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Sample records for cardia

  1. Pathogenesis of achalasia cardia

    Institute of Scientific and Technical Information of China (English)

    Uday C Ghoshal; Sunil B Daschakraborty; Renu Singh

    2012-01-01

    Achalasia cardia is one of the common causes of motor dysphagia.Though the disease was first described more than 300 years ago,exact pathogenesis of this condition still remains enigmatic.Pathophysiologically,achalasia cardia is caused by loss of inhibitory ganglion in the myenteric plexus of the esophagus.In the initial stage,degeneration of inhibitory nerves in the esophagus results in unopposed action of excitatory neurotransmitters such as acetylcholine,resulting in high amplitude non-peristaltic contractions (vigorous achalasia); progressive loss of cholinergic neurons over time results in dilation and low amplitude simultaneous contractions in the esophageal body (classic achaiasia).Since the initial description,several studies have attempted to explore initiating agents that may cause the disease,such as viral infection,other environmental factors,autoimmunity,and genetic factors.Though Chagas disease,which mimics achalasia,is caused by an infective agent,available evidence suggests that infection may not be an independent cause of primary achalasia.A genetic basis for achalasia is supported by reports showing occurrence of disease in monozygotic twins,siblings and other first-degree relatives and occurrence in association with other genetic diseases such as Down's syndrome and Parkinson's disease.Polymorphisms in genes encoding for nitric oxide synthase,receptors for vasoactive intestinal peptide,interleukin 23 and the ALADIN gene have been reported.However,studies on larger numbers of patients and controls from different ethnic groups are needed before definite conclusions can be obtained.Currently,the disease is believed to be multi-factorial,with autoimmune mechanisms triggered by infection in a genetically predisposed individual leading to degeneration of inhibitory ganglia in the wall of the esophagus.

  2. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas

    OpenAIRE

    Zhou, Yong; Wu, Xu-Dong; Shi, Quan; Jia, Jing

    2013-01-01

    Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastr...

  3. SynCardia: the total artificial heart.

    Science.gov (United States)

    Torregrossa, Gianluca; Anyanwu, Anelechi; Zucchetta, Fabio; Gerosa, Gino

    2014-11-01

    The SynCardia total artificial heart (TAH) currently provides the most definitive option for patients with biventricular failure who are not candidates for isolated left ventricular (LV) assist device placement. The techniques for implantation are adaptable to almost all patients with advanced heart failure, including those with severe biventricular cardiomyopathy, complex congenital heart disease, failed LV assist devices, failed transplantations, and acquired structural heart defects that have failed or are not amenable to conventional surgical treatment. Over the years, the implantation technique has evolved in order to minimize the surgical invasiveness of the procedure, in anticipation of additional future surgery. Meticulous hemostasis with double layer sutures, use of Gore-Tex sheets around the TAH and the pericardial cavity, and use of tissue expanders to avoid contraction of pericardial cavity around the device are discussed in detail in the following report. Additionally, we will provide our experience with implantation of TAH in various challenging scenarios, such as patients with a small chest cavity, congenital heart defects, and simultaneous use of extracorporeal membrane oxygenation (ECMO).

  4. Diet quality and markers of endothelial function: The CARDIA study

    NARCIS (Netherlands)

    Sijtsma, F.P.C.; Meyer, K.A.; Steffen, L.M.; Horn, van L.; Shikany, J.M.; Odegaard, A.O.; Gross, M.D.; Kromhout, D.; Jacobs, D.R.

    2014-01-01

    Background and aim: Dietary patterns are associated cross-sectionally with cellular adhesion molecules (CAMs). We studied prospective associations of three dietary patterns with CAMs. Methods and results: In the Coronary Artery Risk Development in Young Adults (CARDIA) study, diet was assessed at ye

  5. Cancer of the esophagus and gastric cardia: recent advances

    NARCIS (Netherlands)

    Tytgat, G.N.; Bartelink, H.; Bernards, R.A.; Giacone, G.; Lanschot, J.J. van; Offerhaus, G.J.; Peters, G.J.

    2004-01-01

    Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. This review p

  6. Cancer of the esophagus and gastric cardia: recent advances.

    NARCIS (Netherlands)

    Tytgat, GN; Bartelink, H.; Bernards, R; Giaccone, G.; Lanschot, van JJ; Offerhaus, GJ; Peters, G.J.

    2004-01-01

    Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. This review p

  7. Inoperable oesophageal and cardia cancer. Benefits from Celestin intubation

    DEFF Research Database (Denmark)

    Qvist, N; Ryttov, N; Larsen, K E

    1987-01-01

    During a 12-year period, 77 consecutive patients with unresectable malignant stricture of the oesophagus or cardia were treated with a Celestin tube for relief of dysphagia of varying degree. Pull-through technique and gastrotomy were used for insertion of the tube in 72 patients, and endoscopy i...

  8. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas.

    Science.gov (United States)

    Zhou, Yong; Wu, Xu-Dong; Shi, Quan; Jia, Jing

    2013-03-28

    Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastric body, a tumor (about 2.5 cm × 2.0 cm) in the lower esophagus, and an infiltrative and stenosing tumor (about 1.0 cm × 2.0 cm) in the gastric cardia were detected. Wedge resection for extraluminal gastric tumor, radical esophagectomy for lower esophageal tumor, and cardiac resection with gastroesophageal (supra-aortic arch anastomoses) were performed. Postoperative histological examination showed synchronous occurrence of gastric GIST, esophageal squamous cell carcinoma, and gastric cardia adenocarcinoma. Furthermore, immunohistochemistry indicated strong staining for c-Kit/CD117, Dog-1, Ki-67 and smooth muscle, while expression of S-100 and CD34 was negative.

  9. Sudden endotracheal tube block in a patient of Achalasia Cardia

    Directory of Open Access Journals (Sweden)

    Ajit Gupta

    2012-01-01

    Full Text Available Endotracheal tube block due to various mechanical causes such as mucous, blood clot, denture, and ampoules have been reported. A patient of achalasia cardia with chronic passive aspiration pneumonitis developed mucoid mass in the respiratory passage which dislodged during the surgical procedure. The episode occurred almost an hour after induction of anesthesia and the dislodged mucoid mass blocked the lumen of endotracheal tube, leading to hypoxia and impending cardiac arrest. However, the patient was salvaged by replacing the tube.

  10. Chronic inflammation-related DNA damage response: a driving force of gastric cardia carcinogenesis.

    Science.gov (United States)

    Lin, Runhua; Xiao, Dejun; Guo, Yi; Tian, Dongping; Yun, Hailong; Chen, Donglin; Su, Min

    2015-02-20

    Gastric cardia cancer (GCC) is a highly aggressive disease associated with chronic inflammation. To investigate the relationship between DNA damage response (DDR) and chronic inflammation, we collected 100 non-tumor gastric cardia specimens of Chaoshan littoral, a high-risk region for esophageal and gastric cardia cancer. A significantly higher proportion of severe chronic inflammation was found in dysplastic epithelia (80.9%) in comparison with that in non-dysplastic tissues (40.7%) (Pchronic inflammation degrees from normal to severe inflammation (Pchronic inflammation-related DNA damage response may be a driving force of gastric cardia carcinogenesis. Based on these findings, DNA damage response in non-malignant tissues may become a promising biomedical marker for predicting malignant transformation in the gastric cardia.

  11. RULE OF CARCINOGENETIC DEVELOPMENT OF GASTRIC CARDIA OBSERVED BY ENDOSCOPY

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the rule of development of early cancer of gastric cardiac in vivo. Methods: A prospective cohort was held in the high incidence area of cancer of esophagus and stomach in china. One hundred and six persons were examined regularly by endoscopy to observe the change of pro-cancer lesions of gastric cardiac by taking biopsy specimen. All specimens were diagnosed through normal pathological process. Results: The 106 subjects were examined twice in 1998 and 2002. Of 8 normal persons, 3 stayed normal, 4 turned to chronic gastritis, 1 developed early gastric cardiac cancer. Of 61 persons with chronic gastritis, 11 were observed to have gland atrophy, 4 with mild atypical hyperplasia, and 2 with highly atypical hyperplasia. Of 9 subjects showing atrophic chronic gastritis, 5 revealed no change, and 4 became chronic gastritis. Of 22 subjects who revealed mild atypical hyperplasia, 17 resolved, 4 showed no change, and 1 advanced to highly atypical hyperplasia. One person with highly atypical hyperplasia reverted to mild atypical hyperplasia. Of 5 subjects with early gastric cardiac cancer without any treatment, 1 became advanced cancer, 1 still stayed in early cancer stage, 3 turned to atypical hyperplasia. Conclusion: 1. The development of early cancer of gastric cardia would proceed through the stages of chronic gastritis, gland atrophy, and atypical hyperplasia. 2. The early cancer and pre-cancer lesions of gastric cardia is reversible, though possessing malignant possibility.

  12. Risk factors for the gastric cardia cancer: a case-control study in Fujian Province

    Institute of Scientific and Technical Information of China (English)

    Lin Cai; Zong-Li Zheng; Zuo-Feng Zhang

    2003-01-01

    AIM: The incidence of gastric cardia cancer has greatlyincreased in the past 2-3 decades, however, the risk factorsfor the disease are still not clearly understood. Theinvestigations among Chinese population on the risk factorsof gastric cardia cancer were also scarcely reported. Wetherefore conducted a case-control study in Fujian province,China, to investigate the potential risk and protective factorsof this disease.METHODS: 191 cardia and 190 non-cardia gastric cancercases, and a total of 222 control cases were included in thisstudy. Standard questionnaires were used in collectingepidemiological factors and the data were then analyzed bythe unconditional logistic regression model.RESULTS: As the factors such as age, gender, smoking,alcohol consumption, and family history of gastric cancerwere controlled, a multivariable analysis was conducted,which revealed that there was a significant correlationbetween the dietary habits such as irregular meal, over andfast eating, and the gastric cardia cancer with the odds ratios(ORs) of 4.2 (95 % confidence interval: 2.3-7.7), 4.7 (2.1-10.8), and 2.7 (1.3-5.3) respectively. Other correlations werealso observed between the gastric cardia cancer and theconsumption of salty fish or pickled vegetable, smoking,and the family cancer history with the ORs of 5.5 (1.4-19.5),1.8 (1.0-3.0), 2.1 (1.3-3.5), and 3.8 (2.3-6.2) respectively.In contrast, the negative correlations were found existingbetween the intake of fresh vegetables and fruits, the useof refrigerator, and the gastric cardia cancer, with the ORsof 0.4 (0.2-0.9), 0.2 (0.1-0.5), and 0.2 (0.1-0.4),respectively. However, dietary habits were associated lesswith non-cardia gastric cancer compared with its cardiacounterpart.CONCLUSION: Dietary habits might be one of the riskfactors for the cardia carcinogenesis among Chinesepopulation.

  13. Achalasia cardia presenting with bilateral broncheactasis in a child

    Directory of Open Access Journals (Sweden)

    Bhavana Venkata Nagabhushana Rao

    2016-01-01

    Full Text Available Achalasia cardia usually presents in the age group of 25 to 60 and rare in children. Dysphagia, regurgitation, vomiting and chest pain are the cardinal symptoms. If they present mainly with respiratory symptoms diagnosis may be difficult and delayed. Bilateral bronchiectasis is rarely reported in patients with achalasia both in adults and children. Sometimes children may be erroneously diagnosed as eating disorder as both may present with similar symptoms hence information that achalasia can occur in children reduces such risk. In those children presenting with chronic respiratory symptoms it is prudent to look for esophageal motility disorders. CT scan, endoscopy, manometry are useful diagnostic tools but gold standard is barium esophgogram to diagnose Achalasia. Chest postural drainage may be delayed in bronchiectatic patients with achalasia. Heller myotomy is standard surgical treatment for children. Untreated Patients may end up with megaesophagus, a progressively dilated esophagus. [Int J Res Med Sci 2016; 4(1.000: 314-316

  14. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  15. Situs inversus totalis with carcinoma of gastric cardia: a case report

    Directory of Open Access Journals (Sweden)

    Ke Pan

    2012-12-01

    Full Text Available Abstract Situs inversus is an uncommon anomaly with rare incidence. Some cases of situs inversus totalis have been described with different types of associations. Here we report a case of situs inversus with carcinoma of the gastric cardia.

  16. A first step beyond traditional boundaries: destination therapy with the SynCardia total artificial heart.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Koerfer, Reiner; Tenderich, Gero

    2014-06-01

    The SynCardia total artificial heart is currently used as a bridge to transplantation therapy in cases of irreversible, acute or chronic, biventricular heart failure. We describe the implementation of this technology in the context of destination therapy in a patient with an end-stage heart failure on grounds of primary amyloidosis.

  17. Effect of body mass index on adenocarcinoma of gastric cardia

    Institute of Scientific and Technical Information of China (English)

    Ji Zhang; Xiang-Qian Su; Xiao-Jiang Wu; Ya-Hang Liu; Hua Wang; Xiang-Nong Zong; Yi Wang; Jia-Fu Ji

    2003-01-01

    AIM: Obesity has been proved as one of the main risk factors for gastric cardia adenocarcinoma (GCA) in the West.The objective of our research was to evaluate the relationship between obesity and the risk of GCA in people from North China.METHODS: A total of 300 patients who had been diagnosed as GCA and had accepted surgical operation at Beijing Cancer Hospital from 1995 to 2002 were enrolled. Data were collected from pathology materials and hospital records. Two hundred and fifty-eight healthy people who had accepted health examination at the same hospital during the same period were enrolled as controls. Height, weight and gender of them at the time of examination were also collected.Obesity was estimated by body mass index (BMI), computed as weight in kilograms per square surface area (Kg/m2).The degree of obesity was determined by using BMI≤ 18.5,24-27.9 and ≥28 (Kg/m2) as the cut-off points for underweight/normal, overweight and obesity, respectively.Associations with obesity were estimated by odds ratios (ORs) and 95 % confidence intervals (CIs). All ORs were adjusted for age and sex.RESULTS: The mean level of BMI was significantly lower in the patient group than that in the control group. The ORs for obesity in age groups 30-59 and 60-79 were 1.15 (95 %CI=0.37-3.65) and 0.16 (95 % CI=0.05-0.44) for males and 0.78 (95 % CI=0.26-2.36) and 0.28 (95 % CI=0.04-2.05)for females, respectively. The ORs for underweight were 2.42 (95 % CI=0.56-10.53) and 4.68 (95 % CI=1.13-19.40)for males in age subgroups 30-59 and 60-79 and 40.7 (95 %CI=9.32-177.92) for females older than 60 yrs. BMI was significantly associated with GCA (P<0.01). Underweight people were at high risk for GCA.CONCLUSION: BMI is an independent risk factor for GCA.Underweight is positively associated with GCA.

  18. Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hyun Kyung [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Kim, Young Hoon, E-mail: yhkrad@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of)

    2015-09-15

    Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination.

  19. Cardiorespiratory Fitness and Coronary Artery Calcification in Young Adults: The CARDIA Study

    OpenAIRE

    Lee, Chong-Do; Jacobs, David R; Hankinson, Arlene; Iribarren, Carlos; SIDNEY, Stephen

    2008-01-01

    Whether cardiorespiratory fitness relates to early subclinical atherosclerotic vascular disease remains unknown. We investigated the relation of cardiorespiratory fitness to coronary artery calcification (CAC) in 2373 African-American and White young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. We measured cardiorespiratory fitness in 1985-1986 (baseline) using a symptom-limited exercise test on a treadmill. Coronary calcium scores were measured in 2001-200...

  20. Expanding Applicability of Total Artificial Heart Therapy: The 50-cc SynCardia Total Artificial Heart.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Guersoy, Dilek; Koerfer, Reiner; Tenderich, Gero

    2015-09-01

    The 50-cc SynCardia total artificial heart is designed to facilitate orthotopic replacement of the native ventricles in patients with a body surface area below 1.7 m(2) in need of long-term circulatory support as a result of end-stage biventricular heart failure. We describe the implementation of this technology in a female patient with irreversible cardiogenic shock on the grounds of acute myocardial infarction and chronic ischemic cardiomyopathy.

  1. Influence of a microscopic positive proximal margin in the treatment of gastric adenocarcinoma of the cardia

    Institute of Scientific and Technical Information of China (English)

    Jian-Guo Shen; Jae-Ho Cheong; Woo-Jin Hyung; Junuk Kim; Seung-Ho Choi; Sung-Hoon Noh

    2006-01-01

    AIM: To investigate the influence of a positive proximal margin in total gastrectomy patients with gastric adenocarcinoma of the cardia.METHODS: Medical records of 191 patients with total gastrectomies for adenocarcinoma of the cardia between 1995 and 2000 were reviewed. The clinicopathologic features associated with a positive margin were determined, and the predictors for survival were analyzed.RESULTS: The incidence of positive proximal margin was 8.4% (16/191). The positive margins were associated with advanced diseases. The tumor size and the depth of tumor invasion were independent risk factors for a positive margin. The mean survival in the positive margin group was 33.9 mo as compared with 62.4 mo in the negative group (P < 0.001). However, the difference in survival lost significance in subgroup analysis according to stage. Multivariate analysis identified that a positive margin was not an independent prognostic factor for survival.CONCLUSION: A positive margin is more of an indication of advanced disease in patients with gastric adenocarcinoma of the cardia rather than an independent prognostic factor for survival.

  2. Appearance of a double bubble in achalasia cardia: a case report

    Directory of Open Access Journals (Sweden)

    Lakhan Shaheen E

    2008-12-01

    Full Text Available Abstract Introduction Achalasia cardia is characterized by failure of the lower esophageal sphincter to relax in response to swallowing and by an absence of peristalsis in the esophageal body. Absence of a gastric air bubble is a well known radiological finding. Pneumatic balloon dilatation results in reappearance of the gastric bubble. Case presentation We report the case of a 43-year-old Indian man with achalasia cardia whose chest X-ray at the time of presentation showed an air bubble in the gastric region causing a diagnostic quandary. Successful dilatation of the lower esophageal sphincter resulted in the appearance of another air bubble in the gastric region. Proper analysis showed that the first bubble was actually a colonic air bubble of the splenic flexure and the appearance of the second bubble was the anticipated gastric air bubble. Conclusion In patients presenting with achalasia cardia, a colonic air bubble may be seen in the gastric region causing diagnostic difficulty. In these patients, a gastric air bubble may appear after pneumatic dilatation. At the end of the procedure, there will be two air bubbles ("double bubble": a colonic and a gastric air bubble. To our knowledge, this finding has not been reported in the literature thus far.

  3. Effect of lymphadenectomy extent on advanced gastric cancer located in the cardia and fundus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To analyze the prognostic impact of lymphade- nectomy extent in advanced gastric cancer located in the cardia and fundus. METHODS: Two hundred and thirty-six patients with advanced gastric cancer located in the cardia and fundus who underwent D2 curative resection were analyzed retrospectively. Relationships between the numbers of lymph nodes (iNs) dissected and survival was analyzed among different clinical stage subgroups. RESULTS: The 5-year overall survival rate of the entire cohort was 37.5%. Multivariate prognostic variables were total LNs dissected (P<0.0001; or number of negative LNs examined, P<0.0001), number of positive INs (P < 0.0001), T category (P < 0.0001) and tumor size (P=0.015). The greatest survival differences were observed at cutoff values of 20 INs resected for stage II (P = 0.0136), 25 for stage III (P < 0.0001), 30 for stage IV (P = 0.0002), and 15 for all patients (P = 0.0024). Based on the statistically assumed linearity as best fit, linear regression showed a significant survival enhancement based on increasing negative INs for patients of stages III (P = 0.013) and IV (P = 0.035). CONCLUSION: To improve the long-term survival of patients with advanced gastric cancer located in the cardia and fundus, removing at least 20 INs for stage II, 25 INs for stage III, and 30 INs for stage 1V patients during D2 radical dissection is recommended.

  4. Differences in proximal (cardia) versus distal (antral) gastric carcinogenesis via retinoblastoma pathway

    Institute of Scientific and Technical Information of China (English)

    Christian Gulmann; Helen Hegarty; Antoinette Grace; Mary Leader; Stephen Patchett; Elaine Kay

    2004-01-01

    AIM: Disruption of cell cycle regulation is a critical event in carcinogenesis, and alteration of the retinoblastoma (pRb)tumour suppressor pathway is frequent. The aim of this study was to compare alterations in this pathway in proximal and distal gastric carcinogenesis in an effort to explain the observed striking epidemiological differences.METHODS: Immunohistochemistry was performed to investigate expression of p16 and pRb in the following groups of both proximal (cardia) and distal (antral) tissue samples: (a) biopsies showing normal mucosa, (b) biopsies showing intestinal metaplasia and, (c) gastric cancer resection specimens including uninvolved mucosa and tumour.RESULTS: In the antrum there were highly significant trends for increased p16 expression with concomitant (and in the group of carcinomas inversely proportional)decreased pRb expression from normal mucosa to intestinal metaplasia to uninvolved mucosa (from cancer resections)to carcinoma. In the cardia, there were no differences in p16 expression between the various types of tissue samples whereas pRb expression was higher in normal mucosa compared with intestinal metaplasia and tissue from cancer resections.CONCLUSION: Alterations in the pRb pathway appear to play a more significant role in distal gastric carcinogenesis.Tt may be an early event in the former location since the trend towards p16 overexpression with concomitant pRb underexpression was seen as early as between normal mucosa and intestinal metaplasia. Importantly, the marked differences in expression of pRb and p16 between the cardia and antrum strongly support the hypothesis that tumours of the two locations are genetically different which may account for some of the observed epidemiological differences.

  5. Adenocarcinoma of gastric cardia in the elderly:Surgical problems and prognostic factors

    Institute of Scientific and Technical Information of China (English)

    Natale Di Martino; Giuseppe Izzo; Angelo Cosenza; Guido Cerullo; Francesco Torelli; Antonio Brillantino; Alberto del Genio

    2005-01-01

    AIM: To analyze retrospectively, our results about patients who underwent surgical treatment for adenocarcinoma of the cardia in relation to age, in order to evaluate surgical problems and prognostic factors.METHODS: From January 1987 to March 2003, 140 patients with adenocarcinoma of the cardia underwent resection in the authors' institution. They were divided into three groups with regard to age. Patients 60 year old (31) were excluded; we also excluded 18 out of 109 patients with poor general status or systemic metastases. So, we compared 51 elderly (≥ 70 year old)and 58 younger patients (≤ 60 year old). The treatment was esophagectomy for type Ⅰ tumors, and extended gastrectomy and distal esophagectomy for type Ⅱ and Ⅲ lesions.RESULTS: Laparotomy was carried out in 91 patients (83.4%), 38 in the elderly (74.5%) and 53 in younger patients (91.3%, P<0.05). Primary resection was performed in 811 cases (89%) without significant differences between the two groups. Postoperative death was higher in the elderly (12.1%) than the other group (4.1%, P<0.05), while morbidity was similar in both groups. A curative resection (R0) was performed in 59 patients (72.8%), 69.6% in the elderly and 75% in the younger group (P>0.05). The overall 3- and 5-year survival rates were 26.7% and 117.8% respectively for the elderly and 40.7% and 35.1% respectively for younger patients (P = 0.1544). Survival rates were significantly associated with R0 resection,pathological node-positive category and tumor differentiation in both groups.CONCLUSION: As the age of the general population increases, more elderly patients with gastric cardia cancer will be candidates for surgical resection. Age alone should not preclude surgical treatment in elderly patients with gastric cardia cancer and a tumor resection can be carried out safely. Certainly, we should take care in defining the surgical treatment in elderly patients, particularly as regarding the surgical approach; although the

  6. NON-THORACOTOMY ESOPHAGECTOMY FOR CARCINOMA OF THE ESOPHAGUS AND CARDIA

    Institute of Scientific and Technical Information of China (English)

    Li Xiangsheng; Ding Yunling; Wu Xuliang

    1998-01-01

    Objective: To try to use Non-Thoracotomy Esophagectomy (NTE) for patient with carcinoma of esophagus and cardia avoiding thoracotomy, and by utilizing a cervical esophagogastric anastomosis in order to reduce perioperative morbidity and mortality. Methods: 18 patients were treated with NTE between 1989 to 1998. Of them, 5adenocarcinoma of the cardia and 13 squamous cell carcinoma of the esophagus (2 upper thoracic, and 11distal third). Everting stripping were performed in all patients. Esophagus were extracted either upwards (n=2)or downwards (n=16). The esophageal substitute was a resulting gastric tube (n=5) or the stomach (n=13) and was positioned in the posterior mediastinum. Results:The mean age of the patients was 64 years (ranged 40 to 72). The male:female ratio was 10:8. The mean intraoperative blood loss was 400 ml. There was no hospital deaths. Only one patient had a cervical esophagogastric anastomotic leakage. Conclusion: NTE is to be recommended becauseof its operative ease, safety and rare operative complications. CT scanning of the thorax and bronchoscopy is necessary before using the technique of NTE.

  7. 25. Clinicopathologic analysis on 13 823 carcinomas of esophagus and cardia in Chaoshan littoral of China

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Background: Chaoshan is the close region and Chaoshan people who came from old Changan and Henan thousands years ago are relative isolation population with high-risk of esophageal carcinoma (EC) and cardiac carcinoma(CC) in China. However there were no report about detail clinicopathologic data of cancer of esophagus and cardia in Chaoshan district before. Methods: The data of age, sex. ABO blood type and X-ray or pathological diagnosis of the patients with carcinoma of esophagus or cardia were collected from The tumor hospital. The First affiliated hospital, The Second affiliated hospital of Shantou University Medical College, the Center hospital of Shantou and the populalion hospital of Jieyang. In this study. Clinicopathologic data of 9 650 patients with EC and 4 173 patients with CC in Chaoshan population were analyzed. Results and Conclusion: The male to female ratio was 3∶1 in EC and 4.75∶1 in CC, indicating EC and CC was more common in the male than in the female. The average affected age of EC was 54.61 year old. CC was 58.14 year old. The most common affected site of esophageal carcinoma was the middle third of esophagus(72.00%); the second was the lower third (15.30%). The main gross type of esophageal carcinoma was ulcerative type (41.50%); the medullary type ranks second (39.60%). In histological types of EC, squamous cell carcinoma accounted for overwhelming majority(96.44%).

  8. Nurse-led follow-up of patients after oesophageal or gastric cardia cancer surgery: A randomised trial

    NARCIS (Netherlands)

    E.M.L. Verschuur (Els); E.W. Steyerberg (Ewout); H.W. Tilanus (Hugo); S. Polinder (Suzanne); M.L.E. Essink-Bot (Marie-Louise); K.T.C. Tran (Khe); A. van der Gaast (Ate); L.P. Stassen (Laurents); E.J. Kuipers (Ernst); P.D. Siersema (Peter)

    2009-01-01

    textabstractBetween January 2004 and February 2006, 109 patients after intentionally curative surgery for oesophageal or gastric cardia cancer were randomised to standard follow-up of surgeons at the outpatient clinic (standard follow-up; n=55) or by regular home visits of a specialist nurse (nurse-

  9. Implantation technique of the 50-cm3 SynCardia Total Artificial Heart: does size make a difference?

    Science.gov (United States)

    Spiliopoulos, Sotirios; Guersoy, Dilek; Dimitriou, Alexandros Merkourios; Koerfer, Reiner; Tenderich, Gero

    2015-01-01

    Despite downsizing, implantation technique of the 50-cm(3) SynCardia Total Artificial Heart and settings of the Companion driver remain unchanged. Owing to the absence of de-airing nipples, de-airing procedure is even more crucial and has to be performed carefully.

  10. Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the prognostic impact of the metastatic lymph node ratio (MLR) in advanced gastric cancer from the cardia and fundus. METHODS: Two hundred and thirty-six patients with gastric cancer from the cardia and fundus who underwent D2 curative resection were analyzed ret- rospectively. The correlations between MLR and the total lymph nodes, positive nodes and the total lymph nodes were analyzed respectively. The influence of MLR on the survival time of patients was determined with univariate Kaplan-Meier survival analysis and mul- tivariate Cox proportional hazard model analysis. And the multiple linear regression was used to identify the relation between MLR and the 5-year survival rate of the patients. RESULTS: The MLR did not correlate with the total lymph nodes resected (r = -0.093, P = 0.057). The 5-year overall survival rate of the whole cohort was 37.5%. Kaplan-Meier survival analysis identified that the following eight factors influenced the survival time of the patients postoperatively: gender (X2 = 4.26, P = 0.0389), tumor size (X2 = 18.48, P < 0.001), Borrmann type (X2 = 7.41, P = 0.0065), histological grade (X2 =5.07, P = 0.0243), pT category (X2 = 49.42, P < 0.001), pN category (X2 = 87.7, P < 0.001), total number of re- trieved lymph nodes (X2 = 8.22, P = 0.0042) and MLR (X2 = 34.3, P < 0.001). Cox proportional hazard model showed that tumor size (X2 = 7.985, P = 0.018), pT category (X2 = 30.82, P < 0.001) and MLR (X2 = 69.39, P < 0.001) independently influenced the prognosis. A linear correlation between MLR and the 5-year survival was statistically significant based on the multiple lin- ear regression (β = -0.63, P < 0.001). Hypothetically, the 5-year survival would surpass 50% when MLR was lower than 10%. CONCLUSION: The MLR is an independent prognostic factor for patients with advanced gastric cancer from the cardia and fundus. The decrease of MLR due to adequate number of total resected lymph nodes can improve the survival.

  11. EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-wei; Yong-wei; MA Cai-fen; SHAN Bao-en; WANG Shi-jie; WEN Deng-gui; LI Ying-sai; YU Wei-fang; WANG Shun-ping; ER Li-mian; CONG Qing-wen; WANG Jun-he; LI Su-ping

    2006-01-01

    Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods: Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results: The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70~80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion: The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.

  12. Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China

    Institute of Scientific and Technical Information of China (English)

    Min Su; Shan-Ming Lu; Dong-Ping Tian; Hu Zhao; Xiao-Yun Li; DeRui Li; Zhi-Chao Zheng

    2001-01-01

    AIM To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhebitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the psst has made Cheoshan a relatively closed area and kept its culture and costure of old China thousend years ago.``METHODS Data on age, sex, ABO blood type and X-rayor psthological diagnose of the pstients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 pstients with esophageal carcinoma (EC) and 2 955 patients with cardiac cancer (CC) in Chaoshen district were retrospectively assessed for their association with ABO blood groups.``RESULTS The distribution of ABO blood groups in patients with EC or CC was similar to the norrnal local population in Chaoshen. However, blood group B in male patients with CC and in the pstients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B: O was 1. 1415 (P<0.05)and 1 .2696 (P<0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation.``CONCLTUSION ABO blood group B is associated with the incidence of CC in male individuals and carcinona in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.``

  13. Primary adenocarcinomas of lower esophagus, esophagogastric junction and gastric cardia: in special reference to China

    Institute of Scientific and Technical Information of China (English)

    Li-Dong Wang; Shu Zheng; Zuo-Yu Zheng; Alan G. Casson

    2003-01-01

    Gastric cardia adenocarcinoma (GCA) is an under-studied subject. The pathogenesis, molecular changes in the early stage of carcinogenesis and related risk factors have not been well characterized. There is evidence, however, that GCA differs from cancer of the rest of the stomach in terms of natural history and histopathogenesis. Adenocarcinomas of the lower esophagus, esophagogastric junction (EGJ)and gastric cardia have been given much attention because of their increasing incidences in the past decades, which is in striking contrast with the steady decrease in distal stomach adenocarcinoma. In China, epidemiologically, GCA shares very similar geographic distribution with esophageal squamous cell carcinoma (SCC), especially in Linzhou (formerly Linxian County), Henan Province, North China,the highest incidence area of esophageal SCC in the world.Historically, both GCA and SCC in these areas were referred to as esophageal cancer (EC) by the public because of the common syndrome of dysphagia. In Western countries,Barrett's esophagus is very common and has been considered as an important precancerous lesion of adenocarcinoma at EGJ. Because of the low incidence of Barrett's esophagus in China, it is unlikely to be an important factor in early stage of EGJ adenocarcinoma development.However, Z line up-growth into lower esophagus may be one of the characteristic changes in these areas in early stage of GCA development. Whether intestinal metaplasia (IM) is a premalignant lesion for GCA is still not clear. Higher frequency of IM observed at adjacent GCA tissues in Henan suggests the possibility of IM as a precancerous lesion for GCA in these areas. Molecular information on GCA,especially in early stage, is very limited. The accumulated data about the changes of tumor suppressor gene, such as p53 mutation, and ontogeny, such as C-erbB2, especially the similar alterations in GCA and SCC in the same patient,indicated that there might be some similar risk factors,such as

  14. Gender Differences in the Association between Sleep Duration and Body Composition: The Cardia Study

    Directory of Open Access Journals (Sweden)

    Marie-Pierre St-Onge

    2010-01-01

    Full Text Available Sleep duration has been inversely associated with body mass index (BMI. We examined the relationship between self-reported sleep duration and BMI, waist circumference, and percent body fat in Black and White individuals from the CARDIA study. Box-Tidwell regression models were adjusted for age and race (Model 1, additional lifestyle and demographic variables (Model 2, and physical activity (Model 3. There were significant interactions between sleep and gender for the main outcome variables. In men, there was a trend for an inverse relationship between reported sleep duration and BMI in Model 2  (β=−0.20,P=.053 but not model 3  (β=−0.139,P=.191. In women, inverse relationships were observed between sleep duration and BMI (β=−0.294,P=.005 and waist circumference (β=−0.442,P=.059, in Model 2. These associations became nonsignificant in model 3 (BMI: β=−0.172,P=.084; waist circumference: β=−0.161,P=.474. Our results are consistent with previous findings that sleep is associated with BMI and other body composition variables. However, the relationship between self-reported sleep duration and body composition may be stronger in women than in men.

  15. Do neighborhood socioeconomic deprivation and low social cohesion predict coronary calcification?: the CARDIA study.

    Science.gov (United States)

    Kim, Daniel; Diez Roux, Ana V; Kiefe, Catarina I; Kawachi, Ichiro; Liu, Kiang

    2010-08-01

    Growing evidence suggests that neighborhood characteristics may influence the risk of coronary heart disease. No studies have yet explored associations of neighborhood attributes with subclinical atherosclerosis in younger adult populations. Using data on 2,974 adults (1,699 women, 1,275 men) aged 32-50 years in 2000 from the Coronary Artery Disease Risk Development in Young Adults (CARDIA) Study and 2000 US Census block-group-level data, the authors estimated multivariable-adjusted associations of neighborhood socioeconomic deprivation and perceived neighborhood cohesion with odds of coronary artery calcification (CAC) 5 years later. Among women, the quartiles of highest neighborhood deprivation and lowest cohesion were associated with higher odds of CAC after adjustment for individual-level demographic and socioeconomic factors (for deprivation, odds ratio = 2.49, 95% confidence interval: 1.22, 5.08 (P for trend = 0.03); for cohesion, odds ratio = 1.87, 95% confidence interval: 1.10, 3.16 (P for trend = 0.02)). Associations changed only slightly after adjustment for behavioral, psychosocial, and biologic factors. Among men, neither neighborhood deprivation nor cohesion was related to CAC. However, among men in deprived neighborhoods, low cohesion predicted higher CAC odds (for interaction between neighborhood deprivation and cohesion, P = 0.03). This study provides evidence on associations of neighborhood deprivation and cohesion with CAC in younger, asymptomatic adults. Neighborhood attributes may contribute to subclinical atherosclerosis.

  16. Quantitative assessment of the response to therapy in achalasia of the cardia.

    Science.gov (United States)

    Robertson, C S; Hardy, J G; Atkinson, M

    1989-06-01

    Radionuclide oesophageal transit studies and manometry have been carried out in 15 patients with achalasia of the cardia, before treatment, after a course of nifedipine and after pneumatic bag dilatation. Transit studies were also done in 10 patients after cardiomyotomy and in 10 normal subjects. Images were recorded with the subjects seated in front of a gamma camera while swallowing a 10 ml bolus of 99Tcm-tin colloid and then after a further drink of 50 ml water. There was marked retention of tracer in the oesophagus in patients with achalasia compared with rapid clearance in control subjects. Bag dilatation significantly reduced lower oesophageal sphincter pressure but there was no significant difference in the 50% clearance time or percentage dose retained at 100s before and after the treatments. Oesophageal clearance of tracer after the additional drink of water, was improved by bag dilatation. Oesophageal transit in the patients after cardiomyotomy was similar to that in patients who had undergone bag dilatation. There was considerable retention of the tracer in the oesophagus overnight, but this did not result in pulmonary aspiration. Radionuclide oesophageal transit studies provided a quantitative assessment of therapy in achalasia and the proportion of tracer retained after the additional drink proved to be a sensitive measure of response to treatment. Nifedipine proved ineffective as a treatment for achalasia. Bag dilatation and cardiomyotomy were of similar value.

  17. Difference of Gene Expression Profiles between Barrett's Esophagus and Cardia Intestinal Metaplasia by Gene Chip

    Institute of Scientific and Technical Information of China (English)

    CHANG Ying; LIU Bin

    2006-01-01

    The difference of gene expression profile changes in Barrettes esophagus (BE) and cardia intestinal metaplasia (CIM) epithelium was studied and the novel associated genes were screened in the early stage by cDNA microarray. The cDNA retro-transcribed from equal quantity mRNA from BE and CIM epithelial tissues were labeled with Cy3 and Cy5 fluorescence as probes. The mixed probe was hybridized with three pieces BiostarH-40s double dot human whole gene chip. The chips were scanned with a ScanArray 4000. The acquired images were analyzed using GenePix Pro 3.0 software. It was found a total of 141 genes were screened out that exhibited differentially expression more than 2 times in all three chips. It was identified that in gene expression profiles of BE, 74 genes were up-regulated and 67 down-regulated as compared with CIM. The comparison between the difference of gene expression profile changes in BE and CIM epithelia revealed that there existed the difference between BE and CIM at gene level. 141 genes with the expression more than two time were probably related to the occurrence and development of BE and the promotion or progress in adenocarcinoma.

  18. Physiological characterization of the SynCardia total artificial heart in a mock circulation system.

    Science.gov (United States)

    Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

    2015-01-01

    The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving biventricular replacement system for a wide variety of patients with end-stage heart failure. Although the clinical performance of the TAH is established, modern physiological characterization, in terms of elastance behavior and pressure-volume (PV) characterization has not been defined. Herein, we examine the TAH in terms of elastance using a nonejecting left ventricle, and then characterize the PV relation of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Furthermore, we show that the TAH has a PV relation behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload-dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload; however, this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared with the human heart.

  19. Proteome analysis of human gastric cardia adenocarcinoma by laser capture microdissection

    Directory of Open Access Journals (Sweden)

    Wang Yan

    2007-10-01

    Full Text Available Abstract Background The incidence of gastric cardiac adenocarcinoma (GCA has been increasing in the past two decades in China, but the molecular changes relating to carcinogenesis have not been well characterised. Methods In this study, we used a comparative proteomic approach to analyse the malignant and nonmalignant gastric cardia epithelial cells isolated by navigated laser capture microdissection (LCM from paired surgical specimens of human GCA. Results Twenty-seven spots corresponding to 23 proteins were consistently differentially regulated. Fifteen proteins were shown to be up-regulated, while eight proteins were shown to be down-regulated in malignant cells compared with nonmalignant columnar epithelial cells. The identified proteins appeared to be involved in metabolism, chaperone, antioxidation, signal transduction, apoptosis, cell proliferation, and differentiation. In addition, expressions of HSP27, 60, and Prx-2 in GCA specimens were further confirmed by immunohistochemical and western blot analyses. Conclusion These data indicate that the combination of navigated LCM with 2-DE provides an effective strategy for discovering proteins that are differentially expressed in GCA. Such proteins may contribute in elucidating the molecular mechanisms of GCA carcinogenesis. Furthermore, the combination provides potential clinical biomarkers that aid in early detection and provide potential therapeutic targets.

  20. Expression of p53 protein in Barrett’s adenocarcinoma and adenocarcinoma of the gastric cardia and antrum

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2005-01-01

    Full Text Available Background/Aim. Most studies of esophageal and gastric adenocarcinomas have shown a very high rate of p53 gene mutation and/or protein overexpression, but the influence of the tumor site upon the frequency of p53 protein expression has not been evaluated (gastroesophageal junction, Barret's esophagus, and antrum. The aim of our study was to analyze the correlation between the selected clinico-pthological parameters, and p53 protein overexpression in regards to the particular tumor location. Methods. The material comprised 66 surgical specimens; 10 were Barrett’s carcinomas, 25 adenocarcinomas of the gastric cardia (type II adenocarcinoma of the esophagogastric junction - EGJ, and 31 adenocarcinomas of the antrum. Immunostaining for p53 protein was performed on formalin-fixed, paraffin-embedded tissue sections, using the alkaline phosphatase - antialkaline phosphatase (APAAP method. The cases were considered positive for p53 if at least 5% of the tumor cells expressed this protein by immunostaining. Results. There was no significant difference observed between the studied groups in regards to age, sex, Lauren’s classification and tumor differentiation. There was, however, a significant difference observed in the depth of tumor invasion between Barrrett’s adenocarcinoma and adenocarcinoma of the cardia compared with the adenocarcinoma of the antrum. Namely, at the time of surgery, both Barrett’s adenocarcinomas and adenocarcinomas of the cardia, were significantly more advanced comparing with the adenocarcinomas of the antrum. Overexpression of p53 was found in 40% (4/10 of Barrett’s adenocarcinomas, 72% (18/25 of adenocarcinoma of the cardia and 65% (20/31 of adenocarcinoma of the antrum. No significant differences in p53 expression in relation to sex, type (Lauren of tumor, depth of invasion, lymph node involvement, or tumor differentiation were observed in any of the analyzed groups of tumors. Patients with more advanced Barrett

  1. 中国贲门癌流行概况%Epidemiology of gastric cardia cancer in China

    Institute of Scientific and Technical Information of China (English)

    彭侠彪; 陈万青; 陈志峰; 梁智恒; 欧志雄; 魏矿荣

    2014-01-01

    国内现有贲门癌流行病学资料甚少,且主要为食管胃癌高发区资料;贲门癌多发于食管胃癌高发区,但流行趋势与食管胃癌相反;由于定义、诊断和编码等问题,缺乏贲门解剖部位所发生癌症流行病学资料;与食管胃癌相比,贲门癌可能病因不同。本文系统回顾了现有资料,对国内贲门癌的地域分布、发病水平、性别年龄、流行趋势和发病因素展开描述。%All current data available about epidemiology of gastric cardia cancer in China were reviewed thoroughly. It was found that few data existed, and mainly came from high incidence areas of Chinese esophageal and stomach cancer. Compared with the overall decline of esophageal and stomach cancer, the trend of gastric cardia cancer has been increasing. The real epidemiological data is hard to obtain as of such problems as definition, diagnosis and code;its etiology may be different from that of esophageal and stomach cancer. Based on the collected data, this paper is a general description of the distribution area, popularity, sex and gender preference, trend and etiology of gastric cardia cancer.

  2. “Layer-to-Layer” Esophagogastric Anastomosis Combined with Intrathoracic Esophageal Mucosal Extention in Patients with Esophageal and Cardia Cancer

    Institute of Scientific and Technical Information of China (English)

    SHIZhongqi; CAIPing; YANYu; CHENYinchun; LIUJunhua; YOUQinshen; CAIJixiang; XIZhongxia

    2005-01-01

    Objective: To evaluate the clinical value of intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosa extended varied in plane and to study the effective methods to prevent anastomotic leaking or stricture postoperatively. Methods: From May 1985 to December 2002, 2 240 esophageal and stomach cardia cancer patients treated by intrathoracic esophagogastric “layer-to-layer”anastomosis with esophageal mucosa extended varied in plane were retrospectively analyzed. Results:There was no anastomotic leaking and severe stricture in all above cases. Conclusion: Intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosal extended varied in plane is an effective method to prevent anastomotic leaking and stricture postoperatively.

  3. An Asian population-based survival analysis of patients with distal esophageal and gastric cardia adenocarcinomas

    Institute of Scientific and Technical Information of China (English)

    ZHENG Bin; ZHENG Wei; ZHU Yong,; WU Wei-dong; CHEN Chun

    2012-01-01

    Background Gastroesophageal junction adenocarcinomas include adenocarcinomas of the distal esophagus(DE)and gastric cardia(GC).It is controversial whether these tumors are the same entity and whether they have the same survival rates.Patients with DE and GC adenocarcinomas have a similar survival rate in the US;however,data are lacking in Asian countries.Therefore,we conducted a retrospective study to understand the implications of the tumor location in the survival of Asian patients.Methods A total of 209 patients with pathologically confirmed DE and GC adenocarcinomas,from 2005 to 2007,were included in the study.We identified patients with adenocarcinomas of the DE(DE group,n=91)and GC(GC group)(n=118).We performed an unadjusted survival analysis using the Kaplan-Meier method,and used a Cox proportional hazards regression model to adjust for potential confounding covariates.Results We found no significant difference between the overall survival of the DE and GC groups.The 3-year survival rates were 44.8% and 53.0%,respectively,and the 5-year survival rates were 27.9% and 30.2%,respectively(P=0.162).We found no significant difference in early staging,advanced staging,different T staging,and different N staging,between the groups.Both advanced post-operative N staging and advanced AJCC staging had a significant adverse effect on survival.Conclusions Patients with DE and GC adenocarcinomas have similar survival rates in the Asian population.Both post-operative N staging and AJCC staging are prognostic factors.

  4. Longitudinal association of body mass index with lung function: The CARDIA Study

    Directory of Open Access Journals (Sweden)

    Barr R Graham

    2008-04-01

    Full Text Available Abstract Background Lung function at the end of life depends on its peak and subsequent decline. Because obesity is epidemic in young adulthood, we quantified age-related changes in lung function relative to body mass index (BMI. Methods The Coronary Artery Risk Development in Young Adults (CARDIA study in 1985–86 (year 0 recruited 5,115 black and white men and women, aged 18–30. Spirometry testing was conducted at years 0, 2, 5 and 10. We estimated 10 year change in FVC, FEV1 and FEV1/FVC according to baseline BMI and change in BMI within birth cohorts with initial average ages 20, 24, and 28 years, controlling for race, sex, smoking, asthma, physical activity, and alcohol consumption. Measurements and Main Results Participants with baseline BMI 2 experienced 10 year increases of 71 ml in FVC and 60 ml in FEV1 and neither measure declined through age 38. In contrast, participants with baseline BMI ≥ 26.4 kg/m2 experienced 10 year decreases of 185 ml in FVC and 64 ml in FEV1. FEV1/FVC increased with increasing BMI. Weight gain was also associated with lung function. Those who gained the most weight over 10 years had the largest decrease in FVC, but FVC increased with weight gain in those initially thinnest. In contrast, FEV1 decreased with increasing weight gain in all participants, with maximum decline in obese individuals who gained the most weight during the study. Conclusion Among healthy young adults, increasing BMI in the initially thin participants was associated with increasing then stable lung function through age 38, but there were substantial lung function losses with higher and increasing fatness. These results suggest that the obesity epidemic threatens the lung health of the general population.

  5. Age, smoking and overweight contribute to the development of intestinal metaplasia of the cardia

    Institute of Scientific and Technical Information of China (English)

    Christian Felley; Hanifa Bouzourene; Marianne Bründler G VanMelle; Antoine Hadengue; Pierre Michetti; Gian Dorta; Laurent Spahr; Emiliano Giostra; Jean Louis Frossard

    2012-01-01

    AIM:To assess the role of Helicobacterpylori (H.pylori),gastroesophageal reflux disease (GERD),age,smoking and body weight on the development of intestinal metaplasia of the gastric cardia (IMC).METHODS:Two hundred and seventeen patients scheduled for esophagogastroduodenoscopy were enrolled in this study.Endoscopic biopsies from the esophagus,gastroesophageal junction and stomach were evaluated for inflammation,the presence of H.pylori and intestinal metaplasia.The correlation of these factors with the presence of IMC was assessed using logistic regression.RESULTS:IMC was observed in 42% of the patients.Patient age,smoking habit and body mass index (BMI)were found as potential contributors to IMC.The risk of developing IMC can be predicted in theory by combining these factors according to the following formula:Risk of IMC =a + s-2B where a =2,...6 decade of age,s =0for non-smokers or ex-smokers,1 for < 10 cigarettes/d,2 for > 10 cigarettes/d and B =0 for BMI < 25 kg/m2 (BMI < 27 kg/m2 in females),1 for BMI > 25 kg/m2 (BMI > 27 kg/m2 in females).Among potential factors associated with IMC,H.pylori had borderline significance (P =0.07),while GERD showed no significance.CONCLUSION:Age,smoking and BMI are potential factors associated with IMC,whileH.pylori and GERDshow no significant association.IMC can be predicted in theory by logistic regression analysis.

  6. Clinicopathological characteristics of Barrett's carcinoma, cardia carcinoma type II and distal gastric carcinoma: Influence of observed parameters on the five-year postoperative survival of patients

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2009-01-01

    Full Text Available Introduction. In the past two decades, the increased frequency of distal esophageal adenocarcinoma, esophagogastric junction and proximal gastric adenocarcinoma has been observed. The vast majority of these tumours are diagnosed in advanced stages, when the prognosis is poorer than in other gastric cancers. Objective. The aim of our study was to analyze the demographic and clinicopathological characteristics of patients operated on for Barrett's, cardia and distal gastric adenocarcinomas, as well as to study the influence of manifestations of each cancerogenetic indication on the studied clinicopathological parameters and to analyze the 5-year survival rate of patients surgically treated for cardia adenocarcinoma in relation to the patients operated on for distal gastric adenocarcinoma. Methods. We analyzed gender and age, tumour type, depth of tumour invasion, involvement of blood and lymph vessels in 66 patients surgically treated at the Centre for Oesophageal Surgery of the Institute for Digestive Diseases of the Belgrade Clinical Centre. Results. Except for significant differences in the depth of tumour invasion during surgery, there were no other statistically significant differences between the studied groups of patients. In the patients operated on for Barrett's and cardia cancers, the tumours invaded more deeply the wall layers, i.e. they were significantly more invasive than the distal gastric tumour. The lymph node involvement was present in 87.5% of patients with Barrett's cancer, in 80% with cardia cancer and in 87% with distal gastric cancer. The 3-year survival rate of patients operated on for cardia cancer was 47.4% and the 5-year survival rate was 31.6%, while the 3-year survival rate of patients operated on for distal gastric cancer was 46.2% and the 5-year survival rate was 34.6%. These differences were not statistically significant (Wilcoxon 0,036; p=0,85. Singly, the patients' gender, cancer type and the degree of tumour

  7. Cytochrome p450 2E1 polymorphisms and the risk of gastric cardia cancer

    Institute of Scientific and Technical Information of China (English)

    Lin Cai; Zong-Li Zheng; Zuo-Feng Zhang

    2005-01-01

    AIM: Genetic polymorphisms of drug-metabolizing enzymes have recently been shown to affect susceptibility to chemical carcinogenesis. Cytochrome P450 2E1 (CYP2E1)enzyme catalyzes the metabolism of many procarcinogens,such as N-nitrosamines and related compounds. The gene coding for this enzyme is polymorphic and thus may play a role in gastric cardia cancer (GCC) etiology. In this hospital-based case-control study, we evaluate the relationship between genetic polymorphisms of CYP2E1and the risk of GCC.METHODS: The study subjects comprised 159 histologically confirmed GCC cases identified via hospital cancer registry and surgical records at five hospitals in Fuzhou, Fujian Province, China, between April and November 2001.Controls were 192 patients admitted to the same hospitals for nonmalignant conditions. The genotypes of CYP2E1were detected by a PCR-based RFLP assay. The odds ratios were estimated by logistic regression analyses and were adjusted for potential confounding factors.RESULTS: The distribution of three genotypes of CYP2E1in GCC cases and controls was significantly different (X2 = 16.04, P<0.01). The frequency of the CYP2E1 (c1/c1)genotype in GCC cases and controls was 60.4% and 40.1%,respectively. The CYP2E1 (c1/c1) genotype was associated with an increased risk for GCC (the adjusted (OR) was 2.37, 95% confidence interval (CI): 1.52-3.70). Subjects who carried the CYP2E 1 (c1/c1) genotype and were habitual smokers were at a significantly higher risk of developing GCC (OR = 4.68, 95%CI: 2.19-10.04) compared with those who had the CYP2E1 (c1/c2or c2/c2') genotype and did not smoke.CONCLUSION: These results suggest that the CYP2E 1genotype may influence individual susceptibility to development of GCC, and that the risk increases significantly in smokers.

  8. Prognosis in adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia evaluated by uPAR-immunohistochemistry

    DEFF Research Database (Denmark)

    Laerum, Ole Didrik; Ovrebo, Kjell; Skarstein, Arne;

    2012-01-01

    Adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia in humans are highly invasive tumours with poor prognosis. The localisation of urokinase-type plasminogen activator receptor (uPAR) was determined in 66 patients; 60 with adenocarcinomas and six cases with Barrett......'s oesophagus. uPAR was expressed in nearly all cases of invasive adenocarcinomas by populations of cancer cells, macrophages and myofibroblasts at both the invasion front and the tumour core. In areas with high-grade dysplasia or with Barrett's metaplasia adjacent to the tumour tissue, no u......PAR-positive macrophages. Scoring of uPAR-positivity might be a useful parameter for onset of invasion and prognosis in these adenocarcinomas....

  9. 26. Relationship between ABO Blood Groups and Carcinoma of Esophagus and Cardia in Chaoshan Littoral of China

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abstract: Background. Chaoshan is the only littoral among the six high-risk areas of esophageal carcinoma (EC) in China and the relatively isolatal society for the inconvenient transport gives an opportunity to study the genetics of carcinoma of esophagus and cardia. Some reports had suggested that ABO blood groups were associated with tumors, but their relation remained controversial. Methods: The data of age, sex, ABO blood type and X-ray or pathological diagnosis of the patients with carcinoma of esophagus or cardia were collected from The tumor hospital, First affiliated hospital, Second affiliated hospital of Shantou University Medical College; the Center hospital of Shantou and the Center hospital of Jieyang. In this study, 6 685 patients with EC and 2 955 patients with cardiac cancer(CC) in Chaoshan district were retrospectively assessed the association with ABO blood groups. Results: The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, there was 2.3% excess of blood group B in male patients with CC and 4.7% excess in the patients with carcinoma in the upper third esophagus, compared with the corresponding controls. The relative risk B:O was 1.1415 (P<0.05) and 1.2696 (P<0.05), respectively No relationship between ABO blood groups and tumor differentiation was found. Conclusion: ABO blood group B was associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varied in the different geographical and ethnic groups, as a result, proper controls were very important for such study.

  10. E-cadherin gene C-160A promoter polymorphism and risk of non-cardia gastric cancer in a Chinese population

    Institute of Scientific and Technical Information of China (English)

    Yan Lu; Yao-Chu Xu; Jing Shen; Rong-Bin Yu; Ju-Yin Niu; Jian-Tao Guo; Xu Hu; Hong-Bing Shen

    2005-01-01

    AIM: To test the hypothesis that E-cadherin gene (CDH1)C-160A promoter variant genotype is associated with an increased risk for developing gastric cancer.METHODS: In this population-based case-control study of gastric cancer in Jiangsu Province, China, we performed polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to genotype the C-160A polymorphism of CDH1 promoter in 206 non-cardia gastriccancer patients and 261 age- and sex-matched but unrelated cancer-free controls.RESULTS: The frequencies of genotypes CC, CA and AA were 57.8%, 36.4% and 5.8% in gasfric cancer cases,respectively, and 58.2%, 34.9% and 6.9% in controls respectively. The distributions of CDH1 genotypes were not significantly different between gastric cancer cases and controls (P = 0.87 for genotype frequency and P = 0.92for allele frequency). Compared with the CC genotype, the CA and AA genotypes were not associated with an increased risk for non-cardia gastric cancer (adjusted odds ratios (OR)= 1.15, and 95% confidence interval (95% CI) = 0.78-1.72for CA genotype, and OR = 0.90 and 95% CI = 0.42-2.01for AA genotype).CONCLUSION: E-cadherin gene C-160A promoter polymorphism may not play a major role in the etiology of non-cardia gastric cancer in Chinese population.

  11. [Critical assessment of a new endoscopic anatomic concept for the so-called cardia in the sense of the notions of Parmenides and Martin Heidegger].

    Science.gov (United States)

    Riegler, M; Asari, R; Cosentini, E P; Wrba, F; Schoppmann, S F

    2014-04-01

    Current endoscopic anatomy interposes the gastric cardia between the tubular oesophagus and the proximal stomach. In contrast to that, recent evidence unfolds a different view. Using "PubMed" and "Scopus" searches, we examined if the novel understanding regarding the cardia goes in line with the concept of unfolding, as described by Heidegger based on the ancient didactic poetry of Parmenides. What has been taken as gastric cardia in fact represents reflux-damaged, dilated, columnar lined oesophagus (CLO): dilated distal oesophagus (DDO). Due to its macroscopic gastric appearance it cannot be discriminated from the stomach by endoscopy. Differentiation between DDE and proximal stomach requires the histopathology of measured multi-level biopsies obtained from the DDO and the proximal stomach. Cardaic, onxytocardiac mucosa and intestinal metaplasia (IM; Barrett's oesophagus) define CLO and thus the oesophageal location, while oxyntic mucosa (OM) of the proximal stomach verifies a gastric biopsy location. Endoscopically visible CLO and DDO define the morphological manifestation of reflux: the squamo-oxyntic gap (SOG). Biopsies obtained from the level of the diaphragmatic impressions allow differentiation between an enlarged hiatus with normal anatomic content (CLO; oesophagus) vs. hernia with abnormal content (OM; stomach). Non-dysplastic Barrett's oesophagus exists in 10 %-17 % of asymptomatic and in 20 %-100 % (with increasing CLO length) of reflux symptom-positive individuals (annual cancer risk: 0.2 %-0.7 %). These data justify biopsy of an endoscopically normal appearing squamocolumnar junction for the exclusion of Barrett's oesophagus and cancer risk. In the absence of contraindications, cancer risk-based therapy of dysplastic Barrett's oesophagus includes radiofrequency ablation (RFA) ± endoscopic resection. The perception of the cardia as reflux damaged DDO mirrors the concept of unfolding, as described by the interpretation of the didactic poem

  12. Concomitant chemoradiotherapy with folfox-cetuximab in stage III oesophagus and cardia carcinomas: final results of the phase-II Erafox study of the Gercor group; Chimioradiotherapie concomitante par folfox-cetuximab dans les carcinomes du cardia et de l'oesophage de stade III: resultats definitifs de l'etude de phase II Erafox du groupe Gercor

    Energy Technology Data Exchange (ETDEWEB)

    Lledo, G.; Mammar, V.; Michel, P. [Hopital Jean-Mermoz, Lyon (France); Dahan, L. [CHU Rouen, Rouen (France); Mineur, L.; Dupuis, O. [Institut Sainte-Catherine, 84000 Avignon (France); Galais, M.P. [CHU Timone, Marseille (France); Chibaudel, B. [InstitutJean-Godinot, Reims (France); Jovenin, N. [Gercor, Paris (France); Gramont, A. de [Hopital Saint-Antoine, Paris (France)

    2011-10-15

    The authors report and discuss the results of a French national multicentre study which aimed at assessing the efficiency and tolerance of a folfox- and cetuximab-based chemotherapy concomitant with a radiotherapy for the treatment of stage-III cardia and oesophagus cancers. Patients (60 men and 19 women) have been selected according to the carcinoma type, performance index, age, weight loss over the last six months. Results are discussed in terms of response, steadiness, advancement, grade 3 and 4 toxicity, and side effects. The therapeutic efficiency corresponds to an objective response rate of 77 per cent, and tolerance profile seems to be acceptable for patients suffering from locally advanced cardia and oesophagus cancer. Short communication

  13. The gene expression profile of cardia intestinal metaplasia is similar to that of Barrett's esophagus, not gastric intestinal metaplasia.

    Science.gov (United States)

    Oh, D S; DeMeester, S R; Tanaka, K; Marjoram, P; Kuramochi, H; Vallbohmer, D; Danenberg, K; Chandrasoma, P T; DeMeester, T R; Hagen, J A

    2011-09-01

    The etiology and significance of cardia intestinal metaplasia (CIM) is disputed. CIM may represent a form of Barrett's esophagus due to reflux or could reflect generalized gastric intestinal metaplasia due to Helicobacter pylori. The aim of this study was to utilize gene expression data to compare CIM to Barrett's and gastric intestinal metaplasia. Endoscopic biopsies were classified by endoscopic and histologic criteria as CIM (n= 33), Barrett's (n= 25), or gastric intestinal metaplasia of the antrum or body (n= 18). The squamocolumnar and gastroesophageal junctions were aligned in CIM patients and patients with diffuse gastric intestinal metaplasia were excluded. H. pylori was tested for in the biopsies of all patients. After laser-capture microdissection, quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression of a panel of nine genes that has been shown to differentiate Barrett's from other foregut mucosa. Cluster analysis with linear discriminant analysis of the expression data was used to classify each sample into groups based solely on similarity of gene expression. Cluster analysis was performed for three groups (CIM vs. Barrett's vs. gastric intestinal metaplasia) and two groups (CIM + Barrett's vs. gastric intestinal metaplasia). There was no difference in H. pylori infection among groups (P= 0.66). Clustering into three groups resulted in frequent misclassification between CIM and Barrett's while misclassification of gastric intestinal metaplasia was uncommon. The CIM and Barrett's groups were then combined for two group clustering and linear discriminant analysis correctly predicted 95% of CIM and Barrett's samples and 83% of gastric intestinal metaplasia samples based on gene expression alone. In conclusion, the gene expression profiles of CIM and Barrett's esophagus were similar in 95% of biopsies and differed significantly from that of gastric intestinal metaplasia. The indistinguishable gene

  14. Race- and sex-specific associations of parental education with insulin resistance in middle-aged participants: the CARDIA study.

    Science.gov (United States)

    Tamayo, Teresa; Jacobs, David R; Strassburger, Klaus; Giani, Guido; Seeman, Teresa E; Matthews, Karen; Roseman, Jeffrey M; Rathmann, Wolfgang

    2012-05-01

    Low childhood socioeconomic status (SES) has been linked with insulin resistance (HOMA-IR) in adulthood. Our aim was to examine if maternal and paternal education, as indicators of childhood SES, equally contributed to increased HOMA-IR in later life. Of 5,115 adults from the Coronary Artery Disease Risk Development in Young Adults (CARDIA) Study aged 18-30 years in 1985-1986, data on 1,370 females and 1,060 males with baseline and 20 year follow-up data were used to estimate associations of maternal and paternal education with HOMA-IR, adjusting for personal education, BMI, lipids, blood pressure, and lifestyle factors. Parental education was determined as high with ≥ 12 years of schooling and classified as both high, only mother high, only father high, both low education. Distinct combinations of maternal and paternal education were associated with HOMA-IR across race and sex groups. Lowest year 20 HOMA-IR in European American (EA) females occurred when both parents were better educated, but was highest when only the father had better education. HOMA-IR was lowest in African American (AA) participants when the mother was better educated but the father had less education, but was highest when both parents were better educated. Parental education was unrelated to HOMA-IR in EA males. Associations of parental education with HOMA-IR are seen in AA females, AA males, and EA females but not in EA males. The distinct combinations of parental education and their associations with HOMA-IR especially in AA participants need to be addressed in further research on health disparities.

  15. The neighborhood energy balance equation: does neighborhood food retail environment + physical activity environment = obesity? The CARDIA study.

    Directory of Open Access Journals (Sweden)

    Janne Boone-Heinonen

    Full Text Available BACKGROUND: Recent obesity prevention initiatives focus on healthy neighborhood design, but most research examines neighborhood food retail and physical activity (PA environments in isolation. We estimated joint, interactive, and cumulative impacts of neighborhood food retail and PA environment characteristics on body mass index (BMI throughout early adulthood. METHODS AND FINDINGS: We used cohort data from the Coronary Artery Risk Development in Young Adults (CARDIA Study [n=4,092; Year 7 (24-42 years, 1992-1993 followed over 5 exams through Year 25 (2010-2011; 12,921 person-exam observations], with linked time-varying geographic information system-derived neighborhood environment measures. Using regression with fixed effects for individuals, we modeled time-lagged BMI as a function of food and PA resource density (counts per population and neighborhood development intensity (a composite density score. We controlled for neighborhood poverty, individual-level sociodemographics, and BMI in the prior exam; and included significant interactions between neighborhood measures and by sex. Using model coefficients, we simulated BMI reductions in response to single and combined neighborhood improvements. Simulated increase in supermarket density (from 25(th to 75(th percentile predicted inter-exam reduction in BMI of 0.09 kg/m(2 [estimate (95% CI: -0.09 (-0.16, -0.02]. Increasing commercial PA facility density predicted BMI reductions up to 0.22 kg/m(2 in men, with variation across other neighborhood features [estimate (95% CI range: -0.14 (-0.29, 0.01 to -0.22 (-0.37, -0.08]. Simultaneous increases in supermarket and commercial PA facility density predicted inter-exam BMI reductions up to 0.31 kg/m(2 in men [estimate (95% CI range: -0.23 (-0.39, -0.06 to -0.31 (-0.47, -0.15] but not women. Reduced fast food restaurant and convenience store density and increased public PA facility density and neighborhood development intensity did not predict reductions

  16. Alterations of p53 and PCNA in cancer and adjacent tissues from concurrent carcinomas of the esophagus and gastric cardia in the same patient in Linzhou, a high incidence area for esophageal cancer in northern China

    Institute of Scientific and Technical Information of China (English)

    Hong Chen; Li-Dong Wang; Mei Guo; She-Gan Gao; Hua-Qin Guo; Zong-Min Fan; Ji-Lin Li

    2003-01-01

    AIM: To characterize the alteration and significance of p53and PCNA in cancer and adjacent tissues of concurrent cancersfrom the esophagus and gastric cardia in the same patient.METHODS: P53 and PCNA protein accumulation in 25patients with concurrent cancers from the esophagus andgastric cardia (CC, concurrent carcinomas of esophagealsquamous cell carcinoma and gastric cardia adenocarcinoma)were detected by immunohistochemical method (ABC).RESULTS: In CC patients, both esophageal squamous cellcarcinoma (SCC) and gastric cardia adenocarcinoma (GCA)tissues showed different positive immunostaining extent ofp53 and PCNA protein (P>0.05). The positive immunostainingrates for p53 and PCNA were 60 % (15/25) and 92 % (23/25), respectively in SCC; and 40 % (10/25) and 88 % (22/25), respectively in GCA. "Diffuse" immunostaining patternwas frequently observed in both p53 and PCNA. Highcoincidence rates for p53 and PCNA positive staining wereobserved in SCC and GCA from the same patients, andaccounted for 56 % and 96 %. In SCC patients, with thelesions progressed from normal esophageal epithelium (NOR)to basal cell hyperplasia (BCH) to dysplasia (DYS) tocarcinomain situ (CIS) to SCC, the positive rates for p53were 27 %, 50 %, 50 %, 29 % and 72 %, and 55 %, 70 %,75 %, 71% and 93 % for PCNA, respectively. In GCA, withthe lesions progressed from normal gastric cardia epitheliumto DYS to CIS to GCA, the positive rates of p53 expressionwere 44 %, 27 %, 22 % and 36 % respectively, the differencewas not significant; the positive rates of PCNA proteinexpression were 67 %, 64 %, 67 % and 86 %, respectively.The x2 test, Fisher's Exact Test, Mantel-Haenszel x2 Testand Kappa Test were used for the statistics.CONCLUSION: The high coincident alterations for P53 andPCNA in SCC and GCA from the same patient indicate thepossibility of similar molecular basis, which providesimportant molecular basis and etiological clue for similargeographic distribution and risk factors in SCC and GCA.

  17. [Application of a suspending abdominal retractor and stapling device in resection of carcinoma of the gastric cardia using a trans diaphragm approach].

    Science.gov (United States)

    Lin, C H

    1989-10-01

    The article describes the structure assemblage and Clinical application of a Suspending abdominal retractor. From the experience gained in 40 cases of cardial carcinoma operated on, it was found that the device has the following advantages: (1) there is no need for a thoracotomy, and hence the operative trauma is much reduced; (2) good exposure of the upper abdomen and lower mediastinum; (3) adequate length of the lower esophagus and as many as 110 lymph nodes can be resected. Postoperative complications were relatively few. The incidence of residual carcinoma at the esophageal Stump was 2.5%, being much lower than in cases using a single abdominal incision, and similar to those using a combined left thoracoabdominal incision. It was concluded that this operative approach, applying the device recommended, is a relatively ideal procedure for resection of carcinoma of the gastric cardia, especially in elderly patients with poor general health.

  18. X-ray Diagnosis of Gastric Cardia Cancer Causes for Misdiagnosis%胃底贲门癌X线诊断漏诊原因分析与管理

    Institute of Scientific and Technical Information of China (English)

    高越

    2015-01-01

    目的:探讨运用X线诊断胃底贲门癌时,出现漏诊的原因。方法分析2014年2月-2015年2月35例胃底贲门癌漏诊患者的临床资料。结果35例漏诊原因分别为:12例患者大口吞钡;10例患者胃泡气体不足;8例患者未进行空腹检查;5例患者为粘膜聚集。结论胃底贲门癌的疾病特点比较复杂,漏诊原因较多,采取多种措施,可以提高诊断率。%Objective To investigate the application of X-ray diagnosis of gastric cardia carcinoma, appear the causes of misdiag-nosis. Methods Clinical data of 35 cases of gastric cardia cancer misdiagnosed patients from Feb. 2014 Feb. 2015. Results 35 cas-es of missed diagnosis were as follows: 12 cases of patients with barium swallow, 10 cases of patients with stomach gas deficiency;8 patients without fasting examination; 5 patients for mucosal aggregation. Conclusion The characteristics of gastric cardia cancer is complicated, and the reasons of missed diagnosis are more. If we take some measures, the diagnosis rate can be improved.

  19. 近端胃切除术和全胃切除术治疗贲门癌%Surgical treatment effects in cancer of the cardia and esophagogastric junction

    Institute of Scientific and Technical Information of China (English)

    Yumin Zhou; Jiong Pan; Yuwei Sheng; Hao Liu; Ziping Fan

    2007-01-01

    Objective:To evaluate the treatment effects of total gastrectomy(TG)and proximal gastrectomy(PG) for cancer of the cardia and esophagogastric junction.Methods:forty-five patients with cancer of the cardia and esophagogastric junction underwent surgical resection.Of them.29 were treated using proximal gastrectomy and 16 total gastrectomy.The 3-year and 5-year survival rate and the postoperative complication rate and mortality rate were followed up and compared between the two groups.Results:The 3-year and 5-year survival rates of group PG were 44.8%and 20.7%.of group TG were 37.5% and 18.8%,respectively,and the differences were not statistically significant(χ2=3.84,P>0.05;χ2=3.89,P>0.05).The postoperative complication and mortality rate of group PG were 13.7%and 6.8%.of group TG was all 6%.respectively.Conclusio:Proximal and total gastrectomy treatment effects can not significantly influence the prognosis of patients in progressive stage of cancer of cardia and esophagogastric junction.

  20. Histochemical studies on intestinal metaplasia adjacent to gastric cardia adenocarcinoma in subjects at high-incidence area in Henan, north China

    Institute of Scientific and Technical Information of China (English)

    She-Gan Gao; Hua-Qin Guo; Jun-Kuan Wang; Xiao-Shan Feng; Bao-Gen Ma; Li-Dong Wang; Zong-Min Fan; Ji-Lin Li; Xin He; Rui-Feng Guo; Dong-Ling Xie; Xin-Wei He; Shan-Shan Gao

    2005-01-01

    AIM: To characterize the histochemical type and pattern of intestinal metaplasia (IM) adjacent to gastric cardia adenocarcinoma (GCA) and distal gastric cancer (GC) in Linzhou, Henan Province, China.METHODS: Alcian-blue-periodic acid Schiff and high iron diamine-Alcian blue histochemical methods were performed on 142 cases of IM, including 49 cases of GCA and 93 cases of GC. All the patients were from Linzhou, Henan Province, China, the highest incidence area for both GCA and squamous cell carcinoma. Radio- or chemotherapy was not applied to these patients before surgery.RESULTS: The detection rate of IM in tissues adjacent to GCA tissues was 44.9%, which was significantly lower than that in GC tissues (80.64%, P<0.01). The rates of both incomplete small intestinal and colonic IM types identified by histochemistry in GCA tissues (31.82% and 63.64%, respectively) were significantly higher than those in GC (5.33% and 21.33%, respectively, P<0.01).CONCLUSION: IM in GCA and GC should be considered as a separate entity. Further research is needed to evaluate whether neoplastic progression of IM is related to its mucin profile in GCA.

  1. Fast food price, diet behavior, and cardiometabolic health: differential associations by neighborhood SES and neighborhood fast food restaurants in the CARDIA Study

    Science.gov (United States)

    Gordon-Larsen, Penny; Rummo, Pasquale E.; Meyer, Katie A.; Howard, Annie Green; Shikany, James M.; Guilkey, David K.

    2015-01-01

    Little research has addressed whether neighborhood context influences associations between fast food price, diet, and cardiometabolic health. We investigated these associations using 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data (n=4,469, observations=21,134). We found a negative association between fast food price and consumption, with stronger inverse associations in more (vs. less) deprived neighborhoods [3rd tertile: β=−0.68 (95% CI: (−0.85, −0.51); 1st tertile: β=−0.22 (95% CI: −0.42, −0.02) ; p-interaction-0.002], and a similar association for BMI [3rd tertile: β=−1.34 (95% CI: −1.54, −1.14); 1st tertile: β=−0.45 (95% CI: −0.66, −0.25); p-interaction<0.001], but not insulin resistance [3rd tertile: β=− 0.07 (95% CI: −0.24, 0.09); 1st tertile: β=0.09 (95% CI: −0.08, 0.26); p-interaction=0.40]. We observed no modification of fast food price by fast food availability. Future research on obesity disparities should consider potential differences in the association between fast food prices and health outcomes across neighborhood socioeconomic levels. PMID:26319447

  2. Fast food price, diet behavior, and cardiometabolic health: Differential associations by neighborhood SES and neighborhood fast food restaurant availability in the CARDIA study.

    Science.gov (United States)

    Rummo, Pasquale E; Meyer, Katie A; Green Howard, Annie; Shikany, James M; Guilkey, David K; Gordon-Larsen, Penny

    2015-09-01

    Little research has addressed whether neighborhood context influences associations between fast food price, diet, and cardiometabolic health. We investigated these associations using 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data (n=4,469, observations=21,134). We found a negative association between fast food price and consumption, with stronger inverse associations in more (vs. less) deprived neighborhoods [3rd tertile: β=-0.68 (95% CI: (-0.85, -0.51); 1st tertile: β=-0.22 (95% CI: -0.42, -0.02); p-interaction-0.002], and a similar association for BMI [3rd tertile: β=-1.34 (95% CI: -1.54, -1.14); 1st tertile: β=-0.45 (95% CI: -0.66, -0.25); p-interaction<0.001], but not insulin resistance [3rd tertile: β=-0.07 (95% CI: -0.24, 0.09); 1st tertile: β=0.09 (95% CI: -0.08, 0.26); p-interaction=0.40]. We observed no modification of fast food price by fast food availability. Future research on obesity disparities should consider potential differences in the association between fast food prices and health outcomes across neighborhood socioeconomic levels.

  3. Associations of retrospective and concurrent lipid levels with subclinical atherosclerosis prediction after 20 years of follow-up: the Coronary Artery Risk Development in Young Adults (CARDIA) study

    Science.gov (United States)

    Raynor, Lewis A.; Schreiner, Pamela J.; Loria, Catherine M.; Carr, J. Jeffrey; Pletcher, Mark J.; Shikany, James M.

    2017-01-01

    Purpose Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we sought to determine how well lipids measured at baseline and at 20 years predict the presence of subclinical atherosclerosis. Methods Complete risk factor, coronary artery calcification (CAC), and carotid intima media thickness (CIMT) data were available for 2435 participants. Lipids were categorized into quartiles, CAC at Y20 was dichotomized as present/absent, and CIMT was dichotomized as ≥84 or <84th overall percentile. Multivariable logistic regression was used to model the association between lipids and CAC/CIMT. C statistics were used to assess the discriminative value of each lipid measure in predicting the presence of CAC or CIMT at Y20. Results Lipid levels measured in young adulthood as well as middle age were both associated with subclinical disease in middle age. The discriminatory value of lipids was virtually identical at baseline, when participants were 18–30 years of age, and 20 years later. Neither baseline nor Y20 lipid data were strong predictors of Y20 subclinical disease despite statistically significant associations. Conclusions These results are consistent with a growing body of evidence that early-life exposure to nonoptimal lipids matters and lifestyle modifications administered earlier in the lifespan could slow the progress of the atherosclerotic plaques. PMID:23889858

  4. Despite shared susceptibility loci, esophageal squamous cell carcinoma embraces more familial cancer than gastric cardia adenocarcinoma in the Taihang Mountains high-risk region of northern central China

    Institute of Scientific and Technical Information of China (English)

    WEN Deng-gui; YANG Yi; WEN Xiao-duo; SHAN Bao-en

    2013-01-01

    Background In China,esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) share susceptibility loci,but different rates of multiple primary cancer and male/female ratio suggest the proportion of familial cancer is not equal.Methods The percent of cases with a positive family history,median onset age,rate of multiple primary cancer,and male/female ratio associated with upper,middle,lower third ESCC and GCA were compared to reveal the proportion of familial cancer.The 7267 subjects analyzed constituted all ESCC and GCA cases in whom the cancer was resected with cure intention between 1970 and 1994 at the 4th Hospital of Hebei Medical University.Results A positive family history for cancer was most often associated with the multiple primary ESCC and/or GCA cases,e.g.with 42% of the males and 59% of the females.For upper,middle,lower third ESCC and GCA,the percent of cases with a positive family history decreased by 38.5%,26.3%,26.5%,and 11.2% in males (P <0.000) and 25.0%,22.3%,23.9%,and 9.8% in females (P <0.0001).Median onset age increased from 49,52,55,to 56 years old in males and from 50,53,55,to 56 years old in females (both P <0.0001) for upper,middle,lower third ESCC and GCA.Male/female ratio increased from 2.2,2.1,2.2,to 6.2:1 for upper,middle,lower third ESCC and GCA (P<0.0001).For upper,middle,lower third ESCC and GCA,the percent of multiple primary cancers decreased from 21.2%,2.3%,2.2%,to 1.5% in males and from 14.3%,2.4%,3.4%,to 3.1% in females.The preponderance of males,smoking,drinking,or onset-age ≥50 years was significantly higher in GCA than in ESCC,and the difference in the rates of multiple primary cancers between the preponderant and the non-preponderant cases was significant in GCA,but not in ESCC,suggesting non-equal requirement for genetic susceptibility when environmental hazards did not exist.Conclusions The proportion of familial cancer in upper gastrointestinal

  5. Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: results from the CARDIA study.

    Science.gov (United States)

    Black, C N; Penninx, B W J H; Bot, M; Odegaard, A O; Gross, M D; Matthews, K A; Jacobs, D R

    2016-02-23

    Depression may be accompanied by increased oxidative stress and decreased circulating anti-oxidants. This study examines the association between depressive symptoms, F2-isoprostanes and carotenoids in a US community sample. The study includes 3009 participants (mean age 40.3, 54.2% female) from CARDIA (Coronary Artery Risk Development in Young Adults). Cross-sectional analyses were performed on data from the year 15 examination (2000-2001) including subjects whose depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and had measurements of plasma F2-isoprostanes (gas chromatography/mass spectrometry) or serum carotenoids (high-performance liquid chromatography). Carotenoids zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, β-carotene were standardized and summed. Longitudinal analyses were conducted using the data from other examinations at 5-year intervals. Cross-lagged analyses investigated whether CES-D predicted F2-isoprostanes or carotenoids at the following exam, and vice versa. Regression analyses were controlled for sociodemographics, health and lifestyle factors. F2-isoprostanes were higher in subjects with depressive symptoms (CES-D ⩾ 16) after adjustment for sociodemographics (55.7 vs 52.0 pg ml(-1); Cohen's d = 0.14, P depression predicts subsequent F2-isoprostane and carotenoid levels. Neither F2-isoprostanes nor carotenoids predicted subsequent depression. In conclusion, depressive symptoms were cross-sectionally and longitudinally associated with increased F2-isoprostanes and decreased carotenoids. The association with F2-isoprostanes can largely be explained by lifestyle factors, but lower carotenoids were independently associated with depressive symptoms.

  6. Is surgical treatment of cancer of the gastric cardia or esophagus associated with a concurrent major pulmonary operation feasible?One center's experience

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-xin; LIU Tong-lin; WANG Pei; LI Jian

    2012-01-01

    Background Pulmonary complications are a major cause of mortality after operation for cancer of the gastric cardia or esophagus.Although the risk involved in gastric cardiectomy or esophagectomy associated with a concurrent major pulmonary operation is expected to be much higher,it has seldom been evaluated on the basis of clinical experience.The aim of this study was to investigate the possibility and feasibility of the gastric cardiectomy or esophagectomy associated with a major pulmonary operation.Methods From August 2003 to January 2011,14 patients underwent concurrent gastric cardiectomy or esophagectomy and a major pulmonary operation in our hospital.This included eight for pulmonary invasion of esophageal carcinoma,and six for synchronous lung tumor.All patients underwent systematic lymph node dissection for cardiac or esophageal cancer.To prevent postoperative complications,the operative approach and dissection procedures for cardiac or esophageal carcinoma were modified according to the associated pulmonary operation and the extent of cancer invasion.All thoracotomies for cardiectomy or esophagectomy were performed on the same side as the major pulmonary operation.Results All patients underwent a curative operation.There were no deaths or postoperative complications in the six synchronous lung tumor patients.In the eight pulmonary invasion patients,one patient died of respiratory failure 11 days after operation,and postoperative complications developed in four of them,but none was fatal.Six patients were still alive.Conclusions Curative gastric cardiectomy or esophagectomy associated with concurrent major pulmonary operation is not contraindicated in patients in good condition.In selected patients,when the operative procedures for cardiectomy or esophagectomy are appropriately modified to minimize the effect of the associated pulmonary operation,the treatment is associated with a low operative morbidity and mortality with an acceptable long-term survival.

  7. How do individual-level sociodemographics and neighbourhood-level characteristics influence residential location behaviour in the context of the food and built environment? Findings from 25 years of follow-up in the CARDIA Study

    Science.gov (United States)

    Rummo, Pasquale E; Guilkey, David K; Shikany, James M; Reis, Jared P; Gordon-Larsen, Penny

    2017-01-01

    Background Little is known about how diet-related and activity-related amenities relate to residential location behaviour. Understanding these relationships is essential for addressing residential self-selection bias. Methods Using 25 years (6 examinations) of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study (n=11 013 observations) and linked neighbourhood-level data from the 4 CARDIA baseline cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; Oakland, California, USA), we characterised participants’ neighbourhoods as having low, average or high road connectivity and amenities using non-hierarchical cluster analysis. We then used repeated measures multinomial logistic regression with random effects to examine the associations between individual-level sociodemographics and neighbourhood-level characteristics with residential neighbourhood types over the 25-year period, and whether these associations differed by individual-level income. Results Being female was positively associated with living in neighbourhoods with low (vs high) road connectivity and activity-related and diet-related amenities among high-income individuals only. At all income levels, a higher percentage of neighbourhood white population and neighbourhood population physical activity opportunities, and may help mitigate residential self-selection bias in built environment studies. PMID:27660400

  8. Candidate Genes from Molecular Pathways Related to Appetite Regulatory Neural Network and Adipocyte Homeostasis and Obesity: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

    Science.gov (United States)

    Friedlander, Yechiel; Li, Guo; Fornage, Myriam; Williams, O. Dale; Lewis, Cora E.; Schreiner, Pamela; Pletcher, Mark J.; Enquobahrie, Daniel; Williams, Michelle; Siscovick, David S.

    2010-01-01

    Background Appetite regulatory neural network and adipocyte homeostasis molecular pathways are critical to long-term weight maintenance. Genetic variation in these pathways may explain variability of obesity in the general population. Aims The associations of four genes in these pathways (leptin (LEP), leptin receptor (LEPR), neuropeptide Y2 receptor (NPY2R) and peptide YY (PYY)) with obesity-related phenotypes were examined among participants in the CARDIA Study. Participants were 18-30 years old upon recruitment (1985-86). Weight, BMI and waist circumference were measured at baseline and at years 2, 5, 7, 10, 15, and 20. Genotyping was conducted using tag SNPs that characterize the common pattern of genetic variation in these genes. Race-specific linear regression models were used to examine associations of the various SNPs with obesity-related measurements, controlling for sex and age. The overall association based on the 7 repeated anthropometric measurements was tested with GEE. False discovery rate was used to adjust for multiple testing. Results In African-Americans, SNPs across the LEP gene demonstrated significant overall associations with obesity-related phenotypes. The associations between rs17151919 in LEP gene with weight tended to increase with time (SNP × time interaction p=0.0193). The difference in weight levels associated with each additional minor allele ranged from 2.6 kg at entry to 4.8 kg at year 20. Among African-American men, the global tests indicated that SNPs across the NPY2R gene were also associated with waist circumference measurements (p=0.0462). In Caucasians, SNPs across the LEP gene also tended to be associated with weight measurements (p=0.0471) and rs11684664 in PYY gene was associated with obesity-related phenotypes (p= 0.010-0.026) in women only. Conclusions Several SNPs in the LEP, NPY2R and PYY but not the LEPR genes were associated with obesity-related phenotypes in young adults. The associations were more prominent for the

  9. 山西省贲门癌患者血缘亲属患病风险比较研究%Studies on the risks of cardia neoplasm among immediate relatives of the patients in Shanxi province

    Institute of Scientific and Technical Information of China (English)

    王国平; 韩小友; 丁悌; 苏文; 李建民; 高泽锋

    2012-01-01

    目的 对比分析贲门癌病例组与对照组血缘亲属患病风险,了解家族中危险亲属人群患贲门癌的新线索.方法 采用病例对照方法,对贲门癌病例组和对照组各772例进行逐层分析,比较两组各血缘亲属父系、母系贲门癌患病相对危险度(RR)及差异.结果 (1)合计和男性病例组一级亲属贲门癌患病危险显著高于对照组(RR=2.61,95%CI:1.44~ 4.73,P<0.01).(2)以父系和母系亲属逐层分析,合计和男性病例组父系亲属贲门癌患病危险显著高于对照组(P<0.05),母系亲属中男性贲门癌患病危险显著高于对照组(P<0.05);进一步分析显示,合计和男性病例组中父系亲属中男性、母系亲属中女性贲门癌患病危险显著高于对照组(P<0.05).(3)贲门癌患者一级亲属患贲门癌危险度显著高于对照组(P<0.05).(4)贲门癌患者父系亲属与对照组患病危险的差异无统计学意义(P>0.05),贲门癌患者母系亲属患病危险显著高于对照组(P<0.05).结论 山西省贲门癌患者血缘亲属中贲门癌发病危险人群主要是一级亲属,应对此高风险人群开展防癌知识普及和筛查.%Objective To analyze the different risks of cardia neoplasms in the immediate relatives of the cardia cancer patients,through a case-control study.Methods A case-control study was adopted on 772 cases and 772 controls,and relative risk (RR) were measured to compare the results from patemal or matrilineal groups.Results (1)Risk of the 1st grade kinship to the male cardia-cancer-patient group was obviously higher than that of the control group with RR=2.61 (95%CI:1.44-4.73,P<0.01).(2) The risks of both paternal (P<0.05) and matrilineal (P<0.05) in the male cardia-cancer-patients were obviously higher than that of the control groups while the risk of those male cardia-cancer-patients in the paternal was higher than that of the control group (P<0.05),so as the case for female patients in the

  10. 食管癌、贲门癌术后胸胃瘘20例临床分析%A Clinical Analysis of 20 Cases of Thoracic Gastric Fistulas after Esophagectomy and Cardia Resection/

    Institute of Scientific and Technical Information of China (English)

    丁国文; 陈锁成; 孙斌; 董长青; 唐巍峰; 施益军; 邵爱中; 孙扬永; 顾海勇

    2012-01-01

      目的:探讨食管癌、贲门癌术后胸胃瘘的治疗方法。方法:对笔者所在医院20例胸胃瘘患者的治疗进行回顾性分析。早期胃瘘及后期瘘口较大的12例胃瘘进行再次手术,手术方式包括行胃瘘修补术7例,结肠代食管术2例,坏死胃壁及吻合口切除重新吻合2例,1例行扩清术;中晚期胃瘘瘘口较小的8例患者采用保守治疗,包括2例胸腔引流,6例经瘘口内引流。结果:20例患者中有17例治愈出院,3例死亡,死亡率15%。结论:食管癌贲门癌术后胃瘘的治疗方式,根据胃瘘发生的时间、范围而定,术后早期胃瘘及晚期胃瘘较大的病例选用手术治疗,术后晚期胃瘘瘘口小的病例适合保守治疗。%  Objective:To investigate the treatment of thoracic gastric fistulas after esophagectomy and cardia resection.Methods:Twenty cases with thoracic gastric fistulas after esophagectomy and cardia resection were enrolled in this study.12 cases with early gastric fistula and lager fistula were re-operated. Including gastric fistula repair (7 cases),colon replace esophagus (2 cases),re-anastomosis (2 cases) and dissection surgery (1 cases).8 cases with small fistulas in advanced gastric fistula were treated by conservative treatment.Including thoracic drainage (2 cases) and fistula drainage (6 cases).Results:Seventeen cases were cured,3 patients died,the mortality rate is 15%.Conclusion:The treatment of thoracic gastric fistulas after esophagectomy and cardia resection were depend on the time and size of fistulas.Early fistula and large fistula of advanced gastric fistula select operation.large fistula of advanced gastric fistula prefer conservative treatment.

  11. Effects of short-term parenteral nutrition support with chemotherapy on tumor cell kinetics in gastric cardia cancer patients%静脉营养支持对晚期贲门腺癌化疗效果的影响

    Institute of Scientific and Technical Information of China (English)

    刘建东; 魏文杰; 杨景国

    2001-01-01

    @@静脉营养支持对晚期贲门腺癌化疗效果的影响 刘建东  魏文杰  杨景国  Effects of short-term parenteral nutrition support with chemotherapy on tumor cell kinetics in gastric cardia cancer patients 作者单位:刘建东(北京普仁医院外科 100062)       魏文杰(北京普仁医院外科 100062)       杨景国(北京普仁医院外科 100062)

  12. Distribution and chemical coding patterns of cocaine- and amphetamine-regulated transcript-like immunoreactive (CART-LI) neurons in the enteric nervous system of the porcine stomach cardia.

    Science.gov (United States)

    Rękawek, W; Sobiech, P; Gonkowski, S; Żarczyńska, K; Snarska, A; Waśniewski, T; Wojtkiewicz, J

    2015-01-01

    The aim of this study was to determine the presence of cocaine- and amphetamine-regulated transcript-like immunoreactive (CART-LI) neurons and co-localisation of CART with vesicular acetylcholine transporter (VAChT), neuronal nitric oxide synthase (n-NOS), vasoactive intestinal polypeptide (VIP), substance P (SP) and leu-enkephalin (LENK) in the enteric nervous system of the porcine gastric cardia by using a double-labelling immunofluorescence technique. CART-LI neurons were observed in the myenteric plexus (18.2±2.6%). A dense network of CART-LI nerve fibers was mainly observed in the muscular layer. CART showed co-localization mainly with VAChT, n-NOS, VIP and to a lesser degree with LENK and SP. Distribution of CART and its co-localization with other neurotransmitters suggest that this peptide plays an important role in gastric motility in the pig.

  13. Risk factors of gastric cardia cancer in rural area of southeastern Shanxi province: a case-control study%山西东南部贲门癌危险因素病例对照研究

    Institute of Scientific and Technical Information of China (English)

    杨建洲; 纪爱芳; 魏武; 原建慧; 王金胜

    2012-01-01

    目的 探讨山西省东南部地区农村居民饮食、行为等各种影响因素与贲门癌( GCC)发生的关系.方法 在山西省东南部地区,采用以人群为基础的1∶2配对病例对照研究方法,对120例GCC患者和240名对照进行问卷调查,采用单因素和多因素条件logistic回归对所获资料进行分析.结果 胃癌家族史(OR=2.83,95%CI=1.74~3.94)、吸烟(OR=2.89,95% CI=1.57 ~5.30)、喜食烫食(OR=1.32,95% CI=1.12~2.79)可能是GCC的危险因素;体质指数≥24(OR =0.20,95% CI =0.06~0.67)、经常饮茶(OR=0.43,95% CI =0.15 ~0.78)、常吃新鲜水果(OR =0.62,95% CI=0.36~0.91)可能是GCC的保护因素.结论 生活习惯和饮食习惯是农村居民GCC的主要危险因素之一,应对其采取综合性的预防措施.%Objective To explore the risk factors of gastric cardia cancer in rural area of southeastern Shanxi province. Methods A population based 1: 2 matched case-control study was conducted in rural area of southeastern Shanxi province. A total of 120 gastric cardia cancer patients and 240 matched controls were investigated with face-to-face ques-tinnaire survey. The data were analyzed with conditional logistic model analysis. Results The family history of gastric cancer(odds ratio[OR] =2.83,95% confidence interval [ CI ]: 1. 74 - 2. 94), cigarette smoking ( OR =2. 89,95% CI: 1.57 -5.30),and preference of taking hot food( OR = 1. 32,95% Cl-1. 12-2.79) significantly increased the risk of developing gastric cardia cancer, while body mass index 3= 24 (OR = 0. 20,95 % CI: 0.06 - 0. 67), drinking tea ( OR = 0.43, 95% Cl: 0. 15 - 0. 78), and eating fresh fruits frequently ( OR = 0. 62,95% CI: 0. 36 - 0. 91) were protective factors. Conclusion Living and eating habits are risk factors of gastric cardia cancer in southeastern Shanxi province. The corresponding comprehensive prevention strategies targeting related risk factors are required.

  14. The clinical trial research of preoperative induced hypertension chemotherapy on the Ⅲ staging cardia or fundus of stomach carcinoma%Ⅲ期贲门胃底癌患者术前药物诱导性高压化疗的临床试验研究

    Institute of Scientific and Technical Information of China (English)

    Jianwen Zhai; Haiping Yang; Heping Li; Fushen Yang; Xiaogang Yang

    2007-01-01

    Objective:To observation the therapeutic effect and the adverse reaction of preoperative induced hypertension chemotherapy (IHC) on the Ⅲ staging cardia or fundus of stomach carcinoma. Methods:49 cases of the Ⅲ staging cardia or fundus of stomach carcinoma were divided into two groups at random. The observation group included 19 cases and the control group included 30 cases. Every case used one cycle chemotherapy. The observation group (IHC group) used chemotherapy and AT Ⅱ. The control group (simple chemotherapy group) used simple chemotherapy. All cases of the two groups operated after 3 weeks rest. The specimen's DNA was analyzed by flow cytometry. Results:The effective power of observation group was 63.2% (12/19), exairesis ratio was 84.2% (16/19). The effective power of control group was 30% (9/30), exairesis ratio was 63.3% (19/30). DNA ploid determination:13 cases were diploid and 5 cases were heteroploid in the observation group, 9 cases were diploid and 16 cases were heteroploid in the control group. The operative complications and risks of the two groups did not increase. Conclusion:IHC can increase the therapeutic effect of Ⅲ staging cardia or fundus of stomach carcinoma obviously. IHC is one of the chemotherapy methods that have good future. It has good value of clinic enlarge trial.

  15. THE CURATIVE EFFECT OF THE RADICAL CORRECTION OF CARCINOMA OF GASTRIC CARDIA AND ESOPHAGEAL CARCINOMA ON GASTROESOPHAGEAL REFLUX%贲门癌、食管下段癌预防术后返流的术式研究

    Institute of Scientific and Technical Information of China (English)

    张力军

    2014-01-01

    Objective To explore the curative effect of the radical correction of carcinoma of gastric cardia and esophageal carcinoma on gastroesophageal reflux .Methods 100 cases of carcinoma of gastric cardia and esophageal carcinoma were divided into the observation group and the contrast group by using random sim-ple blind control study .The contrast group was treated with conventional esophagogastrostomy .After the observation group received routine double stapling technique ,the cardiac structure was established by half wrapping the gastric wall sutured at stoma and by overhanging and embedding pleura mediastinalis outside lower esophagus ,the gastric greater curvature was lifted to be fixed with pleura mediastinalis to form the structure of undus of stomach ,and the transverse suture of 1/3 circle about 3cm under anterior gastric wall stoma was used to make stomach full-thickness bulge under stoma .Postoperative reflux esophagitis was observed .Results More than 35 cases showed no reflux and less than 15 cases got reflux in the observation group while less than 20 cases got no reflux and more than 30 cases got reflux( P<0 .01) .Conclusion The combined use of routine esophagus-stomach anastomosis and the augmentation technique of half w rapping lower esophagus and forming full-thickness inward bulging under anterior gastric wall can effectively re-duce the occurrence of gastroesophageal reflux after the radical correction of carcinoma of gastric cardia and e-sophageal carcinoma .%目的:探讨贲门癌、食管下段癌根治术预防胃食管返流的有效方法。方法采用随机单盲对照研究,将100例贲门癌、食管下段癌患者分为观察组和对照组。对照组采用常规食管胃吻合法,观察组在常规吻合器吻合后,将胃壁半包绕缝合在吻合口及食管下段外加纵隔胸膜悬吊包埋建立类似贲门样结构,将胃大弯侧向上提与纵隔胸膜固定形成胃底样结构,胃前壁吻合口下方约3cm

  16. Chemotherapy or radio-chemotherapy for advanced adenocarcinoma of the oesophagus and cardiac orifice; Adenocarcinomes du bas oesophage et du cardia: quelle chimiotherapie ou chimioradiotherapie dans le traitement des recidives et des metastases

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, J.F.; Duffaud, F.; Dahan, L.; Ries, P.; Ville, E.; Laugier, R. [Centre Hospitalier Universitaire de la Timone, 13 - Marseille (France)

    2001-11-01

    Adenocarcinomas of esophagus and cardia represent in France approximately 20 to 40% of the esophagus cancers. They have a high risk to develop lymph nodes metastases and liver metastases. Currently, only 50 to 70% of patients may benefit from surgical curative resection at diagnosis, but more than 50% of them will recur. The standard of treatment of these metastatic adenocarcinomas is chemotherapy. Three large randomized comparative studies, between chemotherapy and supportive care, showed that chemotherapy significantly extends the median of survival (from 3-4 months to 10-12 months) and improves the quality of life. Currently, the combination of epirubicin-cisplatin-continuous 5FU (ECF) is the most effective regimen but it is difficult to administer and tolerate because of the long continuous 5FU infusion. In France, the most commonly used combination regimen still associates 5FU and cisplatin. New drugs (such as docetaxel, CPT11, oxaliplatin) used alone or in combination, especially with 5U, are very promising. Radio-chemotherapy is the preferred treatment for locoregional recurrences, because it improves dysphagia and enables to obtain complete tumor responses. Current results from concomitant radio-chemotherapy studies for esophagus cancer, based on 5FU alone, 5FU-cisplatin or 5FU-mitomycin, given as preoperative treatment or as exclusive treatment, support to use radio-chemotherapy for the treatment of loco-regional recurrences after surgical resection. Nevertheless, the optimal radio-chemotherapy schedule still remain to be defined (dose, duration, splitting of radiotherapy, choice of anticancer drugs). (authors)

  17. 食管癌贲门癌胃癌高危人群的内镜筛查结果分析%Analysis of results of endoscopic screening of esophageal, gastric cardia and gastric cancers in high risk population

    Institute of Scientific and Technical Information of China (English)

    张建功; 王福让; 张亚冰; 全培良; 刘曙正; 孙喜斌; 陆建邦

    2014-01-01

    目的 探讨筛查人群年龄、性别和活检率等对于食管癌胃癌检出率和早诊率的影响.方法 选择河南省食管癌9个高发市县,将40~69岁设定为高危人群.排除有胃镜检查禁忌证者,按照国家癌症早诊早治技术方案,对筛查对象的食管、贲门、胃进行内镜检查并做组织学诊断.结果 3年共筛查40 156人,发现各类癌前病变18 459例,占筛查人群的46.0%;癌症916例,检出率为2.3%,其中早期癌763例,早诊率为83.3%.结论 在食管癌、胃癌高发区的高危人群中开展内镜筛查对实施上消化道癌早诊早治是可行的.对于影响筛查效果的相关因素进行探索分析,有助于食管癌、贲门癌和胃癌早诊早治项目的深入开展.%Objective To summarize the results of endoscopic screening of esophageal,gastric cardiac and gastric cancers in the high-risk population,and analyze the influencing factors such as age,gender and biopsy rate on their detection and early diagnosis rates.Methods Nine high incidence cities and counties of esophageal cancer in Henan province were included in this study.People aged 40-69 years were set to the target population.Excluding contraindications for gastroscopy,in accordance with the national technical scheme of early cancer diagnosis and treatment,gastroscopic screening and biopsy pathology for human esophageal,cardiac and gastric cancers were carried out.Results During the 3-year period,a total of 40 156 subjects were screened.Among them,18 459 cases of various precancerous lesions (46.0%) were detected.The cancer detection rate was 2.3% (916 cases),including 763 cases of early cancers.The diagnosis rate of early cancers was 83.3%.Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach,respectively.Conclusions The results of this study demonstrate that endoscopic screening is feasible for early detection,diagnosis and

  18. 非贲门胃癌63例数字胃肠X线机检查结果分析%Digital gastrointestinal examination results of cardia gastric cancer 63 cases analysis

    Institute of Scientific and Technical Information of China (English)

    赵晋太; 刘宽荣

    2013-01-01

    目的:探讨非贲门胃癌的数字胃肠X线机表现,提高其检出及诊断水平。方法对2006年1月-2009年12月手术治疗的63例非贲门胃癌患者数字胃肠X线机检查结果进行统计分析。结果46例确诊,3例可疑癌;14例再行双对比造影,11例确诊,3例未确诊,诊断符合率为95.24%(60/63)。35例可见淋巴结转移灶。结论 DR诊断非贲门胃癌,晚期较易确诊,早期需双对比造影方可确诊。临床应结合内窥镜、病检综合判断,提高诊断水平。%Objective To explore the clinical X-ray manifestations of digital gastrointestinal cardia cancer of the stomach, improve the level of X-ray detection and diagnosis of the disease. Methods In January 2006-December 2009, the surgical treatment of 63 cases of cardiac cancer of the stomach by digital gastrointestinal examination results were analyzed. Results 46 cases. diagnosed, 3 cases of suspected cancer;14 cases of double contrast radiography, 11 cases of diagnosed, 3 cases was not confirmed. Diagnosis coincidence rate was 95.24% (60/63), 35 cases of lymph node metastases. Conclusion Digital gastrointestinal diagnosis of non cardiac cancer of the stomach,terminal diagnosis more easily, need double contrast angiography can confirmed early. Clinical and endoscopic, disease screening combination, improve the diagnostic level.

  19. Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities.

    Science.gov (United States)

    Cunningham, Timothy J; Seeman, Teresa E; Kawachi, Ichiro; Gortmaker, Steven L; Jacobs, David R; Kiefe, Catarina I; Berkman, Lisa F

    2012-09-01

    Inflammation is etiologically implicated in cardiometabolic diseases for which there are known racial/ethnic disparities. Prior studies suggest there may be an association between self-reported experiences of racial/ethnic discrimination and inflammation, particularly C-reactive protein (CRP). It is not known whether that association is influenced by race/ethnicity and gender. In separate hierarchical linear models with time-varying covariates, we examined that association among 901 Black women, 614 Black men, 958 White women, and 863 White men in the Coronary Artery Risk Development in Young Adults (CARDIA) study in four US communities. Self-reported experiences of racial/ethnic discrimination were ascertained in 1992-93 and 2000-01. Inflammation was measured as log-transformed CRP in those years and 2005-06. All analyses were adjusted for blood pressure, plasma total cholesterol, triglycerides, homeostatic model assessment for insulin resistance (HOMA-IR), age, education, and community. Our findings extend prior research by suggesting that, broadly speaking, self-reported experiences of racial/ethnic discrimination are associated with inflammation; however, this association is complex and varies for Black and White women and men. Black women reporting 1 or 2 experiences of discrimination had higher levels of CRP compared to Black women reporting no experiences of discrimination (β = 0.141, SE = 0.062, P discrimination and not independent of modifiable risks (smoking and obesity) in the final model. White women reporting 3 or more experiences of discrimination had significantly higher levels of CRP compared to White women reporting no experiences of discrimination independent of modifiable risks in the final model (β = 0.300, SE = 0.113, P racial/ethnic discrimination and CRP was not statistically significant among Black and White men reporting 1 or 2 experiences of discrimination. Further research in other populations is needed.

  20. The clinical analysis about the dilatation for the stoma narrow after operation of carcinoma of esophago cardia%扩张治疗242例食管贲门癌术后吻合口狭窄疗效分析

    Institute of Scientific and Technical Information of China (English)

    林焕雄; 蔡文

    2010-01-01

    目的 总结扩张治疗食管贲门癌术后吻合口狭窄的临床疗效.方法 采用沙氏扩张器治疗242例吻合口狭窄患者.结果 共行扩张治疗647例次,平均2.67次/人.有效率99.1%,痊愈率达87.6%.结论 采用沙氏扩张器是治疗食管贲门癌术后吻合口狭窄一种安全、简便、有效手段之一.%Objective The author summarizes the clinical curative effect about the dilatation for the stoma narrow after operation of carcinoma of esophago cardia. Methods 242 patients included were expanded with Savary-Gilliard dilator. Results 647 expanding therapies were made, average 2.67 times per patient. The effective rate is 99.1%,the recovery rate is 87.6%. Conclusion The dilatation using Savary-Gilliard dilator is one of the safe, convenient, effective methods in the treatment of stoma narrow after operation of carcinoma of esophago cardia.

  1. A modified Mediterranean diet score is associated with a lower risk of incident metabolic syndrome over 25 years among young adults: the CARDIA (Coronary Artery Risk Development in Young Adults) study.

    Science.gov (United States)

    Steffen, Lyn M; Van Horn, Linda; Daviglus, Martha L; Zhou, Xia; Reis, Jared P; Loria, Catherine M; Jacobs, David R; Duffey, Kiyah J

    2014-11-28

    The Mediterranean diet has been reported to be inversely associated with incident metabolic syndrome (MetSyn) among older adults; however, this association has not been studied in young African American and white adults. The objective of the present study was to evaluate the association of a modified Mediterranean diet (mMedDiet) score with the 25-year incidence of the MetSyn in 4713 African American and white adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. A diet history questionnaire was used to assess dietary intake at baseline, year 7 and year 20 and a mMedDiet score was created. Cardiovascular risk factors were measured at multiple examinations over 25 years. The MetSyn was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Cox proportional-hazards regression analysis was use to evaluate associations for incident MetSyn across the mMedDiet score categories adjusting for demographic characteristics, lifestyle factors and BMI. Higher mMedDiet scores represented adherence to a dietary pattern rich in fruit, vegetables, whole grains, nuts and fish, but poor in red and processed meat and snack foods. The incidence of MetSyn components (abdominal obesity, elevated TAG concentrations and low HDL-cholesterol concentrations) was lower in those with higher mMedDiet scores than in those with lower scores. Furthermore, the incidence of the MetSyn was lower across the five mMedDiet score categories; the hazard ratios and 95 % CI from category 1 to category 5 were 1·0; 0·94 (0·76, 1·15); 0·84 (0·68, 1·04); 0·73 (0·58, 0·92); and 0·72 (0·54, 0·96), respectively (P trend= 0·005). These findings suggest that the risk of developing the MetSyn is lower when consuming a diet rich in fruit, vegetables, whole grains, nuts and fish.

  2. Efficacy of total gastrectomy jejunal loop p-generation treatment of gastric cardia gastric fundus%全胃切除空肠p袢代胃术治疗胃底贲门癌的疗效分析

    Institute of Scientific and Technical Information of China (English)

    马莱; 黄灿; 徐春华

    2014-01-01

    目的:探讨全胃切除空肠p袢代胃术治疗胃底贲门癌的临床应用价值,提高患者生存质量。方法从本院收治的胃底贲门癌患者中选取57例符合研究条件的患者作为研究对象,采用单盲抽样方法抽取其中30例作为实验组,采用全胃切除空肠p袢代胃术治疗,其余患者作为对照组,采用标准Roux-en-Y吻合术式治疗,并收集两组患者的相关数据进行对比,包括手术时间、术中的出血情况、排空时间、饮食的次数、饮食量以及并发症的发生率。结果通过对比我们发现,实验组与对照组的手术所需时间以及手术中出血量的差异无统计学意义( p>0.05),实验组患者的饮食次数、排空时间、饮食量均显著优于对照组(p 0.05), the experimental group of patients with eating times, emptying time, the diet were significantly superior in the control group (p <0.05). The complication rate in the experimental group was significantly lower than the control group (p <0.05). Conclusion: p total gastrectomy jejunal loop generation stomach and gastric cardia cancer treatment has a good effect, can improve the survival of patients, there is a high clinical value.

  3. Nursing of achalasia of cardia with peroral endoscopic myotomy%经口内镜下肌切开术治疗贲门失弛缓症的护理

    Institute of Scientific and Technical Information of China (English)

    包正英; 韩树堂; 张其德; 肖君; 姜素峰; 杨帆

    2012-01-01

    Objective To discuss the clinical methods and nursing of peroral endoscopic myotomy (POEM) in treating achalasia of cardia (AC). Methods The clinical data of 6 POEM patients diagnosed with AC were retrospectively reviewed. The main procedures of POEM were composed of esophageal mucosal incision,submucosal tunneling by endoscopic submucosal dissection (ESD),endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips. The nursing cooperation and care were performed during the preoperative,intraoperative and postoperative periods. Results All the 6 patients underwent POEM successfully. The operation duration ranged from 60 to 128 mins with an average length of 76. 5 mins. The length of submucosal tunnel was 9 to 12cm with an average length of 10. 3 cm. The length of endoscopic myotomy of inner circular muscle was 7 to 10 cm with an average length of 8. 2 cm. One patient had pneumohy-poderma,and another patient had left pneumothorax. Patients were followed up for 1 to 10 months. Dysphagia was relieved significantly during the follow - up period in all six patients. Conclusion POEM is very effective to relieve dysphagia in a short term. However,further observation is needed to evaluate long - term efficacy and complications. The high - level endoscopy operation skills are expected from the doctor. The key to a successful surgery includes the close intraoperative cooperation among medical staff,careful clinical observation of the progression and dedicated care.%目的 探讨经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)的临床方法和护理.方法 研究确诊为AC并接受POEM治疗的6例患者的临床资料.POEM主要步骤:食管黏膜层切开;分离黏膜下层,建立黏膜下“隧道”;胃镜直视下切开环形肌;金属夹关闭黏膜层切口.护士做好术前、术中配合和术后护理工作.结果 6例患者均成功完成POEM手术,手术时间60~ 128 min,平均76.5 min,黏膜下隧道长度9

  4. 大直径球囊扩张治疗80例贲门失弛缓症的中远期疗效评价分析%Large-diameter balloon dilation for the treatment of achalasia of cardia: an analysis of mid-to-long term efficacy in 80 cases

    Institute of Scientific and Technical Information of China (English)

    宋锦文; 印建国; 杨艳; 刘晓红; 王志宏

    2011-01-01

    目的 探讨并总结大直径(40 mm)球囊扩张治疗贲门失弛缓症的方法及中远期疗效.方法 80例患者病程3 ~ 23年.Mellow-Pinkas吞咽困难分级(0 ~ 4级)为:Ⅰ级6例,Ⅱ级60例,Ⅲ级14例;均经钡餐透视(12例行胃镜检查)证实.在2%利多卡因咽部喷雾麻醉下,以球囊间歇(间隔3 ~ 5 min)、逐渐扩张贲门狭窄部至球囊最大径40 mm,重复2 ~ 3次.术后常规预防出血和感染,2 ~ 3 h即可进食较凉流质饮食、3 d内进半流质饮食并逐渐过度为正常进食.术后随访问2 ~ 10年.结果 操作成功率100%,其中1次操作治疗成功96.3%(77/80),2次扩张(3例先经小球囊预扩)成功3.7%(3/80).术后破裂行手术修补1例(1.2%).术后随访平均6.27年,其中大于10年4例,6 ~ 10年44例,3 ~ 5年21例,2年11例,吞咽困难缓解率100%,其中能正常进食90%(72/80),正常进食时偶有轻度梗噎感10.0%(8/80).轻度食管反流占15.0%(12/80).结论 从患者接受程度、疗效及并发症等综合评价,大直径球囊扩张术是目前治疗贲门失弛缓症的最佳方法.具有操作简单、创伤小、费用低且中远期疗效较好的优点,可作为成年人贲门失弛缓症的首选治疗方法.%Objective To discuss the technical points of large diameter (40 mm ) balloon dilation in treating achalasia of cardia, and to assess its mid-to-long term efficacy. Methods A total of 80 patients of achalasia of cardia with a disease course of 3 - 23 years were enrolled in this study. According to Mellow-Pinkas standard of the dysphagia grading (from 0 to IV), the patients were classified into grade I(n= 6). Grade Ⅱ(n = 60) and grade Ⅲ(n = 14). The diagnosis was confirmed by barium meal examination in all patients. Under spraying anesthesia of pharyr.geal portion with 2% lidocaine. The intensified guide wire was inserted, into the stomach through mouth, under fluoroscopy guidance. Ihe ooste-n s balloon v 4-0 mm in diameter / was pushed along Uie

  5. 食管癌及贲门癌术后隐匿胸腔瘘的诊断与治疗%Diagnosis and management of concealed thoracic cavity fistula in postoperative patients with esophageal or cardia carcinoma

    Institute of Scientific and Technical Information of China (English)

    徐启良

    2014-01-01

    目的 探讨食管癌及贲门癌术后隐匿胸腔瘘的诊断、治疗方法.方法 回顾性分析2010年1月至2013年9月40例行胸内胃食管吻合术的食管癌、贲门癌患者资料.40例患者出现高热、白细胞升高等脓毒血症表现,早期均无造影剂渗漏,但CT显示吻合口或胃残端周围出现散在小气泡、少量包裹性积液,存在吻合口或胃残端早期微小瘘口的可能,定义为隐匿胸腔瘘.20例按隐匿胸腔瘘处理,给予禁食、抗感染治疗、保持胃肠减压通畅、鼻肠管肠内营养等治疗;另20例按术后未出现胸腔瘘进行常规治疗,给予降温及抗生素治疗.比较两组胸腔瘘发生情况,总结泛影葡胺食管造影及胸部CT扫描隐匿胸腔瘘的特点.结果 按吻合口瘘处理的20例患者泛影葡胺食管造影及胸部CT扫描显示,有2例(10%)发展为较小的吻合口瘘,未按胸腔瘘处理的20例患者中有17例(85%)发展为胸腔瘘,6例并发多器官衰竭死亡.结论 食管癌、贲门癌术后出现脓毒血症表现,泛影葡胺食管造影及胸部CT扫描显示吻合口或胃残端周围有小气泡、不规则包裹性积液为隐匿胸腔瘘的特异性征象,应按胸腔瘘处理.%Objective To investigate diagnosis and treatment of concealed thoracic cavity fistula in the postoperative patients of esophagus or cardia carcinoma.Methods The clinical data of 40 patients were analyzed who presented with unexplained sepsis (elevated white blood cell count and temperature>38 ℃) after esophagectomy and intrathoracic anastomosis from January 2010 to September 2013.All patients underwent oral meglumine diatrizoate esophageal imaging and computerized tomography scan of the chest.None of the patients had any sign of contrast leak in the early in these diagnostic examinations,but their chest CT scan all showed peri-anastomotic or the gastric remnant diffuse bubble and bit encapsulated effusion.Twenty patients were treated as concealed

  6. 沉默信息调节因子2相关酶1在贲门癌中表达的意义及相互关系%Expressions of SIRT 1, E-cadherin and MLH 1 in gastric cardia carcinoma and their relationship

    Institute of Scientific and Technical Information of China (English)

    冯安宁; 樊祥山; 黄勤; 章宜芬; 叶庆; 吴鸿雁; 杨军; 张丽华

    2011-01-01

    目的 沉默信息调节因子2相关酶l( silent mating type information regulation 2 homolog 1,SIRT 1)是活性依赖烟酰胺腺嘌呤二核苷酸( nicotinamide adenine dinucleotide,NAD)的去乙酰化酶,可能参与某些肿瘤的形成及进展,并对多种肿瘤相关基因的蛋白活性及基因沉默的调控中起重要作用.文中研究SIRT1及上皮钙黏蛋白(epithelial cad-herin,E-cadherin)和错配修复蛋白1(Mutl homoolog 1,MLH1)在贲门癌中表达的临床病理学意义及相互关系. 方法 应用组织芯片技术和免疫组化EnVision二步法检测176例贲门癌患者癌组织中SIRT1、E-cadherin、MLH 1蛋白的表达.结果 SIRT1表达阳性率与淋巴结转移数目及TNM分期呈正相关.E-cadherin和MLH 1表达与淋巴结转移数目、TNM分期呈负相关.90例有随访资料病例中,SIRT1阳性患者3年生存率及平均生存时间显著低于SIRT1阴性患者.E-cadherin强阳性表达患者3年生存率及平均生存时间显著高于弱阳性表达患者,MLH 1阳性表达患者的3年生存率及平均生存时间高于MHLI阴性患者,差异均有统计学意义. 结论 贲门癌中SIRT 1阳性表达与肿瘤恶性程度正相关.E-cadherin表达程度及MLH 1阳性表达与肿瘤恶性程度负相关,SIRT 1可能通过E-cadherin、MLH 1等抑癌基因的沉默作用促进贲门癌的形成,影响其恶性生物学行为.%Objective SIRT1 is a NAD+ ( nicotinmide nicotinamide adenine dinucleotide) -dependent deacetylase, which may be involved in the formation and progression of many types of carcinoma, and plays an important role in regulating protein function and gene silencing of certain tumor-related genes. The objective of the research is to investigate the clinicopathological significance of the expressions of SIRT1, MLH1 and E-cadherin in gastric cardia carcinoma and their relationship. Methods We detected the ex-pressiond of SIRT 1, MLH 1 and E-cadherin proteins in the gastric cardia carcinoma tissues of 176

  7. 无痛内镜下球囊扩张治疗食管贲门狭窄的疗效分析%Clinical effect analysis of painless endoscopic pneumatic balloon dilation in the treatment of the stricture of esophagus and cardia

    Institute of Scientific and Technical Information of China (English)

    陆启峰; 王桂周

    2012-01-01

    目的 探讨内镜下球囊导管扩张术对食管、贲门及吻合口良性狭窄的临床疗效及安全性.方法 对35例食管、贲门、吻合口良性狭窄患者做无痛胃镜下球囊导管扩张治疗.结果 扩张成功率为100%,首次均扩张至狭窄段直径≥12 mm,术后吞咽不畅等症状得到迅速缓解.随访3个月,总有效率为88.6%.多数患者扩张后局部少许渗血,无大出血、穿孔的发生.结论 无痛内镜下球囊导管扩张术是治疗食管、贲门、吻合口良性狭窄的安全有效方法.%Objective To exlpore the effect and safety of endoscopic pneumatic dilation in the treatment of the benign stricture of esophagus and carclia.Methods 35 patients with the benign stricture of esophagus,eardia and anastomosis were treated with painless endoscopic pneumatic balloon dilation.Results The rate of stricture improvement was 100%,and the entire anastomosis diameter was extended over 12 am,at the first time,difficulty in swallowing was obviously relieved.Following up three months,the total effecttive percentage of stricture improvement was 88.6%,and no serious complication occurred in all cases.Conclusion Endoscopic pneumatic balloon dilation is effective and safe to treat the benign stricture of esophagus and cardia

  8. 抗反流支架与常规支架治疗远端食管贲门处狭窄的系统评价%Antireflux stents versus conventional stents for management of stenosis of distal esophageal and gastric cardia: An systematic review

    Institute of Scientific and Technical Information of China (English)

    胡学军; 张虎; 邵国安; 王尚前; 刘贵峰; 徐永耀; 陆红

    2012-01-01

    AIM: To evaluate the efficacy and safety of anti-reflux stents versus conventional stents for the management of stenosis of distal esophageal and gastric cardia in patients with esophageal that evaluated anti-reflux stents versus conventional stents in the treatment of stenosis of distal esophageal and gastric cardia in patients with esophageal cancer were electronically searched from the PubMed (1978-2011), EMbase (1966-2011), CBM (1978-2011), Cochrane Library (2011, Issue 11) and CNKI (1979-2011) databases, and relevant published and unpublished data and their references (either in English or Chinese), were also searched manually. The data were extracted and the methodological quality of the incorporated studies was evaluated by two reviewers independently. The RevMan 5.1 software was used for meta-analysis. RESULTS: Five RCTs involving 234 patients were included. Meta-analysis showed that anti-reflux stents and conventional stents had no significant differences in terms of the incidences of pain (RR = 0.41, 95% CI: 0.16,1.06), stent migration (RR = 1.02, 95% CI: 0.50, 2.11), obstruction (RR = 1.02, 95% CI: 0.52,1.99), gastroesophageal reflux (RR = 1.68,95% CI: 0.52,5.48), bleeding (RR = 1.39, 95% CI: 0.44, 4.40), and perforation of the esophagus and stomach (RR = 0.70, 95% CI: 0.25, 2.00). CONCLUSION: The overall curative efficacy of anti-reflux stents for the stenosis of distal esophageal and gastric cardia in patients with esophageal cancer is not better than that of conventional stents. Because of the generally low quality and a small number of studies in the incorporated research, the above conclusion remains to be validated by carrying out more randomized controlled trials with multiple center samples and enough follow-up time.%目的:评价置入抗反流支架和常规支架治疗食管癌远端食管贲门处狭窄患者的疗效及安全性.方法:计算机检索PubMed(1978-2011)、EMbase(1966-2011)、CBM(1978-2011)、Cochrane Library(2011年第10

  9. Prognosis analysis of surgical treatment for cancer of stonmach fundus and cardia with invasion to body and tail of the pancreas%胃底贲门癌侵及胰体尾外科治疗的预后分析

    Institute of Scientific and Technical Information of China (English)

    黄昌明; 卢辉山; 李平; 谢建伟; 林碧娟; 张祥福

    2008-01-01

    目的 探讨影响胃底贲门癌侵及胰体尾外科治疗预后的因素.方法 对135例胃底贲门癌侵及胰体尾患者进行手术.其中剖腹探查术20例,联合脾及胰体尾切除术115例.对影响手术的预后进行单因素及多因素分析,并分析术后的并发症发生率和病死率.结果 剖腹探查术和联合脾及胰体尾切除术患者的中位生存期分别为4.7个月和30.5个月,差异有统计学意义(X2=403.8,P<0.01).联合脾及胰体尾切除术患者的3、5年生存率分别为48.3%、26.6%;肿瘤的直径、大体分型、浸润深度、淋巴结转移、No.10或No.11淋巴结转移、根治程度和受侵脏器切除数目为影响预后的相关因素:其中浸润深度、淋巴结转移分期、手术根治程度及受侵脏器切除数目为影响预后的独立因素.术后并发症发牛率和病死率分别为20.0%和3.5%.结论 对于胃底贲门癌侵及胰体尾患者.施行联合脾及胰体尾切除术能够提高疗效.如果患者无淋巴结转移、或无不可根治因素存在、或无合并其他脏器受侵.施行联合脾及胰体尾切除术疗效最好.%Objective To investigate the prognostic factors of surgical treatment for the cancer of stomach fundus and cardia with invasion to body and tail of the pancrea.Methods A total of 135 patients with cancer of stomach fundus and eardia invading body and tail of the pancrea undergone surgical treatment were enrolled in this study.Twenty of them underwent iaparotomy,while 115 underwent gastrectomy with panereaticosplenectomy,even combined with the resection of other organs for macroscopic invasion to adjacent organs during surgery. The 3-,5-year survival rates,morbility of postoperative complications and mortality were foUowed up. The prognostic factors were evaluated by univariate and multivariate analyses. Results The median survival time of the patients undergone laparotomy was 4.7 months,of patients treated by gastrectomy combined with

  10. 胃底贲门癌根治术后不同消化道重建方式的效果比较%Comparative analysis of different kinds of digestive tract reconstruction after radical gastrectomy in the treatment of gastric cardia carcinoma

    Institute of Scientific and Technical Information of China (English)

    贾晓斌; 吉锋英; 毕红革

    2015-01-01

    目的:探讨胃底贲门癌根治术后三种不同消化道重建方式效果。方法:收集胃底贲门癌患者32例,随机分为间置空肠吻合术组、空肠食管Roux‐en‐Y吻合术组、食管残胃后壁吻合术组3组,比较3组患者的治疗效果。结果:食管残胃后壁吻合术组返流性食管炎发生率高于间置空肠吻合术组(P<0.05);手术后,间置空肠吻合术组患者在整体健康状况、便秘、恶心呕吐上评分均低于空肠食管Roux‐en‐Y吻合术组和食管残胃后壁吻合术组(P<0.05);间置空肠吻合术组患者的腹泻评分高于空肠食管Roux‐en‐Y吻合术组和食管残胃后壁吻合术组(P<0.05)。结论:间置空肠吻合术重建消化道具有较低的返流性食管炎发生率和较好的预后。%Objective:To compare the different kinds of digestive tract reconstruction after radical gas‐trectomy in the treatment of gastric cardia carcinoma .Methods :32 patients randomly divided into interstitial anasto‐mosis group ,jejunal Roux‐en‐Y anastomosis group ,the posterior wall of esophagus gastric remnant anastomosis group ,Compare the treatment effect between the three groups .Result :The posterior wall of esophagus gastric remnant anastomosis group was higher than the stromal anastomosis group in the incidence rate of reflux esophagitis (P<0 .05);after the operation ,interstitial anastomosis group was lower than jejunal Roux‐en‐Y anastomosis group and the posterior wall of esophagus gastric remnant anastomosis group in overall health ,constipation ,nausea and vomiting ,diarrhea (P<0 .05);interstitial anastomosis group was higher than jejunal Roux‐en‐Y anastomosis group and the posterior wall of esophagus gastric remnant anastomosis group(P<0 .05) ,were more than those of jejunal Roux‐en‐Y anastomosis group and the posterior wall of esophagus gastric remnant anastomosis group (P<0 .05) . Conclusion :Interstitial

  11. 心电图Ⅱ导联R波第一峰时限分布特征及其在宽QRS波心动过速鉴别诊断中的应用%Characteristic of R-wave peak time and its value in differential diagnosis of wide QRS complex tachy-cardias

    Institute of Scientific and Technical Information of China (English)

    杨志平; 林亚洲; 张建成; 陈建泉; 吴梅琼; 连亮华; 吴卫; 陈林

    2015-01-01

    目的:探讨心电图Ⅱ导联R波第1峰时限( RWPT)分布特征及其在宽QRS波心动过速鉴别诊断中的应用价值。方法入选因阵发性室上性心动过速于2013年9月至2014年3月在福建省立医院、福建省心血管病研究所心电生理研究室行射频消融术患者32例,男18例,女14例,年龄12~68(46.1±13.4)岁。32个病例164份心室不同部位起搏12导联心电图,2名心电工作者双盲法手工测量RWPT,并比较不同部位心室起搏RWPT差异。结果164份起搏心电图中152份(92.7%)RWPT≥50 ms,12例(7.3%) RWPT<50 ms均位于左心室游离壁、左心室基底部起搏组;右心室高位间隔组(91.4±13.6)ms、右心室中位间隔组(80.2±12.8)ms具有较高RWPT,左心室心底部组(54.6±15.5)ms、左心室游离壁组(51.3±9.5) ms, RWPT 较低( P<0.05)。结论心电图Ⅱ导联第1峰时限 RWPT≥50 ms是宽QRS波心动过速判定为室性心律失常的简单、快捷、有效指标,特别对于右心室间隔部、流入道起源室性心动过速(室速),而对于左心室心底部、左侧游离壁起源室性心动过速鉴别敏感性较差。%Objective This study was to clarify the characteristic of R-wave peak time ( RWPT ) in multi-chamber ventricular pacing model, to verify its value in differential diagnosis of wide QRS complex tachy-cardias. Methods Thirty-two patients with tachycardias underwent multi-chamber ventricular pacing after ra-diofrequency catheter ablation (RFCA) procedure, and 164 pacing electrocardiogram(ECG) were recorded. The RWPT ( DⅡ) were measured by two experienced electrophysiologist with double-blind method. Results The RWPT were≥50 ms in 152 ECG ( 92. 7%) , the RWPT were <50 ms in 12 ECG. The RWPT were ( 91. 4 ± 13. 6)ms when paced at high right ventricular septum, the RWPT were (80. 2±12. 8)ms when paced at middle right ventricular septum,the RWPT were (54. 6±15. 5)ms when paced at left ventricular freewall group (51. 3

  12. Pseudoachalasia of the cardia secondary to nongastrointestinal neoplasia.

    Science.gov (United States)

    Ulla, Jose Luis; Fernandez-Salgado, Estela; Alvarez, Victoria; Ibañez, Alberto; Soto, Santiago; Carpio, Daniel; Vazquez-Sanluis, Javier; Ledo, Luis; Vazquez-Astray, Enrique

    2008-06-01

    A minor proportion of patients with achalasia eventually have a neoplasm and, as a consequence, pseudoachalasia is diagnosed. A neoplasm may either involve gastrointestinal junction or present a paraneoplastic effect. Over the global diagnoses of achalasia issued in 5 years of experience in our motility unit, we have found 13% (3/23 cases) of pseudoachalasia (2-4% in previous series, probably due to the fact that the population assisted was mainly composed of elderly patients). The origin of the neoplasm was bladder, prostate and metastases from epidermoid carcinoma of vocal chord. Treatment of primary neoplasm, besides classical approach (with dilatation of botulinum injection) may help in the resolution of this clinical disorder.

  13. 家族史、BMI、吸烟、饮酒与贲门癌发病风险及预后的关系%Influence of family history,BMI,smoking,and alcohol drinking on risk and prognosis of gastric cardia cancer

    Institute of Scientific and Technical Information of China (English)

    杨霞; 李吉林; 王立东; 王建坡; 崔纪丽; 蔺红丽; 侯志超; 朱文亮; 宋昕; 李学民; 王心东

    2013-01-01

    Aim : To explore the influence of family history (FH ), body mass index ( BMI ), smoking, and alcohol drinking on the risk and prognosis oi gastric cardia cancer( GCC ). Methods: A total ol 16 605 patients with GCC and 26 053 controls were enrolled for retrospective investigation on FH, smoking, alcohol drinking, and BMI. Out of the 16 605 cases,2 000 subjects were followed-up by telephone or interviewed at home until November 2011. Survival analysis and hazard ratio( HR ) estimated using Kaplan-Meier and multivariate Cox proportional hazard regression model were perfomed. Re- sults: Positive FH was strikingly related with the high risk for GCC( P < 0. 001 , OR = 2. 012,95% CI =1. 874 ~2. 160 ); the underweight group had nearly 4-folds elevated GCC risk than the normal weight group ( OR =3.864,95% CI = 3.459 ~ 4. 317 ),and it was noteworthy that overweight was a protective factor for GCC( OR = 0. 323,95% CI = 0. 293 ~ 0. 357 ); smoking was closely related with high risk for GCC( P < 0.001 ,OR = 1.979,95% CI = 1.785 ~2. 194 ); otherwise, the role of alcohol drinking was weak for GCC risk ( P < 0.001 , OR =0.749,95% CI = 0.678 -0.827 ). Further analysis of the relationship between FH ,BMI, smoking .alcohol drinking and survival showed that only FH was related with longer survival of patients with GCC( P =0. 010, RR =0.677,95% CI = 0.502 -0.912 ). Conclusion : Positive FH , smoking and underweight are related with the higher risk lor GCC, while alcohol drinking is a weak risk factor for GCC;positive FH could be an independent lactor for better prognosis of GCC.%目的:探讨家族史、BMI、吸烟、饮酒与贲门癌发病风险及预后的关系.方法:采用问卷调查记录16 605例贲门癌患者和26 053例非癌就诊者的家族史、吸烟、饮酒情况,并测量其身高和体质量.对贲门癌患者中电话或住址明确的2 000例进行电话或入户随访,以死亡或搬迁为随访中止事件.生存分析及死亡

  14. Clinical efficacy of total gastrectomy stomach surgery on behalf of jejunal loop P for gastric cardia cancer%全胃切除空肠P袢代胃术治疗胃底贲门癌的临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    黄志坚; 叶文飞

    2014-01-01

    Objective To integrative clinical efficacy of total gastrectomy stomach surgery on behalf of jejunal loop P for gastric cardia cancer. Methods 65 patients with this disease were randomly divided into observed group (33 cases) and control group (32 cases). Patients in observed group received the treatment of total gastrectomy stomach surgery on behalf of jejunal loop P, while others received the treatment of near side gastrectomy. The curative effect, survival rate and complications of the two groups were compared. Results There was no significant difference in operation time, intraoperative blood loss, incision healing time and hospital stay time between the two groups (P>0.05). 3, 6 and 12 months after the treatment, the gastric emptying time and quantity of each diet in observed group were significantly higher than that of the control group (P<0.05). 3 and 6 months after the treatment, the times of daily diet in observed group was significantly lower than that of the control group (P<0.05). The three year survival rate in observed group was 66.7%, which was significantly higher than that of the control group which was 40.6%(P<0.05). The rates of gastric emptying rate and total complications in observed group were 0.0%and 9.1%, which were significantly lower than that of the control group which were 15.6%and 31.3%(P<0.05). Conclusion Total gastrectomy stomach surgery on behalf of jejunal loop P can improve the survival rate and quality of life, and reduce the occurrence of complications. It is worthy of clinical promotion.%目的:探讨研究全胃切除空肠 P 袢代胃术治疗胃底贲门癌的临床疗效研究。方法将符合标准的65例胃底贲门癌患者,随机分成观察组33例与对照组32例,观察组患者使用全胃切除空肠P袢代胃术进行治疗,对照组患者采用常规近侧胃切除术进行治疗。比较观察组与对照组的疗效、生存率与不良反应发生情况。结果两组患者在手术时间、术中出

  15. Temporary self-expanding cardia stents for the treatment of achalasia: an experimental study in dogs%暂时性自膨胀贲门支架治疗犬贲门失弛缓症模型的实验研究

    Institute of Scientific and Technical Information of China (English)

    朱悦琦; 程英升; 李明华; 赵俊功; 李烽; 陈尼维

    2011-01-01

    目的 评价应用暂时性可回收贲门覆膜支架(TRC-CS)治疗犬贲门失迟缓症模型的有效性并探讨理想的回收时间.方法 84条贲门失弛缓症模型犬随机分为7组(每组12条):对照组(CG;无支架置入)、标准支架置入组(NSCG;标准食管支架)和5组治疗组(TGs)置入(TRC-CS).NSCG支架置入后4 d取出,5组TGs支架分别在4 d(4 d-TG)、2周(2 w-TG)、1个月(1 m-TG)、3个月(3 m-TG)和6 个月(6 m-TG)取出.支架置入前、支架取出后和1周,1、3和6个月随访时分别行食管下段括约肌压力(LESP)测试和时间-钡餐检查进行疗效评价.NSCG和4 d-TG组在每个随访点各处死3条犬行组织病理学检查评价支架置入后的炎症反应.结果 支架置入和取出以及随访过程中所有犬均能很好耐受.在6个月随访结束时,2 w-TG和1 m-TG组表现出较低的支架移位率(n=2),而NSCG和3 m-TG组各有4只犬支架移位,6 m-TG组有6只犬支架移位.与建模后相比,2 w-TG和1m-TG组的LESP(P < 0.05)和钡餐高度(P=0.014 4和0.040 9)都有明显的改善.增殖细胞核抗原(PCNA)和抗α-平滑肌动蛋白抗原免疫组化染色提示NSCG和4 d-TG组在各不同随访点的炎症反应没有明显差异.结论 TRC-CS置入可以有效治疗犬贲门失迟缓症模型.LESP和时间-钡餐检查提示理想的支架回收时间在2周~ 1个月.%Objective To assess the performance, efficiency and optimal removal time of a newly designed temporary retrievable cardia covered stent (TRC-CS) for the treatment of achalasia in a dog model.Methods Eighty-four achalasia-like dog models were randomly divided into seven groups of 12, a control group (CG; no stent insertion) , a standard stent control group (NSCG, standard esophageal stent) and five treatment groups (TG, TRC-CS). Stents were retrieved at 4 days after insertion in the NSCCJ and at 4 days (4d-TCJ) , 2 weeks (2w-TG) , I month (lm-TG) . 3 months (3m-TG) , and 6 months (6m-TG) in the TGs

  16. Status and prognosis of lymph node metastasis in patients with cardia cancer - a systematic review

    DEFF Research Database (Denmark)

    Okholm, Cecilie; Svendsen, Lars Bo; Achiam, Michael P

    2014-01-01

    BACKGROUND: Adenocarcinoma of the gastroesophageal junction (GEJ) has a poor prognosis and survival rates significantly decreases if lymph node metastasis is present. An extensive lymphadenectomy may increase chances of cure, but may also lead to further postoperative morbidity and mortality...... identifying relevant studies describing lymph node metastasis and the associated prognosis. Lymph node stations were classified according to the Japanese Gastric Cancer Association guidelines. RESULTS: The highest incidence of metastasis is seen in the nearest regional lymph nodes, station no. 1......-3 and additionally in no. 7, 9 and 11. Correspondingly the best survival is seen when metastasis remain in the most locoregional nodes and survival equally tends to decrease as the metastasis become more distant. Furthermore, the presence of lymph node metastasis significantly correlates to the TNM-stage. Incidences...

  17. Sleep duration: how well do self-reports reflect objective measures? The CARDIA Sleep Study

    OpenAIRE

    Lauderdale, Diane S.; Knutson, Kristen L.; Yan, Lijing L.; Liu, Kiang; Rathouz, Paul J.

    2008-01-01

    Recent epidemiologic studies have found that sleep duration is associated with obesity, diabetes, hypertension and mortality. These studies have used self-reported habitual sleep duration, which has not been well validated. We model the extent to which self-reported habitual sleep reflects average objectively measured sleep. Eligible participants at the Chicago site of Coronary Artery Risk Development in Young Adults Study were invited to participate in a 2003-2004 ancillary sleep study; 82% ...

  18. Comparison of kinome profiles of Barrett's esophagus with normal squamous esophagus and normal gastric cardia

    NARCIS (Netherlands)

    van Baal, Jantine W. P. M.; Diks, Sander H.; Wanders, Ronald J. A.; Rygiel, Agnieskza M.; Milano, Francesca; Joore, Jos; Bergman, Jacques J. G. H. M.; Peppelenbosch, Maikel P.; Krishnadath, Kausilia K.

    2006-01-01

    The precursor metaplastic mucosal lesion that predisposes for esophageal adenocarcinoma is Barrett's esophagus. Because the signal transduction events that occur in Barrett's esophagus are poorly understood, this study aimed at generating a comprehensive description of cellular kinase activity in Ba

  19. Expression of EpCam and Villin in Barrett’s Esophagus and in Gastric Cardia

    Directory of Open Access Journals (Sweden)

    Mario Anders

    2008-01-01

    Full Text Available In the current study we aimed to clarify the potential of EpCAM and villin as in vivo biomarkers for both Barrett esophagus (BE-associated neoplasia and BE versus cardiac mucosa. Immunohistochemical staining in BE with various degrees of intraepithelial neoplasia (IN, Barrett carcinoma (BC and in normal cardiac mucosa (CM revealed a lack of EpCam and villin in squamous esophageal epithelium. All specimens of IN and BC showed EpCam with varying staining intensities. In 57% of CM samples a weak signal was detected; the remainder displayed strong EpCam expression. Villin was found in 97% of BE specimens and in all those with IN; 37% of BC and 75% of CM specimens were also positive. We conclude that expression of EpCam and villin differs only between squamous epithelium and BE. Determination of these proteins does not allow discrimination between different degrees of neoplasia or between esophageal intestinal metaplasia and cardiac mucosa.

  20. [Radiotherapy in cancers of the oesophagus, the gastric cardia and the stomach].

    Science.gov (United States)

    Créhange, G; Huguet, F; Quero, L; N'Guyen, T V; Mirabel, X; Lacornerie, T

    2016-09-01

    Localized oesophageal and gastric cancers have a poor prognosis. In oesophageal cancer, external radiotherapy combined with concomitant chemotherapy is accepted as part of the therapeutic armamentarium in a curative intent in the preoperative setting for resectable tumours; or without surgery in inoperable patients or non-resectable tumours due to wide local and/or regional extension. Data from the literature show conflicting results with no clinical evidence in favour of either a unique dose protocol or consensual target volume definition in the setting of exclusive chemoradiation. In the preoperative setting, chemoradiotherapy has become the standard in oesophageal cancer, even though there is no evidence that surgery may be beneficial in locally advanced tumours that respond to radiotherapy and chemotherapy. The main cause of failure after exclusive chemoradiotherapy in oesophageal cancer is locoregional relapse suggesting that doses and volumes usually considered may be inadequate. In gastric cancer, radiotherapy may be indicated postoperatively in patients with resected tumours that include less than D2 lymph node dissection or in the absence of perioperative chemotherapy. Preoperative chemoradiotherapy in gastric cancers is still under investigation. The evolving techniques of external radiotherapy, such as image-guided radiotherapy (IMRT) and volumetric modulated arctherapy (VMAT) have reduced the volume of lung and heart exposed to radiation, which seems to have diminished radiotherapy-related morbi-mortality rates. Given this, quality assurance for radiotherapy and protocols for radiotherapy delivery must be better standardized. This article on the indications for radiotherapy and the techniques used in oesophageal and gastric cancers is included in a special issue dedicated to national recommendations from the French society of radiation oncology (SFRO) on radiotherapy indications, planning, dose prescription, and techniques of radiotherapy delivery.

  1. Family Structure, Psychosocial Factors, and Cardiovascular Risk Factors in the NHLBI CARDIA Study

    Science.gov (United States)

    2013-11-21

    activity and sedentary lifestyle is another risk factor for heart health and cardiovascular disease (2). For example, in one study (36), the fewer...are directly associated with other risk factors such as obesity, inactivity, and lifestyle . Although tobacco is considered to have negative effects...change in family structure such as divorce, marriage, birth of a child ) (13). Further investigation into the influence of psychosocial variables

  2. Neighborhood socioeconomic status and food environment: a 20-year longitudinal latent class analysis among CARDIA participants.

    Science.gov (United States)

    Richardson, Andrea S; Meyer, Katie A; Howard, Annie Green; Boone-Heinonen, Janne; Popkin, Barry M; Evenson, Kelly R; Kiefe, Catarina I; Lewis, Cora E; Gordon-Larsen, Penny

    2014-11-01

    Cross-sectional studies suggest that neighborhood socioeconomic (SES) disadvantage is associated with obesogenic food environments. Yet, it is unknown how exposure to neighborhood SES patterning through adulthood corresponds to food environments that also change over time. We used latent class analysis (LCA) to classify participants in the U.S.-based Coronary Artery Risk Development in Young Adults study [n=5,114 at baseline 1985-1986 to 2005-2006] according to their longitudinal neighborhood SES residency patterns (upward, downward, stable high and stable low). For most classes of residents, the availability of fast food and non-fast food restaurants and supermarkets and convenience stores increased (prestaurants, more convenience stores, and the same number of supermarkets in their neighborhoods than the advantaged residents. In addition to targeting the pervasive fast food restaurant and convenient store retail growth, improving neighborhood restaurant options for disadvantaged residents may reduce food environment disparities.

  3. Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study.

    Science.gov (United States)

    Park, Jong Suk; Xun, Pengcheng; Li, Jing; Morris, Steve J; Jacobs, David R; Liu, Kiang; He, Ka

    2016-03-16

    Data on primary prevention of zinc status and diabetes risk are sparse and inconsistent. Of note, the previous studies measured either dietary zinc intake with questionnaire or zinc status in serum or hair. Toenail zinc levels are reliable biomarkers of a relatively long-term exposure. A total of 3,960 American young adults, aged 20-32 years, free of diabetes at baseline in 1987 when toenail clippings were collected, were examined for incident diabetes through 2010. Toenail zinc levels were measured with an inductively-coupled-plasma mass spectroscopy method. Incident diabetes cases were identified by fasting or non-fasting plasma glucose levels, oral glucose tolerance tests, hemoglobin A1C levels, and/or antidiabetic medications. During the 23-year follow-up, 418 incident diabetes occurred. After adjusted for age, sex, ethnicity, study center, body mass index, education, smoking status, alcohol consumption, physical activity, family history of diabetes, homeostasis model assessment of insulin resistance, and other dietary and non-dietary potential confounders, the hazard ratio of incident diabetes comparing the highest to the lowest quartile of toenail zinc levels was 1.21 (95% CI: 0.90-1.63; Ptrend = 0.20). Findings from this study do not support the hypothesis that zinc status is inversely and longitudinally associated with the incidence of diabetes in American young adults.

  4. Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study

    OpenAIRE

    Jong Suk Park; Pengcheng Xun; Jing Li; Steve J. Morris; Jacobs, David R; Kiang Liu; Ka He

    2016-01-01

    Data on primary prevention of zinc status and diabetes risk are sparse and inconsistent. Of note, the previous studies measured either dietary zinc intake with questionnaire or zinc status in serum or hair. Toenail zinc levels are reliable biomarkers of a relatively long-term exposure. A total of 3,960 American young adults, aged 20–32 years, free of diabetes at baseline in 1987 when toenail clippings were collected, were examined for incident diabetes through 2010. Toenail zinc levels were m...

  5. IGF-1, IGFBP-3, and nutritional factors in young black and white men: the CARDIA Male Hormone Study.

    Science.gov (United States)

    Colangelo, Laura A; Chiu, Brian C-H; Liu, Kiang; Kopp, Peter A; Gann, Peter H; Gapstur, Susan M

    2005-01-01

    Nutritional factors might play a role in regulating serum levels of insulin-like growth factors (IGFs), which are associated with some cancers. We examined the associations of nutritional factors with IGF-1 and IGF binding protein-3 (IGFBP-3). Serum IGF-1 and IGFBP-3 levels and dietary intake were measured in 459 black and 682 white male subjects of the Coronary Artery Risk Development in Young Adults study at the Year 7 (1992-1993) exam. Analysis of covariance and multivariable linear regression were used to assess associations of IGFs with dietary factors by race. IGF-1 was positively associated with magnesium in both black and white men (P = 0.008 and 0.05, respectively). Calcium was positively significantly related to IGF-1 in black men (P = 0.04) and marginally so in white men (P = 0.09). In black men, IGFBP-3 was positively associated with magnesium (P = 0.02), and one serving of milk per day was associated with an 8.23-ng/ml higher IGF-1 concentration (P = 0.05). Tests for interaction, however, revealed no differences between blacks and whites in the associations of nutrients with IGF-1 or IGFBP-3. In conclusion, the associations of dietary factors with serum IGF-1 and IGFBP-3 observed in our study corroborate those from other studies and generally do not differ between black and white men.

  6. Characteristics associated with self-rated health in the CARDIA study: Contextualising health determinants by income group

    Directory of Open Access Journals (Sweden)

    Shilpa Nayak

    2016-12-01

    SRH is a multidimensional measure; CTA is useful for contextualizing risk factors in relation to health status. Findings suggest that for lower income groups, addressing contributors to chronic burden is important alongside lifestyle/medical factors. In a proportionate universalism context, in addition to differences in intensity of public health action across the socioeconomic gradient, differences in the type of interventions to improve SRH may also be important.

  7. Transabdominal operation for carcinoma of the gastric cardia: application of pulling-up retractor and EEA stapler.

    Science.gov (United States)

    Misumi, A; Misumi, K; Harada, K; Murakami, A; Kondo, H; Akagi, M

    1989-01-01

    In order to ascertain the advantages of the combined use of the pulling-up retractor and EEA stapler, we reviewed 88 patients who underwent surgery for upper stomach cancer between 1978 and 1986. The length of resected esophagus was significantly longer in patients operated on using an abdominal approach with this combination, as in those using a thoracoabdominal approach, than in those who were operated on using an abdominal approach with only the retractor or without the instruments (p less than 0.05). A relatively high incidence of leakage occurred at the anastomosis of the esophagus to the stomach or jejunum following operation using a transabdominal approach without the instruments. Pulmonary complication tended to be decreased in the non-thoracotomized patients compared to the thoracotomized patients. Postoperative radiogram following the combined use showed an esophagogastrostomy at a high level in the mediastinum. Our combination technique enables lymphadenectomy in the lower mediastinum and a sufficiently long enough resection of the esophagus without fatal complications.

  8. Distribution of toenail selenium levels in young adult Caucasians and African Americans in the United States: The CARDIA Trace Element Study

    Energy Technology Data Exchange (ETDEWEB)

    Xun, Pengcheng; Bujnowski, Deborah [Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, 2221 McGavran-Greenberg, Campus Box: 7461, Chapel Hill, NC (United States); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Liu, Kiang [Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States); Steve Morris, J. [Research Reactor Center, University of Missouri-Columbia, Columbia, MO (United States); Guo, Zhongqin [Department of Epidemiology and Biostatistics, School of Public Health, Ningxia Medical University, Ningxia (China); Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, 2221 McGavran-Greenberg, Campus Box: 7461, Chapel Hill, NC (United States); He, Ka, E-mail: kahe@unc.edu [Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, 2221 McGavran-Greenberg, Campus Box: 7461, Chapel Hill, NC (United States); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)

    2011-05-15

    Background: Data on selenium (Se) levels in American young adults, especially in African Americans, are lacking. Objective: This study presented toenail Se distributions in American young adults of both genders, including both Caucasians and African Americans; and explored potential predictors of toenail Se levels. Data and methods: Data from the Coronary Artery Risk Development in Young Adults study among 4252 American young adults, aged 20-32 in 1987 was used to examine toenail Se levels by instrumental neutron-activation analysis. The distribution of Se levels was described and multivariable linear regression was used to examine potential modifiers of toenail Se concentration within ethnicity-gender subgroups. Results: The geometric mean of toenail Se in this cohort was 0.844 {mu}g/g (95% CI, 0.840-0.849 {mu}g/g) and the median was 0.837 {mu}g/g (95% CI, 0.833-0.844 {mu}g/g). Median levels from lowest to highest quintile were 0.691, 0.774, 0.838, 0.913 and 1.037 {mu}g/g. Se levels varied geographically, and were generally in accordance with its concentrations in local soil. Males, African Americans, current smokers, heavy drinkers and less educated participants were more likely to have low Se levels. Conclusion: This study suggests that toenail Se levels vary geographically depending on soil Se concentrations. In addition to gender, ethnicity and education level, smoking status and alcohol consumption are two important indicators of Se status since they are modifiable lifestyle factors. Findings from this study might aid public health professionals in identifying people at relatively high or low Se levels, so that chronic disease prevention efforts can be directed toward these subgroups. - Research highlights: {yields} Average of toenail Se levels in this cohort was 0.844 {mu}g/g (95% CI, 0.840-0.849 {mu}g/g). {yields} Toenail Se levels vary geographically depending on soil Se concentrations. {yields} Males, African Americans and less educated participants have low Se levels. {yields} Smoking status and alcohol consumption are two important indicators of Se status.

  9. 152例贲门癌临床病理分析%Clinico-pathological analysis about gastric cardia carcinoma (152 cases)

    Institute of Scientific and Technical Information of China (English)

    陈洁; 刘艺侠; 刘钧; 赵永年

    2001-01-01

    目的:探讨贲门癌的临床病理特征,为临床诊断与治疗提供参考.方法:对我院附属医院1993-1998年间手术切除的152例贲门癌的临床病理资料进行分析.结果:152例中平均年龄56.9岁,男女之比5.33:1,肉眼溃疡型占84.9%,组织学类型高分化腺癌占34.9%,侵及浆膜或侵透浆膜占84.2%,淋巴道占50.7%,淋巴结转移与肿瘤浸润深度、肉眼类型有关(P<0.05).结论:贲门癌早期难以发现,就诊时多属晚期,常常已发生浸润、转移,故预后差.应对高发区进行普查,以便早期发现早期诊治,以延长患者生存时间.

  10. [Mollusks in the Bou Grara Sea (southern, Tunisia): initial biometric data on Cerastoderma glaucum Poirêt, 1789 (Bivalvia, Eulamellibranchia, Cardiae)].

    Science.gov (United States)

    Zaouali, J

    1979-12-01

    The statistical study of Cerastoderma glaucum in the little harbour of Bou Grara points out the presence of 21 ribs on the valves, a mean growth of 19,3 mm for the first year of life and a mean longevity of two years; the formation of rest rings is made at summer period. The dynamical study of the population shows its large homeostasy.

  11. Changes in waist circumference and body mass index in the US CARDIA cohort: fixed-effects associations with self-reported experiences of racial/ethnic discrimination.

    Science.gov (United States)

    Cunningham, Timothy J; Berkman, Lisa F; Kawachi, Ichiro; Jacobs, David R; Seeman, Teresa E; Kiefe, Catarina I; Gortmaker, Steven L

    2013-03-01

    Prior studies examining the association between self-reported experiences of racial/ethnic discrimination and obesity have had mixed results and primarily been cross-sectional. This study tests the hypothesis that an increase in self-reported experiences of racial/ethnic discrimination predicts gains in waist circumference and body mass index in Black and White women and men over eight years. In race/ethnicity- and gender-stratified models, this study examined whether change in self-reported experiences of racial/ethnic discrimination predicts changes in waist circumference and body mass index over time using a fixed-effects regression approach in SAS statistical software, providing control for both measured and unmeasured time-invariant covariates. Between 1992-93 and 2000-01, self-reported experiences of racial/ethnic discrimination decreased among 843 Black women (75% to 73%), 601 Black men (80% to 77%), 893 White women (30% to 23%) and 856 White men (28% to 23%). In fixed-effects regression models, controlling for all time-invariant covariates, social desirability bias, and changes in education and parity (women only) over time, an increase in self-reported experiences of racial/ethnic discrimination over time was significantly associated with an increase in waist circumference (β=1.09, 95% CI: 0.00-2.19, p=0.05) and an increase in body mass index (β=0.67, 95% CI: 0.19-1.16, p=0.007) among Black women. No associations were observed among Black men and White women and men. These findings suggest that an increase in self-reported experiences of racial/ethnic discrimination may be associated with increases in waist circumference and body mass index among Black women over time.

  12. Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: A prospective cohort study

    NARCIS (Netherlands)

    Steevens, J.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2010-01-01

    Objective: Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective

  13. DNA repair gene XRCC3 Thr241Met polymorphism and susceptibility to cardia and non-cardia gastric cancer: a case- control study%DNA损伤修复基因XRCC3 Thr241Met多态与贲门癌、非贲门部胃癌易感性关系的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    黄贵培; 郑宗立; 蔡琳

    2006-01-01

    目的探讨福建人群DNA损伤修复基因XRCC3 Thr241Met多态与贲门癌、非贲门部胃癌易感性的关系,分析基因与环境因素在癌症发生中的联合作用.方法采用共同对照组的病例对照研究方法,应用PCR-RFLP技术检测基因型,应用非条件logistic回归计算OR值及其95%CI.结果 XRCC3三种基因型(野生型CC、杂合突变型CT、纯合突变型TT)在贲门癌组的分布频率分别为43.2%、46.5%、10.3%;在非贲门部胃癌组的分布频率为53.2%、40.9%、5.8%;在对照组的分布频率分别为59.6%、35.1%、5.3%.经多因素分析结果显示携带变异基因型(CT+TT)个体罹患贲门癌的风险增加(OR=1.76,95%CI:1.07~2.90).XRCC3变异基因型与饮酒、新鲜蔬菜摄入和慢性胃炎对贲门癌发生存在协同作用;与吸烟、慢性胃炎对非贲门部胃癌发生存在协同作用.结论XRCC3基因多态与贲门癌发生有关,贲门癌与非贲门部胃癌的危险因素不尽相同.

  14. 幽门螺杆菌在贲门粘膜不同位点感染差异与贲门癌发生关系的研究%The relationship between helicobactor pylori infection and gastric cardia carcinoma in different site of gastric cardia

    Institute of Scientific and Technical Information of China (English)

    赖少清; 王国清

    2001-01-01

    目的比较贲门不同位点幽门螺杆菌(H.pylori)感染的差异;研究H.pylori感染与贲门癌之间的关系.方法对我国食管癌高发区河北省涉县偏店、固新两乡201例当地居民进行上消化道内镜普查,在贲门区不同位点(内镜下9°、12°、3°和6°点位)取活检,活检组织经HE染色进行病理诊断,Giemsa染色找H.pylori.结果河北省涉县居民H.pylori感染率61.2%;在H.pylori感染者中,内镜下12°点位H.pylori人群感染率为56.7%,对侧6°点位H.pylori人群感染率35.8%,P<0.05.检出贲门癌11例,其中9例发生在12°点位,1例发生在9°点位.1例发生在6°点位.结论贲门粘膜H.pylori感染的差异与贲门癌发生有相关性.

  15. Pressure measurement before and after the delation of the esophagus in patients with achalasia of cardia%贲门失迟缓症患者扩张前后食管测压研究

    Institute of Scientific and Technical Information of China (English)

    范一宏; 吕宾

    2002-01-01

    目的:贲门失迟缓症(achalasia)是原发性食管运动障碍性疾病,食管扩张术是治疗贵门失迟缓症较为有效的治疗方法.为了解贲门失迟缓症患者扩张前后食管压力的变化,对扩张前后的测压研究作一综述.方法:阅读有关文献20篇,对贲门失迟缓症患者扩张前后食管下段括约肌(LES)、食管体部、食管上段括约肌(UES)测压表现进行归纳分析.结果:贲门失迟缓症患者存在不完全性LES松弛以及食管体缺乏蠕动,扩张后LESP下降至17或10mmHg以下或>40%术前水平、LES松弛率增加及剩余压<6mmHg提示治疗可能成功.结论:诊断贲门失迟缓症较特异的方法是食管测压,食管扩张术是治疗贲门失迟缓症较为有效的方法.至目前为止,尚无明确的扩张疗效的测压评价标准,进一步的评价标准还需进行大量的临床研究.

  16. Preoperational Management for Patient with Cardia Carcinoma Complicated with Diabetes Melitus%食管癌贲门癌伴糖尿病的围手术期处理

    Institute of Scientific and Technical Information of China (English)

    朱以芳; 张小军

    2002-01-01

    @@ 1 糖尿病的病理生理糖尿病(diabetes melitus,DM)主要分为2型,1型DM和2型DM,1型DM一般发生在儿童、青少年和年轻人,2型糖尿病是老年人的常见病,60岁以上发病较为普遍.手术时,创伤引起的应激反应使机体内分泌代谢发生明显改变.DM患者本身就存在内分泌代谢障碍,其与没有DM的患者相比,围手术期并发症发生的危险性及死亡率大大增加.具体的并发症主要包括:高血糖导致的高渗性利尿;高渗状态下可出现血液黏滞性增高,血栓形成和脑水肿;酮症和DM酮症酸中毒;蛋白质分解和氨基酸转运减少至伤口愈合延迟,白细胞功能降低易发生感染.

  17. 贲门粘膜癌癌前病变与幽门螺杆菌感染关系的研究%Relationship between Precancerous Lesions of Gastric Cardia and Helicobacter Pylori Infection

    Institute of Scientific and Technical Information of China (English)

    赖少清; 王国清

    2001-01-01

    目的:研究幽门螺杆菌(Helicobacter.pylori,H.pylori)感染与贲门癌癌前病变发生的关系.方法:对我国食管癌高发区河北省涉县偏店、固新两乡的 201例当地居民进行上消化道内镜普查,在贲门区不同位点(贲门脊根部内镜下 12点位和对侧内镜下 6点位)取活检,活检组织经 HE染色进行病理诊断,Giemsa染色找 H.pylori. 结果:河北省涉县居民 H.pylori感染率 61.2%;在 H.pylori感染者中,贲门脊根部 H.pylori阳性率 97.3%,对侧 6点位 H.pylori阳性率 64.3%,P< 0.05. H.pylori在贲门粘膜慢性活动性胃炎组织中阳性检出率为 88%.结论:H.pylori感染与河北省涉县居民贲门癌癌前病变的发生有密切关系.

  18. Tumor de reto e cárdia sincrônicos: relato de caso e revisão da literatura Rectum and cardia cynchronous tumor: case report and literature review

    Directory of Open Access Journals (Sweden)

    Robson Luis Silveira Jara

    2007-03-01

    Full Text Available Os autores relatam um caso raro de um paciente de 77 anos, que desenvolveu dois tumores sincrônicos do trato gastrintestinal, localizados em topografia de reto e cárdia. Feito o diagnóstico de ambos simultaneamente. Foi submetido à cirurgia em dois tempos e evoluiu bem, realizando a reconstrução do trato gastrintestinal três meses após a primeira intervenção. Não encontramos na literatura nenhum outro relato desta combinação de tumores.We discuss a 77-year-old man who developed two cancers: adenocarcinoma of the stomach and adenocarcinoma of the rectum. He was submitted at the surgery developed for two interventions and evolved aright. To the best of our knowledge, no other patient with the combination of these two cancers has been reported in the literature.

  19. 同期发生食管贲门双源癌16例诊治分析%Diagnosis and treatment of 16 cases of concurrent cancers from esophagus and gastric cardia

    Institute of Scientific and Technical Information of China (English)

    刘岩青; 孟德强; 王付龙; 刘全印

    2013-01-01

    目的 探讨同期发生的食管贲门双源癌的外科治疗方法及疗效.方法 2002年8月-2010年7月,共收治同期发生的食管贲门双源癌16例,均为男性,年龄52~ 67(60.4±4.8)岁,均行手术治疗.采用左侧开胸切口行食管贲门双源癌切除术14例,胸腹联合切口行食管贲门双源癌切除2例,术中消化道重建用胃代食管胸腔内吻合术.结果 本组围术期无死亡病例.术后发生阵发性心房纤颤2例,经治疗后缓解;肺部感染2例,给予抗感染治疗后治愈.术后切口感染2例,经换药痊愈.10例患者获得随访,1、3、5年生存率为100%、40%、20%.结论 同期发生的食管贲门双源癌患者,经积极手术治疗,预后良好,生活质量明显提高.

  20. Evaluation of CT and US in diagnosis of cardia carcinoma (with 67 reports)%贲门癌的CT及B超诊断价值(附67例报告)

    Institute of Scientific and Technical Information of China (English)

    颜朝晖

    2004-01-01

    目的:探讨CT常规扫描及B超探查食管胃连接区的解剖,分析CT、B超在贲门癌诊断中的价值以及对外科治疗的指导价值.方法:收集220例正常者和67例贲门癌患者检查资料,分析正常CT解剖形态和贲门癌的CT表现,并与B超检查作比较,与手术结果作对照.结果:正常贲门CT分为锥体型、管状型和镰刀型3种形态;贲门癌CT可分为单纯管壁增厚型、肿块型和外侵型3型.术前诊断准确率CT为97%,B超为98.5%.结论:正确认识CT、B超下食管胃连接区的影像有利于提高CT、B超对贲门癌的检出率,可估计贲门癌手术切除的可能性.

  1. Prospective study of Helicobacter pylori antigens and gastric noncardia cancer risk in the Nutrition Intervention Trial cohort

    OpenAIRE

    Murphy, Gwen; Freedman, Neal D; Michel, Angelika; Fan, Jin-Hu; Taylor, Philip R.; Pawlita, Michael; Qiao, You-Lin; Zhang, Han; Yu, Kai; Abnet, Christian C.; DAWSEY, Sanford M.

    2015-01-01

    Helicobacter pylon (H. pylori) infection is the strongest known risk factor for gastric non-cardia adenocarcinoma (GNCA). We used multiplex serology to determine whether seropositivity to 15 H. pylori proteins is associated with the subsequent development of non-cardia gastric cancer in Linxian, China.

  2. Socioeconomic status and stomach cancer incidence in men: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Loon, A.J.M. van; Goldbohm, R.A.; Brandt, P.A. van den

    1998-01-01

    Study objective - To study the association between socioeconomic status (SES) and stomach cancer incidence (cardia and non-cardia) and the role of lifestyle factors in explaining this association. Design - Prospective cohort study on diet and cancer that started in 1986. Data were collected by means

  3. Vodka consumption, tobacco smoking and risk of gastric cancer in Poland.

    Science.gov (United States)

    Jedrychowski, W; Boeing, H; Wahrendorf, J; Popiela, T; Tobiasz-Adamczyk, B; Kulig, J

    1993-08-01

    A multicentre hospital-based incident case-control study with 520 male gastric cancer cases aged vodka drinking, smoking cigarettes had no significant effect on risk. The estimated relative risk (RR) increased to 2.27 (95% confidence interval [CI] : 0.97-5.28) for intestinal cardia cancer for those who smoked cigarettes without filters. The RR for stomach cancer grew as the frequency and amount of vodka drunk increased. People drinking vodka at least once a week had about a threefold higher risk compared to non-drinkers (RR = 3.06, 95% CI : 1.90-4.95). The effect of vodka drinking on risk was particularly strong for non-cardia cancers of the intestinal type. Those who usually drank vodka before breakfast had an elevated risk (RR = 2.98, 95% CI : 1.60-5.53) which was also present in all the subgroups investigated. Cardia and non-cardia cancer showed differences with respect to the interaction between tobacco smoking and vodka drinking. For cancers of the cardia region the risk was low for non-smokers or those who drank small amounts of vodka. The risk for cardia cancer increased considerably for smokers of cigarettes without filters and vodka drinkers who consumed large amounts (RR = 3.70, 95% CI : 1.13-12.06). For the non-cardia region a uniform increase could be observed for vodka drinking regardless of cigarette smoking status.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Trans-abdominal ultrasonography in diagnosis of achalasia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-quan; CHEN Xiao-hua

    2002-01-01

    Objective: To assess the clinical value of trans-abdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffering from achalasia as the patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. Real-time trans-abdominal ultrasonography (TAUS) was employed to investigate the lower esophagus and cardia of all subjects through water provocative test, and the sonographic findings were compared. After treated by administration of drugs, pneumatic balloon dilation or intrasphincteric injection of botulinum toxin, the 8 patients with achalasia were re-examined by TAUS for longitudinal comparison. Results: (1) The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly in accordance with the drinking action to allow water enter the stomach. (2) All the patients with achalasia were found to have dilation of lower esophagus before taking water. During a 10-min continuous TAUS scanning, 5 patients demonstrated absence of relaxation of cardias and no passage of water from the esophagus into the stomach.The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test all the 8 patients had water retardation within the lower esophagus. (3)The patients with cardiac carcinoma had an ultrasound feature of enlargement of cardiac ring and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water, while being taken,passed the cardia more slowly than in normal condition. Conclusion: TAUS is a readily accepted examination on patients because they need only to drink a little water. By demonstrating the size of cardia, thickness of cardiac wall and monitoring the water flow through the cardia, TAUS can quickly give reliable diagnostic clues to achalasia. TAUS also can be used for making assessment of therapeutic

  5. Related factors for mediastinal lymph node metastasis in gastric cardia adenocarcinoma:A report of 118 cases%贲门腺癌纵隔淋巴结转移相关因素分析(附118例报告)

    Institute of Scientific and Technical Information of China (English)

    汪金钱; 解明然; 魏大中

    2014-01-01

    Objective:To investigate the related factors affecting the mediastinal lymph node metastasis in patients with gastric cardial adenocarcinoma for indications of necessary lymph node dissection .Methods:The clinical data were retrospectively analyzed in 118 cases of gastric cardial adenocarcinoma undergone surgical treatment in our department between Jan.2011 and May 2013.The outcomes of mediastinal lymph node metastasis were determined on the pathological finding basis of the patients.Results:Totally,362 pieces of mediastinal lymph nodes were dissected,mean(3.1 ±0.4)pieces,and the rate and ratio of mediastinal lymph node metastasis were 25.4%(30/118) and 11.6%(42/362),respectively.The metastasis to the mediastinal lymph nodes was associated with tumor size,pathological tumor depth,differentiation and presence or absence of involvement of the lower esophagus .The results were statistically significant (P≤0.05).Conclusion:Metastasis status of the mediastinal lymph nodes for cardial adenocarcinoma is associated with pathological factors,and occurs more common in cases with poorly differentiated and larger sized tumor ( >3 cm in diameter) ,deeper invasion and involvement of lower esophagus.Thus,conventional dissection of the mediastinal lymph nodes,especially the lymph nodes at the inferior mediastinum,is necessary for those types of patients.%目的:探讨贲门腺癌纵隔淋巴结转移相关因素,以明确纵隔淋巴结清扫指征。方法:回顾性分析2011年1月~2013年5月118例左胸入路手术治疗贲门腺癌患者临床资料,分析患者临床病理资料与纵隔淋巴结转移的关系。结果:全组病例共清扫纵隔淋巴结362枚,平均清扫每例淋巴结数(3.1±0.4)枚。纵隔淋巴结转移率为25.4%(30/118),转移度为11.6%(42/362)。肿瘤长度、浸润深度、分化程度、肿瘤是否累及食管下段与纵隔淋巴结转移有关,结果有统计学意义(P≤0.05)。结论:贲门腺癌其分化程度越低,肿块越大(最大直径超过3 cm),浸润越深,食管下端累及越容易发生纵隔淋巴结转移。临床工作中对这些患者应该常规行纵隔淋巴结清扫(主要是下纵隔淋巴结)。

  6. A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer

    DEFF Research Database (Denmark)

    Siemsen, Mette; Svendsen, Lars Bo; Knigge, Ulrich

    2003-01-01

    BACKGROUND: Both curved array and radial scanning echoendoscopy are used for locoregional staging of cancer arising in the esophagus or cardia. The accuracy of TNM staging of these malignancies by curved array and radial EUS was compared in a prospective, randomized study. METHODS: Patients...... with cancer of the esophagus or cardia were examined by both curved array and radial echoendoscopy in randomized order by the same endosonographer in an unblinded fashion. The staging results and the examination time for the two echoendoscopies were compared and statistically analyzed, and finally compared......, respectively, 15 and 12 minutes (pcancer of the esophagus or cardia. The choice of echoendoscope for TNM staging in patients with these malignancies is, therefore, a question...

  7. Serum ghrelin; a new surrogate marker of gastric mucosal alterations in upper gastrointestinal carcinogenesis.

    Directory of Open Access Journals (Sweden)

    Alireza Sadjadi

    Full Text Available BACKGROUND: A few studies have indicated inverse relationships between serum ghrelin and gastric and esophageal cancers but those associations have been restricted to specific populations, including smokers and overweight individuals. We examined the association between ghrelin and gastroesophageal cancers and atrophic gastritis in a population-based setting. METHODS: In total 220 gastroesophageal cancers, comprising non-cardia and cardia gastric cancer, esophageal adenocarcinoma, esophageal squamous cell carcinoma (SCC and age and gender-matched controls were recruited. Serum ghrelin, pepsinogen I/II ratio (PGI/II and anti-H.pylori IgG antibodies were measured. Relationships between ghrelin and gastroesophageal cancers, after adjustment for PGI/II ratio, H.pylori status and smoking, were tested using logistic regression. Furthermore, in 125 endoscopically normal volunteers, with and without histological atrophic gastritis, the relationship with ghrelin was compared. RESULTS: Serum ghrelin (lowest vs. highest quintile was inversely associated with gastric cancer: OR (95% CI 8.71 (1.70-44.59 for cardia and 6.58 (1.26-34.46 for non-cardia cancer. Lower serum ghrelin was also associated with esophageal SCC: OR (95% CI 5.69 (1.36-23.78, but not with esophageal adenocarcinoma. A similar association was observed between gastric cancer (cardia and non-cardia and esophageal SCC when serum ghrelin was analysed as a continuous scaled variable. In endoscopically-normal volunteers, extensive atrophic gastritis was associated with low serum ghrelin [OR (95% CI 0.25 (0.10-0.64]. CONCLUSION: Inverse associations between ghrelin and some gastroesophageal cancers suggest a potential role for serum ghrelin as a biomarker of upper gastrointestinal cancers and atrophic gastritis. In areas with a high incidence of gastric and/or esophageal cancer, screening might be more effectively targeted to individuals with low serum ghrelin in addition to the PGI/II ratio.

  8. Diverging trends in recent population-based survival rates in oesophageal and gastric cancer.

    Directory of Open Access Journals (Sweden)

    Jesper Lagergren

    Full Text Available BACKGROUND: Survival trends in oesophageal and gastric cancer need to be updated. A nationwide Swedish population-based study in 1961-2009 was based on registry data. METHODOLOGY/PRINCIPAL FINDINGS: Relative survival rate, i.e. the ratio of the observed to the expected survival, adjusted for age, sex, and calendar period, and presented with 95% confidence intervals (CI, was the main outcome measure. The expected survival was calculated using the corresponding Swedish general population with no exclusions. The relative survival rates in oesophageal and gastric cardia adenocarcinoma have improved since the 1990s (p for trend <0.001, but not in oesophageal squamous cell carcinoma or gastric non-cardia adenocarcinoma. The relative 5-year survival rates during the two recent periods 1990-1999 and 2000-2008 were 12.5% (95%CI 10.1%-14.9% and 10.3% (95%CI 8.5-12.0% for oesophageal squamous cell carcinoma, 12.5% (95%CI 10.1%-14.9% and 14.6% (95%CI 12.6-16.6% for oesophageal adenocarcinoma, 11.1% (95%CI 9.6%-12.6% and 14.3% (95%CI 12.3-16.3% for gastric cardia adenocarcinoma, and 20.2% (95%CI 19.2%-21.1% and 19.0% (95%CI 17.7-20.2% for gastric non-cardia adenocarcinoma. The 3-year survival in tumour stage III in 2004-2008 was about 25% for all four tumour types. CONCLUSIONS/SIGNIFICANCE: The survival in oesophageal and cardia adenocarcinoma is increasing, but the lack of such increase in oesophageal squamous cell carcinoma and gastric non-cardia adenocarcinoma is a concern.

  9. Immunohistochemical study on localization of serotonin immunoreactive cells in the gastrointestinal tract of the European catfish (Silurus glanis, L.).

    Science.gov (United States)

    Köprücü, S; Yaman, M

    2015-02-01

    In this study, it was aimed to identify the distribution of serotonin immunoreactive cells within the gastrointestinal tract (GIT) of European catfish (Silurus glanis). For this purpose, the tissue samples were taken from the stomach (cardia, fundus and pylorus region) and intestine (anterior, middle and posterior region). They were examined by applying the avidin-biotin-immunoperoxidase method. The serotonin containing immunoreactive cells are presented in all regions of the GIT. It was determined to be localized generally in different distribution within the stomachs and intestines of S. glanis. It was found that the most intensive regions of immunoreactive cells were the cardia stomach and posterior of intestine.

  10. Cereal fiber intake may reduce risk of gastric adenocarcinomas : The EPIC-EURGAST study

    NARCIS (Netherlands)

    Mendez, M. A.; Pera, Guillem; Aguclo, Antonio; Bueno-de-Mesquita, H. Bas; Palli, Domenico; Boeing, Heiner; Carneiro, Ftima; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Goeran; Manjer, Jonas; Johansson, Ingegerd; Stenling, Roger; Martinez, Carmen; Dorronsoro, Miren; Barricarte, Aurelio; Tormo, Maria J.; Quiros, Jose R.; Allen, Naomi; Key, Timothy J.; Bingham, Sheila; Linseisen, Jakob; Kaaks, Rudolf; Overvad, Kim; Jensen, Majken; Olsen, Anja; Tjonneland, Anne; Peeters, Petra H. M.; Numans, Mattijs E.; Ocke, Marga C.; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Lund, Eiliv; Slimani, Nadia; Jenab, Mazda; Ferrari, Pietro; Riboli, Elio; Gonzalez, Carlos A.

    2007-01-01

    Numerous case-control studies suggest dietary fiber may reduce risk of gastric cancer, but this has not been confirmed prospectively. A previous case-control study reported reduced risk of gastric cardia adenocarcinomas associated with cereal fiber, but not with fruit or vegetable fiber. To date, di

  11. Longitudinal trends in diet and effects of sex, race, and education on dietary quality score change: the Coronary Artery Risk Development in Young Adults study

    NARCIS (Netherlands)

    Sijtsma, F.P.C.; Meyer, K.A.; Steffen, L.M.; Shikany, J.M.; Horn, van L.; Harnack, L.J.; Kromhout, D.; Jacobs, D.R.

    2012-01-01

    Background: The food supply and dietary preferences have changed in recent decades. Objective: We studied time- and age-related individual and population-wide changes in a dietary quality score and food groups during 1985–2006. Design: The Coronary Artery Risk Development in Young Adults (CARDIA) st

  12. Barrett's esophagus : high cancer-risk groups, cardiovascular co-morbidity and interaction with Helicobacter pylori

    NARCIS (Netherlands)

    S. Gudlaugsdottir (Sunna)

    2002-01-01

    textabstractBarrett's esophagus (BE) has come to be regarded as an impOliant premalignant condition. In recent years the incidence of adenocarcinoma of the esophagus and of the gastric cardia has risen dramatically. Analyses of cancer incidence data fi'om nine areas of the United States revealed ste

  13. Modulation of intrinsic cardiac neurons by spinal cord stimulation : implications for its therapeutic use in angina pectoris

    NARCIS (Netherlands)

    Foreman, RD; Linderoth, B; Ardell, JL; Barron, KW; Chandler, MJ; Hull, SS; TerHorst, GJ; DeJongste, MJL; Armour, JA

    2000-01-01

    Objective: Electrical stimulation of the dorsal aspect of the upper thoracic spinal cord is used increasingly to treat patients with severe angina pectoris refractory to conventional therapeutic strategies. Clinical studies show that spinal cord stimulation (SCS) is a safe adjunct therapy for cardia

  14. Interstitial cells of Cajal in human gut and gastrointestinal disease

    DEFF Research Database (Denmark)

    Vanderwinden, J M; Rumessen, J J

    1999-01-01

    of their functional significance. Alterations of ICC reported in achalasia of cardia, infantile hypertrophic pyloric stenosis, chronic intestinal pseudoobstruction, Hirschsprung's disease, inflammatory bowel diseases, slow transit constipation, and some other disorders of GI motility as well as in gastrointestinal...... stromal tumors are reviewed, with emphasis on the place of ICC in the pathophysiology of disease....

  15. Sleep Disorders in Patients with Bronchial Asthma

    OpenAIRE

    Cukic, Vesna; Lovre, Vladimir; Dragisic, Dejan

    2011-01-01

    Respiratory disturbances during sleep are recognized as extremely common disorders with important clinical consequences. Breathing disorders during sleep can result in broad range of clinical manifestations, the most prevalent of which are unrefreshing sleep, daytime sleepiness and fatigue, and cognitive impairmant. There is also evidence that respiratory-related sleep disturbances can contribute to several common cardiovascular and metabolic disorders, including systemic hypertension, cardia...

  16. Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran

    NARCIS (Netherlands)

    Malekzadeh, R; Sotoudeh, M; Derakhshan, MH; Mikaeli, J; Yazdanbod, A; Merat, S; Yoonessi, A; Tavangar, M; Ardakani, BA; Sotoudehmanesh, R; Pourshams, A; Asgari, AA; Doulatshahi, S; Alizadeh, BZ; Arshi, S; Madjidpoor, A; Moomen, SM; Fleischer, DE

    2004-01-01

    Background/Aims: Ardabil Province, in northwestern Iran, has the highest rate of gastric ( predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions.

  17. Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran

    NARCIS (Netherlands)

    Malekzadeh, R; Sotoudeh, M; Derakhshan, M H; Mikaeli, J; Yazdanbod, A; Merat, S; Yoonessi, A; Tavangar, M; Abedi, B Ardakani; Sotoudehmanesh, R; Pourshams, A; Asgari, A Ali; Doulatshahi, S; Alizadeh, B Ziad; Arshi, S; Madjidpoor, A; Mir Moomen, S; Fleischer, D E

    2004-01-01

    BACKGROUND/AIMS: Ardabil Province, in northwestern Iran, has the highest rate of gastric (predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions. M

  18. Selenium Status and the Risk of Esophageal and Gastric Cancer Subtypes: The Netherlands Cohort Study

    NARCIS (Netherlands)

    Steevens, J.; Brandt, P.A. van den; Goldbohm, R.A.; Schouten, L.J.

    2010-01-01

    Background & Aims: Selenium may protect against the development of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric cardia adenocarcinoma (GCA). Only in very few studies have the associations with ESCC and GCA been investigated, and no epidemiologic studies exi

  19. The stereoisomers quinine and quinidine exhibit a marked stereoselectivity in the inhibition of hepatobiliary transport of cardiac glycosides

    NARCIS (Netherlands)

    Hedman, A; Meijer, DKF

    1998-01-01

    Background / Aims: Certain basic (cationic) drugs are known to interact with the hepatic transport, and renal and/or biliary clearance of cardia glycosides. The mechanisms behind these interactions are not fully understood, In the present study our was to investigate the effects of the two diastereo

  20. S1P-Yap1 signaling regulates endoderm formation required for cardiac precursor cell migration in zebrafish.

    Science.gov (United States)

    Fukui, Hajime; Terai, Kenta; Nakajima, Hiroyuki; Chiba, Ayano; Fukuhara, Shigetomo; Mochizuki, Naoki

    2014-10-13

    To form the primary heart tube in zebrafish, bilateral cardiac precursor cells (CPCs) migrate toward the midline beneath the endoderm. Mutants lacking endoderm and fish with defective sphingosine 1-phosphate (S1P) signaling exhibit cardia bifida. Endoderm defects lead to the lack of foothold for the CPCs, whereas the cause of cardia bifida in S1P signaling mutants remains unclear. Here we show that S1P signaling regulates CPC migration through Yes-associated protein 1 (Yap1)-dependent endoderm survival. Cardia bifida seen in spns2 (S1P transporter) morphants and s1pr2 (S1P receptor-2) morphants could be rescued by endodermal expression of nuclear localized form of yap1. yap1 morphants had decreased expression of the Yap1/Tead target connective tissue growth factor a (Ctgfa) and consequently increased endodermal cell apoptosis. Consistently, ctgfa morphants showed defects of the endodermal sheet and cardia bifida. Collectively, we show that S1pr2/Yap1-regulated ctgfa expression is essential for the proper endoderm formation required for CPC migration.

  1. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease

    NARCIS (Netherlands)

    J.K. Min (James); A. Dunning (Allison); H. Gransar (Heidi); S. Achenbach (Stephan); F.Y. Lin (Fay); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); F. Cademartiri (Filippo); E. Maffei (Erica); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.B. D'Agostino (Ralph); A. Delago (Augustin); J. Friedman (John); M. Hadamitzky (Martin); J. Hausleiter (Jörg); S.W. Hayes (Sean W.); P.A. Kaufmann (Philipp A.); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); L.E.J. Thomson (Louise); T.C. Villines (Todd); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); H. Marques (Hugo); D.S. Berman (Daniel S.); M. Pencina (Michael)

    2015-01-01

    textabstractObjective To develop a clinical cardiac risk algorithm for stable patients with suspected coronary artery disease based upon angina typicality and coronary artery disease risk factors. Methods Between 2004 and 2011, 14,004 adults with suspected coronary artery disease referred for cardia

  2. Achalasia: A case report on its effect during surgical decision making for laparoscopic sleeve gastrectomy in the young morbidly obese patient

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Oviedo, MD, FACS

    2016-01-01

    Conclusion: The patient has already undergone a POEM procedure, which was chosen to maintain the gastric fundus, cardia, and gastroesophageal junction (GEJ architecture as opposed to a LHM with Dor fundoplication, which would have altered the anatomy, thus making a concomitant laparoscopic sleeve gastrectomy an unfeasible option.

  3. Drinking hot beverages is not associated with risk of oesophageal cancers in a Western population

    OpenAIRE

    2001-01-01

    We performed a nationwide population-based case-control study of hot beverage consumption and oesophageal cancer in Sweden. Drinking beverages very hot did not increase the risk for oesophageal squamous cell carcinoma, oesophageal adenocarcinoma, or gastric cardia adenocarcinoma. © 2001 Cancer Research Campaign http://www.bjcancer.com

  4. Relationship of a hiatal hernia to the function of the body of the esophagus and the gastroesophageal junction

    Energy Technology Data Exchange (ETDEWEB)

    DeMeester, T.R.; Lafontaine, E.; Joelsson, B.E.; Skinner, D.B.; Ryan, J.W.; O' Sullivan, G.C.; Brunsden, B.S.; Johnson, L.F.

    1981-10-01

    One hundred two patients referred to our Esophageal Function Laboratory without endoscopic evidence of esophagitis were divided into two groups on the basis of the presence of a hiatal hernia on endoscopic examination. Fifty-three patients had a hiatal hernia and 49 did not. Both groups and 30 normal volunteer subjects had esophageal manometry and 24 hour esophageal pH monitoring. The incompetency of the cardia in patients with a hiatal hernia was dependent upon loss of components responsible for the antireflux mechanism, mainly a decrease in distal esophageal sphincter pressure and a decrease in the length of the sphincter exposed to the positive-pressure environment of the abdomen. These deficiencies were not related to the presence of a hiatal hernia and were similar to those of patients with an incompetent cardia without a hiatal hernia. Patients with a hiatal hernia and an incompetent cardia had significantly more esophageal exposure to refluxed acid than without a hiatal hernia. On the basis of the number of reflux episodes that lasted 5 minutes or longer and radioisotope transit studies, this increased acid exposure was due to both a loss of competency of the cardia and poor esophageal clearance secondary to the presence of a hiatal hernia. Reduction of the hernia and anchoring the distal esophagus into the abdomen not only may improve the antireflux mechanism, but corrects the clearance abnormality as well. The presence of a hiatal hernia has a detrimental effect on the clearance function of the body of the esophagus and may aggravate the effects of gastroesophageal reflux due to an incompetent cardia.

  5. Spatial and sex-specific dissection of the Anopheles gambiae midgut transcriptome

    Directory of Open Access Journals (Sweden)

    Mahairaki Vassiliki

    2007-01-01

    Full Text Available Abstract Background The midgut of hematophagous insects, such as disease transmitting mosquitoes, carries out a variety of essential functions that mostly relate to blood feeding. The midgut of the female malaria vector mosquito Anopheles gambiae is a major site of interactions between the parasite and the vector. Distinct compartments and cell types of the midgut tissue carry out specific functions and vector borne pathogens interact and infect different parts of the midgut. Results A microarray based global gene expression approach was used to compare transcript abundance in the four major female midgut compartments (cardia, anterior, anterior part of posterior and posterior part of posterior midgut and between the male and female Anopheles gambiae midgut. Major differences between the female and male midgut gene expression relate to digestive processes and immunity. Each compartment has a distinct gene function profile with the posterior midgut expressing digestive enzyme genes and the cardia and anterior midgut expressing high levels of antimicrobial peptide and other immune gene transcripts. Interestingly, the cardia expressed several known anti-Plasmodium factors. A parallel peptidomic analysis of the cardia identified known mosquito antimicrobial peptides as well as several putative short secreted peptides that are likely to represent novel antimicrobial factors. Conclusion The A. gambiae sex specific midgut and female midgut compartment specific transcriptomes correlates with their known functions. The significantly greater functional diversity of the female midgut relate to hematophagy that is associated with digestion and nutrition uptake as well as exposes it to a variety of pathogens, and promotes growth of its endogenous microbial flora. The strikingly high proportion of immunity related factors in the cardia tissue most likely serves the function to increase sterility of ingested sugar and blood. A detailed characterization of the

  6. Topography Of Helicobacter Pylori Gastritis In Different Biopsy Sites Of Gastric Mucosa Of Residents Of A High Risk Area For Gastric Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Mikaeili J

    2004-08-01

    Full Text Available Background: Many recent studies have examined potential risk factors of H. pylori gastritis to improve our understanding of the early events in gastric carcinogenesis. We evaluated the extent and topography of chronic gastritis in a high risk area for gastric cardia cancer and investigated the critical role of H.pylori, risk index and age in its pathogenesis. Materials and Methods: During a national population-based endoscopic survey, we enrolled 508 participants aged ≥40 from urban and rural areas of Meshkin-Shahr, Ardebil province of Iran. After informed consent, all underwent complete upper GI endoscopy. At least one mucosal biopsy was obtained from 6 standard sites: three of antrum (sites 1, 2, 3, two of corpus (sites 4, 5 and one of cardia (site 6. Severity, activity and combined inflammatory scores (CIS of chronic gastritis and H.pylori infection status were assessed according to modified Sydney Classification of Gastritis. Statistical effects of H.pylori, age, gender, and residency place on mean gastritis severity, activity and CIS were separately calculated in each site. Results: Total of 508 participants with mean age (±SD of 54.6(±SD were enrolled. 234(46.1% were male and 274(53.9% were female. Histologically 80.5% of cases were H.pylori positive. Mean activity scores of all sites except for site 5 are significantly (P<0.01 higher in H.pylori + cases. Mean CIS of all sites was significantly (P<0.01 higher in H.pylori + patients. In 44% of infected subjects, CIS of the corpus was at least equally as severe as that in antrum. Also in 54% of H.pylori + cases, cardia’s CIS was ≥ than antral CIS. Age had a significant (P<0.01 negative relationship with CIS of antral site, but this relationship in cardia was positive and more potent. Conclusion: H.pylori is the main cause of gastritis activity in all sites of stomach; this causality is more potent in antrum and cardia. Continuous cardia inflammation in advanced age may contribute to

  7. Pathology findings and validation of gastric and esophageal cancer cases in a European cohort (EPIC/EUR-GAST)

    DEFF Research Database (Denmark)

    Carneiro, Fátima; Moutinho, Cátia; Pera, Guillem

    2007-01-01

    OBJECTIVE: Cardia, non-cardia and intestinal and diffuse subtypes of gastric cancer may have different trends and etiological factors. However, the available information is not always collected in population cancer registries, and heterogeneous criteria have been applied for the histopathological...... classification of tumors. We describe the pathological features of incident gastric and esophageal cancers identified within the European Prospective Investigation into Cancer and Nutrition (EPIC). MATERIAL AND METHODS: In an investigation on gastric and esophageal cancer (EUR-GAST) in the EPIC project......, a validation study of diagnoses reported by EPIC centers was conducted by a European panel of pathologists. Original pathology reports, stained slides of tumors and the respective paraffin blocks were requested from the centers. RESULTS: The whole series encompassed 467 cancer cases (gastric and esophageal...

  8. Granulocytic Sarcoma of the Stomach Presenting as Dysphagia during Pregnancy

    Directory of Open Access Journals (Sweden)

    Anuradha Sekaran

    2011-01-01

    Full Text Available Granulocytic sarcoma also known as extramedullary myeloid sarcoma or chloroma is an uncommon manifestation of leukemia and presents as a deposit of leukemic cells outside the bone marrow. We report a case of a twenty-five-year-old pregnant woman who presented with progressive dysphagia and recurrent postprandial vomiting. Upper GI endoscopy had shown large flat laterally spread nodular lesions in the cardia and proximal body of stomach. Biopsies from the gastric lesion showed granulocytic sarcoma of the stomach. Concurrent peripheral and bone marrow picture was suggestive of acute myeloid leukemia (AML–M4. There is limited reported literature on granulocytic sarcoma of the stomach. Concurrent gastric granulocytic sarcoma involving cardia and AML in pregnancy has not been reported till date.

  9. Association of dietary fat intakes with risk of esophageal and gastric cancer in the NIH-AARP diet and health study.

    Science.gov (United States)

    O'Doherty, Mark G; Freedman, Neal D; Hollenbeck, Albert R; Schatzkin, Arthur; Murray, Liam J; Cantwell, Marie M; Abnet, Christian C

    2012-09-15

    The aim of our study was to investigate whether intakes of total fat and fat subtypes were associated with esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), gastric cardia or gastric noncardia adenocarcinoma. From 1995-1996, dietary intake data was reported by 494,978 participants of the NIH-AARP cohort. The 630 EAC, 215 ESCC, 454 gastric cardia and 501 gastric noncardia adenocarcinomas accrued to the cohort. Cox proportional hazards regression was used to examine the association between the dietary fat intakes, whilst adjusting for potential confounders. Although apparent associations were observed in energy-adjusted models, multivariate adjustment attenuated results to null [e.g., EAC energy adjusted hazard ratio (HR) and 95% confidence interval (95% CI) 1.66 (1.27-2.18) p for trend gastric cancer risk; although a protective effect of polyunsaturated fat intake was seen for EAC in subjects with a normal BMI.

  10. Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review.

    Science.gov (United States)

    Kalya, Anantharam; Jaroszewski, Dawn; Pajaro, Octavio; Scott, Robert; Gopalan, Radha; Kasper, Diane; Arabia, Francisco

    2013-01-01

    Cardiac allograft rejection and failure may require mechanical circulatory support as bridge-to-retransplantation. Prognosis in this patient group is poor and implantable ventricular assist devices have had limited success due to organ failure associated with the high dose immunosuppression required to treat ongoing rejection. We present a case from our institution and the world-wide experience utilizing the SynCardia CardioWest Total Artificial Heart (TAH-t; SynCardia Systems, Inc., Tucson, AZ, USA) for replacement of the failing graft, recovery of patient and end-organ failure with ultimate bridge to retransplantation. We present our experience and review of world-wide experience for use of TAH-t in this type patient.

  11. Neurohumoral activation in heart failure: the role of adrenergic receptors

    OpenAIRE

    Patricia C. Brum; Rolim, Natale P. L.; BACURAU, Aline V. N.; Alessandra Medeiros

    2006-01-01

    Heart failure (HF) is a common endpoint for many forms of cardiovascular disease and a significant cause of morbidity and mortality. The development of end-stage HF often involves an initial insult to the myocardium that reduces cardiac output and leads to a compensatory increase in sympathetic nervous system activity. Acutely, the sympathetic hyperactivity through the activation of beta-adrenergic receptors increases heart rate and cardiac contractility, which compensate for decreased cardia...

  12. Cross-Sectional Associations Between Measures of Sleep and Markers of Glucose Metabolism Among Subjects With and Without Diabetes

    OpenAIRE

    Knutson, Kristen L.; Van Cauter, Eve; Zee, Phyllis; Liu, Kiang; Lauderdale, Diane S

    2011-01-01

    OBJECTIVE To examine whether sleep duration and quality are associated with fasting glucose, fasting insulin, or estimated insulin resistance in a community-based sample of early middle-aged adults. RESEARCH DESIGN AND METHODS This was an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Habitual sleep duration and fragmentation were estimated from 6 days of wrist actigraphy collected in 2003–2005. Insomnia was defined as self-reported difficulty falling ...

  13. Gastroesophageal flap valve status distinguishes clinical phenotypes of large hiatal hernia

    Institute of Scientific and Technical Information of China (English)

    Haruka; Kaneyama; Mitsuru; Kaise; Hiroshi; Arakawa; Yoshinori; Arai; Keisuke; Kanazawa; Hisao; Tajiri

    2010-01-01

    AIM: To investigate two distinct clinical phenotypes of reflux esophagitis and intra-hernial ulcer (Cameron lesions) in patients with large hiatal hernias. METHODS: A case series study was performed with 16 831 patients who underwent diagnostic esophagogastroduodenoscopy for 2 years at an academic referral center. A hiatus diameter ≥ 4 cm was defined as a large hernia. A sharp fold that surrounded the cardia was designated as an intact gastroesophageal flap valve (GEFV), and a loose fold or disappearance of...

  14. Association between oral health and gastric precancerous lesions

    OpenAIRE

    Salazar, Christian R.; Francois, Fritz; Li, Yihong; Corby, Patricia; Hays, Rosemary; Leung, Celine; Bedi, Sukhleen; Segers, Stephanie; Queiroz, Erica; SUN, JINGHUA; Wang, Beverly; Ho, Hao; Craig, Ronald; Cruz, Gustavo D.; Blaser, Martin J.

    2011-01-01

    Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precanc...

  15. Focus on renal congestion in heart failure

    OpenAIRE

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2015-01-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardia...

  16. Treatment and survival in a population-based sample of patients diagnosed with gastroesophageal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Deirdre P Cronin-Fenton; Margaret M Mooney; Limin X Clegg; Linda C Harlan

    2008-01-01

    AIM:To examine the extent of use of specific therapies in clinical practice,and their relationship to therapies validated in clinical trials.METHODS:The US National Cancer Institutes' Patterns of Care study was used to examine therapies and survival of patients diagnosed in 2001 with histologically-confirmed gastroesophageal adenocarcinoma (n = 1356).The study re-abstracted data and verified therapy with treating physicians for a population-based stratified random sample.RESULTS:Approximately 62% of patients had stomach adenocarcinoma (SAC),while 22% had gastric-cardia adenocarcinoma (GCA),and 16% lower esophageal adenocarcinoma (EAC).Stage IV/ unstaged esophageal cancer patients were most likely and stage I -111 stomach cancer patients least likely to receive chemotherapy as all or part of their therapy;gastric-cardia patients received chemotherapy at a rate between these two.In multivariable analysis by anatomic site,patients 70 years and older were significantly less likely than younger patients to receive chemotherapy alone or chemoradiation for all three anatomic sites.Among esophageal and stomach cancer patients,receipt of chemotherapy was associated with lower mortality;but no association was found among gastric-cardia patients.CONCLUSION:This study highlights the relatively low use of clinical trials-validated anti-cancer therapies in community practice.Use of chemotherapy-based treatment was associated with lower mortality,dependent on anatomic site.Findings suggest that physicians treat lower esophageal and SAC as two distinct entities,while gastric-cardia patients receive a mix of the treatment strategies employed for the two other sites.

  17. Cardiac arrythmias

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950269 Radiofrequency ablation of atrioventricularaccessory pathways in treating supraventricular tachy-cardia.LI Zhongcheng(李忠诚),et al.Dept Cardiol,2nd Affili Hosp,Tianjin Med Univ.Tianjin,300000.Tianjin Med J 1994;22(12):707-709Twenty-nine atrioventricular accessory pathwaysin 27 patients with WPW syndrome were ablated withradiofrequency current.It included 15 males and 12fameles,aged 19~63(37.8±17.8) years old,13 cases

  18. Biomedical engineering fundamentals

    CERN Document Server

    Bronzino, Joseph D

    2014-01-01

    Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering.Biomedical Engineering Fundamentals, the first volume of the handbook, presents material from respected scientists with diverse backgrounds in physiological systems, biomechanics, biomaterials, bioelectric phenomena, and neuroengineering. More than three dozen specific topics are examined, including cardia

  19. Interobserver reproducibility in pathologist interpretation of columnar-lined esophagus.

    Science.gov (United States)

    Mastracci, Luca; Piol, Nataniele; Molinaro, Luca; Pitto, Francesca; Tinelli, Carmine; De Silvestri, Annalisa; Fiocca, Roberto; Grillo, Federica

    2016-02-01

    Confirmation of endoscopically suspected esophageal metaplasia (ESEM) requires histology, but confusion in the histological definition of columnar-lined esophagus (CLE) is a longstanding problem. The aim of this study is to evaluate interpathologist variability in the interpretation of CLE. Thirty pathologists were invited to review three ten-case sets of CLE biopsies. In the first set, the cases were provided with descriptive endoscopy only; in the second and the third sets, ESEM extent using Prague criteria was provided. Moreover, participants were required to refer to a diagnostic chart for evaluation of the third set. Agreement was statistically assessed using Randolph's free-marginal multirater kappa. While substantial agreement in recognizing columnar epithelium (K = 0.76) was recorded, the overall concordance in clinico-pathological diagnosis was low (K = 0.38). The overall concordance rate improved from the first (K = 0.27) to the second (K = 0.40) and third step (K = 0.46). Agreement was substantial when diagnosing Barrett's esophagus (BE) with intestinal metaplasia or inlet patch (K = 0.65 and K = 0.89), respectively, in the third step, while major problems in interpretation of CLE were observed when only cardia/cardia-oxyntic atrophic-type epithelium was present (K = 0.05-0.29). In conclusion, precise endoscopic description and the use of a diagnostic chart increased consistency in CLE interpretation of esophageal biopsies. Agreement was substantial for some diagnostic categories (BE with intestinal metaplasia and inlet patch) with a well-defined clinical profile. Interpretation of cases with cardia/cardia-oxyntic atrophic-type epithelium, with or without ESEM, was least consistent, which reflects lack of clarity of definition and results in variable management of this entity.

  20. Sleep-apnea risk and subclinical atherosclerosis in early-middle-aged retired National Football League players

    Science.gov (United States)

    Luyster, Faith S; Dunn, Reginald E; Lauderdale, Diane S; Carnethon, Mercedes R; Tucker, Andrew M; Vogel, Robert A; Lincoln, Andrew E; Knutson, Kristen L; Pellman, Elliot J; Strollo, Patrick J

    2017-01-01

    Purpose Limited data from former National Football League (NFL) players suggest that obstructive sleep apnea (OSA) may be highly prevalent after retirement. It remains unclear whether the high prevalence of OSA in retired players is comparable to nonathletes. This retrospective analysis compared sleep apnea (SA) risk in retired NFL players to a community cohort (CARDIA Sleep study), and examined associations between SA risk and cardiovascular risk factors, including subclinical atherosclerosis. Materials and methods Retired NFL players (n=122) were matched to CARDIA Sleep participants by age ±2 years (range 37–55 years), body mass index ±2 kg/m2, race, and male sex. Participants underwent electron-beam computed tomography to measure coronary artery calcium (CAC) and completed the Berlin Questionnaire to determine SA risk. The presence of CAC was defined as an Agatston score >0. Results Retired NFL players had a greater prevalence of high SA risk than the matched CARDIA Sleep participants (27% vs 11.5%, P=0.002). Compared to the CARDIA Sleep participants, retired players were less likely to smoke, and had higher blood pressure, lower fasting glucose levels, and higher cholesterol levels. However, there was no difference in the prevalence of detectable CAC (30% vs 30%, P=1). In both players and the community cohort, SA risk was not significantly associated with CAC after controlling for age, race, and body mass index. Conclusion Retired NFL players have a greater prevalence of high SA risk but similar prevalence of CAC compared with a well-matched community cohort. PMID:28260958

  1. Curative effect of photodynamic therapy for 42 cases of moderate or late stage in esophagus cancer

    Science.gov (United States)

    Bai, Xiao-Min; Shen, Guang-Rong; Chen, Weng-Ge; Guo, Tao

    1998-11-01

    34 patients with advanced esophagus cancer and 8 cases of cancer of gastric cardia were treated by photodynamic therapy. The therapeutic effectiveness of the treatment was evaluated according the criteria used in China. CR 63.2 percent SR 11.3 percent, MR 2 percent. The total effective rate was 76.5 percent. There was no significant side effect in this group except mild skin photosensitization and pigmentation and exacerbation of pain in a few cases.

  2. Tea, coffee, carbonated soft drinks and upper gastrointestinal tract cancer risk in a large United States prospective cohort study

    Science.gov (United States)

    Ren, JS; Freedman, ND; Kamangar, F; Dawsey, SM; Hollenbeck, AR; Schatzkin, A; Abnet, CC

    2010-01-01

    The authors investigated the relationship between hot tea, iced tea, coffee and carbonated soft drinks consumption and upper gastrointestinal tract cancers risk in the NIH-AARP Study. During 2,584,953 person-years of follow-up on 481,563 subjects, 392 oral cavity, 178 pharynx, 307 larynx, 231 gastric cardia, 224 gastric noncardia cancer, 123 esophageal squamous cell carcinoma (ESCC) and 305 esophageal adenocarcinoma (EADC) cases were accrued. Hazard ratios (HRs) and 95% Confidence Intervals (95%CIs) were calculated by multivariate-adjusted Cox regression. Compared to non-drinking, the hazard ratio for hot tea intake of ≥1 cup/day was 0.37 (95%CI: 0.20, 0.70) for pharyngeal cancer. The authors also observed a significant association between coffee drinking and risk of gastric cardia cancer (compared to drinking >3 cups/day was 1.57 (95%CI: 1.03, 2.39)), and an inverse association between coffee drinking and EADC for the cases occurring in the last three years of follow-up (compared to drinking >3 cups/day was 0.54 (95%CI: 0.31, 0.92)), but no association in earlier follow-up. In summary, hot tea intake was inversely associated with pharyngeal cancer, and coffee was directly associated with gastric cardia cancer, but was inversely associated with EADC during some follow-up periods. PMID:20395127

  3. Genetic polymorphism of the phospholipase C epsilon 1 gene and risk of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Liu Xinyang; Zhang Xiaowei; Wang Zhichao; Chang Jinjia; Wu Zheng; Zhang Zhe; Wang Shanshan

    2014-01-01

    Background The pathogenesis of gastric cancer (GC) involves environmental and genetic factors.Recently,two genome-wide association studies found that phospholipase C epsilon 1 (PLCE1) polymorphisms might be related to GC risk,and several studies further validated this finding.However,these studies yielded inconsistent results.Methods A comprehensive database search was performed to identify eligible studies.Odds ratios with 95% confidence intervals were calculated to assess the strength of the association between PLCE1 rs2274223,rs753724,and rs11187842 and risk of GC.Subgroup analyses,publication bias,and sensitivity analyses were also conducted.Results Eleven studies (12 cohorts) were included in the meta-analysis.Based on 13 676 cases and 23 569 controls,a significant association between PLCE1 rs2274223 and GC risk was detected under various genotypic models.In the subgroup analyses,the association was significant for cardia GC,but weak for non-cardia GC.The association under the heterozygote model was detected for PLCE1 rs753724 and rs11187842 based on three studies involving 2768 cases and 3890 controls.Conclusions Our findings demonstrate that the presence of the G allele at rs2274223 of the PLCE1 gene may contribute to susceptibility to GC,especially cardia GC.PLCE1 rs753724 and rs11187842 are associated with GC risk under the heterozygote model.Further well-designed large studies are warranted to validate these findings.

  4. Family history of cancer and risk for esophageal and gastric cancer in Shanxi, China

    Directory of Open Access Journals (Sweden)

    Goldstein Alisa

    2009-08-01

    Full Text Available Abstract Background Family history (FH by different relative types and risk of upper gastrointestinal (UGI cancers has been only rarely reported; the data on UGI cancer survival are sparse. Methods 600 esophageal squamous cell carcinoma (ESCC cases, 598 gastric cardia adenocarcinoma cases, and 316 gastric non-cardia adenocarcinoma cases, and 1514 age-, gender-, and neighborhood-matched controls were asked for FH in first degree relatives and non-blood relatives. Odds ratios (ORs and 95% confidence intervals (CIs from logistic regressions, and hazard ratios (HRs from Cox proportional hazard regressions were estimated. Results Increased ESCC risk was associated with FH of any cancer (OR = 1.72, 95% CI = 1.39–2.12, FH of any UGI cancer (OR = 2.28, 95%CI = 1.77–2.95 and FH of esophageal cancer (OR = 2.84, 95%CI = 2.09–3.86, but not FH of non-UGI cancer. Individuals with two or more affected first-degree relatives had 10-fold increased ESCC risk. FH of gastric cardia cancer was associated with an increased risk of all three cancers. Cancer in non-blood relatives was not associated with risk of any UGI cancer. FH of UGI cancer was associated with a poorer survival rate among younger ESCC cases (HR = 1.82, 95%CI = 1.01–3.29. Conclusion These data provide strong evidence that shared susceptibility is involved in esophageal carcinogenesis and also suggest a role in prognosis.

  5. Hemochromatosis (HFE) gene mutations and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

    Science.gov (United States)

    Agudo, Antonio; Bonet, Catalina; Sala, Núria; Muñoz, Xavier; Aranda, Núria; Fonseca-Nunes, Ana; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie Christine; Vineis, Paolo; Panico, Salvatore; Palli, Domenico; Tumino, Rosario; Grioni, Sara; Quirós, J Ramón; Molina, Esther; Navarro, Carmen; Barricarte, Aurelio; Chamosa, Saioa; Allen, Naomi E; Khaw, Kay-Tee; Bueno-de-Mesquita, H Bas; Siersema, Peter D; Numans, Mattijs E; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Kaaks, Rudof; Canzian, Federico; Boeing, Heiner; Meidtner, Karina; Johansson, Mattias; Sund, Malin; Manjer, Jonas; Overvad, Kim; Tjonneland, Anne; Lund, Eiliv; Weiderpass, Elisabete; Jenab, Mazda; Fedirko, Veronika; Offerhaus, G Johan A; Riboli, Elio; González, Carlos A; Jakszyn, Paula

    2013-06-01

    Hereditary hemochromatosis (HH) is a strong risk factor for hepatocellular cancer, and mutations in the HFE gene associated with HH and iron overload may be related to other tumors, but no studies have been reported for gastric cancer (GC). A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), including 365 incident gastric adenocarcinoma and 1284 controls matched by center, sex, age and date of blood collection. Genotype analysis was performed for two functional polymorphisms (C282Y/rs1800562 and H63D/rs1799945) and seven tagSNPs of the HFE genomic region. Association with all gastric adenocarcinoma, and according to anatomical localization and histological subtype, was assessed by means of the odds ratio (OR) and 95% confidence interval (CI) estimated by unconditional logistic regression adjusted for the matching variables. We observed a significant association for H63D with OR (per rare allele) of 1.32 (CI = 1.03-1.69). In subgroup analyses, the association was stronger for non-cardia anatomical subsite (OR = 1.60, CI = 1.16-2.21) and intestinal histological subtype (OR = 1.82, CI = 1.27-2.62). Among intestinal cases, two tagSNPs (rs1572982 and rs6918586) also showed a significant association that disappeared after adjustment for H63D. No association with tumors located in the cardia or with diffuse subtype was found for any of the nine SNPs analyzed. Our results suggest that H63D variant in HFE gene seems to be associated with GC risk of the non-cardia region and intestinal type, possibly due to its association with iron overload although a role for other mechanisms cannot be entirely ruled out.

  6. Polymorphisms of Helicobacter pylori signaling pathway genes and gastric cancer risk in the European Prospective Investigation into Cancer-Eurgast cohort.

    Science.gov (United States)

    Companioni, Osmel; Bonet, Catalina; Muñoz, Xavier; Weiderpass, Elisabete; Panico, Salvatore; Tumino, Rosario; Palli, Domenico; Agnoli, Claudia; Vineis, Paolo; Boutron-Ruault, Marie-Christine; Racine, Antoine; Clavel-Chapelon, Françoise; Travis, Ruth C; Khaw, Kay-Tee; Riboli, Elio; Murphy, Neil; Vergnaud, Anne-Claire; Trichopoulou, Antonia; Benetou, Vassiliki; Trichopoulos, Dimitrios; Lund, Eiliv; Johansen, Dorthe; Lindkvist, Björn; Johansson, Mattias; Sund, Malin; Ardanaz, Eva; Sánchez-Cantalejo, Emilio; Huerta, Jose M; Dorronsoro, Miren; Ramón Quirós, José; Tjonneland, Anne; Mortensen, Lotte Maxild; Overvad, Kim; Chang-Claude, Jenny; Rizzato, Cosmeri; Boeing, Heiner; Bueno-de-Mesquita, H Bas; Bueno de Mesquita, H Bas; Siersema, Peter; Peeters, Petra H M; Numans, Mattijs E; Carneiro, Fatima; Licaj, Idlir; Freisling, Heinz; Sala, Núria; González, Carlos A

    2014-01-01

    Helicobacter pylori is a recognized causal factor of noncardia gastric cancer (GC). Lipopolysaccharide and peptidoglycan of this bacterium are recognized by CD14, TLR4 and NOD2 human proteins, while NFKB1 activates the transcription of pro-inflammatory cytokines to elicit an immune response. Single nucleotide polymorphisms (SNPs) in these genes have been associated with GC in different populations. We genotyped 30 SNPs of these genes, in 365 gastric adenocarcinomas and 1,284 matched controls from the European Prospective Investigation into Cancer cohort. The association with GC and its histological and anatomical subtypes was analyzed by logistic regression and corrected for multiple comparisons. Using a log-additive model, we found a significant association between SNPs in CD14, NOD2 and TLR4 with GC risk. However, after applying the multiple comparisons tests only the NOD2 region remained significant (p = 0.009). Analysis according to anatomical subtypes revealed NOD2 and NFKB1 SNPs associated with noncardia GC and CD14 SNPs associated with cardia GC, while analysis according to histological subtypes showed that CD14 was associated with intestinal but not diffuse GC. The multiple comparisons tests confirmed the association of NOD2 with noncardia GC (p = 0.0003) and CD14 with cardia GC (p = 0.01). Haplotype analysis was in agreement with single SNP results for NOD2 and CD14 genes. From these results, we conclude that genetic variation in NOD2 associates with noncardia GC while variation in CD14 is associated with cardia GC.

  7. A Survey of Esophageal Cancer in Cixian County of Hebei Province

    Institute of Scientific and Technical Information of China (English)

    JunHou; ZhifengChen; CuilanGuo; ShaosenLi; WenlongBai; GuolimngJin; YuxiaWang; FanshuMeng; FengGao; XujingLu; ZhifangWang; GangKuang

    2004-01-01

    OBJECTIVE To characterize the histologic types of esophageal cardiac mucosa by endoscopic survey in a high-risk cancer area of China. METHODS An endoscopic survey with Lugol,s staining was carried out in Cixian County, Hebei Province from December 2001 to May 2002. The data were processed using computer SPSS 10.0 software. RESULTS The incidences of mild esophagitis, moderate esophagitis, and severe esophagitis were for 2013 cases, 34.9%(703), 1.6%(33) and 0.1% (2)respectively; those with mild dysplasia, moderate dysplasia, severe dysplasia of the esophagus were 8.6% (172), 7.8% (157) and 2.6% (53) respectively; those with carcinoma in situ, intramucosal carcinoma, invasive squamous carcinoma of the esophagus were 2.5%(50), 0.2% (4) and 0.7%(14) respectively. The histologic-detecting rates of non-atrophic gastritis, and atrophic gastritis of the cardia were 36.3%(730), 11.5% (232) respectively; those with mild dysplasia, severe dysplasia of the cardia were 2.5%(51), 0.8%(17) respectively; those with intramucosal adenocarcinoma, invasive adenocarcinoma of the cardia were 0.1% (3), 0.8%(17) respectively. The early-detection rate of esophageal cancer was 79.4%(54/68). The survey rate(examined population to covered population) was 73.8% (2013/2725). CONCLUSIONS Esophageal endoscopic screening with Lugol's solution staining has an advantage over esophageal balloon cytology, in that the histological diagnoses of esophageal cardiac diseases can be obtained, thus contributing to the prevention of subsequent disease. In using the staining method the detection rate of early esophageal cancer is higher than that revealed by balloon cytology.

  8. Fruit and vegetable intake and the risk of gastric adenocarcinoma: a reanalysis of the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study after a longer follow-up.

    Science.gov (United States)

    Gonzalez, Carlos A; Lujan-Barroso, Leila; Bueno-de-Mesquita, H B; Jenab, Mazda; Duell, Eric J; Agudo, Antonio; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Clavel-Chapelon, Françoise; Touillaud, Marina; Teucher, Birgit; Kaaks, Rudolf; Boeing, Heiner; Steffen, Annika; Trichopoulou, Antonia; Roukos, Dimitrios; Karapetyan, Tina; Palli, Domenico; Tagliabue, Giovanna; Mattiello, Amalia; Tumino, Rosario; Ricceri, Fulvio; Siersema, Peter D; Numans, Mattijs E; Peeters, Petra P H; Parr, Christine L; Skeie, Guri; Lund, Eiliv; Quirós, J Ramón; Sánchez-Cantalejo, Emilio; Navarro, Carmen; Barricarte, Aurelio; Dorronsoro, Miren; Ehrnström, Roy; Regner, Sara; Khaw, Kay-Tee; Wareham, Nick; Key, Timothy J; Crowe, Francesca L; Blaker, Hendrik; Romieu, Isabelle; Riboli, Elio

    2012-12-15

    In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively.

  9. The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents.

    Science.gov (United States)

    Ryan, Thomas D; Jefferies, John L; Zafar, Farhan; Lorts, Angela; Morales, David L S

    2015-01-01

    Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

  10. Botulinum toxin injection for hypercontractile or spastic esophageal motility disorders: may high-resolution manometry help to select cases?

    Science.gov (United States)

    Marjoux, S; Brochard, C; Roman, S; Gincul, R; Pagenault, M; Ponchon, T; Ropert, A; Mion, F

    2015-01-01

    Endoscopic injections of botulinum toxin in the cardia or distal esophagus have been advocated to treat achalasia and spastic esophageal motility disorders. We conducted a retrospective study to evaluate whether manometric diagnosis using the Chicago classification in high-resolution manometry (HRM) would be predictive of the clinical response. Charts of patients with spastic and hypertensive motility disorders diagnosed with HRM and treated with botulinum toxin were retrospectively reviewed at two centers. HRM recordings were systematically reanalyzed, and a patient's phone survey was conducted. Forty-five patients treated between 2008 and 2013 were included. Most patients had achalasia type 3 (22 cases). Other diagnoses were jackhammer esophagus (8 cases), distal esophageal spasm (7 cases), esophagogastric junction outflow obstruction (5 cases), nutcracker esophagus (1 case), and 2 unclassified cases. Botulinum toxin injections were performed into the cardia only in 9 cases, into the wall of the distal esophagus in 19 cases, and in both locations (cardia and distal esophagus) in 17 cases. No complication occurred in 31 cases. Chest pain was noticed for less than 7 days in 13 cases. One death related to mediastinitis occurred 3 weeks after botulinum toxin injection. Efficacy was assessed in 42 patients: 71% were significantly improved 2 months after botulinum toxin, and 57% remained satisfied for more than 6 months. No clear difference was observed in terms of response according to manometric diagnosis; however, type 3 achalasia previously dilated and with normal integrated relaxation pressure (4s-integrated relaxation pressure botulinum toxin. Endoscopic injections of botulinum toxin may be effective in some patients with spastic or hypercontractile esophageal motility disorders. The manometric Chicago classification diagnosis does not seem to predict the results. Prospective randomized trials are required to identify patients most likely to benefit from

  11. PREGNANCY IN CARDIO-VASCULAR SURGERY

    Directory of Open Access Journals (Sweden)

    D. Kazemi

    1968-01-01

    Full Text Available The Evol uulan 0 f pregnancy in Cardia V modern. Pertaining Literatu' - asculare Surgery discussed and re revlsed ?4 pe I C thought that any Pregnant . - . rsona ases arc analysed and it was f f . woman suffering fro M' I o allure in the pregnancy sho Id h . III itra stenosis with a history Meanwhilie the causes of our utwo dave hMitral C. omml.ssurotcmy as soon as possible minwhile the causes of our two deaths are discussed.

  12. Heterotopic Pancreatic Pseudocyst Radiologically Mimicking Gastrointestinal Stromal Tumor

    Science.gov (United States)

    Sarsenov, Dauren; Tırnaksız, Mehmet Bülent; Doğrul, Ahmet Bülent; Tanas, Özlem; Gedikoglu, Gökhan; Abbasoğlu, Osman

    2015-01-01

    Heterotopic pancreas is a relatively common variant of foregut embryologic dystopia that can be described as pancreatic tissue found outside the normal anatomic location, being independent from vascular supply of normal pancreas. Having all features of pancreatic tissue except for the major duct structures, this ectopic tissue may be clinically recognized when pathologic changes take place. Inflammation, hemorrhagic or obstructive states, and eventually malignancy-related problems may become a diagnostic challenge for clinician and finally lead to consequences of misdiagnosis. In this article we will discuss a case of heterotopic pancreatic tissue located in gastric cardia, which was diagnosed preoperatively as gastrointestinal stromal tumor. PMID:25785332

  13. Endoscopic enucleation of gastrointestinal stromal tumors of the stomach: Report of five cases

    Institute of Scientific and Technical Information of China (English)

    Toshio Katoh; Yoshiyuki Itoh; Tomomi Mohri; Hiroshi Suzuki

    2008-01-01

    Gastrointestinal stromal tumor (GIST) of the stomach was treated by endoscopic enucleation in five patients.They were three men and two woman, aged 36-56 years.Tumors located in the cardia were completely enucleated endoscopically without any serious complication.The largest diameter of removed tumors ranged from 1.2 to 2.5 cm.Histopathological diagnosis was GIST with low risk of malignancy (mitotic index < 5/50 high power field) in all cases.The patients were disease-free for 10.5-42.2 mo after endoscopic enucleation.

  14. Le traitement chirurgical des adénocarcinomes de la jonction oesogastrique: Expérience marocaine à travers une série de 149 cas

    OpenAIRE

    Glaoui, Meryem; Naciri, Sarah; Ghanem, Samia; Belkouchi, Abdelkader; Errihani, Hassan

    2011-01-01

    Introduction L'incidence du cancer de la Jonction oesogastrique (JOG) ne cesse d'augmenter depuis les deux dernières décades aussi bien dans les pays industrialisés que dans les pays en voie de développement notamment le Maroc. Le rapprochement sur le plan étiopathogénique des adénocarcinomes (ADK) du cardia et ceux du bas oesophage reste un sujet de controverse posant le problème du choix thérapeutique chirurgical, notamment l’étendu de la résection. Le but de ce travail est de dresser le pr...

  15. Peroral Endoscopic Myotomy (POEM) in a Patient with Complete Heart Block-a Case Report.

    Science.gov (United States)

    Dubale, Nachiket; Date, Suhas; Pujari, Rajendra; Bapaye, Amol

    2013-12-01

    Achalasia cardia is the commonest esophageal motility disorder. Recently, a new endoscopic procedure-peroral endoscopic myotomy (POEM)-has emerged for treating this chronic and debilitating condition. It has shown comparable success rates in prospective studies with conventional Heller's myotomy with lesser rates of postoperative reflux. Literature regarding this procedure from India is scarce due to its limited availability. This case report illustrates the use of POEM in a patient with a permanent cardiac pacemaker and demonstrates its safety and efficacy in such a situation.

  16. [New method of treating achalasia is now being tested. Minimally Invasive POEM has produced promising results so far].

    Science.gov (United States)

    Håkanson, Bengt; Tsai, Jon; Kumagai, Koshi; Efendic, Enes; Lundell, Lars; Thorell, Anders

    2014-11-11

    Achalasia of the cardia is a motor disorder of the esophagus and lower esophageal sphincter with dysphagia as the dominating symptom. The diagnosis is based on esophageal manometry and barium swallow. During work-up dysphagia of other origin should be excluded by endoscopy. Standard treatment of achalasia today is laparoscopic esophagogastromyotomy with partial fundoplication or pneumatic dilatation of the lower esophageal sphincter. POEM (PerOral Endoscopic Myotomy), a new minimally invasive technique, has recently been introduced in Sweden. So far, 45 patients have been treated. POEM is currently being compared with laparoscopic esophagogastromyotomy within a European randomized multicenter study.

  17. Pentalogy of Cantrell: A case report

    Directory of Open Access Journals (Sweden)

    Amir Hossein Jafarian

    2011-01-01

    Full Text Available Cantrell′s pentalogy (CP, a rare congenital malformation, consists of the supraumbilical abdominal wall defect, the sterna lower part defect and agenesis of the anterior portion of the diaphragm, an absence of the diaphragmatic part of the pericardium, and a malformation of cardia. This case report presents a female neonate, who was born at 32 weeks of conception, weighing 1300 g and was admitted one hour after delivery. She had the five anatomical defects known for Cantrell′s Pentalogy. Moreover, autopsy revealed a bilateral cleft lip and palate, a patent ductus arteriosus, and an atrial and ventricular septal defect.

  18. Sleep-apnea risk and subclinical atherosclerosis in early-middle-aged retired National Football League players

    Directory of Open Access Journals (Sweden)

    Luyster FS

    2017-02-01

    Full Text Available Faith S Luyster,1 Reginald E Dunn,2 Diane S Lauderdale,3 Mercedes R Carnethon,4 Andrew M Tucker,5 Robert A Vogel,6 Andrew E Lincoln,2 Kristen L Knutson,7 Elliot J Pellman,8–10 Patrick J Strollo Jr11 1School of Nursing, University of Pittsburgh, Pittsburgh, PA, 2Sports Medicine Research Center, MedStar Health Research Institute, Baltimore, MD, 3Department of Public Health Sciences, University of Chicago, 4Department of Preventive Medicine, Northwestern University, Chicago, IL, 5MedStar Sports Medicine, MedStar Union Memorial Hospital, Baltimore, MD, 6Cardiology Section, Department of Veterans Affairs Medical Center, Denver, CO, 7Department of Medicine, University of Chicago, Chicago, IL, 8ProHealth Care Associates, Lake Success, 9Department of Medicine, 10Department of Orthopedics, Mount Sinai School of Medicine, New York, NY, 11Department of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Purpose: Limited data from former National Football League (NFL players suggest that obstructive sleep apnea (OSA may be highly prevalent after retirement. It remains unclear whether the high prevalence of OSA in retired players is comparable to nonathletes. This retrospective analysis compared sleep apnea (SA risk in retired NFL players to a community cohort (CARDIA Sleep study, and examined associations between SA risk and cardiovascular risk factors, including subclinical atherosclerosis.Materials and methods: Retired NFL players (n=122 were matched to CARDIA Sleep participants by age ±2 years (range 37–55 years, body mass index ±2 kg/m2, race, and male sex. Participants underwent electron-beam computed tomography to measure coronary artery calcium (CAC and completed the Berlin Questionnaire to determine SA risk. The presence of CAC was defined as an Agatston score >0.Results: Retired NFL players had a greater prevalence of high SA risk than the matched CARDIA Sleep participants (27% vs 11

  19. Unusual clinical course of metachronous melanomas of the upper digestive system

    Institute of Scientific and Technical Information of China (English)

    Andrzej Dabrowski; Krzysztof Zinkiewicz; Justyna Szumilo; Witold Zgodzinski; Grzegorz Cwik; Tomasz Skoczylas; Grzegorz Wallner

    2005-01-01

    Melanoma of the gastrointestinal tract is a rare, highly malignant neoplasm of poor prognosis. This is description of an unusual case of surgically treated patient with two metachronous malignant melanomas of the stomach and the esophagus. The former lesion was located in the cardia and effectively treated with R0 total gastrectomy. The latter was recognized after 67 mo and appeared as irregular, flat, pigmented areas located in the mid esophagus. Subtotal esophagectomy via right-sided thoracotomy, laparotomy and left-sided cervicotomy was performed, but neoplastic cells were found in distal margin (R1). Fourteen months after esophagectomy multiple lung metastases were detected. Patient died 2 mo later.

  20. The Thoratec system implanted as a modified total artificial heart: the Bad Oeynhausen technique.

    Science.gov (United States)

    Arusoglu, Latif; Reiss, Nils; Morshuis, Michiel; Schoenbrodt, Michael; Hakim-Meibodi, Kavous; Gummert, Jan

    2010-12-01

    The CardioWest™ total artificial heart (SynCardia Systems, Tuscon, AZ, USA) is the only FDA-approved total artificial heart determined as a bridge to human heart transplantation for patients dying of biventricular heart failure. Implantation provides immediate hemodynamic restoration and clinical stabilization, leading to end-organ recovery and thus eventually allowing cardiac transplantation. Occasionally, implantation of a total artificial heart is not feasible for anatomical reasons. For this patient group, we have developed an alternative technique using the paracorporeal Thoratec biventricular support system (Thoratec, Pleasanton, CA, USA) as a modified total artificial heart. A detailed description of the implantation technique is presented.

  1. "Big IGF-II"-induced hypoglycemia secondary to gastric adenocarcinoma.

    Science.gov (United States)

    Morbois-Trabut, L; Maillot, F; De Widerspach-Thor, A; Lamisse, F; Couet, C

    2004-06-01

    Non-islet cell tumor-related hypoglycemia is a rare phenomenon. We report the case of a 63 Year-old man admitted for hemiparesia and a capillary blood glucose of 20 mg/dL. The presence of an immature form of IGF-II that can mimic the effect of insulin, namely "big IGF-II", explained this patient's hypoglycaemia. A moderately differentiated adenocarcinoma of the cardia with metastatic extension to the stomach and the liver was demonstrated. Octreotide failed to control the hypoglycaemia, therefore prednisolone (2 mg/kg per day) and enteral feeding prevented new episodes of severe hypoglycaemia.

  2. Association of tooth loss and oral hygiene with risk of gastric adenocarcinoma.

    Science.gov (United States)

    Shakeri, Ramin; Malekzadeh, Reza; Etemadi, Arash; Nasrollahzadeh, Dariush; Abedi-Ardekani, Behnoush; Khoshnia, Masoud; Islami, Farhad; Pourshams, Akram; Pawlita, Michael; Boffetta, Paolo; Dawsey, Sanford M; Kamangar, Farin; Abnet, Christian C

    2013-05-01

    Poor oral health and tooth loss have been proposed as possible risk factors for some chronic diseases, including gastric cancer. However, a small number of studies have tested these associations. We conducted a case-control study in Golestan Province, Iran, that enrolled 309 cases diagnosed with gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-locations) and 613 sex, age, and neighborhood matched controls. Data on oral health were obtained through physical examination and questionnaire including tooth loss, the number of decayed, missing, and filled teeth, and frequency of tooth brushing. ORs and 95% confidence intervals (95% CI) were obtained using conditional logistic regression models adjusted for potential confounders. Standard one degree-of-freedom linear trend test and a multiple degree-of-freedom global test of the effect of adding oral hygiene variables to the model were also calculated. Our results showed apparent associations between tooth loss and decayed, missing, filled teeth (DMFT) score with risk of gastric cancer, overall and at each anatomic subsite. However, these associations were not monotonic and were strongly confounded by age. The results also showed that subjects who brushed their teeth less than daily were at significantly higher risk for gastric cardia adenocarcinoma ORs (95% CI) of 5.6 (1.6-19.3). We found evidence for an association between oral health and gastric cancer, but the nonmonotonic association, the relatively strong effect of confounder adjustment, and inconsistent results across studies must temper the strength of any conclusions.

  3. Totally laparoscopic trans-hiatal gastroesophagectomy for benign diseases of the esophago-gastric junction

    Institute of Scientific and Technical Information of China (English)

    Jean-Louis Dulucq; Pascal Wintringer; Ahmad Mahajna

    2007-01-01

    AIM: To prospectively present our initial experience with totally laparoscopic transhiatal esophagogastrectomies for benign diseases of the cardia and distal esophagus.METHODS: Laparoscopic gastric mobilization and tubularization combined with transhiatal esophageal dissection and intrathoracic esophagogastric anastomosis accomplished by a circular stapler was done in 3 patients. There were 2 females and 1 male patient with a mean age of 73 + 5 years.RESULTS: Two patients were operated on due to benign stromal tumor of the cardia and one patient had severe oesophageal peptic stenosis. Mean blood loss was 47 ± 15 mL and mean operating time was 130 +10 min. There were no cases that required conversion to laparotomy. All patients were extubated immediately after surgery. Soft diet intake and ambulation times were 5.1 ± 0.4 d and 2.6 ± 0.6 d, respectively. There were no intraoperative and postoperative complications and there were no perioperative deaths. The average length of hospital stay was 9.3 + 3 d. All procedures were curative and all resected margins were tumor free. The mean number of retrieved lymph nodes was 18 ± 8.CONCLUSION: Laparoscopic transhiatal esophagogastrectomy for benign lesions has good effects and proves feasible and safe.

  4. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk

    DEFF Research Database (Denmark)

    Sanikini, Harinakshi; Dik, Vincent K; Siersema, Peter D

    2015-01-01

    association was observed between gastric cardia cancer risk and caffeinated coffee consumption (HR 1.98, 95%-CI: 1.16-3.36, P-trend=0.06; quartile 3 vs. non/quartile 1) and per increment of 100mL/day (HR 1.09, 95%-CI: 1.04-1.14). In conclusion, consumption of total, caffeinated and decaffeinated coffee...... no significant association between overall gastric cancer risk and consumption of total coffee (HR 1.09, 95%-CI: 0.84-1.43; quartile 4 vs. non/quartile 1), caffeinated coffee (HR 1.14, 95%-CI: 0.82-1.59; quartile 4 vs. non/quartile 1), decaffeinated coffee (HR 1.07, 95%-CI: 0.75-1.53; tertile 3 vs. non/tertile 1......) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive...

  5. Morphogenesis and three-dimensional movement of the stomach during the human embryonic period.

    Science.gov (United States)

    Kaigai, N; Nako, A; Yamada, S; Uwabe, C; Kose, K; Takakuwa, T

    2014-05-01

    The stomach develops as the local widening of the foregut after Carnegie stage (CS) 13 that moves in a dramatic and dynamic manner during the embryonic period. Using the magnetic resonance images of 377 human embryos, we present the morphology, morphometry, and three-dimensional movement of the stomach during CS16 and CS23. The stomach morphology revealed stage-specific features. The angular incisura and the cardia were formed at CS18. The change in the angular incisura angle was approximately 90° during CS19 and CS20, and was stomach revealed that the stomach gradually becomes "deflected" during development. The stomach may appear to move to the left laterally and caudally due to its deflection and differential growth. The track of the reference points in the stomach may reflect the visual three-dimensional movement. The movement of point M, representing the movement of the greater curvature, was different from that of points C (cardia) and P (pyloric antrum). The P and C were located just around the midsagittal plane in all the stages observed. Point M moved in the caudal-left lateral direction until CS22. Moreover, the vector CP does not rotate around the dorsoventral axis, as widely believed, but around the transverse axis. The plane CPM rotated mainly around the longitudinal axis. The data obtained will be useful for prenatal diagnosis in the near future.

  6. Tibetan herbal formula Padma Digestin modulates gastrointestinal motility in vitro

    Institute of Scientific and Technical Information of China (English)

    Bruno; M; Balsiger; Magali; Krayer; Andreas; Rickenbacher; Beatrice; Flogerzi; Cecile; Vennos; Juergen; M; Gschossmann

    2013-01-01

    AIM:To examine the effects of Padma Digestin on the smooth muscle motility of different gastrointestinal segments in vitro . METHODS:The effects of the ethanolic extract of Padma Digestin (at 8.16 mg/mL or 81.6mg/mL) on the contractility and susceptibility to acetylcholine (ACh) of muscle strips from the cardia, antrum, pylorus, duodenum, jejunum, ileum and colon of male Wistar rats were analyzed.RESULTS:Compared with the control treatment, the Padma Digestin extract had a procontractile effect on the antral smooth muscle strips. Padma Digestin decreased ACh sensitivity in cardia muscle strips and increased it in those from the antrum and pylorus. In the intestinal segments, spontaneous contractility was inhibited in both the duodenal and jejunal strips, whereas reactivity to ACh was inhibited in the jejunal strips only. In the colonic samples, Padma Digestin inhibited spontaneous and ACh-stimulated contractility at a low dose but seems to have increasing effects at a high dose. CONCLUSION:Padma Digestin extract has regionspecific effects on the contractility and excitability of gastrointestinal smooth muscle. Our results support the traditional use of Padma Digestin for maldigestion and functional gastrointestinal disorders.

  7. Endoscopic survey of esophageal cancer in a high-risk area of China

    Institute of Scientific and Technical Information of China (English)

    Xu-Jing Lu; Jun Hou; Zhi-Feng Chen; Cui-Lan Guo; Shao-Sen Li; Wen-Long Bai; Guo-Liang Jin; Yu-Xia Wang; Fan-Shu Meng; Feng Gao

    2004-01-01

    AIM: To characterize the histological types of esophageal and cardiac mucosa by endoscopic survey of a population in a high-risk area of esophageal cancer of China.METHODS: A selected cohort of residents in Cixian County during December 2001 and May 2002 was surveyed by using Lugol′s staining, followed by computer-based statistical analysis of the data with SPSS 10.0 software.RESULTS: Histologically, the detection rates of squamous epithelial acanthosis, squamous epithelial atrophy, and basal cell hyperplasia in the esophagus were 1.9% (38/2 013),0.1% (3/2 013) and 0.9% (18/2 013) respectively, and those of mild, moderate, and severe esophagitis were 34.9% (703/2 013), 1.6% (33/2 013) and 0.2% (2/2 013)respectively. Mild, moderate, and severe esophageal dysplasia were detected in 8.6% (172/2 013), 7.8% (157/2 013) and 2.6% (53/2 013) respectively in the selected population,whereas in situ carcinoma, intramucosal carcinoma, invasive squamous carcinoma of the esophagus in 2.5% (50/2 013),0.2% (4/2 013) and 0.7% (14/2 013) respectively. The detection rates of non-atrophic gastritis and atrophic gastritis of the cardia were 36.3% (730/2 013) and 11.5% (232/2 013) respectively,with mild and severe dysplasia of the cardia detected in 2.5% (51/2 013) and 0.8% (17/2 013), respectively, in this population; the rates of intramucosal adenocarcinoma and invasive adenocarcinoma of the cardia were 0.1% (3/2 013)and 0.8% (17/2 013) respectively. The detection rate of esophageal cancer at early stage was 79.4% (54/68). The survey rate (ratio of examined population to expected population) was 73.8% (2 013/2 725).CONCLUSION: Histologic types of the esophageal and cardiac mucosa were characterized by endoscopic survey in a high-risk population of esophageal cancer, which may help the early detection and treatment of esophageal and cardiac cancers and dysplasia, and reduce the mortality of such malignancies.

  8. Localization of the glycoprotein Cb42 in larvae of the screwworm fly Chrysomya bezziana (Diptera: Calliphoridae

    Directory of Open Access Journals (Sweden)

    Creig Eisemanni

    2000-10-01

    Full Text Available The glycoprotein Cb-peritrophin-42 was localized in third instar larvae of Chrysomya bezziana using primary antibodies raised against a non-glycosylated bacterial recombinant form of this protein. Both immunofluorescent antibody techniques on unfixed whole mounts of gut tissues and immunogold electron microscopy techniques on ultra-thin sections of fixed and embedded tissues were employed. The protein was shown to be exposed over the whole of both surfaces of the peritrophic membrane and to occur throughout its thickness. Immunogold labelling indicated that Cb-peritrophin-42 was expressed in the peritrophic membrane-secreting cells of the cardia, a specialized peritrophic membrane-forming organ situated at the junction of the foregut and midgut. The accessibility of Cb-peritrophin-42 present in intact peritrophic membrane to the primary antibodies used in the immunofluorescent antibody localization indicates that this glycoprotein is a potential molecular target for vaccination of host animals against larvae of Chrysomya bezziana.

  9. [Pathomorphology of myocardium in the neuroleptic malignant syndrome].

    Science.gov (United States)

    Volkov, V P

    2012-01-01

    It was performed morphometric analysis of 55 cases which formed 4 groups: 1 - control group - 10 patients without neuroleptic treatment and heart diseases; 2 - 12 patients without heart disease treated with antipsychotic drugs; 3 - 17 - without cardiaс pathology who died from neuroleptic malignant syndrome (NMS); 4 - 16 patients with neuroleptic cardiomyopathy (NCMP) who died from NMS. The damage of myocardium in NMS is a relatively acute process involving disturbances of microcirculation, interstitial edema and dystrophic-degenerative changes of cardiomyocytes (CMC). These changes worsen the previous abnormal state of the heart muscle (microfibrosis, CMC atrophy) caused by cardiotoxic side-effects of neuroleptics. The severity of the total myocardium damage in NMS is directly depended on the absence or presence of NCMP.

  10. Treatment of 104 Cases of Chemotherapy-Induced Leukopenia by Injection of Drugs into Zusanli

    Institute of Scientific and Technical Information of China (English)

    尹先哲; 尹德印; 刘新群; 丁旭萌

    2001-01-01

    @@From April 1992 to April 1998, 104 cases of chemotherapy-induced leukopenia were treated by injection into Zusanli (ST 36) with a mixture consisting of dexamethasone, 654-2, ATP and inosine. The therapeutic results were satisfactory as reported in the following. Clinical Data In this series, all the 127 cases were definitely diagnosed by pathological examination. Of them, 93 were male and 34 female, ranging in age from 12 to 75 years. 38 cases were carcinoma of esophagus, 22 carcinoma of cardia of stomach, 21 cancer of lung, 11 hepatic carcinoma, 8 lymphoma, 8 mammary cancer, 7 carcinoma of colon, and 12 other kinds of the tumors. Leukocyte count was below 4.0×109/L in all the patients after being treated by chemotherapy.

  11. Potassium permanganate ingestion as a suicide attempt

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2012-01-01

    Full Text Available Potassium permanganate is a highly corrosive, water-soluble oxidizing antiseptic. A 68- year-old female patient was admitted to our Emergency Department after ingestion of 3 tablets of 250 mg potassium permanganate as a suicide attempt. The physical exam revealed brown stained lesions in the oropharynx. Emergency endoscopy was performed by the gastroenterologist after the third hour of ingestion. Emergency endoscopy revealed multiple superficial (Grade I-II lesions on the esophagus and cardia, which were considered secondary to the caustic substance. The mainstay in the treatment of potassium permanganate is supportive and the immediate priority is to secure the airway. Emergency endoscopy is an important tool used to evaluate the location and severity of injury to the esophagus, stomach and duodenum after caustic ingestion. Patients with signs and symptoms of intentional ingestion should undergo endoscopy within 12 to 24 h to define the extent of the disease.

  12. Proceedings from an international conference on ablation therapy for Barrett's mucosa. Brittany, France, 31 August-2 September 1997.

    Science.gov (United States)

    Bremner, C G; Demeester, T R

    1998-01-01

    The increasing incidence of adenocarcinoma of the lower esophagus and cardia arising in Barrett's metaplastic epithelium continues to be of great concern because medical and surgical efforts to reverse the process have been disappointing. A potential answer to the problem is removal of the metaplastic epithelium. Modern technology has introduced physical and chemical modalities which facilitate ablation of the neo-epithelium endoscopically. These techniques have been used in several centers, and preliminary results are encouraging. This report summarizes the proceedings of an international symposium on ablative therapy held in Brittany, France in August 1997. Twenty-eight speakers contributed to the talks on the pathology, pathogenesis, current therapy experimental studies and clinical experience of ablation of Barrett's esophagus.

  13. Small heat shock protein Hsp27 is required for proper heart tube formation.

    Science.gov (United States)

    Brown, Daniel D; Christine, Kathleen S; Showell, Christopher; Conlon, Frank L

    2007-11-01

    The small heat shock protein Hsp27 has been shown to be involved in a diverse array of cellular processes, including cellular stress response, protein chaperone activity, regulation of cellular glutathione levels, apoptotic signaling, and regulation of actin polymerization and stability. Furthermore, mutation within Hsp27 has been associated with the human congenital neuropathy Charcot-Marie Tooth (CMT) disease. Hsp27 is known to be expressed in developing embryonic tissues; however, little has been done to determine the endogenous requirement for Hsp27 in developing embryos. In this study, we show that depletion of XHSP27 protein results in a failure of cardiac progenitor fusion resulting in cardia bifida. Furthermore, we demonstrate a concomitant disorganization of actin filament organization and defects in myofibril assembly. Moreover, these defects are not associated with alterations in specification or differentiation. We have thus demonstrated a critical requirement for XHSP27 in developing cardiac and skeletal muscle tissues.

  14. Outpatient experience with oesophageal endoscopic dilation.

    Science.gov (United States)

    Jani, P G; Mburugu, P G

    1998-07-01

    Between March 1990 and August 1997, outpatient endoscopic balloon dilation was performed for oesophageal strictures which developed secondary to malignancies, peptic strictures, post surgical narrowing, achalasia cardia, corrosive ingestion and other causes. A total of 169 dilations were performed in the 92 cases with an average of 1.8 dilation/case (Range 1 to 8). Dilation was possible in all 92 cases without the need for fluoroscopic monitoring. Twenty three (13.6%) of the dilations were performed using pneumatic balloon while in 146(86.4%) cases wire guided metal olives were used. There were nine minor complications which were treated with medication on an outpatient basis and four major complications which required inpatient care. Three of these had perforation of the oesophagus and one died. One other patient developed aspiration pneumonia and subsequently died.

  15. Cancer in persons working in dry cleaning in the Nordic countries

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Andersen, Aage; Rylander, Lars

    2006-01-01

    U.S. studies have reported an increased risk of esophageal and some other cancers in dry cleaners exposed to tetrachloroethylene. We investigated whether the U.S. findings could be reproduced in the Nordic countries using a series of case-control studies nested in cohorts of laundry and dry......-cleaning workers identified from the 1970 censuses in Denmark, Norway, Sweden, and Finland. Dry-cleaning work in the Nordic countries during the period when tetrachloroethylene was the dominant solvent was not associated with an increased risk of esophageal cancer [rate ratio (RR) = 0.76; 95% confidence interval...... (CI), 0.34-1.69], but our study was hampered by some unclassifiable cases. The risks of cancer of the gastric cardia, liver, pancreas, and kidney and non-Hodgkin lymphoma were not significantly increased.Assistants in dry-cleaning shops had a borderline significant excess risk of cervical cancer...

  16. Serrated adenoma of stomach: A premalignancy?

    Directory of Open Access Journals (Sweden)

    Divya Achutha Ail

    2015-01-01

    Full Text Available Serrated adenoma is a newly described entity in the group of gastric adenomas. Until date only 20 cases of gastric serrated adenoma have been reported. It is an important entity to be diagnosed accurately as it has a very high-risk of malignant transformation, especially those located in the cardia of stomach. Serrated adenoma associated with adenocarcinoma is more frequent in the elderly, but pure serrated adenoma is common in the young, in whom follow-up is mandatory. Gastric serrated adenoma has distinct location, definite histomorphology and characteristic Ki-67 immunohistochemical staining. Ki-67 staining helps to differentiated pure serrated adenoma from those associated with adenocarcinoma. We present a young adult male, incidentally detected to have gastric serrated adenoma.

  17. Carcinosarcoma of the stomach: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Carcinosarcomas are rare, malignant, biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma, along with its clinical, macroscopic and histopathological features. Macroscopically, a specimen of deformed stomach was obtained that measured 200 mm × 150 mm × 100 mm. A 150 mm × 100 mm ×50 mm exophytic tumoral mass (Borrmann type Ⅰ)was found, which involved the posterior wall from the cardia to the antrum. Histopathologically, a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia, with interposed fascicles of fusiform atypical cells and numerous large, rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18, epithelial membrane antigen, carcinoembryonic antigen, chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively, and the patient died 4 mo later. A review of the available literature is also presented.

  18. Mutations of the AAAS gene in an Indian family with Allgrove's syndrome

    Institute of Scientific and Technical Information of China (English)

    Ashis Mukhopadhya; Sumita Danda; Angela Huebner; Ashok Chacko

    2006-01-01

    The triple A or Allgrove's syndrome is an autosomal recessive disorder characterized by the triad of achalasia cardia, alacrima and ACTH resistant adrenocortical insufficiency. Mutations of the Achalasia-Addisonianism-Alacrima-Syndrome (AAAS) gene on chromosome 12q13 are associated with this syndrome. We report an Indian family where two siblings were homozygous for a known mutation of the AAAS gene and presented with the classical triad of symptoms. The mother and the brother were heterozygous and asymptomatic. The affected siblings had iron deficiency anemia and the younger sister had pes cavus and palmoplantar keratosis.Neurological symptoms were absent in both affected children. Recognition of this syndrome can lead to early treatment of adrenal insufficency and genetic counselling.

  19. Endoscopic therapy for esophageal hematoma with blue rubber bleb nevus syndrome

    Institute of Scientific and Technical Information of China (English)

    Mika; Takasumi; Takuto; Hikichi; Tadayuki; Takagi; Masaki; Sato; Rei; Suzuki; Ko; Watanabe; Jun; Nakamura; Mitsuru; Sugimoto; Yuichi; Waragai; Hitomi; Kikuchi; Naoki; Konno; Hiroshi; Watanabe; Katsutoshi; Obara; Hiromasa; Ohira

    2014-01-01

    A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal(GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injectionneedle to reduce the pressure within it. Finally, argon plasma coagulation(APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic the rapy, the eso phage alulcerhealed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC.

  20. Study of the impact of the dose-volume factor on the biological tolerance after sus-meso-colic irradiation involving the liver as critical organ; Etude de l'impact du facteur dose-volume sur la tolerance biologique hepatique apres irradiation sus-mesocolique impliquant le foie comme organe critique

    Energy Technology Data Exchange (ETDEWEB)

    Malek, K.; Boudam, Y.; Colonna, M.; Rebischung, C.; Durand, A.; Sihanath, R.; Jacques, B. [CHU de Grenoble, 38 - Grenoble (France); Zhang, H. [Hospital, Montreal (Canada)

    2009-10-15

    Purpose: during the adjuvant or radical radio-therapies of cardia, stomach, pancreas, biliary tracts adenocarcinomas or any other supra-meso-colic tumor localisation, the principal critical organs are the marrow, the kidneys, and the liver. The doses delivered in this area are about 55 Gy in classical fractionation. This dose exceeds broadly the liver toxic dose (5% of toxicity at five years) that is 25 Gy and according the irradiated liver volume, we could expect to observe reactions to irradiation. Some observations show that this can happen and a systematic study of the evolution of enzymatic parameters in function of the irradiated liver volume should allow to show if a correlation exists between the values of the dose-volume histogram and the biological data. (N.C.)

  1. [Giant esophageal fibrovascular polyp].

    Science.gov (United States)

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

    2003-01-01

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

  2. [Heart and sports: when can it be dangerous?].

    Science.gov (United States)

    Keller, D I

    2007-12-19

    Performing sports regularly has many positive effects on the cardiovascular and other systems. The shade side of the sport (not only high-performance-, but also amateur sports) is sudden cardia death, a dramatic event for the patient and his family. Many cardiac disorders, which lead to sudden cardiac death, are inherited. One of the most common causes of sudden cardiac death is autosomal-dominant inherited hypertrophic cardiomyopathy characterized by its wide phenotype and genotype heterogeneity. This specific disease will be elucidated in this paper. In order to prevent sudden cardiac death in athletes, a structured cardiovascular screening is mandatory at the beginning of the sport career. If an inherited disorder leading to sudden cardiac death is diagnosed, family screening will be necessary.

  3. Immunohistochemical localization of epidermal growth factor in the second-trimester human fetus

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Kryger-Baggesen, N; Nexø, Ebba

    1996-01-01

    midtrimester human fetuses with a gestational age ranging from 13 to 22 weeks. The first detectable EGF immunoreactivity occurred in week 15-16 fetuses in the placenta, the skin, the distal tubules of the kidney, the surface epithelium of the stomach, and the tips of the small intestinal villi, as well...... as in a few Paneth cells. Glandular structures, such as the glands of the cardia and the pyloric part of the stomach, Brunner's glands of the duodenum, the pancreas, and the submucous glands of the trachea, showed positive EGF immunoreactivity later (week 17). Thus, apart from the kidney, staining...... of the surface epithelia seems to precede staining of the EGF-producing glandular structures and EGF is not present in the glands before these have already differentiated....

  4. Hiatal hernia in a harbor seal (Phoca vitulina) pup.

    Science.gov (United States)

    Biancani, Barbara; Field, Cara L; Dennison, Sophie; Pulver, Robert; Tuttle, Allison D

    2012-06-01

    A 2-wk-old stranded harbor seal (Phoca vitulina) rescued by Mystic Aquarium showed signs of the presence of a hiatal hernia during rehabilitation. Contrast radiographs of esophagus and stomach revealed an intrathoracic radiodensity that contains filling defects typical of stomach, consistent with gastric rugal folds. Mural thickening was observed at the level of the cardia consistent with a diagnosis of a hiatal hernia. Although clinical improvement was noted with medical therapy and tube feeding, surgical correction of the hiatal hernia was considered necessary for full resolution. However, owing to the animal's low body weight, the corrective hernia surgery was postponed until the body condition improved. The seal needed to be surgically treated for a corneal ulcer, and while anesthetized with isoflurane, the seal became dyspneic and developed cardiac arrhythmias; ultimately cardiac arrest ensued. Resuscitation was unsuccessfully attempted and the seal was euthanized. Necropsy confirmed the radiographic diagnosis and further characterized a paraesophageal hiatal hernia.

  5. Hiatal hernia following total gastrectomy with Roux-en-Y reconstruction.

    Science.gov (United States)

    Murata, S; Yamazaki, M; Kosugi, C; Hirano, A; Yoshimura, Y; Shiragami, R; Suzuki, M; Shuto, K; Koda, K

    2014-01-01

    Hiatal hernias after total gastrectomy for advanced gastric cancer are very rare. We review a case of a 44-year-old male who presented with dyspnea and chest pain 2 days after total gastrectomy, lower esophagectomy, and splenectomy with retrocolic Roux-en-Y reconstruction approached by a left thoracoabdominal incision for gastric cancer at the cardia. Plain and cross-sectional imaging identified a large hiatal hernia protruding into the right thorax containing left-sided transverse colon and small intestine. Our patient underwent a laparotomy, and after hernia reduction the hiatal defect was repaired by direct suturing. He experienced anastomotic leakage and right pyothorax, but recovered. The potential cause is discussed here and the published literature on this rare complication is reviewed briefly.

  6. Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation

    Science.gov (United States)

    Goldoni, Marcos Bertozzi; Kruse, Cristine; Diedrich, João Alfredo; Giacomazzi, Caroline Becker; Negri, Estéfano Aurélio; Koop, Matheus; Sampaio, José Artur; Fontes, Paulo Roberto Ott; Waechter, Fábio Luiz

    2016-01-01

    Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation. The vein was dissected and sectioned near the cardia; the proximal segment was ligated with suture and the distal segment was anastomosed to the donor portal vein. Gastroportal anastomosis is an excellent option for portal reconstruction in the presence of thrombosis or hypoplasia. It allows an adequate splanchnic drainage and direction of hepatotrophic factors to the graft. PMID:27595034

  7. [Dilatation of anastomotic stricture by Nd:YAG laser beam under endoscopy].

    Science.gov (United States)

    Lu, Z C; Chen, L G; Zhang, Y Y

    1994-11-01

    Anastomotic stricture has become a common complication following surgical treatment of upper gastrointestinal cancers. A technique was devised to alleviate the stricture with Nd. YAG laser beam under endoscopy. The laser beam was applied at 3-4 different points near the anastomotic stoma. The thermal effect of the beam would cut the scar tissues in and underneath the mucosa, leading to dilatation of the stoma. A total of 48 patients with cancer of the esophagus (n = 21), gastric cardia (n = 20), body of stomach (n = 6) and gastric stump (n = 1) with postoperative anastomotic stricture was so treated. According to the degree of dilatation, the result of treatment upon longterm follow-up was good (the anastomotic stoma was enlarged more than 6 mm) in 41 (85.4%), fair (the stoma enlarged 4-5 mm) in 5 (10.4%) and poor in the remaining 2. Due precautions should be made to avoid bleeding and perforation.

  8. DEXTROCARDIA WITH SITUS INVERSUS TOTALIS IN NEONATE : CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nagraj

    2015-03-01

    Full Text Available Dextrocardia with situs inversus are rare congenital anomalies which can be asymptomatic and compatible with normal life. They are characterized by mirror images of all intra - thoracic and intra - abdominal viscera. Our aim is to report an incidental finding of dextrocardia with situs inversus in a neonate with sepsis and also to report other associated anomalies with it. Most cases of situs inversus have been reported either in adults or in cadavers during dissection. Very few in number have been detected in neonates. Here is a one such case report. A day - old term male neonate presented with features of septic shock. Physical examination revealed cardiac apex on the 4th right intercostal space, along the mid - clavicular line. Chest radiograph and abdominal ultrasound confirmed the diagnosis of dextro cardia with situs inversus along with renal agenesis and ectopia

  9. Endoscopic microwave coagulation therapy of postoperative hemorrhage from a stapled anastomosis.

    Science.gov (United States)

    Umano, Yasukazu; Horiuchi, Tetsuya; Inoue, Masaya; Shono, Yoshiharu; Oku, Yoshimasa; Tanishima, Hiroyuki; Tsuji, Takeshi; Tabuse, Katsuyoshi

    2005-01-01

    We experienced three cases of postoperative hemorrhage from a stapled gastrointestinal anastomosis, and established endoscopic microwave coagulation therapy (EMCT) with a cylinder-type electrode. We were able to treat postoperative hemorrhage over the entire circumference of stapled anastomosis successfully. Two patients had undergone a lower third thoracic esophagogastrectomy through a left thoraco-abdominal approach for gastric cancer in the cardia, while the other case had undergone Billroth I gastrectomy. They each had fresh bleeding from the stapled anastomosis after the operation. Emergency endoscopic examination was immediately performed. Endoscopy revealed bleeding on the suture line. We performed hemostasis endoscopically with microwave coagulation therapy safely. They were discharged from the hospital without complications such as leakage and stenosis. Since EMCT with the cylinder-type electrode can coagulate shallowly and widely, it is very effective for hemorrhage from a stapled anastomosis.

  10. Estudo da dinmica esofágica através de cintilografia como possível meio de diagnóstico precoce de aperistalse em indivíduos chagásicos Assessment of esophageal dynamics by radionuclide scintigraphy a potential method for early diagnosis of aperistalsis in patients with Chagas disease

    Directory of Open Access Journals (Sweden)

    Horácio Marioni Filho

    1984-06-01

    Full Text Available Determinaram-se o tempo de trânsito esofágico (TTE e o tempo decorrido até a abertura da cárdia (TDAC para um líquido de prova administrado por via oral em 40 voluntários (Grupo I e em 106 pacientes com enfermidade de Chagas (Grupo II, pelo estudo cintilográfico do esôfago com pertecnetato-99mTc. Imagens seqüenciais do trânsito esofagiano do traçador foram obtidas com câmara de cintilação. Curvas de variação da atividade versus tempo na região da cárdia foram registradas por seleção de área de interesse e com o auxílio de um processador multi-canal. No Grupo I o TTE e TDAC foram superponíveis, com média x = 13,2s, desvio padrão δ — l,35s e coeficiente de variação 10%, estabelecendo-se o valor de 15,9s (x + 2 δ como limite superior da mortalidade. Dos 106 chagásicos, 39 (36,8% apresentaram apenas o TTE aumentado; 6 (5,6% apenas o TDAC e 7 (6,6% ambos os tempos aumentados. Os valores foram alterados em 36,0% dos pacientes do sexo masculino e em 51,0% dos pacientes do sexo feminino. Sintomas de disfagia e/ou pirose estavam presentes em 51,1% dos pacientes com tempos aumentados e em 24,6% dos com tempos normais. Os Autores propõem a determinação dos dois parâmetros — TTE e TDAC pelo método ensaiado como possível meio de diagnóstico precoce da peristalse do esôfago e de avaliação de tratamentos instituídos.The esophageal transit time of a 99mTc labelled test drink (swallow to arrival at the cardia — TTE — and the time elapsed from swallow to opening of the cardia — TDAC — were assessed by scintigraphy in 40 healthy volunteers (Group I and in 106 patients with Chagas disease. The passage of the radioactive liquid through the esophagus and the cardia into the stomach was depicted in 2 sec sequential images. A time/activity curve in the region of the cardia was obtained by a multichannel analyzer, from which the 2 parameters were calculated. In the subjects of group I, TTE was the same as TDAC. The

  11. CHARACTERISTIC OF RESISTANCE OF ERYTHROCYTES IN CARDIOSURGICAL PATIENTS WITH VARIOUS DEGREE OF MANIFESTATION OF POSTPERFUSION HEMOLYSIS

    Directory of Open Access Journals (Sweden)

    I. V. Maltseva

    2013-01-01

    Full Text Available The resistance of red cells to the mechanic, osmotic, and acid factors, as well as the permeability of red-cell membrane to low-molecular hydrophilic substances in patients with ischemic heart disease (IHD with moderate (24 patients and pronounced (13 patients hemolysis after surgery under conditions of cardia bypass has been studied. It is found that the development of pronounced hemolysis (in contrast to the moderate one is associated with the high permeability of the red-cell membrane before surgery at the reduced acid and mechanic resistance of cells, which decreases after surgery and combines with normalization of acid resistance of red cells with the red-cell membrane permeability kept at the initially high level. The osmotic resistance of red cells in IHD patients is increased regardless of the level of hemolysis and the stage of the study, and its minimal level is observed only in patients with moderate hemolysis before surgery.

  12. Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

    Science.gov (United States)

    Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; So, Jimmy Bok Yan; Huang, Zhiwei

    2011-03-01

    Raman spectroscopy is an optical vibrational technology capable of probing biomolecular changes of tissue associated with cancer transformation. This study aimed to characterize in vivo Raman spectroscopic properties of tissues belonging to different anatomical regions in the upper gastrointestinal (GI) tract and explore the implications for early detection of neoplastic lesions during clinical gastroscopy. A novel fiber-optic Raman endoscopy technique was utilized for real-time in vivo tissue Raman measurements of normal esophageal (distal, middle, and proximal), gastric (antrum, body, and cardia) as well as cancerous esophagous and gastric tissues from 107 patients who underwent endoscopic examinations. The non-negativity-constrained least squares minimization coupled with a reference database of Raman active biochemicals (i.e., actin, histones, collagen, DNA, and triolein) was employed for semiquantitative biomolecular modeling of tissue constituents in the upper GI. A total of 1189 in vivo Raman spectra were acquired from different locations in the upper GI. The Raman spectra among the distal, middle, and proximal sites of the esophagus showed no significant interanatomical variability. The interanatomical variability of Raman spectra among normal gastric tissue (antrum, body, and cardia) was subtle compared to cancerous tissue transformation, whereas biomolecular modeling revealed significant differences between the two organs, particularly in the gastroesophageal junction associated with proteins, DNA, and lipids. Cancerous tissues can be identified across interanatomical regions with accuracies of 89.3% [sensitivity of 92.6% (162/175) specificity of 88.6% (665/751)], and of 94.7% [sensitivity of 90.9% (30/33) specificity of 93.9% (216/230)] in the gastric and esophagus, respectively, using partial least squares-discriminant analysis together with the leave-one tissue site-out, cross validation. This work demonstrates that Raman endoscopy technique has

  13. The role of the liver histological and necroinflammatory activity in the development of portal hypertension syndrome

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    Dzyubanovsky I.Ya.

    2013-01-01

    Full Text Available Background. Liver cirrhosis is the most often cause of the portal hypertension syndrome development, though structural and morphological liver remodeling usually begins on the stage of chronic hepatitis. Morphologic patterns of the development of portal hypertension syndrome on the pre-clinical stage are still poorly investigated. Objective. To determine the histological and necroinflammatory activity of the liver in patients with portal hypertension. Methods. Patients were divided into four groups: I group (n=38 – chronic hepatitis without clinical signs of portal hypertension; II group (n=42 - chronic hepatitis transforming to cirrhosis with clinical signs of portal hypertension (varicose veins of the esophagus and/or the cardia, splenomegaly, ascitis; III group (n=34 – complicated portal hypertension on the background of liver cirrhosis (bleeding from the varices of the esophagus and/or the cardia, hypersplenism; control group (n=30 - physically healthy individuals aged 23-37 years. An integrated evaluation of the liver histological and necroinflammatory activity through the set of laboratory tests was performed (the method of “FibroTest-ActiTest”; immunofermental analysis of L-FABP concentration. Results. It is found that the patients with pre-clinical stage of portal hypertension syndrome show portal and periportal fibrosis with single septa, and the patients with clinical stages of portal hypertension show portal and periportal cirrhosis with multiple septa. Patients with the complications of portal hypertension show cirrhosis of the liver. With the increase of the necroinflammatory activity the portal pressure increases directly. This fact was confirmed with the increase of L-FABP protein level in the plasma, along with the increase of the actitest results. Conclusion. The diagnostic methodic of “FibroTest-ActiTest” and the plasma level of L-FABP are the modern models for chronic liver disease histological and

  14. Determinants of Aortic Root Dilatation and Reference Values Among Young Adults Over a 20-Year Period: Coronary Artery Risk Development in Young Adults Study.

    Science.gov (United States)

    Teixido-Tura, Gisela; Almeida, Andre L C; Choi, Eui-Young; Gjesdal, Ola; Jacobs, David R; Dietz, Harry C; Liu, Kiang; Sidney, Stephen; Lewis, Cora E; Garcia-Dorado, David; Evangelista, Artur; Gidding, Samuel; Lima, João A C

    2015-07-01

    Aortic size increases with age, but factors related to such dilatation in healthy young adult population have not been studied. We aim to evaluate changes in aortic dimensions and its principal correlates among young adults over a 20-year time period. Reference values for aortic dimensions in young adults by echocardiography are also provided. Healthy Coronary Artery Risk Development in Young Adults (CARDIA) study participants aged 23 to 35 years in 1990-1991 (n=3051) were included after excluding 18 individuals with significant valvular dysfunction. Aortic root diameter (ARD) by M-mode echocardiography at year-5 (43.7% men; age, 30.2 ± 3.6 years) and year-25 CARDIA exams was obtained. Univariable and multivariable analyses were performed to assess associations of ARD with clinical data at years-5 and -25. ARD from year-5 was used to establish reference values of ARD in healthy young adults. ARD at year-25 was greater in men (33.3 ± 3.7 versus 28.7 ± 3.4 mm; P<0.001) and in whites (30.9 ± 4.3 versus 30.5 ± 4.1 mm; P=0.006). On multivariable analysis, ARD at year-25 was positively correlated with male sex, white ethnicity, age, height, weight, 20-year gain in weight, active smoking at baseline, and 20-year increase in diastolic, systolic, and mean arterial pressure. A figure showing the estimated 95th percentile of ARD by age and body surface area stratified by race and sex is provided. This study demonstrates that smoking, blood pressure, and increase in body weight are the main modifiable correlates of aortic root dilation during young adulthood. Our study also provides reference values for ARD in young adults.

  15. Transabdominal intramediastinal esphagogastrostomy for the treatment of gastric cordial cancer%经腹手术治疗贲门癌155例临床分析

    Institute of Scientific and Technical Information of China (English)

    魏文波; 陈海鹏; 蔡淡龙; 杨志通; 谢容明

    2008-01-01

    目的 探讨治疗贲门癌的手术人路及吻合方法.方法 对155例贲门癌患者经腹切开膈肌脚入路,行胃浆肌瓣覆盖-食管胃黏膜吻合.结果 全组病例无死亡、无吻合口漏及食管切缘癌残留.术后并发症发生率5.8%.结论 经腹切开膈肌脚,行胃浆肌瓣覆盖-食管胃黏膜吻合术能有效地预防吻合口漏,适用于浸润食管长度<2cm的贲门癌的手术治疗.%Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.

  16. Effects of alcohol consumption on biomarkers of oxidative damage to DNA and lipids in ethanol-fed pigs.

    Science.gov (United States)

    Petitpas, F; Sichel, F; Hébert, B; Lagadu, S; Beljean, M; Pottier, D; Laurentie, M; Prevost, V

    2013-03-01

    Chronic alcohol consumption is known to result in tissue injury, particularly in the liver, and is considered a major risk factor for cancers of the upper respiratory tract. Here we assessed the oxidative effects of subchronic ethanol consumption on DNA and lipids by measuring biomarkers 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) and malondialdehyde (MDA), respectively. Physiological responses of pigs (n = 4) administered ethanol in drinking water for 39 days were compared with those of water-fed pigs (n = 4). Alcoholisation resulted in serum ethanol concentration of 1.90 g L(-1) and in a moderate but significant increase in alanine aminotransferase activity, an index of liver injury. However, between the alcoholised and control groups there were no significant differences in the levels of 8-oxodG (8-oxodG per 10(6) 2'deoxyguanosine) from leucocytes (2.52 ± 0.42 Vs 2.39 ± 0.34) or from target organs, liver, cardia and oesophagus. Serum MDA levels were also similar in ethanol-fed pigs (0.33 ± 0.04 μM) and controls (0.28 ± 0.03 μM). Interestingly, levels of 8-oxodG in cardia were positively correlated with those in oesophagus (Spearman correlation coefficient R = 1, P alcohol consumption may not cause oxidative damage to DNA and lipids as measured by 8-oxodG and MDA, respectively. The duration of alcoholisation and the potential alcohol-induced nutritional deficiency may be critical determinants of ethanol toxicity. Relevant biomarkers, such as factors involved in sensitization to ethanol-induced oxidative stress are required to better elucidate the relationship between alcohol consumption, oxidative stress and carcinogenesis.

  17. 胃造口双管法治疗食管手术后吻合瘘的疗效观察%Clinical Observation of Gastrostomize with Double Vessel for Postoperative Fistula in the Anastomotic Stoma of Esophagogastrostomy

    Institute of Scientific and Technical Information of China (English)

    曹恒昌; 范昭; 王永剑; 乌达

    2009-01-01

    Objective To investigate the improvement in therapies of postoperative fistula in the anastomotic stoma of carcinoma of esophagus or gastric cardia.Methods 27cases of carcinoma of esophagus or gastric cardia,which were found postoperative fistula in the anastomotic stoma,received gastrostomize with double vessel by which gastrointestinal decompression and intestinal tract nutritional support were taken.Results 25 patients fully recovered to leave hospital.while 2 cases died of severe septic shock and multiple organ failure.Conclusion Therapies of gastrointestinal decompression and intestinal tract nutritional support by gastrostomize with double vessel could efficiently promote healing of fistula in the anastomotic stoma,degrade the death rate notably.%目的 探讨食管癌贲门癌术后吻合口瘘的治疗方法 的改进.方法 对食管癌贲门癌手术后出现吻合口瘘的27例患者,分别于确诊的当日或第一日行胃造口术,置入双管,行胃肠减压和肠道内营养支持治疗.结果 25例患者痊愈出院2例患者因重度感染性休克,多器官衰竭死亡.结论 经胃双管法的胃肠减压和肠内营养可有效地促进吻合口瘘的愈合,显著降低食管手术吻合口瘘的死亡率.

  18. Gastric extremely well differentiated adenocarcinoma of gastric phenotype: as a gastric counterpart of adenoma malignum of the uterine cervix

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    Ae Lee Won

    2005-05-01

    Full Text Available Abstract Background Most of gastric adenocarcinoma can be simply diagnosed by microscopic examination of biopsy specimen. Rarely the structural and cellular atypia of tumor cells is too insignificant to discriminate from benign foveolar epithelium. Case presentation A 67-year-old male presented with a gastric mass incidentally found on the abdominal computed tomography (CT for routine medical examination. Gastric endoscopic examination revealed a huge fungating mass at the cardia and mucosal biopsy was performed. Microscopically the biopsy specimen showed proliferation of bland looking foveolar epithelia in the inflammatory background and diagnosed as foveolar epithelial hyperplasia. Because the clinical and endoscopic features of this patient were strongly suggestive of malignancy, the patient underwent radical total gastrectomy. The resected stomach revealed a huge fungating tumor at the cardia. The cut surface of the tumor was whitish gelatinous. Microscopically the tumor was sharply demarcated from surrounding mucosa and composed of very well formed glandular structures without significant cellular atypia, which invaded into the whole layer of the gastric wall. Tumor glands were occasionally complicated or dilated, and glandular lumina were filled with abundant mucin. Immunohistochemically the tumor cells revealed no overexpression of p53 protein but high Ki-67 labeling index. The tumor cells and intraluminal mucin were diffusely expressed MUC1 and MUC5AC and only focally expressed MUC2. On abdominal CT taken after 12 months demonstrated peritoneal carcinomatosis and multiple metastatic foci in the lung. Conclusion The clinicopathologic profiles of gastric extremely well differentiated adenocarcinoma of gastric phenotype include cardiac location, fungating gross type, very similar histology to foveolar epithelial hyperplasia, foveolar mucin phenotype, lack of p53 overexpressoin and high proliferative index.

  19. Cruciferous vegetable consumption and gastric cancer risk: a meta-analysis of epidemiological studies.

    Science.gov (United States)

    Wu, Qi-Jun; Yang, Yang; Wang, Jing; Han, Li-Hua; Xiang, Yong-Bing

    2013-08-01

    The relationship between consumption of cruciferous vegetables (CV) and risk of gastric cancer has been investigated by many studies, but remains controversial. We carried out a meta-analysis to summarize available evidence from epidemiological studies on this point. Relevant published reports of CV intake and gastric cancer were identified using MEDLINE (PubMed), EMBASE, and Web of Science databases through to the end of September 2012. We pooled the relative risk from individual studies using a fixed- or random-effects model and carried out heterogeneity and publication bias analyses. Sixteen case-control and six prospective studies were included in our analysis. When all studies were pooled, we yielded a significantly inverse association between CV (relative risk = 0.81; 95% confidence interval, 0.75-0.88) intake and gastric cancer risk, with little heterogeneity (Q = 27.27, P = 0.292, I(2) = 12.0%). Specific analysis for cabbage intake yielded similar result. When separately analyzed, case-control studies of CV intake yielded significant results and the results of prospective studies showed borderline statistical significance. Moreover, significant results were consistent for high-quality studies, for North American, European, and Asian studies, for studies on males, and for studies on non-cardia gastric cancer. Findings from this meta-analysis provide evidence that high intake of CV was inversely associated with the risk of gastric cancer and non-cardia gastric cancer in humans. Further studies on other specific CV, food preparation methods, and stratified results by anatomic cancer site and histological type should be extended in the future.

  20. Heading toward the right direction--solution package for endoscopic submucosal tunneling resection in the stomach.

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    Jiaoyang Lu

    Full Text Available The emerging submucosal tunneling and endoscopic resection (STER technique provides definitive histological diagnosis as well as a therapeutic method for the gastric submucosal tumors (SMTs. We aim to present our experience and discuss key technical issues of STER.45 patients with gastric SMTs arising from MP received STER. First, a mucosal incision was made 3 cm proximal to the tumour, a submucosal tunnel was subsequently built from the incision to the tumor. The tumor was gradually exposed and dissected from surrounding tissue and retrieved from the tunnel. The initial mucosal incision was closed by metal clips. For SMTs in the gastric fundus near cardia, the submucosal tunnel was built from lower esophagus, through the angle of His, to the tumor for resection.STER was successfully performed in 43 patients; the other two were converted to surgery. Mean operating time was 79.3 min (range 45-150 min. Mean tumor size was 1.4 cm (range 0.5-5 cm. Of the total 47 resected SMTs, 36 were GISTs, 10 were leiomyomas and 1 was schwannoma. Complete resection was achieved in all patients. Intra-procedural peumoperitoneum occurred in 3 cases because of iatrogenic perforation, no special treatment was given. 7 patients presented with mild abdominal pain/distention and fever were given antibotics. No severe post-operative complication happened. No tumor recurrence occurred in the median 11 month follow-up period.Based on short-term follow-up observation, STER is a feasible, safe and minimally invasive method for the diagnosis and treatment of small (<3 cm SMTs in gastric body, antrum and proximal cardia.

  1. Neither gastric topological distribution nor principle virulence genes of Helicobacterpylori contributes to clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    Yan Wing Ho; Khek Yu Ho; Felipe Ascencio; Bow Ho

    2004-01-01

    AIM: Studies on Helicobacter pylori(Hpylori) and gastroduodenal diseases have focused mainly on the distal sites of the stomach, but relationship with the gastric cardia is lacking. The aim of this study is to determine if the gastric topology and genotypic distribution of H pylori were associated with different upper gastrointestinal pathologies in a multiethnic Asian population.METHODS: Gastric biopsies from the cardia, body/corpus and antrum were endoscoped from a total of 155 patients with dyspepsia and/or reflux symptoms, with informed consent. H pylori isolates obtained were tested for the presence of 26kDa, ureC, cagA, vacA, iceA1, iceA2 and babA2 genes using PCR while DNA fingerprints were generated using random amplification polymorphic DNA(RAPD).RESULTS: H pyloriwas present in 51/155 (33%) of patients studied. Of these, 16, 15 and 20 were isolated from patients with peptic ulcer diseases, gastroesophageal reflux diseases and non-ulcer dyspepsia, respectively. Of the H pylori positive patients, 75% (38/51) had H pylori in all three gastric sites.The prevalence of various genes in the H pylori isolates was shown to be similar irrespective of their colonization sites as well as among the same site of different patients.The RAPD profiles of H pylori isolates from different gastric sites were highly similar among intra-patients but varied greatly between different patients.CONCLUSION: Topographic colonization of H pylori and the virulence genes harboured by these isolates have no direct bearing to the clinical state of the patients. In multiethnic Singapore, the stomach of each patient is colonized by a predominant strain of H pylori, irrespective of the clinical diagnosis.

  2. 河北省食管癌和胃癌高发区居民胃癌发生部位的变化及趋势分析%Analysis of the changing trends of frequency and localization of gastric cancers arising from different sites of the stomach in population of the high incidence area of esophageal and gastric cancers in Hebei province

    Institute of Scientific and Technical Information of China (English)

    赵晨燕; 张祥宏; 薛丽英; 邢凌霄; 王俊灵; 李学民; 米建民; 靳国梁

    2008-01-01

    目的 探讨河北省食管癌和胃癌高发区居民胃癌发生部位的变化.方法 回顾性分析1993-2006年河北省食管癌高发区磁县和胃癌高发区赞争县伞部首诊为胃癌的4334例患者的临床资料,比较不同地区、不同年份、不M性别和不同年龄患者贲门、胃体和胃窦部位胃癌的构成比,分析当地胃癌发生部位的变化及趋势.结果 两地伞部旨诊胃癌患者巾,贲门癌占68.0%,明显高于胃体痛(24.2%)和胃窦癌(7.9%;X2=124.396,P<0.0001).1993-2006年间,贲门痛在胃癌中所占的比例呈逐渐增高的趋势.磁县患者中,贲门癌所占的比例为71.2%,明显高于赞皇县(51.2%;X2=109.648,P<0.0001).磁县贲门癌比例逐渐增多的同时,胃体癌比例呈逐渐减少的趋势;而赞争县胃癌构成比的变化主要体现在胃窦癌逐渐减少.性别对胃癌发生部位的变化无明显影响;但不同部位胃癌患者的年龄构成比存在着差异(X2=58.380,P<0.0001),其中<50岁组胃体癌所占的比例在所有年龄组中最高,为34.2%,而贲门癌在61~70岁组中所占的比例最高,为71.6%.结论 贲门是河北省胃癌高发区磁县和食管癌高发区赞皇县居民胃癌发生的主要部位.在流行病学因素不变的条件下,磁县胃癌患者中,贲门痛的构成比将继续上升,胃体癌的构成比将继续下降;而赞皇县患者中,胃窦癌的构成比将继续下降.%Objective To analyze the changing trends of frequency and localization of gastric cancers arising from the gastric cardia,corpus and antrum during the past 14 years in population of the high incidence area of esophageal and gastric carcinoma in Hebei province.China.Methods The clinicopathological data of 4334 cases of gastric carcinomas among the local residents of Cixian and Zanhuang counties,initially diagnosed in our department from 1993 to 2006.were retrospectively analyzed.The proportion of gastric carcinomas arising from the gastric cardia,corpus and

  3. Transabdominal ultrasonography in the diagnosis of achalasia Transabdominal ultrasonography in the diagnosis of achalasia%贲门失弛缓症的经腹超声诊断

    Institute of Scientific and Technical Information of China (English)

    章建全; 陈晓华

    2001-01-01

    目的:探讨经腹超声诊断贲门失弛缓症的临床应用价值。方法:选择8名贲门失弛缓症患者,设立10名正常人和8名贲门癌患者作对照,对3组受试者进行经腹超声饮水试验,比较三者的超声表现;并对贲门失弛缓症患者经药物治疗、球囊扩张或肉毒杆菌毒素注射前后的超声表现进行比较。结果:(1)正常人饮水试验前食管腔及贲门口闭合,饮水时贲门迅速开放,水流快速通过。(2)贲门失弛缓症患者饮水试验前食管下段已经扩张;饮水时连续观察10 min,贲门始终不弛张、水流不能通过者5例,贲门间断性张开、水流间断通过者3例;饮水试验后30 min再检查时见全部患者的食管中仍滞留有水。(3)贲门癌患者饮水前表现为贲门环增大、贲门壁增厚,食管未扩张;饮水时水流通过贲门较缓慢。结论:经腹超声检查因只需饮少量水而易为患者接受;而且它通过显示贲门环的大小、贲门壁厚度以及饮水时水流通过贲门的状态,而达到迅捷、可靠地诊断贲门失弛缓症,故也是合适的治疗评价手段。%Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were

  4. 贲门癌根治术术中管状吻合器的使用优点及技巧探讨%Forte and technique of circular stapler application in radical correction of gastric eardia carcinoma

    Institute of Scientific and Technical Information of China (English)

    朱群山; 陈平; 赵伟; 孙振华

    2009-01-01

    目的 探讨贲门癌根治术(食管空肠吻合及残胃食管吻合)术中管状吻合器的使用优点及技巧.方法 1998年~2007年本院753例贲门癌根治术行食管空肠吻合或残胃食管吻合重建消化管,术中均使用一次性管状吻合器.结果 本组753例,无手术死亡,行胸腹联合手术6例(0.80%),无吻合口漏发生,吻合器切割不全2例(0.26%),发生吻合口狭窄4例(0.53%),腹腔感染1例(0.13%),膈疝1例(0.13%),术后标本病理检查上切缘癌累及1例,下切缘均未累及.结论 在贲门癌根治术中,管状吻合器的运用简化了手工操作程序,可靠、安全、省时,降低贲门癌进胸手术比例,手术创伤小,恢复快,能有效地预防吻合口瘘和狭窄.但吻合器吻合也不是绝对安全的,吻合口瘘、出血、狭窄等并发症仍有一定的发生率,术中技巧值得在今后的工作中进一步总结、探讨.%Objective To investigate forte and technique in radical correction of gastric eardia carcinoma (esophagojejunostomy and gastric stump esophago anastomosis). Methods 753 Patients with gastric cardia carcinoma admitted to our hospital from 1998 to 2007 treated with radical correction by jejuno-osophagus an-astomosis and esophagogastric anastomosis to digestive tract reconstruction, circular staplers were used in all cases. Results There was no death (no leakage、bleeding and stricture of anastornotic entrance stenosis)in these cases by thoracoabdominal approach 6 cases, anastomotic leakage 0 case, pero-eutting 2 cases, steno-sis 4 cases, infection of abdominal cavity 1 case, diaphragmatic hernia 1 case, pathologic diagnosis of exam-ple after operation , the upper cut positive 1 case, the lower cut negative in all cases. Conclusions in rad-ical correction gastric cardia carcinoma, the application of circular stapler makes this procedure simple, reli-ability, safety and time saving, descends the ratio of radical correction of gastric cardia carcinoma by thora

  5. Analysis of Lymph Node Metastases of 1,526 Cases with Thoracic Esophageal and Cardiac Carcinomas:A Random Sampling Report from the Fourth Hospital of Hebei Medical University from 1996 to 2004

    Institute of Scientific and Technical Information of China (English)

    Wei Liu; Linan Song; Yumin Ping; Xianli Meng; Rui Wang; Junfeng Liu; Xiaoling Wang; Xishan Hao; Yong Chen; Haixin Li; Shijie Wang; Peizhong Wang; Ying Jin; Liyun Guan; Qian Fan

    2008-01-01

    OBJECTIVE To summarize the regular pattern and state oflymph node metastasis of patients with esophageal and cardiaccarcinomas,so as to analyze factors influencing lymph nodemetastasis.METHoDS Clinical data collected from 1,526 thoracicesophageal and cardiac carcinoma patients who were admitted inthe Fourth Hospital of Hebei Medical University during a periodfrom January 1996 to December 2004,were randomly selectedand an Access Database of the patient's information was set up.Eight clinico-pathologic factors,including the patient's age,tumorlocation and size,pathological classification,the depth of tumorinvasion,vascular tumor embolus(VTE),the state of surroundingorgan encroachment and the status of tumor residues,wereidentified.A correlation between these factors and metastases wasstatistically analyzed using SPSSl3.0 software.RESULTS Lymph node metastatic sites from esophagealcarcinomas included the thoracic and abdominal cavit. LymphAnode metastasis from the superior esophageal carcinomasmainly occurred in the neck and thoracic cavity.There was atwo-way lymph node metastasis in the patients with the middleesophageal carcinoma.The inferior esophageal carcinomas mainlymetastasized to the ParaesOphageal,paragastric cardia,and leftgastric artery lymph nodes.The rate and degree of the metastasisfrom the inferior esophageal carcinomas were significantly highercompared to those of the superior and the middle esophagealcarcinomas (P0.05).Multifactoriallogistic regression analysis showed that the tumor size.depth oftumor encroachment,VTE,and tumor residues could all bringabout obvious impation lymph-node metastases (P<0.05).CONCLUSION Lymph node metastasis from superioresophageal carcinomas mainly occurs in the neck and thoraciccavity.The middle esophageal carcinomas presented a two-waylymph-node metastasis(both the upwards and the downwards),and the lymph node metastasis from inferior esophageal carcinomas mainly occurred in the thoracic and abdominal cavities

  6. Helicobacter pylori virulence genes and microevolution in host and the clinical outcome: review article

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Bakhti

    2014-12-01

    Full Text Available Helicobacter pylori (H. pylori is the causative agent in development of gastroduode-nal diseases, such as chronic atrophic gastritis, peptic ulcers, mucosa associated lym-phoid tissue (MALT lymphoma, and gastric cancer. H. pylori has been associated with inflammation in cardia, showing the fact that infection with this bacterium could also be a risk factor for gastric cardia cancer. Gastric cancer is the fourth most common cancer worldwide. This is the second leading cause of cancer-related deaths, and ap-proximately 700,000 people succumb each year to gastric adenocarcinoma. It has been estimated that 69% of the Iranian population currently harbor H. pylori infection. The prevalence of duodenal ulcer and gastric cancer is high in Iranian populations. However, this has been largely influenced by geographic and/or ethnic origin. Epidemi-ology studies have shown that host, environmental, and bacterial factors determine the outcome of H. pylori infection. The bacterium contains allelic diversity and high genet-ic variability into core- and virulence-genes and that this diversity is geographically and ethnically structured. The genetic diversity within H. pylori is greater than within most other bacteria, and its diversity is more than 50-fold higher than that of human DNA. The maintenance of high diversification makes this bacterium to cope with particular challenges in individual hosts. It has been reported that the recombination contributed to the creation of new genes and gene family. Furthermore, the microevolution in cagA and vacA genes is a common event, leading to a change in the virulence phenotype. These factors contribute to the bacterial survival in acidic conditions in stomach and protect it from host immune system, causing tissue damage and clinical disease. In this review article, we discussed the correlation between H. pylori virulence factors and clin-ical outcomes, microevolution of H. pylori virulence genes in a single host

  7. Development of the diabetes typology model for discerning Type 2 diabetes mellitus with national survey data

    Science.gov (United States)

    Bellatorre, Anna; Jackson, Sharon H.

    2017-01-01

    Objective To classify individuals with diabetes mellitus (DM) into DM subtypes using population-based studies. Design Population-based survey Setting Individuals participated in 2003–2004, 2005–2006, or 2009–2010 the National Health and Nutrition Examination Survey (NHANES), and 2010 Coronary Artery Risk Development in Young Adults (CARDIA) survey (research materials obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center) Participants 3084, 3040 and 3318 US adults from the 2003–2004, 2005–2006 and 2009–2010 NHANES samples respectively, and 5,115 US adults in the CARDIA cohort Primary outcome measures We proposed the Diabetes Typology Model (DTM) through the use of six composite measures based on the Homeostatic Model Assessment (HOMA-IR, HOMA-%β, high HOMA-%S), insulin and glucose levels, and body mass index and conducted latent class analyses to empirically classify individuals into different classes. Results Three empirical latent classes consistently emerged across studies (entropy = 0.81–0.998). These three classes were likely Type 1 DM, likely Type 2 DM, and atypical DM. The classification has high sensitivity (75.5%), specificity (83.3%), and positive predictive value (97.4%) when validated against C-peptide level. Correlates of Type 2 DM were significantly associated with model-identified Type 2 DM. Compared to regression analysis on known correlates of Type 2 DM using all diabetes cases as outcomes, using DTM to remove likely Type 1 DM and atypical DM cases results in a 2.5–5.3% r-square improvement in the regression analysis, as well as model fits as indicated by significant improvement in -2 log likelihood (pwaist circumference), which provide additional validation of the DTM-defined classes. Conclusions Our Diabetes Typology Model reflects a promising first step toward discerning likely DM types from population-based data. This novel tool will improve how large

  8. Congenital Hiatus Hernia%先天性食管裂孔疝

    Institute of Scientific and Technical Information of China (English)

    江泽熙

    1986-01-01

    From 1977 to 1984, 7 cases of congenital hiatus hernia were surgically treated. 3 were sliding hernia and 4 combined type(right paresophageal hernia combined with sliding hernia). 5 cases underwent Belsey operation and 2Nissen's operation. The 5 patients who had had Belsey repair vomited again after operation. 3 of them had barium meal reflux. Two recurrent cases were reoperated on by the same procedure but the results were still unsatisfactory. The causes of the unsuccessful Belsey repair operation in our group were as follows:1)Because of lack of understanding of combined hernia, a transthoracic approach failed in redution of the paraesophageal hernia on the contralateral side, 2)The 270°wrap did not calibrate the cardia to produce a compe tent sphincter mechanism 3)Separation of the sutures that were placed in an attenuated phrenoesophageal membrane to fix the cardia. In the latest two cases we used Nissen's fundoplication and postoperative symptom's disappeared-The short-term results followed up by Barium meal and questionaire were good. It seems to us that Nissen's repair is better than Belsey's, but longer follow-up is needed before knowing the long-term results. According to the author, preoperative studies of x-ray findings should be stressed in order to decide the surgical procedure, which will have direct influence on the results.%@@ Skinner DB(1)根据解剖缺陷及临床表现,将食管裂孔疝分为四型:Ⅰ型--滑动疝,食管裂孔轻度扩张,膈食管膜变薄,贲门及胃底上移,有不同程度的返流;Ⅰ型--食管旁疝,膈食管膜缺损,有腹膜形成的疝囊,贲门位置正常,无返流;Ⅲ型--混合型,食管旁疝与滑动疝同存,有返流;及Ⅳ型--多器官型(Multipleorgan Hiatal Hernia),部份结肠或小肠也进入食管旁疝囊内.以Ⅰ、Ⅱ型最多,前者占95%,后者约3.5%(以下称Ⅰ、Ⅱ、Ⅲ型).

  9. The role of TLR2, TLR4 and CD14 genetic polymorphisms in gastric carcinogenesis: a case-control study and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Natalia Castaño-Rodríguez

    Full Text Available BACKGROUND: In addition to Helicobacter pylori infection, host genetic factors contribute to gastric cancer (GC. Recognition of H. pylori is known to involve Toll-like receptors (TLR, which subsequently leads to activation of NF-κB. Thus, the overall aim of this study was to estimate for the first time the pooled effect size of polymorphisms in TLR2, TLR4 and CD14 on GC development through a meta-analysis. METHODS: A case-control study comprising 284 ethnic Chinese individuals (70 non-cardia GC cases and 214 functional dyspepsia controls was conducted for the genotyping of TLR2 -196 to -174del, CD14 -260 C/T and TLR4 rs11536889 using PCR, RT-PCR and mass spectrometry. Case-control studies of TLR2, TLR4 and CD14 polymorphisms and GC were searched up to June 2012. Pooled odds ratios and 95% confidence intervals were obtained by means of the random effects model. RESULTS: In our ethnic Chinese case-control study, the TLR4 rs11536889 C allele increased the risk of GC (OR: 1.89, 95%CI: 1.23-2.92 while the CD14 -260 T allele was protective (OR: 0.62, 95%CI: 0.42-0.91. TLR2 -196 to -174 increased the risk of GC only in H. pylori-infected individuals (OR: 3.10, 95%CI: 1.27-7.60. In the meta-analysis, TLR4 Asp299Gly showed borderline results in the general analysis (pooled OR: 1.58, 95%CI: 0.98-2.60, nevertheless, stratified analysis by ethnicity showed that the mutant allele was a definitive risk factor for GC in Western populations (pooled OR: 1.87, 95%CI: 1.31-2.65. There was a potential association between the TLR2 -196 to -174 deletion allele and GC in Japanese (pooled OR: 1.18, 95%CI: 0.96-1.45. TLR4 Thr399Ile did not provide significant results. CONCLUSIONS: TLR4 rs11536889 and CD14 -260 C/T are associated with non-cardia GC in Chinese. Based on our meta-analysis, the TLR signalling pathway is involved in gastric carcinogenesis, TLR4 Asp299Gly and TLR2 -196 to -174del showing associations with GC in an ethnic-specific manner.

  10. 山西省阳城县5073例上消化道内窥镜筛查结果分析%Analysis on 5073 persons of upper gastrointestinal endoscopic screening in Yangcheng county Shanxi province

    Institute of Scientific and Technical Information of China (English)

    王新正; 张永贞; 元芳梅; 王芳; 刘宽荣

    2009-01-01

    Objective To summarize endoscopic screening results of early detection and treatment of esophageal cancer in Yangcheng County,and to improve detection rate of precancerous lesions.Methods Analyze 5073 examples who were checked by endoscopy and iodine dyeing and cardia ridge root biopsy.Results Sex rate(male to female)was 0.99:1,there were statistics significant difference between two group (P>0.05);male's detection rate of dysplasia and cancer was obvious higher than female's(P<0.01);The early detection rate of esophagus,cardia,stomach was 73.33%,71.88%,44.44%respectively.Conclusion To use endoscopy and iodine dyeing and cardic ridge root biopsy can increase the detection rate of precancerous lesions in esophageal cancer high risk region.%目的 总结阳城县食管癌早诊早治项目内窥镜筛查情况和早期诊断结果.方法 对5073例应用内窥镜检查+碘染色+指示性活组织检查及贲门脊根部定点活组织检查的普查资料进行分析.结果 参加筛查的男女比为0.99:1,两组差异无统计学意义(P>0.05);不典型增生和癌的检出率男性明显高于女性(P<0.01);食管、贲门、胃的早期诊断率{早期诊断病例[重度不典型增生和(或)原位癌、黏膜内癌]/重度不典型增生和(或)原位癌以上病例}分别为73.33%、71.88%、44.44%.结论 在食管癌高发区应用内窥镜检查+碘染色+指示性活组织检查可提高食管癌癌前病变的检出率,同时要重视对早期贲门癌的诊断,建议食管癌高发区常规内窥镜检查时应做碘染色+指示性活组织检查和对贲门脊根部的定点活组织检查,以提高癌前病变的检出率.

  11. Total artificial heart in the pediatric patient with biventricular heart failure.

    Science.gov (United States)

    Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

    2014-01-01

    Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would

  12. The proximal gastric corpus is the most responsive site of motilin-induced contractions in the stomach of the Asian house shrew.

    Science.gov (United States)

    Dudani, Amrita; Aizawa, Sayaka; Zhi, Gong; Tanaka, Toru; Jogahara, Takamichi; Sakata, Ichiro; Sakai, Takafumi

    2016-07-01

    The migrating motor complex (MMC) is responsible for emptying the stomach during the interdigestive period, in preparation for the next meal. It is known that gastric phase III of MMC starts from the proximal stomach and propagates the contraction downwards. We hypothesized that a certain region of the stomach must be more responsive to motilin than others, and that motilin-induced strong gastric contractions propagate from that site. Stomachs of the Suncus or Asian house shrew, a small insectivorous mammal, were dissected and the fundus, proximal corpus, distal corpus, and antrum were examined to study the effect of motilin using an organ bath experiment. Motilin-induced contractions differed in different parts of the stomach. Only the proximal corpus induced gastric contraction even at motilin 10(-10) M, and strong contraction was induced by motilin 10(-9) M in all parts of the stomach. The GPR38 mRNA expression was also higher in the proximal corpus than in the other sections, and the lowest expression was observed in the antrum. GPR38 mRNA expression varied with low expression in the mucosal layer and high expression in the muscle layer. Additionally, motilin-induced contractions in each dissected part of the stomach were inhibited by tetrodotoxin and atropine pretreatment. These results suggest that motilin reactivity is not consistent throughout the stomach, and an area of the proximal corpus including the cardia is the most sensitive to motilin.

  13. Novel therapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yue; Zhang; Shenhong; Wu

    2015-01-01

    Gastric cancer(GC) is a common lethal malignancy.Gastroesophageal junction and gastric cardia tumors are the fastest rising malignancies due to increasing prevalence of obesity and acid reflex in the United States.Traditional chemotherapy remains the main treatment with trastuzumab targeting human epidermal growth factor receptor 2 positive disease.The median overall survival(OS) is less than one year for advanced GC patients; thus,there is an urgent unmet need to develop novel therapy for GC.Although multiple targeted agents were studied,only the vascular endothelial growth factor receptor inhibitor ramucirumab was approved recently by the United States Food and Drug Administration because of its 1.4 mo OS benefit(5.2 mo vs 3.8 mo,P = 0.047) as a single agent; 2.2 mo improvement of survival(9.6 mo vs 7.4 mo,P = 0.017) when combined with paclitaxel in previously treated advanced GC patients.It is the first single agent approved for previously treated GC and the second biologic agent after trastuzumab.Even with limited success,targeted therapy may be improved by developing new biomarkers.Immune therapy is changing the paradigm of cancer treatment and is presently under active investigation for GC in clinical trials.More evidence supports GC stem cells existence and early stage studies are looking for its potential therapeutic possibilities.

  14. Fast rate (≥ 250 beats/min) right ventricular burst stimulation is useful for ventricular tachycardia induction in arrhythmogenic right ventricular cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Ling-Min WU; Jing-Ru BAO; Yan YAO; Bing-Bo HOU; Li-Hui ZHENG; Shu ZHANG

    2016-01-01

    Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy (ARVC) ablation is ventricular tachy-cardia (VT) non-inducibility. The study aimed to assess whether fast rate (≥ 250 beats/min) right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows: Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate (< 250 beats/min); Step C, burst stimulation with fast rate (≥ 250 beats/min); Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT (83.5%), among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients (65.9%). Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility (OR: 1.1; 95% CI: 1.0–1.1;P = 0.019).ConclusionFast rate (≥ 250 beats/min) right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.

  15. [Total transgastric highly selective vagotomy (author's transl)].

    Science.gov (United States)

    Petropoulos, P C

    1981-01-01

    By replacing the transection and excision of the hiatal cardioesophageal branches of the vagus nerve including the nerve branches accompanying those arteries entering the proximal gastric fundus and the gastric branches of the nerves of Laterjet by a seromuscular incision along the lesser curvature from the incisura to the cardia continuing in an arch below the oesophagogastric junction downwards along the greater curvature to a level between the estimated entrance of the short gastric and left gastroepiploic vessels, a total transgastric highly selective vagotomy is achieved. The danger of free exposure of the mucosa is prevented by interposing a free omental graft sutured into the gap in the gastric musculature. The graft protects against complications due to regeneration of the divided vagal branches. This operation is much less extensive, less invasive and significantly more simple than HSV. Completeness of vagotomy is less invasive and significantly more simple than HSV. Completeness of vagotomy is controlled intra-operatively both a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. Twelve to twenty months after applying TTrHSV the mortality was nil in only a restricted number of patients with duodenal ulcers and the morbidity was insignificant. Previous ulcer symptoms disappeared. Dumping syndrome, recurrence of ulceration and other significant complications were not observed. Data of basal and stimulated acid secretion during the 12 to 20 month period after the operation are given.

  16. Expression and Prognostic Significance of Human Epidermal Growth Factor Receptors 1 and 3 in Gastric and Esophageal Adenocarcinoma.

    Directory of Open Access Journals (Sweden)

    Charlotta Hedner

    Full Text Available Gastric and esophageal adenocarcinomas are major global cancer burdens. These cancer forms are characterized by a poor prognosis and a modest response to chemo- radio- and targeted treatment. Hence there is an obvious need for further enhanced diagnostic and treatment strategies. The aim of this study was to examine the expression and prognostic impact of human epidermal growth factor receptor 1 (HER1/EGFR and 3 (HER3, as well as the occurrence of EGFR and KRAS mutations in gastric and esophageal adenocarcinoma.Immunohistochemical expression of EGFR and HER3 was analysed in all primary tumours and a subset of lymph node metastases in a consecutive cohort of 174 patients with adenocarcinoma of the stomach, cardia and esophagus. The anti-HER3 antibody used was validated by siRNA-mediated knockdown, immunohistochemistry and quantitative real-time PCR. EGFR and KRAS mutation status was analysed by pyrosequencing tecchnology.High EGFR expression was an independent risk factor for shorter overall survival (OS, whereas high HER3 expression was associated with a borderline significant trend towards a longer OS. KRAS mutations were present in only 4% of the tumours and had no prognostic impact. All tumours were EGFR wild-type. These findings contribute to the ongoing efforts to decide on the potential clinical value of different HERs and druggable mutations in gastric and esophageal adenocarcinomas, and attention is drawn to the need for more standardised investigational methods.

  17. Multimodality management of resectable gastric cancer: A review

    Institute of Scientific and Technical Information of China (English)

    Helen; Shum; Lakshmi; Rajdev

    2014-01-01

    Adenocarcinoma of the stomach carries a poor prognosis and is the second most common cause of cancer death worldwide. It is recommended that surgical resection with a D1 or a modified D2 gastrectomy(with at least 15 lymph nodes removed for examination), be performed in the United States, though D2 lymphadenectomies should be performed at experienced centers. A D2 lymphadenectomy is the recommended procedure in Asia. Although surgical resection is considered the definitive treatment, rates of recurrences are high, necessitating the need for neoadjuvant or adjuvant therapy. This review article aims to outline and summarize some of the pivotal trials that have defined optimal treatment options for non-metastatic non-cardia gastric cancer. Some of the most notable trials include the INT-0116 trial, which established a benefit in concurrent chemoradiation and adjuvant chemotherapy. This was again confirmed in the ARTIST trial, especially in patients with nodal involvement. Later, the Medical Research Council Adjuvant Gastric Infusional Chemotherapy trial provided evidence for the use of perioperative chemotherapy. Targeted agents such as ramucirumab and trastuzumab are also being investigated for use in locally advanced gastric cancers after demonstrating a benefit in the metastatic setting. Given the poor response rate of this difficult disease to various treatment modalities, numerous studies are currently ongoing in an attempt to define a more effective therapy, some of which are briefly introduced in this review as well.

  18. Stability of randomly amplified polymorphic DNA fingerprinting in genotyping clinical isolates of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Feng-Chan Han; Han-Chong Ng; Bow Ho

    2003-01-01

    AIM: Hpylorigenomes are highly diversified. This project was designed to genotype Hpyloriisolates by the polymerase chain reaction (PCR)-based randomly amplified polymorphic DNA (RAPD) fingerprinting technique and to verify its stability by Southern blotting and DNA sequencing.METHODS: Clinical isolates of Hpyloriwere cultured from gastric antra and cardia of 73 individuals, and genomic DNA was prepared for each isolate. RAPD was carried out under optimized conditions. 23S rDNA was regarded as an internal control, and a 361 bp rDNA fragment (RDF) was used as a probe to screen the RAPD products by Southern blotting.Ten RDFs from different clinical isolates and the flanking regions (both upstream and downstream) of four RDFs were amplified and sequenced.RESULTS: Hpyloriisolates from different individuals had different RAPD profiles, but the profiles for isolates cultured from different gastric sites of a given individual were identical in all but one case. Isolates from 27 individuals were RDF positive by Southern blotting. Sequences of the RDFs and their flanking regions were almost the same between the RDF positive and negative isolates as determined by Southern blotting. There was no binding site for random PCR primer inside the sequences.CONCLUSION: RAPD is very useful in genotyping H pylori grossly on a large scale. However, it seems unstable in amplification of low yield fragments, especially those that do not appear as visible bands on the agarose gel stained with EB, since the palmer is partially matched to the template.

  19. Lectin histochemistry of gastrointestinal glycoconjugates in the greater horseshoe bat, Rhinolophus ferrumequinum (Schreber, 1774).

    Science.gov (United States)

    Scillitani, Giovanni; Zizza, Sara; Liquori, Giuseppa Esterina; Ferri, Domenico

    2007-01-01

    Mucins in the gastrointestinal tract of Rhinolophus ferrumequinum were investigated by histochemistry and lectin histochemistry to evaluate morphofunctional variations of different regions and their possible physiological and evolutionary implications. Histochemical methods included periodic acid-Schiff (PAS), Alcian blue (AB) at pH 2.5 and 1.0 and high-iron-diamine AB pH 2.5. Binding of lectins Con A, DBA, WGA, LTA, LFA, PNA and SBA; LFA, PNA and SBA with prior sialidase treatment; and paradoxical Con A were evaluated. The oesophagus lacked glands. The stomach was divided into a short cardias, a wide fundus and a brief pylorus. The surface muciparous cells secreted sulpho- and sialomucins with N-acetylgalactosamine (GalNAc) residues, N-acetyllactosamine and (beta1,4 N-acetylglucosamine)(n) chains. Towards the pylorus, N-acetylgalactosamine residues disappeared and acidity decreased. Cardiac glands, neck cells in the fundic glands, pyloric and duodenal Brunner's glands all shared neutral, stable class-III mucins, mainly with N-acetylgalactosamine sequences. The intestine was divided into a duodenum, a jejuno-ileum and a short rectum. The goblet cells produced sulpho- and sialomucins with sialylated N-acetylgalactosamine sequences, (beta1,4 N-acetylglucosamine)(n) and N-acetyllactosamine, whose sialylation increased towards the rectum. The main features of the mucins are probably associated with the requirements of fast absorption and food passage and in protection against mechanical and pathogenic injuries.

  20. Genome editing with RNA-guided Cas9 nuclease in Zebrafish embryos

    Institute of Scientific and Technical Information of China (English)

    Nannan Chang; Changhong Sun; Lu Gao; Dan Zhu; Xiufei Xu; Xiaojun Zhu; Jing-Wei Xiong

    2013-01-01

    Recent advances with the type Ⅱ clustered regularly interspaced short palindromic repeats (CRISPR) system promise an improved approach to genome editing.However,the applicability and efficiency of this system in model organisms,such as zebrafish,are little studied.Here,we report that RNA-guided Cas9 nuclease efficiently facilitates genome editing in both mammalian cells and zebrafish embryos in a simple and robust manner.Over 35% of sitespecific somatic mutations were found when specific Cas/gRNA was used to target either etsrp,gata4 or gata5 in zebrafish embryos in vivo.The Cas9/gRNA efficiently induced biallelic conversion of etsrp or gata5 in the resulting somatic cells,recapitulating their respective vessel phenotypes in etsrpy11 mutant embryos or cardia bifida phenotypes in fautm236a mutant embryos.Finally,we successfully achieved site-specific insertion of mloxP sequence induced by Cas9/gRNA system in zebrafish embryos.These results demonstrate that the Cas9/gRNA system has the potential of becoming a simple,robust and efficient reverse genetic tool for zebrafish and other model organisms.Together with other genome-engineering technologies,the Cas9 system is promising for applications in biology,agriculture,environmental studies and medicine.

  1. Immunocytochemical Identification and Localization of Diffuse Neuroendocrine System (DNES) Cells in Gastrointestinal Tract of Channel Catfish (Ictalurus punctatus)

    Institute of Scientific and Technical Information of China (English)

    HE Min; WANG Kai-yu; ZHANG Yu

    2009-01-01

    To detect distribution and relative frequency of diffuse neuroendocrine system (DNES) cells in the gastrointestinal tract of channel catfish (Ictalurus punctatus), the intestinal tract of channel catfish was divided into seven portions from proximal to distal: the enlarged area after oesophagus, cardia, fundus, pylorus, and anterior, middle, and posterior intestine. Immunohistochemical method using the strept avidin-biotin-complex (SABC) was employed. All antisera between seven portions of the channel catfish were compared statistically using statistical package for the social science (SPSS). Five types of DNES cells were determined: neuropeptide Y-immunoreactive (NPY-IR) cells were demonstrated in both anterior and middle intestine; serotonin (5-HT) immunoreactive cells were detected throughout the whole gastrointestinal tract; vasoactive intestinal peptide (VIP) positive cells were at the highest frequency in pylorus; glucagon-immunoreactive (GLU-IR) cells were moderate in number in the fundus and anterior, middle intestine, and no immunoreactivity was determined in the other portions; somatostatin (SOM) positive cells were more abundant in the anterior and middle intestine. The regional distribution and relative frequency of immunoreactive cells in the channel catfish, Ictalurus punctatus, are essentially similar to those of other fish. However, some characteristics are observed in this species, which further proved that the diversity of the physiological function of DNES cells was based on their morphology.

  2. N-CWS抗宫颈HPV感染的研究进展

    Institute of Scientific and Technical Information of China (English)

    迟源; 李红玉; 王雪峰; 李巨

    2009-01-01

    红色诺卡氏菌细胞壁骨架(No-Cardia rubra Cell Wall skeleton,N-CWS)是一种非特异性免疫调节剂,可有效增强人体固有免疫应答,增强巨噬细胞吞噬病原体和自然杀伤细胞(natural killer cell,NK)杀伤病原体的能力,同时激活人体适应性免疫应答,增强T细胞、B细胞有效识别和杀灭病原体和病毒的能力.人乳头瘤病毒(humabnpapilloma virus,HPV)感染与宫颈癌及其癌前病变发生密切相关,宫颈HPV感染的尽早预防是阻断其癌变的关键.N-CWS是预防HPV感染和阻止宫颈癌变的重要途径.近年来从天然药物开发抗病毒化合物已成为研究热点.

  3. Retinol-binding protein, acute phase reactants and Helicobacter pylori infection in patients with gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Nicolas Tsavaris; Christos Koufos; Athanasios Archimandritis; Christos Kosmas; Petros Kopterides; Dimitrios Tsikalakis; Hlias Skopelitis; Fotini Sakelaridi; Nikitas Papadoniou; Michalis Tzivras; Vasilios Balatsos

    2005-01-01

    AIM: To determine the serum levels of c-reactive protein (CRP), transferrin (TRF), a2-macroglobulin (A2M),ceruloplasmin (CER), a1-acid glycoprotein (AAG), prealbumin (P-ALB) and retinol-binding protein (RBP) in gastric carcinoma patients and to explore their possible correlation with underlying Helicobacter pylori (H pylon)infection.METHODS: We measured the serum levels of CRP, TRF,A2M, CER, AAG, P-ALB, and RBP in 153 preoperative patients (93 males; mean age: 63.1±11.3 years) with non-cardia gastric adenocarcinoma and 19 healthy subjects.RESULTS: The levels of CRP, CER, RBP, andAAG in cancer patients were significantly higher than those in healthy controls (P<0.0001), while no difference was found regarding the TRF, P-ALB, and A2M levels. Cancer patients with H pylori infection had significantly lower RBP values compared to non-infected ones (P<0.0001)and also higher values of CRP and AAG (P = 0.09 and P = 0.08, respectively).CONCLUSION: High serum levels of CRP, CER and AAG in cancer patients do not seem to be related to H pylori infection. Retinol-binding protein seems to discriminate between infected and non-infected patients with gastric carcinoma. Further studies are needed to explore if it is directly involved in the pathogenesis of the disease or is merely an epiphenomenon.

  4. Long-term results of Troidl's technique of endoscopic pneumatic dilatation for achalasia of the esophagus. A prospective clinical trial.

    Science.gov (United States)

    Eypasch, E; Troidl, H; Sommer, H; Vestweber, K H

    1987-01-01

    In a prospective clinical trial, 26 consecutive patients underwent endoscopic pneumatic dilatation over a 10-year period. Dilatation was achieved by means of a balloon attached to a normal gastrointestinal fiberscope. With the endoscope in an inverse position, the device was placed in the cardia and the dilatation process was monitored macroscopically. Before dilatation, patients suffered from dysphagia (92%), reduced speed of swallowing (100%), symptom aggravation under stress (73%), weight loss (50%), aspiration, pain, regurgitation, and vomiting. After dilatation and long-term follow-up (mean of 5 years), symptoms could be markedly reduced, especially the speed of eating and symptom aggravation under stress. Excellent and good results (Visick scale) were achieved in 76%. Fair results were achieved in 20%. To date, perforation and other complications have not occurred. Mortality was zero. Our series was an uncontrolled trial, so the results are hardly comparable to other studies. Furthermore, the small number of patients in our study represents a weak point with regard to complications. We conclude that the main advantages of the procedure are its simplicity and practicability. The simple procedure may be the method of choice in elderly patients. Of course, no final decision can be made until a well-designed controlled trial has been carried out.

  5. Prospective study of serum B vitamins levels and oesophageal and gastric cancers in China

    Science.gov (United States)

    Ren, Jiansong; Murphy, Gwen; Fan, Jinhu; Dawsey, Sanford M.; Taylor, Philip R.; Selhub, Jacob; Qiao, Youlin; Abnet, Christian C.

    2016-01-01

    B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell carcinomas (OSCCs), 255 gastric cardia adenocarcinomas (GCAs), and an age- and sex-matched sub-cohort of 947 individuals. Baseline serum riboflavin, pyridoxal phosphate (PLP), folate, vitamin B12, and flavin mononucleotide (FMN) were measured for all subjects. We estimated the associations with Cox proportional hazard models, with adjustment for potential confounders. Compared to those in the lowest quartile of serum riboflavin, those in the highest had a 44% lower risk of OSCC (HR: 0.56, 95% CI: 0.41 to 0.75). Serum vitamin B12 as a continuous variable was observed to be significantly inversely associated with OSCC (HR: 0.95, 95% CI: 0.89 to 1.01, P for score test = 0.041). Higher serum FMN levels were significantly associated with increased risk of OSCC (HR: 1.08, 95% CI: 1.01 to 1.16) and GCA (HR: 1.09, 95% CI: 1.00 to 1.20). Our study prompted that B vitamins have the potential role as chemopreventive agents for upper gastrointestinal cancers. PMID:27748414

  6. Endoscopic Aspects of Gastric Syphilis

    Directory of Open Access Journals (Sweden)

    Mariana Souza Varella Frazão

    2012-01-01

    Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.

  7. Gastrointestinal stromal tumor (GIST coexisting with pancreatic cancer and hepatic hemangioma

    Directory of Open Access Journals (Sweden)

    M. A. Beltrán

    2014-11-01

    Full Text Available The occurrence of gastric gastrointestinal stromal tumors (GIST associated to pancreatic adenocarcinoma has been reported in 0.2% pancreatic cancers. There are no published reports on distal pancreatic adenocarcinoma associated to gastric antral GIST. Herein, we discuss a 75 years-old female patient who was admitted to our institution with upper digestive hemorrhage. The endoscopy showed large, superficial erosions over the cardias and, on the posterior wall of the antrum, a rounded sub-mucosal non-eroded lesion suspected of gastric GIST. An abdominal computed tomography scan found a hepatic hemangioma on the left hepatic lobe. In the pancreatic distal body and tail a solid exophytic lesion was identified. The surgical findings confirmed the radiologic diagnostic. The biopsy reported a hepatic hemangioma. The pancreatic tail and the proximal part of the body harbored a well-differentiated ductal adenocarcinoma measuring 3.4 cm x 3 cm x 2.5 cm with negative margins. The gastric tumor measured 4 cm x 2.5 cm x 1 cm, was positive for CD117, CD34, and DOG-1; it had a positive Ki67 in less than 2%, and 2 or less mitoses per 50 high-power fields. This uncommon case illustrates the occurrence of synchronous tumors of different cellular origins in the same patient, which were diagnosed during the study for another unrelated condition. The individual incidence of these tumors is low and if associated they probably will continue to be found incidentally.

  8. [The surgical treatment of stomach cancers. A review of 759 operations (author's transl)].

    Science.gov (United States)

    Giuli, R

    759 patients were studied, deriving from the Statistics of the Department from the last twenty years and the result of an inquiry sent out to the French members of the Collegium Internationale Chirurgiae Digestival. For 602 tumors of the cardia, the long term results of the upper gastrectomies were, inspite of area of non-invaded lymph nodes for 1/3 of the patients, the same for the two sources of statistics, with almost no survival after the fourth year. On the contrary, however, the percentages of survival of total gastrectomies "by choice" are 40 and 31% after five years. As for the cancers of the lower part, the result was not as precise and the apparent or proved non invaded state of lymph nodes during the operation make us rather tend towards a partial gastrectomy. (Combined with a mortality rate inferior to those of total gastrectomies). As for the total of gastric cancers, the total gastrectomies "by necessity" (eith by tumor growth or lymph tive therapy in a specialized center permit fifty per cent after five years, for the patients who would have been condemned by any other therapeutical act. The nutritional consequences of the total gastrectomies were studied and permitted to conclude that post operative therapy in a specialized center permit fifty per cent of the patients of work age to take up their professional activities again and, on the whole, sixty five per cent of them to have completely satisfactory independance.

  9. [Effectiveness of chemoradiotherapy for a patient with local recurrence of advanced gastric cancer followed by curable gastrectomy].

    Science.gov (United States)

    Natsume, Soichiro; Iwasaki, Yoshiaki; Yajima, Kazuhito; Yuu, Ken; Oohinata, Ryouki; Ishiyama, Satoshi; Takahashi, Keiichi; Maeda, Yoshiharu

    2014-11-01

    We report here the effectiveness of chemoradiotherapy for a patient with local recurrence followed by curable gastrectomy. A 57-year-old man presented with a history of total gastrectomy with distal pancreatectomy and splenectomy, D2 lymphadenectomy, and Roux-en-Y reconstruction for advanced gastric cancer arising from the cardia. Esophageal intramural metastasis and lymph node metastasis around the right recurrent nerve were detected by chest-abdominal computed tomography and gastrointestinal endoscopy 27 months after the initial gastrectomy. Stable disease was achieved following 7 courses of chemotherapy using S-1 plus CDDP. Concurrent chemoradiotherapy including administration of S-1 and radiation of total 50 Gy (2 Gy/25 Fr) was selected for local tumor control. The patient was not able to eat solid food because of esophageal stenosis from regrowth of intramural metastasis of the esophagus 60 months after the chemotherapy. A WallFlex™ Duodenal Stent was placed to improve the dysphagia 67 months after chemotherapy. The patient died from recurrence of gastric cancer 69 months after completion of the initial chemotherapy and 2 months after the stent insertion.

  10. Analysis of the proteases activity in 13 organs of the doll fish (Andrias davidianus) digestive system%中国大鲵消化系统13种器官的蛋白水解酶种类和活性分析

    Institute of Scientific and Technical Information of China (English)

    乔志刚; 辛泽华; 李吉学; 沈国民; 徐存拴

    2003-01-01

    Protease activity in 13 doll fish, Andrias davidianus, digestive organs: tongue, esophagus, cardia, stomach,pylorus, duodenum, jejunum, ileum, rectum, cloacal chamber, liver, pancreas, gall bladder were analysed with gelatine polyacrylamide gel-electrophoresis (G-PAGE). Compared to rats and rhesus monkeys (Macaca mullatta tcheliensis ),protease activity in the Andrias davidianus digestive system was more varied and stronger. The activity of acid proteases>that of the neutral proteases>that of the alkaline proteases. The kinds and activities of neutral and alkaline proteases in the Andrias davidianus digestive system wereare very different, while the kinds of acid proteases in them were very simi-lar, but their activities are different. Analysing the activities of proteases in these organs shows that protease activity in the duodenum > that in rectum > that in stomach > that in pancreas > that in liver. Experimental results suggest that the function of the rectum and liver in Andrias daviclianus may be as important as that of the duodenum and pancreas in food degradation.

  11. Epidemiology of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Katherine D Crew; Alfred I Neugut

    2006-01-01

    The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.

  12. Pseudoaneurysm of the splenic artery mimicking a solid lesion

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    Raffaele Pezzilli

    2016-08-01

    Full Text Available A 64-year-old man presented to the hospital because of hematemesis; on admission, he had weakness and pale skin, tachycardia and hypotension. Laboratory tests revealed severe anemia (hemoglobin 7.8 g/dL; liver, renal and pancreatic function tests were normal. An upper digestive endoscopy revealed a gastric ulcer of the cardia, treated with metallic clips and adrenalin injection. The patient was treated with fluids and was transfused with three units of red blood cells. In the previous two months, due to the presence of bloating and diarrhea, associated with abdominal distension, a colon-computed tomography (CT revealed a large retroperitoneal hypodense mass, 53x37 mm in size, without contrast enhancement localized between the body and the tail of the pancreas and the stomach, near the splenic artery and without signs of infiltration. To better define the mass, endoscopic ultrasound and biopsy were performed; however histopathology of multiple biopsies was not diagnostic, because of the presence of necrotic tissue and inflammatory cells. Since hematemesis recurred, the patient underwent a second upper digestive endoscopic examination, but no source of bleeding was found. Then a new contrast enhanced CT was performed that showed a size reduction of the mass, the presence of blood in the stomach and a small pseudoaneurysm of the splenic artery. Because of these findings an angiograpghic study was carried out; angiography confirmed a splenic artery pseudoaneurysm that was successfully embolized with metal microcoils.

  13. Combination therapy with brentuximab vedotin and cisplatin/cytarabine in a patient with primarily refractory anaplastic lymphoma kinase positive anaplastic large cell lymphoma.

    Science.gov (United States)

    Heidegger, Simon; Beer, Ambros J; Geissinger, Eva; Rosenwald, Andreas; Peschel, Christian; Ringshausen, Ingo; Keller, Ulrich

    2014-01-01

    Anaplastic large cell lymphoma (ALCL) is a common subtype of the heterogeneous group of peripheral T-cell lymphomas, which is characterized by large pleomorphic cells with strong expression of CD30. Translocations involving ALK, the anaplastic lymphoma kinase gene, are associated with a favorable clinical outcome. Such ALK-positive ALCLs are usually responsive to a multidrug chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). However, there is no general consensus on the optimal therapy for relapsed or refractory ALCL. We report the case of a 24-year-old male suffering from ALK-positive ALCL with an uncommon manifestation of only extranodal disease in the gastric cardia region that showed primary refractoriness to standard CHOP chemotherapy. A combination therapy consisting of the anti-CD30 drug conjugate, brentuximab vedotin, and classical lymphoma salvage regimen DHAP (cisplatin, high-dose cytarabine and dexamethasone) was administered. Following two treatment cycles in 21-day intervals, the lymphoma showed considerable regression based on imaging diagnostics and no evidence of vital lymphoma in a subsequent biopsy. We did not observe any increase in toxicity; in particular, polyneuropathy and febrile neutropenia were not observed. In summary, we report that the antibody-drug conjugate brentuximab vedotin and a classical regimen used for aggressive lymphoma, DHAP, could be combined as salvage therapy in a case of refractory ALK-positive ALCL. Phase I/II studies will be required for safety and efficacy analysis.

  14. Indirect effect of financial strain on daily cortisol output through daily negative to positive affect index in the Coronary Artery Risk Development in Young Adults Study.

    Science.gov (United States)

    Puterman, Eli; Haritatos, Jana; Adler, Nancy E; Sidney, Steve; Schwartz, Joseph E; Epel, Elissa S

    2013-12-01

    Daily affect is important to health and has been linked to cortisol. The combination of high negative affect and low positive affect may have a bigger impact on increasing HPA axis activity than either positive or negative affect alone. Financial strain may both dampen positive affect as well as increase negative affect, and thus provides an excellent context for understanding the associations between daily affect and cortisol. Using random effects mixed modeling with maximum likelihood estimation, we examined the relationship between self-reported financial strain and estimated mean daily cortisol level (latent cortisol variable), based on six salivary cortisol assessments throughout the day, and whether this relationship was mediated by greater daily negative to positive affect index measured concurrently in a sample of 776 Coronary Artery Risk Development in Young Adults (CARDIA) Study participants. The analysis revealed that while no total direct effect existed for financial strain on cortisol, there was a significant indirect effect of high negative affect to low positive affect, linking financial strain to elevated cortisol. In this sample, the effects of financial strain on cortisol through either positive affect or negative affect alone were not significant. A combined affect index may be a more sensitive and powerful measure than either negative or positive affect alone, tapping the burden of chronic financial strain, and its effects on biology.

  15. Oesophagitis, signs of reflux, and gastric acid secretion in patients with symptoms of gastro-oesophageal reflux disease

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, K.E.; Ask, P.; Boeryd, B.; Fransson, S.G.; Tibbling, L.

    1986-01-01

    In a study comprising 100 patients referred to a surgical clinic with symptons suggestive of gastro-oesophageal reflux disease, the value of different diagnostic procedures was investigated. Positive acid perfusion and 24-h pH tests were the commonest findings. Forty-nine per cent showed normal oesophageal mucosa or diffuse oesophagitis at endoscopy. The severity of heartburn and regurgitation did not differ between patients with normal oesophageal mucosa and oesophagitis of various severities. The severity of macroscopic oesophagitis was significantly corelated to the total reflux time, the presence of reflux or a hiatal hernia at radiology, an open cardia or reflux at endoscopy, pressure transmission or reflux, and low lower oesophageal sphincter pressure at manometry. Gastric hypersecretion was found in 66% of the patients. Gastric acid secretion was not correlated to the severity of oesophagitis or to the findings at 24-h pH test. In patients with severe oesophagitis the sensivity for radiologic, manometric and endoscopic signs of incompetence of the gastro-oesophageal junction was 94%.

  16. Evaluation of the treatment effect of laparoscopic surgery on benign diseases of gastroesophageal junction%腹腔镜手术治疗胃食管结合部良性疾病的疗效评估

    Institute of Scientific and Technical Information of China (English)

    秦鸣放; 赵宏志

    2011-01-01

    Benign diseases of gastroesophageal junction include gastroesophageal reflux disease,hiatal hernia and achalasia of the cardia.Surgical intervention is superior in the treatment of moderate to severe cases.With the rapid development of laparoseopic technology,minimally invasive surgical procedures,such as laparoscopic fundoplication,laparoscopic rear of hiatal hernia and laparoscopic cardiamyotomy are widely applied with excellent efficacy.According to our experience and clinical study,laparoscopic surgery,with advantages of minimal trauma,rapid recovery,safety and reliable efficacy,could be the first-line treatment for benign diseases of gastroesophageal junction.%@@ 胃食管结合部良性疾病临床上以胃食管反流病、食管裂孔疝和贲门失驰缓症较为常见.针对上述疾病的中、重度患者,非手术治疗效果不佳,最终需要施行外科手术[1].

  17. New method of displaying of bovine cardiac lymphatic vessels%牛心淋巴管显示新方法

    Institute of Scientific and Technical Information of China (English)

    许银辉; 申彪; 周楠茜; 吴满洋; 卢帅伟; 王猛; 黄俊友; 张爱梅; 李逸

    2011-01-01

    Objective To explore a new method to display the superficial lymphatic vessels of the cattle cardia. Methods The superficial lymphatic vessels were displayed by new type of lymphatic casting agent perfusion method and acid corrosion technology. Results The superficial lymphatic vessels could be seen with naked eyes after perfusion, and there were eighteen strips of integrity lymphatic stereo cast structure and lymphatic nodes after acid corrosion. Conclusion The new perfusion method can show the distribution of lymphatic vessels very well,and the specimen can be preserved for a long-term.%目的 探索显示牛心浅表淋巴管的新方法.方法 用新型淋巴管铸型剂灌注及酸腐蚀技术显示牛心浅表淋巴管.结果 灌注后肉眼可见牛心浅表淋巴管,腐蚀后显示18条完整立体管型结构及其淋巴结.结论 该灌注法能够很好的呈现出淋巴管的外形分布,并可长期保存.

  18. Diet, H pylori infection and gastric cancer: evidence and controversies.

    Science.gov (United States)

    Rocco, Alba; Nardone, Gerardo

    2007-06-07

    Despite decreasing incidence and mortality rates, gastric cancer (GC) still remains the fourth most common cancer and the second most common cause of cancer-related deaths worldwide. Due to the limited treatment options, at present, prevention is likely to be the only effective means of controlling this disease. The success of a prevention strategy depends upon the understanding of etiological and pathogenic mechanisms underlying gastric carcinogenesis. The etiology of GC is multi-factorial, however, in the recent years, mounting evidence suggests that environmental factors play a key role. The most important environmental factors implicated in the pathogenesis of GC are diet and H pylori infection. Thus, modifications in lifestyle and dietary habit associated with eradication of H pylori infection could hypothetically represent the most promising potential targets for GC prevention. In this review we will address the evidence and the controversies on the role of these agents in non-cardia GC by focusing on retrospective and prospective observational studies and interventional trials.

  19. Barrett's esophagus and its correlation with gastroesophageal reflux in Chinese

    Institute of Scientific and Technical Information of China (English)

    Jun Zhang; Xiao-Li Chen; Kang-Min Wang; Xiao-Dan Guo; Ai-Li Zuo; Jun Gong

    2004-01-01

    AIM: To study the prevalence of Barrett's esophagus in Chinese and its correlation with gastroesophageal reflux.METHODS: This study was carried out in a large prospective series of 391 patients who had undergone upper endoscopy.The patients were divided into 3 groups according to the position of squamocolumnar junction (SCJ). Reflux esophagitis (RE) and its degree were recorded. Intestinal metaplasia (IlMl) in biopsy specimen was typed according to histochemistry and HE and alcian blue (pH2.5) staining separately. Results correlating with clinical, endoscopic, and pathological data were analysed.RESULTS: The prevalence of IM endoscopically appearing Long-segment Barrett's Esophagus (LSBE) was 26.53%,Short-segment Barrett's Esophagus (SSBE) was 33.85% and gastroesophageal junction (GFJ) was 34.00% . IM increased with age of above 40 years old and no difference was found between male and female. Twelve were diagnosed as dysplasia (7 low -grade, 5 high-grade), 16 were diagnosed as cardiac adenocarcinoma and 1 as esophageal adenocarcinoma. The more far away the SCJ moved upward above GFJ, the higher the prevalence and the more severe the RE were.CONCLUSION: There was no difference of the prevalence of IM in different places of SCJ, and IM increased with age of above 40 years old. It is important to pay attention to dysplasia in the distal esophagus and gastro-esophageal junction, and adenocarcinoma is more common in cardia than in esophagus. BE is a consequence of gastroesophageal reflux disease.

  20. The gastric cancer

    Directory of Open Access Journals (Sweden)

    Pelayo Correa

    2013-09-01

    Full Text Available Gastric cancer ranks fourth in incidence and second in mortality among all cancers worldwide. Despite the decrease in incidencein some regions of the world, gastric cancer continues to present a major clinical challenge due to most cases beingdiagnosed in advanced stages with poor prognosis and limited treatment options. The development of gastric cancer is acomplex and multi-factored process involving a number of etiological factors and multiple genetic and epigenetic alterations.Among the predisposing factors are: Helicobacter pylori infection, high salt intake, smoking, and, in a small percentage ofpatients, a family genetic component. More than 90% of stomach cancers are adenocarcinomas, which are classified intotwo major histological groups: intestinal and diffuse. Intestinal adenocarcinoma is preceded by a sequence of gastric lesionsknown as Correa´s cascade. According to the anatomical position, adenocarcinomas are classified as proximal (originatingin the cardia and distal (originating in the body and antrum. This is a classification that recognizes two different clinicalentities. In general, the only possible cure for the disease is resection of the tumor in an early stage for which the identificationand monitoring of at-risk patients play a significant role. With the exception of Japan, no effective early detection programsexist. Anti-H. pylori has been shown to be an effective measure in the prevention of gastric cancer.

  1. Structure and Function of the Gastrointestinal Tract of the Green Turtle (Chelonia mydas) Hatchling

    Institute of Scientific and Technical Information of China (English)

    Hualing CHEN; Mingbin YE; Yuyan LU; Jinxia DUAN; Pipeng LI; Hexiang GU

    2015-01-01

    The gastrointestinal tracts of four Chelonia mydas hatchlings were examined at the anatomical, histological and ultrastructural level. Our results show that the gastrointestinal tract (GI) is composed by esophagus, stomach, small intestine (SI) and large intestine (LI), and histologically of mucosa, submucosa, muscularis externa (ME) and serosa. The esophagus is marked by conical papillae lined by keratinized stratified squamous epithelium, whereas the remaining GI by simple columnar epithelium; esophageal diverticulum is absent. The stomach covered with mucous granule cells, contains cardia, fundic regions and pylorus, which are separately characterized by cardiac glands, fundic glands and pyloric glands, and have the thickest submucosa and ME of the GI. The ME of the esophagus mainly consist of one layer of circular smooth muscle whereas the rest of GI of two layers, inner circular muscle and outer longitudinal muscle. The SI is slightly longer than the LI and the GI is approximately 5.11 times of the carapace length. The SI is lined with longitudinal zigzag folds and characterized by absorptive cells with longer and denser microvilli, whereas the LI by transversal folds, goblet cells and lymphoid nodules. Only intestinal glands appear in duodenum. Endocrine cells are observed in all sections of the GI and accounted for the largest proportion in duodenum. The results demonstrate a perfect combination of the structure and function of the GI and reveal that the digestion and absorption primarily occurs in the foregut. C. mydas hatchling may prefer carnivorous diet.

  2. Preoperative chemoradiotherapy for locally advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Pepek Joseph M

    2013-01-01

    Full Text Available Abstract Background To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT for gastric cancer. Methods Patients with gastroesophageal (GE junction (Siewert type II and III or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS, local control (LC and disease-free survival (DFS were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Results Forty-eight patients were included. Most (73% had proximal (GE junction, cardia and fundus tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75% underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Conclusions Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated.

  3. Does Cytokeratin7/20 immunoreactivity help to distinguish Barrett's esophagus from gastric intestinal metaplasia? Results of a prospective study of 75 patients.

    Science.gov (United States)

    Schilling, D; Spiethoff, A; Rosenbaum, Anika; Hartmann, D; Eickhoff, A; Jakobs, R; Weickert, U; Rebe, M; Bohrer, M H; Riemann, J F

    2005-01-01

    Barrett's esophagus is a recognized risk factor for the development of esophageal dysplasia and carcinoma. Unfortunately, gastric incomplete intestinal metaplasia arising in Short Segment Barrett's esophagus can be indistinguishable histologically on hematoxylin/eosin stains. Distinct patterns of CK 7 and CK 20 immunohistochemical expression have been demonstrated to be both highly sensitive and specific for Barrett's esophagus, but have not been found in gastric metaplasia. The aim of our study was to test whether immunostaining with CK 7/20 helps to distinguish between Barrett's epithelium and gastric incomplete metaplasia. Cases of long segment Barrett's esophagus, short segment Barrett's esophagus, and cases with a normal gastroesophageal junction, as well as specimens with gastric antral intestninal metaplasia, were examined: three patterns were defined. Barrett's pattern (superficial CK 20 staining; superficial and crypt CK 7 staining); gastric pattern (superficial and crypt staining of both markers); other patterns (different from Barrett and gastric types). Seventy-five patients were enrolled in this study, 26 with long segment Barrett's esophagus, 21 with short segment esophagus, 13 with intestinal metaplasia of the cardia, and 18 with antral intestinal metaplasia. The Barrett pattern showed a high specificity of 97%, but a sensitivity of only 30% in patients with short segment Barrett esophagus. Our results do not confirm the hypothesis that CK 7/20 immunostaining can be used for a reliable differentiation between incomplete intestinal metaplasia and Barrett's epithelium.

  4. Role of Helicobacter pylori in gastric cancer: Updates

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Helicobacter pylori (H. pylori ) infection is highly prevalentin human, affecting nearly half of the world'spopulation; however, infection remains asymptomaticin majority of population. During its co-existence withhumans, H. pylori has evolved various strategies tomaintain a mild gastritis and limit the immune responseof host. On the other side, presence of H. pylori is alsoassociated with increased risk for the development ofvarious gastric pathologies including gastric cancer (GC).A complex combination of host genetics, environmentalagents, and bacterial virulence factors are consideredto determine the susceptibility as well as the severityof outcome in a subset of individuals. GC is one of themost common cancers and considered as the third mostcommon cause of cancer related death worldwide. Manystudies had proved H. pylori as an important risk factorin the development of non-cardia GC. Although both H.pylori infection and GC are showing decreasing trendsin the developed world, they still remain a major threatto human population in the developing countries. Thecurrent review attempts to highlight recent progress inthe field of research on H. pylori induced GC and aimsto provide brief insight into H. pylori pathogenesis,the role of major virulence factors of H. pylori thatmodulates the host environment and transform thenormal gastric epithelium to neoplastic one. This reviewalso emphasizes on the mechanistic understanding ofhow colonization and various virulence attributes of H.pylori as well as the host innate and adaptive immuneresponses modulate the diverse signaling pathways thatleads to different disease outcomes including GC.

  5. Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma.

    Science.gov (United States)

    Eivaz-Mohammadi, Sahar; Gonzalez-Ibarra, Fernando; Abdul, Waheed; Tarar, Omer; Malik, Khurram; Syed, Amer K

    2014-01-01

    A 25-year-old Hispanic female with a history of anemia, schizoaffective disorder, and psychosis was admitted for anemia associated with fatigue, weakness, shortness of breath, night sweats, weight loss, and abdominal and lower back pain for the past two months. On routine management, she was found to have a positive serum b-HCG of 80.4 (0-5 mIU/mL) but the patient denied any sexual activity in her life. During her admission, U/S of the pelvis was noncontributory. CT angiogram of the chest was significant for prominent mediastinal and hilar lymph nodes, diffusely thickened stomach suggesting gastric malignancy with multiple hypoenhancing lesions in the liver and diffuse lytic lesions in the spine and sacrum suspicious for metastatic disease. The MRI of the abdomen confirmed the CT angiogram findings. After these findings, EGD was performed which showed lesions in the antrum, body of the stomach, fundus, and cardia on the lesser curvature of the stomach body correlating with carcinoma. The biopsy was positive for Her2, b-HCG producing poorly differentiated gastric adenocarcinoma. Patient underwent one successful round of chemotherapy with Taxotene, Cisplatin, and 5-FU for Stage IV gastric adenocarcinoma.

  6. H pylori infection and reflux oesophagitis: A case-control study

    Institute of Scientific and Technical Information of China (English)

    Rahim Masjedizadeh; Eskandar Hajiani; Koorosh MoezArdalan; Saeed Samie; Mohammad-Javad Ehsani-Ardakani; Ali Daneshmand; Mohammad-Reza Zali

    2006-01-01

    AIM: To examine the relationship between H pylori and gastro-oesophageal reflux disease (GORD) in Iran.METHODS: In this study 51 GORD patients (referred to endoscopy at Taleghani hospital) were compared with 49 age-sex matched controls. Diagnosis of H pylori was made by gastric mucosal biopsy and rapid urease test (positive if the result of one or both diagnostic methods was positive). Updated Sydney system was used to report histopathological changes.RESULTS: The frequency of H pylori infection based on rapid urease test and histology was 88.2% (45) in patients and 77.6% (38) in controls, which showed no significant difference. The frequency of H pylori infection was significantly higher in the antrum than in the corpus and cardia. The mean activity, inflammation,and gastritis scores were also higher in the antrum of patients than in the antrum of controls. The mean scores were significantly higher in the corpus of controls than in the corpus of patients. Diffuse active gastritis was observed in a significantly larger number of controls,while the frequency of diffuse chronic gastritis was higher in patients. There was no significant difference in the frequency of other histological findings between patients and controls.CONCLUSION: H pylori infection cannot prevent GORD in this region.

  7. Animal study for airway inflammation triggered by gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    LAI Yun-gang; WANG Zhong-gao; JI Feng; WU Ji-min; CHEN Xiu; LI Zhen; DONG Shu-kui

    2009-01-01

    Background Gastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory istress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.Methods Sixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach, While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of intedeukin (IL)-5, -6, -8 in it were measured.Results Compared with control group, the study group presented a neutrophil pattem of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.Conclusion The gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

  8. Detection of telornerase activity and cytology in diagnosis of cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Qiang Wang; Qing Ming Wu; Sheng Bao Li

    2000-01-01

    AIM To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells ofcardia obtained from endoscopic brushing in the cardiac cancer.METHODS The techniques of the qualitative TRAP-silver staining and quantitative TRAP-PCR-ELISAwere employed to detect telomerase activity in the exfoliated cells of cardia obtained from endoscopicbrushing in 72 cases with cardial lesions, cytological diagnosis was made at the same time.RESULTS Telomerase activity with cardiac cancer group (1.521 ± 0. 192) was significantly higher than thatwith cardialitis group (0.065± 0.014). Positive rate of telomerase activity detected in cardiac cancer group(88.89%) was significantly higher than that with cardialitis group (11.11%), the former was significantlyhiger than cytological examination (77.78%). The diagnostic rate of cardiac cancer reached 93.33% iftelomerase activity and cytology were examined at the same time.CONCLUSION Cytology and telomerase activity in the exfoliated cardiac cells may be an effective andsensitive methods in the diagnosis of cardiac cancer. This research can be a basis for the mass screening ofcardiac cancer.

  9. [Minimally Invasive Treatment of Esophageal Benign Diseases].

    Science.gov (United States)

    Inoue, Haruhiro

    2016-07-01

    As a minimally invasive treatment of esophageal achalasia per-oral endoscopic myotomy( POEM) was developed in 2008. More than 1,100 cases of achalasia-related diseases received POEM. Success rate of the procedure was more than 95%(Eckerdt score improvement 3 points and more). No serious( Clavian-Dindo classification III b and more) complication was experienced. These results suggest that POEM becomes a standard minimally invasive treatment for achalasia-related diseases. As an off-shoot of POEM submucosal tumor removal through submucosal tunnel (per-oral endoscopic tumor resection:POET) was developed and safely performed. Best indication of POET is less than 5 cm esophageal leiomyoma. A novel endoscopic treatment of gastroesophageal reflux disease (GERD) was developed. Anti-reflux mucosectomy( ARMS) is nearly circumferential mucosal reduction of gastric cardia mucosa. ARMS is performed in 56 consecutive cases of refractory GERD. No major complications were encountered and excellent clinical results. Best indication of ARMS is a refractory GERD without long sliding hernia. Longest follow-up case is more than 10 years. Minimally invasive treatments for esophageal benign diseases are currently performed by therapeutic endoscopy.

  10. The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations.

    Science.gov (United States)

    Wells, Dennis; Villa, Chet R; Simón Morales, David Luís

    2017-01-01

    While use of the total artificial heart (TAH) is growing, the use of the device is not uniform across the gender and age spectrum because the vast majority of implants are in adult males. SynCardia has recently developed a smaller 50 cc TAH that was designed to accommodate patients with a body surface area as low as 1.2 m(2) (potentially even lower using virtual implantation). Herein, we describe the early use of the 50 cc TAH (10 implants in the US and 18 outside the US). Twenty-eight devices have been implanted worldwide. Nineteen (68%) patients were female, 4 (14%) were 21 years of age or younger, and 2 (7%) had a diagnosis of congenital heart disease (1 Fontan). The smallest patient, by body surface area, was 1.35 m(2). Six patients (21%) have been placed on the Freedom Driver, all of whom have survived. Fourteen patients (50%) have had a positive outcome to date. The development of the 50 cc TAH has expanded the population of patients who may benefit from TAH support and thus may help improve outcomes for patients who have had limited biventricular support options to date.

  11. A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation.

    Science.gov (United States)

    Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Betterton, Edward; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

    2016-12-09

    With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use.

  12. Veno-venous extracorporeal membrane oxygenation using a double-lumen bi-caval cannula for severe respiratory failure post total artificial heart implantation.

    Science.gov (United States)

    Miessau, J; Yang, Q; Unai, S; Entwistle, J W C; Cavarocchi, N C; Hirose, H

    2015-07-01

    We report a unique utilization of a double-lumen, bi-caval Avalon cannula for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) during placement of a total artificial heart (TAH, SynCardia, Tucson, AZ). A 22-year-old female with post-partum cardiomyopathy was rescued on veno-arterial (VA) ECMO because of cardiogenic shock. The inability to wean ECMO necessitated implantation of the TAH as a bridge to transplant. In addition, the patient continued to have respiratory failure and concomitant VV ECMO was planned with the implant. During TAH implantation, the Avalon cannula was placed percutaneously from the right internal jugular vein into the inferior vena cava (IVC) under direct vision while the right atrium was open. During VV ECMO support, adequate flows on both ECMO and TAH were maintained without adverse events. VV ECMO was discontinued, without reopening the chest, once the patient's respiratory failure improved. However, the patient subsequently developed a profound respiratory acidosis and required VV ECMO for CO2 removal. The Avalon cannula was placed in the femoral vein to avoid accessing the internal jugular vein and risking damage to the TAH. The patient's oxygenation eventually improved and the cannula was removed at the bedside. The patient was supported for 22 days on VV ECMO and successfully weaned from the ventilator prior to her orthotropic heart transplantation.

  13. [A case of metastatic gastric cancer originating from transverse colon cancer].

    Science.gov (United States)

    Nushijima, Youichirou; Nakano, Katsutoshi; Sugimoto, Keishi; Nakaguchi, Kazunori; Kan, Kazuomi; Maruyama, Hirohide; Doi, Sadayuki; Okamura, Shu; Murata, Kohei

    2014-11-01

    Metastatic gastric cancer is uncommon, and metastasis of colorectal cancer to the stomach is extremely rare. We report a case of metastatic gastric cancer that originated from transverse colon cancer. A 52-year-old woman underwent a left hemicolectomy and D3 lymph node dissection based on a diagnosis of transverse colon cancer. The pathology results were as follows: mucinous adenocarcinoma, type 2, 6 × 11 cm, ss, ly1 v1, pm (-), dm (-), n1 (+), P0, H0, M0, Stage IIIa. The patient received XELOX as postoperative adjuvant therapy for 6 months. One year and 3 months after the left hemicolectomy, gastroscopy revealed a submucosal tumor in the lower body of the stomach and an incipient cancer in the cardia of the stomach, and a colonoscopy revealed an incipient cancer in the transverse colon. An endoscopic ultrasonography fine needle aspiration biopsy of the submucosal tumor in the lower body of the stomach was performed. Histology showed that this tumor was a mucinous adenocarcinoma similar to the primary transverse colon cancer, which led to a diagnosis of metastatic gastric cancer originating from transverse colon cancer. Distant metastasis was not detected. Endoscopic submucosal dissection of the incipient gastric cancer was performed, as were distal gastrectomy and partial colectomy. Peritoneal dissemination and para-aortic lymph node recurrence were detected 7 months after the second surgery.

  14. Social Hierarchy and Depression: The Role of Emotion Suppression

    Science.gov (United States)

    Langner, Carrie A.; Epel, Elissa; Matthews, Karen; Moskowitz, Judith T.; Adler, Nancy

    2017-01-01

    Position in the social hierarchy is a major determinant of health outcomes. We examined the associations between aspects of social hierarchy and depressive symptoms with a specific focus on one potential psychological mechanism: emotion suppression. Suppressing negative emotion has mental health costs, but individuals with low social power and low social status may use these strategies to avoid conflict. Study 1 assessed perceived social power, tendency to suppress negative emotion, and depressive symptoms in a community sample of women. Low social power was related to greater depressive symptoms, and this relationship was partially mediated by emotion suppression. Study 2 examined education as a proxy for social hierarchy position, anger suppression, and depressive symptoms in a national, longitudinal cohort study (The Coronary Artery Risk Development in Young Adults (CARDIA) study). Similar to Study 1, low education levels were correlated with greater depressive symptoms, and this relationship was partially mediated by anger suppression. Further, suppression mediated the relationship between low education and subsequent depression up to 15 years later. These findings support the theory that social hierarchy affects mental health in part through a process of emotion suppression. PMID:22808688

  15. Fifteen-Year Prospective Analysis of Television Viewing and Adiposity in African American and Caucasian Men and Women

    Directory of Open Access Journals (Sweden)

    Chung-Yu Chen

    2015-08-01

    Full Text Available There are limited data from long-term prospective studies on the association between television (TV viewing and obesity. We investigated this association between TV viewing and body mass index (BMI and waist circumference (WST over 15 years on 3,269 participants from the Coronary Artery Risk Development in Young Adults (CARDIA study. We used cross-lagged panel models at exam Years 5, 10, 15, and 20 over 15 years to assess the association between TV viewing and obesity. The cross-lagged effects of TV viewing on anthropometry were significant from exam Year 5 to Year 10 (B = 0.034 for BMI and 0.036 for WST. However, the cross-lagged effects of TV viewing at Years 10 and 15 on obesity at Years 15 and 20, respectively, were nonsignificant. The findings indicate that higher levels of TV viewing predicted higher BMI and WC in young adulthood, but this association was not observed as individuals aged over the following decade.

  16. Photodynamic therapy of gastric cancer

    Science.gov (United States)

    Kharnas, Sergey S.; Kuzin, N. M.; Zavodnov, Victor Y.; Sclyanskaya, Olga A.; Linkov, Kirill G.; Loschenov, Victor B.; Meerovich, Gennadii A.; Torshina, Nadezgda L.; Stratonnikov, Alexander A.; Steiner, Rudolf W.

    1996-01-01

    Photodynamic therapy (PDT) with the use of laser endoscopic spectrum analyzer (LESA-5), the spectral-analyzing video-imaging system, Kr laser and various types of catheters for different tumor localizations, and Phthalocyanine aluminum photosensitizers in patients with gastric cancer was discussed. PDT was carried out in fifteen patients with gastric cancer. There were the following indications for PDT: early gastric cancer (3 patients), malignant stenosis of the cardia or pyloric portion of the stomach (4 patients), cancer of gastric stump with stenosis of gastrojejunal anastomosis (1 patient), preoperative treatment of patients with large but probably resectable gastric tumor size (7 patients). Usually we used 3 - 4 seances of laser treatment 10 - 30 minutes long. Concentration of photosensitizer in normal and malignant tissue was controlled by LESA-5. Treatment was monitored by spectral-analyzing video- imaging system in fluorescent light. The results show high efficiency of PDT especially in patients with early gastric cancer (necrosis of all tumor mass, i.e. complete regression of tumor). For all other patients we obtained partial regression of gastric cancer.

  17. Upper gastrointestinal burns by peroxyacetic acid in children: a review of seven cases

    Institute of Scientific and Technical Information of China (English)

    Zhibin Niu; Keren Zhang; Weilin Wang

    2006-01-01

    Objective: To study the clinical features of upper gastrointestinal burns by peroxyacetic acid (PA) in children and improve its treatment and outcome. Methods: The clinical materials of 7 cases with upper gastrointestinal burns by PA including clinical presentation, treatment and outcomes were reviewed. Results: There were six boys and one girl. The concentration of the swallowed PA was from 10% to 20% and the amount was 3-10 ml. The mainly burns were located in esophagus in one case, stomach in three cases, both esophagus and stomach in three cases. The gastrostomy and operation of dilating esophagus were performed in the cases with esophageal stricture. The pyloroplasty or gastroduodenostomy was performed in the cases with pyloric obstruction. All the cases were followed up for 12-18 months, dysfunction of esophagus or(and) cardia as well as stiffness and hypodynamia of the stomach was showed in most of the patients. Conclusion: The degree of upper gastrointestinal burns by PA varied according to different concentrations of PA which was swallowed. Correct emergent measures in the acute stage of the bums was very important, gastric tube should be inserted and go through esophagus and pylorus and must be retained for 5-8 weeks to prevent the stricture of esophagus and pylorus, otherwise the tube could act as a passage of nutriment. Prophylaxis of upper gastrointestinal burns by PA is very important because the treatment of the burns is difficulty and the outcomes are not always satisfactory.

  18. Resectable adenocarcinoma of the oesophago-gastric junction care: Which perioperative treatment?; Prise en charge des adenocarcinomes de la jonction oesogastrique resecables: quel traitement perioperatoire?

    Energy Technology Data Exchange (ETDEWEB)

    Crehangea, G.; Maingon, P. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. de Radiotherapie, 21 - Dijon (France); Bonnetain, F. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. de Biostatistiques, 21 - Dijon (France); Chauffert, B. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. d' Oncologie Medicale, 21 - Dijon (France); Rat, P. [Centre Hospitalier Universitaire le Bocage, Service de Chirurgie Digestive, 21 - Dijon (France); Bedenne, L. [Centre Hospitalier Universitaire le Bocage, Service d' Hepatogastroenterologie, 21 - Dijon (France)

    2008-09-15

    Adenocarcinoma of the oesophago-gastric junction has an ominous prognosis. Until now, oesophageal adenocarcinoma care was close to the squamous cell cancer one whereas adenocarcinoma of the cardia was mixed with gastric cancers. Results from randomized studies mixed them without making distinctions. Nevertheless, context, natural history and clinical outcome differ. Five-year survival rate is around 40 %, all stages included. Results from several phase-III studies or meta-analysis allowed to define three therapeutic strategies applicable to adenocarcinoma of the oesophagus and the oesophago-gastric junction. In Europe, in the case of a resectable tumour, preoperative chemotherapy became a standard treatment since results from the Magic trial. In the United States, post-operative radio chemotherapy according to the 'Macdonald' scheme is used in case of a resected tumour with a R0 surgery. Actually, modern techniques of irradiation could reduce the rate of gastro-intestinal toxicities. The survival benefit from preoperative radio chemotherapy is still very controversial with high rates of postoperative morbidity and mortality. We have performed a review of the literature with a methodological analysis of data with a high level of evidence in order to advise perioperative treatment guidelines for patients with a resectable adenocarcinoma of the lower oesophagus or gastro-oesophageal junction. Results from pre- or postoperative strategies and the role of radiotherapy will need to be analysed in the future through a randomized study. (authors)

  19. 苯扎氯铵对食管下端肌间神经毁损效果的研究%The effect of benzalkonium chloride in the damage of the myenteric plexus of lower esophagus in rats

    Institute of Scientific and Technical Information of China (English)

    赵艳民; 梁振; 李仲荣; 朱利斌; 刘征吉; 陈肖鸣

    2009-01-01

    目的 观察苯扎氯铵(BAC)毁损食管下端括约肌肌间神经的效果及毁损后不同时间神经组织的改变,为建立合适的贲门失迟缓症动物模型奠定基础.方法 80只健康的雄性SD大鼠随机分为二组:BAC组和生理盐水对照组各40只;开腹手术将0.4%BAC脑棉敷于大鼠食管下端30 min,术后1、2、4、8周分别处死大鼠,观察食管下端肌间神经组织的变化.结果 术后1周BAC组食管下端出现部分肌间神经元、神经纤维变性坏死;术后第二周肌间神经元密度为(1.25±1.58)个/横切面,与对照组(5.38±2.33)个/横切面相比,明显减少(P<0.01);术后4周和术后8周肌间神经元进一步减少,但这种减少与术后第二周的差异无统计学意义(P>0.05).BAC对不同神经递质的神经元毁损为非选择性的.结论 0.4BAC能成功毁损大鼠食管下端肌间神经元,肌间神经元毁损的动物玎丁用于贲门失弛缓症实验研究.%Objective To establish the appropriate animal model of achalasia in the cardia and to observe the effect of Benzalkonium Chloride(BAC) in the damag of the myenteric plexus of lower esophagus in rats and the changes of neurons at different time points.Methods Eighty male SD rats were randomly divided into two experimental groups (40 rats respectively in the BAC group and control groups).The 0.4% benzalkonium chloride was applied on the lower esophagus for 30 minutes during the laparotomy on rats.The changes of the neuron in lower esophagus were observed under microscope after sacrifice of rats at 1,2,4 and 8 weeks respectively.Results One week after the operation,degeneration and necrosis were observed in parts of the neurons and the nerve fibers in the myenteric plexus of lower esophagus in the BAc group.Two weeks after the operation,density of neurons in BAC group was 1.25±0.71 neurons per cross section,which was significantly lower than that in the control group (5.38±2.33 neurons per cross section

  20. 美洲黑石斑鱼消化道的形态结构%The morphology of the digestive tract of Centropristis striata

    Institute of Scientific and Technical Information of China (English)

    李海燕; 竺俊全; 陈飞; 丁理法

    2011-01-01

    The morphological and histological structures of the digestive tract in Centropristis striata were observed by optical microscopes. The digestive tract includes the orol-pharyngeal cavity , esophagus , stomach and intestines. The orol-pharyngeal cavity is big;there are jaw teeth, palato-teeth and vomerine teeth; tongue consists of basihyoid covered by mucosa. The esophagus, stomach and intestines stratified into mucous membrane layer, submucosa, muscularis and outer membrane. Esophageal mucosa layer villi fell into columnar epithelium and squamous epithelium; the surface of the squamous epithelium was the goblet cell layer; there are esophagealgland in the submucosa of esophagus. V-shaped stomach comprises cardia, bady of stomach and pylorus ; stomach mucosa epithelium is simple columnar epithelium; gastric gland locates in the lamina propria of cardia and bady of stomach. Intestines are schilfig and Sshaped, which are consisted by foregut, midgut and hindgut; mucous membrane layer protuberates to the gut cavity and forms volume villi; epithelium is simple columnar epithelium; the epithelial free surface contains a dense array of microvilli which form striated border; epithelium contains goblet cells whose quantity decreases from front to back; the average ratio between the length of the intestine and the body length is 1. 6. Conjunctive sites of stomach and intestine contain 3 pairs multi-finger pyloric caecum whose histologic structure is the same as intestines'.%采用解剖和光镜技术观察了美洲黑石斑鱼消化道的形态及组织学结构.消化道由口咽腔、食道、胃、肠构成.口咽腔较大,具颌齿、腭齿及犁齿;舌由基舌骨突出部分覆盖粘膜构成.食道、胃及肠均由粘膜层、粘膜下层、肌层及外膜构成.食道粘膜层绒毛分柱状上皮区及扁平上皮区,扁平上皮区表面为杯状细胞层;食道粘膜下层中有食道腺.胃呈V形,由贲门部、胃体部及幽门部组成,胃壁粘膜层上

  1. Morphology of the digestive tract and liver of Plecoglossus altivelis%香鱼消化道及肝脏的形态结构特征

    Institute of Scientific and Technical Information of China (English)

    卢明明; 李海燕; 竺俊全; 李明云

    2012-01-01

    The morphological characteristics of the digestive tract and liver in Plecoglossus altivelis were observed by paraffin section and photomicrography techniques. The digestive tract includes the orol-pharyngeal cavity, esophagus, stomach and intestine. The orol-pharyngeal cavity is big, long and narrow; in the front of its bottom wall there are a pair of mucous plait; on the edge of the two jaws there are broad flat pectinate jaw teeth; there are teeth on the palate bone and hyoid bone, but no teeth on the vomer. Tongue is formed by the projecting part of basihyoid covered by mucosa. Tongue mucosa epithelium is stratified squamous epithelium, and contains many goblet cells and taste buds. The esophagus, stomach and intestines all consist of mucous membrane layer, submucosa, muscularis and outer membrane. The mucosa of esophagus is stratified squamous epithelium with developed goblet cells. V-shaped stomach comprises cardia, body of stomach and pylorus. Stomach mucosa epithelium is simple columnar epithelium. There are gastric glands in the lamina propria of cardia and body of stomach. Intestine is short and consists of foregut, midgut and hindgut. The mucous epithelium of intestinal wall is simple columnar epithelium and the free surface of it contains a dense array of microvilli. Lots of goblet cells are distributed in the intestinal epithelium. Conjunctive sites of intestines and pylorus contain 350 — 400 pyloric caecums whose histological structure is the same as intestines. The liver is singular and coated by the serosa. The shape of hepatocyte is irregular and the boundaries of hepatic lobules are inconspicuous.%采用解剖及石蜡切片显微技术观察了香鱼消化道及肝脏的组织学结构.香鱼消化道由口咽腔、食道、胃及肠构成.口咽腔大且狭长,其底壁前部有一对粘膜褶,两颌边缘着生宽扁梳状齿,腭骨及舌骨具齿,犁骨无齿;舌由基舌骨突出部分覆盖粘膜构成,舌粘膜上皮为复层扁平上

  2. Correlation of Epstein-Barr virus and its encoded proteins with Helicobacter pylori and expression of c-met and c-myc in gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Bing Luo; Yun Wang; Xiao-Feng Wang; Yu Gao; Bao-Hua Huang; Peng Zhao

    2006-01-01

    AIM: To investigate the interrelationship of Epstein-Barr virus (EBV) and EBV- encoded proteins with Helicobacter pylori (H pylori) infection and the expression of c-met and c-myc oncogene proteins in gastric carcinoma, and to explore their role in gastric carcinogenesis.METHODS: One hundred and eighty-five gastric carcinoma tissues were detected by polymerase chain reaction (PCR)-Southern blot for EBV genome and in situ hybridization (ISH) for EBV-encoded small RNA 1 (EBER1). Gastric carcinoma with positive EBER1 signals was confirmed EBV-associated gastric carcinoma (EBVaGC). The status of H pylori infection in 185 gastric carcinomas was assessed by rapid urease test and PCR.The samples with positive PCR and urease test were defined as H pylori infection. The expression of c-met and c-myc oncogene proteins in tissues of EBVaGC and matched EBV-negative gastric carcinoma (EBVnGC) were examined by immunohistochemistry. RT-PCR and Southern hybridization were used to detect the expression of nuclear antigens (EBNAs) 1 and 2, latent membrane protein (LMP) 1, early genes BARF1 and BHRF1 in EBVaGC cases.RESULTS: The positive rate of H pylori and EBV in 185 gastric carcinomas was 59.45% (110/L85) and 7.03% (13/185) respectively. No difference was found in sex, age, pathological differentiation, clinical stages and lymph node metastasis between H pylori-positive and H pylori-negative gastric carcinomas. However, the positive rate of H pylori infection in the antrum gastric carcinomas was higher than that of cardia and body gastric carcinomas. In our series, age, pathological differentiation, clinical stages, lymph node metastasis and location of cancer were not different between EBVnGC and EBVaGC, while the positive rate of EBV in male patients was significantly higher than that of female patients. The positivity of Hpyloriin EBV-associated and EBV-negative gastric carcinomas was 46.15% (6/13) and 81.40%(104/172) respectively. There was no significant correlation between

  3. Relationship between the positive rates of the results of the tumor markers six of esopha-geal carcinoma preoperativly and the esophageal clinical parameters postoperativly%食管癌术前血浆肿瘤标志物检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    孙宝林; 余守强; 甄福喜

    2016-01-01

    目的:探讨术前检测食管癌血浆六项肿瘤标志物的临床意义。方法:回顾手术治疗的食管癌临床资料138例,分析术前 NSE、AFP、CEA、CA72-4、CA19-9、C19六项肿瘤标志物与术后病理特征的关系。结果:138例患者年龄43~81(63.46±6.787)岁,男105例,女33例;鳞癌114例,腺癌24例;位于贲门16例;六项肿瘤标志物含量最高者为 NSE 占26.1%(36/138),最低者为 CA19-9占2.2%(3/138)。食管鳞癌中 NSE阳性率高;食管腺癌、贲门癌中 AFP、CEA 阳性率高,CA72-4阳性率在 Tis -T2组中升高,均有统计学意义;而 CA19-9和 C19阳性率在各病例组均无显著增高。结论:六项肿瘤标志物在食管癌患者术前血浆中阳性率较低。仅显示 AFP、CEA 在食管腺癌、贲门癌中,CA72-4在 Tis -T2期中,NSE 在食管鳞癌略高。%Objective:To investigate the clinical application value of the preoperative levels of six tumor markers for patients with esophageal cancer underwent esophagogectomy.Methods:The records of 138 cases with esophageal cancer underwent esophagogectomy were reviewed and the relationship between the results of preoperative esophageal six tumor markers and the pathological characteristics after esophagectomy was assessed.Results:The characteristics of 138 caes were as follow:Aged 43 ~81(63.46 ±6.787),105 male and 33 female,114 cases of squamous carcino-ma,24 cases of adenocarcinoma and 16 cases of cardia carcinoma.The positive rate of NSE was 26.1%(36 /138),the highest rate in six tumor markers and CA19 -9 was only 2.2%(3 /138),the lowest.The positive rate of AFP in the lower esophagus and cardia cancer and adenocarcinoma group,CEA in the esophageal adenocarcinoma group,CA72-4 in Tis -T2 group and NSE in the esophageal squamous cell carcinoma group was statistically increased (P<0.05).Whereas,the CA19 -9 and C19 in each group had no statistical significance

  4. 经腹手术治疗贲门胃底部癌的治疗体会%The Treatment Experience of Abdominal Operation Patients with Stomach Cancer

    Institute of Scientific and Technical Information of China (English)

    周远东

    2013-01-01

      目的临床分析经腹手术治疗贲门胃底部癌的治疗效果。方法选取我院2010年3月至2012年3月收治的200例贲门胃底部癌患者,按照随机分配的方法,将其分为研究组与对照组,每组100例。研究组给予经腹手术治疗,对照组给予经胸部手术治疗,对比两组的治疗效果。结果经过治疗后,研究组手术病死率1.0%,并发症发生率5.0%,对照组手术病死率6.0%,并发症发生率37.0%,研究组治疗效果明显优于对照组,两组对比存在显著性差异(P <0.05)。结论针对贲门胃底部癌患者,实施经腹手术治疗,可清除第2站、3站淋巴结,具有出血少、损伤小、并发症少、手术时间短、病死率低等优点,值得临床推广应用。%Objective Clinical analysis of abdominal operation patients with gastric bottom cancer treatment effect. Methods In our hospital from 2010 March to 2012 March treated 200 cases of patients with carcinoma of the cardia of the stomach bottom, according to a random distribution method, which can be divided into study group and control group, 100 cases in each group. The study group were given abdominal operation treatment, control group was given after chest operation treatment, the therapeutic effects were compared between the two groups. Results After treatment, the study group operation mortality was 1%, the incidence of complications was 5%, operation mortality rate of 6% in control group, the incidence of complications was 37%, study the effect in treatment group was obviously superior to the control group, there was significant difference between two groups(P<0.05). Conclusion According to the cardia of the stomach bottom of cancer patients, the implementation of abdominal operation treatment, can remove the second stations, 3 stations of lymph nodes, with less bleeding, less injury, less complication, short operation time, mortality is low advantage, it is worthy of clinical

  5. Gastric cancer burden of last 40 years in North China (Hebei Province): A population-based study.

    Science.gov (United States)

    Liang, Di; Liang, Suoyuan; Jin, Jing; Li, Daojuan; Shi, Jin; He, Yutong

    2017-01-01

    Gastric cancer (GC) is the second leading cause of cancer death in China. It is well known that Cixian in Hebei Province is one of the highest risk areas of GC in China and worldwide. This study aims to accurate assessment of GC burden and trend in high-risk area (Hebei Province) from 1973 to 2013. The authors analyzed GC data from 21 population-based cancer registries which represented 15.25% of the entire population of Hebei Province. The collected data were stratified by 5-year age groups, gender, and area. Mortality of GC was extracted from national death surveys from 1973 to 1975, 1990 to 1992, 2004 to 2005, and 2011 to 2013. Trend analysis (1988-2013) in a high-risk area (Cixian) used the Joinpoint Model. The age-period-cohort model was used to estimate the effects of age, period, and birth cohort in GC incidence in Cixian from 1988 to 2013. The crude incidence of GC in 2011 to 2013 was 40.37/100,000 (57.53/100,000 in males and 22.55/100,000 in females). The corresponding age-standardized rate by world age-standard population was 32.18/100,000 (48.87/100,000 in males and 17.53/100,000 in females), which was 2.66-fold (2.81-fold in male and 2.34-fold in female) higher than that in the world (12.1/100,000, 17.4/100,000 in males and 7.5/100,000 in females). Males in rural areas had the highest incidence, with an age-standardized rate of 70.51/100,000. Gastric cardia cancer was primary anatomical subsite which accounting for 59.59% in GC, followed by gastric corpus (13.92%), gastric antrum (11.43%), gastric fundus (4.99%), and overlapping lesion of gastric (4.17%). The age-standardized rate of mortality from GC displayed a significant downward trend (P = 0.019) in Hebei Province from the 1990s (31.44/100,000) to the 2010s (24.63/100,000). In Cixian, the incidence of GC rose from 1988 (38.25/100,000) to 2009 (65.11/100,000). Cixian, where population-based screening of upper gastrointestinal cancer was performed, experienced the increasing rate of GC from 2000

  6. Bouveret's syndrome complicated by a distal gallstone ileus

    Institute of Scientific and Technical Information of China (English)

    Rasim Gencosmanoglu; Resit Inceoglu; Caglar Baysal; Sertac Akansel; Nurdan Tozun

    2003-01-01

    AIM: Gastric outlet obstruction caused by duodenal impaction of a large gallstone migrated through a cholecystoduodenal fistula has been referred as Bouveret's syndrome. Endoscopic lithotomy is the first-step treatment,however, surgery is indicated in case of failure or complication during this procedure.METHODS: We report herein an 84-year-old woman presenting with features of gastric outlet obstruction due to impacted gallstone. She underwent an endoscopic retrieval which was unsuccessful and was further complicated by distal gallstone ileus. Physical examination was irrelevant.RESULTS: Endoscopy revealed multiple erosions around the cardia, a large stone in the second part of the duodenum causing complete obstruction, and wide ulceration in the duodenal wall where the stone was impacted. Several attempts of endoscopic extraction by using foreign body forceps failed and surgical intervention was mandatory. Preoperative ultrasound evidenced pneumobilia whilst computerized tomography showed a large stone, 5 cm×4 cm×3 cm, loggingat the proximal jejunum and another one, 2.5 cm×2 cm×2 cm,in the duodenal bulb causing a closed-loop syndrome. She underwent laparotomy and the jejunal stone was removed by enterotomy. Another stone reported as located in the duodenum preoperatively was found to be present in the gallbladder by intraoperative ultrasound. Therefore,cholecystoduodenal fistula was broken down, the stone was retrieved and cholecystectomy with duodenal repair was carried out. She was discharged after an uneventful postoperative course.CONCLUSION: As the simplest and the least morbid procedure, endoscopic stone retrieval should be attempted in the treatment of patients with Bouveret's syndrome.When it fails, surgical lithotomy consisting of simple enterotomy may solve the problem. Although cholecystectomy and cholecystoduodenal fistula breakdown is unnecessary in every case, conditions may urge the surgeon to perform such operations even though they carry high

  7. X-ray diagnosis of synchronous multiple primary carcinoma in the upper gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hao Yang; Jian-Bo Gao; Song-Wei Yue; Hua Guo; Xue-Hua Yang

    2011-01-01

    AIM: To analyze the radiological features of multiple primary carcinoma (MPC) in the upper gastrointestinal (GI) tract, study its biological characteristics and evaluate X-ray examination in its diagnosis.METHODS: Hypotonic double-contrast GI radiography was performed in 59 multiple primary carcinoma cases, pathologically proved by surgery or endoscopy biopsy.Radiological findings were analyzed.RESULTS: Of the 59 cases, esophageal MPC (EMPC) was seen in 24, esophageal and gastric MPC (EGMPC) in 27 and gastric MPC (GMPC) in 8.Of the 49 lesions found in 24 EMPC, hyperplastic type was seen in 23, medullary type in 9.The lesions were located at the upper (n = 17), middle (n = 19) or lower (n = 13) segment of the esophagus.In 27 EGMPC, the esophageal lesions were located at the middle (n = 16) or lower (n = 11) segment of the esophagus, while the gastric lesions were located at the gastric cardia (n = 16), fundus (n = 1), body (n = 3) and antrum (n = 7).The esophageal lesions were mainly of the hyperplastic type (n = 12) or medullary type (n = 7), while the gastric lesions were mainly of the hyperplastic type (n = 18).A total of 119 lesions in the 59 patients with synchronous multiple carcinoma were proved by surgery or endoscopy biopsy, and preoperative upper radiographic examination detected 100 of them (84.03% sensitivity).Eighteen (52.94%) of the T1 lesions were found during preoperative diagnosis by radiographic examination.Moreover, only 3 (3.53%) of the T2-4 lesions were misdiagnosed.CONCLUSION: Hypotonic double-contrast upper gastrointestinal examination, providing accurate information about lesion morphology, location and size, can serve as a sensitive technique for the preoperative diagnosis of MPC.

  8. Allometric scaling of brain regions to intra-cranial volume: An epidemiological MRI study.

    Science.gov (United States)

    de Jong, Laura W; Vidal, Jean-Sébastien; Forsberg, Lars E; Zijdenbos, Alex P; Haight, Thaddeus; Sigurdsson, Sigurdur; Gudnason, Vilmundur; van Buchem, Mark A; Launer, Lenore J

    2017-01-01

    There is growing evidence that sub-structures of the brain scale allometrically to total brain size, that is, in a non-proportional and non-linear way. Here, scaling of different volumes of interest (VOI) to intra-cranial volume (ICV) was examined. It was assessed whether scaling was allometric or isometric and whether scaling coefficients significantly differed from each other. We also tested to what extent allometric scaling of VOI was introduced by the automated segmentation technique. Furthermore, reproducibility of allometric scaling was studied different age groups and study populations. Study samples included samples of cognitively healthy adults from the community-based Age Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik Study) (N = 3,883), the Coronary Artery Risk Development in Young Adults Study (CARDIA) (N =709), and the Alzheimer's Disease Neuroimaging Initiative (ADNI) (N = 180). Data encompassed participants with different age, ethnicity, risk factor profile, and ICV and VOI obtained with different automated MRI segmentation techniques. Our analysis showed that (1) allometric scaling is a trait of all parts of the brain, (2) scaling of neo-cortical white matter, neo-cortical gray matter, and deep gray matter structures including the cerebellum are significantly different from each other, and (3) allometric scaling of brain structures cannot solely be explained by age-associated atrophy, sex, ethnicity, or a systematic bias from study-specific segmentation algorithm, but appears to be a true feature of brain geometry. Hum Brain Mapp 38:151-164, 2017. © 2016 Wiley Periodicals, Inc.

  9. High-resolution array comparative genomic hybridization of chromosome 8q: evaluation of putative progression markers for gastroesophageal junction adenocarcinomas.

    Science.gov (United States)

    van Duin, M; van Marion, R; Vissers, K J; Hop, W C J; Dinjens, W N M; Tilanus, H W; Siersema, P D; van Dekken, H

    2007-01-01

    Amplification of 8q is frequently found in gastroesophageal junction (GEJ) cancer. It is usually detected in high-grade, high-stage GEJ adenocarcinomas. Moreover, it has been implicated in tumor progression in other cancer types. In this study, a detailed genomic analysis of 8q was performed on a series of GEJ adenocarcinomas, including 22 primary adenocarcinomas, 13 cell lines and two xenografts, by array comparative genomic hybridization (aCGH) with a whole chromosome 8q contig array. Of the 37 specimens, 21 originated from the esophagus and 16 were derived from the gastric cardia. Commonly overrepresented regions were identified at distal 8q, i.e. 124-125 Mb (8q24.13), at 127-128 Mb (8q24.21), and at 141-142 Mb (8q24.3). From these regions six genes were selected with putative relevance to cancer: ANXA13, MTSS1, FAM84B (alias NSE2), MYC, C8orf17 (alias MOST-1) and PTK2 (alias FAK). In addition, the gene EXT1 was selected since it was found in a specific amplification in cell line SK-GT-5. Quantitative RT-PCR analysis of these seven genes was subsequently performed on a panel of 24 gastroesophageal samples, including 13 cell lines, two xenografts and nine normal stomach controls. Significant overexpression was found for MYC and EXT1 in GEJ adenocarcinoma cell lines and xenografts compared to normal controls. Expression of the genes MTSS1, FAM84B and C8orf17 was found to be significantly decreased in this set of cell lines and xenografts. We conclude that, firstly, there are other genes than MYC involved in the 8q amplification in GEJ cancer. Secondly, the differential expression of these genes contributes to unravel the biology of GEJ adenocarcinomas.

  10. The Characteristics of Gastrin Receptor Expression in Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    HUANGGuangjian; ZHANGYanling; LEZhuqin; YUFen; ZHANGGuangming; DENShouzhen; NIQuanxing

    2003-01-01

    Objective: To investigate the characteristics and significance of gastrin receptor (GR) expression in gastric cancer. Methods: The content and affinity of GR were determined in 34 specimens of gastric cancer using radioligand binding assay. The correlation was analyzed between GR expression in tumors and tumor sites, stages, grades, DNA of gastric cancer cells, GR of adjacent normal gastric mucosa, survival time. Results: Among the 34 cases of gastric cancer, 16 patients (47.1%) had positive GR in specimens of gastric cancer, with high-affinity GR in 14 cases (41.2%) and low-affinity GR in 2 cases. Of high-affinity GR, 9 cases had cancers with GR>10 fmol/mg.protein (39.5±14.4 fmol/mg.protein), 5 cases with GR≤10fmol/mg.protein (6.0±2.8 fmol/mg.protein). High-affinity GR was easier to be expressed in cancers ofgastric body (7/9) and cardia (3/6) than in gastric antrum (4/19). The expression of GR in gastric cancer accorded well with that in normal gastric mucosa at the same sites, but with more high-special binding sites than the latter (39.5±14.4 vs 26.1±16.6 fmol/mg.protein). A significantly greater proportion of patients withⅢ+Ⅳ stages (13/24) had high-affinity GR compared with I+II stages (1/10) of gastric cancers. During a follow-up of 23-61 months, 11 of 13 cases with high-affinity GR were dead, whereas 4 of 11 cases with low-affinity or negative GR were dead in Ⅲ+Ⅳ stages of gastric cancer. Conclusion: GR is an important factor in the autocrine growth of gastric cancer cells, and helpful in the prediction of prognosis and guidance of treatment with GR antagonists.

  11. Evaluation of contrast-enhanced helical hydro-CT in staging gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Wen-Zhou Wei; Jie-Ping Yu; Jun Li; Chang-Sheng Liu; Xiao-Hua Zheng

    2005-01-01

    AIM: To discuss the helical computed tomography (CT) characteristics of gastric cancer and evaluate the diagnostic value of contrast-enhanced helical hydro-CT (HHCT) in staging gastric cancer.METHODS: A total of 50 patients with gastric cancer were included in this study. The CT findings in them were retrospectively analyzed and correlated with pathologic findings at surgery. All patients were preoperatively imaged by plain and contrast-enhanced helical CT after orally ingesting 1 000-1 500 mL water. Peristalsis was minimized by intra-venous administration of spasmolytics.RESULTS: The foci of gastric cancer became more prominent in all the 50 patients and showed strong enhancement in contrast-enhanced HHCT. The tumor was located at the gastric cardia in 14 cases, at the gastric fundus in 3 cases, at the gastric body in 8 cases, at the gastric antrum in 4 cases, at the gastric fundus and the body in 8 cases, at the gastric body and antrum in 11 cases, and at three segments of the stomach in 2 cases.The CT features of gastric cancer were focal or diffuse mural thickening, soft tissue mass, cancerous ulcer, stenosis of stomach, infiltration to adjacent tissues, lymph node and distant metastases. Strong contrast enhancement of the gastric wall was closely related to gastric cancer. The accuracy rate of contrast-enhanced HHCT in staging gastric cancer was 86% (43/50). The detection rate of lymph node metastases by CT was 60% (12/20).CONCLUSION: Contrast-enhanced HHCT is a reliable method to diagnose and stage gastric cancer.

  12. Production of ghrelin by the stomach of patients with gastric cancer.

    Science.gov (United States)

    Kizaki, Junya; Aoyagi, Keishiro; Sato, Takahiro; Kojima, Masayasu; Shirouzu, Kazuo

    2014-01-01

    Poor nutrition and weight loss are important factors contributing to poor quality of life (QOL) after gastrectomy in patients with gastric cancer. Ghrelin is a hormone produced by the stomach that, plays a role in appetite increase and fat storage. The present study aims to clarify the location of ghrelin mRNA in the stomach, changes in blood ghrelin concentrations after gastrectomy and whether or not they are associated with the reconstruction method in patients with gastric cancer. We collected seven normal mucosa samples from different parts of six totally resected stomachs with gastric cancer. We extracted RNA from the normal mucosa, synthesized cDNA from total RNA (1 μg), and then quantified ghrelin mRNA using quantitative real-time polymerase chain reaction (Q-PCR). Ghrelin blood concentrations were measured using enzyme-linked immunosorbent assay (ELISA) kits in 74 patients with gastric cancer (total gastrectomy (TG), n=23; distal gastrectomy (DG), n=30; proximal gastrectomy (PG), n=11; pylorus preserving gastrectomy (PPG), n=10). In order, the ghrelin gene was expressed most frequently in the gastric body, followed by the fornix, cardia, antrum and pylorus ring. Blood ghrelin concentrations after surgery similarly changed in all groups. The average blood ghrelin concentrations were significantly higher in the DG and PPG groups than in the TG group on postoperative days (POD) 1, 7, 30, 90 and 180. However, blood ghrelin concentrations did not significantly differ between the DG and TG groups on POD 270 and 360. Cells that produce ghrelin are supposed to be located mostly in the fundic gland of the stomach. We speculate that the production of ghrelin from other organs increases from around nine months after total gastrectomy. Therefore, evaluating the nutritional status and the weight of patients at nine months after total gastrectomy is important to help these patients improve their QOL.

  13. The role of leptin in gastric cancer: Clinicopathologic features and molecular mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Nyeong [Department of Internal Medicine, Hanyang University College of Medicine, Seoul (Korea, Republic of); Choi, Ho Soon, E-mail: hschoi96@hanyang.ac.kr [Department of Internal Medicine, Hanyang University College of Medicine, Seoul (Korea, Republic of); Yang, Sun Young [Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul (Korea, Republic of); Park, Hyun Ki; Lee, Young Yiul; Lee, Oh Young; Yoon, Byung Chul; Hahm, Joon Soo [Department of Internal Medicine, Hanyang University College of Medicine, Seoul (Korea, Republic of); Paik, Seung Sam [Pathology, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2014-04-18

    Highlights: • Leptin and Ob-R are expressed in gastric adenoma and early and advanced cancer. • Leptin is more likely associated with differentiated gastric cancer or cardia cancer. • Leptin proliferates gastric cancer cells via activating the STAT3 and ERK1/2 pathways. - Abstract: Obesity is associated with certain types of cancer, including gastric cancer. However, it is still unclear whether obesity-related cytokine, leptin, is implicated in gastric cancer. Therefore, we aimed to investigate the role of leptin in gastric cancer. The expression of leptin and its receptor, Ob-R, was assessed by immunohistochemical staining and was compared in patients with gastric adenoma (n = 38), early gastric cancer (EGC) (n = 38), and advanced gastric cancer (AGC) (n = 38), as a function of their clinicopathological characteristics. Gastric cancer cell lines were studied to investigate the effects of leptin on the signal transducer and activator of transcription-3 (STAT3) and extracellular receptor kinase 1/2 (ERK1/2) signaling pathways using MTT assays, immunoblotting, and inhibition studies. Leptin was expressed in gastric adenomas (42.1%), EGCs (47.4%), and AGCs (43.4%). Ob-R expression tended to increase from gastric adenoma (2%), through EGC (8%), to AGC (18%). Leptin induced the proliferation of gastric cancer cells by activating STAT3 and ERK1/2 and up-regulating the expression of vascular endothelial growth factor (VEGF). Blocking Ob-R with pharmacological inhibitors and by RNAi decreased both the leptin-induced activation of STAT3 and ERK1/2 and the leptin-induced expression of VEGF. Leptin plays a role in gastric cancer by stimulating the proliferation of gastric cancer cells via activating the STAT3 and ERK1/2 pathways.

  14. Inducible nitric oxide synthase polymorphism is associated with the increased risk of differentiated gastric cancer in a Japanese population

    Institute of Scientific and Technical Information of China (English)

    Yasuyuki Goto; Takafumi Ando; Mariko Naito; Hidemi Goto; Nobuyuki Hamajima

    2006-01-01

    AIM: To examine the association of inducible nitric oxide synthase (iNOS) C150T polymorphism with gastric cancer, as well as with gastric atrophy and H pylori seropositivity.METHODS: A single nucleotide polymorphism of iNOS C150T was examined for 454 Japanese health checkup examinees (126 males and 328 females) aged 35 to 85 years without a history of cancer and 202 gastric cancer patients (134 males and 68 females) aged 33 to 94 years with pathologically confirmed diagnosis of gastric adenocarcinoma.RESULTS: The iNOS C150T polymorphism was not associated with gastric atrophy or with H pylori seropositivity. The odds ratio (OR) of the C/T +T/T for gastric cancer was increased without statistical significance (OR=1.19, 95% confidence interval (CI):0.68-2.08). In the differentiated subgroup (n = 113),however, the OR of the C/T genotype for gastric cancer was significant (OR = 2.02, 95% CI: 1.04-3.92) relative to the C/C genotype. In addition, considering the location of gastric cancer (n = 105), there were significant differences between the controls and non-cardia group with the OR of 2.13 (95% CI: 1.08-4.18) for C/T and 1.94(95% CI: 1.00-3.78) for C/T + T/T.CONCLUSION: The iNOS C150T polymorphism is associated with the risk of H pylori-related gastric cancer in a Japanese population. This polymorphism may play an important role in increasing the risk of gastric cancer in Asian countires with the highest rates of gastric cancer.

  15. Submucosal tunnel endoscopy: Peroral endoscopicmyotomy and peroral endoscopic tumor resection

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Peroral endoscopic myotomy (POEM) is an innovative,minimally invasive, endoscopic treatment for esophagealachalasia and other esophageal motility disorders,emerged from the natural orifice transluminal endoscopicsurgery procedures, and since the first human caseperformed by Inoue in 2008, showed exciting results ininternational level, with more than 4000 cases globallyup to now. POEM showed superior characteristics thanthe standard 100-year-old surgical or laparoscopic Hellermyotomy (LHM), not only for all types of esophagealachalasia [classical (Ⅰ), vigorous (Ⅱ), spastic (Ⅲ),Chicago Classification], but also for advanced sigmoidtype achalasia (S1 and S2), failed LHM, or other esophagealmotility disorders (diffuse esophageal spasm,nutcracker esophagus or Jackhammer esophagus). POEMstarts with a mucosal incision, followed by submucosaltunnel creation crossing the esophagogastric junction(EGJ) and myotomy. Finally the mucosal entry is closedwith endoscopic clip placement. POEM permittedrelatively free choice of myotomy length and localization.Although it is technically demanding procedure, POEMcan be performed safely and achieves very goodcontrol of dysphagia and chest pain. Gastroesophagealreflux is the most common troublesome side effect,and is well controllable with proton pump inhibitors.Furthermore, POEM opened the era of submucosal tunnelendoscopy, with many other applications. Based onthe same principles with POEM, in combination withnew technological developments, such as endoscopicsuturing, peroral endoscopic tumor resection (POET), issafely and effectively applied for challenging submucosalesophageal, EGJ and gastric cardia tumors (submucosaltumors), emerged from muscularis propria. POET showedup to know promising results, however, it is restricted tospecialized centers. The present article reviews the recentdata of POEM and POET and discussed controversialissues that need further study and future perspectives.

  16. 22 years of photodynamic therapy in China

    Science.gov (United States)

    Li, Jun-Heng

    2005-07-01

    The development of laser medicine in China is correlated with the development of laser science in China. The first Chinese ruby laser was created in 1961. Chinese pharmacists produced the Chinese HpD in 1981 and the first case of PDT was treated using Chinese HpD and Chinese laser equipment in the same year in Beijing. Its success brought attention establishing a research group supported by the government in 1982. A systemic research on PDT was then carried out and obvious results were achieved. The step taken for PDT also accelerated the researches on other kinds of laser medicine and surgery. Since 1982, thousands of patients of malignant tumors including tumors of the lung, esophagus, cardia, stomach, rectum, bladder, other urinary genital organs, face and mouth, eyes, ENT, head and neck, breast, and skin were treated using PDT in China. HpD fluorescence was examined in some centers. Except the superficial tumor cases, PDT procedures were done through the endoscopes. Since 1990"s, imaging guided percutaneous PDT was adopted in the organs cannot be reached by the endoscopes, such as liver cancer, peripheral lung cancer and others. PDT can be used for non-malignant cases such as occlusion of blood vessels, for example, we invented the treatment of port wine stains by PDT. Regular surgical operation combined with PDT for cerebral glioma showed to be a very good combination. HpD has been approved by the Chinese Government as a photosensitizer, so it is legal to be used in PDT. There are some second generation photosensitizers under studying in China, such as Hematoporphyrin monomethyl ether (HMME) etc. Lasers used for PDT now are mostly the diode laser of 630nm for the cancers. Research studies for PDT in China may be focalized on the aspects as new photosensitizers; the dosimetry in laser irradiation; atoptosis induced by PDT; preclinical and clinical studies for PDT new indications and new technologies.

  17. ROLE OF PRE-OPERATIVE INVESTIGATIONS IN PREVENTING THE POST-OPERATIVE COMPLICATIONS OF THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    Kamreddy Ashok

    2015-11-01

    Full Text Available Thyroid surgeries are performed worldwide for various indications. In the past complications of thyroid surgeries were reported more than 24%. With an increase in accuracy in Cytological reporting, non-invasive radiological investigations to know the extent of the tumor and infiltration of malignant tumors, the complications are reduced to less than 4%. AIM: To evaluate the predictability of pre-operative investigations in preventing the post-operative complications of thyroid surgery. MATERIALS AND METHODS: A prospective study conducted on 86 patients by investigating before thyroid surgeries with FNAC, ultrasonography, CT scan, X-ray Neck lateral view, MRI, 2D ECHO of Cardia, isotope scanning, video laryngoscopy and thyroid function tests. Demographic characteristics of the patients and indications for thyroid surgeries were used to predict the post-operative complications. Post-operative investigations included serum calcium levels, Thyroid function tests and serum Electrolyte levels to diagnose the complications. RESULTS: sensitivity of FNAC was 93.33%, ultra sound Neck was 92.83%, serum calcium was 89.16%, in thyroid function tests it was 77.66%. With X-Ray Neck the specificity was 57.66%, CT scan was 44.50%, MRI was 15%, and isotope study was 30.6%, Doppler study was 33.83% and 2DEcho was 27.83%. Pre-operative assessment was Airway obstruction 3.48%, hematoma formation 4.65%, RLN palsy 3.48%, Hypocalcaemia 33.72%, wound infection 4.65% were the complications encountered. CONCLUSIONS: Thorough investigations prior to surgery of thyroid, proper selection of the surgical procedure, tumor location knowledge, understanding the pathophysiology of the thyroid disease and type of anesthesia gives confidence to the surgeon and avoids complications. The methods applied in the present study had a definitive role in preventing hypocalcaemia with an incidence of 33.72% and RLN palsy 3.48%. These were added upon by the experience of the operating

  18. Anatomy of the alimentary tract of Salminus brasiliensis (Cuvier, 1817 (Pisces, Characidae, Salmininae

    Directory of Open Access Journals (Sweden)

    Eliane Menin

    2008-06-01

    Full Text Available The alimentary tract of Salminus brasiliensis shows anatomic adaptations to its carnivorous, ichthyophagous feeding habit, particularly regarding the distensible esophagus and stomach, especially the caecal region, and the relatively short intestine. The great distensibility of the wall of the anterior intestine is due mainly to the pattern of the mucous membrane, which exhibits thick longitudinal folds. In the anterior intestine the transport of the food is facilitated by the longitudinal pattern of the mucous folds. In the esophagus and pyloric region, related to the propulsion of food to the net organ, the muscular tunica is more developed than in the rest of the alimentary tract. The pyloric constriction regulates the food flux to the middle intestine. Due to the pattern of mucous membrane of the middle and posterior intestines, in net form, the material being processed can be retained for a greater length of time. The intestinal effective absorption area is amplified due to the tubular structure of the middle intestine, of the mucous intestinal folds, and the pyloric caeca. The alimentary tract of S. brasiliensis is similar in structure to that of other Salmininae and to the majority of the piscivorous Characiformes such as Acestrorhynchus britskii and A. lacustris, although in these two the ileum-rectal valve is found. It also differs from the alimentary tracts of Hoplias malabarius and H. lacerdae, in that the esophagus has variable caliber, the stomach possesses a wider cardia, and the intestinal arrangement is different from “N”, besides the presence of the ileum-rectal valve.

  19. Role of dissection of secondary branches of splenic pedicle in portal hypertension cases undergoing splenectomy

    Institute of Scientific and Technical Information of China (English)

    LIU Ying-bin; ZHANG Zhi-ping; WU Xiang-song; FEI Xiao-zhou; QUAN Zhi-wei; Li Song-gang; LI Ji-yu; CAO Li-ping; PENG Shu-you; KONG Ying; WANG Xuan; WANG Jian-wei; LI Jiang-tao; WANG Yong; CHEN Yan; CHEN De-qing; WENG Wei-hong

    2008-01-01

    Background It is well known that conventional splenectomy,which requires careful handling and ligation of tissue of the splenic hilum,can easily cause complications such as splenic fever and pancreatic fistula.Here,we use the technique of dissection of the secondary branches of the splenic pedicle to handle the hilum in the portal hypertension patients who are subjected to splenectomy.Methods We retrospectively compared and analyzed the complications,postoperative hospital stay,operative time,and occurrence of hemorrhage in 121 patients with portal hypertension undergoing splenectomy and devascularization of the gastric cardia from January 1999 to December 2007.The selected cases consisted of 51 patients undergoing conventional splenectomy and 70 patients undergoing dissection of secondary branches of the splenic pedicle.In addition,we analyzed the relationship between size of the spleen and occurrence of complications.Results The incidence of pancreatic fistula and splenic fever (0/70 and 9/70) was lower in patients undergoing dissection of secondary branches of the splenic pedicle as compared with that of the conventional group (5/51 and 18/51 respectively).In addition,there was no significant difference in operative time and volume of blood loss between two groups.The spleen thickness of those patients who had pancreatic fistula and splenic fever was significantly greater than those without complications.Conclusions These results indicate that dissection of secondary branches of the splenic pedicle in portal hypertension patients undergoing splenectomy can decrease the incidence of splenic fever and pancreatic fistula,and shorten the postoperative hospital stay,especially in the patients with a large spleen.So dissection of secondary branches of the splenic pedicle is a valuable technique for splenectomy.

  20. Laparoscopic antireflux surgery--technique and results.

    Science.gov (United States)

    Fingerhut, A; Etienne, J C; Millat, B; Comandella, M G

    1997-09-01

    Although gastroesophageal reflux disease (GERD) can be effectively treated by proton-pump inhibitors, surgery is still the only means of definitive cure of the disease. After introduction of laparoscopic surgery, there has been a clear trend to surgical repair of the incompetent cardia. The indications for surgical treatment are: endoscopically proven esophagitis, persistent or recurrent complaints under medical treatment, esophageal stricture and/or pH-metrically proven acid reflux as well as reflux-induced coughing (chronic aspiration). Although the laparoscopic antireflux operations is a technically demanding procedure, it can be performed with similar results as compared to conventional surgery. The operative technique is reported in detail. From January 1992 to March 1997, 146 consecutive patients with GERD have been operated on laparoscopically. The overall conversion rate was 8.2% (n = 12). 133 patients were operated on according to the Nissen procedure including hiatoplasty. The Toupet operation was performed in only one case. 84 men and 42 women had a mean age of 49 years (20-76). The median duration of symptoms was 48 months (1-600). Except five patients all had medical treatment for at least 2 years. Twice pneumatic balloon dilatation of an esophageal stricture was necessary preoperatively. The median operation time was 210 minutes (70-660). Conversion to open surgery because of intraoperative complications was necessary in 6 patients. Postoperative complications occurred in 14 patients, all of them being successfully treated conservatively. No patient died. 121 patients (90.3%) had follow up examinations for at least 6 months. Retreatment was necessary in 5 cases: 1x slipped Nissen (laparoscopic repair), 1x intrathoracic hernia (conventional reoperation), 2x dysphagia > 4 months postoperatively (endoscopic balloon dilatation) and 1x recurrent ulcer (conventional operation). With a correct indication, laparoscopic Nissen repair for GERD is a suitable

  1. An Anti-Coagulation Conundrum: Implantation of Total Artificial Heart in a Patient with Heparin-Induced Thrombocytopenia Type II

    Science.gov (United States)

    Cios, Theodore J.; Salamanca-Padilla, Yuliana; Guvakov, Dmitri

    2017-01-01

    Patient: Male, 44 Final Diagnosis: Heparin-induced thrombocytopenia Type II Symptoms: Congestive heart failure • short of breath Medication: — Clinical Procedure: LVAD explantation • TAH insertion Specialty: Anesthesiology Objective: Rare co-existance of disease or pathology Background: Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery. Case Report: We present the case of a patient who underwent SynCardia Total Artificial Heart (TAH) implantation following a recent left ventricular assist device (LVAD) placement. The patient was receiving argatroban for type II HIT with anuric renal failure, and developed a thrombus which occluded the inflow cannula of the LVAD. Based on a published study and after establishing consensus with the surgical, anesthesiology, perfusion, and hematology teams, we decided to use tirofiban as an antiplatelet agent to inhibit the platelet aggregation induced by heparin, and ultimately used heparin as the anticoagulant for cardiopulmonary bypass. Conclusions: When selecting anticoagulation for a HIT-positive patient requiring CPB, so that benefits outweigh risks, it is of paramount importance that the decision be based on a multitude of factors. The team caring for the patient should have a shared mental model and be familiar with the pharmacology, devices used, and local practices. These three elements should be integrated with patient-specific comorbidities

  2. Characterization of gastric cancer models from different cell lines orthotopically constructed using improved implantation techniques

    Institute of Scientific and Technical Information of China (English)

    Yan Li; Bo Li; Chun-Ping Xiang; Yu Zhang; Yuan-Yuan Li; Xiao-Ling Wu

    2012-01-01

    AIM: To develop orthotopic gastric cancer mouse models from different cell lines and characterize the tumor features to assist further in preclinical trials and clinical treatment strategies. METHODS: Human gastric cancer SGC-7901 and BGC- 823 cell suspensions were injected subcutaneously into nude mice to develop solid tumors, and tumor tissue pieces were then implanted under the serous coat of the stomach. An autopsy was performed on all animals of the SGC-7901 and BGC-823 models to observe the primary tumor growth and metastases using pathological and immunohistochemical methods. RESULTS: Both models showed large tumors in situ resulting in pressure and infiltration of the adjacent organs. The gastric cavity became smaller, along with stenosis of the cardia or pylorus. There were biological and statistical differences between the two models. The metastasis rate in involved organs (lymph nodes, kidney, spleen, testis) was significantly higher in the BGC-823 model compared to the SGC-7901 model (P < 0.05 or P < 0.01). The median survival of the BGC-823 model was shorter than that of SGC-7901 (23 d vs 84 d, P < 0.05). Histopathologically, the primary tumor and metastatic lesions of the two models showed obvious atypia and mucus in the cytoplasm. Compared with the SGC-7901 model, BGC-823 appeared more poorly differentiated (absence of adenoid structure), had a smaller volume, and richer capillary structure. Immunohistochemical staining revealed cytokeratin 20 and epithelial membrane antigen expression was positive in the SGC-7901 tumors, while negative in BGC-823 ones. CONCLUSION: Models using the SGC-7901 and BGC-823 cell lines were established which could function in gastric cancer research on carcinogenesis mechanism and drug discovery. The two models showed different tumor behavior and the latter was more malignant than the former.

  3. Training model for teaching endoscopic submucosal dissection of gastric tumors Modelo para el aprendizaje y entrenamiento en la técnica de disección endocópica submucosa de tumores gástricos

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    E. Vázquez-Sequeiros

    2009-08-01

    Full Text Available Introduction: the elevated risk of complications and technical complexity of endoscopic submucosal dissection (ESD has limited its implementation in our medical system. Objective: to design and evaluate a training program for learning the ESD technique. Methods: four endoscopists with no experience with ESD underwent a 4-step training program: 1 review of the existing literature, didactic material, and theoretical aspects of ESD; 2 ESD training in an ex-vivo animal model; 3 ESD training in an in-vivo animal model(supervised by ESD expert; and 4 ESD performance in a patient. A standard gastroscope and an ESD knife (IT, Flex or Hook-knife Olympus® were employed. The classical ESD technique was performed: rising of the lesion, circumferential incision, and submucosal dissection. Results: ex-vivo animal model: 6 x swine stomach/esophagus -cost < 100 euro; 6 x ESD: antrum (n = 2, body (n = 3 and fundus/cardia (n = 1-; size of resected specimen: 4-10 cm; ESD duration: 105-240 minutes; therapeutic success: 100%; complications: perforation (1/6: 16% sealed with clips. In-vivo animal model: 6 ESD (antrum/body of stomach: 4; esophagus: 2; size: 2-5 cm; duration: 40-165 minutes; success: 100%; complications: 0%. Patient: ESD of a gastric lesion located in the antrum/body; size: 3 cm; duration 210 minutes; a complete resection was achieved; no complications. Conclusions: the results of the present study support the usefulness of this model for learning ESD in our system.

  4. [Longitudinal studies in the prevention of cardiovascular diseases].

    Science.gov (United States)

    Balaguer Vintró, Ignacio

    2004-01-01

    Longitudinal studies of well defined cohorts have contributed to the identification of risk factors of coronary heart disease and other clinical complications of atherosclerosis. After commenting on the conclusions of experimental atherosclerosis and risk factors suggested by the study of a series of myocardial infarction in young adults and their matched controls, we discuss the methodology, management and results of longitudinal studies carried out in the United States since 1949: Twin Cities, Framingham, Pooling Project, Western Collaborative, Puerto Rico Evans County, NI-IION-SAN, San Francisco, Harvard, Bogalusa and CARDIA. Special attention is given to the hypothesis proposed at the beginning of the Framingham Study and the obstacles and changes to continue the project after the first twenty-four years. We also expose the Seven Countries Study, designed and managed by Ancel Keys, as the first study performed with centralized methodology in various countries, and the studies in various European countries: Whitehall, Manresa, Paris, British Regional, Northwick Park, Caerphilly, Speedwell and PROCAM. We analyse the role of the longitudinal studies in the methodology of later studies: sons and daughters of the Framingham participants, longitudinal studies based on questionnaires, studies of the other risk factors, prevalence of risk factors in retrospective studies, trials of primary prevention (MRFIT, WHO European Collaborative Trial and Gotenburg Study) and the participation of the trained teams in the MONICA Project. We present the issues still under debate in connection with the methodology and results of the longitudinal studies: problems in the periodic examination of the participants in the epidemiologic studies, changes in definition of the new cases of acute cardiovascular events, use and selection of risk functions based on coronary charts to calculate the individual risk and cardiovascular risk factors as yet unknown.

  5. Prevalence, distribution and pattern of gastric lesions in slaughtered pigs in south-western Nigeria

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    Oladipo O. Omotosho

    2016-03-01

    Full Text Available Gastric lesions, especially ulceration, cause significant economic losses in the swine industry worldwide. The study was designed to assess its prevalence, distribution and pattern in pigs in south-western Nigeria. Slaughter house surveys were conducted on three government-established abattoirs in Lagos, Ogun and Oyo states. Stomachs from 480 pigs were assessed for gross lesions, which were graded using a modification of a standard technique. Tissues from different regions of the stomach were routinely stained to assess histopathologic changes. Data were presented as frequency counts and analysed using analysis of variance and chi-square technique. Significance was determined at p ≤ 0.05. Gastric lesions were encountered across the four regions of the stomach with a point prevalence of 57.29%. The prevalence of lesions in the non-glandular region was 32.9%, with severe hyperkeratosis (13.13% being most frequently observed (p < 0.05. Erosions were significantly higher in the cardia (8.54% (p < 0.05, followed by fundus (8.33%. Gastric ulcers were significantly higher in the fundus (19.58% (p < 0.05. Scars of healed ulcers and lacerations were also observed in the fundus (5.42% (p < 0.05. The gastric lesion distribution across the four regions of the stomach and the occurrence of ulceration in the fundus showed an unusual pattern, which is rarely reported in other parts of the world. The reason for these findings in pigs in Nigeria is not fully understood; therefore, further studies are required to identify and manage these factors for increased productivity, improved animal welfare and enhanced food security.Keywords: prevalence; gastric; lesions; fundic ulcers; pigs

  6. Role of anesthetics in protecting the heart against myocardial ischemia-reperfusion injury%麻醉药物对心肌缺血再灌注损伤的保护研究进展

    Institute of Scientific and Technical Information of China (English)

    刘保江; 郭志佳

    2008-01-01

    心肌缺血再灌注损伤(MIRI)是临床上一类非常常见而严重的并发症,被麻醉学界广泛关注.实际上,自从1985年Freedman首次报道安氟醚能改善缺血后心功能以来,如何找到防治MIRI经济有效的方法,已经成为这个领域多年来研究的方向.大量实验证明,多种麻醉药物对MIRI具有不同方面的保护作用.此文综述了国内外关于麻醉药物以及具有中国特色和优势的中药复方制剂对MIRI保护研究的进展,其中重点综述几种代表性药物,如瑞芬太尼、丙泊酚、咪达唑仑、参附注射液等,并总结了近年来这一方向的研究成果.%Cardiac injury following ischemia-reperfusion cgn lead to miocardial cell death and result in cardiac dysfunction.A wide railge of cardiae factors have been studied now.This review aims to provide an overview of current data on the role of anesthetics,such as isoflurane,sufentanil,propofol,midazolam,especially Shenfu injection,on proteting against myocardial ischemia reperfusion injury.

  7. No significant association between halitosis and upper gastrointestinal endoscopic findings: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Adnan Tas; Seyfettin K(o)klü; (I)lhami Yüksel; (O)mer Ba(s)ar; Erdem Akbal; Ahmet Cimbek

    2011-01-01

    Background Previous studies have focused on the relationship between halitosis,gastroesophageal reflux disease and Helicobacter pylori.In this study we aimed to investigate the interaction between halitosis and upper gastrointestinal endoscopic findings.Methods Patients who previously had dyspepsia and had undergone endoscopic examination were included in the study.Symptoms of dyspepsia were investigated by means of a questionnaire that investigated halitosis.Patients who suffered from objective halitosis (confirmed by questions both to the patient and their relatives) were further investigated.Patients with known local or systemic causes of halitosis or structural disorders at endoscopy were excluded.Results The study included 358 patients (121 men and 237 women) with dyspeptic symptoms.The patients with and without halitosis had mean ages of (39.4+13.5) and (43.1±14.9) years,respectively.Patients without halitosis were significantly older than those in the halitosis group (P <0.05).Patients in the halitosis group had significantly higher frequencies of regurgitation,bloating and nausea (P <0.05) when compared to patients without halitosis.Endoscopic findings,including esophagitis,open cardia,hiatal hernia,gastritis and duodenitis,were comparable in the two groups.Conclusions The frequency of halitosis was high in patients with dyspepsia who underwent upper gastrointestinal endoscopy.Halitosis had a close relationship with several upper gastrointestinal symptoms,including regurgitation,nausea and bloating.There was no significant association between upper gastrointestinal endoscopic findings and halitosis.

  8. 中介蝮蛇消化道5羟色胺细胞的免疫组织化学定位%Immunohistochemical Localization on 5-HT Cells in the Digestive Tract of Gloydius intermedius

    Institute of Scientific and Technical Information of China (English)

    张珈宁; 张欣; 李淑兰

    2012-01-01

    To study the morphology and density of 5-hydroxytryptamine (5-HT) cells in the digestive tract of the Gloydius intermediu. The method of the ABC immunohistochemical technique. The results showed that the 5-HT cells could be observed throughout the digestive tract with the highest density in the gastric pylorus and the lowest density in the rectum. What could be seen throughout the whole digestive tract was round or oval of closed-type 5-Htcells; the open-type 5-HT cells were tadpole-shaped or cone-shaped and mainly located in the esophagus, gastric cardia, gastric pylorus and sections of small intestine. The distribution characteristics of 5-HT cell might be related to the feeding habits and the living environment or function of various parts of the digestive tract.%为了研究中介蝮蛇(Gloydius intermedius)消化道5-羟色胺(5-hydroxytryptamine,5-HT)细胞的形态和分布规律.应用免疫组织化学ABC法.结果表明:5-HT细胞在其整个消化道中均有分布.其中以胃幽门部分布密度最高,直肠部分布密度最低.在整个消化道中,均可见到呈圆形或椭圆形的闭合型5-HT细胞;开放型5-HT细胞呈蝌蚪形、锥体形,集中分布于食管、贲门、幽门和小肠各段.表明5-HT细胞分布的特点可能与中介蝮蛇的食性、生活环境或消化道各部位的功能有关.

  9. Evaluation of Intraoperative Radiotherapy for Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Huanlong Qin; Chaohong Lin; Xiulong Zhang

    2005-01-01

    OBJECTIVE To study the proper sites and doses of intraoperative radiotherapy (IORT) for gastric carcinoma and the effects of this treatment.METHODS A total of 106 cases of stage Ⅰ- Ⅳ gastric carcinoma who received a D2 or D3 radical resection operation combined with IORT were analyzed. Sixty-seven patients with gastric cancer of the antrum and body received distal gastrectomy. The sites of irradiation were at the celiac artery and hepatoduodenal ligament area. Another 39 patients with carcinoma of the cardia and upper part of the gastric body and whole stomach received proximal gastrectomy or total gastrectomy. The sites of irradiation for this group were the upper margin of the pancreas and the regional paraaorta.The therapeutic effects (including survival and complications) of these 106cases who received a combined operation IORT (IORT group) were compared with 441 cases treated during the same time period by a radical resection operation alone (operation group).RESULTS The radiation dose below 30 Gy was safe. The therapeutic method of the operation combined with IORT did not prolong the survival time of patients with stage Ⅱ and Ⅳ gastric cancer, but the 5-year survival rates of patients with stage Ⅱ and Ⅲ gastric cancers were significantly improved.While the 5-year survival rates of the stage Ⅲ cancer patients receiving D2 resection combined with IORT had marked improvement, for those receiving a D3 radical resection, only the postoperative survival rates at 3 and 4 years of those cases in stages Ⅲ cancers were improved (P<0.005-0.001). The 5-year survival rate for those patients was raised only 4.7%(P>0.05).CONCLUSION The 5-year survival rates of patients with stages Ⅱ and Ⅲ gastric carcinoma who received a D2 lymphadenectomy combined with IORT were improved and had no influence on the postoperative complications and mortality.

  10. Evaluation of intraoperative radiotherapy for gastric carcinoma with D2 and D3 surgical resection

    Institute of Scientific and Technical Information of China (English)

    Huan-Long Qin; Chao-Hong Lin; Xiu-Long Zhang

    2006-01-01

    AIM: To study the proper sites and doses of intraoperative radiotherapy (IORT) for gastric carcinoma and the effects of this treatment.METHODS: A total of 106 patients with stage Ⅰ -Ⅳ gastric carcinoma who Received D2 or D3 radical operation combined with IORT were analyzed. Sixty-seven patients with gastric cancer of the antrum and body underwent distal gastrectomy. The sites of irradiation were at the celiac artery and hepatoduodenal ligment area. Another 39 patients with carcinoma of the cardia and upper part of the gastric body and whole stomach underwent proximal gastrectomy or total gastrectomy. The sites of irradiation for this group were the upper margin of the pancreas and the regional para-aorta. The therapeutic effects (including survival and complications) of these 106 cases Received operation combined with IORT (IORT group) were compared with 441 cases treated during the same time period by a radical operation alone (operation group).RESULTS: The radiation dose below 30 Gy was safe.The therapeutic method of the operation combined with IORT did not prolong the survival of patients with stage Ⅰ and Ⅳ gastric cancer, but the 5-year survival rates of patients with stage Ⅱ and Ⅲ gastric cancers were significantly improved. The 5-year survival rates of the stages Ⅲ cancer patients receiving D2 resection combined with IORT were markedly improved, while for those receiving D3 radical resection, only the postoperative 3- or 4-year survival rates were improved (P < 0.005-0.001). The 5-year survival rate for those patients was raised only by 4.7% (P > 0.05).CONCLUSION: The 5-year survival rates of patients lymphadenectomy combined with IORT were improved,and there was no influence on the postoperative complications and mortality.

  11. Evaluation of density and distribution of CART-immunoreactive structures in gastrointestinal tract of hypertensive rats.

    Science.gov (United States)

    Kasacka, Irena; Piotrowska, Zaneta

    2012-01-01

    The prevalence of CART (cocaine- and amphetamine-regulated transcript) throughout the organism, multiplicity of functions fulfilled by that peptide, and the collected evidence confirming CART contribution to blood pressure regulation prompted us to undertake the research aiming to identify, localize, and assess changes in CART-immunopositive structures of the gastrointestinal tract (GI tract) of rats with renovascular hypertension. The two-kidney one-clip model of arterial hypertension was used to evaluate the location and density of CART-containing structures in the stomach (cardia, fundus, and pylorus), duodenum, jejunum, ileum, and colon of hypertensive rats. The study was carried out on the GI tract of 20 rats. Ten rats were subjected to the renal artery clipping procedure and after a 6-week period each of them developed stable hypertension. An immunohistochemical localization of CART was performed on paraffin GI tract sections from all the study animals. CART was detected in the extensive population of neurons, particularly within the myenteric plexuses all along the GI tract, and also in neuroendocrine cells, being especially numerous in the stomach and a few in the small intestine. The hypertension significantly increased the density of CART-positive structures in the rat GI tract. The differences between the hypertensive rats and the control animals concerned not only the density of CART-immunoreactive structures but also the staining intensity. As this study provides novel findings, we are planning further molecular examinations to better understand the impact of hypertension on the functioning and activity of CART in the GI tract.

  12. Trajectories of metabolic syndrome development in young adults.

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    Vivian T W Poon

    Full Text Available BACKGROUND: Metabolic syndrome (MetS is a constellation of metabolic aberrations that collectively increase the risk for cardiovascular disease and type 2 diabetes. Greater understanding of MetS developments may provide insight into targeted prevention strategies for individuals at greatest risk. The purpose of this study was to i identify distinct patterns of longitudinal MetS development and; ii develop a character profile that differentiates groups by level of MetS risk. METHODS AND RESULTS: Data from the Coronary Artery Risk Development in Young Adults (CARDIA study (n = 3 804; 18-30 y was obtained by limited access application from the National Heart, Lung, and Blood Institute and used for this analysis. MetS, as defined by the Harmonized criteria, was assessed over a 20 year follow-up period. Group-level trajectory analysis identified 4 distinct groups with varying rates of component development [No (23.8% of sample; Low (33.5%; Moderate (35.3%; and High MetS (7.4%]. After adjusting for covariates, individuals in the At-Risk groups (Low, Moderate and High MetS were more likely to be of black ethnicity (1.37, 1.14-1.66, have a family history of cardiovascular disease (1.61, 1.31-1.97 and history of dieting (1.69, 1.20-2.39 when compared to the No Risk trajectory group (No MetS. Conversely, increasing baseline education (0.76, 0.65-0.89 and aerobic fitness (0.55, 0.47-0.64 was inversely associated with At-Risk group membership. CONCLUSIONS: Results suggest distinct profiles of MetS development that can be identified by baseline risk factors. Further research is necessary to understand the clinical implication of intermediate MetS development groups with respect to overall cardiometabolic risk.

  13. Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health.

    Science.gov (United States)

    Hudson, Darrell L; Puterman, Eli; Bibbins-Domingo, Kirsten; Matthews, Karen A; Adler, Nancy E

    2013-11-01

    Greater levels of socioeconomic position (SEP) are generally associated with better health. However results from previous studies vary across race/ethnicity and health outcomes. Further, the majority of previous studies do not account for the effects of life course SEP on health nor the effects of racial discrimination, which could moderate the effects of SEP on health. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we examined the relationship between a life course SEP measure on depressive symptoms and self-rated health. A life course SEP was constructed for each participant, using a framework that included parental education and occupation along with respondents' highest level of education and occupation. Interaction terms were created between life course SEP and racial discrimination to determine whether the association between SEP and health was moderated by experiences of racial discrimination. Analyses revealed that higher levels of life course SEP were inversely related to depressive symptoms. Greater life course SEP was positively associated with favorable self-rated health. Racial discrimination was associated with more depressive symptoms and poorer self-rated health. Analyses indicated a significant interaction between life course SEP and racial discrimination on depressive symptoms in the full sample. This suggested that for respondents with greater levels of SEP, racial discrimination was associated with reports of more depressive symptoms. Future research efforts should be made to examine whether individuals' perceptions and experiences of racial discrimination at the interpersonal and structural levels limits their ability to acquire human capital as well as their advancement in education and occupational status.

  14. A prospective study of vitamin and mineral supplement use and the risk of upper gastrointestinal cancers.

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    Sonja P Dawsey

    Full Text Available We examined the association of use of multivitamins or single vitamin/mineral supplements with risk of four upper gastrointestinal cancers in the NIH-AARP Diet and Health Study cohort with 11 years of follow-up. After exclusions, 490,593 persons were included in our analytic cohort and 1780 upper gastrointestinal cancers were accrued. Hazard ratios (HRs and 95% confidence intervals (CIs were calculated using Cox models with adjustment for potential confounders. We observed no significant associations between multivitamin use and risk for the four cancer outcomes in crude or adjusted models. Among individual vitamin or mineral supplements, use of iron supplements was associated with significantly lower risk of esophageal adenocarcinoma (HR = 0.68, 95% CI = 0.49 to 0.94 and a significantly increased risk of gastric noncardia adenocarcinoma (HR = 1.59, 95% CI = 1.24 to 2.05. For gastric noncardia adenocarcinoma, we saw associations with zinc use (HR = 1.28, 95% CI = 1.01 to 1.62 and vitamin C use (HR = 0.79 95% CI = 0.65 to 0.96. Calcium use, some of which was reported as antacids and used to treat reflux disease, was associated with higher risk of esophageal adenocarcinoma (HR = 1.27, 95% CI = 1.06 to 1.52 and gastric cardia adenocarcinoma (HR = 1.27, 95% CI = 1.03 to 1.56 cancers. We saw no evidence that multivitamin use was associated with reduced risk of four highly fatal upper gastrointestinal cancers, but there were some differences in risk with reported use of individual supplements.

  15. Red and processed meat intake is associated with higher gastric cancer risk: a meta-analysis of epidemiological observational studies.

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    Hongcheng Zhu

    Full Text Available BACKGROUND: Red and processed meat was concluded as a limited-suggestive risk factor of gastric cancer by the World Cancer Research Fund. However, recent epidemiological studies have yielded inconclusive results. METHODS: We searched Medline, EMBASE, and the Cochrane Library from their inception to April 2013 for both cohort and case-control studies which assessed the association between red and/or processed meat intake and gastric cancer risk. Study-specific relative risk estimates were polled by random-effect or fixed-effect models. RESULTS: Twelve cohort and thirty case-control studies were included in the meta-analysis. Significant associations were found between both red (RR: 1.45, 95% CI: 1.22-1.73 and processed (RR: 1.45, 95% CI: 1.26-1.65 meat intake and gastric cancer risk generally. Positive findings were also existed in the items of beef (RR: 1.28, 95% CI: 1.04-1.57, bacon (RR: 1.37, 95% CI: 1.17-1.61, ham (RR: 1.44, 95% CI: 1.00-2.06, and sausage (RR: 1.33, 95% CI: 1.16-1.52. When conducted by study design, the association was significant in case-control studies (RR: 1.63, 95% CI: 1.33-1.99 but not in cohort studies (RR: 1.02, 95% CI: 0.90-1.17 for red meat. Increased relative risks were seen in high-quality, adenocarcinoma, cardia and European-population studies for red meat. And most subgroup analysis confirmed the significant association between processed meat intake and gastric cancer risk. CONCLUSIONS: Our findings indicate that consumption of red and/or processed meat contributes to increased gastric cancer risk. However, further investigation is needed to confirm the association, especially for red meat.

  16. Esophageal Cancer in Iran: A Review

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    Siavosh Nasseri-Moghaddam

    2010-01-01

    Full Text Available Esophageal cancer is the second and third most common malignancy in Iranian malesand females, respectively, claiming lives of approximately 5800 Iranians each year.Squamous cell carcinoma (SCC is presently the most common type accounting forabout 90% of all esophageal cancers in Iran. Recent studies have shown that there isa gradual increase in the incidence of adenocarcinoma of the distal esophagus alongwith gastric cardia adenocarcinoma. Thirty-five years ago, the age standardizied rate (ASR of esophageal SCC in thecity of Gonbad (Golestan Province, northeast of Iran was found to be one of the highestrates for any single cancer that had been reported worldwide (ASR >100/105/year.Recent studies have shown that the incidence of SCC in Gonbad has declined to lessthan half of what it was in the past. This decline in the incidence of esophageal SCCparallels an improvement in the socioeconomic situation of people living in thisregion. According to recent cancer registry data in Iran there is still an obviousintracountry variability between the incidence of esophageal cancer in the south withan ASR of 3 for males and 2 for females in Kerman and 43 and 36 in the northeasternprovince of Golestan. The reasons for this very high rate of SCC in northeastern Iranhave been the subject of several studies during the past 35 years. According to resultsof these studies the suspected risk factors are: low intake of fruits and vegetables, drinkinghot tea, consumption of opium products and tobacco, H.pyloriinfection in the stomach,using unhealthy drinking water from cisterns and genetic susceptibility. The mainsuspected mutagens are polycyclic aromatic hydrocarbons (PAH and N-nitrosocompounds. In order to embark primary and secondary prevention of this fatal cancer,further prospective studies are presently underway in the region. The Golestanesophageal cancer cohort study which follows of 50,000 subjects is on going. We expectsimple and feasible evidence based

  17. Hostility Modifies the Association between TV Viewing and Cardiometabolic Risk

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    Anthony Fabio

    2014-01-01

    Full Text Available Background. It was hypothesized that television viewing is predictive of cardiometabolic risk. Moreover, people with hostile personality type may be more susceptible to TV-induced negative emotions and harmful health habits which increase occurrence of cardiometabolic risk. Purpose. The prospective association of TV viewing on cardiometabolic risk was examined along with whether hostile personality trait was a modifier. Methods. A total of 3,269 Black and White participants in the coronary artery risk development in young adults (CARDIA study were assessed from age 23 to age 35. A cross-lagged panel model at exam years 5, 10, 15, and 20, covering 15 years, was used to test whether hours of daily TV viewing predicted cardiometabolic risk, controlling confounding variables. Multiple group analysis of additional cross-lagged panel models stratified by high and low levels of hostility was used to evaluate whether the association was modified by the hostile personality trait. Results. The cross-lagged association of TV viewing at years 5 and 15 on clustered cardiometabolic risk score at years 10 and 20 was significant (B=0.058 and 0.051, but not at 10 to 15 years. This association was significant for those with high hostility (B=0.068 for exam years 5 to 10 and 0.057 for exam years 15 to 20 but not low hostility. Conclusion. These findings indicate that TV viewing is positively associated with cardiometabolic risk. Further, they indicate that hostility might be a modifier for the association between TV viewing and cardiometabolic risk.

  18. Cancers of the upper gastro-intestinal tract: a review of somatic mutation distributions.

    Science.gov (United States)

    Abedi-Ardekani, Behnoush; Hainaut, Pierre

    2014-04-01

    Cancers of the upper gastro-intestinal tract (UGIT) comprise esophageal, esophago-gastric junction, stomach and duodenal cancers. Together, these cancers represent over 1.5 million cases and are the cause of about 1.25 million deaths annually. This group of cancers encompasses diseases with marked disparities in etiology, geographic distribution, histopathological features and frequency. Based on histological origin, squamous cell carcinoma of the esophagus (ESCC), which arises through a dysplasia-carcinoma sequence within the squamous mucosa, is a completely different cancer than junction, stomach and duodenal cancers, which develop within glandular epithelia through cascades involving inflammation, metaplasia, dysplasia and carcinoma. At the frontline between these two histological domains, cancers of the esophago-gastric junction constitute a mixed group of glandular tumors including distal esophageal adenocarcinomas and cancers arising within the most proximal part of the stomach - the cardia. Most of UGIT cancers are sporadic, although familial susceptibility genes have been identified for stomach and rare cases of ESCC. We have used the COSMIC database (http://www.sanger.ac.uk/genetics/CGP/cosmic/) to identify genes commonly mutated in UGIT cancers. Regardless of etiology and histopathology, three genes are mutated in at least 5% of UGIT cancers: TP53, CDKN2a and PIK3CA. Another three genes, NFE2L2, PTCH1 and NOTCH1, are mutated in ESCC only. Conversely, genes of the RAS family and of the CDH1/APC/CTNNB1 pathway are mutated only in non-squamous cancers, with differences in mutated genes according to topography. We review the potential functional significance of these observations for understanding mechanisms of UGIT carcinogenesis.

  19. Establishment of transgenic lines to monitor and manipulate Yap/Taz-Tead activity in zebrafish reveals both evolutionarily conserved and divergent functions of the Hippo pathway.

    Science.gov (United States)

    Miesfeld, Joel B; Link, Brian A

    2014-08-01

    To investigate the role of Hippo pathway signaling during vertebrate development transgenic zebrafish lines were generated and validated to dynamically monitor and manipulate Yap/Taz-Tead activity. Spatial and temporal analysis of Yap/Taz-Tead activity suggested the importance of Hippo signaling during cardiac precursor migration and other developmental processes. When the transcriptional co-activators, Yap and Taz were restricted from interacting with DNA-binding Tead transcription factors through expression of a dominant negative transgene, cardiac precursors failed to migrate completely to the midline resulting in strong cardia bifida. Yap/Taz-Tead activity reporters also allowed us to investigate upstream and downstream factors known to regulate Hippo signaling output in Drosophila. While Crumbs mutations in Drosophila eye disc epithelia increase nuclear translocation and activity of Yorkie (the fly homolog of Yap/Taz), zebrafish crb2a mutants lacked nuclear Yap positive cells and down-regulated Yap/Taz-Tead activity reporters in the eye epithelia, despite the loss of apical-basal cell polarity in those cells. However, as an example of evolutionary conservation, the Tondu-domain containing protein Vestigial-like 4b (Vgll4b) was found to down-regulate endogenous Yap/Taz-Tead activity in the retinal pigment epithelium, similar to Drosophila Tgi in imaginal discs. In conclusion, the Yap/Taz-Tead activity reporters revealed the dynamics of Yap/Taz-Tead signaling and novel insights into Hippo pathway regulation for vertebrates. These studies highlight the utility of this transgenic tool-suite for ongoing analysis into the mechanisms of Hippo pathway regulation and the consequences of signaling output.

  20. FETAL ECHOCARDIOGRAPHY: A STUDY OF CLINICAL OUTCOME

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    Rajanish

    2014-01-01

    Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and

  1. Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review

    Institute of Scientific and Technical Information of China (English)

    Jessica; Hopkins; Noah; J; Switzer; Shahzeer; Karmali

    2015-01-01

    Endoscopic treatments for gastroesophageal reflux disease(GERD) have become increasingly popular in recent years. While surgical intervention with the Laparoscopic Nissen Fundoplication remains the gold standard, two endoscopic interventions, specifically, are gaining traction in clinical use(Esophy X and Stretta). The Esophy X(Endo Gastric Solutions, Inc., Redmond, WA, United States) was developed as a method of restoring the valve at the GE junction through an endoluminal fundoplication(ELF) technique. Long-term data suggests that transoral incisional fundoplication(TIF) with Esophy X may be effective for symptom control and proton pump inhibitor reduction or cessation for up to 2-6 years. There is no evidence that Esophy X is more effective than surgical intervention. TIF may be most effective for patients with HH < 2 cm and Hill Grade I/II valves. Stretta(Mederi Therapeutics, Greenwich, CT, United States) was approved by the Food and Drug Administration in 2000. It delivers radiofrequency energy to the lower esophageal sphincter and gastric cardia. Published reviews of the literature are conflicted in their recommendations of Stretta in the management of GERD. The literature suggests that the Stretta procedure has an acceptable safety profile and may be effective in reducing symptom burden and quality of life scores up to 8 years post-intervention. However, there does not appear to be any sustained improvement in objective outcomes and there is no evidence that Stretta results in improved outcomes as compared to surgical intervention. Treatment modalities for GERD, as a field, suffer from a lack of standardization in primary and secondary outcomes. Although many studies have looked at health related quality of life, the tools used to do so are markedly heterogeneous. Future directions for the endoscopic treatment of GERD include novel techniques like endoscopic submucosal dissection.

  2. Clinical presentation and endoscopic management of Dieulafoy's lesions in an urban community hospital

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To identify rates of occurrence, common clinical and endoscopic features, and to review the outcome of endoscopic management of Dieulafoy's lesions in the upper gastrointestinal (GI) tract in an urban community hospital setting.METHODS: Endoscopic data from esophagogastroduo denoscopies (EGDs), done at Wyckoff Heights Medical Center, Brooklyn, NY between 2000 and 2006 were reviewed to identify patients with Dieulafoy's lesions.Demographic data, medical history, examination findings,lab data, endoscopic findings and details of therapy for patients treated for Dieulafoy's lesions were reviewed retrospectively.RESULTS: Dieulafoy's lesions were documented to be the cause of bleeding in approximately 1% of patients presenting with upper gastrointestinal bleeding,while they were detected in only 2 patients when the indications for EGDs were different from active GI bleeding. When we analyzed EGDs performed in patients above age 65 years presenting with gastrointestinal bleeding, prevalence of Dieulafoy's lesions approached 10 percent. The most common location of the lesion was the body of stomach (7), followed by the cardia (4) and the esophagus (2). One patient had this lesion in the fundus and one patient in the duodenal apex.All patients were initially treated endoscopically with epinephrine injection, in eight cases heater probe was applied following epinephrine and endoscopic clips were applied in two cases. All but one of the patients did well in near and intermediate term follow-up (average followup period of 18 mo). One patient died of multi-organ failure during the same hospital stay. Average length hospital stay was 7 d.CONCLUSION: Community hospital gastroenterologists and endoscopists should be aware that Dieulafoy's lesions are an uncommon cause of upper GI bleeding among elderly patients. Early accurate diagnosis through emergent endoscopy and endoscopic therapy, especially in patients with multiple co-morbid conditions, can be very effective and life

  3. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition.

    Science.gov (United States)

    Jeurnink, S M; Büchner, F L; Bueno-de-Mesquita, H B; Siersema, P D; Boshuizen, H C; Numans, M E; Dahm, C C; Overvad, K; Tjønneland, A; Roswall, N; Clavel-Chapelon, F; Boutron-Ruault, M C; Morois, S; Kaaks, R; Teucher, B; Boeing, H; Buijsse, B; Trichopoulou, A; Benetou, V; Zylis, D; Palli, D; Sieri, S; Vineis, P; Tumino, R; Panico, S; Ocké, M C; Peeters, P H M; Skeie, G; Brustad, M; Lund, E; Sánchez-Cantalejo, E; Navarro, C; Amiano, P; Ardanaz, E; Ramón Quirós, J; Hallmans, G; Johansson, I; Lindkvist, B; Regnér, S; Khaw, K T; Wareham, N; Key, T J; Slimani, N; Norat, T; Vergnaud, A C; Romaguera, D; Gonzalez, C A

    2012-09-15

    Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79-0.97 and 0.76; 95% CI 0.62-0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.

  4. An analysis of the physiological FDG uptake in the stomach with the water gastric distention method

    Energy Technology Data Exchange (ETDEWEB)

    Kamimura, Kiyohisa [Fujimoto Hayasuzu Hospital, Department of Radiology, Miyazaki (Japan); Kagoshima University Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Fujita, Seigo; Yano, Tatsuhiko; Ogita, Mikio; Umemura, Yoshiro; Fujimoto, Toshiro [Fujimoto Hayasuzu Hospital, Department of Radiology, Miyazaki (Japan); Nishii, Ryuichi; Wakamatsu, Hideyuki; Nagamachi, Shigeki [Miyazaki Medical College, Department of Radiology, Miyazaki (Japan); Nakajo, Masayuki [Kagoshima University Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan)

    2007-11-15

    Physiological FDG uptake in the stomach is a common phenomenon, especially noted at the cardia. Water intake just before scanning will result in gastric distention and thinning of the gastric wall, which in turn may lead to a reduction in the physiological uptake in the gastric wall. In the current study, we investigated whether gastric distention by water intake just before PET imaging reduces physiological FDG uptake in the stomach. The patient population comprised 60 patients who underwent whole-body FDG-PET imaging for cancer screening following gastroscopy performed within the preceding week. All patients took 400 ml of water for hydration and were administered 185 MBq of FDG intravenously. The patients were randomly divided into two groups: a group with additional water intake (AW group; n = 30) and a group without additional water intake (NW group; n = 30). In the AW group, an additional 400 ml of water was given just before PET imaging. For quantitative analysis, the stomach was classified into three areas [upper (U), middle (M) and lower (L)], and the degree of FDG uptake in each area was evaluated using standardised uptake values (SUVs). In the NW group, the mean SUVs in the U, M and L areas were 2.41 {+-} 0.75, 2.28 {+-} 0.73 and 1.61 {+-} 0.89, respectively, while in the AW group they were 1.82 {+-} 0.66, 1.73 {+-} 0.56 and 1.48 {+-} 0.49, respectively, and 2.21 {+-} 0.38 in the oesophago-gastric junction. The mean SUVs in the U and M areas in the AW group were significantly lower than those in the NW group (p < 0.05). Additional water intake just before PET imaging is an effective method for suppressing physiological FDG uptake in the stomach. (orig.)

  5. 经口内镜下肌切开术治疗25例贲门失弛缓症围手术期护理

    Institute of Scientific and Technical Information of China (English)

    袁媛

    2015-01-01

    目的::探讨经口内镜下肌切开术治疗贲门失弛缓症的临床护理方法。方法:对2013年1月-2014年11月确诊为贲门失弛缓症(AC)并接受 POEM治疗护理进行回顾性分析。结果:25例患者均成功行POEM治疗。其中3例术中少许渗血,经内镜下电凝止血,出血停止;1例出现胸前区皮下气肿,3-4天后气肿消退。结论:POEM治疗AC 短期疗效肯定,可以迅速缓解患者吞咽困难,但其长期疗效及远期并发症仍有待随访观察,而围手术期的护理,有助于减少术后并发症的发生。%Objective:To investigate the clinical nursing method of peroral endoscopic myotomy for achalasia.Methods:from 2013 January -2014 year in March confirmed the diagnosis of achalasia of the cardia (AC)and received POEM treatment were retrospectively analyzed.Results:5 paG tients were successfully treated with POEM.Among them a little in 3 cases,bleeding,endoscopic eG lectric coagulation hemostasis,stop bleeding;1 cases chest subcutaneous emphysema emphysema subsided,3-4 days.Conclusion:OEM treatment must AC short-term curative effect,can rapidly reG lieve dysphagia in patients,but its long-term efficacy and complications remains to be observed,and nursing in the peri operation period,help to reduce the incidence of postoperative complications.

  6. Nonconstrictive epicarditis mimicking a cardiac mass in a 71-year-old Caucasian man: a case report and review of the literature

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    Margolis Asa M

    2009-01-01

    Full Text Available Abstract Introduction Isolated cases of epicarditis are rare. Thus far, all have occurred with constrictive physiology as most cases involve both parietal and visceral pericardium. We report the first case of asymptomatic epicarditis that involved only the visceral pericardium presenting without constrictive physiology. Case presentation A 71-year-old male with a history of atrial fibrillation, coronary artery disease, pericardial effusion, type-2 diabetes and hypothyroidism presented with 5 weeks of fatigue and 1 day of dizziness. Physical examination was significant for pallor and tachycardia. Laboratory analysis revealed a hemoglobin count of 7.2 g/dl and iron deficiency anemia. The patient was transfused and evaluated by endoscopic ultrasound. A polypoid mass in the gastric cardia was found and later diagnosed as gastric adenocarcinoma (staged as T1N0M0. The pericardial effusion was evaluated with transthoracic echocardiography which showed a 2.0 × 2.7 cm mass associated with the right atrium. Transesophageal echocardiography confirmed the mass but did not reveal constrictive physiology. Whole-body contrast computed tomography failed to demonstrate metastatic disease. Biopsy of the cardiac mass revealed epicarditis without parietal pericardium involvement. Partial gastrectomy was performed to remove the gastric adenocarcinoma. Conclusion This is the first reported case of asymptomatic epicarditis. Our case was especially unusual because the epicarditis presented as an incidental cardiac mass. The clinical picture was complicated due to the concomitant presence of gastric adenocarcinoma and chronic pericardial effusion. This case demonstrates that epicarditis should be considered in the differential diagnosis of cardiac masses.

  7. A novel genetic polymorphism of inducible nitric oxide synthase is associated with an increased risk of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jing Shen; Run-Tian Wang; Li-Wei Wang; Yao-Chu Xu; Xin-Ru Wang

    2004-01-01

    AIM: Inducible nitric oxide synthase (iNOS) plays a central role in the pathway of reactive oxygen and nitrogen species metabolism when Helicobacter pylori ( H pylori) infection occurs in humans. iNOS Ser608 Leu allele, a novel genetic polymorphism (C/T) occurring within exon 16 of the iNOS reductase domain, may have a dramatic effect on the enzymatic activity. The aim of this study was to determine whether iNOS C/T polymorphism was associated with increased susceptibility to gastric cancer.METHODS: We conducted a population based case-control study in a high gastric cancer incidence area, Yangzhong,China. Questionnaires from 93 patients with intestinal type gastric cancer (IGC), 50 with gastric cardia cancer (GCC)and 246 healthy controls were obtained between 1997 and1998, and iNOS genotyping was carried out. Odds ratios(ORs), interaction index (γ), and 95% confidence intervals for the combined effects of iNOS genotype and H pylori infection, cigarette smoking or alcohol drinking were estimated.RESULTS: The frequency of (CT+TT) genotypes was higher in cases than in control group (24.48% vs23.17%), but the difference was not statistically significant. After adjusting for age and gender, past cigarette smokers with (CT+TT)genotypes had a significantly increased risk of IGC (OR = 3.62,95% CI: 1.23-10.64), while past alcohol drinkers with(CT+TT) genotypes had a significantly increased risk of GCC (OR = 3.33, 95% CI: 1.14-9.67).H pylori CagA negative subjects with (CT+TT) genotypes had a significantly increased risk of both IGC and GCC (OR = 2.19 and 3.52, respectively).CONCLUSION: iNOS Ser608Leu allele may be a potential determinant of susceptibility to cigarette -alcohol induced gastric cancer, but larger studies are needed to confirm the observations.

  8. BENEFICIAL EFFECTS OF CAPTOPRIL ON PROGNOSIS IN ELDERLY PATIENTSWITH ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    蔡煦; 沈卫峰; 李明洲; 龚兰生

    1998-01-01

    This study sought to investigate the effects of early and long-term intervention with angiotensin-converting enzyme(ACE) inhibitor captopril on the elderly patients with acute myocardial infarction(AMI), and observe its in-hospitsl and post-hospital outcomes during serial follow-up of 54 months. Methods. 631 elderly patients(60~75 years old) with AMI and without cardioganie shock were hospitalized within 72 hours of symptoms and were randondy allocated to captopril (n= 361; treatment group) and conventional treatment (n=270,contro1 group), The survival and cardiac events(congestive heart failure, reinfarction, severe arthythmias and cardiac death)of each group were determined during hospitalization and follow-up. Results. During hospitalization, the survival was higher in treatment group than in control group(P<0. 0001). On the other hand, in treatment group lower mortality was true for patients with anterior myocardial infarction(P= 0. 001 ) or with anterior+inferior myocardial infarction(P= 0. 026), but not statistically significant in ones with inferior myocardial infarction(P= 0. 061). During follow-up, the occurrence of cardiae death, heart failure, reinfaretion and severe arrhythmiss were lower in treatment group(P=0.0001, P=0.05, P=0. 0004 and P=0.027). So higher survival(P= 0.005) and lower total cardiac events(P=0. 0008) could be seen in treatment group over this period. Conclusions. Early and long-term treatment with captopril in the elderly patients with AMI has beneficial outcomes in both in-hospital and follow-up periods,

  9. Combination therapy with brentuximab vedotin and cisplatin/cytarabine in a patient with primarily refractory anaplastic lymphoma kinase positive anaplastic large cell lymphoma

    Directory of Open Access Journals (Sweden)

    Heidegger S

    2014-06-01

    Full Text Available Simon Heidegger,1 Ambros Beer,2 Eva Geissinger,3 Andreas Rosenwald,3 Christian Peschel,1 Ingo Ringshausen,1 Ulrich Keller11III Medical Department, 2Nuclear Medicine Department, Technische Universität München, Munich, Germany; 3Institute of Pathology, University of Würzburg, Würzburg, GermanyAbstract: Anaplastic large cell lymphoma (ALCL is a common subtype of the heterogeneous group of peripheral T-cell lymphomas, which is characterized by large pleomorphic cells with strong expression of CD30. Translocations involving ALK, the anaplastic lymphoma kinase gene, are associated with a favorable clinical outcome. Such ALK-positive ALCLs are usually responsive to a multidrug chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone. However, there is no general consensus on the optimal therapy for relapsed or refractory ALCL. We report the case of a 24-year-old male suffering from ALK-positive ALCL with an uncommon manifestation of only extranodal disease in the gastric cardia region that showed primary refractoriness to standard CHOP chemotherapy. A combination therapy consisting of the anti-CD30 drug conjugate, brentuximab vedotin, and classical lymphoma salvage regimen DHAP (cisplatin, high-dose cytarabine and dexamethasone was administered. Following two treatment cycles in 21-day intervals, the lymphoma showed considerable regression based on imaging diagnostics and no evidence of vital lymphoma in a subsequent biopsy. We did not observe any increase in toxicity; in particular, polyneuropathy and febrile neutropenia were not observed. In summary, we report that the antibody-drug conjugate brentuximab vedotin and a classical regimen used for aggressive lymphoma, DHAP, could be combined as salvage therapy in a case of refractory ALK-positive ALCL. Phase I/II studies will be required for safety and efficacy analysis.Keywords: anaplastic large cell lymphoma (ALCL, refractory/relapsed lymphoma, anti-CD30 drug conjugate, DHAP

  10. Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study.

    Science.gov (United States)

    Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Goldbohm, R Alexandra; Keszei, András P; Peters, Susan; Kauppinen, Timo; Kromhout, Hans; van den Brandt, Piet A

    2014-10-15

    The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n = 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariable-adjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer.

  11. Cancer Incidence and Mortality in Ardabil: Report of an Ongoing Population-Based Cancer Registry in Iran, 2004-2006

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    M Babaei

    2009-12-01

    Full Text Available "nBackground: Ardabil cancer registry is the first population-based cancer registry in Iran that was established in 2000. The first report from this registry revealed that Ardabil has one of the highest rate of gastric cardia cancer and the lowest rate of cer­vical cancer in the world. We aim to update the cancer incidence in this area by the second follow up report from this registry."nMethod: Data on all newly diagnosed cancer cases between 2004 and 2006 were actively collected. CanReg4 software was used for data entry and the data of cancer-related death were obtained from the comprehensive death registry system."nResults: More than 4300 new cases were registered during 3 years. Diagnosis of cancer was based on histopathology in 69%, clinical investigation 8%, clinical only 5%, and Death Certificate Only (DCO in 18% of cases. In terms of age-stan­dardized rate (/100,000, the five leading cancers in men (excluding skin cancer were stomach (51.8, esophagus (19.5, blad­der (13.1, lung and bronchus (10.8, and colorectal (9.6; in women, they were stomach (24.9, esophagus (19.7, breast (11.9, colon and rectum (7.4, and brain tumors (6.9. According to death registration data, upper gastrointestinal can­cers constituted more than 43% of cancer-related death in Ardabil."nConclusions: The ASR for gastric cancer is among the highest rate for this cancer in male and female in the world. Most of the cancers, especially in female, have a significant increase compared to previous report from Ardabil. This is most likely due to the change in the registration practice.  

  12. Metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico: prevalência e aspectos clínico-epidemiológicos Specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease: prevalence and clinical-demographic features

    Directory of Open Access Journals (Sweden)

    Leiber C. Caum

    2003-12-01

    , esofagite mais intensa e sem associação com tabaco ou álcool.BACKGROUND: Specialized intestinal metaplasia can be categorized according endoscopic and histological findings in long segment Barrett, short segment Barrett and specialized intestinal metaplasia of cardia. Barrett's esophagus is an acquired disease that is found in about 10%-13% of patients undergoing endoscopy for symptoms of gastroesophageal reflux disease and it is well established as predisposing to esophageal adenocarcinoma. The columnar epithelium with goblet cells replaces the normal squamous epithelium. OBJECTIVE: To determine the prevalence and clinical-demographic characteristics of specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease. METHODS: From April to October 2002, 402 patients referred to upper endoscopy due gastroesophageal reflux disease were evaluated through of a symptom questionnaire about clinical and demographic features and submitted to upper endoscopy with four-quadrant biopsies 1 cm below escamocolumnar junction. RESULTS: Eighteen point four percent of patients had specialized intestinal metaplasia, 0.5% long segment Barrett esophagus, 3.2% short segment Barrett's esophagus and 14.7% specialized intestinal metaplasia of cardia. Patients with Barrett's esophagus showed a tendency to be male and specialized metaplasia of cardia to be female. All patients with Barrett's esophagus were white. There was not association between symptoms of gastroesophageal reflux disease and specialized intestinal metaplasia, but patients with Barrett's esophagus showed a tendency to have symptoms over 5 years and had more hiatal hernia and esophagitis. The use of alcohol and tobacco was not related to the presence of specialized intestinal metaplasia. CONCLUSIONS: Barrett's esophagus was more related to the male gender, gastroesophageal reflux disease symptoms for 5 years or longer, more intense esophagitis and hiatal hernia, but was not related to the use of

  13. Prevalence of Helicobacter pylori infection and intestinal metaplasia in subjects who had undergone surgery for gastric adenocarcinoma in Northwest Italy

    Institute of Scientific and Technical Information of China (English)

    Giorgio Palestro; Donata Campra; Miguel Angel Cutufia; Elena Margaria; Giancarlo Spinzi; Aldo Ferrara; Giorgio Marenco; Mario Rizzetto; Antonio Ponzetto; Rinaldo Pellicano; Gian Ruggero Fronda; Guido Valente; Marco De Giuli; Tito Soldati; Agostino Pugliese; Stefano Taraglio; Mauro Garino

    2005-01-01

    AIM: To investigate the seroprevalence of Helicobacter pylori(H pylorri) infection and its more virulent strains as well as the correlation with the histologic features among patients who had undergone surgery for gastric cancer (GC).METHODS: Samples from 317 (184 males, 133females, mean age 69±3.4 years) consecutive patients who had undergone surgery for gastric non-cardia adenocarcinoma were included in the study. Five hundred and fifty-five (294 males, 261 females, mean age 57.3±4.1 years) patients consecutively admitted to the Emergency Care Unit served as control. Histological examination of tumor, lymph nodes and other tissues obtained at the time of surgery represented the diagnostic "gold standard". An enzyme immunosorbent assay was used to detect serum anti-H pylori(IgG)antibodies and Western blotting technique was utilized to search for anti-CagA protein (IgG).RESULTS: Two hundred and sixty-one of three hundred and seventeen (82.3%) GC patients and 314/555 (56.5%)controls were seropositive for anti-H pylori (P<0.0001;OR, 3.58; 95%CI, 2.53-5.07). Out of the 317 cases, 267(84.2%) were seropositive for anti-CagA antibody vs 100 out of 555 (18%) controls (P<0.0001; OR, 24.30;95%CI, 16.5-35.9). There was no difference between the frequency of H pyloriin intestinal type carcinoma (76.2%) and diffuse type cancer (78.8%). Intestinal metaplasia (IM) was more frequent but not significant in the intestinal type cancer (83.4% vs 75.2% in diffuse type and 72.5% in mixed type). Among the patients examined for IM, 39.8% had IM type Ⅰ, 8.3% type Ⅱ and 51.9% type Ⅲ (type Ⅲ vs others, P = 0.4).CONCLUSION; This study confirms a high seroprevalence of H pyloriinfection in patients suffering from gastric adenocarcinoma and provides further evidence that searching for CagA status over H pylori infection might confer additional benefit in identifying populations at greater risk for this tumor.

  14. Acalasia: estudio de 27 casos en el Hospital Calderón Guardia

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    José A. Mainieri-Hidalgo

    2003-03-01

    Full Text Available Se estudiaron en forma retrospectiva los expedientes clínicos de 27 pacientes diagnosticados con acalasia en el Hospital Dr. R. A. Calderón Guardia (HCG vistos durante el período de 11 años comprendido entre 1991 y 2001, encontrando una tasa de 0.3 por 100.000 habitantes la cual es menor que la informada en la literatura. Esto posiblemente debido a que la ausencia en nuestro medio de manometría esofágica dificulta el diagnóstico de pacientes en estadio temprano o con enfermedad leve o moderada. La presentación clínica fue muy similar a la reportada por otros autores con una relación hombre mujer de 1.7 a 1 y edad promedio de 42 años. Los síntomas con un promedio de evolución de 7 años, fueron el más frecuente, la disfagia que se presentó en todos los casos, seguida de vómito, dolor torácico, pérdida de peso y datos de reflujo gastroesofágico. La esofagoscopía y la esofagografía mostraron hallazgos de enfermedad avanzada como dilatación esofágica importante, retención de restos alimentarios y cardias con espasmo que se superó fácilmente al presionar con el endoscopio. El tratamiento que se administró fue solamente médico (Nifedipina o Isorbide a 6 pacientes, dilataciones y tratamiento médico a 7 y quirúrgico (esofagomiotomía a 14, a tres de estos se les agregó un procedimiento anti-reflujo. La evolución se valoró con base en datos clínicos, encontrando que todos los pacientes con tratamiento médico y dilataciones continúan sintomáticos y con tratamiento. De los operados hay uno que ha requerido dilataciones 5 y 9 años después de la intervención, dos que no tuvieron procedimiento anti-reflujo, están en tratamiento por este problema y el resto se encuentran asintomáticos sin que se presentaran complicaciones quirúrgicas.

  15. Epidemiology of Helicobacter pylori and gastric cancer.

    Science.gov (United States)

    Kikuchi, Shogo

    2002-01-01

    Findings in epidemiological studies of the relationship between Helicobacter pylori and gastric cancer have been inconsistent: many studies have yielded a positive relationship, whereas several studies have shown no relationship. The inconsistency arises because of the occurrence of seroreversion during the period between the time that H. pylori exerts a carcinogenic effect and the time of blood sampling. When this seroreversion is taken into account, there is an epidemiologically positive association between H. pylori status and the risk for gastric cancer. In addition to the epidemiological evidence, experimental studies using Mongolian gerbils have shown that H. pylori infection elevates the risk for gastric cancer. It is concluded that H. pylori is a causal factor for gastric cancer. In the creation of preventive strategies against gastric cancer by the eradication of H. pylori, determination of the time at which H. pylori plays a role as a carcinogen is important. Three hypotheses have been proposed in regard to this timing: that H. pylori infection in childhood or the teenage years acts as a factor that produces precancerous lesions with irreversible damage in the gastric mucosa, that in adulthood it acts as an initiator, and also in adulthood, that it acts as a promoter. As these hypotheses are not mutually exclusive, the extent to which each hypothesis plays a part in explaining gastric carcinogenesis should be evaluated. Only a small proportion of subjects infected with H. pylori have gastric cancer during their lifetime. Interleukin-1 polymorphism, a host factor, and CagA, a virulence factor of H. pylori, are suspected to be risk factors for gastric cancer in subjects with H. pylori infection. Dietary factors, especially vitamin C, and patterns of precancerous lesions also seem to influence the relationship between H. pylori and gastric cancer. H. pylori seems to reduce the risk for esophageal and for some gastric cardia adenocarcinomas. This finding, as

  16. Obesity and diabetes epidemics: cancer repercussions.

    Science.gov (United States)

    Hjartåker, Anette; Langseth, Hilde; Weiderpass, Elisabete

    2008-01-01

    The prevalence of overweight (body mass index, BMI, between 25 and 30 kg/m2) and obesity (BMI of 30 kg/m2 or higher) is increasing rapidly worldwide, especially in developing countries and countries undergoing economic transition to a market economy. One consequence of obesity is an increased risk of developing type II diabetes. Overall, there is considerable evidence that overweight and obesity are associated with risk for some of the most common cancers. There is convincing evidence of a positive association between overweight/obesity and risk for adenocarcinoma of the oesophagus and the gastric cardia, colorectal cancer, postmenopausal breast cancer, endometrial cancer and kidney cancer (renal-cell). Premenopausal breast cancer seems to be inversely related to obesity. For all other cancer sites the evidence of an association between overweight/obesity and cancer is inadequate, although there are studies suggesting an increased risk of cancers of the liver, gallbladder, pancreas, thyroid gland and in lymphoid and haematopoietic tissue. Far less is known about the association between diabetes mellitus type I (also called insulin dependent diabetes mellitus or juvenile diabetes), type II diabetes (called non-insulin dependent diabetes mellitus or adult onset diabetes mellitus) and cancer risk. The most common type of diabetes mellitus, type II, seems to be associated with liver and pancreas cancer and probably with colorectal cancer. Some studies suggest an association with endometrial and postmenopausal breast cancer. Studies reporting on the association between type I diabetes mellitus, which is relatively rare in most populations and cancer risk are scanty, but suggest a possible association with endometrial cancer. Overweight and obesity, as well as type II diabetes mellitus are largely preventable through changes in lifestyle. The fundamental causes of the obesity epidemic-and consequently the diabetes type II epidemic-are societal, resulting from an

  17. Genetic association of gastric cancer with miRNA clusters including the cancer-related genes MIR29, MIR25, MIR93 and MIR106: results from the EPIC-EURGAST study.

    Science.gov (United States)

    Espinosa-Parrilla, Yolanda; Muñoz, Xavier; Bonet, Catalina; Garcia, Nadia; Venceslá, Adoración; Yiannakouris, Nikos; Naccarati, Alessio; Sieri, Sabina; Panico, Salvatore; Huerta, José M; Barricarte, Aurelio; Menéndez, Virginia; Sánchez-Cantalejo, Emilio; Dorronsoro, Miren; Brennan, Paul; Duarte-Salles, Talita; B As Bueno-de-Mesquita, H; Weiderpass, Elisabete; Lund, Eiliv; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Racine, Antoine; Numans, Mattijs E; Tumino, Rosario; Canzian, Federico; Campa, Daniele; Sund, Malin; Johansson, Mattias; Ohlsson, Bodil; Lindkvist, Björn; Overvad, Kim; Tjønneland, Anne; Palli, Domenico; Travis, Ruth C; Khaw, Kay-Tee; Wareham, Nick; Boeing, Heiner; Nesi, Gabriella; Riboli, Elio; Gonzalez, Carlos A; Sala, Núria

    2014-11-01

    MicroRNAs (miRNAs) are post-transcriptional gene regulators involved in a wide range of biological processes including tumorigenesis. Deregulation of miRNA pathways has been associated with cancer but the contribution of their genetic variability to this disorder is poorly known. We analyzed the genetic association of gastric cancer (GC) and its anatomical and histological subtypes, with 133 single-nucleotide polymorphisms (SNPs) tagging 15 isolated miRNAs and 24 miRNA clusters potentially involved in cancer, in 365 GC cases and 1,284 matched controls within the European Prospective Investigation into Cancer and Nutrition cohort. Various SNPs were associated with GC under the log-additive model. Furthermore, several of these miRNAs passed the gene-based permutation test when analyzed according to GC subtypes: three tagSNPs of the miR-29a/miR-29b-1 cluster were associated with diffuse subtype (minimum p-value = 1.7 × 10(-4) ; odds ratio, OR = 1.72; 95% confidence interval, CI = 1.30-2.28), two tagSNPs of the miR-25/miR-93/miR-106b cluster were associated with cardia GC (minimum p-value = 5.38 × 10(-3) ; OR = 0.56, 95% CI = 0.37-0.86) and one tagSNP of the miR-363/miR-92a-2/miR-19b-2/miR-20b/miR-18b/miR-106a cluster was associated with noncardia GC (minimum p-value = 5.40 × 10(-3) ; OR = 1.41, 95% CI = 1.12-1.78). Some functionally validated target genes of these miRNAs are implicated in cancer-related processes such as methylation (DNMT3A, DNMT3B), cell cycle (E2F1, CDKN1A, CDKN1C), apoptosis (BCL2L11, MCL1), angiogenesis (VEGFA) and progression (PIK3R1, MYCN). Furthermore, we identified genetic interactions between variants tagging these miRNAs and variants in their validated target genes. Deregulation of the expression of these miRNAs in GC also supports our findings, altogether suggesting for the fist time that genetic variation in MIR29, MIR25, MIR93 and MIR106b may have a critical role in genetic susceptibility to GC and

  18. A Recurrent Case of Pentalogy of Cantrell: A Rare Case with Sonological Findings and Review of Literature

    Science.gov (United States)

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Prathyusha, Ivvala Sai; Gautam, Munnangi Satya; Raidu, Deepthi; Amogh, V.N.

    2017-01-01

    Summary Background Pentalogy of Cantrell (POC) is an extremely rare and complex congenital anomaly. Ultrasound is a valuable, safe, nonionizing, cost effective, widely available, and easily reproducible imaging tool and is indispensible in the diagnosis of POC. Despite the rarity of POC, it is imperative for a radiologist to be aware of its wide spectrum of presentation on ultrasound in first trimester of gestation. Most reported cases in literature till now have been sporadic. In this paper, we aimed to report for the first time in literature, a recurrent case of POC detected in the first trimester in a mother whose previous pregnancy also was terminated in the second trimester medically due to the ultrasound diagnosis of POC. We also discuss the role of ultrasound and other imaging modalities in a case of POC as well as the differential diagnoses which can mimic POC. Case Report A 23-year-old G2P0A1 (Gravida2, para0, abortion1) woman with a gestational age of around 12 weeks was referred for a routine first trimester ultrasound scan. The antenatal ultrasound scan showed a single, live, intrauterine gestation corresponding to a gestational age of 11 weeks and 5 days. The fetal heart was visualized outside the chest through a defect in the lower sternum in association with anterior diaphragmatic and ventral abdominal wall defects suggestive of thoraco-abdominal variety of ectopia cardis. There was a membrane covered, midline, abdominal wall defect at the base of the umbilical cord insertion containing the herniated abdominal organs including the liver, bowel loops and the ectopic cardia. There was a breach in the normal outline of the lower sternum indicating a sternal deficiency. The fetal pericardium was absent. The nuchal translucency was grossly increased. Pentalogy of Cantrell was diagnosed on ultrasound and the patient was explained about the poor prognosis of this condition. An informed consent was obtained after she opted for medical termination of

  19. CARDIOVASCULAR RISK FACTORS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

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    Z ABDEYASDAN

    2003-12-01

    Full Text Available Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. So the present study was planned with the goals to determine and compare the cardia-vascular risk factors in the diabetic children with type 1 of diabetes mellitus. Method: This was an analytic, cross sectional study that has been done in two groups (case-control. In this research, 148 children, suffering from the typel diabetes mellitus being supported by the metabolism and endocrine research center, were chosen in the continues case manner and for the control group, 148 children, matched with the study group (according to the age and the sex, at 6-18 years old from the schools in Isfahan city randomly and at 2-6 years from the neiborhoods of the case group. The data-gathering tool was the questionnaires includes lipid profile, blood pressure, weight and height. To analyze the data we used the analytic (t student and logistic regression and descriptive (mean and standard deviation statistic methods and SPSS. Results: Findings revealed that the means of Lipid profile, systolic blood pressure and body mass index had not statistically significant differences in the two groups. But the mean of diastolic blood pressure and the mean arterial blood pressure in the control group were more than the case group and this difference was significant. The mean, 75 and 95 percentiles for cholesterol and LDL in all the age groups, mean, 75 and 95 percentile for triglyceride in all the age groups except the age group of 1-4 years in the diabetic and non diabetic groups were

  20. Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

    Institute of Scientific and Technical Information of China (English)

    Rasim Gencosmanoglu; Ebru Sen-Oran; Ozlem Kurtkaya-Yapicier; Erol Avsar; Aydin Sav; Nurdan Tozun

    2003-01-01

    AIM: To analyze gastric polypoid lesions in our patientpopulation with respect to histopathologic features and demographic, clinical, and endoscopic characteristics of patients.METHODS: Clinical records and histopathologic reports of patients with gastric polypoid lesions were analyzed retrospectively. All lesions had been totally removed by either endoscopic polypectomy or hot biopsy forceps. The histopathologic slides were re-evaluated by the same histopathologist.RESULTS: One-hundred and fifty gastric polypoid lesions were identified in 91 patients. There were 53 (58%) women and 38 (42%) men with a median age of 53 (range, 31 to 82) years. The most frequent presenting symptom was dyspepsia that was observed in 35 (38.5%) patients.Symptoms were mostly related to various associated gastric abnormalities such as chronic gastritis or H pylori infection rather than polypoid lesion itself. Polypoid lesions were commonly located in the antrum followed by cardia. Out of 150 lesions, 80 (53%) had the largest dimensions less than or equal to 5 mm and only 7 were pedunculated. The frequencies of hyperplastic polyps, foveolar hyperplasia, and fundic gland polyps were 46%, 18%, and 14% respectively.We also detected gastritis varioliformis in 12 specimens,lymphoid follicles in 9, 4 adenomatous polyps in 4, polypoid lesions with edematous mucosa in 4, inflammatory polyps in 3, and carcinoid tumor in 1. Adenomatous changes were observed within two hyperplastic polyps and low grade dysplasia in one adenoma. Histopathologic evaluation of the surrounding gastric mucosa demonstrated chronic gastritis in 72 (79%) patients and H pylori infection in 45 (49%).CONCLUSION: Hyperplastic polyps are the most frequently encountered subtype of gastric polypoid lesions. They are usually associated with chronic gastritis or H pylori gastritis. Contrary to the previous belief, they may harbour adenomatous changes or dysplastic foci.Therefore, endoscopic polypectomy seems as a safe and fast

  1. 食管胃结合部腺癌流行趋势、病因及防治%Adenocarcinoma of the esophagogastric junction:epidemic trends, causes, prevention and therapy

    Institute of Scientific and Technical Information of China (English)

    陈志峰

    2012-01-01

    Population epidemiology analysis of esophageal cancer for the high risk region in China finds that: incidence of esophageal squamous cell carcinoma has decreased and that of adenocarcinoma of the esophagogastric junction(AEG) has increased significantly. European and American scholars believe that obesity and stomach-esophageal reflux disease are independent risk factors of the two types of cancer. In the high risk region of esophageal cancer in China, the heritability is (29.67±4.32)% and the segregation ratio is 0.181, 95% CI (0.15-0.21). Esophageal cancer belongs to multi-gene genetic disease. According to the evolution of the pathological mechanism of gastric cardia adenocarcinoma and the WHO's clinical treatment principles, cardiac severe atypicalhyperplasia were mainly endoscopic resection in the high riskregion in China. Paying attention to the intervention ofatrophic gastritis or active gastritis may be the realisticmeasures to reduce intestinal metaplasia and the incidence ofAEG.%国内食管癌高发区人群流行病学分析发现:食管鳞癌发病率下降;食管胃结合部腺癌(AEG)发病率显著上升.欧美学者认为,肥胖和胃食管反流性疾病是这两类肿瘤的独立危险因素.我国食管癌高发区的遗传度为(29.67±4.32)%,分离比0.181,95%CI:0.15~0.21,属于多基因遗传病.根据AEG的病理演变机理和WHO的临床处理原则,目前食管癌高发区对贲门重度不典型增生者主要采用内镜下切除;而重视萎缩性或活动性胃炎的干预治疗,对降低肠化,减少AEG的发病也可能是比较现实的措施之一.

  2. Los estudios longitudinales en la prevención de las enfermedades cardiovasculares

    Directory of Open Access Journals (Sweden)

    Ignacio Balaguer Vintró

    2004-01-01

    Full Text Available Los estudios longitudinales de cohortes bien definidas han contribuido a la identificación de los factores de riesgo de la cardiopatía coronaria y otras complicaciones clínicas de la aterosclerosis. Después de comentar las conclusiones de los estudios de la aterosclerosis experimental y los factores de riesgo sugeridos por el estudio de una serie de infartos de miocardio en adultos jóvenes en comparación con controles apareados, se expone la metodología, el desarrollo y los resultados de los estudios longitudinales realizados en Estados Unidos desde 1949: Twin Cities, Framingham, Pooling Project, Western Collaborative, Puerto Rico, Evans County, NI-HONSAN, San Francisco, Harvard, Bogalusa y CARDIA. Se presta especial atención a las hipótesis propuestas al inicio del estudio de Framingham y a los obstáculos y cambios para continuar el proyecto después de los primeros veinticuatro años. A continuación se expone el Seven Countries Study, ideado y dirigido por Ancel Keys y primer estudio realizado con metodología centralizada en varios países, y los estudios longitudinales realizados en diversos países de Europa: Whitehall, Manresa, París, British Regional, Northwick Park, Caerphilly, Speedwell, PROCAM. Se analiza el papel de los estudios longitudinales en la metodología de los estudios posteriores: hijos e hijas de los participantes en Framingham, estudios longitudinales basados en cuestionarios, estudios de otros posibles factores de riesgo, prevalencia de factores de riesgo en estudios retrospectivos, ensayos de intervención primaria (MRFT, WHO European Collaborative Trial y el de Goteburgo y la participación de los equipos entrenados en el Proyecto MONICA. Se señalan los temas todavía en debate en relación con la metodología y los resultados de los estudios longitudinales: exámenes periódicos de los participantes en las cohortes de los estudios epidemiológicos, cambios en la definición de nuevos casos de accidentes

  3. Prevalence of left ventricular dyssynchrony in patients with heart failure assessed by a novel programmer-cardioGRAF

    Institute of Scientific and Technical Information of China (English)

    Can-Zhan Zhu; Naoto Takahashi; Akira Yamamoto; Masahira Ishikawa; Naomi Kawaguchi; Takahiro Uchida; Kazuo Munakata

    2009-01-01

    Objectives Left ventricular systolic dyssynchrony is the most important determinant of response to cardiac resynchronization therapy (CRT), playing a vital role to predict improvement of systolic function or LV reverse remodeling. CardioGRAF is a novel programmer based on the ECG gated single photon emission computed tomography (G-SPECT) imaging to detect LV systolic and diastolic dyssynchrony simultaneously. This study was to investigate the prevalence of systolic and diastolic left ventricular (LV) dyssynchrony in patients with heart failure. Methods We retrospectively studied 69 patients with heart disease, including 31 patients who had symptoms of heart failure (NYHA class Ⅱ-Ⅲ), and 38 patients who had no symptoms of heart failure (NYHA class Ⅰ). G-SPECT data were analyzed by cardiaGRAF, and measurements included the time to end systole (TES), the time to peak ejection (TPE), the time to peak filling (TPF), TES+TPF and maximal difference (MD) of each parameters were obtained, using the 95th percentile of the control group as a cutoffof 150 ms for MD-TES, 139 ms for MD-TPE, 345 ms for MD-TPF and 315 ms for MD-TES+TPF. Results The prevalence of LV systolic dyssynchrony was significantly higher in heart failure patients with reduced LV ejection fraction (LVEF)<45% (72% for MD-TES; 64% for MD-TPE) compared with heart failure patients with preserved LVEF=45% (14% for both MD-TES and MD-TPE; P=0.002, P=0.005, respectively); The prevalence of MD-TES<150 ms was higher in NYHA class Ⅲ patients (64%) compared with NYHA class Ⅱ patients (27%, P=0.049). However, the prevalence of the LV diastolic dyssynchrony were high but not difference between NYHA class Ⅲ(47% for both MD-TPF and MD-TES+TPF) and class Ⅲ(63% for MD-TPF; 69% for MD-TES+TPF; P=NS) patients as well as between patients with preserved LVEF (43% for both MD-TPF and MD-TES+TPF) and patients with reduced LVEF(64% for MD-TPF; 72% for MD-TES+TPF; P=NS). Conclusions The prevalence of LV systolic

  4. [Transgastric laparo-endoscopic approach for difficult access lesions. Experimental mode].

    Science.gov (United States)

    Tapia-Vega, Marcel Adalid; Morales-Chávez, Carlos Ernesto; Aguirre-Olmedo, Itzé; Cuendis-Velázquez, Adolfo; Rojano-Rodríguez, Martín Edgardo; Cárdenas-Lailson, Luis Eduardo

    2014-01-01

    Antecedentes: las neoplasias gástricas pueden tratarse de forma segura y eficaz mediante laparoscopia. Debido a su localización algunas lesiones son inaccesibles mediante cirugía laparoscópica, como alternativa se propone el abordaje transgástrico. Objetivo: exponer los resultados con la aplicación de una técnica laparo-endoscópica en un modelo animal que mantenga funcional la anatomía, para resecar neoplasias gástricas de la pared posterior del estómago, próximas al cardias y a la región pre-pilórica. Material y métodos: el estudio se efectuó entre los meses de mayo a diciembre de 2011en el Hospital General Gea González y consistió en experimentar en 12 cerdos la técnica laparo-endoscópica para resección de neoplasias gástricas de la pared posterior. La inserción de los trócares intragástricos se realizó mediante endoscopia. Se efectuaron tres gastrotomías en la pared anterior y con visión endoscópica los trócares se introdujeron con el auxilio laparoscópico. El estómago se insufló con CO2. La lesión se resecó manteniendo un margen circunferencial de 20 mm, se suturaron las gastrotomías, se utilizaron la prueba de t de Student y la prueba exacta de Fisher para el análisis estadístico. Resultados: todas las resecciones fueron exitosas y se efectuaron en un tiempo promedio de 102.33 minutos (± 4.50), hubo dos complicaciones y ninguna defunción transoperatoria. Conclusiones: el abordaje laparoscópico transgástrico es factible y seguro para resecar neoplasias de la pared posterior del estómago, próximas a la unión esófago-gástrica y área prepilórica.

  5. Review on chemistry and pharmacology of Rabdosia rubescens%冬凌草的化学和药理作用研究

    Institute of Scientific and Technical Information of China (English)

    高世勇; 王珑

    2014-01-01

    To introduce the results of researching the chemical composition , pharmacological effects, anti-tumor mechanisms and clinical application of Rabdosia rubescens , this paper summarized the research on Rabdosia rubescens at home and abroad systematically by a lot of literature .It showed that Rabdosia rubescens contained some chemical compositions , inclu-ding terpenoids, alkaloids, steroids, flavonoids, volatile oils, amino acids, organic acids, monosaccharides , and has some pharmacological effects , such as anti-tumor, anti-inflamma-tory, immune-enhancing, anti-oxidation,anti-mutation and anti-hypertension.The anti-tumor mechanisms are shown as follows: repression of cell cycle , decrease of telomerase activity , inhibition of cell membrane sodium pump activity , inducing tumor cell apoptosis and reversal of multidrug resistance .In clinical , it has effect on esophageal cancer , gastric cardia canc-er, liver cancer , breast cancer and other cancers . This paper showed that Rabdosia rubescens has extensive pharmacological effects and good anticancer activity .%介绍冬凌草的化学成分、药理作用、抗肿瘤机制、临床应用等方面的研究成果。通过文献系统地介绍了国内外目前关于冬凌草的研究。研究发现冬凌草中含有萜类、生物碱、甾体、黄酮、挥发油、氨基酸、有机酸、单糖等化学成分,并具有抗肿瘤、抗菌消炎、免疫增强、抗氧化、抗突变、降压等药理作用,而其抗肿瘤机制包括阻遏细胞周期、下调端粒酶活性、抑制细胞膜钠泵活性、诱导肿瘤细胞凋亡、逆转多药耐药等,在临床上对食管癌、贲门癌、肝癌、乳腺癌等多种癌症均具有疗效。表明冬凌草具有广泛的药理作用和良好的抗癌活性。

  6. Risk factors of gastric cancer specific for tumor location and histology in Cali, Colombia

    Institute of Scientific and Technical Information of China (English)

    Francia Campos; Gabriel Carrasquilla; Chihaya Koriyama; Mauricio Serra; Edwin Carrascal; Tetsuhiko Itoh; Mitsuharu Nomoto; Suminori Akiba

    2006-01-01

    AIM: To examine histology- and tumor-location specific risk factors of gastric cancer (GC).METHODS: This was a case-control study. The study subjects were 216 GC patients newly diagnosed during the period 2000-2002 and 431 controls selected from non-cancer patients matching in age, gender, and hospital. We obtained information on lifestyles, dietary habits, and others by a questionnaire.RESULTS: The subjects who were not eldest among his/her siblings were at a slightly elevated GC risk (OR 1.3; 95% CI 0.8-2.0). Salting meals before tasting was related to an increased GC risk (OR 3.5; 95% CI 1.6-7.3). Frequent consumptions of fruits (OR 0.3; 95% CI 0.1-1.0) and vegetables (OR 0.3; 95% CI 0.1-1.0) were related to decreased GC risks. On the other hand, frying foods (OR 1.9; 95% CI 1.0-3.6) and cooking with coal (OR 1.8; 95% CI 1.3-2.6) were related to increased GC risks.Neither Lauren's histological classification (intestinal and diffuse types) nor tumor location significantly affected those associations except birth order. The subjects who were not eldest among his/her siblings had an increased risk of GCs in the distal and middle thirds, and their ORs were 1.7 (95% CI 1.0-2.8) and 1.9 (95% CI 0.8-4.3),respectively. The corresponding OR in the upper third stomach was 0.3 (95% CI 0.1-0.9). The differences of those three ORs were statistically significant (P = 0.010).CONCLUSION: The present study shows that birth order, salt intake, consumption of fruits and vegetables,the type of cooking, and cigarette smoking are related to GC risk. In histology and tumor-location specific analyses, non-eldest person among their siblings is related to an increased GC risk in the distal and middle thirds of the stomach, and is related to a decreased GC risk in the cardia.

  7. Immunohistochemical study on gastrointestinal endocrine cells of four reptiles

    Institute of Scientific and Technical Information of China (English)

    Xu-Gen Huang; Xiao-Bing Wu

    2005-01-01

    AIM: To darify the types, regional distributions and distribution densities as well as morphological features of gastrointestinal (GI) endocrine cells in various parts of the gastrointestinal track (GIT) of four reptiles, Gekko japonicus, Eumeces chinensis, Sphenomorphus indicus and Eumeces elegans.METHODS: Paraffin-embedded sections (5 μm) of seven parts (cardia, fundus, pylorus, duodenum, jejunum, ileum,rectum) of GIT dissected from the four reptiles were prepared. GI endocrine cells were revealed by using immunohistochemical techniques of streptavidin-peroxidase (S-P) method. Seven types of antisera against 5-hydroxytryptamine (5-HT), somatostatin (SS), gastrin (GAS),glucagon (GLU), substance P (SP), insulin and pancreatic polypeptide were identified and then GI endocrine cells were photomicrographed and counted.RESULTS: The GI endocrine system of four reptiles was a complex structure containing many endocrine cell types similar in morphology to those found in higher vertebrates.Five types of GI endocrine cells, namely 5-HT, SS, GAS,SP and GLU immunoreactive (IR) cells were identified in the GIT of G. japonicus, E. chinensis and S. indicus, while in the GIT of E. elegans only the former three types of endocrine cells were observed. No PP- and INS- IR cells were found in all four reptiles. 5-HT-IR cells, which were most commonly found in the pylorus or duodenum, distributed throughout the whole GIT of four reptiles. However, their distribution patterns varied from each other. SS-IR cells,which were mainly found in the stomach especially in the pylorus and/or fundus, were demonstrated in the whole GIT of E. chinensis, only showed restricted distribution in the other three species. GAS-IR cells, with a much restricted distribution, were mainly demonstrated in the pylorus and/or the proximal small intestine of four reptiles. GLU-IR cells exhibited a limited and species-dependent variant distribution in the GIT of four reptiles. SP-IR cells were found throughout the

  8. Esophagogastric pathology in morbid obese patient: preoperative diagnosis and influence in the selection of surgical technique

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    Sergio Estévez-Fernández

    2015-07-01

    Full Text Available Introduction: Given the difficulty in accessing to the excluded stomach after gastric bypass and the increase in gastroesophageal reflux after sleeve gastrectomy, it is justified to perform a preoperative fibrogastroscopy. The influence of the fibrogastroscopy (FGS findings in the therapeutic approach is analyzed. Patients and methods: A retrospective study of preoperative FGS findings is performed, from 04/06 to 12/12. The influence of the FGS results on the surgical technique selection, in the endoscopic or medical treatment and its relation to gastric fistula is analyzed by means of multivariate regression (confounding factors: Age, body mass index, arterial hypertension, diabetes mellitus, antiplatelet therapy, surgical technique (bariatric surgery, sleeve gastrectomy. Results: Three hundred thirty one patients are included: 32.6% biopsy of gastric lesion; 27% gastritis; 18.1% hiatal hernia; 3% metaplasia; 0.6% Barrett esophagus; 2.1% esophagitis; 0.3% dysplasia; 0.3 Schatzky's ring; 1.5% incompetent cardia; 2.4% duodenitis; 0.3% gastric erosions; 0.6% gastric xanthoma; 1.8%, gastric polyp; 1.6% duodenal ulcer; 0.6% papulo-erosive gastritis; 0.6% esophageal papilloma; 0.3% submucosal tumor. Helicobacter pylori+ 30.2% (triple therapy eradication in all patients. The FGS findings led to a variation in the surgical technique or to the completion of endoscopic treatment in 22.2% of cases. The gastric lesions did not influence the development of gastric fistula. Independent prognostic factors of fistula: Sleeve gastrectomy (7.9% vs. 2.7%; p = 0.02; OR: 1.38 IC95: 1.01-1.87 and the body mass index > 50 kg/m² (6.7% vs. 2.2%; p = 0.04; OR: 3.7 IC95: 1.12-12.4. Conclusions: The diagnosis of gastroesophageal disease through preoperative FGS motivated variations in the therapeutic approach in 52% of patients, so we consider essential to include the preoperative FGS in bariatric surgery.

  9. Sociodemographic differences in fast food price sensitivity

    Science.gov (United States)

    Meyer, Katie A.; Guilkey, David K.; Ng, Shu Wen; Duffey, Kiyah J.; Popkin, Barry M.; Kiefe, Catarina I.; Steffen, Lyn M.; Shikany, James M.; Gordon-Larsen, Penny

    2014-01-01

    Importance Fiscal food policies (e.g., taxation) are increasingly proposed to improve population-level health, but their impact on health disparities is unknown. Objective We estimated subgroup-specific effects of fast food price changes on fast food consumption and cardio-metabolic outcomes, hypothesizing inverse associations between fast food price with fast food consumption, BMI, and insulin resistance and stronger associations among blacks (vs. whites) and participants with relatively lower education or income. Design 20-year follow-up (5 exams) in a biracial U.S. prospective cohort: Coronary Artery Risk Development in Young Adults (CARDIA) (1985/86–2005/06, baseline n=5,115). Participants Aged 18–30 at baseline; designed for equal recruitment by race (black/white), educational attainment, age, and gender. Exposures Community-level price data from the Council for Community and Economic Research (C2ER) temporally- and geographically-linked to study participants’ home address at each exam. Main outcome and measures Participant-reported number of fast food eating occasions per week; BMI (kg/m2) from clinical assessment of weight and height; homeostatic model assessment insulin resistance (HOMA-IR) from fasting glucose and insulin. Covariates included individual- and community-level social and demographic factors. Results In repeated measures regression, multivariable-adjusted associations between fast food price and consumption were non-linear (quadratic, p<0.001), with significant inverse estimated effects on consumption at higher prices; estimates varied according to race (interaction term p=0.04), income (p=0.07), and education (p=0.03). For example, at the 10th percentile of price ($1.25/serving), blacks and whites had mean fast food consumption (times/week) of 2.2 (95% CI: 2.1–2.3) and 1.6 (1.5–1.7), respectively, while at the 90th percentile of price ($1.53/serving), respective mean consumption estimates were 1.9 (1.8–2.0) and 1.5 (1.4–1.6). We

  10. The NOD-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer: a case-control study and gene expression analyses.

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    Natalia Castaño-Rodríguez

    Full Text Available BACKGROUND: Currently, it is well established that cancer arises in chronically inflamed tissue. A number of NOD-like receptors (NLRs form inflammasomes, intracellular multiprotein complexes critical for generating mature pro-inflammatory cytokines (IL-1β and IL-18. As chronic inflammation of the gastric mucosa is a consequence of Helicobacter pylori infection, we investigated the role of genetic polymorphisms and expression of genes involved in the NLR signalling pathway in H. pylori infection and related gastric cancer (GC. MATERIALS AND METHODS: Fifty-one genetic polymorphisms were genotyped in 310 ethnic Chinese (87 non-cardia GC cases and 223 controls with functional dyspepsia. In addition, gene expression of 84 molecules involved in the NLR signalling pathway was assessed in THP-1 cells challenged with two H. pylori strains, GC026 (GC and 26695 (gastritis. RESULTS: CARD8-rs11672725, NLRP3-rs10754558, NLRP3-rs4612666, NLRP12-rs199475867 and NLRX1-rs10790286 showed significant associations with GC. On multivariate analysis, CARD8-rs11672725 remained a risk factor (OR: 4.80, 95% CI: 1.39-16.58. Further, NLRP12-rs2866112 increased the risk of H. pylori infection (OR: 2.13, 95% CI: 1.22-3.71. Statistical analyses assessing the joint effect of H. pylori infection and the selected polymorphisms revealed strong associations with GC (CARD8, NLRP3, CASP1 and NLRP12 polymorphisms. In gene expression analyses, five genes encoding NLRs were significantly regulated in H. pylori-challenged cells (NLRC4, NLRC5, NLRP9, NLRP12 and NLRX1. Interestingly, persistent up-regulation of NFKB1 with simultaneous down-regulation of NLRP12 and NLRX1 was observed in H. pylori GC026-challenged cells. Further, NF-κB target genes encoding pro-inflammatory cytokines, chemokines and molecules involved in carcinogenesis were markedly up-regulated in H. pylori GC026-challenged cells. CONCLUSIONS: Novel associations between polymorphisms in the NLR signalling pathway (CARD8

  11. Clinical relevance of aberrant polypoid nodule scar after endoscopic submucosal dissection

    Science.gov (United States)

    Arantes, Vitor; Uedo, Noriya; Pedrosa, Moises Salgado; Tomita, Yasuhiko

    2016-01-01

    AIM To describe a series of patients with aberrant polypoid nodule scar developed after gastric endoscopic submucosal dissection (ESD), and to discuss its pathogenesis and clinical management. METHODS We reviewed retrospectively the endoscopic database of two academic institutions located in Brazil and Japan and searched for all patients that underwent ESD to manage gastric neoplasms from 2003 to 2015. The criteria for admission in the study were: (1) successful en bloc ESD procedure with R0 and curative resection confirmed histologically; (2) postoperative endoscopic examination with identification of a polypoid nodule scar (PNS) at ESD scar; (3) biopsies of the PNS with hyperplastic or regenerative tissue, reviewed by two independent experienced gastrointestinal pathologists, one from each Institution. Data were examined for patient demographics, Helicobacter pylori status, precise neoplastic lesion location in the stomach, tumor size, histopathological assessment of the ESD specimen, and postoperative information including medical management, endoscopic and histological findings, and clinical outcome. RESULTS A total of 14 patients (10 men/4 women) fulfilled the inclusion criteria and were enrolled in this study. One center contributed with 8 cases out of 60 patients (13.3%) from 2008 to 2015. The second center contributed with 6 cases (1.7%) out of 343 patients from 2003 to 2015. Postoperative endoscopic follow-up revealed similar findings in all patients: A protruded polypoid appearing nodule situated in the center of the ESD scar surrounded by convergence of folds. Biopsies samples were taken from PNS, and histological assessment revealed in all cases regenerative and hyperplastic tissue, without recurrent tumor or dysplasia. Primary neoplastic lesions were located in the antrum in 13 patients and in the angle in one patient. PNS did not develop in any patient after ESD undertaken for tumors located in the corpus, fundus or cardia. All patients have been

  12. Echocardiographic Diagnosis of 63 Children with Dextrocardia%超声心动图诊断小儿右位心63例

    Institute of Scientific and Technical Information of China (English)

    金兰中; 马桂琴; 李国敏

    2001-01-01

    目的:探讨超卢心动图对右位心及其伴随的心血管畸形的诊断价值。方法:探头移至胸骨右缘显示心脏。按van Pranph方法对右位心进行诊断分型。结果:63例右位心,右旋心型41例,合并心血管畸形的38例。镜像右位心型17例,心内结构正常的9例。未定位型(中心型)5例,均合并复杂心血管畸形。结论:当确定心脏大部分及心火位于右侧胸腔,可观察左右心房关系以确定右位心类型。超声心动图能快速、准确及可靠地诊断右位心。%To evaluate the clinical utility of echocardiography in the diagnosis of dextrocardia and concomitant cardiovascular malformations. Methods:The detector was set on the right edge of sternums to display hearts on the screen, and the diagnostic classification was made based on Van Pranph Method. Results: Among the 63 patients diagnosed of dextrocardia, 41 patients were diagnosed as dexversion, 38 patients were found to have concomifant cardiovascular malformations, 17 patients were diagnosed as mirror-image dextrocardia, 9 patients were found with normal intracardial structure, and 5 patients were diagnosed as mesocardia or uncertain-cardia annexed with complicated cardiovascular malformation. Conclusions: When a majority of the heart and its apex are found to lie on the right side of the thorax, diagnostic classification of dextrocardia can be confirmed by investigating the relationship between the left and right atria, Echocardiography is a reliable and convenient method for diagnosis of dextrocardia.

  13. The study of new methods in gastrointestinal stromal tumor therapy%胃肠道间质瘤治疗新方法的探讨

    Institute of Scientific and Technical Information of China (English)

    郭花; 余东亮; 谢惠; 盛剑秋; 余长忠; 金鹏; 李娜; 赵晓军; 王海红; 王昕; 李爱琴

    2012-01-01

    Objective To explore the efficacy and safety of laparoscopy combined with endoscopy and endoscopio submucosal excavation (ESE) in gastrointestinal stromal tumor therapy. Methods 37 patients were identified gastrointestinal stromal tumor by endoscopy, endoscopic ultrasonography, pathology and immunohistochemical methods. 28 patients underwent endoscopic submucosal excavation ( ESE) , 9 patients underwent laparoscopy combined with endoscopy. Results The turner was resected completely in all. All patients underwent endoscopic therapy resected the tumor completely. No bleeding and abodminal pain happened during and after the operation. Patient with gastric cardia tumor remained good function after the tumor resection. Conclusion Laparoscopy combined with endoscopy and ESE are minimal invasive, safe and effective new methods in gastrointestinal stromal tumor therapy.%目的 探讨胃镜与腹腔镜双镜联合及内镜黏膜下挖除术(endoscopic submucosal excavation,ESE)治疗胃肠道间质瘤的效果和安全性.方法 经胃(肠)镜、超声内镜及病理学、免疫组化证实的胃肠道间质瘤患者37例,对其中28例患者采用ESE、9例采用胃镜与腹腔镜双镜联合进行瘤体切除.结果 ESE及双镜联合治疗的所有患者均完整切除瘤体,两种方法均无术中及术后迟发性出血、剧烈腹痛等并发症,瘤体位于贲门者,切除后患者贲门功能保持良好,术后随访无复发.结论 胃镜与腹腔镜双镜联合技术及ESE是治疗胃肠道间质瘤的微创、安全、有效的新方法.

  14. Nursing endoscopic submucosal excavation in submucosal tumors%内镜黏膜下挖除术治疗消化道黏膜下肿瘤的护理

    Institute of Scientific and Technical Information of China (English)

    潘学勤; 吴萍

    2012-01-01

    目的 探讨内镜黏膜下挖除术(ESE)处理消化道黏膜下肿瘤(SMT)的临床护理方法.方法 以2009年1月至2010年11月内镜发现的黏膜下病灶22例(食道11例、贲门2例、胃8例、结肠1例)患者作为护理对象,通过术前EUS检查明确病灶大小、位置、性质,进行ESE治疗.结果 20例(91%)完整挖除,2例ESE术后创面仍有肿瘤残留且病理报告低度恶性,后行外科手术扩大切除治疗.3例穿孔均保守治愈.术后随访2~18个月,20例完整挖除患者均未见复发.结论 加强对行ESE患者的精心护理,可以减少并发症,提高手术成功率.%Objective To study the nursing of endosoopic submucosal excavation (ESE) in submucosal tumors(SMTs). Methods A total of 22 patients with SMT of gastrointestinal tract who were detected and confirmed by endoscopy from January 2009 to November 2010 were enrolled in the study. Among them, 11 patients had lesions located in esophagus, 2 in cardia, 8 in stomach, and 1 in rectum. Endoscopic ultrasonography (EUS) was applied to confirm the size, location, and nature of the lesions. The patients were treated with ESE. Results Twenty patients (91%) had complete ESE, and 2 received extra surgeries because of the residual and low malignant tumor in the wound after ESE. Three patients were treated conservatively because of perforations. The folbw - up of 2 to 18 months revealed that no recurrence occurred. Conclusion Good and corresponding nursing can reduce the incidence of complications and increase the success rate of surgery.

  15. Intervenciones coronarias percutáneas en pacientes diabéticos

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    Igor F. Palacios

    2009-01-01

    Full Text Available Es bien conocido que la diabetes confiere un riesgo mayor de desarrollo de enfermedadcoronaria y que conlleva un pronóstico adverso a largo plazo con tratamiento médico encomparación con los pacientes no diabéticos. Los diabéticos presentan además una incidenciamayor de infarto de miocardio con mayor mortalidad frente a los no diabéticos. En consecuencia,es frecuente que los diabéticos con enfermedad coronaria requieran tratamientomediante revascularización miocárdica. Los resultados a largo plazo del tratamiento médicoy de las estrategias intervencionistas o quirúrgicas en los pacientes diabéticos con enfermedadcoronaria son peores que en los no diabéticos. Es sumamente importante reconocereste hecho porque la presencia de diabetes aumenta en extremo el riesgo de complicacionesy de reestenosis.El seguimiento a largo plazo de los ensayos clínicos que compararon los resultados de laangioplastia (ATC con la cirugía de revascularización miocárdica (CRM demuestran quela cirugía continúa siendo la estrategia recomendada para los pacientes diabéticos con enfermedadmultivaso. Sin embargo, los recientes avances en las intervenciones coronariaspercutáneas (ICP han producido un cambio en el paradigma de la revascularización coronariaen los pacientes diabéticos.En el presente artículo de revisión se analizan los resultados de los estudios comparativosentre CRM e IPC realizados en tres etapas diferentes del desarrollo tecnológico de los métodospercutáneos: la angioplastia con balón, con stent convencional y los más recientes constents farmacológicos, que parecen haber mejorado el pronóstico de la ATC en los pacientesdiabéticos. A la luz de estos resultados, se discuten las indicaciones actuales de las guíasinternacionales para seleccionar el tratamiento de revascularización en estos pacientes.Finalmente, se comentan los resultados de estudios recientes, como BARI 2D y CARDIA, ylos que se encuentran en curso (FREEDOM, que

  16. Dietary Flavonols Intake and Risk of Esophageal and Gastric Cancer: A Meta-Analysis of Epidemiological Studies

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    Yan Xie

    2016-02-01

    Full Text Available Background: Esophageal cancer (EC and gastric cancer (GC are common cancers and leading causes of cancer deaths worldwide. Many studies have investigated the association between dietary flavonols intake and the risk of EC and GC, but the results are inconsistent. Hence, we conducted a systematic analysis of relevant population-based studies to assess the association and derive a more precise estimation. Methods: The Cochrane, PubMed and Embase databases were searched to identify articles published through January 2016 that met the predetermined inclusion criterion. Twelve studies involving 4593 patients and 519,378 controls were included. Results: The summary odds ratios (ORs of EC, GC and the two combined were respectively 0.88 (95% CI: 0.73–1.08, 0.80 (95% CI: 0.70–0.91 and 0.83 (95% CI: 0.74–0.92 for the highest category of dietary flavonols intake compared with the lowest. No significant heterogeneities were observed in these studies. Further analysis showed that the pooled ORs of EC and GC for cohort, population-based case-control and hospital-based case-control studies were 0.90 (95% CI: 0.61–1.34, 0.92 (95% CI: 0.72–1.18, 0.68 (95% CI: 0.38–1.24 and 0.83 (95% CI: 0.65–1.06, 0.84 (95% CI: 0.45–1.59, 0.70 (95% CI: 0.56–0.88. The subgroup analyses revealed a significant association of flavonol intake with a reduced risk of noncardia gastric adenocarcinoma but not gastric cardia adenocarcinoma. Moreover, significant inverse associations of flavonol intake with GC risk were observed in women but not in men, in smokers but not in nonsmokers, in European populations but not in American populations. Similarly, a significant inverse association of flavonols intake with EC risk was also observed in smokers but not in nonsmokers. Conclusion: High intake of dietary flavonols is significantly related to a reduced risk of GC, especially in women and smokers.

  17. A Rare Case of Gastric Variceal Hemorrhage Secondary to Infiltrative B-Cell Lymphoma

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    Adrienne Lenhart

    2016-10-01

    Full Text Available Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena. On admission to hospital, he was found to have a hemoglobin level of 3.4 g/l. Emergent esophagogastroduodenoscopy showed isolated bleeding gastric varices (IGV1 by Sarin classification in the fundus and cardia with subsequent argon plasma coagulation injection. He was transferred to our tertiary center where work-up revealed normal liver function tests, and abdominal ultrasound showed patent hepatic/portal vasculature without cirrhosis. MRI demonstrated a large heterogeneously enhancing mass in the pancreatic tail, with invasion into the spleen and associated splenic vein thrombosis. Surgery consultation was obtained, but urgent splenectomy was not recommended. The patient instead underwent splenic artery embolization to prevent future bleeding from his known gastric varices. Pathology from a CT-guided biopsy was consistent with diffuse large B-cell lymphoma. PET imaging showed uptake in the splenic hilum/pancreatic tail region with no additional metastatic involvement. He was evaluated by the Hematology Department to initiate R-CHOP chemotherapy. During his outpatient follow-up, he reported no further episodes of melena or hematemesis. To the best of our knowledge, there have only been two published case reports of large B-cell lymphoma causing upper gastrointestinal bleeding from isolated gastric varices. These cases were treated with splenectomy or

  18. 胃肠超声造影在临床诊断的应用%Gastric Ultrasound Imaging in Clinical Diagnosis

    Institute of Scientific and Technical Information of China (English)

    寇铁虹

    2014-01-01

    目的:探讨胃肠超声造影在诊断胃肠疾病方面的应用价值。方法348例受检者空腹口服超声助显剂,使胃内形成中等回声界面,超声依次检查食道下段、贲门胃底、胃体(大弯及小弯侧)、胃角部胃窦部、幽门、十二指肠球部。结果超声造影可以清晰显示胃壁各层回声,胃的蠕动快慢、及胃内病变的部位、形态、大小、累及深度、腹腔大血管周围淋巴结等情况。结论口服助显剂胃肠超声造影检查方便、价廉、无创,是对胃镜和 X 线钡餐检查的有效补充方法,适合应用于对胃肠疾病的筛查。%Objective To evaluate the gastrointestinal contrast-enhanced ultrasound in the diagnosis of gastrointestinal diseases. Methods 348 cases of oral ultrasonic significantly aid subjects on an empty stomach, the stomach formation of medium interface of the echo,ultrasonic inspection in turn lower segment of the esophagus and cardia gastric bottom, the body (large bending and little side),stomach Angle distal stomach,pylorus and duodenal bulb. Results Contrast-enhanced ultrasound can clearly show the hole in the stomach wal layers echo, how peristalsis of the stomach and the stomach in the lesion area, shape, size, involving the depth, abdominal lymph nodes around the great vessels,and so on and so forth. Conclusion Oral dose of gastrointestinal contrast-enhanced ultrasound examination is convenient, inexpensive,noninvasive,is the effective complement to gastroscope and X-ray barium meal examination method, suitable for application in screening for gastrointestinal diseases.

  19. Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy.

    Science.gov (United States)

    Iwamoto, Junichi; Saito, Yoshifumi; Honda, Akira; Matsuzaki, Yasushi

    2013-03-21

    Low-dose aspirin (LDA) is clinically used for the prevention of cardiovascular and cerebrovascular events with the advent of an aging society. On the other hand, a very low dose of aspirin (10 mg daily) decreases the gastric mucosal prostaglandin levels and causes significant gastric mucosal damage. The incidence of LDA-induced gastrointestinal mucosal injury and bleeding has increased. It has been noticed that the incidence of LDA-induced gastrointestinal hemorrhage has increased more than that of non-aspirin non-steroidal anti-inflammatory drug (NSAID)-induced lesions. The pathogenesis related to inhibition of cyclooxygenase (COX)-1 includes reduced mucosal flow, reduced mucus and bicarbonate secretion, and impaired platelet aggregation. The pathogenesis related to inhibition of COX-2 involves reduced angiogenesis and increased leukocyte adherence. The pathogenic mechanisms related to direct epithelial damage are acid back diffusion and impaired platelet aggregation. The factors associated with an increased risk of upper gastrointestinal (GI) complications in subjects taking LDA are aspirin dose, history of ulcer or upper GI bleeding, age > 70 years, concomitant use of non-aspirin NSAIDs including COX-2-selective NSAIDs, and Helicobacter pylori (H. pylori) infection. Moreover, no significant differences have been found between ulcer and non-ulcer groups in the frequency and severity of symptoms such as nausea, acid regurgitation, heartburn, and bloating. It has been shown that the ratios of ulcers located in the body, fundus and cardia are significantly higher in bleeding patients than the ratio of gastroduodenal ulcers in patients taking LDA. Proton pump inhibitors reduce the risk of developing gastric and duodenal ulcers. In contrast to NSAID-induced gastrointestinal ulcers, a well-tolerated histamine H2-receptor antagonist is reportedly effective in prevention of LDA-induced gastrointestinal ulcers. The eradication of H. pylori is equivalent to treatment with

  20. 内镜下激光和微波治疗上消化道恶性梗阻临床疗效分析%Comprehensive analysis of clinical curative effect on endoscopic laser and microwave treat upper gastrointestinal malignant obstruction

    Institute of Scientific and Technical Information of China (English)

    于晓辉; 王兆林; 王维; 王静舞

    2016-01-01

    目的:通过回顾性研究分析,对胃镜下微波凝固疗法(microwave coagulation therapy,MCT)和激光光动力疗法(laser photodynamic therapy,LPDT)单独和联合治疗中晚期食管癌(esophageal cancer,EC)、贲门-胃底癌(cardia-gastric cancer,CG,C)所致的梗阻临床疗效进行评价.方法:选择535例EC和CGC作为处理组,其中142例EC、206例CGC行MCT,43例EC、64例CGC行LPDT,42例EC、38例CGC行MCT和LPDT联合治疗;选择放弃任何治疗的48例晚期EC和73例CGC共121例作为对照组,仅进行对症支持治疗.对MCT和LPDT单独和联合治疗中晚期EC、CGC所致的梗阻临床疗效进行回顾性分析.结果:处理组患者经不同的方法进行2~3个疗程,MCT法、LPDT法和MCT和LPDT联合法的有效率分别为78.16%、98.13%、93.75%,三种方法6个月累积生存率分别为69.3%、78.5%、81.2%,对照组6个月生存率仅55%.结论:MCT和LPDT单独或联合治疗均能很大程度地解决EC、CGC造成的梗阻,提高患者的生活质量,延长患者生存时间,具有很好的临床疗效.

  1. EPIDEMIOLOGICAL STUDY OF CARCINOMA OESOPHAGUS

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    Shafi

    2016-05-01

    Full Text Available Oesophageal malignancies are not an uncommon disease entity in this part of India. It is observed in both the sexes. Patients present with progressive dysphagia for solids. The duration of symptoms varies from 6 months to 2 years. Among the various aetiological factors, smoking, alcohol intake, spicy hot food intake, industrial pollution and achalasia cardia are a few worth mentioning. AIM OF THE STUDY To evaluate the differences in the predisposing factors causing squamous cell carcinoma and adenocarcinoma of oesophagus in this part of India. MATERIALS AND METHODS The study is conducted in the Department of Surgery at Government Medical College Hospital, Kozhikode; Kerala. One hundred patients attending the Department with history of Dysphagia were included after thorough history taking, clinical and endoscopic examination and found to have malignant growths in the oesophagus which was confirmed by biopsy and histopathological examination. Various aetiological factors were elicited and analysed in both the histological varieties of malignancy of oesophagus. OBSERVATIONS AND RESULTS Significant number of patients with history of paan chewing presented with histological picture of squamous cell carcinoma as compared to patients who had adenocarcinoma. Gastroesophageal reflux disease was more commonly associated with adenocarcinoma. Out of 37 patients with adenocarcinoma, 31 patients had history of gastroesophageal reflux disease (83.8%. 6 patients had no history of gastroesophageal reflux disease (16.2% within histology. Consumption of hot drinks, tea and coffee more than 10 per day has been analysed. 52 were consuming, 48 were not consuming, P value 0.179 non-significant. CONCLUSIONS Squamous cell carcinoma is more prevalent as compared to adenocarcinoma in present study. The main factor that has emerged is lifestyle, dietary habit, smoking and alcohol, and environmental factor. Consumption of alcohol and smoking is known risk factors in

  2. 胃上部癌根治术保留胰脾功能性清除脾门和脾动脉干淋巴结的临床意义%Radical resection of gastric carcinoma with pancreas and spleen preservation and functional cleaning of lymph nodes

    Institute of Scientific and Technical Information of China (English)

    秦环龙; 林超鸿

    2002-01-01

    目的观察胃癌手术保留胰脾清除脾门和脾动脉干淋巴结(即No 10、11)合理性和可行性.方法分析439例手术切除的胃贲门、体部和全胃癌侵入胰脾情况;对54例胃癌患者在术中从贲门和体部浆膜下注入亚甲兰观察胃的淋巴流向;63例胃癌采用保留胰脾功能性清除No 10、11 淋巴结方法,与同期保胰法和胰脾切除法比较,分析No 10、11淋巴结转移率,观察术后并发症发生率和生存率.结果 439例胃贲门、体部和全胃癌侵入胰脾机会不多,分别为5.7%(25/439)和2.3%910/439);5 4例胃的美兰淋巴引流不进入脾脏和胰腺内.保留胰脾法、保胰法和脾胰切除法3组No 10、1 1淋巴结转移率分别为17.5%(11/63),19.1%(12/63);20.8%(45/216),25%(54/216);20%( 6/30),23%(7/30),差异无显著意义.63例保留胰脾法术后并发症发生率和病死率均较保留胰法和胰脾联合切除法低,而生存期较高,5年、10年生存率分别为57.5%、52%,57.4%、47 .4%和37.3%、30%.Ⅱ、Ⅲa期患者保留胰脾手术的5年、10年生存率明显改善.结论保胰脾法是一个安全、切实可行的保留脏器功能的胃癌根治手术,术后并发症低、生存率高 .尤对Ⅱ、Ⅲa期患者应行保留胰脾手术.%Objective To study the clinical value of radical resection of gastric carcinoma with pancr eas and spleen preservation (PSP) and functional cleaning of lymph nodes (LNs) o f the spleen hillus and along the splenic artery.Methods Pancreas and spleen involvement was retrospectively reviewed among 439 cases of resectable carcinoma of the gastric cardia,gastric corpus and total stomach. Du ring gastric surgery, 2 ml of methylene blue was injected into the subserosal sp ace of the gastric cardia or corpus to observe the spread of lymphatic flow in 5 4 cases of gastric carcinoma. The metastatic rate of LNs in splenic hillus and along the trunk of the splenic artery (No10, No11), postoperative complications and survival rates

  3. Splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension%自体脾移植联合食管横断吻合术治疗肝硬化门静脉高压症

    Institute of Scientific and Technical Information of China (English)

    陈汝福; 霍景山; 陈积圣; 周泉波

    2008-01-01

    目的 本研究比较自体脾移植联合食管横断吻合术与脾切除联合食管横断吻合术治疗门静脉高压症(PHT)的疗效.方法 将30例研究对象平均分为两组.研究组行脾次全切除加自体脾腹膜后移植及食管横断吻合术;对照组行脾切除加食管横断吻合术.于术前1周及术后6个月通过三维动态增强磁共振血管成像(3D DCE MRA)检测其门静脉主干(MPV)管腔横截面积、血流量、血流速度等门静脉系统血流动力学参数及食管胃底曲张静脉的变化,并观察自体移植脾在腹膜后的侧支血管形成与血流方向的改变.并同步检查血清肝纤维化指标及肝功能的重要指标. 结果术后两组MPV的管腔横截面积、MPV的平均流速和MPV的平均流量均比术前明显减小(P<0.05).且术后研究组MPV的平均流速和平均流量均少于对照组(P<0.05).两组手术后胃底曲张静脉、食管曲张静脉均消失或明显改善;两组手术前后肝功能的重要指标均差异无统计学意义(P>0.05).研究组血清透明质酸水平在术后显著下降(P<0.05),研究组移植脾成活良好,并建立了广泛的侧支循环. 结论自体脾移植联合食管横断吻合术是一种优于脾切除加断流术治疗肝硬化PHT的方法,且未对肝功能造成负面影响.%Objective To evaluate the efficacy of splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension(PTH).Methods Thirty patients were divided into study group(15 cases)and control group(15 cases).Patients in study group Underwent splenic autotransplantation after splenectomy and cardia-esophageal devascularization plus lower esophagus transaction,and those in control group had all except splenic autotransplantation.The cross section area,blood velocity,blood flow of MPV(main portal vein)and changes of cardia-esophageal varices were evaluated by 3D DCE MRA at 1 week before operation and 6 months after,and blood

  4. 上消化道不同部位黏膜下肿瘤的临床病理学特征%Clinicopathological features of submucosal tumors in different upper gastrointestinal locations

    Institute of Scientific and Technical Information of China (English)

    齐志鹏; 钟芸诗; 周平红; 徐美东; 时强; 蔡世伦; 姚礼庆

    2016-01-01

    Objective To analyze the clinicopathological characteristics of upper gastrointestinal submucosal tumors ( SMTs ) . Methods Clinicopathological data of 1 743 patients with 1 775 upper gastrointestinal SMTs in our department from January 2008 to December 2012 were retrospectively analyzed. Results The first finding was that in 702 esophagus cases,leiomyoma(92�59%,650/702) was the most common type of esophageal SMTs. Second, in 1 045 gastric cases, there were 405 lesions at gastric fundus, the most common type of SMTs were 249 ( 61�48%) GISTs and 144 ( 35�56%) leiomyoma. In 307 lesions located at body,the most common type of SMTs were 143( 46�58%) GISTs and 90( 29�32%) leiomyoma. In 191 lesions located at antrum, the most common type of SMTs were 83( 43�46%) heterotopia pancreas and 45(23�56%) hamartoma, followed by 28(14�66%) lipoma and 20(10�47%) GISTs. In 142 lesions located at cardia, the most common type of SMTs was 110 ( 77�46%) leiomyoma. Third, in 28 duodenum cases, there were 19 lesions at duodenal bulb, the most common type of SMTs was 10 heterotopia pancreas, 4 Brunner gland adenoma and 3 GISTs. In 9 lesions located at descending duodenum,the most common type of SMTs was 4 lipomyoma, followed by 2 ectopic pancreas,1 GISTs and 2 others. Conclusion Leiomyoma is the most common type of esophageal SMTs. In gastric fundus and body, the most common type of SMTs are GISTs and leiomyoma. In antrum, the most common type of SMTs are heterotopia pancreas and hamartoma, but in cardia, that is leiomyoma.In duodenal bulb, the most common type of SMTs are heterotopia pancreas, Brunner gland adenoma and GISTs,and in descending duodenum, is lipomyoma.%目的:探讨不同部位上消化道黏膜下肿瘤( SMTs)的临床病理学特征。方法2008年1月至2012年12月,在复旦大学附属中山医院内镜中心行胃镜下诊疗,经病理确诊为上消化道SMTs,且资料记录完整的1743例患者(1775例次诊

  5. Imaging Analysis of Pulmonary Hyaline Membrane Disease in Newborns%新生儿肺透明膜病的影像诊断

    Institute of Scientific and Technical Information of China (English)

    韩海; 欧阳大军; 曾晓春; 朱凯帮; 吕铭; 黄婉红

    2011-01-01

    目的 探讨新生儿肺透明膜病的影像特征,提高对本病的认识和早期诊断能力.方法 回顾性分析经临床及病理证实的105例新生儿肺透明膜病的X线表现.结果 本组105例中27例表现为肺野肺透光度下降及呈弥漫颗粒状阴影;33例表现为肺野透光度减低、斑片状密度阴影;26例肺野透光度明显下降,广泛斑片状阴影,心缘及膈面模糊;19例肺野呈均匀致密影,称为"白肺" .其中合并肺炎24例,肺出血13例,动脉导管未闭19例,气胸7例,缺氧缺血性脑病(HIE)11例.结论 新生儿肺透明膜病的影像表现各种各样,其中磨玻璃征、肺纹理被掩盖不能分辨和支气管充气征在本病中具有特征性表现.普通X线检查和结合临床是诊断新生儿肺透明膜病的可靠方法.%Objective To investigate the imaging features of pulmonary hyaline membrane disease ( HMD) in newborns and to improve the early diagnoscic ability. Methods X - ray findings of 105 newborns with clinically and pathologically proved HMD were analyzed retrospectively. Results Twenty - seven casea of 105 newboms with HMD had fine reticular changing and diffuse granular opacities in the lung field,33 cases had decreased hyalinization of lung field , mottling shadows with high density, and 26 cases cardiae border and diaphragmatic face hazy. ninteen cases presented as "white lung , of whom, 24 cases were complicated with pneumonia,19 casea were complicated with pulmonary hemorrhage , and 13 cases had patent ductus arterious , 7 casea were complicated with pneumothorax and 11 cases hypoxic ischemic encephalopathy ( HIE) . Conclusion There are various images of HMD in newboms. Ground glass opacity of the whole lungs and pulmonary grain concealed and the aerial bronchogram are three charactenstic findings of HMD. Conventional X - ray chest radiography combining the clinical Bymptoms ia considered the most reliable diagnostic tool in HMD diagnosis in newborns.

  6. 全胃切除消化道重建术对胃癌合并Ⅱ型糖尿病血糖的影响%Total gastrectomy reconstruction procedures on blood sugar of gastric cancer concomitance T2DM

    Institute of Scientific and Technical Information of China (English)

    汪启斌; 董荣坤; 张笃; 马芷琴

    2012-01-01

    目的 研究全胃切除加消化道重建术对胃癌合并Ⅱ型糖尿病(T2DM)术后血糖的影响.方法 将胃底贲门癌合并T2DM患者25例行全胃切除加Roux-Y吻合术(A组);选取同期的远端胃癌合并T2DM患者25例行毕Ⅱ式手术(B组)作为对照组;比较两组术后第一个月及丰年的血糖、C肽、糖化血红蛋白变化,采用t检验.结果 ①A组手术前后血糖、糖化血红蛋白及C肽改善无显著性差异(P>0.05),B组手术前后血糖、糖化血红蛋白及C肽的变化有显著性差异(P<0.05).②两组间术后对比差异有显著性(P<0.05).结论 ①全胃切除加Roux-Y吻合术对术后近期血糖无明星影响.②毕Ⅱ式术后近期血糖有明显改善,该术式对糖尿病有治疗作用.③胃与术后糖尿病改善有密切关系.④迷走神经肝支可能影响肠-胰岛轴.%Objective To explore the effect of total gastrectomy adding reconstruction procedures on blood sugar of gastric cancer concomitance T2DM. Methods 25 cases were operated total gastrectomy and Roux-Y on gastric bottom and cardia cancer consolidation type 2 diabetes mellitus (A group),at the same time,25 cases gastric sinuses cancer were performed Billioth 1KB group) ,to be collating group. To compare preoperative and postoperative the blood sugar. HbAlc and C peptide among A and B, using t test to analyze. Results 1. The difference was no significant that A group preoperative and postoperative the biood sugar, HbAlc and C peptide. The difference was significant that B group preoperative and postoperative the blood sugar, HbAlc and C peptide. 2. The postoperative difference was significant among A group and B. Conclusion The operation total gastrectomy adding Roux-Y don't evidently produce an effect on postoperative blood sugar in the near future. The operation Billroth II do evidently affect on postoperative blood sugar in the near future, it show that the operation can treat T2DM. 3. The relation of stomach and

  7. 经左胸腹全胸腔镜食管胃交界区腺癌外科治疗(附17例报告)%The treatment of adenocarcinoma of the esophagogastric junction (AEG) by endoscopic radical oesophagectomy (report of 17 cases)

    Institute of Scientific and Technical Information of China (English)

    宿学家; 张志勇; 朱斌; 谭鑫; 范波

    2014-01-01

    目的:研究探讨胸腔镜下食管胃交界部腺癌(adenocarcinoma of the esophagogastric junction AEG)的手术体位、入路和手术方法的可行性及安全性。方法2011年11月至2014年03月对17例A E G行右侧卧位经左胸腹完全腔镜下根治术:右侧卧位经左胸行腔镜下下段食管的游离及清扫纵隔淋巴结,开膈肌,第七肋间肋弓下、腹直肌外缘做5cm长切口,腔镜辅助下游离贲门、胃及清扫胃左动脉、网膜淋巴结,普通消化道吻合器行食管胃吻合。结果无中转开胸。总手术时间:110-190m i n,平均146m i n。术中无大出血,总出血量30-150m l,平均110m l。共清扫纵隔淋巴结104枚,平均每例6.1枚;清扫腹腔淋巴结133枚,平均每例7.8例。术后住院9-14d,平均11d。住院期间病人无死亡。术后并发症:肺部感染2例,无吻合口漏。结论右侧卧位经左胸腹全腔镜下AEG的外科治疗是可行安全的,近期效果良好,并发症少,达到左侧开胸手术效果。但其长期疗效需要进一步研究、随访。%Objective To study the feasibility and safety of thoracoscopic surgery posturals and methods of the adenocarcinoma of the esophagogastric junction(AEG).Methods A total of 17 patients with AEG were operated with the right lateral endoscopic radical oesophagectomy from November 2011 to March 2014 : freeing the lower esophagus and clean mediastinal lymph nodes using thoracoscopy under the right side of the supine line, then opening the diaphragm and cuting 5cm long incision under the left seventh rib and the outer rectus abdominis, next by endoscopic-assisting freeing cardia, stomach and sweeping left gastric artery and omental lymph nodes, last esophagogastrostomy using a common gastrointestinal stapling. Results No transit thoracotomy. The total operation time :110-190min, average 146min. No massive hemorrhage, bleeding volume 30-150ml, average 110ml. Sweeping a total of 104

  8. ENDOSCOPIC DIAGNOSES OF ESOPHAGEAL AND GASTRIC CARDIAL TUMOR AND DISEASES%食管和贲门部良、恶性肿瘤与其他疾病的内镜检查

    Institute of Scientific and Technical Information of China (English)

    冯纯伟; 周鑫官; 吴维继; 倪庆增; 蒋向民; 张庆震

    2001-01-01

    目的:总结内镜诊断食管、贲门部良、恶性肿瘤与疾病的内镜特征。方法:采用回顾性分析讨论。结果:24年间对3?731例行内镜检查,1?937例诊断为癌,镜检阳性率51.9%(1?937/3?731)。诊断食管癌1?167例,贲门癌615例,食管癌放疗后癌复发74例,食管、贲门癌术后吻合口复发81例,其癌活检阳性率分别为88.9%(1 037/1 167)、83.4%(513/615)、79.7%(59/74)、和93.8%(76/81)。良性肿瘤和其他疾病174例。无出血、穿孔及意外死亡等并发症发生。本文结合肿瘤专科特点,对食管多发癌和食管、胃重复癌、食管癌放疗后癌复发、术后吻合口癌复发及食管、贲门良性肿瘤与其他疾病的内镜诊断进行讨论。结论:纤维内镜对食管、贲门部良、恶性肿瘤及其他疾病的诊断和鉴别诊断有重要意义,可为肿瘤的治疗提供有益的帮助。%Objective:To evaluate the diagnostic characteristics of endoscopic findings of esophageal and gastric cardial tumor and diseases.Methods:By retrospective analysis and discussion.Results:During 24-year period,3731 patients were undergone endoscopic examination.1937 patients were diagnosed as carcinoma,in which the positive rate of endoscopic examination was 51.9%(1937/3731).Among the patients,the esophageal carcinoma was found in 1167 cases,the gastric cardial in 615,the esophageal recurrence of post-irradiation in 74,and the anastomotic recurrence of post-operative esophageal and gastric cardial carcinoma in 81,for which the positive rate of endoscopic biopsy was 88.9%(1077/1167),83.4%(513/615),79.7%(59/74)and 93.8%(76/81),respectively.Esophageal and gastric cardial benign tumor and diseases were found in 174 cases.No complications occurred such as hemorrhage,perforation,unexpected death and so on.In this article,we have stress on discussion about the multiple esophageal carcinoma,the double carcinomas of esophagus and gastric cardia,the esophageal recurrence of

  9. Epidemiological features of gastric cancer detected by gastroscopy in Qinghai between 1979 and 2008%1979-2008年青海地区经胃镜检出胃癌6362例

    Institute of Scientific and Technical Information of China (English)

    荣光宏; 熊元治; 杨永耿; 刘芝兰; 赵相; 逯艳艳

    2012-01-01

    overall detection rate of gastric cancer tended to decrease in recent years, an increase in the detection rate was note in Tu and Mongolian people. Age of onset of gastric cancer has gradually increased in recent years. There was an upward trend in the incidence of cardia cancer in recent years. CONCLUSION: There are several features of gastric cancer detected in Qinghai between 1979 and 2008, including high detection rate, young average patient age, high proportion of male patients, and low degree of differentiation. Overall, the detection rate of gastric cancer decreased and average age of onset increased in recent years.

  10. Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions

    Institute of Scientific and Technical Information of China (English)

    Hong Shi; Xiu-Hua Yu; Xin-Zhang Guo; Yuan Guo; Hong Zhang; Bin Qian; Zhang-Rui Wei

    2012-01-01

    AIM:To investigate the value of two-dimensional (2D) and three-dimensional (3D) double contrast-enhanced ultrasonography (DCUS) imaging for evaluation of gastric lesions.METHODS:2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases.Initially,liquid-based ultrasound contrast agent (Xinzhang(R)) was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions,and then a microbubble-based contrast agent (SonoVue) was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes.The parameters derived from time-intensity curves including the arrival time (AT),time to peak (TTP),peak intensity (PI) and enhanced intensity (EI) were measured on the 2D DCUS imaging.3D DCUS of the lesions was acquired to demonstrate the value of this imaging mode.RESULTS:There were 22 cases with benign lesions including chronic gastritis (n =5),gastric ulcer (n =9),gastric polyps (n =3),gastric stromal tumors (n =5),and 24 cases with malignant lesions including gastric cancer (n =20),gastric cardia carcinoma (n =3) and post-operative recurrent gastric cancer (n =1) in the study.The oral contrast-enhanced ultrasonography (CEUS) imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions.With optimal scanning window and imaging display under oral CEUS,intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations.Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure,from the inside out,hyperechoic mucosa,hypoechoic muscularis and hyperechoic serosa,respectively.There were statistical significant differences of AT (8.68 ± 2.06 vs 10.43 ± 2.75,P =0.017),PI (34.64 ± 6.63 vs 29.58 ± 8.22,P =0

  11. A Meta analysis for the relation of heart rate and postinfarction angina pectoris in Chinese population%心率影响梗死后心绞痛发生率的国内Meta分析

    Institute of Scientific and Technical Information of China (English)

    李婧; 陈汉想; 李伟

    2014-01-01

    By Meta analysis ,we determined the influence of heart rate on postinfarction angina pectoris incidence in Chinese population with acute myocardial infarction .A comprehensive collection of an epidemiological study pub-lished domestically on the relationship between resting heart rate and postinfarction angina pectoris in AMI patients , was carried out , for making the Meta analysis by using RevMan software with fixed effects model and random effects model.We calculated the relative risk (RR) of postinfarction angina pectoris risk of AMI patients in slow heart rate group relative to quick heart rate group ,and evaluated the influence of heart rate level with AMI on occurrence of postinfarction angina pectoris , and analyzed the publication bias by funnel plot .The 7 articles were included .The total sample size was 1888 cases.There were 1030 cases in the heart rate slow group ,and postinfarction angina pec-toris appeared in 128 cases.The heart rate quick group was 858 cases, 247 cases combined with postinfarction angi-na pectoris;RR=0 .46 ,95%confidence interval was ( 0 .38-0 .55 ) .Funnel plot analysis showed no presence of publication bias .There is a correlation between heart rate level and postinfarction angina pectoris occurrence in AMI patients .Postinfarction angina pectoris is increased in heart rate quick patients .Slowing down the heart rate may re-duce the risk of postinfarction angina pectoris .%采用Meta分析( Meta analysis )的方法确定我国人群心率对急性心肌梗死( Acute myo-cardia infarction ,AMI)患者梗死后心绞痛发生的影响。全面收集国内发表的有关AMI患者静息心率与梗死后心绞痛关系的文献,对符合条件的所有研究结果利用RevMan软件进行固定效应模型的Meta分析。计算AMI患者心率慢组相对心率快组发生梗死后心绞痛的危险( rel-ative risk,RR),评价心率快慢对AMI患者梗死后心绞痛发生的影响,并用漏斗图分析发表性

  12. Clinical significance of combined detection of serum levels of multiterm tumor markers in patients with upper gastrointestinal cancer%上消化道恶性肿瘤患者血清多项肿瘤标志物联合检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    刘兴君; 韩存芝; 马晋峰; 张羽捷

    2009-01-01

    Objective To evaluate clinical significance of the CEA, CA19-9, CA242, AFP, CA724,SCC, TPA, TPS combined detection for the clinical diagnosis of gastrointestial cancer. Methods 373 cases of upper digestive tract malignant tumor patient and 50 cases of healthy serum sample were detected for eight markers, evaluating the relationship between the level of markers and illness. Results 8 marker diagnostic positive rates were: CEA 26.80 %, CA19-9 27.34 %, CA242 34.14 %, AFP 2.84 %, SCC 19.72 %, CA724 12.13 %, TPA 34.15 %, TPS 30.89 %. The total positive rate of joint detection of 8 markers was 89.05 %.Preoperative CEA, CA242, SCC-positive patients had a shorter survival time. CA242 and CA19-9 levels with upper gastrointestinal malignancies were positively correlated. Conclusion The combined detection of a number of markers in different pathological type and clinical staging is statistically significant, and the positive rate is much higher than any single marker test results. CA19-9 and CA242 may be the best combination of monitoring the disease. CA724, CA242 and SCC can be as adverse prognostic indicators for cardia, stomach,esophageal malignant tumors, respectively.%目的 评价痛胚抗原(CEA)、唾液酸化岩藻戊糖(CA19-9)、胃肠道癌抗原(CA242)、甲胎蛋白(AFP)、胃癌及卵巢癌抗原(CA724)、鳞状上皮细胞癌抗原(SCC)、组织多肽抗原(TPA)、细胞角蛋白(TPS)8项标志物联合检测,对上消化道恶性肿瘤的临床诊断、评价疗效及预后等方面的临床意义.方法 对373例上消化道恶性肿瘤患者及50名健康体检者血清标本进行8项标志物检测,评价标志物水平与病情的关系.结果 8项标志物诊断阳性率分别为:CEA 26.80%,CA19-9 27.34%,CA24234.14%,AFP 2.84%,SCC 19.72%,CA724 12.13%,TPA 34.15%,TPS;30.89%.8项标志物联合检查的总阳性率为89.05%.术前CEA、CA242、SCC阳性患者的生存时间较短.上消化道恶性肿瘤患者血清CA242和CA19-9水平

  13. 18F-FDG PET/CT在原发灶不明的脑转移瘤中的诊断价值%The value of 18F-FDG PET/CT in diagnosing brain metastases from unknown primary tumor

    Institute of Scientific and Technical Information of China (English)

    刘春利; 李毅红

    2013-01-01

    目的 探讨18F-FDG PET/CT在查找原发灶不明的脑转移瘤中的价值.方法 回顾性分析17例原发灶不明的脑转移瘤患者的全身18F-FDG PET/CT检查资料.结果 17例患者均经活检确诊原发灶,准确率100%.原发性肺癌13例,占76%,其中有2例在第二次行PET/CT检查时才检出原发灶;原发性肝癌2例,占12%;原发性贲门癌1例,占6%;原发性升结肠癌1例,占6%.在检查到原发灶的基础上,18F-FDG PET/CT亦发现10例合并转移者,其中合并肺转移者2例、合并淋巴结转移者3例、合并骨转移者2例及合并其他部位转移者3例,共发现病灶61处;2例肝癌患者单发脑转移灶中均有脑卒中.结论 18F-FDG PET/CT在查找原发灶不明的脑转移瘤原发灶中有重要价值,并为临床分期及治疗提供有利帮助.%Objective To investigate the value of 18F-FDG PET/CT in diagnosis of brain metastases from unknown primary tumor.Method The 18F-FDG PET/CT findings of 17 patients with brain metastases from unknown primary tumor were retrospectively analyzed.Results Primary tumors of the seventeen cases were confirmed by biopsy,the accuracy rate was 100%.There were thirteen cases with primary lung cancer,accounted for 76%,including two cases of lung cancer which were found in the second PET/CT examination,two cases with liver cancer,accounted for 12%,one case with cardia cancer,accounted for 6%,one case with the ascending colon cancer,accounted for 6%.On the base of founding the primary tumor,18F-FDG PET/CT also found 10 cases accompanied by lung metastasis (2 cases),lymph node metastases (3 cases),bone metastases (2 cases)and other sites of metastases (3 cases),a total of 61 lesions were detected.Two cases of liver cancer patients with single brain metastases had cerebral apoplexy.Conclusion 18F-FDG PET/CT contributes important value in finding brain metastases from unknown primary tumor,and is very helpful for clinical staging and treatment.

  14. Detecção do vírus Epstein-Barr (EBV em adenocarcinomas gástricos procedentes dos estados do Ceará e de São Paulo Epstein-Barr virus (EBV detection in gastric carcinomas from Ceará and São Paulo states, in Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Antonio Pereira de Lima

    2011-04-01

    remain contentious. OBJECTIVE: The objective of this study was to analyze clinical-pathological features of gastric adenocarcinomas from two Brazilian states, São Paulo and Ceará, by correlating them with EBV detection. MATERIALS AND METHODS: One hundred ninety-two gastric adenocarcinoma cases were selected from hospitals in São Paulo and Ceará, of which 160 were submitted to RNA in situ hybridization for EBV detection. RESULTS: Eleven (6.9% out of 160 cases were EBV-positive with intense nuclear staining in tumor cells. Among these, two cases also showed stained infiltrating lymphocytes. There was no staining in normal or preneoplastic tissue. São Paulo and Ceará yielded the respective results: 3/60 (5% and 8/100 (8%. In both states, EBV was more prevalent among elder male patients with little to moderately differentiated intestinal tumors in advanced stage. Ceará cases substantiated a relative increase in EBV(+ tumors located in the cardia, whereas São Paulo cases presented an increase in the gastric corpus. CONCLUSION: The frequency of EBV(+ tumors is similarly described in the literature. Among our findings, the elevated percentage of EBV(+ tumors in the gastric corpus, which was observed in São Paulo cases, is unprecedented in the literature.

  15. Effects of microtubule stabilizer on connexin 43 of isolated cardiac myocytes under hypoxia injury%微管稳定剂Taxol对缺氧心肌细胞Cx43蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    王德国; 王新; 刘玉; 王星; 邢文; 李祥东; 杨胜; 王安才; 孙贤林

    2012-01-01

    Aim To observe the effects of mierotu-bule stabilizer ( Taxol) on eonnexin43 ( Cx43 ) expression and distribution of eardiae myoeyles and investi-gate its new value as an anti-arrhylhmie agent. Methods Cardiae myoevles isolated from aduk rats were exposed to hypoxia for 120 min with or without taxol ( a kind of mierotubule stabilizer ) in different. eoneentra-tions. Cellular survival was assayed by trypan blue dye-exelusion. Cx43 expression was determined by western blots. Cx43 distribution was deteeted by immu-nofluoreseenee staining and observed under laser sean-ning eonfoeal mieroseope. Results The cell viability under hypoxie eondition was redueed signifieantly whieh showed only few numbers of rod-shaped eells. Taxol promoted cell survival in a dose-dependent man- ner at the range of0. 1~10 nmol · L-1 . At the range of 100 nmol o L-1~ 10 μmol · L~1 , taxol lead toredueed cell survival. Taxol in a dose-dependent manner improved Cx43 expression even although exeessive taxol also suppressed Cx43. Cx43 was loeat ed in both ends of intaet eardiae myoeyles ( interealated disk ) and redistributed in both sides of the cell under hypoxie eonditions. Taxol dose-dependently inhibited lateraliza-tion of Cx43 in lower eoneentration and further de-ereased Cx43 in the interealated disk. Conclusions Cx43 redistribution indueed by hypoxie is proteeted by low dosage of taxol. Mierotubule stabilizer may be ae-ted as a new anti-arrhythmie agent.%目的 观察微管稳定剂Taxol对缺氧心肌细胞Cx43表达和分布的影响,探讨其作为新的抗心律失常药物的潜在价值.方法 酶解法分离的大鼠心肌细胞缺氧120 min,并以不同浓度的Taxol干预;台盼蓝排斥实验测定细胞存活率;免疫印迹检测Cx43的蛋白表达,免疫荧光染色后激光共聚焦显微镜观察分析Cx43的分布.结果 Taxol在0.1~10 nmol·L-1浓度下成剂量依赖性地提高杆状细胞数,促进细胞存活,而100 nmol·L-1~10 μmol·L-1浓度下杆状细胞数

  16. 肝硬化门静脉高压症断流术后贲门失迟缓的诊治%Diagnosis and treatment of post-operative achalasia after pericardial devascularization in patients with portal hypertension from liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    罗大勇; 李恒; 王润之; 张伟; 肖国丰

    2014-01-01

    Objective:To investigate the diagnosis and surgical approach to post operative achalasia after pericardial devasculatirzation in patients with por-tal hypertension resulted from liver cirrhosis.Methods:The clinical data were retrospectively examined in 43 of 282 patients undergone conventional sple-nectomy plus pericardial vessel devascularization complicated with post-oerative achalasia to a certain degree.Results: After operation,43 patients com-plained of catch sensation of food intake and dysphagia.By symptomatic treatment and psychological intervention,remission occurred in 34,and 9 were giv-en enteral nutrition via nasojejunal tube,in which 4 were relieved and 5 remained no remission.The clinical picture included vomiting after food intake due to thread-like stenosis of cardia by the findings of barium meal X-ray for the upper digestive tract.Endoscopic balloon dilation was applied to the 5 cases, and remission occurred in 4 by one intervention and in 1 by twice.No relapse occurred in the follow-up period.Conclusion:Esophageal stenosis after peri-cardial devascularization is closely associated with gender,devascularization position,preoperative intravascular interventional therapy of repeated bleeding, intraoperative esophagus muscular injury and spraying esophageal mucosal surface with non-absorbing chemical glue.Early detection and treatment should be necessary for this disease,and interventional treatment or endoscopic balloon dilation is effective and recommended to the failure of conservative treat-ment.%目的:探讨肝硬化门静脉高压症行贲门周围血管离断术后发生贲门失迟缓的诊治方法。方法:对我院2008年1月~2013年5月共行脾切除+贲门周围血管离断术282例术后发生不同程度的贲门失迟缓的43例(15.2%)病例资料进行分析总结。结果:43例在术后出现进食梗咽感、吞咽困难,给予心理安慰、对症治疗缓解34例;另9例经鼻肠管给

  17. EARLY DIAGNOSIS OF CONGENITAL HEART DISEASE%新生儿先天性心脏病早期诊断

    Institute of Scientific and Technical Information of China (English)

    冉建瑜

    2011-01-01

    [Objective] To improve the diagnosis rate, reduce mortality and morbidity of congenital heart disease, summarize the early diagnosis of congenital neart disease characteristics. [Methods] From January 2008 -December 2010, 61 neonatal children with congenital heart disease admitted to our hospital were diagnosed by color Doppler ultrasound, retrospectively analyzed to the clinical features of children with congenital heart disease performance and auxiliary examination. [ Re-Sults] The qolor Doppler ultrasound investigation showed that newborns with congenital heart disease mainly were found with ventricular septal defect, followed by atri^l septal defect. CR film showed expansion of the heart shadow in 20 cases (32.7%) , lung field congestion in 16 patients (26.2%), lung field ischemia in 9 patients (14.8%) . ECG showed right ventricular hypertrophy in 20 cases (32.7%), ECG left side in 9 cases (14.8%), arrhythmia in 8 patients (13.1%) , supraventricular brady-cardia in 3 patients (4.9%), sT-segment depression in 1 case (1.6%). [Conclusion] Neonatal congenital heart disease is deficiency in clinical manifestations, shortness of breath is common, and the majority pathological type is ventricular septal defect. Color Doppler ultrasound examination is with a unique advantage.%[目的]为提高临床诊断率,降低先心病病死率及致残率,总结新生儿先天性心脏病患者早期诊断特点.[方法]选择2008年1月-2010年12月住院新生儿科的先心病患儿共61例,所有患儿均经过彩色多普勒超声明确诊断,回顾分析心儿先天性心脏病临床特征性表现及各辅助检查结果.[结果]彩超查显示,新生儿先天性心脏病中以室间隔缺损居多,其次为房间隔缺损.CR拍片显示心影扩大者20例(32.7%),肺野淤血者16例(26.2%),肺野缺血者9例(14.8%).心电图检查显示右室肥厚者20例(32.7%),心电左偏者9例(14.8%),心率不整者8例(13.1%),室上性心动过缓者3例(4.9%),s-T段压低者1

  18. RETROSPECTIVE INVESTIGATION ON THE MORTALITY OF MALIGNANT TUMORS AND ITS DISEASE BURDEN AMONG RESIDENTS IN YUHUATAI DlSTRICT%雨花台区2007年居民恶性肿瘤死因及疾病负担回顾性调查

    Institute of Scientific and Technical Information of China (English)

    徐翠林; 蒋宁卫; 包磊; 周守君

    2011-01-01

    [目的]了解雨花台区居民恶性肿瘤死亡状况和疾病负担情况,为预防和控制恶性肿瘤的发生提供科学依据.[方法]采用回顾性调查方式,收集2007年全部恶性肿瘤(包括良性脑部肿瘤)死亡病例计361例,按照2:1比例随机抽取180例组成样本,进行入户问卷调查.[结果]收回有效问卷151(83.9%)份,死亡年龄1~86周岁,平均66.41周岁,较平均期望寿命低11.67岁(2007年雨花台区平均期望寿命为78岁).按系统分析死亡原因主要为消化系统肿瘤,计85(56.3%)例,恶性肿瘤的前10位死因顺位分别是肺癌、胃癌、肝癌、食管癌、贲门癌、直肠癌、胰腺癌、肾癌、胆囊癌、乳腺癌.患者确诊后在平均生存时间18.4个月,潜在寿命损失均数11.57年/例.[结论]恶性肿瘤对患者的生命健康和生存质量和经济情况造成了重大损失,肺癌和消化系统肿瘤是引起肿瘤死亡的主要原因.%[Objective] To design to describe the mortality of malignant tumors and its disease burden among residents in Yuhuatai District in Nanjing in Jiangsu Province, and to provide a scientific basis for the control and protection of the development of malignant tumors. [Methods] With the retrospective investigation method, all 361 death cases caused by malignant (including the innocence brain tumor) tumor in Yuhuatai District in 2007 were collected, 180 samples of them were randomly chosen with 1 : 2 ratio for door questionnaires research. [Results] 151 questionnaires (83.9%) were taken back, the death age was from 1 to 86, and the average age was 66.41, shorter than the expected age 78.08. A total of 85 deaths were caused by the digestive system tumors, the top ten malignant tumors causing death were pulmonary cancer, stomach cancer, hepatic cancer, esophageal cancer, carcinoma of gastric cardia, rectal cancer, pancreatic cancer, renal cancer, gallbladder cancer and mammary adenocarcinoma. The medium survival time after diagnosis was 18

  19. Evaluación de la terapia nutricional perioperatoria en pacientes con neoplasia del tracto gastrointestinal superior Evaluation of perioperative nutritional therapy in patients with gastrointestinal tract neoplasms

    Directory of Open Access Journals (Sweden)

    MªB. Gómez Sánchez

    2011-10-01

    Full Text Available Objetivos: La enfermedad oncológica se acompaña de un grado importante de desnutrición que se asocia con elevadas tasas de morbi-mortalidad postoperatoria. El propósito de este estudio fue evaluar la efectividad de un programa de apoyo nutricional perioperatorio de cara a reducir complicaciones postoperatorias, estancias hospitalarias y mortalidad entre pacientes sometidos a cirugía oncológica del tracto digestivo superior. Métodos: Estudio prospectivo aleatorizado sobre una muestra de pacientes intervenidos por cáncer gastrointestinal alto (esófago, estómago, cardias y duodeno/páncreas durante un periodo de 4 años. Se realizó una valoración nutricional y se administró de forma perioperatoria una formula enteral inmunomoduladora a un grupo de pacientes malnutridos (DS, mientras que otro grupo de pacientes malnutridos (DNS y los normonutridos (NN recibieron consejo dietético antes de la cirugía y después de esta sueros por vía intravenosa hasta la reintroducción de la dieta normal. Las variables estudiadas fueron edad, sexo, estadio tumoral, tipo de neoplasia y estancia hospitalaria. También se recogieron la situación nutricional, mortalidad, complicaciones postoperatorias y alteraciones gastrointestinales. Para el análisis estadístico realizamos un estudio de frecuencias y aplicamos el test de Chi-cuadrado en las variables cualitativas. Para las cuantitativas usamos la ANOVA y el test Post-hoc de Tukey. Se consideraron significativos aquellos valores de p Objectives: Cancer is usually associated to an important level of desnutrition together with a postoperative morbidity and mortality increase. The purpose of this study was evaluating its efficacy perioperative nutritional support to reduce surgical complications, stances and mortality significantly in patients undergoing higher digestive tract procedures. Method: A prospective, randomized trial was done among a sample of neoplasic patients undergoing higher intestinal

  20. Revista de Revistas.

    Directory of Open Access Journals (Sweden)

    Cristina Polo Usaola

    1991-01-01

    ez Manrique, A. Ayesterán Ruiz y J. Miró. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines, marzo-abril 1991; núm. 2, vol. XIX, 127-134.148:153-161. José García-Noblejas Profilaxis con litio en las psicosis puerperal. La experiencia de 3 centros. D. E. Stewart, J. L. Klompen Hower, R. E. Kendel" M. Van Huist. British Journal Psychiatry, marzo 1991. Rosa Gutiérrez Cook Medley Hostility Scale and subsets: Relationship to demographic and psychosocial characteristics in young adults in the cardia study Larry Scherwitz, Laura Perkins, Margaret Chesney, Glenn Hughes. Psychosomatic Medicine. Vol. 53, enero-febrero 1991, núm. 1. Encarnación Llanos Cerrato Comentario de revista: Devenir Editions Eshel. París. Periodicidad: Trimestral. Jose Luis Pedreira Massa

  1. SPLUNC1基因在人体组织中的表达分布特征%Expressions of short palate, lung and nasal epithelium clone 1 in different human tissues

    Institute of Scientific and Technical Information of China (English)

    王爽; 李文路; 吕丽春; 姚开泰

    2016-01-01

    Objective To examine the expression patterns of short palate, lung and nasal epithelium clone 1 (SPLUNC1) gene in human tissues. Methods In situ hybridization was used to detect the expression of SPLUNC1 gene in 37 different human tissues. Results We found that SPLUNC1 gene was not expressed in squamous epithelial cells of the palate, epidermis, esophagus, or the esophagus-cardia junction, metaplastic squamous cells in the nasopharynx, trachea, or uterus cervix, or tumor cells of esophageal squamous cell carcinoma or lung squamous cell carcinoma. SPLUNC1 gene was not expressed in the single layer columnar epithelia cells in the stomach, gallbladder, jejunum, colon, endometrium, or uterus cervix. SPLUNC1 expression was detected mainly in pseudostratified columnar epithelial cells in the nasopharynx, trachea and bronchi, and was gradually down-regulated from the upper to lower end of the respiratory tract, but was not detected in the lung tissues. SPLUNC1 expression was detected not only in the duct and serous gland cells in the parotid and submandibular glands, but also in cells of submucosal serous glands in the nasopharynx and lung, but not in the cells of the mucosal glands. The parietal cells of the gastric submucosa and epithelial cells of the lobula and ducts of the mammary glands expressed SPLUNC1. The adenocarcinoma cells in the lung, stomach, colon, mammary gland, uterus endometrium and cervix showed strong expressions of SPLUNC1 gene. Conclusion SPLUNC1 expression is highly cell-specific in association with the cell functions.%目的:探讨人SPLUNC1基因在人体组织中的表达分布特征。方法采用原位杂交方法检测人体37种组织中SPLUNC1基因的细胞学定位。结果原位杂交结果显示:SPLUNC1在上腭、表皮、食管及食管-贲门部的鳞状上皮,鼻咽部、气管、宫颈部化生的鳞状上皮及食管和肺的鳞状细胞癌中均不表达;在胃粘膜、胆囊、空肠、结肠、子宫内膜及腺体

  2. 副肿瘤综合征与神经系统损害的相关分析%Study on relationship between paraneoplastic syndrome and nerver system injury

    Institute of Scientific and Technical Information of China (English)

    郭晓玲; 李柱一

    2002-01-01

    .In addition, activity of telomerase which is recently determined tumor marker provides objective base for timely and correct diagnosis of tumors. Laboratory examination and clinical symptoms should be considered during diagnosing tumors.For example,a subject was admmited due to complained abdominal pain, diarrhea,vomiting,headache.After treatment,these symptoms showed no improvement but deterioration accompanied by increased cerebral spinal liquid pressure.Reexamination indicated CEA increase,broad bean like,hard lymphoid in left greater supraclavicular fossa ,interosseous muscles atrophy, and circumferential sense dysfunction of extremities.In the end,cardia signet-ring cell carcinoma was proved by gastroscopic biopsy.

  3. Gastric Large Cell Neuroendocrine Carcinoma

    Science.gov (United States)

    Rustagi, Tarun; Alekshun, Todd J.

    2010-01-01

    Case: A 63-year-old male presented with unintentional weight loss of 20 pounds over a 4-month duration. He reported loss of appetite, intermittent post-prandial nausea, bloating and early satiety. He also complained of dyspepsia and had been treated for reflux during the previous 2 years. He denied vomiting, dysphagia, odynophagia, abdominal pain, melena, hematochezia, or alterations in bowel habits. Additionally, he denied fevers, night sweats, cough, or dyspnea. He quit smoking 25 years ago, and denied alcohol use. His past medical history was significant for basal cell carcinoma treated with local curative therapy and he was without recurrence on surveillance. Pertinent family history included a paternal uncle with lung cancer at the age of 74. Physical examination was unremarkable except for occult heme-positive stools. Laboratory evaluation revealed elevated liver enzymes (ALT-112, AST-81, AlkPhos-364). CT scan of the chest, abdomen and pelvis showed diffuse heterogeneous liver with extensive nodularity, raising the concern for metastases. Serum tumor-markers: PSA, CEA, CA 19-9, and AFP were all within normal limits. Screening colonoscopy was normal, but esophagogastroduodenoscopy revealed a malignant-appearing ulcerative lesion involving the gastro-esophageal junction and gastric cardia. Pathology confirmed an invasive gastric large cell neuroendocrine carcinoma. Ultrasound-guided fine needle aspiration of a hepatic lesion revealed malignant cells with cytologic features consistent with large-cell type carcinoma and positive immunostaining for synaptophysin favoring neuroendocrine differentiation. A PET-CT demonstrated intense diffuse FDG uptake of the liver, suggesting diffuse hepatic parenchymal infiltration by tumor. There were multiple foci of intense osseous FDG uptake with corresponding osteolytic lesions seen on CT scan. The remaining intra-abdominal and intra-thoracic structures were unremarkable. The patient will receive palliative systemic therapy

  4. EXPRESSION AND CLINICAL SIGNIFICANCE OF CD44 IN THE PERIPHERAL BLOOD OF PATIENTS WITH CASTRIC CANCER

    Institute of Scientific and Technical Information of China (English)

    XU; Shen-hua

    2001-01-01

    of Chinese subjects [J]. Cancer 1995; 75:1065.[13]Mao WM, Zheng S, Gao YL. Expression and clinical significance of P53, P21, nm23, CD44 cardia carcinoma [J]. Chin J Dig 1999; 19:1329.[14]Pan X, Chen GR, Zhao J, et al. The expression of CD44 in biopsy tissue by endoscopy [J]. China J Endoscopy l996; 2:36.[15]Zhao Jun, Pan Xue, Yin Geping. A clinical research of CD44 molecule in gastrointestinal neoplasm [J]. Chin J Clin Oncol Rehabilitation 1998; 5:24.

  5. 中性粒细胞/淋巴细胞比值对急性心肌梗死患者预后的价值%Prognostic value of Neutrophil-to-Lymphocyte ratio in patients with ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    郭星梅; 王东昕; 韩聪聪; 李姮; 崔丽; 徐延敏

    2015-01-01

    目的:探讨中性粒细胞/淋巴细胞比值(NLR)对急性ST段抬高型心肌梗死(STIMI)并行经皮冠状动脉介入(PCI)治疗患者发生不良事件的预测价值。方法选取我院326例STIMI患者,根据NLR分为T1组(≤3.46)、T2组(3.47~6.75)和T3组(>6.75)。收集患者一般临床资料、实验室指标、冠脉造影结果、术后TIMI分级及左室射血分数(LVEF),记录患者住院期间心力衰竭、支架内血栓再形成、室速/室颤、房颤、房室传导阻滞、心源性休克等不良事件的发生情况以及随访6个月主要心血管不良(MACE)事件如非致命性心梗、死亡、心衰再入院、缺血性卒中的发生情况。结果 T3组住院期间心衰、房颤、室速/室颤及心源性休克的发生率明显高于其余两组(P6.75). Basic clinical data,laboratory indexes,coronary angiography results, TIMI grading and left ventricular ejection fraction(LVEF) were collected in all groups. Incidence of adverse events in hospital such as acute heart failure, thrombosis, ventricular tachy⁃cardia and ventricular fibrillation, atrial fibrillation, atrioventricular block and cardiogenic shock, were recorded. Major ad⁃verse cardiac events(MACE), death of all causes, non-fatal MI, ischemic stroke and readmission due to heart failure at the 6-month follow-up were also noted. Results The incidence of heart failure, atrial fibrillation, ventricular tachycardia/ven⁃tricular fibrillation and cardiogenic shock was higher in group T3 than those in the other two groups(P < 0.05).The inci⁃dence of multivessel coronary artery disease was significantly higher in group T3 than that in group T1 (54.1% vs 37.0%, P<0.05). The percentage of TIMI grade 3 in post-operative infracted artery was significantly lower than that in group T1 (83.5%vs 94.4%). Left ventricular ejection fraction was significantly lower in group T3 than that of group T1 during hospital⁃ization (0.48 ± 0

  6. Differential expression of Orexin A in gastrointestinal tract betw een yak and cattle%Orexin A在牦牛和黄牛消化道中的表达差异

    Institute of Scientific and Technical Information of China (English)

    丁艳平; 孟媛; 张晋平; 邵宝平

    2016-01-01

    通过分析促食欲素A(Orexin A)在牦牛和黄牛消化道不同部位的分布特征及表达差异,探讨Orexin A对牦牛能量代谢的调节作用.运用免疫组织化学SP法检测Orexin A在牦牛和黄牛胃肠道的表达,利用Image‐ProPlus 6.0软件对其表达强度进行半定量分析.结果表明, Orexin A在牦牛和黄牛的皱胃、幽门、贲门和十二指肠均有表达,但表达特征不同;牦牛胃和十二指肠中Orexin A阳性反应产物极显著地低于黄牛(P<0.01);牦牛胃肠道中Orexin A阳性反应产物的吸光度分布为:皱胃区>幽门区>贲门区>十二指肠区(P<0.01).推测牦牛通过胃肠道Orexin A的低表达,调节中枢及外周组织的激素水平,从而维持机体能量代谢水平,适应青藏高原的特殊环境.%To explore the regulation effect of Orexin A on energy metabolism of yak by analyzing the difference of distribution and expression in gastrointestinal tract between yak and cattle . Immunohistochemistry is used to localize the expression of Orexin A in the gastrointestinal tract of the yak ,Image‐ProPlus 6.0 software is used to semi‐quantitative analyse the intensity of expression of Orexin A . Results show that Orexin A is widely expressed in the abomasum ,pylorus and duodenum cardia in yak and cattle ,which have different expressional characteristics ;The mean absorbance of Orexin A positive reaction product in stomach tissue and duodenum of yak is significantly lower than that of cattle ( P<0.01);By comparing the mean absorbance of Orexin A positive reaction product in the yak , it is found that its expression from strong to weak successively is abomasums area , pyloric region , cardiac region , and then duodenum area (P<0.01) .It indicats that the lower expression of Orexin A could regulate the hormone levels in the central and peripheral tissues to maintain its energy balance to adapt to the extreme environment of the Tibetan

  7. Comportamiento del cáncer gástrico en pacientes de la EPS-s provincia de García Rovira (Santander, en el periodo 2007-2014 / Gastric Cancer Behavior in EPS-s (Health Insurance Company in The Province of García Rovira (Santander, during the 2007 – 2014 Period / Comportamento do câncer gástrico nos pacientes da EPS-s da província de Garcia Rovira (Santander no periodo de 2007-2014

    Directory of Open Access Journals (Sweden)

    Diana Mireya Cuadros- Picón, MD.

    2015-03-01

    Full Text Available Introducción: El cáncer gástrico es en Colombia y Santander, la primera causa de muerte por tumores malignos, a pesar de no ser la primera neoplasia en frecuencia. Objetivo: Teniendo en cuenta lo anterior, el cáncer gástrico es un problema de salud pública y en nuestro medio no existen estudios analíticos que permitan caracterizar esta población; lo que se propone es una investigación en la cual se caracterice el comportamiento en la población con cáncer gástrico en la provincia de García Rovira, Santander, en el periodo 2007-2014. Metodología: Estudio analítico con 57 historias clínicas revisadas de pacientes de una empresa promotora de salud del régimen subsidiado (EPS-s con diagnóstico de cáncer gástrico confirmado por histopatología. Las variables consideradas fueron: sexo, edad, estadio, patología, localización, tratamiento y sobrevida, se realizó análisis univariado teniendo en cuenta la variable edad categorizada por rangos (hasta 50 años, 51 a 60 años, 61 a 70 años, y más de 70 años; variables cualitativas descritas en tabla de frecuencias, porcentajes e intervalos de confianza; el análisis bivariado se realizó buscando el valor P del test de Fisher, los datos fueron analizados en el paquete estadístico Stata. Resultados y conclusiones: Los resultados mostraron que los hombres representan un 77.2% de los casos de cáncer gástrico estudiados; el 68.4% del total de los pacientes tenía más de 60 años. Se encontraron diferencias significativas en la localización del tumor por sexo, ya que en las mujeres el cáncer se localizó en el antro pilórico mientras que en los hombres fue predominantemente en el cardias y el cuerpo del estómago (p<0.05; por su parte, las variables estadio clínico y tratamiento recibido se encontraron asociados de manera estadística a mortalidad (p<0.05. [Cuadros-Picón DM, Reyes-Soto Y. Comportamiento del cáncer gástrico en pacientes de la EPS-s provincia de García Rovira

  8. 南昌地区消化性溃疡的临床特点和季节变化规律%Clinical characteristics and the regularity of seasonal changes of peptic ulcer in Nanchang area

    Institute of Scientific and Technical Information of China (English)

    舒徐; 李国华; 吕农华; 朱萱; 陈幼祥; 王崇文

    2008-01-01

    Objectives To investigate the clinical characteristics and the regularity of seasonal changes that influence peptic ulcer (PU) in Nanehang area and to provide a theoretical basis for the treatment and prevention of PU.Methods Data collected from patients with PU diagnosed by clinic and gastroendoseopy between October 2003 to May 2008 were retrospectively analyzed.The PU was further divided into gastric ulcer,duodenal ulcer and complex ulcer.The lesion of gastric ulcer was calculated by five locations that were antral,angular,corporal,pyloric canal,fundic and cardia.The lesion of duodenal ulcer was calculated by five locations that were anterior wall of bulb,posterior wall,lesser curvature, greater curvature and postbulbar.The climate changes that influnced the incidence of PU disease were also observed.The detective rates of different types of PU were analyzed and its association with gender,age, lesion locations,seasons,Helicobacter pylori (Hp) infection and complications were also investigated. Results Among 83 888 patients who underwent endoscopy,PU was found in 21 308 patients (25.4%) including 66.33% duodenal ulcer,24.88% gastric ulcer and 8.79% complex ulcer.The male and femal ratio was 2.44 : 1 in PU,2.53 : 1 in duodenal ulcer,2.26 : 1 in gastric ulcer,and 2.33 : 1 in complex ulcer.The average age of patients with gastric ulcer was 48.0 years that was about 6.7 years higher than that of patients with duodenal ulcer.The prevalence of duodenal ulcer and gastric ulcer peaked in the 30- 39 years and 50-59 years,respectively.PU was more common from December to February (30.17%) and less common from June to August (22.54%) (P<0.01) .The 57.43% of duodenal ulcer was found on anterior wall of bulb,18.26% on greater curvature,13.21% on lesser curvature,7.34% on posterior wall and 3.76% on postbulbar.The 45.69% of gastric ulcer was found on antral,20.54% on angular, 15.54% on corporal,9.36% on pyloric canal,and 8.87% on fundic and cardia.The 91.83% (12 318/ 13 414

  9. Meta-analysis of association of tumor necrosis factor alpha-308 gene promoter polymorphism with gastric cancer%肿瘤坏死因子α-308位点基因多态性与胃癌易感性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    陆培华; 汤韵; 李晨; 沈伟; 纪律; 郭榆江; 陶国清

    2010-01-01

    Objective To assess the association between tumor necrosis factor-alpha(TNF-α)gene promoter region-308 gene polymorphisms and gastric cancer(GC)susceptibility.Methods Published work about TNF-α-308 and GC from PubMed,EMBASE,Cochrane library in English and from Wanfang,CBM in Chinese were searched for relevant articles published by the end of July,2009.Thirty-nine relevant articles were selected and 26 of them met the criteria.The correlated index was extracted for aggregate analysis in RevMan 4.2.Results There were 5225 GC patients and 8473 controls for TNF-α-308 in 26 papers.Overall,allele contrast(G:A and AA:GG)genotype of TNF-α-308 polymorphisms produced significant results in worldwide populations,the OR values were 0.85(95% CI:0.76-0.96 ,P=0.01)and 1.19(95%CI:1.01-1.39,P=0.03).Subgroup analysis showed that OR values of G:A and AA:GG in west population were 0.79(95 % CI:0.70-0.89,P < 0.01)and 1.26(95 % CI:1.04-1.52,P = 0.02),while in east populations subgroup analysis,the OR was 0.97(95% CI:0.75-1.26,P= 0.84).No significant association was observed in non-cardia GC and Helicobacter pylori positive GC,the OR values were 0.90(95% CI:0.79-1.02,P=0.10)and 1.08(95% CI:0.62-1.88,P=0.79).Conclusion TNF-α-308 A allele and AA genotype were associated with a statistically significant increased risk of gastric cancer in western people.%目的 评价肿瘤坏死因子α(TNF-α)基因启动子区-308位点基因多态性与胃癌易感性.方法 检索PubMed、EMBASE数据库、Cochrane图书馆(1966年至2009年7月)及万方、中国生物医学文献数据库(1979年至2009年7月)文献,收集TNF-α-308位点基因多态性与胃癌易感性的病例对照研究,共检索到39篇相关文献,26篇纳入研究.应用RevMan 4.2对各研究结果进行异质性检验和效应值合并.结果 26篇纳入本研究的文献中,共计有5225例胃癌患者和8473例(名)对照人群.总研究人群TNF-α-308位点基因G:A的OR=0.85(95%CI:0.76~0.96,P=0.01),AA

  10. 两种龟消化道黏膜上皮的扫描电镜观察%Observations on the mucosa of digestive tract in two turtles by SEM

    Institute of Scientific and Technical Information of China (English)

    李贵生; 唐福星

    2014-01-01

    利用扫描电镜对黄喉拟水龟和乌龟的消化道黏膜上皮进行了观察。结果显示,黄喉拟水龟胃黏膜上皮有发达的沟、回结构,在胃的贲门区可见指状突起的黏膜上皮细胞。胃体部的黏膜上皮细胞较大,柱状,表面多数呈五边形或六边形。在一些黏膜上皮细胞中,可见明显的分泌孔。在胃的幽门区,可见突起的微脊。在十二指肠中,可见横行的主皱襞和次皱襞,表面分布着形态不规则的细胞,可见沟、回结构;表面有很多杯状细胞,大多呈圆形。在回肠,可见纵行皱襞,吸收细胞表面不规则,有很多肠腺开口。大肠的黏膜皱襞较浅,可见杯状细胞分布于其中。乌龟胃黏膜上皮表面结构与黄喉拟水龟相似。可见两种不同形状的黏膜上皮细胞,一种为中央凹陷,排列紧密,呈鳞状;另一种为中央稍突起,呈不规则型。胃底部可见很多分泌细胞,在这些细胞中可见乳头状突起,在一些乳头状突起的中央可见分泌孔。小肠上皮细胞结构与黄喉拟水龟相似。大肠黏膜上皮细胞中可见簇状排列的黏液分泌细胞。在两种龟的胃黏膜上皮细胞中均可见胃小凹结构,但未见微绒毛结构,也无杯状细胞。%The mucosa of digestive tract in Mauremys mutica and Chinemys reevesii were studied by scanning electron microscope.The results showed that,in Mauremys mutica,there are developed channel and promontory in stomach.There are fingerlike protuberant mucosa epithilia in the cardia section of stom-ach.The mucosa epithilia is larger,stylolitic,pentagon or hexagon on stomach body surface.In some mucosa epithilia,there are obvious secretory hole.In the pyloric section of stomach,the protuberant tiny ridge is seen.In duodenum,there are transverse main plica and petit plica.There are irregular cells in the surface of duodenum,and the channel and promontory are seen.There are many circular

  11. Acalasia: estudio de 27 casos en el Hospital Calderón Guardia

    Directory of Open Access Journals (Sweden)

    José A. Mainieri-Hidalgo

    2003-03-01

    Full Text Available Se estudiaron en forma retrospectiva los expedientes clínicos de 27 pacientes diagnosticados con acalasia en el Hospital Dr. R. A. Calderón Guardia (HCG vistos durante el período de 11 años comprendido entre 1991 y 2001, encontrando una tasa de 0.3 por 100.000 habitantes la cual es menor que la informada en la literatura. Esto posiblemente debido a que la ausencia en nuestro medio de manometría esofágica dificulta el diagnóstico de pacientes en estadio temprano o con enfermedad leve o moderada. La presentación clínica fue muy similar a la reportada por otros autores con una relación hombre mujer de 1.7 a 1 y edad promedio de 42 años. Los síntomas con un promedio de evolución de 7 años, fueron el más frecuente, la disfagia que se presentó en todos los casos, seguida de vómito, dolor torácico, pérdida de peso y datos de reflujo gastroesofágico. La esofagoscopía y la esofagografía mostraron hallazgos de enfermedad avanzada como dilatación esofágica importante, retención de restos alimentarios y cardias con espasmo que se superó fácilmente al presionar con el endoscopio. El tratamiento que se administró fue solamente médico (Nifedipina o Isorbide a 6 pacientes, dilataciones y tratamiento médico a 7 y quirúrgico (esofagomiotomía a 14, a tres de estos se les agregó un procedimiento anti-reflujo. La evolución se valoró con base en datos clínicos, encontrando que todos los pacientes con tratamiento médico y dilataciones continúan sintomáticos y con tratamiento. De los operados hay uno que ha requerido dilataciones 5 y 9 años después de la intervención, dos que no tuvieron procedimiento anti-reflujo, están en tratamiento por este problema y el resto se encuentran asintomáticos sin que se presentaran complicaciones quirúrgicas.This is a retrospecti ve study of the clinical records of 27 patients diagnosed with achalasia at the Dr. R. A. Calderón Guardia Hospital during a period of eleven years from 1991 to

  12. Esophagogastrostomy by side-to-side anastomosis in prevention of anastomotic stricture:a randomized clinical trial%食管胃侧侧吻合预防吻合口狭窄的临床随机对照研究

    Institute of Scientific and Technical Information of China (English)

    马瑞东; 张文通; 许起荣; 陈龙奇

    2010-01-01

    目的 评价使用食管胃侧侧吻合术预防术后吻合口狭窄的效果.方法 2007年11月至2008年9月连续收治行食管癌、贲门癌切除术的患者160例,2例拒绝随机分组,3例不符合人选标准,其余155患者完全随机分组为食管胃侧侧吻合组、吻合器吻合组与手工吻合组,通过术后3个月食管造影测量吻合口直径确定吻合口狭窄的发生率(吻合口直径≤O.8 cm为吻合口狭窄).结果 术后死亡1例,行剖胸探查1例.术后并发吻合口漏4例(其中手工吻合3例,吻合器吻合1例).随访率为96.1%(失访6例,侧侧吻合组1例,手工吻合组3例,吻合器组2例).共144例患者进行了意向治疗分析(侧侧吻合组45例,手工吻合组52例,吻合器组47例).三组患者术前情况类似,侧侧吻合组术后吻合13狭窄率(0)低于手工吻合组(9.6%)及吻合器组(19.1%,Fisher 精确概率法,P=0.005),而三组之间的术后胃食管反流程度学差异无统计学意义(χ~2=1.681,P=0.432).结论 食管胃侧侧吻合术能够有效地预防吻合口狭窄,同时并不加重胃食管反流.%Objective To compare a side-to-side esophagogastric anastomosis with conventional hand-sewn or stapled esophagogastrostomy for prevention of anastomotic stricture by randomized clinical trial.Methods Between November 2007 and September 2008,160 patients with esophageal carcinoma or gastric cardia cancer were consecutively admitted and underwent surgical treatment.After excluding 5 patients (2 refused to participate in and 3 did not meet inclusion criteria),the remaining 155 patients were completely randomized to receive either a side-to-side esophagogastric anastomosis(SS group),or the conventional hand-sewn(HS group),or a circular stapled(CS group)anastomosis,after the removal of esophageal tumor,The primary outcome measured the incidence of anastomotic stricture at 3 months after the operation(defined as the diameter of the anastomotie orifice≤0.8 cm on esophagogram

  13. A survey of perioperative nutritional support in digestive system cancer patients%消化系统恶性肿瘤病人围手术期营养支持现况调查

    Institute of Scientific and Technical Information of China (English)

    方玉; 杨锐; 王艳莉; 辛晓伟; 张联

    2012-01-01

    Objective:To learn the current status of perioperative nutritional support in digestive system cancer patients. Methods:A retrospect survey was done in the digestive system cancer major operation patients who discharged from our hospital during one month in 2010. The rationality of perioperative nutritional support was analyzed. Results-. 180 of patients were eligible. The proportion of parental nutrition ( PN) and enteral nutrition( EN) was 3.2 :1. Totally 5. 2% of patients received preoperative nutritional support, and 100% patients received postoperative nutritional support. The average duration of perioperative nutrition support was (12. 1 ±8. 3) days , and median duration of postperative nutrition support was 13.3 days in pancreas, 13.2 days in oesophagus and cardia carcinoma patients,8.0 days in gastric carcinoma patients,5.4 days in liver carcinoma patients,5. 1 days in colon and rectum carcinoma patients. The average energy supply by postoperative nutritional support was 5 633.3 ~693. 7 kJ( 1346.4 ± 165.8 kcal)/d ,32.8% of patients was feed 104.6 kJ ~ 125.5 kJ (25~30 kcal)/(kg ? D) and 28.4% of patients was feed <83.68 kJ(20 kcal)/(kg ? D) , 7.8% of patients was feed <62.76 kJ( 15 kcal)/(kg ? D). Furthermore, 92.7% of patients with PN received intravenous immunonutrition supplementation, such as glutamine and fish oil, and 14. 8% of patients with EN received a formula enriched with ω-3 fatty acids.The cost of nutrition remedy was RMB ¥ (7024.4 ±7330. 2) per head and RMB ¥ (611.6 ±473. 5) per day, the daily average cost of nutritional remedy was higher in the PN group (RMB ¥749. 1 ± 477.3) than in EN group (RMB ¥ 218.0±100.4) (P<0.01). Conclusion-. The perioperative nutritional support to digestive system cancer patients has been generally recognized. The application of nutritional support is inappropriate in some patients,underfeeding and overfeeding. It's necessary to reinforce the dissemination of evidence-based guideline.%目的:调查我

  14. 贲门失弛缓症的内镜治疗与外科手术处理方法比较%Comparison of endoscopic balloon dilation with surgical therapy in management of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    曾晓清; 陈世耀; 王剑; 马丽黎; 倪燕君; 王群; 姚礼庆

    2009-01-01

    目的 比较手术与内镜治疗贲门失弛缓症的疗效与安全性.方法 收集复旦大学附属中山医院2002年1月至2007年12月诊断为贲门失弛缓症患者,分为内镜下球囊扩张治疗组、胸/腹腔镜手术组和传统开胸手术组.比较不同治疗方法的疗效、复发率、安全性.结果 共有98例患者符合入选与排除标准纳入研究.内镜下球囊扩张治疗57例,胸/腹腔镜治疗24例,传统开胸手术治疗17例.所有患者均完成治疗,内镜治疗组1例(1.6%)发生食管破裂;腔镜治疗组2例(8.3%)发生食管瘘;传统手术治疗组1例(5.9%)发生术后严重肺部感染、急性呼吸窘迫综合征和感染性休克.其余患者在治疗后吞咽困难均有不同程度缓解,术后1个月通过症状评价及X线或内镜检查均证实治疗成功.内镜组5例复发,复发率8.9%,复发时间5~31个月(中位复发时间8个月),再次扩张或支架治疗有效.胸/腹腔镜组1例复发,复发率4.2%,复发时间6个月,扩张治疗有效.手术组无复发病例.结论 与传统开胸手术及胸/腹腔镜微创手术相比,内镜下球囊扩张简便易行,且并发症较少,值得临床推广应用.尽管其存在一定的复发率,但仍可通过再扩张或内镜下可回收支架等措施补救处理.%Objective To compare the effects and safety of endoscopic balloon dilation with surgical therapy in treating esophageal achalasia. Methods The patients who were diagnosed as achalasia of cardia from Jan. 2002 to Dec. 2007 were consecutively collected. All patients were divided into endoscopic balloon dilation group (endoscopy group), thorascopic / laparoseopic surgery group (telescopy group) and standard thoracotomy group (operation group). The efficacy, relapse rate and safety were compared among three groups. Results Ninety eight patients were enrolled. There were 57 patients in endoscopy group, 24 patients in telescopy group, and 17 patients in opreation group. All of the patients

  15. 冒癌表达胃泌素受体的特征%The Characteristics of Gastrin Receptor Expression in Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    黄广建; 张延龄; 乐竹琴; 余枫; 张光明; 邓守真; 倪泉兴

    2003-01-01

    Objective: To investigate the characteristics and significance of gastrin receptor (GR) expressionin gastric cancer. Methods: The content and affinity of GR were determined in 34 specimens of gastriccancer using radioligand binding assay. The correlation was analyzed between GR expression in tumorsand tumor sites, stages, grades, DNA of gastric cancer cells, GR of adjacent normal gastric mucosa, survivaltime. Results: Among the 34 cases of gastric cancer, 16 patients (47.1%) had positive GR in specimens ofgastric cancer, with high-affinity GR in 14 cases (41.2%) and low-affinity GR in 2 cases. Of high-affinityGR, 9 cases had cancers with GR>10 fmol/mg.protein (39.5±14.4 fmol/mg.protein), 5 cases with GR≤10fmol/mg.protein (6.0±2.8 fmol/mg.protein). High-affinity GR was easier to be expressed in cancers ofgastric body (7/9) and cardia (3/6) than in gastric antrum (4/19). The expression of GR in gastric canceraccorded well with that in normal gastric mucosa at the same sites, but with more high-special binding sitesthan the latter (39.5±14.4 vs 26.1±16.6 fmol/mg.protein). A significantly greater proportion of patientswith Ⅲ+Ⅳ stages (13/24) had high-affinity GR compared with Ⅰ+Ⅱ stages (1/10) of gastric cancers. Duringa follow-up of 23-61 months, 11 of 13 cases with high-affinity GR were dead, whereas 4 of 11 cases withlow-affinity or negative GR were dead in Ⅲ+Ⅳ stages of gastric cancer. Conclusion: GR is an importantfactor in the autocrine growth of gastric cancer cells, and helpful in the prediction of prognosis and guidanceof treatment with GR antagonists.%目的研究胃癌表达胃泌素受体(gastrin receptor,GR)的特征及意义.方法 应用受体的放射配基结合分析法测定34例胃癌标本GR含量及其亲和力,并比较胃癌表达的GR与其部位、分期、分级、胃癌细胞DNA含量、邻近正常胃粘膜的GR及患者生存期的关系.结果 34例胃癌组织中,16例(47.1%)胃癌GR阳性,其中14例(41.2%)

  16. Radiología en Acalasia y Pseudoacalasia Radiology in Achalasia and Pseudoachalasia

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    Ricardo Luis Videla

    2008-12-01

    sphincter; pseudoachalasia: absence of primary peristalsis and narrowed lower esophageal segment. The clinical variables studied were: age, sex, duration of dysphagia and presence or absence of Chagas disease. The radiological variables were obtained from barium studies, determining stenosis length and maximum esophagus diameter. The statistical analysis of the variables was made with test T of student. Results: 64 patients, 55 of primary achalasia, eight of pseudoachalasia and one of secondary achalasia were included for the study. Malignant pseudoachalasia: three esophageal carcinomas, two carcinomas of the cardias and one metastasis of pulmonary cancer. Benign etiology: one peptic stenosis and one leiomyomatosis. One patient with Chagas disease was considered secondary achalasia. The clinical variables that showed significant differences were: The age, that in the primary achalasia group was 56 ± 16 years and in malignant pseudoachalasia group was 68 ± 8 years with p <0,01 (significant. The duration of dysphagia in primary achalasia was 40 ±50 months, and in malignant pseudoachalasia was 11, 33± 6.74 months, p<0,001 (significant. The stenosis length for primary achalasia was 2,17 ± 0,63 cm, and for malignant pseudoachalasia 3,91 ± 1,56, p<0,05 (significant. Finally the maximum esophagus diameter in primary achalasia group was 5,40 ± 1,67 cm and for malignant pseudoachalasia 3,66± 0,81 p<0.001 (significant. Conclusion: Primary achalasia is more frequent in patients younger than 55 years with lasting of dysphagia of more than one year. The maximum esophagus diameter is over 4 cm and the stenosis length shorter than 2 cm. Malignant pseudoachalasia is more frequent in older patients of 65 years, with the duration of dysphagia less of 1 year. The maximum esophagus diameter is under 4 cm and the length of the narrowed segment is greater to 2 cm.

  17. 芝麻素对自发性高血压大鼠心肌氧化应激损伤的保护作用%Effect of sesamin on the protein iNOS and c-fos expression in myocardia of spontaneously hypertensive rats

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    李伟; 杨解人; 李文星; 张俊秀; 唐丽娟; 杨慧; 熊莺

    2015-01-01

    synthase ( iNOS) and c-fos.Results:SHR group demonstrated hypertrophied myocardia with disordered arrangement .Large quantity of inflammatory cells and adipose tissue infiltration were seen in the myocardial tissues,and the expression of T-SOD was significantly reduced (P<0.01 ),whereas the protein iNOS and c-fos expression in myo-cardia was significantly up-regulated(P <0.01).Myocardial pathological lesions were improved to a certain degree in the rats treated with sesamin and captopril,and T-SOD content was significantly increased (P<0.01),whereas the expression of iNOS and c-fos was notably reduced in dose-dependent manner(P <0.01) .Co nclusion:Sesamin could decrease the expression of iNOS and c-fos protein and enhance the ability of T-SOD, suggesting that it can be protective effect on myocardial injury in spontaneously hypertensive rats.

  18. 三维标测系统指导下复杂心律失常的经导管射频消融治疗%Three-dimensional mapping for radiofrequency catheter ablation of complex cardiac arrhythmias

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    洪浪; 王洪; 赖珩莉; 尹秋林; 陈章强; 陆林祥; 邱赞; 肖承伟

    2009-01-01

    目的:探讨在三维标测系统指导下,经导管复杂心律失常射频消融治疗的有效性与安全性. 方法:选择2006年2月至2008年9月住院患者98例,其中阵发性房颤50例、持续性或永久性房颤6例、心房扑动9例、房性心动过速(房速)9例、室性心动过速(室速)或频发室性早搏24例.在EnSite NavX或Array系统(72例)或CARTO系统(26例)指导下进行射频消融手术. 结果:84例一次手术成功(85.71%),7例再次导管消融成功,成功率合计92.86%.50例房颤一次手术成功,5例再次消融后3例成功.9例心房扑动患者中7例一次手术成功,1例复发再次消融成功.9例房速中7例一次手术成功,1例复发再次消融成功.24例室速、室早患者中20例一次消融成功,4例行再次消融2例成功.共有并发症6例:心包填塞4例,左前降支远端栓塞1例、术后肺栓塞1例. 结论:三维标测系统可清晰地显示心脏三维立体结构,对复杂疑难心律失常的射频消融治疗具有较好的指导作用,提高消融的成功率并增加手术安全性.%Objective:To explore the validity and safety of radiofrequeney catheter ablation of complex cardiac arrhythmias guided by a three-dimensional mapping system. Methods.. A cohort of 98 consecutive inpatients were registered from February 2006 to September 2008, of which 68 cases were male and 30 cases were female, with an average age of (50.2 ± 19. 7) years ranging from 9 to 88 years of age. These patients suffered from various arrhythmias including paroxysmal atrial fibrillation (50 cases), persistent or permanent atrial fibrillation (6 cases), atrial flutter (9 cases), atrial tachy-cardia (9 cases), ventricular tachycardia or frequent episode ventricular premature beat (24 cases). A total of 72 cases underwent radiofrequency catheter ablation of arrhythmias guided by an En-Site3000/NavX or Array mapping system, and 26 cases guided by a CARTO mapping system. Re-suits:Successful ablation of

  19. Predictive risk factors for delayed sternal closure in the patients under the age of three months old with congenital cardiac disease%3个月内复杂先天性心脏病患儿术后延迟关胸的因素分析

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    张惠锋; 贾兵; 陈张根; 李炘; 叶明; 陶麒麟; 陈刚

    2008-01-01

    Objective To analyze the risk factors related with delayed sternal closure(DSC)in the patients under three months old with complex cardiac disease.Methods One hundred and nineteen patients underwent median sternotomy and cardiopulmonary bypass(CPB)between Jan 2000 to Oct 2006.The age ranged from 1 to 90 days(mean 44±26 days)and the weight ranged from 2.2 kg to 7.1 kg(mean 3.9±0.89 kg).SPSS v 11.5 software was used to analyze the factors including the age,gender,weight,preoperative conditions,diagnose,prematurity,requirement for preoperative mechanic ventilation,preoperative SPO2,cardia-thoracic area ratio,left ventricular faction,CPB duration,clamping time,total circulatory arrest with profound hypothermia.Results Forty-seven patients had DSC.The rate of DSC iS over 75% for IAA or TAPVD(infracardiac)or TGA/VSD.The risk factors including age(P=0.032),pre-operative mechanic ventilation(P=0.001),CPB duration(P=0.000),total circulatory arrest with profound hypothermia(P=0.001).They were statistically significant(multivariate logistic regression).Conclusions DSC is a simple,safe and efficient procedure for the complex cardiac diseases.DSC iS related to IAA or TAPVD(infracardiac)or TGA/VSD.Age,pre-operative mechanic ventilation,CPB duration,total circulatory arrest with profound hypothermia are the risk factors for DSC.Understanding the factors iS helpful in the clinical decision making process.%目的 探讨3个月内的复杂先天性心脏病患儿术后行延迟关胸的危险因素.方法 2000年1月~2006年10月收治119例胸骨正中切口并进行体外循环的患儿,男97例,女22例,年~龄1~90 d,平均(44±26)d,体重2.2~7.1 kg,平均(3.9±0.9)kg,分析年龄、性别、体重、术前胸围、诊断、是否为早产儿、术前是否机械通气、SpO2、胸片测得的心胸比例、心超测得的左心射血分数、体外循环时间、主动脉阻断时间、深低温停循环等因素与延迟关胸的相关性.结果 延迟关胸47

  20. 胃癌17号染色体异倍体改变及TP53和拓扑异构酶Ⅱα蛋白过表达与病理诊断的相关性%Correlation between aneuploidy of chromosome 17,over-expression of TP53 and TOP Ⅱα,and the clinicopathoiogical features and diagnosis of gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    鲁海珍; 吴玉鹏; 罗巍; 韩亚玲; 蔡岩; 徐昕; 梁晶; 刘尚梅; 王明荣

    2009-01-01

    Objective The purpose of this study was to investigate the markers which can be used in auxiliary diagnosis of gastric adenocarcinoma (GAC),and their correlation with their clinicopathological features.Methods 122 surgical specimens including 99 gastric adenocarcinoma (GAC),18 adjacent mucosa and 5 distal normal mucosa were collected,and analyzed by in situ hybridization (FISH).The centromere probe cen17,specific for chromosome 17,which was reported to be frequently amplified in GAC,was selected for the FISH analysis.The clinicopathological features of the 99 GAC cases were reviewed,and the level of TP53 and TOP Ⅱα gene expression,located in chromosome 17,was detected using tissue microarray (TMA),compared with that of corresponding adjacent normal mucosa.Data were analyzed with SPSS 11.5 for Windows.Results The statistical results of FISH and TMA showed that 58.6% of cen17 in tumor tissues were aneuploid,and 45.5% of TP53 and 84.7% of TOP Ⅱα were over-expressed in GAC samples,significantly higher than those in non-tumor gastric mucosa (0,12.1% and 14.1%,respectively) (P =0.000).58 GAC tissues were aneuploid of cen 17,including 26 cases TP53-positive and 49 cases TOP Ⅱα-positive.The expression of TP53 in non-tumor gastric mucosa with dysplasia was significantly higher than that in the mucosa without dysplasia (P=0.009).Aneuploidy of cen17 was more frequent in grade 1 or 2 than in grade 3 GAC(P<0.05).Higher frequency of aneuploidy of cen17 was also observed in the gastric cardia than in pylorus (P<0.05),while no correlation was found between aneuploidy of cen17 and age,sex of patients,lymph node metastasis,and clinical stage of tumors.Over-expression of TP53 protein was associated with the size of tumors (P<0.05).In addition,a negative correlation was observed between over-expression of TOP Ⅱα and lymph node metastasis (LNM) as well as TNM classification (P<0.05).Conclusion Detection of aneuploidy of cen17 as well as over-expression of TP53 and

  1. Complicações pós-operatórias após gastrectomia total no câncer gástrico: análise de 300 doentes Postoperative complications after total gastrectomy in the gastric cancer: analysis of 300 patients

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    Nelson Adami Andreollo

    2011-06-01

    cirurgião, de sua equipe, empregando técnica cirúrgica aprimorada para minimizar as complicações pós-operatórias. As complicações pós-operatórias requerem cuidados no controle das infecções, das vias aéreas e cuidados nutricionais, diminuindo a mortalidade, aumentando a sobrevida e contribuindo para a qualidade de vida do doente.BACKGROUND: A total gastrectomy is considered a procedure with a high level of complexity, has high complication rates, both local and general, because patients are mostly with clinical conditions and nutritional compromised by disease. AIM: To analyse the results and complications of the total gastrectomy in gastric cancer in the period from 1972 to 2007. METHODS: Were reviewed the medical records of 300 patients with gastric adenocarcinoma, divided into two periods: from 1972 to 1992 - comprising 108 patients (36% and from 1993 to 2007 - comprising 192 patients (64%. They were 67.3% males, 70.7% whites, with ages ranging from 25 to 86 years (mean 63.4 years. The lesions were located in cardia - 40 cases (13.3%, gastric fundus - 83 cases (27.6%, gastric body - 77 cases (25.6%; plastic linitis- 45 cases (15%; gastric stump - 33 cases (11% and antrum and body gastric - 22 cases (7.3%. A total gastrectomy with extended lymphadenectomy to level D2 was performed in 246 cases (82%. RESULTS: The reconstruction technique used was the esophagus-jejunal anastomosis end-to-side Roux-en-Y in 257 patients (86.7%. The general complications in the period from 1972 to 1992 totalized 47 cases (43.5%, mainly involving the respiratory (28 cases - 25.9% and urinary tract (10 cases - 9.2%. In the period from 1993 to 2007 amounted to 48 cases (25%, mainly respiratory complications (27 cases - 14%, followed by urinary (12 cases - 6.2%. The local complications from 1972 to 1992 totalized 45 cases (30.8% and in the period from 1993 to 2007 amounted to 28 cases (14.5%, being the most frequent the digestive fistulas. The operative mortality through 30 days

  2. Interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery%介入治疗股浅动脉硬化闭塞19例分析

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    祝慧鹏; 周艺琳; 冯翔; 李鸣; 包俊敏; 景在平

    2009-01-01

    Objective To explore the methods and mid-term results of interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery(SFA).Methods From January 2005 to August 2008,Nineteen cases with 22 diseased lower limbs were admitted.According to Fontaine stage system,there were 6 stage Ⅱb limbs(moderate to severe intermittent claudication),8 stage Ⅲ limbs(rest pain),and 8 stage Ⅳ limbs(6 with ulcer and 2 with gangrene).The mean lesion length was 8.8 cm(5~13 cm).On the basis of the TransAtlantic Inter-Society Consensus(TASC)femoropopliteal classification,the lesions were classified as type B in 4 limbs,type C in 17,and D in 1.Follow up examinations with color duplex ultrasound and/or arteriography were carried out to determine the patency.The improvement of clinical symptoms after operation was analyzed.Results 17 limbs were revascularization successfully,2 limbs were turned to bypass operation,3 limbs were judged untreatable.The technical success rate is 77.3%,and the clinical improvement of symptoms was achieved in 100% of the 17 limbs on which the procedure was successful.The 17 limbs were followed up for a mean of 12.5 months(range 3-33 months).One patient died of cardia infarction one month postoperatively.SFA occlusion happened in 4 limbs.At one year postoperatively,the patency rate was 75%(13/17)after primary operation.Conclusions Primary endovascular treatment of SFA occlusion diseases is a safe,minimally invasive,and effective method.%目的 探讨股浅动脉硬化闭塞介入治疗的方法和疗效.方法 回顾性分析2005年1月至2008年8月介入治疗的19例(22条下肢)股浅动脉硬化闭塞症患者的临床资料.其中Fontaine Ⅱb期(中、重度间歇跛行)6条,Ⅲ期(静息痛)8条,Ⅳ期(组织缺损)8条(其中足部溃疡6条,足趾坏疽2条).股浅动脉病变的平均长度8.8 cm(5.0~13 cm).病变TASC分型B型4条,C型17条,D型1条.通过彩色血管超声和(或)动脉造影观察病变段动脉

  3. Clinical characteristics of gastric cancer in elderly patients%老年胃癌患者的临床特点分析

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    徐华明

    2013-01-01

    Objective To investigate the clinical characteristics of diagnosis,treatment and prognosis of gastric cancer in elderly patients.Methods A total of 245 patients with gastric cancer in our hospital were retrospectively analyzed.Results Abdominal satiety and pain were the most common symptoms,which were higher in elderly group than in non elderly group (91.6% vs.76.5%,P<0.05).Tumors mostly located in cardia and fundus of the stomach in elderly group (47.9%) and in antrum in non-elderly group (54.4%).3.1% of elderly patients had multi-original tumors,while tumors in non elderly patients were from single-original tumor.The incidences of comorbid chronic diseases were higher in elderly group than in non-elderly group.The surgery and radical operation (RO) resection rates were 80.0% and 71.3 %,which were similar in both groups.98.7% of gastric cancer patients received chemotherapy.Although the proportion of patients who received three lines or more chemotherapy was lower in elderly group than in non-elderly patients,which did not reacha statistical difference (3.5% vs.9.8%,x2=3.197,P>0.05).Most elderly patients chose FOLFOX/XELOX chemotherapy regimen (75.4%) as compared with non-elderly patients.There was no significant difference in the median survival time between the elderly patients and the non-elderly patients (27.8 months vs.28.7 months,P>0.05).Conclusions Most elderly patients with gastric cancer may present with abdominal satiety and pain at first.Tumors mostly locate in cardiac and fundus of the stomach and multi-original tumors are more common in elderly patients.Preoperative and postoperative complications are higher in elderly patients.Most elderly patients can receive surgery and chemotherapy.The surgery rate is similar in elderly and non-elderly groups.%目的 探讨老年胃癌患者的临床特点、诊治方法和预后特点. 方法 2008年1月至2012年12月间本院收治的245例胃癌患者的临

  4. 门静脉高压症巨脾切除+贲门周围血管离断术后发热的原因分析及处理%Analysis and Treatment of Postoperative Fever in Portal Hypertension Splenectomy+Ben Peripheral Vascular Transection

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    丁建忠; 李强; 王锦华

    2013-01-01

    Objective: To investigate patients with portal hypertension underwent splenectomy pericardial blood vessel broken postoperative persistent fever risk factors and treatment methods that clinical guidance. Methods:Collect hospital in January 2005~2012 5 treated patients with portal hypertension splenectomy the+cardia surrounding blood vessels from the off surgery in patients treated 236 cases of clinical data, screening of patients with postoperative persistent fever, a comparative analysis of persistent postoperative fever of risk factors, and summarizes the approach. Results:Of the 236 cases of patients with persistent fever after 35 cases, mainly due to the infection in 22 cases, five cases of splenic vein thrombosis, unexplained eight cases. After symptomatic treatment, 32 cases recovered, 3 cases of death, cause of death was infection with liver and kidney function failure in 1 case, 1 cases of severe pneumonia, splenic vein thrombosis cases. Univariate analysis, display emergency surgery, classification of poor liver function, operative time>4h after surgery is not for total parenteral nutrition, postoperative platelet significantly higher in the major risk factors that cause patients with persistent fever (P<0.05). fever was no significant relationship with the patient sex and age. Conclusion: Splenectomy+pericardial blood vessel transection of postoperative persistent fever because complex clinical risk factors should be based on the heat, a rigorous screening can be surgery, perioperative anti-infection effective to enhance the nutritional status of patients, as far as possible to shorten the operation time to effectively reduce the persistent postoperative fever.%  目的:探讨肝硬化门静脉高压患者行脾切除+贲门周围血管离断术后持续发热的危险因素及处理方法,以为临床提供指导。方法:收集本院2005年1月~2012年5收治肝硬化门静脉高压行脾切除+贲门周围血管离断术治疗的患者236例

  5. Characteristics of the lymph node metastases and influencing factors and their value in target region delineation in postoperative radiotherapy for thoracic esophageal carcinoma%胸段食管癌的淋巴结转移规律及其对确定术后放射治疗靶区范围的价值

    Institute of Scientific and Technical Information of China (English)

    李幼梅; 祝淑钗; 刘志坤; 宋长亮; 王玉祥; 王士杰

    2010-01-01

    Objective To explore the distribution of lymph node metastases, to analyze the cliniopathologic factors of thoracic esophageal carcinoma after curative resection, and to provide the criteria of irradiated region delineation in radiotherapy for esophageal carcinoma. Methods The clinicopathological data of 763 patients who underwent esophagecotomy from Jun 2002 to Jun 2006 were retrospectively analyzed. The regularity of lymph node metastases of thoracic esophageal cancer and clinicopathological factors were stratified and analyzed with SPSS13.0 software. Results Of the 763 patients, a total of 5846 lymph nodes were dissected with an average of 7.7 lymph nodes in each case. Metastatic lymph nodes were 711, the ratio of metastatic lymph node was 12.2% , and 297 patients had lymph node involved, the lymph node metastasis rate was 38.9%. The metastatic lymph nodes of upper-thoracic esophagus were mainly observed in the supraclavicular and paratracheal regions (P<0.05), the metastatic lymph nodes of middlethird thoracic esophagus were bidirectional, and those of the lower-third thoracic esophagus mainly metastasized to the regions adjacent to the esophagus, gastric cardia and gastric artery (P< 0.05 ). Both the metastasis ratio and rate of lymph nodes adjacent to the gastric artery in the lower-thoracic esophageal cancer were significantly higher than those in the middle-third and upper-third thoracic esophageal cancers ( P =0.007, P = 0.001). The multiple factors logistic regression analysis showed that tumor length, depth of tumor invasion, vascular tumor emboli and distant metastasis were major factors for lymphatic metastasis (P<0.01). For the whole group of patients the lymph node metastatic rate was 28.5% in upper-thoracic esophageal cancer, significantly lower than 38.8% of the lower-thoracic esophageal cancer (P =0.039) and 43.4% in the middle-thoracic esophageal cancer (P=0.010). However, the lymph node metastatic rates were 37.0% , 37.9% and 41.4% in the upper

  6. Antagonistic Effect of Nalmefene on Postoperative Respiratory Depression in Patients Undergoing Laparoscopic Cholecystectomy%纳美芬对腹腔镜胆囊切除术患者术后呼吸抑制的拮抗作用

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    康志雄

    2014-01-01

    -my.The systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),mean ar-terial pressure(MAP)and blood oxygen saturation(SpO2 )were recorded before administration,2 minutes after administration,10 minutes after administration and 5 minutes after extubation.The respiratory recovery rate,extubation time and adverse reactions(restlessness,hypertension,tachy-cardia,allergic reaction and pulmonary edema)were observed 10 minutes after administration.In addition,consciousness score and analgesic score were determined 5 and 30 minutes after extuba-tion(Ramsay and VAS scores were used).Results The extubation time was(5.4±0.3)minutes in group A and (6.1±0.4)minutes in group B.The difference in extubation time was not signifi-cant between the two groups(P >0.05).In addition,there were no significant differences between the two groups in SBP,DBP and SpO2 2 and 10 minutes after administration and 5 minutes after extubation,as well as in VAS score 30 minutes after extubation and Ramsay score 5 minutes after extubation(P > 0.05 ).Compared with group B,the respiratory recovery rate significantly in-creased in group A 10 minutes after administration(P 0.05).Conclusion Nalmefene is effective and safe for antagonizing the postoperative respiratory depression and results in higher respiratory recovery rate than naloxone in patients undergoing laparoscopic cholecystectomy.

  7. 内镜黏膜下挖除术治疗消化道黏膜下肿瘤108例分析%Analysis of 108 cases of submucosal tumor treated by endoscopic submucosal excavation

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    张明黎; 王业涛; 宋继中; 丁西平; 王巧民; 盛明伶; 卫梅枝

    2013-01-01

    目的 探讨内镜黏膜下挖除术治疗消化道黏膜下肿瘤的疗效和安全性.方法 选择2010年至2013年经内镜、超声内镜及增强CT检查发现,以向腔内生长为主的消化道黏膜下肿瘤108例进行内镜黏膜下挖除术.完整挖除病变后送病理检查,术后1、3、6、12、24个月内镜随访.结果 108例病变中位于食管27例,贲门8例,胃部59例,十二指肠2例,直肠12例.最大径为0.5~5.5 cm,平均为2.1cm,操作时间为18~240min,平均为105 min.3例胃部黏膜下肿瘤分别因肿瘤向腔外生长、与肌层紧密粘连无法分离、穿孔大无法修补而转腹腔镜手术;3例胃底黏膜下肿瘤操作失败而放弃,其余102例病变(94.44%)一次性完整切除.术中穿孔19例(17.59%),其中1例行转腹腔镜手术,18例在内镜下有效缝合.术中出血0~50 mL不等,无术后出血.术后发生颈部皮下气肿8例,气腹9例,左侧腮腺肿胀1例.9例失访,其余99例随访1~24个月,无一例复发.结论 内镜黏膜下挖除术能一次性完整挖除较大的,以向腔内生长为主的黏膜下肿瘤,可提供完整的病理诊断资料且安全、有效.%Objective To evaluate the efficacy and safety of endoscopic submucosal excavation in the treatment of suhmucosal tumor.Methods From 2010 to 2013,a total of 108 cases of suhmucosal tumor detected by endoscopic,endoscopic ultrasonography and computed tomography (CT) scan,most of which grew toward the lumen,were treated by endoscopic suhmucosal excavation.After the lesions were completely excavated,pathological examination were performed.All the cases were followed up with endoscopic examination at one,three,six,12 and 24 months after operation.Results Among 108 cases of lesions,27 cases were located in esophagus,eight in cardia,59 in stomach,two in duodenum and 12 cases in rectum.The diameters of the lesions ranged from 0.5 to 5.5 cm (median 2.1 cm).Operation time was between 18 and 240 minutes (median 105 minutes

  8. Clinical observation of low-dose domestic type for S-1 capsules combined with three dimentional conformal radiation in the treatment of aged patients with cardiac cancer%低剂量国产替吉奥胶囊联合三维适型放疗治疗老年贲门癌

    Institute of Scientific and Technical Information of China (English)

    王刚; 陈公安; 刘旭; 苗旺; 朱眉

    2015-01-01

    Objective To observe the curative effect and safety of the domestic type for S-1 capsule combined the three-dimensional conformal radiotherapy (3-DCT) in the treatment of aged patients with cardiac cancer.Methods Forty-six elderly patients with cardia cancer were studied from January 2009 to September 2011.After ruling out the contraindications of chemotherapy and radiotherapy,the patients were given oral chemotherapy with the domestic S-1 capsules (Weikangda),40 mg,2 times/day,d1-14,21 days for one circle,combined with synchronous three dimentional conformal radiation on local primay lessions and metastatic nudes.It' s dose was 1.8 Gy/time,five times a week,DT 39.6-54 Gy.It took 4-5.5 weeks to complete the radiation,following with a total 3-6 cycles of chemotherapy.The gastrointestinal side effects and bone marrow suppression were observed,and the treatment tolerance were researched during the treatment.The recent curative effect and follow-up of 1,2 year survival rate were studied.Results The patients' digestive tract symptoms were improved after radiation over 2 months and 4 months.The objective response rate (CR + PR) was 82.6%,1 year survival rate was 84.7% and 2 year survival rate was 65.2%.Conclusions The domestic type for S-1 capsule combined the three-dimensional conformal radiotherapy (3-DCT) in the treatment of aged patients with cardiac cancer is practicable and safe,the clinical currative effect is better and the further clinical research is recommend.%目的 观察国产替吉奥胶囊联合三维适型放疗治疗老年责门癌的疗效及安全性.方法 2009年1月至2011年9月收治46例老年贲门癌患者,排除放化疗禁忌证后,第1周期化疗开始口服国产替吉奥胶囊(维康达)40 mg,2次/d,第1~14天,21 d为1个周期,同步贲门原发病灶及周围淋巴结行三维适型放疗,1.8 Gy/次,每周5次,DT39.6 ~ 54.0 Gy,4~5.5周完成放疗,继续完成共3~6个周期的化疗.治疗过程中观察患者的消化

  9. 上海市与肥胖相关的恶性肿瘤发病趋势分析%Trend Analysis on Obesity-Associated Cancer Incidences in Shanghai

    Institute of Scientific and Technical Information of China (English)

    周峰; 吴春晓; 柯居中; 郑莹; 鲍萍萍; 彭鹏; 龚杨明; 向詠梅; 黄哲宙

    2013-01-01

    To describe the incidence trends of obesity-associated cancers,and to provide basis for cancercontrol-related policy making and prevention program evaluation in Shanghai.[Methods] Incidence rate data from Shanghai cancer registry system were coded by ICD-10 and ICD-O-3 and analyzed.Average annual percentage change (AAPC) and annual percentage change (APC) based on log linear model was adopted to describe the incidence trend.Population attributable risk percent (PARP) was employed to estimate the obesity-associated incidence cases.[Results] Whether over the long-term (1973-2008) or short-term (2002-2008) period,the breast cancer incidence rate of females at age of 50 years old and above was increasing continually and significantly with an AAPC of 2.34% in urban areas during 1973-2008 and an APC of 4.00% in suburb areas during 2002-2008.The incidence rates of endometrial cancer of all females and of the 50 years old and above did not present significant trends of variation.The colorectum cancer presented significant ascending trends,except among the suburb females,for the urban with an AAPC of 2.33% during 1973-2008 and the suburb with an APC of 2.51% during 2002-2008.The kidney cancer showed significant ascending trends for the urban residents with an AAPC of 5.20% during 1973-2008 and the suburb residents with an APC of 7.57% during 2002-2008.During 2002-2008,the esophagus and gastric cardia adenocarcinoma presented significant descending trends,except among the suburb males,for the urban residents with an APC of 10.49% and the suburb residents with an APC of 2.94%.In 2009,the obesity-associated incidence number of the above 5 cancers was 1431,accounting for 11.37% of the total incidence count of the above 5 cancers.The endometrial cancer had the largest proportion of the obesity-associated cancers and covered 23.41% of its total incidence cases.[Conclusion] Multiple strategies including obesity control and screening for high risk populations

  10. On histology of digestive system of wild and cultivated grey mullet Mugil cephalus%野生鲻鱼和养殖鲻鱼消化系统的组织学观察

    Institute of Scientific and Technical Information of China (English)

    于娜; 李加儿; 区又君

    2011-01-01

    野生与养殖鲻鱼(Mugil cephalus)的消化系统在形态和组织结构上存在一定差异.(1)形态方面:食道粗而短,胃呈球形,包括贲门部、盲囊部、胃体部和幽门部4个区域,胃与肠相接处有2个指状幽门盲囊,肠道在腹腔内盘旋5圈.肝脏黄褐色,右叶较左叶大,未发现独立的胰脏.养殖鲻鱼消化道周围包裹更多脂肪,胃较小但胃腔更大,肠道比野生鲻鱼长.野生鲻鱼和养殖鲻鱼的肠道系数分别为2.909和3.0800(2)组织学研究表明:食道分扁平上皮层区域和单层柱状上皮层区域,粘膜肌层较厚;野生鲻鱼食道粘膜层的表面可见角质化细胞,野生鲻鱼纵行的肌束更粗.胃粘膜由单层柱状上皮组成,在贲门部和盲囊部有丰富的胃小凹和胃腺,养殖鲻鱼的粘膜褶及小粘膜褶高度大于野生鲻鱼.胃体部的粘膜层上皮中有较多的呈空泡状的杯状细胞,胃体部和幽门部肌层较厚,几乎为整个胃壁的厚度,野生鲻鱼胃壁肌层更厚.幽门盲囊组织学特征与前肠类似,上皮由单层柱状上皮细胞组成,丰富的微绒毛形成明显的纹状缘,上皮中杯状细胞的数目明显增多,前肠多于中肠,后肠的杯状细胞最多,且养殖鲻鱼多于野生鲻鱼.野生鲻鱼伸向腔内的粘膜褶,呈分支状,不规则,养殖鲻鱼无分支,呈长条状.肝脏中肝小叶不明显,肝细胞索明显.胰腺呈弥散状分布于胃、肠、总胆管等的周围系膜中.%Results showed that there were some differences between wild and cultivated grey mullet in the shape and histology of digestive system. ( 1 ) In terms of morphology: oesophagus was crude and short; the spherical stomach was divided into four portions: cardia, gastric caeca, fundic stomach and pyloric part.There were two finger-shape pyloric caeca, intestine was circled 5 laps in the abdominal cavity. Brown liver,right lobe was larger than the left lobe, single pancreas was not found. For cultivated mullet, the

  11. Clinical analysis of 25 cases of meningeal carcinomatosis%脑膜癌病25例临床分析

    Institute of Scientific and Technical Information of China (English)

    汤武装; 张丽; 张晓雷; 胡秀秀

    2013-01-01

    were found in 5 cases, hearing-impaired were found in 3 cases, dizziness were found in 3 cases, fever were found in 2 cases, neck pain were found in 1 case. No meningeal enhancement were found in cranial CT and (or) cranial MRI scan among 20 patients, 5 patients underwent cranial MRI enhanced scan showed 2 cases of meningeal enhancement, 1 case of swelling of the cerebral cortex, 1 case of hydrocephalus and 1 case of the left cerebellar vermis suspicious nodules. CSF pressure increases in 12 cases, 16 cases of protein increase, and 14 cases of sugar and chlorine decrease. 23 patients with CSF cytology were found atypical cells, and 17 patients with CSF immunohistochemical staining were found metastatic cancer. Primary tumor source of 17 patients were found by the clinical and pathological, 10 cases were diagnosed with lung cancer (from which 1 case was mergered former buccal mucosa squamous cell carcinoma), 3 cases were diagnosed with gastric cancer, 2 cases were diagnosed with cardia cancer, 1 case of breast cancer, 1 case of suspicious ovarian cancer, and 8 cases of unknown source. Conclusion MC is a special form of malignant brain metastases, clinical manifestations are complex but lack of specificity. The main manifestations are increased intracranial pressure in early stage. Cranial MRI enhanced scan may provide some referential value for the diagnosis of MC. CSF cytology combined with immunohistochemical staining is the main method to diagnose MC.

  12. 盐酸右美托咪啶在七氟醚稳态吸入下对脑功能状态指数的影响%Dexmedetomidine decreases cerebral state index under the steady-state anesthesia of sevoflurane

    Institute of Scientific and Technical Information of China (English)

    钟桥生; 屈献锋; 王文勇; 杨礼; 王筱斐; 杨小平

    2014-01-01

    Objective To investigate the effects of dexmedetomidine on cerebral state index(CSI) under the steady- state anesthesia of sevoflurane. Methods Sixty patients scheduled for elective gynecologic laparoscopic operation were randomly divided into two groups with 30 in each. Al patients were induced with sevoflurane, the end- tidal concentrations of sevoflurane in two groups were adjusted to 1.0 MAC and maintained for 15 min after tracheal intubation. A load dose of 0.4μg/kg dexmedetomidine was injected for 10 min fol owed by infusion of 0.4μg/ (kg·h) until the end of trial in group D;same volume of 0.9%normal saline was given in group C. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR) and CSI were recorded at lying stil for 5 min(T0), immediately after intubation(T1), steady state of sevoflu-rane (T2), infusion after 5, 10, 15, 20, 25 and 30 min (T3, T4, T5, T6, T7 and T8). The incidence of hypotension, hypertension, tachy-cardia and bradyrhythmia were recorded. Results SBP, DBP, MBP, HR and CSI at T4~T8 were significantly lower in group D than those in group C and T2(P0.05). Conclusion Dexmedetomidine can reduce the CSI under the steady- state anesthesia of sevoflurane and lower blood pressure and heart rate at the same time.%目的:观察盐酸右美托咪啶在七氟醚稳态吸入下对脑功能状态指数(CSI)的影响。方法选取择期妇科腹腔镜手术的患者60例,采用随机数字表法分为盐酸右美托咪啶组(D组)和0.9%氯化钠溶液对照组(C组),各30例。七氟醚吸入诱导,气管插管后调整七氟醚呼气末浓度为1.0 MAC并维持15min后,D组盐酸右美托咪啶以负荷量0.4μg/kg微量泵静脉泵注10min,再以维持量0.4μg/(kg·h)静脉持续泵注;C组给予等量0.9%氯化钠溶液。记录静卧5min后(T0)、气管插管后(T1)、七氟醚达稳态(T2)、泵注5(T3)、10(T4)、15(T5)、20(T6)、25

  13. 胸内食管吻合口隐匿瘘的诊断与治疗%Diagnosis and Management of Concealed Intrathoracic Anastomotic Leak of Esophagus

    Institute of Scientific and Technical Information of China (English)

    刘奎; 杨秀芝; 王明钊; 王栋; 王滋宗; 沈毅; 魏煜程

    2012-01-01

    Objective To investigate diagnosis and treatment of concealed intrathoracic anastomotic leak of the esophagus. Methods We retrospectively analyzed the clinical data of 32 patients who presented with unexplained sepsis (temperature > 38 ℃ and elevated white blood cell count) after esophagectomy and intrathoracic anastomosis for esophageal carcinoma or gastric cardia carcinoma in Affiliated Hospital, Medical College of Qingdao University from January 2006 to December 2010. All the patients underwent oral water-soluble contrast esophagogram and oral water-soluble contrast computerized tomography of the chest. None of the patients had any sign of contrast leak in these diagnostic examinations, but their chest computerized tomography all showed peri-anastomotic bubble and encapsulated effusion. Fifteen patients were treated as concealed intrathoracic anastomotic leak of the esophagus, including fasting, broad spectrum antibiotic treatment, -. prolonged gastrointestinal decompression and enteral nutrition via naso-intestinal feeding tube. The other 17 patients were not treated as anastomotic leak of the esophagus and only received broad spectrum antibiotic treatment. Results None of the 15 patients who were treated as concealed intrathoracic anastomotic leak finally developed anastomotic leak proved by oral water-soluble contrast esophagogram and computerized tomography of the chest (0%, 0/15). Among the 17 patients who were not treated as anastomotic leak, fourteen patients developed anastomotic leak later (82. 4%, 14/17), 2 patients died of aorto-esophageal fistula and 3 patients died of multiple organ dysfunction syndrome. Conclusion Peri-anastomotic bubble and irregular encapsulated effusion in oral water-soluble contrast esophagogram and computerized tomography of the chest should be considered as specific signs of concealed intrathoracic anastomotic leak of esophagus after esophagectomy and intrathoracic anastomosis. Patients with such signs should be treated

  14. 多西紫杉醇对可切除的淋巴结阳性乳腺癌的疗效分析%The effect of adjuvant docetaxel for operable node - positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    郭立伟; 黄自明; 王蓉; 薛明兴; 魏刚

    2014-01-01

    To compare docetaxel plus epirubicin and cyclophosphamide(TEC)with fluorouracil plus epirubicin and cyclophosphamide(FEC)as adjuvant chemotherapy for operable node - positive breast cancer. Meth-ods:From July 2005 to July 2007,we randomly assigned 62 women with axillary node - positive breast cancer to six cycles of treatment with either trial group(TEC)or control group(FEC)as adjuvant chemotherapy after modified rad-ical mastectomy to analyse 5 - year disease - free survival,overall survival and adverse effect. Results:The rate of five- year disease - free was 70. 0%(21 / 30)in the TEC group significantly higher than that[40. 6%(13 / 32)]in the FEC group(P = 0. 020). The rate of five - year overall survival was 50. 0%(16 / 32)in the FEC group significantly lower than that[76. 7%(23 / 30)]in the TEC group(P = 0. 030). The incidence of grade 3 or 4 neutropenia was 53 . 1 %( 17 / 32 )in the FEC group and 63. 3%(19 / 30)in the TEC group(P = 0. 416). Rates of febrile neutro-penia were 6. 3%(2 / 32)and 10. 0%(3 / 30),respectively(P = 0. 587). The damages to liver,kindey and cardia were not significantly different in the two groups(P ﹥ 0. 05). Quality of life scores decreased during chemotherapy but returned to baseline levels after therapy,but scores in the FEC group were significantly lower than those in the TEC group on the 24th month after completing the sixth chemotherapy(P = 0. 032). Conclusion:Adjuvant chemotherapy with TEC as compared with FEC significantly improves the rates of five - year disease - free and overall survival among women with operable node -positive breast cancer,and its adverse effects such as myelosuppression are not unacceptable.%目的:比较含多西紫杉醇的化疗方案(TEC)与 FEC 方案对可切除的淋巴结阳性乳腺癌的疗效。方法:2005年7月至2007年7月,将我科62例行乳腺癌改良根治术后的腋窝淋巴结阳性病人随机分为 TEC 组(试验组)和 FEC 组(对照组),并行6

  15. 伊伐布雷定治疗窦性心动过速的 Meta 分析%A Meta-analysis of ivabradine in treatment of inappropriate sinus tachycardia

    Institute of Scientific and Technical Information of China (English)

    邱爽; 杨波; 平海芹; 王慧

    2015-01-01

    Objective To systemic evaluate clinical curative effect of ivabradine in treatment of sinus tachycardia. Methods Through the retrieval of Wanfang database, VIP database, China journal full text database, PubMed, EMBASE database, database SCI/SSCI/A&HCI, science direct database, Springer electronic journals and electronic books, the Co-chrane Database, all evaluation of Ivabradine for treatment of sinus tachycardia random or non-randomized control trials ( re-trieval time from state of the database to January 2015), the included studies were evaluated by Jadad quality score, resting heart rate, average heart rate, maximum heart rate, minimal heart rate, daytime heart rate, maximum exercise heart rate were weighted the mean difference (WMD) as the therapeutic index, and the results were analyzed by Rev man 5.2 software.Re-sults A total of 8 studies were included, all were English literature, and the total number of cases was 231, the treatment group with 116 cases, and the control group with 115 cases.Meta-analysis shows that for sinus tachycardia patients, Ivabra-dine can effectively reduce the resting heart rate (WMD=-29.55, 95%CI -32.69 to -26.41, P <0.01), average heart rate (WMD=-23.41, 95%CI -24.81 to -22.00, P <0.01), the maximum heart rate (WMD=-28.69, 95% CI -32.03 to -25.34, P <0.01), the minimal heart rate (WMD=-11.42, 95%CI -13.86 to -8.98, P <0.01), the day-time heart rate (WMD=-23.90, 95%CI -25.91 to -21.89, P <0.01), and the maximum exercise heart rate (WMD=-25.20, 95%CI -34.40 to -15.99, P <0.01).Conclusion Ivabradine showed certain curative effect for sinus tachy-cardia, while its long-term efficacy and safety needed to be confirmed by high quality randomized controlled trials and evidence based medicine.%目的:系统评价伊伐布雷定治疗窦性心动过速的临床疗效。方法通过检索万方数据库、维普数据库、中国期刊全文数据库、PubMed数据库、Embase数据库、SCI/SSCI/A&HCI数据库、Science Direct数

  16. ارتباط حضور ژن cagA در عفونت هليكوباكتر پيلوري با بيماريهای گاستريت و زخمهای دئودنال و آدنوکارسينومای Correlation of cagA positive Helicobacter pylori Infection with clinical outcomes in Alzahra hospital, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Hajieh Ghasemian Safaei

    2008-08-01

    اد که بين ژنوتيپ cagA و سن، ميزان تحصيلات، محل سکونت و مثبت بودن تست اوره­آز سريع، رابطه معنی داری وجود نداشت(pvalue>0.05. ولی بين سن و بيماری آدنوکارسينوما ارتباط معنی داری وجود داشت.  (pvalue>0.05

    • BACKGROUND: Helicobacter pylori causes chronic active gastritis, peptic ulcer, non-cardia gastric cancer and mucosal– associated lymphoid tissue (MALT lymphoma. Different genotypes of  Helicobacter pylori are confirmed from disease geographical areas. Its association with clinical disease remained controversial. The aim of the present study was to investigate the relationship of the cagA genotype of Helicobacter pylori isolates with clinical manifestations and its relation to age and sex of patients.
    • METHODS: A total of 100 patients (60 male and 40 female biopsy specimens were obtained from 3 groups of patients (40 chronic active gastritis, 40 duodenal ulcers and 20 non-gastric gastric cancers. Biopsies were cultured on specific medium and after growth colonies were confirmed as Helicobacter pylori. DNA extraction and polymerase chain reaction (PCR were used to detect the presence or absence of cagA gene.
    • RESULTS: From a total of 100

    • Neoplasias do trato alimentar superior de bovinos associadas ao consumo espontâneo de samambaia (Pteridium aquilinum Neoplasms of the upper digestive tract of cattle associated with spontaneous ingestion of bracken fern (Pteridium aquilinum

      Directory of Open Access Journals (Sweden)

      Marione A. Moreira Souto

      2006-06-01

      of disease and necropsied. The main gross and microscopic alterations were found in identical areas of the UDT. They consisted of papillomas, transforming papillomas, and squamous cell carcinomas (SCCs. Metastases of SCCs to regional lymph nodes and other organs, such as liver and lungs, were also observed (18/30. Twenty-nine bovine had papillomas of various sizes in several areas of the UDT. The digestive papillomatosis ranged from mild (45%, to moderate (38%, to severe (17%. Three developing phases were observed microscopically in the examined papillomas: an early growing phase, a developing phase, and a regressing phase. In 16 cases, there was malignant transformation of papillomas into SCCs. The SCCs were solitary (12/30 or multiple (18/30 and were histologically well, moderately, or poorly differentiated. Grouping the distribution of SCCs of larger extension in the UDT into cranial region (base of the tongue, pharynx/oropharynx, and epiglottis, medial region (esophagus, and caudal region (cardia and rumen, the distribution was cranial in 39%, middle in 16%, and caudal in 45% of the cases. By the same grouping criteria, but considering the total number of times SCCs of varied extensions were diagnosed in the cranial, middle, and caudal regions, the percentages changed to 34%, 26%, and 40%, respectively. The epidemiological and histomorphological evidences found in this study are in agreement with the observations that point out the co-carcinogenesis between bovine papillomavirus type 4 infection and chemicals of bracken fern in the pathogenesis of the SCCs in the UDT of cattle. However, the presence of pre-neoplastic changes and SCCs in situ or in early stages of development, independently of the presence of papillomas, clearly indicates the possibility of development of SCCs from normal epithelium, probably due to the direct action of the chemical carcinogens contained in bracken fern.

    • A comparitive study between conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gastrointestinal endoscopy%笑气清醒镇静镇痛与丙泊酚静脉麻醉用于胃镜检查的临床价值比较研究

      Institute of Scientific and Technical Information of China (English)

      徐胜浩; 岳辉; 李清峰; 杨文娟; 何锋坚; 邓三花; 彭芊芊; 刘素英

      2014-01-01

      Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with

    • The Progress in Clinical and Basic Research of the Effect ofAcupuncture in Treating Disorders of Gastrointestinal Motility

      Institute of Scientific and Technical Information of China (English)

      2000-01-01

      Though the function of “spleen” in TCM refers to a lot of systems, it is mainly related to digestive system, reflecting changes of physiology and pathology of gastrointestinal tract. The deficiency of Spleen Qi is correlated to the disorders of gastrointestinal motility.(19) In recent years the research has been developed in adjustment of Spleen and Stomach function and the improvement of gastrointestinal motility by acupuncturing mainly Zusanli, which formed a theoretic base for acupuncture therapy of disorders of gastrointestinal motility.Effect of Acupuncture on Gastric Peristalsis  Observation by gastroendoscopy and B-ultrasonography showed that, acupuncture at Zusanli could decrease gastric tension and resolve spasm of cardia, gastric body and pylorus, and improve delayed opening of pylorus, so as to make gastric hyperperistalsis tend to go placid and normalize retarding. It is demonstrated that acupuncture at Zusanli could adjust the function of gastric peristalsis bi-directionally.(20,21) In healthy volunteers after acupuncture at Zusanli the frequency and the amplititude of gastric peristalsis both increased. In patients whose pylorus ring could not open during the operation of gastroscopy, acupuncture at Zusanli could relax and open it. Acupuncture at Neiguan could produce either opening or closing the bi-directional effect of pylorus.(22) In patients with disorders of gastrointestinal motility it was observed that the amplititude and frequency of constriction of sphincter pylori increased and the strength and frequency of stomach improved after acupuncture at Zusanli according to the measurement of gastroscopic manometry.(23) Acupuncture may accelerate or reduce the speed of gastric evacuation.(24,25) In addition, acupuncture can increase the volume of gastric antrum. Observed by B-ultrasonography, acupuncture Zusanli, Shangjuxu (ST37), Chongyang (ST42) and Neiting (ST44) in the lower extremity section of the Yangming meridian of the foot could

    • Myostatin基因及其与动物双肌性状间关系的研究进展%Myostatin and Its Double-Muscling Phenotype in Animals

      Institute of Scientific and Technical Information of China (English)

      王建起; 曹文广

      2014-01-01

      突变,狗的c.939-940delTG突变和人类的c.373+5G>A突变;此外在绵羊中还存在一个靶向MSTN基因的miRNA功能获得型纯合突变c.2360G>A(也称g.6223G>A)也可引起双肌性状。双肌动物在19世纪初就已记载,不仅表现有更多的肌肉,而且有更少的骨骼和脂肪,然而双肌性状也会带来一些缺点,包括产奶率下降、雌性繁殖力下降、难产增加和幼畜死亡率增加,因此运用基因工程技术合理优化 MSTN 功能的发挥且又降低双肌性状副作用的方法来培育优质肉用家畜品种一直是研究热点。在牛中还存1个保守性错义突变p.F94L,并不会改变 MSTN 的功能,所以不会发生双肌表型的副作用,但可引起肌肉重量增加,并降低肌内和肌外的脂肪含量,且不会影响肉嫩度,因此目前p.F94L突变已较理想地用于肉牛的分子标记育种。本文综述了哺乳动物MSTN基因的结构、表达、信号转导、生理功能、突变体、双肌表型和在家畜育种中的最新研究进展,旨在为更深入理解哺乳动物MSTN作用机理及为肉用家畜品种的培育提供参考。%Myostatin (MSTN), also known as growth differentiation factor 8(GDF-8), is a member of the transforming growth factor β(TGF-β) superfamily, which was first obtained from screening a murine skeletal muscle complementary DNA library in 1997. The gene of MSTN consists of three exons and two introns, the gene is very conservative as only three or fewer differences exist among the amino acid sequences of mature peptide in all studied species. High levels of expression of MSTN has been found mainly in skeletal muscle although it is expressed in multiple tissues, including the cardia, adipose, placenta, mammary gland, uterus, olfactory neuron, liver, spleen, lung, and kidney, etc. The mature MSTN is liberated as a homogeneous dimer from prepromyostatin through proteolytic processing of signal peptidase, furin and BMP-1/tolloid family

  1. 氟西汀合用小剂量奥氮平对重度抑郁症患者睡眠及焦虑躯体症状的改善作用%Improvement of sleep and anxiety in patients of major depression with fluoxetine combined with small dose of olanzapine

    Institute of Scientific and Technical Information of China (English)

    瞿玮; 覃园园

    2005-01-01

    的脱落率;两组各观察时段的减分率.结果:奥氮平组脱落率明显低于阿普唑仑组(P<0.05),而且于治疗后1周显效(显效率67%);奥氮平组各观察时段HAMD及HAMA的评分较阿普唑仑组明显低(P<0.01),睡眠障碍及躯体化因子各观察时段改善比阿普唑仑组更明显(P<0.01).结论:小剂量奥氮平合并氟西汀治疗重度抑郁症,能迅速改善抑郁症患者睡眠及焦虑的躯体症状,显著提高其生活质量.%BACKGROUND: Major depression is a subtype of depression. Application of thymoleptics alone has bad effect. It has shown from relevant studies abroad that application of fluoxetine combined with atypical antipsychotic drugs maybe an effective treating strategy.OBJECTIVE: To observe the curative effects of fluoxetine combined with olanzapine and the time of its taking effect.DESIGN: Comparative study of open clinical test with completely random sampling for the first visit outpatients SETTING: A psychological consulting clinic in a hospital of a Military Medical College of Chinese PLA.PARTICIPANTS: Totally 140 patients visiting psychological counseling outpatient clinic in the hospital were collected from January 2004 to August 2004. Inclusion criteria: According to the diagnostic criterion of depression of CCMD-3, patients with total scores of 17 items in Hamilton depression rating scale≥28and age ≥18 years old .EXclusion criteria;①slight to middle edgree of depression(Hamt≤27);②secondary depression;③convalesscent period of schizophrenia and other affective disorder caused by psychosis;④severe of unstable body diseases ,including diseases of liver,kidney,cardiae vessel,respiration,gastro-intestine,endocrine,nervous system,innune system or hematological system,cet.⑤drug or alcohol addict;⑥women in pregnancy and lactation. Totally 110 patients accorded with the inclusive criteria. Among them, there were 40 males and 70 females with the course of disease for 4 months to 5 years, aged 18 to 63 with the

  2. Correlation between hypertension and clinical probable Parkinson disease: Cohort analysis of 4 335 people in Linxian County with nutritional intervention%高血压与临床很可能帕金森病的关联性:林县营养干预4 335人队列人群资料分析

    Institute of Scientific and Technical Information of China (English)

    范金虎; 张亚黎; 刘颖; 孙秀娣; 乔友林

    2006-01-01

    BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four