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Sample records for cardia

  1. Achalasia cardia in a premature infant

    OpenAIRE

    Shettihalli, Naveen; Venugopalan, Vikranth; Ives, Nicholas Kevin; Lakhoo, Kokila

    2010-01-01

    Achalasia cardia is defined as a neuromuscular disorder of the oesophagus with abnormal motility and failure of relaxation of the distal oesophagus. It is an uncommon but well-recognised entity in infants and children. However, achalasia in a preterm baby has not been previously described. We report the condition in a premature infant with unusual presentation, treated successfully with Heller's oesophagomyotomy and fundoplication.

  2. Achalasia Cardia in Infants: Report of Two Cases

    OpenAIRE

    Chatterjee, Souvik; Gajbhiye, Vishal; De, Avidip; Nath, Sasanka; Ghosh, Dipak; Das, Sukanta Kumar

    2013-01-01

    Achalasia cardia is a neuromuscular disorder of unknown etiology involving the body of the esophagus and lower esophageal sphincter (LES). It is characterized by aperistalsis of the body of the esophagus and failure of relaxation of lower esophageal sphincter. It usually affects patients between the ages of 30 and 60 years. It is unusual in childhood and extremely rare in infants. We report two cases of achalasia cardia in infants. Both cases were treated with open Heller’s esophagocardiomyot...

  3. Pneumatic dilatation in achalasia cardia results and follow-up.

    Directory of Open Access Journals (Sweden)

    Supe A

    1990-10-01

    Full Text Available Pneumatic dilatation is one of the more recent methods in the management of achalasia cardia. Fifty dilatations were done in 42 patients with achalasia cardia over 5 years. There was a significant decrease in the maximum diameter of the oesophagus and a significant increase in diameter in the narrowed lower oesophageal segment in all the patients. Of the patients studied, 95.23% were relieved of their symptoms after only one to two sessions. There were no immediate complications. Out of the 38 patients on long term follow up, 8 (21.05% had recurrence of symptoms. On repeat dilatations, 4 (50% of them had good response. Late complication like reflux oesophagitis was observed in only 1 patient over a median follow up period of 22 months. It was thus concluded that pneumatic dilatation is a safe, simple and effective procedure in managing patients with achalasia cardia.

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

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    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.

  5. 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.

  6. Gastric cardia adenocarcinoma in Taiwanese men: positive associations due to selection bias.

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    Cervantes, Diana Treviño; Fischbach, Lori Ann

    2010-03-28

    The factors associated with an increase in gastric cardia adenocarcinoma are poorly understood. Environmental factors such as Helicobacter pylori (H. pylori) infection and diet have been hypothesized to play a role in the recently increased risk of this disease, but additional studies are needed. In conducting studies to establish the relationship between potential risk factors and gastric cardia adenocarcinoma, it is necessary to carefully consider the role of bias. In a recently published study, the reported associations between H. pylori as well as post-meal physical exertion and gastric cardia adenocarcinoma may have been greatly influenced by selection bias. PMID:20333802

  7. 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.

  8. Laparoendoscopic Removal of a Benign Gastric Stromal Tumor at the Cardia

    OpenAIRE

    Singaporewalla, Reyaz Moiz; Ganesan, Baladas Haridas; Ee Lee, Tan Daniel

    2006-01-01

    Objective: Gastrointestinal stromal tumors are the most common submucosal masses in the stomach and are mostly benign. Minimally invasive surgery is being increasingly used for their excision. Tumors close to the cardia often require a stapled resection of stomach. We report a technique for enucleating a 4-cm, well-circumscribed gastric submucosal tumor at the cardia, avoiding gastric transection. Methods: A gastroscope was introduced to distend the stomach. A laparoscope was inserted through...

  9. Cutaneous metastasis of gastric cardia adenocarcinoma in a patient: a case report

    OpenAIRE

    Ying WANG; Kong, Guoqiang; Yuan, Xiaozhi; Gao, Shegan

    2014-01-01

    A large proportion of gastric cardia adenocarcinoma (GCA) present initially in an advanced stage in China. Skin metastasis of primary GCA rarely occurs and the incidence of it is still unclear yet. Here we report one case of skin metastasis from GCA in a 58-year-old male patient who underwent gastric cardia resection in 2002 and did not undergo chemotherapy. However, he was diagnosed with anastomotic stoma adenocarcinoma by gastroscopy and histological biopsy in 2012.4. Then he underwent four...

  10. Achalasia cardia presenting with bilateral broncheactasis in a child

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    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

  11. Outcome of Achalasia Cardia Managed with Transabdominal Hellers Cardiomyotomy and Anterior Dor Patch

    International Nuclear Information System (INIS)

    Objectives: To evaluate relief of dysphagia and apprearance of reflux symptoms in patients of achalasia cardia treated with Trans abdominal cardiomyotomy and anterior Dor patch. Study Design: Quasi experimental study. Place and duration of study: Combined Military Hospital Quetta and Combined Military Hospital Rawalpindi from Jan 2006 to Jan 2012. Methodology: Twenty three cases were diagnosed to have achalasia cardia on barium swallow, upper GI endoscopy and CT scan chest in selective cases. They were treated with transabdominal modified Hellers cardiomyotomy and anterior Dor patch as an antireflux procedure. Relief of dysphagia and occurrence of reflux symptoms were evaluated clinically. Results: All (100%) operated patients had symptomatic relief of dysphagia over follow up of six months. No patient had post op reflux symptoms. Conclusion: Transabdominal Hellers cardiomyotomy with anterior Dor patch is a safe and effective surgical option for achalasia cardia. (author)

  12. Synchronous Ectopic Pancreases in the Cardia and Antrum of the Stomach: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yie, Mi yeon; Kim, Min Jeong; Lee, In Jae; Yang, Dae Hyun; Jun, Sun Young; Min, Kwang seon [Hallym University Medical Center, Anyang (Korea, Republic of); Jang, Kyung Mi [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-04-15

    Ectopic pancreas is most commonly found in the antrum of the stomach, duodenum, or proximal jejunum. Rarely ectopic pancreas in the proximal stomach has been reported. Moreover, the coexistence of two ectopic pancreases at gastric cardia and antrum in a patient has not been reported. Ectopic pancreas usually appears as a submucosal mass, and it is difficult to differentiate between ectopic pancreas and other common submucosal tumors, such as a gastrointestinal stromal tumor (GIST) or leiomyoma. Here, we present a case of the coexistence of two ectopic pancreases at cardia and antrum of the stomach in a 60-year-old man, which was preoperatively misdiagnosed as GIST

  13. Laparoscopic myotomy in achalasia cardia treatment: Experience after 36 operations

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    Bjelović Miloš

    2013-01-01

    Full Text Available Introduction. Laparoscopic Heller­Dor operation, a standard method in the treatment of achalasia, has been performed at the Center for Esophageal Surgery of the First Surgical Clinic since April 2006. Objective. The aim of this study was to present this surgical procedure and initial experiences after 36 consecutive laparoscopic Heller­Dor operations. Methods. This partly retrospective, partly prospective study presented our results after laparoscopic Heller­Dor operation (presentation of the treatment method. We performed a standard anterior esophagocardioymiotomy, without releasing the posterior aspect of the cardia, and anterior partial fundoplication. The type and severity of symptoms and their duration were evaluated based on questionnaires fulfilled by patients. The diagnosis was made based on radiological, endoscopic and manometric findings. Laparoscopic surgery as the method of treatment was evaluated based on the duration of surgery, intra­ and postoperative complications, time interval until the initiation of oral feeding, length of hospital stay, need for additional therapeutic measures after the operation and effect of surgery on the severity of symptoms. Results. Preopereratively, dysphagia was the predominant symptom in all patients, while regurgitation was much lower (44%. The average duration of operation was 127 minutes. Postoperative hospitalization lasted on the average 5.7 days. From 36 treated patients, 34 (94.4% considered that the effect of treatment was good or excellent. Postoperative dysphagia was present in two patients (5.6% and was successfully solved by balloon dilatation. Conclusion. Laparoscopic Heller­Dor operation is an effective and safe surgical procedure in resolving symptoms of achalasia and today presents the method of the first choice in the treatment of this disease.

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

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    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.

  15. 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.

  16. Multistage resection of esophageal squamous cell cancer of the cardia – successful despite complications

    Science.gov (United States)

    Ptach, Anna; Sadowski, Andrzej; Chruścicka, Iwona; Pęksa, Rafał; Rak, Piotr

    2015-01-01

    Surgery is the treatment of choice for squamous cell esophageal cancer. Complete resection of the esophagus with reconstruction of the digestive tract is performed for tumors located in the chest or cardia. The aim of the report is to present the case of a complete esophageal and gastric resection complicated by colon graft necrosis. The patient was a 45-year-old woman diagnosed with cancer of the cardia infiltrating the distal section of the esophagus and the body and fundus of the stomach. The initial surgical procedure included the opening of three body cavities followed by resection of the thoracic esophagus, stomach, and a portion of the left hepatic lobe. Right colon interposition was performed to restore digestive tract continuity. On the 8th day, a leak was observed in the esophagointestinal anastomosis. Management consisted in two surgical procedures, one of which ended in the removal of the colon patch. The fourth and final procedure was conducted after 10 months. PMID:26702285

  17. 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....... Therefore, the optimal treatment of cardia cancer remains controversial. A systematic review of English publications dealing with adenocarcinoma of the cardia was conducted to elucidate patterns of nodal spread and prognostic implications. METHODS: A systematic literature search based on PRISMA guidelines...... 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...

  18. Prosthetic rehabilitation in patient with achalasia cardia — A rare case report

    Science.gov (United States)

    Kondaka, Sudheer; Rao, Bathala L.; Reddy, Juturi R.; Akula, Rajesh

    2016-01-01

    Achalasia Cardia is an idiopathic esophageal motor disorder distinguished by the loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter. The oral manifestation of the disease is dental erosion caused by the regurgitation of the gastric contents and vomiting. A female patient aged 14 years reported to the Department of Prosthodontics, Lenora Institute of Dental Sciences, with complaints concerning aesthetics and pain in relation to several teeth. Patient gave history of loss of tooth structure over the past few years with associated sensitivity and pain in several teeth. Patient also gave history of inability to consume sufficient amount of food owing to the repeated vomiting. This paper aims to present a rare case report of achalasia cardia by rehabiliting the remaining teeth with overlay denture.

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

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    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.

  20. Do Neighborhood Socioeconomic Deprivation and Low Social Cohesion Predict Coronary Calcification?: The CARDIA Study

    OpenAIRE

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

    2010-01-01

    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 associati...

  1. CHILDHOOD FAMILY PSYCHOSOCIAL ENVIRONMENT AND CAROTID INTIMA MEDIA THICKNESS: THE CARDIA STUDY

    OpenAIRE

    Loucks, Eric B.; Taylor, Shelley E.; Polak, Joseph F.; Wilhelm, Aude; Kalra, Preety; Karen A. Matthews

    2013-01-01

    Little is known about whether the childhood family psychosocial environment (characterized by cold, unaffectionate interactions, conflict, aggression, neglect and/or low nurturance) affects coronary heart disease (CHD) risk. Objectives were to evaluate associations of childhood family psychosocial environment with carotid intima media thickness (IMT), a subclinical measure of atherosclerosis. The study population included 2,659 CARDIA study participants, aged 37-52 years. Childhood family psy...

  2. Heterotopic pancreatic tissue in the gastric cardia: A case report and literature review

    OpenAIRE

    Filip, Rafał; Walczak, Ewa; Huk, Jacek; Radzki, Radosław P; Bieńko, Marek

    2014-01-01

    The heterotopic pancreas, which is usually described as an untypical presence of pancreatic tissue without any anatomic or vascular continuity with the pancreas, is relatively rare. Clinical manifestations may include bleeding, inflammation, pain and obstruction; however, in most cases it remains silent and is diagnosed during autopsy. Here, we report a case of ectopic pancreatic lesion located in the gastric cardia. The patient was a 73-year-old woman who had a history (over four months) of ...

  3. Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: The CARDIA Study

    OpenAIRE

    Bennett, Wendy L.; Liu, Su-Hsun; Yeh, Hsin-Chieh; Nicholson, Wanda K.; Gunderson, Erica P; Lewis, Cora E.; Clark, Jeanne M.

    2013-01-01

    We compared pre- to post-pregnancy change in weight, body mass index (BMI), waist circumference, diet and physical activity in women with and without gestational diabetes mellitus (GDM). Using the Coronary Artery Risk Development in Young Adults (CARDIA) study we identified women with at least one pregnancy during 20 years of follow-up (n=1,488 with 3,125 pregnancies). We used linear regression with generalized estimating equations to compare pre- to post-pregnancy changes in health behaviors...

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

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    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.

  5. 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.

  6. Comparison of global gene expression of gastric cardia and noncardia cancers from a high-risk population in china.

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    Gangshi Wang

    Full Text Available OBJECTIVE: To profile RNA expression in gastric cancer by anatomic subsites as an initial step in identifying molecular subtypes and providing targets for early detection and therapy. METHODS: We performed transcriptome analysis using the Affymetrix GeneChip U133A in gastric cardia adenocarcinomas (n = 62 and gastric noncardia adenocarcinomas (n = 72 and their matched normal tissues from patients in Shanxi Province, and validated selected dysregulated genes with additional RNA studies. Expression of dysregulated genes was also related to survival of cases. RESULTS: Principal Component Analysis showed that samples clustered by tumor vs. normal, anatomic location, and histopathologic features. Paired t-tests of tumor/normal tissues identified 511 genes whose expression was dysregulated (P<4.7E-07 and at least two-fold difference in magnitude in cardia or noncardia gastric cancers, including nearly one-half (n = 239, 47% dysregulated in both cardia and noncardia, one-fourth dysregulated in cardia only (n = 128, 25%, and about one-fourth in noncardia only (n = 144, 28%. Additional RNA studies confirmed profiling results. Expression was associated with case survival for 20 genes in cardia and 36 genes in noncardia gastric cancers. CONCLUSIONS: The dysregulated genes identified here represent a comprehensive starting point for future efforts to understand etiologic heterogeneity, develop diagnostic biomarkers for early detection, and test molecularly-targeted therapies for gastric cancer.

  7. Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA Study

    Science.gov (United States)

    Petrov, Megan E.; Kim, Yongin; Lauderdale, Diane S.; Lewis, Cora E.; Reis, Jared P.; Carnethon, Mercedes R.; Knutson, Kristen L.; Glasser, Stephen P.

    2014-01-01

    Objective To determine the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate (eGFR). Methods From 2003 to 2005, an ancillary sleep study was conducted at the Chicago site of the Coronary Artery Disease in Young Adults (CARDIA) study. Community-based black and white adults (aged 32–51 years) wore a wrist actigraph up to six nights to record sleep duration and fragmentation. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Participants without history of cardiovascular or chronic kidney diseases, proteinuria, or hypertension at the 2000–2001 CARDIA examination were followed over 10 years (n = 463). eGFR was estimated from serum creatinine (eGFRCr) at the 2000–2001, 2005–2006, and 2010–2011 CARDIA examinations, whereas cystatin-C-estimated eGFR (eGFRCys) was measured at the 2000–2001 and 2005–2006 examinations. Generalized estimating equation regression and linear models estimated the associations of each sleep parameter with changes in eGFRCr and eGFRCys, controlling for cardiovascular and renal risk. Results Sleep parameters were not related to 5-year change in eGFRCys. However, each 1 h decrease in sleep duration was significantly associated with a 1.5 mL/min/1.73 m2 higher eGFRCr [95% confidence interval (CI), 0.2–2.7], and each one-point increase in PSQI was significantly associated with a 0.5 mL/min/1.73 m2 higher eGFRCr (95% CI, 0.04–0.9) over 10 years. Conclusion In this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years. PMID:25037841

  8. 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.

  9. Candida esophagitis in achalasia cardia: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Praveen

    2007-01-01

    Full Text Available Candida albicans is by far the most common cause of infectious esophagitis. In most patients, this infection is secondary to an immuno-compromised state. In nearly 25% of the cases, underlying causes of esophageal stasis, e.g., achalasia and scleroderma, facilitate fungal colonization of the esophagus. Double contrast esophagography is a highly sensitive tool for diagnosing candida esophagitis. This report discusses the uncommon association of Candida esophagitis with achalasia cardia, their radiographic features and a short review of the available literature.

  10. Brittleness of diabetes due to achalasia cardia managed successfully by multiple innovative strategies

    Directory of Open Access Journals (Sweden)

    Vimal Upreti

    2013-01-01

    Full Text Available Achalasia cardia is an infrequent disorder of esophageal dysmotility that has failure of the lower end of the esophagus to relax with swallowing as hallmark abnormality. Diabetes mellitus, on the other hand, can afflict the motor activity of gastrointestinal tract by causing autonomic neuropathy. Combination of these diseases can be very distressing to a patient. We present a 45-year-old lady co-affected with both these disorders who presented with severe hypoglycemia and was managed successfully using the multiple strategies to treat achalasia and diabetes.

  11. Radioisotope monitoring of gastro-esophageal reflux in patients with achalasia cardiae after surgical treatment

    International Nuclear Information System (INIS)

    Results of a radioisotope method of the gastro-esophageal reflux are presented in patients with achalasia cardiae after different types of surgical treatment. Both Belsey-Mark and modified Nissen techniques are effective in preventing spontaneous gastroesophageal reflux, however 2 patients after Nissen fundoplication demonstrated gastro-esophageal reflux provoked by abdominal compression. This simple, noninvasive and physiologic method is an appropriate diagnostic tool for evaluating the efficiency of different anti reflux surgical techniques and is recommended for follow-up studies of patients after gastro-esophageal surgical intervention. (N.T.). 8 refs., 1 fig

  12. 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%).

  13. 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.

  14. Detection of abdominal lymph node metastases from esophageal and cardia cancer by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shima, S.; Sugiura, Y.; Yonekawa, H.; Ogata, T. (National Defence Medical Coll., Tokorosawa, Saitama (Japan))

    1982-03-01

    In order to evaluate the sensitivity of computed tomography (CT) scan in detecting the abdominal lymph node metastases, preoperative CT scan was performed in 16 patients with carcinoma of the esophagus and gastric cardia. Ten patients (62.5%) had pathological evidence of lymph node metastases in the abdominal cavity and 4 of them were identified to involve the para-aortic nodes. CT scan correctly demonstrated the lymph node metastases in the para-aortic and celiac axisis areas, but failed to detect other abdominal lymph node involvements, which were small enough to be excised by operation. The para-aortic nodes on the CT scan showed the following two features; one was nodular mass in shape, which did not obscure the aorta or inferior vena cava, and the other was conglomerated mass, which was difficult to be distinguished from the aorta. The former was resectable and the latter was not.

  15. [Esophageal intubation for palliative treatment in advanced carcinoma of the esophagus and cardia].

    Science.gov (United States)

    Domene, C E; Cecconello, I; Volpe, P; Zilberstein, B; Sakai, P; Ishioka, S; Pinotti, H W

    1998-01-01

    This is a report of 121 cases of advanced esophageal and cardia cancer managed by endoscopic and surgical esophageal intubation. They were submitted to surgical intubation 69 (53%) patients, and 52 (47%) to endoscopic intubation. There were 32.5% of technical complications in endoscopic intubation and 26.5% in surgical intubation. Perfuration was more frequent (11.5%) in endoscopic intubation than surgical group. Mortality rate was 17.3% for endoscopic and 5.8% for surgical intubation. Perfuration was the main cause of death in endoscopic intubation. Survival rate was 3.5 months for endoscopic and 4.7 months for surgical intubation. The majority of patients died of cancer evolution--caquexia (55.5%), carcinomatosis (4.5%) and brain methastasis (1.1%). The results of endoscopic and surgical intubation in this group of patients recommend its use in patients with advanced esophageal and cardic cancer. PMID:9699358

  16. Long-term follow-up study of dilation with temporary cardia stent in different diameters for achalasia

    International Nuclear Information System (INIS)

    Objective: To determine the curative effect of dilation for achalasia with temporary cardia stent in different diameters based on a long-term follow-up. Methods: Th study cohort was comprised of 135 patients of achalasia. Among them differentiated by stent diameters as followings: 30 patients were treated under fluoroscopy with dilation of temporary cardia stent in 20 mm diameter (group A), 30 patients with dilation of temporary cardia stent in 25 mm diameter (group B), and 75 patients with dilation of temporary cardia stent in 30 mm diameter (group C). 135 cardia stents were temporarily placed in the 135 patients and withdrawn after 3-5 days via gastroscopy. All the stents were inserted and withdrawn successfully. the follow-up in all groups lasted 6-128 months. Results: Six (20.0%) out of 30 patients, 6(20.0%) out of 30 patients, 5(22.7%) out of 22 patients, 6 (37.5%) out of 16 patients, 5 out of 9 patients, 3 out of 3 patients in group A exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. Four (13.3%) out of 30 patients, 4(13.3%) out of 30 patients, 3(13.0%) out of 23 patients, 4(22.2%) out of 18 patients, 5(45.4%) out of 11 patients, and 3 out of 4 patients in group B exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. No (0.0%) out of 75 patients, 1(1.5%) out of 66 patients, 4(8.3%) out of 48 patients, 6(18.2%) out of 33 patients, 6(33.3%) out of 18 patients, 2 out of 5 patients in group C exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. Conclusion: Dilation with temporary cardia metal stent in 30 mm diameter is the best dilation for achalasia in long-term follow-up. (authors)

  17. 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.``

  18. 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.

  19. Marriage and parenthood in relation to obesogenic neighborhood trajectories: The CARDIA study.

    Science.gov (United States)

    Boone-Heinonen, Janne; Howard, Annie Green; Meyer, Katie; Lewis, Cora E; Kiefe, Catarina I; Laroche, Helena H; Gunderson, Erica P; Gordon-Larsen, Penny

    2015-07-01

    Marriage and parenthood are associated with weight gain and residential mobility. Little is known about how obesity-relevant environmental contexts differ according to family structure. We estimated trajectories of neighborhood poverty, population density, and density of fast food restaurants, supermarkets, and commercial and public physical activity facilities for adults from a biracial cohort (CARDIA, n=4,174, aged 25-50) over 13 years (1992-93 through 2005-06) using latent growth curve analysis. We estimated associations of marriage, parenthood, and race with the observed neighborhood trajectories. Married participants tended to live in neighborhoods with lower poverty, population density, and availability of all types of food and physical activity amenities. Parenthood was similarly but less consistently related to neighborhood characteristics. Marriage and parenthood were more strongly related to neighborhood trajectories in whites (versus blacks), who, in prior studies, exhibit weaker associations between neighborhood characteristics and health. Greater understanding of how interactive family and neighborhood environments contribute to healthy living is needed. PMID:26093081

  20. 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.

  1. 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

  2. Differential Associations of Weight Dynamics With Coronary Artery Calcium Versus Common Carotid Artery Intima-Media Thickness: The CARDIA Study

    OpenAIRE

    Lee, Duk-Hee; Steffes, Michael W.; Gross, Myron; Park, Kyong; Holvoet, Paul; Kiefe, Catarina I.; Lewis, Cora E.; Jacobs, David R.

    2010-01-01

    Change and fluctuation in body mass index (BMI; weight (kg)/height (m)2) may be associated differently with coronary artery calcification (CAC) than with carotid artery intima-media thickness (IMT). The authors analyzed data on 2,243 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, initially aged 18–30 years, who were examined every 2–5 years over a 20-year period (1985–2006). BMI at year 0 was associated positively and linearly with CAC at year 20; however...

  3. A newly-designed temporary cardia stent for the treatment of achalasia:an experimental study in canine models

    International Nuclear Information System (INIS)

    Objective: To assess the efficacy and safety of a newly-designed temporary covered cardia stent for the treatment of achalasia in canine models and to investigate the histopathological changes at different points of follow-up time after the stent was removed. Methods: The canine achalasia model was created by injecting benzyl-dimethyl-tetradecyl ammonium chloride (BAC) circumferentially into the lower esophageal sphincter (LES) of the dogs. Twenty-four dogs with achalasia were randomly and equally divided into two groups with 12 dogs in each group: control group (using routine esophageal stents) and study group (using newly-designed temporary covered cardia stents). Under fluoroscopic guidance stents were implanted in the esophagus and were taken away from the esophagus 4 days after stent insertion in experimental dogs of both groups. LES pressures and timed barium esophagography (TBE) were performed in all dogs before and immediately after the stenting procedure, as well as at one week, 3 and 6 months after the stent was removed. Every three dogs were sacrificed each time at one week, 3 and 6 months after the stent was removed. The esophageal cardia was excised and sent for pathological examination. Results: All animals well tolerated the stent insertion / removal and the follow-up procedures. No severe complications such as esophageal perforation occurred. Comparison between two groups showed that stent migration occurrence was much lower in study group (n = 1) than that in control group (n = 5). The reduction of LES pressures in study group was more significant in comparison with control group (at 6-month follow-up, P = 0.027). The difference in barium column product (height x width) between 0-min and 5-min TBE was statistically significant in study group (at 3-month follow-up, P = 0.009). Integrated analysis of multi-comparison for LES pressures among subgroups of each group revealed that the dogs in study group exhibited better outcomes than the dogs in

  4. Temporary self-expanding cardia stents for the treatment of achalasia: an experimental study in dogs

    International Nuclear Information System (INIS)

    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 NSCG and at 4 days (4 d-TG), 2 weeks (2 w-TG), 1 month (1 m-TG), 3 months (3 m-TG), and 6 months (6 m-TG) in the TGs. lower esophageal sphincter pressure (LESP) and a timed barium esophagram were assessed before stent insertion, after stent retrieval, and at 1-week, 1-, 3- and 6-month follow-up. Three dogs in NSCG and 4 d-TG were sacrificed for histological examination at each follow-up to investigate the inflammatory reaction after stent insertion. Results: Stent insertion/removal and the follow-up procedures were well tolerated. At 6-month follow-up, the 2 w-TG and 1 m-TG demonstrated an acceptable stent migration (n=2 in both TGs versus n=4 in NSCG, n=4 in 3 m-TG, and =6 in 6 m-TG), improved LESP compared to after BAC injection (P<0.05), and improved timed barium height (p=0.0144 and 0.0409). Mouse-proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin staining revealed no inflammatory reaction difference between the NSCG and 4d-TG at each follow-up. Conclusion: The TRC-CS was effective in the treatment of achalasia in a dog model. LESP measurements, timed barium esophagram studies suggest an optimal stent retrieval time of between 2 w∼1 m. (authors)

  5. Fast food restaurants and food stores: longitudinal associations with diet in young adults: The CARDIA Study

    Science.gov (United States)

    Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I.; Shikany, James M.; Lewis, Cora E.; Popkin, Barry M.

    2011-01-01

    Background A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts – neighborhoods with little or no access to healthy foods – by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. Methods We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of U.S. young adults (n=5,115, 18–30 years at baseline), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from four examination periods (n=15,854 person-exam observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and meeting fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within 1 kilometer (km), 1–2.9km, 3–4.9km, and 5–8km of respondents’ homes. Models were sex-stratified, controlled for individual sociodemographics and neighborhood poverty, and tested for interaction by individual-level income. Results Fast food consumption was related to fast food availability in low-income respondents, particularly within 1–2.9km of homes among men [coefficient (95% CI) up to: 0.34 (0.16, 0.51)]. Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake and relationships between grocery store availability and diet outcomes were mixed. Conclusions Our findings provide some evidence for zoning restrictions on fast food restaurants within 3km of low-income residents, but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change. PMID:21747011

  6. 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.

  7. Assessment of Differential Item Functioning in the Experiences of Discrimination Index: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

    OpenAIRE

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

    2011-01-01

    The psychometric properties of instruments used to measure self-reported experiences of discrimination in epidemiologic studies are rarely assessed, especially regarding construct validity. The authors used 2000–2001 data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study to examine differential item functioning (DIF) in 2 versions of the Experiences of Discrimination (EOD) Index, an index measuring self-reported experiences of racial/ethnic and gender discrimination. DI...

  8. 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.

  9. Large-diameter balloon dilation for the treatment of achalasia of cardia: an analysis of mid-to-long term efficacy in 80 cases

    International Nuclear Information System (INIS)

    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 pharyngeal portion with 2% lidocaine, the intensified guide wire was inserted into the stomach through mouth under fluoroscopy guidance. The Boston's balloon (40 mm in diameter) was pushed along the guidewire to the stricture site at the cardia and was gradually inflated with 15% contrast medium by using the 'graded intermittent inflation' technique. Namely, the balloon was inflated to a maximum diameter and was kept in this condition for five minute, and then the balloon was deflated for 3-5 minutes. The above procedure was repeated 2-3 times. For the severe stricture, pre-dilatation with 20-25 mm diameter balloon was carried out. As a routine, postoperative measures to prevent possible bleeding and infection were adopted. The patient was allowed to take cool liquid diet 2-3 hours after the procedure, to have semi-liquid diet within three days and then to take normal diet. The patients were followed up for 2-10 years. Results: The balloon insertion was technically successful in all of the 80 patients. The success rate of single and twice manipulations was 96.3% (77/80) and 3.7% (3/80), respectively. Postoperative rupture of the cardia region was seen in one patient, and surgical repair had to be carried out. The follow-up time ranged from 2 years to 10 years (mean 6.27 years). No recurrent stenosis occurred in all patients. The remission rate of dysphagia was 100%. The swallowing function returned to normal in 90% of

  10. 山西省贲门癌遗传流行病学研究%Studies on hereditary epidemiology of cardia cancer in Shanxi province

    Institute of Scientific and Technical Information of China (English)

    王媛; 韩小友; 丁悌; 唐泽忠; 许翊; 王全红

    2010-01-01

    目的 探讨山西省贲门癌发病因素中遗传因素的作用.方法 采用病例对照研究方法 ,对病例及对照的Ⅰ、Ⅱ、Ⅲ级亲属所有成员的姓名、性别、出生和死亡日期以及疾病诊断与治疗进行调查.用Falconer法和Li-Mentel-Gart法计算贲门癌的遗传度和分离比.结果 (1)病例组Ⅰ、Ⅱ、Ⅲ级亲属的贲门癌患病率分别是0.54%、0.04%、0.05%;病例组Ⅰ、Ⅱ、Ⅲ级亲属的上消化道癌患病率分别为2.50%、0.36%、0.13%.贲门癌与上消化道癌患病呈现Ⅰ>Ⅱ>Ⅲ级亲属的趋势,表现为家族聚集性,男女性均如此.(2)贲门癌先证者Ⅰ级亲属患贲门癌的遗传度为11.71%,其中女性为14.72%,男性为14.01%;贲门癌先证者Ⅰ级亲属患上消化道癌的遗传度为13.87%,其中女性为23.08%,男性为11.49%,均低于25%,属低遗传肿瘤.(3)病例组同胞中上消化道分离比为0.0452,其中男性为0.0441,女性为0.0507,均低于0.25,不符合单基因遗传方式,属多基因遗传方式.结论 遗传因素是贲门癌的危险因素,但不是山西省贲门癌高发的主要危险因素.%Objective Studies on cardia-cancer caused by hereditary factors. Methods Case-control method was adopted,with information including name,sex,date of birth,date of death of all the Ⅰ,Ⅱ,Ⅲ relatives of the patients,diagnosis and the treatment collected. The hereditary probability of cardia cancer and the separation degree were calculated by Falconer and Li-Mentel-Gart. Results (1) Prevalence rates of cardia-cancer on relative Ⅰ,relative Ⅱ,relative Ⅲ of cardia-cancer patients appeared to be 0.54%,0.04%,and 0.05% respectively. Prevalence rates of upper-digestive-tract-cancer of relative Ⅰ,relative Ⅱ,relative Ⅲ of cardia-cancer patients showed as: 2.50%,0.36% and 0.13% respectively. Data showed that relative Ⅰ> relative Ⅱ> relative Ⅲ and family cluster existed in both males and females. (2) Cardia-cancer hereditary probability of the relative

  11. Endoscopic assessment of effacement of balloon waist during pneumatic dilatation of primary achalasia cardia under topical anesthesia

    International Nuclear Information System (INIS)

    Balloon dilatation of Primary Achalasia Cardia (PAC) is usually performed under antegrade endoscopic guidance, with conscious sedation. The main goals of this prospective study were to assess the safety and efficacy of pneumatic dilatation without conscious sedation and to determine the endoscopic signs of effacement of the balloon waist. Pneumatic dilatation was successfully performed as outdoor procedure without conscious sedation in patients (n= 25; mean age 42.56 years) with endoscopic and radiologic diagnosis of PAC. Immediate relief of symptoms was observed in 23 (92%) cases. Effacement of the balloon waist under endoscopic vision was appreciated in all cases in the present study. Common complications of pneumatic dilatation were chest pain in all (100%) subjects and mild local bleeding in 17 (68%) patients. There was no cancellation of procedure. Re-dilatation was required in 2 (8%) cases. The duration of follow-up was from 6 weeks to 23 months. Pneumatic dilatation of PAC can be safely performed as same day procedure, without conscious sedation. Obliteration of the balloon waist can be readily determined by antegrade endoscopic assessment of stretch on the lower oesophageal sphincter (EASL). (author)

  12. Variants in the Adiponectin Gene and Serum Adiponectin: The Coronary Artery Development in Young Adults (CARDIA) Study

    Science.gov (United States)

    Wassel, Christina L.; Pankow, James S.; Jacobs, David R.; Steffes, Michael W.; Li, Na; Schreiner, Pamela J.

    2016-01-01

    Circulating adiponectin is involved in the atherosclerotic process and has been associated with cardiovascular disease as well as obesity, insulin resistance, metabolic syndrome, and type 2 diabetes. The adiponectin gene (ADIPOQ) encodes the circulating protein adiponectin and affects its expression. Only a small proportion of all known ADIPOQ polymorphisms have been investigated in relation to circulating adiponectin concentrations. Using data from 3,355 African-American and white men and women aged 33–45 at the year 15 examination from the Coronary Artery Development in Young Adults (CARDIA) Study the association between 10 single-nucleotide polymorphisms (SNPs) within ADIPOQ and serum adiponectin was examined using linear regression. SNPs were chosen based on a tagSNP approach. Models were stratified by self-reported race to control for population stratification, and Bonferroni corrected for multiple comparisons. ADIPOQ SNPs rs17300539 (P Significant interactions were found between waist and rs182052 (P = 0.0029) and between rs9882505 and smoking (P = 0.001) in whites. Many ADIPOQ SNPs have not yet been examined, and additional studies are needed to determine whether these may be functional variants. PMID:20395949

  13. Gene expression profiling in Barrett's esophagus and cardia intestinal metaplasia:A comparative analysis using cDNA microarray

    Institute of Scientific and Technical Information of China (English)

    Ying Chang; Jun Gong; Bin Liu; Jun Zhang; Fei Dai

    2004-01-01

    AIM: To study the difference of gene expression profile changes in Barrett's esophagus (BE) and cardia intestinal metaplasia (CIM) and to screen the novel genes in the early stage by cDNA microarray.METHODS: cDNA retrotranscribed from an equal amount of mRNA from BE and CIM epithelial tissues was labeled with Cy3 and Cy5 fluorescence as probes. The mixed probe was hybridized with three pieces of BiostarH-40 s 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.RESULTS: A total of 141 genes were screened out that exhibited different expression in all three chips. There were 74 upregulated and 67 downregulated genes in gene expression profiles of BE which were two times of that in CIM.CONCLUSION: There is a difference in gene expression level between BE and CIM epithelia. These 141 genes probably relate to the occurrence and development of BE and the progression to adenocarcinoma.

  14. 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

  15. Reduced MUTYH, MTH1, and OGG1 expression and TP53 mutation in diffuse-type adenocarcinoma of gastric cardia.

    Science.gov (United States)

    Kohno, Yukiko; Yamamoto, Hidetaka; Hirahashi, Minako; Kumagae, Yoshiteru; Nakamura, Masafumi; Oki, Eiji; Oda, Yoshinao

    2016-06-01

    The effects of oxidative stress in adenocarcinomas of gastric cardia (AGCs) have not been fully elucidated. With a strict definition of AGC, we examined the immunohistochemical expressions of inducible nitric oxide synthase; 8-hydroxy-deoxyguanosine; and the base excision repair enzymes such as MUTYH, MTH1, and OGG1, and TP53 mutational status. Sixty-three cases of AGC were characterized by younger patient age (P = .0227) and more frequent venous invasion (P = .0106) compared with the adenocarcinomas of pylorus (APs). 8-hydroxy-deoxyguanosine was accumulated (P = .0011), whereas MUTYH (P = .0325) and OGG1 (P = .0007) were decreased, in the AGCs compared with the adjacent mucosa, but these differences were not detected in the APs. Among the AGCs, lower expressions of MUTYH (P = .0013) and MTH1 (P = .0059) were each significantly associated with diffuse-type histology. A lower expression of OGG1 was correlated with higher T-stage (P = .0011), lymphatic invasion (P = .004), and lymph node metastasis (P = .0094). In addition, the presence of TP53 mutation was associated with diffuse-type histology (P = .0153) and a lower level of MUTYH (P = .0221). The AGCs also showed a relatively high rate of a transversion-type mutation of TP53 (50%), whereas all TP53 mutations in the APs were transition type. Age 62years or older (P = .0073), diffuse-type histology (P = .0020), and TP53 mutation (P = .0066) were each associated with worse survival in the AGC patients. Our results indicate that oxidative stress accumulation and a downregulation of base excision repair enzymes may play an important role in the pathogenesis of AGC, in particular diffuse-type AGCs. Diffuse-type AGC might involve molecular pathways different from those of other subsets of gastric cancer. PMID:26980051

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

    Science.gov (United States)

    Nayak, Shilpa; Hubbard, Alan; Sidney, Stephen; Syme, S Leonard

    2016-12-01

    An understanding of factors influencing health in socioeconomic groups is required to reduce health inequalities. This study investigated combinations of health determinants associated with self-rated health (SRH), and their relative importance, in income-based groups. Cross-sectional data from year 15 (2000 - 2001) of the CARDIA study (Coronary Artery Risk Development in Young Adults, USA) - 3648 men and women (mean 40 years) - were split into 5 income-based groups. SRH responses were categorized as 'higher'/'lower'. Health determinants (medical, lifestyle, and social factors, living conditions) associated with SRH in each group were analyzed using classification tree analysis (CTA). Income and SRH were positively associated (p income-based gradient for lifestyle/medical/social factors/living conditions. Profiles, and relative importance ranking, of multi-domain health determinants, in relation to SRH, differed by income group. The highest ranking variable for each income group was chronic burden-personal health problem (income groups, more risk factors and chronic burden indicators were associated with SRH. Social support, control over life, optimism, and resources for paying for basics/medical care/health insurance were greater (%) with higher income. 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. PMID:27413683

  17. Tumor suppressor gene p16 and Rb expression in gastric cardia precancerouslesions from subjects at a high incidence area in northern China

    Institute of Scientific and Technical Information of China (English)

    Yun Zhou; Li-Huo Jiao; Yong-Min Bai; Li-Dong Wang; Shan-Shan Gao; Yong-Xin Li; Zong-Min Fan; Xin Zhao; Yi-Jun Qi; Jun-Ping Wei; Jian-Xiang Zou; Gang Liu

    2002-01-01

    AIM: To further understand the molecular basis for gastriccardia carcinogenesis and to provide etiological clues.METHODS: Endoscopic mucosa biopsy and histopathologicalexaminations were made on 37 subjects from a high incidencearea for both esophageal and gastric cardia carcinomas innorthem China. All the biopsy samples were fixed in 850 mi. -1 Lalcohol and embedded in paraffin. Each block contained onepiece of tissue and was serially section at 5 μm.Immunohistochemistry (ABC) was carried out on these gastriccardia samples to determine the alterations of p16 and Rb.RESULTS: Based on the histopathlogical examinationtherewere 11 cases of chronic superficial gastritis, 12 cases ofchronic atrophic gastritis and 14 cases of dysplasia. Theimmunostaining demonstrated different levels of unclearimmunostaining of p16 and Rb in normal gastric cardiatissue and the tissues with different severity of lesions. Withthe lesions progressing, the positive immunostaining ratesfor pi6 protein had a decreasing tendency. In contrast, thepositive immunostaining rate for Rb protein had anincreasing tendency. There was a significant negativerelationship between the two parameters. Changes of p16wasCSG 11(100 % ), CAG 7(58 % ), DYS 4(29 % ) andchanges of Rb was CSG 2(18 %), CAG 8(67 %) and DYS 12(86 %), (p<0.05).CONCLUSION: The alterations of p16 and Rb protein may playa role in the early stages of gastric cardia carcinogenesis.

  18. 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

  19. NATURAL HISTORY OBSERVATION FOR ESOPHAGEAL AND CARDIA PRECURSORS BY REPETITIVE ENDOSCOPIC SCREENING OF 301 SUBJECTS IN SHEXIAN

    Institute of Scientific and Technical Information of China (English)

    Denggui Wen; Shunping Wang; Limian Er; Caifen Ma; Shijie Wang; Liwei Zhang; Yingsai Li; Weifang Yu; Xiaoling Wang; Junhe Wang; Suping Li; Yongwei Li

    2007-01-01

    OBJECTIVE To investigate the natural history of fast developing esophageal and cardia precursors.METHODS Repetitive endoscopic screenings were performed among 40-69-year-olds in the high-incidence areas for esophageal cancer in Shexian.RESULTS The initial diagnosis and the lag-time for 7 subsequently identified severe dysplasia (SD) subjects were as follows: in one subject 13 months after a baseline diagnosis of normal epithelium, in another subject 7 months after a baseline diagnosis of base cell hyperplasia (BCH), in four subjects 3,4,4, and 10.5 months after baseline diagnosis of mild dysplasia (mD), and in one subject 12.5 months after a baseline diagnosis of moderate dysplasia (MD). The initial diagnosis and the lag-time for 6 subsequently identified carcinomas in situ or intramucosal carcinoma cases were: in one case 48 months after a baseline diagnosis of mD, in 2 cases 4 and 13 months after baseline diagnoses of MD, and in the other 3 cases 3.5, 9, and 17.5 months after baseline diagnoses of SD. The initial diagnosis and lagtime for 3 subsequently identified invasive cancer cases were: in one case 50 months after a baseline diagnosis of MD, in 2 cases 14 and 19 months after baseline diagnoses of SD. In addition, during a 4-year-follow-up of 18 subjects after endoscopic mucosa resection, 9 of them were found to have developed precursors again at other sites, and also additional findings were obtained for 11 of the 16 dysplasia cases by repetitive biopsy in less than 2 months after the initial endoscopy.CONCLUSION A 5-year screening interval for BCH and mD, and a 3-year interval for MD may be too long for the fast developing precursors. Periodic screenings with shorter intervals should be considered to control the number of interval cases due to fast development, multifocal carcinogenesis, and false negative results inherent in one-time endoscopic biopsy sampling.

  20. 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-interactionfast 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

  1. 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

    2016-01-01

    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 < 0.001). There was no difference in F2-isoprostanes after further adjustment for health and lifestyle factors. Carotenoids were lower in those with CES-D scores ⩾ 16, even after adjustment for health and lifestyle factors (standardized sum 238.7 vs 244.0, Cohen's d = -0.16, P < 0.001). Longitudinal analyses confirmed that 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

  2. Polymorphism of A133S and promoter hypermethylation in Ras association domain family 1A gene (RASSF1A) is associated with risk of esophageal and gastric cardia cancers in Chinese population from high incidence area in northern China

    International Nuclear Information System (INIS)

    The role of tumor suppressor gene RASSF1A in the esophageal and gastric cardia carcinogenesis is still inconclusive. In this study, the polymorphism, promoter methylation and gene expression of RASSF1A were characterized in esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA). We firstly analyzed the prevalence of RASSF1A A133S in a total of 228 cancer patients with ESCC (n=112) and GCA (n=116) and 235 normal controls by polymerase chain reaction (PCR) and restriction enzyme-digestion assay. Then, the promoter methylation status of the RASSF1A in ESCC (n=143), GCA (n=92) and corresponding adjacent normal tissues were further investigated using methylation-specific PCR (MSP) approach. Finally, the RASSF1A protein expression were determined in ESCC (n=27), GCA (n=24) and the matched adjacent normal tissues by immunohistochemical method. The frequency of 133Ala/Se and Ser/Ser genotype was significantly higher in GCA patients than in normal controls (19.0% vs. 10.2%, P=0.02). Compared with Ala/Ala genotype, Ala/Se and Ser/Ser genotype significantly increased susceptibility to GCA (OR=2.06, 95% CI=1.09–3.97). However, this polymorphism had no association with ESCC (P=0.69). The promoter methylation of RASSF1A gene was significantly increased the risk to both ESCC (OR=5.90, 95% CI=2.78–12.52) and GCA (OR=7.50, 95% CI= 2.78–20.23). Promoter methylation of RASSF1A gene in ESCC was also associated with age and cancer cell differentiation (for age: OR=3.11, 95% CI=1.10–8.73; for differentiation: OR=0.29, 95% CI=0.12–0.69). RASSF1A positive expression was significantly decreased the risk of GCA (OR=0.16, 95% CI=0.03–0.83). In contrast, there was no statistical significance between RASSF1A positive expression and ESCC. The expression of RASSF1A protein trend to be positively related with older GCA patients (OR=16.20, 95% CI=1.57–167.74). The present findings suggest that alterations of RASSF1A may play an important role in gastric

  3. 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.

  4. 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.

  5. 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 < 0.05). This association was not statistically significant among Black women reporting 3 or more experiences of 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 < 0.01). The association between self-reported experiences of racial/ethnic discrimination and CRP was not

  6. Risk Factors of Postoperative Respiratory Failure in Patients with Carcinoma of Gastric Cardia%贲门癌患者术后呼吸功能衰竭的高危因素研究

    Institute of Scientific and Technical Information of China (English)

    高立平; 刘俊峰; 曹富民

    2013-01-01

    Objective To investigate the risk factors of postoperative respiratory failure in patients with carcinoma of gastric cardia ( CGC ). Methods The risk factors of post - operative respiratory failure were analyzed in 61 CGC patients using chi square test and multivariable Logistic regression analysis. Results Univariate analysis showed that age, comorbidity with chronic obstructive pulmonary disease ( COPD ), poor pulmonary function, use of endobronchial tube during anesthesia, operation duration, and intraoperative fluid input were significantly associated with incidence of postoperative respiratory failure. Mult-ivariate logistic regression analysis indicated that severe ( OR = 24. 892, P =0. 000 ) and moderate ( OR = 14. 722, P =0. 000 ) preoperative pulmonary function, old age ( OR = 1. 336, P = 0. 000 ), use of single - lumen endobronchial tube during anaesthesia ( OR = 5. 786, P = 0. 009 ), and excessive intraoperative fluid input ( OR = 4. 571, P = 0. 003 ) were significantly associated with incidence of postoperative respiratory failure. Conclusion Poor preoperative pulmonary function, old age, use of single -lumen endobronchial tube during anaethesia, and excessive intraoperative fluid input are the risk factors of postoperative respiratory failure in CGC patients.%目的 探讨贲门癌患者术后发生呼吸功能衰竭的高危因素.方法 应用χ2检验及二分类Logistic回归分析等统计学方法,对61例术后发生呼吸功能衰竭的贲门癌患者的高危因素进行分析.结果 单因素分析结果显示:年龄、术前合并慢性阻塞性肺疾病(COPD)、肺功能[肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)]、麻醉气管插管、手术持续时间及术中液体输入量对贲门癌患者术后呼吸功能衰竭发生的影响有统计学意义(P<0.05).Logistic回归分析结果显示,术前中度及重度肺功能障碍、高龄、术中麻醉单腔气管插管及术中过多液体输入量对贲门

  7. Long-term effects of radical resectin plus interstitial implantation of 125Ⅰ radioactive seeds in the treatment of cancer of the cardia%125Ⅰ粒子组织间插置治疗贲门癌的远期疗效

    Institute of Scientific and Technical Information of China (English)

    张继军; 梁彦; 高翔; 程晓斌; 莫晓潮

    2009-01-01

    Objective To evaluate the long-term effect of interstitial implantation of radioactive iadine-125 (125Ⅰ) seeds as an adjunctive technique to the radical resection in the treatment of cancer of the cardia. Methods From March 2001 to Match 2003, one hundred and eighteen patients with cancer of the cardia underwent radical resection in our department. Fifty-seven patients (group A) were treated with radical resection plus interstitial implantation of radioactive 125Ⅰ seeds during surgery, and 61 patients (group B) were treated with radical resection along. The rate of 3-year and 5-year survival, postoperative complications and mortality were compared between the two groups. Results The demographic data of the two groups were comparable, as well as metastatic status of the lymph nodes, cancer staging, and the type of operation. One hundred and thirteen patients were followed for 5 years. The overall rate of follow up was 95.8%, 96.5% in group A and 95.1% in group B. The differences in the rates of 3-year and 5-year survival between group A (59.6% and49.1%) and group B (41.0% and 31.1%) were statistically significant (X2 =4.072, P0.05, for the rate of postoperative complications; X2 =0.333, P>0.05, for the mortality rate). There were 26 and 37 deaths in group A and B respectively. Six deaths in group A and 13 deaths in group B were attributed to local recurrence, and 17 deaths in group A and 21 deaths in group B were attributed to remote metastasis. Non-neoplasma diseases such as vascular events, diabetes mellitus, pulmonary infection and severe malnutrition were the causes of 3 deaths in each group. Conclusion As a safe and effective method, interstitial implantation of radioactive 125 seeds should be recommended in combination with radical resection to improve the long-term outcomes of patients with cancer of the cardia.%目的 探讨贲门癌根治术中组织间插置125Ⅰ粒子治疗贲门癌的临床价值.方法 118例贲门癌病人施行根治性

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

    DEFF Research Database (Denmark)

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

    1987-01-01

    five. One-third of the patients benefited from the operation, i.e. experienced good palliation and no serious complications. The mortality rate was 27%. The authors conclude that all patients with difficulty in swallowing saliva should be intubated, as good palliation was achieved in all such patients...

  9. Day surgery for achalasia cardia: Time for consensus?

    Science.gov (United States)

    Naumann, D N; Zaman, S; Daskalakis, M; Nijjar, R; Richardson, M; Super, P; Singhal, R

    2016-02-01

    Introduction Laparoscopic Heller's myotomy (LHM) is the most effective therapy for achalasia of the oesophagus. Most case series of LHM report a length of hospital stay (LOS) >1 day. We present 14 years of experience of LHM to examine the safety and feasibility of LHM as a day case procedure. Methods We retrospectively examined patients undergoing elective LHM for achalasia at our institution between 2000 and 2014. Demographics, episode statistics, prior investigations and interventions were collated. Outcomes, including LOS, complications and re-interventions, were compared for the periods before and after a consensus decision at our institution in 2008 to perform LHM as a day case procedure. Results Sixty patients with a mean age of 41±13 years were included, of whom 58% were male. The median LOS for all patients was 1 day (interquartile range [IQR] 0-2.25). Overall, LHM was performed as a day case in 27 (45%) cases, at 2/26 (7.7%) in the first period versus 25/34 (73.5%) in the second (p<0.01). There were no significant differences in age, gender or previous interventions between day surgery and non-day surgery groups. One patient required subsequent unplanned surgery, while six (10%) needed endoscopic treatment of recurrent symptoms within 12 months. Conclusions LHM can be performed safely as a day case procedure. Complication rates are low, with only a small proportion of patients requiring endoscopic treatment for symptom recurrence within 1 year. PMID:26829668

  10. Pulmonary uptake in indium-111-antimyosin fab fragment imaging following human cardia transplantation

    International Nuclear Information System (INIS)

    Recent studies suggest that cardiac uptake of 111In-labeled antimyosin monoclonal antibody may be estimated semiquantitatively by calculating a heart-to-lung activity ratio, with pulmonary uptake serving as a reference region. The authors obtained 96 111In-antimyosin scintigraphs to monitor rejection occurrence after heart transplantation in 26 patients. On five scintigraphs, the count rate density in ROIs over the lungs was markedly higher (mean 53% higher) than that in the immediately preceding and following scintigraphs, whereas the activity in the heart was essentially unchanged. Four of these scintigraphs coincided with ongoing pulmonary infection and the fifth with an occurrence of a high anti-CMV titer. The mechanism of apparent nonspecific antimyosin accumulation in the lungs is uncertain, although increased capillary permeability may be one possibility. Attention should be given to activity in the lungs if this activity is used as a reference in studies of 111In-antimyosin uptake in the heart. 15 refs., 3 figs., 1 tab

  11. 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 (psocioeconomically disadvantaged neighborhood residents had fewer fast food and non-fast food restaurants, 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. PMID:25280107

  12. Radioisotopic monitoring of esophageal motility in patients with achalasia cardiae after surgical treatment

    International Nuclear Information System (INIS)

    Results of the radioisotope esophageal motility studies in patients after surgical treatment of achalasia are presented. 28 patients were studied. In both group of the patients (after Belsey-Mark and modified Nissen antireflux surgical techniques) slightly delayed esophageal transit time was found. Mean transit time of the esophagus proved to be a useful practical parameter. This simple, noninvasive, physiological radioisotope technique is recommended for follow-up studies of patients after gastroesophageal surgery. (N.T.). 10 refs., 2 figs

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

    OpenAIRE

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

    2014-01-01

    Cross-sectional studies suggest 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 US-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 re...

  14. Combined measure of neighborhood food and physical activity environments and weight-related outcomes: The CARDIA study.

    Science.gov (United States)

    Meyer, Katie A; Boone-Heinonen, Janne; Duffey, Kiyah J; Rodriguez, Daniel A; Kiefe, Catarina I; Lewis, Cora E; Gordon-Larsen, Penny

    2015-05-01

    Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set of food and physical activity resources, yet most research examines discrete characteristics. We characterized neighborhoods with respect to their composition of features, and quantified associations with diet, physical activity (PA), body mass index (BMI), and insulin resistance (IR) in a longitudinal biracial cohort (n=4143; aged 25-37; 1992-2006). We used latent class analysis to derive population-density-specific (food stores/restaurants. In lower population density areas, a latent class with higher food and PA resource diversity (relative to other clusters) was significantly associated with higher diet quality. In higher population density areas, a cluster with relatively more natural food/specialty stores; fewer convenience stores; and more PA resources was associated with higher diet quality. Neighborhood clusters were inconsistently associated with BMI and IR, and not associated with fast food consumption, walking, biking, or running. PMID:25723792

  15. 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

    2016-01-01

    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 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. PMID:26980156

  16. Distributions and Determinants of Mercury Concentrations in Toenails among American Young Adults: the CARDIA Trace Element Study

    Science.gov (United States)

    Xun, Pengcheng; Liu, Kiang; Morris, J. Steve; Jordan, Joanne M.; He, Ka

    2012-01-01

    Background Since data on mercury (Hg) levels in Caucasians and African Americans (AAs) of both genders are lacking, this study aims to present toenail Hg distributions and explore the potential determinants using data from the Coronary Artery Risk Development in Young Adults Trace Element Study. Methods Data from 4344 Americans, aged 20–32 in 1987, recruited from Oakland, Chicago, Minneapolis and Birmingham were used to measure toenail Hg levels by instrumental neutron-activation method. The Hg distribution was described with selected percentiles and geometric means. Multivariable linear regression (MLR) was used to examine potential determinants of Hg levels within ethnicity-gender subgroups. Results The geometric mean of toenail Hg was 0.212 (95% CI: 0.207–0.218) μg/g. Hg levels varied geographically with Oakland the highest [0.381 (0.367–0.395) μg/g] and Minneapolis the lowest [0.140 (0.134–0.147) μg/g]. MLR analyses showed that male gender and AA ethnicity were negatively associated with toenail Hg levels; and that age, living in Oakland city, education level, alcohol consumption and total fish intake were positively associated with toenail Hg concentrations within each ethnicity-gender subgroup. Current smokers were found to have higher Hg only in AA men. Conclusions This study suggested age, gender, ethnicity, study center, alcohol, education level and fish consumption consistently predict toenail Hg levels. As fish consumption was the key determinant, avoiding certain types of fish that have relatively high Hg levels may be crucial in reducing Hg intake. PMID:22926255

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

    International Nuclear Information System (INIS)

    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 μg/g (95% CI, 0.840-0.849 μg/g) and the median was 0.837 μg/g (95% CI, 0.833-0.844 μg/g). Median levels from lowest to highest quintile were 0.691, 0.774, 0.838, 0.913 and 1.037 μg/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: → Average of toenail Se levels in this cohort was 0.844 μg/g (95% CI, 0.840-0.849 μg/g). → Toenail Se levels vary geographically depending on soil Se concentrations. → Males, African Americans and less educated participants have low Se levels. → Smoking status and alcohol consumption are two important indicators of Se status.

  18. Changes in waist circumference and body mass index in the US CARDIA cohort: Fixed-effect 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.

    2013-01-01

    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-effect 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-effect 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 (b=1.09, 95% CI: 0.00–2.19, p=0.05) and an increase in body mass index (b=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. PMID:22856616

  19. 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. PMID:22856616

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

    OpenAIRE

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

    2012-01-01

    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 ...

  1. Fat mass modifies the association of fat-free mass with symptom-limited treadmill duration in the Coronary Artery Risk Development in Young Adults (CARDIA) Study123

    OpenAIRE

    Zhu, Na; Jacobs Jr, David R; Sidney, Stephen; Sternfeld, Barbara; Carnethon, Mercedes; Lewis, Cora E.; Shay, Christina M.; Sood, Akshay; Bouchard, Claude

    2011-01-01

    Background: The assessment of fat mass and fat-free mass in relation to the symptom-limited maximal exercise duration (Maxdur) of a treadmill test allows for insight into the association of body composition with treadmill performance potential.

  2. 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.

  3. 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

  4. 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...

  5. STRUCTURE OF MIDGUT AND PERITROPHIC MATRIX IN THE LAST INSTAR LARVAE OF CULEX PIPIENS (DIPTERA: CULICIDAE)

    OpenAIRE

    YIKILMAZ, Mehmet Salih; DEVECİ, Önder

    2010-01-01

    ABSTRACT Larval midgut and peritrophic matrix (PM) of Culex pipiens were investigated by light and electron microscope. Foregut and anterior  midgut together form the special folding area called cardia. Cardia and gastric caeca are located in the thorax. Abdominal midgut follows the gastric caeca and lies between the first and the fifth abdominal segments. The luminal  surfaces of the structures mentioned above are lined by single layered epithelial cells. However, the cell sizes an...

  6. Desenvolvimento pós-embrionário do intestino anterior de Dermatobia hominis (Linnaeus Jr. (Diptera, Cuterebridae Post-embryonic development of Dermatobia hominis (Linnaeus Jr. (Diptera, Cuterebridae foregut

    Directory of Open Access Journals (Sweden)

    Ana Maria Vieira

    2001-03-01

    Full Text Available Foregut in D. hominis (Linnaeus Jr., 1781 as the majority of the larval Diptera somatic tissue, is made up of polytenic cells, and grows at the expenses of the polytenization of its nuclei followed by the increase in size of each cell. The oesophagus, of ectodermic origem, is interiorly covered by a chitinous squamous epithelium that rests upon a very thin basal lamina. This sheet is surrounded by thick muscle bundles. The oesophagus intussuscepts the midgut forming the cardia. The cardia, with three epithelial layers: two internal ones, of ectodermal origin and one external of endodermic origin. At the anterior portion of the cardia, between these two types of epithelium, there is a cluster of small, non polytenic cells, forming the imaginal disk of the foregut. Metamoiphosis begins at the end of the larval period with signs of nuclear degeneration of all the polytenic cells, as well as the increase in number of the imaginal disk ones. The oesophagic portion intussuscepted into the cardia, everts; its cells suffer apoptosis and are replaced by the new cells growing from the imaginal disk. The external layer cells also degenerate and are pinched off into the lumen of the very anterior portion of the midgut. The newly formed oesophagus intussuscepts "de novo" to form the two internal layers of the adult cardia. At the same time the midgut regenerative cells grow anteriorly to form the new external layer of the adult cardia.

  7. Assessment of esophageal dynamics by radionuclide scintigraphy a potential method for early diagnosis of aperistalsis in patients with Chagas disease

    International Nuclear Information System (INIS)

    The esophageal transit time of a sup(99m) Tc 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. Sequential images of tracer esophageal transit were obtained by scintigraphy chamber. A time/activity curve in the region of the cardia was obtained by a multichannel analyzer, from which the 2 parameters were calculated. The assessment of TTE and TDAC by scintigraphic technique is proposed as a screening test for early recognition of esophageal motor disorders as well as for follow-up studies after treatment. (M.A.C.)

  8. Progress in intervention procedure of achalasia

    International Nuclear Information System (INIS)

    Achalasia is a primary esophageal motility disorder, with the main symptom of dysphagia; and caused by the tonus increase and abnormal relaxation of the lower esophageal sphincter(LES). The etiology remains unclear, the objective of the current treatment approaches for achalasia containing the reduction of the LES tone and obstruction to relieve the patients' symptoms; including pharmacologic treatment, botulinum toxin treatment, surgical myotomy, pneumatic dilatation and cardia stent dilatation. The temporary cardia stent dilatation possesses some better advantages and effects; and ought to be the first choice of minimal invasive interventional management for achalasia. (authors)

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

    Science.gov (United States)

    Ren, J S; Freedman, N D; Kamangar, F; Dawsey, S M; Hollenbeck, A R; Schatzkin, A; Abnet, C C

    2010-07-01

    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 non-cardia cancer, 123 Oesophageal Squamous Cell Carcinoma (ESCC) and 305 Oesophageal 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 > or =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 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 3 years of follow-up (compared to 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

  10. Diagnosing cardiac contusion : old wisdom and new insights

    NARCIS (Netherlands)

    Sybrandy, KC; Cramer, MJM; Burgersdijk, C

    2003-01-01

    Cardiac contusion is usually caused by blunt chest trauma and therefore is frequently suspected in patients involved in car or motorcycle accidents. The diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardia

  11. The promise of CaMKII inhibition for heart disease : preventing heart failure and arrhythmias

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Edwards, Andrew G.; McCulloch, Andrew D.; Brown, Joan Heller

    2013-01-01

    Introduction: Calcium-calmodulin-dependent protein kinase II (CaMKII) has emerged as a central mediator of cardiac stress responses which may serve several critical roles in the regulation of cardiac rhythm, cardiac contractility and growth. Sustained and excessive activation of CaMKII during cardia

  12. 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

  13. 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.

  14. Recurrent achalasia after Heller-Toupet procedure: Laparoscopic extended redo heller myotomy and floppy Dor

    Directory of Open Access Journals (Sweden)

    Golash Vishwanath

    2007-01-01

    Full Text Available Recurrences of symptoms after the surgery for achalasia cardia are not uncommon. There are several causes of recurrences but the early recurrences are speculated to be secondary to incomplete myotomy and late recurrence due to fibrosis after the myotomy or megaesophagus. These recurrences can be managed by regular dilation failing which a redo surgery is indicated. Laparoscopic approach is now standard because of the obvious benefits for patients and surgeons. Extent of myotomy and addition of fundoplication are debatable issue in the management of achalasia cardia but evidence suggests that some kind of fundoplication would be necessary after the complete division of lower esophageal sphincter. We present our experience in a case of recurrent achalasia, secondary to incomplete myotomy managed laparoscopically by extended myotomy and a floppy anterior fundoplication. Patient is asymptomatic six months after the surgery and radiologically there is free passage of barium in the stomach.

  15. Triple A syndrome with ophthalmic manifestations in two siblings

    Directory of Open Access Journals (Sweden)

    Babu Kalpana

    2007-01-01

    Full Text Available Triple A syndrome (Allgrove syndrome is a rare, autosomal recessive disorder characterized by adrenocorticotropic hormone resistant adrenal insufficiency, alacrima, achalasia of the esophageal cardia, progressive neurological degeneration and occasionally autonomic instability. We report the ophthalmic manifestations in 2 siblings from a consanguineous family with this syndrome. A routine ophthalmic examination showed absence of palpebral portion of lacrimal gland, dry eyes and sluggish pupillary reflexes in both eyes of these patients. Both of these patients had achalasia cardia while the boy additionally had increased serum cortisol levels. Topical ocular lubricants were prescribed for both of them and Heller′s cardiomyotomy with fundus plication was done for achalasia. These cases would create an awareness of this rare condition in ophthalmology in addition to suggesting its management.

  16. Role of gamma-glutamyltransferase in cardiovascular diseases

    OpenAIRE

    Jiang, Shengyang; Jiang, Donglin; Tao, Yijia

    2013-01-01

    Cardiovascular diseases are threatening human health with rising morbidity and mortality rates. Gamma-glutamyltransferase (GGT) has been found to be involved in the pathogenesis of cardiovascular diseases, especially coronary artery disease, and the prognosis of cardiovascular disease may be predicted by increasing GGT levels. GGT levels are related to cardiovascular emergencies of chronic heart failure, and an elevated GGT level has been shown to be an independent predictive maker for cardia...

  17. Obesity Preserves Myocardial Function During Blockade of the Glycolytic Pathway

    OpenAIRE

    Dijon Henrique Salomé de Campos; André Soares Leopoldo; Ana Paula Lima-Leopoldo; André Ferreira do Nascimento; Silvio Assis Oliveira-Junior; Danielle Cristina Tomaz da Silva; Mario Mateus Sugizaki; Carlos Roberto Padovani; Antonio Carlos Cicogna

    2014-01-01

    Background: Obesity is defined by excessive accumulation of body fat relative to lean tissue. Studies during the last few years indicate that cardiac function in obese animals may be preserved, increased or diminished. Objective: Study the energy balance of the myocardium with the hypothesis that the increase in fatty acid oxidation and reduced glucose leads to cardiac dysfunction in obesity. Methods: 30-day-old male Wistar rats were fed standard and hypercaloric diet for 30 weeks. Cardia...

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

    OpenAIRE

    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 (...

  19. 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

  20. Asymptomatic Disseminated Cysticercosis

    OpenAIRE

    Vaidya, Ashima; Singhal, Suman; Dhall, Sonia; Manohar, Ashish; Mahajan, Harsh

    2013-01-01

    Cysticercosis is a common problem world wide. However, disseminated cysticercosis is rare. Still rarer is asymptomatic disseminated cysticercosis. We are reporting here a rare case of asymptomatic disseminated cysticercosis which involved brain, face, orbit, lungs, heart, pancreas and spleen in a young Nigerian male, who sought medical attention for dysphagia which was diagnosed as achalasia cardia. Despite widespread dissemination of cysticercosis which involves multiple organs, the individu...

  1. Breakfast Frequency and Development of Metabolic Risk

    OpenAIRE

    Odegaard, Andrew O; Jacobs, David R.; Steffen, Lyn M.; Horn, Linda Van; Ludwig, David S.; Pereira, Mark A

    2013-01-01

    OBJECTIVE The relation of breakfast intake frequency to metabolic health is not well studied. The aim of this study was to examine breakfast intake frequency with incidence of metabolic conditions. RESEARCH DESIGN AND METHODS We performed an analysis of 3,598 participants from the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study who were free of diabetes in the year 7 examination when breakfast and dietary habits were assessed (1992–1993) and participated in at ...

  2. 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.

  3. Achalasia of esophagus - case report

    International Nuclear Information System (INIS)

    The author presents the characteristic features in the radiologic of the achalasia on a case of a 67 year old patient. The patient had a long - standing dysphagia and odynophagia, which had progressed gradually during 21 years to the third stage of the disease with atonic oesophagus. The most important problem still remains the differentiating from the cardia - type gastric carcinoma and fibroendoscopy with/or without biopsy is an inevitable supplementary diagnostic method in differential diagnostic procedure. (authors)

  4. Esophageal Cancer in Iran: A Review

    OpenAIRE

    Siavosh Nasseri-Moghaddam; Shahryar Semnani; Hajiamin Marjani; Alireza Sadjadi

    2010-01-01

    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 (...

  5. Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance

    OpenAIRE

    Liu, Kevin Sze-Hang; Wong, Irene Oi-Ling; Leung, Wai K.

    2016-01-01

    Gastric cancer (GC) is one of the leading causes of cancer related death in the world, particularly in East Asia. According to the Correa’s cancer cascade, non-cardia GC is usually developed through a series of mucosal changes from non-atrophic gastritis to atrophic gastritis (AG), intestinal metaplasia (IM), dysplasia and adenocarcinoma. Atrophic gastritis and IM are therefore generally considered to be pre-neoplastic gastric lesions. Helicobacter pylori (H. pylori) infection is an important...

  6. What is Obesity Doing to Your Gut?

    OpenAIRE

    Lee, Yeong Yeh

    2015-01-01

    Obesity is a fast-emerging epidemic in the Asia-Pacific region, with numbers paralleling the rising global prevalence within the past 30 years. The landscape of gut diseases in Asia has been drastically changed by obesity. In addition to more non-specific abdominal symptoms, obesity is the cause of gastro-oesophageal reflux disease, various gastrointestinal cancers (colorectal cancer, hepatocellular carcinoma, oesophageal adenocarcinoma, gastric cardia adenocarcinoma, pancreatic cancer and ga...

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

    OpenAIRE

    Mukhopadhya, Ashis; Danda, Sumita; Huebner, Angela; Chacko, Ashok

    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 heterozygo...

  8. Pulse transit times to the capillary bed evaluated by laser Doppler flowmetry

    OpenAIRE

    Bernjak, Alan; Stefanovska, Aneta

    2009-01-01

    The pulse transit time (PTT) of a wave over a specified distance along a blood vessel provides a simple non-invasive index that can be used for the evaluation of arterial distensibility. Current methods of measuring the PTT determine the propagation times of pulses only in the larger arteries. We have evaluated the pulse arrival time (PAT) to the capillary bed, through the microcirculation, and have investigated its relationship to the arterial PAT to a fingertip. To do so, we detected cardia...

  9. Corpus gastritis is protective against reflux oesophagitis

    OpenAIRE

    El-Serag, H; Sonnenberg, A.; Jamal, M.; Inadomi, J; Crooks, L.; Feddersen, R

    1999-01-01

    BACKGROUND—Gastric acid is important in the pathogenesis of reflux oesophagitis. Acid production by the gastric corpus is reduced in corpus gastritis.
AIMS—To determine whether corpus gastritis protects against reflux oesophagitis.
METHODS—Patients presenting for elective oesophagogastroduodenoscopy were studied. Two biopsy specimens were taken from the antrum, corpus, and cardia and stained with haematoxylin/eosin and Diff-Quick II stains. The presence and severity of gastritis were graded a...

  10. Vitamin D Receptor Expression in the Mucosal Tissue at the Gastroesophageal Junction

    OpenAIRE

    Trowbridge, Ryan; Sharma, Poonam; Hunter, William J.; Agrawal, Devendra K.

    2012-01-01

    Barrett’s Esophagus is considered to be a precursor to adenocarcinoma and the information on VDR expression in normal and Barrett’s esophagus is significantly lacking. In this study, we examined the expression of VDR in the lower esophagus and gastric cardia of normal and Barrett’s esophagus by immunofluorescence. Columnar mucosa but not squamous mucosa at the gastroesophageal junction showed positive immunofluorescence to VDR. Submucosal glands and ducts deep to the normal squamous mucosa st...

  11. Health Behavior Change after Blood Pressure Feedback.

    Directory of Open Access Journals (Sweden)

    Jia Pu

    Full Text Available Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (p<0.05. We found no evidence of differences in health behavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing

  12. 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 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 esophageal botulinum toxin treatment. PMID:25212219

  13. H. pylori seropositivity before age 40 and subsequent risk of stomach cancer: a glimpse of the true relationship?

    Directory of Open Access Journals (Sweden)

    Christina Persson

    Full Text Available Stomach carcinogenesis involves mucosal and luminal changes that favor spontaneous disappearance of Helicobacter pylori. Therefore, the association between the infection and cancer risk might typically be underestimated. As acquisition of the infection almost invariably occurs before adulthood, the serostatus at age 16-40 should best reflect the lifetime occurrence of the infection. We therefore conducted a case-control study nested within a historic cohort of about 400,000 individuals who donated sera before age 40 to either of two large Swedish Biobanks between 1968 and 2006, and whose records were linked to complete nationwide registers. For each stomach adenocarcinoma case occurring at least 5 years after serum donation 2 controls were selected matched on age, sex and year of donation and biobank. Serum immunoglobulin G antibodies against H. pylori cell-surface antigens (Hp-CSAs were measured with an enzyme-linked immunosorbent assay and antibodies against CagA with an immunoblot assay. Conditional logistic regression models were used to estimate odds ratios (ORs for stomach adenocarcinoma among H. pylori infected relative to uninfected. We confirmed 59 incident cases of stomach adenocarcinoma (41 non-cardia tumors during follow-up. ORs for non-cardia stomach adenocarcinoma among subjects with Hp-CSA antibodies (regardless of CagA serostatus, antibodies against CagA (regardless of Hp-CSA serostatus, and antibodies to both, relative to those who were seronegative to both, were 17.1 (95% confidence interval [CI] 4.0-72.9, 10.9 (95% CI 3.2-36.9, and 48.5 (95% CI 5.8-407.4, respectively. H. pylori infection is a much stronger risk factor for non-cardia stomach adenocarcinoma than initially realized. However, further studies are needed to answer whether it is a necessary cause, as the possibility of misclassification of H. pylori status could not be ruled out in our study.

  14. Health Behavior Change after Blood Pressure Feedback.

    Science.gov (United States)

    Pu, Jia; Chewning, Betty A; Johnson, Heather M; Vanness, David J; Young, Henry N; Kreling, David H

    2015-01-01

    Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA) repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (pbehavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing blood pressure feedback may have promise as part of a multi-method approach

  15. Recurrent achalasia in a child with Williams-Beuren syndrome.

    Science.gov (United States)

    Pereza, Nina; Barbarić, Irena; Ostojić, Sasa; Cace, Neven; Kapović, Miljenko

    2011-09-01

    Williams-Beuren syndrome is a multysistem genetic disorder caused by the 1.6Mb hemizygous deletion involving the elastin gene in the region q11.23 of chromosome 7. The phenotype of Williams-Beuren syndrome is extremelly variable but the most common findings include cardiovascular disease, distinctive facies, mental retardation, a specific congitive profile, endocrine abnormalities, growth retardation and connective tissue abnormalities. Although gastrointestinal difficulties are one of the most constant and prominent finding of the syndrome, including gastro-esophageal reflux (GER), poor suckling, vomiting, constipation, prolonged colic, rectal prolapse, inguinal, umbilical and hiatal hernia, there have been no reports of achalasia in association with Williams-Beuren syndrome in the literature. We present the case of a boy with Williams-Beuren syndrome, achalasia and recurrent postoperative stenosis of the cardia. After Heller myotomy, the boy developed severe restenosis of the cardia with abundant adhesions which repeated after every treatment, five times in periods shorter than one month. Eventually, he developed GER, errosive gastritis and hiatal hernia which led to severe malnutrition and failure to thrive. Although the genetic defect causing Williams-Beuren syndrome might not be the direct cause of achalasia we suggest that the frequent development of severe restenosis of cardia due to tight adhesions could be the consequence of elastin gene haploinsufficiency and altered structure and function of elastic fibers in esophageal connective tissue. This case highlights the importance of early diagnosis of esophageal motor disorders in childhood which should be included in the differential diagnosis when a child with Williams-Beuren syndrome presents with dysphagia and/or regurgitation. PMID:22053584

  16. Optimal revascularization strategy for diabetic patients with multivessel coronary artery disease: the duel between old hero and young warrior.

    Science.gov (United States)

    Celik, Turgay; Iyisoy, Atila; Yuksel, U Cagdas; Isik, Ersoy

    2009-01-01

    Given the results of the BARI and ARTS I trials and a meta-analysis, coronary artery bypass surgery has been preferred to percutaneous coronary intervention in diabetics with multivessel coronary artery disease requiring hypoglycemic treatment and in whom internal mammary artery grafts can be used. This approach was strongly recommended in a 2002 ACC/AHA Task Force on the management of patients with acute coronary syndrome. But, these recommendations were made before the availability of drug-eluting stents. We strongly believe that the ongoing, multi-centre FREEDOM, CARDia and SYNTAX trials will elucidate the optimal revascularization strategy for diabetic patients with multivessel disease in the near future. PMID:17692947

  17. 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.

  18. Familial esophageal achalasia in mother and son

    Directory of Open Access Journals (Sweden)

    Sumesh Raj

    2013-04-01

    Full Text Available Familial esophageal achalasia a rare presentation, is most often described in monozygotic twins or siblings. Parent/child association is very rare and exhaustive review of the literature found about 5 times as many instances of affected siblings than instances of affected parent/child. Only seven instances of parent/child association have been reported till date. We report a 75 -year-old lady with achalasia cardia and her son who developed the same illness one year later. Mother was treated by Heller's surgery and son is presently on medical management. [Int J Res Med Sci 2013; 1(2.000: 142-144

  19. Laparoscopic Heller′s cardiomyotomy in cirrhosis with oesophageal varices

    Directory of Open Access Journals (Sweden)

    Dalvi Abhay

    2010-01-01

    Full Text Available Surgical intervention in cirrhosis of liver with portal hypertension is associated with increased morbidity and mortality. This is attributed to liver decompensation, intra-operative bleeding, prolonged operative time, wound related and anaesthesia complications. Laparoscopic surgery in cirrhosis is advantageous but is associated with technical challenges. We report one such case of hepatitis C cirrhosis with oesophageal varices and symptomatic achalasia cardia, who was successfully treated by laparoscopic cardiomyotomy after thorough preoperative workup and planning. In the review of literature on pubmed, no such case is reported.

  20. [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

    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. PMID:25386642

  1. Clinico-roentgenological diagnosis of esophagus dyskinesia

    International Nuclear Information System (INIS)

    Modern data on clinico-roentgenological manifestations of esophagus dyskinesia are generalized. Using experience gained for many years in the examination of numerous patients and critical analysis of domestic and foreign literature, the classification of dyskinesia types is suggested. Part of the material is studied, using the most recent methods - roentgenocinematography and roentgenotonometry of esophagus. The description of cardiospasm, esophagospasm, esophagus, hypokinesia, achalasia and chalasia of cardia is given. Problems of differential diagnosis both of intragroup and similar to the clinical manifestations of esophagus diseases, are considered

  2. Two Uncommon Paraneoplastic Neurological Syndromes in a Child With Hodgkin Lymphoma.

    Science.gov (United States)

    Srinivasan, Arathi; Satish, Gayathri; Scott, Julius X; Madhavan, Ramprakash; Sathiyasekaran, Malathi

    2016-08-01

    Paraneoplastic neurological syndromes (PNS) are rare, remote effects of cancer that are usually caused by an altered immune response to the tumor and not due to the tumor mass, metastasis, infection, ischemia, or metabolic derangements. PNSs can affect any area of the central, the peripheral, and the autonomic nervous systems. These are rare in lymphomas compared with solid tumors attributed to their presentation even in late stages and the absence of onconeural antibodies. We present a child with stage IIB Hodgkin lymphoma who presented with dual PNS, achalasia cardia, and Holmes Adie pupil occurring synchronously with the cancer. PMID:27164530

  3. Vómitos en en recién nacido

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. VOMITOS EN EL RECIEN NACIDO. 1. CONCEPTOS GENERALES El vÓmito es la expulsión brusca de contenido gástrico por relajación del cardias y contracción sincrónica del estómago y de la prensa abdominal. Por lo tanto el contenido del vómito esta mezclado con jugo gástrico y se encontrará modificado en mayor o menos proporción...

  4. 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...

  5. Inverse Associations Between Perceived Racism and Coronary Artery Calcification

    Science.gov (United States)

    EVERAGE, NICHOLAS J.; GJELSVIK, ANNIE; MCGARVEY, STEPHEN T.; LINKLETTER, CRYSTAL D.; LOUCKS, ERIC B.

    2014-01-01

    PURPOSE: To evaluate whether racial discrimination is associated with coronary artery calcification (CAC) in African-American participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS: The study included American Black men (n = 571) and women (n = 791) aged 33 to 45 years in the CARDIA study. Perceived racial discrimination was assessed based on the Experiences of Discrimination scale (range, 1–35). CAC was evaluated using computed tomography. Primary analyses assessed associations between perceived racial discrimination and presence of CAC using multivariable-adjusted logistic regression analysis, adjusted for age, gender, socioeconomic position (SEP), psychosocial variables, and coronary heart disease (CHD) risk factors. RESULTS: In age- and gender-adjusted logistic regression models, odds of CAC decreased as the perceived racial discrimination score increased (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90–0.98 per 1-unit increase in Experiences of Discrimination scale). The relationship did not markedly change after further adjustment for SEP, psychosocial variables, or CHD risk factors (OR, 0.93; 95% CI, 0.87–0.99). CONCLUSIONS: Perceived racial discrimination was negatively associated with CAC in this study. Estimation of more forms of racial discrimination as well as replication of analyses in other samples will help to confirm or refute these findings. PMID:22365645

  6. Screening for amplification genomic loci and genes associated prognosis in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:We used a high-resolution array-based comparative genomic hybridization (aCGH) coupled with patient clinical information to identify prognosis-related genomic loci and genes.Methods: aCGH coupled with patient clinical information was applied to identify prognosis-related loci and genes with high-frequency recurrent gains in 129 GC cases. The candidate loci and genes were validated using an independent cohort of 384 cases through branched DNA signal ampliifcation analysis.Results:A copy number gain of three chromosome regions, namely, 8q22, 8q24and 20q11-q13, conferred poor survival for patients. In addition, MYC, TNFRSF11B, ESRP1, CSE1L and MMP9 were found to be well correlated. Further validation verified that only MYC and TNFRSF11B within 8q24 are related to survival. Patients with gains in both MYC and TNFRSF11B presented poorer survival than those with no gains, particularly those with non-cardia GC. Gains in both of these genes were also a signiifcant independent prognostic indicator.Conclusion:Copy number gains in MYC and TNFRSF11B located at 8q24are associated with survival in GC, particularly non-cardia GC.

  7. Iron in Relation to Gastric Cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

    Science.gov (United States)

    Cook, Michael B.; Kamangar, Farin; Weinstein, Stephanie J.; Albanes, Demetrius; Virtamo, Jarmo; Taylor, Philip R.; Abnet, Christian C.; Wood, Richard J.; Petty, Gayle; Cross, Amanda J.; Dawsey, Sanford M.

    2012-01-01

    Background Iron is an essential micronutrient that can have carcinogenic effects when at high or low concentrations. Previous studies of iron in relation to gastric cancer have not assessed subtype-specific relationships. We used the prospective ATBC Cancer Prevention Study to assess whether iron metrics were associated with gastric cardia cancer (GCC) and gastric noncardia cancer (GNCC). Methods We selected 341 incident gastric cancer cases (86 cardia, 172 noncardia, and 83 non-specified), accrued during 22 years of follow-up, and 341 individually matched controls. We measured prediagnostic serum iron, ferritin, unsaturated iron binding capacity (UIBC), and C-reactive protein. Total iron binding capacity (TIBC) and transferrin saturation were estimated from these metrics. Dietary iron exposures were estimated from a food frequency questionnaire. Multivariable logistic regression was used for analysis. Results Serum iron metrics were not associated with GCC, except for a potential ‘n’-shaped relationship with TIBC (global p=0.038). GNCC was inversely associated with serum ferritin (global p=0.024), serum iron (global p=0.060) and, possibly, transferrin saturation. TIBC appeared to share a ‘u’shaped relationship with GNCC (global p=0.033). Dietary iron exposures were not associated with either subsite. Adjustment for Helicobacter pylori and gastric atrophy had little effect on observed associations. Conclusions We found little evidence for the involvement of iron exposure in the pathogenesis of GCC. GNCC was associated with an iron profile similar to that of iron deficiency. PMID:23001240

  8. Biodistribution of [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide in dogs: uptake in the stomach and intestines but not in the spleen points towards interspecies differences

    Energy Technology Data Exchange (ETDEWEB)

    Robben, Joris E-mail: J.H.Robben@vet.uu.nl; Claude Reubi, Jean; Pollak, Yvonne; Voorhout, George

    2003-04-01

    The purpose of the present study was to establish the tissue distribution in abdominal organs and the excretion of radioactivity after intravenous administration of [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide in healthy dogs. In five Beagle dogs computed tomography and single photon emission computed tomography (SPECT) at 24 h after injection of [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide revealed accumulation of radioactivity in the kidneys, gall bladder, gastric fundus and cardia, intestinal tract, but not in the spleen. These findings were confirmed by in vitro scintigraphy of single abdominal organs. This also demonstrated accumulation of radioactivity in the pancreas and located the radioactivity in the gastrointestinal tract primarily in the wall itself. In vitro autoradiography with {sup 125}I-[Tyr{sup 3}]-octreotide on tissue samples in two dogs revealed sst receptors in the medullary part of the kidney, the basal two-thirds of the gastric mucosa of the cardia and fundus, Peyer's patches and neural plexus of the gastrointestinal tract. No sst receptors were demonstrated in the liver, spleen, and pancreas. These results differ to findings in man, where there is uptake in the spleen but not in the stomach, most likely caused by interspecies variations in sst receptor subtype expression.

  9. Study on relationship between ABO blood type and clinical characteristics of gastric cancer patients%ABO血型与胃癌患者临床特征关系的研究

    Institute of Scientific and Technical Information of China (English)

    袁泉; 周旭春

    2014-01-01

    目的:调查胃癌病人高危因素、原发灶部位和aBo血型并讨论其关系,为制定高危人群的筛查和随访方案、提高胃癌的胃镜检查阳性率提供参考信息。方法搜集整理资料进行回顾性分析。结果胃癌男性多见,男女比约为1.8:1;胃癌高发年龄为51~70岁;胃癌发生于贲门胃底外的其他胃癌最多,包括胃体、胃角、胃窦,比例约为1:2.58。与血型的关系,胃癌病人中B型和a型血最多,男性B型血(P=0.001)和o型血(P<0.001)人群更不易发生胃癌,女性B型血更不易发生贲门胃底癌(P<0.001);原发于其他部位的胃癌较发生贲门胃底癌多,这和是否为中青年人(≤60岁)或老年人(>60岁)无关;贲门胃底癌以51-60岁多见,发生于其他部位的胃癌多见于61~70岁;71~80岁女性贲门胃底癌的发生率高于同年龄组的男性。结论①B型血和o型血可能是男性胃癌的保护因素;B型血可能是女性罹患贲门胃底癌的保护因素;②各年龄段贲门胃底癌的发生率均较同年龄段发生其他部位的胃癌低③对71到80岁可疑胃癌的女性在行胃镜检查时更应注意观察贲门胃底区域;4.血型和胃癌原发灶部位可能无关。%Objective to investigate the high risk factors, primary locations and aBo blood groups of gastric cancer patients and their relation to provide information for establishing screening and follow-up plan for the high-risk, increasing positive rate of endoscopy detecting for gastric cancer as a result. Method collecting and sorting data for retrospective analysis. Results Male overwhelms female in gastric cancer occurrence, with a ratio of 1.8:1;high incidence during the age of 51 to 70;primary location found in gastric body, angle and antrum most, with a ration of 2.58:1 to and cardia-fundus cancer. as to blood group, patients with bold group B or a is most seen. Male with blood group B or o (P=0

  10. 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.

  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

    2015-12-01

    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. Prenatal MRI diagnosis of fetal cerebral tuberous sclerosis

    International Nuclear Information System (INIS)

    Tuberous sclerosis (TS) is an autosomal dominant phakomatosis. A high percentage of spontaneous mutations leads to the diagnosis of new cases in normal families. This diagnosis is suspected at antenatal ultrasound on the discovery of multiple cardiac tumors. Antenatal cerebral ultrasound shows a normal appearance in affected fetuses. Eight fetuses with multiple cardia tumors were studied with antenatal MRI with, in five cases, an abnormal appearance showing hyperintense subependymal and cortical nodules on T1-weighted images. Among the three remaining patients MRI was non-contributive in one due to movement artefact, one had abnormal postnatal MRI consistent with TS and one had a normal postnatal and clinical examination. We conclude that MRI is a valuable tool in making the diagnosis of TS in fetuses with multiple cardiac tumors. (orig.)

  13. Prenatal MRI diagnosis of fetal cerebral tuberous sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Sonigo, P. [Dept. of Pediatric Imaging, Hopital des Enfants-Malades, Paris (France); Elmaleh, A. [Dept. of Pediatric Imaging, Hopital des Enfants-Malades, Paris (France); Fermont, L. [Pediatric Cardiology Dept., Inst. de Puericulture, Paris (France); Delezoide, A.L. [Fetal Pathology Dept., Hopital des Enfants-Malades, Paris (France); Mirlesse, V. [Fetal Medicine Unit, Inst. de Puericulture, Paris (France); Brunelle, F. [Dept. of Pediatric Imaging, Hopital des Enfants-Malades, Paris (France)

    1996-01-01

    Tuberous sclerosis (TS) is an autosomal dominant phakomatosis. A high percentage of spontaneous mutations leads to the diagnosis of new cases in normal families. This diagnosis is suspected at antenatal ultrasound on the discovery of multiple cardiac tumors. Antenatal cerebral ultrasound shows a normal appearance in affected fetuses. Eight fetuses with multiple cardia tumors were studied with antenatal MRI with, in five cases, an abnormal appearance showing hyperintense subependymal and cortical nodules on T1-weighted images. Among the three remaining patients MRI was non-contributive in one due to movement artefact, one had abnormal postnatal MRI consistent with TS and one had a normal postnatal and clinical examination. We conclude that MRI is a valuable tool in making the diagnosis of TS in fetuses with multiple cardiac tumors. (orig.)

  14. Nutritional analysis of Cardiaalliadora Oken species, associated with hydroponia

    International Nuclear Information System (INIS)

    Forestry industry is one in constant growth; Colombia has a favorable stage for development of this activity which generates a lot of employment. Forestry species Cardia alliodora is a pioneer one of quick growth, abundantly regenerated and adapted to ecological conditions from the sea level to 1900 meters above sea level. This species are very common in colombian coffee zone and is specially exploited in furniture industries. This study uses an hydroponic system in greenhouse conditions to simulate lacking of 12 bio-elements stages, with contribution of field data; the species nutritional request was established. The study determined 12 bio-elements concentration in three samples and allowed to establish the relationships in time by elements and the N,P,K and K,Ca,Mg ratios

  15. 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. PMID:16334775

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

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Andersen, Aage; Rylander, Lars;

    2006-01-01

    (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 not......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...

  17. First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart.

    Science.gov (United States)

    Khalpey, Zain; Kazui, Toshinobu; Ferng, Alice S; Connell, Alana; Tran, Phat L; Meyer, Mark; Rawashdeh, Badi; Smith, Richard G; Sweitzer, Nancy K; Friedman, Mark; Lick, Scott; Slepian, Marvin J; Copeland, Jack G

    2016-01-01

    The 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH. PMID:26809081

  18. Epidemiology of Gastric Cancer in Northwest Iran: 2003-2011

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    Firouz Amani

    2015-07-01

    Full Text Available Background: Gastric cancer is the fifth most common cancer in the world and the third leading cause of death from cancer worldwide. This study aims to assess the epidemiology of gastric cancer in Ardabil Province, Iran. Methods: This was a descriptive cross-sectional study performed on 1056 patients with gastric cancer registered in the Ardabil Cancer Registry. Data were collected by a checklist and analyzed by statistical methods in SPSS version 19. Results: Out of 1056 cases, 37% were smokers and 80.9% were illiterate. There were 73.1% male cases. Adenocarcinoma was the most common (89.5% type of cancer and prevalent in males. The tumors were mostly located in the gastric cardia. Most cases were from rural areas. Conclusion: Results showed that the incidence of gastric cancer in Ardabil Province was higher in males compared to females. Compared to the country standards the incidence of gastric cancer was higher.

  19. 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.

  20. Gastric lipase: localization of the enzyme in the stomach

    International Nuclear Information System (INIS)

    Isolated gastric glands prepared from human and rabbit stomach secrete lipase in response to secretagogues. They have investigated the localization of this enzyme in three species (rabbit, baboon, guinea pig). Gastric mucosa was sampled from the cardia (C), fundus-smooth (FS), fundus-ruggae (FR) and the antral area (A). Lipase activity was measured in mucosal homogenates using 3H-triolein as substrate and is expressed in units (U) = nmols free fatty acid released/min/mg wet weight. The localization of lipase is compared with that of pepsin (measured by hydrolysis of 2% hemoglobin at pH 1.8 and expressed in I.U.). Lipase is localized in a well defined area in the rabbit and is diffusely distributed in both guinea pig and baboon. The distribution of lipase and pepsin containing cells differs in all three species. The cellular origin of gastric lipase remains to be determined

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  3. The Association between the Clinical Symptoms of Heterotopic Gastric Mucosa in the upper Esophagus and its Pathologic Types%上食管胃黏膜异位症的临床与病理分析

    Institute of Scientific and Technical Information of China (English)

    张春芬; 陈宏伟; 李延伟

    2011-01-01

    Objective To investigate the association between the clinical symptoms of heterotopic gastric mucosa in the upper esophagus and its pathologic types. Methods The biopsies were taken from red mucosa for pathological examination when upper esophagus was observed by endoscope in 15 713 cases. Results 14 eases of cardia gastric mucosa and 3 cases of fundic gastric mucosa were detected in 18 patients with unfavorable gulping. 1 case of cardia gastric mucosa and 9 cases of fundic gastric mucosa were detected in 11 patients with local burning sensation or pain. The pathologic types were significantly different. Conclusion The symptoms of heterotopic gastric mucosa in the upper esophagus are closely related with pathologic types.%目的 研究上食管胃黏膜异位症的临床症状与病理特征的关系.方法以在某医院进行胃镜检查的15 713人为研究对象,在常规内镜操作中经食管上段时,观察到边界清楚的红色黏膜,取检进行病理学检查.结果症状表现为下咽不利的患者有18例,其中贲门型胃黏膜有14例,胃底型黏膜3例;局部烧灼感或者疼痛的患者有11例,其中贲门型胃黏膜有1例,胃底型黏膜有9例;其病理学类型存在明显差异.结论 上食管胃黏膜异位症的症状与病理学类型相关.

  4. Biodistribution and trafficking of hydrogel nanoparticles in adult mosquitoes.

    Directory of Open Access Journals (Sweden)

    Cynthia C H Paquette

    2015-05-01

    Full Text Available Nanotechnology offers great potential for molecular genetic investigations and potential control of medically important arthropods. Major advances have been made in mammalian systems to define nanoparticle (NP characteristics that condition trafficking and biodistribution of NPs in the host. Such information is critical for effective delivery of therapeutics and molecules to cells and organs, but little is known about biodistribution of NPs in mosquitoes.PRINT technology was used to construct a library of fluorescently labeled hydrogel NPs of defined size, shape, and surface charge. The biodistribution (organ, tissue, and cell tropisms and trafficking kinetics of positively and negatively charged 200 nm x 200 nm, 80 nm x 320 nm, and 80 nm x 5000 nm NPs was determined in adult Anopheles gambiae mosquitoes as a function of the route of challenge (ingestion, injection or contact using whole body imaging and fluorescence microscopy. Mosquitoes readily ingested NPs in sugar solution. Whole body fluorescence imaging revealed substantial NP accumulation (load in the alimentary tracts of the adult mosquitoes, with the greatest loads in the diverticula, cardia and foregut. Positively and negatively charged NPs differed in their biodistribution and trafficking. Following oral challenge, negatively charged NPs transited the alimentary tract more rapidly than positively charged NPs. Following contact challenge, negatively charged NPs trafficked more efficiently in alimentary tract tissues. Following parenteral challenge, positively and negatively charged NPs differed in tissue tropisms and trafficking in the hemocoel. Injected NPs were also detected in cardia/foregut, suggesting trafficking of NPs from the hemocoel into the alimentary tract.Herein we have developed a tool box of NPs with the biodistribution and tissue tropism characteristics for gene structure/function studies and for delivery of vector lethal cargoes for mosquito control.

  5. 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.

  6. 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.

  7. Incidência e fatores predisponentes da migração da fundoplicatura pela técnica de Nissen-Rossetti no tratamento da doença do refluxo Gastroesofágico Incidence and predisponent factors for the migration of the fundoplication by Nissen-Rossetti technique in the surgical treatment of GERD

    Directory of Open Access Journals (Sweden)

    Paulo Afonso Nunes Nassif

    2012-06-01

    Full Text Available RACIONAL: A doença do refluxo gastroesofágico é uma das enfermidades do trato gastrointestinal mais frequentes atualmente. A fundoplicatura de Nissen-Rossetti é técnica operatória muito empregada para o tratamento cirúrgico, sendo a migração intratorácica da válvula uma das principais complicações. OBJETIVO: Avaliar a incidência da migração da fundoplicatura e seus fatores de risco. MÉTODO: Analisou-se retrospectivamente 207 prontuários de pacientes submetidos à fundoplicatura videolaparoscópica pela técnica de Nissen-Rossetti para tratamento da doença do refluxo. As variáveis analisadas foram: sexo, idade, esofagite, grau de esofagite, tamanho da hérnia, alargamento da cárdia, encurtamento esofágico. Para as variáveis quantitativas, foi considerado o teste t de Student. Para as nominais, foi considerado o teste de Qui-quadrado ou o teste exato de Fisher. Valores de pBACKGROUND: Gastroesophageal reflux is the gastrointestinal tract disease most frequently find nowadays. The Nissen-Rossetti fundoplication is widely used for the surgical treatment, and intrathoracic migration of the valve is the most frequent complication. AIM: To assess the incidence of the fundoplication and its risk factors. METHODS: Were analyzed retrospectively medical records of 207 patients undergoing laparoscopic fundoplication by the Nissen-Rossetti technique for the treatment of reflux disease. The variables analyzed were: sex, age, esophagitis grade, size of the herniation, enlargement of the cardia and esophageal shortening. For quantitative variables, was considered the Student's t test. For the nominal, was considered the chi-square or Fisher's exact test. P values ​​<0.05 were considered statistically significant. RESULTS: Of the total, 135 were women (65.22% and 72 men (34.78% with mean age of 47.43 years. The size of the hernia varied between 2 and 6 cm. Two hundred patients had esophagitis (96.62% and 113 (56.50% grade I, 75 grade

  8. Method selection and evaluation of midtrimester and long-term therapeutic efficiency of achalasia with three methods of interventional procedure

    International Nuclear Information System (INIS)

    Objective: To study method selection and evaluation of midtrimester and long-term therapeutic efficiency of achalasia with three methods of interventional procedure. Method: 50 cases achalasia with 30 cases performing with balloon dilation (group A) and 5 cases with permanent metallic internal stent dilation (group B) and 15 cases with temporary metallic internal stent dilation (group C) under fluoroscopy. Results: 30 cases of group A had 56 times of dilations (mean 1.9 times). The mean diameter of cardia was (2.4 +- 1.2) mm before dilation and (9.7 +- 3.0) mm after dilation. The mean dysphagia scores were 2.4 +- 1.2 grades before dilation and 1.0 +- 0.3 grades after dilation. Complications in 30 cases included chest pain (n = 9), reflux (n = 8) and bleeding (n = 3). 18(60%) of 30 cases showed dysphagia relapse during follow-up over 6 months, 18(90%) of 20 cases showed dysphagia relapse during follow-up over 12 months. 5 uncovered expandable metal stents were permanently placed in 5 cases of group B. The mean diameter of cardia was (3.2 +- 2.0) mm before dilation and (18.4 +- 1.7) mm after dilation. The mean dysphagia scores were (2.4 +- 1.1) grade before dilation and (0.4 +- 0.2) grade after dilation. Complications in 5 cases included chest pain (n = 3), reflux (n = 4), bleeding (n = 1) and hyperplasia of granulation tissue (n 2). 3(60%) in 5 cases showed dysphagia relapse during follow-up over 6 months, 1(50%) in 2 cases were dysphagia relapse during follow-up over 12 months. 15 covered expandable metal stents were temporarily placed in 15 cases of group C and drawn out at the 3-7 days via gastroscopy. The mean diameter of cardia was (3.4 +- 2.9) mm before dilation and (14.7 +- 2.9) mm after dilation. The mean dysphagia scores were (2.5 +- 1.1) grades before dilation and (0.6 +- 0.3) grades after dilation. Complications in 15 cases included chest pain (n = 3), reflux (n = 3) and bleeding (n = 2). 3(20%) in 15 cases showed dysphagia relapse during follow-up over 6

  9. Array-based comparative genomic hybridization for the detection of DNA sequence copy number changes in Barrett's adenocarcinoma.

    Science.gov (United States)

    Albrecht, Bettina; Hausmann, Michael; Zitzelsberger, Horst; Stein, Hubert; Siewert, Jörg Rüdiger; Hopt, Ulrich; Langer, Rupert; Höfler, Heinz; Werner, Martin; Walch, Axel

    2004-07-01

    Array-based comparative genomic hybridization (aCGH) allows the identification of DNA sequence copy number changes at high resolution by co-hybridizing differentially labelled test and control DNAs to a micro-array of genomic clones. The present study has analysed a series of 23 formalin-fixed, paraffin wax-embedded tissue samples of Barrett's adenocarcinoma (BCA, n = 18) and non-neoplastic squamous oesophageal (n = 2) and gastric cardia mucosa (n = 3) by aCGH. The micro-arrays used contained 287 genomic targets covering oncogenes, tumour suppressor genes, and DNA sequences localized within chromosomal regions previously reported to be altered in BCA. DNA sequence copy number changes for a panel of approximately 50 genes were identified, most of which have not been previously described in BCA. DNA sequence copy number gains (mean 41 +/- 25/BCA) were more frequent than DNA sequence copy number losses (mean 20 +/- 15/BCA). The highest frequencies for DNA sequence copy number gains were detected for SNRPN (61%); GNLY (44%); NME1 (44%); DDX15, ABCB1 (MDR), ATM, LAMA3, MYBL2, ZNF217, and TNFRSF6B (39% each); and MSH2, TERC, SERPINE1, AFM137XA11, IGF1R, and PTPN1 (33% each). DNA sequence copy number losses were identified for PDGFB (44%); D17S125 (39%); AKT3 (28%); and RASSFI, FHIT, CDKN2A (p16), and SAS (CDK4) (28% each). In all non-neoplastic tissue samples of squamous oesophageal and gastric cardia mucosa, the measured mean ratios were 1.00 (squamous oesophageal mucosa) or 1.01 (gastric mucosa), indicating that no DNA sequence copy number chances were present. For validation, the DNA sequence copy number changes of selected clones (SNRPN, CMYC, HER2, ZNF217) detected by aCGH were confirmed by fluorescence in situ hybridization (FISH). These data show the sensitivity of aCGH for the identification of DNA sequence copy number changes at high resolution in BCA. The newly identified genes may include so far unknown biomarkers in BCA and are therefore a starting point for

  10. 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

  11. Desmoplastic Small Round Cell Tumor of Stomach

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

    Full Text Available Desmoplastic small round cell tumor (DSRCT is an extremely uncommon, highly aggressive, and malignant mesenchymal neoplasm of undetermined histogenesis. Less than 200 case reports have been documented in literature so far. Herein, we report a 26-year-old otherwise healthy female patient who presented with a 1-month history of epigastric pain. On physical examination, a palpable, slightly mobile, and tender epigastric mass was detected. All laboratory tests were normal. A chest, abdominal, and pelvic contrast-enhanced computed tomography (CT scans showed a 3.8 × 7.2 × 8.7 cm ill-defined mass, involving gastric fundus and extending into gastric cardia and lower gastroesophageal junction. It was associated with multiple enlarged gastrohepatic lymph nodes; the largest measured 1.2 cm. There was no evidence of ascites or retroperitoneal or mesenteric lymphatic metastases. Patient underwent total gastrectomy with D2 lymphadenectomy, splenectomy, and antecolic Roux-en-Y esophagojejunal anastomosis. Histopathological examination revealed coexpression of mesenchymal, epithelial, and neural markers. The characteristic chromosomal translocation (t(11; 22(p13; q12 was demonstrated on fluorescence in situ hybridization (FISH technique. Diagnosis of DSRCT of stomach was confirmed. Patient received no postoperative radiotherapy or chemotherapy. A postoperative 3-month followup failed to show any recurrence. In addition, a literature review on DSRCT is included.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 视黄酸及相关基因在心脏发育中的作用%The Role of Retinoic Acid and Related Genes in the Cardiac Development

    Institute of Scientific and Technical Information of China (English)

    侯佳; 桂永浩

    2008-01-01

    Retinoic acid,the biologically active form of vitamin A,plays a critical role in normal development.Either an excess or a deficit of retinoic acid produces cardiac defects that vary depending on the severity and the timing of the insult.However,the mechanism of the interaction of retinoic acid and related cardiae genes that leads to cardiac malformation is not elucidated.The review presents retinoic acid's biological character and associated cardiac defects,and then discusses the regulation of retinoic acid and several related genes in the cardiac development.%视黄酸是维生素A在体内重要的生物活性形式,在胚胎和胎儿发育的关键阶段发挥着重要作用.视黄酸水平过高或过低可导致心脏发育异常,但其导致心脏畸形的确切机制尚不明确.本文就视黄酸的生物学特性、视黄酸异常导致的心脏畸形及其与相关心脏转录因子在心脏发育中的作用作一综述.

  17. Application Experience of Pulse-activating Injection in Hypotension Caused by Tracheal Intubation%生脉注射液在气管插管后血压降低中的运用

    Institute of Scientific and Technical Information of China (English)

    郭来; 齐文升; 王颖辉

    2009-01-01

    生脉注射液具有益气养阴、复脉固脱之功效,广泛用于严重感染、血容量不足引起的血压降低.在气管插管后血压降低时,应用生脉注射液也取得了较好的临床疗效.本文对气管插管后血压降低应用生脉注射液的用法用量、注意事项等进行了归纳.%Pulse-activating injection has the functions of supplementing qi and nourishing yin, and recovering pulse from a collapse state. It is applied in hypotension caused by serious infection or hypovolemia extensively. Pulse-activating injection can be also used to treat hypotension caused by tracheal intubation with good effects. Appropriate application according to state of illness is very important, such as controlling infection and supplementing blood-volume, etc. When applied in cardia insufficiency, vasodilating agent should be used together to regulate dropping rate.

  18. Gastric Small-Cell Carcinoma Found on Esophagogastroduodenoscopy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Natassja Frances

    2013-01-01

    Full Text Available Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC. Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation. Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible.

  19. Occupation and stomach cancer in a cohort of Swedish men.

    Science.gov (United States)

    Chow, W H; McLaughlin, J K; Malker, H S; Weiner, J A; Ericsson, J L; Stone, B J; Blot, W J

    1994-10-01

    Using the Cancer-Environment Registry of Sweden, which links the 1960 census information on employment with cancer incidence data from 1961-1979, we conducted a systematic, population-based assessment of stomach cancer incidence by industry and occupation for men in Sweden. Nearly 17,000 stomach cancer cases were diagnosed during the 19 years of follow-up. Stomach cancer incidence was elevated among miners and quarrymen, farmers and fishermen, and craftsmen and production workers. Men who held white collar jobs, including professional and technical, administrative and management, clerical, and sales jobs, had a reduction in stomach cancer incidence. Examination of specific jobs revealed generally elevated rates of stomach cancer among men who may be exposed to dusty work environments, such as quarry workers, stone cutters, circular and plane operators, construction workers, crane operators, heavy laborers, and shop and construction metal workers. These occupational associations mostly were observed for stomach cancers of noncardia origin, and no significant associations were found with cardia cancers. We had no information on dietary or other potential confounding factors and cannot make inferences about the role of occupation per se, but the current findings support those of earlier investigations and add to the evidence of a small but significant occupational role in stomach carcinogenesis. PMID:7810549

  20. Proteomic analysis of gastric cancer and immunoblot validation of potential biomarkers

    Institute of Scientific and Technical Information of China (English)

    Nina Ko(c)evar; Federico Odreman; Alessandro Vindigni; Snje(z)ana Frkovi(c) Grazio; Radovan Komel

    2012-01-01

    AIM:To search for and validate differentially expressed proteins in patients with gastric adenocarcinoma.METHODS:We used two-dimensional gel electrophoresis and mass spectrometry to search for differentially expressed proteins in patients with gastric adenocarcinoma.A set of proteins was validated with immunoblotting.RESULTS:We identified 30 different proteins involved in various biological processes:metabolism,development,death,response to stress,cell cycle,cell communication,transport,and cell motility.Eight proteinswere chosen for further validation by immunoblotting.Our results show that gastrokine-1,39S ribosomal protein L12 (mitochondrial precursor),plasma cell-induced resident endoplasmic reticulum protein,and glutathione S-transferase mu 3 were significantly underexpressed in gastric adenocarcinoma relative to adjacent non-tumor tissue samples.On the other hand,septin-2,ubiquitin-conjugating enzyme E2 N,and transaldolase were significantly overexpressed.Translationally controlled tumor protein was shown to be differentially expressed only in patients with cancer of the gastric cardia/esophageal border.CONCLUSION:This work presents a set of possible diagnostic biomarkers,validated for the first time.It might contribute to the efforts of understanding gastric cancer carcinogenesis.

  1. Salivary secretion during meals in lactating dairy cattle

    DEFF Research Database (Denmark)

    Beauchemin, K.A.; Eriksen, L.; Nørgaard, Peder;

    2008-01-01

    period: barley silage, alfalfa silage, long-stemmed alfalfa hay, or chopped barley straw. Saliva secretion was measured during the morning meal by collecting masticates through the rumen cannula at the cardia of each cow. Rate of salication (213 g/min) was not affected by forage source. However, the...... forage sources differed in eating rate (g og DM/min), which led to differences in ensalivation of forages (g of saliva/g of DM and g of saliva/g of NDF). On the basis of DM, ensalivation (g of saliva/g of DM) was greatest for straw (7.23) and similar for barley sialge, alfalfa silage, and alfalfa hay (4.......15, 3.40, and 4.34 g/g of DM, respectively). Higher ensalivation of straw could be accounted for by its higher neutral detergent fiber (NDF) content; ensalivation of NDF (g of saliva/g of NDF) was actually greatest for long-stemmed alfalfa hay (12.4) and similar for the other chopped forages (8.9). Cows...

  2. 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.

  3. Radionuclide esophageal transit time for the assessment of pneumatic dilation in patients with achalasia

    Directory of Open Access Journals (Sweden)

    El-Desouki Mahmoud

    1999-01-01

    Full Text Available Objective: The aim of this study was to assess the value of radionuclide esophageal transit time (RET in prediction of the results of pneumatic dilation in patients with achalasia. Patients and methods: Thirty patients (13 males with a mean age of 37 ± 15.6 years (range 17-73 years were included in the study. All patients were diagnosed to have idiopathic achalasia of the cardia and selected for pneumatic dilation. Each patient had three RET, two the same day of dilation (pre-and postdilation and a third follow up one within three months of dilation (4 patients failed to come for follow up and were excluded. Results: Several parameters were derived from RET studies, T/50: time required for 50% of activity in the esophagus to be cleared, T/10 : time required for 90% of activity in the esophagus to be cleared and percentage clearance at 10 min. These parameters were compared to response of dysphagia to dilation. It was evident that the higher the esophageal clearance postdilation, the better the outcome. When immediate post dilation clearance was 85% or more the success rate was 83.3% whereas when it was 20-50% the success rate was only 21.4%. No relation was found between T/50, T/10 and dysphagia response. Conclusion: RET appears to be a useful quantitative procedure in the assessment of pneumatic dilation outcome in achalasia patients.

  4. 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%.

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

    International Nuclear Information System (INIS)

    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%

  6. 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.

  7. The value of 18F-FDG PET/CT in diagnosing brain metastases from unknown primary tumor

    International Nuclear Information System (INIS)

    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. (authors)

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

    Science.gov (United States)

    Hedner, Charlotta; Borg, David; Nodin, Björn; Karnevi, Emelie; Jirström, Karin; Eberhard, Jakob

    2016-01-01

    Background 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. Methods 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. Results and Discussion 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. PMID:26844548

  9. [Complete Response in a Patient with HER2-Positive Gastric Cancer and Multiple Lung Metastases with Trastuzumab-Containing Chemotherapy].

    Science.gov (United States)

    Nakata, Wachiko; Tokuyama, Nobuyuki; Yagioka, Hiroshi; Suyama, Yuki; Ogura, Keiji

    2016-05-01

    We report the case ofa 79-year-old Japanese woman diagnosed with human epidermal growth factor receptor 2(HER2)- positive gastric cancer ofthe cardia with multiple lung metastases that showed complete response to trastuzumab-containing chemotherapy. First, we administered tegafur/gimeracil/oteraci(l S-1)and cisplatin(CDDP)concurrently to the patient. Next, we switched to trastuzumab in combination with capecitabine and CDDP because gastric cancer tissue indicated HER2-positivity. Considering the patient's age and renal function, the dose of CDDP was decreased to 50% after starting the medication. Before the 2nd course of trastuzumab-containing chemotherapy, oral mucositis(Grade 3)and hand-foot syndrome (Grade 1)were observed. Therefore, a one-step dose reduction ofcapecitabine was necessary. After the 4th course, the primary gastric tumor was no longer visible endoscopically. After the 7th course, computed tomography(CT)showed the disappearance ofall lung metastases. Accordingly, the patient was considered to be completely responsive to the medication. After the 12th course, recurrence of the tumor was not identified and at the request of the patient, the trastuzumab-containing chemotherapy was discontinued. Regular follow-up showed no evidence ofrecurrence 8 months after discontinuing treatment and the patient was in good condition 21 months after her initial diagnosis. PMID:27210096

  10. Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance.

    Science.gov (United States)

    Liu, Kevin Sze-Hang; Wong, Irene Oi-Ling; Leung, Wai K

    2016-01-21

    Gastric cancer (GC) is one of the leading causes of cancer related death in the world, particularly in East Asia. According to the Correa's cancer cascade, non-cardia GC is usually developed through a series of mucosal changes from non-atrophic gastritis to atrophic gastritis (AG), intestinal metaplasia (IM), dysplasia and adenocarcinoma. Atrophic gastritis and IM are therefore generally considered to be pre-neoplastic gastric lesions. Helicobacter pylori (H. pylori) infection is an important initiating and promoting step of this gastric carcinogenesis cascade. Emerging long-term data showed that eradication of H. pylori reduced the risk of subsequent cancer development. It however remains confusing whether eradication of the bacterium in individuals with pre-neoplastic gastric lesions could regress these changes as well as in preventing cancer. Whilst H. pylori eradication could likely regress AG, the presence of IM may be a point of no return in this cascade. Hence, surveillance by endoscopy may be indicated in those with extensive IM or those with incomplete IM, particularly in populations with high GC risk. The optimal interval and the best tool of surveillance endoscopy remains to be determined in future studies. PMID:26811668

  11. Foxa2 mediates critical functions of prechordal plate in patterning and morphogenesis and is cell autonomously required for early ventral endoderm morphogenesis

    Directory of Open Access Journals (Sweden)

    Zachary Harrelson

    2012-01-01

    Axial mesendoderm is comprised of prechordal plate and notochord. Lack of a suitable Cre driver has hampered the ability to genetically dissect the requirement for each of these components, or genes expressed within them, to anterior patterning. Here, we have utilized Isl1-Cre to investigate roles of the winged helix transcription factor Foxa2 specifically in prechordal plate and ventral endoderm. Foxa2loxP/loxP; Isl1-Cre mutants died at 13.5 dpc, exhibiting aberrations in anterior neural tube and forebrain patterning, and in ventral foregut morphogenesis and cardiac fusion. Molecular analysis of Foxa2loxP/loxP; Isl1-Cre mutants indicated that Foxa2 is required in Isl1 lineages for expression of notochord and dorsal foregut endoderm markers, Shh. Brachyury, and Hlxb9. Our results support a requirement for Foxa2 in prechordal plate for notochord morphogenesis, axial patterning, and patterning of dorsal foregut endoderm. Loss of Foxa2 in ventral endoderm resulted in reduced expression of Sox17, Gata4, and ZO proteins, accounting at least in part for observed lack of foregut fusion, cardia bifida, and increased apoptosis of ventral endoderm.

  12. 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.

  13. Chemical digestion and radionuclidic assay of TiNi-encapsulated 32P intravascular brachytherapy sources

    International Nuclear Information System (INIS)

    A very quantitative, destructive assay procedure was devised for accurately measuring the 32P activity content of TiNi-encapsulated intravascular brachytherapy sources and was applied to four different sources (termed 'seeds') which were developed and provided by Guidant Intravascular Intervention (formerly NeoCardia). These seeds are intended for use in the prophylactic treatment of restenosis following balloon angioplasty in heart-disease patients. The assays involved the dissolution of the TiNi jacket, extraction of the activity from the internal 32P-containing source material, quantitative solution transfers, and a gravimetrically-based dilution; followed by liquid scintillation (LS) spectrometry of the resulting master solution with 3H-standard efficiency tracing using composition-matched LS cocktails. The LS spectrometry utilized a previously-developed method for resolving the always-present 33P impurity. The protocol included provisions for accounting for all possible losses of 32P in the digestion procedure (based on radiochemical tracing experiments), for any unrecovered activity in the remaining source material, and for any residual activity in the solution-transfer and containing vessels. Sections of the TiNi jackets adjacent to the cut-off active seed portions were also assayed for any contained activity. Such destructive assays were required for relating measurements of the absorbed dose spatial distribution for the seeds to theoretic dose modelling and for establishing calibration factors for subsequent non-destructive radionuclidic measurements on the seeds

  14. 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)

  15. 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.

  16. Preoperative radiotherapy in gastric cancer: CTV definition for conformal therapy according to tumor location.

    Science.gov (United States)

    Cellini, Francesco; Valentini, Vincenzo; Pacelli, Fabio; D'Ugo, Domenico; Mantini, Giovanna; Balducci, Mario; Gambacorta, Maria Antonietta; Nori, Stefania

    2003-01-01

    In the past radiation oncologists had not a major interest in the treatment of gastric cancer, but the positive outcomes of the Intergroup Study (INT-0116) supported the role of locoregional control in promoting better survival. To reduce the toxicity and the risk of residual disease in locally advanced tumors after surgery,a preoperative approach was tentatively considered. The aim of this manuscript is to define the location of nodal area at risk for cancer involvement according to the tumor location (cardias, corpus, antrum) on CT images to help the radiotherapist in the contouring process of the CTV for preoperative conformal treatment of gastric cancer. The analysis of both the percentage of nodal involvement detected at surgery and of the site of recurrence after radical surgery can direct to the areas to be considered at risk with its contouring on CT. Preoperative conformal-three dimensional radiotherapy of gastric cancer requires clear and well defined contouring guide-lines to allow the evaluation of clinical outcomes and the analysis if the area at risk for recurrence has changed after the preoperative approach. PMID:15018320

  17. Social hierarchy and depression: the role of emotion suppression.

    Science.gov (United States)

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

    2012-01-01

    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; Cutter et al., 1991). Much as in 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

  18. Esophageal Transit Scintigraphy, Manometry, and Barium Swallow in Assessment of Response to Balloon Dilatation in Achalasia

    Directory of Open Access Journals (Sweden)

    M.J. Ehsani Ardakani

    2006-08-01

    Full Text Available Background/Objective: Achalasia is a motility disorder of unknown etiology, characterized by absent esophageal peristalsis and loss of lower esophageal sphincter relaxation. Balloon dilatation is the most effective non-surgical treatment for patients with achalasia. Manometry, scintigraphy and radiology are three techniques that provide an objective measure of success after balloon dilatation. The objective of this study was to determine the best predictor of success after balloon dilatation in patients with achalasia. Patients and Methods: 17 patients with achalasia of cardia who referred to Taleghani Hospital in 2003, were evaluated, both symptomatically and objectively (esophageal manometry, timed barium esophagogram, and scintigraphic emptying index, before and after treating with pneumatic dilatation of esophagus. The degree of patient symptom improvements after treat-ment was recorded and correlated with improvement in some indices derived by the above-mentioned three methods. Results: 12 (70.6% of 17 patients had score improvements of ≥80%. All the pre-treatment diagnostic indices were significantly (P<0.05 different from those after therapy. There was no significant difference between the two groups in terms of improvement in symptoms according to the indices of barium swallow or scintigraphy. No association between the patient symptom scores and improvement in either the barium height or emptying index was found. Conclusion: In evaluation of efficacy of pneumatic dilatation of esophagus for treatment of achalasia, we should not only rely on transit or barium study.

  19. 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.

  20. Leiomyoma of the oesophagus in an HIV-infected patient

    International Nuclear Information System (INIS)

    A 30-year-old man was referred for investigation of a mediastinal mass found incidentally on a chest radiograph. He had a history of chronic cough and a 15-pack per year history of smoking. He was known to be HIV positive, having being diagnosed 7 years previously. The radiograph showed a left-sided opacity adjacent to the thoracic aorta. At the time of the referral the patient had been asymptomatic and denied dysphagia and odynophagia. Thoracic and abdominal CT scans revealed a distal oesophageal mass extending to the cardia of the stomach, with splenomegaly but no lymphadenopathy. Two direct endoscopic biopsies failed to provide a pathological diagnosis. A percutaneous transhepatic cutting biopsy under CT guidance provided tissue and the diagnosis. In the light of the benign nature of the neoplasm and the absence of symptoms, no further interventions were undertaken. The tumour tissue was submitted for microbiological analysis but was not found to contain Epstein-Barr virus. The patient was commenced on antiretroviral therapy. Follow-up CT scans in 1996 and 1998 showed no change in the mass characteristics; it remained 4 cm long and 3 cm wide with no local infiltration and no associated lymphadenopathy. Copyright (2001) Blackwell Science Pty Ltd

  1. The changing and its interaction of determining serum gastrin levels and helicobacter pylori test during chronic atrophic gastritis into gastric cancer

    International Nuclear Information System (INIS)

    Objective: To study the changing and its interaction of determining serum gastrin levels and Helicobacter pylori test during chronic atrophic gastritis into gastric cancer. Methods: RIA and 13C-urea breath test (13C-UBT) determined the Gs levels and Hp infection rate in 63 rate cases (first visit) patients, 48 cases (after one year return visit) patients, 35 cases (after three year return visit) patients and 30 cases (after five years return visit) patients with CAG 90 cases patients with gastric cancer (and different position) and 61 cases normal controls. They all were done study compared. Results: Serum Gs levels in 63 cases (first visit) patients, 48 cases (after one year return visit) patients, 35 cases (after three year return visit) patients and 30 cases (after five years return visit) patient with CAG were significantly higher (t=4.716, 5.218, 5.624, 6.179, 6.5772, all P0.05). Serum Gs levels in 90 cases with gastric cancer (and different position) was significantly higher (t=4.221, P<0.05; t=4.436, P<0.01) than 61 cases normal controls and the highest serum Gs level was found in cancer of cardia and fundus. And Hp infection rate was 88.8%. Conclusion: The early diagnosis on gastric cancer was very important by determining serum Gs and Hp infection rate. (authors)

  2. 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.

  3. 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.

  4. Genome-Wide Interaction with Insulin Secretion Loci Reveals Novel Loci for Type 2 Diabetes in African Americans

    Science.gov (United States)

    Keaton, Jacob M.; Hellwege, Jacklyn N.; Ng, Maggie C. Y.; Palmer, Nicholette D.; Pankow, James S.; Fornage, Myriam; Wilson, James G.; Correa, Adolfo; Rasmussen-Torvik, Laura J.; Rotter, Jerome I.; Chen, Yii-Der I.; Taylor, Kent D.; Rich, Stephen S.; Wagenknecht, Lynne E.; Freedman, Barry I.; Bowden, Donald W.

    2016-01-01

    Type 2 diabetes (T2D) is the result of metabolic defects in insulin secretion and insulin sensitivity, yet most T2D loci identified to date influence insulin secretion. We hypothesized that T2D loci, particularly those affecting insulin sensitivity, can be identified through interaction with insulin secretion loci. To test this hypothesis, single nucleotide polymorphisms (SNPs) associated with acute insulin response to glucose (AIRg), a dynamic measure of first-phase insulin secretion, were identified in African Americans from the Insulin Resistance Atherosclerosis Family Study (IRASFS; n = 492 subjects). These SNPs were tested for interaction, individually and jointly as a genetic risk score (GRS), using genome-wide association study (GWAS) data from five cohorts (ARIC, CARDIA, JHS, MESA, WFSM; n = 2,725 cases, 4,167 controls) with T2D as the outcome. In single variant analyses, suggestively significant (Pinteraction<5×10−6) interactions were observed at several loci including LYPLAL1 (rs10746381), CHN2 (rs7796525), and EXOC1 (rs4289500). Notable AIRg GRS interactions were observed with SAMD4A (rs11627203) and UTRN (rs17074194). These data support the hypothesis that additional genetic factors contributing to T2D risk can be identified by interactions with insulin secretion loci. PMID:27448167

  5. 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

  6. 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

  7. Epigenetic silencing of miR-137 is a frequent event in gastric carcinogenesis.

    Science.gov (United States)

    Steponaitiene, Ruta; Kupcinskas, Juozas; Langner, Cosima; Balaguer, Francesc; Venclauskas, Linas; Pauzas, Henrikas; Tamelis, Algimantas; Skieceviciene, Jurgita; Kupcinskas, Limas; Malfertheiner, Peter; Link, Alexander

    2016-04-01

    MicroRNAs (miRNA) are involved in posttranscriptional regulation of gene expression and are dysregulated during carcinogenesis. CpG island methylation of miR-137 is a common event in different cancers; however, the role of miR-137 in gastric cancer (GC) remains largely unexplored. In this study we aimed to characterize the epigenetic alterations of miR-137 in gastric carcinogenesis. We analyzed total 295 tissues including paired primary gastric cancer (T-GC) with corresponding adjacent gastric mucosa (N-GC), paired primary colorectal cancer (CRC) tissues with corresponding non-tumorous mucosa, gastric tissues from controls (N), and patients with chronic/atrophic gastritis (CG) with and without Helicobacter pylori infection. Bisulfite pyrosequencing and TaqMan RT-PCR were used to analyze miR-137 methylation and expression, respectively. Survival differences were evaluated using Kaplan-Meier analyses. miR-137 CpG island methylation was more frequent in tumorous compared to non-tumorous conditions and higher in CRC than in GC. In comparison to N-GC, miR 137 methylation level was lower in N and CG tissues, which correlates with Correas cascade. MiR-137 methylation inversely correlates with global LINE-1 methylation and miR-137 expression. miR-137 methylation was higher in intestinal type GC compared to diffuse one, and higher in antrum compared to cardia and corpus, however, miR-137 methylation was associated with worse prognosis in diffuse, but not in intestinal type of GC. The expression in colon was significantly higher compared to any gastric tissues suggesting functional difference. In summary, miR-137 methylation is a frequent event in gastrointestinal cancers which occurs early in stepwise manner during gastric carcinogenesis and inversely correlates with global methylation. © 2015 Wiley Periodicals, Inc. PMID:25663388

  8. Usefulness of additional prone pad compression study in upper gastrointestinal series for detecting early gastric cancer

    International Nuclear Information System (INIS)

    To evaluate the usefulness of prone pad study in upper gastrointestinal series(UGIS) for the detection of early gastric cancer(EGC). During an eight-month period, 88 of 170 patients who underwent gastrectomy due to EGC were also the subjects of prone pad study as well as double contrast(n=3D92), mucosal relief(n=3D76), or compression(n=3D91) studies. The EGCs were single in 84 patients and double in four. We compared prone pad study with the three other techniques for detecting a tumor and depicting the surrounding mucosal changes. Lesional conspicuity was rated 'complete', 'incomplete', 'suspicious', or 'undetected'. The depiction of surrounding mucosal change was rated 'excellent', 'good', 'fair', or 'poor'. Mean tumor size was 3.2cm, with a range of 0.3-9cm. Tumors were located in the antrum(n=3D55), angle(n=3D13), lower or mid body(n=3D16), or the sign body and cardia(n=3D5). Among the 92 EGCs evaluated, UGIS missed the lesion in three cases(sensitivity, 97 %). The rates of 'complete' lesional conspicuity were 49 % in prone pad, 29 % in compression, 20 % in double contrast, and 9 % in mucosal relief. The rates of 'excellent' in depicting surrounding mucosal change were 45 % in prone pad, 11 % in double contrast, 9 % in mucosal relief, and 9 % in compression. The tumor was demonstrated only in prone pad study in five (5 %) of the 92 EGCs. Prone pad study during UGIS improves both the detection rate of EGC and the depiction of mucosal change around the tumor

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

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    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.

  10. 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.

  11. Application of rapid bedside detection blood NT-proBNP in differential diagnosis of dyspnea in the emergency department

    International Nuclear Information System (INIS)

    Objective: To study rapid bedside detection of NT-proBNP with anti-coagulated venous blood on the significance of differential diagnosis between cardiogenic dyspnea and palmonary dyspnea in emergency room. Methods: 158 patients with dyspnea from our emergency department were divided into cardiogenic group 82 cases, pulmonary group 76 cases and 58 healthy persons as control. All patients within 30 min after hospitalized blood NT-proBNP were measured by rapid bedside technique. Also ultrasonic ECG were examined within 48hr. Results: (1) Blood NT-proBNP level of cardiogenic group (2026.4±122.7 pg/ml): prominently higher than those in controls (P0.05). (2) Cardiogenic group: According to NYHA, grading and staging of CHF, cardias function grade II (n=15), grade III (n=42), grads IV (n=25). Mean level of blood NT-proBNP were 1513, 2598, 4537 pg/ml individually. The concentration of blood NT-proBNP was correlated with severity of CHF. (3) Correlation coefficient of NT-proBNP levels on cardiac function grade II, III, IV and LVEF (left ventricular ejection fraction) were r=0.722 (P<0.05), r=0.615 (P<0.01) and r=0.529 (P<0.01) respectively expressed higher negative correlation. Conclusion: In the case of acute dyspnea, bedside NT-proBNP estimation can be ruled out patients from cardiogenic dyspnea rapidly. The more higher of plasma NT-proBNP combined with ultrasonic ECG indicates between the NT-proBNP level and grading or staging of cardiac function correlated apparently. The more severe of CHF, the more higher of blood NT-proBNP level simultaneously. Detection of blood NT-proBNP concentration may serve as predicator for left ventricles of heart insufficiency. (authors)

  12. 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.

  13. 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.

  14. Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Arto Kokkola; Johanna Louhimo; Pauli Puolakkainen; Henrik Alfthan; Caj Haglund; Hilpi Rautelin

    2005-01-01

    AIM: To study whether examination of CagA antibodies could increase the odds ratio for gastric cancer in a casecontrol study, and how often other serum markers of gastric cancer risk could be found in Helicobacter pylorinegative patients.METHODS: H pylori CagA and parietal cell antibodies(PCAs), and serum pepsinogen Ⅰ (SPGI) levels were compared between patients with gastric cancer and controls who received endoscopic examination due to reasons other than gastrointestinal malignancy.RESULTS: The odds ratio (OR) for gastric cancer was2.9 (95% CI 1.4-5.8) in H pylori+ patients, and 2.4 (95%CI 1.2-4.9) in CagA+ patients. When results of H pylori and CagA antibodies were combined, OR increased to5.0 (95% CI 2.5-10.0). Furthermore, if cardia cancer patients were excluded, the OR increased to 6.8 (95% CI3.1-14.8). Among patients with a low SPGI level, the OR was 12.0 (95% CI 4.1-35.3). However, the risk was significant only in the older age group. The number of patients with low SPGI was significantly higher in H pylori-/CagA+ patients as compared to other cancer patients.CONCLUSION: Examination of both H pylori and CagA antibodies increases the OR for gastric cancer in our casecontrol study. CagA antibodies are important in detecting previous H pylori infection in advanced atrophic gastritis or cancer when spontaneous decline of H pylori antibodies occurs. SPGI may be helpful in screening elderly gastric cancer patients.

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

    Science.gov (United States)

    Eleftheriadis, Nikolas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Maselli, Roberta; Santi, Grace

    2016-01-25

    Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction (EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection (POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors (submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. PMID

  16. The potential and perspective of peroral endoscopic esophageal myotomy for achalasia.

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    Fuchs, K H; Schulz, T; Varga, G; Babic, B; Breithaupt, W

    2015-07-01

    The therapeutic spectrum of this disorder consists of medical therapy, endoscopic balloon dilatation, endoscopic Botox injection, open or laparoscopic cardia myotomy, and most recently transesophageal endoscopic myotomy (POEM peroral endoscopic myotomy). The most important requirement is a well-experienced team in interventional flexible endoscopy. The endoscopist as well as the assisting staff should have experience in advanced therapeutic endoscopic techniques and hemostasis to handle all necessary endoscopic instruments such as injection needles, needle knife, triangle knife, coagulation graspers, and endoscopic clip handling and closures. In addition, advanced surgical and especially laparoscopic skills and experience as well as surgical knowledge about esophageal disease must be available in case of conversion and/or consultation. Prior to this procedure, the patient undergoes a detailed diagnostic work-up to confirm the diagnosis of achalasia. The procedures are performed in general anesthesia. The patient is brought in a supine position, and the abdomen is free for inspection and palpation during the procedure. The myotomy can be performed in different locations around the esophageal circumference. In Europe, several centers with large experience in esophageal disease, laparoscopy, and especially advanced interventional endoscopy have started to introduce this POEM-technique in their clinical practice. Initial success and low complication rates are quite promising and show a great future perspective for this technique. In the USA, POEM is a procedure with a substantial increase in numbers performed in the past years with a low complication rate. The largest series are performed in Asia with a great clinical success. The perspective of POEM may be the lesser access trauma. Its potential can be also realized in Redo cases, where experienced centers have initial experience with POEM after POEM and POEM after LHMD. PMID:25651951

  17. Gestational Diabetes Mellitus is Strongly Associated with Non-Alcoholic Fatty Liver Disease

    Science.gov (United States)

    Ajmera, Veeral H.; Gunderson, Erica P.; VanWagner, Lisa B.; Lewis, Cora E.; Carr, John J.; Terrault, Norah A.

    2016-01-01

    Insulin resistance is central to the development of non-alcoholic fatty liver disease (NAFLD), and gestational diabetes mellitus (GDM) is an early marker of insulin resistance. We hypothesized that a history of GDM would identify women at higher risk of NAFLD in middle age. Women from the multicenter Coronary Artery Risk Development in Young Adults (CARDIA) cohort study who delivered ≥ 1 birth, were free of diabetes prior to pregnancy(ies), and underwent CT quantification of hepatic steatosis 25 years following cohort entry (Y25: 2010–2011) were included (n = 1115). History of GDM by self-report, validated in a subsample by review of antenatal glucose testing, and metabolic risk factors were assessed prospectively. NAFLD was defined by liver attenuation (LA) ≤ 40 Hounsfield Units on CT scan after exclusion of other causes of hepatic steatosis. Of 1,115 women meeting selection criteria (57% black, 43% white, median age 25 years at baseline), 124 (11%) reported a history of GDM and 75 (7%) met the CT definition for NAFLD at year 25. The crude risk of NAFLD at the 25-year visit was significantly higher in women with GDM compared to those without (14% vs. 5.8%, OR: 2.56, 95% CI: 1.44–4.55, pdiabetes mellitus (DM) into the final model attenuated the association between GDM and NAFLD (OR: 1.48, 95% CI: 0.73 – 3.02, p=0.28). Conclusion GDM is a risk marker for NAFLD and represents an opportunity to identify women at risk for NAFLD at a young age and may be mediated by the development of incident DM. PMID:27002796

  18. 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.

  19. 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

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

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    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

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

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    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

  2. Genome sequence analysis of Helicobacter pylori strains associated with gastric ulceration and gastric cancer

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    Peek Richard M

    2009-01-01

    Full Text Available Abstract Background Persistent colonization of the human stomach by Helicobacter pylori is associated with asymptomatic gastric inflammation (gastritis and an increased risk of duodenal ulceration, gastric ulceration, and non-cardia gastric cancer. In previous studies, the genome sequences of H. pylori strains from patients with gastritis or duodenal ulcer disease have been analyzed. In this study, we analyzed the genome sequences of an H. pylori strain (98-10 isolated from a patient with gastric cancer and an H. pylori strain (B128 isolated from a patient with gastric ulcer disease. Results Based on multilocus sequence typing, strain 98-10 was most closely related to H. pylori strains of East Asian origin and strain B128 was most closely related to strains of European origin. Strain 98-10 contained multiple features characteristic of East Asian strains, including a type s1c vacA allele and a cagA allele encoding an EPIYA-D tyrosine phosphorylation motif. A core genome of 1237 genes was present in all five strains for which genome sequences were available. Among the 1237 core genes, a subset of alleles was highly divergent in the East Asian strain 98-10, encoding proteins that exhibited H. pylori strains associated with gastric cancer or premalignant gastric lesions. Conclusion These data provide insight into the diversity that exists among H. pylori strains from diverse clinical and geographic origins. Highly divergent alleles and strain-specific genes identified in this study may represent useful biomarkers for analyzing geographic partitioning of H. pylori and for identifying strains capable of inducing malignant or premalignant gastric lesions.

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

    International Nuclear Information System (INIS)

    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.)

  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. Trajectories of metabolic syndrome development in young adults.

    Directory of Open Access Journals (Sweden)

    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.

  6. FETAL ECHOCARDIOGRAPHY: A STUDY OF CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    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

  7. 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

  8. Sweetened carbonated beverage consumption and cancer risk: meta-analysis and review.

    Science.gov (United States)

    Boyle, Peter; Koechlin, Alice; Autier, Philippe

    2014-09-01

    There is speculation on an association between sweetened, carbonated beverage consumption and cancer risk. This study aimed to examine this issue. Over 50 independent estimates of risk were available, 11 for colas specifically. A random-effects meta-analysis was carried out with tests for publication bias performed as well as Higgins and Thompson's I measure of the percentage of heterogeneity between studies that could not be explained by chance. Over all the different sites of cancer, the summary relative risk (SRR), when all 55 independent estimates were considered together, was SRR=1.03 [95% confidence interval (0.96; 1.11)]. When individual cancer sites were considered, there was no significant increase or decrease in the meta-analysis estimate of risk of cancer of the pancreas, bladder, kidney, squamous cell or adenocarcinoma of the oesophagus, colon, gastric cardia, gastric noncardia, prostate, breast, larynx and ovary or of the oral cavity, pharynx or glioma. There was no evidence in a sensitivity analysis from those studies that reported results separately for colas of an associated risk of pancreas cancer [SRR=1.00, 95% confidence interval (0.61; 1.65)]. The results for all other forms of cancers were considerably hampered by poor methodology and small numbers of studies (mainly one report on each cancer site studied). Overall, the findings are reassuring in terms of the association between soft drinks, including colas, and cancer risk, although the quality of many of the studies is quite poor by acceptable, modern standards and no study has been carried out with use of carbonated beverages as a primary hypothesis. PMID:24625472

  9. Cancer Incidence and Mortality in Ardabil: Report of an Ongoing Population-Based Cancer Registry in Iran, 2004-2006

    Directory of Open Access Journals (Sweden)

    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.  

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

    International Nuclear Information System (INIS)

    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

  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. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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。

  18. Result of surgical therapy in esophagogastric junction adenocarcinoma

    International Nuclear Information System (INIS)

    To assess the outcome of surgical therapy and choice of surgical strategy for patients with adenocarcinoma of the gastroesophageal junction. Between February 1989 and January 2005 during 16 years, 335 patients (65 female, 270 male, mean age 56 years) with esophagogastric junction adenocarcinoma underwent surgical operation. The choice of surgical approach was based on the anatomical location of the tumor mass. Outcome of surgery, histopathologic characteristics, demographic data and long term survival rates were compared among three types of tumor defined as follows. Type I: Adenocarcinoma of the distal esophagus which infiltrates the esophagogastric junction from above. Type II: True carcinoma of the cardia arising immediately at the esophagogastric junction. Type III: Subcardial gastric carcinoma that infiltrates the esophagogastric junction and distal esophagus from below. Of the 335 patients undergoing resection, 110 (33%) had type I, 96 (28%) had type II, and 129 (39%) had type III. The preponderance of the male sex and the prevalence of metaplasia in distal esophagus decreased from type I to type III tumors (P<0.01). The prevalence of undifferentiated tumors increased from type I to type III tumors (P<0.01). Esophagectomy with resection of the proximal stomach for type I and extended total gastrectomy with transhiatal resection of the distal esophagus for type II and III were the primary procedures. The mean number of removed lymph node was higher in type III and II compared to type I tumors. The overall postoperative 30-day mortality was 8.4%. The death rate in transthoracic esophagectomy was higher than with extended total gastrectomy. The classification of adenocarcinoma of the esophagogastric junction into type I, II and III tumors helps in the selection of surgical approach. Type I tumors are approached as distal esophageal cancer. Type III tumors are a special form of gastric cancer and treated as a gastric cancer. The relation of type II tumors to

  19. 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

  20. The relation of Hyperlipidemia and fatty liver in the elderly of Shanghai community%上海社区老年人高脂血症与脂肪肝的关系调查分析

    Institute of Scientific and Technical Information of China (English)

    滕斌; 王泰蓉; 吴玲; 徐宜; 林乐平; 杨涛

    2014-01-01

    目的:调查分析上海老年人高脂血症与脂肪肝的关系。方法:分析在五里桥街道社区卫生服务中心体检的524名老年人的临床资料,按性别、年龄分层分析老年人高脂血症与脂肪肝的关系,比较不同性别和年龄分层高脂血症和脂肪肝的检出率。结果:社区各年龄层次老年肪肝人群高三酰甘油检出率显著高于非脂肪肝人群(P<0.01)。女性脂肪肝检出率63.89%,高于男性的49.5%(P<0.01),高三酰甘油人群的脂肪肝检出率显著高于正常三酰甘油人群(P<0.01)。结论:控制血脂水平,对于降低脂肪肝的发生率,预防心脑血管事件有着重要意义。%Objective:To investigate the relation of Shanghai elderly hyperlipidemia and fatty liver. Methods:The physical examination data of 524 elderly people from Wuliqiao street community health service center were collected. The relationship between hyperlipidemia and fatty liver in the elderly was analyzed by gender and age, the detection rates of hyperlipidemia and fatty liver of different gender and age were compared. Results:The detection rate of triglycerides in the eldly with fatty liver was higher than that in the eldly without fatty liver(P<0. 01). The detection rate of fatty liver in female(63. 89%) was higher than that in male(49,5%) (P<0. 01). The detection rate of fatty liver in the elderly with high triglycerides was higher than that in the elderly with normal triglycerides(P <0. 01). Conclusions:Controlling blood lipid levels can reduce the incidence of fatty liver,and prevent Cardia-cerebrovascular disease.

  1. 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.

  2. 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.

  3. Enfermedad inflamatoria crónica intestinal canina: hallazgos endoscópicos, bioquímicos y anatomopatológicos del tracto gastrointestinal anterior

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    R Crespo

    2015-01-01

    Full Text Available Se ha realizado un estudio retrospectivo a 26 perros, machos y hembras, que acudieron al Servicio de Medicina Interna (Unidad de Endoscopia del Hospital Clínico Veterinario de la Facultad de Veterinaria de la Universidad de Murcia (España, a los que se les diagnosticó enfermedad inflamatoria crónica intestinal del tracto gastrointestinal anterior. Los casos se eligieron en función del diagnóstico clínico, endoscópico y anatomopatológico realizado, con el objetivo de evaluar potenciales correlaciones entre estos parámetros. La disminución de proteínas totales y la albúmina no fue estadísticamente significativa en relación con el grado de inflamación de la mucosa gastrointestinal, no obstante, los animales que presentaban un infiltrado de tipo linfoplasmocitario tenían tendencia a la pérdida de albúmina. Se encontró una correlación estadísticamente significativa (P < 0,05 entre el tipo de infiltrado y la presencia de congestión en la mucosa de estómago y duodeno. Una mayor congestión a estos niveles se corresponde con el infiltrado linfoplasmocitario. También se obtuvo un resultado que, a pesar de no ser estadísticamente significativo, sí se aproxima a la significación estadística (P < 0,1 entre el grado de congestión y la intensidad del infiltrado, ya que un grado de congestión mayor de la mucosa se corresponde con una mayor intensidad de infiltrado linfoplasmocitario, tanto a nivel gástrico como duodenal. Además se vio que la friabilidad está asociada a inflamación en duodeno, y los animales que no tenían un correcto cierre del cardias presentaban esofagitis por reflujo.

  4. Gastric cancer—a clinicopathological study in a tertiary care centre of North-eastern India

    Science.gov (United States)

    Mandal, Sanjeet Kumar; Harsha, Hiriyur S; Sharma, Birkumar M.; Singh, Th Sudhirchandra

    2014-01-01

    Background The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. It remains the fifth most common cancer among males and seventh most common cancer among females in India. Materials and methods We conducted a retrospective study using the data base of 158 patients of primary gastric cancer diagnosed in the Department of Surgery at Regional Cancer Centre, RIMS, Manipur, India from July 2009 to June 2013. Results Our study revealed a male to female ratio of 2.16:1, distribution of age varied from 28 to 91 years. Majority of the men were in the age group of more than 60 years (45.37%) and majority of females were of 51-60 years (44%). Nearly 7.6% patients had a positive family history. Dietary history of intake salted, fermented fish was present in 67.7% of patients, whereas history of consumption of smoked meat was found in 77.8% of patients. Only 27.8% of patients in our study had history of regular consumption of fresh fruits. About 35.4% of the patients had poor drinking water source. Nearly, 67.6% of males and 44% of females had smoking history. Combined consumption of alcohol and smoking was present in 33.5% of patients. Vague abdominal discomfort was the most common presenting symptom in 61.4% of patients. The most common site of gastric cancer in our study was antrum (50.6%) followed by cardia (17.1%). The most common histological type was adenocarcinoma (95.6%). Most of our patients presented in locally advanced stage (62.7%). Conclusions Our analysis suggests that poor dietary habits such as smoked mead, dried fish and excessive use of tobacco are associated with high occurrence of gastric cancer in this part of the India. Increasing the awareness regarding the aetiology and varied clinical presentation among general population and health providers is needed for prevention and early detection. PMID:24772342

  5. Association between novel PLCE1 variants identified in published esophageal cancer genome-wide association studies and risk of squamous cell carcinoma of the head and neck

    International Nuclear Information System (INIS)

    Phospholipase C epsilon 1 (PLCE1) (an effector of Ras) belonging to the phospholipase family plays crucial roles in carcinogenesis and progression of several cancers, including squamous cell carcinoma of the head and neck (SCCHN). A single nucleotide polymorphism (SNP, rs2274223) in PLCE1 has been identified as a novel susceptibility locus in genome-wide association studies (GWAS) of esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) that share similar risk factors with SCCHN. Therefore, we investigated the association between potentially functional SNPs in PLCE1 and susceptibility to SCCHN. We genotyped three potentially functional SNPs (rs2274223A/G, rs3203713A/G and rs11599672T/G) of PLCE1 in 1,098 SCCHN patients and 1,090 controls matched by age and sex in a non-Hispanic white population. Although none of three SNPs was alone significantly associated with overall risk of SCCHN, their combined effects of risk alleles (rs2274223G, rs3203713G and rs11599672G) were found to be associated with risk of SCCHN in a locus-dose effect manner (Ptrend = 0.046), particularly for non-oropharyngeal tumors (Ptrend = 0.017); specifically, rs2274223 was associated with a significantly increased risk (AG vs. AA: adjusted OR = 1.29, 95% CI = 1.01-1.64; AG/GG vs. AA: adjusted OR = 1.30, 95% CI = 1.03-1.64), while rs11599672 was associated with a significantly decreased risk (GG vs. TT: adjusted OR = 0.54, 95% CI = 0.34-0.86; TG/GG vs. TT: adjusted OR = 0.76, 95% CI = 0.61-0.95). Our findings suggest that PLCE1 variants may have an effect on risk of SCCHN associated with tobacco and alcohol exposure, particularly for those tumors arising at non-oropharyngeal sites. These findings, although need to be validated by larger studies, are consistent with those in esophageal and gastric cancers

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. Estudo comparativo experimental da estenose esofagogástrica nas suturas manual e mecânica Experimental comparative study of esophagogastric stenosis in manual and mechanic sutures

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    Francisco Américo Fernandes Neto

    2000-04-01

    hemostasia, preservação do aporte sangüíneo, controle de infeção, escolha do fio ou do grampeador apropriado e a adequada coaptação das margens viscerais.Twenty eight pigs were randomly distributed to two groups of 14 animals ("A" and "B". Cardia's anatomic diameter was mouldred and measured with a small latex balloon filled with alginato injection. The animals were then submitted to an esophagogastric section. In group "A", anastomosis was performed with separated sutures using 910 poliglactina "000" and in the group "B" the suture was performed with ILS stapler. Seven pigs, from both subgroups "A1" and "B1", were submitted to a new operation and evaluated after seven days while two other sub-groups from seven animals each ("A2" and "B2" had the operation on the 14th day. The anatomic parts were macroscopically examined, followed by a pressure test, histological study and the identification and measurement moulds. The medial percentual difference of stenosis (delta P, was evaluated by the media of the cardias' diameter before and after manual and mechanics suture. Statistical analysis showed that there is no significant percentual media difference of stenosis and operative time ("deltas Ps". The "delta P" stenosis in the manual suture was 25,44% at the 7th postoperative day and 15,88% at the 14th postoperative day. In the mechanics suture the percentual on the 7th and 14th day were 22,80% and 23,04%. The stenosis did not cause any trouble to the esophagogastric alimentary transit. Macroscopically, there were no free leakage observed in the abdominal cavity, although the microscopic evaluation showed a blocked partial suture ruptures in three animals. Adesions were more prevalent with manual sutures. A bad coaptation between visceral edges of the anastomosis in a few clippings resulted in a fibriform reparation with areater stenosis. Regarding hand made sutures, more perianastomotic inflamatory changes were observed in this subset of animals, while the stapling of

  11. 贝氏高原鳅消化道的结构%Study on the Structure of the Digestive Tract in Triplophysa bleekeri

    Institute of Scientific and Technical Information of China (English)

    熊洪林; 姚艳红; 王志坚

    2012-01-01

    Anatomical, histological, histochemical and TEM methods were used to observe the structures of the digestive tract in Triplophysa bleekeri. The digestive tract in T. bleekeri is composed of oral-pha-ryngeal cavity, esophagus, stomach, intestine and anus. The oral-pharyngeal cavity is wide and the upper wall contains plentiful mucous cells and taste buds while the bottom contains club-like cells. There are short microvilli on the top of stratified squamous epithelial cells of the esophagus. Mitochondria are often seen while rough endoplasmic reticulum, smooth endoplasmic reticulum, Golgi complex and lysosome are occasionally detected in the epithelial cells. A large number of mucous cells are among the epithelial cells and there is a well-developed tublovesicular system. A few fibrocytes and reticular fibers and many bundles of collagen fibers exist in the basement membrane. The muscle layer consists of striated muscles and the circular muscles are developed. The simple columnar epithelial cells of the V-shaped stomach contain a large number of secretory granules with a strongly positive PAS reaction, and plentiful mitochondria are located in the lower part of the cells. There are no goblet cells in the mucosa, but lots of single tubular glands are located in the cardia and the body of the stomach. The gastric glandular cells contain a large number of zymogen granules, mitochondria and rough endoplasmic reticulum and the tublovesicular system is arranged around the gastric glandular cells. The muscle layers of the body of the stomach change greatly: near the cardia part, the inner is longitudinal and the outer circular; in the midst, the inner is thin and circular but the outer thick and longitudinal; near the pyloric part, the inner is circular and the outer longitudinal. The intestine circles around the stomach are "φ" in shape and there are developed mucous folds. A large number of microvilli stick out of the free parts of simple columnar epithelial cells. Many

  12. 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

  13. Relative contribution of ruminal buffering systems to pH regulation in feedlot cattle fed either low- or high-forage diets.

    Science.gov (United States)

    Chibisa, G E; Beauchemin, K A; Penner, G B

    2016-07-01

    The relative contribution of ruminal short-chain fatty acid (SCFA) absorption and salivary buffering to pH regulation could potentially change under different dietary conditions. Therefore, the objective of this study was to investigate the effects of altering the ruminal supply of rapidly fermentable carbohydrate (CHO) on absorptive function and salivation in beef cattle. Eight heifers (mean BW±SD=410±14 kg) were randomly allocated to two treatments in a crossover design with 37-day periods. Dietary treatments were barley silage at 30% low forage (LF) or 70% high forage (HF) of dietary dry matter (DM), with the remainder of the diet consisting of barley grain (65% or 25% on a DM basis) and a constant level (5%) of supplement. The LF and HF diets contained 45.3% and 30.9% starch, and 4.1% and 14.0% physically effective fiber (DM basis), respectively. Ruminal pH was continuously measured from day 17 to day 23, whereas ruminal fluid was collected on day 23 to determine SCFA concentration. Ruminal liquid passage rate was determined on day 23 using Cr-ethylenediaminetetraacetic acid. Eating or resting salivation was measured by collecting masticate (days 28 and 29) or saliva samples (days 30 and 31) at the cardia, respectively. On days 30 and 31, the temporarily isolated and washed reticulo-rumen technique was used to measure total, and Cl--competitive (an indirect measure of protein-mediated transport) absorption of acetate, propionate and butyrate. As a result of the higher dietary starch content and DM intake, the ruminal supply of rapidly fermentable CHO, total ruminal SCFA concentration (118 v. 95 mM; P<0.001) and osmolality (330 v. 306 mOsm/kg; P=0.018) were greater in cattle fed LF compared with HF. In addition, feeding LF resulted in a longer duration (2.50 v. 0.09 h/day; P=0.02) and a larger area (0.44 v. 0.01 (pH×h)/day; P=0.050) that pH was below 5.5. There was no diet effect on total and Cl--competitive absorption (mmol/h and %/h) of acetate, propionate

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 日本鳗鲡消化系统的形态学及组织学研究%Morphology and Histology Studies on the Digestive System of Japanese Eel,Anguilla japonica

    Institute of Scientific and Technical Information of China (English)

    孙媛; 陈真锋

    2012-01-01

    利用解剖学和组织学显微技术对日本鳗鲡(Anguilla japonica)的消化系统进行形态学及组织学研究.结果显示,日本鳗鲡消化道由口咽腔、食道、胃、小肠和直肠组成.口咽腔较大,黏膜上皮为复层扁平上皮,内含较多的杯状细胞.食道、胃及肠均由黏膜层、黏膜下层、肌层和浆膜层构成.食道短,黏膜上皮包括复层扁平上皮和单层柱状上皮.胃膨大,呈Y形,由贲门部、胃体部和幽门部组成,盲囊部发达.胃壁黏膜为单层柱状上皮,胃腺位于胃体部.肠道短,包括小肠和直肠,由前向后杯状细胞和黏膜褶皱不断减少.消化腺包括肝脏和胰脏,肝小叶分界不明显,肝细胞内脂肪滴明显.胰脏包括外分泌部和内分泌部,外分泌部由许多腺泡组成,胰岛散布在外分泌部内.%The morphology and histology structures of the digestive system of Japanese eel, Anguilla japonica were studied by using the anatomy and light microscope. The result showed that the digestive tract in A. Japonica was composed of buccal— pharynx cavity, esophagus, stomach, small intestine and rectum. The buccal-pharynx cavity was large, and its mucosa was composed of stratified squamous epitheliums with some goblet cells. The esophagus, stomach and intestine were composed of the mucosa, submucosa, muscularis and serosa layers. The esophagus was short, and stratified and simple columnar squamous epitheliums were identified. The stomach was expanded, Y—shaped, and composed of cardia, body of stomach and pylorus, and the gastric caecum was conspicuous. The stomach mucosa was comprised of simple columnar squamous epitheliums and the stomach gland was located in the body of the stomach. The intestines was short and included the small intestine and the rectum. From foregut to hindgut, the number of goblet cells and intestinal villus reduced gradually. The digestive glands were composed of the liver and the pancreas. The liver lobule was

  19. Basic Principles of Gastric Vomiting With Chinese Medicine Treatments%中医药治疗胃癌呕吐的基本原则

    Institute of Scientific and Technical Information of China (English)

    王朝晖

    2013-01-01

    胃癌进展期(中晚期)常表现为上腹部疼痛,消化道出血,穿孔,幽门梗阻,呕吐等相应症状.而呕吐症状是胃癌较为常见的症状之一,常常导致患者消瘦,乏力,代谢障碍等.初起患者仅有食后不适,饱胀及轻度恶心感,但是随着病程的进展,肿瘤引起的梗阻及胃功能絮乱的症状日渐加重.同时,贲门部癌可导致幽门梗塞进而可出现频繁呕吐,吐前疼痛,吐后疼痛缓解,呕吐物中有食糜,并有腐败臭味.呕吐前常出现上腹胀满疼痛,吐后胀痛有所缓解.中医理论认为脾胃虚弱,痰毒瘀结使中焦运化不利,气机絮乱,最终出现呕吐等症状[1].疾病初起可见食少嗳气,呕吐时作,隐隐作痛.继之,气滞血瘀,脉络失和,则见呕血;久之痰瘀互结,或郁热伤阴,则呕血鲜红;痰浊内聚,则呕吐痰涎;病程迁延,则以气血双亏为主,呕吐无力,多为干呕.%Gastric cancer in advanced stage often appears abdominal pain,gastrointestinal hemorrhage,perforation,obstruction of the pylorus,vomiting and other accompanying symptoms.And vomiting is the more common symptom of gastric cancer,which results in weight loss,weakness,and metabolic disorders and so on.At beginning,there is only discomfort after eating,fullness and mild nausea,but as the disease progresses,tumor-induced obstruction and gastric functional disorder symptoms become aggravated day by day.Meanwhile,carcinoma of the gastric cardia and pylorus infarction can cause frequent vomiting,which appears that vomiting after pain,pain relief after vomiting,vomiting with chyme,and corruption.Vomiting usually occurs before epigastric distention pain,and after vomiting the pain gets eased.Chinese medicine theory believes that the weakness of the spleen and stomach as well as phlegm stagnancy can lead to adverse Qi disorder,and eventually vomiting.In early stage,less intake of food,belching,vomiting,aching are the manifestations.Afterwards,qi stagnation and blood

  20. 多层螺旋CT血管显像对胃癌微创靶向治疗的影响研究分析%Research analysis of Multislice CT angiography imaging effect on gastric cancer targeted therapy of minimally invasive

    Institute of Scientific and Technical Information of China (English)

    陈少轩; 姚力

    2016-01-01

    Objective Multislice CT angiography imaging study analysis the clinical impact of minimally invasive tar-geted therapy for gastric carcinoma. Method Select 60 patients with gastric cancer in our hospital between January 2013 and January 2016. Use SIEMENS CT to continuous volume scan the area for roof insulation between abdominal aortic bifurcation;use SIEMENS Syng system for processing. Then the maximum density line 3 d projection Thin lay-er maximum density projection mode volume label line of arterial vascular remodeling,respectively. Maximum density projection line venous phase imaging was used to vascular remodeling,the blood vessel diameter and distribution of received in accordance with the state to adjust image layer thickness and angle,to obtain a thin layer of maximum density projection imaging,arteriovenous and cancer of the blood around the stomach does not understand the sup-ply. Result In this study,left gastric vein of 60 cases,left gastric vein imaging of 57 cases(95. 0%),left gastric vein are close to the lining of the stomach area and left gastric arterial phase,phase is in the wall of the stomach,with the left gastric artery phase from the line,the other import point,23(38. 33%)of the portal vein,splenic vein 16 (26. 67%),spleen Angle of 10(16. 67%). Gastric cardia area of 27 cases of gastric cancer,blood vessels supplying the main for the left gastric artery(45. 0%),gastric antrum district 23 cases of gastric cancer,main for retinal right gastric artery or blood vessels supplying the right gastric artery 38. 33%,area of gastric small turn 7 cases of gastric cancer,blood vessels supplying the main for the left gastric artery(11. 67%),stomach big bend area 3 cases of gas-tric cancer,blood vessels supplying the mainly for retinal left gastric artery(5. 0%). Conclusion The vascular ima-ging patterns in MSCT stomach volume label Maximum density projection,a thin layer of maximum density projection joint reconstruction method is effective for the

  1. Radiología en Acalasia y Pseudoacalasia Radiology in Achalasia and Pseudoachalasia

    Directory of Open Access Journals (Sweden)

    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.

  2. Protective effects of tetrahydroxystilbeneglucoside on cardiac dysfunction in experimental diabetic cardiomyopathy%二苯乙烯苷对糖尿病大鼠心肌损伤的保护作用

    Institute of Scientific and Technical Information of China (English)

    李彩蓉; 甘受益; 黄红霞; 蔡飞

    2016-01-01

    Aim To study the protective effect of tetra-hydroxystilbeneglucoside ( TSG ) on cardiac injury and the mechanism involved in silent mating type informa-tion regulation 2 homolog 1 ( SIRT1 ) and adenosine monophosphate-activated protein kinase( AMPK) in the diabetic rats. Methods Type 2 diabetic rats were sac-rificed after administration with TSG for 8 weeks. Blood glucose, blood lipids, liverfunction,creatine ki-nase ( CK ) , lactate dehydrogenase ( LDH ) as well as myocardial nonesterified fatty acids( NEFA) were deter-mined by using biochemical test. The concentration of myocardial fatty acid transport proteins ( FATPs ) and-fatty acid β-oxidase ( FA-β-oxidase ) , and the levels of tumor necrosis factor alpha ( TNF-α) , interleukin -6 ( IL-6 ) , interleukin-1β( IL-1β) in serum were also measured by ELISA method and radio immunoassay re-spectively. The protein expressions of TNF-α, IL-6, IL-1β, SIRT1 and AMPK were detected by Western blot. Results Treatment of TSG reduced the contentof blood lipids, NEFA and collagen without affecting the content of blood glucose and insulin. The levels of TNF-α, IL-6 and IL-1βin serum as well as the protein expressions of TNF-α, IL-6 and IL-1β of cardia were also inhibited by administration with TSG. Treatment of TSG caused a significantly increased concentration of myocaidial FATPs and FA-β-oxidase, and dramatically restored the decreased protein expressions of SIRT1 and pAMPK in diabetic rats. Conclusion The protec-tive mechanisms of TSG against diabetic rats are in-volved in the alleviation of inflammatory mediator injury and improving energy metabolism.%目的:探讨二苯乙烯苷( TSG)对糖尿病大鼠心肌损伤的作用及对沉默信息调节因子2的哺乳动物同源体1(SIRT1)和磷酸腺苷活化的蛋白激酶(AMPK)蛋白影响。方法建立2型糖尿病大鼠模型,分组给药,16周时处死大鼠,生化法测定血糖、血脂、肝功能及肌酸激酶( CK)、乳酸脱氢酶( LDH)

  3. 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

  4. Effects of Esmolol on hemodynamics and tissue oxygenation of the patients with septic shock and tachycardia%艾司洛尔对合并快速心律失常的感染性休克患者血流动力学及组织氧合的影响

    Institute of Scientific and Technical Information of China (English)

    陆非平; 陈炜; 韩聪聪; 古旭云; 张静妹; 刘龙

    2012-01-01

    ( MAP),Central Venous Pressure ( CVP),Cardiae Index ( CI),Stroke Volume Index ( SVI),Systemic Vascular Resistance Index (SVRI),Lactate,Centrol Venous Oxygen Saturation (SCVO2 ) were recorded before and 2,3,4 hours after the Esmolol treatment.Results Heart rate of Esmolol group was reduced at all time points after treatment,The difference of that from the control group was significant ( H R: [ 108 ± 16 ] beats/min vs.[ 132 ± 18 ] beats/min,[ 101 ± 14] beats/min vs.[ 135 ± 19 ] beats/min,[ 106 ± 21 ] beats/rin vs.[ 129 ± 14]beats/min,all P < 0.01 ).Compared to the control group,Stroke Volume Index of Esmolol group was significantly increased at each time point ( SVI: [32 ± 12] ml/m2 vs.[22 ±8] ml/m2,[34 ± 14] ml/m2 vs.[21 ±6] ml/m2,[37 ± 10] ml/m2vs.[23 ±9] ml/m2,all P <0.05).Lactate of Esmolol group was significantly decreased at the end of the 3rd,4th hour of Esmolol treatment ( lactate: [ 1.6 ± 1.1 ] mmol/L vs.[ 2.7 ± 1.2 ]mmol/L,[ 1.3 ± 0.9 ] mmol/Lvs.[ 2.8 ± 1.4 ] mmol/L,both P < 0.01.There were no significant differences in MAP,CI,SVRI,SCVO2 between the two groups at each time point ( all P > 0.05 ).Conclusion Esmolol can reduce heart rate significantly,improve cardiac work and tissue perfusion in septic shock patients with tachycardia.It is a feasible and safe treatment for this kind of patients.

  5. 2013年牌楼社区卫生服务中心65岁以上老年人健康体检结果分析%Arched community health service center in 201 3 at age 65 or older health check-up result analysis

    Institute of Scientific and Technical Information of China (English)

    王素兰

    2014-01-01

    previous patients with hypertension and more than 1 9 6 people are newly found.FPG of 3 1 1 people are abnormal,which there are 230 people with diabetes before,81 people are found with high glucose,420 are found with hyperlipemia,1 23 of the 3 1 1 people are found that the creatinine index is high and 1 5 6 of them are found the BUN index is high.Last,we conclude that over-weight,hypertension,hyperglycemia,and hyperlipidemia are main dangerous factors to the health of the elder.According to the elder’s different healthy condition,we make different precaution and control measures to control these dangerous factors.Through this,it can reduce the accident caused by cardia- cerebrovascular disease and take some effective precaution measures.We advocate healthy life and we do our best to improve the healthy condition and living quality of the elder in our community.The anal-ysis of the material is such important to the prevention of chronic disease.

  6. 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.

  7. 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

  8. 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