BACKGROUND Ampullary adenocarcinomas are a rare disease.They can be classified anatomically or according to their histology into intestinal,pancreatobiliary,and mixed subtypes,with different subtypes having distinct p...BACKGROUND Ampullary adenocarcinomas are a rare disease.They can be classified anatomically or according to their histology into intestinal,pancreatobiliary,and mixed subtypes,with different subtypes having distinct prognoses and potential treatments.We report a clinical case of a patient with mixed type adenocarcinoma of the ampulla of Vater,with predominantly intestinal histology,associated with an isolated and synchronous peritoneal carcinomatosis.It is the only case reported in the literature of duodenal ampulla cancer with synchronous peritoneal metastases,with long-term survival.CASE SUMMARY A 53-year-old male patient with non-insulin-dependent diabetes presented with acute abdominal pain in the right hypochondrium.Images revealed dilatation of the biliary tract and the duct of Wirsung,without a clear obstructive factor.Upper gastrointestinal endoscopy revealed a tumor in the duodenal papilla.Biopsies confirmed an adenocarcinoma.In the first surgical step,a biliodigestive bypass was performed in association with resection of the carcinomatosis.Peritoneal metastases was found during the intraoperative period.Subsequently,chemotherapy with the folinic acid,fluorouracil,and oxaliplatin regimen was administered based on histology,and a favorable response was achieved.After a multidisciplinary discussion,the Whipple procedure was performed.A delayed biopsy showed disease-free margins.The patient achieved 5 years of overall survival in August 2024,and 4 years of disease-free survival in September 2024.CONCLUSION We conclude that an important value of this work is showing individualized treatment for a patient with cancer.展开更多
A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm ava...A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm avascular mass and an absence of normal testicular parenchyma.Tumor markers were unremarkable.A CT scan demonstrated no lymphadenopathy but identified a prominent left spermatic cord.Due to a suspicion of chronic torsion vs.malignancy,a left radical orchiectomy was performed.Pathology identified a hemorrhagic paratesticular venous malformation without signs of germ cell neoplasia,a rare entity.展开更多
Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), mu...Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), multifactorial diseases due to obesogenic environment (availability of convenience food, media influence, etc.), psycho-social factors (social support systems, cultural/environmental influence, etc.) and genetic variants. Other causes are a subgroup of etiological factors (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome). Obesity is measured clinically by several common tools apart from body mass index (BMI), such as waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio, and neck circumference. WC and WHR are common tools for measuring central obesity while BMI measures generalized obesity. Aims: The goal of this study is to assess the prevalence of obesity amongst health workers of David Umahi Federal University Teaching Hospital, Uburu, Ebonyi state, Southeast Nigeria and to note the prevailing factors. A reliable estimate of the prevalence of obesity among health workers will contribute to the statistics needed to sway policymakers in the country to take urgent and substantial action on the increasing prevalence of obesity, especially in the healthcare industry. Methodology: The study was carried out between May 2024 and June 2024 at the David Umahi Federal University Teaching Hospital situated in Uburu, Ohaozara Local government area of Ebonyi state, Southeast Nigeria. The questionnaire was designed using the Finnish diabetic risk score (FINDRISC). It contained basic comprehending questions on age, gender, exposure to high blood pressure medication, and anthropometric measurement amongst others. Weight was taken with a portable weighing scale and height, with a stadiometer. Both were taken with shoes and headgear removed. The BMI was calculated using the weight (kg) divided by the square of the height (m2). Result: Generally, the prevalence of obesity (>30 kg/m2) in this study was low 17.6% (38), Overweight (BMI 25 - 30), 38.9%, (84) healthy Weight, (BMI 18.5 - 24.9), 43.5% (94). The study revealed that a family history of diabetes was significantly related to higher BMI, with participants more likely to be overweight or obese (p = 0.00030). Similarly, participants with a personal history of diabetes were predominantly in the obese category (p = 0.00038). Waist circumference also showed a strong association with BMI, as larger waist measurements were more common among obese individuals (p = 9.2 × 10−8). In contrast, the analysis found no significant relationships between BMI and age, gender, high blood pressure, or exercise habits. Conclusion: The socio-demographic determinants of obesity in this study were gender, age < 45 years and exposure to exercise. These determinants should form the areas of focus for interventions such as health education and the design of work environments as environments designed to promote physical activities while working will reduce the prevalence of obesity in tertiary institutions.展开更多
BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary significantly...BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary significantly.AIM To identify the clinical factors associated with progression-free survival(PFS)after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal,ovarian,and gastric cancers.METHODS We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival(OS)in patients recruited between 2015 and 2020.Logistic regression models were used to assess the prognostic factors for the risk of recurrence within 1 year.Kaplan–Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and OS.RESULTS Of the 80 enrolled patients,39 had an unfavorable PFS(<1 year)and 41 had a favorable PFS(≥1 year).Simple logistic models revealed that the patients with a completeness of cytoreduction score of 0(CC-0)or length of CRS≤6 h had a favorable PFS[odds ratio(OR)=0.141,P=0.004;and OR=0.361,P=0.027,respectively].In multiple logistic regression,achieving CC-0 was the strongest prognostic factor for a favorable PFS(OR=0.131,P=0.005).A peritoneal cancer index score>12 was associated with a lower rate of achieving CC-0(P=0.027).The favorable PFS group had a significantly longer OS(median 81.7 mo vs 17.0 mo,P<0.001).CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term survival.This study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.展开更多
Cytosteatonecrosis of the newborn (CSNN), though rare, is a benign panniculitis that causes various skin lesions (hardened, purplish plaques/nodules). This condition can occur in infants of diabetic mothers or those w...Cytosteatonecrosis of the newborn (CSNN), though rare, is a benign panniculitis that causes various skin lesions (hardened, purplish plaques/nodules). This condition can occur in infants of diabetic mothers or those who have experienced birth asphyxia and may be unfamiliar to some healthcare practitioners. CSNN can lead to complications such as life-threatening hypercalcemia and metabolic disorders. This case study reports on a two-week-old newborn with CSNN, admitted to the neonatal intensive care unit at the Pediatric Center of Mohammed VI Hospital in Marrakech. The infant, born to a diabetic mother, was initially treated for neonatal respiratory distress. Four days after discharge, a biopsy-confirmed the diagnosis of CSNN, revealing lesions on the scalp, thighs and neck. At 1.5 months, the patient developed a scalp abscess and hypercalcemia. Hypercalcemia was effectively managed with hyperhydration and diuretics, resulting in the normalization of calcium levels. Abdominopelvic and transthoracic cardiac ultrasounds were normal. By six months, the patient’s skin lesions had spontaneously regressed.展开更多
Background: Urinalysis is a simple and cost effective medical tool used in the assessment of urinary abnormalities for early detection and prompt management of asymptomatic pathologies. Aim: This study assessed the ur...Background: Urinalysis is a simple and cost effective medical tool used in the assessment of urinary abnormalities for early detection and prompt management of asymptomatic pathologies. Aim: This study assessed the urine profile of newly employed health workers of a Teaching Hospital in South East Nigeria. Method: A descriptive retrospective approach was employed to assess the urine parameters of 512 employees. Results: Abnormal findings occurred in 30.7% of the population, with ascorbic acid being the most common (11.5%) while the least was nitrite constituting 0.58% of the population. The study also revealed that only one male employee had abnormal urine pH. There was no significant association (p > 0.05) between gender and urine abnormalities. Conclusion: Routine urinalysis should be included in pre-employment medical exams for disease surveillance.展开更多
Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study...Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study aimed to identify differences in the proliferative indices among variants of cBCC and cSCC diagnosed at a tertiary healthcare center. Method: Skin biopsies histologically diagnosed as cBCC and cSCC between 2012 and 2018 at the Federal Medical Centre (FMC) Umuahia, Abia State, Nigeria, were analyzed. Archival formalin-fixed, paraffin-embedded (FFPE) tissue blocks were retrieved along with clinical data, and were prepared on charged microscope slides and the immunohistochemical staining was carried out. The primary antibody used in this study was clone BioCare CRM325C (RM) and adenotonsillar tissue blocks/slides served as positive controls. Ki-67 immunohistochemistry was performed on fresh 4µm sections of the tumor specimens. Results: The application of Ki-67 immunoperoxidase on both BCC and SCC cohort, yielded an intense observable brownish nuclear stain in areas of dense proliferating tumour cells on both cutaneous tumours. The average Ki-67 index for all cSCC cases was 24.7%, with a range of 2.3% - 80%, while the mean for cBCC was 15.8%, ranging from 1.2% - 45.6%. Variants with high proliferative indices were observed in 11.9% of cBCC cases and 29.1% of cSCC cases. Among the low proliferative index category, cSCC accounted for 5.4%, while cBCC represented 14.3%. For mild proliferative indices, cSCC cases made up 7.3% and cBCC, 11.9%. The majority of cases showed moderate proliferative indices, with 61.9% for cBCC and 58.2% for cSCC. Overall, there was a significant difference in proliferative indices between cSCC, cBCC, and their variants. Conclusion: The study found a significantly higher rate of cell proliferation, measured by Ki-67 immunostaining, in cSCC and its variants compared to cBCC. However, certain variants of cBCC also exhibited high Ki-67 expression, indicating they can be as aggressive as some cSCC variants.展开更多
Background: Diarrheal diseases have globally decreased over the past few decades, yet they remain one of the top three causes of mortality in children under five years, especially in sub-Saharan Africa and Nigeria. Se...Background: Diarrheal diseases have globally decreased over the past few decades, yet they remain one of the top three causes of mortality in children under five years, especially in sub-Saharan Africa and Nigeria. Seasonal peaks of diarrheal episodes continue to contribute significantly to childhood mortality in these regions. One of the notable causes of diarrhea in children is parasitic infections, particularly Cryptosporidium, which poses a serious health risk. In Nigeria, the burden of Cryptosporidium diarrhea is under-researched, making it imperative to investigate its prevalence and associated risk factors. Study Objectives: The study aims to determine the prevalence and risk factors associated with Cryptosporidium diarrhea among children aged five years and below in selected health institutions in Abakaliki, South-East Nigeria. Methodology: This cross-sectional study was conducted from January to May 2017, recruiting 200 children under five years with diarrhea from health institutions in Abakaliki. Fecal specimens were analyzed for Cryptosporidium oocysts using light microscopy with modified Ziehl-Neelsen staining and immunofluorescent antibody test (IFAT). Deoxyribonucleic acid (DNA) was extracted from positive samples using QIAmp® DNA stool kit, followed by Polymerase Chain Reaction (PCR) and molecular genotyping. Results: Cryptosporidium was detected in 0.5% (1/200) of children via light microscopy and 6.5% (13/200) via IFAT. All positive samples were confirmed as Cryptosporidium hominis by PCR. The prevalence of infection was significantly higher in children from institutionalized homes (50.0%) compared to monogamous homes (6.2%) (p Conclusion: Cryptosporidium hominis is a notable cause of diarrhea among children in Abakaliki, primarily transmitted through human-to-human contact. The study underscores the need for targeted interventions in childcare institutions to prevent outbreaks. Health authorities should promote breastfeeding and enhance education on hygiene practices in vulnerable populations.展开更多
AIM: To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS: Using a cross-sectional hospital-based study, we analyzed physical examin...AIM: To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS: Using a cross-sectional hospital-based study, we analyzed physical examination data from 9311 healthy subjects with overnight physical examinations performed between January 2004 and December 2006. Examined data included gender, age, life style, anthropometric measurements, blood pressure, biochemical and hematological studies, H. pylori infection detected by esophagogastroduodenoscopy and biopsy urease tests, and colorectal adenomas detected with a complete total colonoscopy. RESULTS: The prevalence values for H. pylori infection, metabolic syndrome, and colorectal adenoma were39.2%, 18.7%, and 20.7%, respectively. Colorectal adenoma risk factors included male gender [odd ratio (OR): 2.005, 95% conf idence interval (CI): 1.740-2.310, P < 0.001], advanced age (OR: 1.046, 95% CI: 1.040-1.052, P < 0.001), smoking (OR: 1.377, 95% CI: 1.146-1.654, P = 0.001), increased body fat (OR: 1.016, 95% CI: 1.007-1.026, P = 0.001), higher white blood cell count (OR: 1.038, 95% CI: 1.005-1.073, P = 0.025), H. pylori infection (OR: 1.366, 95% CI: 1.230-1.517, P < 0.001), and metabolic syndrome (OR: 1.408, 95% CI: 1.231-1.610, P < 0.001). In addition, concomitant H. pylori infection with metabolic syndrome further increased the probability of colorectal adenomas. CONCLUSION: Our study revealed H. pylori infection with concomitant metabolic syndrome might further increase the risk of colorectal adenomas.展开更多
AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node statu...AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status. METHODS: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens froma consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A χ2 test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer. RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k=0.50) and low for BVI (k=0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P=0.001, P=0.013, and IHC: P=0.001, P=0.019). The mor-phologic features associated with LVI were location of the tumor in the distal third of the stomach (P=0.039), Borrmann's macroscopic type (P=0.001), organ inva-sion (P=0.03) and the depth of tumor invasion (P=0.001). The presence of BVI was related only to the depth of tumor invasion (P=0.003). CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis.展开更多
AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive be...AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS： Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.RESULT： Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions （mean follow-up period, 56 too）. All 9 cases of EWDA could be classified into gastric phenotype （5 lesions） and intestinal phenotype （4 lesions）. The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cellsand their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION： Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-expression. Because of its resemblance to normal gastric mucosa or mucosa with intestinal metaplasia, EWDA is often misdiagnosed. To prevent the misdiagnosis of such lesions, the clinical and pathologic characteristics should be taken into consideration.展开更多
AIM: To characterize tumor necrosis factor receptor-associated protein 1 (TRAP1) expression in the progression of ulcerative colitis (UC)-associated colorectal cancer.
AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute cholecystitis.METHODS: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 wer...AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute cholecystitis.METHODS: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to laparotomy.RESULTS: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients(41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines(TG13) for the severity of cholecystitis, 86 and 14 patients had grade Ⅰ and grade Ⅱ acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients(89%). Conversion laparotomy was performed in 12 patients(12%). Postoperative complications of Clavien-Dindo grade Ⅲ or greater were observed in 4 patients(4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after onset.CONCLUSION: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion.展开更多
Cholestatic liver diseases(CLD)begin to develop after an impairment of bile flow start to affect the biliary tree.Cholangiocytes actively participate in the liver response to injury and repair and the intensity of thi...Cholestatic liver diseases(CLD)begin to develop after an impairment of bile flow start to affect the biliary tree.Cholangiocytes actively participate in the liver response to injury and repair and the intensity of this reaction is a determinant factor for the development of CLD.Progressive cholangiopathies may ultimately lead to end-stage liver disease requiring at the end orthotopic liver transplantation.This narrative review will discuss cholangiocyte biology and pathogenesis mechanisms involved in four intrahepatic CLD:Primary biliary cholangitis,primary sclerosing cholangitis,cystic fibrosis involving the liver,and polycystic liver disease.展开更多
Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.I...Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.展开更多
AIM:To determine the effects of genetic variants associated with gallstone formation and capsaicin (a pungent component of chili pepper) metabolism on the risk of gallbladder cancer (GBC).METHODS: A total of 57 patien...AIM:To determine the effects of genetic variants associated with gallstone formation and capsaicin (a pungent component of chili pepper) metabolism on the risk of gallbladder cancer (GBC).METHODS: A total of 57 patients with GBC, 119 patients with gallstones, and 70 controls were enrolled in this study. DNA was extracted from their blood or paraffi n block sample using standard commercial kits. The statuses of the genetic variants were assayed using Taqman SNP Genotyping Assays or Custom Taqman SNP Genotyping Assays.RESULTS:The non-ancestral T/T genotype of apolipoprotein B rs693 polymorphism was associated with a decreased risk of GBC (OR:0.14,95% CI:0.03-0.63). The T/T genotype of cholesteryl ester transfer protein (CETP) rs708272 polymorphism was associated with an increased risk of GBC (OR:5.04,95% CI:1.43-17.8).CONCLUSION: Genetic variants involved in gallstone formation such as the apolipoprotein B rs693 and CETP rs 708272 polymorphisms may be related to the risk of developing GBC in Chilean women.展开更多
Several risk factors,which include heredity,ultra-violet (UV) light and chronic inflammation,contribute to pterygium development.However,there is no report integrating these factors in the pathogenesis of pterygium.Th...Several risk factors,which include heredity,ultra-violet (UV) light and chronic inflammation,contribute to pterygium development.However,there is no report integrating these factors in the pathogenesis of pterygium.The aim of this review is to describe the connection between heredity,UV,and inflammation in pterygium development.Existing reports indicate that sunlight exposure is the main factor in pterygium occurrence by inducing growth factor production or chronic inflammation or DNA damage.Heredity may be a factor.Our studies on factors in pterygium occurrence and recurrence identify that heredity is crucial for pterygium to develop,and that sunlight is only a trigger,and that chronic inflammation promotes pterygium enlargement.We propose that genetic factors may interfere with the control of fibrovascular proliferation while UV light or(sunlight)most likely only triggers pterygium development by inducing growth factors which promote vibrant fibrovascular proliferation in predisposed individuals.It also just triggers inflammation and collagenolysis,which may be promoters of the enlargement of the fibrovascular mass.Pterygium probably occurs in the presence of exuberant collagen production and profuse neovascularisation.展开更多
Basaloid squamous cell carcinoma （BSC） of the esophagus is a rare malignant disease. We report here a patient with recurrent esophageal BSC, who was successfully treated by systemic chemotherapy containing 5-fluorou...Basaloid squamous cell carcinoma （BSC） of the esophagus is a rare malignant disease. We report here a patient with recurrent esophageal BSC, who was successfully treated by systemic chemotherapy containing 5-fluorouracil （5-FU） and cisplatin （CDDP）. A 57-year-old woman was diagnosed as having SCluamous cell carcinoma of the esophagus upon endoscopic examination. Curative esophagectomy with lymph node dissection was performed under the thoracoscope. The pathological diagnosis of the surgical specimen was BSC. Five months after operation, the patient was diagnosed as having a recurrence of the BSC with metastases to the liver and spleen, and a right paraclavicular lymph node. She was given systemic chemotherapy consisting of continuous infusion of 800 mg/d of 5-FU and 3 h infusion of 20 mg/d of CDDP for 5 consecutive days every 4 wk. The metastatic lesions in the spleen and right paraclavicular lymph node disappeared, and the liver metastasis was apparently reduced in size after 2 courses of chemotherapy. The tumor regression was seen over 6 courses, with progression afterwards. Although subsequent treatment with CPT-11 and CDDP was not effective, docetaxel and vinorelbine temporarily controlled the tumor growth for 2 mo. 5-FU and CDDP combination may be useful for the patients with advanced BSC.展开更多
AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive p...AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive proximal colon polyps size, removed in 2001, and originally as hyperplastic polyps by general at Indiana University, were reviewed in pathologists.CONCLUSION： Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.展开更多
BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).I...BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each other.AIM To study the histologic and clinical features of PSC patients with and without IBD.METHODS We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years 1999-2013.PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration.Clinical data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were noted.RESULTS PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to UC.They required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC patients.The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD.No PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of IBD.The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.展开更多
文摘BACKGROUND Ampullary adenocarcinomas are a rare disease.They can be classified anatomically or according to their histology into intestinal,pancreatobiliary,and mixed subtypes,with different subtypes having distinct prognoses and potential treatments.We report a clinical case of a patient with mixed type adenocarcinoma of the ampulla of Vater,with predominantly intestinal histology,associated with an isolated and synchronous peritoneal carcinomatosis.It is the only case reported in the literature of duodenal ampulla cancer with synchronous peritoneal metastases,with long-term survival.CASE SUMMARY A 53-year-old male patient with non-insulin-dependent diabetes presented with acute abdominal pain in the right hypochondrium.Images revealed dilatation of the biliary tract and the duct of Wirsung,without a clear obstructive factor.Upper gastrointestinal endoscopy revealed a tumor in the duodenal papilla.Biopsies confirmed an adenocarcinoma.In the first surgical step,a biliodigestive bypass was performed in association with resection of the carcinomatosis.Peritoneal metastases was found during the intraoperative period.Subsequently,chemotherapy with the folinic acid,fluorouracil,and oxaliplatin regimen was administered based on histology,and a favorable response was achieved.After a multidisciplinary discussion,the Whipple procedure was performed.A delayed biopsy showed disease-free margins.The patient achieved 5 years of overall survival in August 2024,and 4 years of disease-free survival in September 2024.CONCLUSION We conclude that an important value of this work is showing individualized treatment for a patient with cancer.
基金VMR is funded by the AUA and Urology Care Foundation(Research Scholars Award)as well as an NIH NRSA training grant(5T32DK060442-20)HT is funded by the AUA and Urology Care Foundation(Research Scholars Award),SUFU(Chemodenervation Grant),and the Office of Faculty Development at Harvard Medical School.
文摘A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm avascular mass and an absence of normal testicular parenchyma.Tumor markers were unremarkable.A CT scan demonstrated no lymphadenopathy but identified a prominent left spermatic cord.Due to a suspicion of chronic torsion vs.malignancy,a left radical orchiectomy was performed.Pathology identified a hemorrhagic paratesticular venous malformation without signs of germ cell neoplasia,a rare entity.
文摘Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), multifactorial diseases due to obesogenic environment (availability of convenience food, media influence, etc.), psycho-social factors (social support systems, cultural/environmental influence, etc.) and genetic variants. Other causes are a subgroup of etiological factors (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome). Obesity is measured clinically by several common tools apart from body mass index (BMI), such as waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio, and neck circumference. WC and WHR are common tools for measuring central obesity while BMI measures generalized obesity. Aims: The goal of this study is to assess the prevalence of obesity amongst health workers of David Umahi Federal University Teaching Hospital, Uburu, Ebonyi state, Southeast Nigeria and to note the prevailing factors. A reliable estimate of the prevalence of obesity among health workers will contribute to the statistics needed to sway policymakers in the country to take urgent and substantial action on the increasing prevalence of obesity, especially in the healthcare industry. Methodology: The study was carried out between May 2024 and June 2024 at the David Umahi Federal University Teaching Hospital situated in Uburu, Ohaozara Local government area of Ebonyi state, Southeast Nigeria. The questionnaire was designed using the Finnish diabetic risk score (FINDRISC). It contained basic comprehending questions on age, gender, exposure to high blood pressure medication, and anthropometric measurement amongst others. Weight was taken with a portable weighing scale and height, with a stadiometer. Both were taken with shoes and headgear removed. The BMI was calculated using the weight (kg) divided by the square of the height (m2). Result: Generally, the prevalence of obesity (>30 kg/m2) in this study was low 17.6% (38), Overweight (BMI 25 - 30), 38.9%, (84) healthy Weight, (BMI 18.5 - 24.9), 43.5% (94). The study revealed that a family history of diabetes was significantly related to higher BMI, with participants more likely to be overweight or obese (p = 0.00030). Similarly, participants with a personal history of diabetes were predominantly in the obese category (p = 0.00038). Waist circumference also showed a strong association with BMI, as larger waist measurements were more common among obese individuals (p = 9.2 × 10−8). In contrast, the analysis found no significant relationships between BMI and age, gender, high blood pressure, or exercise habits. Conclusion: The socio-demographic determinants of obesity in this study were gender, age < 45 years and exposure to exercise. These determinants should form the areas of focus for interventions such as health education and the design of work environments as environments designed to promote physical activities while working will reduce the prevalence of obesity in tertiary institutions.
基金the Chang Gung Medical Foundation,No.CMRPG6L0091,No.CMRPG6L0092,and No.CMRPG6L0093.
文摘BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary significantly.AIM To identify the clinical factors associated with progression-free survival(PFS)after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal,ovarian,and gastric cancers.METHODS We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival(OS)in patients recruited between 2015 and 2020.Logistic regression models were used to assess the prognostic factors for the risk of recurrence within 1 year.Kaplan–Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and OS.RESULTS Of the 80 enrolled patients,39 had an unfavorable PFS(<1 year)and 41 had a favorable PFS(≥1 year).Simple logistic models revealed that the patients with a completeness of cytoreduction score of 0(CC-0)or length of CRS≤6 h had a favorable PFS[odds ratio(OR)=0.141,P=0.004;and OR=0.361,P=0.027,respectively].In multiple logistic regression,achieving CC-0 was the strongest prognostic factor for a favorable PFS(OR=0.131,P=0.005).A peritoneal cancer index score>12 was associated with a lower rate of achieving CC-0(P=0.027).The favorable PFS group had a significantly longer OS(median 81.7 mo vs 17.0 mo,P<0.001).CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term survival.This study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.
文摘Cytosteatonecrosis of the newborn (CSNN), though rare, is a benign panniculitis that causes various skin lesions (hardened, purplish plaques/nodules). This condition can occur in infants of diabetic mothers or those who have experienced birth asphyxia and may be unfamiliar to some healthcare practitioners. CSNN can lead to complications such as life-threatening hypercalcemia and metabolic disorders. This case study reports on a two-week-old newborn with CSNN, admitted to the neonatal intensive care unit at the Pediatric Center of Mohammed VI Hospital in Marrakech. The infant, born to a diabetic mother, was initially treated for neonatal respiratory distress. Four days after discharge, a biopsy-confirmed the diagnosis of CSNN, revealing lesions on the scalp, thighs and neck. At 1.5 months, the patient developed a scalp abscess and hypercalcemia. Hypercalcemia was effectively managed with hyperhydration and diuretics, resulting in the normalization of calcium levels. Abdominopelvic and transthoracic cardiac ultrasounds were normal. By six months, the patient’s skin lesions had spontaneously regressed.
文摘Background: Urinalysis is a simple and cost effective medical tool used in the assessment of urinary abnormalities for early detection and prompt management of asymptomatic pathologies. Aim: This study assessed the urine profile of newly employed health workers of a Teaching Hospital in South East Nigeria. Method: A descriptive retrospective approach was employed to assess the urine parameters of 512 employees. Results: Abnormal findings occurred in 30.7% of the population, with ascorbic acid being the most common (11.5%) while the least was nitrite constituting 0.58% of the population. The study also revealed that only one male employee had abnormal urine pH. There was no significant association (p > 0.05) between gender and urine abnormalities. Conclusion: Routine urinalysis should be included in pre-employment medical exams for disease surveillance.
文摘Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study aimed to identify differences in the proliferative indices among variants of cBCC and cSCC diagnosed at a tertiary healthcare center. Method: Skin biopsies histologically diagnosed as cBCC and cSCC between 2012 and 2018 at the Federal Medical Centre (FMC) Umuahia, Abia State, Nigeria, were analyzed. Archival formalin-fixed, paraffin-embedded (FFPE) tissue blocks were retrieved along with clinical data, and were prepared on charged microscope slides and the immunohistochemical staining was carried out. The primary antibody used in this study was clone BioCare CRM325C (RM) and adenotonsillar tissue blocks/slides served as positive controls. Ki-67 immunohistochemistry was performed on fresh 4µm sections of the tumor specimens. Results: The application of Ki-67 immunoperoxidase on both BCC and SCC cohort, yielded an intense observable brownish nuclear stain in areas of dense proliferating tumour cells on both cutaneous tumours. The average Ki-67 index for all cSCC cases was 24.7%, with a range of 2.3% - 80%, while the mean for cBCC was 15.8%, ranging from 1.2% - 45.6%. Variants with high proliferative indices were observed in 11.9% of cBCC cases and 29.1% of cSCC cases. Among the low proliferative index category, cSCC accounted for 5.4%, while cBCC represented 14.3%. For mild proliferative indices, cSCC cases made up 7.3% and cBCC, 11.9%. The majority of cases showed moderate proliferative indices, with 61.9% for cBCC and 58.2% for cSCC. Overall, there was a significant difference in proliferative indices between cSCC, cBCC, and their variants. Conclusion: The study found a significantly higher rate of cell proliferation, measured by Ki-67 immunostaining, in cSCC and its variants compared to cBCC. However, certain variants of cBCC also exhibited high Ki-67 expression, indicating they can be as aggressive as some cSCC variants.
文摘Background: Diarrheal diseases have globally decreased over the past few decades, yet they remain one of the top three causes of mortality in children under five years, especially in sub-Saharan Africa and Nigeria. Seasonal peaks of diarrheal episodes continue to contribute significantly to childhood mortality in these regions. One of the notable causes of diarrhea in children is parasitic infections, particularly Cryptosporidium, which poses a serious health risk. In Nigeria, the burden of Cryptosporidium diarrhea is under-researched, making it imperative to investigate its prevalence and associated risk factors. Study Objectives: The study aims to determine the prevalence and risk factors associated with Cryptosporidium diarrhea among children aged five years and below in selected health institutions in Abakaliki, South-East Nigeria. Methodology: This cross-sectional study was conducted from January to May 2017, recruiting 200 children under five years with diarrhea from health institutions in Abakaliki. Fecal specimens were analyzed for Cryptosporidium oocysts using light microscopy with modified Ziehl-Neelsen staining and immunofluorescent antibody test (IFAT). Deoxyribonucleic acid (DNA) was extracted from positive samples using QIAmp® DNA stool kit, followed by Polymerase Chain Reaction (PCR) and molecular genotyping. Results: Cryptosporidium was detected in 0.5% (1/200) of children via light microscopy and 6.5% (13/200) via IFAT. All positive samples were confirmed as Cryptosporidium hominis by PCR. The prevalence of infection was significantly higher in children from institutionalized homes (50.0%) compared to monogamous homes (6.2%) (p Conclusion: Cryptosporidium hominis is a notable cause of diarrhea among children in Abakaliki, primarily transmitted through human-to-human contact. The study underscores the need for targeted interventions in childcare institutions to prevent outbreaks. Health authorities should promote breastfeeding and enhance education on hygiene practices in vulnerable populations.
基金Supported by Buddhist Dalin Tzu Chi General Hospital
文摘AIM: To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS: Using a cross-sectional hospital-based study, we analyzed physical examination data from 9311 healthy subjects with overnight physical examinations performed between January 2004 and December 2006. Examined data included gender, age, life style, anthropometric measurements, blood pressure, biochemical and hematological studies, H. pylori infection detected by esophagogastroduodenoscopy and biopsy urease tests, and colorectal adenomas detected with a complete total colonoscopy. RESULTS: The prevalence values for H. pylori infection, metabolic syndrome, and colorectal adenoma were39.2%, 18.7%, and 20.7%, respectively. Colorectal adenoma risk factors included male gender [odd ratio (OR): 2.005, 95% conf idence interval (CI): 1.740-2.310, P < 0.001], advanced age (OR: 1.046, 95% CI: 1.040-1.052, P < 0.001), smoking (OR: 1.377, 95% CI: 1.146-1.654, P = 0.001), increased body fat (OR: 1.016, 95% CI: 1.007-1.026, P = 0.001), higher white blood cell count (OR: 1.038, 95% CI: 1.005-1.073, P = 0.025), H. pylori infection (OR: 1.366, 95% CI: 1.230-1.517, P < 0.001), and metabolic syndrome (OR: 1.408, 95% CI: 1.231-1.610, P < 0.001). In addition, concomitant H. pylori infection with metabolic syndrome further increased the probability of colorectal adenomas. CONCLUSION: Our study revealed H. pylori infection with concomitant metabolic syndrome might further increase the risk of colorectal adenomas.
基金Supported by Grants from Coordenao de Aperfeioamentode Pessoal de Nível Superior
文摘AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status. METHODS: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens froma consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A χ2 test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer. RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k=0.50) and low for BVI (k=0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P=0.001, P=0.013, and IHC: P=0.001, P=0.019). The mor-phologic features associated with LVI were location of the tumor in the distal third of the stomach (P=0.039), Borrmann's macroscopic type (P=0.001), organ inva-sion (P=0.03) and the depth of tumor invasion (P=0.001). The presence of BVI was related only to the depth of tumor invasion (P=0.003). CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis.
基金Supported by Grants-in-aid for Cancer Research from the Ministry of Education, Science and Culture, Japan and the Fukuoka Cancer Society, Fukuoka, Japan
文摘AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS： Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.RESULT： Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions （mean follow-up period, 56 too）. All 9 cases of EWDA could be classified into gastric phenotype （5 lesions） and intestinal phenotype （4 lesions）. The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cellsand their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION： Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-expression. Because of its resemblance to normal gastric mucosa or mucosa with intestinal metaplasia, EWDA is often misdiagnosed. To prevent the misdiagnosis of such lesions, the clinical and pathologic characteristics should be taken into consideration.
基金Supported by Grants from National Institutes of Health,No.R21CA164548from Crohn’s and Colitis Foundation of America
文摘AIM: To characterize tumor necrosis factor receptor-associated protein 1 (TRAP1) expression in the progression of ulcerative colitis (UC)-associated colorectal cancer.
文摘AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute cholecystitis.METHODS: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to laparotomy.RESULTS: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients(41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines(TG13) for the severity of cholecystitis, 86 and 14 patients had grade Ⅰ and grade Ⅱ acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients(89%). Conversion laparotomy was performed in 12 patients(12%). Postoperative complications of Clavien-Dindo grade Ⅲ or greater were observed in 4 patients(4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after onset.CONCLUSION: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion.
文摘Cholestatic liver diseases(CLD)begin to develop after an impairment of bile flow start to affect the biliary tree.Cholangiocytes actively participate in the liver response to injury and repair and the intensity of this reaction is a determinant factor for the development of CLD.Progressive cholangiopathies may ultimately lead to end-stage liver disease requiring at the end orthotopic liver transplantation.This narrative review will discuss cholangiocyte biology and pathogenesis mechanisms involved in four intrahepatic CLD:Primary biliary cholangitis,primary sclerosing cholangitis,cystic fibrosis involving the liver,and polycystic liver disease.
基金Supported by The Buddhist Dalin Tzu-Chi General Hospital
文摘Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.
基金Supported by (in part) A Grant-in-Aid for Scientific Research (C) (2007,#19590582) from the Japanese Ministry of Education,Science,Sports and Culture
文摘AIM:To determine the effects of genetic variants associated with gallstone formation and capsaicin (a pungent component of chili pepper) metabolism on the risk of gallbladder cancer (GBC).METHODS: A total of 57 patients with GBC, 119 patients with gallstones, and 70 controls were enrolled in this study. DNA was extracted from their blood or paraffi n block sample using standard commercial kits. The statuses of the genetic variants were assayed using Taqman SNP Genotyping Assays or Custom Taqman SNP Genotyping Assays.RESULTS:The non-ancestral T/T genotype of apolipoprotein B rs693 polymorphism was associated with a decreased risk of GBC (OR:0.14,95% CI:0.03-0.63). The T/T genotype of cholesteryl ester transfer protein (CETP) rs708272 polymorphism was associated with an increased risk of GBC (OR:5.04,95% CI:1.43-17.8).CONCLUSION: Genetic variants involved in gallstone formation such as the apolipoprotein B rs693 and CETP rs 708272 polymorphisms may be related to the risk of developing GBC in Chilean women.
文摘Several risk factors,which include heredity,ultra-violet (UV) light and chronic inflammation,contribute to pterygium development.However,there is no report integrating these factors in the pathogenesis of pterygium.The aim of this review is to describe the connection between heredity,UV,and inflammation in pterygium development.Existing reports indicate that sunlight exposure is the main factor in pterygium occurrence by inducing growth factor production or chronic inflammation or DNA damage.Heredity may be a factor.Our studies on factors in pterygium occurrence and recurrence identify that heredity is crucial for pterygium to develop,and that sunlight is only a trigger,and that chronic inflammation promotes pterygium enlargement.We propose that genetic factors may interfere with the control of fibrovascular proliferation while UV light or(sunlight)most likely only triggers pterygium development by inducing growth factors which promote vibrant fibrovascular proliferation in predisposed individuals.It also just triggers inflammation and collagenolysis,which may be promoters of the enlargement of the fibrovascular mass.Pterygium probably occurs in the presence of exuberant collagen production and profuse neovascularisation.
文摘Basaloid squamous cell carcinoma （BSC） of the esophagus is a rare malignant disease. We report here a patient with recurrent esophageal BSC, who was successfully treated by systemic chemotherapy containing 5-fluorouracil （5-FU） and cisplatin （CDDP）. A 57-year-old woman was diagnosed as having SCluamous cell carcinoma of the esophagus upon endoscopic examination. Curative esophagectomy with lymph node dissection was performed under the thoracoscope. The pathological diagnosis of the surgical specimen was BSC. Five months after operation, the patient was diagnosed as having a recurrence of the BSC with metastases to the liver and spleen, and a right paraclavicular lymph node. She was given systemic chemotherapy consisting of continuous infusion of 800 mg/d of 5-FU and 3 h infusion of 20 mg/d of CDDP for 5 consecutive days every 4 wk. The metastatic lesions in the spleen and right paraclavicular lymph node disappeared, and the liver metastasis was apparently reduced in size after 2 courses of chemotherapy. The tumor regression was seen over 6 courses, with progression afterwards. Although subsequent treatment with CPT-11 and CDDP was not effective, docetaxel and vinorelbine temporarily controlled the tumor growth for 2 mo. 5-FU and CDDP combination may be useful for the patients with advanced BSC.
文摘AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive proximal colon polyps size, removed in 2001, and originally as hyperplastic polyps by general at Indiana University, were reviewed in pathologists.CONCLUSION： Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.
文摘BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each other.AIM To study the histologic and clinical features of PSC patients with and without IBD.METHODS We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years 1999-2013.PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration.Clinical data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were noted.RESULTS PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to UC.They required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC patients.The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD.No PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of IBD.The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.
