AIM: To evaluate how long patients with small bowel obstruction caused by postoperative adhesions can tolerate conservative treatment.METHODS: The records of patients with small bowel obstruction due to postoperative ...AIM: To evaluate how long patients with small bowel obstruction caused by postoperative adhesions can tolerate conservative treatment.METHODS: The records of patients with small bowel obstruction due to postoperative adhesions were retrospectively reviewed. Data collected included the number of admissions, type of management for each admission,duration of conservative treatment, number of repeat laparotomies, and operative findings.RESULTS: One hundred fifty-five patients with this condition from January 1999 to December 2001, for a total of 293 admissions were enrolled in this study. Medical treatment alone was given in 220 admissions, and repeat laparotomy was performed in 73 admissions. The period of observation in patients managed medically ranged from 2 to 12 days (average: 6.9 days), while for those who underwent surgery,the range was 1 to 14 days (average 5.4 days). At surgery,adhesions were the only finding in 46 cases, while there were intestinal complications in 27, or 9.2 % of all 293admissions. Fever and leukocytosis greater than 15 000/mm3were prediction of intestinal complications.CONCLUSION: With closely monitoring, most patients with small bowel obstruction due to postoperative adhesions could tolerate supportive treatment and recover well averagely within 1 week, although some patients require more than 10 days of observation.展开更多
Rectal cancer classification is important to determine the preoperative chemoradiation therapy and to select appropriate surgical technique. We reviewed the Western and Japanese rectal cancer classification and we pro...Rectal cancer classification is important to determine the preoperative chemoradiation therapy and to select appropriate surgical technique. We reviewed the Western and Japanese rectal cancer classification and we propose our new classification based of Magnetic resonance imaging(MRI). We determine the relation of the tumor to fixed parameters in MRI, which areperitoneal reflection and levator ani muscle. Then, we classify the rectal cancer into four levels based on tumor distal margin and invasion to MRI parameters. We applied all three classifications to 60 retrospectively collected patients of different rectal cancer distance and we compared our classifications to the others. Based on each level we standardize our surgical approach. For stages Ⅰ-Ⅲ, We found that level Ⅰ where tumor distal margin is located above the peritoneal reflection and all of them were received low anterior resection(LAR) without chemoradiation. Level Ⅱ where tumor distal margin is located from the peritoneal reflection and above the levator ani insertion on the rectum. 90% of them were received LAR ± chemoradiation. Level Ⅲ where tumor distal margin is located at the level of levator ani insertion or invading any part of the levator ani. 60% of them had ULAR + coloanal anastomosis ± chemoradiation. Level Ⅳ where the tumor distal margin is located below the levator ani insertion; 77% were received APR ± chemoradiation. The overall kappa for all levels between surgeons and radiologist was 0.93(95%CI: 0.87-0.99), which is indicating almost perfect agreement. We concluded that the management of rectal tumors differed among each tumor level and our new MRI based classification might facilitate the prediction of surgical and chemoradiation management with better communication among a multidisciplinary team comparing to other classifications.展开更多
The present review aims to illustrate the strategies that are being implemented to regenerate or bioengineer livers for clinical purposes.There are two general pathways to liver bioengineering and regeneration.The fir...The present review aims to illustrate the strategies that are being implemented to regenerate or bioengineer livers for clinical purposes.There are two general pathways to liver bioengineering and regeneration.The first consists of creating a supporting scaffold,either synthetically or by decellularization of human or animal organs,and seeding cells on the scaffold,where they will mature either in bioreactors or in vivo.This strategy seems to offer the quickest route to clinical translation,as demonstrated by the development of liver organoids from rodent livers which were repopulated with organ specific cells of animal and/or human origin.Liver bioengineering has potential for transplantation and for toxicity testing during preclinical drug development.The second possibility is to induce liver regeneration of dead or resected tissue by manipulating cell pathways.In fact,it is well known that the liver has peculiar regenerative potential which allows hepatocyte hyperplasia after amputation of liver volume.Infusion of autologous bone marrow cells,which aids in liver regeneration,into patients was shown to be safe and to improve their clinical condition,but the specific cells responsible for liver regeneration have not yet been determined and the underlying mechanisms remain largely unknown.A complete understanding of the cell pathways and dynamics and of the functioning of liver stem cell niche is necessary for the clinical translation of regenerative medicine strategies.As well,it will be crucial to elucidate the mechanisms through which cells interact with the extracellular matrix,and how this latter supports and drives cell fate.展开更多
BACKGROUND:Douglas described choledochal cysts in 1852 and Todani proposed an anatomy-based classification in 1977. The classification is the most extensively used,but does not include some rare variations.We present ...BACKGROUND:Douglas described choledochal cysts in 1852 and Todani proposed an anatomy-based classification in 1977. The classification is the most extensively used,but does not include some rare variations.We present a case of hepatic duct diverticulum,one of the variations,and discuss its diagnosis and treatment. METHODS:A 57-year-old woman presented with upper abdominal pain and discomfort associated with nausea and vomiting.She was finally diagnosed with cholelithiasis and right hepatic duct diverticulum. RESULT:The patient underwent resection of the hepatic duct diverticulum and cholecystectomy,and was asymptomatic 26 months after surgery. CONCLUSIONS:Hepatic duct diverticulum is a rare form of choledochal cyst,not included in Todani’s classification. Todani’s classification including this and other uncommon variations of choledochal cysts must be reviewed.The best diagnostic imaging methods and treatment for choledochal cysts must be defined.展开更多
To perform a meta-analysis of observational studies on inflammatory markers levels and occurrence of colorectal adenoma.METHODSPubMed and EMBASE databases were searched until March 2016 for the articles reporting on t...To perform a meta-analysis of observational studies on inflammatory markers levels and occurrence of colorectal adenoma.METHODSPubMed and EMBASE databases were searched until March 2016 for the articles reporting on the circulating levels of inflammatory markers,including:C-reactive protein(CRP),interleukin-6(IL-6),and tumor necros is factor-alpha(TNF-α)and risk of colorectal adenoma.Random-effects models were used to calculate summary odds ratios(ORs)with 95%CIs for the highest vs lowest category of exposure.Heterogeneity was assessed by using the Q test and I<sup>2</sup>statistic.Subgroup analyses were also performed to test for potential source of heterogeneity.RESULTSA total of 14 case-control studies were included.Ten studies on CRP including a total of 3350 cases and 4168 controls showed non-significant summary(OR=1.23,95%CI:0.98-1.54;I<sup>2</sup>=54%,P<sub>heterogeneity</sub>=0.01)in the general analysis,but significant increased odds when considering only advanced adenoma(OR=1.59,95%CI:1.09-2.32;I<sup>2</sup>=44%,P<sub>heterogeneity</sub>=0.15).Subgroup and stratified analyses revealed a potential influence of smoking status and aspirin use on the association between CRP levels and colorectal adenoma.Five studies examined the association between circulating levels of TNF-αand colorectal adenoma risk,including a total of 1,568 cases and 2,832 controls.The summary OR for the highest vs the lowest category of exposure was 1.00(95%CI:0.77-1.29).The relationship between circulating IL-6 levels and colorectal adenoma risk was investigated in 7 studies including a total of 1936 cases and 3611 controls.The summary OR for the highest vs the lowest category of exposure was 1.19(95%CI:0.92-1.55).CONCLUSIONSummary of current evidence suggests a positive association of CRP levels and advanced colorectal adenoma risk.The role of potential confounding factors should be further evaluated.展开更多
AIM To establish cell line and patient-derived xenograft(PDX) models for neuroendocrine carcinomas(NEC) which is highly desirable for gaining insight into tumor development as well as preclinical research includingbio...AIM To establish cell line and patient-derived xenograft(PDX) models for neuroendocrine carcinomas(NEC) which is highly desirable for gaining insight into tumor development as well as preclinical research includingbiomarker testing and drug response prediction.METHODS Cell line establishment was conducted from direct in vitro culturing of colonic NEC tissue(HROC57). A PDX could also successfully be established from vitally frozen tumor samples. Morphological features, invasive and migratory behavior of the HROC57 cells as well as expression of neuroendocrine markers were vastly analyzed. Phenotypic analysis was done by microscopy and multicolor flow cytometry. The extensive molecular-pathological profiling included mutation analysis, assessment of chromosomal and microsatellite instability; and in addition, fingerprinting(i.e., STR analysis) was performed from the cell line in direct comparison to primary patient-derived tissues and the PDX model established. Drug responsiveness was examined for a panel of chemotherapeutics in clinical use for the treatment of solid cancers.RESULTS The established cell line HROC57 showed distinct morphological and molecular features of a poorly differentiated large-cell NEC with KI-67 > 50%. Molecular-pathological analysis revealed a Cp G island promoter methylation positive cell line with microsatellite instability being absent. The following mutation profile was observed: KRAS(wt), BRAF(mut). A high sensitivity to etoposide, cisplatin and 5-FU could be demonstrated while it was more resistant towards rapamycin. CONCLUSION We successfully established and characterized a novel patient-derived NEC cell line in parallel to a PDX model as a useful tool for further analysis of the biological characteristics and for development of novel diagnostic and therapeutic options for NEC.展开更多
Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that ma...Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their preoperative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow preoperative diagnosis of these lesions.展开更多
AIM: To investigate estrogen receptors expression in duodenal familial adenomatous polyposis (FAP) and any relationship with epithelial proliferation/apoptosis markers.METHODS: Twenty-two patients affected by FAP unde...AIM: To investigate estrogen receptors expression in duodenal familial adenomatous polyposis (FAP) and any relationship with epithelial proliferation/apoptosis markers.METHODS: Twenty-two patients affected by FAP undergoing duodenal resection for malignancies were recruited. Controls were 15 healthy subjects undergoing endoscopy for dyspeptic symptoms. ER-α, ER-α, Ki-67, TUNEL and caspase 3 expression (labeling index: percentage of positive cells) were evaluated by immunohistochemistry or immunofluorescence and examined by light or confocal microscopy. Samples were assigned to four groups: normal tissue, low (LGD) and high-grade dysplasia (HGD), adenocarcinoma (AC). One-way analysis of variance, corrected by Bonferroni’s test, and Pearson’s correlation test were applied for statistical analysis.RESULTS: ER-beta showed a progressive decline: normal tissue (23.5 ± 4.9), LGD (21.1 ± 4.8), HGD (9.3 ± 3.5), AC (7.1 ± 3.1). The normal tissue of FAP subjects expressed ER-beta like the controls (23.9 ± 6.2). Conversely, ER-α showed a progressive increase from normal tissue (24.8 ± 5.6) to AC (52.0 ± 8.2); the expression in normal tissue was similar to controls (22.5 ± 5.3). Ki67 demonstrated a statistically significant progressive increase at each disease stage up to AC. TUNEL did not reveal differences between controls and normal tissue of FAP subjects, but progressive decreases were observed in LGD, through HGD to AC. Pearson’s correlation test showed a direct relationship between ER-β and TUNEL LI (r = 0.8088, P < 0.0001). Conversely, ER-α was inversely correlated with TUNEL LI (r = - 0.7257, P < 0.0001). The co-expression of ER-β and caspase 3 declined progressively from normal to neoplastic tissue.CONCLUSION: This study confirmed that ER-β is strongly decreased in duodenal FAP carcinomas, declining in a multiple step fashion, thereby suggesting a putative anti-carcinogenic effect. ER-α showed the opposite trend. ER-β/caspase 3 co-expression suggests this hormone’s possible involvement in apoptosis. Hormonal influences in FAP duodenal tumorigenesis, and modulation of these as a possible chemoprevention strategy, may be a promising approach.展开更多
This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine(RM) will have in the progress of gastrointestinal(GI) medicine...This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine(RM) will have in the progress of gastrointestinal(GI) medicine.RM is a multidisciplinary field aiming to replace,regenerate or repair diseased tissues or organs.The past decade has been marked by numerous ground-breaking achievements that led experts in the field to manufacture functional substitutes of relatively simple organs.This progress is paving the ground for investigations that aims to the bioengineering and regeneration of more complex organs like livers,pancreas and intestine.In this special issue,the reader will be introduced,hand-in-hand,to explore the field of RM and will be educated on the progress,pitfalls and promise of RM technologies as applied to GI medicine.展开更多
Extracranial carotid artery aneurysm represents an ,uncommon vascular condition with relatively higherincidence in China than in the West.1 The complication with infection and rupture is even rarer, but potentially le...Extracranial carotid artery aneurysm represents an ,uncommon vascular condition with relatively higherincidence in China than in the West.1 The complication with infection and rupture is even rarer, but potentially lethal. Management of this condition is challenging but urgent because of high risks for embolization, generalized sepsis, further expansion, rupture, and life threatening.L2 We present an exceptional case of carotid aneurysm at bifurcation complicated with rupture and infection and discuss the pathogenesis and various aspects of diagnosis and surgical management.展开更多
Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying l...Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying liver disease and its functional reserve. From risk factors to management, HCC reveals a considerable geographic and institutional variation throughout the world. Although many staging and/or scoring systems have been proposed, each prognostic system has several benefits and limitations on its own. Therefore, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. In this review, currently available staging systems for assessing the prognosis of HCC, their uses, limitations, and future prospects are revisited.展开更多
文摘AIM: To evaluate how long patients with small bowel obstruction caused by postoperative adhesions can tolerate conservative treatment.METHODS: The records of patients with small bowel obstruction due to postoperative adhesions were retrospectively reviewed. Data collected included the number of admissions, type of management for each admission,duration of conservative treatment, number of repeat laparotomies, and operative findings.RESULTS: One hundred fifty-five patients with this condition from January 1999 to December 2001, for a total of 293 admissions were enrolled in this study. Medical treatment alone was given in 220 admissions, and repeat laparotomy was performed in 73 admissions. The period of observation in patients managed medically ranged from 2 to 12 days (average: 6.9 days), while for those who underwent surgery,the range was 1 to 14 days (average 5.4 days). At surgery,adhesions were the only finding in 46 cases, while there were intestinal complications in 27, or 9.2 % of all 293admissions. Fever and leukocytosis greater than 15 000/mm3were prediction of intestinal complications.CONCLUSION: With closely monitoring, most patients with small bowel obstruction due to postoperative adhesions could tolerate supportive treatment and recover well averagely within 1 week, although some patients require more than 10 days of observation.
文摘Rectal cancer classification is important to determine the preoperative chemoradiation therapy and to select appropriate surgical technique. We reviewed the Western and Japanese rectal cancer classification and we propose our new classification based of Magnetic resonance imaging(MRI). We determine the relation of the tumor to fixed parameters in MRI, which areperitoneal reflection and levator ani muscle. Then, we classify the rectal cancer into four levels based on tumor distal margin and invasion to MRI parameters. We applied all three classifications to 60 retrospectively collected patients of different rectal cancer distance and we compared our classifications to the others. Based on each level we standardize our surgical approach. For stages Ⅰ-Ⅲ, We found that level Ⅰ where tumor distal margin is located above the peritoneal reflection and all of them were received low anterior resection(LAR) without chemoradiation. Level Ⅱ where tumor distal margin is located from the peritoneal reflection and above the levator ani insertion on the rectum. 90% of them were received LAR ± chemoradiation. Level Ⅲ where tumor distal margin is located at the level of levator ani insertion or invading any part of the levator ani. 60% of them had ULAR + coloanal anastomosis ± chemoradiation. Level Ⅳ where the tumor distal margin is located below the levator ani insertion; 77% were received APR ± chemoradiation. The overall kappa for all levels between surgeons and radiologist was 0.93(95%CI: 0.87-0.99), which is indicating almost perfect agreement. We concluded that the management of rectal tumors differed among each tumor level and our new MRI based classification might facilitate the prediction of surgical and chemoradiation management with better communication among a multidisciplinary team comparing to other classifications.
文摘The present review aims to illustrate the strategies that are being implemented to regenerate or bioengineer livers for clinical purposes.There are two general pathways to liver bioengineering and regeneration.The first consists of creating a supporting scaffold,either synthetically or by decellularization of human or animal organs,and seeding cells on the scaffold,where they will mature either in bioreactors or in vivo.This strategy seems to offer the quickest route to clinical translation,as demonstrated by the development of liver organoids from rodent livers which were repopulated with organ specific cells of animal and/or human origin.Liver bioengineering has potential for transplantation and for toxicity testing during preclinical drug development.The second possibility is to induce liver regeneration of dead or resected tissue by manipulating cell pathways.In fact,it is well known that the liver has peculiar regenerative potential which allows hepatocyte hyperplasia after amputation of liver volume.Infusion of autologous bone marrow cells,which aids in liver regeneration,into patients was shown to be safe and to improve their clinical condition,but the specific cells responsible for liver regeneration have not yet been determined and the underlying mechanisms remain largely unknown.A complete understanding of the cell pathways and dynamics and of the functioning of liver stem cell niche is necessary for the clinical translation of regenerative medicine strategies.As well,it will be crucial to elucidate the mechanisms through which cells interact with the extracellular matrix,and how this latter supports and drives cell fate.
文摘BACKGROUND:Douglas described choledochal cysts in 1852 and Todani proposed an anatomy-based classification in 1977. The classification is the most extensively used,but does not include some rare variations.We present a case of hepatic duct diverticulum,one of the variations,and discuss its diagnosis and treatment. METHODS:A 57-year-old woman presented with upper abdominal pain and discomfort associated with nausea and vomiting.She was finally diagnosed with cholelithiasis and right hepatic duct diverticulum. RESULT:The patient underwent resection of the hepatic duct diverticulum and cholecystectomy,and was asymptomatic 26 months after surgery. CONCLUSIONS:Hepatic duct diverticulum is a rare form of choledochal cyst,not included in Todani’s classification. Todani’s classification including this and other uncommon variations of choledochal cysts must be reviewed.The best diagnostic imaging methods and treatment for choledochal cysts must be defined.
文摘To perform a meta-analysis of observational studies on inflammatory markers levels and occurrence of colorectal adenoma.METHODSPubMed and EMBASE databases were searched until March 2016 for the articles reporting on the circulating levels of inflammatory markers,including:C-reactive protein(CRP),interleukin-6(IL-6),and tumor necros is factor-alpha(TNF-α)and risk of colorectal adenoma.Random-effects models were used to calculate summary odds ratios(ORs)with 95%CIs for the highest vs lowest category of exposure.Heterogeneity was assessed by using the Q test and I<sup>2</sup>statistic.Subgroup analyses were also performed to test for potential source of heterogeneity.RESULTSA total of 14 case-control studies were included.Ten studies on CRP including a total of 3350 cases and 4168 controls showed non-significant summary(OR=1.23,95%CI:0.98-1.54;I<sup>2</sup>=54%,P<sub>heterogeneity</sub>=0.01)in the general analysis,but significant increased odds when considering only advanced adenoma(OR=1.59,95%CI:1.09-2.32;I<sup>2</sup>=44%,P<sub>heterogeneity</sub>=0.15).Subgroup and stratified analyses revealed a potential influence of smoking status and aspirin use on the association between CRP levels and colorectal adenoma.Five studies examined the association between circulating levels of TNF-αand colorectal adenoma risk,including a total of 1,568 cases and 2,832 controls.The summary OR for the highest vs the lowest category of exposure was 1.00(95%CI:0.77-1.29).The relationship between circulating IL-6 levels and colorectal adenoma risk was investigated in 7 studies including a total of 1936 cases and 3611 controls.The summary OR for the highest vs the lowest category of exposure was 1.19(95%CI:0.92-1.55).CONCLUSIONSummary of current evidence suggests a positive association of CRP levels and advanced colorectal adenoma risk.The role of potential confounding factors should be further evaluated.
文摘AIM To establish cell line and patient-derived xenograft(PDX) models for neuroendocrine carcinomas(NEC) which is highly desirable for gaining insight into tumor development as well as preclinical research includingbiomarker testing and drug response prediction.METHODS Cell line establishment was conducted from direct in vitro culturing of colonic NEC tissue(HROC57). A PDX could also successfully be established from vitally frozen tumor samples. Morphological features, invasive and migratory behavior of the HROC57 cells as well as expression of neuroendocrine markers were vastly analyzed. Phenotypic analysis was done by microscopy and multicolor flow cytometry. The extensive molecular-pathological profiling included mutation analysis, assessment of chromosomal and microsatellite instability; and in addition, fingerprinting(i.e., STR analysis) was performed from the cell line in direct comparison to primary patient-derived tissues and the PDX model established. Drug responsiveness was examined for a panel of chemotherapeutics in clinical use for the treatment of solid cancers.RESULTS The established cell line HROC57 showed distinct morphological and molecular features of a poorly differentiated large-cell NEC with KI-67 > 50%. Molecular-pathological analysis revealed a Cp G island promoter methylation positive cell line with microsatellite instability being absent. The following mutation profile was observed: KRAS(wt), BRAF(mut). A high sensitivity to etoposide, cisplatin and 5-FU could be demonstrated while it was more resistant towards rapamycin. CONCLUSION We successfully established and characterized a novel patient-derived NEC cell line in parallel to a PDX model as a useful tool for further analysis of the biological characteristics and for development of novel diagnostic and therapeutic options for NEC.
文摘Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their preoperative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow preoperative diagnosis of these lesions.
文摘AIM: To investigate estrogen receptors expression in duodenal familial adenomatous polyposis (FAP) and any relationship with epithelial proliferation/apoptosis markers.METHODS: Twenty-two patients affected by FAP undergoing duodenal resection for malignancies were recruited. Controls were 15 healthy subjects undergoing endoscopy for dyspeptic symptoms. ER-α, ER-α, Ki-67, TUNEL and caspase 3 expression (labeling index: percentage of positive cells) were evaluated by immunohistochemistry or immunofluorescence and examined by light or confocal microscopy. Samples were assigned to four groups: normal tissue, low (LGD) and high-grade dysplasia (HGD), adenocarcinoma (AC). One-way analysis of variance, corrected by Bonferroni’s test, and Pearson’s correlation test were applied for statistical analysis.RESULTS: ER-beta showed a progressive decline: normal tissue (23.5 ± 4.9), LGD (21.1 ± 4.8), HGD (9.3 ± 3.5), AC (7.1 ± 3.1). The normal tissue of FAP subjects expressed ER-beta like the controls (23.9 ± 6.2). Conversely, ER-α showed a progressive increase from normal tissue (24.8 ± 5.6) to AC (52.0 ± 8.2); the expression in normal tissue was similar to controls (22.5 ± 5.3). Ki67 demonstrated a statistically significant progressive increase at each disease stage up to AC. TUNEL did not reveal differences between controls and normal tissue of FAP subjects, but progressive decreases were observed in LGD, through HGD to AC. Pearson’s correlation test showed a direct relationship between ER-β and TUNEL LI (r = 0.8088, P < 0.0001). Conversely, ER-α was inversely correlated with TUNEL LI (r = - 0.7257, P < 0.0001). The co-expression of ER-β and caspase 3 declined progressively from normal to neoplastic tissue.CONCLUSION: This study confirmed that ER-β is strongly decreased in duodenal FAP carcinomas, declining in a multiple step fashion, thereby suggesting a putative anti-carcinogenic effect. ER-α showed the opposite trend. ER-β/caspase 3 co-expression suggests this hormone’s possible involvement in apoptosis. Hormonal influences in FAP duodenal tumorigenesis, and modulation of these as a possible chemoprevention strategy, may be a promising approach.
文摘This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine(RM) will have in the progress of gastrointestinal(GI) medicine.RM is a multidisciplinary field aiming to replace,regenerate or repair diseased tissues or organs.The past decade has been marked by numerous ground-breaking achievements that led experts in the field to manufacture functional substitutes of relatively simple organs.This progress is paving the ground for investigations that aims to the bioengineering and regeneration of more complex organs like livers,pancreas and intestine.In this special issue,the reader will be introduced,hand-in-hand,to explore the field of RM and will be educated on the progress,pitfalls and promise of RM technologies as applied to GI medicine.
文摘Extracranial carotid artery aneurysm represents an ,uncommon vascular condition with relatively higherincidence in China than in the West.1 The complication with infection and rupture is even rarer, but potentially lethal. Management of this condition is challenging but urgent because of high risks for embolization, generalized sepsis, further expansion, rupture, and life threatening.L2 We present an exceptional case of carotid aneurysm at bifurcation complicated with rupture and infection and discuss the pathogenesis and various aspects of diagnosis and surgical management.
文摘Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying liver disease and its functional reserve. From risk factors to management, HCC reveals a considerable geographic and institutional variation throughout the world. Although many staging and/or scoring systems have been proposed, each prognostic system has several benefits and limitations on its own. Therefore, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. In this review, currently available staging systems for assessing the prognosis of HCC, their uses, limitations, and future prospects are revisited.
