:26283860

  1. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

    PubMed

    van Dijk, Myrthe M; van Hanegem, Nehalennia; de Lange, Maria E; Timmermans, Anne

    2015-01-01

    We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and the patient satisfaction with each technique. No previously reported studies have compared TCRP and LNG-IUD as treatment for HMB in premenopausal women with an endometrial polyp. Likewise, no studies are available on LNG-IUD as a treatment for HMB in the presence of an endometrial polyp. Several studies have found the LNG-IUD to be an effective treatment option for HMB, with high patient satisfaction rates. Evidence of the effectiveness of TCRP as treatment of HMB is scarce. Patient satisfaction is reported relatively good, although persistent or recurrent symptoms appear to be frequent. We conclude that no evidence is available on LNG-IUD as treatment for HMB in women with an endometrial polyp. We hypothesize that LNG-IUD could be a good alternative to TCRP for treating HMB in premenopausal women with a polyp; however, further evidence is needed, and a randomized controlled trial should be performed.

  2. Benign serrated colorectal fibroblastic polyps/intramucosal perineuriomas are true mixed epithelial-stromal polyps (hybrid hyperplastic polyp/mucosal perineurioma) with frequent BRAF mutations.

    PubMed

    Agaimy, Abbas; Stoehr, Robert; Vieth, Michael; Hartmann, Arndt

    2010-11-01

    Colorectal fibroblastic polyp and intramucosal perineurioma are 2 synonyms for a recently described benign mucosal lesion with a predilection for the rectosigmoid colon. These lesions are characterized by aggregates of bland spindled cells separating and distorting mucosal crypts. The latter frequently showed a serrated architecture. The pathogenesis of fibroblastic polyp/intramucosal perineurioma and the nature of serrated crypts observed in them are poorly understood. We analyzed the clinicopathological features of 29 fibroblastic polyps and investigated them for the first time for mutations known to be involved in serrated colorectal epithelial polyps (BRAF, KRAS, and PIK3CA). Patients were 23 women and 6 men with a mean age of 64 years (range: 47 to 84 y). All lesions represented asymptomatic solitary polyps (mean size 3.5 mm) localized predominantly in the rectosigmoid colon (81%). Hyperplastic polyps, classical adenoma, and sessile serrated adenoma/lesion coexisted in 12 (44%), 12 (44%), and 5 (17%) patients, respectively. All lesions showed irregular aggregates of bland spindled cells separating and distorting mucosal crypts. Serrated (hyperplastic) crypts were observed on the top or contiguous with the lesion in all cases. Immunohistochemistry revealed expression of at least one perineurial cell marker (epithelial membrane antigen, claudin-1, and glucose transporter-1) in 26 out of 27 lesions (96%), but expression of CD34 was less common (8 of 27; 30%). Immunostaining for hMLH1 showed a normal nuclear expression. Molecular analysis in 22 cases showed V600E BRAF mutation in 14 cases (63%) and KRAS mutation in 1 (4%). The remainder were wild-type for all 3 genes. Our results indicate that serrated fibroblastic polyps/intramucosal perineuriomas represent a unique type of mixed epithelial-stromal polyps (hybrid hyperplastic polyp/mucosal perineurioma). The perineurial stromal component might be derived from modified pericryptic fibroblasts as a consequence

  3. Serrated Polyps at CT Colonography: Prevalence and Characteristics of the Serrated Polyp Spectrum.

    PubMed

    Kim, David H; Matkowskyj, Kristina A; Lubner, Meghan G; Hinshaw, J Louis; Munoz Del Rio, Alejandro; Pooler, B Dustin; Weiss, Jennifer M; Pickhardt, Perry J

    2016-08-01

    Purpose To report the prevalence and characteristics of serrated polyps identified in a large, average-risk population undergoing screening computed tomographic (CT) colonography. Materials and Methods This HIPAA-compliant retrospective study was approved by the institutional review board of the University of Wisconsin School of Medicine and Public Health. The need for informed consent was waived. Nine thousand six hundred examinations from 8289 patients were enrolled in a single-institution CT colonography-based screening program (from 2004 to 2011) and were evaluated for the presence of nondiminutive serrated lesions and advanced adenomas. The prevalence and characteristics of these lesions were tabulated. Generalized estimating equation regressions of polyp characteristics that may contribute to visualization of serrated lesions were investigated, including polyp size, location, and morphologic appearance; histologic findings; and presence or absence of contrast material tagging. Results Nondiminutive serrated lesions (≥6 mm) were seen at CT colonography-based screening with a prevalence of 3.1% (254 of 8289 patients). Sessile serrated adenomas (SSAs) and traditional serrated adenomas (TSAs) constituted 36.8% (137 of 372) and 4.3% (16 of 372) of serrated lesions, respectively; hyperplastic polyps (HPs) accounted for 58.9% (219 of 372 lesions). SSA and TSA tended to be large (mean size, 10.6 mm and 14.1 mm, respectively), with size categories and polyp subgroups significantly associated (P < .0001). SSA tended to be proximal in location (91.2%, 125 of 137 lesions) and flat in morphologic appearance (39.4%, 54 of 137 lesions) compared with TSA and HP. The presence of high-grade dysplasia in serrated lesions was uncommon when compared with advanced adenomas (one of 372 lesions vs 22 of 395 lesions, respectively; P < .0001). Multivariate analysis showed that contrast material tagging markedly improved serrated polyp detection with an odds ratio of 40.4 (95

  4. Classification of colon polyps in NBI endoscopy using vascularization features

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

    The evolution of colon cancer starts with colon polyps. There are two different types of colon polyps, namely hyperplasias and adenomas. Hyperplasias are benign polyps which are known not to evolve into cancer and, therefore, do not need to be removed. By contrast, adenomas have a strong tendency to become malignant. Therefore, they have to be removed immediately via polypectomy. For this reason, a method to differentiate reliably adenomas from hyperplasias during a preventive medical endoscopy of the colon (colonoscopy) is highly desirable. A recent study has shown that it is possible to distinguish both types of polyps visually by means of their vascularization. Adenomas exhibit a large amount of blood vessel capillaries on their surface whereas hyperplasias show only few of them. In this paper, we show the feasibility of computer-based classification of colon polyps using vascularization features. The proposed classification algorithm consists of several steps: For the critical part of vessel segmentation, we implemented and compared two segmentation algorithms. After a skeletonization of the detected blood vessel candidates, we used the results as seed points for the Fast Marching algorithm which is used to segment the whole vessel lumen. Subsequently, features are computed from this segmentation which are then used to classify the polyps. In leave-one-out tests on our polyp database (56 polyps), we achieve a correct classification rate of approximately 90%.

  5. The angiomatous polyp and the angiofibroma: two different lesions

    SciTech Connect

    Som, P.M.; Cohen, B.A.; Sacher, M.; Choi, I.S.; Bryan, N.R.

    1982-07-01

    Five cases of angiomatous polyps that were initially interpreted as angiofibromas are presented. Although they are similar to angiofibromas, angiomatous polyps have a distinctly different pattern of growth on computed tomography and a different angiographic appearance. In addition, they are more easily extirpated at surgery than are angiofibromas.

  6. Hairy polyp can be lethal even when small in size.

    PubMed

    Koike, Yuhki; Uchida, Keiichi; Inoue, Mikihiro; Ohtsu, Kazuya; Tanaka, Takaaki; Otake, Kohei; Tanaka, Koji; Kusunoki, Masato

    2013-06-01

    A case of sudden cardiopulmonary arrest in a 3-month-old girl is presented. The patient had barely recovered from hypoxic encephalopathy when she presented with repeated respiratory distress. Computed tomography and endoscopic analysis revealed a shiny polyp in the lateral wall of the nasopharynx, and this polyp was suspected to be the main cause of respiratory distress. After referral to our hospital, surgical removal was performed, and the histopathological diagnosis was hairy polyp. Hairy polyp is a rare congenital benign tumor that sometimes induces respiratory distress. This polyp can potentially induce a life-threatening event. In a systematic review of 40 reported cases, polyps of ≤ 3.0 cm in diameter have a higher risk of respiratory distress than do those >3.0 cm in diameter (P = 0.01). Small hairy polyps may be lethal because of delayed diagnosis. To locate small hairy polyps, physicians should not hesitate to perform further examination because there is the possibility of oversight with only physical examination.

  7. Assisted reproductive technique increases the risk of placental polyp.

    PubMed

    Baba, Tsuyoshi; Endo, Toshiaki; Ikeda, Keiko; Shimizu, Ayumi; Morishita, Miyuki; Kuno, Yoshika; Honnma, Hiroyuki; Kiya, Tamotsu; Ishioka, Shin-ichi; Saito, Tsuyoshi

    2013-06-01

    The purpose of this study was to clarify the risk factors and outcomes of placental polyp. This retrospective study was conducted on 1645 patients delivered or aborted in Sapporo Medical University from 2007 through 2011. Transvaginal color Doppler ultrasonography, hysteroscopy, contrast-enhanced MRI or 3D-CT angiography were performed. There were 1532 deliveries and 113 abortions. Seventy-one (4.3%) were ART-conceived and the remaining 1574 (95.7%) were non-ART pregnancies. Fifteen (0.91%) cases were confirmed as having placental polyp. Nine cases of placental polyp were identified among the 1574 (0.57%) as non-ART-related pregnancies, and 6 were identified among the 71 (8.5%) as ART-related pregnancies. Thus, pregnancies achieved through ART showed 20x greater incidence of complicating placental polyp than pregnancies achieved through without ART (p = 9.02 × 10(-6); odds ratio, 19.59; 95% confidence interval, 5.27-72.84, logistic regression analysis). Evaluation of blood flow within the polyp showed that in five of seven patients with low blood flow, the polyps spontaneously dropped off 79-115 days postpartum. Thus, ART-related pregnancies may be a risk factor of placental polyp, and spontaneous drop-off of the polyp is often observed in cases with low blood flow within the mass.

  8. Risk factor assessment of endoscopically removed malignant colorectal polyps

    PubMed Central

    Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schonegg, R; Maurer, C; Husler, J; Halter, F; Schmassmann, A

    1998-01-01

    Background—Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. 
Aims—To determine the significance of histological findings of patients with malignant polyps. 
Methods—Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67months). 
Results—Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16(42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. 
Conclusion—As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk. 

 Keywords: malignant polyps; colon cancer; colonoscopy; polypectomy; histology PMID:9824349

  9. Endoscopy and polyps-diagnostic and therapeutic advances in management

    PubMed Central

    Steele, Scott R; Johnson, Eric K; Champagne, Bradley; Davis, Brad; Lee, Sang; Rivadeneira, David; Ross, Howard; Hayden, Dana A; Maykel, Justin A

    2013-01-01

    Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options. PMID:23885138

  10. Shape estimation of gastrointestinal polyps using motion information

    NASA Astrophysics Data System (ADS)

    Ruano, Josue; Martinez, Fabio; Gomez, Martin; Romero, Eduardo

    2013-11-01

    Polyp size quanti cation is currently the main variable for deciding the patient treatment during an endoscopic procedure. Nowadays, the polyp size is estimated by an expert, even when using devices that are provided with calibrated grids. As such estimation is highly subjective, automatic approaches have come to be appealing but also challenging because the polyp shape and appearance variability, the di erent types of motion present during the capture and the specular highlight noise. This work presents a novel approach to automatically estimate gastrointestinal polyp shapes in a video endoscopic sequence using spatiotemporal information. For doing so, a local spatio temporal descriptor is built up to obtain an initial segmentation since the polyp is the region with more movement. Then, an initial polyp manual segmentation outlines a region of interest (RoI) in the rst frame of the sequence and used as a reference for the polyp tracking during the sequence. Afterward, an exhaustive cross-correlation of the initial shape is carried out along the sequence and fused with the motion descriptor to re ne the original segmentation. The proposed approach was evaluated in 15 real video sequences achieving an average DSC score of 0:67% .

  11. 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

  12. 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

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

    PubMed

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

    2016-08-16

    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

  14. A morphologic reappraisal of endoscopically but not histologically apparent polyps and the emergence of the overlooked goblet cell--rich hyperplastic polyp.

    PubMed

    Sethi, Aisha; Hanson, Joshua Anspach

    2015-08-01

    Goblet cell--rich hyperplastic polyps (GCRHP) are morphologically subtle compared to microvesicular hyperplastic polyps (MVHP) and are believed to be the most commonly unrecognized serrated polyp, though this has not been systematically studied. We hypothesize that a gastrointestinal pathologist's review of endoscopically but not histologically apparent polyps will identify previously missed GCRHPs, a finding that may be clinically significant if the addition of this subtype of serrated polyp contributes to sufficient numeric criteria for a clinical diagnosis of serrated polyposis syndrome (SPS). Two blinded reviews were performed on 160 endoscopically but not histologically apparent polyps by a gastrointestinal pathologist, separated by a 6 month "washout period." A final review diagnosis of GCRHP was applied to all polyps with complete agreement on both reviews. Patient records were then searched to determine if the addition of a GCRHP resulted in sufficient numeric criteria for a clinical diagnosis of SPS. Fourteen (9%) polyps were reclassified as GCRHPs. The majority (n = 12, 86%) were originally called "colonic mucosa with surface hyperplastic change (CMWSHC)." Two polyps (1%) were re-classified as MVHPs. No other serrated or adenomatous polyps were identified. For each patient, the addition of a hyperplastic polyp did not result in a clinical diagnosis of SPS, though one patient fell short of this diagnosis by only one polyp. GCRHPs are the most commonly underdiagnosed serrated polyp and are often called CMWSHC. The addition of previously missed GCRHPs is unlikely to contribute to a diagnosis of SPS in an individual patient.

  15. 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

  16. [Hyperplastic polyp with neoplastic transformation in a patient with atrophic gastritis and multiple gastric neuroendocrine tumors].

    PubMed

    Moura, E G H; Domingos, T A; Alvarado, H; Iriya, K; Kishi, H S; Martins, B C; Moura, E T H; P, P Sakai

    2012-01-01

    Hyperplastic gastric polyps are often found at GI endoscopy and are not considered premalignant lesions, although some cases of malignancy have been reported. Neuroendocrine tumors, conversely, are rare and account for approximately 1% to 2% of gastric polyps. Both hyperplastic gastric polyps and neuroendocrine tumors are related to gastric atrophy. The case of a hyperplastic polyp with multifocal areas of adenocarcinoma within the polyp associated to multiple gastric neuroendocrine tumors is reported.

  17. Rate and Risk Factors of the Advanced Adenomas Among Diminutive Colorectal Polyps.

    PubMed

    Aktekin, Ali; Comunoglu, Nil; Odabasi, Mehmet; Muftuoglu, Tolga; Gurleyik, Gunay; Abanonu, Gul Babacan

    2015-12-01

    Only 49 % of diminutive colorectal polyps are neoplastic, but a tiny percentage contains advanced histology. We aimed to determine the rate of advanced diminutive polyps and to evaluate the influence of age, gender, number, and localization. Patients undergoing a videocolonoscopy in October 2010 and April 2012 were collected prospectively. Subjects with polyps ≤5 mm in diameter were recruited into the study. The presence of a villous component of >25 % and a high degree of dysplasia were categorized as polyps with advanced histology. Two hundred eight diminutive polyps were identified in 102 patients. Twenty (9.6 %) diminutive polyps in 13 (12.74 %) patients showed advanced histology. The probability of having an advanced diminutive polyp was higher in patients who have more than one polyp or have polyps localized all along the colon or only to the distal part (p < 0.001 and p = 0.002). Having more than one polyp increases the likelihood of having advanced diminutive polyp according to a multivariate analysis (p = 0.003). Polyps accompanying any dysplastic diminutive polyp, being one of multiple polyps, and distributed all along the colon or localized to only the distal part have an increased probability of being an advanced diminutive polyp (p < 0.001, p = 0.047, p < 0.001, and p = 0.008). Multivariate logistic regression demonstrated that only any accompanying dysplastic diminutive polyp increases the probability of a polyp being advanced diminutive (p = 0.034). Diminutive polyps could have advanced histology. Multiple polyps located in the whole colorectum or to the distal part or accompanying any advanced polyps may harbor an advanced histology and should be removed.

  18. Histology subtypes and polyp size are associated with synchronous colorectal carcinoma of colorectal serrated polyps: a study of 499 serrated polyps.

    PubMed

    Zhu, Hailong; Zhang, Guofeng; Yi, Xianghua; Zhu, Xuyou; Wu, Yunjin; Liang, Jun; Zhang, Suxia; Zeng, Yu; Fan, Desheng; Yu, Xiaoting; He, Jian; He, Guozhong; Chen, Zheng; Duan, Shengzhong; Zhang, Lanjing

    2015-01-01

    Sessile serrated adenomas (SSA) and traditional serrated adenomas (TSA) are considered as precursors of colorectal cancer, and are often diagnostic challenges. Their true prevalence is masked by significant inter-observer variations. To investigate the true prevalence and synchronous colorectal carcinoma (sCRC) of colorectal serrated polyps (CSP) and their associated factors, we first retrospectively identified all colorectal polyps collected at our institution between June 1995 and May 2013. After centrally reclassifying all CSP to reduce inter-observer variations, Chi-square tests and logistic regression analyses were used to analyze the potential factors. Among the included 5501 colorectal polyps, 499 CSP of 428 patients were identified and studied, including 353 hyperplastic polyps (HP, 70.7%), 80 SSA (16.0%), 61 TSA (12.2%) and 5 mixed polyp (1.0%). Diagnostic disagreements were found in 68 CSP (13.63% of CSP). SSA and TSA were more often larger than 5 mm and in proximal colon than HP. SSA were also more likely associated with older age (p=0.005), size ≥5 mm (p<0.001) and ≥3 polyps (p=0.004) than HP in distal colon, but only more likely associated with older age (p=0.006) in proximal colon. Multivariate regression analysis demonstrated that CSP with sCRC, compared with CSP without sCRC, were linked to CSP size ≥1 cm (vs <1 cm, odds ratio [OR] 4.412, 95% confidence interval [CI] 1.684-11.556, P=0.003) and a diagnosis of SSA or TSA (vs HP, OR 6.194, 95% CI 1.870-20.513, P=0.003 and OR 6.754, 95% CI 1.981-23.028, P=0.002, respectively), but not age, gender, polyp number and polyp shape. SSA and TSA are similarly often associated with sCRC (P=0.460). In conclusion, histology subtypes and polyp size may serve as markers for sCRC of CSP. SSA and TSA may warrant careful endoscopic examinations and similar follow-up intervals.

  19. Can Colorectal Polyps and Cancer Be Found Early?

    MedlinePlus

    ... at the entire colon and rectum. Double-contrast barium enema: This is an x-ray test of ... can find some polyps. Sigmoidoscopy, colonoscopy, double contrast barium enema, and CT colonography are good at finding ...

  20. Dysphagia caused by a fibrovascular polyp: a case report.

    PubMed

    Blacha, Marielle Mj; Sloots, Cornelius Ej; Van Munster, Ivo P; Wobbes, Theo

    2008-01-01

    A 73-year old man presented with dysphagia for liquid and solid food. Barium contrast study of the esophagus and esophagoscopy demonstrated a fibrovascular polyp. This, almost 10 cm benign esophageal tumor, was removed surgically by a cervical esophagotomy. A fibrovascular polyp is a rare benign tumor of the esophagus, which, however, may give serious complications as asphyxia resulting from laryngeal obstruction leading to sudden death.

  1. Dysphagia caused by a fibrovascular polyp: a case report

    PubMed Central

    Blacha, Marielle MJ; Sloots, Cornelius EJ; Van Munster, Ivo P; Wobbes, Theo

    2008-01-01

    A 73-year old man presented with dysphagia for liquid and solid food. Barium contrast study of the esophagus and esophagoscopy demonstrated a fibrovascular polyp. This, almost 10 cm benign esophageal tumor, was removed surgically by a cervical esophagotomy. A fibrovascular polyp is a rare benign tumor of the esophagus, which, however, may give serious complications as asphyxia resulting from laryngeal obstruction leading to sudden death. PMID:19019249

  2. Hairy polyp of the tongue: a case report.

    PubMed

    Erdogan, Seyda; Tunali, Nurdan; Canpolat, Tuba; Tuncer, Recep

    2004-12-01

    Hairy polyps or dermoids of the oro- and nasopharynx are benign lesions containing elements of both ectodermal and mesodermal origin. Because of its rarity, we report a case of hairy polyp arising from the tongue in a 40-day-old infant. The lesion was covered by squamous epithelium and a central core of fibroadipose tissue, minor salivary glands, and cartilage. We discuss the clinicopathological features, terminology, etiology, and differential diagnosis of this condition.

  3. The Colonoscopist's Expertise Affects the Characteristics of Detected Polyps

    PubMed Central

    Jung, Da Kyoung; Kim, Tae Oh; Kang, Mi Seon; Kim, Mo Se; Kim, Min Sik; Moon, Young Soo

    2016-01-01

    Background/Aims: The influence of the endoscopist on the polyp detection rate (PDR) is underappreciated in clinical practice. Moreover, flat lesions or lesions of the proximal colon are more difficult to detect. Here, we evaluated the differences in the PDR and the characteristics of detected polyps according to the experience of the colonoscopist. Methods: We collected data on 2,549 patients who underwent screening colonoscopy performed by three fellows. The PDR was calculated according to the percentage of patients who had at least one polyp (method A) and according to the percentage of detected lesions (method B). The primary outcome included the change in the PDR, and the secondary outcome included the change in the characteristics of the detected polyps with increasing experience of the colonoscopist. Results: No proportional correlation was found between the PDR and increasing experience in colonoscopy with method A; however, with method B, the PDR increased after 400 colonoscopies (p=0.0209). With method B, the detection rates of small polyps (<5 mm) (p=0.0015) and polyps in proximal sites (p=0.0050) increased after 300 colonoscopies. Conclusions: Our study demonstrated that the quality of a colonoscopy, measured by using the PDR, may increase when performed by experienced fellows. PMID:26855926

  4. Management of Diminutive Colon Polyps Based on Endoluminal Imaging.

    PubMed

    Lieberman, David; Brill, Joel; Canto, Marcia; DeMarco, Daniel; Fennerty, Brian; Gupta, Neil; Laine, Loren; Lightdale, Charles; Montgomery, Elizabeth; Odze, Robert; Rex, Douglas; Sharma, Prateek; Kochman, Michael; Tokar, Jeffrey

    2015-11-01

    Diminutive colon polyps, defined as 5 mm or less, are encountered increasingly at colonoscopy. The risk of serious pathology in such polyps is low. There is a risk and cost of resecting all such polyps and sending tissue for pathologic evaluation. Enhancement of endoluminal imaging may enable discrimination of neoplastic vs non-neoplastic polyps. If this discrimination can be performed accurately with high confidence, it may be possible to either resect and discard diminutive adenomas, or inspect and do-not-resect diminutive hyperplastic polyps. In 2011, an expert group recommended thresholds of 90% negative predictive value for adenomas, and 90% accuracy in predicting appropriate surveillance intervals. Since 2011, criteria for polyp discrimination have been published and validated by experts and nonexperts. In vivo studies have been performed to compare endoscopic impression and pathologic diagnosis. An expert panel was convened in late 2014 to review the literature to determine if the proposed thresholds for discrimination can be attained and to recommend the next steps for introducing changes in clinical practice. We conclude that threshold levels can be achieved with several endoscopic image enhancements. The next steps to implementation of practice change include acquiring data on training and competence, determining best practices for auditing performance, understanding patient education needs, and the potential cost benefit of such changes.

  5. Hyaluronan synthases and hyaluronidases in nasal polyps.

    PubMed

    Panogeorgou, T; Tserbini, E; Filou, S; Vynios, D H; Naxakis, S S; Papadas, T A; Goumas, P D; Mastronikolis, N S

    2016-07-01

    Nasal polyps (NPs) are benign lesions of nasal and paranasal sinuses mucosa affecting 1-4 % of all adults. Nasal polyposis affects the quality of patient's life as it causes nasal obstruction, postnasal drainage, purulent nasal discharge, hyposmia or anosmia, chronic sinusitis, facial pain and snoring. Without treatment, the disease can alter the craniofacial skeleton in cases of extended growth of polyps. The development of NPs is caused by the hyperplasia of nasal or paranasal sinuses mucosa, and edema of extracellular matrix. This is usually the result of high concentration of high molecular mass hyaluronan (HA) which is either overproduced or accumulated from blood supply. The size of HA presents high diversity and, especially in pathologic conditions, chains of low molecular mass can be observed. In NPs, chains of about 200 kDa have been identified and considered to be responsible for the inflammation. The purpose of the present study was the investigation, in NPs and normal nasal mucosa (NM), of the expression of the wild-type and alternatively spliced forms of hyaluronidases, their immunolocalization, and the expression of HA synthases to examine the isoform(s) responsible for the increased amounts of HA in NPs. Hyaluronidases' presence was examined on mRNA (RT-PCR analysis) and protein (immunohistochemistry) levels. Hyaluronan synthases' presence was examined on mRNA levels. Hyaluronidases were localized in the cytoplasm of epithelial and inflammatory cells, as well as in the matrix. On mRNA level, it was found that hyal-1-wt was decreased in NPs compared to NM and hyal-1-v3, -v4 and -v5 were substantially increased. Moreover, HAS2 and HAS3 were the only hyaluronan synthases detected, the expression of which was almost similar in NPs and NM. Overall, the results of the present study support that hyaluronidases are the main enzymes responsible for the decreased size of hyaluronan observed in NPs; thus they behave as inflammatory agents. Therefore, they

  6. 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

  7. A practical automated polyp detection scheme for CT colonography

    NASA Astrophysics Data System (ADS)

    Li, Hong; Santago, Pete

    2004-05-01

    A fully automated computerized polyp detection (CPD) system is presented that takes DICOM images from CT scanners and provides a list of detected polyps. The system comprises three stages, segmentation, polyp candidate generation (PCG), and false positive reduction (FPR). Employing computer tomographic colonography (CTC), both supine and prone scans are used for improving detection sensitivity. We developed a novel and efficient segmentation scheme. Major shape features, e.g., the mean curvature and Gaussian curvature, together with a connectivity test efficiently produce polyp candidates. We select six shape features and introduce a multi-plane linear discriminant function (MLDF) classifier in our system for FPR. The classifier parameters are empirically assigned with respect to the geometric meanings of a specific feature. We have tested the system on 68 real subjects, 20 positive and 48 negative for 6 mm and larger polyps from colonoscopy results. Using a patient-based criterion, 95% accuracy and 31% specificity were achieved when 6 mm was used as the cutoff size, implying that 15 out of 48 healthy subjects could avoid OC. One 11 mm polyp was missed by CPD but was also not reported by the radiologist. With a complete polyp database, we anticipate that a maximum a posteriori probability (MAP) classifier tuned by supervised training will improve the detection performance. The execution time for both scans is about 10-15 minutes using a 1 GHz PC running Linux. The system may be used standalone, but is envisioned more as a part of a computer-aided CTC screening that can address the problems with a fully automatic approach and a fully physician approach.

  8. Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy

    PubMed Central

    Yang, Jehn-Hsiahn; Chen, Chin-Der; Chen, Shee-Uan; Yang, Yu-Shih; Chen, Mei-Jou

    2015-01-01

    Background An endometrial polyp is a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data. Methods This case-series report included 168 premenopausal women who suffered from endometrial polyps and underwent hysteroscopic polypectomy. All of them were awaiting a future pregnancy. Office hysteroscopy was done before and after hysteroscopic polypectomy, in which preoperative hysteroscopy examined the number, type, and location of endometrial polyps, and postoperative hysteroscopy checked the polyp recurrence. Surgical indications, either infertility or the presentation of abnormal uterine bleeding, and follow-up duration were recorded. Results Seventy-three out of 168 (43%) women had polyp recurrence after hysteroscopic polypectomy. Multivariate logistic regression analysis revealed that more endometrial polyps (P = 0.015) and longer duration of follow-up (P = 0.004) were significantly associated with an increased risk of postoperative polyp recurrence. The type of endometrial polyps was not correlated with polyp recurrence potential, whereas pedunculated type endometrial polyps were closely related to the presentation of abnormal uterine bleeding (P = 0.001). Conclusions A higher number of endometrial polyps and longer follow-up duration are associated with a greater potential of polyp recurrence after hysteroscopic polypectomy. PMID:26660149

  9. Sessile serrated adenoma/polyps with a depressed surface: a rare form of sessile serrated adenoma/polyp.

    PubMed

    Lee, Eun-Jung; Kim, Mi-Jung; Chun, Sung-Min; Jang, Se-Jin; Kim, Do Sun; Lee, Doo Han; Youk, Eui Gon

    2015-06-20

    Sessile serrated adenoma/polyps (SSA/Ps) usually appear flat to sessile with a smooth-appearing surface. However, macroscopic appearances of SSA/P can vary from flat-elevated to nodular and can even show a pedunculated configuration as we previously reported. The aim of the current study was to evaluate the clinicopathologic features of another under-recognized form of SSA/P which shows a depressed surface. Among 634 cases of sessile serrated adenoma/polyp, a total of seven sessile serrated adenoma/polyps showing a depressed surface were identified in 6 patients during the review of endoscopic images between January 2013 and November 2013. One of these was found during the review of previous endoscopic images of the same patient. Patients were more often middle-aged to elderly men (83.3%) and had synchronous conventional adenomas and/or SSA/Ps except for one man. The polyps usually occurred in the proximal colon (71.4%) and the mean size of polyps was 9.3 mm (range; 6-13 mm). Most cases (71.4%) were of a flat-elevated type, and the remaining polyps (28.6%) were sessile. The majority of polyps (85.7%) showed a mucus cap. All but one of the cases (85.7%) showed BRAF-V600E mutations. Our findings are that SSA/Ps can show a central depression although such cases are rare. The endoscopic and clinicopathologic features of SSA/Ps showing a depressed surface appear to be similar to usual SSA/Ps except for the presence of a depressed surface and marked male preponderance. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1562070886167874 .

  10. 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. PMID:26826415

  11. Automatic colonic polyp shape determination using content-based image retrieval

    NASA Astrophysics Data System (ADS)

    Aman, Javed M.; Yao, Jianhua; Summers, Ronald M.

    2011-03-01

    Polyp shape (sessile or pedunculated) may provide important clinical implication. However, the traditional way of determining polyp shape is both invasive and subjective. We present a less-invasive and automated method to predict the shape of colonic polyps on computed tomographic colonography (CTC) using the content-based image retrieval (CBIR) approach. We classify polyps as either sessile (SS) or pedunculated (PS) in shape. The CBIR uses numerical feature vectors generated from our CTC computer aided detection (CTC-CAD) system to describe the polyps. These features relate to physical and visual characteristics of the polyp. Feature selection was done using a support vector machine classifier on a training set of polyp shapes. The system is evaluated using an independent test set. Using receiver operating curve (ROC) analysis, we showed our system is as accurate as a polyp shape classifier. The area under the ROC curve was 0.86 (95% confidence interval [0.77, 0.93]).

  12. Regression of fundic gland polyps following acquisition of Helicobacter pylori

    PubMed Central

    Watanabe, N; Seno, H; Nakajima, T; Yazumi, S; Miyamoto, S; Matsumoto, S; Itoh, T; Kawanami, C; Okazaki, K; Chiba, T

    2002-01-01

    The prevalence of Helicobacter pylori infection is very low in patients with fundic gland polyps (FGPs) of the stomach. We report here two cases with multiple FGPs that regressed following new H pylori acquisition. Patient Nos I and II had multiple FGPs in normal fundic mucosa without inflammatory changes or atrophy. Both were not infected with H pylori. Following acquisition of H pylori infection however, all FGPs in both patients completely disappeared except for one FGP in patient No I. Although the size of the remaining polyp in patient No I was greatly reduced after H pylori acquisition, it became enlarged again after eradication. Interestingly, in the remaining polyp, we found an activating β-catenin gene mutation whereas no such mutations were detected in FGPs of patient No II. Thus H pylori infection may have an inhibitory effect on the development of FGPs. PMID:12377817

  13. Oral polyp as the presenting feature of Beckwith-Wiedemann syndrome in a child.

    PubMed

    Kujan, Omar; Raheel, Syed Ahmed; King, David; Iqbal, Fareed

    2015-01-01

    Beckwith-Wiedemann syndrome (BWS) is a congenital growth disorder characterised by abdominal wall defects, macroglossia and somatic gigantism. A number of associated features, including gastrointestinal and urinary tract polyps, have been described, but there are no previous reports of oral polyps occurring in this syndrome. We describe the first case of BWS presenting with an oral polyp. Clinicians should be alert to the possibility of BWS if other features of the syndrome are present, in children with oral polyps. PMID:26323977

  14. Structure and signaling at hydroid polyp-stolon junctions, revisited

    PubMed Central

    Harmata, Katherine L.; Somova, Emily L.; Parrin, Austin P.; Bross, Lori S.; Glockling, Sally L.; Blackstone, Neil W.

    2015-01-01

    ABSTRACT The gastrovascular system of colonial hydroids is central to homeostasis, yet its functional biology remains poorly understood. A probe (2′,7′-dichlorodihydrofluorescein diacetate) for reactive oxygen species (ROS) identified fluorescent objects at polyp-stolon junctions that emit high levels of ROS. A nuclear probe (Hoechst 33342) does not co-localize with these objects, while a mitochondrial probe (rhodamine 123) does. We interpret these objects as mitochondrion-rich cells. Confocal microscopy showed that this fluorescence is situated in large columnar cells. Treatment with an uncoupler (2,4-dinitrophenol) diminished the ROS levels of these cells relative to background fluorescence, as did removing the stolons connecting to a polyp-stolon junction. These observations support the hypothesis that the ROS emanate from mitochondrion-rich cells, which function by pulling open a valve at the base of the polyp. The open valve allows gastrovascular fluid from the polyp to enter the stolons and vice versa. The uncoupler shifts the mitochondrial redox state in the direction of oxidation, lowering ROS levels. By removing the stolons, the valve is not pulled open, metabolic demand is lowered, and the mitochondrion-rich cells slowly regress. Transmission electron microscopy identified mitochondrion-rich cells adjacent to a thick layer of mesoglea at polyp-stolon junctions. The myonemes of these myoepithelial cells extend from the thickened mesoglea to the rigid perisarc on the outside of the colony. The perisarc thus anchors the myoepithelial cells and allows them to pull against the mesoglea and open the lumen of the polyp-stolon junction, while relaxation of these cells closes the lumen. PMID:26231625

  15. 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.

  16. Familial Occurrence of Enteric Muco-Submucosal Elongated Polyp

    PubMed Central

    Nakamura, Kenji; Okamoto, Takeshi; Imamura, Noriatsu; Ishii, Naoki; Fujita, Yoshiyuki

    2016-01-01

    We report 2 cases of enteric muco-submucosal elongated polyps (EMSEPs) that presented with gastrointestinal bleeding. The 2 patients are siblings. They both had a history of percutaneous coronary intervention for coronary artery disease and were on dual antiplatelet therapy. They underwent endoscopic resection of the polyps, which displayed identical endoscopic and histological features compatible with EMSEP. This is the first report of familial occurrence of EMSEP, suggesting possible genetic involvement. It is also important to note that the use of antiplatelet agents appears to be a predisposing factor for gastrointestinal bleeding from EMSEP. PMID:27807549

  17. Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: randomised controlled non-inferiority study

    PubMed Central

    Cooper, Natalie A M; Middleton, Lee; Diwakar, Lavanya; Smith, Paul; Denny, Elaine; Roberts, Tracy; Stobert, Lynda; Jowett, Susan; Daniels, Jane

    2015-01-01

    Objective To compare the effectiveness and acceptability of outpatient polypectomy with inpatient polypectomy. Design Pragmatic multicentre randomised controlled non-inferiority study. Setting Outpatient hysteroscopy clinics in 31 UK National Health Service hospitals. Participants 507 women who attended as outpatients for diagnostic hysteroscopy because of abnormal uterine bleeding and were found to have uterine polyps. Interventions Participants were randomly assigned to either outpatient uterine polypectomy under local anaesthetic or inpatient uterine polypectomy under general anaesthesia. Data were collected on women’s self reported bleeding symptoms at baseline and at 6, 12, and 24 months. Data were also collected on pain and acceptability of the procedure at the time of polypectomy. Main outcome measures The primary outcome was successful treatment, determined by the women’s assessment of bleeding at six months, with a prespecified non-inferiority margin of 25%. Secondary outcomes included generic (EQ-5D) and disease specific (menorrhagia multi-attribute scale) quality of life, and feasibility and acceptability of the procedure. Results 73% (166/228) of women in the outpatient group and 80% (168/211) in the inpatient group reported successful treatment at six months (intention to treat relative risk 0.91, 95% confidence interval 0.82 to 1.02; per protocol relative risk 0.92, 0.82 to 1.02). Failure to remove polyps was higher (19% v 7%; relative risk 2.5, 1.5 to 4.1) and acceptability of the procedure was lower (83% v 92%; 0.90, 0.84 to 0.97) in the outpatient group Quality of life did not differ significantly between the groups. Four uterine perforations, one of which necessitated bowel resection, all occurred in the inpatient group. Conclusions Outpatient polypectomy was non-inferior to inpatient polypectomy. Failure to remove a uterine polyp was, however, more likely with outpatient polypectomy and acceptability of the procedure was slightly lower. Trial

  18. Gene expression profiling of serrated polyps identifies annexin A10 as a marker of a sessile serrated adenoma/polyp.

    PubMed

    Gonzalo, David Hernandez; Lai, Keith K; Shadrach, Bonnie; Goldblum, John R; Bennett, Ana E; Downs-Kelly, Erinn; Liu, Xiuli; Henricks, Walter; Patil, Deepa T; Carver, Paula; Na, Jie; Gopalan, Banu; Rybicki, Lisa; Pai, Rish K

    2013-08-01

    Sessile serrated adenomas/polyps (SSA/Ps) are precursors of colon cancer, particularly those that exhibit microsatellite instability. Distinguishing SSA/Ps from the related, but innocuous, microvesicular hyperplastic polyp (MVHP) can be challenging. In this study seven gastrointestinal pathologists reviewed 109 serrated polyps and identified 60 polyps with histological consensus. Microarray analysis was performed on six distal consensus MVHPs < 9 mm, six proximal consensus SSA/Ps > 9 mm, and six normal colon biopsies (three proximal, three distal). Comparative gene expression analysis confirmed the close relationship between SSA/Ps and MVHPs as there was overlapping expression of many genes. However, the gene expression profile in SSA/Ps had stronger and more numerous associations with cancer-related genes compared with MVHPs. Three genes (TFF2, FABP6, and ANXA10) were identified as candidates whose expression can differentiate SSA/Ps from MVHPs, and the differences in expression were confirmed by quantitative RT-PCR. As ANXA10 showed the most promise in differentiating these polyps, the expression of ANXA10 was evaluated by immunohistochemistry in consensus SSA/Ps (n = 26), MVHPs (n = 21), and normal colon (n = 9). Immunohistochemical expression of ANXA10 was not identified in separate samples of normal colon or in the normal colonic epithelium adjacent to the serrated polyps. Consistent with the microarray and quantitative RT-PCR experiments, immunohistochemical expression of ANXA10 was markedly increased in SSA/Ps compared to MVHPs (p < 0.0001). An ANXA10 score ≥ 3 has a sensitivity of 73% and a specificity of 95% in the diagnosis of an SSA/P. In conclusion, we show that SSA/Ps and MVHPs have significant overlap in gene expression, but also important differences, particularly in cancer-related pathways. Expression of ANXA10 may be a potential marker of the serrated pathway to colon cancer.

  19. 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

  20. Immunochromatography and cardiotoxicity of sea nettle (Chrysaora quinquecirrha) polyps and cysts.

    PubMed

    Olson, C E; Cargo, D G; Calton, G J; Burnett, J W

    1985-01-01

    The cardiotoxicity and polypeptide content of sea nettle (Chrysaora quinquecirrha) polyps and cysts were studied. Crude polyp preparations were lethal to mice. Both crude polyp and cyst preparations were toxic to embryonic chick cardiocytes. The polyp cardiotoxin factor was purified ten-fold by immunosorbent chromatography using anti-sea nettle or anti-man-o'war (Physalia physalis) monoclonal antibodies. Even though the polyps were incubated at a constant temperature, it appeared that there was an inverse relationship between the presence of proteins of 160,000 and 55,000 mol. wt as winter progressed. PMID:2859673

  1. 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

  2. Lymphangiomatous Polyp of Palatine Tonsil in A Child Presenting with Dysphagia and Dysarthria

    PubMed Central

    Khatib, Yasmeen; Gite, Vinod; Shoeb, Mohammed; Oraon, Asha

    2015-01-01

    Pedunculated lymphangiomatous polyps of the tonsil are rare benign lesions that have been described in literature using varied nomenclature. Majority of the cases have been reported in adults with varying clinical symptoms. We report a case of lymphangiomatous polyp of left palatine tonsil in a 14-year-old male child who presented with dysphagia and dysarthria. Clinical examination revealed a large pedunculated polyp arising from upper pole of left tonsil. Patient underwent left tonsillectomy with excision of the polyp. Based on histopathological features a diagnosis of pedunculated lymphangiomatous polyp was made. We discuss the clinical and histopathological features of this lesion with differential diagnosis and short review of literature. PMID:26155482

  3. 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

  4. Thermal and Osmotic Tolerance of 'Irukandji' Polyps: Cubozoa; Carukia barnesi.

    PubMed

    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

  5. Primary pulmonary carcinoid tumor with metastasis to endometrial polyp

    PubMed Central

    Momeni, Mazdak; Kolev, Valentin; Costin, Dan; Mizrachi, Howard H.; Chuang, Linus; Warner, Richard R.P.; Gretz, Herbert F.

    2012-01-01

    INTRODUCTION A carcinoid tumor occurring in the endometrium has been documented in the literature, but there is no report in regard to carcinoid tumor metastasis to endometrium. PRESENTATION OF CASE We report a case of a malignant carcinoid metastasis to an endometrial polyp. Patient underwent hysteroscopy, and polypectomy. The pathology demonstrated an endometrial polyp containing a 4 mm x 5 mm nodule of metastatic carcinoid tumor, consistent with metastasis from patient's known pulmonary carcinoid. The tumor was morphologically similar to the tumors of the right lung, with similar immune-profile. DISCUSSION This patient presented with a suspicious pelvic ultrasound. Due to her age, the first priority was to exclude uterine cancer. The endometrial polyp, which was found, had a small focus of metastatic carcinoid tumor. To the best of our knowledge, this finding has not been previously recorded in the literature. Our patient also had a history of metastatic carcinoid tumor to breast. This finding is also very uncommon. CONCLUSION This is the first case in the literature described a malignant carcinoid metastasis to an endometrial polyp. PMID:23127865

  6. 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.

  7. 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.

  8. Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review

    PubMed Central

    Pereira, Nigel; Petrini, Allison C.; Lekovich, Jovana P.; Elias, Rony T.; Spandorfer, Steven D.

    2015-01-01

    Endometrial polyps are benign localized lesions of the endometrium, which are commonly seen in women of reproductive age. Observational studies have suggested a detrimental effect of endometrial polyps on fertility. The natural course of endometrial polyps remains unclear. Expectant management of small and asymptomatic polyps is reasonable in many cases. However, surgical resection of endometrial polyps is recommended in infertile patients prior to treatment in order to increase natural conception or assisted reproductive pregnancy rates. There is mixed evidence regarding the resection of newly diagnosed endometrial polyps during ovarian stimulation to improve the outcomes of fresh in vitro fertilization cycles. Hysteroscopy polypectomy remains the gold standard for surgical treatment. Evidence regarding the cost and efficacy of different methods for hysteroscopic resection of endometrial polyps in the office and outpatient surgical settings has begun to emerge. PMID:26301260

  9. Resection of Diminutive and Small Colorectal Polyps: What Is the Optimal Technique?

    PubMed Central

    Lee, Jun

    2016-01-01

    Colorectal polyps are classified as neoplastic or non-neoplastic on the basis of malignant potential. All neoplastic polyps should be completely removed because both the incidence of colorectal cancer and the mortality of colorectal cancer patients have been found to be strongly correlated with incomplete polypectomy. The majority of colorectal polyps discovered on diagnostic colonoscopy are diminutive and small polyps; therefore, complete resection of these polyps is very important. However, there is no consensus on a method to remove diminutive and small polyps, and various techniques have been adopted based on physician preference. The aim of this article was to review the diverse techniques used to remove diminutive and small polyps and to suggest which technique will be the most effective. PMID:27450226

  10. Feasibility of coblation versus laser resection in recurrent nasal polyps

    NASA Astrophysics Data System (ADS)

    Ilgner, Justus; Schramm, Karsten; Duwel, Philip; Donner, Andreas; Westhofen, Martin

    2005-04-01

    Introduction: Chronic sinusitis with nasal polyps is one of the commonest diseases of the upper airways, with a recurrence rate of about 15%. Minimally-invasive endoscopic laser procedures have been established to reduce the need for conventional revision surgery whenever medical follow-up fails. However, laser surgery requires special considerations for surgical, safety and economic aspects. This study evaluates the feasibility of coblation versus laser resection for recurrent nasal polyps. Material and methods: 6 nasal polyps were harvested each from the ostiomeatal complex of patients undergoing microscopic endonasal surgery for chronic sinusitis. 3 were dissected using a Neodymium:YAG laser system (Dornier MediLas 5060N) set at 10, 20 and 30w in cw mode with a 600μm bare fiber in contact mode with negative feedback power control, while further 3 polyps were dissected using a Coblation system (ArthroCare® Coblator® I) with a 30° angled and a 0° straight probe with 2.4 mm outer diameter. The specimens were examined histologically for carbonization and coagulation as well as unaltered tissue. Results: Laser resection resulted in a carbonization zone of 30μm in depth plus a coagulation zone of about 100μm, depending on the water content and type of tissue. While the carbonization zone was smaller with coblation, coagulation zones were comparable, leaving ample amount of unaltered tissue available for further diagnosis. Conclusion: Both resection techniques are generally feasible to be used in day case surgery for recurrent polyps. While the coblation system required no special safety requirements, accessibility of the sinuses was limited by the rigidity of applicators that are available.

  11. Improving initial polyp candidate extraction for CT colonography

    NASA Astrophysics Data System (ADS)

    Zhu, Hongbin; Fan, Yi; Lu, Hongbing; Liang, Zhengrong

    2010-04-01

    Reducing the number of false positives (FPs) as much as possible is a challenging task for computer-aided detection (CAD) of colonic polyps. As part of a typical CAD pipeline, an accurate and robust process for segmenting initial polyp candidates (IPCs) will significantly benefit the successive FP reduction procedures, such as feature-based classification of false and true positives (TPs). In this study, we introduce an improved scheme for segmenting IPCs. It consists of two main components. One is geodesic distance-based merging, which merges suspicious patches (SPs) for IPCs. Based on the merged SPs, another component, called convex dilation, grows each SP beyond the inner surface of the colon wall to form a volume of interest (VOI) for that IPC, so that the inner border of the VOI beyond the colon inner surface could be segmented as convex, as expected. The IPC segmentation strategy was evaluated using a database of 50 patient studies, which include 100 scans at supine and prone positions with 84 polyps and masses sized from 6 to 35 mm. The presented IPC segmentation strategy (or VOI extraction method) demonstrated improvements, in terms of having no undesirably merged true polyp and providing more helpful mean and variance of the image intensities rooted from the extracted VOI for classification of the TPs and FPs, over two other VOI extraction methods (i.e. the conventional method of Nappi and Yoshida (2003 Med. Phys. 30 1592-601) and our previous method (Zhu et al 2009 Cancer Manag. Res. 1 1-13). At a by-polyp sensitivity of 0.90, these three methods generated the FP rate (number of FPs per scan) of 4.78 (new method), 6.37 (Nappi) and 7.01 (Zhu) respectively.

  12. Demographic and Clinical Features of Endometrial Polyps in Patients with Endometriosis

    PubMed Central

    Wang, Ningning; Zhang, Yufeng; Liu, Bin

    2016-01-01

    Aims. To compare the clinical features of endometrial polyps (EPs) between patients with endometriosis (EM) (EM group) and without EM (non-EM group). Methods and Results. Seventy-six cases in the EM group and 133 cases in the non-EM group underwent laparotomy or hysteroscopy and laparoscopy; later, it was confirmed that the results by pathology from July 2002 to April 2008 in the Department of Gynecology and Obstetrics at the First Affiliated Hospital of Sun Yat-sen University. The recurrence of EPs was followed up after the surgery until 2013. The following parameters were assessed: age, gravidity, parity, infertility, and menstrual cycle changes, as well as polyps diameters, locations, number, association with the revised American Fertility Society (r-AFS) classification, and their recurrence. On review, 76 EPs cases of EM group histologically resembled EPs but the majority of EPs with EM occurred in primary infertility cases and in fewer pregnancy rate women who had stable and smaller EPs without association with the AFS stage. The recurrence rate of EPs in EM group was higher than that in non-EM group. Conclusion. It is important to identify whether infertile patients with EM are also having EPs. Removing any coexisting EPs via hysteroscopy would be clinically helpful in treating endometriosis-related infertility in these patients. PMID:27243030

  13. Inflammatory myoglandular polyp of the cecum: case report and review of literature

    PubMed Central

    2010-01-01

    Background Inflammatory myoglandular polyp (IMGP) is a rare non-neoplastic polyp of the large bowel, commonly with a distal localization (rectosigmoid), obscure in its pathogenesis. Up till now, 60 cases of IMGP have been described in the literature, but none located in the cecum. Case presentation We report a case of a 53-year-old man who was admitted to our hospital for further evaluation of positive fecal occult blood test associated to anemia. A colonoscopy identified a red, sessile, lobulated polyp of the cecum, 4.2 cm in diameter, partially ulcerated. The histological examination of the biopsy revealed the presence of inflammatory granulation tissue with lymphocytic and eosinophil infiltration associated to a fibrous stroma: it was diagnosed as inflammatory fibroid polyp. Considering the polyp's features (absence of a peduncle and size) that could increase the risk of a polypectomy, a surgical resection was performed. Histological examination of the specimen revealed inflammatory granulation tissue in the lamina propria, hyperplastic glands with cystic dilatations, proliferation of smooth muscle and multiple erosions on the polyp surface: this polyp was finally diagnosed as IMGP. There was also another little polyp next to the ileocecal valve, not revealed at the colonoscopy, 0.8 cm in diameter, diagnosed as tubulovillous adenoma with low grade dysplasia. Conclusions This is the first case of IMGP of the cecum. It is a benign lesion of unknown pathogenesis and must be considered different from other non-neoplastic polyps of the large bowel such as inflammatory cap polyps (ICP), inflammatory cloacogenic polyps, juvenile polyps (JP), inflammatory fibroid polyps (IFP), polyps secondary to mucosal prolapse syndrome (MPS), polypoid prolapsing mucosal folds of diverticular disease. When symptomatic, IMGP should be removed endoscopically, whereas surgical resection is reserved only in selected patients as in our case. PMID:20102635

  14. 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

  15. Prediction of polyp histology on CT colonography using content-based image retrieval

    NASA Astrophysics Data System (ADS)

    Aman, Javed M.; Yao, Jianhua; Summers, Ronald M.

    2010-03-01

    Predicting the malignancy of colonic polyps is a difficult problem and in general requires an invasive polypectomy procedure. We present a less-invasive and automated method to predict the histology of colonic polyps under computed tomographic colonography (CTC) using the content-based image retrieval (CBIR) paradigm. For the purpose of simplification, polyps annotated as hyperplastic or "other benign" were classified as benign polyps (BP) and the rest (adenomas and cancers) were classified as malignant polyps (MP). The CBIR uses numerical feature vectors generated from our CTC computer aided detection (CTC-CAD) system to describe the polyps. These features relate to physical and visual characteristics of the polyp. A representative database of CTC-CAD polyp images is created. Query polyps are matched with those in the database and the results are ranked based on the similarity to the query. Polyps with a majority of representative MPs in their result set are predicted to be malignant and similarly those with a majority of BPs in their results are benign. For evaluation, the system is compared to the typical optical colonoscopy (OC) size based classification. Using receiver operating curve (ROC) analysis, we show our system is sufficiently better than the OC size method.

  16. Effect of CADe on radiologists' performance in detection of "difficult" polyps in CT colonography

    NASA Astrophysics Data System (ADS)

    Suzuki, Kenji; Hori, Masatoshi; Iinuma, Gen; Dachman, Abraham H.

    2013-03-01

    To investigate the actual usefulness of computer-aided detection (CADe) of polyps as a second reader, we conducted a free-response observer performance study with radiologists in the detection of "difficult" polyps in CT colonography (CTC) from a multicenter clinical trial. The "difficult" polyps were defined as the ones that had been "missed" by radiologists in the clinical trial or rated "difficult" in our retrospective review. Our advanced CADe scheme utilizing massive-training artificial neural networks (MTANNs) technology was sensitive and specific to the "difficult" polyps. Four board-certified abdominal radiologists participated in this observer study. They were instructed, first without and then with our CADe, to indicate the location of polyps and their confidence level regarding the presence of polyps. Our database contains 20 patients with 23 polyps including 14 false-negative (FN) and 7 "difficult" polyps and 10 negative patients. With CADe, the average by-polyp sensitivity of radiologists was improved from 53 to 63% at a statistically significant level (P=0.037). Thus, our CADe scheme utilizing the MTANN technology improved the diagnostic performance of radiologists, including expert readers, in the detection of "difficult" polyps in CTC.

  17. Detection Rate, Distribution, Clinical and Pathological Features of Colorectal Serrated Polyps

    PubMed Central

    Cao, Hai-Long; Chen, Xue; Du, Shao-Chun; Song, Wen-Jing; Wang, Wei-Qiang; Xu, Meng-Que; Wang, Si-Nan; Piao, Mei-Yu; Cao, Xiao-Cang; Wang, Bang-Mao

    2016-01-01

    Background: Colorectal serrated polyp is considered as histologically heterogeneous lesions with malignant potential in western countries. However, few Asian studies have investigated the comprehensive clinical features of serrated polyps in symptomatic populations. The aim of the study was to evaluate the features of colorectal serrated polyps in a Chinese symptomatic population. Methods: Data from all consecutive symptomatic patients were documented from a large colonoscopy database and were analyzed. Chi-square test or Fisher's exact test and logistic regression analysis were used for the data processing. Results: A total of 9191 (31.7%) patients were detected with at least one colorectal polyp. The prevalence of serrated polyps was 0.53% (153/28,981). The proportions of hyperplastic polyp (HP), sessile serrated adenoma/polyp (SSA/P), and traditional serrated adenoma (TSA) of all serrated polyps were 41.2%, 7.2%, and 51.6%, respectively, which showed a lower proportion of HP and SSA/P and a higher proportion of TSA. Serrated polyps appeared more in males and elder patients while there was no significant difference in the subtype distribution in gender and age. The proportions of large and proximal serrated polyps were 13.7% (21/153) and 46.4% (71/153), respectively. In total, 98.9% (89/90) serrated adenomas were found with dysplasia. Moreover, 14 patients with serrated polyps were found with synchronous advanced colorectal neoplasia, and large serrated polyps (LSPs) (odds ratio: 3.446, 95% confidence interval: 1.010–11.750, P < 0.05), especially large HPs, might have an association with synchronous advanced neoplasia (AN). Conclusions: The overall detection rate of colorectal serrated polyps in Chinese symptomatic patient population was low, and distribution pattern of three subtypes is different from previous reports. Moreover, LSPs, especially large HPs, might be associated with an increased risk of synchronous AN. PMID:27748334

  18. Human Papillomavirus (HPV) Prevalence in Nasal and Antrochoanal Polyps and Association with Clinical Data

    PubMed Central

    Knör, Mareike; Tziridis, Konstantin; Agaimy, Abbas; Zenk, Johannes; Wendler, Olaf

    2015-01-01

    Objectives The pathogenesis of sinonasal polyposis remains unclear, in spite of several investigative approaches. Antrochoanal polyps, a subgroup of sinonasal polyposis along with allergic- and chronic-inflammatory nasal polyps, mostly originate from the maxillary sinus and develop as a unilateral, pedunculated mass towards the nasopharynx. The human papillomavirus (HPV) is discussed as a possible causative and influencing factor in development and progression of sinonasal polyposis. This study aims to elucidate HPV frequency in nasal polyps and antrochoanal polyps. Materials and Methods Genomic DNA from 257 tissue specimens (166 nasal polyps, 39 antrochoanal polyps and 52 nasal turbinates) was subjected to three different established HPV- polymerase chain reaction assays, testing for 37 low- and high-risk HPV. In addition, immunohistochemical analyses for HPV16 were carried out, as well as immunohistochemistry and western blots of p16, a biomarker for HPV induced cancer. Results HPV-DNA was detected in 53.8% of antrochoanal polyps, 15.1% of nasal polyps, and 5.8% of nasal turbinates. HPV16 was the predominant type with a detection rate of 76% in nasal polyps and 62% in antrochoanal polyps. Immunohistochemically, HPV positive tissues stained positive for HPV16 antigens and p16 in epithelial cell layers. No significant p16 overexpression was traceable in antrochoanal polyps, nasal polyps and nasal turbinates by western blot. There was no correlation of HPV-status with sex, age, smoking, alcohol consumption or allergic background. Conclusion The present study shows a significant frequency of high-risk type HPV16 in antrochoanal polyps. Absence of oncogenic transformation or correlation of the HPV-status with clinical data suggests a latent superinfection, possibly because of anatomical proximity to the oropharynx. PMID:26509801

  19. [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. PMID:8731834

  20. [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.

  1. Endometrial polyp in an African wild dog (Lycaon pictus).

    PubMed

    Cho, H S; Park, N Y

    2006-11-01

    An 8-year-old female African wild dog (Lycaon pictus) from a zoo in Gyeonggi province, Republic of Korea presented with a 3.0 x 2.0 x 2.5 cm in size, smooth-surfaced, solitary pedunculated mass protruding into the uterine lumen. Microscopically, the mass was covered with epithelium, contained endometrial gland tissue, and was dilated in the vascularised stroma. Within the mass, there was extensive diffuse haemorrhage with several blood vessels apparently plugged with fibrin. At the base of the mass, the spaces lined with epithelium near the attachment of the stalk were interpreted to be glandular structures. There were segments of cuboidal epithelium found on the surface of the mass, which was similar to the lining the uterus. A diagnosis of an endometrial polyp was made based on the gross and histology findings. This is the first case report of a spontaneous endometrial polyp in an African wild dog.

  2. European position paper on rhinosinusitis and nasal polyps 2007.

    PubMed

    Fokkens, Wytske; Lund, Valerie; Mullol, Joaquim

    2007-01-01

    Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we can make progress with research in this area. Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Rhinosinusitis (including nasal polyps) is defined as inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip), +/- facial pain/pressure, +/- reduction or loss of smell; and either endoscopic signs of polyps and/or mucopurulent discharge primarily from middle meatus and/or; oedema/mucosal obstruction primarily in middle meatus, and/or CT changes showing mucosal changes within the ostiomeatal complex and/or sinuses. The paper gives different definitions for epidemiology, first line and second line treatment and for research. Furthermore the paper describes the anatomy and (patho)physiology, epidemiology and predisposing factors, inflammatory mechanisms, evidence based diagnosis, medical and surgical treatment in acute and chronic rhinosinusitis and nasal polyposis in adults and children. Evidence based schemes for diagnosis and treatment are given for the first and second line clinicians. Moreover attention is given to complications and socio-economic cost of chronic rhinosinusitis and nasal polyps. Last but not least the relation to the lower airways is discussed. PMID:17844873

  3. Oncocytoma presenting as a choanal polyp: a case report.

    PubMed

    Klausen, O G; Steinsvåg, S; Olofsson, J

    1992-06-01

    Oncocytomas account for less than 1% of all salivary gland neoplasms. Histochemical methods and electron microscopy showing the large amount of characteristic mitochondria have made the definition of the tumor more precise. A solid oncocytoma originating in the nose and presenting as a choanal polyp is described. Pre- and postoperative CT scans are shown as light and electron microscopy photomicrographs. The tumor had no invasive or other malignant characteristics and was therefore classified as a benign oncocytoma.

  4. 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

  5. Improving Polyp Detection Algorithms for CT Colonography: Pareto Front Approach.

    PubMed

    Huang, Adam; Li, Jiang; Summers, Ronald M; Petrick, Nicholas; Hara, Amy K

    2010-03-21

    We investigated a Pareto front approach to improving polyp detection algorithms for CT colonography (CTC). A dataset of 56 CTC colon surfaces with 87 proven positive detections of 53 polyps sized 4 to 60 mm was used to evaluate the performance of a one-step and a two-step curvature-based region growing algorithm. The algorithmic performance was statistically evaluated and compared based on the Pareto optimal solutions from 20 experiments by evolutionary algorithms. The false positive rate was lower (p<0.05) by the two-step algorithm than by the one-step for 63% of all possible operating points. While operating at a suitable sensitivity level such as 90.8% (79/87) or 88.5% (77/87), the false positive rate was reduced by 24.4% (95% confidence intervals 17.9-31.0%) or 45.8% (95% confidence intervals 40.1-51.0%) respectively. We demonstrated that, with a proper experimental design, the Pareto optimization process can effectively help in fine-tuning and redesigning polyp detection algorithms.

  6. Automatic polyp detection using global geometric constraints and local intensity variation patterns.

    PubMed

    Tajbakhsh, Nima; Gurudu, Suryakanth R; Liang, Jianming

    2014-01-01

    This paper presents a new method for detecting polyps in colonoscopy. Its novelty lies in integrating the global geometric constraints of polyps with the local patterns of intensity variation across polyp boundaries: the former drives the detector towards the objects with curvy boundaries, while the latter minimizes the misleading effects of polyp-like structures. This paper makes three original contributions: (1) a fast and discriminative patch descriptor for precisely characterizing patterns of intensity variation across boundaries, (2) a new 2-stage classification scheme for accurately excluding non-polyp edges from an overcomplete edge map, and (3) a novel voting scheme for robustly localizing polyps from the retained edges. Evaluations on a public database and our own videos demonstrate that our method is promising and outperforms the state-of-the-art methods. PMID:25485377

  7. Endocervical Polyp With Florid "Epidermal Metaplasia": Report of a Previously Undescribed Phenomenon.

    PubMed

    Angra, Seema; McCluggage, W Glenn

    2016-09-01

    Endocervical polyps are common benign lesions which rarely result in diagnostic problems, although a variety of alterations occasionally complicate histologic interpretation. We report an unusual, and not previously described, finding of florid "epidermal" metaplasia with keratinization and extensive formation of skin appendages structures (sebaceous and sweat glands and hair follicles) within an endocervical polyp. The features closely resembled an epidermal inclusion cyst. We speculate on the possible pathogenesis of this rare phenomenon and review unusual findings in endocervical polyps. PMID:27167675

  8. Computer-assisted polyp matching between optical colonoscopy and CT colonography: a phantom study

    NASA Astrophysics Data System (ADS)

    Roth, Holger R.; Hampshire, Thomas E.; Helbren, Emma; Hu, Mingxing; Vega, Roser; Halligan, Steve; Hawkes, David J.

    2014-03-01

    Potentially precancerous polyps detected with CT colonography (CTC) need to be removed subsequently, using an optical colonoscope (OC). Due to large colonic deformations induced by the colonoscope, even very experienced colonoscopists find it difficult to pinpoint the exact location of the colonoscope tip in relation to polyps reported on CTC. This can cause unduly prolonged OC examinations that are stressful for the patient, colonoscopist and supporting staff. We developed a method, based on monocular 3D reconstruction from OC images, that automatically matches polyps observed in OC with polyps reported on prior CTC. A matching cost is computed, using rigid point-based registration between surface point clouds extracted from both modalities. A 3D printed and painted phantom of a 25 cm long transverse colon segment was used to validate the method on two medium sized polyps. Results indicate that the matching cost is smaller at the correct corresponding polyp between OC and CTC: the value is 3.9 times higher at the incorrect polyp, comparing the correct match between polyps to the incorrect match. Furthermore, we evaluate the matching of the reconstructed polyp from OC with other colonic endoluminal surface structures such as haustral folds and show that there is a minimum at the correct polyp from CTC. Automated matching between polyps observed at OC and prior CTC would facilitate the biopsy or removal of true-positive pathology or exclusion of false-positive CTC findings, and would reduce colonoscopy false-negative (missed) polyps. Ultimately, such a method might reduce healthcare costs, patient inconvenience and discomfort.

  9. Measurement of colonic polyp size from virtual colonoscopy studies: Comparison of manual and automated methods

    NASA Astrophysics Data System (ADS)

    Gurcan, Metin N.; Ernst, Randy; Oto, Aytekin; Worrell, Steve; Hoffmeister, Jeff; Rogers, Steve

    2006-03-01

    Polyp size is an important feature descriptor for clinical classification and follow-up decision making in CT colonography. Currently, polyp size is measured from computed tomography (CT) studies manually as the single largest dimension of the polyp head, excluding the stalk if present, in either multi-planar reconstruction (MPR) or three-dimensional (3D) views. Manual measurements are subject to intra- and inter-reader variation, and can be time-consuming. Automated polyp segmentation and size measurement can reduce the variability and speed up the process. In this study, an automated polyp size measurement technique is developed. Using this technique, the polyp is segmented from the attached healthy tissue using a novel, model-based approach. The largest diameter of the segmented polyp is measured in axial, sagitttal and coronal MPR views. An expert radiologist identified 48 polyps from either supine or prone views of 52 cases of the Walter-Reed virtual colonoscopy database. Automated polyp size measurements were carried out and compared with the manual ones. For comparison, three different statistical methods were used: overall agreement using chance-corrected kappa indices; the mean absolute differences; and Bland-Altman limits of agreement. Manual and automated measurements show good agreement both in 2D and 3D views.

  10. Syndromic Gastric Polyps: At the Crossroads of Genetic and Environmental Cancer Predisposition.

    PubMed

    Brosens, Lodewijk A A; Giardiello, Francis M; Offerhaus, G Johan; Montgomery, Elizabeth A

    2016-01-01

    Gastric polyps occur in 1-4 % of patients undergoing gastroscopy. Although most are sporadic, some gastric polyps are part of an underlying hereditary syndrome. Gastric polyps can be seen in each of the well-known gastrointestinal polyposis syndromes, but also in Lynch syndrome and in several rare not primarily gastrointestinal syndromes. In addition, Gastric Adenocarcinoma and Proximal Polyposis of the Stomach (GAPPS) is a recently described heritable syndrome characterized by isolated gastric polyposis and risk of gastric cancer.Some of these syndromes are associated with an increased risk of gastric cancer, whereas others are not. However, the neoplastic potential and the precursor status of these gastric polyps are not always clear, even in syndromes with a well-established risk of gastric cancer. For instance, the neoplastic potential of Peutz-Jeghers polyps is debatable, despite the well-established risk of gastric cancer in this syndrome. Also fundic gland polyps and gastric foveolar-type adenomas in FAP carry a low risk of malignant transformation. In contrast, gastric juvenile polyps are precursor lesions of gastric cancer in juvenile polyposis syndrome through neoplastic progression of juvenile polyps in these patients.Although these hereditary syndromes with gastric polyps are rare, recognition is important for individual patient management. Furthermore, the initiation and progression of these lesions can be influenced by environmental factors such as Helicobacter Pylori infection. This makes these rare lesions an appropriate model for understanding the clonal evolution of early gastric cancer in the wider population. PMID:27573780

  11. Risk Factors of Advanced Adenoma in Small and Diminutive Colorectal Polyp

    PubMed Central

    2016-01-01

    The aims of this study were to review the clinicopathological characteristics of diminutive (≤ 5 mm) and small polyps (> 5 mm but < 10 mm) and to evaluate the risk factors of advanced adenoma for polyps of diameter < 10 mm in the colon. The medical records of 4,711 patients who underwent first colonoscopy at outpatient clinics or health promotion center were reviewed retrospectively. We analyzed the presence and risk factors of advanced adenoma, which was defined as a villous or tubulovillous polyp, high-grade dysplasia or intramucosal carcinoma histologically. Total 5,058 polyps were detected in the 4,711 patients, and 93.0% (4,704/5,058) polyps were < 10 mm in size. Among them, advanced adenoma was noted in 0.6% (28/4,704) with a villous component in 19, high-grade dysplasia in 3, and adenocarcinoma in 6. Advanced and non-advanced adenomas differed significantly in age group, gender, and polyp size. Multivariate analysis showed that an advanced age (> 65 years), a male gender, and a polyp size of > 5 mm were risk factors of advanced adenoma. The incidence of advanced adenoma in polyps of < 10 mm was 0.6%. Polyp size, male gender, and age of > 65 years are independent risk factors of advanced adenoma. PMID:27510386

  12. Endoscopic resection of a giant fibrovascular polyp of the oesophagus with the assistance of ultrasonic shears.

    PubMed

    Lobo, Niyati; Hall, Andrew; Weir, Justin; Mace, Alasdair

    2016-01-14

    Giant fibrovascular polyps of the oesophagus are rare benign tumours originating from the upper oesophagus. A 58-year-old woman presented with a 6-week history of a sore throat, odynophagia and progressive dysphagia, managing only a soft diet. CT of the neck and thorax, and barium swallow, both demonstrated a giant fibrovascular polyp measuring approximately 7 cm in length arising from the proximal oesophagus. The patient underwent endoscopic resection of the polyp with the assistance of ultrasonic shears. We present the case of a giant fibrovascular polyp and describe our novel technique for successful endoscopic resection using ultrasonic shears.

  13. Colon polyp morphology on double-contrast berium enema: its pathologic predictive value

    SciTech Connect

    Ott, D.J.; Gelfand, D.W.; Wu, W.C.; Ablin, D.S.

    1983-11-01

    The morphologic appearance of 96 polyps seen on double-contrast barium enema was reviewed to assess the predictive value of various signs described to diagnose malignancy. Size, surface contour, basal indentation, and pedunculation were studied. Sessile polyps had an appreciable incidence of malignancy, with size being the best indicator of that risk. Pedunculation was found to be a reliable sign of benignity in predicting the absence of malignant invasion into the adjacent colonic wall. Polyps under 1 cm and having a smooth contour were invariably benign. Conversely, polyps larger than 1 cm with a lobulated contour and basal indentation had a significant incidence of malignancy.

  14. Clear cell adenocarcinoma present exclusively within endometrial polyp: report of two cases.

    PubMed

    Ishida, Mitsuaki; Iwai, Muneo; Yoshida, Keiko; Kagotani, Akiko; Okabe, Hidetoshi

    2014-01-01

    Endometrial polyp is a common benign lesion that protrudes into the endometrial surface. The incidence of carcinoma within endometrial polyp is thought to be low, however, postmenopausal women with endometrial polyps are at an increased risk. Endometrial clear cell adenocarcinoma is a distinct and relatively rare subtype of endometrial carcinoma, and recent studies have proposed putative precursor lesions of clear cell adenocarcinoma, namely clear cell endometrial glandular dysplasia (EmGD) and clear cell endometrial intraepithelial carcinoma (EIC). Herein, we describe two cases of clear cell adenocarcinoma present exclusively within endometrial polyp and discuss the association of its precursor. Two postmenopausal Japanese females, 66-year-old (Case 1) and 54-year-old (Case 2) presented with abnormal genital bleeding. Cytological examination of both cases revealed adenocarcinoma, thus, hysterectomy was performed. Histopathological studies demonstrated clear cell adenocarcinoma within exclusively endometrial polyp in both cases. The peculiar finding in Case 1 was presence of atypical glandular cells with large round to oval nuclei and clear cytoplasm within the atrophic endometrial glands in the surrounding endometrial tissue, which corresponded to clear cell EIC. A recent study showed that 33% of uteri had at least one focus of clear cell EmGD in endometrial polyps. Accordingly, clear cell adenocarcinoma and clear cell EmGD can occur in association with endometrial polyps more frequently than previously thought. Therefore, detailed histopathological examination is important in diagnosis of endometrial polyps, especially in the postmenopausal women, moreover cytological examination is a useful tool in the postmenopausal women with endometrial polyps.

  15. Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study

    PubMed Central

    Elhanafi, Sherif; Saadi, Mohammed; Lou, Wynee; Mallawaarachchi, Indika; Dwivedi, Alok; Zuckerman, Marc; Othman, Mohamed O

    2015-01-01

    AIM: To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori (H. pylori) status in a predominantly Hispanic population. METHODS: We conducted a retrospective study of all esophagogastroduodenoscopies performed at our institution. Demographic, endoscopic and histopathological data were reviewed. Categorization of patients into Hispanic and Non-Hispanic was based on self-identification. Patients without resection/biopsy were not included in the analysis. Identification of polyps type was based on histological examination. One way analysis of variance was used to compare continuous variables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp types. Unadjusted and adjusted comparisons of demographic and clinical characteristics were performed according to the H. pylori status and polyp type using logistic regressions. RESULTS: Of 7090 patients who had upper endoscopy, 335 patients had gastric polyps (4.7%). Resection or biopsy of gastric polyps was performed in 296 patients (88.4%) with a total of 442 polyps removed or biopsied. Of 296 patients, 87 (29%) had hyperplastic polyps, 82 (28%) had fundic gland polyps and 5 (1.7%) had adenomatous polyps. Hyperplastic polyps were significantly associated with positive H. pylori status compared with fundic gland polyps (OR = 4.621; 95%CI: 1.92-11.13, P = 0.001). Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps (OR = 6.903; 95%CI: 1.41-33.93, P = 0.0174). Out of 296 patients, 30 (10.1%) had a follow-up endoscopy with a mean duration of 26 ± 16.3 mo. Interval development of cancer was not noted in any of the patients during follow up period. CONCLUSION: Gastric hyperplastic polyps were significantly associated with positive H. pylori status and portal hypertensive gastropathy as compared with fundic gland polyps. PMID:26265993

  16. 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.

  17. An Adaptive Paradigm for Computer-Aided Detection of Colonic Polyps

    PubMed Central

    Wang, Huafeng; Liang, Zhengrong; Li, Lihong C.; Han, Hao; Song, Bowen; Pickhardt, Perry J.; Barish, Matthew A.; Lascarides, Chris E.

    2015-01-01

    Most previous efforts in developing computer-aided detection (CADe) of colonic polyps apply similar measures or parameters to detect polyps regardless their locations under an implicit assumption that all the polyps reside in a similar local environment, e.g., on a relatively flat colon wall. In reality, this implicit assumption is frequently invalid, because the haustral folds can have a very different local environment from that of the relatively flat colon wall. We conjecture that this assumption may be a major cause of missing detection of polyps, especially small polyps (<10mm linear size) located on the haustral folds. In this paper, we take the concept of adaptive-ness and present an adaptive paradigm for CADe of colonic polyps. Firstly, we decompose the complicated colon structure into two simplified sub-structures, each of which has similar properties, of (1) relatively flat colon wall and (2) ridge-shaped haustral folds. Then we develop local environment descriptions to adaptively reflect each of these two simplified sub-structures. To show the impact of the adaptive-ness of the local environment descriptions upon the polyp detection task, we focus on the local geometrical measures of the volume data for both the detection of initial polyp candidates (IPCs) and the reduction of false positives (FPs) in the IPC pool. The experimental outcome using the local geometrical measures is very impressive such that not only the previously-missed small polyps on the folds are detected, but also the previously miss-removed small polyps on the folds during FP reduction are retained. It is expected that this adaptive paradigm will have a great impact on detecting the small polyps, measuring their volumes and volume changes over time, and optimizing their management plan. PMID:26348125

  18. High-resolution sonography for distinguishing neoplastic gallbladder polyps and staging gallbladder cancer.

    PubMed

    Kim, Jung Hoon; Lee, Jae Young; Baek, Jee Hyun; Eun, Hyo Won; Kim, Young Jae; Han, Joon Koo; Choi, Byung Ihn

    2015-02-01

    OBJECTIVE. The purposes of this study were to compare staging accuracy of high-resolution sonography (HRUS) with combined low- and high-MHz transducers with that of conventional sonography for gallbladder cancer and to investigate the differences in the imaging findings of neoplastic and nonneoplastic gallbladder polyps. MATERIALS AND METHODS. Our study included 37 surgically proven gallbladder cancer (T1a = 7, T1b = 2, T2 = 22, T3 = 6), including 15 malignant neoplastic polyps and 73 surgically proven polyps (neoplastic = 31, nonneoplastic = 42) that underwent HRUS and conventional transabdominal sonography. Two radiologists assessed T-category and predefined polyp findings on HRUS and conventional transabdominal sonography. Statistical analyses were performed using chi-square and McNemar tests. RESULTS. The diagnostic accuracy for the T category was T1a = 92-95%, T1b = 89-95%, T2 = 78-86%, and T3 = 84-89%, all with good agreement (κ = 0.642) using HRUS. The diagnostic accuracy for differentiating T1 from T2 or greater than T2 was 92% and 89% on HRUS and 65% and 70% with conventional transabdominal sonography. Statistically common findings for neoplastic polyps included size greater than 1 cm, single lobular surface, vascular core, hypoechoic polyp, and hypoechoic foci (p < 0.05). The value of HRUS in the differential diagnosis of a gallbladder polyp was more clearly depicted internal echo foci than conventional transabdominal sonography (39 vs 21). A polyp size greater than 1 cm was independently associated with a neoplastic polyp (odds ratio = 7.5, p = 0.02). The AUC of a polyp size greater than 1 cm was 0.877. The sensitivity and specificity were 66.67% and 89.13%, respectively. CONCLUSION. HRUS is a simple method that enables accurate T categorization of gallbladder carcinoma. It provides high-resolution images of gallbladder polyps and may have a role in stratifying the risk for malignancy.

  19. Local fractal dimension based approaches for colonic polyp classification.

    PubMed

    Häfner, Michael; Tamaki, Toru; Tanaka, Shinji; Uhl, Andreas; Wimmer, Georg; Yoshida, Shigeto

    2015-12-01

    This work introduces texture analysis methods that are based on computing the local fractal dimension (LFD; or also called the local density function) and applies them for colonic polyp classification. The methods are tested on 8 HD-endoscopic image databases, where each database is acquired using different imaging modalities (Pentax's i-Scan technology combined with or without staining the mucosa) and on a zoom-endoscopic image database using narrow band imaging. In this paper, we present three novel extensions to a LFD based approach. These extensions additionally extract shape and/or gradient information of the image to enhance the discriminativity of the original approach. To compare the results of the LFD based approaches with the results of other approaches, five state of the art approaches for colonic polyp classification are applied to the employed databases. Experiments show that LFD based approaches are well suited for colonic polyp classification, especially the three proposed extensions. The three proposed extensions are the best performing methods or at least among the best performing methods for each of the employed databases. The methods are additionally tested by means of a public texture image database, the UIUCtex database. With this database, the viewpoint invariance of the methods is assessed, an important features for the employed endoscopic image databases. Results imply that most of the LFD based methods are more viewpoint invariant than the other methods. However, the shape, size and orientation adapted LFD approaches (which are especially designed to enhance the viewpoint invariance) are in general not more viewpoint invariant than the other LFD based approaches.

  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. 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

  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. 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.

  4. 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

    2016-04-01

    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 aff ect 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 eff ects on the amounts of released medusae.

  5. 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. PMID:25863519

  6. Pictorial review of colonic polyp and mass distortion and recognition with the CT virtual dissection technique.

    PubMed

    Christensen, Kevin N; Fidler, Jeff L; Fletcher, Joel G; Maccarty, Robert; Johnson, C Daniel

    2010-09-01

    Virtual dissection is a three-dimensional (3D) display technique for CT colonography that could potentially reduce interpretation times. With virtual dissection, the 3D model of the colon is "sliced" open along a centerline trace, rendering a 360° view of the endoluminal mucosa as a rectangular image. However, one must be familiar with several pitfalls and limitations to avoid errors in interpretation. One of the main limitations is the anatomic distortion that results. Polyp shape and colonic folds can be distorted and colonic or polyp mobility can lead to mischaracterization of polyps. Distorted folds, which frequently occur at flexures, can mimic polyps. Annular constricting masses can lead to skip areas, where the abnormality is not displayed. Various entities including diverticula and stool can mimic polyps at virtual dissection. Finally, technical errors such as an inadequate centerline trace can render a polyp occult. The purpose of this review is to demonstrate the spectrum of appearances of polyps at virtual dissection, with an emphasis on more difficult to detect polyps. In addition, 10 interactive virtual dissection quiz cases are presented along with corresponding two-dimensional and 3D endoluminal fly-through views.

  7. 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.

  8. 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…

  9. Intermittent gastric outlet obstruction caused by a prolapsing antral gastric polyp

    PubMed Central

    Parikh, Mehul; Kelley, Brian; Rendon, Gabriel; Abraham, Bincy

    2010-01-01

    Most gastric polyps have an asymptomatic presentation and are an incidental finding on upper endoscopy. Symptomatic presentations can range from an ulcerated polyp leading to anemia and occult bleed to complete gastric outlet obstruction. We report a case of an 89-year-old woman who presented with postprandial nausea and early satiety. Her upper endoscopy revealed a 2 cm pedunculated hyperplastic polyp arising from the antrum of the stomach which was seen prolapsing into the pylorus causing intermittent gastric outlet obstruction. In the present report, we statistically analyzed 39 prolapsing gastric polyps previously reported in the English literature and demonstrate the current utility of monopolar snare polypectomy in establishing a histological diagnosis while offering simultaneous treatment. Additionally, we review the literature for the management of all hyperplastic gastric polyps in relation to advancements in digestive endoscopy. PMID:21160624

  10. Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management.

    PubMed

    Rosty, Christophe; Hewett, David G; Brown, Ian S; Leggett, Barbara A; Whitehall, Vicki L J

    2013-03-01

    Approximately 30% of colorectal carcinomas develop via the serrated neoplasia pathway characterized by widespread DNA methylation and frequent BRAF mutation. Serrated polyps represent a heterogeneous group of polyps which are the precursor lesions to serrated pathway colorectal carcinomas. The histological classification of serrated polyps has evolved over the last two decades to distinguish three separate entities: hyperplastic polyp, sessile serrated adenoma (SSA), and traditional serrated adenoma (TSA). The malignant potential of SSAs and TSAs has been clearly demonstrated. SSAs are more challenging to detect by colonoscopy and are likely to account for some interval carcinomas of the proximal colon. Serrated polyposis syndrome is now widely recognized as conferring a high risk of colorectal carcinoma although its cause remains elusive. The current understanding of the actual malignant potential of each serrated polyp subtype is still limited due to the lack of large-scale prospective studies. Patient management guidelines have been recently updated although high-level evidence to support them is still required.

  11. Difficult polypectomy-giant hypopharyngeal polyp: case report and literature review.

    PubMed

    Pallabazzer, Giovanni; Santi, Stefano; Biagio, Solito; D'Imporzano, Simone

    2013-09-21

    Giant esophageal and hypopharyngeal polyps are benign tumors rarely encountered in clinical practice. In most cases, they are completely asymptomatic; however, despite the rarity of these tumors, interest in giant esophageal polyps derives from their degree of growth (characterized by slow growth into the esophageal lumen) and their mobility. In fact, if regurgitation occurs, they can ascend into the oral cavity and be aspirated into the airways, with potentially lethal consequences. The removal of these giant polyps is recommended. An adequate preoperative evaluation to identify the correct origin of the stalk is mandatory for a successful endoscopic or surgical treatment. A 60-year-old man was admitted to our hospital for anemia. The patient underwent gastroscopy, contrast computed tomography and endoscopic ultrasound. At the conclusion of the procedure, during the extraction of the echoendoscope, the patient began retching and regurgitated the polyp, without experiencing respiratory distress. The patient underwent a left cervicotomy and polyp dissection via a pharyngotomy.

  12. 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.

  13. Knowledge of the anatomical polyp location might bias the pathological classification of histologically equivocal colorectal serrated polyps - a consensus study performed by pathology trainees.

    PubMed

    Gunia, Sven; Berg, Tobias; Gradhand, Elise; Becker, Susann

    2011-02-15

    Colorectal serrated polyps (CSPs) comprise hyperplastic polyps (HPs), traditional (TSAs) and sessile (SSAs) serrated adenomas, as well as inflammatory cloacogenic polyps (ICPs). These lesions have typical anatomical locations and share a histomorphological overlap. In this study, we assessed the so far neglected issue as to what extent the histological classification of these lesions performed by pathology trainees is biased by the pathologists' knowledge of the polyp location in dependency on the duration of their training. To reach this aim, 49 CSPs were classified by three pathology trainees blinded to clinical data. In a second round of examination, the same raters were provided with the polyp location. A third round was conducted after a consensus conference. Intra- and inter-rater analyses were performed using Kappa (K) statistics and Spearman correlations. Our data suggest that the histological classification of CSPs performed by pathology trainees might be influenced in a clinically significant fashion by knowledge of the anatomical polyp location depending on the duration of their pathology training.

  14. Embryonal rhabdomyosarcoma of the cervix presenting as a cervical polyp in a 16-year-old adolescent: a case report

    PubMed Central

    2014-01-01

    Introduction Embryonal rhabdomyosarcoma of the female genital tract is rare in the cervix. It has been mainly discussed in the context of individual case studies. It tends to occur in children and young women. Treatment ranges from radical surgery to conservative surgery, followed by chemotherapy. Case presentation A 16-year-old Moroccan adolescent girl presented to our center with a protruding mass from her vaginal introitus, as a polyp of 6cm. An examination revealed a polyp within her vagina, thought to be arising from her cervix and a polypectomy was performed. Microscopic findings are consistent with an embryonal rhabdomyosarcoma (botryoide type). A computed tomography of her thorax, abdomen and pelvis were performed and residual disease was found as a mass located at her cervix, which measured approximately 4.5cm in its widest dimensions, without evidence of metastatic disease. Due to the fact that she is young, after discussions in a multidisciplinary meeting, she was subsequently treated with four cycles of multi-agent chemotherapy. Two cycles of chemotherapy and radiotherapy were administered due to the lack of response, but she presented vaginal bleeding with persistence of the same mass in computed tomography. Hence a total interadnexal hysterectomy was made. A histologic examination found residual embryonal rhabdomyosarcoma (botryoide type) located in all her cervix and she is currently under chemotherapy. Conclusions The presence of a cervical polyp in an adolescent is a gynecologic oddity and must necessarily be examined histologically because it might be a rhabdomyosarcoma. This is extremely important because diagnosis at an early stage of the disease is a highly favorable prognostic factor that allows “fertility-sparing surgery” for these young patients. PMID:24986146

  15. Cancer emerging from the recurrence of sessile serrated adenoma/polyp resected endoscopically 5 years ago.

    PubMed

    Chino, A; Nagayama, S; Ishikawa, H; Morishige, K; Kishihara, T; Arai, M; Sugiura, Y; Motoi, N; Yamamoto, N; Tamegai, Y; Igarashi, M

    2016-01-01

    Since the serrated neoplastic pathway has been regarded as an important pathway of colorectal carcinogenesis, few reports have been published on clinical cases of cancer derived from sessile serrated adenoma/polyp, especially on recurrence after resected sessile serrated adenoma/polyp. An elderly woman underwent endoscopic mucosal resection of a flat elevated lesion, 30 mm in diameter, in the ascending colon; the histopathological diagnosis at that time was a hyperplastic polyp, now known as sessile serrated adenoma/polyp. Five years later, cancer due to the malignant transformation of the sessile serrated adenoma/polyp was detected at the same site. The endoscopic diagnosis was a deep invasive carcinoma with a remnant sessile serrated adenoma/polyp component. The carcinoma was surgically removed, and the pathological diagnosis was an adenocarcinoma with sessile serrated adenoma/polyp, which invaded the muscularis propria. The surgically removed lesion did not have a B-RAF mutation in either the sessile serrated adenoma/polyp or the carcinoma; moreover, the initial endoscopically resected lesion also did not have a B-RAF mutation. Immunohistochemistry confirmed negative MLH1 protein expression in only the cancer cells. Lynch syndrome was not detected on genomic examination. The lesion was considered to be a cancer derived from sessile serrated adenoma/polyp recurrence after endoscopic resection, because both the surgically and endoscopically resected lesions were detected at the same location and had similar pathological characteristics, with a serrated structure and low-grade atypia. Furthermore, both lesions had a rare diagnosis of a sessile serrated adenoma/polyp without B-RAF mutation. This report highlights the need for the follow-up colonoscopy after endoscopic resection and rethinking our resection procedures to improve treatment. PMID:26538462

  16. 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

  17. 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

  18. [Intranasal meningocele presenting as a nasal polyp--case report].

    PubMed

    Kosztyła-Hojna, Bozena; Popko, Mariola

    2008-01-01

    Intranasal meningocele occurs rarely. It is difficult to diagnose because its appearance resembles common polyps. If it coexists with other inborn cranio-facial malformation they are easier to diagnose. In the case investigated by us, the 32 year-old woman's ailments suggested intranasal polyps and we discovered the meningocele localized intranasal on the right. The CT scan of the nasal sinuses is the most reliable examination for the developing diagnosis. The CT findings revealed the meningocele protruding from the anterior cranial fosse through the lamina cribrosa to the right nasal cavity. During the operation the meningocele was removed and the durra mater was sutured. The bony-mucosal lesion was covered with composite graft taken from bony part of nasal septum and mucosal part of the inferior turbinate. The graft has been incorporated into the surrounding tissue. Neither a cerebrospinal fluid leak nor any other complications have been reported within the past 6 years. Therefore, we consider this a successful procedure. PMID:18634248

  19. Nasopharyngeal polyp causing sensory disturbances: a case report.

    PubMed

    Sabeh, Abrar Majed; Ahmed, Iffat Mirza

    2016-04-01

    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

  20. Phenotype and polyp landscape in serrated polyposis syndrome: a series of 100 patients from genetics clinics.

    PubMed

    Rosty, Christophe; Buchanan, Daniel D; Walsh, Michael D; Pearson, Sally-Ann; Pavluk, Erika; Walters, Rhiannon J; Clendenning, Mark; Spring, Kevin J; Jenkins, Mark A; Win, Aung K; Hopper, John L; Sweet, Kevin; Frankel, Wendy L; Aronson, Melyssa; Gallinger, Steve; Goldblatt, Jack; Woodall, Sonja; Arnold, Julie; Walker, Neal I; Jass, Jeremy R; Parry, Susan; Young, Joanne P

    2012-06-01

    Serrated polyposis syndrome (SPS), also known as hyperplastic polyposis, is a syndrome of unknown genetic basis defined by the occurrence of multiple serrated polyps in the large intestine and associated with an increased risk of colorectal cancer (CRC). There are a variety of SPS presentations, which may encompass a continuum of phenotypes modified by environmental and genetic factors. To explore the phenotype of SPS, we recorded the histologic and molecular characteristics of multiple colorectal polyps in patients with SPS recruited between 2000 and 2010 from genetics clinics in Australia, New Zealand, Canada, and the United States. Three specialist gastrointestinal pathologists reviewed the polyps, which they classified into conventional adenomas or serrated polyps, with various subtypes, according to the current World Health Organization criteria. Mutations in BRAF and KRAS and mismatch repair protein expression were determined in a subset of polyps. A total of 100 patients were selected for the study, of whom 58 were female and 42 were male. The total polyp count per patient ranged from 6 to 150 (median 30). The vast majority of patients (89%) had polyposis affecting the entire large intestine. From this cohort, 406 polyps were reviewed. Most of the polyps (83%) were serrated polyps: microvesicular hyperplastic polyps (HP) (n=156), goblet cell HP (n=25), sessile serrated adenoma/polyps (SSA/P) (n=110), SSA/P with cytologic dysplasia (n=28), and traditional serrated adenomas (n=18). A further 69 polyps were conventional adenomas. BRAF mutation was mainly detected in SSA/P with dysplasia (95%), SSA/P (85%), microvesicular HP (76%), and traditional serrated adenoma (54%), whereas KRAS mutation was present mainly in goblet cell HP (50%) and in tubulovillous adenoma (45%). Four of 6 SSA/Ps with high-grade dysplasia showed loss of MLH1/PMS2 expression. CRC was diagnosed in 39 patients who were more often found to have a conventional adenoma compared with patients

  1. Sporadic and syndromic hyperplastic polyps and serrated adenomas of the colon: classification, molecular genetics, natural history, and clinical management.

    PubMed

    East, James E; Saunders, Brian P; Jass, Jeremy R

    2008-03-01

    There is now strong evidence for an alternative pathway of colorectal carcinogenesis implicating hyperplastic polyps and serrated adenomas. This article briefly reviews the evidence for this serrated pathway, provides diagnostic criteria for clinically significant hyperplastic polyps and allied serrated polyps, and suggests how this information may be translated into safe, effective guidelines for colonoscopy-based colon cancer prevention. Consideration also is given to the definition and management of hyperplastic polyposis syndrome. The currently proposed management plan for serrated polyps is tentative because of incomplete knowledge of the nature and behavior of these polyps. This article highlights key areas warranting further research.

  2. 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

  3. 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

  4. Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy

    PubMed Central

    Lenci, Marco Antonio; do Nascimento, Vanessa Alessandra Lui; Grandini, Ana Beatriz; Fahmy, Walid Makin; Depes, Daniella de Batista; Baracat, Fausto Farah; Lopes, Reginaldo Guedes Coelho

    2014-01-01

    ABSTRACT Objective: To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy. Methods: The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm. Results: Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal. Conclusion: Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer. PMID:24728240

  5. [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.

  6. Pathogenesis and management of serrated polyps: current status and future directions.

    PubMed

    Anderson, Joseph C

    2014-11-01

    Hyperplastic or serrated polyps were once believed to have little to no clinical significance. A subset of these polyps are now considered to be precursors to colorectal cancers (CRC) in the serrated pathway that may account for at least 15% of all tumors. The serrated pathway is distinct from the two other CRC pathways and involves an epigenetic hypermethylation mechanism of CpG islands within promoter regions of tumor suppressor genes. This process results in the formation of CpG island methylator phenotype tumors. Serrated polyps are divided into hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs). The SSA/P and the TSA have the potential for dysplasia and subsequent malignant transformation. The SSA/Ps are more common and are more likely to be flat than TSAs. Their flat morphology may make them difficult to detect and thus explain the variation in detection rates among endoscopists. Challenges for endoscopists also include the difficulty in pathological interpretation as well surveillance of these lesions. Furthermore, serrated polyps may be inadequately resected by endoscopists. Thus, it is not surprising that the serrated pathway has been linked with interval cancers. This review will provide the physician or clinician with the knowledge to manage patients with serrated polyps.

  7. [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.

  8. Malignant and premalignant changes in the endometrium of women with an ultrasound diagnosis of endometrial polyp.

    PubMed

    Gambadauro, P; Martínez-Maestre, M Á; Schneider, J; Torrejón, R

    2014-10-01

    The association between polyps and endometrial cancer is under debate. The main objectives of this study were to study the frequency and the characteristics of malignant and premalignant endometrial changes in women with endometrial polyp at ultrasound. The study population consisted of 1,390 consecutive patients that were referred to office hysteroscopy because of the ultrasonographic diagnosis of endometrial polyps. A total of 16 cases of endometrial neoplasia were diagnosed (1.15%). The frequencies of atypia and cancer in our population were 0.14% and 1.01%, respectively. All patients, except one, were postmenopausal (93.8%). All had undergone the initial ultrasonographic assessment because of symptoms (bleeding in the 93.8%). The neoplasia was not confined to the polyp in 75% of the cases. Nine cases had a lower risk disease (56.25%; atypical hyperplasia or endometrial cancer stage IA-G1,2), while seven had a higher risk cancer (43.75%; ≥ stage IA-G3). Patients with a higher risk disease were found to be significantly younger, and their polyps were smaller, albeit non-significantly. In spite of the common practice to refer all women with an ultrasound diagnosis of polyp to hysteroscopy, our data show how the prevalence of endometrial neoplasia in these patients is low (1.15%). Moreover, the malignancy is not confined to a polyp in most of the cases.

  9. 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.

  10. 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.

  11. [Capacities of transabdominal ultrasound study in the diagnosis of polyps of the stomach and colon].

    PubMed

    Gorshkov, A N; Gracheva, N I

    2002-01-01

    The data obtained from studies of 84 patients with polyps of the stomach and colonic were used to consider the capacities of transabdominal and transrectal ultrasound studies and their diagnostic efficiency in the diagnosis of polyps of the stomach and colon. The ultrasound semiotics of polyps of the gastric and colon was described. A place of transabdominal ultrasound sonography (US) in the algorithm of radiation and endoscopic studies was established. This investigation led to the conclusion that transabdominal US, along with indirect diagnosis, permits solution of number of fundamental problems facing prior to polypectomy--these are primarily to define the nature of a detected polyp (epithelial and non-epithelial), based on an analysis of the laminar structure of the wall of an organ at the polyp base, a possible polyp malignancy and the degree of invasion into the depths of the gastric wall, as well as to detect a feeding vessel (in the CDC mode) and to predict the likelihood of possible complications. It is advisable to use transabdominal US in a complex of diagnostic techniques for polyps of the stomach and colon.

  12. Nomenclature, molecular genetics and clinical significance of the precursor lesions in the serrated polyp pathway of colorectal carcinoma.

    PubMed

    Liang, John J; Alrawi, Sadir; Tan, Dongfeng

    2008-01-01

    Serrated adenomas (SAs) are part of the distinct serrated polyp pathway of colorectal carcinogenesis characterized by microsatellite instability and deficiency in DNA mismatch repair. Sessile SA is a recently recognized lesion that typically presents as a large sessile polyp, but lacks the conventional dysplasia. It is more frequently found on the right side than on the left side of the colon, and is thought to represent an intermediate form in the hyperplastic polyp to sessile SA, traditional SA, and colon cancer sequence. Many terms have been used and are still in use in the literature to describe this lesion, such as "hyperplastic polyposis", "giant hyperplastic polyposis," "large hyperplastic polyps," "hyperplastic-adenomatous polyposis syndrome," "giant hyperplastic polyp," and "mixed epithelial polyp." The purpose of this paper is to review and clarify the confusing nomenclature, and to provide a framework for understanding the genetic alterations and clinical significance of these precursor lesions in the serrated polyp pathway of colorectal caner.

  13. 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.

  14. 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

  15. Giant rectal polyp prolapse in an adult patient with the Peutz-Jeghers syndrome.

    PubMed

    Cano-Contreras, Ana Delfina; Meixueiro-Daza, Arturo; Grube-Pagola, Peter; Remes-Troche, Jose Maria

    2016-01-01

    Peutz-Jeghers Syndrome (PJS) is an autosomal dominant intestinal polyposis syndrome characterised by the presence of hamartomatous polyps and mucocutaneous pigmentation. Prolapse of the polyps through the anus is an infrequent manifestation in children with PJS, and this complication is extremely rare in adult patients. We report the case of a 30-year-old man recently diagnosed with PJS who was seen at the emergency department because of the abrupt onset of severe anal pain with a foreign body sensation in the anal canal and rectal bleeding.Physical examination revealed a giant prolapsed polyp. PMID:27444139

  16. Acute kidney transplant failure following transurethral bladder polyp fulguration.

    PubMed Central

    Collins, Bradley H.; Marroquin, Carlos E.; Tuttle-Newhall, Janet E.; Kuo, Paul C.; Preminger, Glenn M.; Butterly, David W.

    2005-01-01

    Ureteral obstruction and anastomotic leak represent the most common urologic complications of kidney transplantation. Delay in diagnosis or treatment can lead to allograft loss. Obstruction of the ureter occurs in 2% of kidney transplant recipients. Although the majority of cases are immediate technical complications of the operation, subsequent manipulation of the genitourinary system can result in iatrogenic ureteral injury. We report the case of a long-term kidney transplant recipient who developed obstructive uropathy and acute renal failure requiring dialysis after undergoing cystoscopy and bladder polyp fulguration. The etiology was inadvertent thermal injury of the ureteroneocystostomy incurred during the procedure. After attempted percutaneous management, definitive open repair resulted in a return of allograft function to baseline. Images Figure 1 Figure 2 PMID:15779509

  17. Gene Signature in Sessile Serrated Polyps Identifies Colon Cancer Subtype.

    PubMed

    Kanth, Priyanka; Bronner, Mary P; Boucher, Kenneth M; Burt, Randall W; Neklason, Deborah W; Hagedorn, Curt H; Delker, Don A

    2016-06-01

    Sessile serrated colon adenoma/polyps (SSA/P) are found during routine screening colonoscopy and may account for 20% to 30% of colon cancers. However, differentiating SSA/Ps from hyperplastic polyps (HP) with little risk of cancer is challenging and complementary molecular markers are needed. In addition, the molecular mechanisms of colon cancer development from SSA/Ps are poorly understood. RNA sequencing (RNA-Seq) was performed on 21 SSA/Ps, 10 HPs, 10 adenomas, 21 uninvolved colon, and 20 control colon specimens. Differential expression and leave-one-out cross-validation methods were used to define a unique gene signature of SSA/Ps. Our SSA/P gene signature was evaluated in colon cancer RNA-Seq data from The Cancer Genome Atlas (TCGA) to identify a subtype of colon cancers that may develop from SSA/Ps. A total of 1,422 differentially expressed genes were found in SSA/Ps relative to controls. Serrated polyposis syndrome (n = 12) and sporadic SSA/Ps (n = 9) exhibited almost complete (96%) gene overlap. A 51-gene panel in SSA/P showed similar expression in a subset of TCGA colon cancers with high microsatellite instability. A smaller 7-gene panel showed high sensitivity and specificity in identifying BRAF-mutant, CpG island methylator phenotype high, and MLH1-silenced colon cancers. We describe a unique gene signature in SSA/Ps that identifies a subset of colon cancers likely to develop through the serrated pathway. These gene panels may be utilized for improved differentiation of SSA/Ps from HPs and provide insights into novel molecular pathways altered in colon cancer arising from the serrated pathway. Cancer Prev Res; 9(6); 456-65. ©2016 AACR.

  18. Male and female stem cells and sex reversal in Hydra polyps.

    PubMed

    Bosch, T C; David, C N

    1986-12-01

    Single interstitial stem cells of male polyps of Hydra magnipapillata give rise to clones that differentiate either male or female gametes. To test the sexual stability of these clones, stem cells were recloned. The results indicate that stem cells from female clones are stable in their sexual differentiation capacity; male stem cells, by comparison, switch sexual phenotype at the rate of 10(-2) per cell per generation. As a result, female polyps contain only female stem cells; male polyps contain a mixture of male and female stem cells. A model is presented in which the sexual phenotype of Hydra polyps is controlled by (i) the switching rate of male and female stem cells and (ii) the repression of female differentiation by male stem cells.

  19. Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept.

    PubMed

    Snover, Dale C; Jass, Jeremy R; Fenoglio-Preiser, Cecilia; Batts, Kenneth P

    2005-09-01

    Serrated polyps of the large intestine, including traditional hyperplastic polyps, traditional serrated adenomas, and more recently described sessile serrated adenomas, have gained increased recognition in recent years because of growing evidence that one of these lesions, the sessile serrated adenoma, might be the precursor lesion for some cases of microsatellite unstable colorectal carcinoma. Nevertheless, there has been some reluctance to embrace the concept of sessile serrated adenoma, and numerous diagnostic challenges exist. This article, which grew out of the Roger C. Haggitt Gastrointestinal Pathology Society Forum presented in Vancouver, Canada, March 6, 2004 as part of the annual meeting of the United States-Canadian Academy of Pathology, reviews the morphologic and molecular evidence for the concept of various polyps in the general category of serrated polyps of the large intestine, in particular the lesion known as the sessile serrated adenoma, and provides a conceptual framework for diagnosis of these lesions.

  20. Newly Developed Endoscopic Treatment for Small Bowel Polyps: Cold Snare Polypectomy.

    PubMed

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

    2016-01-01

    A 72-year-old man with the history of small bowel carcinoma was diagnosed to have a sessile polyp in the jejunum during a follow-up examination. We performed double-balloon endoscopy and removed the polyp by means of cold snare polypectomy. The follow-up endoscopy showed no residual lesion. Cold snare polypectomy has been established as a safe and effective method for the endoscopic treatment of colonic polyps with a low risk of causing electrocautery burns and perforation. However, this technique has not yet been applied for small bowel lesions. This case report, for the first time, shows the feasibility of performing cold snare polypectomy for small bowel polyps. PMID:27629953

  1. Differences in Epidemiologic Risk Factors for Colorectal Adenomas and Serrated Polyps by Lesion Severity and Anatomical Site

    PubMed Central

    Burnett-Hartman, Andrea N.; Passarelli, Michael N.; Adams, Scott V.; Upton, Melissa P.; Zhu, Lee-Ching; Potter, John D.; Newcomb, Polly A.

    2013-01-01

    Using a case-control design, we evaluated differences in risk factors for colorectal polyps according to histological type, anatomical site, and severity. Participants were enrollees in the Group Health Cooperative aged 20–79 years who underwent colonoscopy in Seattle, Washington, between 1998 and 2007 and comprised 628 adenoma cases, 594 serrated polyp cases, 247 cases with both types of polyps, and 1,037 polyp-free controls. Participants completed a structured interview, and polyps were evaluated via standardized pathology review. We used multivariable polytomous logistic regression to compare case groups with controls and with the other case groups. Factors for which the strength of the association varied significantly between adenomas and serrated polyps were sex (P < 0.001), use of estrogen-only postmenopausal hormone therapy (P = 0.01), and smoking status (P < 0.001). For lesion severity, prior endoscopy (P < 0.001) and age (P = 0.05) had significantly stronger associations with advanced adenomas than with nonadvanced adenomas; and higher education was positively correlated with sessile serrated polyps but not with other serrated polyps (P = 0.02). Statistically significant, site-specific associations were observed for current cigarette smoking (P = 0.05 among adenomas and P < 0.001 among serrated polyps), postmenopausal estrogen-only therapy (P = 0.01 among adenomas), and obesity (P = 0.01 among serrated polyps). These findings further illustrate the epidemiologic heterogeneity of colorectal neoplasia and may help elucidate carcinogenic mechanisms for distinct pathways. PMID:23459948

  2. 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

  3. Xanthomatous hyperplastic polyps of the stomach: clinicopathologic study of 5 patients with polypoid gastric lesions showing combined features of gastric xanthelasma and hyperplastic polyp.

    PubMed

    Bassullu, Nuray; Turkmen, Ilknur; Uraz, Suleyman; Yagiz Korkmaz, Pinar; Memisoglu, Resat; Gultekin, Orhan Sami; Bulbul Dogusoy, Gulen

    2013-02-01

    Gastric xanthelasmas are uncommon benign lesions that are macroscopically well-demarcated yellow or yellow-white plaques and are microscopically formed by collections of foamy macrophages. Because gastric hyperplastic polyps may rarely be associated with xanthelasma, we aimed to report 5 cases of combined lesions showing features of gastric xanthelasma and hyperplastic polyps observed over the past 3 years at our institution among 4497 patients who underwent gastric endoscopy. The patients were 3 men and 2 women aged 45 to 78 years. The lesions were located in oxyntic mucosa, except one in the antrum, and measured 2 to 6 mm. Three patients showed associated chronic gastritis; none showed evidence of Helicobacter pylori infection. Combined lesions of hyperplastic polyp with xanthelasma appear to have an association with chronic gastritis, and the lipid accumulation may be the cause of hyperplasia in the overlying mucosa.

  4. Jellyfish life histories: role of polyps in forming and maintaining scyphomedusa populations.

    PubMed

    Lucas, Cathy H; Graham, William M; Widmer, Chad

    2012-01-01

    Large population fluctuations of jellyfish occur over a variety of temporal scales, from weekly to seasonal, inter-annual and even decadal, with some regions of the world reported to be experiencing persistent seasonal bloom events. Recent jellyfish research has focussed on understanding the causes and consequences of these population changes, with the vast majority of studies considering the effect of changing environmental variables only on the pelagic medusa. But many of the bloom-forming species are members of the Scyphozoa with complex metagenic life cycles consisting of a sexually reproducing pelagic medusa and asexually reproducing benthic polyp. Recruitment success during the juvenile (planula, polyp and ephyrae) stages of the life cycle can have a major effect on the abundance of the adult (medusa) population, but until very recently, little was known about the ecology of the polyp or scyphistoma phase of the scyphozoan life cycle. The aim of this review is to synthesise the current state of knowledge of polyp ecology by examining (1) the recruitment and metamorphosis of planulae larvae into polyps, (2) survival and longevity of polyps, (3) expansion of polyp populations via asexual propagation and (4) strobilation and recruitment of ephyrae (juvenile medusae). Where possible, comparisons are made with the life histories of other bentho-pelagic marine invertebrates so that further inferences can be made. Differences between tropical and temperate species are highlighted and related to climate change, and populations of the same species (in particular Aurelia aurita) inhabiting different habitats within its geographic range are compared. The roles that polyps play in ensuring the long-term survival of jellyfish populations as well as in the formation of bloom populations are considered, and recommendations for future research are presented.

  5. [Endoscopic treatment of polyps of the large intestine: authors' experience with 250 cases of polypectomy].

    PubMed

    Pietropaolo, V; Bogliolo, G; Brini, C; Ierfone, N; Gerardi, A; Pontone, P

    1999-01-01

    The Authors report their experience of endoscopic polipectomy. This technique represents a gold standard treatment for polyps of the colon-rectum because it is safe and effective, being correlated with low-risk of complications as perforation and hemorrhage. Hospitality stay was only 24-48 hours. The polyps were histologically examined and grade of dysplasia was determined. The patients underwent surgical resection of the colon when an invasive carcinoma was found. PMID:10444925

  6. Prevalence of colonic polyp and its predictors in patients with acromegaly

    PubMed Central

    Agarwal, Purnima; Rai, Praveer; Jain, Manoj; Mishra, Shambhavi; Singh, Uttam; Gupta, Sushil Kumar

    2016-01-01

    Background: There are conflicting data regarding the prevalence of colorectal polyp in patients with acromegaly. Subjects and Methods: Consecutive forty-seven acromegalic patients (21 men, 26 women), with a mean age of (40 ± 12 years) attending endocrinology outpatient department underwent full colonoscopy. All the patients underwent clinical and biochemical evaluation (glucose suppressed growth hormone (GH), Insulin-like growth factor-1 [IGF-1], fasting insulin, and glucose). The control group (n = 120) for colonoscopy was adult subjects undergoing evaluation for symptoms of irritable bowel syndrome. Clinical and biochemical parameters in acromegalic patients with colonic polyp were compared to those without a polyp. Results: Patients with acromegaly had significantly higher prevalence of colonic polyp as compared to control subjects (10.6% vs. 0.8%). None of the patients with polyp had skin tags. There was no significant difference between subjects with and without colonic polyp in duration of illness, basal, and glucose-suppressed GH and most recent IGF-1. Fasting blood sugar was significantly higher (P < 0.05) in adenoma group after adjusting for age, body mass index (BMI), and insulin levels. Patients in adenoma group showed a trend toward male gender and younger age as compared to those without adenoma. Conclusions: Subjects with acromegaly as compared to control have a higher prevalence of colonic polyps. There was no association of polyps seen with age, BMI, skin tags, homeostasis model assessment of insulin resistance index, duration of disease, and basal and glucose-suppressed GH and IGF-1 levels. There were no specific predictive factors detected. Screening full colonoscopy is recommended in all cases with acromegaly. PMID:27366708

  7. Metaplastic Ossification in a Juvenile Rectal Polyp: A Rare Histological Finding

    PubMed Central

    Garg, Monika; Kaur, Jasveen; Bindroo, Samridhi; Sharma, Anuradha; Mahajan, Nanak Chand

    2013-01-01

    An osseous metaplasia is a phenomenon which has been described in a wide variety of tissue types with respect to both neoplastic and non-neoplastic conditions. However, an osseous metaplasia is exceedingly rare in colonic polyps. We are herein representing a case of osseous metaplasia in a juvenile rectal polyp in a six year old boy, with review of the literature on the suggested mechanisms of its aetiology. PMID:23814740

  8. 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.

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

    PubMed Central

    FUKUSHIMA, Kenjiro; EGUCHI, Nozomi; OHNO, Koichi; KANEMOTO, Hideyuki; TAKAHASHI, Masashi; IGARASHI, Hirotaka; OHMI, Aki; NAKASHIMA, Ko; TSUJIMOTO, Hajime

    2015-01-01

    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. PMID:26460312

  10. 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

  11. Expression of Vascular Endothelial Growth Factor in Nasal Polyp and Chronic Rhinosinusitis

    PubMed Central

    Azizzadeh Delshad, Alireza; Jalali Nadoushan, Mohammadreza; Davati, Ali; Rostami, Aida

    2016-01-01

    Background: Nasal inflammatory disorders such as chronic rhinosinusitis and nasal polyp are among the most prevalent complications with high socioeconomic costs. Vascular Endothelial Growth Factor (VEGF) plays a key role in angiogenesis and cell proliferation. In the present study the effect of VEGF on the development and prognosis of chronic rhinosinusitis and nasal polyp was investigated. Methods: This cross sectional study was performed on the nasal histological specimens of two groups of patients suffering from nasal polyp or chronic rhinosinusitis, and the expression of VEGF in the two groups was compared immunohistochemically. Based on the percentage of VEGF-positive cells the specimens were classified into four scores. Furthermore, the relations between the VEGF expression and some demographic characteristics were evaluated. Results: The VEGF immunohistochemistry findings indicated a significantly higher expression of VEGF in nasal polyp group compared to chronic rhinosinusitis without nasal polyp group. In terms of VEGF-expression scoring, in both groups most of the specimens were classified as score-2, namely indicating 10-50% of VEGF-positive epithelial cells. In both groups no significant relation between VEGF expression and age or sex of the patients could be seen. Conclusion: Local modulation of VEGF expression might be taken as a putative therapeutic strategy in management of sinunasal inflammatory disorders, especially nasal polyps. PMID:27781069

  12. Advanced technology for the improvement of adenoma and polyp detection during colonoscopy.

    PubMed

    Moriyama, Tomohiko; Uraoka, Toshio; Esaki, Motohiro; Matsumoto, Takayuki

    2015-04-01

    Early detection and removal of adenomatous polyps reduces colorectal cancer death. However, many studies have reported that up to 20% of adenomas can be missed during colonoscopy. To improve visualization and reduce the blind spot of the colonic mucosa for an increase in the adenoma detection rate, many endoscopic techniques and technologies have been developed. The benefit of the high-definition endoscope for improving adenoma and polyp detection is marginal. Wide-angle colonoscope has failed to improve adenoma detection compared to standard colonoscopy. Although the cap-assisted colonoscope can reduce cecal intubation times, it does not seem to improve adenoma and polyp detection. The diagnostic accuracy of the colon capsule endoscope is low compared to the conventional colonoscope. Third Eye(®) retroscope(®) , which provides additional retrograde viewing, has revealed significant improvement in adenoma and polyp detection compared to standard colonoscopy. However, this device increases procedural times. Recently developed full-spectrum endoscopy colonoscope and extra-wide-angle-view colonoscope have demonstrated a significantly lower miss rate of polyps. However, clinical trials are mandatory to determine the efficacy of these novel technologies for cancer screening. In addition, education and training for these novel techniques and technologies should seriously be considered to improve adenoma and polyp detection. PMID:25556542

  13. What can be the criteria of outpatient-based endoscopic resection for colon polyp?

    PubMed Central

    Kim, Hyung Hun; Kim, Sung Eun; Cho, Eun Joo

    2014-01-01

    AIM: To investigate whether out-patient based endoscopic mucosal resection (EMR) for colon polyps ≤ 10 mm is safe. METHODS: Between January 2004 and December 2012, a total of 3015 EMR cases conducted in 1320 patients were retrospectively reviewed. The factors contributing delayed hemorrhage were analyzed. We calculated the probability of delayed bleeding after stratifying conditions of specific risk factors. RESULTS: The size of the polyp (95%CI: 1.096-1.164, P < 0.001) and patients with chronic renal failure (95%CI: 1.856-45.106, P = 0.007) were identified as independent risk factors for delayed bleeding in multivariate analysis. 95%CI for percent of delayed bleeding according to polyp size was determined for the following conditions: size ≤ 10 mm, 0.05%-0.43%; 20 mm ≥ size > 10 mm, 0.54%-2.08%; size > 20 mm, 4.22%-11.41%. 95%CI was determined for the risk of serious immediate bleeding for a polyp ≤ 10 mm was 0.10%-0.56%. Finally, 95%CI for percent of incomplete resection was 0.07%-0.49% in polyps ≤ 10 mm. CONCLUSION: It seems acceptable to perform outpatient-based EMR for colon polyps ≤ 10 mm. PMID:25324921

  14. A Comprehensive Computer-Aided Polyp Detection System for Colonoscopy Videos.

    PubMed

    Tajbakhsh, Nima; Gurudu, Suryakanth R; Liang, Jianming

    2015-01-01

    Computer-aided detection (CAD) can help colonoscopists reduce their polyp miss-rate, but existing CAD systems are handicapped by using either shape, texture, or temporal information for detecting polyps, achieving limited sensitivity and specificity. To overcome this limitation, our key contribution of this paper is to fuse all possible polyp features by exploiting the strengths of each feature while minimizing its weaknesses. Our new CAD system has two stages, where the first stage builds on the robustness of shape features to reliably generate a set of candidates with a high sensitivity, while the second stage utilizes the high discriminative power of the computationally expensive features to effectively reduce false positives. Specifically, we employ a unique edge classifier and an original voting scheme to capture geometric features of polyps in context and then harness the power of convolutional neural networks in a novel score fusion approach to extract and combine shape, color, texture, and temporal information of the candidates. Our experimental results based on FROC curves and a new analysis of polyp detection latency demonstrate a superiority over the state-of-the-art where our system yields a lower polyp detection latency and achieves a significantly higher sensitivity while generating dramatically fewer false positives. This performance improvement is attributed to our reliable candidate generation and effective false positive reduction methods. PMID:26221684

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

    PubMed

    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

    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. 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 December 2004 to September 2007 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. 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. Future investigation of BaP exposure and colorectal neoplasia should analyze whether associations are dependent upon anatomic location.

  16. Adaptive deformable model for colonic polyp segmentation and measurement on CT colonography

    SciTech Connect

    Yao Jianhua; Summers, Ronald M.

    2007-05-15

    Polyp size is one important biomarker for the malignancy risk of a polyp. This paper presents an improved approach for colonic polyp segmentation and measurement on CT colonography images. The method is based on a combination of knowledge-guided intensity adjustment, fuzzy clustering, and adaptive deformable model. Since polyps on haustral folds are the most difficult to be segmented, we propose a dual-distance algorithm to first identify voxels on the folds, and then introduce a counter-force to control the model evolution. We derive linear and volumetric measurements from the segmentation. The experiment was conducted on 395 patients with 83 polyps, of which 43 polyps were on haustral folds. The results were validated against manual measurement from the optical colonoscopy and the CT colonography. The paired t-test showed no significant difference, and the R{sup 2} correlation was 0.61 for the linear measurement and 0.98 for the volumetric measurement. The mean Dice coefficient for volume overlap between automatic and manual segmentation was 0.752 (standard deviation 0.154)

  17. Effect of 6-minute colonoscopy withdrawal time policy on polyp detection rate in a community hospital.

    PubMed

    Baker, Scott L; Miller, Roberta A; Creighton, Amy; Aguilar, Pedro S

    2015-01-01

    In 2002, a U.S. Multi-Society Task Force on colorectal cancer recommended a 6-minute or more withdrawal time as an indicator of a quality colonoscopy. In 2006, found a correlation between longer withdrawal time and an increased rate in the detection of adenomas. In January 2008, the endoscopy department at our institution adopted the Multi-Society Task Force recommendation. The aim of our study was to evaluate the effect of a minimal 6-minute withdrawal time policy at our institution on polyp detection rate. All colonoscopies performed for screening indications from April 2007 to September 2008 were reviewed retrospectively. Group I (pre-policy) was compared with Group II (post-policy). Data collected included age, gender, indication, polyp detection rate, size, and withdrawal time. Unpaired t tests evaluated pre- and postprocedure results. Fisher's exact tests were used to compare detection rates between withdrawal time less than 6 minutes and more than 6 minutes. Mann-Whitney U Tests were performed to analyze the significance between the number of polyps detected for withdrawal time less than 6 minutes versus more than 6 minutes. A total of 1,342 colonoscopies were available for analysis in Group I and 1,316 in Group II. Polyp detection rate was 46.6% in Group I versus 48.2% in Group II (p = .39), a non-statistically significant difference; however, there was a trend toward identifying small- and medium-sized polyps in Group II. Small polyps can carry a risk of severe dysplasia (). Data were then analyzed for withdrawal time. The polyp detection rate was 20.9 in procedures that took less than 6 minutes versus 48.3 in those that took more than 6 minutes (p ≤ .01). In this study, a 6-minute or more withdrawal time increased the polyp detection rate by 133% for all polyp sizes, especially small and medium. Small polyps (5 mm or less) should be removed and not ignored. A 6-minute or more withdrawal time should be mandatory in those patients without a previous colon

  18. Texture feature extraction and analysis for polyp differentiation via computed tomography colonography

    PubMed Central

    Hu, Yifan; Song, Bowen; Han, Hao; Pickhardt, Perry J.; Zhu, Wei; Duan, Chaijie; Zhang, Hao; Barish, Matthew A.; Lascarides, Chris E.

    2016-01-01

    Image textures in computed tomography colonography (CTC) have great potential for differentiating non-neoplastic from neoplastic polyps and thus can advance the current CTC detection-only paradigm to a new level toward optimal polyp management to prevent the deadly colorectal cancer. However, image textures are frequently compromised due to noise smoothing and other error-correction operations in most CT image reconstructions. Furthermore, because of polyp orientation variation in patient space, texture features extracted in that space can vary accordingly, resulting in variable results. To address these issues, this study proposes an adaptive approach to extract and analyze the texture features for polyp differentiation. Firstly, derivative operations are performed on the CT intensity image to amplify the textures, e.g. in the 1st order derivative (gradient) and 2nd order derivative (curvature) images, with adequate noise control. Then the Haralick co-occurrence matrix (CM) is used to calculate texture measures along each of the 13 directions (defined by the 1st and 2nd order image voxel neighbors) through the polyp volume in the intensity, gradient and curvature images. Instead of taking the mean and range of each CM measure over the 13 directions as the so-called Haralick texture features, the Karhunen-Loeve transform is performed to map the 13 directions into an orthogonal coordinate system where all the CM measures are projected onto the new coordinates so that the resulted texture features are less dependent on the polyp spatial orientation variation. While the ideas for amplifying textures and stabilizing spatial variation are simple, their impacts are significant for the task of differentiating non-neoplastic from neoplastic polyps as demonstrated by experiments using 384 polyp datasets, of which 52 are non-neoplastic polyps and the rest are neoplastic polyps. By the merit of area under the curve of receiver operating characteristic, the innovative ideas

  19. 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

  20. Inhibition of intestinal polyp growth by oral ingestion of bovine lactoferrin and immune cells in the large intestine.

    PubMed

    Iigo, Masaaki; Alexander, David B; Xu, Jiegou; Futakuchi, Mitsuru; Suzui, Masumi; Kozu, Takahiro; Akasu, Takayuki; Saito, Daizo; Kakizoe, Tadao; Yamauchi, Koji; Abe, Fumiaki; Takase, Mitsunori; Sekine, Kazunori; Tsuda, Hiroyuki

    2014-10-01

    Studies using animal models have demonstrated that ingestion of bovine lactoferrin (bLF) inhibits carcinogenesis in the colon and other organs of experimental animals. As a result of these studies, a blinded, randomized, controlled clinical trial was conducted in the National Cancer Center Hospital, Tokyo, Japan to determine whether ingestion of bLF had an effect on the growth of colorectal polyps in humans. Patients with colorectal polyps ≤5 mm diameter and likely to be adenomas ingested 0, 1.5, or 3.0 g bLF daily for 1 year. Ingestion of 3.0 g bLF suppressed the growth of colorectal polyps and increased the level of serum human lactoferrin in trial participants 63 years old or younger. The purpose of the present study was to investigate correlations between immune parameters and changes in polyp size. Trial participants with regressing polyps had increased NK cell activity, increased serum hLF levels (indicating increased neutrophil activity), and increased numbers of CD4+ cells in the polyps. These findings are consistent with a correlation between higher immune activity and suppression of colorectal polyps. In addition, participants with regressing polyps had lower numbers of PMNs and increased numbers of S100A8+ cells in the polyps, consistent with a correlation between lower inflammatory potential in the colon and suppression of colorectal polyps. Trial participants ingesting bLF had increased serum hLF levels, a possible increase in systemic NK cell activity, and increased numbers of CD4+ and CD161+ cells in the polyps. Taken together, our findings suggest that bLF suppressed colorectal polyps by enhancing immune responsiveness.

  1. Increased Detection of Colorectal Polyps in Screening Colonoscopy Using High Definition i-SCAN Compared with Standard White Light

    PubMed Central

    Kim, Woo Jung; Park, Sang Young; Park, Iksoo; Lee, Wook Jin; Park, Jaechan; Chon, Nuri; Oh, Tak Geun; Kim, Kwang Hyun

    2016-01-01

    Background/Aims: The aim of this study was to evaluate the efficacy of high definition (HD) i-SCAN for colorectal polyp detection in screening colonoscopy. Methods: We retrospectively analyzed the records of 501 patients who had undergone screening colonoscopy performed by three endoscopists with either HD i-SCAN (n=149) or standard white light (n=352) from January 2, 2014 through June 30, 2014. Patient information and inter-endoscopist variation as well as polyp number, endoscopic findings, and pathologic characteristics were reviewed. Results: The detection rates of colorectal and neoplastic polyps were significantly higher using HD i-SCAN than standard white light colonoscopy (52% vs. 38.1%, p=0.004 for colorectal polyps; and 37.2% vs. 27.9%, p=0.041 for neoplastic polyps). Analysis of endoscopic findings revealed no difference in detected polyp size between HD i-SCAN and standard white light colonoscopy (4.59±2.35 mm vs. 4.82±2.81 mm, p=0.739), but non-protruding polyps were more commonly detected by i-SCAN than by standard white light colonoscopy (24.6% vs. 13.5%, p=0.007). Conclusions: Colonoscopy using HD i-SCAN had a significantly higher detection rate of colorectal polyps, including neoplastic polyps, because of improved sensitivity for detecting non-protruding lesions. PMID:26855927

  2. Severe respiratory distress at birth caused by a hairy polyp of the Eustachian tube: Transoral endoscopy-guided treatment.

    PubMed

    Cantarella, Giovanna; Gaffuri, Michele; Pugni, Lorenza; Pignataro, Lorenzo; Mosca, Fabio

    2015-08-01

    Hairy polyps are rare developmental lesions, which present as masses mainly consisting of fatty tissue covered by skin, seldom localized in the nasopharynx, causing respiratory obstruction. We describe the case of a female newborn affected by a hairy polyp arising from the left Eustachian tube, who presented severe respiratory distress soon after birth. The polyp was successfully removed transorally under videoendoscopic guidance. This case highlights the importance of including hairy polyp in the differential diagnosis of respiratory distress at birth because this type of tumor can be lethal and requires prompt treatment. A transoral endoscopy-guided approach can allow successful and minimally invasive excision even in a newborn.

  3. Vitamin D decreases the secretion of eotaxin and RANTES in nasal polyp fibroblasts derived from Taiwanese patients with chronic rhinosinusitis with nasal polyps.

    PubMed

    Wang, Ling-Feng; Chien, Chen-Yu; Tai, Chih-Feng; Chiang, Feng-Yu; Chen, Jeff Yi-Fu

    2015-02-01

    Eosinophils are important inflammatory cells involved in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Vitamin D and its derivatives, in addition to their classic role as regulators of electrolytes homeostasis, have modulatory effects in immunological and inflammatory responses. Such properties suggest that vitamin D might also play a role in inflammatory airway diseases such as CRSwNP. In this study, we investigated the effect of vitamin D derivatives (calcitriol and tacalcitol) on the secretion of eotaxin and Regulated on Activation, Normal T Cell Expressed and Secreted (RANTES), the two major eosinophil chemoattractants, in fibroblasts derived from the polyps of Taiwanese CRSwNP patients. Patients diagnosed with eosinophilic CRSwNP but without malignancies or asthma and undergoing elective endoscopic sinus surgery were recruited. Three primary fibroblast cultures were established using the polyp specimens obtained from these patients. The third to eighth passages of the fibroblasts were used for in vitro studies. Nasal polyp-derived fibroblasts were stimulated with IL-1β (10 ng/mL) for 24 hours, followed by replacement with media alone or with calcitriol or tacalcitol (10 μM) and incubation for another 24 hours. After the treatments, the levels of secreted eotaxin and RANTES were evaluated by ELISA assays. The results showed that IL-1β could substantially stimulate the secretion of eotaxin (p < 0.01) and RANTES (p < 0.01) in nasal polyp-derived fibroblasts. More importantly, this stimulatory effect was significantly suppressed by adding calcitriol (p ≤ 0.002 for eotaxin and p ≤ 0.008 for RANTES) or tacalcitol (p ≤ 0.009 for eotaxin and p ≤ 0.02 for RANTES). Therefore, the inhibitory effect of vitamin D derivatives on eotaxin and RANTES secretion might shed light not only on the disease mechanism, but also on the potential use of vitamin D in pharmacotherapy of Taiwanese patients with CRSwNP.

  4. Filiform polyps and filiform polyp-like lesions are common in defunctioned or diverted colorectum resection specimens.

    PubMed

    Gill, Pelvender; Chetty, Runjan

    2013-08-01

    We describe filiform polyps (FPs) in a series of defunctioned rectums with diversion colitis. A 6-year search of all defunctioned rectal resection specimens revealed 8 cases with 17 macroscopically observed FPs. They occurred in 4 females and 4 males aged between 12 and 64 years. Four had defunctioning colostomies for ulcerative colitis, 3 for Crohn disease and 1 for diverticular disease. Multiple lesions were seen in 6 of 8 cases: 1 case having 4 FPs, 1 patient with 3 lesions, and 4 cases with 2 lesions. The FP varied in length from 4 to 11 mm; mean length was 7.8 mm. No evidence of mucosal prolapse was seen in any of the polypoid lesions. In 65 cases without grossly observed polypoid lesions, prominent mucosal polypoid projections in keeping with FP were seen in 47 cases. These were observed in nonulcerated sections and were histologically identical to the 17 macroscopically observed FPs ranging from 3 to 8 mm, and 3 to 5 such polypoid lesions were seen in 20 cases. We suggest that FP and FP-like lesions are commonly encountered in defunctioned resection specimens.

  5. The addition of high magnifying endoscopy improves rates of high confidence optical diagnosis of colorectal polyps

    PubMed Central

    Iwatate, Mineo; Sano, Yasushi; Hattori, Santa; Sano, Wataru; Hasuike, Noriaki; Ikumoto, Taro; Kotaka, Masahito; Murakami, Yoshitaka; Hewett, David G.; Soetikno, Roy; Kaltenbach, Tonya; Fujimori, Takahiro

    2015-01-01

    Background and study aims: The real-time optical diagnosis of colorectal polyps with high confidence predictions can achieve high levels of accuracy. Increasing the rates of high confidence optical diagnosis can improve the clinical application of real-time optical diagnosis in routine practice. The primary aim of this prospective study was to evaluate whether high magnifying endoscopy improves the rates of high confidence narrow-band imaging (NBI) – based optical diagnosis for differentiating between neoplastic and non-neoplastic colorectal lesions according to the NBI international colorectal endoscopic (NICE) classification. Patients and methods: Consecutive adult patients undergoing colonoscopy with a high magnifying (maximum, × 80) colonoscope between April and August 2012 were recruited. The optical diagnosis for each polyp was evaluated during colonoscopy in two consecutive stages by the same endoscopist, who first used NBI with non-magnifying endoscopy (NBI-NME), then NBI with magnifying endoscopy (NBI-ME). A level of confidence was assigned to each prediction. Results: The analysis included 124 patients (mean age, 56.4 years; male-to-female ratio, 72:52) with 248 polyps smaller than 10 mm. Of the 248 polyps, 210 were 1 to 5 mm in size and 38 were 6 to 9 mm in size; 77 polyps were hyperplastic, 4 were sessile serrated adenomas/polyps, 160 were low grade adenomas, 5 were high grade adenomas, and 2 were deep submucosal invasive carcinomas. The rate of high confidence optical diagnosis when NBI-ME was used was significantly higher than the rate when NBI-NME was used for diminutive (1 – 5 mm) polyps (92.9 % vs 79.5 %, P < 0.001) and for small (6 – 9 mm) polyps (94.7 % vs 84.2 %, P = 0.048). Conclusion: High magnifying endoscopy significantly improved the rates of high confidence NBI-based optical diagnosis of diminutive and small colorectal polyps. Study registration: UMIN 000007608 PMID:26135657

  6. The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study

    PubMed Central

    2015-01-01

    Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids. PMID:26327901

  7. The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study.

    PubMed

    Woźniak, Sławomir

    2015-06-01

    Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids. PMID:26327901

  8. 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

  9. Endometrial polyps smaller than 1.5 cm do not affect ICSI outcome.

    PubMed

    Isikoglu, M; Berkkanoglu, M; Senturk, Z; Coetzee, K; Ozgur, K

    2006-02-01

    This study aimed to determine whether the presence of endometrial polyps discovered during ovarian stimulation affects the outcomes of intracytoplasmic sperm injection (ICSI) cycles. This retrospective descriptive study was conducted in a private assisted reproductive technology unit. Medical records of ICSI cycles performed between January 2003 and December 2004 were reviewed. Patients were divided into three groups: patients with endometrial polyps discovered during ovarian stimulation (group 1, n=15), patients who underwent hysteroscopic polyp resection prior to their ICSI cycle (group 2, n=40) and patients without polyps (group 3, n=956). Main outcome measures were clinical pregnancy rates and implantation rates. Age of the patients, age of the husbands, body mass index, total amount of gonadotrophins used, length of stimulation, peak oestradiol concentrations, peak endometrial thickness and number of embryos replaced were not significantly different between the groups, nor were the pregnancy and implantation rates. Only one patient (12.5%) from the first group experienced miscarriage within 12 weeks of pregnancy. In conclusion, endometrial polyps discovered during ovarian stimulation do not negatively affect pregnancy and implantation outcomes in ICSI cycles.

  10. 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

  11. An investigation of the rate of cyclooxygenase-2 expression on the surface of adenomatous and colorectal adenocarcinoma polyps

    PubMed Central

    Baghaei, Ramin; Beiraghdar, Mozhdeh; Sobhani, Ahmad; Rafei, Rahmatolah; Kolahi, Leila; Foladi, Lotfolah

    2015-01-01

    Background: Colorectal cancer (CRC) (adenomatous, adenocarcinoma) is one of the major causes of mortality and morbidity in human societies. Considering the importance of cyclooxygenase-2 (COX-2) expression in the incidence of CRC, in this study, the rate of COX-2 gene expression on polyps and CRCs were addressed. Materials and Methods: This is a cross-sectional descriptive analytic study carried out on the blocks of sampled tissue of adenomatous and colorectal adenocarcinoma polyps on 68 patients referred to Digestive Clinic in Isfahan Shariati Hospital in 2013. Patients were divided into two groups of polyps (n = 52) and cancer (n = 16). Given the presence of CRC or polyps by colonoscopy, samples were sent to the laboratory to measure the rate of COX-2 gene expression using immunohistochemistry. Results: In polyp group, 41 individuals (78.8%) had two or <2 polyps, 24 cases (46.2%) had a tubular polyp, and about a third of all patients had a big polyp. The most frequency of the polyp site was related to sigmoid with 19 cases (36.54%), in cancer group, it was related to the rectum with 9 cases (56.25%) that there was no significant difference between two groups (P < 0.05). The overall prevalence of COX-2 expression was positive in 51 cases (75%) and negative in 17 cases (25%). COX-2 gene expression was separately observed in 38 individuals (73.10%) in the polyp group and in 13 cases (81.25%) in the cancer group, and no significant difference was found (P > 0.05). Conclusion: There is no relationship between COX-2 gene expression and the surface of adenomatous and colorectal adenocarcinoma polyps. PMID:26601088

  12. Endoscopical polypectomy of the gastric polyp with electro-coagulation wire loop.

    PubMed

    Oshiba, S; Ueno, K; Mochizuki, F; Asaki, S; Ito, S

    1976-01-01

    A forward-viewing fiberscope equipped with two channels was designed for safer and easier gastric polypectomy under endoscopic control using electro-surgical technique. No electrical accident, bleeding, perforation or significant complications were noticed. Mucosal ulcerations at the polypectomy site healed within a month leaving minor scars behind. In 30 cases, U1 II gastric ulcers developed after polypectomy, which healed leaving convergence of mucosal folds behind. Fiberscopic excision of gastric polyps was also useful for establishing a reliable diagnosis of gastric polyp cancer which is sometimes overlooked by routine biopsy procedure. It may be the "perfect biopsy". The patient with gastric polyp who is aware of his own illness and feels uneasy can be released from his anxiety and regain both physical and mental health at the cost of minimal risks of endoscopic polypectomy.

  13. Osseous Metaplasia in an Inflammatory Polyp of the Rectum: A Case Report and Review of the Literature

    PubMed Central

    Odum, Brian R.; Bechtold, Matthew L.; Diaz-Arias, Alberto

    2012-01-01

    Osseous metaplasia is a rare finding in colonic neoplasms. We report a case osseous metaplasia in a 74 year-old male who underwent surveillance colonoscopy and found to have a 7 mm rectal polyp. Histopathologic examination revealed an inflammatory polyp with osseous metaplasia.

  14. 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. PMID:27163839

  15. Detection of colon polyps by a novel, polymer pattern-based full blood test

    PubMed Central

    2013-01-01

    Numerous studies have shown that early screening for the presence of pre-cancerous colon polyps and their subsequent removal decreases the risk of developing colon cancer. Colonoscopy is currently the most effective screening method, but due to the invasive nature of the procedure many patients avoid forgo testing. Futhermore, the procedure itself requires perfect execution by the gastroenterologist. Against this backdrop, a non-invasive blood screening method for the detection of colon polyps that has higher sensitivity than current screening techniques would be beneficial in the early identification of patients at risk for colon cancer. A prospective, double-blinded, controlled clinical study was designed to demonstrate the diagnostic performance of Polyp Specific Polymer analysis, a novel laboratory methodology. The primary objective of this clinical trial was to estimate the diagnostic accuracy of the Polyp Specific Polymer analysis for colon polyps using colonoscopy and histological tests as the diagnostic accuracy standards. Secondary objectives of this trial included estimating positive and negative predictive values for colon polyps, investigating reliability, determining covariates influencing diagnostic accuracy and obtaining absolute and relative frequencies of valid test results. In patients undergoing screening colonoscopy and histology examination, a sensitivity of 72.4% and a specificity of 62.3% could be proven. These results indicate that using this improved screening method it is possible to effectively identify the highest-risk candidates for endoscopy, thereby advancing the goal of decreasing the incidence or mortality of colorectal cancer in the selected population. Moreover, this diagnostic tool has potential socio-economic implications, conserving healthcare resources by enabling higher patient selectivity for endoscopy and eventual transfer to curative prevention via polypectomy. By combining the best-established low-risk screening elements

  16. Genetic association analysis of CIITA variations with nasal polyp pathogenesis in asthmatic patients.

    PubMed

    Bae, Joon Seol; Pasaje, Charisse Flerida A; Park, Byung Lae; Cheong, Hyun Sub; Kim, Jeong-Hyun; Uh, Soo-Taek; Park, Choon-Sik; Shin, Hyoung Doo

    2013-03-01

    Nasal polyps are abnormal lesions arising mainly from the nasal mucosa and paranasal sinuses. Since the human class II, major histocompatibility complex, transactivator (CIITA) is a positive regulator of class II, major histocompatibility complex gene transcription, the CIITA gene is thought to be involved in the presence of nasal polyps in asthma and aspirin hypersensitive patients. To investigate the association between CIITA and nasal polyposis, 18 single nucleotide polymorphisms (SNPs) were genotyped in 467 asthmatics who were classified into 158 aspirin-exacerbated respiratory disease (AERD) and 309 aspirin-tolerant asthma (ATA) subgroups. Differences in the frequency distribution of CIITA variations between polyp-positive cases and polyp-negative controls were determined using logistic analyses. Initially, a total of 9 CIITA variants were significantly associated with the presence of nasal polyps in the overall asthma, AERD and ATA groups [P=0.001-0.05, odds ratio (OR)=0.53-2.35 in the overall asthma group; P=0.01-0.02, OR=2.45-2.66 in the AERD group; P=0.001‑0.05, OR=0.45-2.61 in the ATA group using various modes of genetic inheritance]. One the variations (rs12932187) retained this association after multiple testing corrections (Pcorr=0.01) in the overall asthma group. In addition, two variations (rs12932187 and rs11074938) were associated with the presence of nasal polyps following multiple testing corrections (Pcorr=0.02 and 0.04, respectively) in the ATA group. These novel findings suggest that rs12932187 and rs11074938 may constitute susceptibility markers of inflammation of the nasal passages in asthma patients. PMID:23292525

  17. Gastric hyperplastic polyps coexisting with early gastric cancers, adenoma and neuroendocrine cell hyperplasia.

    PubMed

    Karpińska-Kaczmarczyk, K; Lewandowska, M; Białek, A; Ławniczak, M; Urasińska, E

    2016-03-01

    Gastric hyperplastic polyps (GHP) constitute up to 93% of all benign epithelial polyps of the stomach. The average probability of malignant transformation in GHP is 0.6-22% in large series. The aim of the study was to present the coexistence of GHP with early gastric cancer (EGC), gastric adenoma (GA), neuroendocrine cell hyperplasia (NH) and well-differentiated neuroendocrine tumour (NET G1). Three cases were studied to reveal clinical data and morphological changes and to assess the relationship between GHP and accompanying gastric neoplastic lesions. PMID:27179272

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

    PubMed

    Gómez, Estanislao J; Izcovich, Ariel

    2016-01-01

    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. PMID:27513877

  19. Orally delivered microencapsulated probiotic formulation favorably impacts polyp formation in APC (Min/+) model of intestinal carcinogenesis.

    PubMed

    Urbanska, Aleksandra Malgorzata; Bhathena, Jasmine; Cherif, Sofiane; Prakash, Satya

    2016-01-01

    The development of intestinal polyps in an orthotopic colorectal mouse model, receiving a probiotic yogurt formulation containing microencapsulated live Lactobacillus acidophilus cells was investigated. The expression of various immunohistochemical markers namely CD8, Mac-1, Ki-67, and cleaved caspase-3, was evaluated. Results suggest that the probiotic formulation decreases overall intestinal inflammation. Mice receiving the probiotic formulation were found to develop almost two-fold fewer tumors in the small intestines. In the large intestine, however, there was no significant difference observed among polyp numbers. The formulation appears to have potential application in the prevention of various GI pathological conditions. PMID:25060720

  20. Uterine endometrial polyp with severe hemorrhage and cystic endometrial hyperplasia-pyometra complex in a dog.

    PubMed

    Gumber, Sanjeev; Springer, Nora; Wakamatsu, Nobuko

    2010-05-01

    The current report describes an unusual presentation of uterine endometrial polyp with severe hemorrhage and cystic endometrial hyperplasia-pyometra complex in a 9.5-year-old female Doberman Pinscher. The dog presented with a 2-day history of bloody discharge from the vulva and an enlarged abdomen. The postmortem examination revealed a markedly distended right uterine horn with a large pedunculated mass (17 cm x 9 cm x 4 cm) and blood. Based on the histological findings, the diagnosis of uterine endometrial polyp was made. PMID:20453227

  1. 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.

  2. Attraction Propagation: A User-Friendly Interactive Approach for Polyp Segmentation in Colonoscopy Images

    PubMed Central

    Du, Ning; Wang, Xiaofei; Guo, Jianhua; Xu, Meidong

    2016-01-01

    The article raised a user-friendly interactive approach-Attraction Propagation (AP) in segmentation of colorectal polyps. Compared with other interactive approaches, the AP relied on only one foreground seed to get different shapes of polyps, and it can be compatible with pre-processing stage of Computer-Aided Diagnosis (CAD) under the systematically procedure of Optical Colonoscopy (OC). The experimental design was based on challenging distinct datasets that totally includes 1691 OC images, and the results demonstrated that no matter in accuracy or calculating speed, the AP performed better than the state-of-the-art. PMID:27191849

  3. RNA Sequencing of Sessile Serrated Colon Polyps Identifies Differentially Expressed Genes and Immunohistochemical Markers

    PubMed Central

    Delker, Don A.; Pop, Stelian; Neklason, Deborah W.; Bronner, Mary P.; Burt, Randall W.; Hagedorn, Curt H.

    2014-01-01

    Background Sessile serrated adenomas/polyps (SSA/Ps) may account for 20–30% of colon cancers. Although large SSA/Ps are generally recognized phenotypically, small (<1 cm) or dysplastic SSA/Ps are difficult to differentiate from hyperplastic or small adenomatous polyps by endoscopy and histopathology. Our aim was to define the comprehensive gene expression phenotype of SSA/Ps to better define this cancer precursor. Results RNA sequencing was performed on 5′ capped RNA from seven SSA/Ps collected from patients with the serrated polyposis syndrome (SPS) versus eight controls. Highly expressed genes were analyzed by qPCR in additional SSA/Ps, adenomas and controls. The cellular localization and level of gene products were examined by immunohistochemistry in syndromic and sporadic SSA/Ps, adenomatous and hyperplastic polyps and controls. We identified 1,294 differentially expressed annotated genes, with 106 increased ≥10-fold, in SSA/Ps compared to controls. Comparing these genes with an array dataset for adenomatous polyps identified 30 protein coding genes uniquely expressed ≥10-fold in SSA/Ps. Biological pathways altered in SSA/Ps included mucosal integrity, cell adhesion, and cell development. Marked increased expression of MUC17, the cell junction protein genes VSIG1 and GJB5, and the antiapoptotic gene REG4 were found in SSA/Ps, relative to controls and adenomas, were verified by qPCR analysis of additional SSA/Ps (n = 21) and adenomas (n = 10). Immunohistochemical staining of syndromic (n≥11) and sporadic SSA/Ps (n≥17), adenomatous (n≥13) and hyperplastic (n≥10) polyps plus controls (n≥16) identified unique expression patterns for VSIG1 and MUC17 in SSA/Ps. Conclusion A subset of genes and pathways are uniquely increased in SSA/Ps, compared to adenomatous polyps, thus supporting the concept that cancer develops by different pathways in these phenotypically distinct polyps with markedly different gene expression profiles. Immunostaining

  4. A Role for the Epidermal Growth Factor Receptor Signaling in Development of Intestinal Serrated Polyps in Mice and Humans

    PubMed Central

    Bongers, Gerold; Muniz, Luciana R.; Pacer, Michelle E.; Iuga, Alina C.; Thirunarayanan, Nanthakumar; Slinger, Erik; Smit, Martine J.; Reddy, E. Premkumar; Mayer, Lloyd; Furtado, Glaucia C.; Harpaz, Noam; Lira, Sergio A.

    2012-01-01

    Background & Aims Epithelial cancers can be initiated by activating mutations in components of the mitogen-activated protein kinase (MAPK) signaling pathway such as BRAF, KRAS, or epidermal growth factor receptor (EGFR). Human intestinal serrated polyps are a heterogeneous group of benign lesions, but some progress to colorectal cancer. Tumors that arise from these polyps frequently contain activating mutations in BRAF or KRAS, but little is known about the role of EGFR activation in their development. Methods Polyp samples were obtained from adults during screening colonoscopies at Mount Sinai Hospital in New York. We measured levels of EGFR protein and phosphorylation in human serrated polyps by immunohistochemical and immunoblot analyses. We generated transgenic mice that express the ligand for EGFR, HB-EGF, in the intestine. Results EGFR and the extracellular-regulated kinases (ERK)1/2 were phosphorylated in serrated areas of human hyperplastic polyps (HPPs), sessile serrated adenomas, and traditional serrated adenomas. EGFR and ERK1/2 were phosphorylated in the absence of KRAS or BRAF activating mutations in a subset of HPP. Transgenic expression of the EGFR ligand HB-EGF in the intestines of mice promoted development of small cecal serrated polyps. Mice that expressed a combination of HB-EGF and US28 (a constitutively active, G-protein–coupled receptor that increases processing of HB-EGF from the membrane) rapidly developed large cecal serrated polyps. These polyps were similar to HPPs and had increased phosphorylation of EGFR and ERK1/2 within the serrated epithelium. Administration of pharmacologic inhibitors of EGFR or MAP kinase to these transgenic mice significantly reduced polyp development. Conclusions Activation of EGFR signaling in the intestine of mice promotes development of serrated polyps. EGFR signaling is also activated in human HPPs, sessile serrated adenomas, and traditional serrated adenomas. PMID:22643351

  5. Optical diagnosis of malignant colorectal polyps: is it feasible?

    PubMed Central

    van der Vlugt, Manon; van Doorn, Sascha Corrie; Wang, Junfeng; Bastiaansen, Barbara AJ; Brosens, Lowewijk AA; Fockens, Paul; Dekker, Evelien

    2016-01-01

    Background and study aims: As colorectal cancer screening programs are being implemented worldwide, an increasing number of early (T1) cancers are being diagnosed. These cancers should be recognized during colonoscopy because they require a specific therapeutic approach. Several studies have shown that Asian experts can reliably recognize T1 cancers during colonoscopy. In daily practice, however, accurate endoscopic diagnosis of T1 cancers still seems challenging. We evaluated the performance of optical diagnosis of T1 cancers by European colonoscopy experts, general gastroenterologists and gastrointestinal fellows. Patients and methods: We collected endoscopic images of 43 colonic lesions: 19 T1 cancers (excluding intramucosal carcinoma) and 24 benign polyps ranging from 7 mm to 30 mm in size. Seven colonoscopy experts, 7 general gastroenterologists, and 14 gastrointestinal fellows assessed these images. We calculated sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) and their 95 % confidence intervals for optical diagnosis of T1 cancers. Results: Overall sensitivity for correct diagnosis of T1 cancers was 60 % (95 % CI;45 – 72). Sensitivity was highest for experts (67 %: 95 %CI; 48 – 81), when compared to general gastroenterologists (53 %: 95 %CI; 37 – 69) and gastrointestinal fellows (59 %: 95 %CI;45 – 72). The overall NPV was 75 % (95 %CI;60 – 86); NPV was lowest for general gastroenterologists 72 % (95 %CI;57 – 83) vs 78 % (95 %CI;63 – 89) for experts and 75 % (95 %CI;60 – 85) for gastrointestinal fellows. Conclusions: In this image-based study, both sensitivity for the optical diagnosis of a T1 cancer and NPV for excluding a T1 cancer were insufficient. Experts performed best with a sensitivity of 67 % and a NPV of 78 %, while the performance of fellows in the last year of training was comparable to that of experts. Our study

  6. Diagnostic Challenges Caused by Endoscopic Biopsy of Colonic Polyps: A Systematic Evaluation of Epithelial Misplacement With Review of Problematic Polyps From the Bowel Cancer Screening Program, United Kingdom.

    PubMed

    Panarelli, Nicole C; Somarathna, Thusitha; Samowitz, Wade S; Kornacki, Susan; Sanders, Scott A; Novelli, Marco R; Shepherd, Neil A; Yantiss, Rhonda K

    2016-08-01

    Endoscopic mucosal biopsy may misplace mucosal elements into the submucosa of colonic adenomas, mimicking invasive adenocarcinoma. Biopsy-related misplacement can be more challenging to recognize than typical misplaced epithelium (pseudoinvasion) in pedunculated polyps. We compared the features of 16 polyps with biopsy-related misplaced epithelium with those of 10 adenomas with pseudoinvasion and 10 adenomas with invasive adenocarcinoma and performed Ki67 and p53 immunostaining on all cases. Features of misplaced epithelium in polyps referred to the Bowel Cancer Screening Program Expert Board in the United Kingdom were also evaluated for the same morphologic features. Biopsy-related epithelial misplacement occurred in adenomas throughout the colon and often appeared infiltrative (69%), including epithelial cells singly dispersed within reactive fibroinflammatory stroma or granulation tissue (44%). Misplaced epithelium displayed only low-grade cytologic features and was associated with extruded mucin (75%), tattoo pigment (63%), and misplaced normal glands (38%); scant lamina propria and muscularis mucosae were often present (88% and 44%, respectively). Cases referred to the Bowel Cancer Screening Program Expert Board also contained infiltrative-appearing misplaced epithelium (91%) that was cytologically low grade (72%), contained nondysplastic glands (11%), and showed other signs of injury. In contrast, misplaced epithelium in pedunculated polyps always had a lobular contour with a rim of lamina propria, hemorrhage, and/or hemosiderin. Invasive carcinomas showed malignant cytology and desmoplasia; most (70%) lacked features of trauma. Ki67 and p53 staining was patchy and weak in the misplaced epithelium, whereas invasive carcinomas showed increased staining for one or both markers. Pathologists should be aware that endoscopically manipulated adenomas may contain misplaced epithelium that simulates malignancy. PMID:26975041

  7. 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

  8. Poly-P storage by natural biofilms in streams with varying biogeochemistry

    NASA Astrophysics Data System (ADS)

    Carrick, H. J.

    2015-12-01

    Anthropogenic inputs of nitrogen (N) and phosphorus (P) have increased in many watersheds throughout the world; these inputs have been linked to the eutrophication of inland and coastal waters worldwide. We selected and surveyed 20, third-order streams that supported a range of water column biogeochemical conditions (conductivity, nutrient concentrations) located in the mid-Atlantic region, USA. Biofilm biomass, algal taxonomic composition, and nutrient stoichiometry (C, N, P, and poly-P) were measured at all stream sites. Pulse-amplitude modulation fluorometry (PAM) was used to estimate photosynthetic parameters for stream biofilms (e.g., alpha, Pmax), while microbiology techniques were used to verify poly-P storage by pro- and eukaryotic components of the biofilm (e.g., epi-fluorescent staining). As anticipated, chlorophyll ranged over 2 orders of magnitude among the streams (range 10-1,000 mg/m2). Biofilm chlorophyll and algal biovolume levels increased with water column nutrient contents, while the C:P ratio within the biofilm decreased. Both pro and eukaryotic organisms were present in resident biofilms and actively stored intracellular poly-P. Finally, the rate of photosynthetic within the biofilms appeared to be driven the nutritional condition of the biofilms; pmax and alpha values increased with significantly with stream biofilm poly-P content (r2 = 0.35 and 0.44, respectively). These results indicated that where nutrients are plentiful, biofilms P storage is favored, and this is likely a key regulator of stream biofilm biomass and productivity.

  9. Effects of vitamin antioxidant supplementation on cell kinetics of patients with adenomatous polyps.

    PubMed Central

    Cahill, R J; O'Sullivan, K R; Mathias, P M; Beattie, S; Hamilton, H; O'Morain, C

    1993-01-01

    Colonic crypt cell proliferation is used as an indicator of risk of colorectal carcinoma. Subjects with adenomatous polyps and cancer have an increased cell proliferation and a shift of the proliferative zone towards the apex of the crypt. Epidemiological and in vitro studies have confirmed a link between vitamins A, E, C, beta-carotene, and colorectal cancer. In vitro bromodeoxyuridine immunohistochemical technique was used to assess the effect of daily oral supplementation with vitamin E (160 mg), vitamin C (750 mg), or beta-carotene (9 mg) on the colonic crypt cell proliferation in patients with adenomatous polyps (n = 40) compared with normal subjects with no colonic disease (n = 20). The patients were given supplementation for one month and colonic biopsy specimens were taken before and at the end of the trial. Patients with adenomatous polyps had a significantly higher mean labelling index per cent than controls (p < 0.001). Vitamin C or beta-carotene supplementation, however, significantly reduced the total proliferation (p < 0.005) whereas vitamin E supplementation had no effect on the colonic crypt cell proliferation. beta-carotene reduced cell proliferation at the base of the crypt only. Vitamin C reduced cell proliferation in all the crypt compartments from the apex to the base to those values seen in age and sex matched controls. These findings indicate that prolonged supplementation with vitamin C may reduce the recurrence of adenomatous polyps. PMID:8344584

  10. Three-dimensional flow patterns in a scaled, physical vocal fold model with a unilateral polyp

    NASA Astrophysics Data System (ADS)

    Seawright, Angela; Erath, Byron; Plesniak, Michael

    2009-11-01

    Trauma to the vocal folds often causes the formation of polyps; affecting the efficiency of speech and making voice rough and breathy. The change in flow characteristics due to a unilateral polyp positioned on the medial surface of a 7.5 times life-size physical vocal fold model was investigated. Previously reported phase-averaged intraglottal particle image velocimetry (PIV) investigations in a coronal plane indicated significant variations in the flow behavior on different anterior offset planes relative to the polyp. Flow three-dimensionality was investigated by resolving the temporal evolution of the flow with laser Doppler velocimetry (LDV). Data were acquired superior to the glottal exit. Physiological values of Reynolds, Strouhal, and Euler numbers were matched. Results were compared to velocity fields generated by healthy vocal fold motion. The glottal jet trajectory, flow separation points, and the velocity distribution along the vocal fold walls were influenced. Thus, a polyp significantly disturbs and modifies the airflow through the vocal folds, which has implications on both the fluid-structure energy exchange and the sound production.

  11. 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.

  12. 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

  13. 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.

  14. Computer vision approach to detect colonic polyps in computed tomographic colonography

    NASA Astrophysics Data System (ADS)

    McKenna, Matthew T.; Wang, Shijun; Nguyen, Tan B.; Burns, Joseph E.; Petrick, Nicholas; Sahiner, Berkman; Summers, Ronald M.

    2012-03-01

    In this paper, we present evaluation results for a novel colonic polyp classification method for use as part of a computed tomographic colonography (CTC) computer-aided detection (CAD) algorithm. Inspired by the interpretative methodology of radiologists using 3D fly-through mode in CTC reading, we have developed an algorithm which utilizes sequences of images (referred to here as videos) for classification of CAD marks. First, we generated an initial list of polyp candidates using an existing CAD system. For each of these candidates, we created a video composed of a series of intraluminal, volume-rendered images focusing on the candidate from multiple viewpoints. These videos illustrated the shape of the polyp candidate and gathered contextual information of diagnostic importance. We calculated the histogram of oriented gradients (HOG) feature on each frame of the video and utilized a support vector machine for classification. We tested our method by analyzing a CTC data set of 50 patients from three medical centers. Our proposed video analysis method for polyp classification showed significantly better performance than an approach using only the 2D CT slice data. The areas under the ROC curve for these methods were 0.88 (95% CI: [0.84, 0.91]) and 0.80 (95% CI: [0.75, 0.84]) respectively (p=0.0005).

  15. 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…

  16. Isolated abdominal wound recurrence of an endometrial adenocarcinoma confined to a polyp

    SciTech Connect

    Barter, J.F.; Hatch, K.D.; Orr, J.W. Jr.; Shingleton, H.M.

    1986-11-01

    An unusual case of Stage IB moderately well-differentiated endometrial adenocarcinoma that was confined to a polyp and recurred only in the abdominal wound is presented. Eighteen months following complete excision, local electron beam therapy, and the institution of hormonal therapy, the patient is alive and without other evidence of recurrence. The mechanisms of metastasis in this case are discussed.

  17. Ulcerative colitis and a bleeding polyp detected on Tc-99m-pertechnetate abdominal scintigraphy

    SciTech Connect

    Howman-Giles, R.

    1981-10-01

    Two children with rectal bleeding were diagnosed as having ulcerative colitis and a bleeding colonic polyp respectively using abdominal scanning with Tc-99m pertechnetate. Early flow studies are recommended with careful attention paid to the amount of time abnormal areas of activity are seen on the abdominal scan.

  18. The value of hysteroscopic biopsy in the diagnosis of endometrial polyps.

    PubMed

    Spadoto-Dias, Daniel; Bueloni-Dias, Flávia Neves; Elias, Leonardo Vieira; Leite, Nilton José; Modotti, Waldir Pereira; Lasmar, Ricardo Bassil; Dias, Rogério

    2016-07-01

    Several studies have demonstrated that the combination of hysteroscopy with endometrial biopsy is more accurate in differentiating endometrial polyps from endometrial hyperplasia and cancer. However, blind biopsy not always confirms hysteroscopic findings due to high rates of inadequate or insufficient material. The objective of this clinical, prospective, and comparative study was to establish a correlation between the histological results of office-based endometrial biopsies (hysteroscopically guided and blind) with the surgical polypectomy specimens. We evaluated 82 patients with hysteroscopic diagnosis of endometrial polyp, who randomly underwent hysteroscopically guided biopsy or blind biopsy, referred for surgical resection. A total of 36 women (43.9%) underwent hysteroscopically guided biopsy and 46 women (56.1%) underwent blind biopsy. The sensitivity of hysteroscopically guided biopsy for the diagnosis of endometrial polyps ranged between 35.3 and 36.8%, when carried out at the apex and base of the lesion, compared with 29.2% for blind biopsy. Specificity was 33.3, 50, and 60%, respectively, for each biopsy. The positive predictive values were 75, 77.8, and 87.5%, and negative predictive values were 8.3, 14.3, and 8.1% respectively, compared with surgical polypectomy specimens. The office-based endometrial biopsies had low diagnostic accuracy for endometrial polyps compared with surgical polypectomy specimens. PMID:27638896

  19. 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

  20. Colorectal Polyps Missed at Optical Colonoscopy Despite Prior Detection and Localization by CT Colonography

    PubMed Central

    Pooler, B. Dustin; Kim, David H.; Weiss, Jennifer M.; Matkowskyj, Kristina A.; Pickhardt, Perry J.

    2015-01-01

    Purpose To retrospectively evaluate and characterize non-diminutive colorectal polyps detected prospectively at CT colonography (CTC) but not confirmed at subsequent non-blinded optical colonoscopy (OC). Materials and Methods This study was IRB approved; the need for signed informed consent was waived. Over 113 months, 9,336 adults (mean age 57.1 years) underwent CTC, yielding 2,606 non-diminutive (≥6 mm) polyps. Of 1,731 polyps undergoing subsequent non-blinded OC (ie, endoscopists provided advance knowledge of specific polyp size, location, and morphology at CTC), 181 (10%) were not confirmed at initial endoscopy (discordant), of which 37 were excluded (awaiting or lost to follow-up). After discordant polyp review, 66 of the 144 lesions were categorized as likely CTC false-positives (no further action) and 78 were categorized as potential OC misses. Results 22% (31/144) of all discordant lesions were confirmed as OC false-negatives including 40% (31/78) of those with OC/CTC follow-up. OC missed lesions measured an average of 8.5 ± 3.3 mm in diameter and were identified with higher confidence at prospective CTC evaluation (mean 2.8 vs 2.3 on a 3-point confidence scale, p=0.001). OC missed lesions were more likely than OC-CTC concordant polyps to be located in the right colon (71%, 22/31 vs 47%, 723/1535, p=0.010). Most (81%, 21/26) ultimately resected OC misses were neoplastic (adenomas or serrated lesions), of which 43% (9/21) were characterized as advanced lesions with 89% (8/9) of advanced lesions occurring in the right colon. Conclusion In clinical practice, polyps prospectively identified at CTC but not confirmed at subsequent non-blinded (ie, despite a priori knowledge of the CTC findings) OC require additional review, as a substantial proportion may represent OC false-negatives. Most OC false-negatives demonstrated clinically significant histopathology with a large majority of advanced lesions occurring in the right colon. PMID:26280354

  1. 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

  2. Expression profiling of pattern recognition receptors and selected cytokines in miniature dachshunds with inflammatory colorectal polyps.

    PubMed

    Igarashi, Hirotaka; Ohno, Koichi; Maeda, Shingo; Kanemoto, Hideyuki; Fukushima, Kenjiro; Uchida, Kazuyuki; Tsujimoto, Hajime

    2014-05-15

    Inflammatory colorectal polyps (ICRPs) are commonly seen in miniature dachshund (MD) dogs; typically, multiple polyps form with severe neutrophil infiltration. ICRP is thought to be a novel form of inflammatory bowel disease (IBD), but its etiology has not been investigated. The innate immune system is implicated in the pathogenesis of both human and canine IBD. Therefore, the aim of the current study was to evaluate the messenger RNA (mRNA) expression profiles of pattern recognition receptors (PRRs) and cytokines in ICRPs. Polyp tissues were collected by colonoscopic biopsies from 24 MDs with ICRPs. Non-polypoid colonic mucosa was collected from all MDs with ICRPs and 21 clinically healthy beagles (as the controls). The expression levels of the mRNAs encoding toll-like receptors (TLRs) 1-10; nucleotide-binding oligomerization domain (NOD)-like receptors NOD1 and NOD2; and cytokines IL-1β, IL-6, IL-8/CXCL8, and TNF-α were evaluated by quantitative real-time RT-PCR. Three of the 10 well-known candidate reference genes were selected as housekeeper genes based on analyses from the GeNorm, NormFinder, and BestKeeper programs. Levels of TLR1, TLR2, TLR4, TLR6, TLR7, TLR8, TLR9, TLR10, NOD2, and all cytokines were significantly upregulated in the polyps relative to those in the controls. There was significant decrease in the expression levels of TLR3 and NOD1 in the polyp tissues compared to the non-polypoid colonic mucosa obtained from MDs with ICRPs. All upregulated PRR mRNAs were positively correlated with all proinflammatory cytokine mRNAs. This study demonstrated the dysregulation of PRRs and proinflammatory cytokines in ICRPs of MDs, which may play an important role in the pathogenesis of this disease.

  3. Colonoscopic polyp detection rate is stable throughout the workday including evening colonoscopy sessions

    PubMed Central

    Thurtle, David; Pullinger, Michael; Tsigarides, Jordan; McIntosh, Iris; Steytler, Carla; Beales, Ian

    2014-01-01

    Objective: Polyp detection rate (PDR) is an accepted measure of colonoscopy quality. Several factors may influence PDR including time of procedure and order of colonoscopy within a session. Our unit provides evening colonoscopy lists (6-9 pm). We examined whether colonoscopy performance declines in the evening. Design: Data for all National Health Service (NHS) outpatient colonoscopies performed at Norfolk and Norwich University Hospital in 2011 were examined. Timing, demographics, indication and colonoscopy findings were recorded. Statistical analysis was performed using multivariate regression. Results: Data from 2576 colonoscopies were included: 1163 (45.1%) in the morning, 1123 (43.6%) in the afternoon and 290 (11.3%) in the evening.  Overall PDR was 40.80%. Males, increasing age and successful caecal intubation were all significantly associated with higher polyp detection. The indications ‘faecal occult blood screening’ (p<0.001) and ‘polyp surveillance’ (p<0.001) were strongly positively associated and ‘anaemia’ (p=0.01) was negatively associated with PDR. Following adjustment for  covariates, there was no significant difference in PDR between sessions. With the morning as the reference value, the odds ratio for polyp detection in the afternoon and evening were 0.93 (95% CI = 0.72-1.18) and 1.15 (95%CI = 0.82-1.61) respectively. PDR was not affected by rank of colonoscopy within a list, sedation dose or trainee-involvement. Conclusions: Time of day did not affect polyp detection rate in clinical practice. Evening colonoscopy had equivalent efficacy and is an effective tool in meeting increasing demands for endoscopy. Standardisation was shown to have a considerable effect as demographics, indication and endoscopist varied substantially between sessions. Evening sessions were popular with a younger population PMID:25132961

  4. Distance weighted 'inside disc' classifier for computer-aided diagnosis of colonic polyps

    NASA Astrophysics Data System (ADS)

    Hu, Yifan; Song, Bowen; Pickhardt, Perry J.; Liang, Zhengrong

    2015-03-01

    Feature classification plays an important role in computer-aided diagnosis (CADx) of suspicious lesions or polyps in this concerned study. As one of the simplest machine learning algorithms, the k-nearest neighbor (k-NN) classifier has been widely used in many classification problems. However, the k-NN classifier has a drawback that the majority classes will dominate the prediction of a new sample. To mitigate this drawback, efforts have been devoted to set weight on each neighbor to avoid the influence of the "majority" classes. As a result, various weighted or wk-NN strategies have been explored. In this paper, we explored an alternative strategy, called "distance weighted inside disc" (DWID) classifier, which is different from the k-NN and wk-NN by such a way that it classifies the test point by assigning a corresponding label (instead a weight) with consideration of only those points inside the disc whose center is the test point instead of the k-nearest points. We evaluated this new DWID classifier with comparison to the k-NN, wk-NN, support vector machine (SVM) and random forest (RF) classifiers by experiments on a database of 153 polyps, including 116 neoplastic (malignance) polyps and 37 hyperplastic (benign) polyps, in terms of CADx or differentiation of benign from malignancy. The evaluation outcomes were documented quantitatively by the Receiver Operating Characteristics (ROC) analysis and the merit of area under the ROC curve (AUC), which is a well-established evaluation criterion to various classifiers. The results showed noticeable gain on the polyp differentiation by this new classifier according to the AUC values, as compared to the k-NN and wk-NN, as well as the SVM and RF. In the meantime, this new classifier also showed a noticeable reduction of computing time.

  5. Registration of central paths and colonic polyps between supine and prone scans in computed tomography colonography: Pilot study

    SciTech Connect

    Li Ping; Napel, Sandy; Acar, Burak; Paik, David S.; Jeffrey, R. Brooke Jr.; Beaulieu, Christopher F.

    2004-10-01

    Computed tomography colonography (CTC) is a minimally invasive method that allows the evaluation of the colon wall from CT sections of the abdomen/pelvis. The primary goal of CTC is to detect colonic polyps, precursors to colorectal cancer. Because imperfect cleansing and distension can cause portions of the colon wall to be collapsed, covered with water, and/or covered with retained stool, patients are scanned in both prone and supine positions. We believe that both reading efficiency and computer aided detection (CAD) of CTC images can be improved by accurate registration of data from the supine and prone positions. We developed a two-stage approach that first registers the colonic central paths using a heuristic and automated algorithm and then matches polyps or polyp candidates (CAD hits) by a statistical approach. We evaluated the registration algorithm on 24 patient cases. After path registration, the mean misalignment distance between prone and supine identical anatomic landmarks was reduced from 47.08 to 12.66 mm, a 73% improvement. The polyp registration algorithm was specifically evaluated using eight patient cases for which radiologists identified polyps separately for both supine and prone data sets, and then manually registered corresponding pairs. The algorithm correctly matched 78% of these pairs without user input. The algorithm was also applied to the 30 highest-scoring CAD hits in the prone and supine scans and showed a success rate of 50% in automatically registering corresponding polyp pairs. Finally, we computed the average number of CAD hits that need to be manually compared in order to find the correct matches among the top 30 CAD hits. With polyp registration, the average number of comparisons was 1.78 per polyp, as opposed to 4.28 comparisons without polyp registration.

  6. Automated scheme for measuring polyp volume in CT colonography using Hessian matrix-based shape extraction and 3D volume growing

    NASA Astrophysics Data System (ADS)

    Suzuki, Kenji; Epstein, Mark L.; Xu, Jianwu; Obara, Piotr; Rockey, Don C.; Dachman, Abraham H.

    2010-03-01

    Current measurement of the single longest dimension of a polyp is subjective and has variations among radiologists. Our purpose was to develop an automated measurement of polyp volume in CT colonography (CTC). We developed a computerized segmentation scheme for measuring polyp volume in CTC, which consisted of extraction of a highly polyp-like seed region based on the Hessian matrix, segmentation of polyps by use of a 3D volume-growing technique, and sub-voxel refinement to reduce a bias of segmentation. Our database consisted of 30 polyp views (15 polyps) in CTC scans from 13 patients. To obtain "gold standard," a radiologist outlined polyps in each slice and calculated volumes by summation of areas. The measurement study was repeated three times at least one week apart for minimizing a memory effect bias. We used the mean volume of the three studies as "gold standard." Our measurement scheme yielded a mean polyp volume of 0.38 cc (range: 0.15-1.24 cc), whereas a mean "gold standard" manual volume was 0.40 cc (range: 0.15-1.08 cc). The mean absolute difference between automated and manual volumes was 0.11 cc with standard deviation of 0.14 cc. The two volumetrics reached excellent agreement (intra-class correlation coefficient was 0.80) with no statistically significant difference (p(F<=f) = 0.42). Thus, our automated scheme efficiently provides accurate polyp volumes for radiologists.

  7. 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

  8. Do Not Be Fooled by Fancy Mutations: Inflammatory Fibroid Polyps Can Harbor Mutations Similar to Those Found in GIST.

    PubMed

    Bjerkehagen, Bodil; Aaberg, Kristin; Steigen, Sonja E

    2013-01-01

    Goal. Surgeons that remove a typical polyp from the stomach or small intestine should be reluctant to accept a diagnosis of GIST just because there is a mutation in platelet-derived growth factor receptor alfa (PDGFRA). Background. A subtype of gastric and intestinal polyps is denoted as inflammatory fibroid polyp (IFP). In some of these cases a mutation in PDGFRA is found, leading to the diagnosis of gastrointestinal stromal tumor (GIST). Study. This study includes two patients that had polyps removed from the ileum, and an extended investigation was performed with immunohistochemical staining and mutation analyses. Results. The tumors did not show typical immunohistochemical staining for markers used to diagnose GIST, but the mutation analysis revealed a mutation in PDGFRA exon 12. On the basis of the mutation analysis, both polyps were primarily diagnosed as GISTs, but the diagnosis was later changed to inflammatory fibroid polyp. Conclusion. It is important that both surgeons and pathologists be aware that IFP can harbor a mutation in PDGFRA where further treatment and follow-up is different with the two different diagnoses. A mutation analysis can be misleading when taken out of the context of clinical observations, histological characteristics and immunohistochemical staining.

  9. 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. PMID:26941874

  10. Biological dosimetry by chromosome aberration scoring with parallel image processing with the Heidelberg POLYP Polyprocessor system

    SciTech Connect

    Bille, J.; Scharfenberg, H.; Maenner, R.

    1983-01-01

    Chromosome aberrations in human peripheral blood are recognized parameters of cellular damage and are used as indicators of exposure to ionizing radiation. In order to reach the low dose range, up to 10,000 metaphase cells each consisting of 46 chromosomes have to be analysed for each radiation exposed person. In order to perform this task within reasonable time limits the application of the Heidelberg POLYP Polyprocessor is considered. The POLYP consists of a number of processor modules and several global memory modules which are interconnected by a multi-common-bus for parallel data transfers and a multiple synchronization bus for processor/task-scheduling. The system is designed for handling large amounts of data in real time as is typical for image processing applications.

  11. 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.

  12. 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.

  13. 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

  14. Correlation of Computed Tomography with Pathological Features in Angiomatous Nasal Polyps

    PubMed Central

    Dai, Li-Bo; Zhou, Shui-Hong; Ruan, Ling-Xiang; Zheng, Zhou-Jun

    2012-01-01

    Background Angiomatous nasal polyps (ANPs), also known as angiectatic polyps, have rarely been reported in the literature. ANPs are characterized by extensive vascular proliferation and ectasia. ANPs can grow rapidly and exhibit aggressive clinical behavior that could simulate malignancy preoperatively, and they are easily confused with other diseases. In the present study, we analyzed the correlation between the computed tomography (CT) findings of nasal angiomatous polyps and their pathological features. Methods We evaluated CT findings and pathological features of 31 surgically proven ANPs. Results The study population included 16 males and 15 females aged between 27 and 81 years (mean age, 53.5 years). On CT, the masses were heterogeneous; they had a soft tissue density and filled the maxillary and/or nasal cavities. Calcifications were found in 2 of the 31 cases. The lesions showed a clear boundary (15/31). The low-density shading on CT was related to the inflammatory, necrotic, and cystic changes, and the high-density shading on CT was related to hemorrhagic areas of the mass. On contrast-enhanced CT, the center of the lesions was non-enhanced with peripheral intensification due to occlusion or compression of feeder vessels of the polyp center, and the inflammatory cells and neovascularization around the edge of the mass. The most common site of maxillary wall erosion was the medial wall (21/31), followed by the posterior lateral wall (3/31), upper wall (2/31), and septum (3/31). Of these, the nasal cavity and/or maxillary sinus were enlarged in 28 cases. These findings were associated with the chronic progress of nasal angiomatous changes. Conclusions CT of ANPs may demonstrate benign bone changes associated with the lesions and may also reflect the fact that ANPs do not invade peripheral soft tissue. CT demonstrated these lesions consistently and provided information useful for surgical planning. PMID:23300910

  15. Detection of the c-myc oncogene product in colonic polyps and carcinomas.

    PubMed Central

    Stewart, J.; Evan, G.; Watson, J.; Sikora, K.

    1986-01-01

    The c-myc oncogene has been implicated in the processes of normal cell proliferation and differentiation. Elevated levels of c-myc mRNA and its gene product (p62c-myc), have been detected in a variety of solid tumours and cultured cel lines. Its precise role in normal cell function and in neoplastic transformation and progression has yet to be elucidated. We have used a monoclonal antibody, raised by peptide immunisation, to determine the distribution by immunoperoxidase staining of the c-myc oncogene product in archival specimens of colonic polyps and carcinomas. Samples from 42 patients with colon carcinoma, 24 with benign polyps and 15 normal colon biopsies were examined. Normal colon revealed maximum staining in the mid-zone of the crypts, corresponding to the zone of differentiation and maturation. The staining was predominantly cytoplasmic. Adenomatous polyps revealed the most intense pattern of staining in areas of dysplastic change. Colonic tumours showed a wide range of staining. Well differentiated tumours contained more cytoplasmic p62c-myc than poorly differentiated tumours. These findings suggest that the c-myc oncogene product may play an important role in the evolution of colonic neoplasia. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:3511934

  16. Oncogene Mutations in Colorectal Polyps Identified in the Norwegian Colorectal Cancer Prevention (NORCCAP) Screening Study

    PubMed Central

    Lorentzen, Jon A.; Grzyb, Krzysztof; De Angelis, Paula M.; Hoff, Geir; Eide, Tor J.; Andresen, Per Arne

    2016-01-01

    Data are limited on oncogene mutation frequencies in polyps from principally asymptomatic participants of population-based colorectal cancer screening studies. In this study, DNA from 204 polyps, 5 mm or larger, were collected from 176 participants of the NORCCAP screening study and analyzed for mutations in KRAS, BRAF, and PIK3CA including the rarely studied KRAS exons 3 and 4 mutations. KRAS mutations were identified in 23.0% of the lesions and were significantly associated with tubulovillous adenomas and large size. A significantly higher frequency of KRAS mutations in females was associated with mutations in codon 12. The KRAS exon 3 and 4 mutations constituted 23.4% of the KRAS positive lesions, which is a larger proportion compared to previous observations in colorectal cancer. BRAF mutations were identified in 11.3% and were associated with serrated polyps. None of the individuals were diagnosed with de novo or recurrent colorectal cancer during the follow-up time (median 11.2 years). Revealing differences in mutation-spectra according to gender and stages in tumorigenesis might be important for optimal use of oncogenes as therapeutic targets and biomarkers. PMID:27656095

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

    PubMed

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

    2016-02-23

    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.

  18. 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

  19. Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps.

    PubMed

    Saunders, Brian P; Tsiamoulos, Zacharias P

    2016-08-01

    Almost all large and complex colorectal polyps can now be resected endoscopically. Piecemeal endoscopic mucosal resection (PEMR) is an established technique with fairly low complication risk and good short-term and medium-term outcomes. Several modifications to the basic injection and snare technique have been developed contributing to safer and more complete resections. Delayed bleeding requiring reintervention is the most troublesome complication in 2-7% of patients, particularly in those with comorbidities and large, right-sided polyps. Endoscopic submucosal dissection (ESD) has become popular in Japan and has theoretical advantages over PEMR in providing a complete, en bloc excision for accurate histological staging and reduced local recurrence. These advantages come at the cost of a more complex, expensive and time-consuming procedure with a higher risk of perforation, particularly early in the procedure learning curve. These factors have contributed to the slow adoption of ESD in the West and the challenge to develop new devices and endoscopic platforms that will make ESD easier and safer. Currently, ESD indications are limited to large rectal lesions, in which procedural complications are easily managed, and for colorectal polyps with a high risk of containing tiny foci of early submucosally invasive cancer, whereby ESD may be curative compared with PEMR. PMID:27353401

  20. Oncogene Mutations in Colorectal Polyps Identified in the Norwegian Colorectal Cancer Prevention (NORCCAP) Screening Study.

    PubMed

    Lorentzen, Jon A; Grzyb, Krzysztof; De Angelis, Paula M; Hoff, Geir; Eide, Tor J; Andresen, Per Arne

    2016-01-01

    Data are limited on oncogene mutation frequencies in polyps from principally asymptomatic participants of population-based colorectal cancer screening studies. In this study, DNA from 204 polyps, 5 mm or larger, were collected from 176 participants of the NORCCAP screening study and analyzed for mutations in KRAS, BRAF, and PIK3CA including the rarely studied KRAS exons 3 and 4 mutations. KRAS mutations were identified in 23.0% of the lesions and were significantly associated with tubulovillous adenomas and large size. A significantly higher frequency of KRAS mutations in females was associated with mutations in codon 12. The KRAS exon 3 and 4 mutations constituted 23.4% of the KRAS positive lesions, which is a larger proportion compared to previous observations in colorectal cancer. BRAF mutations were identified in 11.3% and were associated with serrated polyps. None of the individuals were diagnosed with de novo or recurrent colorectal cancer during the follow-up time (median 11.2 years). Revealing differences in mutation-spectra according to gender and stages in tumorigenesis might be important for optimal use of oncogenes as therapeutic targets and biomarkers. PMID:27656095

  1. Oncogene Mutations in Colorectal Polyps Identified in the Norwegian Colorectal Cancer Prevention (NORCCAP) Screening Study

    PubMed Central

    Lorentzen, Jon A.; Grzyb, Krzysztof; De Angelis, Paula M.; Hoff, Geir; Eide, Tor J.; Andresen, Per Arne

    2016-01-01

    Data are limited on oncogene mutation frequencies in polyps from principally asymptomatic participants of population-based colorectal cancer screening studies. In this study, DNA from 204 polyps, 5 mm or larger, were collected from 176 participants of the NORCCAP screening study and analyzed for mutations in KRAS, BRAF, and PIK3CA including the rarely studied KRAS exons 3 and 4 mutations. KRAS mutations were identified in 23.0% of the lesions and were significantly associated with tubulovillous adenomas and large size. A significantly higher frequency of KRAS mutations in females was associated with mutations in codon 12. The KRAS exon 3 and 4 mutations constituted 23.4% of the KRAS positive lesions, which is a larger proportion compared to previous observations in colorectal cancer. BRAF mutations were identified in 11.3% and were associated with serrated polyps. None of the individuals were diagnosed with de novo or recurrent colorectal cancer during the follow-up time (median 11.2 years). Revealing differences in mutation-spectra according to gender and stages in tumorigenesis might be important for optimal use of oncogenes as therapeutic targets and biomarkers.

  2. 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

  3. Computed tomographic colonography (CTC): Possibilities and limitations of clinical application in colorectal polyps and cancer.

    PubMed

    Heuschmid, Martin; Luz, Oliver; Schaefer, Juergen F; Kopp, Andreas F; Claussen, Claus D; Seemann, Marcus D

    2004-04-01

    Colorectal cancer is the second leading cause of cancer-related deaths in Europe and the United States. Most colorectal cancers develop from adenomatous polyps over a number of years. Early detection of polyps eliminates the risk of subsequent carcinomas. Computed tomographic (CT) colonography is a diagnostic technique detecting colorectal neoplasms. With the introduction of multidetector-row computed tomography (MD-CT), CT colonography (CTC) has gained influence as a new diagnostic tool in early detection of colonic pathologies by acquiring volumetric CT data sets of the abdomen. This volumetric data is analyzed using CTC workstations, which provide an interactive display of 2D and 3D images of the colon. In several studies, CTC revealed a high accuracy (sensitivity/patient: 83-100% and specificity/patient: 93-100%) in detecting pathological colonic changes. Furthermore, CTC is an excellent diagnostic technique for the evaluation of patients with incomplete conventional colonoscopy and allows the assessment of extracolonic abdominal and pelvic organs. In this article, the status of CT colonography as a method of detecting colonic polyps and colorectal carcinomas using single- and multidetector-row CT will be reviewed.

  4. Three-Dimensional Flow Separation Induced by a Model Vocal Fold Polyp

    NASA Astrophysics Data System (ADS)

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

    2012-11-01

    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. A recent in-vitro investigation of a model polyp in a driven vocal fold apparatus demonstrated that such a geometric abnormality considerably disrupts the glottal jet behavior and that this flow field adjustment was a likely reason for the severe degradation of the vocal quality in patients. Understanding of the formation and propagation of vortical structures from a geometric protuberance, and their subsequent impact on the aerodynamic loadings that drive vocal fold dynamic, is a critical component in 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. Unsteady three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  5. The Influence of Screening for Precancerous Lesions on Family-Based Genetic Association Tests: An Example of Colorectal Polyps and Cancer

    PubMed Central

    Schmit, Stephanie L.; Figueiredo, Jane C.; Cortessis, Victoria K.; Thomas, Duncan C.

    2015-01-01

    Unintended consequences of secondary prevention include potential introduction of bias into epidemiologic studies estimating genotype-disease associations. To better understand such bias, we simulated a family-based study of colorectal cancer (CRC), which can be prevented by resecting screen-detected polyps. We simulated genes related to CRC development through risk of polyps (G1), risk of CRC but not polyps (G2), and progression from polyp to CRC (G3). Then, we examined 4 analytical strategies for studying diseases subject to secondary prevention, comparing the following: 1) CRC cases with all controls, without adjusting for polyp history; 2) CRC cases with controls, adjusting for polyp history; 3) CRC cases with only polyp-free controls; and 4) cases with either CRC or polyps with controls having neither. Strategy 1 yielded estimates of association between CRC and each G that were not substantially biased. Strategies 2–4 yielded biased estimates varying in direction according to analysis strategy and gene type. Type I errors were correct, but strategy 1 provided greater power for estimating associations with G2 and G3. We also applied each strategy to case-control data from the Colon Cancer Family Registry (1997–2007). Generally, the best analytical option balancing bias and power is to compare all CRC cases with all controls, ignoring polyps. PMID:26306664

  6. Quantitative radiology: automated measurement of polyp volume in computed tomography colonography using Hessian matrix-based shape extraction and volume growing

    PubMed Central

    Epstein, Mark L.; Obara, Piotr R.; Chen, Yisong; Liu, Junchi; Zarshenas, Amin; Makkinejad, Nazanin; Dachman, Abraham H.

    2015-01-01

    Background Current measurement of the single longest dimension of a polyp is subjective and has variations among radiologists. Our purpose was to develop a computerized measurement of polyp volume in computed tomography colonography (CTC). Methods We developed a 3D automated scheme for measuring polyp volume at CTC. Our scheme consisted of segmentation of colon wall to confine polyp segmentation to the colon wall, extraction of a highly polyp-like seed region based on the Hessian matrix, a 3D volume growing technique under the minimum surface expansion criterion for segmentation of polyps, and sub-voxel refinement and surface smoothing for obtaining a smooth polyp surface. Our database consisted of 30 polyp views (15 polyps) in CTC scans from 13 patients. Each patient was scanned in the supine and prone positions. Polyp sizes measured in optical colonoscopy (OC) ranged from 6-18 mm with a mean of 10 mm. A radiologist outlined polyps in each slice and calculated volumes by summation of volumes in each slice. The measurement study was repeated 3 times at least 1 week apart for minimizing a memory effect bias. We used the mean volume of the three studies as “gold standard”. Results Our measurement scheme yielded a mean polyp volume of 0.38 cc (range, 0.15-1.24 cc), whereas a mean “gold standard” manual volume was 0.40 cc (range, 0.15-1.08 cc). The “gold-standard” manual and computer volumetric reached excellent agreement (intra-class correlation coefficient =0.80), with no statistically significant difference [P (F≤f) =0.42]. Conclusions We developed an automated scheme for measuring polyp volume at CTC based on Hessian matrix-based shape extraction and volume growing. Polyp volumes obtained by our automated scheme agreed excellently with “gold standard” manual volumes. Our fully automated scheme can efficiently provide accurate polyp volumes for radiologists; thus, it would help radiologists improve the accuracy and efficiency of polyp volume

  7. Computer-assisted detection of colonic polyps with CT colonography using neural networks and binary classification trees.

    PubMed

    Jerebko, Anna K; Summers, Ronald M; Malley, James D; Franaszek, Marek; Johnson, C Daniel

    2003-01-01

    Detection of colonic polyps in CT colonography is problematic due to complexities of polyp shape and the surface of the normal colon. Published results indicate the feasibility of computer-aided detection of polyps but better classifiers are needed to improve specificity. In this paper we compare the classification results of two approaches: neural networks and recursive binary trees. As our starting point we collect surface geometry information from three-dimensional reconstruction of the colon, followed by a filter based on selected variables such as region density, Gaussian and average curvature and sphericity. The filter returns sites that are candidate polyps, based on earlier work using detection thresholds, to which the neural nets or the binary trees are applied. A data set of 39 polyps from 3 to 25 mm in size was used in our investigation. For both neural net and binary trees we use tenfold cross-validation to better estimate the true error rates. The backpropagation neural net with one hidden layer trained with Levenberg-Marquardt algorithm achieved the best results: sensitivity 90% and specificity 95% with 16 false positives per study.

  8. The impact of detection and treatment on lifetime medical costs for patients with precancerous polyps and colorectal cancer.

    PubMed

    Howard, David H; Tangka, Florence K; Seeff, Laura C; Richardson, Lisa C; Ekwueme, Donatus U

    2009-12-01

    Understanding the costs associated with early detection of disease is important for determining the fiscal implications of government-funded screening programs. We estimate the lifetime medical costs for patients with screen-detected versus undetected polyps and early-stage colorectal cancer. Typically, cost-effectiveness studies of screening account only for the direct costs of screening and cancer care. Our estimates include costs for unrelated conditions. We applied the Kaplan-Meier Smoothing Estimator to estimate lifetime costs for beneficiaries with screen-detected polyps and cancer. Phase-specific costs and survival probabilities were calculated from the Surveillance, Epidemiology, and End Results-Medicare database for Medicare beneficiaries aged >or=65. We estimate costs from the point of detection onward; therefore, our results do not include the costs associated with screening. We used a modified version of the model to estimate what lifetime costs for these patients would have been if the polyps or cancer remained undetected, based on assumptions about the 'lead time' for polyps and early-stage cancer. For younger patients, polyp removal is cost saving. Treatment of early-stage cancer is cost increasing. PMID:19142856

  9. 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

  10. Effects of seawater pH on growth and skeletal U/Ca ratios of Acropora digitifera coral polyps

    NASA Astrophysics Data System (ADS)

    Inoue, Mayuri; Suwa, Ryota; Suzuki, Atsushi; Sakai, Kazuhiko; Kawahata, Hodaka

    2011-06-01

    The impact of ocean acidification caused by the increasing atmospheric CO2 has been studied in marine calcifiers, including hermatypic corals. However, the effect of elevated pCO2 on the early developmental life-cycle stage of corals has been little studied. In this study, we reared polyps of Acropora digitifera in seawater at pHT 6.55, 7.31, 7.64, 7.77, and 8.03, controlled by CO2 bubbling. We measured the dry weights of polyp skeletons after the 40-d experiment to investigate the relationship between the seawater aragonite saturation state and polyp growth. In addition, we measured skeletal U/Ca ratio to estimate their pH dependence. Skeletal weights of coral polyps increased with the aragonite saturation state and reached an apparent saturation plateau above pH 7.77. U/Ca ratios had a strong inverse relationship with pH and a negligible relationship with skeletal growth rate (polyp weight), suggesting that skeletal U/Ca could be useful for reconstructing paleo-pH.

  11. Blood lipids and colorectal polyps: testing an etiologic hypothesis using phenotypic measurements and Mendelian randomization

    PubMed Central

    Passarelli, Michael N.; Newcomb, Polly A.; Makar, Karen W.; Burnett-Hartman, Andrea N.; Potter, John D.; Upton, Melissa P.; Zhu, Lee-Ching; Rosenfeld, Michael E.; Schwartz, Stephen M.; Rutter, Carolyn M.

    2015-01-01

    Purpose Studies linking cholesterol levels to the development of colorectal neoplasia are inconsistent, and Mendelian randomization has been suggested as a way to help avoid problems with confounding and reverse causation. Methods We genotyped individuals who received a colonoscopy at Group Health (1998–2007) for 96 of 102 single-nucleotide polymorphisms (SNPs) identified by the Global Lipids Genetics Consortium. Participants included 139 advanced adenoma cases, 518 non-advanced adenoma cases, 380 non-adenomatous polyp cases, and 754 polyp-free controls. All had at least one available pre-colonoscopy lipid measurement from electronic records maintained by Group Health. Results Advanced adenoma cases were more likely than controls to have higher pre-colonoscopy zenith low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC) (odds ratio, OR, per 20 mg/dL LDL increase: 1.16, 95% confidence interval, CI, 1.03–1.30; per 40 mg/dL TG increase: 1.09, 1.03–1.16; and per 20 mg/dL TC increase: 1.09, 1.02–1.18). For these traits, genotype-polyp ORs using weighted allele scores were not statistically significant (OR per increase in score scaled to a 20 mg/dL LDL increase: 1.17, 0.78–1.75; a 40 mg/dL TG increase: 1.12, 0.91–1.38; a 20 mg/dL TC increase: 0.99, 0.71–1.38). Conclusions Cholesterol levels may be associated with advanced adenomas, but larger studies are warranted to determine whether this association can be attributed to genetics. PMID:25618792

  12. Development of Advanced Imaging Criteria for the Endoscopic Identification of Inflammatory Polyps

    PubMed Central

    Sussman, Daniel A; Barkin, Jodie A; Martin, Aileen M; Varma, Tanya; Clarke, Jennifer; Quintero, Maria A; Barkin, Heather B; Deshpande, Amar R; Barkin, Jamie S; Abreu, Maria T

    2015-01-01

    OBJECTIVES: Inflammatory polyps (IPs) are frequently encountered at colonoscopy in inflammatory bowel disease (IBD) patients and are associated with an increased risk of colon cancer. The aim of this prospective endoscopic image review and analysis was to describe endoscopic features of IPs in IBD patients at surveillance colonoscopy and determine the ability to endoscopically discern IPs from other colon polyps using high-definition white light (WL), narrow band imaging with magnification (NBI), and chromoendoscopy (CE). METHODS: Digital images of IPs using WL, NBI, and CE were reviewed by four attending gastroenterologists using a two-round modified Delphi method. The ability to endoscopically discern IPs from other colon polyps was determined among groups of gastroenterology fellows and attendings. IPs were classified by gross appearance, contour, surface pattern, pit pattern, and appearance of surrounding mucosa in IPs, as well as accuracy of diagnosis. RESULTS: Features characteristic of IPs included a fibrinous cap, surface friability and ulceration, an appendage-like appearance, the halo sign with CE, and a clustering of a multiplicity of IPs. The overall diagnostic accuracy for IP identification was 63% for WL, 42% for NBI, and 64% for CE. High degrees of histologic inflammation significantly improved the accuracy of diagnosis of IP with WL and CE, whereas the use of NBI significantly impaired IP accuracy. CONCLUSIONS: The overall diagnostic accuracy when applying these criteria to clinical images was modest, with incremental benefit with addition of CE to WL. CE showed promise predicting IP histology in actively inflamed tissue. Institutional Review Board approval was obtained. ClinicalTrials.gov Identifier: NCT01557387. PMID:26583503

  13. Curcumin suppresses intestinal polyps in APC Min mice fed a high fat diet.

    PubMed

    Pettan-Brewer, Christina; Morton, John; Mangalindan, Ruby; Ladiges, Warren

    2011-01-01

    Colorectal cancer (CRC) is a leading cause of cancer deaths in the United States. Various risk factors have been associated with CRC including increasing age and diet. Epidemiological and experimental studies have implicated a diet high in fat as an important risk factor for colon cancer. High fat diets can promote obesity resulting in insulin resistance and inflammation and the development of oxidative stress, increased cell proliferation, and suppression of apoptosis. Because of the high consumption of dietary fats, especially saturated fats, by Western countries, it is of interest to see if non-nutrient food factors might be effective in preventing or delaying CRC in the presence of high saturated fat intake. Curcumin (Curcuma longa), the main yellow pigment in turmeric, was selected to test because of its reported anti-tumor activity. APC Min mice, which develop intestinal polyps and have many molecular features of CRC, were fed a diet containing 35% pork fat, 33% sucrose, and a protein and vitamin mineral mixture (HFD) with or without 0.5% curcumin. These cohorts were compared to APC Min mice receiving standard rodent chow (RC) with 8% fat. APC Min mice fed the HFD for 3 months had a 23% increase in total number of polyps compared to APC Min mice on RC. Curcumin was able to significantly reverse the accelerated polyp development associated with the HFD suggesting it may be effective clinically in helping prevent colon cancer even when ingesting high amounts of fatty foods. The anti-tumor effect of curcumin was shown to be associated with enhanced apoptosis and increased efficiency of DNA repair. Since curcumin prevented the gain in body weight seen in APC Min mice ingesting the HFD, modulation of energy metabolism may also be a factor.

  14. HPP1: A transmembrane protein-encoding gene commonly methylated in colorectal polyps and cancers

    PubMed Central

    Young, Joanne; Biden, Kelli G.; Simms, Lisa A.; Huggard, Phillip; Karamatic, Rozemary; Eyre, Helen J.; Sutherland, Grant R.; Herath, Nirmitha; Barker, Melissa; Anderson, Gregory J.; Fitzpatrick, David R.; Ramm, Grant A.; Jass, Jeremy R.; Leggett, Barbara A.

    2001-01-01

    Adenomas are the precursors of most colorectal cancers. Hyperplastic polyps have been linked to the subset of colorectal cancers showing DNA microsatellite instability, but little is known of their underlying genetic etiology. Using a strategy that isolates differentially methylated sequences from hyperplastic polyps and normal mucosa, we identified a 370-bp sequence containing the 5′ untranslated region and the first exon of a gene that we have called HPP1. Rapid amplification of cDNA ends was used to isolate HPP1 from normal mucosa. Using reverse transcription–PCR, HPP1 was expressed in 28 of 30 (93%) normal colonic samples but in only seven of 30 (23%) colorectal cancers (P < 0.001). The 5′ region of HPP1 included a CpG island containing 49 CpG sites, of which 96% were found to be methylated by bisulfite sequencing of DNA from colonic tumor samples. By COBRA analysis, methylation was detected in six of nine (66%) adenomas, 17 of 27 (63%) hyperplastic polyps, and 46 of 55 (84%) colorectal cancers. There was an inverse relationship between methylation level and mRNA expression in cancers (r = −0.67; P < 0.001), and 5-aza-2-deoxycytidine treatment restored HPP1 expression in two colorectal cancer cell lines. In situ hybridization of HPP1 indicated that expression occurs in epithelial and stromal elements in normal mucosa but is silenced in both cell types in early colonic neoplasia. HPP1 is predicted to encode a transmembrane protein containing follistatin and epidermal growth factor-like domains. Silencing of HPP1 by methylation may increase the probability of neoplastic transformation. PMID:11120884

  15. Celecoxib Alters the Intestinal Microbiota and Metabolome in Association with Reducing Polyp Burden.

    PubMed

    Montrose, David C; Zhou, Xi Kathy; McNally, Erin M; Sue, Erika; Yantiss, Rhonda K; Gross, Steven S; Leve, Nitai D; Karoly, Edward D; Suen, Chen S; Ling, Lilan; Benezra, Robert; Pamer, Eric G; Dannenberg, Andrew J

    2016-09-01

    Treatment with celecoxib, a selective COX-2 inhibitor, reduces formation of premalignant adenomatous polyps in the gastrointestinal tracts of humans and mice. In addition to its chemopreventive activity, celecoxib can exhibit antimicrobial activity. Differing bacterial profiles have been found in feces from colon cancer patients compared with those of normal subjects. Moreover, preclinical studies suggest that bacteria can modulate intestinal tumorigenesis by secreting specific metabolites. In the current study, we determined whether celecoxib treatment altered the luminal microbiota and metabolome in association with reducing intestinal polyp burden in mice. Administration of celecoxib for 10 weeks markedly reduced intestinal polyp burden in APC(Min/+) mice. Treatment with celecoxib also altered select luminal bacterial populations in both APC(Min/+) and wild-type mice, including decreased Lactobacillaceae and Bifidobacteriaceae as well as increased Coriobacteriaceae Metabolomic analysis demonstrated that celecoxib caused a strong reduction in many fecal metabolites linked to carcinogenesis, including glucose, amino acids, nucleotides, and lipids. Ingenuity Pathway Analysis suggested that these changes in metabolites may contribute to reduced cell proliferation. To this end, we showed that celecoxib reduced cell proliferation in the base of normal appearing ileal and colonic crypts of APC(Min/+) mice. Consistent with this finding, lineage tracing indicated that celecoxib treatment reduced the rate at which Lgr5-positive stem cells gave rise to differentiated cell types in the crypts. Taken together, these results demonstrate that celecoxib alters the luminal microbiota and metabolome along with reducing epithelial cell proliferation in mice. We hypothesize that these actions contribute to its chemopreventive activity. Cancer Prev Res; 9(9); 721-31. ©2016 AACR. PMID:27432344

  16. 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. PMID:21933164

  17. Staphylococcal enterotoxin B influences the DNA methylation pattern in nasal polyp tissue: a preliminary study

    PubMed Central

    2013-01-01

    Staphylococcal enterotoxins may influence the pro-inflammatory pattern of chronic sinus diseases via epigenetic events. This work intended to investigate the potential of staphylococcal enterotoxin B (SEB) to induce changes in the DNA methylation pattern. Nasal polyp tissue explants were cultured in the presence and absence of SEB; genomic DNA was then isolated and used for whole genome methylation analysis. Results showed that SEB stimulation altered the methylation pattern of gene regions when compared with non stimulated tissue. Data enrichment analysis highlighted two genes: the IKBKB and STAT-5B, both playing a crucial role in T- cell maturation/activation and immune response. PMID:24341752

  18. inv(12)(p11.2q13) in an endometrial polyp.

    PubMed

    Walter, T A; Fan, S X; Medchill, M T; Berger, C S; Decker, H J; Sandberg, A A

    1989-08-01

    A benign endometrial polyp from a 50-year-old postmenopausal woman has been cytogenetically investigated. A single clonal karyotypic anomaly, inv(12)(p11.2q13), was found in about 30% of cells analyzed after short-term culture. This finding contributes further to the hypothesis that the chromosomal segment 12q13-q14, which is also involved in chromosomal rearrangements in uterine leiomyomas, pleomorphic adenomas of the salivary glands, lipomas, and myxoid liposarcomas, contains a gene or genes that are related to cellular proliferation rather than to malignant transformation.

  19. 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

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

    PubMed

    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 Wm(2)), current (1.60 Wm(2)), future-high (1.77 Wm(2))) 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

  1. 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

  2. Automated image-based colon cleansing for laxative-free CT colonography computer-aided polyp detection

    SciTech Connect

    Linguraru, Marius George; Panjwani, Neil; Fletcher, Joel G.; Summer, Ronald M.

    2011-12-15

    Purpose: To evaluate the performance of a computer-aided detection (CAD) system for detecting colonic polyps at noncathartic computed tomography colonography (CTC) in conjunction with an automated image-based colon cleansing algorithm. Methods: An automated colon cleansing algorithm was designed to detect and subtract tagged-stool, accounting for heterogeneity and poor tagging, to be used in conjunction with a colon CAD system. The method is locally adaptive and combines intensity, shape, and texture analysis with probabilistic optimization. CTC data from cathartic-free bowel preparation were acquired for testing and training the parameters. Patients underwent various colonic preparations with barium or Gastroview in divided doses over 48 h before scanning. No laxatives were administered and no dietary modifications were required. Cases were selected from a polyp-enriched cohort and included scans in which at least 90% of the solid stool was visually estimated to be tagged and each colonic segment was distended in either the prone or supine view. The CAD system was run comparatively with and without the stool subtraction algorithm. Results: The dataset comprised 38 CTC scans from prone and/or supine scans of 19 patients containing 44 polyps larger than 10 mm (22 unique polyps, if matched between prone and supine scans). The results are robust on fine details around folds, thin-stool linings on the colonic wall, near polyps and in large fluid/stool pools. The sensitivity of the CAD system is 70.5% per polyp at a rate of 5.75 false positives/scan without using the stool subtraction module. This detection improved significantly (p = 0.009) after automated colon cleansing on cathartic-free data to 86.4% true positive rate at 5.75 false positives/scan. Conclusions: An automated image-based colon cleansing algorithm designed to overcome the challenges of the noncathartic colon significantly improves the sensitivity of colon CAD by approximately 15%.

  3. 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.

  4. Label-free imaging of goblet cells as a marker for differentiating colonic polyps by multiphoton microscopy Label-free imaging of goblet cells

    NASA Astrophysics Data System (ADS)

    Zhuo, S. M.; Wu, G. Z.; Chen, J. X.; Zhu, X. Q.; Xie, S. S.

    2012-06-01

    Discrimination of adenomas from hyperplastic polyps can reduce the risk of unnecessary complications and healthcare cost. However, it is challenging during colonoscopy screening, and histological analysis remains the ``gold standard'' for the final diagnosis. Here, we describe a label-free imaging method, multiphoton microscopy (MPM), to the discrimination between adenomas and hyperplastic polyps. We find that multiphoton imaging provides cellular and subcellular details to the identification of adenomas from hyperplastic polyps. In particular, there is significant difference in the population density of goblet cells among normal colon, hyperplastic polyp, and adenoma, providing substantial potential to become a quantitative intrinsic marker for in vivo clinical diagnosis of early colonic lesions. To our knowledge, this is the first demonstration of the potential of MPM for differentiation of colonic polyps.

  5. 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

  6. Giant Inflammatory Fibroid Polyp of the Hepatic Flexure of Colon Presenting with an Acute Abdomen

    PubMed Central

    Shrestha, Pradita

    2016-01-01

    Background. Inflammatory Fibroid Polyp (IFP) of the colon is an exceedingly rare condition. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm) polyps mostly found in the caecum (15 cases) with only 3 in the descending colon. Case Presentation. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy. A mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted. Right hemicolectomy with ileotransverse anastomosis was performed. The mass was subsequently reported to be IFP. Conclusion. IFP is a very rare condition with clinical presentation depending upon its size and location. Definitive diagnosis is possible with histopathological examination of tissue aided by immunohistochemical studies. Surgical resection has been the most common method of treatment especially for large and giant colonic IFPs owing to challenges in terms of diagnosis and technical difficulties associated with endoscopic methods. PMID:27781129

  7. Magnifying chromoendoscopic and endocytoscopic findings of juvenile polyps in the colon and rectum

    PubMed Central

    TAKEDA, KENICHI; KUDO, SHIN-EI; MORI, YUICHI; MISAWA, MASASHI; KUDO, TOYOKI; WAKAMURA, KUNIHIKO; HAYASHI, TAKEMASA; MIYACHI, HIDEYUKI; ISHIDA, FUMIO; INOUE, HARUHIRO

    2016-01-01

    A precise endoscopic diagnosis is necessary for endoscopic therapy for neoplastic and non-neoplastic lesions, including juvenile polyps (JPs). Therefore, the present study aimed to clarify the characteristic endoscopic findings of JPs. A total of 154 JPs were evaluated by magnifying chromoendoscopy, 20 of which were also assessed by endocytoscopy using an ultra-high magnification endoscope. Endoscopic images were evaluated in terms of gross appearance, color, pit pattern, surface inflammatory changes and vascularity of polyps. Endocytoscopic images were evaluated with regard to the morphology of glandular cavities, nuclei of glandular cells and interstitial features. Reddish surfaces (98.1%), surface erosion (92.2%), open pits (90.3%) and low pit density (90.3%) were observed in the majority of JPs by chromoendoscopy. In addition, dilated ductal openings surrounded by normal glandular cells (100%), greater distances between gland basal layers (100%) and interstitial infiltration by inflammatory cells (100%) were observed in all JPs examined by endocytoscopy. These findings indicate that there is a tetralogy of magnifying chromoendoscopic findings characteristic of JPs: Reddish surfaces, surface erosion, open pits and low pit density. There is also a triad of endocytoscopic findings characteristic of JPs, namely dilated ductal openings surrounded by normal glandular cells, greater distances between gland basal layers, and interstitial infiltration by inflammatory cells. The aforementioned magnifying chromoendoscopic and endocytoscopic characteristics of JPs may be useful factors for diagnosing JPs. PMID:26870195

  8. 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

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

    PubMed

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

    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

  10. Serrated polyposis associated with a family history of colorectal cancer and/or polyps: The preferential location of polyps in the colon and rectum defines two molecular entities.

    PubMed

    Silva, Patrícia; Albuquerque, Cristina; Lage, Pedro; Fontes, Vanessa; Fonseca, Ricardo; Vitoriano, Inês; Filipe, Bruno; Rodrigues, Paula; Moita, Susana; Ferreira, Sara; Sousa, Rita; Claro, Isabel; Nobre Leitão, Carlos; Chaves, Paula; Dias Pereira, António

    2016-09-01

    Serrated polyposis (SPP) is characterized by the development of multiple serrated polyps and an increased predisposition to colorectal cancer (CRC). In the present study, we aimed to characterize, at a clinical and molecular level, a cohort of SPP patients with or without a family history of SPP and/or polyps/CRC (SPP-FHP/CRC). Sixty-two lesions from 12 patients with SPP-FHP/CRC and 6 patients with sporadic SPP were included. The patients with SPP-FHP/CRC presented with an older mean age at diagnosis (p=0.027) and a more heterogeneous histological pattern of lesions (p=0.032) than the patients with sporadic SPP. We identified two molecular forms of SPP-FHP/CRC, according to the preferential location of the lesions: proximal/whole-colon or distal colon. Mismatch repair (MMR) gene methylation [mutS homolog 6 (MSH6)/mutS homolog 3 (MSH3)] or loss of heterozygosity (LOH) of D2S123 (flanking MSH6) were detected exclusively in the former (p=3.0x10-7), in most early lesions. Proximal/whole‑colon SPP-FHP/CRC presented a higher frequency of O-6-methylguanine-DNA methyltransferase (MGMT) methylation/LOH, microsatellite instability (MSI) and Wnt mutations (19/29 vs. 7/17; 16/23 vs. 1/14, p=2.2x10-4; 15/26 vs. 2/15, p=0.006; 14/26 vs. 4/20, p=0.02) but a lower frequency of B-raf proto-oncogene, serine/threonine kinase (BRAF) mutations (7/30 vs. 12/20, p=0.0089) than the distal form. CRC was more frequent in cases of Kirsten rat sarcoma viral oncogene homolog (KRAS)-associated proximal/whole-colon SPP-FHP/CRC than in the remaining cases (4/4 vs. 1/8, p=0.01). Thus, SPP-FHP/CRC appears to be a specific entity, presenting two forms, proximal/whole-colon and distal, which differ in the underlying tumor initiation pathways. Early MGMT and MMR gene deficiency in the former may underlie an inherited susceptibility to genotoxic stress.

  11. Serrated polyposis associated with a family history of colorectal cancer and/or polyps: The preferential location of polyps in the colon and rectum defines two molecular entities.

    PubMed

    Silva, Patrícia; Albuquerque, Cristina; Lage, Pedro; Fontes, Vanessa; Fonseca, Ricardo; Vitoriano, Inês; Filipe, Bruno; Rodrigues, Paula; Moita, Susana; Ferreira, Sara; Sousa, Rita; Claro, Isabel; Nobre Leitão, Carlos; Chaves, Paula; Dias Pereira, António

    2016-09-01

    Serrated polyposis (SPP) is characterized by the development of multiple serrated polyps and an increased predisposition to colorectal cancer (CRC). In the present study, we aimed to characterize, at a clinical and molecular level, a cohort of SPP patients with or without a family history of SPP and/or polyps/CRC (SPP-FHP/CRC). Sixty-two lesions from 12 patients with SPP-FHP/CRC and 6 patients with sporadic SPP were included. The patients with SPP-FHP/CRC presented with an older mean age at diagnosis (p=0.027) and a more heterogeneous histological pattern of lesions (p=0.032) than the patients with sporadic SPP. We identified two molecular forms of SPP-FHP/CRC, according to the preferential location of the lesions: proximal/whole-colon or distal colon. Mismatch repair (MMR) gene methylation [mutS homolog 6 (MSH6)/mutS homolog 3 (MSH3)] or loss of heterozygosity (LOH) of D2S123 (flanking MSH6) were detected exclusively in the former (p=3.0x10-7), in most early lesions. Proximal/whole‑colon SPP-FHP/CRC presented a higher frequency of O-6-methylguanine-DNA methyltransferase (MGMT) methylation/LOH, microsatellite instability (MSI) and Wnt mutations (19/29 vs. 7/17; 16/23 vs. 1/14, p=2.2x10-4; 15/26 vs. 2/15, p=0.006; 14/26 vs. 4/20, p=0.02) but a lower frequency of B-raf proto-oncogene, serine/threonine kinase (BRAF) mutations (7/30 vs. 12/20, p=0.0089) than the distal form. CRC was more frequent in cases of Kirsten rat sarcoma viral oncogene homolog (KRAS)-associated proximal/whole-colon SPP-FHP/CRC than in the remaining cases (4/4 vs. 1/8, p=0.01). Thus, SPP-FHP/CRC appears to be a specific entity, presenting two forms, proximal/whole-colon and distal, which differ in the underlying tumor initiation pathways. Early MGMT and MMR gene deficiency in the former may underlie an inherited susceptibility to genotoxic stress. PMID:27430658

  12. Serrated polyposis associated with a family history of colorectal cancer and/or polyps: The preferential location of polyps in the colon and rectum defines two molecular entities

    PubMed Central

    Silva, Patrícia; Albuquerque, Cristina; Lage, Pedro; Fontes, Vanessa; Fonseca, Ricardo; Vitoriano, Inês; Filipe, Bruno; Rodrigues, Paula; Moita, Susana; Ferreira, Sara; Sousa, Rita; Claro, Isabel; Leitão, Carlos Nobre; Chaves, Paula; Pereira, António Dias

    2016-01-01

    Serrated polyposis (SPP) is characterized by the development of multiple serrated polyps and an increased predisposition to colorectal cancer (CRC). In the present study, we aimed to characterize, at a clinical and molecular level, a cohort of SPP patients with or without a family history of SPP and/or polyps/CRC (SPP-FHP/CRC). Sixty-two lesions from 12 patients with SPP-FHP/CRC and 6 patients with sporadic SPP were included. The patients with SPP-FHP/CRC presented with an older mean age at diagnosis (p=0.027) and a more heterogeneous histological pattern of lesions (p=0.032) than the patients with sporadic SPP. We identified two molecular forms of SPP-FHP/CRC, according to the preferential location of the lesions: proximal/whole-colon or distal colon. Mismatch repair (MMR) gene methylation [mutS homolog 6 (MSH6)/mutS homolog 3 (MSH3)] or loss of heterozygosity (LOH) of D2S123 (flanking MSH6) were detected exclusively in the former (p=3.0×10−7), in most early lesions. Proximal/whole-colon SPP-FHP/CRC presented a higher frequency of O-6-methylguanine-DNA methyltransferase (MGMT) methylation/LOH, microsatel-lite instability (MSI) and Wnt mutations (19/29 vs. 7/17; 16/23 vs. 1/14, p=2.2×10−4; 15/26 vs. 2/15, p=0.006; 14/26 vs. 4/20, p=0.02) but a lower frequency of B-raf proto-oncogene, serine/threonine kinase (BRAF) mutations (7/30 vs. 12/20, p=0.0089) than the distal form. CRC was more frequent in cases of Kirsten rat sarcoma viral oncogene homolog (KRAS)-associated proximal/whole-colon SPP-FHP/CRC than in the remaining cases (4/4 vs. 1/8, p=0.01). Thus, SPP-FHP/CRC appears to be a specific entity, presenting two forms, proximal/whole-colon and distal, which differ in the underlying tumor initiation pathways. Early MGMT and MMR gene deficiency in the former may underlie an inherited susceptibility to genotoxic stress. PMID:27430658

  13. Aural polyps

    MedlinePlus

    ... underlying cause. Your doctor may first recommend: Avoiding water in the ear Steroid medicines Antibiotic ear drops If a cholesteatoma is the underlying problem or the condition fails to clear, then surgery may be needed.

  14. The relationship of pulp polyp with the presence and concentration of immunoglobulin E, histamine, interleukin-4 and interleukin-12.

    PubMed

    Sattari, Mandana; Haghighi, Ali K; Tamijani, Hasan D

    2009-12-01

    The aim of this study was to evaluate the relationship between pulp polyp formation and immunoglobulin E (IgE), histamine and interleukin-4 (IL-4) as the most important mediators which are involved in allergy. Thirty-two samples including 16 pulp polyps and 16 normal pulps were gathered. After homogenising the pulpal tissue samples, enzyme-linked immunosorbent assay (ELISA) techniques were used to assess the concentration of IgE, histamine, IL-4 and IL-12. The two groups showed statistically significant differences in terms of both the concentration and presence of IgE, histamine and IL-4 (P < 0.001); both presence and concentration of IgE, histamine and IL-4 were higher in pulp polyps than in normal pulps. There is not any significant difference between case and control groups regarding IL-12. The results of this study give rise to the possibility of type I hypersensitivity reaction being involved in pulp polyp's pathogenesis. PMID:19961456

  15. 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.

  16. Vocal fold nodule vs. vocal fold polyp: answer from surgical pathologist and voice pathologist point of view.

    PubMed

    Wallis, Lesly; Jackson-Menaldi, Cristina; Holland, Wayne; Giraldo, Alvaro

    2004-03-01

    Vocal fold polyps and nodules are caused by inflammation caused by stress or irritation. Our study involved looking retrospectively at 30 patients. A clinical diagnosis was established by an otolaryngologist and voice pathologist through videostroboscopic analysis. Histological sections after removal of the vocal fold lesion were available for microscopic examination. All of these cases have also been previously evaluated and photographed. A clinical diagnosis of either a polyp or a laryngeal nodule have been made and documented. Two pathologists made the histological evaluation separately initially unaware of the clinical diagnosis. Their impression was recorded. After the clinical diagnosis become available and comparison between the clinical and pathological diagnosis were made, a retrospective review of the tissue was attempted to reconcile the differences. In conclusion, after careful histological evaluation, no definitive histological distinction can be made between laryngeal nodules and polyps. Our data showed no distinction between the two entities when compared for the presence of edema, fibrin, inflammation, and amyloid-like material. A statistically significant difference was found in the size of the specimen and the presence of telangiectasias. Based on our data, a biopsy larger than 0.3 cm could be a polyp and a biopsy less than 0.3 cm could be a nodule.

  17. 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

  18. 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

  19. 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.

  20. Increased risk of colorectal polyps in patients with non-alcoholic fatty liver disease undergoing liver transplant evaluation

    PubMed Central

    Bhatt, Birju D.; Lukose, Thresiamma; Siegel, Abby B.; Brown, Robert S.

    2015-01-01

    Background Screening colonoscopy is a standard part of the liver transplant (LT) evaluation process. We aimed to evaluate the yield of screening colonoscopy and determine whether non-alcoholic fatty liver disease (NAFLD) was associated with an increased risk of colorectal neoplasia. Methods We retrospectively assessed all patients who completed LT evaluation at our center between 1/2008-12/2012. Patients <50 years old and those without records of screening colonoscopy, or with greater than average colon cancer risk were excluded. Results A total of 1,102 patients were evaluated, 591 met inclusion criteria and were analyzed. The mean age was 60 years, 67% were male, 12% had NAFLD and 88% had other forms of chronic liver disease. Overall, 42% of patients had a polyp found on colonoscopy: 23% with adenomas, 14% with hyperplastic polyps and with 1% inflammatory polyps. In the final multivariable model controlling for age, NAFLD [odds ratio (OR) 2.41, P=0.001] and a history of significant alcohol use (OR 1.69, P=0.004) were predictive of finding a polyp on colonoscopy. In addition, NAFLD (OR 1.95, P=0.02), significant alcohol use (OR 1.70, P=0.01) and CTP class C (OR 0.57, P=0.02) were associated with adenoma, controlling for age. Conclusions Screening colonoscopy in patients awaiting LT yields a high rate of polyp (43%) and adenoma (22%) detection, perhaps preventing the accelerated progression to carcinoma that can occur in immunosuppressed post-LT patients. Patients with NAFLD may be at a ~2 fold higher risk of adenomas and should be carefully evaluated prior to LT. PMID:26487938

  1. QuickView video preview software of colon capsule endoscopy: reliability in presenting colorectal polyps as compared to normal mode reading.

    PubMed

    Farnbacher, Michael J; Krause, Horst H; Hagel, Alexander F; Raithel, Martin; Neurath, Markus F; Schneider, Thomas

    2014-03-01

    OBJECTIVE. Colon capsule endoscopy (CCE) proved to be highly sensitive in detection of colorectal polyps (CP). Major limitation is the time-consuming video reading. The aim of this prospective, double-center study was to assess the theoretical time-saving potential and its possible impact on the reliability of "QuickView" (QV), in the presentation of CP as compared to normal mode (NM). METHODS. During NM reading of 65 CCE videos (mean patient´s age 56 years), all frames showing CPs were collected and compared to the number of frames presented by QV at increasing QV settings (10, 20, ... 80%). Reliability of QV in presenting polyps <6 mm and ≥6 mm (significant polyp), and identifying patients for subsequent therapeutic colonoscopy, capsule egestion rate, cleansing level, and estimated time-saving potential were assessed. RESULTS. At a 30% QV setting, the QV video presented 89% of the significant polyps and 86% of any polyps with ≥1 frame (per-polyp analysis) identified in NM before. At a 10% QV setting, 98% of the 52 patients with significant polyps could be identified (per-patient analysis) by QV video analysis. Capsule excretion rate was 74% and colon cleanliness was adequate in 85%. QV´s presentation rate correlates to the QV setting, the polyp size, and the number of frames per finding. CONCLUSIONS. Depending on its setting, the reliability of QV in presenting CP as compared to NM reading is notable. However, if no significant polyp is presented by QV, NM reading must be performed afterwards. The reduction of frames to be analyzed in QV might speed up identification of candidates for therapeutic colonoscopy. PMID:24325660

  2. 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

  3. 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.

  4. 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. PMID:23651692

  5. Dietary Lignan and Proanthocyanidin Consumption and Colorectal Adenoma Recurrence in the Polyp Prevention Trial

    PubMed Central

    Bobe, Gerd; Murphy, Gwen; Albert, Paul S.; Sansbury, Leah B.; Lanza, Elaine; Schatzkin, Arthur; Cross, Amanda J.

    2011-01-01

    Lignans and proanthocyanidins are plant polyphenols that have shown protective properties against colorectal neoplasms in some human studies. Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) to prospectively evaluate the association between lignan and proanthocyanidin intake, estimated from databases linked to a food frequency questionnaire, and adenoma recurrence in 1,859 participants of the Polyp Prevention Trial. Overall, individual or total lignans or proanthocyanidins were not associated with colorectal adenoma recurrence. However, in sex-specific analyses, total lignan intake was positively associated with any adenoma recurrence in women (highest versus lowest lignan intake quartile OR = 2.07, 95% CI: 1.22-3.52, P trend = 0.004) but not in men (P interaction = 0.04). To conclude, dietary lignan and proanthocyanidin consumption was not generally related to colorectal adenoma recurrence; however, high lignan intake may increase the risk of adenoma recurrence in women. PMID:21618513

  6. Functional heterogeneity of mast cells isolated from different microenvironments within nasal polyp tissue.

    PubMed Central

    Finotto, S; Dolovich, J; Denburg, J A; Jordana, M; Marshall, J S

    1994-01-01

    Nasal polyposis is a chronic inflammatory condition of the upper airways characterized by infiltration of activated inflammatory cells, including mast cells, both in the epithelium and in the stroma. The aim of this work was to study human mast cells derived from two different anatomical sites within the same nasal polyp tissue. To this end, we isolated two distinct mast cell populations, one from the epithelial and the other from the stromal layers of individual human nasal polyp tissues. We examined the mediator content of the two mast cell populations and found that stromal mast cells had a significantly higher content of tryptase compared with the epithelial mast cells from the same tissue. In addition, mast cells from the stromal compartment, but not those from the epithelium, released a significant amount of histamine after anti-IgE stimulation. By contrast, both populations released over 50% of the total histamine after non-specific stimuli (A23187 10(-6) M). The content of mediators and the response to immunological activation were not significantly altered in patients receiving topical steroid therapy. It remains to be determined if the observed differences are the result of an intrinsic characteristic of the mast cell populations localized to separate tissue compartments, or reflect a different in vivo exposure to stimuli such as antigens, or different surrounding structural or infiltrating cells. In conclusion, these data provide evidence of functional heterogeneity and differences in mediator content between mast cell subpopulations from a single human tissue. The failure of release of epithelial mast cell mediators from an immunologic stimulus may have implications concerning acute effects of antigen exposure in nasal polyposis. Images Fig. 1 PMID:7508349

  7. Antioxidant enzymes and lipid peroxidation in endometrium of patients with polyps, myoma, hyperplasia and adenocarcinoma

    PubMed Central

    2009-01-01

    Background Oxidative stress and impaired antioxidant system have been proposed as a potential factors involved in the pathophysiology of diverse disease states, including carcinogenesis. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of gynecological diseases in order to evaluate the antioxidant status in endometrium of such patients. Methods Endometrial tissues of gynecological patients with different diagnoses were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. Results Superoxide dismutase activity was significantly decreased (50% in average) in hyperplastic and adenocarcinoma patients. Activities of both glutathione peroxidase and glutathione reductase were increased 60% and 100% on average, in hyperplastic patients, while in adenocarcinoma patients only glutathione reductase activity was elevated 100%. Catalase activity was significantly decreased in adenocarcinoma patients (47%). Lipid hydroperoxides level was negatively correlated to superoxide dismutase and catalase activities, and positively correlated to glutathione peroxidase and glutathione reductase activities. Conclusions This study provided the first comparison of antioxidant status and lipid peroxidation in endometrial tissues of patients with polyps, myoma, hyperplasia and adenocarcinoma. The results showed that patients with premalignant (hyperplastic) and malignant (adenocarcinoma) lesions had enhanced lipid peroxidation and altered uterine antioxidant enzyme activities than patients with benign uterine diseases, polyps and myoma, although the extent of disturbance varied with the diagnosis. Further investigation is needed to clarify the mechanisms responsible for the observed alterations and whether lipid hydroperoxide levels and antioxidant enzyme activities in uterus of gynecological patients might be used as

  8. Multimodal Optical Microscopy Methods Reveal Polyp Tissue Morphology and Structure in Caribbean Reef Building Corals

    PubMed Central

    Sivaguru, Mayandi; Fried, Glenn A.; Miller, Carly A. H.; Fouke, Bruce W.

    2014-01-01

    An integrated suite of imaging techniques has been applied to determine the three-dimensional (3D) morphology and cellular structure of polyp tissues comprising the Caribbean reef building corals Montastraeaannularis and M. faveolata. These approaches include fluorescence microscopy (FM), serial block face imaging (SBFI), and two-photon confocal laser scanning microscopy (TPLSM). SBFI provides deep tissue imaging after physical sectioning; it details the tissue surface texture and 3D visualization to tissue depths of more than 2 mm. Complementary FM and TPLSM yield ultra-high resolution images of tissue cellular structure. Results have: (1) identified previously unreported lobate tissue morphologies on the outer wall of individual coral polyps and (2) created the first surface maps of the 3D distribution and tissue density of chromatophores and algae-like dinoflagellate zooxanthellae endosymbionts. Spectral absorption peaks of 500 nm and 675 nm, respectively, suggest that M. annularis and M. faveolata contain similar types of chlorophyll and chromatophores. However, M. annularis and M. faveolata exhibit significant differences in the tissue density and 3D distribution of these key cellular components. This study focusing on imaging methods indicates that SBFI is extremely useful for analysis of large mm-scale samples of decalcified coral tissues. Complimentary FM and TPLSM reveal subtle submillimeter scale changes in cellular distribution and density in nondecalcified coral tissue samples. The TPLSM technique affords: (1) minimally invasive sample preparation, (2) superior optical sectioning ability, and (3) minimal light absorption and scattering, while still permitting deep tissue imaging. PMID:25226350

  9. Functional analysis of pattern recognition receptors in miniature dachshunds with inflammatory colorectal polyps

    PubMed Central

    IGARASHI, Hirotaka; OHNO, Koichi; FUJIWARA-IGARASHI, Aki; KANEMOTO, Hideyuki; FUKUSHIMA, Kenjiro; GOTO-KOSHINO, Yuko; UCHIDA, Kazuyuki; TSUJIMOTO, Hajime

    2014-01-01

    Inflammatory colorectal polyps (ICRPs) frequently occur in miniature dachshunds (MDs) in Japan. MDs with ICRPs develop multiple polyps with severe neutrophil infiltration that respond to immunosuppressive therapy. Therefore, ICRPs are thought to constitute a novel, breed-specific form of canine inflammatory bowel disease (IBD). Pattern recognition receptors (PRRs) play a key role in the distinction of pathogens from commensal bacteria and food antigens. Dysfunction resulting from genetic disorders of PRRs have been linked to human and canine IBD. Therefore, we analyzed the reactivity of PRRs in MDs with ICRPs. Twenty-six MDs with ICRPs and 16 control MDs were recruited. Peripheral blood-derived monocytes were obtained from each dog and then stimulated with PRR ligands for 6 and 24 hr; subsequently, messenger RNA (mRNA) expression levels and protein secretion of IL-1β were quantified using quantitative real-time PCR and ELISA, respectively. The levels of IL-1β mRNA and protein secretion after stimulation with a nucleotide-binding oligomerization domain 2 (NOD2) ligand were significantly greater in monocytes from ICRP-affected MDs than in those from control MDs. In addition, IL-1β protein secretion induced by toll-like receptor (TLR) 1/2, TLR2 and TLR2/6 stimulation was also significantly greater in ICRP-affected MDs. These results suggest that reactivity against NOD2, TLR1/2, TLR2 and TLR2/6 signals is enhanced in ICRP-affected MDs and may play a role in the pathogenesis of ICRPs in MDs. Additional studies of the genetic background of these PRRs should be performed. PMID:25650150

  10. Cronkhite-Canada syndrome associated with serrated adenoma and malignant polyp: a case report and a literature review of 13 cronkhite-Canada syndrome cases in Korea.

    PubMed

    Yun, So Hee; Cho, Jin Woong; Kim, Ji Woong; Kim, Joong Keun; Park, Moon Sik; Lee, Na Eun; Lee, Jae Un; Lee, Young Jae

    2013-05-01

    Cronkhite-Canada syndrome (CCS) is a rare nonfamilial polyposis syndrome characterized by epithelial disturbances both in the gastrointestinal tract and in the epidermis. The pathologic finding of the polyp is usually a hamartomatous polyp of the juvenile type; however, the possibility of serrated adenoma associated malignant neoplasm was reported in some Japanese cases. Up till now in South Korea, 13 CCS cases have been reported, but there was no case accompanied by the colon cancer. We report the first case of CCS associated with malignant colon polyp and serrated adenoma in Korea. A 72-year-old male patient who complained of diarrhea and weight loss was presented with both hands and feet nail dystrophy, hyperpigmentation, and alopecia. Endoscopic examination showed numerous hamartomatous polyps from the stomach to the colon. The pathologic results confirmed colon cancer and serrated adenoma. Helicobacter pylori eradication and prednisolone was used. Thus, the authors report this case along with a literature review.

  11. Mixture of expert 3D massive-training ANNs for reduction of multiple types of false positives in CAD for detection of polyps in CT colonography.

    PubMed

    Suzuki, Kenji; Yoshida, Hiroyuki; Näppi, Janne; Armato, Samuel G; Dachman, Abraham H

    2008-02-01

    One of the major challenges in computer-aided detection (CAD) of polyps in CT colonography (CTC) is the reduction of false-positive detections (FPs) without a concomitant reduction in sensitivity. A large number of FPs is likely to confound the radiologist's task of image interpretation, lower the radiologist's efficiency, and cause radiologists to lose their confidence in CAD as a useful tool. Major sources of FPs generated by CAD schemes include haustral folds, residual stool, rectal tubes, the ileocecal valve, and extra-colonic structures such as the small bowel and stomach. Our purpose in this study was to develop a method for the removal of various types of FPs in CAD of polyps while maintaining a high sensitivity. To achieve this, we developed a "mixture of expert" three-dimensional (3D) massive-training artificial neural networks (MTANNs) consisting of four 3D MTANNs that were designed to differentiate between polyps and four categories of FPs: (1) rectal tubes, (2) stool with bubbles, (3) colonic walls with haustral folds, and (4) solid stool. Each expert 3D MTANN was trained with examples from a specific non-polyp category along with typical polyps. The four expert 3D MTANNs were combined with a mixing artificial neural network (ANN) such that different types of FPs could be removed. Our database consisted of 146 CTC datasets obtained from 73 patients whose colons were prepared by standard pre-colonoscopy cleansing. Each patient was scanned in both supine and prone positions. Radiologists established the locations of polyps through the use of optical-colonoscopy reports. Fifteen patients had 28 polyps, 15 of which were 5-9 mm and 13 were 10-25 mm in size. The CTC cases were subjected to our previously reported CAD method consisting of centerline-based extraction of the colon, shape-based detection of polyp candidates, and a Bayesian-ANN-based classification of polyps. The original CAD method yielded 96.4% (27/28) by-polyp sensitivity with an average of 3

  12. Antenatal mild hydronephrosis with subsequent polyp of the upper ureter in a child presenting with recurrent Dietl's crisis

    PubMed Central

    Patel, Ramnik V; Johal, Navroop; Evans, Kathryn; Mushtaq, Imran

    2014-01-01

    We report a 7-year-old boy who had antenatally diagnosed and postnatally confirmed asymptomatic right congenital hydronephrosis secondary to ureteropelvic junction obstruction with the anteroposterior diameter ranging from 7 to 15 mm on serial ultrasound scans till the age of 6 years. He then presented with recurrent attacks of Dietl's crisis almost every month in the seventh year of his life and eluded diagnosis for over a year at various national hospitals, and ended up with an international referral to us. Investigations of the acute attacks clinched the diagnosis of ureteral polyp causing intermittent crisis and he underwent segmental resection and reconstruction in the form of dismembered Anderson-Hyne pyeloplasty with good recovery. Our case revealed that prenatally detected hydronephrosis may worsen after spontaneous postnatal improvement and a polyp acting as a flip valve may produce intermittent hydronephrosis and symptoms later in life. The child should undergo urgent investigations during acute symptoms. PMID:24832709

  13. A Laparoscopic Management Combined with a Flexible Ureteroscope for Ureteral Polyps of More Than 3 cm Length

    PubMed Central

    Ueda, Kousuke; Nishihara, Kiyoaki; Nakiri, Makoto; Suyama, Shunsuke; Chikui, Katsuaki; Hayashi, Shuichiro; Kurose, Hirofumi; Ogasawara, Naoyuki; Suekane, Shigetaka; Igawa, Tsukasa

    2016-01-01

    Abstract Ureteral polyps are benign tumors of the ureter, which are relatively rare. The etiology has proposed various hypotheses, involving chronic inflammation and congenital disease. Most of them are commonly diagnosed in the upper ureter including the ureteropelvic junction. Some studies have reported polypectomy using a holmium laser, but several studies presented laparoscopic ureteroureterostomy for patients in whom the mentioned procedure is difficult. We underwent laparoscopic ureteroureterostomy with a combination of flexible ureteroscope for ureteral polyps of more than 3 cm length. We used ureteroscopy with a laparoscopic approach to minimize the length of ureter resection. Using the light guide of ureteroscopy is useful to decide the exact and minimal excision range for ureteroureterostomy. PMID:27579437

  14. A Laparoscopic Management Combined with a Flexible Ureteroscope for Ureteral Polyps of More Than 3 cm Length.

    PubMed

    Matsuo, Mitsunori; Ueda, Kousuke; Nishihara, Kiyoaki; Nakiri, Makoto; Suyama, Shunsuke; Chikui, Katsuaki; Hayashi, Shuichiro; Kurose, Hirofumi; Ogasawara, Naoyuki; Suekane, Shigetaka; Igawa, Tsukasa

    2016-01-01

    Ureteral polyps are benign tumors of the ureter, which are relatively rare. The etiology has proposed various hypotheses, involving chronic inflammation and congenital disease. Most of them are commonly diagnosed in the upper ureter including the ureteropelvic junction. Some studies have reported polypectomy using a holmium laser, but several studies presented laparoscopic ureteroureterostomy for patients in whom the mentioned procedure is difficult. We underwent laparoscopic ureteroureterostomy with a combination of flexible ureteroscope for ureteral polyps of more than 3 cm length. We used ureteroscopy with a laparoscopic approach to minimize the length of ureter resection. Using the light guide of ureteroscopy is useful to decide the exact and minimal excision range for ureteroureterostomy. PMID:27579437

  15. Naso-oropharyngeal choristoma (hairy polyps): an overview and current update on presentation, management, origin and related controversies.

    PubMed

    Dutta, Mainak; Roy, Soham; Ghatak, Soumya

    2015-05-01

    This review presents a comprehensive and updated overview of bigerminal choristomas (hairy polyps) of naso-oropharynx/oral cavity, and discusses the controversies related to nosology and origin from a clinico-embryologic perspective. English-language texts of the last 25 years (January 1989-January 2014) were collected from the PubMed/MEDLINE database using the given keywords. Of the 330 records, 64 full-text articles (mostly case reports/series) were selected, incorporating clinical data from 78 patients, after screening through duplicates and the given exclusion criteria. With the available evidence, hairy polyps appear more common than generally believed, and are increasingly being recognized as an important, often-missed cause of respiratory distress and feeding difficulty in neonates and infants. Such a child without any apparent cause should be examined with flexible nasopharyngoscope to specifically look for hairy polyps which might be life-threatening, especially when small. The female preponderance as believed today has been found to be an overestimation in this review. These lesions are characteristically composed of mature ectodermal and mesodermal tissue derivatives presenting as heterotopic masses, hence termed choristoma. However, little is known about their origin, and whether they are developmental malformations or primitive teratomas is debatable. Involvement of Eustachian tube and tonsils as predominant subsites and the speculated molecular embryogenesis link hairy polyps to the development of the first and second pharyngeal arches. They are exceptionally rare in adults, but form a distinct entity in this age-group and could be explained as delayed pluripotent cell morphogenesis or focal neoplastic malformations, keeping with the present-day understandings of the expanded "teratoma family".

  16. Is the use of prophylactic hemoclips in the endoscopic resection of large pedunculated polyps useful? A prospective and randomized study

    PubMed Central

    Castro, José Luis; Rábago, Luis Ramón; Chico, Inmaculada; Olivares, Ana; Ortega, Alejandro; Vicente, Cristina; Carbó, Jorge; Gea, Francisco

    2012-01-01

    Background The methods for preventing post-polypectomy bleeding (PPB) are not standardised and there are groups that use hemoclips for this purpose. Objective To study whether the use of hemoclips reduces PPB complications. Materials and Methods Prospective, randomised study of patients with pedunculated polyps larger than 10 mm. The patients were included in two groups (hemoclip before polypectomy -HC- and standard polypectomy -SP-). This study has been registered with the trial registration number NCT01565993. Results 105 polypectomies were performed (98 patients), 66 (62.9%) in the HC group. The total rate of complications was 10,6% in the HC group (4.5% early bleeding, 1.5% severe delayed bleeding, 4,5% mucosal burns, 1.5% perforation). In the SP group, the rate of total complications was 7,7%, (7,7% early bleeding, no significant differences). In view of the unexpected increase in the morbidity of the hemoclip group, the study was suspended without reaching the sample size. In an ad hoc analysis, which includes the standard polypectomy patients who refused to participate in the study (35 polyps), the total morbidity was 5,7% (no perforations and 2 patients with premature bleeding).When we compared the morbidity of the HC group to the morbidity of SP group plus R group (74 polyps), we also failed to detect any significant differences in terms of PPB, but did in terms of perforation. Conclusion The prophylactic use of hemoclips in polypectomies of large pedunculated polyps leads to a further risk of mucosal burns and perforation that is not acceptable, and does not reduce the risk of PPB. PMID:23687598

  17. Is the use of prophylactic hemoclips in the endoscopic resection of large pedunculated polyps useful? A prospective and randomized study

    PubMed Central

    Castro, José Luis; Rábago, Luis Ramón; Chico, Inmaculada; Olivares, Ana; Ortega, Alejandro; Vicente, Cristina; Carbó, Jorge; Gea, Francisco

    2012-01-01

    Background The methods for preventing post-polypectomy bleeding (PPB) are not standardised and there are groups that use hemoclips for this purpose. Objective To study whether the use of hemoclips reduces PPB complications. Materials and Methods Prospective, randomised study of patients with pedunculated polyps larger than 10 mm. The patients were included in two groups (hemoclip before polypectomy -HC- and standard polypectomy -SP-). This study has been registered with the trial registration number NCT01565993. Results 105 polypectomies were performed (98 patients), 66 (62.9%) in the HC group. The total rate of complications was 10,6% in the HC group (4.5% early bleeding, 1.5% severe delayed bleeding, 4,5% mucosal burns, 1.5% perforation). In the SP group, the rate of total complications was 7,7%, (7,7% early bleeding, no significant differences). In view of the unexpected increase in the morbidity of the hemoclip group, the study was suspended without reaching the sample size. In an ad hoc analysis, which includes the standard polypectomy patients who refused to participate in the study (35 polyps), the total morbidity was 5,7% (no perforations and 2 patients with premature bleeding).When we compared the morbidity of the HC group to the morbidity of SP group plus R group (74 polyps), we also failed to detect any significant differences in terms of PPB, but did in terms of perforation. Conclusion The prophylactic use of hemoclips in polypectomies of large pedunculated polyps leads to a further risk of mucosal burns and perforation that is not acceptable, and does not reduce the risk of PPB. PMID:23687606

  18. Upper tract juvenile polyps in juvenile polyposis patients: dysplasia and malignancy are associated with foveolar, intestinal, and pyloric differentiation.

    PubMed

    Ma, Changqing; Giardiello, Francis M; Montgomery, Elizabeth A

    2014-12-01

    Patients with juvenile polyposis syndrome (JPS), a hereditary autosomal dominant hamartomatous polyposis syndrome, are at increased risk for colorectal adenocarcinoma. The upper gastrointestinal tract is less often involved by JPS than the colorectum, and, consequently, upper tract juvenile polyps (JPs) are not well studied. We reviewed upper endoscopies and corresponding biopsies in JPS patients documented in our Polyposis Registry. A total of 199 upper gastrointestinal biopsies from 69 endoscopies were available in 22 of 41 (54%) JPS patients. Thirteen of the 22 patients (59%) had ≥1 gastric JP; 5 also had 6 small bowel JPs. Gastric JP was identified as early as age 7 in a patient with an SMAD4 gene mutation. Two patients (9%) had high-grade dysplasia in gastric JP. Invasive adenocarcinoma was diagnosed in the gastrectomy specimen of 1 patient. Five patients had a huge gastric polyp burden; 3 underwent total gastrectomy. Three patients died of complications associated with extensive upper JP. Histologically, 8 of the 56 (14%) gastric JPs identified had dysplasia. All of the 8 polyps demonstrated intestinalized and pyloric gland differentiation intermixed with foveolar epithelium. Dysplasia was seen arising in all 3 types of epithelium. The flat gastric mucosa in 11 patients was unremarkable without inflammation or intestinal metaplasia. The 6 small bowel JPs had no dysplasia. Our findings suggest that JPS patients are at increased risk for gastric adenocarcinoma. Detection of malignancy in syndromic gastric JP indicates that the current screening procedures are insufficient in removal of precursor lesions to prevent progression to carcinoma. PMID:25390638

  19. Serrated polyps of the colon and rectum: Endoscopic features including image enhanced endoscopy

    PubMed Central

    Saito, Shoichi; Tajiri, Hisao; Ikegami, Masahiro

    2015-01-01

    In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy (IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated adenoma/polyps (SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging (AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging (NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as “red cap sign” and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as II-dilatation pit (II-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive

  20. 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.

  1. Randomized comparative trial of cervical block protocols for pain management during hysteroscopic removal of polyps and myomas

    PubMed Central

    Lukes, Andrea S; Roy, Kelly H; Presthus, James B; Diamond, Michael P; Berman, Jay M; Konsker, Kenneth A

    2015-01-01

    Purpose To evaluate the efficacy of two cervical block protocols for pain management during hysteroscopic removal of intrauterine polyps and myomas using the MyoSure® device. Patients and methods This was a randomized, comparative treatment trial conducted by five private Obstetrics and Gynecology practices in the USA. Forty premenopausal women aged 18 years and older were randomized to receive either a combination para/intracervical block protocol of 37 cc local anesthetic administered at six injections sites in association with the application of topic 1% lidocaine gel, or an intracervical block protocol of 22 cc local anesthetic administered at three injections sites without topical anesthetic, for pain management during hysteroscopic removal of intrauterine polyps and/or a single type 0 or type 1 submucosal myoma ≤3 cm. The main outcomes were a composite measure of procedure-related pain and pain during the postoperative recovery period, assessed by the Wong-Baker Faces Rating Scale (0= no pain to 10= maximum pain). The lesion characteristics, procedure time, and adverse events were summarized. Results A total of 17 polyps and eight myomas were removed in the para/intracervical block group, with diameters of 1.3±0.5 cm and 1.8±0.8 cm, respectively. In the intracervical block group, 25 polyps with a mean diameter of 1.2±0.7 cm and 7 myomas with a mean diameter of 1.9±0.9 cm were removed. The mean tissue resection time was 1.2±2.0 minutes and 1.2±1.4 minutes for the para/intracervical and intracervical block groups, respectively. The mean composite procedure-related pain score was low for both cervical block protocols, 1.3±1.4 in the para/intracervical block group vs 2.1±1.5 in the intracervical block group. During the postoperative recovery period, the mean pain scores were 0.3±0.7 vs 1.2±1.7 for the para/intracervical and intracervical block groups, respectively. There were no serious adverse events. Conclusion The MyoSure procedure for removal of

  2. 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

  3. 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

  4. 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

  5. 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

  6. Massive-training artificial neural network (MTANN) for reduction of false positives in computer-aided detection of polyps: Suppression of rectal tubes

    SciTech Connect

    Suzuki, Kenji; Yoshida, Hiroyuki; Naeppi, Janne; Dachman, Abraham H.

    2006-10-15

    One of the limitations of the current computer-aided detection (CAD) of polyps in CT colonography (CTC) is a relatively large number of false-positive (FP) detections. Rectal tubes (RTs) are one of the typical sources of FPs because a portion of a RT, especially a portion of a bulbous tip, often exhibits a cap-like shape that closely mimics the appearance of a small polyp. Radiologists can easily recognize and dismiss RT-induced FPs; thus, they may lose their confidence in CAD as an effective tool if the CAD scheme generates such ''obvious'' FPs due to RTs consistently. In addition, RT-induced FPs may distract radiologists from less common true positives in the rectum. Therefore, removal RT-induced FPs as well as other types of FPs is desirable while maintaining a high sensitivity in the detection of polyps. We developed a three-dimensional (3D) massive-training artificial neural network (MTANN) for distinction between polyps and RTs in 3D CTC volumetric data. The 3D MTANN is a supervised volume-processing technique which is trained with input CTC volumes and the corresponding ''teaching'' volumes. The teaching volume for a polyp contains a 3D Gaussian distribution, and that for a RT contains zeros for enhancement of polyps and suppression of RTs, respectively. For distinction between polyps and nonpolyps including RTs, a 3D scoring method based on a 3D Gaussian weighting function is applied to the output of the trained 3D MTANN. Our database consisted of CTC examinations of 73 patients, scanned in both supine and prone positions (146 CTC data sets in total), with optical colonoscopy as a reference standard for the presence of polyps. Fifteen patients had 28 polyps, 15 of which were 5-9 mm and 13 were 10-25 mm in size. These CTC cases were subjected to our previously reported CAD scheme that included centerline-based segmentation of the colon, shape-based detection of polyps, and reduction of FPs by use of a Bayesian neural network based on geometric and texture

  7. Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding

    PubMed Central

    Ashktorab, Hassan; Etaati, Firoozeh; Rezaeean, Farahnaz; Nouraie, Mehdi; Paydar, Mansour; Namin, Hassan Hassanzadeh; Sanderson, Andrew; Begum, Rehana; Alkhalloufi, Kawtar; Brim, Hassan; Laiyemo, Adeyinka O

    2016-01-01

    AIM: To study the accuracy of using high definition (HD) scope with narrow band imaging (NBI) vs standard white light colonoscope without NBI (ST), to predict the histology of the colon polyps, particularly those < 1 cm. METHODS: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55 (37%) were male and median (interquartile range) of age was 56 (19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope (P = 0.7). The ST scope had a positive predictive value (PPV) and positive likelihood ratio (PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope (68%) compare to ST scope (53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp (HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar. CONCLUSION: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both

  8. Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding

    PubMed Central

    Ashktorab, Hassan; Etaati, Firoozeh; Rezaeean, Farahnaz; Nouraie, Mehdi; Paydar, Mansour; Namin, Hassan Hassanzadeh; Sanderson, Andrew; Begum, Rehana; Alkhalloufi, Kawtar; Brim, Hassan; Laiyemo, Adeyinka O

    2016-01-01

    AIM: To study the accuracy of using high definition (HD) scope with narrow band imaging (NBI) vs standard white light colonoscope without NBI (ST), to predict the histology of the colon polyps, particularly those < 1 cm. METHODS: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55 (37%) were male and median (interquartile range) of age was 56 (19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope (P = 0.7). The ST scope had a positive predictive value (PPV) and positive likelihood ratio (PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope (68%) compare to ST scope (53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp (HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar. CONCLUSION: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both

  9. Effect of budesonide and nedocromil sodium on IL-6 and IL-8 release from human nasal mucosa and polyp epithelial cells.

    PubMed

    Xaubet, A; Mullol, J; Roca-Ferrer, J; Pujols, L; Fuentes, M; Pérez, M; Fabra, J M; Picado, C

    2001-05-01

    We investigated the effect of budesonide and nedocromil sodium on the secretion of IL-6 and IL-8 by cultured epithelial cells from healthy nasal mucosa and nasal polyps. Human epithelial cell conditioned media was generated with fetal calf serum (FCS) in the presence or absence of budesonide and/or nedocromil sodium. Budesonide inhibited FCS-induced IL-6 and IL-8 release in a dose-dependent manner. The IC25 (25% inhibitory concentration) of budesonide on IL-6 release was higher in nasal polyp than in nasal mucosa epithelial cells (34 nM vs. 200 pM). The IC25 of budesonide on IL-8 release was higher in nasal mucosa than in nasal polyps (145 pM vs. 4 pM). Nedocromil sodium caused a dose-related inhibitory effect on IL-8 release from nasal mucosa (IC25, 207 nM), while it only had a significant effect in nasal polyps at 10(-5) M. Nedocromil sodium had no effect on IL-6 release. The inhibitory effect of budesonide was higher than that of nedocromil sodium on both nasal polyps and nasal mucosa. Budesonide and nedocromil sodium may exert their anti-inflammatory action in the respiratory mucosa by modulating the secretion of IL-6 and IL-8. The different effect of budesonide and nedocromil sodium on IL-6 and IL-8 release may be explained by differences in the mechanisms which regulate the upregulation of these cytokines in inflammatory responses.

  10. 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

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

    PubMed

    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

  12. Expression of p53 in endometrial polyps with special reference to the p53 signature.

    PubMed

    Sho, Tomoko; Hachisuga, Toru; Kawagoe, Toshinori; Urabe, Rie; Kurita, Tomoko; Kagami, Seiji; Shimajiri, Shohei; Fujino, Yoshihisa

    2016-07-01

    We herein examined the significance of the p53 expression in endometrial polyps (EMPs). A total of 133 EMPs, including 62 premenopausal and 71 postmenopausal women with EMP, were immunohistochemically studied for the expression of estrogen receptor (ER)-alpha, Ki-67 and p53. Apoptotic cells were identified using a TUNEL assay. A DNA sequence analysis of TP53 exons 5 to 9 was performed. Among the premenopausal EMPs, a multivariate analysis showed the labeling index (LI) for Ki-67 to correlate significantly with that for p53 (P<0.001), but not that for apoptosis. On the contrary, among the postmenopausal EMPs, the LI for Ki-67 correlated significantly with that for apoptosis (P<0.001). The p53 signature (p53S) was defined by endometrial epithelial cells, which are morphologically benign in appearance but display 12 or more consecutive epithelial cell nuclei with strong p53 immunostaining. The p53S was found in nine (12.7%) postmenopausal EMPs (mean age: 70.2 years). The median Ki-67 index for the p53S was 7%, with no significant difference from that of the glands of the postmenopausal EMPs without the p53S (P=0.058). The median apoptotic index for the p53S was 0%, which was significantly lower than that of the postmenopausal EMPs without the p53S (P=0.002). Two of four p53Ss showed TP53 mutations according to the DNA sequence analysis. The presence of the p53S is not rare in postmenopausal EMPs with an advanced age. Among postmenopausal EMPs, the LI of Ki-67 significantly correlates with that of apoptosis. However, such a positive correlation between the LI of Ki-67 and apoptosis is not observed in p53S. PMID:26727623

  13. Obesity and risk of colorectal adenomatous polyps: a case-control study in hospital kuala lumpur.

    PubMed

    Ramadas, A; Kandiah, M; Zarida, H; Yunus Gul, A G; Faizal, J A

    2009-03-01

    Colorectal adenomas are precursor lesions of colorectal cancer. Several studies have proposed that obesity is a risk factor for colorectal adenoma. This case-control study examined the relationship between body mass index (BMI), waist circumference, waistto-hip ratio (WHR), body fat percentage and colorectal adenomatous polyps (CRA) in patients who have had a colonoscopy at the Hospital Kuala Lumpur (HKL). Fifty-nine patients (42 males and 17 females) positively identified as having CRA and 59 polypfree subjects were recruited as controls (33 males and 26 females). A pre-tested questionnaire was used to collect socio-economic information, while anthropometric measurements were determined directly by established methods. The mean BMI of female case subjects was significantly higher than control females (25.63 + 4.87 kg/m2 vs. 23.86 + 3.70 kg/m2, p<0.05) but the difference in BMI was not significant in men. The mean WHR of male subjects was significantly higher in the case group (0.92 + 0.07 vs. 0.90 + 0.06, p<0.05). After adjusting for confounders, waist circumference was the only indicator that was found to significantly increase the risk for CRA in women (OR = 6.349, 95% CI = 1.063 - 37.919). Higher BMI, WHR and body fat percentage showed a non-significant risk in female subjects. In men, none of the obesity indicators were found to be significant risk factors for CRA. These findings suggest that abdominal obesity may be a contributing factor to CRA risk particularly in women. A prospective study is needed to confirm the role of obesity in the development of CRA in Malaysians. PMID:22691799

  14. A coral polyp model of photosynthesis, respiration and calcification incorporating a transcellular ion transport mechanism

    NASA Astrophysics Data System (ADS)

    Nakamura, T.; Nadaoka, K.; Watanabe, A.

    2013-09-01

    A numerical simulation model of coral polyp photosynthesis, respiration and calcification was developed. The model is constructed with three components (ambient seawater, coelenteron and calcifying fluid), and incorporates photosynthesis, respiration and calcification processes with transcellular ion transport by Ca-ATPase activity and passive transmembrane CO2 transport and diffusion. The model calculates dissolved inorganic carbon and total alkalinity in the ambient seawater, coelenteron and calcifying fluid, dissolved oxygen (DO) in the seawater and coelenteron and stored organic carbon (CH2O). To reconstruct the drastic variation between light and dark respiration, respiration rate dependency on DO in the coelenteron is incorporated. The calcification rate depends on the aragonite saturation state in the calcifying fluid (Ω a cal). Our simulation result was a good approximation of "light-enhanced calcification." In our model, the mechanism is expressed as follows: (1) DO in the coelenteron is increased by photosynthesis, (2) respiration is stimulated by increased DO in the light (or respiration is limited by DO depletion in the dark), then (3) calcification increases due to Ca-ATPase, which is driven by the energy generated by respiration. The model simulation results were effective in reproducing the basic responses of the internal CO2 system and DO. The daily calcification rate, the gross photosynthetic rate and the respiration rate under a high-flow condition increased compared to those under the zero-flow condition, but the net photosynthetic rate decreased. The calculated calcification rate responses to variations in the ambient aragonite saturation state (Ω a amb) were nonlinear, and the responses agreed with experimental results of previous studies. Our model predicted that in response to ocean acidification (1) coral calcification will decrease, but will remain at a higher value until Ω a amb decreases to 1, by maintaining a higher Ω a cal due to

  15. Comparison of gene expression of SOX2 and OCT4 in normal tissue, polyps, and colon adenocarcinoma using immunohistochemical staining

    PubMed Central

    Talebi, Ardeshir; Kianersi, Kianoosh; Beiraghdar, Mozhdeh

    2015-01-01

    Background: Cancer stem cells have been isolated and characterized in all common cancers. SOX2 and OCT4 are important genes to enhance the self-renewal ability as activate stem cells and inhibit the genes that start differentiation and thus maintain the self-renewal ability of stem cells. Also, the aim of this study is “Comparison of gene expression of SOX2 and OCT4 in normal tissue, polyps, and colon adenocarcinoma using immunohistochemical staining.” Materials and Methods: This cross-sectional study conducted on 20 patients so that for each patient, a sample of healthy tissue, dysplastic polyp tissue, and colon adenocarcinoma were provided as microscopic sections and staining on each tissue was performed through immunohistochemistry method by markers OCT4 and SOX2. The collected data were interred into SPSS version 18.0, (SPSS Inc., Chicago, IL, USA) software and the level of significance were considered as <0.05. Results: The study sample consisted of 20 patients including 11 men (55%) and 9 women (45%) with a mean age of 55.6 ± 9.88 years. There was no association between Oct4 and colorectal cancer (CRC) patients (P > 0.05), but there was a significant correlation between Sox2 expression and CRC (P < 0.05). Patients in many aspects such as race, type of polyp, presence of lymph node, grade and intensity of Sox2 in different types of patients’ tissues (P < 0.05). Conclusion: Regarding our findings, the expression of Sox2 would be a liable marker for evaluating of cancer progression and could be a treatment target of CRC cells. PMID:26645019

  16. Serum CD26 is related to histopathological polyp traits and behaves as a marker for colorectal cancer and advanced adenomas

    PubMed Central

    2010-01-01

    Background Serum CD26 (sCD26) levels were previously found diminished in colorectal cancer (CRC) patients compared to healthy donors, suggesting its potential utility for early diagnosis. Therefore we aimed to estimate the utility of the sCD26 as a biomarker for CRC and advanced adenomas in a high-risk group of patients. The relationship of this molecule with polyp characteristics was also addressed. Methods sCD26 levels were measured by ELISA in 299 symptomatic and asymptomatic patients who had undergone a colonoscopy. Patients were diagnosed as having no colorectal pathology, non-inflammatory or inflammatory bowel disease, polyps (hyperplastic, non-advanced and advanced adenomas) or CRC. Results At a 460 ng/mL cut-off, the sCD26 has a sensitivity and specificity of 81.8% (95% CI, 64.5-93.0%) and 72.3% (95% CI, 65.0-77.2%) for CRC regarding no or benign colorectal pathology. Clinicopathological analysis of polyps showed a relationship between the sCD26 and the grade of dysplasia and the presence of advanced adenomas. Hence, a 58.0% (95% CI, 46.5-68.9%) sensitivity detecting CRC and advanced adenomas was obtained, with a specificity of 75.5% (95% CI, 68.5-81.0%). Conclusions Our preliminary results show that measurement of the sCD26 is a non-invasive and reasonably sensitive assay, which could be combined with others such as the faecal occult blood test for the early diagnosis and screening of CRC and advanced adenomas. Additional comparative studies in average-risk populations are necessary. PMID:20584285

  17. Treating Meningitis

    MedlinePlus

    ... ways to treat bacterial meningitis. 1 They compared steroids (dexamethasone) with pla- cebo. The doctors gave medication ( ... compared anti- biotics by themselves with antibiotics plus steroids. Dr. Fritz and colleagues compared the mortality (deaths) ...

  18. The Peutz-Jeghers kinase LKB1 suppresses polyp growth from intestinal cells of a proglucagon-expressing lineage in mice

    PubMed Central

    Zac-Varghese, Sagen; Trapp, Stefan; Richards, Paul; Sayers, Sophie; Sun, Gao; Bloom, Stephen R.; Reimann, Frank; Gribble, Fiona M.; Rutter, Guy A.

    2014-01-01

    Liver kinase B1 (LKB1; also known as STK11) is a serine/threonine kinase and tumour suppressor that is mutated in Peutz-Jeghers syndrome (PJS), a premalignant syndrome associated with the development of gastrointestinal polyps. Proglucagon-expressing enteroendocrine cells are involved in the control of glucose homeostasis and the regulation of appetite through the secretion of gut hormones such as glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY). To determine the role of LKB1 in these cells, we bred mice bearing floxed alleles of Lkb1 against animals carrying Cre recombinase under proglucagon promoter control. These mice (GluLKB1KO) were viable and displayed near-normal growth rates and glucose homeostasis. However, they developed large polyps at the gastro-duodenal junction, and displayed premature mortality (death from 120 days of age). Histological analysis of the polyps demonstrated that they had a PJS-like appearance with an arborising smooth-muscle core. Circulating GLP-1 levels were normal in GluLKB1KO mice and the polyps expressed low levels of the peptide, similar to levels in the neighbouring duodenum. Lineage tracing using a Rosa26tdRFP transgene revealed, unexpectedly, that enterocytes within the polyps were derived from non-proglucagon-expressing precursors, whereas connective tissue was largely derived from proglucagon-expressing precursors. Developmental studies in wild-type mice suggested that a subpopulation of proglucagon-expressing cells undergo epithelial-mesenchymal transition (EMT) to become smooth-muscle-like cells. Thus, it is likely that polyps in the GluLKB1KO mice developed from a unique population of smooth-muscle-like cells derived from a proglucagon-expressing precursor. The loss of LKB1 within this subpopulation seems to be sufficient to drive tumorigenesis. PMID:25190708

  19. Laparoscopic versus open colorectal resection for cancer and polyps: a cost-effectiveness study

    PubMed Central

    Jordan, Jake; Dowson, Henry; Gage, Heather; Jackson, Daniel; Rockall, Timothy

    2014-01-01

    Background Available evidence that compares outcomes from laparoscopic and open surgery for colorectal cancer shows no difference in disease free or survival time, or in health-related quality of life outcomes, but does not capture the short term benefits of laparoscopic methods in the early postoperative period. Aim To explore the cost-effectiveness of laparoscopic colorectal surgery, compared to open methods, using quality of life data gathered in the first 6 weeks after surgery. Methods Participants were recruited in 2006–2007 in a district general hospital in the south of England; those with a diagnosis of cancer or polyps were included in the analysis. Quality of life data were collected using EQ-5D, on alternate days after surgery for 4 weeks. Costs per patient, from a National Health Service perspective (in British pounds, 2006) comprised the sum of operative, hospital, and community costs. Missing data were filled using multiple imputation methods. The difference in mean quality adjusted life years and costs between surgery groups were estimated simultaneously using a multivariate regression model applied to 20 imputed datasets. The probability that laparoscopic surgery is cost-effective compared to open surgery for a given societal willingness-to-pay threshold is illustrated using a cost-effectiveness acceptability curve. Results The sample comprised 68 laparoscopic and 27 open surgery patients. At 28 days, the incremental cost per quality adjusted life year gained from laparoscopic surgery was £12,375. At a societal willingness-to-pay of £30,000, the probability that laparoscopic surgery is cost-effective, exceeds 65% (at £20,000 ≈60%). In sensitivity analyses, laparoscopic surgery remained cost-effective compared to open surgery, provided it results in a saving ≥£699 in hospital bed days and takes no more than 8 minutes longer to perform. Conclusion The study provides formal evidence of the cost-effectiveness of laparoscopic approaches and

  20. Role of Interleukin-10 on Nasal Polypogenesis in Patients with Chronic Rhinosinusitis with Nasal Polyps

    PubMed Central

    Xu, Jun; Han, Ruining; Kim, Dae Woo; Mo, Ji-Hun; Jin, Yongde; Rha, Ki-Sang; Kim, Yong Min

    2016-01-01

    Background and Objectives Interleukin 10 (IL-10) is a potent anti-inflammatory cytokine. The dysregulation of IL-10 is associated with an enhanced immunopathologic response to infection, as well as with an increased risk for developing numerous autoimmune diseases. In this study, we investigated IL-10 expression in chronic rhinosinusitis with nasal polyps (CRSwNP) and assessed the possible role of IL-10 in the pathogenesis of CRSwNP. Materials and Methods Thirty-five patients with CRSwNP, 12 patients with chronic rhinosinusitis without NP (CRSsNP) and 10 control subjects were enrolled in this study. NP tissues and uncinated tissues (UT) were collected for analysis. Dispersed NP cells (DNPCs) were cultured in the presence or absence of IL-25 and IL-10, and a flow cytometric assay was performed to identify the constitutive cell populations of the DNPCs. Murine NP (n = 18) models were used for the in vivo experiments. Real-time PCR, immunohistochemistry, western blotting analysis and ELISA were performed to measure the expression levels of the selected inflammatory cytokines and inflammation-associated molecules. Results The mRNA expression levels of IL-10, IL-5, IL-17A, IL-25 and interferon gamma (IFN-γ) were significantly higher in the NP tissues than in the UT tissues. Strong positive correlations were observed between IL-10 and a variety of inflammatory cytokines (IL-5, IL-17A, IL-25, IFN-γ) and inflammation-associated molecules (B-cell activating factor; BAFF, CD19). Other than the IL-25 to IL-10 ratio, the expression ratios of the other measured inflammatory cytokines to IL-10 were significantly lower in the CRSwNP group than in the CRSsNP or control groups. Administrating IL-25 into the cultured DNPCs significantly increased the production of IL-10, but administrating IL-10 had no effect on the production of IL-25. Conclusion Increased expression of IL-10, IL-10 related inflammatory cytokine, and IL-10 related B cell activation indicated that IL-10, a potent

  1. miRNA Expression in Colon Polyps Provides Evidence for a Multihit Model of Colon Cancer

    PubMed Central

    Oberg, Ann L.; French, Amy J.; Sarver, Aaron L.; Subramanian, Subbaya; Morlan, Bruce W.; Riska, Shaun M.; Borralho, Pedro M.; Cunningham, Julie M.; Boardman, Lisa A.; Wang, Liang; Smyrk, Thomas C.; Asmann, Yan; Steer, Clifford J.; Thibodeau, Stephen N.

    2011-01-01

    Changes in miRNA expression are a common feature in colon cancer. Those changes occurring in the transition from normal to adenoma and from adenoma to carcinoma, however, have not been well defined. Additionally, miRNA changes among tumor subgroups of colon cancer have also not been adequately evaluated. In this study, we examined the global miRNA expression in 315 samples that included 52 normal colonic mucosa, 41 tubulovillous adenomas, 158 adenocarcinomas with proficient DNA mismatch repair (pMMR) selected for stage and age of onset, and 64 adenocarcinomas with defective DNA mismatch repair (dMMR) selected for sporadic (n = 53) and inherited colon cancer (n = 11). Sporadic dMMR tumors all had MLH1 inactivation due to promoter hypermethylation. Unsupervised PCA and cluster analysis demonstrated that normal colon tissue, adenomas, pMMR carcinomas and dMMR carcinomas were all clearly discernable. The majority of miRNAs that were differentially expressed between normal and polyp were also differentially expressed with a similar magnitude in the comparison of normal to both the pMMR and dMMR tumor groups, suggesting a stepwise progression for transformation from normal colon to carcinoma. Among the miRNAs demonstrating the largest fold up- or down-regulated changes (≥4), four novel (miR-31, miR-1, miR-9 and miR-99a) and two previously reported (miR-137 and miR-135b) miRNAs were identified in the normal/adenoma comparison. All but one of these (miR-99a) demonstrated similar expression differences in the two normal/carcinoma comparisons, suggesting that these early tumor changes are important in both the pMMR- and dMMR-derived cancers. The comparison between pMMR and dMMR tumors identified four miRNAs (miR-31, miR-552, miR-592 and miR-224) with statistically significant expression differences (≥2-fold change). PMID:21694772

  2. Isolation and characterization of multipotent mesenchymal stem cells in nasal polyps

    PubMed Central

    Cho, Jung-Sun; Park, Joo-Hoo; Kang, Ju-Hyung; Kim, Sung Eun; Park, Il-Ho

    2015-01-01

    Mesenchymal stem cells (MSCs) are multipotent progenitor cells in adult tissues. This study aimed to investigate nasal polyp (NP) tissues as a potential new source of multipotent MSCs that maintain their stemness and differentiation potential following multiple rounds of passaging. NP tissues were obtained from 10 patients during endoscopic sinus surgery. After isolating and culturing NP-derived MSCs (npMSCs), the expression levels of the surface markers CD34, CD44, CD45, CD73, CD90, CD105, CD106, CD146 and human leukocyte antigens-class II DR antigen (HLA-DR) were estimated by flow cytometry. NpMSCs were cultured in chondrogenic, osteogenic, adipogenic, or neurogenic differentiation medium. The differentiation potential of npMSCs was analyzed by Alcian blue, alizarin red S, oil red O, and immunocytochemical staining and reverse transcription-polymerase chain reaction. The clonogenic potential of npMSCs was measured using a colony-forming unit assay. Cell proliferation of npMSCs was measured using the 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay. Flow cytometry analysis revealed that npMSCs were negative for hematopoietic lineage markers (CD34, CD45, and HLA-DR) and positive for MSC markers (CD44, CD73, CD90, and CD105). The npMSCs differentiated into osteogenic, adipogenic, chondrogenic, and neurogenic lineages, respectively. Chondrogenically differentiated npMSCs were stained with Alcian blue, osteogenically differentiated npMSCs were stained with alizarin red S, and adipogenically differentiated npMSCs were stained with oil red O. Real-time polymerase chain reaction results showed that the differentiated npMSCs expressed the respective differentiation markers (Sox 9 and Col2A for chondrogenesis, Runx2 and osteocalcin for osteogenesis, fatty acid-binding protein 4 and peroxisome proliferator-activated receptor γ for adipogenesis, TuJ1, neurofilament light chain, and neurofilament heavy chain for neurogenesis). There were no

  3. Inflammatory fibroid polyps of the gastrointestinal tract: spectrum of clinical, morphologic, and immunohistochemistry features.

    PubMed

    Liu, Ta-Chiang; Lin, Ming-Tseh; Montgomery, Elizabeth A; Singhi, Aatur D

    2013-04-01

    Inflammatory fibroid polyps (IFPs) are rare, benign tumors that can arise throughout the gastrointestinal tract. Although the molecular pathogenesis of these lesions has been well characterized, their morphologic features often vary. We report the clinicopathologic findings of the largest series of IFPs to date. A total of 83 IFPs seen at our institution were collected between 1999 and 2012. The specimens included 64 biopsies and 19 resections. A review of the clinical features identified a modest female predominance (47 women and 36 men) with patients ranging in age from 26 to 87 years (mean, 60 y). Involved sites included the esophagus (n=2), stomach (n=31; mainly antrum), small intestines (n=17), appendix (n=1), large intestines (n=31; majority within the rectosigmoid), and anal canal (n=1). Although most patients had a nonspecific presentation, those with small intestinal lesions frequently presented with intussusception. Grossly, the tumors ranged in size from 0.2 to 4.2 cm (mean, 1.7 cm). Histologically, IFPs were centered within the submucosa in all resection specimens, but mucosal extension was found in 74 of 83 (89%) cases. The tumors varied in both cellularity and degree of vascularity. However, the characteristic feature of perivascular onion skinning was present in only 54% (45/83) of the cases. In addition, a short fascicular growth pattern was also noted in 36% (30 of 83) of cases, whereas both features were present in 14 cases (17%). Eosinophils were present in 94% (78 of 83) of cases but varied widely in number from abundant (20/hpf) to sparse (1/hpf). Interestingly, in those cases with sparse eosinophils, prominent hyalinization was also present (11 of 78, 13%). In addition, although the majority of IFPs expressed CD34, 6 of 44 (14%) were negative. No associated dysplasia or malignancy was seen. IFPs represent a diverse set of submucosal-based lesions that commonly extend into the mucosa, making them amenable to endoscopic biopsy. Although their

  4. TGF-beta 1 downregulates CFTR expression and function in nasal polyps of non-CF patients.

    PubMed

    Prulière-Escabasse, Virginie; Fanen, Pascale; Dazy, Anne Catherine; Lechapt-Zalcman, Emmanuèle; Rideau, Dominique; Edelman, Aleksander; Escudier, Estelle; Coste, André

    2005-01-01

    Nasal polyposis is a chronic inflammatory disease of the upper airways. It has been suggested that ion transports and CFTR expression could be modified in epithelial cells from nasal polyps of non-cystic fibrosis patients. We compared human nasal epithelial cells from nasal polyps (NP) with control nasal mucosa (CM). The level of CFTR mRNA was studied by Northern blot analysis and protein expression was studied by immunoprecipitation both ex vivo and in vitro in primary cultures of human nasal epithelial cells at the air-liquid interface. Ion transports were evaluated by short-circuit measurements in vitro. CFTR gene and protein expressions were significantly decreased in NP native tissues and in culture on day 4, when a global defect of ion transports was observed in NP cultures, but not in CM. We evaluated the effect of transforming growth factor (TGF)-beta 1 on CFTR expression and function in NP cultures on day 14 and showed, for the first time, that TGF-beta 1 was able to significantly downregulate the level of CFTR mRNA and cAMP-dependent current in NP cultures. Finally, we showed that the effects of TGF-beta 1 on ion transports could be reversed after 48-h removal of TGF-beta1 in NP cultures. In conclusion, our data strongly suggest that chronic inflammation in nasal polyposis downregulates CFTR gene and protein expression.

  5. Delaunay triangulation-based pit density estimation for the classification of polyps in high-magnification chromo-colonoscopy.

    PubMed

    Häfner, M; Liedlgruber, M; Uhl, A; Vécsei, A; Wrba, F

    2012-09-01

    In this work we propose a method to extract shape-based features from endoscopic images for an automated classification of colonic polyps. This method is based on the density of pits as used in the pit pattern classification scheme which is commonly used for the classification of colonic polyps. For the detection of pits we employ a noise-robust variant of the LBP operator. To be able to be robust against local texture variations we extend this operator by an adaptive thresholding. Based on the detected pit candidates we compute a Delaunay triangulation and use the edge lengths of the resulting triangles to construct histograms. These are then used in conjunction with the k-NN classifier to classify images. We show that, compared to a previously developed method, we are not only able to almost always get higher classification results in our application scenario, but that the proposed method is also able to significantly outperform the previously developed method in terms of the computational demand.

  6. The value of nuclear morphometry in the management of patients with colorectal polyps that contain invasive adenocarcinoma.

    PubMed

    Mitmaker, B; Kyzer, S; Begin, L R; Gordon, P H

    1992-09-01

    Haggitt's classification is a useful guide in the management of patients with large bowel polyps which contain invasive adenocarcinoma in that patients with levels 1 to 3 require no operation. Nuclear morphometry has been shown to be a useful prognostic discriminant for patients with invasive carcinoma of the large bowel. The nuclear shape factor of 44 polyps with invasive carcinoma was studied to determine whether this parameter was of value to define those patients with Haggitt level 4 who should have a resection. The shape factor of 50 interphase nuclei was obtained through the use of image analysis by tracing the nuclear profiles as digitized on a video screen. The nuclear shape factor was defined as the degree of circularity of the nucleus, a perfect circle recorded as 1.0. Our previous experience showed a nuclear shape factor greater than 0.84 was associated with a poor outcome. The overall mean shape factor was 0.71 (0.59-0.85). There was a tendency for the patients with residual disease to have values in the upper range. Our findings suggest that nuclear morphometry fails to add any predictive information in this clinical situation. PMID:1518294

  7. 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)

  8. Antrochoanal polyp: clinical presentation and retrospective comparison of endoscopic sinus surgery and endoscopic sinus surgery plus mini-Caldwell surgical procedures.

    PubMed

    Kelles, Mehmet; Toplu, Yuksel; Yildirim, Ilhami; Okur, Erdogan

    2014-09-01

    Antrochoanal polyp is a benign polypoid lesion orginating from the maxillary sinus antrum and extending to the choana. Our aim was to assess the clinical presentation and associated rhinological findings of antrochoanal polyp patients and to evaluate results of 2 surgical treatments termed endoscopic sinus surgery (ESS) and ESS plus mini-Caldwell operation. The study included 46 patients. Factors such as patient age, sex, history of chronic sinusitis, allergic rhinitis, septal deviations, chonca bullosa, turbinate hypertrophy, and the origin of the polyp were assessed. We also evaluated ESS and ESS plus mini-Caldwell surgical procedures for recurrences, synechia, bleeding, and ostium stenosis. Overall, there were 27 men and 19 women. The ESS approach was used in 26 cases, and 20 cases had combined ESS and mini-Caldwell procedures. The statistical significant difference between the 2 groups was only recurrence (P < 0.05). In the ESS group, bleeding, synechia, and ostium stenosis were seen more than in the ESS + mini-Caldwell group, but there was no significant difference between the 2 groups in bleeding, synechia, and ostium stenosis (P > 0.05). We thought that lower rate of recurrence found in ESS + Caldwell group in this study was associated with better visualization of the maxillary sinus walls and, therefore, easier resection of the remnant polyp. We concluded that higher incidences of bleeding and synechia were related to the mucosal damage occurring in the septum and the inferior concha due to excessive manipulation of endoscope and surgical instruments.

  9. UreA and cagA genes of Helicobacter pylori in Egyptian patients with laryngeal squamous cell carcinoma and benign laryngeal polyps: a cohort study.

    PubMed

    Barakat, Ghada; Nabiel, Yasmin; Ali, Omima; El-Nady, Ghada; Musaad, Ahmed; El-Sharkawy, Asser

    2016-10-01

    This work aims to estimate the prevalence of Helicobacter pylori ureA gene and evaluate cagA gene-positive strains in both patients of laryngeal squamous cell carcinoma (LSCC) and those with benign laryngeal polyps. This study included 49 patients confirmed pathologically to have LSCC and 15 patients with benign laryngeal polyps over a period from June 2013 to March 2015. Samples of laryngeal tissue were collected during direct laryngoscope under general anesthesia to be pathologically evaluated followed by analysis for H. pylori detection. Each laryngeal tissue sample was divided into three parts; one for bacteriological examination, the second for pathological examination and the third for PCR to detect both ureA and cagA genes. Out of 49 LSCC samples, 31 (64.6 %) was positive for ureA by PCR. Out of them, 29 samples (93.5 %) were cagA positive. Only three cases (20 %) of the benign laryngeal polyp were ureA positive by PCR and one of them was cagA positive by PCR. By the bacteriological culture, only eight samples (25.8 %) gave growth. All of them were ureA positive and only seven of them were cagA positive. There was a significant association between presence of H. pylori and LSCC as compared to benign laryngeal polyp which may contribute in the pathogenesis of laryngeal carcinoma. These results should be confirmed by further studies over larger number of cases.

  10. Epithelial cell proliferation in nasal polyps could be up-regulated by platelet-derived growth factor.

    PubMed

    Coste, A; Wang, Q P; Roudot-Thoraval, F; Chapelin, C; Bedbeder, P; Poron, F; Peynègre, R; Escudier, E

    1996-05-01

    The modifications of epithelial differentiation and proliferation observed in nasal polyps (NP) could be related to local secretion of growth factors, among which platelet-derived growth factor (PDGF) could play a key role. We therefore prospectively studied, by immunohistochemistry, proliferating cell nuclear antigen (PCNA, an S-phase cell marker), PDGF, and CD-68 (activated macrophages marker) expression in NP and inferior turbinate mucosa (NM) in 11 patients. Our data show that PCNA and PDGF expression are increased in NP epithelium, while CD-68 expression is increased in NP epithelium and lamina propria when compared to NM. Increased local PDGF secretion by numerous activated macrophages could therefore be involved in epithelial cell proliferation up-regulation in NP. PDGF could also be involved in the pathogenesis of NP via its connective tissue remodeling actions.

  11. Diagnostic accuracy of the double-contrast enema for colonic polyps in patients with or without diverticular disease.

    PubMed

    Morosi, C; Ballardini, G; Pisani, P; Bellomi, M; Cozzi, G; Vidale, M; Spinelli, P; Severini, A

    1991-01-01

    The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The double-contrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.

  12. Composite Epstein-Barr Virus-Associated B-Cell Lymphoproliferative Disorder and Tubular Adenoma in a Rectal Polyp.

    PubMed

    Lo, Amy A; Gao, Juehua; Rao, M Sambasivia; Yang, Guang-Yu

    2016-02-01

    Composite tumors are formed when there is intermingling between two components of separate tumors seen histologically. Cases demonstrating composite tubular adenoma with other types of tumors in the colon are rare. Composite tubular adenomas with nonlymphoid tumors including carcinoids, microcarcinoids, and small cell undifferentiated carcinoma have been reported in the literature. The occurrence of composite lymphoma and tubular adenoma within the colorectal tract is extremely rare. Only three cases have been reported and include one case of mantle cell lymphoma and two cases of diffuse large B-cell lymphoma arising in composite tubular adenomas. We present the first case of composite Epstein-Barr virus-associated B-cell lymphoproliferative disorder and tubular adenoma in a rectal polyp with a benign endoscopic appearance.

  13. Analysis of the depolarizing properties of normal and adenomatous polyps in colon mucosa for the early diagnosis of precancerous lesions

    NASA Astrophysics Data System (ADS)

    Ortega-Quijano, Noé; Fanjul-Vélez, Félix; de Cos-Pérez, Jesús; Arce-Diego, José Luis

    2011-09-01

    Optical characterization of biological tissues by means of polarimetric techniques is an area of growing interest. Polarized light can be used for malignant neoplasms detection. To our knowledge, few studies have so far focused on lesions that are prone to result in cancer. In this work we present a polarimetric study of depolarization in prepathological tissues. Specifically, we will focus on premalignant lesions in human colon due to their clinical relevance. Colonic adenoma, the potential precursor of malignant adenocarcinoma, provokes significant structural modifications in colon mucosa that affect light depolarization. The depolarizing properties of normal and adenomatous polyps mucosa are compared. The average linear degree of polarization is shown to present a strong dependence with the precancerous state of the colonic tissue. This method has the potential to enable an early diagnosis of colon cancer.

  14. Migration and Differentiation of GFP-transplanted Bone Marrow-derived Cells into Experimentally Induced Periodontal Polyp in Mice

    PubMed Central

    Matsuda, Saeka; Shoumura, Masahito; Osuga, Naoto; Tsujigiwa, Hidetsugu; Nakano, Keisuke; Okafuji, Norimasa; Ochiai, Takanaga; Hasegawa, Hiromasa; Kawakami, Toshiyuki

    2016-01-01

    Perforation of floor of the dental pulp is often encountered during root canal treatment in routine clinical practice of dental caries. If perforation were large, granulation tissue would grow to form periodontal polyp. Granulation tissue consists of proliferating cells however their origin is not clear. It was shown that the cells in granulation tissue are mainly from migration of undifferentiated mesenchymal cells of the bone marrow. Hence, this study utilized GFP bone marrow transplantation mouse model. The floor of the pulp chamber in maxillary first molar was perforated using ½ dental round bur. Morphological assessment was carried out by micro CT and microscopy and GFP cell mechanism was further assessed by immunohistochemistry using double fluorescent staining with GFP-S100A4; GFP-Runx2 and GFP-CD31. Results of micro CT revealed alveolar bone resorption and widening of periodontal ligament. Histopathological examination showed proliferation of fibroblasts with some round cells and blood vessels in the granulation tissue. At 2 weeks, the outermost layer of the granulation tissue was lined by squamous cells with distinct intercellular bridges. At 4 weeks, the granulation tissue became larger than the perforation and the outermost layer was lined by relatively typical stratified squamous epithelium. Double immunofluorescent staining of GFP and Runx2 revealed that both proteins were expressed in spindle-shaped cells. Double immunofluorescent staining of GFP and CD31 revealed that both proteins were expressed in vascular endothelial cells in morphologically distinct vessels. The results suggest that fibroblasts, periodontal ligament fibroblasts and blood vessels in granulation tissue were derived from transplanted-bone marrow cells. Thus, essential growth of granulation tissue in periodontal polyp was caused by the migration of undifferentiated mesenchymal cells derived from bone marrow, which differentiated into fibroblasts and later on differentiated into

  15. Immunological profiling in chronic rhinosinusitis with nasal polyps reveals distinct VEGF and GMCSF signatures during symptomatic exacerbations

    PubMed Central

    Divekar, Rohit D.; Samant, Shefali; Rank, Matthew A.; Hagan, John; Lal, Devyani; O’Brien, Erin K.; Kita, Hirohito

    2015-01-01

    Background The mechanisms and immune pathways associated with chronic rhinosinusitis (CRS) are not fully understood. Immunological changes during acute exacerbation of CRS may provide valuable clues to the pathogenesis and perpetuation of the disease. Objective To characterize local and systemic immune responses associated with acute worsening of sinonasal symptoms during exacerbation in CRS with nasal polyps (CRSwNP) compared to controls. Methods This was a noninterventional prospective study of individuals with CRSwNP and normal controls. Subjects underwent a baseline visit with collection of nasal secretions, nasal washes, and serum specimens. Within 3 days of acute worsening of sinonasal symptoms, subjects underwent a study visit, followed by a post-visit 2 weeks later. The Sinonasal Outcome Test-22 (SNOT-22) scores and immunological parameters in the specimens were analyzed using a novel, unsupervised learning method and by conventional univariate analysis. Results Both CRSwNP patients and control subjects showed a significant increase in SNOT-22 scores during acute exacerbation. Increased nasal levels of IL-6, IL-5, and eosinophil major basic protein were observed in CRSwNP patients. A network analysis of serum specimens revealed changes in a set of immunological parameters, which are distinctly associated with CRSwNP but not with controls. In particular, systemic increases in VEGF and GM-CSF levels were notable and were validated by a conventional analysis. Conclusions CRSwNP patients demonstrate distinct immunological changes locally and systemically during acute exacerbation. Growth factors VEGF and GM-CSF may be involved in the immunopathogenesis of subjects with CRS and nasal polyps experiencing exacerbation. PMID:25429844

  16. 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 ...

  17. Insulin, insulin-like growth factor 1 and insulin-like growth factor binding protein 3 serum concentrations in patients with adenomatous colon polyps

    PubMed Central

    Janiak, Adam; Oset, Piotr; Kumor, Anna; Małecka-Panas, Ewa

    2013-01-01

    Introduction Insulin stimulates colonic mucosal cells proliferation directly and by influencing the concentration of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3). Aim To estimate serum concentrations of insulin, IGF-1, and IGFBP-3 and to determine the relationships between them and colorectal adenoma location, dysplasia grading, histological type, and size. Material and methods The study included 60 patients with colorectal adenomatous polyps found on colonoscopy and confirmed pathologically. The control group consisted of 30 individuals with no positive findings on colonoscopy. All patients had their blood drawn for assessment of insulin, IGF-1, and IGFBP-3 serum concentrations. Results One hundred and nine adenomas (6–40 mm in size) were found in 60 study patients. The average age of patients with multiple polyps was significantly higher than that of patients with single pathologies (61.1 vs. 56.7 years respectively (p < 0.05)). A higher adenoma incidence rate was observed in the distal portion of the colon than the proximal one (50 vs. 10 polyps respectively (p < 0.01)). Higher serum levels of IGF-1 and IGFBP-3 were found in patients with adenomatous polyps than in the control group. The average IGF-1 concentration in patients with adenomas located proximally was also significantly higher compared to those located distally (p < 0.05). The insulin concentration was similar in both groups and not related to clinical data of patients. Conclusions The results indicate the role of IGF-1 and IGFBP-3 in early carcinogenesis of the large intestine, and IGF-1 particularly in malignant transformation in the proximal part of the organ. PMID:24868275

  18. Berberine potently attenuates intestinal polyps growth in ApcMin mice and familial adenomatous polyposis patients through inhibition of Wnt signalling

    PubMed Central

    Zhang, Junfang; Cao, Hailong; Zhang, Bing; Cao, Hanwei; Xu, Xiuqin; Ruan, Hang; Yi, Tingting; Tan, Li; Qu, Rui; Song, Gang; Wang, Bangmao; Hu, Tianhui

    2013-01-01

    As a traditional anti-inflammatory Chinese herbal medicine, Alkaloid berberine has been recently reported to exhibit anti-tumour effects against a wide spectrum of cancer. However, the mechanism was largely unknown. Gene chip array reveals that with berberine treatment, c-Myc, the target gene of Wnt pathway, was down-regulated 5.3-folds, indicating that berberine might inhibit Wnt signalling. TOPflash analysis revealed that Wnt activity was significantly reduced after berberine treatment, and the mechanism of which might be that berberine disrupted β-catenin transfer to nucleus through up-regulating the expression of adenomatous polyposis coli (APC) gene and stabilized APC-β-catenin complex. Berberine administration in ApcMin/+ mice exhibited fewer and smaller polyps in intestine, along with reduction in cyclin D1 and c-Myc expression. In clinical practice, oral administration of berberine also significantly reduced the familial adenomatous polyposis patients' polyp size along with the inhibition of cyclin D1 expression in polyp samples. These observations indicate that berberine inhibits colon tumour formation through inhibition of Wnt/β-catenin signalling and berberine might be a promising drug for the prevention of colon cancer. PMID:24015932

  19. The Influence of Snare Size on the Utility and Safety of Cold Snare Polypectomy for the Removal of Colonic Polyps in Japanese Patients

    PubMed Central

    Noda, Hisatsugu; Ogasawara, Naotaka; Sugiyama, Tomoya; Yoshimine, Takashi; Tamura, Yasuhiro; Izawa, Shinya; Kondo, Yoshihiro; Ebi, Masahide; Funaki, Yasushi; Sasaki, Makoto; Kasugai, Kunio

    2016-01-01

    Background Cold snare polypectomy (CSP) has been recently reported to be useful for the removal of small colonic polyps. However, the relationship between the histologically complete resection rate and snare size used during CSP has not been reported. Our aim was to assess the utility of CSP. Methods We analyzed the histologically complete resection rates and the frequency of complications for 175 colon polyps removed by CSP. Moreover, we examined the histologically complete resection rate associated with different snare sizes used during CSP. Results There was no significant difference in the histologically complete resection rate between endoscopic mucosal resection (EMR) (60.9%) and CSP (53.1%). There were also no significant differences in the frequency of complications including perforation and postoperative bleeding between EMR (perforation: none; postoperative bleeding: two patients) and CSP (perforation: none; postoperative bleeding: none). Histological examination revealed that the complete resection rate of CSP using a short snare (61.6%) was significantly higher than that of CSP using a long snare (44.9%; P < 0.05). There were no significant differences in the frequency of complications between CSP using the short snare and that using the long snare. Conclusions CSP is a safe, useful method for the removal of colonic polyps. CSP using the short snare improved the histologically complete resection rates compared to the long snare. Future studies to further assess the utility of CSP are required. PMID:27540440

  20. 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.

  1. Treating oilfield emulsions

    SciTech Connect

    Not Available

    1990-01-01

    This book is divided into the following sections: The Treating Problem of Oilfield Emulsion; The Theory of Emulsions; Emulsions and Production Practices; The Basic Principles of Treating; The Application of Heat in Treating; The Principles of Chemical Treating; Treating with Heater-Treaters; Automatic Central Oil-Treating Systems; Sampling Procedures; Testing for Sediment and Water; Treating Cost Records.

  2. Narrow-band imaging does not improve detection of colorectal polyps when compared to conventional colonoscopy: a randomized controlled trial and meta-analysis of published studies

    PubMed Central

    2011-01-01

    Background A colonoscopy may frequently miss polyps and cancers. A number of techniques have emerged to improve visualization and to reduce the rate of adenoma miss. Methods We conducted a randomized controlled trial (RCT) in two clinics of the Gastrointestinal Department of the Sanitas University Foundation in Bogota, Colombia. Eligible adult patients presenting for screening or diagnostic elective colonoscopy were randomlsy allocated to undergo conventional colonoscopy or narrow-band imaging (NBI) during instrument withdrawal by three experienced endoscopists. For the systematic review, studies were identified from the Cochrane Library, PUBMED and LILACS and assessed using the Cochrane risk of bias tool. Results We enrolled a total of 482 patients (62.5% female), with a mean age of 58.33 years (SD 12.91); 241 into the intervention (NBI) colonoscopy and 241 into the conventional colonoscopy group. Most patients presented for diagnostic colonoscopy (75.3%). The overall rate of polyp detection was significantly higher in the conventional group compared to the NBI group (RR 0.75, 95%CI 0.60 to 0.96). However, no significant differences were found in the mean number of polyps (MD -0.1; 95%CI -0.25 to 0.05), and the mean number of adenomas (MD 0.04 95%CI -0.09 to 0.17). Meta-analysis of studies (regardless of indication) did not find any significant differences in the mean number of polyps (5 RCT, 2479 participants; WMD -0.07 95% CI -0.21 to 0.07; I2 68%), the mean number of adenomas (8 RCT, 3517 participants; WMD -0.08 95% CI -0.17; 0.01 to I2 62%) and the rate of patients with at least one adenoma (8 RCT, 3512 participants, RR 0.96 95% CI 0.88 to 1,04;I2 0%). Conclusion NBI does not improve detection of colorectal polyps when compared to conventional colonoscopy (Australian New Zealand Clinical Trials Registry ACTRN12610000456055). PMID:21943365

  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. An integrated classifier for computer-aided diagnosis of colorectal polyps based on random forest and location index strategies

    NASA Astrophysics Data System (ADS)

    Hu, Yifan; Han, Hao; Zhu, Wei; Li, Lihong; Pickhardt, Perry J.; Liang, Zhengrong

    2016-03-01

    Feature classification plays an important role in differentiation or computer-aided diagnosis (CADx) of suspicious lesions. As a widely used ensemble learning algorithm for classification, random forest (RF) has a distinguished performance for CADx. Our recent study has shown that the location index (LI), which is derived from the well-known kNN (k nearest neighbor) and wkNN (weighted k nearest neighbor) classifier [1], has also a distinguished role in the classification for CADx. Therefore, in this paper, based on the property that the LI will achieve a very high accuracy, we design an algorithm to integrate the LI into RF for improved or higher value of AUC (area under the curve of receiver operating characteristics -- ROC). Experiments were performed by the use of a database of 153 lesions (polyps), including 116 neoplastic lesions and 37 hyperplastic lesions, with comparison to the existing classifiers of RF and wkNN, respectively. A noticeable gain by the proposed integrated classifier was quantified by the AUC measure.

  5. Inflammatory fibroid polyps in children: A new case report and a systematic review of the pediatric literature

    PubMed Central

    Righetti, Laura; Parolini, Filippo; Cengia, Paolo; Boroni, Giovanni; Cheli, Maurizio; Sonzogni, Aurelio; Alberti, Daniele

    2015-01-01

    AIM: To study that inflammatory fibroid polyps (IFPs) in children are extremely uncommon tumors that may occur throughout the gastrointestinal tract. METHODS: A systematic review of the pediatric literature and a report of a new case of IFP is also presented. The PubMed database was searched for original studies on pediatric IFPs since 1960, according to “Preferred reporting items for systematic reviews and meta-analyses” guidelines for systematic reviews. RESULTS: Five studies were finally enclosed, encompassing 6 children with IFPs (mean age 64 mo). Tumors were located in the stomach (2 patients), in the small bowel (2 patients), in the rectum (1 patient) and in the colon (1 patient). Open surgery was performed in all patients and complete excision of the mass was achieved in all cases. All patients are alive and free of symptom. Authors described a further case of a 3-year-old boy with a large duodenal IFP, in whom the tumor was removed by “en block resection”. The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose. An accurate pre-operative assessment is fundamental in order to differentiate IFP from other more aggressive gastrointestinal tumor, enabling unnecessary demolitive surgery. CONCLUSION: When complete resection of the IFP is achieved, the prognosis is excellent. PMID:26566490

  6. Myofibroblast accumulation induced by transforming growth factor-beta is involved in the pathogenesis of nasal polyps.

    PubMed

    Wang, Q P; Escudier, E; Roudot-Thoraval, F; Abd-Al Samad, I; Peynegre, R; Coste, A

    1997-07-01

    Myofibroblasts that express alpha-smooth muscle actin (alpha-SMA) are detected in many chronic inflammatory diseases. Transforming growth factor-beta (TGF-beta) is a potent inducer of myofibroblast accumulation in tissues. In this study, scattered myofibroblasts and TGF-beta were quantified and localized in nasal polyps (NPs) and normal nasal mucosa (NM). NPs were sampled in 16 patients during ethmoidectomy and NM was obtained from 10 control subjects during rhinoplasty. alpha-SMA and TGF-beta were detected using immunohistochemistry and the numbers of labeled cells were quantified (alpha-SMA and TGF-beta indices) and compared between NPs and NM. In eight NPs, in which the pedicle was preserved, alpha-SMA and TGF-beta were evaluated and compared in the pedicle, central, and tip areas. Finally, TGF-beta expression was compared between low (zone 1), moderate (zone 2), and high (zone 3) zones of alpha-SMA positivity. alpha-SMA and TGF-beta indices were significantly higher in NPs than in NM. In the eight selected NPs, alpha-SMA-positive cells were significantly more abundant in the pedicle than in the central and tip areas, whereas TGF-beta-positive cells were significantly more numerous in the pedicle than in the tip area. The number of TGF-beta-positive cells was significantly higher in zone 3 than in zone 1 of alpha-SMA positivity. Myofibroblasts, which are abundant in NPs but rare in NM, could be involved in the growth of NPs by inducing extracellular matrix accumulation. The local development of myofibroblasts in NPs could be controlled by TGF-beta, locally produced by inflammatory cells.

  7. Urinary metabolites of prostanoids and risk of recurrent colorectal adenomas in the Aspirin/Folate Polyp Prevention Study (AFPPS).

    PubMed

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

    2015-11-01

    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 liquid chromatography/mass spectrometry 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 with 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 with 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

  8. Transanal endoscopic microsurgery for advanced polyps and early cancers in the rectum—Long-term outcome

    PubMed Central

    al-Najami, Issam; Rancinger, Carl Philip; Larsen, Morten Kobaek; Thomassen, Niels; Buch, Niels; Baatrup, Gunnar

    2016-01-01

    Abstract Transanal endoscopic microsurgery (TEM) allows for the resection of large adenomas and early stage cancers in the rectum. The rate of complications and recurrence for malignant tumors compared with benign tumors has been questioned. The objective of our study was to analyze the outcome after TEM procedures for adenomas and cancers with focus on local recurrence and complications. All 280 patients who had a TEM procedure between January 2008 and September 2015 were enrolled in a prospective cohort study. Outcome was described for benign and malignant tumors. Mortality, recurrence, and complications were recorded. Two hundred eighty tumors were treated with TEM, 176 (63%) were benign and 104 (37%) were malignant. Complication rates were significantly different in the 2 groups, 10.8% (n = 19) in the benign and 24.0% (n = 25) in the malignant group (P = 0.003). A significant difference in perforation/penetration to the peritoneal cavity was noted (P = 0.034). There were no significant difference in the recurrence rate of 8.3% (n = 13) in the benign and 9.0% (n = 7) in the malignant groups. Thirty days mortality rates were 1.1% in the benign group versus 1.9% in the malignant. Other complications were noted in 2.8% and 3.8% in the benign and malignant group, respectively. TEM seems to be a safe and viable procedure for removing both benign and malignant lesions from the rectum. TEM offers low mortality and complication rates also recurrence after resection of malignant tumors. PMID:27603369

  9. 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.

  10. A novel ureter dilatation method for replacing hydromantic perfusion pump during ureteroscopic lithotripsy in patients with ureteral calculi and ibroepithelial polyps.

    PubMed

    Li, Tengcheng; Fang, Youqiang; Wu, Jieying; Zhou, Xiangfu

    2014-01-01

    This study aimed to evaluate the clinical value of a novel ureter dilatation method during ureteroscopic pneumatic lithotripsy in patients with ureteral calculi and polyps. Clinical information of 86 patients with ureter calculi and polyps who underwent ureteroscopic pneumatic lithotripsy was reviewed. A cavity-distention machine was used in 44 cases to inject normal saline for keeping clear operation view (cavity-distention machine-assisted group). A high handled water bag with artificial water injection (traditional pneumatic lithotripsy group) was used in 42 cases. The total operation time, time of stone removal, stone clearance rate and surgery complications were compared between two groups. All operations were successful with no patients transferred to open surgery. No ureter breakage or avulsion occurred in two groups. Two patients in traditional pneumatic lithotripsy group suffered from ureter perforation. In cavity-distention machine-assisted group and traditional pneumatic lithotripsy group, the total operation time was 30.1±4.8 min and 36.2±6.0 min, respectively (t=-5.22, P<0.01); the time of stone removal was 6.4±1.3 min and 9.3±1.5 min, respectively (t=-9.59, P<0.01); the stone clearance rate was 100% (44/44) and 95.2% (40/42; upper ureter stone immigrated to the renal pelvis in 2, and extraorgan shock wave lithotripsy was performed), respectively. Thus, intraoperative infusion of saline with a cavity-distention machine may replace the hydromantic perfusion pump to maintain a clear operation view and favor the stone removal in lesser time. This method has important clinical value in the treatment of ureteral calculi and polyps.

  11. Real-Time Characterization of Diminutive Colorectal Polyp Histology Using Narrow-Band Imaging: Implications for the Resect and Discard Strategy

    PubMed Central

    Patel, Swati G.; Schoenfeld, Philip; Kim, Hyungjin Myra; Ward, Emily K.; Bansal, Ajay; Kim, Yeonil; Hosford, Lindsay; Myers, Aimee; Foster, Stephanie; Craft, Jenna; Shopinski, Samuel; Wilson, Robert H.; Ahnen, Dennis J.; Rastogi, Amit; Wani, Sachin

    2016-01-01

    BACKGROUND & AIMS Narrow-band imaging (NBI) allows real-time histologic classification of colorectal polyps. We investigated whether endoscopists without prior training in NBI can achieve the following thresholds recommended by the American Society for Gastrointestinal Endoscopy: for diminutive colorectal polyps characterized with high confidence, a ≥90% negative predictive value for adenomas in the rectosigmoid and a ≥90% agreement in surveillance intervals. METHODS Twenty-six endoscopists from 2 tertiary care centers underwent standardized training in NBI interpretation. Endoscopists made real-time predictions of diminutive colorectal polyp histology and surveillance interval predictions based on NBI. Their performance was evaluated by comparing predicted with actual findings from histologic analysis. Multilevel logistic regression was used to assess predictors of performance. Cumulative summation analysis was used to characterize learning curves. RESULTS The endoscopists performed 1451 colonoscopies and made 3012 diminutive polyp predictions (74.3% high confidence) using NBI. They made 898 immediate post-procedure surveillance interval predictions. An additional 505 surveillance intervals were determined with histology input. The overall negative predictive value for high-confidence characterizations in the rectosigmoid was 94.7% (95% confidence interval: 92.6%–96.8%) and the surveillance interval agreement was 91.2% (95% confidence interval: 89.7%–92.7%). Overall, 97.0% of surveillance interval predictions would have brought patients back on time or early. High-confidence characterization was the strongest predictor of accuracy (odds ratio = 3.42; 95% confidence interval: 2.72–4.29; P < .001). Performance improved over time, however, according to cumulative summation analysis, only 7 participants (26.9%) identified adenomas with sufficient sensitivity such that further auditing is not required. CONCLUSIONS With standardized training

  12. 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

  13. Polyps of the Cervix

    MedlinePlus

    ... Drug Information, Search Drug Names, Generic and Brand Natural Products, Search Drug Interactions Pill Identifier News & Commentary ALL NEWS > Resources First Aid Videos Figures Images Audio Pronunciations The ...

  14. 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.

  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; 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.

  16. TAS2R38 bitter taste genetics, dietary vitamin C, and both natural and synthetic dietary folic acid predict folate status, a key micronutrient in the pathoaetiology of adenomatous polyps.

    PubMed

    Lucock, Mark; Ng, Xiaowei; Boyd, Lyndell; Skinner, Virginia; Wai, Ron; Tang, Sa; Naylor, Charlotte; Yates, Zoë; Choi, Jeong-Hwa; Roach, Paul; Veysey, Martin

    2011-08-01

    Taste perception may influence dietary preferences and nutrient intakes contributing to diet-related disease susceptibility. This study examined bitter taste genetics and whether variation in the TAS2R38 gene at three polymorphic loci (A49P, V262A and I296V) could alter dietary and systemic folate levels and dietary vitamin C intake, and whether a nutrigenetic circuit existed that might link bitter taste, folate/antioxidant status and risk for a colonic adenomatous polyp. TAS2R38 diplotype predicted bitter taste (PROP) phenotype (p value <0.00001) and red cell folate status (p=0.0179) consistent with the diplotype that has the broadest range of bitter perception (AVI/PAV) also possessing the highest average red cell folate value. However, TAS2R38 diplotype did not predict dietary intake of methylfolic acid, pteroylmonoglutamic acid or total folic acid. Neither did it predict dietary intake of vitamin C. Despite this, intake of dietary folate predicts red cell folate with analysis pointing to a key nutrient-nutrient interaction between vitamin C intake and systemic folate status. Analysis of 38 patients with an adenomatous polyp and 164 controls showed that individually, dietary nutrient intake, nutrient status and taste diplotype did not influence polyp risk. However, red cell folate status (in individuals below the population median value) did interact with bitter taste diplotype (AVI/PAV) to predict polyp risk (p=0.0145). Furthermore, synthetic folic acid (below median intake) was statistically associated with adenoma occurrence (p=0.0215); individuals with adenomatous polyps had a 1.77× higher intake than controls. Additionally, stepwise regression taking account of all dietary nutrients showed a tight relationship between methylfolic acid (but not pteroylmonoglutamic acid) intake and red cell folate level in those with a low folate status and occurrence of an adenomatous polyp (p=0.0039). These findings point to a role for folate in the pathoaetiology of

  17. 132 Characterization of 2 Epithelial Cell Air-Liquid Interface (ALI) Culture Models for Human Healthy Nasal Mucosa and Nasal Polyps

    PubMed Central

    de Borja Callejas, Fco; Martínez-Antón, Asunción; Roca-Ferrer, Jordi; Cortijo, Julio; Picado, César; Mullol, Joaquim

    2012-01-01

    Background Primary human airway epithelial cells, when submerged in culture, undergo a dedifferentiation with loss of many features of the in vivo airway epithelium. However, when cultured in an air-liquid interface (ALI), cells develop a well-differentiated, polarized, and pseudostratified epithelium. The aim of the current study was to characterize the mucociliary differentiation of human nasal mucosa and polyp epithelial cells cultured using an ALI system. Methods Nasal mucosa (NM, n = 3) and nasal polyps (NP, n = 3) were obtained from patients undergoing nasal corrective surgery and endoscopic sinus surgery, respectively. Epithelial cells were obtained from the explant method, and differentiated in ALI culture during 28 days. Cultures were studied at different time points (0, 7, 14, 21, and 28 days): tissue ultrastructure by scanning electron microscopy (SEM) and transmission electron microscopy (TEM); mucous (MUC5AC, MUC5B) and serous (lactoferrin) cell secretion by ELISA; and cytokeratin 18 (epithelial marker), β-tubulin IV (cilia marker), MUC5AC (goblet cell marker), and p63 (basal cell marker) expression by immunocytochemistry. Results In both NM and NP ALI cultures and at days 14 and 28, a pseudostratified epithelium with ciliated, mucus-secreting and basal cells was observed, and expression of cytokeratin 18, b-tubulin IV, MUC5AC and p63 was detected. In NP cultures, both MUC5AC (day 14: 2.2 ± 0.1-folds; day 28: 3.6-fold ± 0.7-fold) and MUC5B (day 14: 3.2-fold ± 0.6-fold; day 28: 3.1-fold ± 1-fold) increased over time compared to day 0 (P < 0.05). In NM cultures, only MUC5B (day 14: 3.9-fold ± 0.9-fold; day 28: 3.4-fold ± 0.4-fold; P < 0.05) but not MUC5AC increased over time compared to day 0 (P < 0.05). Secretion of lactoferrin was present but showed no changes over time in either NM or NP ALI cultures. Conclusions Epithelial cell ALI cultures provide a well-differentiated human nasal mucosa and polyp tissues that may be used as an in vitro model

  18. How Is Pneumonia Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Pneumonia Treated? Treatment for pneumonia depends on the type ... can go back to their normal routines. Bacterial Pneumonia Bacterial pneumonia is treated with medicines called antibiotics. ...

  19. Use of a frameless LNG-IUS as conservative treatment for a pre-malignant uterine polyp in a premenopausal woman – a case report

    PubMed Central

    Janssens, D; Verbeeck, G; Wildemeersch, D

    2015-01-01

    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. PMID:27729971

  20. Effect of Lipopolysaccharide on Glucocorticoid Receptor Function in Control Nasal Mucosa Fibroblasts and in Fibroblasts from Patients with Chronic Rhinosinusitis with Nasal Polyps and Asthma

    PubMed Central

    Fernández-Bertolín, Laura; Mullol, Joaquim; Fuentes-Prado, Mireya; Roca-Ferrer, Jordi; Alobid, Isam; Picado, César; Pujols, Laura

    2015-01-01

    Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the upper airways frequently associated with asthma. Bacterial infection is a feature of CRSwNP that can aggravate the disease and the response to glucocorticoid treatment. Objective We examined whether the bacterial product lipopolysaccharide (LPS) reduces glucocorticoid receptor (GR) function in control nasal mucosa (NM) fibroblasts and in nasal polyp (NP) fibroblasts from patients with CRSwNP and asthma. Methods NP (n = 12) and NM fibroblasts (n = 10) were in vitro pre-incubated with LPS (24 hours) prior to the addition of dexamethasone. Cytokine/chemokine secretion was measured by ELISA and Cytometric Bead Array. GRα, GRβ, mitogen-activated protein-kinase phosphatase-1 (MKP-1) and glucocorticoid-induced leucine zipper (GILZ) expression was measured by RT-PCR and immunoblotting, GRα nuclear translocation by immunocytochemistry, and GRβ localization by immunoblotting. The role of MKP-1 and GILZ on dexamethasone-mediated cytokine inhibition was analyzed by small interfering RNA silencing. Results Pre-incubation of nasal fibroblasts with LPS enhanced the secretion of IL-6, CXCL8, RANTES, and GM-CSF induced by FBS. FBS-induced CXCL8 secretion was higher in NP than in NM fibroblasts. LPS effects on IL-6 and CXCL8 were mediated via activation of p38α/β MAPK and IKK/NF-κB pathways. Additionally, LPS pre-incubation: 1) reduced dexamethasone’s capacity to inhibit FBS-induced IL-6, CXCL8 and RANTES, 2) reduced dexamethasone-induced GRα nuclear translocation (only in NM fibroblasts), 3) did not alter GRα/GRβ expression, 4) decreased GILZ expression, and 5) did not affect dexamethasone’s capacity to induce MKP-1 and GILZ expression. MKP-1 knockdown reduced dexamethasone’s capacity to suppress FBS-induced CXCL8 release. Conclusion The bacterial product LPS negatively affects GR function in control NM and NP fibroblasts by interfering with the capacity of the

  1. How Are Arrhythmias Treated?

    MedlinePlus

    ... Some arrhythmias are treated with a jolt of electricity to the heart. This type of treatment is ... senses a dangerous ventricular arrhythmia, it sends an electric shock to the heart to restore a normal ...

  2. 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 ...

  3. How Is Hemophilia Treated?

    MedlinePlus

    ... Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical ... Treating donated blood products with a detergent and heat to destroy viruses Vaccinating people who have hemophilia ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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.

  8. 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

  9. Smart'' pump and treat

    SciTech Connect

    Isherwood, W.; Rice, D. Jr.; Ziagos, J. ); Nichols, E. )

    1991-09-01

    Lawrence Livermore National Laboratory (LLNL) is approaching the final phase of the Superfund decision-making process for site restoration and will soon initiate full scale cleanup. Despite some well-publicized failings of the pump and treat approach, we have concluded that intelligent application of this strategy if the best choice for ground water restoration at LLNL. Our proposed approach differs sufficiently from the pump and treat methods implemented at other sites that we call it smart'' pump and treat. Smart pump and treat consists of four distinct, but interrelated, elements: three preremediation strategies and one modification to pump and treat itself. Together, these techniques are an integrated program that utilizes an understanding of crucial aspects of contaminant flow and transport to speed up the remediation of contaminated aquifers. The four elements are: (1) a spatially detailed site characterization, linked with regional hydrogeologic models; (2) directed extraction, where the extraction and recharge locations are controlled by field-determined hydrogeologic parameters; (3) field-validated modeling that the matches the complexity of the collected data; and (4) adaptive pumping, whose pattern varies with time. Together, these techniques minimize the cost and the time to reach regulatory directed cleanup goals and maximize the rate of contaminant removal. 8 refs.

  10. Process for treating biomass

    SciTech Connect

    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.

  11. 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.

  12. Practical heat treating

    SciTech Connect

    Boyer, H.E.

    1984-01-01

    This book presents the heat treating technology. Fundamental information is provided by first explaining briefly the principles of the heat treatment of steel and the concepts of hardness and hardenability. Next, consideration is given to furnaces and related equipment. The major portion of the book, however, is devoted to a discussion of the commonly used heat treatments for carbon and alloy steels, tool steels, stainless steels and cast irons. Sample treatments are given in detail for many of the commercially important and commonly specified grades. Chapters on case hardening procedures, flame and induction heating and the heat treating of non-ferrous alloys complete the book.

  13. 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.

  14. 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…

  15. 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 ...

  16. Preventing and Treating Blood Clots

    MedlinePlus

    ... and Treating Blood Clots Request Permissions Download PDF Preventing and Treating Blood Clots January 20, 2015 To ... 2013, ASCO updated the clinical practice guideline about preventing and treating blood clots for people with cancer ...

  17. 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.

  18. Method of treating depression

    DOEpatents

    Henn, Fritz

    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.

  19. Apparatus for treating wastewater

    SciTech Connect

    Baker, W.E.

    1981-06-09

    Apparatus for treating wastewater includes a settling tank, a sludge digester and a holding tank. Solids from the settling tank are delivered uniformly throughout the seed sludge in the digester and combustible gas is drawn off the top. Sludge from the digester is delivered to the holding tank where further combustible gas evolves and is removed for other uses. The sludge from the holding tank is recycled through the digester or discharged from the system for drying and/or subsequent use.

  20. Fluidized bed heat treating system

    SciTech Connect

    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.

  1. Primary intestinal-type glandular lesions of the vagina: clinical, pathologic, and immunohistochemical features of 14 cases ranging from benign polyp to adenoma to adenocarcinoma.

    PubMed

    Staats, Paul N; McCluggage, W Glenn; Clement, Philip B; Young, Robert H

    2014-05-01

    Primary intestinal-type glandular lesions of the vagina are rare. We report a series of 14 lesions, including 1 intestinal-type polyp without neoplastic features, 3 adenomas (2 with high-grade dysplasia), and 10 adenocarcinomas. Patients ranged in age from 20 to 86 years (mean 60 y) and presented with vaginal bleeding or a mass. No history of diethylstilbestrol exposure, adenosis, or endometriosis was elicited in any patient. The lesions were mostly polypoid, small (0.8 to 2.0 cm), and located in the posterior (6 cases) and lower (7 cases) vagina. One carcinoma metastasized to a para-aortic lymph node; the others were confined to the vagina. The neoplasms exhibited histologic features identical to those seen in primary large intestinal tumors, including variable numbers of goblet cells and in 1 case neuroendocrine cells. Five of the adenocarcinomas contained areas consistent with a precursor adenoma. In 3 cases, a benign urothelium-lined duct was adjacent to the lesion, and in 2 patients benign intestinal-type epithelium was present; no other potential benign precursor lesions were seen. Immunohistochemical analysis was performed on 6 cases; the tumors were positive for CDX-2 (6/6), CK20 (5/6), CEA (5/5), CK7 (4/6), and CA-125 (2/4) and were negative for ER (0/6) and p16 (0/2). Clinical outcome data were available in 3 patients with adenocarcinomas; 1 died of disease in <1 year, and 2 were alive with no evidence of disease at 2 and 7 years. The pertinent literature is reviewed, and the potential origin and differential diagnosis of these lesions are discussed. PMID:24722061

  2. Treating prediabetes with metformin

    PubMed Central

    Lilly, Muriel; Godwin, Marshall

    2009-01-01

    Abstract OBJECTIVE To determine if the use of metformin in people with prediabetes (impaired glucose tolerance or impaired fasting glucose) would prevent or delay the onset of frank type 2 diabetes mellitus. DATA SOURCES MEDLINE was searched from January 1966 to the present, and articles meeting the selection criteria were hand searched. STUDY SELECTION Randomized controlled trials that involved administration of metformin to delay or prevent type 2 diabetes in individuals with impaired glucose tolerance or impaired fasting glucose were included. Development of diabetes was a required outcome measure; follow-up time of at least 6 months was required. Three studies met these criteria. SYNTHESIS The 3 studies varied in ethnicity of the population studied, in the rates of conversion to diabetes from prediabetes, and in the dose of metformin used. In general the studies were well done, although 2 of the 3 did not do true intention-to-treat analyses. A sensitivity analysis was completed by converting all data to intention-to-treat data and assuming a worst-case scenario for the people who were lost to follow-up. CONCLUSION Metformin decreases the rate of conversion from prediabetes to diabetes. This was true at higher dosage (850 mg twice daily) and lower dosage (250 mg twice or 3 times daily); in people of varied ethnicity; and even when a sensitivity analysis was applied to the data. The number needed to treat was between 7 and 14 for treatment over a 3-year period. PMID:19366942

  3. 133 Corticosteroid Rreatment Reduces Tissue Eosinophilia and the Expression of Matrix Metalloproteinases (MMP-1, MMP-2, MMP-7, MMP-9) and Their Tissue Inhibitor (TIMP-1) in Nasal Polyps

    PubMed Central

    de Borja Callejas, Fco; Martínez-Antón, Asunción; Roca-Ferrer, Jordi; Alobid, Isam; Picado, César; Mullol, Joaquim

    2012-01-01

    Background Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) may play an important role in both inflammation and remodeling of nasal polyposis. The aim of the current study was to compare the expression levels of MMPs and TIMP-1 between nasal mucosa and polyps, and to evaluate the effect of corticosteroid treatment in their expression in nasal polyps. Methods Nasal mucosa (NM, n = 12) were obtained from patients undergoing nasal corrective surgery while nasal polyp biopsies (NP, n = 33) were obtained from patients before (week 0) and after 2 (week 2) and 12 (week 12) weeks of corticoisteroid treatment (oral prednisone for 2 weeks and intranasal budesonide for 12 weeks). Matrix metalloproteases (MMP-1, MMP-2, MMP-7, MMP-9) and tissue inhibitor of metalloproteinases type 1 (TIMP-1) expression was evaluated by immunohistochemistry in tissue structural cells (epithelium, glands, vessels) and eosinophils. Results MMP and TIMP-1 expression were found in the epithelium, glands, vessels (in both NM and NP), and in eosinophils (only in NP). Expression of MMP-7 in epithelium (34% of tissues) and MMP-9 (19%) in glands was lower (P < 0.05) in NP than in NM (78 and 67%, respectively). Corticoisteroid treatment reduced tissue eosinophilia (Eos/5 fields) at week 2 (8.0 ± 2.9, P = 0.001) and week 12 (10.0 ± 2.3, P < 0.003) compared to week 0 (25.5 ± 8.4); and also decreased the expression of MMPs and TIMP-1 in eosinophils at week 2 and week 12 compared to week 0 (P < 0.05). In the epithelium, corticosteroids increased MMP-7 and TIMP-1 at week 2 and week 12, while decreased MMP-9 at week 12 (P < 0.05). In vessels, corticosteroids increased MMP-9 at week 2 and decreased MMP-1 at week 12 (P < 0.05). No effects were found in the glands. Conclusions Treatment of nasal polyposis with corticosteroids reduces both tissue eosinophilia and MMP expression in eosinophils while modifying the expression of remodeling markers in nasal polyp structural cells.

  4. 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

  5. Advances in treating psoriasis

    PubMed Central

    Belge, Katharina; Brück, Jürgen

    2014-01-01

    Psoriasis is a T helper (Th)17/Th1-mediated autoimmune disease affecting the skin and joints. So far, distinct traditional oral compounds and modern biologics have been approved in most countries for the treatment of patients with moderate to severe psoriasis or psoriatic arthritis. Yet, the anti-psoriatic therapeutic spectrum is to be extended by a number of novel targeted therapies including biologics and modern oral compounds. The next set of anti-psoriatic biologics targets mainly Th17-associated cytokines such as IL-17 or IL-23. In contrast, modern oral anti-psoriatics, such as dimethyl fumarate (DMF), apremilast or Janus kinase (JAK) inhibitors interfere with intracellular proteins and affect signaling pathways. Here we summarize the current systemic therapies for psoriasis and their immunological mechanism. The recent advances in psoriasis therapy will help treat our patients efficiently and complete our understanding of disease pathogenesis. PMID:24592316

  6. 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.

  7. Treating the Aging Spine.

    PubMed

    Choma, Theodore J; Rechtine, Glenn; McGuire, Robert A; Brodke, Darrel S

    2016-01-01

    Demographic trends make it incumbent on orthopaedic spine surgeons to recognize the special challenges involved in caring for older patients with spine pathology. Unique pathologies, such as osteoporosis and degenerative deformities, must be recognized and treated. Recent treatment options and recommendations for the medical optimization of bone health include vitamin D and calcium supplementation, diphosphonates, and teriparatide. Optimizing spinal fixation in elderly patients who have osteoporosis is critical; cement augmentation of pedicle screws is promising. In the management of geriatric odontoid fractures, nonsurgical support with a collar may be considered for low-demand patients, whereas surgical fixation is favored for high-demand patients. Management of degenerative deformity must address sagittal plane balance, which includes consideration of pelvic incidence. Various osteotomies may prove helpful in this setting. PMID:27049195

  8. 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.

  9. 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

  10. How Is an Aneurysm Treated?

    MedlinePlus

    ... NHLBI on Twitter. How Is an Aneurysm Treated? Aortic aneurysms are treated with medicines and surgery. Small aneurysms ... doing your normal daily activities Treatment for an aortic aneurysm is based on its size. Your doctor may ...

  11. 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 ...

  12. Treating the obese diabetic.

    PubMed

    Kenkre, Julia; Tan, Tricia; Bloom, Stephen

    2013-03-01

    Type 2 diabetes and obesity are intimately linked; reduction of bodyweight improves glycemic control, mortality and morbidity. Treating obesity in the diabetic is hampered as some diabetic treatments lead to weight gain. Bariatric surgery is currently the most effective antiobesity treatment and causes long-term remission of diabetes in many patients. However, surgery has a high cost and is associated with a significant risk of complications, and in practical terms only limited numbers can undergo this therapy. The choice of pharmacological agents suitable for treatment of diabetes and obesity is currently limited. The glucagon-like peptide-1 receptor agonists improve glycemia and induce a modest weight loss, but there are doubts over their long-term safety. New drugs such as lorcaserin and phentermine/topiramate are being approved for obesity and have modest, salutary effects on glycemia, but again long-term safety is unclear. This article will also examine some future avenues for development, including gut hormone analogues that promise to combine powerful weight reduction with beneficial effects on glucose metabolism. PMID:23473594

  13. Odontogenic infection mimicking antral polyps.

    PubMed

    Kaplowitz, G J

    1997-01-01

    Odontogenic infections can extend into the maxillary sinus and produce sinusitis that mimics other pathoses. Infection of odontogenic origin should be considered in the differential diagnosis of maxillary sinusitis. Sinusitis should be considered in the differential diagnosis of maxillary posterior teeth with acute or chronic symptoms.

  14. 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.

  15. 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 ...

  16. Heat treating of manufactured components

    SciTech Connect

    Ripley, Edward B.

    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.

  17. Method for treating waste water

    SciTech Connect

    Lansdell, M.

    1993-07-20

    An activated sludge wastewater treatment process is described comprising: (a) providing a reactor including first, second and third basins each defining an elongated flow path and each having an inlet end and an outlet end, means for hydraulically interconnecting the basins, first, second and third wastewater inlet means for respectively feeding wastewater from a wastewater receiver to the first or the second or the third basin, and first and second treated effluent outlet means for respectively discharging treated effluent from the outlet ends of the first and third basins, (b) the first phase steps of: (i) feeding wastewater from the wastewater receiver to the inlet end of the first basin while interrupting flow from the wastewater receiver to the second and third basins; (ii) permitting flow from the outlet end of the first basin into inlet end of the second basin and from the outlet end of the second basin into the inlet end of the third basin, (iii) discharging treated effluent from the outlet end of the third basin through the second treated effluent outlet means while preventing flow through the first treated effluent outlet means; (iv) subjecting wastewater in at least a portion of the rim and second basins to aerobic treatment while interrupting aerobic treatment of the wastewater in the third basin to allow settling of the sludge in the third basin; (c) the second phase steps of: (i) feeding wastewater to be treated from the wastewater receiver to the inlet end of the second basin while preventing flow from the wastewater receiver to the first and third basins; (ii) permitting flow from the outlet end of the second basin into the inlet end of the third basin; (iii) discharging treated effluent from the outlet end of the third basin through the second treated effluent outlet means while preventing flow through the first treated effluent outlet means.

  18. 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

  19. How Is Respiratory Failure Treated?

    MedlinePlus

    ... Once your doctor figures out what's causing your respiratory failure, he or she will plan how to treat that disease or condition. Treatments may include medicines, procedures, and other therapies. Rate This Content: NEXT >> Updated: December 19, 2011 Twitter ...

  20. Modeling Treated LAW Feed Evaporation

    SciTech Connect

    DANIEL, WE

    2004-07-08

    This task examines the potential of the treated waste feed blends to form sodium-aluminum silicate precipitates when evaporated using the zeolite database. To investigate the behavior of the blended pretreated waste feed, an OLI Environmental Simulation Package Software (OLI ESP) model of the treated low activity waste (LAW) evaporator was built. A range of waste feed compositions representative of Envelope A, B, and C were then fed into the OLI model to predict various physical and chemical properties of the evaporator concentrates. Additional runs with treated LAW evaporator were performed to compare chemical and physical property model predictions and experimental results for small-scale radioactive tests of the treated feed evaporation process.

  1. How Is Cardiogenic Shock Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Cardiogenic Shock Treated? Cardiogenic shock is life threatening and requires emergency medical treatment. ... arrive. The first goal of emergency treatment for cardiogenic shock is to improve the flow of blood and ...

  2. How Is Immune Thrombocytopenia Treated?

    MedlinePlus

    ... Blood Transfusion Bone Marrow Tests Thrombocytopenia Thrombotic Thrombocytopenic Purpura Send a link to NHLBI to someone by ... who have bleeding symptoms, other than merely bruising (purpura), usually are treated. Children who have mild ITP ...

  3. 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 ...

  4. Treating P.A.D.

    MedlinePlus

    ... Home Current Issue Past Issues Special Section Treating P.A.D. Past Issues / Summer 2008 Table of ... is diminished. Illustration courtesy of NHLBI Treatment for P.A.D. is designed to reduce a patient's ...

  5. 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.

  6. Intramural myomas: to treat or not to treat

    PubMed Central

    Thompson, Mayra J; Carr, Bruce R

    2016-01-01

    A debate among gynecologic and reproductive surgeons is whether or not there is a clinical need to treat all intramural myomas. Considerations include myoma size and number, ability to access them, whether or not they compromise the endometrium, and treatment effect on gynecologic, reproductive, and obstetric outcomes. We conducted a detailed study regarding intramural myomas, their prevalence in subject populations, the imaging methods used to detect them, their growth rate, their suspected adverse effects on gynecologic, fertility, and obstetric outcomes, and the effectiveness of various treatment methods. The growing body of evidence reported in the literature supports the need to manage intramural myomas and to treat them appropriately. PMID:27274313

  7. Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.

    PubMed

    AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

    2014-04-01

    We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva.

  8. Chemically treated kindling and process

    SciTech Connect

    Earlywine, R.T.

    1984-10-09

    A chemically treated kindling and process for the production thereof wherein the kindling is comprised of a pressed mixture of wood fibers, alum, and cornstarch, and is saturated with a prepared composition comprising a plurality of chemically distinct compositions, each of the compositions containing a different predetermined amount of refined petroleum wax and refined oil.

  9. 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 ...

  10. Process for treating contaminated soil

    SciTech Connect

    Lebowitz, H.E.; Kulik, C.J.

    1995-10-24

    A process is provided for treating soil contaminated with oils, tars and light hydrocarbons. A slurry is formed with coal, water and the contaminated soil and agitated at elevated temperature, resulting in the transfer of the oil from the soil to the coal. The coal and soil mixture is then dewatered for disposal by burning or burial in a landfill. 2 figs.

  11. 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

  12. Medicines Used to Treat COPD

    MedlinePlus

    ... SERIES #3 The most common medications for treating chronic obstructive pulmonary disease (COPD) are bronchodilators and steroids. Both make breathing ... http://patients.thoracic.org/information-series/en/resources/ chronic-obstructive-pulmonary-disease-copd.pdf Canadian Lung Association http://www.sk. ...

  13. 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.

  14. Mometasone Nasal Spray

    MedlinePlus

    ... allergies. It is also used to treat nasal polyps (swelling of the lining of the nose). Mometasone ... are using mometasone nasal spray to treat nasal polyps, it is usually sprayed in each nostril once ...

  15. Horizontal Gene Transfer Contributed to the Evolution of Extracellular Surface Structures: The Freshwater Polyp Hydra Is Covered by a Complex Fibrous Cuticle Containing Glycosaminoglycans and Proteins of the PPOD and SWT (Sweet Tooth) Families

    PubMed Central

    Böttger, Angelika; Doxey, Andrew C.; Hess, Michael W.; Pfaller, Kristian; Salvenmoser, Willi; Deutzmann, Rainer; Geissner, Andreas; Pauly, Barbara; Altstätter, Johannes; Münder, Sandra; Heim, Astrid; Gabius, Hans-Joachim; McConkey, Brendan J.; David, Charles N.

    2012-01-01

    The single-cell layered ectoderm of the fresh water polyp Hydra fulfills the function of an epidermis by protecting the animals from the surrounding medium. Its outer surface is covered by a fibrous structure termed the cuticle layer, with similarity to the extracellular surface coats of mammalian epithelia. In this paper we have identified molecular components of the cuticle. We show that its outermost layer contains glycoproteins and glycosaminoglycans and we have identified chondroitin and chondroitin-6-sulfate chains. In a search for proteins that could be involved in organising this structure we found PPOD proteins and several members of a protein family containing only SWT (sweet tooth) domains. Structural analyses indicate that PPODs consist of two tandem β-trefoil domains with similarity to carbohydrate-binding sites found in lectins. Experimental evidence confirmed that PPODs can bind sulfated glycans and are secreted into the cuticle layer from granules localized under the apical surface of the ectodermal epithelial cells. PPODs are taxon-specific proteins which appear to have entered the Hydra genome by horizontal gene transfer from bacteria. Their acquisition at the time Hydra evolved from a marine ancestor may have been critical for the transition to the freshwater environment. PMID:23300632

  16. Horizontal gene transfer contributed to the evolution of extracellular surface structures: the freshwater polyp Hydra is covered by a complex fibrous cuticle containing glycosaminoglycans and proteins of the PPOD and SWT (sweet tooth) families.

    PubMed

    Böttger, Angelika; Doxey, Andrew C; Hess, Michael W; Pfaller, Kristian; Salvenmoser, Willi; Deutzmann, Rainer; Geissner, Andreas; Pauly, Barbara; Altstätter, Johannes; Münder, Sandra; Heim, Astrid; Gabius, Hans-Joachim; McConkey, Brendan J; David, Charles N

    2012-01-01

    The single-cell layered ectoderm of the fresh water polyp Hydra fulfills the function of an epidermis by protecting the animals from the surrounding medium. Its outer surface is covered by a fibrous structure termed the cuticle layer, with similarity to the extracellular surface coats of mammalian epithelia. In this paper we have identified molecular components of the cuticle. We show that its outermost layer contains glycoproteins and glycosaminoglycans and we have identified chondroitin and chondroitin-6-sulfate chains. In a search for proteins that could be involved in organising this structure we found PPOD proteins and several members of a protein family containing only SWT (sweet tooth) domains. Structural analyses indicate that PPODs consist of two tandem β-trefoil domains with similarity to carbohydrate-binding sites found in lectins. Experimental evidence confirmed that PPODs can bind sulfated glycans and are secreted into the cuticle layer from granules localized under the apical surface of the ectodermal epithelial cells. PPODs are taxon-specific proteins which appear to have entered the Hydra genome by horizontal gene transfer from bacteria. Their acquisition at the time Hydra evolved from a marine ancestor may have been critical for the transition to the freshwater environment.

  17. [Algorithm for treating preoperative anemia].

    PubMed

    Bisbe Vives, E; Basora Macaya, M

    2015-06-01

    Hemoglobin optimization and treatment of preoperative anemia in surgery with a moderate to high risk of surgical bleeding reduces the rate of transfusions and improves hemoglobin levels at discharge and can also improve postoperative outcomes. To this end, we need to schedule preoperative visits sufficiently in advance to treat the anemia. The treatment algorithm we propose comes with a simple checklist to determine whether we should refer the patient to a specialist or if we can treat the patient during the same visit. With the blood count test and additional tests for iron metabolism, inflammation parameter and glomerular filtration rate, we can decide whether to start the treatment with intravenous iron alone or erythropoietin with or without iron. With significant anemia, a visit after 15 days might be necessary to observe the response and supplement the treatment if required. The hemoglobin objective will depend on the type of surgery and the patient's characteristics.

  18. 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).

  19. Treating severe acute malnutrition seriously

    PubMed Central

    Collins, Steve

    2007-01-01

    Severe acute malnutrition (SAM) affects approximately 13 million children under the age of 5 and is associated with 1–2 million preventable child deaths each year. In most developing countries, case fatality rates (CFRs) in hospitals treating SAM remain at 20–30% and few of those requiring care actually access treatment. Recently, community‐based therapeutic care (CTC) programmes treating most cases of SAM solely as outpatients have dramatically reduced CFRs and increased the numbers receiving care. CTC uses ready‐to‐use therapeutic foods and aims to increase access to services, promoting early presentation and compliance, thereby increasing coverage and recovery rates. Initial data indicate that this combination of centre‐based and community‐based care is cost effective and should be integrated into mainstream child survival programmes. PMID:17449529

  20. 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.

  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. Bioenergy from anaerobically treated wastewater

    SciTech Connect

    Richards, E.A.

    1981-01-01

    Breweries and other processing plants including dairy cooperatives, sugar plants, grain mills, gasohol plants, etc., produce wastewater containing complex organic matter, either in solution or as volatile suspended solids, which can be treated anaerobically to effectively reduce the pollutants by 85-95% and generate a CH4 containing gas. An example anaerobic plant to serve a 10 to the power of 6-bbl brewery is discussed.

  3. Furnace for treating industrial wastes

    SciTech Connect

    Nakamura, T.D.

    1982-08-31

    A furnace for treating sewage sludge, ash from municipal incinerators or other industrial wastes by melting the waste with a high-temperature bed formed from a combustible carbonaceous material for the reuse of the resulting molten product, for example, as aggregate. A gas for combustion is supplied to the bed at an intermediate portion between its upper and lower portions while causing the resulting combustion gas to flow through the bed dividedly upward and downward.

  4. Treating the condemned to death.

    PubMed

    Sargent, D A

    1986-12-01

    Psychiatrists should refrain from treating mentally ill prisoners on death row in order to restore their "competency to be executed." Such "treatment" renders them double agents, in the service of the state as well as the prisoner. Participation in an act that will bring about a prisoner's death is expressly forbidden by the AMA Code of Ethics. It recalls the behavior of Nazi physicians, who used their professional skills not to heal but to kill.

  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. PMID:22702077

  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. Recognizing, diagnosing, and treating rhabdomyolysis.

    PubMed

    Heard, Henry; Barker, James

    2016-05-01

    Rhabdomyolysis is an acute and potentially fatal syndrome characterized by striated muscle breakdown and subsequent release of muscle cell contents into the systemic circulation. The sudden release of large quantities of potassium, calcium, organic acids, and myoglobin into the bloodstream can cause renal tubal toxicity, cardiac dysrhythmias, and death. Complications can be managed and minimized if predicted and treated early, but patients may not have classic symptoms of rhabdomyolysis and may even be asymptomatic on presentation. This article reviews the pathophysiology, causes, diagnosis, and treatment of acute rhabdomyolysis.

  9. Biochemical degradation treats produced water

    SciTech Connect

    1997-01-20

    In Colombia, Kelt Oil Co. employs a lined, reed-based, root-zone filtering system to remove contaminants from water produced with crude oil. The roots of the reeds absorb the contaminants. The treated water is then used for agriculture. Kelt has operated te system for over 1 year near Trinidad, in the Casanare district of eastern Colombia. After 1 year, the system removed 90% of the phenol compounds. It expects 3 years will be required for the system to achieve full efficiency.

  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. 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.

  12. [Actinomyces empyema treated with decortications].

    PubMed

    Shteinberg, Michal; Perek, Shoshan; Ghanem, Nesrin; Sarafov, Israel; Peysakhovich, Yury; Adir, Yochai

    2012-04-01

    Actinomyces infections are rare infections, involving the head and neck, abdominal cavity, and the lung. We report a case of a 66 year old woman with shortness of breath and a pleural effusion from which Actinomyces meyeriwas cultured. The diagnosis was confirmed by the polymerase chain reaction technique. The infection was successfully treated with a combination of ampicillin and surgical decortication. Due to their rarity, Actinomyces infections are not often suspected. These infections are difficult to diagnose due to specific microbiologic requirements for isolation of Actinomyces. In many reviewed cases of Actinomyces infection, patients underwent surgery for presumed cancer but were eventually diagnosed as being infected with actinomycosis. Due to lack of improvement of our patient, surgical decortication was performed, which led to a successful outcome.

  13. [Pathogenetic approaches to treating constipations].

    PubMed

    Luzina, E V

    2014-01-01

    Constipation affects 15-25% of people. Its mechanisms are various. There are constipations due to intestinal dyskinesia (functional constipation, irritated bowel syndrome), slow transit (colonic inertia), and muscular apparatus discoordination ensuring defecation (dyssynergic defecation). The treatment of different types of constipation uses prokinetics (type 4 serotonin receptor agonists, chlorine channels activators and guanylate cyclase C channel activators) or spasmolytics, among which pinaverium bromide (dicetel) has demonstrated its high efficacy. Biofeedback therapy or surgical techniques may be used. There is a need to prescribe laxatives in any type of constipation. A pathogenetic approach to treating constipation is most efficient. The paper characterizes stimulant, osmotic, volume, and emollient laxatives and agents stimulating the urge to defecate. It also gives the data of meta-analyses evaluating the efficacy of different drug groups. Particular emphasis is laid of the effect of lactulose and its first preparation--duphalac. PMID:25306754

  14. Inverse psoriasis treated with ustekinumab.

    PubMed

    Campos, Manuel António; Varela, Paulo; Baptista, Armando; Moreira, Ana Isabel

    2016-01-01

    Inverse psoriasis is characterised by the involvement of flexural skin folds. This form of psoriasis has distinct clinical and therapeutic features. This report refers to the case of a 48-year-old Caucasian man who was observed in our department, with a clinically and biopsy proven diagnosis of inverse psoriasis. For 2 years, the patient was treated with different combinations of corticosteroids, vitamin D analogues and methotrexate, with no satisfactory response. Given the lack of a clinical response and comorbidities, latent tuberculosis was excluded, and we started treatment with ustekinumab. We chose this biological agent because the patient was a long-distance truck driver and refused the possibility of autoinjections. The patient underwent three ustekinumab injections, which resulted in significant improvement of pruritus, erythaematous lesions and quality of life. PMID:27222277

  15. Does oral prednisolone increase the efficacy of subsequent nasal steroids in treating nasal polyposis?

    PubMed Central

    Wongsritrang, Krongthong; Ruttanaphol, Suwalee

    2012-01-01

    Background: Although combined oral and nasal steroid therapy is widely used in nasal polyposis, a subset of patients show an unfavorable therapeutic outcome. This study aimed to evaluate whether oral prednisolone produces any additive effects on subsequent nasal steroid therapy and to evaluate if any clinical variables can predict therapeutic outcome. Methods: Using a 3:2 randomization ratio, 67 patients with nasal polyposis received 50 mg of prednisolone and 47 patients received placebo daily for 2 weeks, followed by mometasone furoate nasal spray (MFNS) at 200 micrograms twice daily for 10 weeks. Clinical response was evaluated by nasal symptom score (NSS), peak expiratory flow index (PEFI), and total nasal polyps score (TNPS). Potential predictor variables were assessed by clinical history, nasal endoscopy, allergy skin test, and sinus radiography. Results: At the end of the 2-week oral steroid phase, the prednisolone group showed significantly greater improvements in all nasal symptoms, nasal airflow, and polyp size than the placebo group. In the nasal steroid phase, while the MFNS maintained the outcome improvements in the prednisolone group, all outcome variables in the placebo group showed continuing improvements. At the end of the nasal steroid phase, there were no significant differences of most outcome improvements between the two groups, except in hyposmia, PEFI, and TNPS (p = 0.049, p = 0.029, and p = 0.005, respectively). In the prednisolone group, patients with polyps grade 3 and endoscopic signs of meatal discharge showed significantly less improvement in total NSS, PEFI, and TNPS than patients with grade 1–2 size and negative metal discharge. Conclusion: In the 12-week treatment evaluation of nasal polyposis, pretreatment with oral steroids had no significant advantage for most nasal symptoms other than earlier relief; however, combined oral and nasal steroid therapy more effectively improved hyposmia, polyps size, and nasal airflow. Polyps size

  16. How Is Idiopathic Pulmonary Fibrosis Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Idiopathic Pulmonary Fibrosis Treated? Doctors may prescribe medicines, oxygen therapy , pulmonary ... PR), and lung transplant to treat idiopathic pulmonary fibrosis (IPF). Medicines Currently, no medicines are proven to ...

  17. 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 ...

  18. How Is Disseminated Intravascular Coagulation Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Disseminated Intravascular Coagulation Treated? Treatment for disseminated intravascular coagulation (DIC) depends ... and treat the underlying cause. Acute Disseminated Intravascular Coagulation People who have acute DIC may have severe ...

  19. 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 ...

  20. 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.

  1. 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.

  2. Method for treating waste water

    SciTech Connect

    Helke, R.C.

    1980-12-02

    A method useful for treating waste water is disclosed wherein waste water is collected in a first vessel and a portion of the large solid particles are filtered from said waste waters. The liquid waste including suspended solid particles is combined with a solids coagulant, effective in coagulating solid particles, and the waste is disinfected. In one embodiment, coagulation and disinfection occurs simultaneously in a single treatment vessel. In the treatment vessel, the disinfectant and the coagulant are reacted with the waste waters to form gas bubbles and coagulated solid particles. The reaction of the disinfectant causes a substantial portion of the coagulated solids contained in the treatment vessel to float to the upper portion of the treatment vessel as a result of being carried to the surface by the gas bubbles. The clarified waste water is then removed from an outer chamber in the treatment vessel. In another embodiment, waste water is disinfected by radiation so that gas bubbles are not formed by the disinfection reaction. In this embodiment the coagulated solids are floated to the surface of the treatment vessel by providing small gas, i.e., air, bubbles in the treatment vessel generated from an extraneous source.

  3. Process of treating gas condensate

    SciTech Connect

    Hitzel, H.

    1984-11-06

    The sewage consists of gas condensates from coal-gasifying plants and/or coal chemical plants and contains the anions SO/sub 4/--, SCN-, NO/sub 3/-, Cl- and F- in a total of at least 2 mval/l and contains organic matter corresponding to a chemical oxygen demand of at least 1000 mg/l. The sewage is passed through a biological purification stage, and a succeeding fine purification stage. In an anion exchanger, strong anions are exchanged with hydrogen carbonate ions. The water leaving the anion exchange stage has an alkalinity of at least 2 mval/l and is passed at least in part through a cation exchanger before the water is recycled to the sewage. The water which has left the anion exchanger may be used as cooling water in a cooling tower before or after the cation exchanger. Organic acids are used for regeneration in the cation exchanger and the regeneration eluate is added to the sewage which is to be treated in the biological purification stage.

  4. 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)

  5. 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

  6. 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

  7. [Is diabetes mellitus worth treating?].

    PubMed

    Towpik, Iwona; Wender-Ozegowska, Ewa

    2014-03-01

    The aim of the paper was to present data that enable us to determine whether treatment of hyperglycemia diagnosed during pregnancy in the era of a steadily growing number of women with gestational diabetes mellitus (GDM) and an ongoing debate about new criteria and diagnostic strategies, is a valid option. GDM is the main metabolic disorder developing during pregnancy complicating around 6% of all pregnancies. Mistreatment of hyperglycemia during pregnancy may cause several fetal complications, especially neonatal overgrowth (macrosomia or LGA). The risk of macrosomia is directly related to maternal hyperglycemia (twice as high as in the control group with glucose levels exceeding 130 mg/dl). Apart from maternal hyperglycemia and fetal hyperinsulinemia, insulin-like growth factors and selected adipocytokines produced by adipose tissue and placenta are among the factors contributing to the development of diabetic fetopathy, whose risk increases by 2-fold with glucose levels exceeding 130 mg/dl. The role of hyperglycemia as a factor inducing several perinatal complications was confirmed by the HAPO study but it is not the sole reason of adverse effects. Also, maternal obesity weight gain during pregnancy and maternal hyperlipidemia seem to be involved in the pathogenesis of feto-maternal complications. Changes in fetal growth, disturbances in the perinatal period, there just some of the negative consequences of maternal GDM. Disturbance of carbohydrate metabolism during pregnancy causes long-lasting consequences for both, the mother and the child, including increased risk of overt diabetes, metabolic syndrome and cardiovascular complications. Children born to GDM mothers are at a significant risk of psycho-motoric disability and a higher risk of schizophrenia. ACHOIS and MFMU studies have confirmed that even mild hyperglycemia, detected and treated in a timely manner significantly improves maternal and fetal outcome. Various meta-analyses have revealed a positive

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. Xanthogranulomatous Cystitis Treated by Transurethral Resection.

    PubMed

    Yamamoto, Sachi; Yoshida, Kanae; Tsumura, Koji; Nomiya, Akira; Yoda, Kenji; Iida, Katsuyuki; Homma, Yukio; Enomoto, Yutaka

    2015-09-01

    Xanthogranulomatous cystitis (XC) is a rare benign chronic inflammatory disease of unknown etiology. Curative treatment of XC requires surgical resection, and most of reported cases were treated by partial cystectomy. Here we describe a case with XC that was treated using transurethral resection.

  13. How Is Long QT Syndrome Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Long QT Syndrome Treated? The goal of treating long QT syndrome (LQTS) is to prevent life-threatening, ... levels. (For more information, go to "What Causes Long QT Syndrome?" ) Many people who have LQTS also ...

  14. 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

  15. Polyps of the Colon and Rectum

    MedlinePlus

    Skip to main content ASCRS Patients Educational Resources Diseases and Conditions Patient Education Library Patient Success Stories Treatments and Screening Resources Find a Surgeon Hereditary Colorectal Cancer Registries Helpful Links Physicians ...

  16. Vocal Cord Nodules, Polyps, and Cysts

    MedlinePlus

    ... affect the degree of disruption of vocal cord vibration and subsequently the severity of hoarseness or other ... source allows the examiner to assess vocal fold vibration. Sometimes a second exam will follow a trial ...

  17. 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.

  18. Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases.

    PubMed

    Adsay, Volkan; Jang, Kee-Taek; Roa, Juan Carlos; Dursun, Nevra; Ohike, Nobuyuki; Bagci, Pelin; Basturk, Olca; Bandyopadhyay, Sudeshna; Cheng, Jeanette D; Sarmiento, Juan M; Escalona, Oscar Tapia; Goodman, Michael; Kong, So Yeon; Terry, Paul

    2012-09-01

    The literature on the clinicopathologic characteristics of tumoral intraepithelial neoplasms (neoplastic polyps) of the gallbladder (GB) is fairly limited, due in part to the variability in definition and terminology. Most reported adenomas (pyloric gland type and others) were microscopic and thus regarded as clinically inconsequential, whereas papillary in situ carcinomas have been largely considered a type of invasive adenocarcinoma under the heading of "papillary adenocarcinomas." In this study, 123 GB cases that have a well-defined exophytic preinvasive neoplasm measuring ≥1 cm were analyzed. The patients were predominantly female (F/M=2:1) with a mean age of 61 y and a median tumor size of 2.2 cm. Half of the patients presented with pain, and in the other half the neoplasm was detected incidentally. Other neoplasms, most being gastrointestinal tract malignancies, were present in 22% of cases. Gallstones were identified in only 20% of cases. Radiologically, almost half were diagnosed as "cancer," roughly half with polypoid tumor, and in 10% the lesion was missed. Pathologic findings: (1) The predominant configuration was papillary in 43%, tubulopapillary in 31%, tubular in 26%. (2) Each case was assigned a final lineage type on the basis of the predominant pattern (>75% of the lesion) on morphology, and supported with specific immunohistochemical cell lineage markers. The predominant cell lineage could be identified as biliary in 50% (66% of which were MUC1), gastric foveolar in 16% (all were MUC5AC), gastric pyloric in 20% (92% MUC6), intestinal in 8% (100% CK20; 75% CDX2; 50%, MUC2), and oncocytic in 6% (17% HepPar and 17% MUC6); however, 90% of cases had some amount of secondary or unclassifiable pattern and hybrid immunophenotypes. (3) Of the cases that would have qualified as "pyloric gland adenoma," 21/24 (88%) had at least focal high-grade dysplasia and 18% had associated invasive carcinoma. Conversely, 8 of 47 "papillary adenocarcinoma"-type cases

  19. Vagus Nerve Stimulation for Treating Epilepsy

    MedlinePlus

    ... is the world’s largest association of neurologists and neuroscience professionals. Neurologists are doctors who identify and treat ... in these children. It also affects thinking and learning ability. Weak evidence shows VNS may help as ...

  20. Therapies for Treating Diabetic Nerve Pain

    MedlinePlus

    ... or neuropathy. 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 ...